case study on fictional character

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Hannibal Lecter: Case study of a fictional character

• Repišti Selman
• antisocial personality disorder
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Writing Psychologically-Realistic Characters in Fiction

A psychiatrist-novelist reveals her writing methods..

Updated May 22, 2024 | Reviewed by Jessica Schrader

• As readers, we usually want fictional characters to be both unique and psychologically realistic.
• Psychiatrist-novelists have a well of clinical experience teaching them how people feel, behave, and grow.
• Writing techniques that help create psychologically-realistic characters are illustrated.
• .Novelists have sometimes-unconscious reasons for choosing certain themes and characters to write about.

Good novelists create characters who are complex. unique, and have relatable human needs and feelings. Joyce Carol Oates is one of our best contemporary novelists, and has created a host of memorable characters. including a hippie, an imagined Marilyn Monroe, and a teenage boy. When she and I met and exchanged novels, she said: “You’re a psychiatrist and a novelist. What a great combination!”

There certainly are superb novelists who are also psychiatrists. Dr. Daniel Mason, for example, is both an inpatient psychiatrist and one of our finest contemporary writers of fiction. However, non- psychiatric physicians have also written psychologically rich characters. Dr. Abraham Verghese, for example, specializes in internal medicine. And many of the greatest novelists of all time who created complex characters: Dickens, Tolstoy, and Dostoevsky were neither psychiatrists nor physicians.

So how, then, are psychiatrist novelists “a great combination"?

The advantages of being a psychiatrist-novelist

Humans are fascinated by other people and their behaviors. From earliest childhood , we listen to and read stories to show how people face challenging situations. We psychiatrists have an added advantage. In our clinical work, we are privileged to hear the most private thoughts and feelings of many people: their fears, the different ways they have tried to protect themselves in difficult and often traumatizing relationships and situations. We also see how they change and grow. When creating fictional characters, we have access to this well of knowledge to write imaginary but psychologically realistic people.

The challenges

When it comes down to the writing, though, physicians have a disadvantage. We're trained to write clinical case histories in a rigid format: presenting problem, history of present illness, past medical history, family history, and so on. This is totally unlike the process fiction authors must master to write characters that come alive on the page. We physicians must put aside that ingrained pattern of straightforward reporting if we are to write good fiction.

One psychiatrist-novelist’s process of writing

Is our process of writing fiction different from that of other novelists? What follows is my own method. I tend to think it is not; readers here may hazard their own guess.

Finding a topic gripping to the novelist

A novelist will spend countless hours in his/her imagination , even more writing sentences, paragraphs, and chapters, then even more rewriting. Because of this heavy expenditure of energy and time, we must find a topic that fascinates us so much we are willing (or needing) to invest the months and years necessary to write about it.

In my case, the idea for my novel of psychological suspense, The End of Miracles , came directly from my clinical work as a psychiatrist. Over a period of a few months, I was asked to see three women, each with an extended false pregnancy , a condition technically named pseudocyesis.

In addition to my clinical interest in evaluating and treating them, and my scientific interest in studying their hormone levels, I also thought: wouldn’t it be fascinating to write a novel in which, at some point, the main character develops pseudocyesis?

Why was this topic so appealing? Only during the course of writing did the realization of the likely roots of my fascination become apparent.

Having an overarching goal

I'd long harbored a creative need to write a novel. I also wanted to add an engrossing book to the world of literature in return for the pleasure I’ve received from reading fiction since my childhood. As a psychiatrist, I set myself additional goals . I wanted to show psychiatrists as they really are, not as the devious or incompetent stereotypes so often portrayed in books or films. I wanted to show that people who develop a serious mental illness are not that different from the rest of us.

Creating the characters

One method I used was to become an actor. I'd pretend to be a particular character and then "listen to" their inner monologue and dialogue. Probably the easiest chapters to write were about the psychiatrist in the novel. I simply imagined myself in my own office, sitting across from the main character, Margo, and having a therapeutic session with her.

Writing the psychological roots of behaviors

It was very important to me to make Margo’s thoughts and actions grow out of her psychology. Once I'd written enough to know her feelings and behaviors in the present, I added to prior chapters instances of thoughts and experiences that were roots of the current ones.

