About Proof

1. About Proof Proof is a story about genius and insanity, trust and uncertainty, love and resentment. It is also a play commenting on society’s treatment of those who suffer from mental illness. Characters: Robert – a brilliant mathematician and father to Claire & Catherine Catherine – an aspiring mathematician who put her dreams on hold to help take care of her ailing father Claire – Catherine’s older sister, lives in New York Hal – former graduate student of Robert Setting: an old house in Chicago, Illinois

2. Free write: Essential Questions for Unit 7 - Proof What is the difference between genius and madness/insanity? How do we determine this? Silent Conversation: Respond and then pass the paper to someone new. Comment on their response. Switch with at least one person in the 5 minutes provided.

3. Free write: Essential Questions for Unit 7 - Proof How do social stigmas (something considered disgraceful) surrounding mental illness impact public policy (the social principles on which laws are based)? Silent Conversation: Respond and then pass the paper to someone new. Comment on their response. Switch with at least one person in the 5 minutes provided.

4. Free write: Essential Questions for Unit 7 - Proof How is mental illness depicted in literature and film? What impact do these have on society’s understanding of mental illness? Silent Conversation: Respond and then pass the paper to someone new. Comment on their response. Switch with at least one person in the 5 minutes provided.

5. Free write: Essential Questions for Unit 7 - Proof How should we address mental illness as a society? Silent Conversation: Respond and then pass the paper to someone new. Comment on their response. Switch with at least one person in the 5 minutes provided.

6. The American Psychiatric Association defines mental illness as: “health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities”

7. Write & Discuss: • List all words or phrases you associate with the term “mental illness.” • Group your words or phrases into two columns labeled “positive” and “negative.” • How does the media portray mental illnesses/people suffering from mental illnesses? • Why would people suffering from mental illnesses be more likely to be portrayed as villains or violent and dangerous than members of other social groups?

8. Write & Discuss: Stereotypes in the Media (1) Myths or stereotypes of individuals with mental illnesses/disorders? • List 5 myths or stereotypes (ex: violent, unable to communicate, contagious…) • Pick one to focus on. (2) Give an example of how this myth/stereotype is shown in the media (ex: Shutter Island, Psycho, etc.) (3) Explain your myth/stereotype, and how it is reinforced through your given media example. (4) Explain why/why not you think this is causes harm to those actually suffering from mental illnesses/disorders.

9. Final Assessment for this Unit: • Argument: How should we address mental health/mental illness as a society? • Multi-Genre Project: • Research current mental health care policies and societal reactions • Create a visual that showcases argument • Write an analytical paragraph to explain the visual This assessment will require synthesizing information from various sources: Proof, a movie of your choice (taken from a list of recommended options), and research done individually.

10. Films About Mental Health: Recommended: • Inside Out (2015) • The Aviator (2004) • A Beautiful Mind (2001) • Proof (2005) – we will read this play & watch this film in class Optional (with permission slip): • Silver Linings Playbook (2012) • Girl, Interrupted (1999) • Good Will Hunting (1997) • Shutter Island

11. Diagnosis of mental illness can be very subjective. A psychological or mental disorder can be defined as a pattern of behavioral or psychological symptoms that causes significant personal distress, impairs the ability to function in one or more important areas of life, or both – an important qualification is that the pattern of behavioral or psychological symptoms must represent a serious departure from the prevailing social and cultural norms. Why could this qualification be problematic?

12. Begin Reading “The Yellow Wallpaper” (finish for homework) & answer the following questions. 1. As you read, list all symptoms you see the woman in the story exhibiting. 2. Do you think she is suffering from a mental illness/disorder? If so, what do you speculate it could be? 3. How is the woman being treated? Do you believe this is effective? Record your answers in your notebook. If you need to complete the reading tonight, a digital copy is available on the class website.

13. Context for “The Yellow Wallpaper” Dr. S. Weir Mitchell, author and physician, 1906 • Nervous Exhaustion (neurasthenia) –weakness, exhaustion, depression, faintness… • a “rest cure” would often be recommended treatment • patient was often not allowed to read, write, feed herself, or talk to others – short term treatment • long-term treatment would include “living as domestic a life as possible

14. “The Yellow Wallpaper” An Example in Literature • Late 19th century – women challenged traditional ideas about gender • Medical & scientific experts justified inequality by saying women were weaker – physically, emotionally, intellectually • Charlotte Perkins Gilman wrote “The Yellow Wallpaper” to challenge this idea and to make a point that restricting women through these types of diagnoses was unhelpful and unethical.

15. According to the NIMH: • An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. • Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness. • In addition, mental disorders are the leading cause of disability in the U.S. and Canada.

16. Nonpsychotic Disorders - Neuroses • Triggered by some sort of anxiety • Symptoms (behaviors) – general uneasiness and inability to cope with many life’s problems • Doesn’t lose contact with with reality • Can function (and do) on a daily basis but are unhappy and troubled with their unhealthy methods of dealing with anxiety • Counseling and therapy are recommended treatments • Most commonly occur during late adolescence and early 30s • Real or imaginary threats to a person’s status (personal, financial, etc.)

