Borderline and antisocial personality disorders in Patrick Bateman

Patrick Bateman in American Psycho

Patrick Bateman exhibits abnormal behavior in several ways in the film American Psycho. Because it is unclear whether his acts of violence are real or imagined, the film allows some leeway in how his behavior is interpreted. Regardless, Bateman gives indications of having borderline personality disorder throughout the film as well as antisocial personality disorder.

From the standpoint of the five perspectives of abnormal psychology and their treatment methods, there are several approaches that could be utilized to help Patrick Bateman. First, an overview of how he presents is necessary so as to see why the methods discussed below are appropriate.

Patrick Bateman exhibits abnormal behavior in the following ways: he intensely dislikes his circle of friends/associates and even his fiance Evelyn, though he longs to impress them -- the scene in which he displays his business card to his associates with the goal of creating envy in them, only to be outshined by an associate with an even better card, is one such example. In order to revenge himself on an associate who only makes dinner plans with him because he has mistaken him for someone else, Bateman lies to him about his actual identity and then murders the associate and covers it up (although, one could interpret the murder scenes as fantasies). Bateman prides himself on his ability to discuss pop music -- moments of grandiosity that make him feel good -- however, these are followed by moments (or fantasies) of violence, as with the associate who is murdered and the prostitutes who are beaten.

Bateman murders several others and has delusions -- such as when the ATM tells him to feed it a kitten he has found -- and when Bateman confesses, he is not believed. The film indicates that this can be taken in two ways: either the society/world in which Bateman lives is so superficial (with characters constantly mistaking characters for other people) that no one really knows who is alive or dead or really believes anything anyone says, much less cares -- or, Bateman has only imagined himself killing others and he is simply fantasizing acts of aggression that he does not really commit. The mood swings that he suffers throughout the film and his overwhelming feeling of emptiness coupled with his obvious anger issues suggest the possibility of borderline personality disorder as well.

His separation from his fiance at the end of the film is a sign of Bateman attempting to break free from the enclosures that he feels are suffocating him. He can identify nothing authentic in his life: he feels the need for cleansing -- catharsis as he calls it in the film\'s final monologue -- but finds that he can have none because there is no one around him with whom he can connect and/or have a real, meaningful relationship. He continues to be isolated and live in his own head and is confused about whether what he has done is real or just in his imagination. He is detached from his environment and his fleeting sexual dalliances have not provided him with any sense of fulfillment.

From the biological perspective is to prescribe medication. In the film, Bateman does take Xanax -- but this treatment does not appear to be particularly helpful.

From the psychodynamic perspective, Bateman could receive psychotherapy, which would assist Bateman in comprehending his personality disorders and realizing the effects they have on his life.

From the humanistic perspective, Bateman could receive existential therapy, which could provide Bateman a philosophical framework from which to view his life and which could help to fill the void inside him; or person-centered therapy could be employed to help Bateman identify his own values as a human being and better accept himself so that he is not so obsessed with gaining acceptance from those he despises.

From the cognitive behavioral perspective, Bateman could receive cognitive behavioral therapy (CBT) which blends together cognitive therapy and behavioral therapy. This would help Bateman to focus on his feelings, moods and actions and then identify positive goals that he could strive to meet in order to have a better life (National Institutes of Mental Health, 2015).

From the sociocultural perspective, group therapy could be used to help Bateman share his perspective among his peers and allow him to listen to theirs, which could in turn draw him out of his own narcissistic quest and become more attuned to the needs of others and thereby become more a part of society and less turned off by those around him.

The perspective that best addresses Bateman\'s abnormal behavior would be a combination of the humanistic approach, the cognitive behavioral approach and the sociocultural approach. The biological approach does not appear to be offering sufficient means of help to Bateman. The psychodynamic approach may be too free-form and not provide enough guidance for Bateman. The sociocultural perspective could be very helpful because it would allow Bateman to air his views and be heard -- which is something he wants very much -- and it could also induce him to listen to others and realize that he is not the only with opinions. However, some cognitive behavioral therapy could be effectively used as well because it would provide Bateman with some behavioral goals to strive to meet -- the direction that he appears to need in his life. Likewise, the humanistic approach could provide him with the philosophical reason to support the attainment of these goals -- it could appeal to his desire to reason and think logically about his life, even as it escalates into illogical fighting. Such a combination of perspectives is not out of the question and indeed researchers have recommended similar approaches in the past for cases of antisocial personality disorder.