Oct 17: V/H/S (2012)

Synopsis

V/H/S is an anthology of short films within an overlying story arc depicted by “Tape 56.” On this tape, a group of thieves attempt to retrieve a VHS tape from a seemingly vacated home with the owner apparently dead in the living room. Over the course of the film, we see the members of the group disappear.

The Videos
In Amateur Night, a night intended for sexual exploits turns awry.

In Second Honeymoon, a vacation taken by a married couple ends with one of the spouses murdered by a mysterious voyeuristic stalker whose identity is revealed at the end of the recording.

In Tuesday the 17th, a group of friends are brought to the woods by Wendy in hopes of finding the killer who murdered her friends the previous year.

In The Sick Thing That Happened to Emily When She Was Younger, Emily is being used as an incubator for aliens by her boyfriend, James.

In 10/31/98, a group of friends attempt to rescue a woman undergoing an exorcism.

THE PSYCHIATRY OF V/H/S

The video tape, Amateur Night, depicts a case (Lily) of Borderline Personality Disorder (BPD). Some characteristics of BPD include unstable affect, inappropriate anger when feeling abandoned, and unstable relationships. After returning to a motel with a group of guys, Lily continues to pursue Clint, forging an intense relationship despite only having met him a couple of hours prior (idealization). The volatile relationship forged with Clint comes to a halt when Clint resists her advances, leaving her enraged. She takes out her anger on Patrick and Shane (devaluation) who, for the entirety of the film, she made clear she did not like. This idealization/devaluation serves as an example of splitting; an ego defense mechanism where a person is seen as either all good or bad. Her feelings of abandonment and unstable affect manifest again at the end of the tape when she switches from crying to growling after Clint again resists her sexual advances.

In the video, Tuesday the 17th, we are introduced to possible substance-induced psychosis. Wendy tells the story of a killer in the woods who doesn’t become manifest until after the group shares marijuana. It is possible that Wendy was in fact the killer after smoking cannabis, and that a similar situation resulted in the events the previous year.

In the video, The Sick Thing That Happened to Emily When She Was Younger, Emily exhibits Cotard syndrome, which is the delusion that a body part has been missing or inserted. Emily believes that there is something in the hematoma in her arm. It is later disclosed that the bump is a tracking device, as James has been using Emily to incubate aliens. This shared delusion between Emily and James due to their relationship exemplifies Folie aI Deux. In addition, we are introduced to Dissociative Amnesia which is manifest when Emily does not recall the events that led to her black eye and arm splint.

Oct 16: Candyman (1992)

Synopsis

Inspired by Clive Barker’s The Forbidden, Candyman is set in the housing projects of Cabrini Green, Chicago. Helen Lyle is a University of Illinois graduate student who sets out to write a thesis about local legends and myths. She learns about a local urban legend, Candyman, who appears after calling his name five times in front of a mirror and uses his hook to split his victims from “groin to gullet.’

Candyman is a film depicting the rite of passage of Helen Lyle. During her evolution, her skepticism turns to fear when after summoning Candyman, a series of murders and a visit from Candyman himself cause her life to spiral out of control.

The Legend

Partly inspired by Hook Man (http://urbanlegends.about.com/od/horrors/a/the_hook.htm), Candyman was the son of a slave whose father became wealthy after mass-producing shoes after the Civil War. As a result, Candyman grew up attending the best schools and later became a well-known artist. Highly sought out by the elite society for his talent in portraits, he was hired by a wealthy man to paint a portrait of his daughter. The two fell in love and had a child. Enraged, his lover’s father organized a lynch mob. During the gruesome attack, the mob cut off Candyman’s right (painting) hand and replaced it with a hook. They then covered him in honey and allowed him to be stung to death as the mob chanted “Candyman, Candyman.” It is said that Candyman returns from his grave to taking revenge when one dares to say his name five times in a mirror.

THE PSYCHIATRY OF CANDYMAN

Candyman is Psychiatric Anthropological film that shines light on the social aspect of urban legends and why they resonate in certain communities. The French anthropologist, Claude Levi-Strauss, identified myths as a type of speech through which a language could be discovered. He is renowned for his structuralist theory of mythology which attempted to explain how fantastical tales could be so similar across cultures. Urban legends are cautionary tales of contemporary folklore that identify taboos represented in all cultures that capture four common themes: a) misunderstandings, b) poetic justice, c) business rip- offs, and d) revenge. Urban legends are a large part of popular culture and often speak to the fears, anxieties, and biases of that culture. In doing so, they provide insight and give us an idea of the moral fabric of the community.

