Abnormal behavior is behavior that deviates from the norm or is average (Kearney & Trull, 2012). There are five perspectives on abnormal behavior, and those are biological, psychodynamic, humanistic, cognitive-behavioral, and sociocultural (Hanley et al.). The behaviors of Patrick Bateman, a character in the film American Psycho, are examined below in conjunction with the five perspectives of abnormal behavior and treatment methods for each.
The movie American Psycho (2000) features a 27-year-old male, Patrick Bateman, who has an alternative psychopathic ego. Bateman is a New York investment-banking executive, and strives to be at the top (Hanley et al.). He is focused on fitting in and though he has real flesh and blood, he does not feel like a human being (Hanley et al.). He kills random people he comes across, as well as those who he thinks are better off than him or are in the way of his success (Hanley et al.). He has a need to kill people in order to fulfill his homicidal behavior.
Bateman portrays abnormal behavior in many scenes. For instance, when he is at a bar one night, he tries to use a drink token, but the bartender tells him he is unable to use it. When she turns around Bateman says with a smile, "You're a fucking ugly bitch. I want to stab you to death, then play around with your blood” (Hanley et al.). There are various other scenes where Bateman is seen lashing out at others (Hanley et al.). As the movie progresses, so does Bateman’s hatred and killing episodes (Hanley et al.). Viewers do not see all the killings, but towards the end of the movie, Bateman leaves a voicemail for his lawyer trying to confess (Hanley et al.). He tells his lawyer he killed twenty or forty people, his old girlfriend, a faggot with a dog, five or ten homeless people, a few random girls, and Paul Allen (Hanley et al.). Bateman tells the lawyer he ate some of their brains and most of the killings he has on tape (Hanley et al.). When he sees the lawyer the next day though, the lawyer does not believe him (Hanley et al.). His lawyer laughs it off and says it is a funny joke (Hanley et al.). At the very end of the film, Bateman narrates his feelings by saying, "…My pain is constant and sharp, and I do not hope for a better world for anyone. In fact, I want my pain to be inflicted on others, and no one to escape…My confession has meant nothing” (Hanley et al.).
Bateman shows many characteristics that are present in schizotypal personality disorder (SPD) and exhibits OCD tendencies. Characteristics of SPD include; lack of close friends or confidants other than first-degree relatives, behavior or appearance that is odd, eccentric, or peculiar, odd beliefs or magical thinking, odd thinking and speech, unusual perceptual experiences, suspiciousness or paranoid ideation, ideas of reference, excessive social anxiety that does not diminish with familiarity, and, last, inappropriate or constricted affect (Chemerinski, Triebwasser, Roussos, & Siever, 2013). In order to be diagnosed with SPD, a person must exhibit at least five of the above symptoms for at least six months (Chemerinski et al.). OCD, on the other hand, is a “chronic debilitating anxiety disorder characterized by two distinct phenomena: obsessions which are recurrent, intrusive thoughts, images or impulses, and/or compulsions which are repetitive covert or overt actions that are carried out to decrease anxiety” (Subramaniam, Soh, Vaingankar, Picco, & Chong, 2013, p. 1)
Biological Model Treatment
The biological model focuses on “genetics, neurotransmitters, brain changes, and other physical factors” (Kearney & Trull, 2012, p. 23). Treatment includes psychiatric medication (Kearney & Trull). For instance, Bateman would take a medication that decreases dopamine, because it typically helps to ease symptoms of schizophrenia (Kearney & Trull).
For Bateman’s OCD symptoms, “pharmacotherapy with an SRI alone is a widely used initial treatment for OCD in patients of all ages” (Freeman, Sapyta, Garcia, Fitzgerald, Khanna, Choate-Summers, & Franklin, 2011, p. 425). Typically, with pharmacotherapy, most patients receive a partial response, with significant residual symptoms (Freeman et al.). It is expert recommendation, that cognitive-behavioral therapy be used alone or in conjunction with pharmacotherapy in order to yield the best results (Freeman et al.).
Psychodynamic Model Treatment
The psychodynamic model of abnormal psychology “focuses on internal personality characteristics” (Kearney & Trull, 2012, p. 23). Using the psychodynamic model, a therapist might treat Bateman using psychodynamic supportive psychotherapy (Ridenour, 2014). Psychodynamic supportive therapy would help to improve Bateman’s ego functioning and reality testing (Ridenour). In order to do this, the therapist would function as an auxiliary ego, which would allow the therapist to lend Bateman his or her stronger ego (Ridenour). The idea is to help the patient build defenses and repress anxiety filled thoughts, ideas, and fantasies (Ridenour). The treatment for SPD is typically long term, difficult, and does not always show favorable results (Ridenour).
