Welcome to Psychosynology, the show where a licensed mental health professional analyzes and examines the effects of psychosynology on a patient's mental health. to diagnose movie or TV show characters. A mental health diagnosis should only be applied by a qualified professional.
This video may contain spoilers. Now I'm going to break this up into four sections. Film information, diagnosis, critical analysis, and final thoughts. So let's get started.
Section 1. Film Information. Black Swan was released in 2010. The film was a critical success and currently enjoys an 85% rating on Rotten Tomatoes. The film was directed by Darren Aronofsky, who has a number of other highly rated films on his resume. Prior to Black Swan, Aronofsky released The Wrestler in 2008, which is his highest rated film on Rotten Tomatoes at 98%. On December 6, 2010, just three days before Black Swan was released, on December 9, The Fighter was released in the US with Aronofsky attached as a producer.
Aronofsky must have been on Cloud 9 at this time. having released three incredibly successful films in just two years'time. Aronofsky didn't direct another film until Noah was released four years later in 2014, which has a qualified positive rating among most critics, but a generally negative one among most moviegoers. The protagonist of Black Swan is Nina Sayers, played by Natalie Portman, whose last film prior to Black Swan was 2009's Brothers.
Portman followed Black Swan with five films the following year. Yes, five films in one year. including 2011's Thor.
Portman has a long career and has participated in many outstanding films, but my personal favorite in her resume is Black Swan. She was totally committed to the role and goes all in. It's hard not to respect her performance here. Nina is a mid to late 20s professional ballerina who is known for her intense dedication to her craft. She's also known for having outstanding technique and form.
Nina lives alone with her mother in an apartment in the city. When Nina has a shot at the role of Swan Queen in a modern dance production of Swan Lake, the pressure of the role combined with her mother's overprotective presence culminate in mental health and physical problems that Nina must navigate as the production moves closer to its premiere date. Section 2. Diagnosis Okay, so let's talk diagnosis. Here are some observations that I made about Nina throughout the film. She has visual, auditory, and tactile hallucinations.
She has persecutory delusions. She's a perfectionist. Dedicated. Her life is ballet.
She's a master of proper technique. She's meek. She's an observer.
She struggles with artful expression. She's socially inhibited slash sheltered. Now, Black Swan has a lot going on, so there's quite a bit to unpack here.
But starting with just the mental health stuff and really trying to hone in on those issues first, I think there are four primary diagnoses that should be considered and explored. A psychotic disorder of some sort, obsessive-compulsive personality disorder, which is not to be confused with obsessive-compulsive disorder, which is quite different, an eating disorder, like perhaps bulimia, and excoriation disorder, also known as skin picking. Let's start with the psychotic disorder.
Now, when most people think of psychosis, which means delusions and or hallucinations, they may immediately think of schizophrenia. I don't think a lot of people know this, but there are actually many things that can cause psychotic symptoms that are not schizophrenia. In the world of mental health, psychotic symptoms can emerge as part of a mood disorder, like depression or bipolar.
It can also be found in PTSD and some personality disorders. There are numerous substances that can result in psychosis, like methamphetamine, marijuana, basalts, and hallucinogenics like PCP or ecstasy. And there are also medical conditions that can cause psychotic symptoms.
When I worked as a civil commitment investigator and mental health first responder, I would often get called to hospital emergency rooms by doctors, nurses, or law enforcement because they thought that somebody was experiencing mental health issues. But upon further testing, we would find that many times the patient actually had medical issues like a UTI or urinary tract infection. And after the UTI was addressed, the psychotic symptoms would cease.
Now that's not to exclude the possibility of a mental health disorder like schizophrenia. But in my field, we're taught to exercise caution and not be so diagnosis happy. And also many times in the DSM, it's clearly stated that if a behavior can be better explained by a substance use or medical issue, then the person probably doesn't meet diagnostic criteria for mental illness. However, in Nina's case, I do think that a psychotic disorder is probable for reasons that I'll get into as we explore the different criteria.
In the DSM, there are a number of psychotic disorders, and most of them have similar or nearly identical criteria. So, let's start with the psychotic disorder. but differ when it comes to the duration of sim symptoms. For instance, there are brief psychotic disorders that only require a few weeks of symptoms being present, and then there are longer-term disorders like schizophrenia that usually require symptoms to be present for months.
