Movies and Mental Illness Paper – Primal Fear “ I believe in the notion that people are innocent until proven guilty. I believe in that notion because I choose to believe in the basic goodness of people. ” The film Primal Fear depicts a defense attorney who takes up the case of an altar boy, Aaron, accused of murdering the Archbishop. As the film progresses, the defendant exhibits Dissociative Identity Disorder (DID) which causes serious challenges to the case for the defense. In this paper we attempt to provide a synopsis of the movie including key scenes where the specific disorder in question is being shown.
Additionally, we discuss key diagnostic as well as psychotherapy steps for this disorder and analyze the movie’s accuracy in depicting Aaron as an individual suffering from DID. Primal Fear is an American thriller released in 1996. It was directed by Gregory Hoblit and featured Richard Gere, Edward Norton and Laura Linney as the main actors. The film’s main character is a Chicago defense attorney, Martin Vail, played by Richard Gere. The film starts by depicting Martin Vail as a reviled Chicago defense attorney who takes up cases of alleged criminals and successfully defends them.
He is an arrogant, brilliant and successful criminal defense attorney who loves a good fight and the media spotlight, both of which he knowingly invites when he volunteers to represent a penniless, bewildered young man accused of murder, Aaron Stampler, played by Edward Norton. Aaron is charged with the murder of Catholic Archbishop Richard Rushman. In the beginning of the film, Rushman is shown being butchered with fingers being cut off and eyes gouged out while Aaron is shown fleeing from cops, with blood staining his clothes, face, and hands.
The alleged murderer had carved a set of letters and numbers – B32. 156 – into Archbishop Rushman’s chest. While Martin’s defene team fails to determine the source or relevance of this particular set of letters and numbers, the prosecuting attorney uses this alphanumeric pattern to establish motive. The letter and first two numbers led to the book in the church library, The Scarlet Letter, and motive is established based on a particular underlined passage on page 156 from the book. “No man, for any considerable period, can wear one face to himself and another to the multitude. The prosecution’s argument is that Aaron believed the bishop to be a two-faced personality and thus decided to murder him. But Vail doesn’t concern himself with questions of guilt or innocence. All he cares about is creating his version of the truth. All he cares about is winning. Vail’s absolute need to win, his antagonism toward his former boss in the prosecutor’s office, complicated and contentious relationship with the prosecutor Janet Venable, and his assertion of innocence on behalf of his client are cornerstones of the movie.
During investigations as part of the trial, Vail’s team discovers that some very powerful public figures and investors, including District Attorney John Shaughnessy, lost millions of dollars in real estate investments due to a decision by the Archbishop not to develop luxury rental properties on certain church lands instead of donating them to public causes and facilities for the poor and underserved. Vail tries to dig a little deeper to search for a motive originating from this discovery.
Vail asks his friend Molly, played by Frances McDormand, to conduct a psychological analysis of Aaron to determine if he suffers from a mental illness. As part of her videotaped sessions with Stampler, at one point Molly watches Stampler turn into a sub-personality when pressured and cornered into talking about his girlfriend Linda’s sexual relationships with other boys. Meanwhile, Tommy Goodman, an associate of Vail’s firm, gets attacked when trying to sift through Aaron Stampler’s apartment. Vail talks to Aaron about the attack and the discussion leads to Alex, another altar boy.
When Vail and Tommy track down Alex, a chase ensues and after a brief scuffle, Alex is cornered. Alex reveals that Archbishop Rushman forced him, Aaron and Aaron’s girlfriend Linda to perform sexual acts as a means for the Archbishop to scourge the devil from his own self. Alex was in Aaron’s apartment looking for the videotape that the Archbishop recorded this sexual act on. Vail makes a search of the Archbishop’s apartment and finds the videotape of Aaron being forced to perform in a sexual act with Alex and Linda. This puts him in a bind.
