Fridenmaker 1!

Megan Fridenmaker
Professor Zlatkin
Rites of Passage: Folklore and Fairy Tales
10 December, 2015

Diagnosing Ofelia: Mental Illness or Coping Method?

Pans Labyrinth by Guillermo Del Toro tells the heartbreaking story of a young girl who tries to
find happiness in a place filled with violence and hatred. In the midst of Fascist Spain, a young girl named
Ofelia has moved with her widowed mother into an old mill to live with her new stepfather. Captain
Vidal, her mothers new husband, is the captain of a violent Fascist movement, and cares nothing about is
new stepdaughter. He is only concerned about his army and the baby his wife is carrying, whom he
believes will be a boy. Ofelia, in order to cope, turns to her storybooks, and creates a world for herself in
which she is the lost princess of the underworld and must complete three tasks in order to return to her
kingdom. However, instead of a healthy make-believe world, she actually see the characters and fully
believes in what she is seeing. Much to the worry of her sick mother and the annoyance of her villainous
stepfather, she lives in this fantasy world and uses it to explain her mothers eventual death and her own
loneliness. Finally, she escapes with her baby brother during a rebel attack on the mill and is told by one
of her hallucinations that she must sacrifice the blood of an innocent in order to be welcomed back to her
kingdom. She refuses, and the Captain finds her and kills her. In one final, heartbreaking vision, Ofelia
sees herself coming into her kingdom, welcomed back as a hero for not spilling innocent blood for selfish
purposes.
Ofelia is truly a heartbreaking character, taking the audience on a perilous journey through her
strangely beautiful make-believe world before her life is cruelly ended. Her hallucinations were
persistent, detailed, and resembled people she was dealing with in her own life, all of which are consistent
symptoms experienced by one suffering from a form of psychosis. However, a childs mind is fragile, and
Ofelia experienced many traumatizing events in her life, such as the death of a parent, her mothers
depression,and the lack of support from her parents. Her mind could have simply turned to the fairy tales

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she loved so much and created a new world to help her cope. Therefore, one can ask the question: how
can Ofelia be diagnosed with a mental illness, and if not, what causes her mind to use hallucinations as a
coping method?
It is quite possible for Ofelia to be diagnosed with a mental illness. Near the beginning of the
movie, Ofelia makes a statement about Carmen (her mother) saying that she could be sad for days at a
time (Pans Labyrinth). This implies that Carmen was suffering from depression, which puts Ofelia at a
higher risk for developing a mental illness of her own, either by genetics or life experiences. Prior to what
was shown in the movie, Ofelia lost her biological father (a traumatizing event in and of itself,) and her
mother married Captain Vidal, a sadistic and utterly terrifying man. While it is never stated how much
time passed in between her fathers death and her mothers re-marriage, the death of a parent can have a
long-lasting negative impact with regards to trust, relationships, self-esteem, feeling of self-worth
loneliness and isolation and the ability to express feelings (Ellis 1). The lack of parental support from her
mother and step-father put Ofelia at risk as well, making her feel rejected by the very people who were
supposed to give her comfort and care.
Mercedes, one of the Captains servants, spent the most time with Ofelia while she was at the
mill, and helped her though the hardship of moving to a foreign place. Unlike Ofelias mother, Mercedes
was always there when Ofelia needed her, and did not treat her as an outcast in her own home when she
began seeing her hallucinations. Emotional support from the parents of children with a mental illness is
crucial to their development and well-being, and Ofelia was given none of that. Combining the death of
her father, her mothers depression, and the lack of emotional support she was given by her parents,
Ofelias young mind could very well have taken a negative turn and developed some form of psychotic
mental illness brought on by the traumatic events she witnessed prior to/during the movie.
However, another valid conclusion is to say that Ofelia is coping with her surroundings by
condensing and displacing all of her trauma into her hallucinations. The events she witnessed prior to/
during the movie were all very traumatic, but not enough to drive her mind over the edge into psychosis.
Carmens depression doesnt automatically predestine her child for a mental illness, and plenty of
children say they can see their imaginary friends and have nothing clinically wrong with them. This
could be considered a more positive reaction than developing a mental illness, and while this coping