Symptoms can be brief or long-term, and the brief symptoms usually follow a significantly stressful event in the person's life, which could be the case in Nina's situation since she was recently cast as the Swan Queen, and so that's a lot of extra stress for her. However, usually in a brief psychotic episode, the symptoms will gradually fade, and since Nina's symptoms actually escalate throughout the film, this points us towards a longer-term psychotic disorder. So let's try to establish some kind of a timeline. Black Swan actually doesn't give us a very good timeline of events, but we do know that it begins before the Swan Lake production has been announced, and it ends on the night of the premiere. You might be shocked to hear this, but ballet isn't my area of expertise, so I actually have no idea how long it takes to put one of these productions together.
When I was in marching band in high school, I know that we would spend months working on a show before ever performing it live at a competition. From what I could find online, it appears that a 12-month timeline is a reasonable assumption for a professional ballet company from the start of a production until the showing. So let's assume the film takes place over about a 12-month period. And since schizophrenia requires multiple months of symptomology to be present before it can be considered as a diagnosis, let's go ahead and start there and see what happens. Schizophrenia.
A. Two or more of the following, each present for a significant portion of time, during a one-month period, or less if successfully treated. At least one of these must be 1, 2, or 3. Okay, so we've got five criteria under A, and Nina only needs to meet two of them. But she has to at least meet one of 1, 2, or 3. A1.
Delusions. Nina definitely has delusions, especially delusions of persecution throughout the film. And these symptoms seem to escalate as the movie progresses. Check.
A2. Hallucinations. Now, like I mentioned earlier, Nina actually has three different types of hallucinations throughout the film.
Visual, auditory, tactile. She sometimes sees her face on other bodies, or sees people or figures who aren't really there. She also hears voices, usually in the form of laughter, from fellow dancers who probably aren't actually laughing at her.
And she develops a lesion on her back from scratching, which I'll get into later, but that may be the sign of a tactile hallucination, or it may not be tactile hallucinations at all because it just could be symbolism. but it's difficult to say and again we'll get into that later but either way she's definitely having at least some types of hallucinations check a3 disorganized speech nina doesn't seem to have any issue with articulation and is pretty clear in her speech nina is able to socialize to an extent that could be considered her baseline throughout the whole movie never really markedly deviating so that's a no a4 grossly disorganized or catatonic behavior nina is punctual motivated and driven throughout the film dutifully showing up for practice and rehearsal and often going above and beyond what is expected. She doesn't appear to be disorganized in her thoughts outside of the paranoia, and she definitely isn't catatonic, so that's a no.
A5 Negative Symptoms. So this usually means a limited emotional expression or a diminished interest in regular activities, but Nina actually shows a pretty normal range of affect and remains obsessed and dedicated to her craft throughout the film, so that's another no. B.
For a significant portion of time since the onset of the disturbance, level of functioning in one or more major areas such as work, interpersonal relations, or self-care is markedly below the level achieved prior to the onset. As the film progresses, Nina really starts to struggle in social and even occupational areas. Her psychotic symptoms worsen and this negatively impacts her performance during the White Swan dance, resulting in a fall. Her mother notices that her self-care is failing and she's scratching herself with more frequency. She begins to lash out more impulsively towards peers and her mother struggling to keep herself composed.
This escalation of symptoms would definitely qualify. Check. Symptoms persist for at least six months.
Again, like I mentioned earlier, we don't get a clear timeline from the film, but based on the information I was able to gather online, it seems reasonable to assume that the timeline of the film is more than six months. The first hallucination in the film actually appears less than 16 minutes in, and it happens prior to Nina landing the role of Swan Queen. So I'm going to assume that the premiere date was more than six months from then. Check. Schizoaffective disorder or a mood disorder with psychotic symptoms has been ruled out.
Schizoaffective disorder is like schizophrenia, but it has a component of mood disorder. And a mood disorder with psychotic symptoms is a lot like schizophrenia. However, Nina doesn't appear to meet classic signs of depression like inability to feel happiness or lack of motivation.
And Nina also doesn't seem to meet classic symptoms of bipolar since she never really has a manic episode throughout the film. Therefore, Nina's symptoms are more consistent with schizophrenia than they are a mood disorder. Check. E. Not caused by substance use or medical issue. Nina only consumes substances a single time in the film, if you don't count smoking a cigarette once or twice.
And that's when she goes out with Lily and they consume alcohol and ecstasy together. Nina does experience some paranoia and hallucinations during that sequence, but she is already experiencing those symptoms before consuming the substances, and she continues to experience the psychotic symptoms long after the substances should have faded from her system. So unless she's doing some other substances off screen that we don't see, her behavior isn't caused by substances.
We do see Nina get checked out medically once during the film, but we don't hear of any significant medical issues during that sequence. She might have something going on medically that we are unaware of, but from the information available to us, her behavior is not due to medical problems either. Check. F. If the client has a history of autism or communication disorder, there are some other considerations to look at before diagnosing schizophrenia.