Introducing this evidence would make Stampler more sympathetic to the jury, but it would also give his client a motive for the murder, which the defense had so far not been able to clearly establish beyond just the sentence from Scarlet Letter. He takes a different route. He decides to take the tape and have it hand delivered by Goodman to Veneable’s apartment. This forces the prosecution to submit the tape as evidence in the courtroom and puts Archbishop Rushman in a bad light. The focus thus shifts to the abuse that Stampler has endured while being in the church as an altar boy.
There is also reference to abuse that Stampler suffered at the hands of his father. Meanwhile, a furious Vail confronts Aaron about the videotape showing sexual acts between Linda, Aaron and Alex. It is at this point that Vail sees the sub-personality of Aaron that Molly had had a glimpse of in one of her sessions. This aggressive sub-personality goes by the name of Roy and has a distinct demeanor that is different from Aaron. Roy openly admits to Vail that he killed Archbishop Rushmore for the abuse that he inflicted on the altar boys.
He also reasoned that he had to do it because Aaron was too weak to be able to do it himself. At this point, it is too late in the case for Vail to change to an insanity plea. To further complicate matters, a key witness that Vail was planning to call as a witness, is murdered. The witness was going to be the basis of Vail’s argument that shady financial dealings involving high profile public figures could possibly be a motive for the murder of Archbishop Rushmore. Undeterred, Vail still tries to shed light on these shady dealings by calling the D.
A. to testify, however, the Judge rules the testimony to be irrelevant to the case and thus stricken from record. At that point Vail has to think of options on how he is going to convince the jury that Aaron did not murder the Archbishop. He decides to call Aaron to testify and pressures him just enough during his examination so that Aaron is on edge when prosecuting attorney Venable starts her questioning. Under intense questioning from Venable, Aaron breaks and turns into the sub-personality Roy and assaults Venable.
This drama plays out in the courtroom and causes the judge to rule a mistrial while also remanding Aaron for 30 days to a mental health facility for further assessment. Venable realizes that she has lost the case. With the mistrial and the personality disorder that played out in the courtroom, the prosecution does not have a case and the defense would take the insanity plea if the prosecution reopened the case, which would not go far. All along, Vail always believed that Aaron was innocent. When he goes to see Aaron in his holding cell and delivers the good news about the case, Aaron is thankful. However, as soon as Vail is bout to leave, he remembers that Aaron has described a detail about the assault that his sub-personality inflicted on Venable in the courtroom which he shouldn’t know if he truly had Dissociative Identity Disorder. He confronts Aaron about this and Aaron eventually reveals that he was staging the dual personality character all along so that he could be declared mentally unfit to stand trial and thus be let go. Vail realizes what he has done, however, at that point with the trial over, there is little he can do except wonder about whether his job is to simply defend his client or to truly help defend the innocent.
Dissociative Identity Disorder characterized by the presence of two or more distinct identities within the individual (Van Dyck ; Spinhoven, 1998). It is typically only diagnosed by a few specialized psychiatrists (Verschuere ; McNally, 2012). A one way amnesic relationship between the primary personality and the alternative subpersonalities is typical of Dissociative Identity Disorder and is part of DSM-IV where amnesia is a criterion for this disorder, however it has been shown to not always hold true (Verschuere ; McNally, 2012)(Gillig, 2009).
Patients suffering from this disorder tend to exhibit a more extreme abuse and trauma history than the general population (Ross ; Ness, 2010). DID is generally viewed as a developmental psychopathology in which alternate identities result from the inability of many traumatized children to develop a uni? ed sense of self that is maintained across various behavioral states. There are several psychometric instruments that need to be used to measure dissociation. Complex trauma related disorders such as DID are most appropriately treated in sequenced stages. Integrated functioning is the goal of treatement for DID.
