The movie “As Good as It Gets” portrays a character, Melvin Udall, who suffers from obsessive-compulsive disorder. Obsessive-compulsive disorder falls under the category of anxiety disorders, which contains a group of disorders that share similar characteristics. Anxiety disorders all typically become aroused over apprehension over an anticipated problem. There are physical, cognitive, and emotional symptoms which are elicited from the apprehension. Physical symptoms may include increased heart rate, increased respiration, sweating, and trembling. Cognitive symptoms may include preoccupation, a loss of concentration, and rumination. Finally, emotional symptoms may include apprehensiveness and terror. These symptoms result from the “flight or fight” response triggered in our body. This response comes from the autonomic nervous system and specifically the parasympathetic nervous system. These are parts of the nervous system which control things we do not think about, like breathing and keeping our heart beating. It is not necessarily bad for the parasympathetic nervous system to become aroused because it help in times of danger, but in the case of someone who suffers from an anxiety disorder, it becomes aroused too easily or too often. Irrational cognitions lead to its arousal.
In the case of someone with obsessive-compulsive disorder, the subject will typically have intrusive and unwilling thoughts (obsessions) which give rise to anxiety. Because of this created anxiety, the subject will feel compelled to perform a behavior related to the obsession. These behaviors (compulsions) become ritualized to a point where they are detrimental to the subject’s functioning because the compulsions are repeated with a high frequency. Examples of obsessions include fear of contamination, aggressive impulses, extreme doubt, and extreme indecision. Examples of compulsions include repeatedly washing one’s hands, checking locks over and over, and pursuing cleanliness and orderliness through elaborate routines. Obsessive-compulsive disorder is a chronic disorder and it is difficult to completely recover from it. It often develops in the subject before age 10 or late in adolescence.
The treatment used to cure obsessive-compulsive disorder, like many anxiety disorders, is through exposure. However, unlike the exposure for most other anxiety disorders which is gradual, the exposure for obsessive-compulsive disorder must be intense. The subject is to be exposed to one of their obsessions, but not be allowed to perform the compulsion associated with the obsession. They can not perform the compulsion at all. For example, if they subject has a fear of contamination and washes their hands multiple times, the treatment would be to make them touch something dirty and not allow them to wash their hands. If you let them wash their hands even once or twice, the treatment would not be effective. Through time their anxiety will extinguish and they will no longer have the obsessions, and in turn, the compulsions.
The movie “As Good as It Gets” is about how the main character, Melvin Udall, is first portrayed as an arrogant, insensitive person who suffers from obsessive-compulsive disorder and by the end, he becomes a more caring person and suffers slightly less from obsessive-compulsive disorder than he does at the beginning of the movie. Melvin is neighbors with an artist named Simon who is robbed and mugged, and goes through some emotional problems. Melvin reluctantly helps him out by watching his dog and by eventually letting Simon move in with him. Carol is a waitress at a diner where Melvin goes for breakfast every day. Eating breakfast at the diner and having Carol serve him is part of Melvin’s routine and when she takes off work one day to take care of her sick son, Melvin becomes very anxious because his routine is interrupted. At this point he starts to become involved with Carol’s life and eventually by the end of the movie they are dating. During the course of the movie, Melvin portrays many obsessions and compulsions.
One obsession that Melvin suffers from is a fear of contamination. Melvin first shows this obsession through the compulsion of cleaning himself. He uses steaming hot water and a brand new bar of soap when washing his hands. He uses the bar of soap for only a few seconds, throws it away, and then opens a new bar of soap to use. When taking showers, Melvin again uses steaming hot water and stays in the shower for much longer than the normal person would. Another way Melvin shows his fear of contamination is by always wearing gloves when he outside of his apartment. He is afraid to touch anything with his bare hands when he does not know that it is clean. He also throws the gloves away after wearing them because he thinks they have been contaminated. Melvin shows extreme anxiety when people try to touch him. The thought of being touched by another person and becoming contaminated controls him, and he makes a very conscious effort to avoid being touched. Lastly, Melvin always brings his own plastic utensils to use at the diner instead of the utensils provided. He thinks that the utensils provided at the diner are not clean, even though everyone else at the diner uses them. This again shows his obsession over contamination.
