Robert: Mathematical Genius or Schizophrenic?

The following essay explores a character in a play and his mental illness. The purpose is to see how his illness grew worse over time and to give a diagnosis and treatment.

Abstract

This case study is an examination of Robert, a character from a play written by David Auburn called Proof. I interviewed Robert’s daughter, Catherine, to help me further examine his behavior against my research of schizophrenia in order to confirm the diagnoses of his mental illness. By use of the criteria listed in the DSM IV, and the expertise of psychologist, Dr. Kim Mueser on schizophrenia, I can fully address Robert’s symptoms as schizophrenia. Robert receives a treatment plan which include medicines and therapy in order to alleviate his schizophrenic symptoms.

An Examination of “Robert” From Proof

This case study will examine Robert, a middle-aged professor, who was brought to my office by his youngest daughter, Catherine, shortly after a recurrence of hallucinations, delusions, and inability to care for himself. When I reviewed some of his preliminary background with Catherine, she reported that for approximately six months Robert was completely dependent on her before going back into one of his “remissions” (Auburn, 2001, Act I, Scene I). From previous medical records of this encounter, his physicians Jackson and Hartig (2010) claim that “just six months later, it becomes clear, from the nonsense with which he fills his notebooks, that his remission has ended” and that he needs an official diagnosis and care from a psychologist (n.p.). After examining him, I hope to confirm his diagnosis of possible schizophrenia and formulate a care and treatment plan for him.

Method

Participant

Robert, approximately fifty years old and a mathematical genius, is known for his excellent proofs and is a professor for Chicago University (Act II, Scene I). Robert was married until his wife passed away; he has two daughters, Catherine and Claire; however, Catherine is the one who takes care of him and has always lived at home (Act I, Scene I). Robert displays many symptoms that are connected to schizophrenia such as hallucinations, delusions, issues with abstract thinking, and inability to care for himself (Mueser, 2004, p. 2064). After conferring with Dr. Waite (2009), an expert in Dementia, about Robert having this illness, I was able to rule out this possibility because Robert’s symptoms and episodes come and go and there is not a steady decline of mental health and memory (p. 2-3).

Measures

I will interview Catherine, Robert’s daughter, about his behaviors and observe Robert in his home environment after his recurrence of symptoms (Act II, Scene IV). Using the ideas of Dr. Kim Mueser, an expert on schizophrenia, and the criteria for schizophrenia found in the DSM IV, I will diagnose Robert’s condition and create a treatment plan.

Procedure

I began my observations with an interview of Catherine, who was able to share about the many different behaviors of Robert such as his constant need for library books (Act I, Scene I). She discovered that Robert was “[talking] to people who weren’t there… [she] realized that he wasn’t reading [the library books]: He believed aliens were sending him messages, and he thought they were giving him ‘answers to everything. The most elegant proofs… Plus fashion tips’” (Act I, Scene I). Catherine admitted that Robert’s “mathematical proofs” were no longer understandable and that she “fed him… [she also] had to make sure he bathed” (Act I, Scene I). Catherine shared that Robert went from being a mathematical genius to having delusions and hallucinations which made him unable to care for himself. Catherine is concerned for Robert because he has episodes, then seems very lucid and sensible, then he goes back into displaying odd behaviors.

After interviewing Catherine, I found it to be necessary to observe Robert in his home environment. This lead to finding examples of what Catherine was trying to convey in her interview about Robert’s odd behaviors, inability to care for himself, and illogical mathematical computations. One example was that after being in a state of remission, Robert sat outside in thirty degree weather, without a coat, writing a proof. (Act II, Scene IV). Robert believed that even though he was very cold, writing the proof was more important than his comfort. He even stated that “work takes priority” (Act II, Scene IV). He truly believed his proof was going to be groundbreaking and vital to the mathematical world, even though it was gibberish (Act II, Scene IV). Here is how his proof reads: “Let X equal the quantity of all quantities X. Let X equal the cold… In March the Lake is a lake of ice…. Let X equal the month of full bookstores” (Act II, Scene IV).

Results

According to European Psychologist, Dr. Kim Mueser (2004), symptoms of schizophrenia is “the loss of contact with reality, including false beliefs (delusions), perceptual experiences not shared by others (hallucinations), or bizarre behaviours” (p. 2064). Robert clearly displays examples of Dr. Mueser’s symptoms by suffering from frequent delusions and hallucinations such as his conversations with imaginary people and beings, his belief that aliens give him mathematical proofs, even though they are incomprehensible. Further, Robert shows his loss of contact with reality because he completely ignores the importance of his comfort and safety by having to first complete his mathematical proofs (Act I, Scene I; Act II, Scene IV).

Another symptom of schizophrenia is problems with abstract thinking (Mueser, 2004, p. 2064). Robert obviously displays this because his mathematical proofs lack connections between ideas (Act II, Scene IV). A vital symptom of this mental illness is the “impaired role functioning or substantial change in personal behaviour” (Mueser, 2004, p. 2064). Catherine’s interview mentions that she must be physically present to ensure Robert’s personal hygiene and his nutritional needs are met, because during his “episodes” he is incapable of caring for himself (Act I, Scene I).

Discussion

Robert displays many of the symptoms tied to schizophrenia; it can be concluded that he has this mental illness. If Robert does not receive psychological care immediately, he may be prone to possible “substance abuse… infectious diseases… Post traumatic Stress Disorder… negative emotions… suicide… [and] cardiovascular diseases” (Mueser, 2004, p. 2064). Robert will continue to have times of remission in which he will appear to be fine but he will ultimately relapse and the episodes may worsen and lead to hospitalization (Mueser, 2004, p. 2066).

In order to prevent these issues from occurring and to help Robert manage his symptoms, there are several methods of treatment. My first suggestion is that he takes “antipsychotics” (Mueser, 2004, p. 2067). These are psychotropic medications that will help him reduce the amount of hallucinations, delusions, and negative emotions; it will also keep Robert from having relapses (Mueser, 2004, p. 2067). Another treatment option along with the medication is “cognitive behavior therapy for psychosis” (Mueser, 2004, p. 2069). This therapy will help Robert deal with any hallucinations he may still have even while on the medication and it will teach him how to deal with any other symptoms he still struggles with (Mueser, 2004, p. 2069). I also suggest having “family psychoeducation” therapy to help Catherine learn how to cope with her father, receive help with the care of Robert, and teach them how to continue a stable relationship with each other (Mueser, 2004, p. 2068).

After undergoing this treatment program, Robert should start to have less severe and frequent symptoms, along with stabilization of his daily behavior patterns, and possess the ability to care for himself more than he is currently able (Mueser, 2004, p. 2069). Ultimately, Robert’s behavior suggests that he struggles with his mental illness, schizophrenia; however, with proper medications and therapy, he should be able to recover to a more functional level.

References

Auburn, D. (2001). Proof. New York: Dramatists Play Service.

Bryer, Jackson R., and Mary C. Hartig, eds. "Proof." The Facts on File Companion to American

Drama, Second Edition. New York: Facts on File, Inc., 2010. Bloom's Literature. Facts

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00882&SID=5&iPin=CAD405&SingleRecord=True (accessed October 29, 2015).

Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. (4th ed., p. 186).

(2000).Washington, DC: American Psychiatric Association.

Mueser, K. T., & McGurk, S. R. (2004). Schizophrenia. The Lancet, 363(9426), 2063-72.

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Waite, J. (2009). What is Dementia. In Dementia Care a Practical Manual. Oxford: Oxford