For the people living in Cabrini Green, the urban legend of Candyman validation for the fears of people living amongst the gruesome crimes against Ruthy Jean and of the young
boy. In the movie, we see that Candyman thrives off the perpetuation of this legend. Upon realizing that Helen may have caused a rift in people believing in his existence, Candyman beckons her to be his victim, with intent on killing her and in so forth, give rebirth to his legend once again.

In his seminal work, Les rites de passage, Arnold Van Gennep described rites of passage as having three phases:

Separation
During this phase, the individual is stripped of the social status that he or she possessed before the ritual. After challenging the authenticity of the urban legend, Candyman appears to Helen “needing to prove his existence.” After a series of murders by the hand hook of Candyman, Helen is stripped of her social status and imprisoned.

The Liminal Period
During this phase, the individual is inducted into the liminal period of transition, a middle stage of the ritual, no longer holding her pre-ritual status (but has not yet attained the status they will hold when the ritual is complete). For Helen, the discovery in the words in the apartment attic, “It was always you, Helen,” highlights the liminal period. She is betwixt and between, with Candyman’s prophesy that Helen will carry on his tradition of inciting fear into the community of Cabrini Green.

The binary motif is seen throughout the movie: Candyman is a African American slave whose “spirit’ resides in the ghettos of Chicago. Helen, a white middle class woman, resides in a luxury condominium. The use of bees as symbolism for Candyman is also important in that they have the capacity to make a sweet honey while also being able to induce great pain. Also, the very way Candyman kills his victims is by splitting them in two.

Re-Assimilation into Society
During this phase, the individual is given her new status. As the prophesy foretells [spoiler alert], Helen ultimately becomes the embodiment of the urban legend.

In using the mirror, Candyman forces its victims to confront the self and the non-self, or the “other” and to project internal conflict onto external images. These visual tools play with the spectator’s impulse control, and most importantly to question it; “No one ever got past four.” The notion of going past four is a common theme throughout the movie. Candyman, with his gruesome tale, plays on humanities infatuation with the grotesque and like Pandora’s Box; its allure compels us to approach the lid. In this case the “lid’ is opened by saying “Candyman” five times in a mirror.

Oct 15: Scream (1996)

Synopsis

On March 18, 1940, in a small Missouri town, Janette Christman babysat for the Womack family. That night, she was raped and strangled with an ironing cord. Along with the death of Marylou Jenkins (who was also raped and strangled with an electrical cord 4 years prior) and the biography of Daniel Harold Rolling (Gainesville Ripper), her murder inspired a genre of film that included When a Stranger Calls (1979). 17 years later, Wes Craven would direct Scream, a slasher film that depicts Sidney Prescott, a high school student in the fictional town of Woodsboro, who is stalked by a mysterious killer known as Ghostface.

THE PSYCHIATRY OF SCREAM

Scream is a horror movie about horror movies. As the plot develops, the characters continually reference the multitude of horror films that inspired their own creation. In this way, Scream is a forerunner to Cabin in the Woods, explaining why audiences are drawn to the genre. Films like Scream resonate with us because the tropes are archetypes of our collective unconscious. In Craven’s film, we learn of the Jungian archetypal warning of what happens when you neglect your responsibility when caring for children. Similar to Halloween (1978) and Friday the 13th (both are, of course, referenced in Scream), Casey is talking to her boyfriend when she’s supposed to be watching the children. Ghostface then represents the keeper of prosocial norms that ensure the preservation of cultural values such as the welfare of children. This is the minor (familial) Father archetype that represents the virtues of sternness and control.

An unplugged version of Blue Oyster Cult’s (BOC) Don’t Fear the Reaper plays softly in the background while Sidney and Billy discuss the intimacy of their relationship. The music is highly symbolic. Among its many themes is its literal message to join the reaper/Ghostface [spoiler alert] who turns out to be Billy. Since Billy is the reaper, Billy is dead (he experienced an emotional death when his mother left him). In joining Billy’s alter ego (reaper), Sidney then would be committing suicide. Billy’s (and BOC’s) message is clarified; this is a murder- suicide. In this way, Scream can be enjoyed as an 80’s version of Shakespeare’s Romeo & Juliette.

