What about Bob Thesis

Abstract

The film unravels the synopsis of the events involving disorders encountered in the psychology. Abnormal psychology is the main area of interest. Bob Wiley (Bob Murray) herein described as a reclusive patient of a hedonic psychiatrist Dr. Leo Marvin (Richard Dreyfuss), is referred from his former doctor who fails to diagnose him of any health related condition.

Frantic, emotional disorders in Bob extremely annoy the psychiatrist, contrary; this is fun for Marvin’s family. He is afraid of leaving his apartment, shaking hands, using elevators, touching doorknobs, riding buses and darkness. He is a troubled patient who seems to fear anything and everything. To his newly referred doctor, Bob feels relieved. He strongly believes Dr. Marvin would help him.

When the good doctor took his family on Long vacation in New Hampshire, he was apparently running away from his patient. Bob is afraid of being alone. The patient manages to outwit the telephone operator in tracking down Marvin’s where-about.

There is a revelation of emotional disconnection within the doctor’s family; his relationship with Fay, his wife, is also disconnected. This is because Leo is a parent with rigid rules and little flexibility. Bob brings closeness and flexibility to this family, which Dr. Marvin resents but the family loves it. As the events unfold in the movie, the misadventure of Bob becomes therapeutic for him progressively.

However, this also results into nervous breakdown of Dr. Marvin majorly because of the shift of attention to Bob by his (Dr. Marvin’s) family. Bob seems to have a lot of trust in his new therapist, who turns out to be mean.

On realizing he is going to lose his family members to his patient, Bob, due to his comic and wittiness which is contrary to his dullness; Dr. Marvin plans to kill his patient instead. Bob views the murder attempt on his life as a symbol of “Death Therapy” exercise by Dr. Marvin arising from faith he has in his doctor.

Throughout the comic movie are the predicaments of the two characters: Dr. Marvin and his patient, Bob. Ironically, Dr. Marvin, a psychiatrist of Bob turns out to be a victim of psychological disorders in need of psychotherapy as the psychological conditions of Bob improves progressively.

Bob Wiley

DSM-IV-TR Diagnosis based on all five axes

In the movie “What About Bob” the character Bob is portrayed as having many mental disorders. However, on taking a keen observation of his behavior, it becomes apparent that he has a single disorder that replicates itself in many forms.

DSM-IV diagnosis reveals that Bob suffers from the following classification of mental disorders: General Anxiety Disorder (G.A.D), Panic Disorder, Agoraphobia, Panic Attack, Factitious Disorder, Specific Phobia and Histrionic Personality Disorder. Under General Anxiety Disorder classification, the character Bob portrays excessive anxiety and worry about many activities (Michelle, 1987).

As an illustration, Bob portrays his anxiety through his fear of contacting things and people arising from his specific phobia to diseases and germs. This is also seen is his fear of leaving his premises and boarding a bus as a means of transport. Secondly, Bob’s worry and anxiety is portrayed in his fear of using an elevator as seen at the beginning of the movie.

He knows he must use the staircase; this leaves him in a bad state of uneasy. Thirdly, Bob’s general anxiety is portrayed in his behavior of restlessness. Other symptoms of Bob’s general anxiety which are not apparent but deeply expressed indirectly in his behavior include: irritability, sleeplessness and muscle tension. This general anxiety distress significantly affects Bob’s self-perception, actions and his interaction with people.

Important to note is that: In this case, one would forgo the diagnosis of G.A.D. in deference to that of phobia (although, as many “phobias” as Bob appeared to have, I would not rest there, either). Bob’s anxiety mainly stems from his specific phobia. Under classification of Specific phobia, Bob is portrayed as a person with many psychological disorders which makes him afraid of virtually everything.

This is seen in Bob’s first encounter with Dr. Marvin where he told his doctor that he has worries about diseases and touching things. Bob’s description of worry highlights his specific phobia which in this case is the fear of diseases and germs. Other examples of Bob’s specific phobia are seen in his constant use of Kleenex when touching things and disinfectants on telephones and other public utilities throughout the movie.

Other highlights of Bob’s specific phobia are portrayed in his fear of using elevators: He opts for a climb of 44 flight stairs instead of using an elevator. His specific phobia is also portrayed in his fear of heights as seen in his fright when he looks out of 44^th floor window, fear of using buses as a means of transport as seen in his difficulty boarding a bus.

Finally, Bob’s specific phobia is expressed in his fear of water, thunderstorm and darkness. Under Agoraphobia classification, Bob is portrayed as a person with excessive anxiety when under occasions or situations in which there is difficulty in escape or lack of help in the face of panic.