Helping the identities to be aware of one another as legitimate parts of the self and to negotiate and resolve their con? icts is at the very core of the therapeutic process. The three main phases of treating DID are – Establishing Safety, Stabilization and Symptom Reduction; Confronting, Working Through and Integrating Traumatic Memories; and finally Integration and Rehabilitation. Outpatient treatment for patients is provided by a psychotherapist in individual outpatient sessions. Inpatient treatment may be necessary depending on the severity of the trauma, however should occur s part of a goal-oriented strategy designed to restore patients’ functioning so that they are able to resume outpatient treatment expeditiously. Pharmacotherapy and hypnosis may be used as non-primary treatments for DID (Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision: Summary Version, 2011). There are three key scenes where the disorder is depicted. In the first scene Molly, the neuropsychologist that is evaluating Aaron, asks him some very pointed questions about his girlfriend Linda. Aaron struggles to talk about Linda and her sexual relations with other altar boys.
When pushed hard about it, Aaron complains of his head hurting and starts to breathe heavily. At that point Molly ceases the questioning and tries to distract Aaron with something more lighthearted. As she attempts this, Aaron turns into a distinctly different personality. He loses his stutter and loses his innocence. He turns into an angry person with a raised voice and no stutter whatsoever. The second scene involves an angry and frustrated Vail entering the questioning room where Aaron and Molly have been having their sessions.
Vail asks Molly to leave the room and proceeds to corner Aaron about hiding the videotape information from Vail. He was angry that Aaron did not disclose information about the videotape which may have changed how Vail approached defending motive in the case. When he repeatedly barrages Aaron with verbal assaults, Aaron once again turns into the alternative personality that Molly had been exposed to. This alternative personality claims that his name is Roy and he exists to protect Aaron from the Archbishop because Aaron was too weak to defend himself.
Roy claims that he killed the Archbishop because Aaron would never be able to do it and he had to put an end to what Aaron was going through. The third and final scene where this alternative personality is revealed again is in the courtroom. Aaron is in the witness stand and amid intense questioning about the murder from prosecuting attorney Venable, he breaks and exhibits the same aggressive alternative personality. He, as Roy, assaults Venable and tries to hurt her. The police eventually overpower him and the entire ourtroom witnesses the disorder play out right in front of them. The evaluation of this disorder in Aaron by Molly, a neuropsychologist, does not depict the reality of how patient diagnosis is conducted. Additionally, while the one way amnesic relationship between Aaron and Roy is typical of Dissociative Identity Disorder it would not be accurate of defense attorney Vail to conclude that Aaron was pretending to suffer from the disorder just because he could remember a very specific detail of what his subpersonality Roy did.
That is because not all patients exhibit this amnesic relationship. One area where the film does have an accurate portrayal of the disorder is trauma. The origination of Aaron’s subpersonality Roy based on childhood abuse and sexual trauma is correctly depicted in the film. Primal Fear, while it may not portray Dissociative Identity Disorder in absolute clinical correctness, does a reasonably good job in communicating the possible origins, symptoms and patient behavior to the general audience.
It brings forth key facets of the illness such as complete dissociation between the two personalities and amnesia when switching from one personality to another. It strives to invoke sympathetic reactions from viewers due to their awareness of the assailant also being a victim in his own right. References Elzinga, B. M. , Van Dyck, R. , & Spinhoven, P. (1998). Three controversies about dissociative identity disorder. Clinical Psychology & Psychotherapy, 5(1), 13-23. Huntjens, R. C. , Verschuere, B. , & McNally, R. J. (2012).
Inter-Identity Autobiographical Amnesia in Patients with Dissociative Identity Disorder. Plos ONE, 7(7), 1-8. doi:10. 1371/journal. pone. 0040580 Paulette Marie Gillig (2009). Dissociative Identity Disorder: A Controversial Diagnosis. Psychiatry (Edgmont) 2009 March; 6(3): 24–29. ROSS, C. A. , & NESS, L. (2010). Symptom Patterns in Dissociative Identity Disorder Patients and the General Population. Journal Of Trauma & Dissociation, 11(4), 458-468. Guidelines for Treating Dissociative Identity Disorder in Adults, Third Revision: Summary Version. (2011). Journal of Trauma & Dissociation, 12(2), 188-212.