Another obsession Melvin has is about organization and control. His apartment is portrayed as being very organized and that he made a conscious effort and took time to organize it. For example, he has jars filled with hundreds of “Skittles” or “M&M’s that are separated by their color. Melvin’s day must also be standardized and routine. He goes to the same diner every day for breakfast and has the same waitress wait on him, which in turn gives him a sense of control. When the waitress is not there to serve him one day, he becomes very anxious because her absence ruins his organized and routine based day. Also, when Melvin is asked to take Simon to visit his parents in Baltimore, Melvin is very reluctant to take Simon partially because he does not want his routine to be interrupted. Melvin is a writer, so he could easily take a couple days off for the trip, but the thought of breaking his routine troubles him.
One last obsession Melvin shows is that of doubt. Melvin has a compulsion of locking the door to his apartment several times, just to make sure it is locked. When Melvin and Carol are going out for dinner, Melvin asks several people if the restaurant serves hard shell crabs. Everyone he asks replies “yes”, but because of his obsession about doubt, he asks multiple people. If he were to only lock the doors once or only ask one person if the restaurant carried hard shell crabs, he would become anxious because his obsession of doubt.
Melvin shows a few other compulsions during the movie which do not seem to have blatant corresponding obsessions. For example, it is stated that Melvin has written 62 books. That is an extreme number of books for anybody to write. The high number of books Melvin has written may be due in part to his obsession about routine and organization. It is not clearly shown in the movie, but part of Melvin’s routine may be to write for so many hours of each day or to write a certain number of pages each day. One other compulsion Melvin shows is that he does not step on cracks. Whether he is walking on a tile floor, a brick pathway, or on the sidewalk, he will make a very conscious effort not to step on any cracks. One way to explain this might be through his obsession about doubt. Something bad may have happened to him in the past when he stepped on a crack, so now he has a recurring thought that something bad will happen to him again if he were to step on a crack. He could have an obsession of doubt about his safety.
The symptoms portrayed in the movie seem very accurate for someone with obsessive-compulsive disorder; however the means through which Melvin’s symptoms are diminished do not match the normal treatment for someone with the disorder. The main way to treat the disorder is through intense exposure to the obsessions without letting the subject perform the compulsions associated with the obsessions. However, in the movie Melvin mentions that his doctor prescribed him medication to deal with his disorder. Medication is not the typical means to treating obsessive-compulsive disorder. Melvin also mentions that his doctor told him he should break his routine. This would be a more correct way for Melvin to overcome his disorder, but it does not sound like his psychologist gave him specific instructions. In my opinion, it seems like Melvin was given the discrepancy to determine when he wants to break his routine and the extent to which he would deviate from the norm. This would not be good judgment in part by the psychologist. They should have probably exposed Melvin to some of his obsessions during therapy and not let him perform the compulsion.
Also in the movie, it is suggested that as Melvin becomes connected to Carol the waitress his symptoms start to diminish. For example, near the end of the movie, Melvin is preoccupied with thoughts about Carol and he forgets to lock his door. Someone with obsessive-compulsive disorder would most likely not forget to perform their ritual of locking their door just because they are thinking about something else. Usually the obsessions are so engraved into their minds that they will stop to perform the compulsions no matter what. His fear of contamination also diminishes to an extent when he is with Carol, as he allows her to kiss him. This exposure seems like a more clinical approach to extinguishing his fear of contamination. It is a sudden and intense exposure to possible contamination. Melvin can not just go and brush his teeth after kissing her because that would be rude and he likes her, so he starts to see his fear of contamination may be irrational and he starts to become more physical. This is shown when he pats Simon on the shoulder later on, which is something he never would have done at the beginning.
Lastly, at the very end of the movie Melvin finally walks on cracks when he is with Carol. He is forced to walk on the cracks because he would look silly walking 10 feet away from her where there are no cracks. It is a sudden and intense exposure to walking on cracks, and Melvin sees that nothing bad happens, so his obsession of doubt may start to diminish. Overall, the movie “As Good as It Gets” does a fairly good job at portraying obsessive-compulsive disorder, however it tries to portray the way it is diminished is through personal connection, rather than through intense exposure to obsessions without the ability to perform the associated compulsions.
