Introduction
The name Adolf Hitler remains popular decades after his death since it conjures images of a madman in power. Undeniably Adolf Hitler is linked to one of the worst genocides in history. He is associated with Nazi concentration camps in Germany and Europe and an evil of such high magnitude that millions of Jewish and others were subjected to unimaginable torture, suffering and in many cases death. The premise of analyzing mental health is grounded on the fact that individuals’ experiences since birth have tremendous impact on their psychology (Whitbourne, 2017). Therefore, an examination of Hitler’s mental health disorders from his later adult years are to no small extent grounded on other disorders from his childhood and early adult life based on information in his personal and family history.
Case Study Formulation
Personal and Family History
Adolf Hitler was 56 years of age when he committed suicide on April 30th 1945. He was born on April 20th 1889 to Alois and Clara Hitler in a small Australian town of Braunau. Hitler had two older step-siblings and two younger blood siblings. During the first five years of his life, he was primarily raised by his mother due to his father’s demanding work schedule. It is reported Hitler was his mother’s favorite and she often lavished him with attention (Toland, 1991). However, this changed when his father was terminated from his job in 1895. Hitler’s father became more involved in his children’s lives. He was a demanding parent who often resorted to physical abuse when his expectations were not met. Adolf made efforts to meet his father’s demands; however, when he lost his youngest brother Edmund to measles in 1899 his performance in school began to deteriorate. However, his father emphasized on school work particularly sciences and language but Hitler had a passion for drawing and art (Hitler, Mein Kampf, 1927). As such, in efforts to keep up with his father’s expectations, he failed courses repeatedly. Hitler’s life took a turn for the worst when he father died when he was merely thirteen years old. He was forced to take responsibilities as the head of the family. Less than a half a decade later Hitler lost his mother to breast cancer when he was 18 (Hitler, The secret diary of Adolf Hitler ; The holocaust within . (Translated), 1993). While he was indifferent to his father’s passing, Hitler’s mother’s death devastated him. Hitler’s struggles and losses within this period may have adversely affected his development.
One core event in the early adult life of Hitler was his enlistment into the army, which resulted in his exposure to mustard gas and the subsequent extended hospitalization. Adolf took the defeat of Germany in the First World War hard that he suffered hysterical blindness as a reaction (Hitler, Mein Kampf, 1927). It was during this time that he described having a vision from God that the defeat of the Germans in the war was the fault of the Jews. Adolf joined politics in 1921 through becoming the head of the National Socialist German Workers Party in 1921. His political career progressed and in 1933 he was Chancellor of Germany and become the German Fuhrer in 1934. He was charismatic and ruled through powerful and persuasive oration along with fear. For instance, he once ordered the killing of 300 German soldiers for allegations of homosexuality.
Adolf had very few personal relationships since he was distrustful of people and tended to disclose very little of himself. For instance, he only had one childhood friend, August Kubizek who is reported to have maintained that relationship until his death in 1945. Research indicates Kubizek was a follower and became engrossed in Hitler’s personality which may explain their long-term friendship (Toland, 1991). On a romantic capacity, his first girlfriend was his niece, Geli, who Hitler had assumed hes guardianship after the death of her parents. Reports indicate Hitler was in control of the relationship and the lady stayed with him purely out of fear (Toland, 1991). She allegedly committed suicide after an argument between the couple in 1931. His other significant romantic relationship was with Eva Braun who he courted the same time he did Geli and grew closer to Eva upon Geli’s death. Eva’s and Hitler’s relationship was characterized with arguments and volatility that Eva attempted suicide in 1932 after a major argument. Hitler paid little attention to her save for sexual purposes and she allegedly stayed with him to enjoy the luxurious life associated with Hitler. The couple married a day before their dual suicide in 1945.
Those close to Hitler reported that he was distrustful of everyone and lived in constant fear of assassination. He was extremely impulsive, constantly angry for no particular reason and with time he become disorganized and presented extreme mood changes. Adolf was treated for depression more than five times in the decade between 1934 and 1944. He also had numerous medical complaints that were managed with various addictive medications including morphine for his abdominal pain, barbiturates for insomnia and depression and methamphetamine.
Symptoms Summary
The client is a 56 years old male presenting signs of confusion and delusional thinking in addition to evidence of possible suicidal ideation. From an initial glance, he appears to be older than his 56 years. The patient presents evidence of verbalize grandiose ideation along with suspicion, extreme distrust and paranoia. The personal and familial history of the client indicates several cases of major depressive episodes along with insomnia. An investigation in his other personal interaction indicated the client maintained very few but spontaneous and passionate relationships. For instance, he had two major sexual relationships which were marked with tales of him trying to control his partners through anger (Hitler, 1993). The client has a history of distrust and suspicion characteristics that might be linked to his rather harsh childhood. The patient’s past shows evidence of delusional thinking characterized with visions and hallucinations. As a political figure, his speeches illustrate evidence of delusional and ignorant thinking. However, the client was very charismatic that a majority of his speeches were met with positive reactions that many Germans rationalized and identified with his ideologies relating to efforts of bring Germany to greatness. Individuals close to his assert that he showcases episodes of rage of minor details in some cases no parent reason, he made impulsive decision and became highly disorganized with time. It is important to mention some of the behaviors evident in the client might be due to his reported history of extensive use of morphine and methamphetamine.
