ABSTRACT: part of the show. She then develops

    ABSTRACT:The aim of this paper is to present a review of the movie “Requiemfor a dream” (2000) from a psychological point of view.

The paper consists offollowing sections; a brief introduction to the movie, its plot and thecharacters. A detailed analysis of the character Sarah Goldfarb played by EllenBurstyn. A descriptive account about stimulant use disorder, that Sarah issuffering from. Then the paper presents an analytical account of the character Sarahthrough different perspectives of psychology. It concludes with an insight intothe field of mental health disorder diagnosis and treatment.

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     INTRODUCTION:The movie “Requiem for a dream”, released in the year 2000,narrates the story of four individuals and their struggle with drug addiction.The movie, directed by Darren Aronofsky is an adaption of the 1978 novel of thesame name by the author Hubert Selby Jr. Though it was a not-very-pleasantexperience to watch the movie again and again, the importance of the subjectthe movie deals with .i.e. substance use disorder, and the extremely convincingway of narration which makes viewers understand and to an extent even feel theconditions which the characters are dealing with, made the author choose themovie.     PLOT:The movie narrates the story of three adults Harry, Marion, andTyrone who are addicted to heroin and engages in drug trade which they see as away to gain money quickly.

On the other side, the movie makes a parallelnarrative of the Sarah Goldfarb, Harry’s mother who suffers from stimulant usedisorder. Sarah gets a call from the T.V show which she is obsessed withinviting her to be a part of the show. She then develops a desire to wear herfavorite red dress to the show. When Sarah finds out that the dress is nolonger fitting her, she goes on a diet which she is unable to carry on due toher obsession for food. Thus Sarah ends up in a clinic, where the physicianprescribes her amphetamine tablets. Soon, she develops an addiction for thetablets which results in her mental breakdown. Though the author is trying togive an insight into stimulant use disorder through an analysis of how themovie portrays it the article will focus mostly on the character Sarah.

Thisfocusing is due to mainly two reasons .i.e. 1)   Sarah is an Americanmiddle-class woman who is unaware of the effects of the pills that she isprescribed. This means, she developed an addiction without any consent orknowledge of hers.

2)   The personality traits ofSarah and the life she is leading gives the audience an idea of the mentalstruggles that a retired women leading a lonely urban life goes through.      CHARACTER ANALYSIS: SARAH:As mentioned above Sarah is a retired widow leaving alone in herapartment. Her son Harry seldom visits her though they are in the same city ofBrooklyn. Sarah before developing an addiction for amphetamine pills is shownto have an obsession for T.V and food. Despite these two obsessions anotherengagement in her life is her interactions with other ladies of the societythat she live in. Thus Sarah could be a representation of an elderlymiddle-class American woman. However, a closer look at her character wouldbring to our notice many aspects of this middle-class women, which signals theneed for a metal health support from a very begin.

The paper now discusses eachof these aspects in a detailed manner drawing inferences from the movie throughdifferent perspectives of mental health disorder. 1)   Psychological Perspective: Most personality theoristsdescribe development of personality in stages. They differ regarding the timeperiod during which they believe personality continues to develop. For example,according to Sigmund Freud personality evolves through a sequence of stepsuntil the age of 5; for Carl Jung middle age is the most important time ofchange for the personality.

This article analyzes Sarah’s personality through ErikErikson’s psychosocial model of development, which focuses on the developmentof the personality over the entire course of life. The author finds this modelof development, which takes a life-span approach, relatively more convincingthan the other theories, which limit the developmental stages to a certain age,mostly childhood period.According to the author,Sarah is at the eighth stage of psychosocial development. This stage is markedby the age group above 55 years. In this stage the individual face a conflictbetween ego integrity and despair. The evaluation of her life has left her in afeel of despair. The reasons for this could be the loneliness she faces despitespending her entire life serving her son and husband.

Second reason could bethe failure to cope up with the fact of ageing. Thus the sense of losing twomost valuable possessions of her life, one her family and second the energeticperson she once was might be the reasons that puts her in this phase of life. In the course of the analysis the author came across an aspect ofthe model that could be considered a drawback of the model. According to thismodel, each developmental stage has its particular crisis, when we resolve theconflict the personality continue its normal developmental sequence and acquirethe strength to confront the next stage’s crisis. If the conflict at any stageremains unresolved, we are less likely to be able to adapt to later problems.

InSarah’s case we can see the same conflict repeating. At the age of 18 eachindividual is to face a conflict between intimacy and isolation. This Sarah hassuccessfully overcome this stage at that particular age; her mention about herhappy married life is the evidence.

However, one could find Sarah facing thesame conflict at a later part of her life.  2)    Sociocultural Perspective: According to thesociocultural perspective while accounting an abnormal behavior one needs toconsider the roles of social and cultural factors, including factors relatingto gender, social class, and ethnicity. The paper will now concentrate onanalyzing how each of these factors played a role in shaping Sarah’spersonality.                                                                                                                                                                                    i.           Gender: Throughout the movie Sarah is seen struggling to fit intodifferent gender based norms. One example of this behavior is her desire toweight loss and wear the dress. This author feels is a result of the generaltendency of the society to attribute a thin body to the image of beauty.

Theinability to achieve this desire gradually develops a sense of low self-esteem,confidence and anxiety in her. Another example is her attempt to be a caringmother. Here Sarah relates Harry’s success in life as the validation of herrole as a nurturing mother.

This again is based on the societal norms orframework according to which each woman is obliged to perform her role as a nurturingmother. Thus the child’s failure is considered to be her failure as well. Thescene where Sarah says, “Oh, I can’t do it.

He is my only son. He is everythingI have” is an evidence of this. Sarah protects Harry despite the how he behaveswith her. This depicts the loving, caring and nurturing person a mother isexpected to be by the society.

