Abnormal Psychology - Agoraphobia

In the movie Copycat (1995), the character, Helen Hudson, provides a portrayal of agoraphobia. In this paper, I will highlight the nature of agoraphobia in the context of Helen Hudson’s fictional portrayal. Next, I will give some suggestions to make the portrayal in the movie more accurate and finish up by telling what I learned about the disorder and the portrayal I selected.

In the movie, criminal psychologist Helen Hudson (Sigourney Weaver), who studied the behavior of serial killers for 20 years, was giving a lecture at the University of San Francisco when the gestures and facial expressions of an attendant, Daryll Lee Cullum (Harry Connick, Jr.) captured her attention. After the lecture, while in the restroom, Daryll Lee attempted to kill her. Thirteen months later, Helen is affected by a panic disorder (panic attack) and falls into the disorder of agoraphobia. Helen lives a terrified existence defined by the walls of her apartment shared with a homosexual companion, Andy (John Rothman), who takes care of her.

When spending time in the prison, Darryl Lee has contact with another psychopath, played by William McNamara, another attendant of the lecture. Daryll Lee told McNamara to kill Helen and to continue his killing spree. He committed each of his crimes in the style of a different known serial killer -- Jeffrey Dahmer, John Wayne Gacy, the Son of Sam, the Boston Strangler and others. Soon Helen goes in and gives some information to the police that she received over the Internet from the killer of several women. Officer M.J. Monaham, played by Holly Hunter, trusts Helen’s knowledge and asks her to cooperate in catching the serial killer (Copycat 1995). The character of Helen Hunter suffers of panic attack with agoraphobia.

There are several examples in the movie which illustrate the symptoms of agoraphobia. She constantly was in her apartment in front of her computer, and isolated herself from the rest of the world. Each time she had the desire to get some work done she was affected by a power which did not let her continue her career. For example, at the time she woke up, sometimes shaking and sweating, she would go into the drawer and take a bunch of antidepressants that after time did not work. This led to abuse of alcohol to prevent some future panic attack.

Getting the newspaper was even a terrible task for her. She would open the door very slowly, making sure that no stranger was around. She would use the broom while lying on the floor and crawling to reach the newspaper. She had a very difficult time. She would whisper the names of all the presidents of the United States of America to calm herself down, and when reaching the goal, she would go back inside extremely fast.

She endured this scene every single day and she would regularly fall into unexpected panic attacks lasting only for a few minutes. Her roommate quickly put a paper bag on her face to help her breath normally. Otherwise, she would sweat, shake, and hyperventilate.

After a while, she used her experience as a psychologist to help the police find the serial killer, and eventually everything went back to normal. During the time that the medication was working she was fine and was able to function normally. However, when mixing alcohol with the medication, she would often become unaware of her actions. For example, she thought she just did something but actually did not. According to the authors of the brochure Phobies-Zéro, often panic attacks lead to the disorder of agoraphobia, but there are other factors that can also lead to panic attacks. One example from this brochure, is that if someone experiences extreme fatigues during a long period of time and some day experiences a traumatic event (such as death of a family member), the chances will increase the occurrence of panic attacks (1994).

According to the DSM IV, people diagnosed with the disorder of agoraphobia are often affected by panic attack. “The criteria for a person who suffers from panic attack is:

1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath or smothering
5. Feeling of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, lightheaded, or faint
9. Derealization (feeling of unreality) or depersonalization (being detached from oneself)
10. Paresthesias (numbness or tingling sensations)
11. Chills or hot flushes.” (1996. p. 396-398).

In the diagnostic criteria for agoraphobia, Morrison (1995), wrote that a person has the fear of becoming terrified in situations from which there is no easy escape or help that can be found if panic attack occurred . The person avoids these situations or places or endures them and possibly has a panic attack, or requires a companion when in these situations. Thus, agoraphobics often will not leave their house sometimes for months.

Agoraphobia affects the self of the person, because the individuals have the threat of constantly aware of having a panic attack, “La peur d’avoir peur.” For this reason, they will ingest medication more and more often because of the fear having another panic attack (Morrison, 1995).

Agoraphobia affects the relationships of a person with others because as soon somebody asks to go out with an agoraphobic, he or she will find excuses not to go.

