Nora Helmer and Dependent Disorder
This essay examines the developement, diagnosis, and treatment of Nora Helmer from A Doll's House.I look into Dependent Personality Disorder, diagnosing her with it, and finally creating a treatment plan in order to lessen her symptoms of the disorder
Abstract
The following case study looks into the mental health of Nora Helmer, a female patient with a possible case of Dependent Personality Disorder. Nora came into my office last week, desperate for help after walking out on her family. Through interviews with family and the patient’s personal confessions, it was found that her condition suggests a strong correlation with her relationship between her husband and father. Treatment for the patient, Nora, will include short-term psychotherapeutic treatment, which will include a long process to help the patient come to terms with her condition. After examining her behaviors, I will come up with a treatment plan in order to help Nora get back on track to recovery.
Qualitative Study of Nora Helmer
The following report is to discuss the progression of Nora Helmer’s mental health as it develops through confrontation of her lies, thinking her family does not need her, and the decision of leaving her husband and family due to her needs not being met. Her need for constant attention along with other symptoms suggest Nora may have Dependent Personality Disorder, a mental disorder that is classified as “long-standing need for the person to be taken care of and a fear of being abandoned or separated from important individuals in his or her life” (Psych Central, 2014).
Patient (Review of Nora Helmer)
This part of the study provides a brief background on the life of Nora Helmer, providing information and insight into the patient’s life, helping better diagnose and recover her.
A few years ago, Nora’s father passed away. At the time her father passed away, her husband was also very ill. In order to help her husband, Nora forged her father’s signature onto a loan to pay for a trip to Italy, which Nora claims was to save her husband’s life (Ibsen, Act 1). She kept this secret from her husband because she knew it would affect his pride and values in regards to borrowing from others, and instead told him her father gave them the money for the trip (Ibsen, Act 1). After taking part in a lie of this magnitude, she remained secretive towards her family, including her husband, children, and nanny, while also putting up a facade for close friends, like Mrs. Linde, in order to make her life seem exceptionally good (Ibsen, Act 1). But, once Krogstad, the man who controlled the loan she forged her father’s signature onto, confronted her about getting her husband to replace him in his job position with Mrs. Linde, he threatened to tell Torvald about the loan if Torvald fires him (Ibsen, Act 1). Nora became frightened of the consequences she would have to face if Krogstad were to tell Torvald about the loan. Nora talked to the nanny and questioned if the children would be fine if she left them (Ibsen, Act 2). When the Nanny said yes, this caused Nora to seem even less important to her family. Torvald ended up firing Krogstad, which led him to revealing to Torvald about the secret loan. Torvald shamed Nora, instead of helping her like she expected him to (Ibsen, Act 3). He told his wife to leave the house and that she could never see the children again (Ibsen, Act 3). This act of neglect caused Nora to feel unloved by her husband. Due to this, despite her husband’s pleas, she ran away leaving Torvald and the children. (Ibsen, Act 3).
Method
Participant
Nora is a middle aged woman, mother of 3 children, and wife of Torvald Helmer. She lives in a Norwegian city. Her exact age is undefined, although it can be assumed she is middle aged because she is married and has children. Since Nora left her family, her exact location of residency remains unknown. She seems to show symptoms of Dependent Personality Disorder. Although Narcissistic Personality Disorder could be a possible mental disorder to look into because some of the symptoms are similar, this would be a disorder that is too far detached from Nora because she seems to show some signs of insecurity.
Measure
Interviews with Nora’s nurse and childhood nanny, and Torvalds’s colleague, Krogstad, a written version of the play by A Doll’s House by Henrik Ibsen, an analysis of A Doll’s House by S. Siddall, and a letter from Harvard Mental Health provided information to develop the behavioral analysis. Articles of the treatment and symptoms of Dependent Personality Disorder by written by my colleagues from Psych Central, and an article on Dependent Personality Disorder by the Cleveland Clinic., provided the basis for the diagnosis and treatment.
Procedure
With the information gathered, there are four clear instances in which Nora’s behavior changes. Her behavior was first recognizable when she constantly accepted the childish treatment she receives from Torvald (Ibsen, Act 1). Nora’s behavior takes another shift when Krogstad confronted her about the loan (Ibsen, Act 1). She became paranoid and anxious about what would happen if her husband found out about the loan. Her behavior continued to get worse when Nora talked to her nurse, Anna, asking her if the children would be okay without their mother there (Ibsen, Act 2). Because of Anna’s response, saying the children would most likely be well off, Nora did not feel needed by her family. The final change seemed to occur when her husband neglected and shamed her when he found out about the loan (Ibsen, Act 3). Nora felt as though Torvald would have helped her, so when he refused to let her see the children, she felt a lack of love from her family, and admitted to feeling like she was just a doll and her husband had been controlling her their entire marriage (Ibsen, Act 3).
