The Wall, St. Croix, U.S. Virgin Islands

Destination 7: The Wall, St. Croix, U.S. Virgin Islands

The Wall is a two mile vertical drop off to the ocean floor. As one wades through the water in St. Croix, tiny colorful fish dart about scattered coral formations that dot the ocean floor. Not even a quarter mile from the beach is The Wall. The depth is recorded from a mere 1,000 foot drop off to 2 miles straight down. The deep blue boundary between the clear turquoise water and the black abyss parallels an event horizon.

Related Film: Movie: Event Horizon (1997)

Synopsis

Taking place in 2047, Event Horizon depicts the events surrounding the ill-fatal rescue mission of 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, [spoiler alert] which unfortunately prove futile.

How it relates to the field of psychiatry

One of the most striking parts of Event Horizon is the universal perceptual disturbance experienced by the members of the Lewis and Clark. While hallucinations are often synonymous with psychotic disorders, general medical conditions and substance abuse must first be ruled out. In the film, it is possible that the hallucinations be 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, whether from hypoxia or electrolyte abnormalities (inadequate intake), could also have contributed to the onset of delirium. Of note, at the end of the film, Starck awakens from a prolonged stasis with a delusion that Dr. Weir is impersonating one of the rescue workers. This particular type of delusion is known as Fregoli syndrome.

While hypoxia may have been a precipitating factor, pathologic grief is likely a predisposing element to the delirium. While adaptive bereavement may include guilt over not spending enough time with the deceased while they were still alive and to hear the voice of the deceased, it is pathologic when the guilt becomes pervasive and persistent or when psychotic features develop. In Dr. Weir’s case, his immense guilt over his wife committing suicide results in hallucinations of her insisting that he stay on the Event Horizon.

Lastly, 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 method of suicide underscores the principle that men use more lethal mechanisms as evidenced by his trying 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 self-inflicted gunshot wounds at a roadside inn at Grinder’s Stand, Tennessee on October 11, 1809.

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Marez Megalla, Anthony Tobia, MD, Maggie Yesalavage, DO.

Copyright © 2017 Rutgers Robert Wood Johnson Medical School. tobiaat@rwjms.rutgers.edu All rights reserved.

Xochimilco, Mexico

Destination 6: Island of the Dolls

Just south of Mexico City, between the canals of Xochimico, there is a small island known as Isla de las Munecas (Island of the Dolls). Local legend has it that a young girl was found drowned in mysterious circumstances many years ago and that the dolls are possessed by her spirit. In addition to hearing them whisper to each other, witnesses claim that the dolls have lured them to island where they saw their heads and arms move and eyes open (http://www.isladelasmunecas.com/).

Related Film: You’re Next (2011)

Synopsis

You’re Next is a black comedy-horror directed by Adam Wingard set in an isolated location in Missouri. The plot is similar to Agatha Christie’s Ten Little Indians (1965), the film adaptation of which focuses on ten people invited to a remote location by a mysterious stranger (with Christie’s isolated snowy mountain exchanged for a cabin estate in the woods). The movies’ shared plots revolve around a series of murders from an unknown assailant(s). You’re Next demonstrates uber-dysfunctional family dynamics from its earliest scene to the disclosure of the mystery doll-faced assailants.

In Joss Whedon’s The Cabin in the Woods, the very fabric of American horror film culture is listed on the “big board.” Five monsters from the bottom-right are listed “dolls.” These iconic phobic objects of our subconscious fears are depicted in Wingard’s 2011 slasher film.

How it relates to the field of psychiatry

The movie begins with 2 murders at a neighboring estate by unknown assailants while “Looking for the Magic” plays in the background (Dwight Twilley Band). After witnessing the cold blooded murders, we meet the Davisons, as each member arrives at a family reunion at their Missouri vacation house. The cold, uneasy interaction of the siblings begins around the dinner table when discord erupts, serving as the prelude to the first kill when Aimee’s (youngest sibling) boyfriend, Tariq, is struck by an arrow. In an attempt to secure safety, Aimee regresses, “You never give me any credit for anything…you don’t believe in me,” and convinces her family that “she’s the fastest” who can reach the car and go for help. Her escape attempt ends in her running into a garrote wire outside of the front door. With 2 “loved ones” dead, the rest of the party must band together to protect themselves from the assassins cloaked in sheep, tiger, and lamb masks.