Bateman may also be treated for obsessive-compulsive disorder (OCD). According to the psychodynamic model, OCD is seen as an “outbreak of unacceptable aggressive and erotic
impulses or as a punishment of the harsh superego” (Kempke & Luyten, 2007, p. 293 ). Bateman had many unacceptable aggressive and erotic impulses. For instance, when Bateman is walking in the alley one night, he sees a homeless man and after talking with him for a few minutes, he kills him and his dog (Hanley, 2000).
Another thing a therapist using the psychodynamic model for treatment may do is examine Bateman’s relationships. Therapists may look to see if he has any deep seated resentment or hatred built up towards those close to him. This is because psychodynamic theorists believe “symptoms of mental disorders are caused by unresolved conflicts” (Kearney & Trull, 2012, p. 31). Unconscious conflict and motivation could also be examined (Kearney & Trull). This could be done through dream analysis or free association (Kearney & Trull).
Humanistic Model Treatment
The humanistic model of abnormal psychology “focuses on personal growth, choice, and responsibility” (Kearney & Trull, 2012, p. 23). Proponents of this model believe that people are born good and have a desire to create meaning in their lives (Kearney & Trull). When they are unable to do so, however, they become alienated and possibly develop a mental disorder (Kearney & Trull). Treatment is nondirective, which means that the therapist does not force his or her worldview or opinions onto his or her clients (Kearney & Trull). The therapist instead helps the client to relieve tensions, develop solutions, and strive for self-actualization (Kearney & Trull).
In the case of Bateman, the therapist would let him talk/confess what he had done while he or she sat there are listened reflectively. At the end of the film, in Bateman’s closing statement, he says that his confession meant nothing (Hanley et al., 2000). It would be good for him to be able to tell someone what he did and for him or her to believe him, instead of brushing it off. Bateman would be able to take responsibility for what he had done and discovered ways to engage in personal growth and create meaning in his life.
Cognitive-behavioral Model and Treatment
The cognitive-behavioral model “focuses on specific thoughts and learning experiences” (Kearney & Trull, 2012, p. 23). Cognitive-behavior therapy is one of the treatment methods associated with the cognitive-behavioral model (Kearney & Trull). Cognitive-behavior therapy is “a large collection of treatment techniques to change patterns of thinking and behaving that contribute to a person’s problems” (Kearney & Trull, p. 39). A few things a cognitive-behavioral therapist may do are schedule activities for Bateman to counteract his fantasies and homicidal ideations, role play with him so that he can improve his social and conversational skills, teach Bateman to avoid personalizing events, and teach Bateman to find alternative solutions to his anger and rage (Kearney & Trull).
When it comes to OCD, cognitive-behaviorists see it as thought intrusions that affect even normal people (Kempke & Luyten, 2007). When the thought intrusions carry a negative connotation, however, anxiety builds up and leads to the impulsive behavior (Kempke & Luyten). The anxiety is diminished when the person engages in the impulsive behavior, and that is why the behavior becomes repeated (Kempke & Luyten). For Bateman, it could be that his negative thought intrusions were his horrific fantasies of killing people. When he engaged in his impulsive behaviors, such as yelling at people when they do not put the sorbet spoon back in the container, his anxiety diminishes.
Sociocultural Model Treatment
The sociocultural model “focuses on external environmental events” (Kearney & Trull, 2012, p. 23). Proponents of the sociocultural model believe that psychological problems develop because of other people and social institutions (Kearney & Trull). In the case of Bateman, the sociocultural model does the best at explaining his psychological problems. Bateman worked for his father’s company, and as a Vice President level executive, there was much expected of him (Hanley et al., 2000). Bateman said once, and made references many times, describing his need and want to fit in (Hanley et al.). He was competitive and jealous of those around him (Hanley et al.). The social institution in which he worked and those around him contributed to his psychological problems (Hanley et al).
In treatment, a cultural assessment should be done and then a person’s individual and global difficulties should be addressed (Kearney & Trull, 2012). For global difficulties, treatment would focus on lessening the stress created for people through discrimination (Kearney & Trull).
When it comes to individual difficulties, family therapy is an important step (Kearney & Trull). The therapist should meet with all family members at the same time to address issues and discuss family roles (Kearney & Trull). The therapist would discuss the stress associated with Bateman’s job and they would go through family therapy. Bateman could discuss his need to fit in and the anger or jealousy he feels towards those he works with.
Bateman from American Psycho, was a man who was clearly in distress. Bateman suffered from a mental disorder, such as SPD and OCD, and the abnormal behavior exhibited by him would be best addressed by looking at the sociocultural perspective of abnormal psychology. There are five total perspectives, and those include biological, psychodynamic, humanistic, cognitive-behavioral, and sociocultural. Those five perspectives were examined above, as well as the treatment methods associated with each.