The Walking Dead: Mental Health, Resiliency & Survival

As a total Walking Dead fan, I have already read through all the comic books and currently watch the newest episodes as they are released.  This post features some spoilers but is intended to analyze the mental health issues and themes of resiliency and survival within the episode, Here's Not Here.

As a psychotherapist, there is something very familiar that consistently draws me into watching and reading about this cultural phenomenon of The Walking Dead. After watching this past weekend's episode, "Here's Not Here," I would like to take some time to dive deeper into analyzing the mental health issues presented and the overall themes of the show.

This episode was a nice break from the typical storyline we have seen so far.  Morgan's backstory before meeting up with Rick's group provided us with important information and a reminder of what it means to be human.  On one hand, we now can begin to understand Morgan's "no kill" way of life and where it came from.  On the other hand we are introduced to Eastman, a character who exudes resilience and humanity, even though he himself had a break earlier on.

Eastman is a Forensic Psychiatrist and was tasked with evaluating a very manipulative prisoner. His evaluation would be the final say in whether this man would be allowed to re-enter society.  It is revealed that this man knew Eastman could see right through his mask and could tell he was a true psychopath.

What is a Forensic Psychiatrist (Evaluator)?- As a forensic psychiatrist there are many different roles you could fill. However, in The Walking Dead, Eastman was more of an evaluator where he was tasked with assessing a criminal's risk for future violent acts. Unlike psychotherapy sessions, sessions with an evaluator are NOT confidential and everything you say can potentially be used in court.

What is a "Psychopath" or Anti-social Personality Disorder (ASPD)?- According to the DSM-V (The diagnostic manual for clinicians) There are certain criteria that must be met to diagnose someone as having ASPD:

  • Impairment in personality functioning:
    • Identity: Ego-centered, self esteem gained from power/pleasure
    • Self direction: Goals based on gratification and against social norms
  • Impairment in social functioning:
    • Empathy: Lack of feelings, remorse, guilt
    • Intimacy: Inability for mutually intimate relationships
  • Pathological personality traits:
    • Antagonism: manipulation, deceit, hostility and lack of empathy
    • Disinhibition: irresponsibility, impulsivity and risk taking

This man becomes intent on ruining Eastman's life and attempts to kill him on the spot but Eastman counters with Aikido techniques and protects himself. Unfortunately, the man breaks out of prison and kills Eastman's wife and his children, then turns himself into the police.  

Eastman was devastated and sought revenge by finding the man while he was working along the highway, kidnaps him and puts him in a jail cell in his mountain cabin where he then starves the man for 47 days until he dies.  


Some of you might ask, "But If Eastman killed this man by allowing him to starve in a slow and very painful way, wouldn't he be considered a "psychopath?"  Nope. And here's why.  

Let's walk through the ASPD criteria with Eastman's behaviors:

  • Identity: Eastman has been and continues to be a very humble person, lacking a grandiose sense of self
  • Self direction: He works in a helping profession, practices a peace-centered martial art (Aikido) and even after his lapse in judgement, still believes in surviving and helping those who come along (people and animals).
  • Empathy: Eastman says he received no gratification from watching his family's murderer starve to death and that he feels so guilty from doing it, he vows never to kill again (even animals for food).  He even apologizes as he knocks Morgan out after Morgan threatens him. Eastman also properly buries walkers and creates custom crosses with their names after finding their driver's licenses.
  • Intimacy: Eastman is perfectly capable of having healthy relationship as evidenced by having been married with children and the compassion he shows Morgan.
  • Antagonism: Eastman never presents with any manipulation, deceitfulness, lack of empathy or hostility throughout the episode.  He actually is very straightforward, a great conversationalist and is constantly giving "an open door" to Morgan.
  • Disinhibition: Again, there is no evidence of any irresponsibility, risk taking, or impulsivity.  Eastman is a fairly routine guy, just trying to make cheese and ride out the zombie outbreak.

Eastman's discipline and resilience after the world has turned upside down in the zombie apocalyptic outbreak not only provides him with the strength to survive, but to care for Morgan who has been deep inside a psychotic break stemming from his neglected Post-traumatic Stress Disorder for quite some time now.


Post-traumatic Stress Disorder (PTSD)- A mental health condition triggered by a traumatic event you have either been apart of or witnessed. 

Many people believe that PTSD is something that only veterans of war experience.  Actually, PTSD is a common psychological diagnosis for people who have survived sexual, physical, emotional or psychological trauma.

Here are the symptoms/behaviors that characterize PTSD:

  • You have experienced trauma as yourself, through a close loved one or you frequently are exposed to traumatic stories through your occupation (first responder, soldier, etc)
  • You experienced 1 or more of the following after the event:
    • You relive the event, have nightmares about the event, experience flashbacks, or you experience ongoing emotional distress or physical symptoms if triggered by something that reminds you of the event.
  • In addition, 1 month after the event you experience:
    • Avoidance of situations/things that remind you of the event, not remembering important parts of the event, view yourself, other and the world in a negative way, lose interest in activities you used to enjoy, feel detached from friends and family, feel emotionally numb, irritable, or have angry outbursts, engage in self-destructive behaviors, always on guard, and difficulty sleeping and concentrating.

After witnessing his wife turn into a zombie and then later watching helplessly as she bit their son, Duane, it is understandable as to why he is experiencing PTSD symptoms (not to mention all the other scary things he has experienced living in the world of The Walking Dead).

However, his mental state is left untreated until meeting Eastman and during this time he experiences another psychological issue, psychotic episodes.


Psychotic episode- A mental break from reality often stemming from another underlying mental health diagnosis.  This involves hearing, seeing or believing in things that aren't real.


In the beginning of Morgan's story in this episode, he is in the middle of having a psychotic break.  He is screaming wildly while talking to someone who is not there, putting himself in danger with the fire and not really caring and believing that trivial phrases like "clear" have a special meaning or significance. 

Later in the episode, Morgan experiences flashbacks while in the forest with Eastman.  With the first flashback, Eastman is able to redirect him using Aikido form.  However, when the walker comes that happens to be the young boy he had killed earlier, he is paralyzed and unable to protect himself.

We further see how the PTSD symptoms inhibit Morgan's ability to think clearly and in the present when he attacks Eastman after Eastman saves him from the walker.  He then regresses in his 'treatment' and is unable to pull himself together to care for Eastman for a period of time.

After awhile though, Morgan pulls himself together and helps Eastman bury more walkers and takes care of him before he 'turns.'  It seems as though Morgan has continued his progress with the coping skills Eastman has taught him and it is evident that Morgan has been changed for the better by Eastman's help.

 

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