The doll-faced killers’ sinister motives are strangely balanced by the abnormal behavior of those they hunt as evidenced by Zee intimately telling Felix, “I wanna f* you on this bed next to your dead mom.” The universal fear of masked faces, depicted as ‘doll’ in Joss Whedon’s Cabin in the Woods (2012), is symbolic of the hidden agenda of “the protagonists.”

The Specific Phobia of dolls, formerly known as pediophobia, is a universal experience that likely has its roots in childhood animism. Jean Piaget posited that a child’s cognitive inability to distinguish the external from the internal world results from animism. While it’s developmentally appropriate for a child at the pre-operational stage (2-7 years) of cognitive development to believe her doll is angry, such should not be the case for the Davison children. Yet, adults universally retain memories of “their maleficent dolls,” which is why movies such as You’re Next resonate with our most primitive archetypal fears.

Crispian’s girlfriend, Erin, is identified as having been raised on a survivalist compound, and becomes the leader of the hunted. Her heroics however come at a price, reminding us that even the most peerless women and men who serve and protect are at risk for posttraumatic stress. One of the more defining scenes – “Death by Blender” – exemplifies this [Spoiler Alert] when Erin demonstrates flat and isolated affect when she reveals to Crispian that she killed Felix, “I stuck a blender in his head and killed him.”

Table 1. Categories of US Monsters
Major Types
Type Example Description
Common Phobias Dolls Currently classified as Specific Phobia, Other Type, pediophobia is the irrational fear of dolls.
Supernatural
Psychopaths
Folkloric Creatures
Minor Types
Type Example Description
The Undead
Demons
Extraterrestrials
Giant Animals
Taken from http://thecabininthewoods.wikia.com/wiki/Monsters

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Anthony Tobia, MD, Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Jacob’s Well, Texas

Destination 5: Jacob’s Well, Texas

Located just northwest of Wimbereley, Tx, there is a karst landscape formed from the dissolution of soluble rock with underground sinkholes and caves. This landscape is found in Cypress Creek and has claimed the lives of no less than 8 divers since 1964. This cryptic landscape is called Jacob’s Well. From the opening in the creek bed, Jacob’s Well descends vertically to a depth of 120 feet before breaking off into 2 underwater passageways. One passageway measures approximately 1,000 feet and the secondary one extends 4,500 feet.

Related Film: The Ring (2002)

Synopsis

The Ring is a remake of Ringu, a 1998 Japanese horror film that draws on the folk tale, BanchA? Sarayashiki. As legend tells it, there was once a beautiful servant named Okiku who worked for a samurai, Aoyama Tessan. Okiku often refused his amorous advances. Despite his trickery, Okiku remained solemn. Aoyama became enraged and threw her down a well to her death. It is said that Okiku became a vengeful spirit (OnryA?) who tormented her murderer.

In the 2002 American adaptation, a group of teens watch “a video tape that kills you when you watch it.” After watching the tape, the phone rings, and a voice on the other end utters “seven days.” Exactly one week later, you die. The film depicts Rachel Keller, an investigative reporter, who is looking into her niece’s death when she discovers the urban legend.

The American adaptation focuses on Samaras lair; giving rise to the alternate theory is that The Ring was inspired by The Tragedy at Road Hill House. In June 1860, 3-year-old Francis “Saville” Kent disappeared from his home. His body was found in a privy on the property. While the boy’s nursemaid, Elizabeth, was initially arrested, Francis’s sister, Constance Kent, would confess to the murder five years later.

A third perspective comes from the study of the corporeal undead. Also known as “utburd,” mylings are phantasmal incarnations of the souls of unbaptized children who are forced to roam the earth until they could persuade someone to bury them properly. Mylings ‘ translated as “that which is taken outside” – refer to the practice of abandoning unwanted children (usually in the woods where death is almost certain). The disclosure that Samara’s biological mother, Evelyn’s, pregnancy was unwanted is the plot focus in the third film in the Ring franchise, Rings (2017). Specifically, it is discovered that Samara was the product of rape and that Evelyn’s imprisonment in a hidden chamber beneath a church’s bell tower while pregnant is proof of Samara having been unbaptized and abandoned; in a word, a myling.

Interestingly, another Asian (Tai) horror film depicting a “floaty girl” continues this narrative. Written and directed by Banjong Pisanthanakun, Shutter (2004) illustrates how mylings chase lone wanderers at night and jump on their backs, demanding to be carried to the graveyard so they can rest in hallowed ground. In The Ring, Rachel discovers Samara’s body, and she’s given a proper burial in 7 days. While proven unsuccessful, Rachel’s plan is confirmed in Rings as a copy of the video is found to contain extra images including a mysterious woman who tells Julia that she must cremate Samara’s physical remains (we won’t tell you if Julia succeeds where Rachel has failed).

