The 2001 film, ‘A Beautiful Mind’, tells the story of John Nash, a brilliant mathematical mind and Nobel prize winner in economics who has suffered from schizophrenia throughout his life. The film faithfully portrays the passages of his illness, from the onset to the stage in which he chooses to ignore the hallucinations that will continue to accompany him throughout his life. John Nash was diagnosed at about 30 years of age with paranoid delusional schizophrenia, a mental illness that leads those affected by it to have delusions (recurrent thoughts that do not adhere to reality) and hallucinations (in his case, visual). Both of these symptoms are masterfully described and represented in the film.
Schizophrenia was introduced by the Swiss psychiatrist Eugen Bleuler in 1911, first identified by the German psychiatrist Kraepelin in 1886 under the name ‘early dementia’. The age of onset is between 15 and 45 years, although it usually begins at the end of adolescence. The person with schizophrenia experiences a distortion of thoughts and feelings. What characterizes it is the total damage it causes in the individual, because the person who suffers it can, feel, think and speak differently than before. They tend to isolate themselves, avoid dating, friends, sleep little or too much, speak alone or laugh for no reason through impaired emotional intelligence.
Since childhood, John lived discreetly. Because his only friends were books, it was impossible for him to socialize and share knowledge with people his age. John Nash was an intelligent person, shy and insecure with the world around him, he never shared much with the outside world, he lived in his personal world interested in his studies, and numbers were the only thing that made him feel really secure. In books, he spent most of his time. As John grew older, strange behaviors began to be observed from others, but for him, it was his norm. His internal reality was not the same as the reality of others, but at the same time it was not his reality. His life was being affected by schizophrenia disease. He heard and saw voices that were not real and that were in his mind. They existed as a plane of perception that did not let him differentiate what was truly real and, as a result, a distortion of perception occurred. This caused a non-objective reality for Nash. He had 'imaginary friends' which gave him the friendship that he was unable to obtain with real people. John was able to develop great mathematical intelligence, but emotional intelligence was not an advantage for him, as it was difficult for him to identify what he was experiencing. He did not open up to others, he was a strictly reserved and uncommunicative person. John Nash used oral, written, body language, and internal language; however, the language that he used was not to please his peers, he only used it to express his ideas.
Paranoid schizophrenia is perhaps the best known and prototypical type of schizophrenia of this disorder. It is considered as such that modality of schizophrenia characterized by a predominant presence of positive symptoms, with mainly psychic-type symptoms in which auditory hallucinations and delusions appear. This type of schizophrenia that John Nash presented during his life. Likewise, he was dealing with the type of schizophrenia that causes the least cognitive deterioration (there are generally no negative symptoms) and that usually has the best response to treatment. Generally, it is found that the hallucinations of patients with this disorder are often in the form of third-person voices that speak about the subject and that tend to have a derogatory and threatening content for the subject. These hallucinations and their content are usually persecutory in nature, the patient feeling that something or someone is trying to harm them and being able to trigger fear, anxiety or aggressive reactions. This is seen in John’s fixation on the risk of being killed by Russians, leading him to constantly be weary of others and even so much as an attempt to remove a tracking device from his body. There was clearly presence of delusions and auditory hallucinations without clear alterations in affectivity, language and without showing associated catatonic behavior.
It could be observed that there is disorganized thinking in John, which in turn influenced language and verbal behavior, but only because he was so focused on studying and discovering new theories that he was very self-conscious and little enabled when speaking, consequently he did not clearly express his ideas. In other words, if there is disorganized thinking due to delusion of grandeur, disorganized and incoherent language will be observed. In this case of schizophrenia, John only presents visual, tactile, and auditory hallucinations as he can admit that he sees and interacts with three people: little Marcy, his friend Charles and his boss Parker. The degree of hallucination that Nash presented was complex since his boss Parker threatened him and he even ordered him to get rid of his wife so that he did not interfere with his work as the nation's secret agent. He is also advised by his best friend Charles in innumerable moments, specifically he was manipulated by him on various occasions so that John that he was real again and did not ignore him. It is observed that John Nash experiences tactile hallucinations of complexity (feels simple contacts on his skin) and of activity (he carries out certain contacts, touches non-existent objects) because it could be seen, in an addition to the hugs that John received from little Marcy and his best friend Charles, and to whom he corresponded.
As for treatment, I would only be recommended to continue with the pharmacological treatment, perhaps some not so strong (avoid insulin shock therapy entirely), to be able to work therapeutically with John. An analytically oriented therapy, perhaps specifically Kleinian oriented, would be helpful in this case. It will seek to locate the patient in reality, show him those aspects of reality that he does not know, and help him integrate them, since they are dissociated from him. An attempt should be made to avoid the generation of anxiety with constant interpretations, which could intensify John’s already apparent regression. The therapeutic approach should focus on the progression and integration of factors dissociated from John’s reality. Show him the healthy and sick aspects, ‘good’ and ‘bad’, that will help him to organize his personality after integrating them. The analyst must seek to place himself as an anchor based in reality in which John can find his return to reality. The analyst should work with any healthy part of the patient's self, however small it may be. In summary, the analyst must first maintain contact with John, to then be able to continue with the analysis, never losing contact with him. Gradually integrating it into society would be useful after a long time in treatment.
The schizophrenic disorder of John Nash appeared when he started his tertiary education, where little by little due to stress, his shyness and the pressure he was exposing himself to for his thesis, led him to have a mental crisis of great amplitude. The delusions that this mathematical genius had of certain matters of daily life allowed him, on the one hand, to find important hidden relationships in things, but on the other hand, this same ability made him lose his ability to distinguish between the real and the imaginary, as a result of paranoid schizophrenia.