In the process of writing this way, I discovered a possible clue as to why I was so attracted to the theme of a false pregnancy. A memory came to mind: 5-year-old me seeing my mother very pregnant, seeing babies in fancy carriages, seeing women nursing their babies. Likely I wanted a baby then, too—yet never got to have one. But these women who’d developed false pregnancies with distended abdomens had found a solution to that problem! Why hadn’t I thought of that? Well, now I had.

Writing suspensefully

I’ve read many thrillers, and now used the techniques I’d observed in them to create tension and a page-turning experience for my own readers. In the most suspenseful sections, I kept chapter lengths short and hinted in their last sentences that something crucial was about to happen,

Sending the book out into the world

Publication was a joy mixed with an unexpected momentary sense of loss. In a way, it resembled what it’s like when a baby is born: for many months, you’ve had a private, intimate relationship, and then it ends. Similarly, when my novel was published, there was a brief sadness about sending it out into the world to make new relationships with its readers.

The audiobook re-creation

When we read a book, we're not actually reading the same book as its other readers. We filter what we see on the page through our own experiences and understanding of the world. With an audiobook, the narrator voices the story and the characters through their own response to the text.

For The End of Miracle 's Audible audiobook, I listened to many of their narrators read aloud sections of other books and of my own before choosing the one whose voice resonated best with the story. I would be entrusting this person to be a kind of co-creator with me. It’s been gratifying to read comments of those who’ve both read and listened, writing they very much liked the print version and loved the audiobook. Then, I am reassured that I made the right choice.

The effect on one listener, though, was unexpected and humorous. My teenage grandson wrote on his Facebook page: “After reading the novel I listened to the audiobook and it was a relief to hear the phrase ‘egg showered in sperm’ in someone else’s voice instead of my grandmother’s.”

Starkman, M. (2016) The End of Miracles: A Novel, She Writes Press.

Monica Starkman, MD is a professor of psychiatry emerita at the University of Michigan. Her novel The End of Miracles is a suspenseful story about a woman who unravels psychologically after harrowing infertility and a tragic miscarriage, the shocking choices she makes, and the psychiatrists and close ones who try to save her.

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Case Studies of Fictional Characters

Strongest Characters in The Case Study of Vanitas: Vanitas, Noe, & More

T he Case Study of Vanitas is a story based in a fictional 19th-century Paris where humans and vampires share the city. The story revolves around Vanitas and his companion, Noe Archiviste. They are on a quest to heal cursed vampires through the Book of Vanitas. It goes into detail about the Vampire born under the Blue Moon. He was isolated because of their fear, and thus, he swore vengeance against the vampires born under the Red Moon. His name was none other than Vanitas. The narrative is a memoir from the eyes of Noe Archiviste. He delves into how he came to meet Vanitas, their journey together, and how it eventually ends.  

Vanitas 

While he derives his name from an old vampire and uses his grimoire The Book of Vanitas. One wouldn't be harshly criticized if they had mistaken Vanitas for a vampire. And that speaks for Vanitas himself, who is a human first and foremost. While he isn't physically weak, he compensates for his lack of strength with his intelligence and grimoire. A combination of these two allows him to manipulate the actual names of vampires, making him a formidable presence within the series.

Noe Archiviste 

The sole survivor of the Archiviste clan, Noe is the narrator of the series and accompanies Vanitas on his journey of curing Vampires. While one may argue that Noe has been defeated several times within the series. It might be accurate, but his compassion and kindness prevent him from having a severe physical altercation.

Despite being a vampire himself, Noe treats vampires and humans as equally good creatures. It’s this good virtue that pulls him down from time to time. But make no mistake, with his ability to relive memories just by drinking the respective person's blood. It is safe to say one wouldn't want to get on his wrong side.

Lucius Oriflamme

He is one of the most powerful and influential characters in The Case Study of Vanitas. Despite his young age, he serves as the Grand Duke to the Vampire Queen herself. He's an aristocrat through and through.

Despite his childlike demeanor, he's quite skilled at manipulating others with his strategic ploys and engagement in political scenarios to further his motive and maintain his clan's position of power. To top it off, he holds Jeanne as his Chevalier.

Prolific, Revered, and the guardian of Lucius Oriflamme, Ruthven is often considered one of the most essential characters in The Case Study of Vanitas. Playing a pivotal role in ending the war between humans and vampires, he now finds himself as a member of the Senate and is well-known amongst humans as well.

