Diagnostic Analysis of Aileen Wuornos as Portrayed by Charlize Theron in Monster

Suicide is a permanent solution to a temporary problem. -Phil Donahue

Abstract

Charlize Theron won a Best Actress Oscar for her portrayal of serial killer, Aileen Wuornos in the film, Monster (Jenkins, 2003). There have been some who have argued about her mental state and whether a specific diagnosis is apt. The following is a clinical diagnosis based on criteria in the DSM-5 and the film itself.

Aileen Wuornos was a 37-year-old Caucasian female. Before incarceration, she was in a relationship with a younger woman named Selby Wall. Their relationship ended after Aileen was taken into custody. She was incarcerated in Florida State Prison and was executed in 2002.

As Ms. Wuornos recalled experiences from her past, significant signs of trauma were observable. An obvious sign in her body language was tremors. This is a common reaction to the experience of a traumatic event. Other observable symptoms included her mistrust and blame of others, as well as a fearful demeanor. Ms. Wuornos exhibited signs of depressivity. As she recalled experiences from her past, other notable signs included issues with abandonment, rejection, anxiety, impulsivity, and hostility. Additionally, she was easily startled and frequently demanded justice for the perceived injustices against her.

These symptoms can be attributed to the trauma of her early childhood. She was sexually assaulted at the age of eight by a friend of her father. Her father did not believe her allegations. The duration of the abuse was not disclosed, but she did mention that she gave a child up for adoption and began to engage in prostitution at the age of thirteen. During her asides in the film, Ms. Wuornos admitted to physical abuse by her father, who later committed suicide.

Ms. Wuornos had a preoccupation with her self-image. She aspired to a fulfilling life and, in her words, was a “diamond in the rough.” She had dreams of falling in love, but she felt she could never love a man after being abused. Ms. Wuornos said that she was suicidal, yet hopeful. Although she never made an attempt, she sat on the edge of an overpass with a gun in her hand on several occasions. As she discussed her suicidal ideation, she described a conversation with God. She said, “I had five dollars and I said to God, ‘I will spend it and after it is gone, so am I. If you’ve got something in this life for me, you better bring it on.’” Although she did not express interest in organized religion per se, her conversations included repeated references to God.

Ms. Wuornos recalled in detail her personal history during her adult years. Most of these memories involved her girlfriend, Selby Wall. Ms. Wall zeroed in on Ms. Wuornos’ need for companionship and took advantage of her kindness. However, Ms. Wall’s only motivation was to be kept by another woman. The only motivation behind Ms. Wuornos becoming and continuing to be a prostitute was money. Ms. Wall’s desperation led directly to Ms. Wuornos’ decision to continue prostitution.

In one instance, Ms. Wuornos suffered a brutal beating and rape during a sexual encounter with a john. This was her justification for killing him. This was an exercise in catharsis, as she wanted to avenge her own rape and previous sexual abuse. These flashbacks eventually drove her to shoot and pistol-whip her rapist. Subsequently, she murdered six other johns, one of whom was a police officer.

Based on observable symptoms and psychosocial factors, Ms. Wuornos showed evidence of Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD). These diagnoses are evidenced by her recollection of traumatic events and personal behaviour listed in the above sections. In researching the DSM-5 (APA, 2013) criteria for PTSD, it was clear that Ms. Wuornos evidenced all of the significant symptoms, behaviours, and causal factors. The same standards were satisfied for her diagnosis of BPD.

For the PTSD diagnosis, the following criteria in the DSM-5 (as cited by APA, 2013) are listed:

Criterion A is a stressor. Ms. Wuornos had direct exposure to sexual violence.

Criterion B is intrusion symptoms. Ms. Wuornos evidenced three of the five listed symptoms, although only one is required for the diagnosis. She re-experienced her traumatic events through flashbacks. She also had intense distress after repeated exposure to events reminiscent of the initial trauma. Most notable were the tremors she exhibited. This was a clear sign of physiological reactivity.

Criterion C is avoidance. Both traumatic feelings and reminders were evident as sub-criteria. Although only one sub-criterion is required, she exhibited both of the two listed.

Criterion D is negative alterations in cognitions and mood. Two of seven sub-criteria are required; three were fulfilled. Ms. Wuornos had persistent and distorted negative beliefs about herself and the world. She had a distrust of men and blamed them for both the traumatic event and for her subsequent behaviors. Persistent anger, fear, and shame were also expressed.

Criterion E is alterations in arousal and reactivity. Two behaviours are required and Ms. Wuornos exhibited four out of six. These included aggressive behaviour, reckless behaviour, hypervigilance, and an exaggerated startle response.

Criterion F is duration. The previous criteria in B, C, D, and E have all lasted for more than one month.

Criterion G is functional significance. Social and occupational impairment and stress are evident.

Criterion H is exclusion. Although she was a recreational drinker, there is no evidence of medication, substance abuse, or other illness/injury that contributed to her disorder. She did not display dissociative symptoms and it was unknown when her PTSD symptoms began.

For the BPD diagnosis, the following criteria in the DSM-5 (as cited by APA, 2013) are listed:

Criterion A is personality functioning. Ms. Wuornos’ self-functioning abilities were impaired due to unrealistic goals and career plans. This demonstrated that she lacked self-direction. Her interpersonal functioning was also impaired, as she had issues with abandonment. Her relationships were marked by both mistrust and neediness.

