Schizophrenia of John Forbes Nash Jr. in 'A Beautiful Mind'

I have chosen to psychoanalyze the character John Forbes Nash Jr. in the film ‘A Beautiful Mind’, within the schizophrenia spectrum. Schizophrenia is a disorder that functions to impair the emotional, behavioral, and cognitive areas of an individual’s life. ‘A Beautiful Mind’ is a biographical drama film depicting the real life of John Forbes Nash Jr. Nash was an extremely brilliant mathematician whose graduate career began at the Princeton University where he earned a doctorate by the age of 22 in mathematics. His work then earned him a teaching position at MIT, and eventually a Nobel Prize. The film depicts the account of his life through Princeton, his marriage, his mental downfall due to schizophrenia, and his eventual victory over schizophrenia. My claim is that Nash meets the criteria for schizophrenia based on the information provided in the film. According to the DSM-5, schizophrenia affects the individual through delusions, hallucinations, disorganized thinking and behavior, and negative symptoms (American Psychiatric Association, 2013). Nash hallucinates multiple people which I believe leads to his delusions. These delusions and hallucinations cause him to be disorganized in his thinking and behavior, exemplify negative symptoms, and ultimately admits him to a psychiatric facility.

John Nash experiences a symptom profile that directly points to schizophrenia. First, he experiences hallucinations. Hallucinations are an auditory or visual experience perceived as voices distinct from the individual’s own thoughts (Hooley et al., 2020). His first hallucination is Charles Herman, his ‘roommate’, whom he meets while adjusting to his dorm room. Throughout the film Charles follows Nash around wherever he goes. He is the most recurrent voice to Nash throughout the film. His second hallucination is Marcee, Charles’ niece, who is usual appearance is accompanied by Charles. She is sweet and offers hugs to Nash. The third hallucination is William Parcher, i.e., ‘big brother’. He is a member of the Department of Defense who Nash believes is a spy sent to watch Nash. These hallucinations drive his delusions, especially Parcher. In one hallucination, Parcher says: “The Russians are in control of a bomb and intend to detonate it on US soil”. His main delusion is that he is a secret agent for the Department of Defense and is trying to stop the Russians by code breaking periodicals. His delusions are specifically persecutory delusions; he believes that Parcher and other spies are pursuing him since he is the code breaker. He also exemplifies disorganized speech which is depicted when he is giving a math lecture at MIT and his words are rapidly incoherent to the point that the audience cannot understand. Furthermore, he matches the criteria for grossly disorganized and abnormal motor behavior. At one point in the movie, he was playing a board game with a classmate and proceeded to throw a tantrum upon losing and rushing away with a distorted, painful face. This does not seem that abnormal, however he then stayed in his room and did not eat for two days. In addition, he was told by a math professor that he did not present a project properly and so he withdrew to his room, hit his head on glass, and threw his desk out the window. He portrayed negative symptoms throughout the film, most noticeably when he withdrew from multiple situations and in one scene he was sitting, unmoving, expressionlessly holding his screaming and crying baby.

According to the DSM-5, Nash specifically meets the diagnostic criteria A through F. The symptom profile in the previous section meets criteria A. He meets criteria B because his level of functioning was lower than before the onset of his disturbances; he refused to go to school after being diagnosed and eventually is unable to work due to his illness (American Psychiatric Association, 2013). Criteria C is met because he shows continuous signs of disturbance for at least 6 months (American Psychiatric Association, 2013). Schizoaffective depressive and bipolar disorder are excluded due to a lack of information on major depressive or manic episodes in the film; this meets criteria D (American Psychiatric Association, 2013). There was no evidence throughout the film that Nash was on any sort of substance, besides the post diagnosis medicine, therefore he meets criteria E. Finally, because we lack information from the film on Nash’s childhood, we cannot diagnose autism spectrum disorder – which meets criteria F (American Psychiatric Association, 2013).

