ANGELES UNIVERSITY FOUNDATION Mac Arthur Highway, 2009 Angeles City, Philippines COLLEGE OF NURSING A.

Y 2011-2012

Sybil
Movie Analysis
SUBMITTED BY: Letran, Rachelle Anne S.
BSN 3-2

SUBMITTED TO: JOY L. DELFIN RN,

2012

1. DSM IV criteria of Dissociative Identity Disorder a. Sybil presented 16 distinct identities or personalities b. At least to identities recurrently taking control of Sybils behavior c. Sybil is unable to recall important personal information: more extensive than ordinary forgetfulness d. Symptoms are not related to any substance use or medical condition 2. The main character in the movie Sybil is named Sybil Isabel Dorsett. She is a college student studying art in the University of Columbia. Her condition at first is said to be hysteria but later termed as multiple personality disorder or when an individual display distinct or multiple identities of himself or herself. In the movie, displays sixteen distinct identities or personality states that recurrently take control of her behavior at different times. These personalities has different identities, referred to as alters, may exhibit differences in speech, mannerisms, attitudes, thoughts, and gender orientation. Like for example Vicky is one of Sybils other self is characterized as this very sophisticated women who speaks French and also known to control of the other personalities within Sybil and also the one responsible for communicating with them. Each of Sybils personality is said to represent an event in her past. Each personality is an outlet in which Sybil expresses her feelings from these events in her life. Peggy Lou is Sybils personality that is always angry and is created because Sybil cant get angry for herself. Peggy is characterized to very violent has a tendency to break glass whenever she expresses her anger. The glass breaking attitude of Peggy was somehow from the memory of Sybil being blamed for breaking a piece of glass ware from their house. Mary is the moral personality of Sybil. Mary is born out of her love for her grandmother and the belief that her parents was instilling to her which is their religious belief. Sybils parents were very religious and Sybil thinks that she is not religious enough for her parents because she always gets punished so Mary was created. Mary is characterized as a very religious person. She would always talk about god and rationalized her actions that if she didnt do this or that she might go to hell; Ruth is the child personality of Sybil who is always afraid of being hurt. During Sybils childhood she was abused by her mother in a variety of ways this includes physical, psychological, and sexual. Examples of these abuses were shouting, being tied up to the piano, and being given enemas. Ruth is described to be always crying and scared that her mother may abuse her again and

when triggered she may display aggression due to the fact that she is defending herself from her mothers abuse; Vicky is Syblis strongest personality. Vicky was born long before and was the one that takes over whenever Sybil was hurt; Sid is Sybils boy personality. She is characterized to be very sophisticated. She also like buying things for Sybil and likes to dress nice and style her hair really good by curling them; Sid is said to have been born because Sybil doesnt want to become like her mother so she tried to be like her father. Sid is characterized to be a good handyman and carpenter. He is said to be the one that fixes everything in Sybils house. Other personalities of Sybil such as Vanessa and Marthias identities who painted at the same time in a scene were not fully seen. When she is under the control of one identity, she is usually unable to remember some of the events that occurred while other personalities were in control. 3. Symptoms of DID can include the following: y Suicide attempts or self-injury was manifested by Sybil when she cut herself using a piece of glass and when she climb to the roof top and let herself fall. y Sybil experiences blackouts in time, resulting in finding herself in places but not recalling how she traveled there. Like when she freaked out when she found herself in Philadelphia and she didnt remember how or when did she went there. Also, she cant recall that she rented in a hotel and she cant remember that she draw the picture she found in her room. y being frequently accused of lying when they do not believe they are lying (for example, being told of things they did but do not recall); y y y y She finds items in her possession but she doesnt recall how those things were acquired. Sybil repeatedly meets people who seem to know her, but whom she does not recognize. She finds paintings or drawings or items she has clearly written but is in handwriting other than their own. Derealization appears in the movie many times like when Sybil said sorry to Dr. Wilbur for missing their sessions however little that she knew she was always present. She was not aware of the time and where she was during those times. y y Depersonalization is when an alter of Sybil is taking control of the body. Depression example of this in the movie was when Sybil was crying in bed and when she saw Peggy Lous drawing she decided to commit suicide but failed.

Flash backs on Sybils childhood triggers her the alters to take control of the body which is depicted on many scenes in the movie.

4.

Nursing Intervensions

Interventions
Maintain Client safety

Rationale
Clients may become violent not just to others but also to him or herself so in order to reduce harm inflicted on the client a safe and secure environment must be implemented.

Respect clients independence and decision making as much as possible

The clients autonomy needs to be respected and his or her decisions must be respected as much as much as possible

Discuss the consequence of the clients action

The client must be brief regarding the consequences of his or her actions. So that the client may understand what to expect or what will happen if he or she had done something.