He sought peace between humans and vampires during the war, even acting as a peacemaker. Having been betrayed by his students, he no longer shares the same passion and is ready to use any means to seek his desires. Cold, ruthless, and feared by vampire society, with his powers yet to be showcased, he's just a testament to the man that is Ruthven.

Jean-Jacques Chastel

Chastel is the protector and longtime companion of Chloe d'Apchier and the last surviving member of the d'Apchiers. His loyalty knows no bounds, as he goes on to sign a contract with the devil itself just to realize Chloe's wish. He turns himself into the very beast the village feared in exchange for his actual name. He wreaks havoc on anyone who tries to hurt Chloe, a symbol of his genuine and sincere feelings towards her.

The post Strongest Characters in The Case Study of Vanitas: Vanitas, Noe, & More appeared first on ComingSoon.net - Movie Trailers, TV & Streaming News, and More .

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6.72: Dependent Personality Disorder

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DSM-IV-TR criteria

• A pervasive and excessive need to be taken are of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
• has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
• needs others to assume responsibility for most major areas of his or her life
• has difficulty expressing disagreement with others because of fear of loss of support or approval NOTE: Do not include realistic fears of retribution.
• has difficulty initiating projects or doing things on his or her own (because of lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
• goes to excessive lengths to obtain nurture and support from others, to the point of volunteering to do things that are unpleasant
• feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
• urgently seeks another relationship as a source of care and support when a close relationship ends
• is unrealistically preoccupied with fears of being left to take care of himself or herself

A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/apsy/?p=446

Associated features

• Dependent individuals are often very pessimistic, self-defeating, and exhibit low self-esteem. They tend to belittle their assets and to refer to themselves as “stupid.” They take criticism very personally, seeing it as “proof” of their worthlessness. Their tendency is to seek out over protection and dominance from others. These individuals become very anxious when faced with a decision and may avoid positions of responsibility. Chronic physical illness or Separation Anxiety Disorder in childhood may predispose an individual to developing Dependent Personality Disorder.
• There may be an increased risk of Mood Disorders, Adjustment Disorder, and Anxiety Disorders.
• These individuals lack self confidence and lack a sense of autonomy. They see themselves as extremely weak and others very powerful. They are extremely dependent on others and have a great need to be taken care of, which makes these individuals cling to others and to be submissive to others’ wishes and demands. When one relationship ends, they become desperate and have to form another relationship to replace the broken one. Some individuals panic if they have to be alone or separated from depended-upon people.
• They do not demonstrate appropriate anger with other people because they are terrified of losing their support. As a result, they remain in psychologically and physically damaging and abusive relationships. They, in effect, lose their individuality because they let others make the decisions, both large and small in their lives.

Child vs. Adult Presentation

• This diagnosis is only cautiously given to children and adolescents, as some dependent behavior may be developmentally appropriate at this time.
• Symptoms in adults are very similar to Separation Anxiety in children.

Gender and Cultural Differences in Presentation

• Prevalence rates are significantly higher in India and Japan, possible because dependent behaviors is expected and encouraged, especially for women.
• Dependent Personality Disorder occurs more frequently in women, and is co-morbid with Borderline, Schizoid, Histrionic, Schizotypal, and Avoidant Personality disorders. There is also co-morbidity within the Axis I disorders of Bipolar Disorder, unipolar depression (or major depressive episode), anxiety disorders, and Bulimia Nervosa .

Epidemiology

• Dependent PD is one of the most reported Personality Disorders in mental health clinics and they do not give a percentage of prevalence. But a reasonable estimate is from 0.5% to 1.5% of people in the general population have this type of PD. There is around 1.4% in outpatient psychiatric settings; there are no significant familial problems.
• It is reported that about 10% of outpatients seen in mental health clinics also have Dependent PD (SAMHSA, 2009).
• Parents who are more authoritative (holds very high standard for achievement and low in giving love and attention to the child) can cause person to develop Dependent PD because the person is not used to making their own choices and decisions. Parenting styles are authoritative, meaning many rules and chores.
• People with Dependent PD have very low sense of self-efficacy. There is restricted development of self-efficacy. They often don’t believe that they are able to do some things by themselves.
• Females diagnosed with Dependent PD generally have a history of depression or depressive symptoms in early adolescent girls.
• Peers may have responded to these individuals with rejection, teasing, and other remarks on their dependence and incompetence, thereby reinforcing the views conveyed by caregivers that the person with DPD is in dire need of constant care.
• Infantile temperament may be an additional variable that interacts with parenting style to further elicit overprotective and authoritarian responses to the individual child.

