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About Charlie and his symptoms of PTSD

HLTH310/510 Mental State Examination (MSE)

1. Select one of the following movies to base your written assignment on:

a) "The Perks of Being a Wallflower"

b) "A Beautiful Mind"

c) "Little Miss Sunshine"

d) "The Kings Speech"

e) "American Beauty"

2. Select one character in the movie you chose to complete a Mental State Examination (MSE) based on the DSM-5 criteria and a Formulation.

Due Date:  See bottom of this page.

This assessment relates to: 
Learning Outcomes 2 - 4

Presenting

For this assignment you are required to write an essay about a character in a movie selected from the list above. Your assignment must include the key criteria of a Mental State Examination (MSE), a Formulation (or plan) and you need to apply the DSM-5 criteria in your assessment. Further details about the presentation of this written assessment will be provided in a recorded session and Power Point presentation.

Referencing

You must use the APA referencing system. Follow the link at the top right of the page for information and examples of APA referencing.

How many references do I need to include?

You are expected to research each Part widely by using the UNE library online catalogue and journal databases to identify relevant books and peer-reviewed journal articles. Please note: Personal experience, newspaper articles, Moodle notes and information obtained from websites, especially those that start with the prefix "wiki", are not a valid source of information for this assignment.

HLTH310 students are expected to find 10+ peer-reviewed sources. (i.e. journal articles, books) in addition to your textbook(s), to support the statements in your essay.

HLTH510 students are expected to find 15+ peer-reviewed sources (i.e. journal articles, books) in addition to your textbook(s), to support the statements in your essay.

Answer

Introduction 

The movie “the perks of being a wallflower” revolves around Charlie. From the beginning of the movie, there is nobody he can talk to. His only companion is his sister and two or three classmates who he barely spoke in the school. Throughout the film, he composes mysterious letters for a "companion," taking into account the ultimate goal of not feeling lonely and isolated (Chbosky, 2012).

Charlie shows the symptoms of post-traumatic stress disorder (PTSD) and depression. He also seems to be experiencing the adverse consequences of desolation and anxiety that may be due to PTSD. Charlie survived sexual abuse with Aunt Helen when Charlie was younger. Because he was abused sexually as a young man, it turns out he is emotionally fragile (Qi, Gevonden & Shalev, 2016). Charlie drinks alcohol, smoke cigarettes and uses doses of drugs such as LSD. However, LSD does not work for him, and it increases merely his movement in his already overactive brain and personality. His first companion was his English pedagogue, Mr. Anderson, who knows Charlie's written abilities (Chbosky, 2012). He also seems to be experiencing the adverse effects of grief that can be rooted in PTSD. He turned out to be rationally unstable because he was sexually abused as a child.

Appearance

Charlie was a very well-groomed man with a tall stature, sturdy build, and average weight. He sometimes seems anxious and impatient, but he did not act, with the observable behavior. His speech was moderate and slow, his voice low. He looked dysphoric and blurred (Baldwin et al., 2014). He could maintain a direct line of reasoning without apparent disorder or stupid associations while communicating with him. He remains incapable of expressing his feelings to his friends and family. He mostly preferred to sit alone like a wallflower and observe people. His primary focus remains fixed on the anonymous unknown letters he composes throughout the movie. Charlie lost his best friend and his aunt Helen at a young age, and he feels guilty for the death of his aunt, Helen (Alisic et al., 2014). These feelings are eating his conscience, and his energy has shifted and efficiently loaded in a negative, painful and harsh manner.

Mood and Affect

While mood represents the feelings that are experienced over a long period, affect refers to the current perceptions of the patient (Alisic et al., 2014).
Affect

When Charlie heard the news of the suicide of his best friend Michael, he became devastated. He had to undergo a counseling session to help manage Michael's loss. During the meeting, the counselor suggested that perhaps Michael feel alone, prompting his step to "Suicide," and Charlie continued to cry and shout that he could talk to him (Baldwin et al., 2014). They were not able to control it, and they had to call his sister to pick him up. From this day onwards his teachers treat it unexpectedly; they gave him better grades, and Charlie saw that his family allowed him to sit unsupervised because he had begun to receive good grades at school. Also, he was depressed after the death of his aunt Helen while she met a road accident while bringing a birthday present for Charlie on his seventh birthday (Chbosky, 2012).


