Analyzing Oliver Queen (Arrow, Season 1)

PSYCHOLOGICAL REPORT

Name: Oliver Jonas Queen
Date of Birth: May 16, 1985
Ethnicity/Race: White
Occupation: Billionaire
Date of Initial Interview: October 10, 2012
Date of Report: April 4, 2017
Therapists: Brandon Saxton, M.S., Katie Gordon, Ph.D.

Presenting Problem:
Oliver was referred by his mother, Moira Queen, for a diagnostic assessment following his return from a deserted island. Oliver was previously presumed dead. In actuality, he was the sole survivor of the sinking of his family yacht, The Queen’s Gambit. He reported living alone on the island for five years before being rescued.

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Family History:
Oliver has one remaining parent and one sister. His father, Robert Queen, was on the yacht when it sunk. Oliver reported that he did not see his father die, but solemnly stated that he, Oliver, had to have been the only one to survive. His mother, Moira, took over the operations of Queen Consolidated after his father passed away. Oliver reported that he is very close to his sister, Thea (or Speedy, as he likes to call her). He reported having some regrets about the type of role model he was to her before the island and wanted to do better for her now.

Educational/Employment History:
Oliver reported never having a job, instead relying on his family’s fortune to make his way. He attended some college. He said that he only went because he was expected to. Beyond that, he reported that his primary goal had been making friends and partying to the extent that the only book he read during all of college was The Odyssey. It was not clear whether he actually completed his studies and received a degree.

Psychiatric/Medical History:
Oliver has no documented psychiatric or serious medical history. However, it should be noted that medical reports indicate that his body is covered with scar tissue following his return from the island. At this time, it is unclear how this scar tissue was obtained. Oliver’s primary care physician indicated that Oliver claimed the injuries happened while attempting to survive. However, the report indicates the injuries are more consistent with weapon or combat trauma. Further assessment may reveal further events that happened on the island.

Assessment & Diagnostic Impressions
All assessment and diagnostic information was collected with Oliver one month after his return from the island (i.e., at the beginning of season one of Arrow). It should be noted that we felt Mr. Queen was not being completely forthright with us during the diagnostic interview. We offer this assessment based on the information we have. As treatment continues, we suspect that what Oliver is willing to report about his time on the island may change (What we are subtly saying is, if you like this post, let us know! We will turn it into a series covering each season!).

Treatment Recommendations
In light of the limited information revealed by Oliver Queen, it is difficulty to conclusively identify the source of his problems. Further assessment should be conducted in order to understand the impact that his time on the island and loss of his father had on him. We recommend that a patient approach is taken, such that the therapists can build a sense of trust and rapport with Oliver over time. Perhaps once Oliver feels more trust in the therapists, we can gain a more precise understanding of the issues he is facing and plan treatment accordingly.

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THE GORDON/SAXTON TEST


1. Was the portrayal of mental illness accurate?
At this point, there is not enough information to determine whether there is a mental illness, accurate or not.

2. Was the character struggling with mental health issues depicted with compassion?
Oliver Queen is an intriguing character because he is depicted as pretty despicable prior to his time on the island. However, when he returns, he has changed so significantly that it’s hard to not feel compassion for the struggles he’s suffered through.
We are also thrilled that the actor who plays Oliver Queen, Stephen Amell, has raised funds and awareness for mental health issues.

Overall rating:
On a scale of what’s a quiver? to master archer, we rate this depiction as……to be determined as the evaluation of Oliver Queen continues in future seasons!

Ridin’ along with “Mad” Max Rockatansky

PSYCHOLOGICAL REPORT

Name: “Mad” Max Rockatansky
Date of Birth: Pre-nuclear apocalypse
Occupation: MFP Pursuit Officer (former)
Road Warrior (current)
Date of Initial Interview: 05/5/2015
Date of Report: 02/01/2017
Therapists: Brandon Saxton, M.S., Katie Gordon, Ph.D.

NOTE: Some information in this report contains chronological gaps and inconsistencies. This information was collected via diagnostic interview (i.e., watching the films, playing the game, and reading the graphic novel) while roaring through the wasteland in Max’s V8 Interceptor: Pursuit Special being pursued by raiders from Gastown. This made for a difficult intake session…

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Presenting Problem:
Max was self-referred to therapy with the goal of reducing his distress levels. After the loss of his family and some other traumatic experiences, Max reported having intrusive thoughts and flashbacks that interfered with his everyday functioning.

Family History:
Max did not disclose much about about his childhood. He mostly responded with grunts when asked about it. In his previous position as a police officer, Max was a highly-skilled driver who often engaged criminals in high-speed chases on the open road. Realizing that he was losing himself in his work, Max retired and moved to the country with his family. Unfortunately, his past followed him. A gang leader took revenge on Max by killing his wife and son in front of him, and he was reduced to a shell of his former self. As a result, he left his life completely behind and became a road warrior in the wasteland.

Occupational History:
Max commandeered the V8 Interceptor: Pursuit Special and his old police gear. He was able to locate and take revenge on each of the gang members who took his family from him. For three years after, Max traveled the wasteland with a dog aptly named Dog. Max moved into his car, which was heavily modified for long distance travel. While scavenging, Max was nearly ambushed by a gyrocopter pilot. Turning the ambush around, Max forced the pilot to bring him to a nearby compound where he could obtain fuel.

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Once there, Max saved people who were under attack with the hope of being rewarded with fuel. Instead, they detained Max and his car. Eventually, Max made a deal with their leader, offering to retrieve a vehicle that they could use to transport gasoline away from the compound in exchange for his car and fuel. After delivering on his end of the deal, Max left the compound. However, he did not make it very far before being run down by Lord Humongous’s gang. Fortunately, he was saved by the gyrocopter pilot. After being nursed back to health, Max agreed to help the people in the compound escape with gasoline. He lead the escape in the tanker. It was then that Max learned that the tanker was filled with sand, and that it was all a ruse to get the hidden fuel away in smaller vehicles.

Many years later, Max was still wandering the wasteland and found his way to Bartertown. Max was forced into entering the Thunderdome, Bartertown’s gladiatorial arena, where he was pitted against Master Blaster. Max was could not bring himself to kill his opponent, who was an innocent man with a disability.

