PSYCHOSOCIAL EXAMININATION IN SCHIZOPHRENIA

Running head: PSYCHOSOCIAL EXAMININATION IN SCHIZOPHRENIA
DAVID HELFGOTT: A PSYCHOSOCIAL EXAMININATION IN SCHIZOPHRENIA
Abstract
This research paper examines the cinematic biographical adaptation of musical child prodigy David Helfgott. The paper will examine Helfgott during the following four stages of psychosocial development based on the psychosocial theory of Erik Erikson: Middle childhood (6-12), Early adolescence (12-18), Later adolescence (18-24) and Middle adulthood (34-60). Erik Erikson was a psychoanalyst who described development as a series of eight psychosocial stages. At each stage there are development tasks to master and a central conflict that the individual can resolve positively or negatively. The nature of the task mastered and the conflict resolution depends largely on the individuals relationship with others and through the individual's own choices.

The examination of David Helfgott will reveal a negative outcome resulting from his apparent Schizophrenia. The paper will provide a five-axis diagnosis, hypothetical explanation of the Schizophrenia origin and finally treatment considerations.
DAVID HELFGOTT: A PSYCHOSOCIAL EXAMININATION IN SCHIZOPHRENIA
Middle childhood: Industry versus Inferiority
During this stage, children make the transition from the world of the home to that of school and peers. Children learn to make things, use tools, and acquire the skills to be a worker and a potential provider. This is also the first time that children receive feedback from outsiders about their accomplishments.

If children can discover pleasure in intellectual stimulation, being productive, seeking success, they will develop a sense of competence. If they are not successful or cannot discover pleasure in the process, they may develop a sense of inferiority and feelings of inadequacy that may haunt them throughout life.In summary, Helfgott appears to have no childhood friends. He is depicted as being close to his siblings. His authoritative father, Peter Helfgott who controls his daily interaction, shadows Helfgott.

School age Helfgott displays concrete operations by playing complicate piano pieces and playing chess. Helfgott displays skilled learning by seeking competence and mastery over music. Helfgott self-evaluation revolves around what his father thinks what is important. Helfgott was never depicted participating in team sports.

Helfgott addresses the psychosocial crisis of industry versus inferiority by striving to be an accomplished pianist. The central process of education is continuous through his music teacher and coaching by his father to always be a winner. Helfgotts prime adapt ego quality of competence reference a general belief in ones ability to get the job done Helfgott does not get the job done. Helfgotts core pathology of inertia, which references a paralysis of thought, and action that prevents productive work Helfgott appears to be passive. He is alone by the events that occur around him.

Helfgott appears to be a normal but he is actually being sustained by his father and music teacher who place energy, enthusiasm or confidence inside of him to take action.Adolescence: Identity versus Role Confusion
During adolescence, we ask ourselves, "Who am I? Who do I want to be?" Answering these questions involves integrating the healthy resolution of all earlier stages. Adolescents must explore, test limits, become autonomous from parents, and commit to an identity, or sense of self. One can only establish an identity after trying out various roles, behaviors, and ideologies. Failure to achieve a sense of identity results in role confusion, an inability to make decisions and choices about vocation, sexual orientation, and one's role in life.
Helfgotts stature in relation to his age appears normal his complexion pale, his face young-looking for chronological age.

His facial expressions appear quizzical with a sheepish grin his eyes darting and hair style unremarkable. Helfgott formal operations appeared to be developing based off his musical ability. The six characteristics of formal operational thought are met. He has the ability to manipulate mentally more than two categories of musical variables simultaneously. He has the ability to think about the changes that come with time for example going to school in America.

He has the ability to hypothesize logical sequences of events for example he was able to predict that musical instruction in America would lead to a fuller life. Helfgott had the ability to foresee the consequences of actions for instance, he realized that if he stayed in Australia and turned down instruction in America that certain career possibilities will be closed to him. Helfgotts had the ability to detect logical consistency and inconsistency in statements made by his father. Example Peter Helfgott, Helfgotts father, told him he would be with him for every, you can not trust anyone and music will always by your friend.

Helfgott understood death, he understood friendship and music is only alive when he plays. Helfgotts ability to think in relative terms about self, others and the world is displayed by Helfgott behaving in a culturally acceptable manner for a young pianist prodigy makes him social acceptable. Helfgotts emotional development appeared victimized by his over bearing father. Helfgotts sexual relationships appeared nonexistent but it was indicated that he was heterosexual and shy with females like most adolescent males.

Helfgott membership in a peer group was never depicted accept for brief words with other musical competition participants. Helfgotts psychosocial crisis of group identity versus alienation concludes premature. Helfgott simply joined with other musicians a group he had always been associated. He is alienated by stopping is social experimentation.

He now has no bounder between adolescents and young adulthood. The outcome for Helfgott is poor social skills.Young Adulthood: Intimacy versus Isolation
During this stage, the young adult must learn how to form intimate relationships, both in friendship and love. The successful completion of this developmental task relies on the resolution of earlier stages. For example, it may be difficult to establish intimacy if you haven't developed a basic sense of trust or a sense of identity.