So the film doesn't show any clear evidence of Nina having a history of mental illness, and we learn pretty little about her childhood in general. So with no information, we can check this one off as well. Okay, so Nina meets two of the five criteria under A when only two are required.
So A is a go. Nina meets B through F. So those are all a go as well.
So as you can see, Nina does actually meet criteria for schizophrenia. Now let's check obsessive compulsive personality disorder. And as we look through this criteria, you'll see why I think Nina might qualify. Obsessive compulsive personality disorder. A pervasive pattern of preoccupation with orderliness.
perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four or more of the following. Okay, so we've got eight criteria here, and Nina only needs to meet four of them. One is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
Nina struggles with this toward the beginning and middle of the film. where she is so obsessed with form and proper technique that she doesn't understand the point of the black swan, which is a more organic, reckless expression of indulgence. Despite her constant practicing, she is unable to truly understand the role.
Nina's descent into madness is what finally allows her to give a perfect, visceral black swan performance, something that I think she would have continued to struggle with if not for the development of psychotic symptoms. Check. 2. Shows perfectionism that interferes with task completion. So this one is debatable, but I don't really think that Nina meets this criteria, and here's why.
Yes, she is committed to perfectionism, but with the exception of the Black Swan role, this perfectionism has actually only helped her career, allowing her to shine and gain an advantage over other dancers. This may have impeded Nina's ability to understand the Black Swan, but it didn't interfere with her trying out for, obtaining, and continuing to work toward mastery of the role. So I'll say no here.
3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships. Nina's life is ballet. Nina doesn't appear to have any leisure activities or any real friendships.
The only reason she went out for drinks with Lily is because Lily insisted on it. Check. 4. Is over-conscientious, scrupulous, and inflexible about matters of morality, ethics, or values.
Nina appears inhibited throughout most of the film by her meekness and rigid value system. Lily, on the other hand, displays a sense of confidence and embodies life in the moment, which is something that Nina seems to envy but can't grasp because it's not part of her nature. Nina releases her inhibitions when she's under the influence of substances, resulting in her having sex with Lily, which is something Nina would probably never do under normal circumstances, though we later learn that whole sequence was a hallucination or a dream. Nina is only liberated of her meekness toward the end of the film when her paranoia and hallucinations have completely freed her by allowing her to act recklessly.
Check. Five, is unable to discard worn out or worthless objects, even when they have no sentimental value. We don't really see this in Nina.
She even has a moment toward the end of the film when she's throwing away stuffed animals and kids things from her room. So this is a no. Six, is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things. Again, we don't really see this in Nina's behavior. So that's another no.
Seven, adopts a miserably spending style toward both self and others. Money is viewed as something to be hoarded for future catastrophes. We don't really see Nina dealing with finances at all throughout the film, so we can't give this a check either.
Another no. A. Shows rigidity and stubbornness.
Nina embodies this pretty much throughout the whole film. Check. So, in my opinion, Nina beats four of the eight criteria and can be diagnosed with obsessive-compulsive personality disorder. Now let's take a look at possible eating disorders.
Here's a list of them from the DSM. There are scenes in the film where Nina is eating an incredibly small meal, is denying herself even a celebratory piece of cake, and it's shown that she throws up in the bathroom. But Nina doesn't appear to have negative thoughts about her body, which is required in anorexia, and she doesn't engage in binges, which is required for bulimia.
So after further evaluation, I think she engages in some unhealthy eating habits, and obviously throwing up in the bathroom after practice probably isn't good, but her behavior is actually closely in line with the behavior of other professional dancers in her field. Her eating behavior doesn't appear to be the source of significant distress in her life, and has actually probably helped her achieve greater things in her career. So I actually don't think that she meets criteria for an eating disorder. Now the last diagnosis I want to take a look at is excoriation or skin picking disorder. So, right away when we look at this disorder, check out Criterion E. The skin picking is not better explained by symptoms of another mental disorder, like delusions or tactile hallucinations in a psychotic disorder.
We know that Nina is experiencing a psychotic disorder, most likely with tactile hallucinations. It appears that she believes she's transforming into a swan, and the marks on her back are from budding wings that fully extend at the end of the film. So basically, since she meets criteria for schizophrenia, and because her symptoms could potentially be better explained by schizophrenia the schizophrenia should be treated first to see if the skin picking continues after the other symptoms lessen or disappear if the skin picking does continue after nina's psychotic behavior has otherwise been addressed then we can return to this diagnosis and reconsider it for further evaluation but for now due to the stipulation in criterion e we can rule out excoriation disorder for the time being so in summary Of the four disorders that we explored, Nina seems to meet criteria for two of them, schizophrenia and obsessive-compulsive personality disorder. We don't have enough evidence of eating disorder, and we can't look more closely at excoriation disorder until the schizophrenia has been addressed. Section 3 Critical Analysis Okay, so now let's discuss a few things about Black Swan, because this film is more than just a mental health case study.
