Pat comes home after being at a mental facility into the care of his mother Dolores and his father Pat Sr. after eight months of treatment for bipolar disorder. He returns home with a hard set goal in mind. He will do whatever it takes in order to win his wife Nikki back, who currently has a restraining order against him. While visiting at a friends house Pat meets Tiffany, a recent widow and fellow neurosis sufferer. Tiffany is the key to Pat learning to move forward and away from his past, but Tiffany herself as many issues to work through.
When we first meet Tittany it is clear that while sne is still troubled and broken, sne is determined to move forward in life and forgive her own mistakes. She has learned to accept herself at this point, flaws and all, even if she doesn't necessarily have a great opinion of herself. Tiffany is an extremely strong woman though. She has accepted herself and therefore refuses to apologize or make excuses for her sadness and what actions manifest from it. Tiffany has sunken into a deep depression following the death of her husband.
The movie gave a detailed look into Tiffanys illness, and yet never outright names what can be deduced as depression. The movie alludes that there is something besides depression that plagues her. It tells of the side effect, which with Tiffany suffers the most from. The disorder instigates her sex drive to turn on and off. Just before her husbands passing this was negatively affecting her marriage. Following his death, Tiffany misguides her guilt into a self-absorbed lifestyle of promiscuity. Preceding the movie, Tiffany is fired from her Job for having ex with everyone she works with.
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It is shown in the movie how men still show up at her parent's front door in attempts to "get-together" with her. Her family suffers from the shame as the town garners glaring repugnance towards Tiffanys actions. We are shown the pained and humiliated looks on her parent's faces as her "suitors" come knocking at their door looking for her. Tiffany still goes about her business in a completely unabashed way which emphasizes the chronic emptiness that has been consuming her. It is when Pat witnesses what these men are there for that something s done about it.
This scene depicts Pats reaction, in which he sends them away and is outraged that these men could seek to use this nice girl for their own gratification. As Tiffany eavesdrops she observes Pats high opinion of her, which is something she hasn't had for awhile and his regard for her advances her own for herself. As mentioned earlier Tiffany shows apparent symptoms of depression. Even before the death of her husband she was suffering from the DSM-IV TR symptoms of depressed mood and a decreased interest and pleasure, which had greatly affected her marriage.
But it is her subsequent actions that make us seek another diagnosis. As Tiffany opens up to Pat we learn that she has a history of extreme emotional reactions, unstable interpersonal relationships, difficulty controlling anger, and impulsive sexual activity. These are DSM-IV criteria for Borderline Personality Disorder. Depression and Borderline Personality Disorder do work hand and hand, so the comorbidity of these disorders is not surprising. There is a scene between Pat and Tiffany where Tiffany plainly demonstrates the act of "splitting".
Splitting is also alled black and white thinking, which is when a person with Borderline Personality Disorder can only see things as an ideal or the epitome of wrong with no leeway in- between. Identity Disturbance is one of the nine criteria for Borderline Personality Disorder in the DSM-IV and is apparent in Tiffany. The way that she reacts after hearing Pats opinion of her, allows a look in to the distorted and bleak self-view that she has of herself. She becomes close to Pat and the movie depicts how she avoids any possibility that Pat could get back with his ex wife.
She doesn't want to risk him bandoning her. This frantic effort to avoid abandonment is yet another criteria for Borderline Personality Disorder. She is open with Pat about how she has been on medication and how she is in therapy, but right up to the end of the movie we are still lett witn a sense that Tittany still needs a lot ot work to get to a healthy place. Long-term Psychotherapy is generally the clearest route to take when it comes to Borderline Personality Disorder.
Medications also help with these disorders by tackling comorbid depression with antidepressants, the paranoia with antianxiety edications and the use of mood stabilizers to help with impulsions and anger. It is said that the medications should be directed at the comorbid symptoms rather than at the borderline personality disorder and its own symptoms, as it is unnecessary to treat the disorder with medication on its own. So in the case of Tiffany I believe it is prudent to medicate her but have the medication be directed at her depression in hopes to stabilize her moods.
I agree with the fact that she has been on medication, but I do believe that intense psychotherapy for her Borderline Personality Disorder is eeded. The movie may have ended happy but she still needs a lot of work in terms of how she processes and regulates her emotions. Dialectal Behavioral Therapy is a form of Psychotherapy that focuses in on regulation of emotions through Cognitive Behavioral techniques. The therapy combines the Cognitive Behavior Techniques which help emotions regulation and Reality Testing which focuses on distress tolerance, acceptance and mindful awareness. It is a therapy derived from Buddhist meditation.
I believe that the two components of this therapy, individual and group, ill benefit Tiffany in the way of her becoming mindful of others and accepting of herself. It is the most effective form of treatment for Borderline Personality Disorder today and therefore is what I would suggest in regards to long-term therapy for Tiffany. The movie leaves us with open eyes toward the idiosyncrasies in people. It highlights how common mental illness is in the eccentrics of its entire cast. The movie brings awareness to mental health issues and portrays Just how frequent and wide-ranging disorders are.
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