Birdy

1. Birdy Stars Nicolas Cage Matthew Modine Director: Alan Parker Angela's Ashes, Evita, Bugsy Malone The Road to Wellville, The Commitments, Mississippi Burning, Midnight Express, Pink Floyd The Wall, Fame

2. Birdy • Based on 1978 Novel • By William Wharton • Born Albert William du Aime • UCLA: B.A. Art;Psychology Ph.D. • Died 10/29/2008 • Novel about World War II Veterans • Movies from other novels: “Dad” and “A Midnight Clear”

3. Agenda Have fun • Watching movie • Learning • Joining conversation

4. After the movie.. • PTSD Clinical issues, day-to-day veterans’ issues, cinematic considerations • Matt Miller, LCSW;Veterans Administration --Clinical considerations  • Tom Price, LCSW,Veteran, St. Patrick Center --Realities for returned veterans

5. History of PTSD • DSM posttraumatic stress disorder • ICD post-traumatic stress disorder • Elsewhere, post traumatic stress disorder

6. PTSD • Term created in the mid-1970s, • Officially added as Anxiety Disorder DSM-III (1980) • DSM-5 (2013) created new category: Trauma and Stressor-Related Disorders

7. PTSD-like descriptions • Ancient Egypt • Greece • Rome • India • Elizabethan England

8. Herodotus • In battle of Marathon in 490 B.C. • Athenian warrior went permanently blind • although “wounded in no part of his body.” • When he saw nearby comrade killed

9. Oddysey • 3-week trip home from the Trojan War becomes a ten-year journey • To avoid dangers of Scylla and Charybdis, • do not resist the dangers (much as modern trauma sufferers must overcome their resistance to memories of the traumatic stressors).

10. Oddysey • Sorceress Circe admonishes him, • "Do the works of war concern you still, and toil? • He is tempted by Sirens and the addictive lotus fruit

11. First Medical Terminology Swiss Military Physicians-1678 • melancholy • incessant thinking of home • disturbed sleep or insomnia • weakness • loss of appetite • anxiety • cardiac palpitations • stupor • Fever

12. First Medical Terminology “Nostalgia”

13. Nostalgia 1863 • Public outcry about numerous “insane soldiers” wandering around • First military hospital for the insane • Most common diagnosis: Nostalgia.

14. French Doctors: maladie du pays, (Disease of the Country) • German doctors: heimweh (Homesick)

15. American Civil War military physicians diagnosed • paralysis • tremors • self-inflicted wounds • nostalgia

16. American Civil War • Jacob Mendes Da Costa-1871 Study • Identified “Soldier’s Heart” • (DaCosta’s Syndrome)severe palpitations; an ailment of the sympathetic nervous system • Soldiers on normal leave often collapsed with emotional illness at home, even when asymptomatic on duty

17. 1901 Schreckneurosen • Bruns and Stierlin studied the symptoms of survivors of volcanic eruptions and mining accidents • they coined the term "Schreckneurosen"- the terror neuroses.

18. Russian Army of 1905 • First army to determine that mental collapse was a direct consequence of the stress of war and to regard it as a legitimate medical condition • German physician Honigman served with Red Cross there, and coined the term “war neurosis” [Kriegsneurose]

19. World War I • High psychiatric casualties attributed to the new large-caliber artillery. • Believed the impact of the shells produced a concussion • Thus the term “shell shock” • Freud:“war neurosis”caused by conflict between a soldier’s “war ego” and his “peace ego.”

20. World War II • 1945, Grinker and Spiegel : • “Combat… or Battle Stress” • “Combat Exhaustion” • “Acute combat reaction" • “Battle Fatigue”

21. 1952 DSM-I • “Gross Stress Reaction” • …exposed to severe physical demands or extreme emotional stress, such as in combat or in civilian catastrophe (fire, earthquake, explosion, etc) • [may be] “previously…normal” • The particular stress involved will be specified as (1)combat or (2) civilian catastrophe

22. DSM-II -1968 • 307.3 Adjustment Reaction of Adult Life • [different coding for different life stages] • Example: Fear associated with military combat and manifested by trembling, running, and hiding.

23. First Medical Terminology “Nostalgia”

24. PTSD—Back to Today • Term created in the mid-1970s, • Officially added as Anxiety Disorder DSM-III (1980) • DSM-5 (2013) created new category: Trauma and Stressor-Related Disorders

25. Clinical Considerations • In what ways was Al prepared and unprepared for the stress of combat before he joined the Army? • How should we diagnose Al, if at all? • How should we diagnose Birdy? • Does Birdy's behavior in the asylum correspond with dissociation, or is it more like a form of catatonia?

26. Clinical Considerations • How does Birdy’s pre-military behavior relate to his post-deployment behavior, if at all? • Did the movie portray Birdy's pre- and post-deployment behaviors as maladaptive coping, or someone "being himself?"

27. Clinical Considerations • How does the movie portray the treatment options available to these two veterans in the Vietnam era, and how has that changed today? • What's up with that ending?!  What does it mean, what does the writer imply about the two men, and what's going to happen to each of them?

28. Cinematic Considerations • Chris Clark, BA, Cinema St. Louis

29. You! • Your comments. • Your questions for panel members • Fill out evaluations

30. You

31. Us