Enough by the Director Michael Apted

In the 2002 thriller film Enough by the director Michael Apted and the writer Nicholas Kazan displays the lifestyle changes a diner waitress named Slim undergoes after marrying a wealthy man named Mitch. While being married to this man, she realizes he is unfaithful and has a towering dominance over her and her freedom. She decides to escape with her daughter to find a place where he won't be able to catch them. As she tries to escape, her husband continues to follow their steps in hope of getting them back. Trying to run away from his grasp, she learns how to defend for herself and her daughter. While learning to defend for herself, she then plans how to put a stop to her possessive/controlling husband. Throughout this film, there are multiple psychological issues such as PTSD, anxiety, depression, NPD disorders. In this movie the controlive husband shows signs of having NPD which is characterised by abnormal behavior characterized by exaggerated feelings of self-importance, excessive need for admiration, and a lack of empathy (Narcissistic personality, 2018). What is seen in the character of Slim, she experiences depression, a persistent feeling of sadness and loss of interest (Mayo Clinic [MC], 2018) when faced that her husband is cheating, she suffers excessive anxiety or worry (National Institute of Mental Health [NIMH],2018) while trying to escape from him she had developed PTSD, flashbacks, nightmares and severe anxiety , as well as uncontrollable thoughts about the event (Mayo Clinic [MC], 2018).

The parts of the brain that are impacted by PTSD are the amygdala, hippocampus, and the ventromedial prefrontal cortex. The hippocampus is responsible for creating and retrieving memories when needed. Patients who suffer from PTSD show a considerable reduction in the volume of the hippocampus. (Wlassoff, 2015). The fear Slim goes through while escaping her husband is connected by the amygdala reacting, it is associated with fear and hormonal secretions (Bailey, 2018) which can explain her reactions towards her husband. While the amygdala is being reacted, so is the ventromedial prefrontal cortex, is responsible for regulating emotional responses triggered by the amygdala. (Wlassoff, 2015).

In the United States women have higher rates of PTSD than men do. Women experience intimate partner violence at a greater rate than men (Smith & Holmes, 2018). Women who experience intimate partner violence can form mental and physical health issues for female survivors (Smith et al., 2018) and can develop PTSD. In the United States the higher affected race group is African Americans, it is because they have higher exposure to assaultive violence (Roberts, Gilman, Breslau, Breslau, & Koenan 2011). For African Americans they have a higher risk of developing PTSD (Roberts et al., 2011).

In the United States, majority of the people that live in the U.S. will have experienced a traumatic event in their life. In the U.S. men are most vulnerable to PTSD between the ages of 41 and 45 years, while women are most vulnerable at ages 51 to 55. (Nauert, 2015). Not only is it adults that are affected by PTSD but it also occurs with children and teenagers. With children they develop PTSD from a range of events such as physical abuse, sexual abuse, neglect, and psychological abuse (Gromisch, 2010). Any age group can develop PTSD and is not only categorized to one age group.

I believe experiences during a person's life contributes to them having PTSD. It is not a psychological issue babies come out with into this world, it is from experience of living life exposed to or threatened by an event involving death, serious injury, or some form of sexual violence.(Licht, Hull, & Ballantyne, 2017, p. 503). To experience traumatic events in one's life is what creates fearful memories that cause stress and results to a psychological issue. Having PTSD is not something that is genetically transferred to offspring, if that were the case then many of veterans children and their children would be diagnosed with PTSD. If it were to be genetically transferred, we would see toddlers reacting and growing up with symptoms. PTSD is something that many people who serve the military face and that is because of the traumatic experiences they see and live through.

Even though Slim is suffering from PTSD, there are no treatments portrayed in the movie. The movie does not focus on how to treat PTSD, but instead displays how a person is affected and receives no help from others for treatment. Being chased by her husband constantly, it does not allow her to find time to seek treatment from a professional. There are treatments for people who have PTSD and many to be effective.
There is a treatment for PTSD called eye movement desensitization and reprocessing, also known as EMDR. There has been decrease in PTSD symptoms, resulting from EMDR therapy (Mevissen et al., 2017). Another treatment approach is cognitive therapy, also known as CT. Having the EMDR treatment that decreased PTSD symptoms, the CT treatment has improved PTSD symptoms and led to greater reductions in depression (Ehlers et al., 2010).

As we try to approach the cause of the development of PTSD, there are many perspectives as to how it is developed. By looking into some of the perspectives of how PTSD is developed, there is a complex understanding for each perspective. The perspectives of cognitive, biological, and developmental are all different and allows an understanding of their perspective. In the variety of perspectives on PTSD, there is not a right perspective on the issue.