Young adults must learn how to develop intimate relationships with other adults. The alternative is alienation, isolation, a fear of commitment, and an inability to depend on others.Helfgott is depicted as not gaining autonomy, the ability to regulate ones own decisions and actions without undue control by ones parents. Helfgott left home for studies in England but his thoughts, emotions and actions reflect his father, Peter Helfgotts goals.

Helfgott did not display a comfortable sense of autonomy. His father, Peter Helfgott, constructs Helfgotts gender identity. Helfgott is taught to be a man he must be a winner, he must be health and strong. Helfgott is a winner when in music but he is not mentally strong or physical.
Helfgotts internal morality consists primarily of internalized parental standards and values, recognized rights and wrongs of his father, Peter Helfgott.

Helfgott is depicted as failing to take control of his personal identity. Example, Helfgott left Australia for studies in England, he encounters strong pressure to violate the moral beliefs instilled by his father. Helfgott is depicted as failing to take control of his personal identity. Fellow students coerce him to spend his money on wine, women and song. His companions never display a desire to participate in thought provoking discussions or challenge life experiences to help advance Helfgott to higher reasoning. Helfgotts career choice was influenced by six major factors.

Helfgott individual desire to be an award-winning pianist. Helfgott has psychosocial emotional fear of failure. Helfgott societal educational experience revolved around music. Helfgotts familial is his early childhood experiences. Helfgott role models stressed music and winning and situational, music was the career course of least resistance.

Middle Age: Generativity versus Stagnation
Generativity refers to the ability to move beyond selfishness, look outside oneself and care for others. Caring for others can occur through parenting, being a mentor, teaching, or providing tools or products that will outlast your lifetime and benefit future generations. During this stage, adults feel a need to be productive and to help the next generation. If this crisis is resolved unsuccessfully, the person will remain self-centered and experience stagnation, the inability to grow from an emotional and psychological standpoint.

Helfgott spent the majority of his early adulthood in and out of mental health institutions. Helfgott appears to have no intimate relationships or any resolution to his earlier developmental tasks and psychosocial crisis. Helfgott is depicted as a broken man who wonders the streets searching for meaning and the path to maturity. Helfgott does not acquire understanding. The management of his household, management of his career, marital relationship and expanded caring relationships is lost due to Helfgotts mental illness and personal handling by well meaning people and finally by his wife Gillian Helfgott.

Nature of Pathology
In my opinion and with a reasonable degree of scholarly certainty David Helfgott a thirty-seven Jewish Australian married male demonstrates characteristic symptoms of schizophrenia disorganized type 295.10.DSM-IV Multiaxial Evaluation
Axis I295.10Schizophrenia, Disorganized
V61.20Parent-Child Relational Problem
Axis IIV71.09No diagnosis
Axis IIINone
Axis IVProblems with primary support group
Problems related to the social environment
Occupational problems/Unemployment
Axis VGAF =40 (current)
Multiaxial Evaluation
The information and assessment of Helfgott are based on my viewing of the cinematic biographical adaptation of his life and additional academic inquiry made through journals and books.

Helfgotts mental illness has a genetic origin. Helfgotts father, Peter Helfgott, had an aunt and sister, Hannah, to suffer from mental illness and institutionalization. The cinematic adaptation depicted a schizophrenogenic family with harsh discipline, overprotection, excessive love, and impossible expectations. I think Helfgotts delusion is he is an adolescent trapped in mans body.Mental Health Treatment Plan
In my opinion Helfgotts present problem of Schizophrenia, Disorganized and Parent-Child Relational Problem requires specialized therapy and pharmacotherapy.
Antipsychotic medications, also known as neuroleptics, are the cornerstone of treatment.

Until the 1990s, antipsychotics generally were much more effective in controlling positive symptoms than negative symptoms. A new generation of antipsychotics provides more effective management of both positive and negative symptoms. These newer antipsychotics include clozapine (Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon) and aripiprazole (Abilify).Although medications are the primary treatment to reduce signs and symptoms, many people with schizophrenia also benefit from non-drug therapies. These may include:
,h Individual therapy. Cognitive therapy would involve a therapist helping Helfgott learn ways of coping with stressful thoughts and situations to reduce his risk of a relapse.

Helfgott may learn to change negative patterns of thought and behavior into ways that put him in control of his thoughts and feelings. Helfgotts illness has made it more difficult for him to do things in is daily life that people without schizophrenia may take for granted. A therapist can also help him comply with his schedule of medications.
,h Family therapy. Helfgott and his family members may benefit from therapy that provides support and education to families. Helfgotts symptoms have a better chance of improving if family members understand his illness, can recognize stressful situations that might trigger a relapse and can help him stick to his schedule of drug treatment.

Conversely, Helfgott may not do as well if family members distance themselves from him and are less understanding.
,h Rehabilitation. Training in social and vocational skills necessary to live independently is an important part of recovery. With the help of a therapist, Helfgott can learn social skills such as good hygiene, cooking and traveling.

People with schizophrenia who are in programs to train them in social skills or for jobs seem to experience much greater improvement in symptoms than do those who don't receive train in social skills.
Today fewer people with schizophrenia require long-term hospitalization because more people than before respond positively to medications or other forms of treatment for schizophrenia.