17. What is Anxiety? • A normal reaction to stress • Helps you cope – signals and alerts the individual to the possibility of danger in order that harm may be avoided • When anxiety is chronic or extreme – that is when it becomes detrimental to your health.

18. Generalized Anxiety Disorder (GAD) • Persistent, chronic, excessive, and global (widespread, not specific) apprehension • Tense or anxious about a wide range of life circumstances – sometimes with little or no justification • Anxiety attached to any object or no object • Also referred to as free-floating anxiety • “Sore tooth” – constant, ongoing sense of uneasiness, distress, apprehension

19. Social Anxiety • Social anxiety - anxiety about social situations, interactions with others, and being evaluated or scrutinized by other people • #1 most common anxiety disorder • 3rd most common mental disorder in the U.S. • 19.2 million Americans suffer from social anxiety disorder • most often it surfaces in adolescence, early adulthood, or even early childhood • more common in women than in men

20. Panic Attacks • A sudden episode of extreme anxiety • Pounding heart, rapid breathing, breathlessness, choking sensation…etc… • Belief that you may die, go crazy, or lose control – not unusual to rush to the hospital or emergency room • Panic disorder = when panic attacks occur frequently or regularly • Appears to come from nowhere – often connected to stressful life events https://www.ted.com/talks/sangu_delle_there_s_no_shame_in_taking_care_of_your_mental_health

21. Phobias • A strong or irrational fear of something, usually a specific object or situation. • Rational: • agreeable to reason; reasonable; sensible     *Rational Fears can harm you          -Ex. Sharks, drowning • Irrational: • deprived of reason; utterly illogical   *Irrational Fear cannot harm you      -Ex. Water

22. Phobia – top 10 A persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding despite the fear, typically disproportional to the actual danger posed, often being recognized as irrational; often tied to traumatic events. Categories: • Fear of particular situations • Fear of features of the natural environment • Fear of injury or blood • Fear of animals or insects Guess the top ten most common phobias…

23. Ten Most Common Phobias • Arachnophobia: The fear of spiders. • Ophidiophobia: The fear of snakes. • Acrophobia: The fear of heights. • Agoraphobia: The fear of situations in which escape is difficult. • Cynophobia: The fear of dogs. • Astraphobia: The fear of thunder and lightning. • Trypanophobia: The fear of injections. • Social Phobias: The fear of social situations. • Pteromerhanophobia: The fear of flying. • Mysophobia: The fear of germs or dirt.

24. OCD – Obsessive Compulsive Disorder • An anxiety disorder – characterized by repetitive thoughts (obsessions) and behaviors (compulsions) • Common Obsessions: • Fear of being contaminated by germs or dirt or contaminating others • Fear of losing control and harming yourself or others • Fear of losing or not having things you might need • Order and symmetry: the idea that everything must line up “just right” • Common Compulsions: • Excessive double-checking of things, such as locks, appliances, and switches • Repeatedly checking in on loved ones to make sure they’re safe • Ordering or arranging things “just so” • Accumulating “junk” such as old newspapers or empty food containers

25. PTSD • Long-lasting anxiety disorder that develops due to an extreme physical or psychological trauma • Generally associated with military combat experiences • Natural disasters, physical or sexual assault, terrorist attacks, shooting sprees – simply witnessing the injury or death of another can result in PTSD • 3 core symptoms: • Frequently recalls the event • Avoids stimuli or situations that tend to trigger memories of the experience • Increased physical arousal – easily startled, trouble sleeping, angry or irritable

26. Mood Disorders • A serious, persistent disturbance in a person’s emotions that causes psychological discomfort, impairs the ability to function, or both. • Major Depression • Bi-polar disorder

27. Stages of Depression • Usually depression goes in 4 stages… Major Depression Depression Dysthymia – chronic low-grade depression Blues

28. SAD – Seasonal Affective Disorder • Episodes of depression occur in autumn and/or winter months • More common among women & those living in northern climates…like the Seattle area…

29. Bi-Polar Disorder • Previously known as manic depression • Person will experience extreme mood swings • Alternating incapacitating depression with extreme euphoria (manic episodes)

30. Dissociative Disorders “Fragmentation of Self” • A normal personality = awareness, memory, & personal identity are associated and well-integrated • Dissociative Experience = these components of personality become separated or divided Examples of temporary breaks or separations from memory or awareness? 3 Basic Disorders: • Amnesia • Fugue • DID

31. Dissociative Amnesia • Partial or total inability to recall important info. • Not due to a medical condition (illness, injury or drug) • Develops amnesia for personal events or info – not usually general knowledge or skills (forgets spouse’s name) • Response to stress, trauma, extremely distressing situations

32. Dissociative Fugue • Appears normal – but has extensive amnesia & is confused about identity • Suddenly and inexplicably travels away from home, sometimes adopts a new identity • Associated with traumatic events or stressful periods • When person “awakens” from fugue state, they may remember their past history but have amnesia for what occurred during the fugue state!