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Because he did not kill Master, Max had to “face the Wheel.” With the Wheel of Fortune deciding his fate, Max was sent into the wasteland to die. Max was saved by a tribe of young children who believed he was their hero of prophecy. Max returned to Bartertown to find Master,  who he believed could help the children. He fled Bartertown with Master in tow, which lead to a terrible road war. Eventually, Master and the tribe of children escaped.

Some time following these events, Max was again run off the road and taken captive. This time, Immortan Joe and his war boys took Max to use him as a “blood bag.” Finding his blood being drained while strapped to the front of a car racing across the dessert, Max was able to escape while the war boys pursued Furiosa, one of Immortan Joe’s Imperators.

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Max joined with Furiosa who was fleeing the warlord dictator, Immortan Joe, with his Wives. Max and Furiosa were ultimately able to escape with the Wives and find Furiosa’s old clan. Furiosa learned that The Green Place that she had been seeking was no longer there. Furiosa decided to take everyone and flee across the wasteland instead. Max, with his own supplies, went in the opposite direction.

Then, Max experienced a flashback of a young girl. This prompted him to go back to Furiosa and her group. He believed that their best bet for a safe home was to take the Citadel from Immortan Joe while his forces were out pursuing them. After yet another destructive road war, Max, Furiosa, and the rest were able to defeat Immortan Joe and his army. They returned to the Citadel as heroes and liberators. However, Max left them behind to continue his life alone.

Psychiatric/Medical History:
Max denied any history of psychiatric treatment. With regard to medical history, Max suffered an injury after being shot in the leg and subsequently wore a leg brace.

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Assessment & Diagnostic Impressions
Max’s symptoms appear to be best captured by a diagnosis of post-traumatic stress disorder (PTSD), as defined by the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition.

As detailed previously, Max has experienced a variety of traumatic events (defined by the DSM-5 as exposure to actual or threatened death, serious injury, or sexual violence). Max’s symptoms primarily seem to be related to the people he has been unable to save throughout his life. For example, Max appears to experience multiple intrusive symptoms in Mad Max: Fury Road. These flashbacks consist of a young girl asking Max for help. They appear to be very distressing. Beyond that, Max also appears to engage in avoidance of situations that remind him of the traumatic events. Specifically, after losing his family, Max is seen refusing to get close to others again and again. This is particularly worth mentioning as solitude in the wasteland almost always means death. Additionally, following the loss of his family, Max appears to have negative changes to his thoughts and moods. He goes from being a light-hearted, family man to a dark killer. His life goal becomes revenge. Additionally, Max appears to have suffered from changes in his arousal and reactivity (e.g., irritable mood, angry outbursts, etc.). Max is always on alert for danger. He rarely falls into a trap (such as the one set by the gyrocopter pilot) and is usually on edge.

Treatment Recommendations
In summary, Max appears to meet full diagnostic criteria for PTSD. Fortunately, evidence-based treatments are available. Such treatments include therapist-guided processing of traumas (e.g., Cognitive Processing Therapy, Prolonged Exposure) and decreasing unhealthy behavioral patterns without focusing directly on the trauma (e.g., Present-Centered Therapy).

THE GORDON/SAXTON TEST

  1. Was the portrayal of mental illness accurate?
    The changes that Max undergoes after losing his family do appear to be within the realm of possibility for someone experiencing such trauma. Max loses his sense of his former self, exhibits extreme negative affect, avoids getting close to others, and experiences many reminders of those he has lost.
  2. Was the character struggling with mental health issues depicted with compassion?
    Overall, Max was not written specifically to depict mental health issues. That being said, he does appear to be a character who, despite intense trauma, is able to rise above and help those in need. Additionally, Max refuses to harm Blaster, of Master Blaster, while battling in the Thunderdome, as Blaster appears to have a developmental disability. So, not only is Max depicted with some compassion, he also displays some. Nice work, George Miller.

Overall rating:
Overall, we rate Mad Max as SHINY AND CHROME! That is, totally awesome. Max is a complex character. He is continually seen trying to shun connections with others, often acting as if he only cares about his own safety and survival. Despite this, he always ends up being guided by his moral compass. Time and time again, we see Max come to the aid of those in need, never able to completely turn away.

Killing Time with Kelly Kapoor

PSYCHOLOGICAL REPORT

Name: Kelly R. Kapoor
Date of Birth: February 5, 1980
Education: High school diploma
Employment: Customer Service Representative, Dunder Mifflin, Scranton (current)
Date of Initial Interview: March 24, 2010
Date of Report: May 16, 2013
Therapists: Katie Gordon, Ph.D., Brandon Saxton, M.S.

Presenting Problem
Kelly Kapoor presented as a 30-year-old woman who was referred for treatment by her on-again/off-again romantic partner, Ryan Howard. Ryan was not very friendly or clear about why he was dropping Kelly off at our office. He kind of just ushered her in, while she was speaking to him rapidly about the latest pop culture drama, and then quickly left the building.

History
Listen; to whoever reads this report, we’ll be honest. It was very hard for us to get any relevant history from Kelly during this interview…we learned that she has three living sisters and one who passed away. She also mentioned that she spent a year in a juvenile detention center for stealing her ex-boyfriend’s father’s boat.

The rest of the interview covered an incredible range of information on various celebrities’ lives. At one point, after asking more about her life, she explained that she had so much to tell us about and then proceeded to report that Brad Pitt and Angelina Jolie had a baby that they named Shiloh. We reiterated our question asking for more information about her life, and she replied that she had just told us more. This example is representative of what the entire interview was like.