Nash’s manic mathematical episodes show overlap into the bipolar disorder, but the lack of major depressive episodes in the film is what ultimately differentiates his diagnosis from the bipolar disorder (American Psychiatric Association, 2013). Autism spectrum disorder also competes for Nash’s diagnosis since he is highly fixated on a specific interest such as his obsession with producing an original mathematical idea, and his lack of awareness and understanding of relationships (American Psychiatric Association, 2013). However, what ultimately separates him from autism is his hallucinations and delusions.

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I believe John Nash’s schizophrenia manifested through multiple factors. First, the film depicted him as twenty-two years old when the symptoms began; this the median age among the highest prevalence rates of schizophrenia in males (Hooley et al., 2020). Second, researchers at the University of Colorado (Leonard, S., Mexal, S., & Freedman, R., 2007) suggest there is evidence that schizophrenia is genetic in nature. According to the research, 80% of individuals with schizophrenia smoke tobacco as compared to 25% of the general population (Leonard et al., 2007). In the film, we do see Nash smoking during some of his hallucinations. However, this could me simply a case of self-medication with nicotine. Third, a nationwide Danish twin study concluded that schizophrenia had a 79% rate of heritability (Hilker et al., 2018). To reinforce this genetic proposal for Nash’s disorder, his son also suffers from schizophrenia. Fourth, a study suggests environmental factors could also be risk factors for schizophrenia (Gejman, Sanders, & Duan, 2010). Nash’s environmental factors include his strong, unyielding wife who supported him throughout the film, his classmates who at first thought he was odd and would make fun of him but eventually supported and encouraged him upon discovering his illness, and his psychiatrist, Dr. Rosen, worked with him throughout the film to help him realize the hallucinations and delusions are not real and provided electroshock therapy and gave him medications. I believe the Cold War era that Nash lived in is another environmental factor, and the fact that he was going to school for mathematics both encouraged his delusions of code breaking. Being seen as an outsider could have encouraged him to start his delusions to feel less isolated and to cope. Fifth, stress could have also been a factor, and some research suggests that stress could cause an increase release of dopamine during a psychotic episode. Dopamine is a neurotransmitter in the brain and is involved in delusions and hallucinations (Brisch et al, 2014). According to a study published in 2012, the research shows there is an increase in dopamine release during a psychotic episode due to stress (Mizrahi et al, 2012). The fact that he was studying mathematics at Princeton is stressful enough, but then having to produce an original idea to be successful only adds more.

The early chapters of the textbook outline the basic scientific views of abnormalities. In chapter one, for something like schizophrenia to be abnormal, it is not caused by any one factor but instead a multitude of factors. The abnormality must clearly distress the individual, and the individual does not adjust well to their distress (Hooley et al., 2020). The disorder could be statistically deviant and may be a disturbance to the standards of society (Hooley et al., 2020). In addition to these, the abnormality may cause social discomfort, irrationally and unpredictability, and may be dangerous to the individual or surrounding people (Hooley et al., 2020). According to chapter three in the text, necessary causes for schizophrenia are psychosis and distress to an extend that impairs the level of functioning (Hooley et al., 2020). In addition, contributory causes would be the stress and environmental factors in Nash’s life (Hooley et al., 2020).

John Nash descended from the height of his mathematical career down the deteriorating slope of schizophrenia. His delusions were born out of his hallucinations, which drove this deterioration of his cognitive, behavioral, and emotional abilities. I believe he knew there was something abnormal going on in his life since it was so apparent to everyone around him that he acted ‘odd’. In one scene he is asked why he has no family or friends and his response was “I like to think it’s because I’m a lone wolf”, proving his isolation. He even feels he is above going to class or doing the same work as his peers when he says, “Classes will dull your mind”. He was absolutely obsessed with mathematics, specifically with the notion he must create an original idea. The schizophrenia clearly was affecting his cognitive function when he gave a lecture at MIT and could not form coherent sentences. He believed his delusions of Russian code breaking and acted out upon it by saving thousands of periodicals and mailing the Department of Defense all the codes he was cracking. At one point in the film, he was so emotionally engrossed with the code breaking that he left his baby in a tub filling with water because he believed ‘Charles’ was watching her. After his wife discovered the baby almost drowning and saved her, Nash did not show any emotional sympathy, but rather stammered ‘Charles’ was watching her. It affected his relationship with his wife by becoming a hard burden on her as he was admitted to psychiatric care near the time his baby was born, and he was treated for years. It also affected his professional relationships as he was unable to teach at MIT anymore.