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mechanism is not ideal, it helped her to get through a lot of the trauma she was experiencing. Ofelias
mind used hallucinations as a coping method to give purpose and meaning to her suffering, but cannot be
diagnosed as a psychotic mental illness.
When looking for different mental illnesses that match Ofelias symptoms, an extreme form of
Adjustment Disorder could fit her description. Adjustment Disorder is an extreme reaction to a stressful
life event, such as moving to a new place. The symptoms can range anywhere from feeling sad and
hopeless to brief episodes of psychosis. In the dissertation A Child Who Sees Ghosts Every Night:
Manifestations of Psychosocial and Familial Stress Following Immigration, a ten-year-old boy named
Joey (pseudonym) reported seeing ghosts every night before bed. He and his parents had immigrated to
the United States when he was young, and they lived in a shabby penthouse above his uncles apartment.
His parents argued a lot, sometimes in front of him, about financial stressors and childcare. He rarely got
out of the house, and his parents worked a lot in order to try and make ends meet. After two years of Joey
seeing these ghosts, his parents took him to a psychiatrist to try and diagnose and help him. Both his
parents and Joey went to separate and joint therapy sessions, and after twelve weeks, the hallucinations
stopped. Joeys parents changed jobs in order to have more time with him, they took him to a park several
times a week, and moved to a nicer, cleaner apartment. Joeys therapist diagnosed him with an extreme
form of adjustment disorder. This decision was made because, after looking at all of the stressors in Joeys
life, his therapist explained that these would put a psychological strain on any person, but for a child, as
Joey pointed out himself, there is the added dimension of not having control over these decisions (Fang
555). When diagnosing what the ghosts could have been, the therapist decided that the ghosts he saw
could be viewed as an imaginative response to the inner struggles he was experiencing (Fang 556).
Therefore, all of the stressors in Joeys life with the added element of not having control over these things
caused him to develop a mental disorder that was curable with therapy and parental support.
Ofelia had one big stressor in common with Joey: moving to a new and foreign place against her
will. During the final mandrake scene in the movie, she begs he mother to let them leave because she is
scared. Being moved to a strange, new, and terrifying place is understandably very difficult for her, but
not having a choice in the matter only makes it worse. However, diagnosing Ofelia with a form of
Adjustment Disorder is a gross understatement. In the article, it is clearly stated that Joeys disorder was

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extreme, and Ofelias symptoms were much worse than his. She would visit places that physically did not
exist (such as the Pale Man scene or the Frog scene,) whereas Joey only saw figures in his bedroom.
Therefore, even an extreme form of Adjustment Disorder does not fully cover the diagnoses she needs.
A mental illness called Brief Psychotic Disorder is brought on by a traumatic event in a persons
life, such as the death of a parent or another traumatic experience. This disorder displays very similar
symptoms to schizophrenia, and the person experiencing it goes through much of the stress and confusion
that a person with diagnosed schizophrenia does. This disorder usually lasts for up to two months before
the mind can come to terms with whatever stressor caused it to experience psychosis.
The article Pre-Onset Abnormalities, Psychosocial Stressors, and the Development of Psychosis:
A Prospective, Population-Based Study by Judy Lorraine Thompson studies a wide range of
schizophrenic and psychotic symptoms, disorders, and causes. The author explains several factors that
could cause schizophrenia or other psychotic disorders, such as peer rejection, parent-child relationships,
and stressful environmental factors (Thompson 14). The author studies several pre-schizophrenia
behavior and symptoms, such as hallucinations, delusions, disorganized speech and
behavior (Thompson 14). These symptoms, along with a stressful environment, are almost guaranteed to
drive a childs psyche over the edge. The author also delves deeply into the parent-child relationship. She
claims that problematic relationships with both the mother and father during adolescence are associated
with the lated development of schizophrenia (Thompson 52). However, the same can also be said for
children of a younger age as well.
At the beginning of the movie, Ofelia sees a praying mantis-type bug on a rock when her car
stops to take a break. She follows it for a few moments, but is called back to her mother so their journey
can continue. She tells her mother that she just saw a fairy (even though it didn't look like one at all,) and
her mother replies saying that she reads too many fairy tales. Later in the evening, as she is lying in bed,
Ofelia sees the praying mantis again, only this time it transforms into a humanoid figure: a fairy. She
follows it to the labyrinth, a place full of mystery as she was told not to go inside. There, she meets the
Faun, and is told of a fantastical kingdom of which she is the lost princess.
These scenes are useful in helping diagnose Ofelia with Brief Psychotic Disorder because she did
not start hallucinating before the evening she first saw the fairy transform. A disorder such as

