November 21, 2019

Social George VI and then his treatment by Australian

Social Anxiety Disorder (SAD) is one of the most common
psychological disorder displayed in an estimated 10% of individuals but is very
rarely explored in cinema. Tom Hopper’s historical drama film the King’s Speech
explores the development and effect of SAD in the adult life of Prince then
King George VI and then his treatment by Australian speech therapist Lionel
Logue. Through dialogue and onscreen actions, it presents a fair and accurate
description of the symptoms and partial treatment of SAD.

SAD is where an individual experiences an excessive fear of
observation or scrutiny in general or discrete situations which leads to
symptoms like trembling, blushing, stammering and in severe cases nausea and
diarrhea (Heimberg & Schneier, 1995). Those effected by
SAD tend to avoid social interactions due to their fear of judgment and their
life is based around this principle of avoidance which can hamper their social
development (Stein & Yu, 1996).  In the King’s Speech, King George is in such
a situation where by being part of the royal family he cannot avoid speeches
and social interactions where his constant stuttering and sweating during these
interactions is affecting him deeply. Throughout the film he displays many symptoms
of an individual with SAD such as constant stuttering, avoiding eye contact,
getting very sweaty and anxious before speeches and trembling while talking.  Another sign of SAD is that throughout the
film he is very self-critical of his actions and doesn’t believe that he will
be a good king as he says “The nation believes that when I speak, I speak
for them. But I can’t speak.”. This sort of self-doubt and negative view
of himself as a poor socializer is very commonly found in individuals with from
SAD (Heimberg & Schneier, 1995). These symptoms lead
to possible conclusion that King George VI has SAD however further differential
diagnosis may be required to know the exact condition. There are many causes
which could have led to this development.

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SAD is thought to develop in early childhood of individuals
and if it is not discovered and properly treated it can have significant
consequences in future life. Hobart Mower’s two factory theory encompassing
Classical and Operant conditioning can be used to explain the development and
maintenance of phobias throughout an individual’s life. This theory states that
an individual first begins to associate neutral stimuli with a feared stimulus
to incite an unconditioned response. After some time, he develops and
unconditional response to the neutral stimuli as well and this unconditioned
response in maintained by negative reinforcement of avoidance (Buck, 2010). In the case of SAD
an individual begins to associate social interactions with unpleasant
unconditioned responses and then begins to avoid them by which he avoids the
unconditioned response, and this eventually spirals leading to further
avoidance. Although the exact conditions which lead to SAD in King George VI are
not fully explained it is discovered while he undergoes therapy that he had a
very unpleasant childhood in the hands of his dominant and highly demanding
father. King George at an early age was placed in the care of a nanny who
physically abused him to the state where he was becoming dangerously
underweight and extremely sick. His father King George V was a very demanding
man who as he states said “I was scared of my father and so will be my
children” and was angered by George’s inability to speak fluently often
exclaiming loudly “Come on spit it out”. Further on he says that he was forced
to change his dominant hand from his left to his right. The above conditions
could all have led to the development of SAD as studies conducted in Sweden
showcased that 58.1 % of patients recall the direct traumatic event which lead
to their development of phobias (Heimberg & Schneier, 1995). A cognitive
behavioral model can further help in understanding the development of SAD.  It assumes that individuals with SAD
inherently believe that other people are very critical of their behavior and
actions and due to this they form mental impressions of themselves in social
situations and this leads to enhanced anxiety response and awareness, which interferes
with their behavior (Heimberg & Schneier, 1995). This is exhibited
in King’s Speech where King George while talking with his brother starts
looking at others facial expressions in the room, such as his brother’s mistress
who appears to be grinning, and due to this his stuttering worsens to such an
extent he is barely able to speak in the situation which leads to his brother
making a mockery of him. It is situations like this which lead to avoidance in
future of these situations as he is reluctant further in the film to meet with
his ministers when he is anointed King of England. Luckily, he is able to
receive treatment later in life which helps him overcome some of these issues.

Cognitive Behavioral Therapy (CBT) is a modern approach to
SAD which has shown significant improvements in social skills and confidence of
patients. Recent studies have indicated that a 12-week session of CBT leads to
significant improvements in severity of CBT in comparison to control subjects (Spence, March, & Hearn, 2017). In comparison to
pharma logical drugs like phenelzine CBT resulted in maintained improvement
over a time while phenelzine produced more rapid but short termed response (Heimberg & Schneier, 1995). It has also been
noted that in some cases this can led to drug addiction which can be overall
harmful for the recipients.  It relies on
modifying safety behaviors and trying to remove self-focused attention into external
ques. It uses techniques like video and audio feedback to correct
self-perception and to violate the individual’s social norms leading to removal
of safety behaviors. As the King’s Speech is set in the early 20th century to
make an accurate judgment on the treatment earlier models need to be studied.
Earlier models of CBT used Social Skill Training which involves use of facial
exercises and improving non-verbal gestures like eye contact and stature (Heimberg & Schneier, 1995). Lionel Logue the
speech therapist in King’s Speech heavily uses this earlier model in his
treatment course. He initially uses facial exercises and tongue twisters to get
King George to speak more freely. He then proceeds to get the King to speak
loudly into windows further removing safety behaviors. At the end of the
therapy he uses verbal techniques to reduce the stuttering by introducing
spacing and making the speeches into songs. The therapy given in the film
doesn’t differ much from earlier models of CBT and some parts of the therapy
presented in the film are still used today.

Overall the King’s Speech gives an accurate account for the
symptoms of SAD and an earlier model of treatment which improves overall
understanding of such disorders and engages the audience in a dramatic way. The
film explains details of SAD including its development and treatment showcasing
a very account of an individual with SAD.


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