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Published by api-26570979

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Published by: api-26570979 on Oct 15, 2008
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A. Subject: Melvin Udall
B. Diagnostic Evaluation
Melvin Udall diagnosed that he has Obsessive Compulsive Disorder. He developed

Melvin Udall has a major Behavioral Disorder which is Personality disorder but can also be classified as anxiety disorder. He tends to be so perfectionist and meticulous in everything he does.

Fear of being contaminated by shaking hands or by touching objects
other have touched.
\ue000He shows this kind of symptoms. He was afraid to touch other things that

have been touch by other person. One situation was that when he needs to open the door, he wiped first the doorknob. He always makes sure that it is clean. He always wears gloves. Another situation was that when he and Carol went out for a date and the waiter offered a coat but her refuse to wear it and buy his own. Thinking this kind of behavior seems to be very different for a normal people.

Continuously struggles involving neatness and details of everyday life.
\ue000All of his things are organized. He put everything in order. Everything has its

own place. When they went out for a trip to Baltimore for Simon to visit his parents. Melvin Udall has his Checklist about the things that he must bring. He also took a long time just for taking a bath. It showed when Melvin and Carol out for a date. Carol fall asleep because she waited too long for Melvin finished taking a bath.

Melvin Udall is a writer who lives alone in his apartment. Udall seems to be
very different or odd from the other people around him. He seems to be so different
because of his strange habits. He is a kind of person that what he wants, he gets, just
like ho he wanted carol, a waitress. He wanted that Carol will serve her during his
breakfast. He wants everything in order. He always makes sure that all of his things
arrange properly, just like when they went out for a trip. He has a checklist of the
things that he needs. He always makes sure that the doors are lock. He most prefers
to use his own things which he thinks that it cleaner than the others. He wipes
everything that he will touch or hold. He doesn\u2019t walk in messy or wet floor/road.
He is very meticulous. He tells everything that is in his mind without thinking if it
would hurt other.

Checking Doors repeatedly to make sure they\u2019re locked.( OCD symptoms involving
\ue000It was very obvious that Melvin Udall always checked the door before he close it.
He feel annoyed that why he makes sure and repeatedly check the he closes the
C. DSM-IV-TR Multiaxial Evaluation Report Form

AXIS I: Clinical Disorder
Other Condition That May Be a Focus Attention
Diagnostic Code

DSM- IV name
__ __ __. __ __
__ __ __. __ __
__ __ __. __ __
AXIS II: Personality Disorders
Metal Retardation
Diagnostic Code
DSM- IV name
__ __ __. __ __
Obsessive Compulsive Disorder
__ __ __. __ __
AXIS III: General Medical Conditions
ICD-9-CM code
ICD-9-CM name
__ __ __. __ __
__ __ __. __ __
__ __ __. __ __
AXIS IV: Psychosocial And environmental Problems
Problems with primary support group
Problems related to the social environment
Specify: It was hard for Melvin to communicate with people,
to say his feelings.
Educational ProblemSpecify:________________________
Occupational problemSpecify:_______________________
Housing problemSpecif y:___________________________
Economic problemSpecif y :_________________________
Problems with access to health care services
Problems related to interaction with the legal system/crime.
Other psychosocial and environmental problems
Specify: His too meticulous that leads him to be afraid
with the things in his environment which he thinks dirty.
AXIS V: Global assessment of functioning Scale
Score: 58
Time Frame:_____
D. Theoretical Conceptualization

A theory that may explain OCD is the psychoanalytic theory of Sigmund Freud. Freud attributed obsessive- compulsive behavior to unconscious conflicts which manifested as symptoms. Freud describes the clinical history of a typical case of touching phobia as follows:

\u201cOnce it starts, in early childhood, the patient shows a strong desire to touch, the aim of which is of far more specialized kind that one would have been inclined to expect. This desire is promptly met with an external prohibition against carrying out that particular kind of touching. The prohibition is accepted, since its finds support from powerful internal forces, and proves stronger than the instinct which is seeking to express itself in the touching. In consequence, however, of the child\u2019s primitive physical constitution, the prohibition does not succeed in abolishing the instinct. It\u2019s only result is to repress the instinct (the desire to touch) and banish it into unconscious. Both the prohibition and instinct persist: the instinct because it has only been repressed and not abolished and the prohibition because, if it ceased, the instinct would force its way through into consciousness and into accrual operation a situation is created which remains undealt with \u2013 a physical fixation \u2013 and everything else follows from continuing conflict between the prohibition and the instinct.\u201d

This can be an explanation why Melvin Udall seems to be afraid to touch ting touched by the other person. The instincts of the desire to touch the thing are being suppressed and drive out into the unconscious. This can be a reason why Melvin seems to be unaware of what he is doing. Unconsciously, he repeated doing it and it became a habit for him to the extent that he\u2019s thinking that it is just normal for him just like checking the doors and wipe he doorknob before opening it. It starts with the instinct of the person. According to Freud an instinct is also said to be conservative because its aim is to conserve equilibrium of the organism by abolishing disturbing excitation. Since as what I have said its being refuse, suppress. An instinct can also be a repetition compulsion. It\u2019s a process that repeats as often as it appears a cycle of event starting with excitement and terminating repose. This explains why Melvin tends to repeat of what he is doing just to feel the satisfaction of his need which is not completely appropriate.

In the movie, it was not clear what the causes of OCD are. Some research has discovered a type of size abnormality in different brain structures. Some researchers believe that there is some type of abnormality in neurotransmitter serotonin. Serotonins have a role in regulating anxiety, involving in such process as sleep and memory function. Melvin Udall is a writer. I think he was able to develop OCD because of some worries about his writings, like the deadline of his writings and also lack of sleep. The neurotransmitter travels from the one nerve to the next synapses, serotonin must bind to the receptors sites located on neighboring nerve cell- it is hypothesized that OCD sufferers may have blocked or damaged receptor sites that prevent serotonin from functioning to its fuel potential . This explanation seems to be just same as the explanation of Freud.

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