Schizophrenia Possession of Multiple Personality Disorder in Fight Club

Case Analysis: Jack
In the film Fight Club, Jack is a single white male, mid-30s, insomniac. He is mildly depressed, bored with his day job, and looking for something more fulfilling in his life. His father left the family when he was young and though they maintained some contact it was negligible. Jack has essentially had no substantial father figure in his life and he feels as though he is trying to compensate for some lack of manliness in his character by joining a fight club, where he can duel with other men who feel the same as he does. The fight club seems to take on a life of its own and soon the members have formed a kind of vigilante squad whose aim is to eliminate the emasculating elements of society that keep men from returning to a hunter/gatherer type of existence. It turns out that Jack has been leading this squad without realizing it: he has dissociative identity disorder (multiple personality disorder).
DSM-5 states that criteria used for diagnosing dissociative identity disorder are that alterations occur in the person’s state of consciousness or in his identity, to produce such symptoms as amnesia, somnambulism, fugue, and multiple personality. DSM-5 also takes into consideration that spirit possession may be an alternate diagnosis. While in the case of someone like Jack Torrance, possession is a real possibility based on what is revealed in the film The Shining, for Jack in Fight Club there is no indication of possession. Instead, the film clearly shows that Jack has multiple personality disorder as he shows symptoms of altered states of consciousness, amnesia, somnambulism, fugue and multiple personalities throughout the film.
Possession would be ruled out as a diagnosis as would schizophrenia because there is no evidence of spirit possession and Jack does not show any symptoms of schizophrenia—no hallucinations, no irrational speech patterns, no disordered thinking or inability to concentrate. He does exhibit anti-social behavior at times but this is perhaps a co-morbidity that stems from some trauma suffered in his childhood as a result of being abandoned by his father. Schizophrenia and possession must be ruled out as diagnoses as the criteria are not met.
Factors contributing to diagnosis of dissociative identity disorder can be seen from Erikson’s model of development, as well as Hirschi’s social bond theory and life course theory. Social bond theory posits that individuals need human contact to assist them in their psychosocial development, and Jack is essentially devoid of human contact, only being able to make friends with people if someone is sitting beside him on a plane on one of his business trips. He is so lonely he develops a second personality so that he can be a different person. From Erikson’s model, he has likely never overcome the conflict of identity vs. role confusion, which is the main conflict of adolescence, and his disorder is a kind of unconscious act of compensation for that fact (Perry & Szalavitz, 2006; Shriner & Shriner, 2014).
From a biological standpoint, it could be that Jack did not receive the necessary nurturing from a father figure in his youth and that is why a certain aspect of his DNA was never triggered over to help him adjust and overcome the conflict of identity vs. role confusion. This theory has been put forward by Naumova et al. (2016) with respect to epigenetics. Psychological factors would be abandonment, isolation, lack of social connection to others, and inability to rest from worry or some anxiety. Jack suffers from emotional exhaustion and feels relief only when he is at a support group where people with terminal illnesses are coping. From a sociocultural perspective, Jack via his 2nd personality Tyler sets out to challenge and destroy the modern world that emasculates men through its constant focus on consumerism and effeminate culture. Jack’s fight club is a way for him to finally address the identity vs. role confusion issues that have plagued him since adolescence when his own father abandoned him. Once Jack comes to terms with his own disorder he is able to accept who he is and take steps to address the issues in his life that may be causing him to seek support in a 2nd personality. The film ends with Jack saying goodbye to his 2nd personality Tyler and reclaiming control over himself.
Treatment recommendations for Jack would include talk therapy intervention and cognitive behavioral therapy (CBT) with particular focus on the miracle question intervention. The goal of talk therapy would be to moderate the feeling of isolation that Jack experiences. At the support groups early in the films he enjoys opening up to others—but he does so in an insincere manner, always pretending to be someone he is not.
What Jack needs is honest talk therapy where he discusses who he is and where he comes from—the way he does with his 2nd personality Tyler. He and Tyler have conversations together. The fact that they do have conversations together could suggest that he is hallucinating his relationship with Tyler, which could perhaps indicate schizophrenia, but he has no other signs of schizophrenic behavior in the film and the hallucinations are perceived to be more of a theatrical/cinematic trick to deceive the audience as to what is really going on with the protagonist than an accurate reflection of his mental state. CBT and the miracle question could be used to help Jack identify the negative triggers that prevent him from addressing issues in a positive manner so that he can resist slipping into the other personality to cope with stress or cultural or trauma-related issues. Optimal functioning would look like a well-adjusted Jack who fits in well with others, has friends, and feels pro-social at work.
References
Naumova, O. Yu., Hein, S., Suderman, M., Barbot, B., Lee, M., Raefski, A., Dobrynin, P. V., Brown, P. J., Szyf, M., Luthar, S. S., & Grigorenko, E. L. (2016). Epigenetic Patterns Modulate the Connection between Developmental Dynamics of Parenting and Offspring Psychosocial Adjustment. Child Development, 87(1), 98–110. https://doi.org/10.1111/cdev.12485
Perry, B. D., & Szalavitz, M. (2006). The boy who was raised as a dog: And other stories from a child psychiatrist's notebook – What traumatized children can teach us about loss, love, and healing. New York, NY: Basic Books.
Shriner, B & M. Shriner. (2014). Essentials of Lifespan Development: A Topical Perspective. Bridgepoint Education: San Diego, CA.