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schizophrenia, while possible, is unlikely because it very rarely manifests itself in a child, and even more
rarely does it occur without a family member also being affected by the same disorder. Prior to moving
into the old mill and having her first encounters with the Captain, Ofelia didnt see the insect as anything
more than a strange bug on a rock. As a young child who enjoyed fairy tales, she would naturally take
something new and unnatural in her mind and give it some outlandish meaning. However, after the first
day at the mill and being introduced to a new father, home, and a new way of life, Ofelia began
hallucinating. This would be enough to rock any childs world, but combining the death of her biological
father, the neglect she received from her mother and step-father, and her mothers depression, it is very
likely that her young mind could not have handled all of the trauma. Since Brief Psychotic Disorder can
only be developed after a traumatizing experience, it would be logical to say that her symptoms are
consistent with this disorder.
Along with having to adjust to a new and frightening life, Ofelia also had to cope with her
mothers depression. While she is shown as a decent yet troubled mother, Carmens depression most
likely gets in the way of her parenting and affects Ofelia more than the movie clearly shows. The
dissertation Factors Associated with Changes in Parental Depressive Symptoms: A Longitudinal
Multilevel Analysis of Parents at High Risk for Child Maltreatment by Melissa Lim Brodowski focuses
on how the depression of a parent can affect the health of a child. The author uses research found by
several therapists and analyzes how the depression of a parent puts the child in danger of maltreatment,
whether this be neglect, physical/emotional abuse, or some other type of maltreatment. She analyzes
depression and its symptoms, stating that depression is a mental health impairment that negatively
impacts functioning related to work, household, caregiving, and other personal and social relationships,
including the ability to provide adequate care for ones children (Brodowski 1). This, she claims, has a
startling affect on the child, and when the child is not acting in a way that the parent can easily cope with,
they tend to abuse their children either physically (lashing out violently) or emotionally (neglect, verbal
abuse, etc.) The author claims that when the parent does not seek help and does not have good support,
the child is in danger of developing their own mental illness from the treatment they get from their parent.
Not being able to properly support Ofelia emotionally had a big affect on her hallucinations: as
she turned to her books for the support she didn't have from her mother, her mind turned her loneliness

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into visions that gave her life and all her suffering purpose. Carmen did not physically abuse her daughter,
nor did she abuse her verbally, but Ofelia mentions that there are periods when she is sad for days at a
time. Generally when someone is sad, they dont want to do much of anything, much less take care of
someone and their responsibilities. Based on what this article describes as the symptoms of depression,
research can help back up the claim that Carmen most likely neglected her daughter, giving Ofelia little to
no emotional support and putting her in danger of developing a mental illness of her own. Several studies
analyzed by Brodowski strongly indicated that living with a depressed parent places the child at
increased risk for a number of psychiatric and behavior problems later in life (Brodowski 30). These
could include, but are not limited to: depression, anxiety, a lesser sense of self esteem, and less
communication between the child and the caretaker (Brodowski 31). Therefore, due to her mothers
depression, the probability that Ofelia could have had a mental illness was very high.
The way a parent reacts to their childs unusual behavior also plays a huge role in the mental
health of a child. If a parent does not react in a supporting manner to their childs struggles, the effect on
the child can be devastating. The dissertation "Parents' Conceptualization of Adolescents' Mental Health
Problems: Who Adopts a Psychiatric Perspective and does it make a Difference? by Tally Moses helps
explain the different ways parents conceptualize and react to their childrens mental illness. Moses claims
that the parents emotional reaction to their childrens illness as well as previous psychiatric problems
affect how their children fare under their care. The reaction of the parents is crucial to their childrens
well-being, and conceptualizing and making sense of the childs problem is/can be very difficult to come
to terms with. Worry, sadness, and guilt are among the top three emotions parents with mentally
challenged children feel, and these emotions can cause them to react in a way that is counterintuitive to
what the child needs. In Ofelias time, mental illness was not recognized as something that needed special
care, and it is understandable that her mother and step-father did not understand what she was going
through. However, this does not give them an excuse to treat her coldly and with neglect.
An excellent example of how Ofelias parents reacted to her hallucinations occurs during the final
mandrake scene in the movie. In this scene, Captain Vidal reaches under the bed and finds the mandrake
root in a bowl of spoiled, foul-smelling milk. He looks up at his stepdaughter with a look of disbelief,
annoyance, and anger, letting her know that he is done with her childish behavior. He wants Ofelia to