How it relates to the field of psychiatry

Two taglines from the movie highlight teaching points in psychiatry. First, “she never sleeps” hallmarks both insomnia as well as the inevitability of death. Interestingly, a story with the same moral, Appointment in Samarra, shares its title name (synonym) with The Ring’s evil antagonist. Second, “she only wants to be heard” represents a major theme in patient-centered medicine, with patient histories – and the need for patients to convey them in a milieu of unconditional positive regard (Carl Rogers) – being a critical component of healthcare.

Another teaching point focuses on whether Samara is “pure evil.” The Ring is a fictional case study of a “bad seed” (see Damien from The Omen, 1976) in the “nature versus nurture’ discussion of the etiology of Antisocial Personality Disorder.

Finally, a third psychiatric teaching point focuses on the nonverbal communication of horses. In The Ring, the horses at the Morgan ranch go mad and drown themselves, a fate similar to the horse on the ferry on the way to Richard Morgan’s island home. The animal’s intuition is scientifically based. As prey animals, horses have hearts 5x the size of humans’. Their electromagnetic pulse (torus) results in a coherent heart rate that synchronizes with humans (or mylings). Institutions of higher education such as Rutgers Robert Wood Johnson Medical School take advantage of the coherent heart rate of horses by partnering with equine centers (Spring Reins of Hope, http://www.springreinsofhope.com/) to run innovative curricula that use horses to teach medical students nonverbal communication to improve bedside manners.

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Anthony Tobia, MD, Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Salem, Massachusetts

Destination 4: Salem, Massachusetts

In late February of 1692, Reverend Samuel Parris called in a doctor to examine his 9-year-old daughter, Betty, and eleven-year-old niece, Abigail Williams who were suffering from “spontaneous fits.” The children were subsequently diagnosed as victims of witchcraft setting off an outbreak of panic which would sweep throughout Salem Village and become one of the most studied and provocative periods in American history.

Related Film: The Witch (2015)

Synopsis

The Witch (2015) is a historical period supernatural horror film written and directed by Robert Eggers that depicts the trials of Thomasin and her family upon their banishment from a Puritan plantation in 1600’s New England.

How it relates to the field of psychiatry

What is wrong with this picture?

After building a farm by the edge of a large, secluded forest far from the Puritan settlement, Thomasin is caring for her newborn brother, Samuel, when she plays Peek-a-Boo. The game is an exercise in object permanence: the ability of a child (Samuel) to understand that objects exist even if they cannot be seen. In his theory of cognitive development, Jean Piaget believed that infants develop this understanding by the end of the sensorimotor stage. Object permanence is accomplished by placing one’s hand’s over the child’s eyes. In the film, Thomasin (shown) “loses her brother” when she places her hands over her own eyes, thus demonstrating profound deficits in cognitive functioning that is developmentally inappropriate (teenager).

Once one understands that The Witch is a case study of a cognitive disorder, then 3 illnesses should be considered in the differential diagnosis: a) Cognitive Disorders such as dementia (Major Neurocognitive Disorder), b) Psychotic Disorders, or c) Dissociative Disorders. Given her age, Major Neurocognitive Disorder is highly unlikely and therefore may be ruled-out.

At Rutgers Robert Wood Johnson Medical School, the first module – titled Necromancy – of our year-long resident Psychopathology course incorporates ghosts (wraiths) and demons. While the former references disorders that are episodic in nature, tales of demonic possession serve to reinforce teaching points of chronic and persistent illnesses such as the Dissociative Disorders (DD). At the completion of the DD block, participants should appreciate that movies about demonic possession may be metaphorically interpreted as case studies of dissociation. Given the widely-held belief that a witch is a woman who had coitus with the devil, tales of witches may be viewed as accounts of demonic possession. Accordingly, the hallmark characteristic of Dissociative Identity Disorder, a disruption of identity, may be described in some cultures as an experience of possession (DSM-5).

