of Charlie, the introverted character we are introduced to, to experience severe symptoms of PTSD. Charlie suffers from a mix of sadness, grief, guilt, anger, and dissociative tendencies-- which eventually lead to his admittance into a psychiatric hospital.
Charlie often experiences high levels of derealization and depersonalization, especially with trauma-related stimuli (referring to his Aunt). In one scene, before Charlie’s girlfriend Sam leaves to go to college, they both have sex-- and Charlie starts to experience dissociations rather than flashbacks from his childhood consisting of his Aunt Helen molesting him. After Sam leaves to go to to college, we then see Charlie have a breakdown-- eventually calling his sister, stating that Aunt Helen’s death was his fault. This leads to Charlie having a blackout, and waking up in a psychiatric hospital where he is finally able to dig out the repressed memories of his Aunt sexually abusing him as a child. The occurrence of Charlie’s experience with sexual abuse evidently correlates to Charlie's dissociations and blackouts-- which rapidly increase throughout the movie, especially occurring when Charlie gets upset about something. For example, when Charlie’s best friend Patrick is being beat up due to his sexuality in school, Charlie has an outburst of aggressive behavior in order to protect his friend. While protecting his friend, Charlie completely blacks out, which is triggered by the trauma-related stimuli of the situation.
According to the DSM-5 criteria for PTSD, symptoms include “persistent distorted blame of self or others for causing the traumatic event or for resulting consequences” (DSM-5). Throughout the movie, we discover through one of Charlie’s dissociations that his Aunt Helen died in a car accident, on the way to Charlie’s birthday party. Often, Charlie experiences alterations in cognitions and mood when he feels that he caused the death of his Aunt Helen-- resulting in him feeling often detached from others. When Charlie has the breakdown before he is admitted into the psychiatric hospital, all of his repressed memories come to surface about his Aunt-- and he is seen continuously saying to himself, “It’s all my fault.” This can be seen as a direct symptom of PTSD, and an explanation as to why Charlie feels overcome with guilt throughout the whole movie.
Due to Charlie’s severe symptoms of PTSD, he must be admitted into a psychiatric hospital and continue on with exposure therapy.
Exposure therapy works by talking about trauma repeatedly with a therapist, which allows the patient to control of thoughts and feelings about the trauma. The character of Charlie is often overwhelmed and afraid of his memories, therefore exposure therapy would help Charlie become more desensitized to these memories-- resulting in less blackouts. I would also recommend EMDR and psychodynamic psychotherapy as a part of Charlie’s treatment. EMDR would help Charlie with his reactions to his traumatic memories, while psychodynamic psychotherapy would help identify what triggers his stressful memories and increase his self confidence. In the movie, Charlie was admitted to a psychiatric hospital and was eventually let out-- being helped by different treatments with his psychiatrists. Although not mentioned in the movie, I would definitely prescribe Charlie an SSRI such as sertraline and paroxetine in order to help Charlie deal with both his depression and his
anxiety.