33. DID • Dissociative Identity Disorder • Most controversial of the dissociative disorders • Involves extensive memory disruptions for personal information along with the presence of two or more distinct personalities or identities within a single person. • “Alters” – alternate personalities – seem to embody different aspects of the individuals personality • Primary personality is often unaware of the existence of the others • Possible explanation: • Form of coping from past traumas – extreme sexual or physical abuse in childhood, a pathological defense mechanism used in order to survive, but very hard to verify objectively due to the unreliability of childhood memories.

34. Somatoform Disorders • Hypochondria – preoccupation with imagined diseases based on the person’s misinterpretation of bodily symptoms or functions – no physical or medical basis for these complaints • Conversion Disorder - a mental health condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation • An attempt to solve a conflict felt inside – numb arms = a woman is afraid of committing violence to a loved one

35. Psychotic Behavior • Behavior so different from normal that contact with reality is often lost. • Psychotics would say something like, “there is nothing wrong with me, it’s the rest of the world that’s messed up!!” – do not recognize their behaviors as unusual • Common Symptoms: • Inappropriate emotional responses • Disorientation • Strange mannerisms • Hallucinations • Delusions

36. Disorientation • Lack of organization in thinking and speaking • Weird speech patterns are common – word salad or bizarre associations • their speech may be rapid and constant • the content of their speech may appear random; for example, they may switch from one topic to another mid-sentence • their train of thought may suddenly stop, resulting in an abrupt pause in conversation or activity

37. Inappropriate Emotional Responses Affect – emotional state or mood • Lack of affect, or almost no emotions being displayed • Emotional extremes • Crying when laughter is called for, and vice versa

38. Strange Mannerisms • Aimless, purposeless behavior • Compulsive movements • Weird grimaces or other facial expressions

39. Hallucinations • NOT a drug-induced state • SENSE distortions • Hearing (auditory) – voices commanding to do something • Seeing (visual) – seeing things not there, often evil or frightening • Smelling (olfactory) – smelling things that aren’t there • Touching (somatic) – feeling things crawling inside body, or something touching body

40. Delusions • False ideas that have no basis in reality • The psychotic individual genuinely believes them • 3 Main types: • Delusions of grandeur/grandiose delusions • Delusions of persecution/paranoid delusions • Delusions of reference - a neutral event is believed to have a special and personal meaning. For example, a person with schizophrenia might believe a billboard or a celebrity is sending a message meant specifically for them.

41. Schizophrenia • Most common type of psychotic disorder • Diagnosed when a person loses touch with reality • Psychological disorder that involves severely distorted beliefs, perceptions, and thought processes • During schizophrenic episodes - loses grip with reality – inner world characterized with chaos, disorientation, frustration • Must have two or more of the following noted characteristics for a month or more to be diagnosed with schizophrenia

42. Symptoms • Either positive or negative • Positive = excess or distortion of normal functioning – delusions, hallucinations, severely disorganized thought process • Negative = reflect an absence or reduction of normal functioning – greatly reduced motivation, speech, expressiveness

43. Negative Symptoms: • FLAT AFFECT: • No emotion or facial expression • Speech is slow and monotonous • ALOGIA: • Greatly reduced production of speech • Reponses are brief and empty • AVOLUTION: • Inability to initiate or persist in goal oriented behaviors • Apathy

44. Paranoid Schizophrenia • Presence of delusions/hallucinations or both • Virtually no cognitive impairment, disorganized behavior, or negative symptoms shown • Well organized delusions of persecution or grandeur are constantly present • Auditory voices are associated with hallucinations • Most common type of schizophrenia

45. Catatonic Schizophrenia • Highly disturbed movements or actions • Afflicted will resist direction from others – will attempt to be rigid and immovable • “Waxy Flexibility” – person can be molded into any position and hold it indefinitely • Extremely rare type of schizophrenia

46. Disorganized Schizophrenia • Disorganized speech, direction, flat affect • Delusions and hallucinations are not well organized and contain fragmented or shifting themes • Behaviors are very particular – have trouble carrying out basic daily routines

47. If time permits… Read through this article to give you more information for this unit. https://opentextbc.ca/caregivers/chapter/chapter-three-an-overview-of-mental-illness/

48. Unit Overview (again): • Argument: How should we address mental health/mental illness as a society? • Multi-Genre Project: • Research current mental health care policies and societal reactions • Create a visual that showcases argument • Write an analytical paragraph to explain the visual This assessment will require synthesizing information from various sources: Proof, a movie of your choice (taken from a list of recommended options), and research done individually.

49. Films About Mental Health: Recommended: • Inside Out (2015) • The Aviator (2004) • A Beautiful Mind (2001) • Proof (2005) – we will read this play & watch this film in class Optional (with permission slip): • Silver Linings Playbook (2012) • Girl, Interrupted (1999) • Good Will Hunting (1997) • Shutter Island

50. Choose your focus film & answer the following questions. • What film have you chosen? (If you chose a film that needs a permission slip, please have that signed and returned to me by Monday) • What mental illness/disorder is presented in your film? • How is this mental illness/disorder portrayed? Symptoms shown, etc.? • How are the people suffering from the mental illness/disorder treated by others?