As Good As It Gets Udall

In the movie, “As Good as it Gets,” Melvin Udall is the patient who has been diagnosed with Obsessive-Compulsive Disorder, OCD. Udall’s age is not provided in the film. However, he is a Caucasian male. Udall’s educational background is briefly mentioned through the mention of his piano lessons and his job as a romance writer of 62 books. The patients’ family history is troublesome. The patient reported that his father stayed in his room for 11 years, coming out only to hit Udall’s hand on the piano with a yardstick when he made a mistake while practicing. Udall also indicates that his grandmother was tough on him and information regarding siblings or place of birth is never mentioned. The patient is single and has never been married. However,

Udall’s diagnosis are Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD). The patient did not meet 5 of the 9 criteria needed for BPD diagnosis. Mainly, he showed no suicidal behavior, no stress related paranoia and no impulsivity. Yet, he displayed feelings of emptiness when he clung to the company of the neighbor’s dog and demonstrated his and Carol’s unstable relationship through their inconsistent feelings, both symptoms of BPD. He did not meet the 3 of 9 criteria needed for ASD, lacking the repeated law breaking, reckless discard for safety, and impulsivity. He showed a lack of remorse when he spoke harshly to Carol regarding her son’s illness and also showed irritability/aggression when Carol did not show up to be his daily waitress, both are symptoms of ASPD. Udall identifies with traits within these Cluster B Personality Disorders, but doesn’t meet criteria for any. As a result of his presentation of many symptoms, but his lack of met criterion, we conclude that the patient meets the diagnosis of Obsessive Compulsive Disorder as well as Other Specified Personality

Udall in response to his diagnosis of OCD is an antidepressant medication, such as an SSRI, to control for biological factors responsible for OCD, such as high activity in the limbic system that is responsible for his impulses and fears. In addition, he will undergo exposure/response prevention treatment as a form of behavioral therapy. He will be exposed to his fear of contamination by having to wash his hands without using a new bar of soap. He will be instructed to walk on cracked floors in different settings, and enter his home without switching the lights and locks back and forth. In addition, he will undergo cognitive-behavioral therapy to address the classical and operant conditioning causing OCD, as well as thought-action fusion. Thought-action fusion is where patients believe that thinking about the behavior is equivalent of doing it. He will learn to not suppress his obsessions, but will be trained to see his obsessions as mere thoughts, not holding any power over his actions. He will be taught that nothing bad will happen to him if he steps on cracks or eats with used silverware. His behavior will change as a result of his changing of thoughts. Research shows that once he understands and believes that he can eat off of used silverware because they have been cleaned, he will be more likely to adapt and adjust accordingly. To treat his diagnoses of Other Specified Personality Disorder, he will undergo treatments used for