Results
Tentative Diagnosis
My report began by interviewing Nora’s close family friend, and nurse, Anna. She explained that Nora’s irregular personality was first apparent to her when Nora asked if the children would be okay without their mother (Ibsen, Act 2). At this point Nora started to feel as if she wasn’t loved enough by her family and that they weren’t loving her the way she deserved to be. This realization came to her when Anna said that yes, the children would be okay. Anna also confessed to over hearing conversations between Nora and Torvald. She explained how Torvald gave Nora pet names, or made condescending comments, saying “I heard Torvald calling Nora his ‘spendthrift’ and saying how ‘expensive it is for a man to keep such a pet’. Nora never complained about his comments and just went along with it, never saying a word” (Siddall, 2008).
My next step in the observation process was to interview Krogstad, Torvald’s longtime colleague. Krogstad explained to me how he was the one who gave Nora the loan. He said “I knew all along that Nora had forged her father’s signature on the loan. Once I found out her friend, Mrs. Linde, was a threat to my current work situation, I threatened to blackmail her with it if Mrs. Linde were to cause me to lose my job” (Ibsen, Act 1). He also added that Nora seemed terrified of Torvald finding out about her illegal action. Both Krogstad and Nora were well aware that Torvald might disown her because of it. From this I could conclude that clearly she loves Torvald, but also could not imagine being away from him or make him unhappy, causing her to make the decision of illegally signing a loan.
My final step in observing Nora’s situation was to examine her story. Nora felt as if her husband did not care enough about her, so she decided to leave her family. She expressed her feelings to me saying “Torvald shamed me when he found out that I took out a loan and illegally signed it, even though I fantasized about him trying to save me the way I saved him. When he didn’t, I felt the only right thing to do for myself was to leave” (Ibsen, Act 3).
Results
According to Psych Central, one symptom of Dependent Personality Disorder is feeling “uncomfortable or helpless when alone” (Psych Central, 2014). Nora displays this symptom when she becomes sad and has feelings of loneliness after finding out her children might not need her after all. This thought of loneliness is also what partially influences her idea of leaving her family. Another symptom that Nora shows is “Willingness to tolerate mistreatment and abuse from others” (Cleveland Clinic, 2013). This is extremely prominent when she accepts the condescending comments from her husband. When Nora was terrified of her husband finding out about the loan, she expressed another symptom of DPD which is “Intense fear of abandonment” (Cleveland Clinic, 2013). The final symptom that Nora shows is “Tendency to be naïve and to live in fantasy” (Cleveland Clinic, 2013). She expresses this when she talk about fantasizing about Torvald saving her from her situation the way she saved him when he was severely ill (Ibsen, Act 3).
Discussion
Through my observations, I conclude that Nora displays many symptoms of Dependent Personality Disorder, and because this it is most likely that she has this mental illness. If Nora decides not to follow through with treatment, she is at high risk of depression, as well as the destruction of personal relationships, according to Psych Central (Psych Central, 2013).
I will first step in Nora’s treatment plan will be to put her in psychotherapy, focusing on solving personal life issues that may be contributing to her illness. As stated by my colleagues at Psych Central, this is the “most effective psychotherapeutic approach” (Psych Central, 2013). Because this mental illness causes patients to become dependent on major figures in their lives, I plan on making this part of her treatment as short term as possible. In the same article, it mentions how “assertiveness training” should be considered in patients with DPD (Psych Central, 2013). Because of Nora’s inability to stand up to her husband when he gives her condescending comments, this will be a major focus in her therapy.
With the current information and background I have on Nora Helmer, I will not be prescribing her any medications at this time. If she begins to show signs of depression or anxiety, medications may be considered. If drugs are to be prescribed, they will be closely monitored because of the patient’s high risk of dependency of the medications (Cleveland Clinic, 2013).
Through psychotherapy alone, Nora’s mental health should show a great improvement in a short period of time. After solving her conflicts in her personal life, including her relationship with her husband, Nora will begin to be more assertive and independent. Hopefully, with this treatment plan, Nora will become more self-sufficient and a noticeable difference in her mental health will occur.
References
Cleveland Clinic. (2013). Dependent Personality Disorder | Center for Behavioral Health | Cleveland Clinic. Retrieved November 5, 2015, Retrieved from http://my.clevelandclinic.org/services/neurological_institute/center-for-behavorial- health/disease-onditions/hic-dependent-personality-disorder
Harvard Mental Health Center. (2007, April). Dependent personality disorder. Retrieved November 5, 2015.
Ibsen, H. (2008, December 8). A Doll's House. Retrieved November 2, 2015. Retreived from https://www.gutenberg.org/files/2542/2542-h/2542-h.htm
Psych Central. (2014). Dependent Personality Disorder Symptoms. Psych Central. Retrieved on November 1, 2015. Retrieved from http://psychcentral.com/disorders/dependent-personality-disorder- symptoms/Psych Central. (2013).
Dependent Personality Disorder Treatment - Psych Central. Retrieved. November 5, 2015, from http://psychcentral.com/disorders/sx13t.htm
Siddall, S. (2008). Christmas Spending. In Henrik Ibsen A Doll's House. Penrith, CA: Humanities- Ebooks, LLP.