                                                                                                                                                                        ii.           SocialClass: Sarahis a widowed middle-class women living in the city of Brooklyn, New York. Amentionable feature of her personality is her ambitious to be popular among herapartment friend circle. She expects the T.V show to create this popularity forher. At one instance she also expresses her desire to be known by a wider rangeof population and being accepted by them. These aspects show her need for socialvalidation.

This could also be considered as an evidence for her lowself-esteem personality trait.                                                                                                                                                                             iii.           Ethnicity: Theincreased use of amphetamine pills in American society can be one of thereasons why Sarah was also prone to its intake. According to studies, 4.7million people in US have tried amphetamine at some point in their life. Thewide use of amphetamine pills as a diet pill increases the danger.

The ethicsof the physician who prescribes Sarah is also questionable. In the movie, thereis very limited interaction between Sarah and her physician. The interactionrarely lasts more than a minute or two. Especially the second time Sarah visitsthe physician she says, “The weight is fine, but I am not okay”. However, thephysician does not pay any attention to what she needs to say.

Instead he endsthe consultation by prescribing her a stronger pill.        THE MENTAL HEALTH DISORDER: STIMULANT USEDISORDER: In”Requiem for a dream” Sarah is suffering from stimulant use disorder, which isa division of substance use disorder which is in turn a division of substancerelated disorder. Stimulants are substances that act on brain and sympatheticnervous system to increase alertness and motor activity. In themovie Sarah takes the stimulant amphetamine.

Biologically amphetamines producetheir effect by causing the release of norepinephrine and dopamine and blockingtheir reuptake. Norepinephrine and dopamine are neurotransmitters.Norepinephrine is involved in excitatory and inhibitory functions at varioussites, such as in neural circuits controlling learning, memory, wakefulness,and eating. Dopamine is involved in inhibitory functions such as voluntarymovement, emotional arousal, learning, memory, and experiencing of pleasure orpain. Their malfunction is associated with depression and schizophreniarespectively. In case of amphetamine use disorder, if brain damage hasoccurred, it can result in social, economic and personality deterioration. §  Diagnosis:Accordingto DSM 5, two (or more) of the following signs or symptoms, developing during,or shortly after, stimulant use are used to diagnose the disorder: 1.Tachycardia or bradycardia.

2.Pupillary dilation.3.Elevated or lowered blood pressure.4.

Perspiration or chills.5.Nausea or vomiting.6.Evidence of weight loss.7.Psychomotor agitation or retardation.

8.Muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias.9. Confusion, seizures, dyskinesia,dystonia, or coma. (American Psychiatric Association, 2013)Sarahis seen to have many of the symptoms, including pupillary dilation, perspiration,weight loss, dyskinesia, and confusion. Towards the end of the movie Sarah isseen to have developed tolerance and withdrawal symptoms.

Tolerance means theneed for an increased amount of the stimulant to achieve intoxication ordesired effect. In the second half of the movie, Sarah overdoses amphetaminepills. As per DSM 5, stimulant withdrawal syndrome is marked by the cessationof or reduction in stimulant use. Sarah experiences withdrawal syndromes duringher stay at the mental health institution.

Dysphoric mood and two (or more) ofthe following physiological changes, mark the stimulant withdrawal syndrome;1.Fatigue.2.Vivid, unpleasant dreams.3.Insomnia or hypersomnia.4.Increased appetite.

5.Psychomotor retardation or agitation. (American Psychiatric Association, 2013)Incase of Sarah she is in a constant dysphoric mood throughout her stay at themental health institution. She also suffers from fatigue, and psychomotorretardation.        THE DEPICTION OF MENTAL HEALH DISORDER TREATMENT IN THE MOVIE: The depiction of mental health disorder treatment in the movie isthe most traumatic part of the movie according to me.

At the time when Sarahwas admitted to the hospital she has detached herself from the real world andhad started to live in a world filled with hallucinations. Though to bring herback to the usual life was hard, I feel it was possible with proper mentalsupport. Through the term proper mental support I mean, a holistic method oftreating the disorder which give great importance to the physical, mental,social, and emotional aspects of the individual. However, the treatment Sarahreceives does no good to her condition, instead it worsens her condition. For example, the way she is forcibly feed and treated develops inher a sense of loss of control over her life. This act can be analyzed byreferring to application of Seligman’s experiment on learned helplessness tothe elderly.

  There, when the residentsof the nursing home were given some degree of personal control, they were happierand more physically active, compared to the residents controlled by theauthority. The author thus argues that the mental health institutions and theirfunctioning should be structured in a way that it gives more freedom andliberty to its inmates. Similar methods of forceful treatment can be noticed inthe movie “A flew over a cuckoo’s nest” as well.     CONCLUSION: Altogether, it was a uniqueexperience to watch the movie. Darren Aronofsky has done an excellent work in portrayingfour different lives and their struggles within a duration two hours. The wayof narrative was extremely useful in understanding the disorder from theperspective of the individual who is dealing with the disorder.

In that way itwas relevant in understanding mental health. As earlier mentioned, it was thecharacter Sarah, who influenced the author the most. Hubert Selby Jr.

has madean extremely convincing narrative of this character. May be because of thereason that, he, himself was suffering from stimulant use disorder at one pointof his life, in a similar way that of Sarah. However, the author would alsoraise a concern, which can be considered as a drawback of the movie. That is, thedepiction of mental health disorder treatment can leave a negative impact onthe viewer’s mind.

This can result in a situation where they doubt thecredibility of the treatment and develop a fear to consult a psychiatrist or apsychologist. Otherwise, this movie is an extremely recommended one foreveryone to watch.