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FONTS

Case Study of Melvin Udall in

"As Good As It Gets"

Behavior Issues

Possible Diagnosis

Lacks

Social Skills

Struggles

to form

relationships

Obsessive Compulsive Disorder

Obsessive Compulsive Personality Disorder

Narcissistic Personality Disorder

Anxiety Disorder

Displays

symptoms

of OCD behavior

Confirmation of Symptoms

Movie Summary.

Acknowledgement

Melvin's need for order and routine interferes with his daily life.

Throughout the film Melvin recognizes that his behaviors are excessive and interfere with his daily functioning.

Melvin's History

Who is Melvin?

Example:

Melvin is so desperate to have Carol serve him at the restaraunt that he pays a private doctor to look after her son so that she will be able to return to work. This illustrates the severity of his disorder and his need for repetition and consistency.

Family History

  • His OCD and tendency to isolate himself might be genetic.
  • He tells Carol and Simon that "his father didn't come out of his room for 11 years, he used to hit me on the hands with a yardstick if I made a mistake playing the piano."

Character Traits

Homophobic

Anti-Semitic

Lacks Empathy

Rude

Insensitive

Self-centered

Demanding

Narcissistic

Identifying Information

50's

Never married

Successful career as a writer

Lives alone

Cares for self

Doesn't let others in

Appears to be financially stable

  • He acknowledges that pills could help him but refuses to take them anyway.
  • He tells the dog, "Don't be like me."
  • He shows distress when he fails to abstain from locking and unlocking the door.

Treatment History

  • The onset of OCD is unknown
  • He was previously diagnosed with OCD by Dr. Green. However he discontinued treatment likely due to the cracked sidewalk outside of the office.
  • Refused to take prescribed medication until he met Carol.

Presenting Problems

-Complains of being tired

-Complains that his head is not clear

-Complains that he doesn't feel like himself

In the film As Good As It Gets, Melvin Udall, played by Jack Nicholson,

is a successful writer who has been diagnosed with obsessive-compulsive disorder.

He is irritable, racist, anti-Semitic, homophobic, and generally

lacking in social skills. He is markedly anxious when there is a change to

his routine and he is unable to eat unless he goes to the same restaurant

each day where he sits at the same table and is served by Carol, played by

Helen Hunt. Carol seems to be the only person who can tolerate Melvin’s

rude behavior. One morning, Carol stops coming to work so that she can

take care of her sick son. Melvin is so desperate to have her at the

restaurant that he pays to have a private doctor look after her son so

that she will be able to return to work. Meanwhile Melvin’s gay, art

dealing neighbor Simon gets beat up and Melvin is forced to care

of his dog Verdel. Up until this point, no one has ever entered

Melvin’s apartment. It is through his relationships with

Carol, Simon, and even the dog, that Melvin starts

to see the importance of relationships

and he begins working towards

curing his disorder.

Melvin's Obsessions and Compulsions

Movie Clip

(WARNING CUSS WORD DISCLAIMER)

The clip portrays two scenes from the film. In the first scene Melvin is trying to refrain from his compulsion of locking the door five times. He is unable to do so and is visibly upset, anxious and stressed.

  • Fear of contamination (O)
  • locks and unlocks door 5 times and turns light switch on and off 5 times. (Checking compulsion)
  • Repetively washes hands with extremely hot water with multiple bars of soap each wash. (Cleanliness compulsion)
  • Brings new wrapped plastic silverware to restaraunts.
  • Shows signs of distress when someone comes close to touching him
  • Wears gloves to avoid touching things. (neighbors dog, cab doors, steering wheel.)
  • Avoids cracks on sidewalk
  • No one is allowed to enter his apartment.
  • Needs order when packing clothes.

Suggested Treatment Plan

In the second scene we see Melvin's lack of social skills as he makes a rude comment and is completely oblivious.

Cognitive Behavior Therapy

  • Therapists are able to identify and modify the intrusive false beliefs that cause anxiety.
  • Changing cognitions leads to an increase in self-efficacy in resisting the ritual.
  • Adding CBT for a patient who already takes medicine helps prevent relapse once the medication is discontinued.
  • This type of therapy can systematically modify the metabolic activity of the brain in the areas that are responsible for OCD tendencies.

Sources

Anxiety Disorders Association of America (n.d.). Obsessive-compulsive disorder (OCD). http://www.adaa.org/

Justin Eckles (2008, February 20). Clips from As Good as It Gets. April 18, 2016, from YouTube

Vorvick, L. J. (2010, February 11). Obsessive-compulsive disorder.

http://www.nlm.nih.gov/medlineplus/ency/article/000929.htm

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