Friday, September 16, 2011

Falling Angels: The Effects of Depression and Alcohol Dependency on Family Relations

     Another bid to buy some time, this is a paper from a Movies and Mental Illness class at Roosevelt.  It goes into much more detail about the film in question than I tend to with reviews.  All the same, I highly recommend the movie.
From left to right: Lou, Sandy, Jim, Mary, and Norma Field
Falling Angels: The Effects of Depression and Alcohol Dependency on Family Relations
      Based on the Barbara Gowdy novel of the same name, Falling Angels (2005) offers a glimpse of the dysfunction of the Field family which has come to be understood as normal and acceptable.  Where the novel spans a period of more than ten years, the film instead focuses on the few months between the fall of 1969 to early January 1970, with repeated flashbacks to an aborted vacation to Disneyland that was instead spent in the family’s backyard underground bomb shelter.  The Field family consists of father Jim, mother Mary, and daughters Norma, Lou, and Sandy.  Though each of the daughters is shown interacting with someone outside of the family – and Jim Field is acknowledged to have a mistress for part of the time shown – the focus is clearly on the intra-family relations and how the home situation has made interpersonal relationships for the Fields abstruse.
     The film opens with the Fields beset by a reporter seeking an answer as to why she was on the roof.  Lou tells the reporter that she was looking for the family cat. (Though there is no cat in the film, the novel does describe the time that the Field girls had adopted a stray cat only to have it killed by the engine of their father’s car, where it had gone to stay warm.)  The Field girls go inside an empty funeral home to see their mother (the she in question) in a small pink casket.  The characters are ably sketched out in this short sequence, with Lou being the vocal rebel, Norma the compliant mediator and caretaker, Sandy the naïve aesthete, Jim the ill-tempered father who has no meaningful relationship with his daughters, and Mary as not really there. 
     From the opening, the film goes back to trace the events that led up to Mary’s death.  Jim is shown to be a control freak who inspects his daughters’ hands and dictates their care for Mary.  In an early flashback, a more severe instance of Jim’s controlling nature can be seen as he wakes his family in the middle of the night, rushes them to the bomb shelter to avoid a (fake) nuclear attack by the Russians, and then tells them that instead of going to Disneyland as he had promised the girls, they will be spending the next two weeks locked underground.  They will follow a strict schedule (as laid out by Jim) for everything, from the order that they will use the latrine (chemical toilet) to when they will be allowed to drink water.  He does not allow his miscalculations – he underestimates the amount of fresh water needed for five people (to the point that the family ends up drinking soapy dishwater and whiskey for the last few days) – or medical situations (such as Norma getting her first period) to interrupt the exercise.  What is not as clear, until much later in the film, is that much of the work Jim is doing to hold his family together may actually be necessary.  Whether it is or not, Jim is trying to apply the structure he learned in the Canadian military and service in World War II to his family in hopes that it will override all of the factors that would threaten to tear his family apart, but does not given much consideration to the thoughts and feelings of his children in doing so.
     Mary is revealed to have had a child with Jim before Norma (the oldest of the girls).  The baby boy, Jimmy, died at Niagra Falls.  It was ruled an accident by the coroner – that Mary slipped and lost control of the baby – which overruled the police’s suspicions of intent on Mary’s behalf.  While Mary obviously carries a great deal of guilt over this incident – which can be seen in her reaction to Lou and Norma while on the church steps and very clearly in a brief conversation with Sandy (“You can’t trick nature.  Can’ to the music and then kill the piper.”), she more often appears to be casually unaware of her environment until stirred by a change.  Mary’s life is shown as one where she is dependent on her adolescent daughters for care, accepting of her husband’s controlling nature (and even understanding of his affairs), and as a captive in her own home.  It is not surprising, then, that when Mary attempts to break free from what her life has become, it takes shape as leaving the house (either running to the church or climbing on the roof).  Aside from these two instances, Mary does not leave the house.