The film also depicts Persistent Complex Bereavement Disorder in its main character. Specifically, Sidney demonstrates intense emotional pain in response to the death of her mother, and remains preoccupied with the circumstances surrounding her death. Given that Sidney is “contemplating suicide” and appears underweight, an eating disorder should also be in the differential diagnosis. Movies that depict matricide (especially by an adolescent female) are analytic depictions of Anorexia Nervosa. Taken together, the audience is made to consider whether Sidney had an active role in her mother’s murder. This consideration sheds a different light on the dynamics between the characters. For example, is Billy’s message to “join the reaper” instead an invitation for Sidney to rejoin Randy and him in another murder spree? This interpretation also transforms the hated character of Gail Weathers, a shallow reporter who is in search of the truth behind the original murder, into one whose harassment of Sidney is deemed justifiable if Sidney actually did play an active role in her mother’s death. It isn’t surprising, then, that it is Gail who just so happens to end the movie with an impromptu news report about the night’s events.

Oct 14: The Amityville Horror (1979; 2005)

Synopsis

The Amityville Horror is a 2005 remake of the 1979 horror film which itself was based on a novel of the same name by Jay Anson. The film chronicles the life of George and Kathy Lutz and their family after they move into a haunted house on Long Island. The house at 412 Ocean Ave. was previously the grizzly scene of a mass homicide committed by Ronald (Ronnie) DeFeo, Jr. who murdered six members of his family on November 19, 1974.

Despite the 1979 film being a traditional “haunted house story,” we learn that The Amityville Horror is about demonic possession when Kathy researches microfiche and discovers “voices told him (Ronnie Defeo) to do it.” After moving into the basement, he “killed them all” just 28 days later (a timeframe also forecasted in Richard Kelly’s 2001 film, Donnie Darko). The movie also references The Shining and Hellraiser (1987) when Kathy discovers that Native Americans were tortured (there are pictures of Clive Barker-esque torture) in a secret room in the basement. The torturer suicided by slitting his throat so that his presence would live forever, thus explaining the spirit possession of George’s body.

THE PSYCHIATRY OF THE AMITYVILLE HORROR

At Rutgers Robert Wood Johnson Medical School, the first module, Necromancy, of our year- long resident Psychopathology course incorporates ghosts (wraiths) and demons. Tales of demonic possession serve to reinforce teaching points of chronic and persistent illnesses. Movies about demonic possession may therefore be metaphorically interpreted as case studies of psychosis. In The Conjuring, the Warrens ended the movie with the discovery of a new haunted house; one we now also investigate from an educational perspective.

The scene of “the DeFeo murders” in Amityville is haunted by the ghosts of the victims. We learn that Chelsea, the youngest daughter of the Lutzes, has an imaginary friend, Jodie. Similar to Stephen King’s The Shining, our provisional thought is that this is developmentally appropriate. However, like Danny Torrence, Chelsea’s behavior becomes maladaptive, and her perceptual disturbances are ultimately deemed not to be age-appropriate. In one scene, we visit the archetypal warning of inappropriate conduct when supervising children; the “bad babysitter.” This archetype – which we will revisit in Scream, Halloween, and Friday the 13th ‘ is a prosocial warning that is violated by Lisa, who is attacked by Jodie and rendered catatonic.

As a tale of demonic possession, George Lutz begins to demonstrate delusions of passivity. He suffers from thought insertion when he succumbs to the delusion that he’s not in control of his own behavior. “All that is psychotic is not schizophrenia” however. In George’s case, schizophrenia is unlikely, given the atypical characteristics of his presentation. Delusions of
passivity are no longer considered first-rank quality (DSM-5), thus allowing for a broader differential diagnosis. The differential exemplifies the biopsychosocial formulation:

Bio:
In the 2005 film, a review of systems (ROS) reveals George to be experiencing coughing, nausea, and vomiting. Anytime an individual manifests respiratory and GI symptoms, alpha-1 anti-trypsin deficiency must be considered in the differential diagnosis. Since it’s new-onset, George’s alpha-1 anti-trypsin deficiency is likely acquired. Might The Amityville Horror be about psychosis secondary to alpha-1 anti-trypsin deficiency? One potential etiology of acquired alpha-1 anti-trypsin deficiency is hypergammaglobulinemia. George’s psychotic behavior may have resulted from being exposed to mold (seen throughout the house) with an impaired immune system (due to hypergammaglobulinemia).
An additional biological theory of George’s psychotic symptoms is sarcoidosis. This autoimmune disease is characterized by lung granulomas, giving rise to pulmonary symptoms, as well as hypercalcemia which would explain his GI and psychiatric symptoms.

