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Running head: A BEAUTIFUL MIND 1 A Beautiful Mind: A Case Study A BEAUTIFUL MIND 2 Diagnostic Impression: Axis I295. 30Schizophrenia, Paranoid Type, Continuous Axis II V71. 09No Diagnosis Axis III None Axis IVPsychosocial and Educational Stressors Axis VGAF = 55 (highest level in past 30 years) Case Study: John Nash suffers from Paranoid Schizophrenia. He is a gifted mathematician who began graduate school at Princeton University in 1947. We will begin Mr. Nash’s history from this point in time, for it is here that his symptoms first began to emerge.
During this time in his life he is in what is known as the prodromal phase of schizophrenia, which is a period before active psychosis, during which time symptoms first appear but aren’t yet prominent or recognized. Some behavioral examples of this include Mr. Nash’s social awkwardness, his grandiosity, and his unique sensory ability (he was able to see a light pattern from a glass and synchronize it perfectly with patterns on one of his school-mate’s ties). It is likely that the stress of this new, unfamiliar, and competitive environment is what caused Mr.
Nash’s first positive symptom of schizophrenia to emerge, a visual and auditory hallucination in the form of a roommate, and later friend, named Charles Herman. Positive symptoms reflect an excess or distortion in normal behavior and experience (i. e. delusions and hallucinations), whereas negative symptoms reflect an absence or deficit in normal behaviors and experience (i. e. blunted affect, alogia, and avolition) (Butcher, Mineka, & Hooley, 2010). For the most part, Mr.
Nash remains socially isolated, not even attending class, devoting all of his time to the pursuit of a “revolutionary [and] original idea in mathematics. ” His only breaks being when Charles, his hallucination, would talk him into taking a break. It is during one of these breaks that John states to himself, through the image of Charles, “I don’t like people much, and they don’t like me,” which is another psychosocial indicator of schizophrenia. It is also at this time that his delusions of grandeur become more pronounced, referring to the professors and the theorists studied in textbooks as “lesser mortals. One day, while interacting with his peers, the stressors of his current environment are reinforced as he is defeated in a mathematical board game by his major competitor, Martin Hansen, who also informs him that he has two papers under review, and two other peers, Bender and Sol, have already published. This stress, along with two days of isolation triggers his hallucination of Charles, who “talks” him into going to a bar. At this bar Mr. Nash runs into his peers once again, and it is at this time that one begins to see negative symptoms of schizophrenia.
John Nash Nobel Prize Acceptance Speech
More specifically, there appears to be deficit in his fluency and productivity of thought and speech, as evidenced by the interaction between himself and a woman at the bar, at which time he tells her, “I don’t know what I’m required to say in order for you to have intercourse with me. ” He is later approached by the department chair and told that he may not get a placement due to the fact that he has not been attending classes, has not published a paper, and his inability to “focus. ” This failure to focus could be impairment in cognition due to his schizophrenia.
This new stressor causes John to reach a breaking point, during which time he smashes his head and throws his desk out of the window because he is frustrated and unable to focus on his work. His thoughts of suicide are expressed through the words of Charles, “…go on, bust your head, kill yourself,” and his throwing his desk out the window indicates his diminished impulse control, both of which are linked to schizophrenia. It is at some point after this that Mr. Nash comes up with the revolutionary discovery of the theory of equilibrium, which would change the face of economics.
Because of this, he was able to receive a placement at the prestigious Massachusetts Institute of Technology. In 1953, Mr. Nash was summoned to the pentagon to help decipher intercepted Russian messages, and it was upon leaving that he first noticed a mysterious man by the name of William Parcher, who is actually another hallucination. Parcher later approaches Mr. Nash at night and takes him to what appears to be a code breaker lab set up in an old warehouse. It is here that he is asked if he will help the Department of Defense by deciphering codes in certain newspapers and periodicals, at which time a devise is implanted into his arm.
