The quote, “Dr. Green, how can you diagnose someone as OCD and then act as though I had some choice about barging in to your office?” from Melvin Udall in As Good as it Gets, perfectly encapsulates the struggle with Obsessive Compulsive Disorder (OCD) and its diagnosis. Jack Nicholson’s portrayal of Melvin Udall, the eccentric author in As Good as it Gets, offers a compelling, albeit sometimes exaggerated, look into the life of someone living with OCD. While the film effectively highlights the disruptive nature of OCD, it also blurs the lines between the disorder’s symptoms and mere eccentricities. This analysis aims to clarify what constitutes an “As Good As It Gets Diagnosis” of OCD by examining Melvin’s symptoms and distinguishing them from his underlying personality traits.
Jack Nicholson as Melvin Udall in "As Good as It Gets" movie poster, illustrating a visual representation of the film being discussed in the context of OCD diagnosis.
Decoding Melvin’s OCD Symptoms: Contamination and Rituals
Melvin’s OCD is prominently displayed through his contamination obsessions and subsequent compulsions designed to alleviate his anxiety. This is a hallmark presentation of OCD. We observe Melvin’s extreme aversion to contamination as he navigates the external world. He uses gloves to avoid contact with perceived contaminants in public spaces, even cautioning strangers against touching him. Dining out becomes a carefully orchestrated event where he foregoes restaurant silverware in favor of his own plastic utensils, carried in a protective bag, ensuring they remain “pure.”
Upon returning to the sanctuary of his apartment, Melvin engages in elaborate cleansing rituals. He meticulously discards his gloves and initiates a multi-step hand-washing process. This involves scalding hot water, a fresh bar of soap for each wash, and repeated washing to eradicate perceived contamination. The discarded soap bars become a visual representation of the relentless nature of his compulsions.
Beyond contamination fears, Melvin also exhibits repeating compulsions, such as switching lights on and off multiple times, and superstitious compulsions, like avoiding sidewalk cracks. The rationale behind these rituals is less transparent to the audience. We are not privy to the specific obsessional thoughts driving these behaviors. Perhaps Melvin believes disaster will strike if the door isn’t locked exactly five times, or maybe stepping on a crack triggers an intense feeling of unease that he desperately tries to avoid. These actions, while seemingly quirky on the surface, are driven by underlying anxieties and compulsions characteristic of OCD.
Distinguishing OCD from Personality Quirks: A Diagnostic Perspective
While As Good as it Gets accurately portrays Melvin’s compulsive rituals, it’s crucial to differentiate these OCD symptoms from his broader personality traits. Viewers might mistakenly attribute Melvin’s social missteps and emotional detachment solely to his OCD. For example, his initial act of throwing his neighbor’s dog down the garbage chute, his insensitive remarks to restaurant patrons, and his blunt statement to a mother about her ill child (“We are all gonna die soon…”) are jarring. These behaviors, however, are more indicative of underlying personality traits rather than direct manifestations of OCD.
Melvin’s pervasive difficulties in cognitive (perceiving himself as exempt from social norms), affective (inappropriate emotional responses), and behavioral domains (avoidance of social interaction) extend beyond the scope of OCD. These patterns suggest the presence of a personality disorder. His rigidity, cognitive inflexibility, and perfectionistic tendencies align with Obsessive Compulsive Personality Disorder (OCPD). His social withdrawal and preference for solitude are features of Schizoid Personality Disorder. Furthermore, his inflated sense of self-importance could point towards Narcissistic Personality Disorder. It’s important to understand that while OCD and personality disorders can co-exist, they are distinct diagnostic categories. An “as good as it gets diagnosis” requires careful differentiation between the two.
The Film’s Impact and the Reality of OCD Treatment
As Good as it Gets effectively balances entertainment with a reasonably accurate portrayal of mental illness. The film successfully illustrates the daily challenges faced by individuals with OCD. We witness how routine tasks become time-consuming ordeals and, more importantly, the profound impact OCD has on Melvin’s relationships. Interestingly, the film suggests a simplified path to overcoming OCD: love. In the movie’s resolution, Melvin’s romantic relationship blossoms, seemingly causing him to forget his door-locking ritual.
While the film offers a feel-good conclusion, it’s essential to recognize that overcoming OCD is rarely as straightforward as finding love. Treatment is typically a more complex and often anxiety-provoking process. However, the good news is that highly effective treatments are available for OCD. Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), and medication are evidence-based approaches that can significantly improve the lives of individuals with OCD. For comprehensive information on these treatments and to seek help, resources like the International OCD Foundation (IOCDF) website at www.iocfoundation.org are invaluable.
©2012 Massachusetts General Hospital OCD and Related Disorders Program | Reprint only with permission
