Written by Noah C. Berman
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“Dr. Green, how can you diagnose someone as OCD and then act as though I had some choice about barging in to your office?”
In As Good as it Gets, Jack Nicholson portrays Melvin Udall, a misanthropic, yet eccentric, author with Obsessive Compulsive Disorder (OCD). Throughout the film, Melvin engages in ritualistic behaviors (i.e., compulsions) that disrupt his interpersonal and professional life. This cinematic representation of psychopathology accurately depicts the functional interference and distress associated with OCD; however, Melvin’s over-the-top eccentricities obscure the boundary between what is “quirky” and what is OCD. To clarify this distinction, I will discuss Melvin’s OCD symptoms with a focus on differentiating them from his underlying personality traits.
Throughout the film, Melvin struggles with contamination-related obsessions and engages in ritualistic behaviors which serve to reduce his obsessional anxiety. This is a very common manifestation of OCD. To avoid potentially “dangerous” contaminants outside of his apartment, Melvin is seen wearing gloves in public and frantically warning fellow pedestrians not to touch (i.e., contaminate) him. He also refuses to use restaurant silverware; rather, he brings untainted plastic utensils wrapped within a protective bag. When Melvin returns to his sterile apartment, he immediately disposes of his gloves and commences a multi-step cleansing ritual. He first washes his hands with scalding hot water, unwraps a brand new bar of soap, and then forces himself to wash off the perceived contaminants. He repeats this ritual over and over again and discards countless bars of soap in the process.
In addition to contamination-related OCD symptoms, Melvin also engages in repeating (e.g., turning the lights on and off five times) and superstitious compulsions (e.g., not stepping on cracks on the sidewalk). In contrast to the washing rituals, it is difficult to infer the purpose of these compulsions, for we, as the viewer, are not privy to the obsessional thought processes that provoke these rituals. It may be that Melvin fears something disastrous might happen if he only locks the door 4 times. On the other hand, he might be worried that if he steps on a crack he “just won’t feel right” and the resulting discomfort will linger indefinitely.
Although Melvin’s compulsive rituals are accurately depicted, his all-to-frequent social faux pas and pervasive emotional insensitivity may be perceived by the viewer to be part and parcel of his OCD. For instance, at the onset of the film, Melvin dumps a neighbor’s dog into a garbage shoot, accosts Jewish patrons at a restaurant, and tells the mother of a severely ill child that “We are all gonna die soon. I will. You will. And it sure as hell sounds like your kid will.” A lay audience member may conflate Melvin’s misanthropic personality with his OCD symptoms. In actuality, Melvin’s broad pattern of difficulties with cognitive (e.g., perceives himself to be exempt from social graces), affective (e.g., inappropriateness of emotional responses), and behavioral experiences (e.g., avoidance of interpersonal relationships), are not part of OCD and may be suggestive of a personality disorder. For example. his rigidity, cognitive inflexibility, and perfectionistic tendencies are typical of Obsessive Compulsive Personality Disorder (OCPD), his penchant for social avoidance and his reclusive lifestyle are indicative of Schizoid Personality Disorder, and his over-inflated sense of self-importance may be symptomatic of Narcissistic Personality Disorder.
Overall, this film suitably balances an accurate representation of mental illness with the requisite plot arc of a Hollywood hit. Looking past the complicated interplay of Melvin’s personality characteristics and his ritualistic behaviors, As Good As it Gets nicely exposes the daily struggles of a man with OCD. We are shown how everyday tasks consume an excessive amount of time, and more strikingly, we see the dramatic toll that OCD takes on Melvin’s relationships. Interestingly though, at the film’s conclusion, Melvin’s budding romantic relationship flourishes and consequently, he forgets to ritualistically lock the door. Although I desperately wish that overcoming OCD was as simple as finding someone to love, treatment tends to be far more anxiety-provoking and complex. Thankfully, however, there are very good treatments available for OCD. For more information on such treatments, explore our website or the website of the International OCD Foundation: www.ocfoundation.org.
©2012 Massachusetts General Hospital OCD and Related Disorders Program | Reprint only with permission