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Diagnostic Impressions
All assessment information was gleaned from behavioral observations (i.e., watching The Office more times than one would think is humanly possible – like, probably thousands of times between the two of us). It appeared that Kelly’s presenting problem was best captured by a diagnosis of histrionic personality disorder, which is “a pervasive pattern of excessive emotionality and attention-seeking.” Specifically, she met criteria for 5 of 8 symptoms of histrionic personality disorder: 1) is uncomfortable in situations in which he or she is not the center of attention (e.g., Kelly’s new year’s resolution was “to get more attention by any means necessary”); 2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior (e.g., she asked a co-worker if she should seduce her new boss, Charles Miner, shortly after meeting him; she started a musical duo with co-worker, Erin, that is ironically called Subtle Sexuality); 3) shows self-dramatization, theatricality, and exaggerated expression of emotion (e.g., in an effort to get her ex-boyfriend and boss, Ryan, to pay attention to her, she asks him, “How dare you?” in the middle of a work meeting that he is conducting and also faked a pregnancy, when deciding between getting back together with Ryan and staying with her boyfriend Ravi, she said, “Ravi makes me incredibly happy. And Ryan puts me through so much drama. So, I guess I just have to decide which of those is more important to me”); 4) is suggestible (i.e., is easily influenced by others or circumstances; e.g., Dwight convinces Kelly to apply for an executive training program to suit his own needs, describing her as a “malleable simpleton who can be bought for a few fashion magazines”); and 5) considers relationships to be more intimate than they actually are (she overestimates the strength of her romantic relationships with Ryan and Darryl, as well as the strength of her friendship with Pam – e.g., she asks Pam if she can be her bridesmaid).

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Treatment Recommendations
Currently, there are not any well-established treatments for histrionic personality disorder that have been tested in large randomized clinical trials. Approaches that have been used effectively include cognitive therapy focused on thoughts and behaviors that emphasize assertiveness and sharing attention with others over theatricality and self-centeredness in interpersonal interactions.

Status at Termination
The last we saw of Kelly was at Dwight and Angela’s wedding. Ryan intentionally induced an allergic reaction in his child, so that Kelly’s husband, Ravi (a pediatrician), would focus on the child’s medical needs, while Kelly and Ryan ran off together. Needless to say, this does not reflect a ton of therapeutic progress or serve as a great prognostic sign for things to come.

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THE GORDON/SAXTON TEST

  1. Was the portrayal of mental illness accurate?

Though it is unlikely that Kelly was purposely designed as a character with histrionic personality disorder, the depiction nonetheless portrays some of the symptoms accurately. However, the symptoms are exaggerated, at times, for comedic effect.

  1. Was the character with mental health issues depicted with compassion?

Kelly was not particularly characterized in a way that elicits compassion. She typically appears to be viewed as annoying and shallow by her co-workers.

Overall ratingIf this depiction of histrionic personality disorder in Kelly Kapoor were to receive a Dundie, it would be the Jenna Maroney-of-30-Rockish Dundie.

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Diagnostics with Dwight

PSYCHOLOGICAL REPORT

Name: Dwight Kurt Schrute III
Date of Birth: January 20, 1968
Ethnicity/Race: Caucasian
Education: High school diploma
Employment:  Assistant to the Regional Manager, Dunder Mifflin, Scranton (past)
Paper Salesman, Staples (past)
Beet Farmer, Schrute Farms (current)
Regional Manager, Dunder Mifflin, Scranton (current)
Date of Initial Interview: 09/23/2010
Date of Report: 05/16/2013
Therapists: Brandon Saxton, M.S., Katie Gordon, Ph.D.

Presenting Problem
Dwight Schrute presented as a 42-year-old male who was referred by his boss, Michael Scott, via the Dunder Mifflin Paper Company. Michael had some concerns that Dwight was “kind of weird” and seemed to “not get along with others.” We’re not sure of the scientific validity of that assessment, so we decided to continue with an assessment of our own. Behavioral symptoms seem to include a variety of interpersonal conflicts that have influenced Dwight socially and vocationally.

Social/Family History
Dwight comes from a large and eccentric family. He recalls his own birth, stating specifically that his father, Cody Schrute, removed him from the womb and his mother bit off the umbilical cord. Dwight has one brother and one sister. Beyond that, he stated that he also had a twin in the womb, but he “reabsorbed” his twin giving him “the strength of a grown man and a little baby.” Dwight was born weighing 13 pounds and five ounces and performed his own circumcision. Growing up, Dwight reports that, as per family tradition, the youngest child raised the other children.

Dwight did not seem to want to spend much time describing his childhood. He did mention that he was shunned by his family from approximately age four through age six after he failed to save the extra oil from a can of tuna. He also reported losing an elementary school spelling bee by misspelling the word “failure.” This writer wonders whether these negative events created an avoidance in Dwight when it came to discussing his childhood. At any rate, Dwight was quick to begin describing his life as an adult and time working at Dunder Mifflin.

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Currently Dwight lives in a nine-bedroom, one-bathroom home located on a 60 acre beet farm that he inherited from his family. Dwight currently lives with his cousin Mose. Beyond growing beets on their farm, they also operate a small bed and breakfast and host events including weddings and garden parties. Currently, Dwight is employed as Assistant Regional Manager (it should be noted that his boss, Michael Scott, clarified that Dwight’s actual title is Assistant to the Regional Manager) at the Dunder Mifflin Paper Company. Dwight has been employed with Dunder Mifflin for several years and is considered one of the top sales staff in the company.

Interpersonally, Dwight seems to have a higher than average amount of conflict with his coworkers. This information was primarily obtained through collateral sources (i.e., Dwight’s coworkers and his personnel file). When asked about some, or most, of these incidents, Dwight seemed to not understand why his coworkers reacted the way that they did. A select list of these conflicts follows (for a more thorough review of these conflicts, please consult the large, surprisingly full, manila folder next to Dwight’s medical file). In one instance, Dwight attempted to test his coworkers’ emergency preparedness by locking them all in the office, simulating a fire, and yelling commands to them through a microphone. His coworker, Stanley, had a heart attack. During a subsequent CPR training, Dwight cut the face off the CPR dummy and wore it a la Silence of the Lambs.

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In another instance, Dwight tricked his coworker Phyllis into coming with him on a sales call. He actually drove her to a bad part of town, took her phone and wallet, and left her to walk home. He did this to help his branch win a corporate weight loss competition by forcing her to exercise. A final example included Dwight asking his coworker, Stanley, to join him on a sales call. Stanley declined. As such, Dwight shot Stanley with a bull tranquilizer, wrapped him in bubble wrap, slid him down the stairs, and loaded him into the car. Dwight then took Stanley, unconscious, with him on the sales call. These three examples are a fairly representative example of the types of behaviors in which Dwight engages at his workplace.

