CASE ANALYSIS: SILVER LINING PLAYBOOK 1

Mental Illness Case Analysis: Silver Lining Playbook (Revised)

Kathleen Shaw

February 21,2020

Abnormal PSY 351

Union Institute & University

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Introduction

In the field of psychology movies can be a superb tool for psychiatric diagnosis and

identifying patterns of behavior that are indicative of mental illness. This case study will focus

on the movie Silver Lining Playbook and the main characters Pat and Tiffany. First a brief

summary of the movie and the challenges these characters face will be reviewed. Then a full

description of the disorders and how accurately they are illustrated. We will pay specific

attention to the behaviors exhibited and how they tie into the diagnosis. A representation of two

or more perspectives will be examined such as how does the family view the illness compared to

how the patient views their illness. What are the similarities and differences in these views. In

conclusion a look at the effects of mental illness on family, society, and the work- place and how

the mental health industry is helping or ineffective in treatment of these patients.

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Mental Illness Case Analysis: Silver Lining Playbook (Revised)

Silver Lining Playbook is a romantic comedy which revolves around the main character

a native Philadelphian Pat Jr. whose mother gets him out of a mental health facility where he was

diagnosed bipolar at the start of the movie. We immediately learn he has been there for 8 months

on a court mandate after he attacked and almost killed a man he found in the shower with his

wife while in the midst of a bipolar episode. Apparently, he has had behavioral and emotional

problems before and as they get home it is revealed that his mother took him out early and he

had not finished his treatment. Pat is obsessed with getting back with his wife Nikki and we soon

see his mania returning and realize he is not taking his meds. The scene where he blasts into his

parents bedroom in the middle of the night ranting about the ending of a book he read is classic

bipolar behavior. Through friends he meets Tiffany the sister of his best friends wife and a very

entertaining crazy boy meets psycho girl plot is born. Tiffany is recently widowed suffering from

depression and what looks like borderline personality which was triggered after her husbands

tragic death. She is emotionally unstable, promiscuous, and volatile. The scene when they first

meet is disturbingly comical as they compare notes about meds and symptoms. The plot thickens

as we meet Pat’s father Pat Sr. who recently lost his job and is now a bookmaker running

numbers. Pat Sr. is pathologically superstitious, a compulsive gambler and displays rigid and

irrational thinking all characteristic of obsessive- compulsive disorder. The story unfolds as we

see Pat Jr still desperate to show Nikki he has changed and win her back and Tiffany who wants

to enter a dance contest but needs a partner. The unlikely pair work together to help each other

out. The comic thread which weaves through the romance is the zany and hilarious escapades

having to do with Pat Sr. and the insane parley he made to try and win back the money he lost
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and open a restaurant. The film is funny and exceptional in its’ ability to characterize mental

illness and the challenges faced by those who suffer from its’ effects.

Bipolar Disorder

The symptoms of Bipolar disorder I are alternating episodes of depression and mania

each lasting weeks or months separated by brief periods of normality (Bennet, P. 2011). During

manic episodes patients experience a decreased need for sleep, fast talking, racing thoughts,

increased energy, distractibility, increase in high risk behavior, a feeling of euphoria. During the

depression episodes of deep sadness or despair, low moods, sluggishness, and hopelessness. The

first symptoms usually present between the age of 20-30 but can occur in adolescence. Lithium

and Depakote are the most commonly used medications to treat Bipolar along with CBT and

family interventions.

In several scenes we see Pat not sleeping, his obsessive and compulsive thought patterns

all revolving around getting his wife back even though she has a restraining order on him. He

seems to be manic through most of the film with excessive energy, flights of ideas, and talking

fast. Pat’s most detrimental behaviors are his inclination towards verbal and physical aggression.