Mood
Charlie is a modest and caring person, but there is also a lot of guilt in him subconsciously. Mostly he acts smart which leads him to good and bad experiences. He sees things and understands that he is lonely. He seemed restless, terrified and uncertain (Roberts et al., 2015). As Charlie's Aunt Helen died in a car crash on Charley's seventh birthday party, Charlie began showing social isolation, ruinous memories. Charlie depicts Helen as highly respected and loving women. However, later in the movie, he discovered that she had psychological issues and routinely assaulted Charlie - clarifying his social isolation, breakdowns and intimate memories. In the course of the novel, he describes the story by composing the progression of the letters of a mysterious individual (Amos, Stein & Ipser, 2014).

He does not show any signs of self-denial and hostility to others. He seemed continually caring for his friends, but, displays an embarrassing anxious behavior, depicting his feelings and memories of the accident-free of his will (Roberts et al., 2015). His judgment was sufficient, and he had limited awareness of his mental health issues due to the trauma caused by his sexual abuse in his childhood by his aunt, Helen.
Speech

Charlie's conversation style is calm and polite. He seems to face difficulty in expressing his feelings to his crush. He prefers to remain alone most of the time. For the most part, he liked to invest his time and energy in writing mysterious letters. His speech is low pitched, calm and composed. However, anxiousness is depicted in his conversation style sometimes when he is unable to express himself emotionally to his friends.


Cognition
He faces difficulty in remembering incidents of his past. His knowledge and thinking, including memories of his childhood, to recall parts of the sexual abuse and negative beliefs about him, identified with the death of his close relative and his feelings of separation from others seems to be disturbed. Psychological abilities (focus, attention, data processing, conversation capabilities) are also interrupted, perhaps due to personal failure or neurological deficit. A propensity for hasty behavior controls the sensation; it was possible that there were problems in handling and communicating feelings in a multifaceted way. There are unambiguous examples of hostility and anger towards others, but the communication of these examples abstains from a change in the absence of participation and renunciation rather than surrendering to dangerous tendencies or developing intensity. Charlie’s self-confidence was low when he tried to express his feelings to his high school crush.


Thoughts

His thoughts are disturbed and suppressed. He shows sure signs of paranoia and delusional thinking. He writes anonymous letters.

Charlie blocks views that remind him about his aunt Helen, and he never realizes that he was not at fault for her death until later in life (while retrospection). Charlie seemed to block all the thoughts or memories he did not want to remember and refused to accept his aunt, for sexually abusing him at the age of five, causing him a mental trauma, primarily as a young child (Roberts, Roberts, Jones & Bisson, 2015). As far as his childhood was concerned, Charlie had a strong relationship with his aunt, so he was influenced by her to trust her to be a brilliant lady, and that her death was his fault. He also ruled out his memory of defeating Brad's companion (as he damages Patrick). Charlie blames a significant part of the problems in his life are caused by his actions and believes that others have no shortcomings (Baldwin et al., 2014). He just wanted to make friends and did not want himself to be categorized as a wrong person. At the end of the story, he shows suicidal tendencies.

Charlie's reasoning was commanded by violence and anxiety due to the death of his closest companion Michael and his aunt, Helen. He felt remorseful for the end of Aunt Helen, who had died in a road accident while bringing a gift on his seventh birthday. His thoughts and reflections are irritated and confused. He feels remorseful for unknown reasons.

He likes to stay alone and does not make friends in high school. He feels restless while talking to his feelings from time to time. His only companion in school is his English instructor who seeks to help him with his writing skills. PTSD is caused by a range of the sensor system disorders where high levels of pressure are observed, and the hormones imbalance appears. The parts of the brain that change after the traumatic accident are amygdala and hippocampus (Yehuda et al., 2015). These parts of the brain interface are associated with fear and thought process. Those parts that are not capable of working with ordinary capacity are the ones that make the retrospection that Charlie has. PTSD consists of sorrow and apprehension, which is why it is readily associated that it's just nervousness and melancholy. The difference is that patients with PTSD have retrospectives thoughts because anxiety and apprehension are part of PTSD; it makes people with PTSD have the disturbed thought process.


Perception
Charlie had a blackout at the end of the story. He had a complete breakdown of emotions that were hidden in his subconscious mind that he realizes after having a relationship with his girlfriend.

Charlie always hoped he would continue his life, feeling remorse, and he never was optimistic. He felt guilty and felt that there would be no place for him in anyone’s life. Frequently, he imagined that no matter what he does, it will not affect (Yehuda et al., 2015). Charlie hoped to understand things, as they are portrayed, through his memories. This is seen in the light of the fact that he recalls that his aunt Helen as a caring and loving lady, but later on in the film, her interfaces with various memories that offend him to trust his death is his guilt (Matos, 2013). The way Charlie remembers and sees circumstance makes him anxious has power interruptions and feels/sees things that are not entirely valid.