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Psychiatric/Medical History
Dwight has not received any formal psychological assessment or treatment. Despite this, there is some indication that he may have suffered from mental health symptoms in the past. For example, in episode 6.12, “Secret Santa,” Dwight says “… I’m just tired. The days are short. I don’t know. Maybe I’m depressed.” In addition, in episode 9.5, “Here Comes Treble,” Dwight says “You don’t think I have anxiety? I have anxiety all the time. Every waking moment of my life is sheer torture.” Taken together, these quotes suggest that Dwight may have previously struggled with an undiagnosed mood or anxiety disorder.

Diagnostic Impressions
All diagnostic assessment information was obtained through an interview with Dwight, his manager, and his workers. Beyond that, we reviewed his HR personnel file (i.e., we watched every episode of The Office. Multiple times). Based on the client’s history and presenting problems, diagnoses related to Cluster B and Cluster C personality disorders were considered. Diagnoses related to depressive and anxiety disorders were not further considered, as the symptoms related to each appeared very brief and not distressing.

A diagnosis related to Cluster B personality disorders, specifically a Narcissistic Personality Disorder, was considered. Dwight only meets the requirement for two of the five or more symptoms required to make the diagnosis. Dwight does exhibit a “grand sense of self-importance.” One example of this behavior in the way in which Dwight persists in calling himself Assistant Regional Manager as opposed to Assistant to the Regional Manager (much to the chagrin of his boss). Dwight also exhibits “arrogant, haughty behaviors or attitudes.” This seems to occur quite often, with Dwight often commenting on how he is a better salesman than his coworkers.

When fully considered, the symptoms that Dwight Schrute is experiencing are best captured by an obsessive-compulsive personality disorder. He exhibits 1) an excessive devotion to work and productivity to the exclusion of leisure activities and friendships (Dwight once comments on a sale that he never takes vacations, sick days, nor celebrates any major holidays – a pattern of behavior that is reinforced when he is named Northeastern Pennsylvania Salesman of the Year), 2) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (Dwight allows himself to be fired to respect his girlfriend, Angela’s, prioritization of privacy in the office; he instigates a formal investigation, including drug testing of every employee of the office, after finding a small amount of marijuana in the parking lot; he goes to excessive lengths to act consistently with his highest personal value, which is respect for authority and hierarchical systems), 3) is reluctant to delegate tasks or to work with others unless they submit to exactly his way of doing thinks (do we need to explain this one?? If you’ve watched the show, you’ve seen this!), 4) shows rigidity and stubbornness (Dwight trying to impress a manager for a promotion despite experiencing acute appendicitis and consistently refuses any flexibility in his actions despite extremely reasonable requests from his coworkers).

 Treatment Recommendations
Currently, there are not any well-established treatments for obsessive-compulsive personality disorder that have been tested in large randomized clinical trials (the gold-standard for testing what treatments work best!) It is worth noting that obsessive-compulsive personality disorder is different from obsessive-compulsive disorder, which is a disorder that does have clear evidence-based treatment for it. Approaches that have been used effectively include cognitive therapy, which focuses on challenging maladaptive thoughts related to the disorder. It’s possible that Dwight developed his personality characteristics as a consequence of being raised according the Schrute Family Rules (as Dwight reports, “Schrute boys must learn 40 rules before the age of five. They are told that if they don’t learn their rules, they will be eaten in their sleep.”) Dwight would likely benefit from therapy focused on flexibility and balance to decrease his rigidity with this rule-set.

Status at Termination (last episode)
Sometime later, Dwight returned to our office for a booster session, although this writer wonders whether the session was necessary. It seemed, perhaps, that Dwight more so wanted to share with us his new station in life. He reported having finally achieved the position of Regional Manager at the Dunder Mifflin Scranton office. Dwight reported that he is currently happily married to Angela. The two of them, and their son, Philip, live at Schrute Farms. In addition, Dwight reported that his relationships with this subordinates (yes, he did use that term) had improved dramatically. He said he now considered them all friends (despite firing Kevin Malone). All in all, it seemed that Dwight had experienced significant symptom reduction and was operating and feeling much happier in life.

The Office - Season 9

THE GORDON/SAXTON TEST

Was the portrayal of mental illness accurate?
Full disclosure: some of Dwight’s behaviors are exaggerated. And we’re thankful for it. He is easily one of our favorite fictional characters for this very reason. Despite this exaggeration, some of the behaviors that Dwight exhibits are not entirely out of the question. Oftentimes individuals who grow up in strict, rigid homes develop these characteristics themselves. This does not always lead to the formation of a mental health disorder, but in Dwight’s more extreme case, it certainly seemed to.

Was the character struggling with mental health issues depicted with compassion?
Overall, we do find the portrayal of Dwight to be a compassionate one. Yes, sometimes he is a nuisance to his coworkers. One could even argue that, at times, he is a danger to them! But overall, as the series progresses we see Dwight develop and evolve into a really caring individual and a capable leader. This is the kind of progression that we hope to see with clients in therapy, so seeing it in one of our favorite fictional characters just seems right.

Overall rating:
Overall, from a rating scale from Toby (yuck) to Dwight (oh, yeah!), we would rate the portrayal of Dwight as Dwight K. Schrute, Manager! The Office is one of our favorite shows and Dwight is a main reason for that. He starts off as a rough-around-the-edges kind of person. Throughout the nine seasons, we see him experience a lot and grow into a really lovable character. By the end, Dwight gets along well with his coworkers, has a family, and finally leads the branch!

Diagnosing Dunder Mifflin’s Finest

PSYCHOLOGICAL REPORT

Name: Michael Gary Scott
Date of Birth: March 15, 1964
Ethnicity/Race: Part English, Irish, German, and Scottish, 2/15 Native American Indian
Education: High school diploma
Employment: Regional Manager, Dunder Mifflin Scranton (past), CEO, Michael Scott Paper Company (past), Director of Paper Distribution, Department of Natural Resources (current)
Date of Initial Interview: 09/23/2010
Date of Report: 05/16/2013
Therapists: Katie Gordon, Ph.D., Brandon Saxton, B.S.