However, this entire experience is nothing more than an elaborate delusion and hallucination. Mr. Nash accepts this assignment, and gradually he becomes completely fixated on doing nothing except code extraction. Around this same time he is asked to dinner by one of his students, Alicia, whom he is almost immediately intrigued by. It is while on this date that his delusional content shifts. Up to this point, his delusions and hallucinations had, for the most part, played into his grandiosity, however, this night, a persecutory theme emerges, as he notices suspicious men watching him.
He continues to see Alicia, while at the same time remaining engrossed in his secret life of code breaking and paranoia. Mr. Nash eventually asks Alicia to marry him, and at the ceremony he sees Parcher parked across the street watching him. Not long after this, while making a package drop-off, a frantic Parcher, who informs him that they are being chased, picks up Mr. Nash. A car pulls up behind them and begins shooting. When he returns home he is clearly distressed, but refuses to tell Alicia what he believes happened to him, instead he locks himself in his bedroom. The next time Parcher shows up Mr.
Nash tells him that he no longer wants to be a part of the operation, however Parcher informs him that if he stops the Russians will find out that he has been working against them. This seems rather indicative of Mr. Nash’s desire to detach from his delusions and hallucinations, while at the same time being completely incapable of doing so. Instead, he becomes even more immersed into his paranoid delusions, at one point telling Alicia that she had to leave because she was no longer safe, and it is at this moment that she begins to realize that there is something very wrong with her husband.
Thus, Alicia decides to contact a psychiatrist named Dr. Rosen. Not long after this, Mr. Nash is scheduled to lecture at the National Math Conference and during his speech suspicious men enter, whom Mr. Nash immediately sees as Russians sent to kill him. At this time he flees and they proceed to chase him. He runs in to Dr. Rosen who introduces himself, however Mr. Nash is still in the grips of active psychosis and he ends up being carried away by the doctor and his men. At McLean Hospital, Dr. Rosen tells Alicia that her husband has Paranoid Schizophrenia, and that a large portion of his reality does not exist.
She at fist denies the extent of his problems, saying that he has “always been a little weird,” however, Dr. Rosen begins to point out evidence that supports what he is saying. Still not completely convinced, she goes to his office, which she finds polluted with newspaper clippings and string. She then goes to where Mr. Nash has been secretly dropping of envelops containing the decoded messages he had deciphered. There she finds an abandoned house with a mailbox full of his unopened packages, which she takes back with her to the hospital in an effort to prove to her husband that reality is not as it seems.
Shortly thereafter he is found in his room with a gash in his arm where he has been looking for the implant. John undergoes insulin shock therapy five times a week for 10 weeks, on top of being placed on antipsychotics. One year later, Mr. Nash has shown improvement in the positive symptoms of schizophrenia he had been experiencing, however the medication has had severe side-affects which include blunted affect, no sex drive, and the inability to do mathematical formulations, which is what has defined him as a person up to this point.
Because of this, he secretly stops taking his medication, and it doesn’t take long for the positive symptoms to return. Alicia later discovers his new refuge which is an old outside workshop, and which is decorated with the same accrual of newspaper and string. In a panic, Alicia attempts to leave the house, and it is at this time that Mr. Nash realizes that one of his hallucinations, Charles’ niece Marcy, has never aged over the years, which finally proves to him that they are not real. Alicia comes back inside and calls Dr. Rosen, however Mr. Nash is ble to convince her to let him try control it on his own, and she agrees. He later goes back to Princeton and asks his old friend Martin, who is now the department chair, if he can “hang around the campus,” hoping that this forced socialization and familiarity might aid in his recovery.
After a few more altercations with his hallucinations, Mr. Nash learns that the only way to live a normal life is to just accept their nonexistence, and ignore them completely. When asked if his hallucinations are gone, he replies “No, but I’ve gotten use to ignoring them, and as a result, they’ve kind of given up on me. Mr. Nash goes on to start teaching at the university, and in 1994 he finds out he is being considered for the Nobel Prize for his Equilibrium Theory, which he ends up winning. In his acceptance speech he dedicates all of his accomplishments to his wife. He and his wife are still happily married and he remains successfully in control of his schizophrenic symptoms, however, he and Alicia’s son has developed the same illness that his Mr. Nash has struggled with for so many years.