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Tuesday, November 9, 2010

Treatment Tuesday - Book Smart v Street Smart

This week's assessment is from Katrina. She's writing a romantic comedy set in present time about Marnie*, a 20-something who grew up in the special education system even though her IQ is slightly above average. She doesn't correctly predict cause-and-effect outcomes, so she learns things the hard way, and she rarely sees other peoples' perspectives unless she stops and makes a specific attempt. Her parents are deceased, and she has a genius older brother is basically a stranger and an overprotective older sister-cum-mother.

Marnie lives in supported living, but when she makes a wrong judgment call that ends in a small fire, her sister moves her into a group home. Marnie wants to get back to living as independently as she can, to become a "grownup" in the very narrow definition her sister uses. Her inner need to accept herself as she is: quirky and offbeat.

* Names have been changed to protect the fictional.

Katrina wants to know: What makes ordinary life so difficult for Marnie? (A diagnosis, if you will.) What would result in her lacking common sense and struggling to learn street smarts, but paradoxically learning certain types of facts easily and quickly? I need to know why she is this way so I can have a more clear understanding of what she can and cannot do.

This was a tough one, Katrina, and I'll tell you why: I couldn't find a single diagnosis that I'd be comfortable giving this character the way you have depicted her. That tells me one of two things: either I'm in need of brushing up on my diagnosing skills, or your character isn't quite feasible at this point.

Her delay in cause-and-effect reasoning doesn't mean she fits into a developmental disorder diagnosis. In fact, I'd say she doesn't, because she's a way more high-functioning adult than most of the diagnoses on that spectrum (like Autism, Asperger's, Pervasive Developmental Disorder, etc). And most all of those diagnoses require a significant social delay which either Marnie doesn't have or you didn't mention.

I looked into diagnoses for her odd, eccentric behaviors, but she doesn't fit anything like Schizotypal Personality Disorder or Schizoid Personality Disorder.

You mentioned maybe adding a savantism aspect to her character to account for her ability to learn certain things super fast. I did a post here on savantism, but that condition would have some significant challenges for the person to overcome that you don't list Marnie as having.

Maybe she gets overstimulated and has difficulty processing what she needs to do at those times, which might make her seem incompetent to those who witness her in that situation. I considered adult ADHD, and I suppose you might want to Google it to see what you come up with.  

However, I suppose a diagnosis of Amnestic Disorder Due to Head Trauma could fit if you could pinpoint her symptoms as the result of memory loss due to a Traumatic Brain Injury. According to what research on the internet I could do with limited time, a Traumatic Brain Injury wouldn't have affected her IQ. (Click here for more info.) However, for her to have the condition above, the injury would have had to impair her ability to learn new information or impair her ability to recall previously learned information or past events. 

See what I mean? This type of rule-out could go on forever (and it did!).

Quirky and offbeat is how you've described Marnie, and I could picture that. Rather than thinking she has some sort of mental problem, couldn't she just be different? I tried really hard to find some diagnosis that might fit, and came up short every time. But since my field is mental health, that's not to say she might not have some other neurological disorder or something like that to account for the symptoms you've given her. You might want to check with a medical doctor to pick their brain.

There isn't a diagnosis for being book smart and lacking in street smarts, but that sounds exactly like what Marnie is suffering from. There are some highly intelligent people who you might laugh at under the right conditions because they seem so inept with commonsensical things, like parking meters or working a fire extinguisher. But you've got her in supported living, which might be for high functioning individuals, but the people who utilize these services would not be okay completely on their own, and a book smart person would be fine on their own.

I could see this a bit better if she weren't in supported living at all, but in a college dorm or something. The supported living/group home part of what you've written doesn't gel at all with her functioning level. So she doesn't take the time to understand other peoples' perspectives and she might not correctly get cause-and-effect all the time, but this wouldn't warrant the type of situation you have her living in. Her family could consider her unreliable or quirky rather than incompetent. She could be gifted--which comes with its own challenges--rather than in special education. I just think it would fit better.

I hope that this hasn't been mentally defeating, because I think Marnie can definitely go the places you want her to go. It just means changing up her backstory a bit. After you chew on this a bit, feel free to email me (or comment below) any additional questions that might come up. Otherwise, I wish you the very best with this book!

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Katrina Stonoff said...

Thanks, Jeannie!

Nope, not mentally defeating. :-) I wrote to you because I'm having trouble making her gel. Marnie is a brand new character who just showed up one day when I was doing a prompt exercise with a friend, and I adore her -- she's so much fun to write -- but I've been struggling to make her believable.

Schizotypal Personality Disorder might work. Her parents were emotionally distant and largely left her caretaking up to her sister (fifteen years older). They live in the country, and she grew up alone. She has no friends -- the only people she's even in contact with are her sister, her social worker, and co-workers at whichever job she hasn't yet been fired from. She's uncomfortable in social situations.

I could add that her mother was schizophrenic. Marnie could think of herself as an alien, not metaphorically but literally (expecting her people to come back for her, maybe keeping a suitcase packed with weird stuff she thinks she'll need). I could add the ideas of reference and belief that she has ESP. Those would work really well into the story that is shaping in my head.

I see that SPD usually manifests in adolescence or adulthood, and that's fine. I don't need for her to have been through the special ed system. Would SPD be enough of a diagnosis, however, to warrant supported living? And could someone with SPD have a successful romantic relationship? Since this is rom-com, that is critical.

Or ... maybe she doesn't actually have a mental illness at all, she's just different (as you said), but because she has the risks factors (i.e. a parent with schizophrenia and a childhood history of neglect) and some of the markers, she's been misdiagnosed. Would that be too much of a stretch? Maybe she's using the alien thing metaphorically but people take her literally.

I could also make her sister a bit more diabolical -- instead of being simply controlling and smothering, she could be actively working to keep Marnie from becoming independent. Maybe the parents left a respectable estate, and as long as Marnie is considered incapable, her sister has control of Marnie's share. So maybe the sister pushed for a diagnosis that isn't accurate, or went to court to have Marnie declared mentally incompetent.

This would also tend to make Marnie suspicious of people, since her primary caregiver hasn't been all that trustworthy, and that's another marker for SPD.

Thanks, Jeannie. I love this character, but she still a Velveteen Rabbit so far -- I want her to be real.

Jeannie Campbell, LMFT said...

katrina - i think you are definitely on to something. let's say that she is "normal" but quirky enough to draw stares, etc. her sister, being diabolical and wanting the estate all to herself, could definitely be villainous enough to pay off some psychologist or friend of the family to say marnie's mentally incompetent. she's in the supported living b/c of the misdiagnosis, and maybe some of the comedy could be her trying to disprove her need of supported living, but instead of disproving it, she makes it clear to others that she needs SOMEone to look after her. but that someone could the be the hero! if's she's truly SPD, a romantic relationship could definitely be a challenge (not that there aren't people with SPD who have spouses or partners). that's why i really like the idea of her being misdiagnosed for some evil purpose of her sister. i think that's FANTASTIC!!

good luck with her. if you're having fun writing her, that's really important. i think with a few tweaks, she'll be wonderful to read as well. :)

Katrina Stonoff said...

Thanks, Jeannie.

I have to say -- this was a LOT of fun! I wrote a scene today that I added a few ideas of reference and some weird superstitions, and it really jazzed up the scene. Made her even more quirky and weird. :-)

And the hero is definitely yin for her yang: he's almost OCD about safety. They're a good fit.

Jeannie Campbell, LMFT said...

katrina! i'm so glad this was helpful. and what an affirmation...writing her with a new spin and it turning out even better than before.

let me know if there is anything i can ever do for you in the future!

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.