Girl Interrupted - Movie on Concurrent Disorders

Girl Interrupted - Movie on Concurrent Disorders

 Girl Interrupted - Movie on Concurrent Disorders

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Susanna's story starts with being admitted to the private psychiatric clinic after a short visit with

a new psychiatrist. She claims that it was presented to her as a short rest, lasting only two weeks,

and it will last almost two years. Her memories of the event described in the film give us the

details that led to this situation: confusion, suicidal tendencies, and isolation. These things did

not seem so unusual to her at the time, although they were evident to others. It is also an

important recurring theme.

Susanna's symptoms included depression, "chronic emptiness and boredom", skin scraping, and

slapping (forms of self-mutilation). She also described suicidal thoughts, aborted attempts, and at

least one near-success attempt. Denying that she is "actually suicidal", she once took 50 aspirins

and passed out in public, only to wake up after having her stomach emptied. She also claims that

although she sometimes had very distorted thinking, she was always aware that this was the case

and never confused those thoughts with reality.

Describing her at the beginning, we can say that Susanna looks depressed, her expression is

frozen, she is fenced off from the surrounding reality, and she manages to fall asleep right during

graduation at school. Any mental disorder develops from complex psychological and biological

factors. People who have experienced adverse events are more likely to develop a psychiatric

disorder. What events is Suzanne going through? Unsuccessful graduation from school,

harassment by a friend of hir father, and an affair with a married man. The role of her family in
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the development of this condition is not very shown in the film. But we see that her family is

more characterized by external signs of well-being than interpersonal communication.

She had "repetitive suicidal behaviour, gestures or threats" and at least one suicide attempt was

detailed. Her admission papers also noted these symptoms, although she did not mention them at

the time. She describes struggles with boredom and "emptiness". In the fifth edition of the

Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for borderline

personality disorder considered a personality disorder, are defined as a pervasive pattern of

instability in interpersonal relationships, self-image and affects, and marked impulsivity

beginning by early adulthood and present in a variety of contexts, as indicated by five or more of

the following:

● fear of abandonment

● unstable or changing relationships

● unstable self-image, including struggles with a sense of self and identity

● stress-related paranoia

● anger regulation problems, including frequent loss of temper or physical fights

● consistent and constant feelings of sadness or worthlessness

● self-injury, suicidal ideation, or suicidal behaviour

● frequent mood swings.

Symptoms of BPD usually begin in late childhood, several years before seeking treatment.
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Like most mental health conditions, and especially personality disorders, people with BPD may

turn to substance use as a way to cope with their disorder.

Before the advent of effective treatments such as DBT, people with BPD were often admitted to

the psychiatric clinic because nothing else worked or because medical professionals didn't know

what else to do. This is exactly the situation in this film. DBT is a skill-based cognitive

behavioural intervention. DBT clients practice: stress tolerance, emotion regulation,

interpersonal effectiveness, and mindfulness. Mindfulness is essential and helps improve other

skills by reducing impulsivity and reactivity, which would be helpful for the problems Susanna

described. Interpersonal effectiveness would be helpful, as one of the main challenges here is

learning how to choose your best friends. Susnna's admiration for some antisocial and suicidal

people suggests that she could use help in building healthier relationships. Emotion regulation is

about changing your life in a way that leads to greater happiness, which anyone who suffers from

depression can benefit from.

However, in Susanna's case, one could most likely start with stress-resistance skills. This is

because her main problem was suicidal tendencies and she did have at least one suicide attempt.

In DBT, they are considered "first stage" targets and are always treated first if they are present.

One of the fastest ways to reduce suicidal behaviour is to provide alternative ways to manage

severe distress.
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Thus, Susanna's first goal would be to learn the skills of adversity tolerance. This skill will

include three targets. First, she will need to acquire the knowledge necessary to use these skills.

Second, she will need to apply these skills to the unique circumstances of her life. This will take

place with her individual therapist where the skills will be discussed and Susanna will be asked

to do daily housework, practicing these skills in a way that makes sense to her. The application

of some skills will vary greatly depending on her life, while the application of others is simple.

For example, she will likely be asked to do deep breathing exercises daily for 1-2 weeks.

Third, Susanna needed to extend the use of these skills to all areas of her life. Of particular

importance is the generalization of skills in situations of high stress. This is achieved through the

use of telephone coaching. When she becomes too depressed to use her stress tolerance skills,

she is asked to call her therapist. Her therapist would provide instant training in skill selection

and skill use. Thanks to this, Susanna learned to use skills even in situations in which she could

not before. After some time, Susanna will be able to suffer without thoughts of suicide.

Medications are not typically used as a front-line approach to treat this BPD, but may be useful

in addressing symptoms related to co-occurring mental disorders such as depression or anxiety.

Medications such as antidepressants, anti-anxiety medications, or mood stabilizers may be

helpful in treating some symptoms.

 Girl Interrupted - Movie on Concurrent Disorders

Reference

1. Borderline Personality Disorder in Girl, Interrupted Retrieved from

https://frtc.ltd/blog/borderline-personality-disorder-in-girl-interrupted

2. Borderline Personality Disorder: DSM-5 Criteria, Comorbidities, and Treatments Retrieved

from https://pro.psycom.net/assessment-diagnosis-adherence/borderline-personality-disorder-

dsm-5-criteria-comorbidities-and-treatments

3. Borderline Personality Disorder And Addiction Retrieved from

https://www.addictioncenter.com/addiction/borderline-personality-disorder/#:~:text=Like

%20most%20mental%20health%20conditions,substance%20use%20disorder%20(SUD).