Tuesday, October 25, 2011

Her Name is Sabine

This is a beautiful, tragic documentary film directed by the actress Sandrine Bonnaire. It uses home movie footage of her sister Sabine along with footage made when Sabine was a resident of a group home for people with serious psychiatric and neurological disabilities. The contrast between the images of the hauntingly beautiful adolescent Sabine and the obese, drooling, anxiety ridden and occasionally violent woman that her sister found  after her five years residence in a psychiatric hospital is profoundly moving. The film also answers a question that I have had for years since seeing Sandrine Bonnaire in the Agnes Varda film Vagabond. I wondered how Bonnaire had 'found' the hauntingly beautiful character she plays. Her Name is Sabine certainly gives a clue to an answer to that question.
I should add that Sabine is described in publicity for the film as 'autistic.' As I recall, someone who I took to be a psychiatrist in the film describes her as a 'psychoinfantile character with autistic features.' [I may not remember this exactly] While I thought that schizophrenia was a reasonable diagnosis for Sabine [especially as she seems to be receiving clozapine treatment], I found it interesting that schizophrenia is not mentioned in the film. I wondered if this was due to stigma or diagnostic peculiarities in France.

6 comments:

  1. she doesnt look schizophrenic to me, more, as sandrine said in her narration, autistic witk some anxiety, mood and impulse control diagnosises. wonder how she was before the clozaril, how she did on other antipsychotics, mood stabilizers etc. of course what do i know? i am not, was not there. im just aware that someone can become psychotic from multiple causes other than schizophrenia. that she was probably snowed in the institution for 5 years, almost certainly developed td there from meds used maybe more for their side effects than main effects in an effort to control her behavior. what happened to sabine there? what changes occured that she became too aggressive at home at age 27 or was it a gradual change? did it have to be that way?
    yes it is so sad, the contrast between the two sabines. it seems she lost herself in the institution, the younger sabine, while troubled, had something for herself that she developed and valued, then 5 years later it was gone. it breaks my heart to see that.
    but you know, there are a lot of things we arent told, maybe dont think to ask in this gripping film. i loved it when sandrine without hesitation, went to the man's side when he was seizing and did the only thing to do and no more. she doesnt mind getting her hands dirty. i can only imagine the regrets and guilt that she might harbor. and while it is easy to condemn the psychiatric system anywhere, the intentions of sabine's family and the institution were good in a world that hasnt valued people with psychiatric illness for centuries. the village idiot may have been tormented by the villagers, but he was protected from outsiders too. for centuries now, they have been placed out of sight of the view of us 'normal ' folk.
    there is so much to say about what this film evokes in us, too much really. so thank you sandrine, sabine, the other residents, the staff and others, for giving me something so powerful and unforgettable. thank you. we all have the best of intentions and things just turn out how they do.

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  2. I think my 41 hear old daughter is higher functioning than Sabine; but she regressed in group homes (five altogether). Without exception, we encountered mean, untrained staff (all the professionals were in the office). I could write a book! Thrilled to say she now owns her own condo, lives independently, takes public transport and NO MEDICATION!!

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  3. I think my 41 hear old daughter is higher functioning than Sabine; but she regressed in group homes (five altogether). Without exception, we encountered mean, untrained staff (all the professionals were in the office). I could write a book! Thrilled to say she now owns her own condo, lives independently, takes public transport and NO MEDICATION!!

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  4. "While I thought that schizophrenia was a reasonable diagnosis for Sabine [especially as she seems to be receiving clozapine treatment], I found it interesting that schizophrenia is not mentioned in the film. "

    Sabine looks HFA ("High Functioning Autistic") in the footage from her young years and LFA in the late footage. However, many psychiatric patients who have never been autistic look LFA after years on anti-psychotic meds.

    I strongly disagree that Sabine must be psychotic, or otherwise she would not have been given Clozapine. I have witnessed a wide variety of psychiatric patients been given anti-psychotic meds for a variety of reasons. More that everything else, they were given to pacify difficult behaviours.


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  5. The following is my experience background for making this comment:

    LFA: I have worked with non-verbal young autistic people in an institution and as a companion for LFA living at home (companion = paid to company client on outings in X hours so the family members can get a break).

    HFA and psychiatric meds: I have aspergers and am quite well functioning now, but have had quite big difficulties when I was younger. Mainly with social isolation and managing my life, but I also spent almost one and a halt year in a psychiatric hospital, mostly in a youth section but also in adult sections, including a closed section. I was never psychotic but was "occasionally" given anti-psychotic meds (Nocinan + Truxal... the former involuntarily) for behavioural reasons. In the case of Nocinan "occasionally" was pretty much constant for somewhere between some weeks and a month and I think a quite high dose.

    I found the effect of the meds on myself (especially Nocinan - maybe because of the dose) to be terrifying, almost life threatening. It dulled the muscles & "auto-function" so much I had to keep reminding myself to breathe. I couldn't keep my thoughts together, and the boundary between awake & dreaming blurred.
    In some cases, I walked right into a wall due to slow motor coordination reaction time... I didn't manage to turn before the walk was there. Overall, I lost my motivation and will power and life fragmented. Ironically, those are problems I can have even without meds... executive dysfunction, clumsiness et.c.... just exaggerated to the extreme with the meds.

    The older Sabine's expressions, manners, posture, attitude, moves/tics and cognitive functioning is typical for adult psychiatric patients who have had these types of drugs over a number of years, regardless of their original diagnoses. I strongly suspect that Sabine is not the first autistic who has been converted from HFA -> LFA to put a lit on violent/difficult behaviours.

    Curiously, these type of meds make people look LF autistic-like who were never autistic at the outset, very visibly and constantly displaying symptoms like stimming-like repetitive moves (side effects of the meds... but unlike stimming they are automatic and outside of control, like tics), repetitive verbal loops (like wanting to repeat the same sentence over and over for emotional assurance, rather than communicate progressively), poor motor coordination and motor control, extreme executive dysfunction, poor emotional control, lack of face expression,...... I don't know where to stop with this list.

    I am horrified when I read about anti-psychotic meds (e.g. risperidone) sometimes given to HFA kids to "improve their behaviour". I know the parents are doing with the best intent, but they don't know what they are doing. Seeing the long term impact on these meds on adults, I can only guess what they may do to the brain development and long term functioning level of kids. Even if the kids seem functionally "improved" at first.

    Personally I think the only reason the meds appear to "improve" behaviour is that it worsens executive functioning so much that it prevents or slows the translation of impulses to behaviour. It has an extremely mind-fragmenting effect and takes away to motivation and ability to "execute" emotions as behaviour.. including both violent impulses, desires and self-direction. It may appear to improve the patients' self control due to the apparent "better behaviour", but that is precisely the opposite of how it works.

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  6. Since watching the film last night I have been haunted by the difference in Sabine pre and post hospitalization. It is just tragic. I also found myself questioning the diagnosis. Having worked in Early Childhood Education with a focus on Autistic Spectrum diagnoses for the last 12 years I was quite confused with Sabine's diagnosis including autism at all. She at no point, before or after hospitalization exhibits ANY of the hallmark elements of autism spectrum diagnoses. I am not an expert, but I didn't notice any "features" that correspond.
    I was happy to come across this post today however. There is very little info to be found about Sabine and I just cannot get her out of my mind. There are so many aspects of her story that unfortuately shout with bells and whistles, the lack of understanding, empathy, interest, money, and services in place for the mentally challenged adult. Such a moving story.

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