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Diagnostic Analysis of Aileen Wuornos

As Portrayed by Charlize Theron in Monster



**Intro to Abnormal Psych**NPSY 3501**Prof. Mary Carol Mazza**


Suicide is a permanent solution to a temporary problem. -Phil Donahue


Charlize Theron won a Best Actress Oscar for her portrayal of serial killer, Aileen Wuornos in
the film, Monster (Jenkins, 2003) her There have been some who have argued about her
mental state and whether a specific diagnosis is apt. The following is an initial assessment taken
after Aileen was remanded to death row. A clinical diagnosis based on criteria in the DSM-5
follows. Aileen Wuornos was a 37-year-old Caucasian female. Before incarceration, she was in
a relationship with a younger woman named Selby Wall. Their relationship ended after Aileen
was taken into custody. She was incarcerated in Florida State Prison and was executed in 2002.

As Ms. Wuornos recalled experiences from her past, significant signs of trauma were
observable. An obvious sign in her body language was tremors. This is a common reaction to
the experience of a traumatic event. Other observable symptoms included her mistrust and
blame of others, as well as a fearful demeanor. Ms. Wuornos exhibited signs of emotional
liability and depressivity. As she recalled experiences from her past, other notable signs included
issues with abandonment, rejection, anxiety, impulsivity, and hostility. Additionally, she was
easily startled and frequently demanded justice for the perceived injustices against her.
These symptoms can be attributed to the trauma of her early childhood. She was sexually
assaulted at the age of eight by a friend of her father. Her father did not believe her allegations.


The duration of the abuse was not disclosed, but she did mention that she gave a child up for
adoption and began to engage in prostitution at the age of thirteen. During her asides in the film,
Ms. Wuornos admitted to physical abuse by her father, who later committed suicide.
Ms. Wuornos had a preoccupation with her self-image. She aspired to a fulfilling life
and, in her words, was a diamond in the rough. She had dreams of falling in love, but she felt
she could never love a man after being abused. Ms. Wuornos said that she was suicidal, yet
hopeful. Although she never made an attempt, she sat on the edge of an overpass with a gun in
her hand on several occasions. As she discussed her suicidal ideation, she described a
conversation with God. She said, I had five dollars and I said to God, 'I will spend it and after it
is gone, so am I. If you've got something in this life for me, you better bring it on.' Although
she did not express interest in organized religion per se, her conversations included repeated
references to God.
Ms. Wuornos recalled in detail her personal history during her adult years. Most of these
memories involved her girlfriend, Selby Wall. Ms. Wall zeroed in on Ms. Wuornos' need for
companionship and took advantage of her kindness. However, Ms. Wall's only motivation was
to be kept by another woman. The only motivation behind Ms. Wuornos becoming and
continuing to be a prostitute was money. Ms. Wall's desperation led directly to Ms. Wuornos'
decision to continue prostitution.
In one instance, Ms. Wuornos suffered a brutal beating and rape during a sexual
encounter with a john. This was her justification for killing him. This was an exercise in
catharsis, as she wanted to avenge her own rape and previous sexual abuse. These flashbacks
eventually drove her to shoot and pistol-whip her rapist. Subsequently, she murdered six other


johns, one of whom was a police officer.
Based on observable symptoms and psychosocial factors, Ms. Wuornos showed evidence
of Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD). These
diagnoses are evidenced by her recollection of traumatic events and personal behavior listed in
the above sections. In researching the DSM-5 (APA, 2013) criteria for PTSD, it was clear that
Ms. Wuornos evidenced all of the significant symptoms, behaviors, and causal factors. The same
standards were satisfied for her diagnosis of BPD.

For the PTSD diagnosis, the following criteria in the DSM-5 (as cited by APA, 2013) are listed:
Criterion A is a stressor. Ms. Wuornos had direct exposure to sexual violence.
Criterion B is intrusion symptoms. Ms. Wuornos evidenced three of the five listed symptoms,
although only one is required for the diagnosis. She re-experienced her traumatic events through
flashbacks. She also had intense distress after repeated exposure to events reminiscent of the
initial trauma. Most notable were the tremors she exhibited. This was a clear sign of
physiological reactivity.
Criterion C is avoidance. Both traumatic feelings and reminders were evident as sub-criteria.
Although only one sub-criterion is required, she exhibited both of the two listed.
Criterion D is negative alterations in cognitions and mood. Two of seven sub-criteria are
required; three were fulfilled. Ms. Wuornos had persistent and distorted negative beliefs about
herself and the world. She had a distrust of men and blamed them for both the traumatic event
and for her subsequent behaviors. Persistent anger, fear, and shame were also expressed.
Criterion E is alterations in arousal and reactivity. Two behaviors are required and Ms.


Wuornos exhibited four out of six. These included aggressive behavior, reckless behavior,
hypervigilance, and an exaggerated startle response.
Criterion F is duration. The previous criteria in B, C, D, and E have all lasted for more than one
Criterion G is functional significance. Social and occupational impairment and stress are
Criterion H is exclusion. Although she was a recreational drinker, there is no evidence of
medication, substance abuse, or other illness/injury that contributes to her disorder. She did not
display dissociative symptoms and it is unknown when her PTSD symptoms began.