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explain herself, but she remains silent until he rips the mandrake root out of the bowl, causing her to
scream No! repeatedly. Her mother comes to her aid, telling the Captain to leave her alone and that she
will deal with her. Carmen asks her daughter what the root is doing under the bed, to which Ofelia
responds that it is the magic root the Faun gave her. The Captain blames all of the fairy tales Ofelia reads,
then leaves at his wifes request. She then explains to Ofelia that she needs to stop this childish nonsense,
and the world isnt like how it is in her books. She says the world is a cruel place, and she needs to learn
that even though it will cause her pain. She then throws the mandrake root into the fire, but crumples to
the floor in pain as the root burns.
The behavior of the Captain in this scene can only be described as harsh and tyrannical. He didn't
listen to Ofelia when she repeatedly screamed no, and only her mother could get him to stop what he
was doing for the sake of her child. This showed Ofelia that she had no real control over what was
happening in her life, even though she was only trying to help her mother in the only way her mind could
fathom. Not being able to stop the Captain from tearing the root out of the bowl was visibly traumatizing
to her, and since the mandrake seemed to be helping her mother get better, it added validation to the
hallucinations she was witnessing. The potential for physical abuse in this scene was very real and most
likely would have happened had her mother not intervened and sent the Captain away. However, Ofelias
mother was not the hero in this scene. Having her mother come to her rescue offered a slight bit of relief,
but she was once again betrayed by her caregivers as her mother explained that she needed to grow out of
her fairytale phase. This reaction, as well as throwing the mandrake into the fire, are evidence of
emotionally neglectful abuse. When Carmen immediately fell to the floor in pain after burning the root, it
was as if her argument was invalidated by her reaction to burning the magical root. This scene only
strengthened Ofelias belief in her delusions while simultaneously distancing herself from her parents,
putting her even more at risk for her psychosis to grow stronger.
It is understandable that Ofelias parents had a very difficult time grasping what was wrong with
their child. Even though the time period and the circumstances were not ideal, Ofelias mental health
condition should not have been ignored and put aside by her misunderstanding parents. The dissertation
Proactive Readiness among Parents of Children with Chronic Mental Health Conditions by Caroline R.
McKinnon focuses on different things parents can do for children who have chronic mental health

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conditions. The author gives examples of different conditions that parents should be prepared for, as well
as different things parents can do to help their children as well as themselves. She claims that parents
need to be ready for when something like a chronic mental illness affects their child, and coping with it
positively greatly reduces the stress on the child. By feeling accepted, the child is less likely to retreat into
themselves, and the chances of making progress with recovery is greatly increased. However, this can be
a difficult role for the parent to play. McKinnon states that Childhood mental health conditions are
prevalent, persistent, serious, and complex. Families are expected to be involved in their child's care, but
may vary in their readiness for taking an active role. (McKinnon 1). This, she states, is completely
normal, but is a stage that needs to be moved past before progress can truly be made (McKinnon 3). Even
though mental disorders were not recognized as actual illnesses during Ofelias time, her parents realized
that something was not right with the way their daughter was acting. Even during this time period, parents
understood that children exhibiting abnormal behaviors required special attention and care. Instead,
Carmen and the Captain both refused to admit that something was seriously wrong with Ofelia and all but
ignored the problem, making any sort of recovery that their daughter could have had impossible. This
article explains that while facing the problem directly is a very difficult step for most parents of children
with mental health problems, it is a step that has to be taken quickly so as to not push their child further
and further into their own illness.
Many children find solace within their group of friends, their bond with their father grows
stronger, or they channel their feelings into other activities, such as art, music, or reading. Ofelias mother
was not capable of taking care of her daughter well, and even though Ofelia did turn to her books and
eventually the hallucinations as a form of coping, it is not conclusive that she had a form of a psychotic
mental illness. Just because Ofelias mother suffers from depression, Ofelia herself is not automatically
predestined to have a mental illness of her own. The article "The Effects of Maternal Depression on Child
Mental Health Problems Based on Gender of the Child." by Sun-mi Cho explains how maternal
depression can affect a childs mental health through research and science, but states that maternal
depression does not necessarily implicate that Ofelia is at high risk of having mental health problems. The
author explains that a mother who is experiencing depression may tend to display less positive affection,