The film has a lot to say about the way young women are used by the system. chewed up and discarded as they age and lose their usefulness. We also see a dominant male at the top of these industries, who behaves exploitatively and abusively toward aspiring young female professionals. This has wide applications beyond just professional ballet companies, including Hollywood. It's interesting that this film came out prior to the Harvey Weinstein revelations, prior to the Me Too movement, and prior to the major societal backlash about slut-shaming.
I can't help but watch this film and think it's strangely predictive of things to come. and a bit ahead of its time in this regard. Now on the other hand, the film also shows that having an abusive mentor can lead to intensely passionate performances and artistic perfection. Some industries, the professional dance industry among them, do tend to reward unhealthy behaviors.
It's been said that some of the most creative and brilliant people to ever live were terribly troubled as well. So maybe there is a relationship between pathological behavior and beauty. We can see something very similar in the film Whiplash from 2014, which came out four years later but has some very similar themes of obsession, abuse, the quest for perfection, and the relationship between these things. And while we're talking about film similarities, this movie also reminded me a lot of Aronofsky's The Wrestler, which came out two years before Black Swan. In The Wrestler, you see a has-been professional who is looking for redemption and dealing with difficult mental health and societal pressures along the way.
The film's ending is very emotionally impactful and quite similar to the ending of Black Swan. Aronofsky is particularly gifted at developing fascinating mental health case studies, and then looking at injustices in society and combining the two. Something else I'd like to point out is Nina's unhealthy enmeshment with her mother.
Nina's mother failed to achieve her career aspirations because she chose to focus on raising her daughter, Nina, instead. She seems to live with considerable regret of not achieving more in life. You also get the sense that she's trying to live vicariously through Nina, trying to take advantage of any success that Nina enjoys. Nina struggles with being dependent on her mother and also with developing more autonomy and freedom.
But despite her mother's endless attempt to control her life, you do get the sense, especially at the end, that they do love each other and that her mother is supportive of her and wants the best for her. They have a moment that must have been pure elation for both of them at the end when they lock eyes before the Swan Queen falls to her death. Aronofsky inserts a lot of subtle cues throughout the film that I think are designed to help the viewer experience what Nina's mental illness might have felt like to her.
A great example of this is early in the film, a little under 25 minutes in, when you quickly see the eyes on a painting move. Little things like this happen to Nina throughout the film, causing her to doubt her own reality, and contributing to her increasing paranoia. It also demonstrates to the audience that we can't be too sure of what's real and what isn't, which reminded me a lot of other movies that play mind games with the audiences, like 1979's Phantasm. Which of these events are symptoms of Nina's psychosis and which are actually happening? Again, this really drives home Nina's struggle and demonstrates how impossible life must feel to her.
And it also adds a perfect hint of ambiguity to the film that to me contributes to the film's timelessness. Lastly, I want to talk a bit about Nina's physical metamorphosis. Not only is Nina's psychosis taking over her life, but she's also physically changing into the Black Swan. This is represented in Nina seeing her face on Lily's body and also in Nina destroying the signs of innocence and youth from her bedroom.
This is partly an assertion of freedom and a development into maturity, but it's also representative of Nina's transformation into something darker. She stops trying to hold back her mental illness and fully indulges in it. using it to help her give a profound performance at the end. It becomes a tool to help her achieve the end she wanted, but was never able to achieve otherwise. Interestingly, this change actually results in her being a weaker white swan as she loses some of her discipline technique, resulting in a sloppier performance and a fall.
But as a result, her black swan demonstration was masterful. I think the message is you can't have both simultaneously. You can't have perfect control, and also perfect artistic freedom, because one will always be at the service of the other.
And that's a duality that you can find throughout many works, and it can even be found in the Bible in Matthew 6 24, no one can serve two masters. Section 4 Final Thoughts So, to me, Black Swan is a movie about a lot of things. The fall from innocence, letting yourself go to achieve something greater than yourself, something beyond.
It's about mental illness and transcendence. It's about transformation, obsession, abuse, and passion. It's about perfection, and it's about beauty.
And that does it for this episode. Like my video and subscribe to my channel for future episodes. And let me know in the comments below if you'd like me to analyze any other movie or TV show characters.
And I'll see you next time on Psychosanology.