Presenting Problem
Michael Scott presented as a 46-year-old man who was referred, interestingly, by all of his employees and supervisors at the Dunder Mifflin Paper Company. Michael was referred primarily due to problems related to a consistent pattern of interpersonal conflicts. The behavioral symptoms Michael was exhibiting have resulted in financial, vocational, and social impairment.

History of Presenting Problem
Behavioral observations were gathered to determine the extent and severity of Michael’s presenting problem. We selected a few of the more diagnostic moments to outline in further detail. An exhaustive outline can be gleaned through watching The Office.

Some of the specific examples that we observed included:

  • Experiencing emotions that are unstable, intense, and/or out of proportion with the given circumstances
    1. When Michael asks Carol (his realtor and, at the time, short-term significant other) to marry him spontaneously at a Diwali celebration
    2. When Michael photoshops himself into a picture of Carol and her children by putting his face over the face of her ex-husband and uses it as a Christmas card
    3. When Michael locks all of his co-workers in the office after they joke that jail seemed better than the office
    4. When a pizza delivery boy does not accept Michael’s coupons and he won’t let him leave the building
    5. Demanding one of his gift baskets back when potential customers won’t give Dunder Mifflin their business
  • Attention-seeking in ways that antagonize others
    1. Getting an iPod for the office Secret Santa exchange instead of sticking to the $20 limit
    2. Buying himself a World’s Best Boss mug
    3. Taking over the corporate-mandated diversity training and making his own “diversity training”
    4. Calling meetings others have to attend, often times for personal reasons
    5. Insisting on being in Phyllis’ wedding party and giving an uninvited toast
  • Behaving irresponsibly, impulsively, and engaging in dangerous risk taking
    1. Quitting his job to start his own paper company on a whim
    2. Reconciling with his ex-girlfriend Jan because she gets breast implants
    3. Promising economically disadvantaged children that he will pay for their college tuition if they graduate from high school when he does not have the resources
    4. Playing with the baler in the warehouse despite how unsafe it is and being explicitly told not to
    5. Planning to jump off a building onto a bounce house

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Family History
Michael was born in Scranton, PA. He reportedly came from a single-parent home (though his mother eventually did remarry) and described his childhood as lonely. Michael stated that he has an older brother as well as a half-sister with whom he had a tumultuous relationship. However, the two did eventually reconcile leading to Michael hiring his nephew Luke as an intern. Michael does not talk much about his childhood but does offer a few memories that seem to stand out to him. For example, Michael was once featured on an episode of the television show Fundle Bundle. On the episode, when asked what he would like to do when he grows up, Michael replies,“I wanna be married and have 100 kids so I can have 100 friends. And no one can say no to being my friend.” Another childhood memory Michael has is attending a baseball game with Jeff, who he identifies as his “mother’s boyfriend, who she married.” Michael went on to say that during the game he “… felt really bad, because the pitcher wasn’t able to play with his friends anymore. But Jeff said that the manager was making a really good move, by taking the pitcher out. He really respected the manager.”

Educational/Employment History
Michael graduated high school on time in Scranton, PA. He was not able to attend college though, as he lost his tuition money in a pyramid scheme. Michael seemed to hold a variety of jobs during/after high school, including a position as a greeter at Men’s Warehouse. He reported receiving his position at Dunder Mifflin after following an attractive women to the office park, where the Scranton office is located. Michael started with the company as a salesman, a position in which he excelled. After becoming the best salesman in the company, evidenced by his winning consecutive awards for best salesman, Michael was promoted to a regional manager position. Unfortunately, it seemed that the qualities that made Michael great at sales did not translate to the managerial position.

Psychiatric/Medical History
After Michael physically reprimanded his nephew, Luke, for being insubordinate, the corporate office mandated that he attend six hours of counseling with Toby Flenderson from the Human Resources department of the Scranton branch. Due to Michael’s strong dislike of Toby, he refused to engage in the counseling process. Michael began the session by refusing to speak and then reporting fictional stories as his own life. Over time though, Michael began to inadvertently share details from his life with Toby. Once he realized this, Michael got angry and refused to participate. Toby eventually gave up on the entire process and allowed Michael to fill out the counseling report himself. The records indicated that Michael was severely depressed and homicidal. We have chosen not to include these results further in this assessment as we question their validity.

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Diagnostic Impressions
As mentioned above, information about the presenting problem was obtained through behavioral observations (i.e., viewing The Office repeatedly) and by filling out a self-report personality questionnaire as we imagined Michael Scott would (this is not a valid method and should not be used in real life).

Because Michael exhibited a persistent pattern of interpersonal problems, it was hypothesized that he might meet criteria for a personality disorder. While Michael had substantial distress and impairment from issues associated with his personality characteristics, he did not meet diagnostic criteria for any of the ten personality disorders that are specified in the current version of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5). Rather, his symptoms were best captured by a category that is used when there are significant personality issues that do not fit within the other categories: other specified personality disorder.

A diagnosis of other specified personality disorder does not provide nuanced details about Michael’s specific presentation, so we utilized the alternative model for personality disorders in the appendix of DSM-5 to further explore his presentation. This model moves away from the traditional categorical models of personality disorder (i.e., you either have a personality disorder or do not, with no in-between) through its focus on dimensional measures of 1) personality functioning impairment in four domains and 2) five research-derived pathological personality traits.

