Running head: SCHIZOPHRENIA: JOHN NASH

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Scholarly Assignment Part#2

Karen MacChesney, 821 426 814
Nurs 219
Professor Anne Senczuk
Tuesday, November 18, 2014

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Schizophrenia: John Nash

Introduction
Of all the mental illnesses that cause suffering in society, schizophrenia is probably responsible
for lengthier hospitalizations, greater chaos in family life, more exorbitant costs to individuals
and governments, and more fears than any other (Townsend, 2011 ). With symptoms typically
evident beginning in adolescence or early adulthood, schizophrenia is a brain disorder affecting
approximately one person in a hundred (Wood et al., 2011). Through its four phases, patients
with schizophrenia typically transition from social withdrawal through to psychotic symptoms
which include delusions, hallucinations, and social dysfunction. It affects the manner in which a
person thinks, acts, and perceives the world around him or her (Townsend, 2011). The 2001
movie A Beautiful Mind is based on the true story of John Nash, a brilliant mathematician who
suffers from schizophrenia. This paper will focus on how schizophrenia affected John Nash and
what nursing strategies and interventions would assist Nash and his family in living with the
disorder.
Summary
Based on the book of the same name, A Beautiful Mind tells the story of John Nash, a
real-life Nobel Laureate in Economics. Having been accepted into the mathematics department
of Princeton, Nash is eventually pressured to publish, but he remains steadfast in his goal for an
original theory, a goal which he eventually achieves and for which he is recognized through a
Nobel Memorial Prize in Economics. However, shortly after his acceptance into the
mathematics department of Princeton, Nash begins to suffer from the first signs of paranoid
schizophrenia. We learn later in the movie that several of the characters, as well as Nashs work

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as a code breaker for the Pentagon, are manifestations of his mental illness. It is not until the
latter scenes that the audience learns that Charles, Parcher, and Marcee, despite being very real,
are hallucinations in Johns mind. Despite his delusional behavior, periods of hospitalization and
an on-again, off-again relationship with medications, Nash learns how to manage his delusions
through living a quiet life. The hallucinations are forever with him, but he learns to ignore them,
and he learns to control the triggers (mainly stress) that intensify their presence. The movie ends
with Nash accepting his Nobel, being recognized both for his theory and for a body of work
accomplished while dealing with mental illness.
Psychosocial Effect of Schizophrenia
Nash exhibits many of the characteristic psychosocial effects of schizophrenia. Among
the most predominant are his hallucinations which emerge from delusions of grandeur and
delusions of persecution. Schizophrenics with delusions of grandeur believe that they are
exceptionally important and that they possess exceptional ability, authority, or knowledge
(Woods et al., 2011). This is evidenced in Nashs behavior during his early days at Princeton,
when he refuses to attend classes because he feels he is too smart. Also, during his time on
campus, Nash losses a game of Weiqi and states that he should not have lost; he is adamant in his
belief that the game must be flawed. Furthermore, Nash believes that he alone is able to help
decipher encrypted enemy code found in newspapers and magazines put there by the Russians.
In addition to these manifestations of delusions of grandeur, Nash also suffers from delusions of
persecution. Individuals with delusions of persecution believe that someone or something is
attempting to spy, harass, conspire against, kill, or harm them in some way (Woods et al.,2011).
This accurately describes Nash, since he is essentially under the false notion that the Russians are
after him. In one hallucination, Nash and Parcher are chased and shot at while driving off from

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the secret drop box where Nash deposits the decoded newspapers and magazines. Unfortunately,
while the hallucinations and delusions exist solely in Nashs mind, he is not the only one affected
by them. His family - specifically his wife Alicia and his son John David - also suffers. And as
he succumbs to these hallucinations, he is often too wrapped up in his delusions to share true
intimacy or emotional connection with his wife. In one scene, Nash is seen holding his crying
son while staring off into the distance; he is not able to truly engage the crying infant.
Recognizing what is happening, it is Alicia who eventually picks up the child and sooths him.
This scene demonstrates one of the instances in which Nashs psychosocial behavior contributes
to physical danger.
Physical Effects of Schizophrenia
While schizophrenia is a disorder of the brain, its effects are often physical as well as
mental. The physical effects of schizophrenia vary from case to case, but John Nash displays
several tell-tale physical symptoms of schizophrenia. Throughout the movie, Nash often has
unusual postures and/or gestures. In several scenes, often when under stress, Nash is seen
holding his right index finger up to the middle of his forehead and flicking it outward.
Furthermore, while standing, Nash also rocks back and forth slightly on his feet. These
movements are known as disorganized motor disturbances; they are purposeless and often
repetitive (Townsend, 2011). Moreover, Nash is at high risk of injury to himself and to others.
During his early time as a student at Princeton University, after becoming frustrated with his
work, he smashes his head on a glass window resulting in a large bleeding gash. Later, while
institutionalized, Nash cuts open his forearm in an attempt to retrieve a microchip device that he
believes had been implanted by the Federal Bureau of Defense. In addition to this self-harm,
Nashs disorder also puts his family at risk. During a hallucination, Nash physically pushes and