Establish a contract with the client regarding the nurse-patient relationship

Part of establishing a therapeutic relationship is to create a contract with the client. This contract will indicate the details regarding the relationship such as the purpose, time, duration, a contract would also prevent the likelihood that the client may act-out during the end of the therapeutic relationship.

Encourage Client to do Journal Writing

Journal writing encourages the client to express his or her feelings through writing. It is a nonviolent way of the client expressing what he or she feels. This promotes self-actualization, improved self esteem

Limit setting

There are certain instances that the client may act-out, become violent or too manipulative towards others and self. In order to prevent that and maintain control of the relationship the nurse must

limit the clients setting. Encourage client to participate group activities and remove client from the activity if client becomes manipulative or violent. Group activities may be appropriate as long as the client is not violent anymore and manipulative. And if incidence of violence occurs the client must be removed from the group to prevent him or her from inflicting harm to others Provide opportunities for clients to share feelings In order to understand how the client feels the nurse must be able to allow the client to share his or her feelings. This will allow the nurse to understand the client and will be able to device appropriate interventions in order to address the clients needs. Accept no gifts or flattery from the client Clients with personality disorder are often manipulative. They use a variety of things to manipulate others such as giving gifts and flattering compliments. In order to reduce the clients manipulative behavior the nurse must be firm at denying any gifts or flattery from the client. This will give the nurse more control and to somehow impose to the client manipulation is not tolerated. Confront clients manipulative behavior Again if client becomes too manipulative confronting the client and telling him or her that her actions are not acceptable will help reduce the clients manipulative behavior. Imposing on her or him that manipulation or any inappropriate behaviors are not tolerated.

5.

The goals of treatment for DID are to relieve symptoms, to ensure the safety of the individual, and to "reconnect" the different identities into one well-functioning identity. Treatment also aims to help the person safely express and process painful memories, develop new coping and life skills, restore functioning,

and improve relationships. The best treatment approach depends on the individual and the severity of his or her symptoms. Treatment is likely to include some combination of the following methods: Psychotherapy

This kind of therapy for mental and emotional disorders uses psychological techniques designed to encourage communication of conflicts and insight into problems. Cognitive therapy

This type of therapy focuses on changing dysfunctional thinking patterns. Medication

There is no medication to treat the dissociative disorders themselves. However, a person with a dissociative disorder who also suffers from depression or anxiety might benefit from treatment with a medication such as an antidepressant or anti-anxiety medicine. Family therapy

This kind of therapy helps to educate the family about the disorder and its causes, as well as to help family members recognize symptoms of a recurrence. Creative therapies (art therapy, music therapy)

These therapies allow the patient to explore and express his or her thoughts and feelings in a safe and creative way. Clinical hypnosis

This is a treatment technique that uses intense relaxation, concentration and focused attention to achieve an altered state of consciousness or awareness, allowing people to explore thoughts, feelings and memories they might have hidden from their conscious minds.

6. Learning Derived
Analyzing a movie is actually done of anyone who watched a movie. It is when they make comments about it or when they react but analyzing the condition of a character is really challenging. Sybil is a good movie and actually I enjoyed watching it with my siblings. I explained to them about the host does not know that she has alters while alters know that theyre in Sybils body. I also began to randomly remember about the discussion like alters has different age, name, gender and right-handedness or left-handedness. Ive learned from the psychiatrist who handled Sybil that you should not easily go with the flow or accept what others belief but then you should have faith in your own knowledge and will. She fought for her theory that Sybils condition is not hysteria but multiple personality disorder (currently known as dissociative identity disorder or DID) even though her fellow psychiatrist are thinking that shes out of league and its worthy because now DID is an accepted diagnosis. We also learned that conditions like schizophrenia should not be ignored, it must be treated because a related cause of DID is severe childhood trauma and severe sexual abuse which a schizophrenic parent is susceptible of. In the movie Sybils mother raped her, use ice water enema on her, tied her on the piano, and did other physical and emotional abuses which lead her to develop different identities. Another possible cause of her disorder is her emotional trauma about her first love that died in front of her eyes. Moreover, alters can talk to each other and sees what happens to the host. Likewise, alters take control of Sybils body whenever they want to and sometimes do things that frustrate Sybil for example Victoria will shop dresses and shoes using and Sybil will have to return them back to the shop. Sybil usually sees thing that she didnt buy at her cabinet, painting that she doesnt remember painted, people who will claim that they know her but are total strangers to her and usually in a place which she cant recall she went to. Another thing which amazed me is the treatment that the psychiatrist used on Sybil, she hypnotize each identity to ground them all to the same ages which is eighteen (18). And what strikes me at the ending is when they found paintings that use different techniques which suggest that they are painted by different artist using the same hand.