Psychosocial:
In the original (1979) film, emphasis is placed on George’s struggle with his faith, perhaps a predisposing factor of his psychosis. In a stress-diathesis model, his psychotic break results from the precipitant of his move to a house that is the scene of the infamous DeFeo murders.

Oct 13: Friday the 13th (1980)

Synopsis

The day of the week didn’t keep faithful, but nobody can argue only one movie could be the topic of discussion on this date! Filmed in Blairstown, NJ, Friday the 13th is a 1980 slasher film written by Victor Miller. New Jersey stands second to no one when it comes to the weird and sinister. Many movies (The Toxic Avenger) and media (War of the Worlds radio broadcast) have either been set in or inspired by (Jaws, Halloween) events that have occurred in the Great Garden State (yes, even The Amityville Horror was partially filmed in Toms River, NJ!).

Friday the 13th depicts a group of teenagers who are murdered one-by-one while attempting to reopen an abandoned campsite. The movie begins in the summer of 1957 with two camp counselors being murdered by an unseen assailant after they sneak away to a cabin to “party.” The film then jumps to present day, and chronicles the ill-fated attempt of Steve Christy and a group of counselors to reopen Camp Crystal Lake. Friday the 13th introduces the uI?ber-slasher, Jason Voorhees, an imposing giant donning a goalie mask and wielding a machete.

THE PSYCHIATRY OF FRIDAY THE 13TH

The Substance Related and Addictive Disorders chapter in the DSM-5 includes the category of Substance-Induced Disorders. Substance-Induced Disorders may include substance intoxication, substance withdrawal, substance-induced mental disorders (e.g. Alcohol-Induced Mood Disorder) and other syndromes caused by the ingestion of a substance (e.g. fetal alcohol syndrome, overdose, etc.).
Friday the 13th serves to teach points of the Substance-Induced Disorders and Syndromes such as the introduction of the fetal alcohol syndrome (FAS) through plot summary. For example, the motive behind the mass murders at Camp Crystal Lake correlates with a case of FAS. [Spoiler Alert] When Mrs. Voorhees reveals herself as the killer, we learn that her rampage is the result of severe mental illness endured from the loss of her son, Jason, who drowned because camp counselors were drinking and having sex instead of supervising the young boy. Just as FAS results from the teratogenic effects of alcohol (in utero), the fate of a young Jason Voorhees resulted directly from the influence of alcohol on camp counselors who were partying instead of supervising the 11-year-old boy swimming in Crystal Lake.

Oct 12: Final Destination (2000)

SYNOPSIS

On this date, October 12, 1997, John Denver was killed when his plane crashed into Monterey Bay near Pacific Grove, California. Final Destination (2000) is the first installment in the Final Destination series, a franchise of horror films involving premonitions. Unlike other horror movies, the franchise is iconic for portraying Death as the major antagonist. Specifically, the movies build on the concept that “cheating” Death is impermissible and thus, death is unavoidable.

The film chronicles the events that unfold after Alex Browning, a high school senior, and his classmates board a plane to Paris for a school trip. Shortly before departure, Alex Browning has a premonition of the plane exploding, causing him to frantically warn everyone about the flight. After being escorted off the plane by security, Alex and several of his classmates soon learn that his vision would come to life. The students’ relief of not being on the plane quickly turns to anguish as they attempt to evade Death’s final ultimatum.

THE PSYCHIATRY OF FINAL DESTINATION

The plot of Final Destination revolves around the concept of premonitions; a term used to describe a psychic ability to see into the future. Specifically, Alex’s vision of his plane exploding allows him and several of his peers to “cheat” Death by avoiding an untimely demise.

As an otherwise well-functioning high school senior, Alex’s premonition calls into question his ability to see into the future. Similar tropes in other movies, such as Donnie Darko, portray psychosis as a core sign of major mental illness (schizophrenia and delusional disorder). However, new onset psychosis as part of a psychiatric disorder is viewed as a diagnosis of exclusion. Therefore, one must consider a vast array of possible etiologies for Alex’s premonition.