Thomasin experiences a disruption of identity, thus allowing The Witch is be viewed as a fictional case account of Dissociative Identity Disorder (DID). Might this formulation actually explain the origins of the “hysteria” in 1692 Salem? Focusing on the biological antecedents (biopsychosocial), ergotism may have played a role in the events leading up to the Salem Witch trials (Caporael L, Science, vol. 192 http://homepages.rpi.edu/~caporl/home/Notes_files/Satan%20Loosed.pdf). Before concluding that DID is the most likely diagnosis, we much first investigate whether Thomasin’s mental status change is not otherwise due to the direct physiologic effects of a substance.

Ergotism is a plant disease that is caused by the consumption of grain contaminated with ergot which is produced by the fungus Claviceps purpurea. Poisoning attributed to Ergot of Rye is referred to as ergotism. Although this fungus is recognized as one species, there are two sets of symptoms: convulsive and gangrenous ergotism (http://www.botany.hawaii.edu/faculty/wong/BOT135/LECT12.HTM).

The clinical features of convulsive ergotism including muscle spasms, mental status changes, hallucinations, sweating, and fever are consistent with the serotonin syndrome. Ergot alkaloids such as dihydroergotamine are serotonin agonists; molecules that bind to serotonin receptors in the brain (mental status changes) and dorsal horn of the spinal cord. (Eadie MJ, Convulsive ergotism: epidemics of the serotonin syndrome?, Lancet Neurol. 2003 Jul; 2(7): 429-34).

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Anthony Tobia, MD, Psychation Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Gates of Hell – Clifton, NJ

Destination 3: The Gates of Hell, Clifton, NJ

Built as a drainage run-off for Weasel Brook, the Gates of Hell is a tunnel system that has lured and captivated teenagers who have dared to explore what lay deep inside its darkened corridors (http://weirdnj.com/stories/gates-of-hell/).

Related Film: Stephen King’s It

Synopsis

Set in the town of Derry, Maine in the 1950’s, Stephen King’s miniseries It depicts a supernatural character, Pennywise the Dancing Clown, that terrorizes a childhood group of friends, the “Losers Club.” Pennywise pulls Georgie to his demise after his paper boat floats into the sewer system deep under the town of Derry. The death of Georgie traumatizes the group and, under his brother’s guidance, they vow to avenge his death and all those devoured by It.

When they hear about a mysterious, unexplained death of a little girl who was brutally murdered 30 years later in Derry, Bill begins to suspect It has returned. They honor their blood pact even if it means re-experiencing their childhood trauma. Stan, the only club member with recall of the events from his childhood, commits suicide, writing the word “IT” on the wall with his blood.

How it relates to the field of psychiatry

It serves as an opportunity to teach the Dissociative Disorders (DD). Much like the presence of the supernatural, demonic (fang teeth and three-fingered creature-like hands) shape-shifter is a chronic reminder of Derry’s sinister past, the DD are severe and persistent mental illnesses defined by a disruption or discontinuity in integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior (1).

Dissociative symptoms occur in the context of traumatic stressors as an attempt to maintain emotional equilibrium, but may result in distress and dysfunction. This is evident in many of the childhood characters in the story. For example, Ben is traumatized by the visions of his dead father (It) trying to lure him into the sewer plant. Eddie struggles with chronic medical illnesses for which he is taunted and harassed. Mike, an African American, has a difficult time transitioning as a new student because of racism and bullying.

In the second half of the story, the losers-as-adults return to Derry to battle the interdimensional predator. All but Stan suffer from severe Dissociative Amnesia, unable to recall the traumatic events of their childhood. They agree to split up and visit the old neighborhood in an effort to recapture their lost memories before It discovers their intentions and devours them. Despite suffering only mild dissociative symptoms, Stan’s completed suicide is a realistic depiction of the impact dissociative disorders can have; an increase risk in suicide attempts among those suffering from DD (2).

The catatonia that Bill’s wife Audra experiences after coming in contact with It’s “deadlights” is a sign seen in extreme cases of dissociation from trauma.

References:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
  2. V. Sar and C. Ross, “Dissociative disorders as a confounding factor in psychiatric research,”Psychiatric Clinics of North America”, vol. 29, no. 1, pp. 129’144, 2006

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Leya Schwartz, Angela Gitau, and Anthony Tobia, MD, Psychation Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Corryvreckan Maelstrom, Scotland

Destination 2: Corryvreckan Maelstrom, Scotland

Description (from http://list25.com/25-creepiest-places-on-earth/)

The Gulf of Corryvreckan is a narrow strait between the islands of Jura and Scarba off the west coast of Scotland. It is famous for its strong tidal currents and standing waves. The whirlpool (maelstrom) which forms at high tide is the third largest whirlpool in the world.