This fear is evident in his description to Dr. Marvin in which he says that he’s much afraid of his heart stopping beating or his bladder might burst when he is looking for a washroom and cannot find one. This anxiety is also expressed in his fear of public utilities such as elevators.

Because Bob cannot avoid the public entirely, he is compelled to endure these situations with excessive distress as seen in his difficulty in using a bus for transport. The agoraphobic disorder of Bob is described as “classic” and it alludes to the difficulties he experiences when there is need to leave his apartments for public places and working outside his apartments. He goes ahead to describe public places as being impossible to Dr. Marvin.

He also tells him that he has fear when out there in public that his bladder might burst while looking for a washroom to no avail. Bob’s Agoraphobic disorder makes him describe his going out as a trigger of dizziness, hot sweats, involuntary trembling, cold sweats and fever blisters among others.

Concerning Panic Attack; Bob does not just display four of the symptoms of panic he claims to experience all of the systems. It is also true that Panic Disorder engulfs him; Bob states that his being out in public triggers recurrent panic attacks and he is persistently concerned about it when out in public. Finally, Bob is classified as having Factitious Disorder.

Bob does intentionally feign the signs and symptoms of Tourette’s syndrome and cardiac arrest in the doctor’s office. Again he is motivated by his pattern of apparently feigning disease or disorder that makes him assume the sick role. We later on realize that the incentive for his behavior is not economic or external.

Bob Wiley portrays symptoms of the afore-mentioned disorders throughout the movie and yet contradicts himself more often than not. He has a specific phobia of diseases and germs and yet still is willing to drop off to the cement of a New York City sidewalk when a garbage track drives past him.

He is also described as a person who is more than willing to see his doctor which is contrary to his fear of public places and things that make him come into contact with diseases and germs. In fact, he is said to enjoy seeing his doctor.

These contradictions as well as various statements which are in contrast with Bob’s psychological disorders has triggered my believe that Bob suffered from another disorder, one that produced and/or sustained the existence of the other disorders.

After consulting a book listing all the Axes of the DSM-IV, I have come to a conclusion that what Bob really suffered from was histrionic personality disorder; a personality disorder is a condition in which an individual displays a pattern of excessive emotions and attention seeking (Bornstein, 1999).

This condition is not only expressed through his other disorders but also through his exaggerated sounds, actions, and facial expressions used to call attention.

Other diagnoses based on DMS were; Axis I (code: 300.21) – which is agoraphobic disorder accompanied by a collection of specific phobias, Axis II (code: 301.6) –which depends on personality disorder and has a characteristic acute separation anxiety, Axis III (code: 300.09) –which is based on what is not known, Axis IV (code: V62.89) –which depends on lives alone, and Avis V-which focuses on global assessment of functioning.

Axis I (code: 300.21), agoraphobia is manifested by a remarkable worry while in situations where there is difficulty to escape or no realistic hope for safety in the face of panic-like occurrences (Burns, 1999).

Axis II (code: 301.6) which majorly depends on an individual’s personality expounds on personality disorder of Bob Wiley. Bob Wiley is a victim of dependent personality disorder which is evidenced by his acute separation anxiety. Bob’s dependent personality is portrayed in our guided -believe that the dependence of Bob on his previous therapist drove that therapist out of practice.

Bob expresses his dependence on Dr. Marvin when he fabricates stories; he plays an impersonate-sister to Dr. Marvin, and fakes his death to find out the where-about of Dr. Marvin’s vacation. All the afore-mentioned actions are characteristic of DSM-IV deviation in normal control of impulses and inter-personal functioning.

Bob portrays his acute separation anxiety arising from his dependent personality when he lies in bed panic-stricken when he begins looking for his doctor (Dr. Marvin).Axis III (code: 300.09) is about conditions which we are not familiar with. As an illustration; when Bob talks of faking illness; we do not have an establishment whether he has any.

Axis IV (code: V62.89) is all about psychosocial and environmental factors around a patient. In the movie there is no mention of any matter arising from this area. However, we can make an inference that Bob’s loneliness has an effect on his mental status having divorced his wife. Finally Axis V (code: 300.23) which gives a rating of psychological, social and functional adaptability of a patient.

Throughout the movie, Bob portrays a range of symptoms which shows that he has psycho-social difficulties in coping with life. He is seen as a person who is afraid of almost everything more so the public domain but he has to cope with it since it is unavoidable. Functionally, Bob is unable to undertake his chores in life normally because he is afraid of even leaving his house.

He says that he fears the public because his heart might stop beating and his bladder might burst when looking for a washing room while out in public to no avail.