We rated personality functioning impairment on the DSM-5 scale from 0 (little or no impairment) to 4 (extreme impairment) based on the match between our behavioral observations and one or more of the descriptions at each level. The results are presented and described below:

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  • Identity (moderate impairment): “Has vulnerable self-esteem controlled by exaggerated concern about external evaluation, with a wish for approval” and “Emotional regulation depends on positive external appraisal. Threats to self-esteem may engender strong emotions such as rage or shame”
  • Self-Direction (some impairment): “May have an unrealistic or socially inappropriate set of personal standards, limiting some aspects of fulfillment”
  • Empathy (severe impairment): “Ability to consider and understand the thoughts, feelings, and behavior of other people is significantly limited” and “is confused about or unaware of impact of own actions on others”
  • Intimacy (severe impairment): “Relationships are based on a strong belief in the absolute need for intimate others”

Pathological personality trait scores were derived from the self-report questionnaire that we filled out as we thought Michael would (again, you should not do this in real life ever). Scores ranged from a minimum of 0 (reflecting low levels of a trait) and a maximum of 3 (reflecting high levels of a trait) and were believed to underlie the functional impairment described above. The results are presented and facets that fit Michael are listed:

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  • Negative Affect: “instability of emotional experiences and mood; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances”
  • Detachment: This refers to a tendency to generally avoid interpersonal experiences and does not apply to Michael.
  • Antagonism: “engaging in behavior designed to attract notice and to make oneself the focus of others’ attention and admiration”
  • Disinhibition: irresponsibility, impulsivity, distractibility, dangerous risk-taking
  • Psychoticism: This reflects odd or bizarre thought processes and behavior and does not apply to Michael.

Treatment Recommendations
In summary, the most appropriate categorical diagnosis for Michael Scott was other specified personality disorder. His significant distress and impairment appeared to be most related to his persistent pattern of speaking and behaving impulsively (reflecting his high levels of disinhibition), paired with an intense need to be liked. When he believed that someone disapproved of him or his behavior (often because he had offended them with his impulsive behavior due to impaired perspective-taking), he tended to spiral into a dysregulated, negative emotional state (consistent with his elevated level of negative affect). He then coped with this painful emotional state by engaging in attention-seeking (reflected in his elevated level of antagonism), and sometimes vengeful, behavior which usually exacerbated the problem.

While there is not a specific scientifically-tested and supported treatment for other specified personality disorder, there are therapeutic strategies designed to specifically strengthen impulse control, increase interpersonal skills, and build adaptive emotional coping. Michael would likely experience improvement in his symptoms if he worked with a therapist in these areas, while capitalizing on his strengths: being a fun-loving person who cares a lot about his relationships with others.

Status at Termination (last episode)
At follow-up, Michael exhibited substantial improvement in his personality functioning. While he retained his unique (and sometimes inappropriate) sense of humor and life perspective, he appeared to become more skilled at navigating interpersonal relationships and formed meaningful relationships with his co-workers. Their affection for Michael was evident as they said good-bye to him when he moved to Colorado to be with his wife, Holly, and their excitement at seeing him a few years later at Dwight & Angela’s wedding. He reported that he and Holly had a fun and mutually supportive marriage and that he enjoyed being a father very much.

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THE GORDON/SAXTON TEST
Was the portrayal of mental illness accurate?
Michael Scott was created as a comedic character who repeatedly offends people by speaking and acting in incredibly inappropriate ways. While the creators of the show were likely aiming to make a character who would make people laugh because of his unusual personality, it is highly doubtful that they had a personality disorder in mind. Thus, by design, Michael Scott is not a realistic representation of someone suffering from a mental disorder. That being said, some of the aspects of his personality that lead to problems (excessive and intense need for others’ approval, disinhibited behavior, marked emotional fluctuation) do represent realistic components of some mental disorders. However, these pathological personality traits do not typically present in the extreme and silly manner that is portrayed in The Office. In conclusion, no, it is not an accurate portrayal of mental illness, but Michael Scott is an incredibly entertaining character.

Was the character struggling with mental health issues depicted with compassion?
In the earlier episodes of The Office, Michael is not presented as a sympathetic character. He ridicules numerous people based on personal qualities (e.g., appearance, age, ethnicity, sexual orientation, ability, gender) and acts in an irrational manner. However, as the seasons progress, the audience sees more of Michael’s sweet, caring, fun side, and this results in more compassion for his struggles and more sympathy about his lack of insight into his role in his own struggles.

Overall rating:
When considered overall, we award The Office with a Dundie for the “Best Television Show Ever!” Although the portrayal of mental illness is not entirely accurate, the writers did not set out with this goal in mind. We can’t fault them for missing a goal that they never had. Beyond that, the show does not seem to add to the stigmatization of mental disorders. In fact, in the episode Here Comes Treble (Season 9, Episode 5) Nellie helps to dispel some of the misconceptions that Dwight holds about individuals suffering from anxiety. And in the episode Stairmageddon (Season 9, Episode 19), Jim approaches Toby to ask what he and Pam can expect from couples counseling. Both episodes normalize experiences related to receiving mental health services.

Diagnosing the Dark Knight

PSYCHOLOGICAL REPORT

Name:  Bruce Wayne, aka Batman
Date of Birth: February 19th
Age: 30 – 32 years of age (in the current Batman comics)
Ethnicity/Race: Caucasian
Education: Degrees in Criminal Science, Forensics, Computer Science, Chemistry, Engineering, Biology, Physics, Advanced Chemistry, and Technology
Date of Initial Interview: 3/01/2016
Date of Report: 3/24/2016
Therapists: Brandon Saxton, Kathryn Gordon

Presenting Problem
Bruce Wayne (Batman) presented as an approximately 30- to 32-year-old man, who was referred for treatment by his former guardian and current butler, Alfred Pennyworth. Alfred primarily had concerns related to the traumatic loss of Bruce’s parents at a young age and the obsessive and unrelenting way that he wages war on the criminals of Gotham City which has resulted in significant distress, physical harm, and in some cases death to his family, co-workers and the individuals he apprehends.

History
Bruce Wayne was born on February 19th in Gotham City. Bruce was the only child of Thomas and Martha Wayne. In addition to his medical career, Thomas and his wife, Martha, owned Wayne Enterprises and were both dedicated philanthropists. They were both heavily involved in efforts to restore Gotham City which was battling a depression, rising crime rates and corruptions, and overall despair. Overall, Bruce reported mostly positive memories regarding his childhood, during which he lived with his parents and butler at Wayne Manor. Bruce identified two traumatic childhood events that helped to shape him into who he is today. The first occurred when he was very young and playing on the grounds surrounding Wayne Manor. While playing, he fell through a hole in the ground that dropped him into a cave system that ran under Wayne Manor. Unfortunately for young Bruce, the cave system was home to hundreds of bats. He reported that this instilled in him a strong fear of bats. Subsequently, he reported seeing one uniquely large bat from the cave system multiple times following the event.