Related Film: Jennifer’s Body (2009)

Movie Synopsis

Jennifer’s Body (2009) is a black comedy that takes place in Devil’s Kettle, a Wisconsin town named after the same anomaly of nature between the islands of Jura and Scarba. The movie chronicles the exploits of Jennifer Check, her BFF Anita “Needy” Lesnicki , and their infatuation with a cryptic indie rock band (Low Shoulder).

The film’s setting; a town named after a waterfall with a whirlpool is homage to Homer’s Scylla and Charybdis. Being “between Scylla and Charybdis” is an idiom derived from Greek mythology, meaning having to choose between two evils. The town’s name then is symbolic of the teenage angst that defines the relationship between its two principle residents.

How it relates to the field of psychiatry

At Rutgers Robert Wood Johnson Medical School, the first module – titled Necromancy – of our year-long resident Psychopathology course incorporates ghosts (wraiths) and demons. While the former references disorders that are episodic in nature, tales of demonic possession serve to reinforce teaching points of chronic and persistent illnesses such as the Dissociative Disorders.

Jennifer’s Body may be viewed as a case study of Dissociative Identity Disorder, the hallmark characteristic of which may be described in some cultures as an experience of possession (DSM5). The film introduces the notion of demonic transference, an untoward consequence of a virgin sacrifice gone wrong. Since Jennifer lost her virginity in junior high, a demon will possess her soul. Jennifer’s body will therefore forever feed on flesh. She describes herself as a different
person – disruption of identity – when she doesn’t feed.

The Dissociative-Eating Disorder Continuum

The movie’s ending parallels that of Carrie, and therefore may be viewed in the context of the Eating and Feeding Disorders (see our Week 1 blog). During the climax at the dance (similar to Carrie’s prom), its disclosed that Jennifer abuses laxatives. Her misuse of cathartics defines purging behavior that may be seen in Anorexia Nervosa or Bulimia Nervosa.

The Eating Disorder-Borderline Personality Disorder Continuum

One sign of an eating disorder is a disturbance in the way in which one’s body weight or shape is experienced. This quality is shared with Borderline Personality Disorder (BPD). Interestingly, Jennifer demonstrates many characteristics that define BPD: unstable self-image; dissociative states under stress (“I feel so empty” said to Chip in the pool scene); lack of empathy (laughing at the death of Melody Lane patrons); intense, unstable intimate relationships; and self-injurious
behavior (burning tongue, cutting).

The Dissociative-Eating-Borderline Personality Disorder Continuum

Some clinicians conceptualize the DID-Eating Disorder-BPD continuum as Posttraumatic Stress Disorder (PTSD). After Jennifer and Needy narrowly escape a horrific fire, Jennifer leaves with the band and is sacrificed at a satanic ritual. Since the fire, Needy demonstrates evidence of PTSD with perceptual disturbances, the first of which is seeing a carnal Jennifer previously thought to be dead. She also describes herself as numb, consistent with feelings of detachment and an inability to experience positive emotions that define PTSD.

The film therefore allows for discussion of Posttraumatic Stress Disorder in both of its main characters. After Jennifer and Needy narrowly escape a horrific fire, Jennifer leaves with the band and is sacrificed at a satanic ritual. Despite her name representing Dependent Personality Disorder, Needy begins to demonstrate evidence of PTSD as evidenced by perceptual disturbances (the first of which is seeing a carnal Jennifer previously thought to be dead). She also describes herself as numb, consistent with feelings of detachment and an inability to experience positive emotions.

Finally, Needy likens Nikolai to the twisted petrified tree she saw as a kid. While Jennifer’s Body takes place in Wisconsin, perhaps Needy grew up in Bernards Township, NJ where locals tell the urban legend of The Devil’s Tree. There are many stories (http://weirdnj.com/stories/devils-tree/) about the origin of the petrified oak including human sacrifices and a portal to hell.

Anthony Tobia, MD, Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Overtoun Bridge, Scotland

Destination 1: Overtoun Bridge, Scotland

Found near the village of Milton in Scotland, this bridge is the location of numerous suicides – over 600 to be exact. Every year since its construction roughly 12 to 15 dogs launch themselves to their deaths…that’s right…dogs. Why? Well although there are numerous theories but no one really knows. One thing is for sure though ‘ the dogs are hell bent on leaving this planet behind as some people have even witnessed dogs jump off, survive, climb back up, and jump off again.