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knocks down his wife. He also puts his son in the bathtub and forgets about him while he
engages in conversation with his delusions.
Holistic Nursing Priority
The complexities of schizophrenia effect many aspects of the sufferer and his/her family,
and it is therefore important that the care and treatment also remedy the patient as a whole as
well as their support system. Holistic nursing is generally described as nursing practice that
incorporates mind-body-spirit principles into the development of a caring-healing relationship
with patients (Lewis, et al., 2014). Holistic nursing principles incorporate the care of the whole
person, including health, wellness, education, and prevention (Dossey, 2010). Schizophrenia is a
complex disorder demanding many interventions and nursing care strategies. The priority in
caring for Nash is to help him cope with the diagnosis of schizophrenia. This is accomplished by
helping John determine what is real and what is in his mind, and by teaching him coping
strategies to manage his disorder.
Nursing Interventions
The nurse plays an important role in the care and treatment of a patient with
schizophrenia. Each schizophrenic patient is different and will require care tailored to their
needs. With John Nash, the nurse must help him decipher what is real and what is not, recognize
the triggers and signs of an oncoming delusional episode and identify ways for John to control
delusional thoughts. The knowledge that Parcher, Charles and Marcee are not real allows Nash
the opportunity to identify their presence as a delusion, and therefore ignore it. Although they
never completely disappear, John is learns that by ignoring the delusions, the episodes become
less frequent. Another trigger for Nash must what for is when he starts to see codes and secret

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messages in newspapers and magazines. When these images begin to appear to Nash, he is
encouraged to recognize them as delusions and ignore them. While this practice will be quite
difficult in the beginning, it will become more natural as time progresses. Nash will be taught
strategies to help control his thoughts, specifically during times of stress when delusions are
more likely. Strategies such as distracting himself from having repetitive thoughts, recognizing
behaviors such as staring as an indication that thoughts are becoming disorganized, and by
anticipating new situations that may increase anxiety thereby enhancing delusional thoughts
(Tsung, 2011).
Interprofessional Collaborative Care Strategies
The care and treatment of a patient suffering from schizophrenia requires collaboration
with many health care professionals. Nash will be cared for by doctors, nurses, psychiatrists,
family and even himself. An essential tool in Johns care, among team these members, is to have
open, effective communication. Active listening and effective communication skills facilitate
both information sharing and decision-making (Klagsburn, n.d). Client-centered care is at the
core of interprofessional collaboration. The Registered Nurses Association of Ontario (2010),
describes client-centered care as Client centred care involves advocacy, empowerment, and
respecting the clients autonomy, voice, self-determination and participation in decisionmaking. With Nash, this is achieved by providing continuity of care having the same
professionals work with Nash whenever possible, and by involving Nash and wife Alicia in care
decisions and applications. Lastly, all members of the interprofessional health care team should
come together often to discuss the patient. Best Practice Guidelines recommend that
Interprofessional care partnerships across organizations agree on an evidence-based approach to

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planning, implementation, and evaluation for joint activities (RNAO, 2013). Interprofessional
collaboration also reaches beyond the hospital or institution and into the community.
Community Resources
There are many community resources available to individuals suffering from a mental
health disorder. It is important to find centers and resources that are close to ones residence and
that are tailored to the particular disorder that needs attention. Nash is lucky to live in Princeton,
which has a number of community resources available. Princeton Healthcare System is available
for inpatient and outpatient treatment and care of schizophrenia sufferers using both
pharmacological and behavioral therapies. Acceptance into their program would assist Nash
with initial inpatient treatment, and continuing support as an outpatient. Also available within
Nashs community, We Live With Schizoprenia, provides support to family members and
caregivers of people with schizophrenia. They offer the use of an online interactive conversation
tool where caregivers can receive personalized tips and meaningful conversations regarding the
management of schizophrenia in a loved one (welivewithsz.com, n.d). Johns wife, Alicia,
would help herself, her husband and their son by reaching out into the community and taking
advantage of the resources available to her.
Conclusion
While this paper focused on many of the negative effects John Nash experiences, all is
not lost and hopeless due to the diagnosis. There are many nursing care strategies, health care
professionals and community resources available in care and treatment. Nash goes on to live a
fulfilling life as a husband, father and professor. The winning of the Nobel Prize is proof that a
diagnosis of schizophrenia does not define a person.

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References

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21st-century global nursing. Alternative therapies in health and medicine, 16(5), 14-6.
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Ian M. (2014). Medical-surgical nursing in Canada: assessment and management of
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Klagsbrun, Joan, (n.d.). Listening and focusing: holistic health care tools for nurses. Retrieved
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Registered Nurses Association of Ontario. (2013). Developing and Sustaining Interprofessional
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Tsuang, Ming T., Faraone, Stephen V., Glatt, Stephen J. (2011). Schizophrenia: the facts.
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We Live With Schizophrenia. Retrieved November 10, 2014 from:

https://www.welivewithsz.com/#caregiving
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