•Anxiety and sarcasm / emotional dysregulation
Scene 14: Rollercoaster
•Frantic efforts to avoid real or imagined abandonment / interpersonal dysregulation
Scene 15: Revenge
•Diagnostic criteria 1, 2, 6, 8 and 9
Scene 16: Bath Time
•Transient, stress-related psychotic episode / cognitive dysregulation
•Self-mutilating behavior / behavior dysregulation
Criterion #3
•Identity disturbance / dysregulation of self
Empathy, Clinician Development and BPD Prognosis
•Guiding questions
•Skills
•DBT and empathy
•Stigma
•Prognosis
•Clinician development
Introduction
With the 1987 movie, “Fatal Attraction,” Adrian Lyne and Paramount Pictures provide an opportunity to visualize the illness, Borderline Personality Disorder (BPD). This disease is characterized by chronic urges for self-injury, overwhelming emotions, impulsivity, and unstable and/or conflictual relationships. BPD can be quite disabling because one’s focus is on the struggle to get through each day. This guide will assist the reader, while viewing the movie, “Fatal Attraction,” in learning about this illness and its effect on people who have it, as well as the people in their lives, including treatment providers.
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 2: Family Affair
This well-named scene introduces all the major characters, those who belong to the family and those involved in the affair. Those in the family, Dan Gallagher, his wife, Beth, his young daughter, Ellen, and the family dog, Quincy, are introduced as an ordinary, although attractive, family. They appear to be pleasant people who like each other and comprise a happy and caring family. Dan appears to be building a successful law career.
Dan’s and Beth’s attractiveness is apparent when they arrive at Dan’s office-related cocktail party, stylishly dressed and away from their apartment. However, it appears that as family life has set in, their day-to-day family life is not about style and attractiveness. This is evidenced by:
•Dan does the work he brings home from the office on the living room couch in his under-briefs, while still wearing the white shirt he wore to the office and black socks.
•The TV blasts a children’s show discussing “slime” through the family living room where Dan is doing his work.
•Toys are spread all over the floor, one of which causes Dan to stub his toe.
•Laundry hangs across the bathroom to dry.
•Beth brushes her teeth with the bathroom door open.
•When the couple returns from their night of partying and cocktails Dan begins to undress at bedside but Beth reminds him that he must first walk the dog.
•Dan returns from his dog walk and heads for the bedroom with a smile which quickly gets wiped away as he discovers his young daughter in the bed with his wife. Beth tells him, “It’s just for the night, honey.”
Alex Forest is also introduced in this scene. She is an attractive woman who has been working for a few weeks as an editor at a publishing house for which Dan’s law firm does the legal work. Alex is alone at the cocktail party. Dan’s chubby friend, Jimmy, who is at the party with his wife, Hildy, makes a pass at Alex while Jimmy is standing with Dan. Alex responds to Jimmy with a look that “could kill.” Following this incident Dan unintentionally meets Alex at the bar and, to be polite, introduces himself to her and makes casual conversation. Their conversation consists of a brief rehash of the incident involving Jimmy, the identification of their work connection and the fact that Dan is married. He gives no indication that he has any social or romantic interest in Alex. However, Alex’s no verbal language suggests that she has some interest in him.
Because of special circumstances they unexpectedly attend the same Saturday business meeting on a week-end that Dan’s wife and daughter are out of town.
People with Borderline Personality Disorder can look deceptively well during first contacts. In fact, they can alternate between being charming and capable to being behaviorally out-of-control (Warner, 2004, P.2; HMHL, 2007, p.6). In this scene Alex is observed in two settings, a party setting and a work setting. At this point there is no specific evidence to indicate that she has Borderline Personality Disorder. There are some clues that, in and of themselves, are not necessarily indicative of Borderline Personality Disorder. However, as Alex’s emotions and behaviors become better known, these clues along with other symptoms and behaviors, may, in fact, be pervasive and meet the DSM-IV-TR diagnostic criteria of Borderline Personality Disorder.
The clues that appear in this scene include Alex’s:
•extremely intense response to Jimmy which may be indicative of criterion # 8, inappropriate intense anger…
•relatively short tenure with the publishing house, which may, upon investigation, be indicative any number of reasons that are related to this disorder, including:
recurrent job losses due to a pattern of undermining oneself at the moment a goal is about to be realized, perhaps due to criterion # 9, paranoid thinking (Kapuchinski, 2007, p. 124).
highly unpredictable behavior which often results in only a rare achievement of the level of an individual’s ability (Kaplan and Sadock, 1991, p.534).
poor stress tolerance which might cause one to impulsively walk away from a job; cause frequent changes in career and training plans; or create workplace dangers due to unpleasant interactions or violence (Fischler and Booth, 1999. pp.124-125).
This may also be attributed to criterion # 2, a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. As a result of this splitting, shifts of allegiance from one person or group to another are frequent (Kapuchinski, 2007, pp. 124-125; and Kaplan and Sadock, 1991, p.534).1`
•interest in a man who is (a) married and (b) has not really expressed an interest in her which may be indicative of criterion # 4, impulsivity…
Once again, these are just clues that may be part, not all, of the diagnostic criteria. In and of themselves, these behaviors do not necessarily meet the criteria for the diagnosis of BPD as stated in the following DSM-IV-TR (APA, 2000, pp.27-35) multiaxial diagnostic system for categorizing mental disorders which guides clinical practice, research and education:
Axis I
Clinical Disorders
Other Conditions That May Be Focus of Clinical Attention
Axis II
Personality Disorders
Mental Retardation
Axis III
General Medical Conditions
Axis IV
Psychosocial and Environmental Problems
Axis V