The Black Swan
PART I: HISTORY
Nina is a young Caucasian woman, in her mid-twenties, who is physically and mentally drained because she is a perfectionist and ballerina in a prestigious dancing company. Nina is single, heterosexual, she is interested in men, and she lives with her mom who is single, controlling, and obsessive, in an apartment in New York. Nina is extremely shy, timid, and over-sheltered. She lives with her mother, who is angry and still upset at the fact that she had to give up her own dancing career at a young age due to the fact that she became pregnant. Because of this Nina experienced some physical abuse from her over controlling mother. ...view middle of the document...
After Nina attacked her mother, eventually breaking her mother’s hand, she became scared and afraid because she did not realize what she was doing and did not know what was happening to her. She also hurt herself in the process and because of this she decided to seek help voluntarily. Nina wants to find out what is happening to her and what is causing her to act out is such atrocious ways. She wants the doctor to help her get better and to start her on a treatment to recovery as soon as possible.
PART II: ASSESSMENT
Mental Status Examination Observations
Nina has an intense fear of weight gain, she has a disturbed body perception and she weighs more than fifteen percent below the expected weight. Nina restricts herself from eating. The only thing she eats is breakfast and that is usually an egg. Nina did not even want to eat the cake that her mom bought her to congratulate her on the lead role in Swan Lake. She constantly rejects the food that her mom gives her because she wants to keep her thin physique in order to be the “perfect” ballerina. Because she wants to be the perfect ballerina so bad, Nina purges on a daily basis to get rid of any of the extra calories she did not burn off during the day in practice dancing. Nina expresses recurrent episodes of purging behavior. It’s so bad that she does not even wait to go home and start purging; she does it right after practice in the bathroom of her dance studio. Nina also experiences delusions. She is aware of where she is and the time and place but at times she believes that she is turning into the black swan. Even though she knows she can’t technically turn into the black swan, her constant obsession in being the best, has made her mind think that she is turning into the “evil” twin. One time the delusion got so bad that she did not know what was happening to her and she hurt her mother and trashed her whole house. She walked into her mother’s studio, which is filled with paintings, and smashed her mother’s hand to the point of eventually breaking it. Nina’s persecutory delusions also make her think that her fellow dancer Lily is trying to steal her role as Swan Queen. Nina experiences many different hallucinations also. She experiences many involuntary, imaginary, sensations that occur without external stimuli. Her hallucinations are vivid and clear, and many times she can’t tell if they are real or not. For example Nina started becoming rebellious in order to achieve the black swan persona. She started becoming friends with a sexy and daring ballerina that came into her studio named Lily. Lily has the perfect personality of a black swan and when she invites Nina to go out one night she does not hesitate even though her mom is against the idea. When Nina returns home from her fun filled night out with Lily, Nina has a fight with her mother and once again goes against her mother’s wishes by taking Lily into her room. Nina spends the night with Lily in her room...