Related Film: The Ring (2002)

Movie Synopsis

The Ring is a remake of Ringu, a 1998 Japanese horror film that draws on the folk tale, BanchA? Sarayashiki. As legend tells it, there was once a beautiful servant named Okiku who worked for a samurai, Aoyama Tessan. Okiku often refused her mater’s amorous advances. Despite his trickery, Okiku remained solemn. Aoyama became enraged, and threw her down a well to her death. It is said that Okiku became a vengeful spirit (Onryo?) who tormented her murderer.

In the 2002 American adaptation, a group of teens watch “a video tape that kills you when you watch it.” After watching the tape, the phone rings, and a voice on the other end utters “seven days.” Exactly one week later, you die. The film depicts Rachel Keller, an investigative reporter, who is looking into her niece’s death when she discovers the urban legend.

The Ring may have also been inspired by The Tragedy at Road Hill House. In June 1860, 3-year-old Francis “Saville” Kent disappeared from his home. His body was found in a privy on the property. While the boy’s nursemaid, Elizabeth, was initially arrested, Francis’s sister, Constance Kent, would confess to the murder five years later.

Yet another perspective comes from the study of the corporeal undead. Also known as “utburd,” mylings are phantasmal incarnations of the souls of unbaptized children who are forced to roam the earth until they could persuade someone to bury them properly. Mylings ‘ translated as “that which is taken outside” – refer to the practice of abandoning unwanted children (usually in the woods where death is almost certain). In The Ring, the teens discover Samara’s myth in a cabin in the woods. Interestingly, another Asian (Tai) horror film depicting a “floaty girl” continues this narrative. Written and directed by Banjong Pisanthanakun, Shutter (2004) illustrates how mylings chase lone wanderers at night and jump on their backs, demanding to be carried to the graveyard so they can rest in hallowed ground. In The Ring, Rachel discovers Samara’s body, and she’s given a proper burial in 7 days.

How it relates to the field of psychiatry

Themes from The Ring and the Overtoun Bridge merge in the field of psychiatry. In the film, the horses (not dogs) at the Morgan ranch went mad and drowned themselves, a fate similar to the horse on the ferry on the way to Richard Morgan’s island home. The horses’s intuition (and perhaps that of dogs on the Overtoun Bridge) is scientifically based. As prey animals, horses have hearts 5x the size of humans’. Their electromagnetic pulse (torus) results in a coherent heart rate that synchronizes with humans (or mylings). Institutions of higher education such as Rutgers Robert Wood Johnson Medical School take advantage of the coherent heart rate of horses by partnering with equine centers (http://www.springreinsofhope.com/) to run innovative curricula that use horses to teach medical students nonverbal communication to improve bedside manners.

Two taglines from the movie highlight additional teaching points in psychiatry. First, “she never sleeps” hallmarks the inevitability of death. Interestingly, a story with the same moral, Appointment in Samarra, shares its title name (synonym) with The Ring’s evil antagonist. Second, “she only wants to be heard” represents a major theme in patient-centered medicine, with patient histories – and the need for patients to convey them in a milieu of unconditional positive regard (Carl Rogers) – being a critical component of healthcare.

A final teaching point focuses on whether Samara is “pure evil.” The Ring is a fictional case study of a “bad seed” (see Damien from The Omen, 1976) in the “nature versus nurture’ discussion of the etiology of Antisocial Personality Disorder.

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Anthony Tobia, MD, Copyright © 2017 Rutgers Robert Wood Johnson Medical School. All rights reserved.

Poveglia Island

Poveglia Island is considered the most haunted location in Italy. In 2007, mass graves were found of bubonic plague victims. In 1922, the existing buildings were converted into a hospital for the mentally ill. According to a local folklore, the treating doctor tortured and butchered many of the patients before going “mad” and jumping to his death from the bell tower. In 1968 the hospital was closed and the island was completely abandoned.

Death Camp, Auschwitz

Auschwitz, known as the Death Camp, was an extermination center created by the Nazis to eliminate the Jews. It was estimated that 2.1 to 2.5 million Jews, Soviet soldiers, Gypsies, and Poles were gassed to death in this place, and their bodies were burned in piles nearby. Tourists who visit the Auschwitz concentration camp are gripped with a sense of despair. Some even break down in tears. There are acounts of people feeling spooked at this place. The picture above is of the inner wall of gas chambers and those white lines are nail marks of the people gassed, who were desperately trying to escape