Socially, Bob is extremely impaired in that he is fearful of coming out of his house and making contacts with other people because of fear of germs and diseases and psychologically, Bob is portrayed in the movie as a patient with many psychological disorders including General Anxiety Disorder (G.A.D), Panic Disorder, Agoraphobia, Panic Attack, Factitious Disorder, Specific Phobia and Histrionic Personality Disorder.

Within the movie a number of treatments were used on Bob. The use of pills and extensive knowledge of them represents his frequent biological treatment. In the beginning of the movie, Bob describes his feelings as good, wonderful and great to highlight his state of mind as a response to a form of cognitive therapy (Rupke, Blecke, & Renfrow, 2006).

The main therapy focused on the use of what is described as Baby Steps which is a form of cognitive therapy or possibly systematic desensitization-like. Bob learned a way of thinking in a smaller perspective. Bob had also been exposed to psychodynamic therapy when he displayed his knowledge and use of free association towards the end of the movie when he was on his way to the mental hospital with the doctor.

The underlying fear of what the best therapy could be leads me to another perspective of thinking that the death therapy which was performed by Dr. Marvin on Bob was the real cure of Bob as far as behavioral model is concerned. This is perhaps true because Bob in this case was not exposed to his normal fears beyond his mastery but to real death threat.

His living alone pre-empties his lonely life; he has no family relation to turn to for love and emotional attachment (Rupke, Blecke, & Renfrow, 2006). Thus, involving him in a world of people may provide him with a meaningful emotional supportive and consequently reduce his craving for attention and eventual extinction of other disorders arising from his histrionic personality disorder.

Throughout the move, Bob’s behavior does not seem to possess any threat to his own life and others and as a result there in no point of reporting his case to a legal institution by the therapist. His behavior is characterized by a remarkable fear of the world around him throughout the movie.

However, from his dealing with Dr. Marvin, his behavior are portrayed as annoying and as a result, his therapist should uphold professional code of ethics to overlook his behavior and instead concentrate on administering therapy on the patient.

Dr Leo Marvin

In the very beginning of the movie he is always positive with Bob telling him that there is always hope for him to get better. He is also assertive because he not only tries to help Bob, but he gives him ways to try and help himself. Throughout the rest of the movie, Dr. Martin becomes aggressive towards Bob. When Bob continues to call and follow him, he gets mad and has a plan to get rid of his him.

On realizing Bob has become too much of a bother he takes him to a mental hospital. Also at Dr. Marvin’s birthday party Bob shows up. Displeased with the presence of Bob, Dr. Marvin becomes greatly angered and takes a negative path or mechanism to address his own anger: The mechanism involves the following three ways: denial, displacement and projection.

In addressing denial Dr. Marvin who is seen throughout the movie as envious and jealous of Bob’s credit and attention from his (Dr. Marvin’s) family refuses to admit his feelings. Bob is seen to gain attention from Dr. Marvin’s family for being sensitive and a good listener, qualities which said to be lacking in Dr. Marvin (LeMaistre, 1985). This makes Dr. Marvin to feel that his patient is taking over his credit.

Projection is the second coping mechanism that Dr. Marvin takes. Projection involves blaming another person for one’s faults. In the movie, Dr. Marvin easily gets angered with Bob and as a result projects his anger in Bob forgetting that he is a patient who needs his medical attention and not blames for what wrongs are going on in Dr. Marvin’s life.

For example, blaming Bob for not taking a good posture in the Good Morning America’s camera and his family affairs. The third defensive mechanism of Dr. Marvin is displacement. In displacement an individual transfers emotions from the original source to the other.

In this case Dr. Marvin who is a psychiatrist becomes unable to manage his anger and instead decides to project it to Bob and his own family. He shouts at Bob constantly throughout the movie and this way, he displaces his anger to Bob.

DSM-IV-TR Diagnosis for Dr. Marvin based on all five axes

Dr. Leo Marvin can be addressed as whole person based on these perspectives. In axis I (code: 300.1), he features principal disorders like panic disorders, his fears are illustrated at his initial interview with Bob, and he anxiously plans to leave his patient for a long vacation.

His attempt to convince Bob to return home and leave him and the family in peace until the vacation is over turns in vain; this worsens his condition and tends to be instrumental in his nervous breakdown. His generalized anxiety disorder is evident when he responds excessively to Bob on several occasions to make him leave the vacation camp to no avail.

He cannot control his emotions on realizing his family members like Bob much than they take notice of him. He has social anxiety disorder, the fear of losing control of his family and incorporating Bob into the family. Some specific disorders are also true, he fear resuming therapy to his new patient and plans hurriedly to leave for a long vacation after the first consultation, he also fears incorporating his patient to the family member.