Diagnosis
At a healthcare provider capacity, I believe Adolf presented symptoms of the Oppositional Defiant Disorder (ODD 313.81) and Conduct Disorder (CD 312.89) as a child. Reports indicate that he was in constant fear of his father but was more concerned with the ridicule rather than the physical punishment. The two disorders are an ingredient for a child developing Antisocial Personality Disorders during the adult years (American Psychiatric Association, 2013). As an adult, Hitler’s behavior is associated with various mental health disorders including but not limited to; Major Depressive Disorder(MDD), Delusional Disorder(DD), Antisocial Personality Disorder(APD), Borderline Personality Disorder(BPD), Substance Use Disorder(SUD) and Narcissistic Personality Disorder(NPD).
The rationale for DD is grounded on Hitler’s conviction that the Jewish were responsible for the defeat of the Germans in the First World War (Hitler, 1993). The vision associated with this assertion might be considered a sign of Schizophrenia but he did not experience impairment in his functioning but persisted with delusional thinking throughout his life. Moreover, Hitler exhibited grandiose thinking in regards to his power and abilities. The justification for Narcissistic personality is grounded on the observation that Hitler showcased a pervasive pattern of need for admiration, ignorance and lack of empathy throughout his adult life (Whitbourne, 2017). Through is personal relationship there is evidence that he expected others to comply with his demands and the devaluation of his partners illustrate lack of empathy. His political speeches illustrate his grandiosity and the need for admiration.
Additionally, Hitler exhibited persistent use of substances despite the fact that he had substance use related problems. While the drugs were initially administered to manage his health complications, the dosage had to be increased overtime to achieve similar results and there were reports of significant distress in the event he did not receive his medication. Some of his delusional thinking and the appearance of being older than his age might be due to substance abuse (Whitbourne, 2017). Evidence of borderline personality disorder is apparent in his unstable interpersonal relationships and impulsive behavior that began in his early adult life. A key example is his violent and unstable relationship with his two lovers, Geli and Eva (Hitler, 1993). Moreover, the unstable and extreme mood swings including extensive rage for minor details pinpoint an underlying problem.
Treatment
It is necessary for the client to seek immediate hospitalization. Hospitalization will encompass thorough medical and psychiatric evaluation due to the urgency of the patient’s suicidal ideation and the evident poor physical state. After detoxification of the SUD, the healthcare providers will initiate psychodynamic psychotherapy that intends to strengthen the individual’s weak ego. Psychodynamic psychotherapy is also important in gaining insights on the client’s evident defense mechanism grounded on black and white thinking (Whitbourne, 2017). The main reason for leaning in the intervention is because of Adolf interactions with his father that might have affected his ego and his tendency to perceive things in two distinct characteristics as either good or bad. After an adequate hospitalization period, the client will be discharged to a supportive living facility with the intention of facilitating real-world living that will be characterized with partial treatment services. The discharge to a supportive living facility from the hospital is an important stage since it will allow the client to work on his interpersonal skills in a supportive environment (American Psychiatric Association, 2013). Depending on the client’s progress within six months in the supportive living facility, the patient will be discharged. However therapy will continue on an outpatient basis initially starting with two weekly visits which can be reduced with time depending on progress. During the outpatient visits, the healthcare facility may explore other treatment options such as dialectical behavior therapy which is important in facilitating the regulation of emotions subsequently better interpersonal and stress management skills. Eventually, group therapy will be recommended to further progress the client’s interpersonal skill in addition to providing evidence to Adolf on how his actions affect others. During the group therapy it is important to discourage Adolf from being the center of attention since this might adversely affect the treatment of NPD.
While Adolf life can improve for the better under the prescribed treatment options and strategies, his prognosis is very is poor. He is 56 years old and in a very bad physical state. Moreover, he lacks a real support system since his mental health state prevented him from building meaningful relationships. Additionally, he is in danger of relapsing into the use of psychoactive substances in efforts of chasing pleasure since the substances have affected the neurotransmitters responsible for the ability to feel pleasure.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Publishing.
Hitler, A. (1973). Mein Kampf. Houghton Mifflin Company
Hitler, A. (1993). The secret diary of Adolf Hitler ; The holocaust within . (Translated). Paperback.
Toland, J. (1991). Adolf Hitler: the definitve biography.
Whitbourne, S. K. (2017). Abnormal psychology: Clinical perspectivea on psychological disorder. New York: McGraw- Hill Education.
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