By looking into these perspectives there will be different views as to how PTSD is developed.
In the perspective of cognitive the amygdala, which is responsible for initiating a variety of hard-wired responses to threat including release of stress hormones, activation of the sympathetic nervous system, and behavioural responses (Brewin, 2001) is an understanding as to how PTSD can be developed. Because the amygdala releases stress hormones that is a factor of PTSD and can be seen as to how it is developed. Not only is the amygdala creating the sense of fear but the hippocampus also appears to have an important role in the extinction of conditioned fear (Brewin, 2001) this explains the flashbacks for those who suffer from PTSD as the strength of fear conditioning and the recurrence of fear (Brewin, 2001). As one of the symptoms of PTSD, having flashbacks is seen in many patients. It does not mean everyone has PTSD because many people have flashbacks, there is a difference between the occuring flashbacks that people who have PTSD have and common flashbacks that are not categorized to be PTSD.

The biological perspective on PTSD the neurotransmitters dopamine, epinephrine, and norepinephrine were mostly investigated for their association with PTSD. (Zhang et al., 2017) may be a leading result for the development of PTSD. Looking into the biological perspective of PTSD it is not a simple issue it is complex disease affected by both genetic and environmental factors (Zhang et al., 2017). Even though it is a biological perspective on PTSD there are other issues that lead PTSD that a biological perspective can see that it differs. Having the biological perspective see that there are other factors of PTSD than biological, it shows the complexity of PTSD. The complexity of PTSD allows multiple approaches from different perspectives to understand the cause of PTSD.

Another perspective on PTSD is the developmental perspective. A way that developmental perspective sees the cause of PTSD is early-life trauma may interfere with the developmental trajectory of the DMN and its associated functions. (Daniels, Frewen, McKinnon, & Lanius, 2011). The DMN stands for default mode network and by having the DMN develop and being interfered with traumatic events exposure to events that disrupt this developmental trajectory may have shared consequences (Daniels et al., 2011) to PTSD. The childhood abuse that one faces lead up to question the development of DMN and is why it is associated with PTSD (Daniels et al., 2011). The perspectives are all connected with the experience of traumatic events and with each one it is seen how it develops to PTSD.

The movie portrays PTSD accurately when seeing how Slim is managing to get away from her husband. When she is running away from her husband, she continues to suffer anxiety, nightmares, and flashbacks. She is continuously on edge when she is outside and inside of her house. When she had bought a house, she was setting up traps and escape routes in case her husband were to come. Even though she has set up traps around the house, she has nightmares of him in the house, comfortably sitting down and watching her. Being confronted by a man she once knew in the past has brought a flashback that she was deceived from the beginning from her husband and gave her the realization of his psychotic behavior.

Even though PTSD is portrayed accurately in this movie, the treatments for PTSD were not. As Slim suffered from PTSD that was mainly caused by her husband, there was no treatment for her to help with PTSD in the movie. There was not a point in the movie that Slim had gone to receive help from a health professional. Neither was there anyone that told her where to get help. During her time from fleeing her husband, she had no time to seek help for herself because she was occupied with a man that is chasing after her and her daughter. She has loved one's that helped her transport to places and gave her some money, but none of them showed her where to get help after the traumatic incidents.

While researching and writing this paper I found that women are more likely to have PTSD than men. That is because women are more likely to be a victim of sexual assault. I find that surprising because I tend to correspond PTSD to men that have experienced traumatic events in the military. There are usually more men in the military than women and I assumed there are fewer women who develop PTSD because they don't enter the military as much as men do. After learning women experience PTSD more than men, it made me realize why that is the case and how they're at higher risk.

After watching the movie Enough I enjoyed the intensity and adrenaline it had given me throughout the movie. Seeing Slim and her husband compete to gain power and custody of their daughter, had created me to feel a sense of needing to fight and keep a look-out for myself. I give Enough 5 out of 5 because of the portrayal of mental abuse and it's progression throughout the movie. From the beginning, her future husband Mitch was very deceptive and lead Slim to believe he was a good caring man. When Slim finds out he is cheating, Mitch then unravels his true self and shows he is superior and becomes physically and verbally intimidating. After seeing the monster that he is, Slim fights her way from him but eventually faces the fact that she needs to face him. Going from a fragile and happily wedded woman, Slim turns into a strong independent woman who becomes a fighter to defend herself and her daughter. The movie Enough showed that a woman was able to fight against her abusive husband and survive his horrific acts.

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