Hallucinations that occur while falling asleep are termed “hypnagogic.” These disturbances in reality occur while one transitions from the awake to sleep state. Commonly associated with narcolepsy, hypnagogic hallucinations often occur in adolescents and are indistinguishable from reality. Other potential causes for altered reality in Alex include substance ingestion. According to the National Institute on Drug Abuse (2014), 27.2% of high school students surveyed reported use of an illicit drug. Hallucinogens, inhalants, and other illicit substances are well-documented causes for psychosis in teenagers.

Following Alex’s premonition, unusual events begin to unfold in the lives of others on the plane. The events are forewarned by “Rocky Mountain High’ throughout the film, reminding the survivors that John Denver died in a plane crash. Thirty-nine days after the plane explosion, a memorial service is held for victims of the tragedy. Later that evening Alex’s friend, Tod, was found strangulated to death in his bathtub. The film depicts his death as a series of events beginning with a leaky toilet; the water on the floor causes him to trip into a clothesline ultimately leading to death by strangulation. Tod’s cause of death is ultimately ruled a suicide.

Posttraumatic stress disorder (PTSD) is a psychiatric condition triggered by exposure to life- threatening or horrifying personal experiences. It is characterized by persistent re-experiencing, hypervigilance, and avoidance of stimuli associated with the traumatic event. When these symptoms last longer than one month, it is diagnosed as PTSD. Acute stress disorder (ASD) is a similar diagnosis when symptoms have persisted for less than one month. PTSD carries a significant association with suicidal attempt. Perhaps Tod truly suffered from an underlying anxiety disorder stemming from the plane explosion he witnessed. One could argue that Tod’s death was a consequence of his untreated psychiatric disorder, PTSD.

Finally, the concept of Death as a personified entity has played a role in many films (The Ring, 2002) and mythologies. For Alex and several other characters in the movie, Death plays a prominent role in their daily functioning. Throughout the movie, these characters work together to outsmart Death and prevent their demise. Their constant belief in this embodiment, despite no factual evidence of its existence, relates to the psychiatric condition termed delusional disorder.

Delusional disorder is the presence of one or more delusions (fixed, false beliefs) that last for at least one month. These beliefs cannot be due to a psychotic disorder (schizophrenia), mood disorder, substance use (e.g., cocaine), or other medical conditions (e.g., infections, dementia, endocrinopathies). Alex’s fixed belief in the presence of Death is consistent with a plausible delusional disorder diagnosis.

The franchise moves forward with Final Destination 2, which picks up with Clear (the last survivor of the plane explosion) voluntarily admitted to a psychiatric hospital. Evidently the role of psychiatry in the franchise is not solely implicit after all.

Oct 11: Paranormal Activity (2007)

SYNOPSIS

Paranormal Activity (2007) is the first of a series of films centered on a young couple, Katie and Micah, who are being haunted by a supernatural presence in their new San Diego home. Katie claims she has been haunted by an evil presence since she was a child. Micah attempts to prove Katie wrong by setting up a camera in their bedroom, and showing her that it is all “in her head.”

As the nights progress, there are more occurrences that become less explainable by just “dreams.” The idea that there is a demon in the house that has long followed Katie becomes more plausible to both Katie and Micah.

Three of Jason Blum’s most famous horror films depict three of the four primary disorders that make up the Dissociative Disorders. Sinister (2012) demonstrates Dissociative Fugue (DSM-IV); Insidious (2010) portrays the features of Dissociative Amnesia; and Paranormal Activity (2007) depicts Dissociative Identity Disorder. The 2007 film depicts the progressive involvement the “demon” plays, wreaking mayhem in their lives.

THE PSYCHIATRY OF PARANORMAL ACTIVITY

Paranormal Activity serves as an opportunity to teach the Dissociative Disorders, specifically Dissociative Identity Disorder (DID). The paranormal activity of demons is viewed as a dissociation that results in identity disruptions, the possession-form phenomena, and the gaps in recall.

One night Katie appears to be in a trance, standing beside the bed staring at Micah for over 2 hours and then leaves the room and ends up outside. The next morning she has no recollection of her leaving the house (Day 15, Katie and Micah’s house):

  • “What do you remember from this? – Were you dreaming?”
  • “I don’t remember anything. I remember standing in the doorway and you pointing a camera at me. And you were all freaked out. I don’t, I don’t remember standing here.”