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The second traumatic event that Bruce reported occurred a while after when he fell into the cave system. Bruce, along with his parents, attended the film The Mask of Zorro. As they were leaving the theater, the Wayne family was confronted by a mugger demanding their valuables. Thomas resisted the mugger which resulted in both he and Martha being shot and killed. Bruce was left alone with the dead bodies of his parents. Bruce identified this as being the most traumatic and defining moment of his life. With the passing of Bruce’s parents, Alfred, the family butler, became his guardian and caretaker. While processing his parents’ murder, Bruce reported experiencing a great deal of distress. At the peak of this transformative process, Bruce recalled finding himself standing in front of the graves of his parents. It was then and there that he vowed to get vengeance for what happened to his parents and to keep that from happening to anyone else ever again. Bruce reported that this was the moment where, in his mind, Bruce Wayne died, and Batman was born.

Holding true to the promise he made at the graves of his parents, Bruce threw himself into his schoolwork. He was very successful and reported performing at the top of his class. After graduating high school, Bruce left the country to travel the world training under a variety of martial arts masters. He sought out the best of each discipline to train under. When he felt prepared, he returned to Gotham City to begin his crusade against the criminal underworld. Bruce started off small by simply patrolling the more dangerous areas of Gotham City on foot. His goal was singular; to learn more about the criminals that ran Gotham City. Unfortunately, one night Bruce was attacked and involved in a street brawl. As a result of the fight, he was seriously injured. Bruce was fortunate enough to make it back to Wayne Manor safely and without being identified. Bloody, broken, and seemingly defeated, Bruce recalled sitting in his father’s study. Contemplating what went wrong, he realized that criminals, although cowardly and superstitious, would never fear a common, unarmed man on the street. At that moment, the large bat he had reported seeing previously made its return. The bat smashed through the window into the study. Though nearing unconsciousness, due to blood loss — the answer was obvious to Bruce. He would become the thing he feared most, a bat.

With the help of Alfred, Bruce worked tirelessly to design a functional, yet frightening suit, weaponry, and base of operations for the Batman. Ultimately, Bruce settled on the cave system under Wayne Manor which he coined “the Batcave.” Bruce reported that he grew quickly as the Batman. As he combined experience to his years of training, he become much more effective and competent. The police force, ripe with corruption, demonized and hunted him. However, there was one officer, James Gordon, who held out against the corruption. After some time, Batman and James Gordon began what would be a long-term professional partnership. As Batman gained more notoriety, the villains he faced evolved from common criminals to supervillains. Bruce reported that some of the more fearsome foes he faced included Edward Nygma, known as The Riddler, Oswald Cobblepot, known as The Penguin, Harvey Dent, known as Two-Face, Pamela Isley, known as Poison Ivy, Dr. Jonathan Crane, known as Scarecrow, and perhaps most fearsome of all, the Joker, whose identity is yet unknown. As the criminals of Gotham City evolved, Batman knew he had to as well.

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To ramp up his war on crime, Batman decided to take a sidekick. Dick Grayson, known at the time as Robin, joined Batman. For quite some time, the two worked well together in what was a major change in the way Batman, who was used to operating alone, battled crime. However, as the criminals became more dangerous, Bruce decided he did not want to place Robin in more danger than was necessary. As such, Batman started to keep Robin on the sidelines. Eventually, the two split, with Dick Grayson taking up the mantle of Nightwing and leaving to operate independently of Batman. Sometime later, Batman took his second Robin, Jason Todd. Todd was a young man whose parents were killed by Two-Face. Bruce reported empathizing with Todd’s experience and wanting to help guide the young man down a path where he could channel his emotional responses for good. Despite this, Todd was much more rebellious and angry in his approach to crime fighting than Dick Grayson was before him. One night, while working solo, Jason Todd was taken, tortured, and killed by the Joker.

Bruce reported that the loss of Jason Todd hit him hard. He returned to fighting crime alone as a much darker force than he ever had been before. This new, darker, less refined Batman was noticed by a young boy named Tim Drake. Tim, an extremely bright young man, was able to work out the identity of Batman and the original Robin, Dick Grayson. He urged Dick Grayson to return to his role as Robin, as he felt that Batman needed someone to stabilize and support him again. Dick Grayson refused to return as Batman’s sidekick. However, through this pursuit, Tim Drake himself ended up becoming the third Robin. Bruce reported refusing to make the same mistake again and insisted that Tim train with the individuals from whom Bruce learned. As a result, Tim was a Robin who was much closer in ability to Batman himself.

Bruce then reported what he identified as the most challenging moment of his career, a time where he was not able to wear the cape and cowl. This period of time was the result of Batman battling and ultimately being defeated by the criminal known as Bane. Bane was able to defeat Batman, physically overpowering him and breaking his spine. While Bruce recovered, one-time villain, Azrael, took the mantel of the Bat. Azrael proved a poor Batman though, becoming so unstable that he was eventually close to executing criminals. Bruce was able to recover and defeat Azrael to reclaim the cowl.

Tim Drake moved onto a new, more independent role as Red Robin. Meanwhile, Bruce’s son, which he didn’t know he had, Damian Wayne, stepped into the role as the next Robin. Damian’s mother was Talia al Ghul, the daughter of Ra’s al Ghul, leader of the League of Assassins. As such, Damian received training from the league and was exceptionally skilled. Bruce, however, clashed with his son’s assassin training and reported trying his best to instill in him the values he had gotten from his parents. However, in an event outside of his control, Damian was killed battling an adult clone of himself known as The Heretic. Bruce reported that this event would have ended him without the support of the Bat-family and Alfred.