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provide less emotional support, and inconsistently respond to their childs every day and emotional
needs (Cho 3).The author then goes into further detail, explaining how
children of depressed mothers have more problems in three domains compared to
controls. First, children of depressed mothers have been found to have abnormalities in
neurobiological functioning, with higher heart rate and lower vagal tone, as well as
higher cortisol level. Second, in the area of cognition and self-concept, children of
depressed mothers show vulnerability to to poor self esteem. They are more likely to
blame themselves for negative outcomes, having a more negative self- attribution style,
and being less likely to recall positive self-descriptive adjectives. Third, with respect to
interpersonal functioning, these children are more likely to display poor social skills,
difficulties with impulse control and lack of motivation (Cho 1).
While this statement may seem conclusive, Cho does say that each child copes with maternal depression
in various ways.
In the dissertation "The Relationship between Parental Warmth, the Effects of Childhood
Witnessed Violence and Pre-Adolescent Delinquency, Joseph Bryan Conrad looks at several studies that
show how different experiences during childhood affect the mental stability of a child during preadolescence. He agrees with his findings, claiming that witnessed violence during childhood will almost
undoubtedly affect the behavior of a child in the future. He also examines the role that parents have on
their childrens mental health, and finds that children with weak bonds with their parents have a greater
risk of ending up a delinquent. This parental relationship is crucial for development and healthy growth
into adulthood, and children who aren't given the attention they need are more likely to resort to
delinquent acts in order to get attention. Those at risk include children who live in adverse and traumatic
environmental circumstances (Conrad 5) and are more prone to adverse developmental changes
including physical, cognitive, psychological, and behavioral problems (Conrad 6). Therefore, children
who live in dangerous or stressful settings are more likely to develop behavioral, physical, psychological,
and cognitive problems that could possibly follow them into adulthood.
As Ofelia read her fairy tales, she learned that life was not always going to be good.When her life
began to go downhill (so to speak,) she was able to turn to her literature and find comfort knowing that

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the evil could all be explained. However, the horrors she witnessed and the trauma she was exposed to
could not all be explained through books, and her fragile mind took her coping one step further. In order
to cope, her preconscious mixed with her conscious mind, allowing her to live in a sort of dreamscape
in order to escape the world in which she lived. While her unconscious was full of the repressed trauma,
some of it leaked into her preconsciousness. Her conscious mind could not handle what was happening,
so the preconscious displaced the stressors into one part of her hallucinations: the Faun. By doing this, her
mind saved itself from having to face the trauma it had experienced- a trauma too large for a young girl to
handle.
Ofelias behaviors would have been seen as delinquent in her time and circumstances. Conrad
admits that, like Ofelia did, children may retreat into themselves as a means of escaping from such
deleterious conditions, eliminating the stimuli or coping with such noxious stimuli (Conrad 9). Several
studies examined by Conrad suggest that adverse life circumstances may actually cause
delinquency (Conrad 10), and since it was not suggested in the movie that Ofelia had exhibited any form
of delinquent behavior prior to moving to the mill, it can be determined that her new and adverse life
circumstances caused her to behave the way she did. However, this being said, most children don't use
hallucinations as a coping method. This can be explained using Conrads theory of Parental Warmth: the
love and warmth a child gets from their parents plays a very large part in their development. When this
is taken away and replaced by parental rejection, the child turns to other means of getting what they need,
either from their group of friends or (in Ofelias case) turning to some activity such as reading. The more
extreme the circumstances, the more extreme the reaction (Conrad 51-52). Ofelias circumstances were
very extreme, so her mind had a very extreme reaction to what she was experiencing. In order to cope, she
created a world for herself in which she was given the utmost attention and care, greatly contrasting her
real world. Her hallucinations, while alarming, were not indicative of any mental illness- they were
simply just her mind having an extreme reaction to the extreme circumstances in which she lived.
As Ofelia learned that life was not always going to have a happy ending, her life began to lose
meaning and had a debilitating effect of how she functioned, so she turned to her fairy tales to help her
cope. The Struggle for Meaning by Bruno Bettleheim explains that reading fairy tales is very good for a
childs development and answers important questions that need to be answered for a child to develop

