Summary
The movie Flight, directed by Robert Zemeckis and starring Denzel Washington, tells the story of a troubled pilot who is able to miraculously save a plane during a crash landing due to mechanical malfunction. However, in the process of the investigation, despite his brilliance and experience as a pilot, his personal problems and incompetent behaviors begin to emerge. This paper will seek to create a psychiatric evaluation case study of the protagonist Whip Whitaker, diagnose him, and develop a treatment plan.
Patient Profile
Captain Whip Whitaker is an African American male. His age is unknown, estimated to be in his late-30s to mid-40s. His occupation is a full-time airline pilot. Previously, Whitaker was a Navy pilot prior to this. He is consistently under a lot of stress, never settles down. The patient is divorced, with one adolescent son who lives with his mother. He maintains little to no contact with them as they resent him and his behavior.
Patient History and Notable Behaviors
- Family history – one of four children, happy childhood, proficiency in academics and sports through school and college. No reported psychiatric family illnesses. Inspired by his father to become a pilot
- Patient medical history – not known or relevant – seems to be in good health as he is allowed to maintain his pilot license. Issues arise when he is recovering from his bouts of drug and alcohol use.
- Patient psychiatric/mental health history – Mental status is present and alert, of sound mind. No personality disorders or intellectual disabilities. The patient struggles with alcohol and drug addiction. Began drinking beer as an adolescent and continued to drink heavily into his time in the military. When in the military, as a pilot, he was given performance-enhancing stimulants, which started his addiction to drugs, particularly his drug of choice, which is cocaine. Near daily use of cocaine and heavy alcohol. He is a high-functioning alcoholic/drug user.
Notable behavior:
- Uses substances heavily and at inappropriate times, such as knowing he must fly and be on high alert.
- Unable to control or reduce drug use
- Refuses to sober up throughout the film, only succeeding once in jail.
- Highly emotional and erratic when drunk. Their emotional state is aggravated due to general situations in life (divorced, alone, addict) and recent events (trauma from crash landing and losing his friend).
- Seems to have self-destructive tendencies; despite the high potential, he would be declared innocent if he stayed sober, but he gets drunk right before the trial.
- Social history – the patient has trouble developing relationships. He has either failed his previous relationships or uses his current ones for his own benefit. Very few friends. However, he does feel an emotional connection and sincere grief when his friend and lover, Katarina, dies in the crash. His social relationships tend to revolve around common drinking or drug use. People genuinely respect Whitaker, but he has trouble understanding why. He has some impairment in reality testing and communication, with major impairment in areas such as family relations, work, judgment, and mood.
Diagnosis
The primary diagnosis for Captain Whitaker is substance-use disorder. This includes alcohol dependency. Based on DSM-V, Whitaker meets several criteria, including:
- taking substance in large amounts
- unable to reduce or stop use
- cravings and urges to use the substance
- neglecting professional, personal, or home life for substance use
- using substances despite it creating issues with relationships
- using substances despite being put in danger
- needing more of the substance to achieve the effect (built-up tolerance)
- continuing to use despite knowing there is a psychological problem.
DSV 5 allows clinicians to indicate how severe they believe the issue is and the problem that substance use serves in a person’s life. Based on the number of symptoms, Whitaker has a severe substance use disorder (Wu et al., 2017).
Another diagnosis for Whittaker is a major depressive disorder, also known as clinical depression. It is a serious mood disorder where the patient experiences persistent sadness, hopelessness, and loss of interest in everything. Whitaker meets several DSM-5 criteria for depression, including 1) marked diminished interest or pleasure, depressed mood for most of the day, every day, 3) feelings of worthlessness or excessive guilt, 4) diminished ability to think or concentrate (Tolentino & Schmidt, 2018). It is largely believed that substance abuse is the patient’s method of coping with depression. The patient has difficulty coping with trauma and his emotions. The patient struggles with some other minor psychological issues, such as occupational stress, antisocial disorder, and grief, that could be worked around with a therapist.
Treatment Plan
It is recommended that substance use disorder is treated with a multifaceted approach. First sobriety needs to be achieved either through rehabilitation or since Whitaker is in prison, special rooms where the inmate is made comfortable. He is likely to experience severe withdrawal symptoms, but eventually will feel better. Whittaker will need to remain under substance-use monitoring for a considerable time. Medical services may be necessary to help if any issues arise after such sudden changes in the body after daily abuse. Medicative alternatives exist, such as Naltrexone, to avoid recessive behavior. The patient will require mental health services. It is recommended he attends Alcoholics Anonymous (AA) or other group therapy sessions. Finally, Whitaker should begin seeing a psychotherapist at least once weekly, which can begin to apply a highly effective therapy, cognitive-behavioral therapy. This approach is used to treat the addiction by making the patient understand the negative thinking patterns and behaviors that are causing the substance abuse and leading to misery in his life (Kiluk et al., 2018).
As for major depressive disorder, it is necessary to consistently monitor the level of depression and potentially relevant co-morbidities. The patient should begin seeing a counselor or a therapist regularly, with cognitive-behavioral therapy being effective for depression as well. If appropriate, the therapist may prescribe anti-depressants, which are classified as selective serotonin uptake inhibitors. Given the wide range and severity of Whitaker’s issues, this may be the case. The patient should be taught healthy skills on stress management and coping, particularly with emotional pain and grief.
Position Statement
Captain Whip Whitaker is a man who suffers from years of severe substance abuse and addiction. These aspects of behaviors led to the destruction of virtually every other aspect of his life, including relationships and family, his job, and his general happiness suffers from this approach to life. The patient has demonstrated many signs of clinical depression, for which he used alcohol as a coping mechanism. Whitaker should aim to remain sober and retain professional psychotherapeutic help. This film and character were chosen because of their inherent complexity as human beings. Whitaker represents a tragic hero who although good at heart, is making the wrong choices that place himself and others in harm’s way. He lacks a strong social support system, so he acts like he is a ‘lone wolf’ but in the end he achieves a level of understanding and transformation that he must take responsibility for himself and his actions and that ultimately give him the motivation to change.
Conclusion
The protagonist Whip Whitaker from the film Flight represents a broken man who is suffering from alcohol abuse and dependency as well as depression, with anti-social and high-risk behaviors. This paper sought to examine his background and provide diagnoses and a competent treatment plan. The prognosis for Whitaker is expected to be positive if he follows all the recommendations and can recover from his disorder to take control of his life.
References
Kiluk, B. D., Nich, C., Buck, M. B., Devore, K. A., Frankforter, T. L., LaPaglia, D. M., Muvvala, S. B., & Carroll, K. M. (2018). A randomized clinical trial of computerized and clinician-delivered CBT in comparison with standard outpatient treatment for substance use disorders: primary within-treatment and follow-up outcomes. American Journal of Psychiatry, 175(9), 853–863.
Tolentino, J. C., & Schmidt, S. L. (2018). DSM-5 criteria and depression severity: Implications for clinical practice. Frontiers in Psychiatry, 9(450).
Wu, L.-T., McNeely, J., Subramaniam, G. A., Brady, K. T., Sharma, G., VanVeldhuisen, P., Zhu, H., & Schwartz, R. P. (2017). DSM-5 substance use disorders among adult primary care patients: Results from a multisite study. Drug and Alcohol Dependence, 179, 42–46.