Scene 17: Late for the Sky
Last bit of reality
Scene 18: Dear Father and Mother
Those most vulnerable to stalking
Idiosyncratic phrasing and construction
Impaired reality testing
Familially of STPD-psychodynamic, biosocial, interpersonal
Scene 19: TV Critic
Intensity of the stalker’s emotions
Scene 20: Looking for Action
Affective style of a person with STPD
Inattentiveness to social conventions
Scene 21: A $10 Room
Diminished desire for intimate contacts
Inability to deal with sexuality
Scene 22: Breakfast with Iris
Impaired reality testing
Ideas of reference
Fearful and dismissing attachment style
Verbal episodic memory deficits
Scene 23: Dancing with Sport
Imagining his rival with Iris
Danger when reality conflicts with distortions
Scene 24: The Palantine Rally
Odd, eccentric and peculiar appearance
Pharmacology for STPD
Scene 25: Suck on This
STPD: Stability vs. psychosis
Scene 26: Shooting Gallery
Psychotic violence
Scene 27: Bang, Bang, Bang.
STPD: Most are not dangerous
Scene 28: Dear Mr. Bickle
Madman vs. sane man
Normalcy does not last
Insight-oriented psychotherapy
Supportive psychotherapy
Cognitive-behavioral therapy
Family and group therapies
Introducing medication
Diagnostic Note
Travis meets DSM-IV-TR diagnostic criteria for STPD
Introduction: Schizotypal Personality Disorder
With the movie, TAXI DRIVER, Martin Scorsese and Columbia Pictures provide an opportunity to learn about schizotypal personality disorder (STPD).
This disorder is included in the range of conditions from those with milder symptoms, i.e., schizotypal and schizoid personality disorders, to the most severe forms of schizophrenia, known as the schizophrenia spectrum. It is a disease of the brain that involves mostly negative and cognitive symptoms such as, discomfort with or incapacity for social relations, apparent indifference to others, and emotional inexpressiveness . STPD also implies eccentric to bizarre beliefs, habits, and appearance. This disorder may look similar to earliest stages of schizophrenia, prior to the first psychotic break and probably reflects a similar hereditary vulnerability (with variably interrelating genes or environmental influences) (Harvard MHL, 2006, p. 20). STPD has a relatively stable course, with only a small proportion of individuals going on to develop schizophrenia or another psychotic disorder. Its prevalence has been reported to occur in approximately 3% of the general population (APA, 2000, p. 699).
STPD is grouped with paranoid personality disorder and schizoid personality disorder to comprise the “odd or eccentric cluster” in the DSM-IV-TR. It first appeared in DSM-III to be distinct from (1) borderline personality disorder, which had originally been too broad in its inclusion of affective instability and schizophrenic-like symptoms and (2) schizoid personality disorder which had been broadly defined to characterize individuals with enduring psychotic-like symptoms (Sperry, 2003, p.239).
This guide will assist the reader, while viewing the movie, in learning about this illness and its effect on people who have it.
To make the best use of this guide:
1.VIEW THE FILM IN ITS ENTIRETY, then
2.READ THE GUIDE, SECTION BY SECTION, AS YOU REVIEW THE CORRESPONDING SCENE FROM THE FILM.
Scene 1: Start
This first scene is short. It displays the names and roles of the actors. However, this is accomplished with visuals that present an idea of what is to follow. It opens with a yellow taxi cab driving through a dense mist, steam erupting from a city street that momentarily blocks vision. Displayed next is a clearly focused image of the eyes of a driver, appearing through the vehicle’s rear view mirror. The driver’s eyes show a reflection of the city lights. The camera shows the city through the eyes of the taxi driver, i.e., blurry, distorted city images of the city lights that are reflected in those eyes. The images of the people in the city are dark. Everything is moving at the wrong speed, slower than the usual New York City cabbie. The colors are off. The music is foreboding. What is seen through the eyes of the taxi driver is off kilter.
Scene 2: Travis Bickle
The main character, Travis Bickle, is introduced as he walks into the office of a New York City taxi cab company and inquires about a job as a driver.
It is not surprising that Travis is applying for this type of job because people with STPD gravitate toward jobs that demand little interaction with others (Sperry, 2003, p. 242).
He tells the interviewer that he wants to drive a cab because he cannot sleep nights and that going to all night porno movies has not been a helpful alternative. When the interviewer asks Travis what he does now, while most people would offer a response about their employment or vocational activities, Travis follows the conversation thread he had begun and responds:
Now? Ride around nights mostly. Subways, buses. [I] figure, you know, [if] I’m gonna do that, I might as well get paid for it.
Interviewing people with STPD usually elicits surprising statements and peculiar ideas (Sperry, 2003, p. 249).
Travis is a 26 year old US Marine veteran of the Vietnam War. He seems to identify with that role as he wears a Marine jacket with a patch from his King Kong Company and displays a Vietnamese flag in his impoverished, messy apartment. Travis’ success at becoming a Marine leads to speculation that Travis was able to meet high standards. However, other than the fact that he was a Marine no real information about Travis’ military career is revealed to support such speculation.
Clinicians dealing with clients who have served in the more recent military must speculate differently as the current US Army has relaxed its standards and entry requirements for recruitment and training. Recruits now pass basic training at a time when the Army has been under terrific pressure to bring in new soldiers. In 2005 the Army raised the limit on the so-called Category 4 recruits it would allow, the designation for soldiers with the lowest scores on its aptitude test. The Army has also been handing out more waivers—including case-by-case exceptions for criminal offenses—which increased by 3 percent last year. Basic training has slipped as well. In years past, basic was geared to "wash out" those unfit for the stresses of military life. Now it has been reformulated to keep as many recruits as possible. The most recent washout numbers show a dramatic decline in standards: currently only 7.6 percent of new recruits fail to get through their first six months of service, down from 18.1 percent in May 2005, according to the latest Army figures. (Childress and Hirsh, 2006).
According