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regularly. He claims that current childrens literature is doing no good for the children of today because
they all of the stories are incredibly shallow and dont teach the children any meaningful life lessons. The
author explains that when giving meaning to a childs life, nothing is more important than the impact of
parents and others who take care of the child; second in importance is our cultural heritage, when
transmitted to the child in the right manner. When children are young, it is literature that carries such
information best (Bettleheim 4). When childrens literature takes out the bad parts of life and only leaves
the good, children are taught that all people are inherently good. However, Bettleheim explains that
children know that they themselves are not good all the time, and when children realize they are not like
the characters in their stories, they see themselves as a monster. Classic fairy tales confront children with
the realities of life, and therefore meaning is established and children know that is it okay not to be a
perfect person.
While there is a lot of evidence supporting Ofelias diagnosis of Brief Psychotic Disorder, this
conclusion could be considered too broad of a solution. Her symptoms are very specific, acute, and
severe: she visited places that physically did not exist, as seen in the Pale Man and giant frog scenes. Both
of these scenes were violent and gruesome, and both were perceived by Ofelia as potentially lifethreatening. The intensity and extremeness of her hallucinations definitely warrant some form of mental
illness, but simply saying she has Brief Psychotic Disorder is a very broad diagnoses. This being said,
Ofelia definitely has a psychological issue, so saying that she uses hallucinations as a coping method but
cannot be diagnosed with a psychotic mental illness is an understatement. However, both of these
interpretations of her situation could be connected- while there is definitely a psychological issue, her
psychosis had very strong preconscious links to her real life, therefore helping her cope with her traumatic
life. Ofelia can be diagnosed with an acute form of Brief Psychotic Disorder in which her intense situation
caused her psychosis to use preconscious links to her real life as a way of dealing with her extreme
psychological stress.
Since Ofelia visited places that didnt physically exist, this provides evidence that her problem is
psychological. The Pale Man scene is an excellent example of this: Ofelia finds herself in the lair of the
Pale Man, a humanoid monster that lures innocent children to their deaths with a grand feast set out
before him. With the key she got from the toads stomach, Ofelia creeps up to the room where he is sitting

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quietly, appearing to be dormant. She unlocks a small door on the wall, pulling out a dagger from the
opening. Several fairies have accompanied her, and urge her to get back to her room before the Pale Man
wakes up. Not heeding their warnings, she picks a large, plump grape and eats it. The Pale Man
immediately awakes, eating two of the fairies and coming after Ofelia. She ends up escaping at the last
minute by drawing a door out of magical chalk and pulling herself up into her bedroom. This place did
not really exist, it was only in her mind. Therefore, her problem is definitely psychological.
There are also very strong preconscious links to Ofelias hallucinations. While her problem is
psychological, her psychosis had preconscious links as a means to explain and interpret the traumatic
stressors happening in her life. For example, the Faun has very strong connections to Captain Vidal. The
Captain is very obsessed with time (he made mention of how Ofelia and her mother were late at the
beginning of the movie,) and the Faun tells Ofelia several times that her time is running out to complete
the three tasks. The Faun is very controlling, as is the Captain, and he doesn't seem to have a problem
with taking innocent life in order to gain something personally. Another preconscious link comes from the
Pale Man scene: the vast feast set out before him links to the dinner that the Captain and his allies had
when Ofelia was retrieving the key from the giant toad. The Pale Mans feast was very extravagant, luring
a child like Ofelia in with the great amounts of food that the children didnt have access to due to the
Facist control over food. The Captain had a great feast with some of his allies, taking advantage of all the
food he controls. These two scenes connect because it shows the greediness of both of the Pale Man and
the Captain, an when someone steals their food they react violently (the Pale Man attacks Ofelia and the
fairies and the Captain goes after the rebels.) Therefore, Ofelias hallucinations are preconsciously linked
to her real life.
In Freudes theory of displacement, things in real life that are too large or hard to handle are
represented by something small and more easily understood. The Pale Man is an excellent example of
how Ofelias mind used displacement to handle Captain Vidal. The Pale Man scene is terrifying to watch:
it is incredibly violent and traumatizing, with obvious links to the Captain (e.g.: the dinner table.) In
psychotic breaks, preconscious content is mistaken for reality Ofelias preconscious mind

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The preconscious is used by the mind to make the person feel more safe and secure in their environment.
If the Pale Man was Ofelias interpretation of security, then this poor little girl was doomed from the start.