Oct 20: Insidious (2013)

Synopsis

Two-Sentence Horror Stories have populated the internet. Among the most unsettling include:

  • I always thought my cat had a staring problem – she always seemed fixated on my face. Until one day, when I realized that she was always looking just behind me1.
  • I awoke to the sound of the baby monitor crackling with a voice comforting my firstborn child. As I adjusted to a new position, my arm brushed against my wife, sleeping next to me2

These two shocking themes merge in Insidious, a horror movie that centers on Josh and Renai Lambert whose son, Dalton, inexplicably becomes comatose. When a family friend, Elise, informs the Lamberts that Dalton is an astral projectionist who is lost in a ghost dimension, there’s a race against time to recover Dalton’s “soul” from The Further before malevolent spirits can possess his body.

THE PSYCHIATRY OF INSIDIOUS

Insidious serves as an opportunity to teach the differential diagnoses of the Dissociative Disorders. Inherent in DSM nosology, there is a hierarchy within which the clinician must remain diagnostically loyal. For example, if Katie from our previous Paranormal Activity post experienced unreality or detachment (cardinal features of Depersonalization/Derealization Disorder), she wouldn’t be diagnosed with Depersonalization/Derealization Disorder because Dissociative Identity Disorder (DID) takes precedence.

Depersonalization/Derealization Disorder
Dalton’s astral projection is a literal example of an “out-of-body experience” defining of Depersonalization/Derealization Disorder. He recalls his experiences as dreams, so his condition is not likely due to Dissociative Amnesia or a fugue state.

Dissociative Amnesia
If Dalton’s father, Josh, is instead the focus of clinical attention, then Insidious captures the salient feature of Dissociative Amnesia as evidenced by Josh’s inability to recall important autobiographical information. By definition, the information is usually stressful in nature such as being haunted by the Bride in Black. Of course, the true etiology of Josh’s trauma isn’t fully revealed until Insidious: Chapter 2 (2013).

Dissociative Amnesia, with Dissociative Fugue
Continuing the formulation of Josh’s most likely diagnosis, we discover [SPOILER ALERT] that one memory of which Josh is amnestic is his ability to astral project. He, too, is what Elise would call “a traveler.” Unlike his son, Dalton, Josh’s travel is purposeful and associated with amnesia, making Insidious a case study of (provisional diagnosis) Dissociative Amnesia, with Dissociative Fugue.

Dissociative Identity Disorder
While Josh is astral projecting to find Dalton, his empty vessel is possessed by the Bride in Black. In the final seconds of Insidious (and all of Insidious: Chapter 2), Josh has a disruption of identity that is experienced as possession. We therefore must reject the provisional diagnosis of Dissociative Amnesia, with Dissociative Fugue in lieu of the most likely diagnosis; Dissociative Identity Disorder.

References
1. Hangukbrian, http://thoughtcatalog.com/michael-koh/2013/07/40-freaking-creepy-ass- two-sentence-stories/
2. https://www.reddit.com/user/doctordevice

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.