     Norma is an introvert who is teased at school – the boys call her “Enorma” and compare her to a cow and the girls openly laugh at her behind her back – and held in little esteem at home.  The only respite from this at school is the new girl, Stella, who befriends Norma.  Through her relationship with Stella, Norma has to come face-to-face with the shame she feels for her mother’s condition (and knowing that her father has mandated that the neighbors know as little as possible as to what goes on in the Field’s home), but she is also given the possibility of having somebody who will love and accept her.  (In the novel, Stella rejects Norma after Norma kisses her and admits to being a lesbian; Norma’s sexuality is left in question in the film.)  Emboldened, Norma is able to make some headway in establishing her identity on her terms, which leads to an improved relationship with her sisters and the grudging respect of her father.  However, this is not without incident, as during her becoming, Norma is nearly molested by her drunk father while he is teaching her how to drive.
     Lou is the most aware of the wrongness of the family situation in the Field’s home.  While neither Norma nor Sandy balks at the dictum to present their hands for inspection, nor will either confront Jim when they believe he is in the wrong, Lou acts out both directly (such as when scrawls the word tyrant on the street in front of their house, stomps on his foot, or accuses him of causing Mary’s death) and indirectly (such as when she does a Nazi salute behind his back or “quits” the family and runs away to the bomb shelter).  Lou is still bound to follow Jim’s rules, though.  She may think that it is wrong for her father to effectively keep Mary prisoner in her own home, but she still acts to bring her home as quickly as possible.  This may be done because she is afraid of Jim’s reaction – he is prone to acts of violence against furniture and game boards – but is also a result of her not knowing any other means by which to handle the situation.  Allowing Mary to seek solace or absolution in the church means allowing for her own weaknesses to shine through, and that is something that Lou cannot afford.  Even in her relationship with Tom, she does not reveal herself until under the effects of LSD.  Instead, she hides behind a character she has created (she acts less intelligent to make herself more appealing) and her wit (to avoid real engagement).  She cannot even bring herself to talk to her mother learning that Mary is aware of Jim’s affairs.
     Sandy may be seen as naïve, and she is in many ways, but she is not lacking in experience or expectations.  Her expectations are low – she wants to marry her high school boyfriend because she is pregnant with Reg Shellman’s baby and because Reg is, ultimately, not what she is willing to accept – and she blithely accepts the roles imposed upon her at home (baby) and school (future housewife).  Sandy is sexually experienced (her older sisters are not), but this is completely hidden from her family until she reveals her pregnancy. 
     At the center of the Field family’s problems are Mary and her depression.  While Mary no doubt could be diagnosed with late onset dysthymic disorder due to the duration of her depression, that alone is not sufficient in describing her situation.  She definitely meets most of the criteria.  Her depressed mood is nearly constant and has lasted for years.  She has hypersomnia, low energy, low self-esteem, and at times appears to have an inability to concentrate.  There is no evidence of a time when she has not been depressed prior to having children.  It is unclear if there were any major depressive episodes during the early periods of her dysthymia.  There is no evidence of any type of manic episode (Mary’s active moments are still somewhat labored and slow, and there does not appear a mood elevation as much as a less foggy presentation).  Mary does not have a psychotic disorder.  It cannot be stated with any certainty that her depression is not directly tied to her alcohol consumption, but it is more likely that her mood is augmented more than dictated by her steady consumption of whiskey.  Most telling, her symptoms have caused near total social impairment, and almost all of her needs require the care and attention of her daughters.
     It is likely that Mary has recurrent major depressive episodes during this time.  In addition to the criteria met under dysthymic disorder, she displays psychomotor retardation, both fatigue and loss of energy, and recurrent thoughts about death.  While Mary does experience bouts of guilt, some of them are understandable.  However, she also has moments of guilt mixed with anger and feelings of worthlessness.  This cannot be taken as part of the normal bereavement process because it has endured for twenty-one years.
     Mary, as mentioned above, consumes a large amount of alcohol.  While it is impossible to properly diagnose alcohol dependence from what is presented in the film – Mary is not shown to have developed a tolerance (though one can be inferred from her drinking coffee cups of whisky at a time throughout the day), does not show any symptoms of withdrawal (though her moments of agitation occur when she is alone and without alcohol), there is no way of telling whether Mary would try to stop drinking, there is no effort necessary to acquire the alcohol nor recovery necessary (she can be nearly constantly intoxicated) – there are some signs that point toward it.  Mary does favor drinking over interacting with her family, her only social interaction.  Jim (and the daughters) believes that she can be bribed off the roof with the promise of more whiskey.  Mary continues to drink despite knowing that it limits her ability to relate to her family and may exacerbate her depression.