Yet he is seeking positivity and to find the silver-lining within his life. In the scenes with Pat and

his therapist Dr. Patel he states he doesn’t want to take the medicine because he fills dull and

lifeless. Non compliancy in continuing medication is typical of individuals with Bipolar because

they like the high and are used to the euphoric feelings it brings. Pat is off his meds for most of

the movie obsessed only with an unrealistic expectation of getting his wife back.
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Borderline Personality Disorder

Borderline personality disorder also known as BPD is a cluster B disorder often

accompanied by major depression, Bipolar , and anxiety disorders. It is chronic and lifelong. The

criteria for BPD are patterns of unstable and intense personal relationships which alternate

between idealization and devaluation, identity disturbance with persistent unstable self- esteem,

impulsivity in sexual behavior, reckless driving, suicidal or self -mutilation, chronic feelings of

emptiness, difficulty controlling anger, and stress related paranoid ideations. Childhood trauma

seems to be a major factor in the development of BPD. The best treatment is psychotherapy

using DBT.

Tiffany is considered a “crazy sex addict” and emotionally unstable. She has a history of

self- harm, emotional volitivity with an inability to have a stable relationship. The guilt she feels

for causing her husbands’ death by being sexually uninterested and depressed has triggered her

BPD into high gear. It is seen through her compulsive/impulsive sexual behavior and explosive

outburst. After her husbands’ death her character traits became magnified and clinically

pathological.

An excellent example is presented where she and Pat Jr. are in the diner and while

trying to get him to pay attention to her and not be thinking about his wife who cheated on him,

he says something that completely upsets her, and she blows up like a time bomb. The scene is a

perfect example of how borderlines vacillate between loving/hating someone close to them

because they are unable to combine multiply aspects of a persons’ character. They are “good” or

“bad” nothing in between and this changes by the moment. Making it almost impossible to have

a healthy interpersonal relationship with them.

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During most of the movie Pat Jr. seems out of touch with the seriousness and ultimate

consequences of his illness. He appears to be in denial but that may be due to him not taking his

medicine. A comment also must be made to justify some of his beliefs. What normal person who

finds their spouse engaged in sex in your home with another does not contemplate or even act on

physical violence. Many people have done this without the diagnosis of Bipolar disorder.

However, the rest of his behavior is classic and until he finds a purpose by learning how to dance

even if the motivation was unrealistic. Only then does he seem to want to get better. Pats’ family

seem to be in a world of their own although they have genuine concern for his mental health,

they are unable to be consistently supportive. Several of them seem to be struggling with their

own demons such as Pat Sr. who struggles with the guilt of Pat Jr’s situation feeling he didn’t

spend enough time with him. Many families may feel guilty for their children’s disorders

especially if they struggle with issue’s themselves. As with most families they just want their

loved one to get better.

Tiffany seems to relate her illness to her husbands’ recent death yet acknowledges she has

had many of these behaviors for a long time. She doesn’t go to therapy like Pat and we have no

real family history of her. Although her sister seems somewhat normal, she has control issues. In

a scene where Tiffany has been texting a man who shows up at the family home, we see her

mother and father desperately trying to protect her and tell him to leave that she is vulnerable and

not well. We get a glimpse of what families go through and how these impulsive behaviors can

affect an entire family. Mostly Tiffany does not seem to accept her illness just the behaviors

which are causing her problems.

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Conclusion

The film Silver Lining Playbook depicted both BPD and Bipolar disorder in a believable

and heartbreaking way. It used comedy and romance to soften the harsh realities that individuals

and their families live with. Explosive and unstable behavior are hallmarks of both disorders and

we see the neighbors of both families watching these episodes unfold. The shame of having a

mental illness causes many people to go untreated and undiagnosed. Mental illness and it’s

disabling affects are a major cause of unemployment, loss of home, and the breakup of families

each year . More education about mental illness and newer treatment options must be accessible

for everyone which in turn strengthens our communities and the children who live in them.
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References

Bennet, P.(2006). Abnormal and Clinical Psychology: An Introductory Textbook. Maidenhead,

England: Open University Press

Marshall, E. (2006). Borderline Girlhoods: Mental Illness, Adolescence, and Femininty in Girl

Interupted. The Lion and the Unicorn, Volume 30, Number 1, pp.117-13

Miller, R. B., & American Psychological, A. (2015). Not So Abnormal Psychology : A

Pragmatic View of Mental Illness. Washington, DC: American Psychological Association.

Young, S. D., & Young, S. D. (2012). Psychology at the movies. Hoboken, NJ, USA: Wiley.