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Introduction
Faculty, residents, and students at my university participated in the Disney Plus Dream Job and watched 30 Disney films in 30 days. While we completed the dream job on Friday, December 13, we’ll continue to post our top 25 blogs on Psychology Today. Our twentieth post is on The Little Mermaid (1989).
Synopsis
The Little Mermaid (1989) is an animated musical film produced by Walt Disney Feature Animation. Loosely based on the Danish fairy tale of the same name by Hans Christian Andersen (1837), the film tells the story of a mermaid princess named Ariel who dreams of becoming human (1).
At the time of this posting, The Little Mermaid holds a rating of 7.6 out of 10 on IMDb and a tomatometer rating of 93% on Rotten Tomatoes.
How it relates to the field of psychiatry
In the spirit of academic liberty, how should one attend to someone who presents with a chief complaint of dysphoria due to conflict with her father about separating from their underwater world of Atlantica? Once investigation reveals that Atlantica does not exist and that Ariel demonstrates a fixed belief, a provisional diagnosis of a psychotic disorder could be made. This provisional diagnosis is supported by Ariel’s use of neologisms (e.g. snarfblatt, dinglehopper) and thought blocking (“What's that word again?”); clinical findings not specific to, but consistent with, psychosis.
Once another medical condition is investigated and ruled-out, one would evaluate for substance use to determine whether Ariel’s fixed belief (delusion) is a direct physiologic effect of a substance. Here, ‘substance’ is defined as a drug (licit or prescribed), herb, or toxin. At first glance, Ariel does not appear to use drugs, nor is she prescribed any medications. It is reasonable to assume that if asked about drugs and alcohol, Ariel would deny their use. In this case, “accidental ingestion” (spiked, occupational exposure, etc.) may be considered. With this in mind, let’s look at what the physical examination reveals to determine what ails Ariel.
There are two elements that are central to the plot of The Little Mermaid: Ariel a) loses her voice in exchange for 2) getting legs. She subsequently has an ataxic gait (who could blame her?) due to neuropathic pain (in the original 1837 version, the Sea Witch sells Ariel a potion that will make her “dance like no human has ever danced before.” However, she will constantly feel as if she is “walking on sharp knives”).
So exposure to what substance (toxin) predisposes to psychosis with the triad of loss of voice, ataxia, and neuropathy? Hint: the element is biomagnified in fish (and therefore creatures that are half-fish).
The consumption of fish is the most significant source of ingestion-related mercury exposure in humans. Exposure to mercury can occur from breathing contaminated water air, eating tainted foods, or from exposure to mercury vapor such as that due to improper disposal of fluorescent lamps (that I believe Scuttle calls den lille havfrue).