     It is likely that Jim’s behavior is in large part a reaction to Mary’s actions (killing baby Jimmy) and depression.  Jim is more than a bit of a monster, but he honestly believes that his actions are for the benefit of his family (though his affairs may only benefit his family in that they make Jim feel better).  While he has clear anger and control issues, as well as instances of alcohol abuse, Jim maintains a level of functionality throughout the film.  Even when he makes the illogical assumption that threatening to shoot Mary if she does not get off the roof (rather than call the fire department and expose the family to the scrutiny of the neighbors), he is acting on his experiences from the war and the assumption that survival (and not quality of life) is the ultimate goal.  Because Mary is not really present as a parent (and cannot be fully trusted with children) and Jim has obvious limitations, his strategy becomes to provide structure instead of love, and support is always conditional on meeting his expectations.
     Treating Mary in 1969-70 would be different from treating her today, but both should start with reducing her dependency on alcohol.  Not only would Mary benefit physically, but she would likely have a reduced sense of depressed mood on a day-to-day basis.  Therapy would not be allowed by Jim – actually, any type of external assistance would be looked upon as a threat by Jim – so Mary would need to leave the house for her treatment.  As Mary’s experiences as very self-directed, she may benefit more from a pharmacological treatment.  Either naltrexone or acamprosate combined with therapy may work, but disulfiram would likely only cause a deeper, darker depression and other adverse effects that overshadow its benefits in reducing the desire to consume alcohol.
     Having begun to address the alcohol dependency, it is likely that Mary would be more open therapy to address her depression.  Ideally, this therapy would eventually expand to include the entire family (Jim appears to let his guard down after the death of Jimmy is related aloud, but at the same time, Mary is already dead), as Mary’s feeling toward and relations with them are undoubtedly tied to her own feeling of depression.  However, this therapy may start with something so simple as getting Mary to initiate some level of socialization.  This is a modest goal, to be sure, but so long as Mary’s entire world consists of her family (whom she is actually desperate to leave – when Mary declares that she has to get out, it is not the bomb shelter but the family to which she is referring), Mary cannot escape the reminders of her killing her first child and unhappily spent years.  While MAIOs (for treating chronic depression dating back many years) and SSRIs (avoiding a side effect of sedation would be better for Mary) could be prescribed, cognitive therapy (because of the depression being tied directly to a severe life event) may be more appropriate, or at the very least incorporated with any medical treatment.  Until Mary can address her feelings about the event at Niagra Falls and toward her family, her depressed mood will persist to some degree.  It is likely that even if her mood were to improve without cognitive therapy, her thoughts above death and guilt would remain. 
     Mary would need to have started treatment at least two years prior to the time covered in the film (excepting the flashbacks).  This allows for her to have a real chance to avoid her untimely end (a happy if unintentional suicide) and to serve as a beneficial factor in her children’s lives during their times of need.  While she may have been able to avoid death by starting later, she would not have been able to offer any support to her children; though there may be some addition by subtraction in regards to the demands placed on the daughters in regards to having to care for her, it is also just as likely that they would have some difficulty adapting to the new situation regarding their mother.
     The rest of the family would also benefit from varying treatments.  Jim could benefit from a self-help group (AA) to help with his bouts of binge drinking.  This could help him to direct his need to control situations at something more productive while encountering a sponsor who he could respect who might encourage a more open-minded approach to life for Jim.  He would also benefit from treatment for his anger issues.  This would likely need to be in the form of behavior treatment (as Jim would likely be suspicious of any medical treatment for himself).  Jim and Mary could benefit from some form of marital counseling, as neither of them are meeting the others needs and have evinced an unwillingness to deal with that problem directly.  All three daughter would benefit with some social skills training, but more specifically with therapy that teaches more appropriate roles and expectations of being parents (as they have had less than ideal role models).  While Lou would also likely benefit from some sort of anger management treatment, what she (more so than either Norma or Sandy) could use is college and the belief that she has a future beyond the kind of life her mother had.

1 comment:

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