Criterion B is pathological personality traits. Unlike Criterion A, the following criteria must be met in order to diagnose a patient. Negative affectivity is characterized by anxiousness, separation insecurity, and depressivity. Ms. Wuornos exhibited unstable emotional reactions and frequent mood changes. Also exhibited was anxiety in reaction to interpersonal stressors. She focused on both the past unpleasant experiences and future negative possibilities. She feared rejection and separation from Selby and expressed frequent periods of depression, hopelessness, shame, and thoughts of suicide. Ms. Wuornos’ acts of dis-inhibition were characterized by impulsivity and risk taking. Ms. Wuornos’ acts of prostitution showed both risk taking and no regard for the outcome of her actions. Her suicidal ideation and her homicidal activities also indicated a denial of the reality of personal danger. Ms. Wuornos’ antagonism and hostility were pronounced. She had persistent angry feelings and irritability in response to perceived insults.

Criterion C is duration. Her functioning and personality traits were consistent over an extended period of time and in comparable circumstances.

Criterion D is standards. Ms. Wuornos’ impairments in functioning and trait expression were not normative within her socio-cultural environment.

Criterion E is exclusion. There is no evidence of medication, substance abuse, or other illness/injury that solely contributes to these behaviours. However, her dysfunctional behaviour was exacerbated by her abuse of alcohol.

Treatment options that might be effective are limited under the circumstances. The efficacy of the suggested treatments would be more apt without the variable of incarceration and impending execution. For the treatment of PTSD (Butcher et. al., 2014), emotional disclosure and meditation would be mildly effective. Emotional disclosure, or the process of bringing feelings to the surface via writing, could have alleviated some of the mental stress and physical symptoms Ms. Wuornos experienced in prison. Antidepressant and anti-psychotic medication could have also been indicated. Intervention or counselling by a member of the clergy, if requested by Ms. Wuornos, could provide a sense of comfort in this stressful environment.

If Ms. Wuornos was being treated on an outpatient basis, other forms of therapy would be available. Dialectical Behaviour Therapy (DBT) would be the most effective treatment for BPD. (as cited by Butcher et. al., 2014) This treatment would have decreased her self-destructive behaviours and increased her ability to cope with past traumas. Ms. Wuornos would need supplemental assistance with life skill development. Anger management would be her most pressing need in DBT. Mentalization could have also been helpful. This may have assisted Ms. Wuornos in recognizing her true emotions and remaining cognizant of these feelings and the feelings of others.

Monster portrays Aileen Wuornos’ descent into the depths of mental illness. There was no evidence that she received treatment, nor was there a clear message about whether treatment could have helped. It is inconclusive as to whether viewers would take anything away from this film in the context of abnormal psychology.

One negative stereotype that may be reinforced is connected to lesbianism and misandry, the contempt for the male gender. The question that is raised is whether or not the distrust and hatred of men would lead a woman to turn to another woman for intimacy. It would seem apparent that these emotions led her to the act of murder. Clearly, Aileen’s choice of Selby represented a safe haven, especially since she never considered herself a lesbian before their encounter at the bar. The skating rink proved to be a venue for Aileen and Selby to feed into each other’s needs and insecurities.

The well-known symptoms of PTSD are shown (as cited by APA, 2013). Aileen Wuornos’ behaviours were real, genuine, and predictable in light of the abuse to which she was subjected. There are no signs of hope or redemption for this broken woman. There are no proverbial silver linings. Viewers may walk away from this film seeing Aileen Wuornos as a sympathetic individual rather than a cold-blooded serial killer. Their sympathy may be based on the fact that she never had a chance in life, never was granted an opportunity for fulfillment, and never received treatment for her traumatic experiences.

There are a number of questions that are raised during Monster. Is Aileen a criminal or a damaged individual? Were her actions premeditated, impulsive, or a reaction to her past? Was the audience understanding or callous, sympathetic or judgemental, compassionate or critical? The mental dysphoria Aileen Wuornos experienced may inspire the audience. It may serve as a point of reference to the necessity of treatment for abnormal behaviour, regardless of its source.

The title of the film, Monster, refers to the name of a ferris wheel which Aileen was afraid to ride as a child. When she rode on the ferris wheel with Selby, she felt positive for one of the few times in the film. This was one fear she conquered. In the middle of the film, Aileen recalls a junior high school assembly, at which a celebrity preached, “All you need in life is love — believe in yourself, then there’s nothing you can’t do.” At the conclusion of the film, as she is led to her prison cell, Aileen prattled off a plethora of affirmative clichés. She acknowledged that under the circumstances, affirmations are exclaimed without any basis in truth. (“Love conquers all.” “Every cloud has a silver lining.” “Faith can move mountains.” “Love will always find a way.” “Everything happens for a reason.” “Where there is life, there is hope.” Oh, well… They gotta tell you somethin’”) As the final credits roll, the song Don’t Stop Believin’ by Journey is played. Perhaps this is also a cliché, but in life, it may be the only philosophy that gives the wounded the strength to survive.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.) Washington, DC., Retrieved from http://www.dsm5.org

Butcher, J. Hooker J., Mineka, S. (2014). Abnormal Psychology, Boston. 152–155, 344–352

Jenkins, P.. (Director) (2003) Monster [Motion picture]. United States. Germany. Media 8 Entertainment and DEJ Productions