Empirically Supported Treatments

Psychotherapy.

• Used as treatment for people with dependent personality disorder. Cognitive-behavioral therapy focuses on patterns of maladaptive thinking and seeks to eliminate them. Often people in cognitive-behavioral therapy set goals that they eventually try to achieve without relying on others. Interpersonal therapy is also a useful approach. Often the patient is receptive to the treatment and seeks help with their personal relationships. With this particular kind of therapy, the therapist will help the patient understand how they interact with others and how this contributes to their dependency issues. This particular therapies purpose is to show the patient that their dependency comes with a high price and that they do have alternatives. Another type of therapy used to treat dependent personality disorder is group therapy. Often people taking part in group therapy must be highly motivated to see improvement. Studies show that time-limited assertiveness-training groups with very clear goals are successful. It has also been said that family or martial therapy can improve a person’s independence by working on the families relationship as a whole.

Cognitive-behavioral therapy

• Cognitive-behavioral approaches attempt to increase the affected person’s ability to act independently of others, improve their self-esteem, and enhance the quality of their interpersonal relationships. Often, patients will play an active role in setting goals. Methods often used in cognitive-behavioral therapy (CBT) include assertiveness and social skills training to help reduce reliance on others, including the therapist.

Interpersonal therapy

• Treatment using an interpersonal approach can be useful because the individual is usually receptive to treatment and seeks help with interpersonal relationships. The therapist would help the patient explore their long-standing patterns of interacting with others, and understand how these have contributed to dependency issues. The goal is to show the patient the high price they pay for this dependency, and to help them develop healthier alternatives. Assertiveness training and learning to identify feelings is often used to improve interpersonal behavior

Group therapy

• When a person is highly motivated to see growth, a more interactive therapeutic group can be successful in helping him/her to explore passive-dependent behavior. If the individual is socially reluctant or impaired in his/her assertiveness, decision-making, or negotiation, a supportive decision-making group would be more appropriate. Time-limited assertiveness-training groups with clearly defined goals have been proven to be effective

Family and marital therapy

• Individuals with dependent personality disorder are usually brought to therapy by their parents. They are often young adults who are struggling with neurotic or psychotic symptoms. The goal of family therapy is often to untangle the enmeshed family relationships, which usually elicits considerable resistance by most family members unless all are in therapy. Marital therapy can be productive in helping couples reduce the anxiety of both partners who seek and meet dependency needs that arise in the relationship.

Medications

• According to the encyclopedia of mental disorders, Individuals with dependent personality disorder can experience anxiety and depressive disorders as well. In these cases, it may occasionally prove useful to use antidepressants or anti-anxiety agents. Unless the anxiety or depression is considered worthy of a primary diagnosis, medications are generally not recommended for treatment of the dependency issues or the anxiety or depressive responses. Persons with dependent personality disorder may become overly dependent on any medication used
• Antidepressants, anti-anxiety agents, sedatives, and tranquilizers.
• Dependency can eventually become an issue for someone using one of these medications, therefore most often they are not prescribed.
• Since dependent personality disorder originates in the patient’s family, the only known preventive measure is a nurturing, emotionally stimulating, and expressive care giving environment

Portrayed in Popular Culture

• Bella/Edward relationship from Twilight
• They are completely dependent on each other to the point of being suicidal without the other
• Peter Pettigrew from Harry Potter
• The once friend of James Potter shifts the target of his submissive behavior from James and his friends to Voldemort and the Death Eaters.
• In The Prisoner of Azkaban , when his transgressions are revealed, Peter soon tries to gain anybody’s approval by groveling and pleading

DSM-V Changes

• Dependent Personality Disorder will be represented and diagnosed by a combination of core impairment in personality functioning and specific pathological personality traits, rather than as a specific type.
• Prominent Personality Traits
• Submissiveness, Anxiousness, Separation Insecurity (APA, 2010)

• Abnormal Psychology: An e-text!. Authored by : Dr. Caleb Lack. Located at : http://abnormalpsych.wikispaces.com/ . License : CC BY-NC-SA: Attribution-NonCommercial-ShareAlike