Karl Patrick E.

Carandang
Psychiatry Submodule
20 April 2022

Anino ng Kahapon Reflection Paper

What made Anino ng Kahapo powerful and moving for me as a film that depicts mental
health conditions and schizophrenia was that it did not depict schizophrenia just in a clinical
sense, isolated and existing in a vacuum, but rather the film puts the focus on Irene, her loved
ones, her community, and the very human experience of sickness and healing and the journey
that they go through. At its core, it is a story about a family coming to terms with an illness.
Irene, who throughout the movie experienced paranoia, visual hallucinations, auditory
hallucinations, and delusions due to her schizophrenia triggered by the bad news around her and
her own traumatic memories during the Martial Law era.
Instances where Irene displayed symptoms of paranoia was when she felt that she was
being watched, and she thought a man was smoking outside, keeping a look out at their house.
This was seen further when later on in the film when confronted with criticism, she starts getting
defensive. Also seen in the film was instances where Irene began experiencing hallucinations,
both visual and auditory. Examples of auditory hallucinations experienced by Irene were
footsteps similar to marching, the opening of the door as if an intruder was trying to get into their
house. An example of visual hallucinations experienced by Irene was when she took in people
who seemed to have an association with when her mother was still around although this did not
exist, hallucinating getting arrested by the military in Brian’s school, and the bed scene. For the
delusional beliefs experienced by Irene, this involved her being under the belief that she is not
sick but getting better and experiencing thoughts that strangers were conspiring against her so
that she would be taken by the military. She also experiences delusions of grandeur where she
thinks that she has a gift from God allowing her to recognize demons
In the film, it can be seen that her family and community came together in different ways
to take care of Irene, with some efforts being more effective than others. Her husband was one
such example. Her husband made the sacrifice of resigning from his job in Dubai and taking
Irene’s job at the hospital to be closer to her and to better take care of her needs. Irene's brother
in law plays along for a while with her delusions, going so far as to have a girlfriend in Irene’s
delusions named Cathy. Some members of the family however were understandably upset in
some instances especially when Irene became very disruptive like her son who was very
frightened when Irene too him out of school.
It should also be noted that many different psychosocial factors affected Irene’s recovery.
Financially, the family was lacking in resources. On a systemic level, it could be seen that the
government, via Philhealth, did not provide for Irene’s medications. Culturally, the local beliefs
also affected the interpretation of Irene’s condition by the people around her, as can be seen
when Irene’s mother in law suggested that she was seeing spirits and advised getting help from
an albularyo. On a social level, the brutality and traumatic memories of Martial Law, a then-state
sponsored historical event perpetrated by a sitting dictator, served as the trigger for Irene’s
condition.
Now, if I was managing Irene as my patient, the first step that has to be taken is
admission to a hospital as Irene is indicated for such as she is noncompliant with prescription,
causing harm to those around her, and has inappropriate disruptive behavior. The therapeutic
goals for Irene would be the control of her symptoms, return to usual levels of functioning, and
choosing an initial treatment modality which would be administered as soon as possible, initially
Clozapine, which is the gold standard for schizophrenia treatment, while warning her of the side
effects of such, namely cardiac and constipation. However, taking into account the financial
constraints of the family, prescription of Clozapine via oral formulation.
This film shows that healing and recovery happens best in the context of a loving and
supportive family. Illness can either bring a family closer or tear them away further. It is the
privilege and deep honor of a physician to be in an influential position to nudge a family and
community towards closeness in support of a sick family member. Illness and healing does not
occur in a vacuum, affecting only one person, but it affects their families and their communities.
The empathy and compassion we as doctors are supposed to give must extend to them as well.