While this serves as a good example of the amnesia that can be experienced in DID, the additional finding of a distinct personality state/experience of possession makes DID more likely than Dissociative Amnesia:

  • “…You went outside and sat on the swing. And I went inside to bring you a blanket ’cause you refused to leave in this catatonic, weird state you were in.”

Later, Micah finds Katie in a catatonic state, sitting in the hallway, gripping a cross so tightly that it bloodies her palm, further describing the catatonia that can be experienced in DID.

In the final scene, when Katie, in another “possessed” state, screams for Micah, he rushes to her rescue…and his demise. Micah’s body is violently hurled at the camera, where we see Katie over his body with a sinister grin on her demonic-looking face. She is the “demon.” Micah’s body was discovered on this date, October 11th.

Oct 10: Event Horizon (1997)

SYNOPSIS

Why not start the weekend off with a Sam Neill double feature and have Event Horizon follow In the Mouth of Madness?! Taking place in 2047, Event Horizon depicts the events surrounding the ill-fatal rescue mission embarked on by the Lewis and Clark in response to distress signals dispatched by the Event Horizon, a ship that disappeared seven years prior. The vessel had ventured into an experimental flight to test a gravity drive, which if successful, would decrease the travel time between two points in the universe. Upon reaching the Event Horizon, many sinister events take place revealing the remnants of the crew from the previous mission. Slowly, the crew of the Lewis and Clark are pulled into the hallucinogenic trances of the Event Horizon with some of the lives of the crew being claimed. Desperate measures are taken to return to earth, which unfortunately prove futile.

THE PSYCHIATRY OF THE EVENT HORIZON

Among the most striking parts of Event Horizon are the hallucinations envisioned by the members of the Lewis and Clark. While hallucinations are often synonymous with psychotic disorders, general medical conditions and substance use must first be ruled out. In the film, it is possible that the hallucinations are due to delirium induced by hypoxia. Many of the hallucinations of the crew members began when they entered the Event Horizon and had less than a day of usable oxygen for the entire crew. The impact of being in stasis, perhaps complicated by electrolyte abnormalities (inadequate intake), could also have contributed to delirium. Of note, at the end of the film, Starck awakens from an over-two-month period of stasis with a delusion that Dr. Weir is impersonating one of the rescue workers. This particular type of delusion is known as the Fregoli syndrome (Weir can assume intermetamorphosis).

The hallucinations, in Dr. Weir’s case, could also be as a result of pathologic grief. While adaptive bereavement may include guilt over actions taken or not taken with the deceased while they were still alive, it is pathologic when the guilt becomes pervasive and debilitating. In Dr. Weir’s case, his pathological guilt over his wife committing suicide results in hallucinations of her insisting that he stay on the Event Horizon.

The character of Ensign Justin depicts the use of dissociation as a defense mechanism. After witnessing horrid images from the gravity core, he enters a catatonic state. When the catatonia resolves, he demonstrates Acute Stress Disorder, constantly reliving the images he saw. This leads him to attempt suicide. His means underscores the principle that men use more lethal mechanisms for suicide, as he tries to leave the ship without a space suit. It’s interesting that a crew member on a ship named Lewis and Clark would prompt a discussion of suicide, as its namesake, Meriwether Lewis, was found with two gunshot wounds at a roadside inn at Grinder’s Stand, Tennessee on this very date in 1809. He died the next morning on October 11, 206 years ago due to wounds from his suicide attempt.

Oct 9: In the Mouth of Madness (1994)

SYNOPSIS

We go back-to-back today with John Carpenter’s In the Mouth of Madness. Considered by Carpenter to be the final piece of the apocalyptic trilogy preceded by The Thing and Prince of Darkness, In the Mouth of Madness is told as a patient history. Dr. Wrenn performs a psychiatric evaluation on John Trent who discloses his history of present illness (HPI) that culminates with admission to an inpatient psychiatric hospital (where the movie begins).

