Destination 19: Killing fields, Cambodia
The Killing Fields are a number of sites in Cambodia where more than a million people were killed and buried by the Khmer Rouge regime during its rule from 1975 to 1979 (https://en.wikipedia.org/wiki/Khmer_Rouge_Killing_Fields).
Related Film: A Nightmare on Elm Street (1984)
A Nightmare on Elm Street (1984) was based on a true story (https://www.ranker.com/list/crime-movies-based-on-true-stories/anncasano?utm_source=facebook&utm_medium=creepy&utm_campaign=horrific_true_story_movies_IMAGE)
The narrative device of Wes Craven’s slasher film, in which knife-for-fingers Freddy Krueger (Robert Englund) kills innocent teenagers in their sleep, is entirely fictionalized. However, Craven based the movie on a Los Angeles Times article.
Craven described the idea for the premise of A Nightmare on Elm Street:
“I’d read an article in the LA Times about a family who had escaped the Killing Fields in Cambodia and managed to get to the U.S. Things were fine and then suddenly the young son was having very disturbing nightmares. He told his parents he was afraid that if he slept, the thing chasing him would get him, so he tried to stay awake for days at a time. When he finally fell asleep, his parents thought this crisis was over. Then they heard screams in the middle of the night. By the time they got to him, he was dead. He died in the middle of a nightmare. Here was a youngster having a vision of a horror that everyone older was denying. That became the central line of Nightmare on Elm Street.”
A Nightmare on Elm Street is a slasher film set in the fictional town of Springwood, Ohio. The plot revolves around Nancy and her teenage friends who are stalked and killed in their dreams by the omnipresent, blade-gloved Freddy Krueger. The reason behind Freddie’s rampage lies in the parents’ sinister secret from years ago.
The greatness of Craven’s film is that the identification with the characters doesn’t end with the movie’s final scene. Instead, it continues following the movie. As anyone whose had a nightmare after watching this film will attest, it’s the moment after you wake up from the terrifying dream that is most horrifying, as it is then that you’re put in the exact same position as the main characters.
Interestingly, the opening scene of Shadow People (2013), a supernatural thriller written and directed by Matthew Arnold, is set in 1979 Cambodia, the final year of the Khmer Rouge regime. Arnold’s film addresses the universal fear of the boogieman, linking to the multiple psychiatric themes in Wes Craven’s A Nightmare on Elm Street (Nightmare).
How it relates to the field of psychiatry
As the title implies, A Nightmare on Elm Street (Nightmare) depicts Nightmare Disorder (ND); repeated awakenings with recollection of terrifying dreams usually involving threats to survival such as being hunted by a child murderer. Upon awakening from her nightmares, Nancy is alert and able to recall her dream in detail, thus reinforcing the teaching point that differentiates ND from Sleep Terror Disorder. With sleep terrors, there is no detailed recall of the dream. While the above sleep disorders (parasomnias) are in the differential diagnosis for what ails the teenagers in the film, so too is a dyssomnia.
Dyssomnias are disturbances in the quality, amount, or timing of sleep. While a discussion of sleep stages is beyond the scope of this blog, the movie is about a recurrent nightmare (REM sleep) that invades the teenagers’ wakeful states. In this way, Nightmare is a metaphor for a dyssomnia defined by REM invasion into the beta state (wakefulness), specifically, Narcolepsy. Narcolepsy usually has its onset in adolescence (e.g. Nancy), is characterized by hallucinations (seeing the boogeyman), and is genetically predisposed. Metaphorically, Nancy and her friends carry the (genetic) burden of their parents.
While it is established that Freddie Krueger was a child murderer, the backstory is that he’s afflicted with Pedophilic Disorder. His having a paraphilia provides depth to the character of Nancy Thompson. Tina, Glen, and Rod are all murdered in bed, the location being symbolic of Freddie’s sexual disorder. While the history of Freddie as a child murderer is ultimately provided by her mother, Nancy’s discovery is metaphorical of the recovery of her lost memories. When Freddie is pursuing her, she runs to the basement of her home which looks distorted, a product of derealization likely due to anxiety. Given the film’s ability to transgress “the boundaries between the imaginary and real,” Nancy’s experience in the basement may be a nightmare (sleep) or a flashback (wakefulness) that is cued by the situation. Specifically, she was likely imprisoned in Freddie’s boiler room (basement). Unlike the other characters, Nancy is “kept alive” by Freddie, and slowly learns the truth/etiology of her nightmares. Freddie considered her special in some respect. Nancy’s mother, Marge, kept Freddie’s hat and glove; bizarre behavior if Freddie was “just a child murderer.” Years prior, Marge likely had an affair with Fred Krueger (which would be consistent with her having separated from her husband in present day), but had a blind eye to her boyfriend’s conduct towards her daughter. Nancy and her friends are victims of the sins of their parents.
Nightmare then is not merely about Sleep and Awake Disorders such as Nightmare Disorder or Narcolepsy. Nancy’s sleep pathology is likely due to Posttraumatic Stress Disorder, having been a victim of childhood sexual abuse.
Anthony Tobia, MD, Copyright © 2018 Rutgers Robert Wood Johnson Medical School.
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