Diagnosis of Adam Sandler Reign over Me

Reign Over Me Alex Chaput 0810758 The movie Reign Over Me is about a man named Charlie Fineman. Charlie used to be a practicing dentist. His whole life was turned upside down when he lost his wife and three daughters in the terrorist attacks on 9/11. One day while Charlie is on the street his old roommate from college, Allen Johnson, sees him and tries yelling for him, but Charlie does not stop. Allen then seems like he knows that something is wrong with Charlie and wants to help. In this movie it is clear to see that Charlie is suffering from Post Traumatic Stress Disorder (PTSD).
This is what would go on Axis 1 of the multi-axial system. For this diagnosis he needs to have 6 or more symptoms from 3 different areas. These areas are re-experiencing, avoidance, and arousal. He has been suffering for over 1 month and is severely distressed and impaired. The traumatic event that Charlie was exposed to was his family dying in the plane crash of 9/11. This event has left him extremely helpless and he has times of horror when he thinks about what has happened. While going about his daily life he acts as if he doesn’t remember any of the tragedy that occurred.
This would be one of the avoidance symptoms. Another of these symptoms would be that he avoids his late wife’s parents as they remind him of his family. The third would be his loss of interest in activities. He used to be a practicing dentist, but now lives off of money from the government. At all times in this movie Charlie has his headphones in order to drown out any thought or mention of his family. Charlie has a breakdown at one point in the movie. It seems as if he has a flashback of his family in his house. These thoughts and memories are recurrent and intrusive which applies to his re-experiencing symptoms.

Another of these is when he shows very intense distress in his court appearance when showed pictures of his family. He then has to be escorted from the courtroom. For his persistent symptoms of increased arousal he seems to have sleep problems as he stays up late into the night playing video games. He also is constantly irritable and has outbursts of anger. He refuses to get help and will not talk about his feelings or his family with anyone. This leads to what seems like him considering attempting suicide. He however then takes a gun out into the city. He gets into a standoff with a cop and it seems like he wants the cop to kill him.
For axes 2 and 3 I didn’t think that Charlie would have anything. He didn’t seem to have a personality disorder, mental retardation, or any medical conditions. There were many psychosocial and environmental factors that Charlie faced for axis 4. One of these environmental factors would be that he still lives in the house that he lived in with his family. This is what caused the flashback of his family. Another factor is the loss of his career. He used to be a successful practicing dentist. He now has no career and lives off of settlement money and money from the government. He has very little social interaction.
He doesn’t confide any of his feelings in friends. All of these things cause distress and impairment in Charlie’s life. On axis 5 I would give Charlie a GAF score of 22. His life is not functional. He cannot control his emotions when memories and thoughts of his family come up. He seems to be a very dirty individual who doesn’t care about what he looks like. He says that he often sees his family’s faces in other people on the street. His life is dangerous to him as well as those around him. Charlie’s PTSD stems from a very specific, very obvious, event. This event is the loss of his family.
He never received any treatment for his problem which did not help. If he had gone to see a grief counselor maybe the PTSD could have been avoided completely. Some more of the etiology factors for his PTSD would be that he had very low levels of social support. He did not have many friends and he lost his entire family. To treat Charlie’s PTSD he could have been prescribed an SSRI. He could have also used prolonged exposure treatment with relaxation training, cognitive restructuring to correct negative assumptions about the trauma, or he could have been trained to develop better coping skills.
In the movie he was receiving some treatment. He was seeing the therapist that Allen had suggested. He quickly would end the sessions as he was uncomfortable talking to her about his past. The end of the movie seemed very abrupt to me. Charlie seems to be doing better, but it is unclear what will happen to him. He has moved out of his old apartment and into a different one. He also has started to communicate slightly more with other people. He also told the story about his family’s death to Allen. It is possible that his life could improve, but I’m not sure if his life could ever be as fulfilling as it was before the event.

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