THE PSYCHIATRY OF IN THE MOUTH OF MADNESS

John Trent is an insurance investigator who was recently hired by Arcane Publishing to investigate the disappearance of Sutter Cane, an author whose novels are purported to cause acute onset of disorientation, memory loss, and paranoia in their readers. The effects fit a diagnosis of delirium, specifically disturbances in cognition (including attention, orientation, and memory) that develop over a short period of time. The disturbance is a direct physiological effect of a medical condition or a substance. Since we see through the perspective of Trent, a closer investigation may reveal the etiology of his delirium (did he give a urine drug screen upon admission to the hospital?).

Trent’s investigation leads him to Hobbs End, the fictional town in Cane’s novels. There, he finds Cane who reveals that they are all characters playing a part in a larger story, the last “chapter” of which is captured in his new novel aptly named In The Mouth of Madness. Cane also informs Trent that his fans’ belief in his stories have freed an ancient monstrous race that will overrun the earth (i.e. the end of the novel and therefore, their ultimate fate).

In viewing the film, one must consider that Trent used cocaine upon being hired while reading Cane’s novel “to research” his new client (the “altered” eyes and nosebleed of the reader killed by Trent are symbolic of cocaine’s intoxication effects). His intoxication “got him caught up” in the novel, where he was unable to differentiate fiction from reality. The cognitive deficits and perceptual disturbances that are pervasive throughout the film are the result of cocaine-induced delirium. Trent’s feelings of derealization and loss of time query the use of lysergic acid diethylamide (LSD). Along with cocaine, LSD has a sympathomimetic effect, so their concurrent use risks sudden cardiac death. Perhaps Carpenter’s theme of the apocalypse is a metaphor for the public health crisis and economic burden of drug use and heart disease in the US.

Oct 8: The Thing (1982)

SYNOPSIS

At the Amundsen’Scott South Pole Station, most personnel leave by the middle of February, leaving a few dozen “winter-overs” (mostly support staff plus a few scientists) who keep the station functional through the months of Antarctic night. The winter personnel are isolated between mid-February and late October. After the last flight has left for the winter, an annual tradition is a double feature viewing of The Thing and The Shining.

So, following yesterday’s blog on The Shining, its only right to examine John Carpenter’s The Thing next. Based on John W. Campbell, Jr.’s novella, Who Goes There?, the movie is about a parasitic , extraterrestrial lifeform that assimilates organisms at the molecular level, thus allowing it to mimic the host phenotypically.

Set in Antarctica, The Thing begins with a Norwegian helicopter pursuing an Alaskan malamute to an American research station. When the last surviving Norwegian is shot and killed, the Americans go to the Norwegian base only to find it burned to the ground. MacReady and the crew learn that the Malamute was alien, and before they could kill it, the thing begins to assimilate the other dogs and members of the research team.

Considered by Carpenter to be the first part of an apocalyptic trilogy along with Prince of Darkness and In the Mouth of Madness, The Thing pays homage to Dracula, depicting the trials of MacReady (modern day Van Helsing), who leads the team as they try to capture and kill the inhuman scourge before it can hibernate and move beyond the continent.

THE PSYCHIATRY OF THE THING

We discover that the thing was trying to freeze itself and hibernate, thus introducing the notion of dyssomnias; sleep abnormalities in the amount, quality, or timing of sleep involving abnormalities in mechanisms generating sleep-wake states (as opposed to parasomnias which are abnormal behaviors occurring in association with/around the time of sleep such as sleep walking). One dyssomnia, Non-24 Hour Sleep-Wake Type (a Circadian Rhythm Sleep-Wake Disorder), is characterized by abnormal synchronization between the 24-h light-dark cycle and the endogenous circadian rhythm. Given that a) the setting of the film is the Antarctic night, b) the alien’s circadian rhythm is longer than 24 hours, c) the alien needs to hibernate, The Thing may be viewed as an exercise in the Sleep-Wake Disorders.

The Thing can also be interpreted as a case study of “mass paranoia;” with imminent danger behind every familiar face, the film oscillates between hypervigilance and Shared Psychotic Disorder. For example, Blair becomes increasingly paranoid, calculating that if the alien escapes Antarctica, all life on earth will be assimilated within a few years.
In the final scene, MacReady and Childs watch the camp burn and acknowledge the futility of their distrust and share a bottle of scotch. The ambiguous ending is clarified 30 years later by Joss Whedon; in The Cabin in the Woods, the scene revealing the “Fail” in Sweden most likely reveals the cataclysmic outcome of The Thing.