Agoraphobia will not affect the person’s life while he or she is under antidepressants, that is the problem since under medication they will sometime show any progress. It could make the disorder worse and worse. Because agoraphobics often abuse alcohol mixed with medication, it will affect their life and their work. Work will be affected anyway if they have to leave their house to get there, which is typical for most people. Since the time of the lecture at the University, when Helen was attacked in the bathroom by the psychopath, she has experienced a terrific period of pain and emotional distress. After this period, the story jumps to thirteen months later. To make the portrayal more accurate; some details could have been added after she was hurt, but before we see her separation with the world. First, I would suggest that during this time Helen could have continued to give lecture after she was hurt, but would not be able to go. Second, when leaving home and taking her car to go somewhere, she would immediately come back home. Those two examples would be a preview of the phase of not wanting going anywhere but staying home.

According to Morrison James panic attacks are very common in the real world; perhaps 30% of all adults experience at least one. We can easily treat these people by giving them a little reassurance by making them breathe into a paper bag. Panic attacks can be severely debilitating if not treated. Often panic attacks mask another illness such as agoraphobia. Sometime when a person visits a psychologist and explains the problem, the doctor will not see anything wrong with the person even after multiple tests such as electroencepathology. A medication such as prozac (antidepressant) is supposed to help is commonly prescribe to the patient. Sometime it will not help because agoraphobics abuse the medication by mixing it with alcoholic beverages to make the medication stronger. This behavior seems to work only temporarily (Morrison, 1995). What will happen when discovering the disorder? According to Goldstein in his book Overcoming Agoraphobia, “Sometimes simply taking care of the diet such as getting rid of caffeine, sugar, and white flour helps considerably in few weeks but not right away.” (1987, 216- 217). Another technique, according to Marie-Andrée Laplante, Présidente Fondatrice de la Fondation Phobies-Zéro au Québec, the patient should take the advice of a psychologist who did suffer from the same disorder. In her clinic, the process of the therapy begins with a period of desensitization, which is organized into groups six times a month for three hours. After one year of therapy, patients are still followed irregularly to make sure that everything is going well. Another therapy offered by this clinic is called psychodrama, which is an individual therapy for three hours every two weeks until seeing any improvement. There psychologists who endured the same disorder make them learn different stages to get rid of this disorder (Author, 1994). According to Goldstein in his book Overcoming Agoraphobia, these stages are as follows: Phase I: Anxiety coping skills, stopping catastrophic thoughts, staying in “the here and now,” breath control

Phase II: Getting out and using your coping skills. Cardinal rules: never avoid, use your coping skills, and let your feeling dictate your behavior, the importance of making a schedule, and take credit for what you do.

Phase III: Reducing anxiety triggered by body sensations. Controlling hyperventilation symptoms; racing heart, dizziness, tingling in the extremities. Reducing fear rapid heart beat and the feeling of not being able your breath (1987, 173). About the portrayal that I selected, it definitely makes me think differently. On November 1995, when I saw this movie for the first time, I thought that it was just a story of a killer and a lady who was disturbed, drinking heavily, and abusing medication instead of seeking help for a serious problem. Since watching it carefully, and doing research, I have discovered what Helen really suffers from, and I think differently. The character that I chose has been described in the movie very close to reality. It is a serious thing; and I have learned that some people actually suffer from the same disorder as Helen. They are sometimes hurt during their life for a long period. Agoraphobics often seek help. However, not until lately have treatments been found that produce real progress in getting rid of this fear. This gives hope that eventually they can return to their normal lives.

Copycat (1995), although fictional, portrays agoraphobia fairly accurately. Many agoraphobics treated with medication which initially help with panic attacks, but will not cure the disorder of agoraphobia. Besides medication, the patient should be followed very carefully by a psychologist that has experienced the same disorder. Having experience this themselves, they will be able to better understand what the patient is going through.

References

DSM IV[Abbildung in dieser Leseprobe nicht enthalten]. (4th ed.). (1996). Diagnostic and statistical manual of mental disorder. Washington, DC: American Psychiatric Association. 396-398.

Goldstein, A. J. (1987). Overcoming agoraphobia: Conquering fear of the outside world. New York: Viking. 172-217.

Milchan, A. & Tarlow, M. (Producer). (1995). Copycat. [Videotape].

Morrison, J. (1995). DSM-IV Made easy. New York, London: The Guilford Press. 248-251.

Promotion, Prevention, and Research. (1994). Phobies-Zéro. [Brochure]. Montreal: Authors.