For the BPD diagnosis, the following criteria in the DSM-5 (as cited by APA, 2013) are listed:
Criteron A is personality functioning. Ms. Wuornos' self-functioning abilities are impaired due
to unrealistic goals and career plans. This demonstrates that she lacked self-direction. Her
interpersonal functioning was also impaired, as she had issues with abandonment. Her
relationships were marked by both mistrust and neediness.
Criterion B is pathological personality traits. Unlike Criterion A, the following criteria must be
met in order to diagnose a patient. Negative affectivity is characterized by emotional liability,
anxiousness, separation insecurity, and depressivity. Ms. Wuornos exhibited unstable emotional
reactions and frequent mood changes. Also exhibited was anxiety in reaction to interpersonal
stressors. She focused on both the past unpleasant experiences and future negative possibilities.
She feared rejection and separation from Selby and expressed frequent periods of depression,
hopelessness, shame, and thoughts of suicide. Ms. Wuornos' acts of disinhibition were


characterized by impulsivity and risk taking. Ms. Wuornos' acts of prostitution showed both risk
taking and no regard for the outcome of her actions. Her suicidal ideations and her homicidal
activities also indicated a denial of the reality of personal danger. Ms. Wuornos' antagonism and
hostility were pronounced. She had persistent angry feelings and irritability in response to
perceived insults.
Criterion C is duration. Her functioning and personality traits were consistent over an extended
period of time and in comparable circumstances.
Criterion D is standards. Ms. Wuornos' impairments in functioning and trait expression were
not normative within her socio-cultural environment.
Criterion E is exclusion. There is no evidence of medication, substance abuse, or other
illness/injury that solely contributes to these behaviors. However, her dysfunctional behavior
was exacerbated by her abuse of alcohol.

Treatment options that might be effective are limited under the circumstances. The
efficacy of the suggested treatments would be more apt without the variable of incarceration and
impending execution. For the treatment of PTSD (Butcher et. al., 2014), emotional disclosure
and meditation may be mildly effective. Emotional disclosure, or the process of bringing
feelings to the surface via writing, could have alleviated some of the mental stress and physical
symptoms Ms. Wuornos experienced in prison. Antidepressant and anti-psychotic medication
could have also be indicated. Intervention or counseling by a member of the clergy, if requested
by Ms. Wuornos, could provide a sense of comfort in this stressful environment.
If Ms. Wuornos was being treated on an outpatient basis, other forms of therapy would be


available. Dialectical Behavior Therapy (DBT) would be the most effective treatment for BPD.
(as cited by Butcher et. al., 2014) This treatment would have decreased her self-destructive
behaviors and increased her ability to cope with past traumas. Ms. Wuornos would need
supplemental assistance with life skill development. Anger management would be her most
pressing need in DBT. Mentalization could have also been helpful. This may have assisted Ms.
Wuornos in recognizing her true emotions and remaining cognizant of these feelings and the
feelings of others.
Monster portrays Aileen Wuornos' descent into the depths of mental illness. There was
no evidence that she received treatment, nor was there a clear message about whether treatment
could have helped. It is inconclusive as to whether viewers would take anything away from this
film in the context of abnormal psychology.
One negative stereotype that may be reinforced is connected to lesbianism and misandry,
the contempt for the male gender. The question that is raised is whether or not the distrust and
hatred of men would lead a woman to turn to another woman for intimacy. It would seem
apparent that these emotions led her to the act of murder. Clearly, Aileen's choice of Selby
represented a safe haven, especially since she never considered herself a lesbian before their
encounter at the bar. The skating rink proved to be a venue for Aileen and Selby to feed into
each other's needs and insecurities.
The well-known symptoms of PTSD are shown (as cited by APA, 2013). Aileen
Wuornos' behaviors were real, genuine, and predictable in light of the abuse to which she was
subjected. There are no signs of hope or redemption for this broken woman. There are no
proverbial silver linings. Viewers may walk away from this film seeing Aileen Wuornos as a


sympathetic individual rather than a cold-blooded serial killer. Their sympathy may be based on
the fact that she never had a chance in life, never was granted an opportunity for fulfillment, and
never received treatment for her traumatic experiences.
There are a number of questions that are raised during Monster. Is Aileen a criminal or a
damaged individual? Were her actions premeditated, impulsive, or a reaction to her past? Was
the audience understanding or callous, sympathetic or judgmental, compassionate or critical?
The mental dysphoria Aileen Wuornos experienced may inspire the audience. It may serve as a
point of reference to the necessity of treatment for abnormal behavior, regardless of its source.
The title of the film, Monster, refers to the name of a ferris wheel which Aileen was
afraid to ride as a child. When she rode on the ferris wheel with Selby, she felt positive for one
of the few times in the film. This was one fear she conquered. In the middle of the film, Aileen
recalls a junior high school assembly, at which a celebrity preached, All you need in life is love
believe in yourself, then there's nothing you can't do. At the conclusion of the film, as she is
led to her prison cell, Aileen prattled off a plethora of affirmative clichs. She acknowledges that
under the circumstances, affirmations are exclaimed without any basis in truth. ("Love conquers
all." "Every cloud has a silver lining." "Faith can move mountains." "Love will always find a
way." "Everything happens for a reason." "Where there is life, there is hope." Oh, well... They
gotta tell you somethin') As the final credits roll, the song Don't Stop Believin' by Journey is
played. Perhaps this is also a clich, but in life, it may be the only philosophy that gives the
wounded the strength to survive.



American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental

Disorders (5th ed.) Washington, DC., Retrieved from

Butcher, J. Hooker J., Mineka, S. (2014). Abnormal Psychology, Boston. 152-155, 344-352

Jenkins, P.. (Director) (2003) Monster [Motion picture]. United States. Germany. Media 8
Entertainment and DEJ Productions