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Assessment & Diagnostic Impressions
All diagnostic assessment information was obtained through this interview and behavioral observation (i.e., Batman comics, television shows, and movies). Based on the client’s history and presenting problems, diagnoses related to posttraumatic stress disorder, cluster B personality disorders, and cluster C personality disorders were considered. Bruce does exhibit some symptoms related to posttraumatic stress disorder. Specifically, he met the following criteria: 1) exposure to actual of threatened death, serious injury, or sexual violence (the murder of his parents), 2) presence of intrusion symptoms associated with the traumatic event, beginning after the traumatic event(s) occurred (Bruce experiences repeated distressing memories, dreams, flashbacks, and distress at symbols of the death of his parents), and 3) marked alterations in arousal and reactivity associated with the traumatic event, beginning or worsening after the traumatic event occurred (the war Bruce wages on Gotham could be defined as reckless or self-destructive behavior with elements of hypervigilance). Ultimately, a diagnosis of posttraumatic stress disorder was ruled out because Bruce does not meet all of the required criteria, specifically avoidance of stimuli associated with the traumatic event, as evidenced by his being the Batman.

A diagnosis related to cluster B personality disorders, specifically borderline personality disorder, was also considered. Bruce only meets the requirements for two of the five or more symptoms required to make the diagnosis. Bruce does experience some identity disturbance (e.g., he sometimes seems unsure of whether he is Bruce Wayne or Batman, many times moving between the two). Bruce also experiences inappropriate, intense anger or difficulty controlling anger at times when dealing with criminals. Taken together though, these two symptoms do not constitute borderline personality disorder.

When fully considered, the symptoms that Bruce Wayne is presenting with are best represented by obsessive-compulsive personality disorder. He experiences 1) an excessive devotion to work and productivity to the exclusion of leisure activities and friendships (he often disregards relaxation and social activities to pursue his mission of justice), 2) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (Bruce refuses to deviate from his moral compass under any circumstances), 3) is reluctant to delegate tasks or to work with others unless they submit to exactly his way of doing things (this is demonstrated both in the way he mentors his sidekicks but also in the way he serves as a tactician for the Justice League), 4) shows rigidity and stubbornness (once again, Bruce does not deviate from his moral compass and refuses to abandon his war on crime even if it means he dies in the line of duty).

Treatment Recommendations
In summary, the most fitting diagnosis for Bruce Wayne (Batman) is obsessive-compulsive personality disorder. Currently, there are not any well-established treatments for obsessive-compulsive personality disorder that have been tested in large randomized clinical trials. It is worth noting that obsessive-compulsive personality disorder is different from obsessive-compulsive disorder, which is a disorder that does have clear evidence-based treatment for it. Approaches that have been used effectively with obsessive-compulsive personality disorder include cognitive therapy, which focuses on challenging maladaptive thoughts related to the disorder. Following his experience of trauma due to an act of evil (i.e., witnessing the murder of his parents as a young boy), Bruce developed a strong moral code focused on helping others through his pursuit of justice and committed firmly to upholding it. While this has been of great benefit to the people of Gotham City and beyond, at times, it has come at the cost of his personal health and happiness. A therapeutic approach that prioritizes flexibility and healthy balance as goals may help Bruce to improve his mental health and experience less symptoms of obsessive-compulsive personality disorder.

Status at Termination
Six months later, Bruce returned to our office. He reported that a lot had happened since our first appointment. During this time, Batman faced off against Joker in what Bruce reported was the hardest battle of his life. The Joker was set to release the Endgame Virus in Gotham City. During the conflict, it appeared that both Batman and the Joker had died. Ultimately, Bruce ended up surviving, but lost all of his memories. The loss of his parents, his training, and his time as Batman, everything that made Bruce the Batman, was gone. Bruce reported that he started living a normal life, getting more involved in Wayne Enterprises, and even meeting someone to whom he got engaged. Bruce was seemingly happy and healthy. However, after some time, it all fell apart. Even without conscious access to his memory, Bruce knew he was supposed to be doing and giving more. His engagement ended and he withdrew from his more active role in Wayne Enterprises. He demanded to a heartbroken Alfred to be taken to his cave, of which he had no memory of. Even though he did not necessarily want to, he decided to be the Batman again.

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THE GORDON/SAXTON TEST

1. Was the portrayal of mental illness accurate?

The symptoms that Bruce Wayne experiences related to obsessive-compulsive personality disorder appear to be accurately depicted. Beyond that, Batman serves as an example of someone who takes what is an extremely traumatic event and uses it to find meaning and purpose in life. He uses the death of his parents as a drive to make positive changes in the world around him as both Bruce Wayne (e.g., pursuing philanthropic efforts such as an orphanage funded by the Wayne Foundation) and Batman (e.g., by keeping criminals off the street to prevent other children from experiencing what he did.

2. Was the character struggling with mental health issues depicted with compassion?

We find the portrayal of mental illness most broadly seen across mediums portraying Batman to be compassionate. Although authors do not typically set out to depict Batman as experiencing mental illness, it is clear that he has experienced severe trauma that influences him throughout his life. Beyond that, many of Batman’s greatest villains experience mental illness more explicitly. Particularly, in the seminal Batman: The Animated Series, these individuals are portrayed very compassionately, with Batman often empathizing with their experiences and seeking to rehabilitate them.

Overall rating: From a rating from Superman (e.g., the worst ever) to Batman (e.g., the best ever) we rate the overall depiction of Batman as… Batman (sorry Superman fans!). For the reasons above, we believe that Batman’s universe serves as an accurate and compassionate depiction of mental illness. Even as a fictional character, Batman has served as a real-life inspiration for others who are also pressed to overcome insurmountable challenges and odds (e.g., such as depicted in the documentary Legends of the Knight) or want to make a difference for those in need (e.g., organizations such as the real life Wayne Foundation).

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**Disclaimer**

Bruce Wayne, the Batman, made his debut in Detective Comics #27 on May 19, 1939. Over the last 75-plus years, Batman has been portrayed in comics, novelizations, video games, television shows, and movies by a variety of different actors, authors and directors across multiple timelines in the DC Comics Multiverse. As such, this evaluation focused on the most well-known canonical story as presented by Bruce Wayne during the timeline in the current Batman series by Scott Snyder and illustrated by Greg Capullo (which we recommend!)