It was hard for Charlie to face reality at the end of what it meant to be because he continued to defeat everything that helped him to remember the pains. He becomes paranoid and insane when his childhood memories of his aunt remind him of his sexual abuse, and then he tries to attempt suicide. Charlie usually needs the happiness of others, and when something goes wrong, he always cries. When he undergoes a counseling session, it is then that he realized that his aunt, was the cause of his pain and depression (Matos, 2013).

Charlie could not remember the actual memories of his aunt, Helen. He remains an introvert without involving with anyone in his school. All the time, Charlie continues to tell the amount his aunt adored him and misses his aunt who died in a car accident, and more than once she goes out and has flashbacks to darken. His pals, Mary, Elizabeth, and Patrick, are in favor of him and Charlie, to please everyone. We finally find that Charlie is capable of experiencing anxiety, unhappiness, and PTSD, and see that he has muted his aunt's memories of being sexually abused as a five-year-old child (Kilpatrick et al., 2013). He strives to kill himself when his companions go to school and become paranoid about each of the retrospections he has, trusting that he killed his aunt. Charlie undergoes mental health treatment and counseling and discovers his reality and what it means to be.


Dissociative symptoms:

Charlie felt detached from his family and friends. He had created his little world with his anonymous letters that he used to write since childhood.

Throughout the film, Charlie does not live in "a line of basic self-esteem." He gives others the chance to overpower him, for example, when Mary Elizabeth gets what he needs, Patrick exploits it, and his aunt destroys his adolescence (Sijbrandij et al., 2015). He gets stuck in school and does not express his feelings because he does not influence him (Matos, 2013). He never took his own decisions and always guaranteed that everyone was cheerful. Besides, he was made fun off in his school parties for his virtuousness. He never took his own emotions at the top of the list of priorities and did not go on with his own life. In this way, he lived in the lack of self-esteem throughout the film, till the end (Meadows, Singh & Grigg, 2012).

Hallucinations:
At the end of the story, Charlie has an emotional breakdown. He becomes paranoid and detached from his friends and family and starts having suicidal ideations. He even tries to kill himself when he starts feeling guilty for the death of his aunt, Helen. However, when he realizes that it was his aunt who was responsible for his pain and depression, he becomes depressed and starts being guided by his inner voices while trying to kill himself (Zetterqvist et al., 2013).

Illusions

By the end of the film, Charlie's psychological instability began to take a more significant part of his life and became bitter again. He felt vulnerable and kept coming out. He had more flashbacks of memories he would not want to remember, and he continued to have to trust the facts that did not exist.
During his breakdown, he perceives his memories differently. He states that his aunt did not hurt him; she loved him all the time, and also says that they were excellent companions (Kilpatrick et al., 2013). He then had an emotional breakdown for his aunt’s death and started crying that it was all his fault that his birthday was to be introduced, it was all my fault that got killed and that she was a caring lady (Meadows, Singh & Grigg, 2012).


Insight and judgment:


Charlie additionally showed avoidance of the turmoil involved in the case. He avoided the circumstances in which he had to talk about the abuse. He faced challenges in his knowledge and state of mind, including the powerlessness to recall parts of the damage and opposing beliefs about himself identified with the death of a close relative and feelings of separation from others (Chbosky, 2012). Finally, Charlie showed variations in the anxiety and reactivity, including the violent upheaval and the mistaken reaction of disbelief. PTSD is a chronic and inconceivable issue that may be related to the drug abuse. Everywhere in the movie, Charlie is seen exploring different types for a range of drugs. Charlie is being treated with psychotherapy towards the end of the film and makes him regain his mental health (Roberts et al., 2015).


Conclusion

The individual experiences a traumatic experience during an individual's lifetime helps to define the DSM-5 diagnostic PTSD criteria (Boks et al., 2015). Determination of the diagnosis requires the conformity of the accompanying facts of indications: unwanted side effects (i.e., dissociative reactions), distorted manifestations, adverse changes in perception and state of mind (i.e., troubles, remembering the parts of the memory associated with traumatic experience) and verified exacerbations and reactivity with trauma. Charlie suffered some signs related to the disability he had encountered as a child, including disturbing memories, disabling reactions (e.g., Retrospections), trouble with the acceptance of the memories associated with the incident and physiological responses.

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