He also develops fear of imagining being abandoned for Bob who is warmly accepted by the entire members. Axis II (code:301.83) , the doctor is suffering from a number of personal disorders, borderline personal disorder makes him develop paranoid thoughts, he develops intense anger against Bob, on realizing the patient may be trying to “cause him harm” to his family members.

He subsequently, on realizing that Bob is fondly accepted by them, develop an intense fear of being abandoned by his loved ones and therefore attempts to avoid the reality of imagining abandonment. This disorder lures him to engage in risky and impulsive behavior of wanting to kill Bob, this later on leads to his self -destruction (house explodes).

He also suffers from histrionic personal disorder, his self- centeredness does not allow him stare the family taking more notice of Bob. He is not ready to neither apologize nor invite Bob for supper. He quickly shifts from emotions and being overly sensitive to criticism from his wife about Bob.

He also suffers dependence personal disorder, his relationship with children and wife is not fatherly, the family member sees him as passive, he has problems in expressing disagreements with the members about Bob. Obsessive compulsive personal disorder is also evident, his rigid behaviors in expediting his thoughts, being inflexible to change and stern measures he imposes on the family as well as Bob alludes to this.

No axis III diagnosed. According to axes IV (code: 309.9), the good doctor has mild symptoms; he lacks adequate family support because they view him as mean and self-centered, he does not want any of family to get close with Bob, his patient.

Other psychosocial issues emanates within the family more so with the wife, theirs is a ‘broken relationship’ he does not rise up to their expectation, he is not comic, always stern and stubborn. Lastly, Axis V (code: 297.1) rates Dr. Marvin as a person with appreciable difficulties in coping with life both psychosocially and functionally.

In the movie, Dr. Marvin is portrayed as jealous and envious of the good reputation of his patient. When his wife comments Bob as sensitive and attentive (good listener), Dr. Marvin becomes envious of Bob because he lacks the reputation and pushed to the extreme with jealousy and envy, he plots to administer death therapy on Bob.

This attribute of Dr. Marvin impairs him from doing his work normally and instead plots to kill his own patient. Socially, Dr. Marvin is unable to socialize with his family because of his strictness and insensitivity.

This makes his family to turn to Bob, an act which makes the doctor to feel alienated from his own family and starts blaming his patient, Bob for it.Psychologically, Dr. Marvin is portrayed in the movie as a patient of many psychological disorders as compared to Bob, his patient.

He is unable to accommodate his patient and instead plots to kill him. Dr. Marvin is unable to control his anxiety and choses to displace and project it to his family and Bob. He blames Bob for what goes wrong in his life.

Talk therapy and psychotherapy would certainly suit well for this good doctor, though according to Michelle (1987), Behavioral and Cognitive Therapy (BCT) could prove to be the best instrument in allowing the Psychiatrist to develop new coping skills, way of thinking and healthy behavior towards his patient and family members (Michelle, 1987).

Dr. Marvin is a patient that possesses a threat to others. This is seen in his attempt to administer death therapy to Bob and the way he projects his predicaments onto his family and Bob as well. It is important that such behavior of Dr. Marvin be made known to an established legal system so that incase it rises to endanger people around him, the therapist is not to blame.

When handling a patient of such a nature, it is important that a therapist adhere to the highest code of ethics and overlook the patient’s utterances which might not be good and concentrate on administering effective treatment to the patient.

In conclusion, the movie What About Bob is more than what appears on the surface as a dealing between Bob Wiley as a patient and Dr. Marvin as his psychotherapist. It is a complex comic which in the beginning presents Bob as a troubled patient with many Psycho-social disorders.

However, as the events unfold, it turns out that Dr. Marvin becomes a much threatened psycho-social patient as the condition of Bob Wiley improves progressively. This majorly arises from his involvements with Bob. It may be thought out that Bob’s progressive improvement results into emotional depreciation of his doctor, Dr. Marvin.

References

Bornstein, R. (1999). Histrionic personality Disorder. Journal of psychopathology and Behavioral Assessment, 21(1), 79-94.

Burns, D.D. (1999). Feeling Good:The New Mood Therapy. New York: Harper.

LeMaistre, D.J. (1985). After The Diagnosis. Cognitive behavior, 45(5), 12-17.

Michelle, F.S.A. (1987). Cognitive Bevavioral Therapy for Treatment of Generalised Anxiety Disorder. New Strategies for combining mindfulness with integrative Cognitive Behavior, 10943(1), 19-42.

Rupke, S.J., Blecke, D., & Renfrow, M. (2006). American Family Physician. Cognitive Therapy for Depression, 73(1), 83-86.