I believe that ‘A Beautiful Mind’ brought a great visual perspective to what hallucinations and delusions can look and feel like to the person affected by them. The biggest part of schizophrenia is confusion, fear, and not understanding what is happening, and they accurately depicted that in the film. It was extraordinary to witness John learn to live with his hallucinations. What I really thought was important that the film did not depict John to exemplify the stigma of a crazy-violent person. The other characters in the film reacted just like you would expect: confused and weirded out by his odd speech and behaviors. Alicia’s unyielding support showed that an individual with schizophrenia can succeed with the aid of family. After his diagnosis and treatment, his wife, friends, and colleagues all treat him with love and care, and I believe that was pivotal in his victory over schizophrenia. I also believe that was important for the viewer to see that schizophrenia can be treated and the individual can return to function in society. The electroshock therapy and medication did help him, but John Nash hated the side effects and eventually stopped all medication and therapy together. Near the end of the movie, as he was rewarded with the Nobel Prize, he explained that he was simply ignoring his hallucinations and delusions and essentially outwilling schizophrenia. The only problem I had with the film was that the end of the movie sort of delivers a message that you can ‘out think’ schizophrenia which is unrealistic since there is no cure. Overall, the movie is a great example that mental illness is something to be understood and treated rather than feared.

References

1. A Beautiful Mind. (2001). Starring Russel Crowe, Ed Harris, & Jennifer Connelly. Movie Database. Retrieved December 2nd, 2019.
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
3. Brisch, R., Saniotis, A., Wolf, R., Bielau, H., Bernstein, H. G., Steiner, J., … Gos, T. (2014). The Role of Dopamine in Schizophrenia from a Neurobiological and Evolutionary Perspective: Old Fashioned, but Still in Vogue. Frontiers in psychiatry, 5, 47. doi:10.3389/fpsyt.2014.00047.
4. Gejman, P. V., Sanders, A. R., & Duan, J. (2010). The Role of Genetics in the Etiology of Schizophrenia. The Psychiatric clinics of North America, 33(1), 35–66. doi:10.1016/j.psc.2009.12.003.
5. Hilker, R., Helenius, D., Fagerlund, B., Skytthe, A., Christensen, K., Werge, T. M., … Glenthøj, B. (2018). Heritability of Schizophrenia and Schizophrenia Spectrum Based on the Nationwide Danish Twin Register. Biological Psychiatry, 83(6), 492–498. doi: 10.1016/j.biopsych.2017.08.017.
6. Hooley, J. M., Nock, M. K., & Butcher, J. N. (2020). Abnormal Psychology (18th ed.). Hoboken, NJ: Pearson. ISBN: 9780135212172.
7. Leonard, S., Mexal, S., & Freedman, R. (2007). Smoking, Genetics and Schizophrenia: Evidence for Self-Medication. Journal of dual diagnosis, 3(3-4), 43–59. doi:10.1300/J374v03n03_05.
8. Mizrahi, R., Addington, J., Rusjan, P, M., Suridjan, I., Ng, A., Boilea, I., Pruessner, J, C., Remington, G., Houle, S., Wilson, A.A. (2012). Increased Stress-Induced Dopamine Release in Psychosis. Biological Psychiatry: A Journal of Psychiatric Neuroscience and Therapeutics. 71(6), 561-567. DOI: https://doi.org/10.1016/j.biopsych.2011.10.009.