A Clockwork Orange is set in futuristic Britain. The main character and narrator, Alex DeLarge, is the leader of a sadistic teen gang. Alex introduces his “droogs”, or friends, as Pete, Georgie, and Dim. After getting intoxicated at the Korova Milk Bar, they perform a series of “ultra-violent” crimes. This includes beating a homeless man, fighting a rival gang, and theft. They also play “Hogs of the Road”, a game in which they steal a car and drive recklessly with the intention of causing harm to pedestrians and/or other drivers. They decide to carry out a “surprise visit”, where they go to a stranger’s home and pretend to be in danger in order to gain entrance. They sing and laugh while harming their victims, a married couple. The man is beaten, bound, and forced to watch his wife being brutally raped. The gang then returns to the Korova for a nightcap. This is when we discover Alex’s love for classical music, and the discontent that the gang feels toward their arrogant leader.
Alex returns home to his parent’s house. He has a drawer full of stolen goods. He listens to Beethoven before going to sleep. The joy he finds in classical music is strongly related to the elation he feels throughout acts of ultra-violence. The next day, Alex plays hooky from school. His parents appear to be very passive, lacking the courage to create boundaries. They believe that Alex is out late due to his “jobs”. Later that day, Alex has sex with two unfamiliar girls. Afterwards, he quarrels with his droogs about a scheme that Georgie constructed. As the gang walk along a marina, Alex clubs Georgie in the groin and kicks him into the water. Dim swings his chain at Alex, who ducks out of the way, resulting in Dim in the water as well. Alex deceivingly offers his hand to Dim; when he reaches for it, Alex cuts him with a knife. It appears that everything is restored while the gang further discuss Georgie’s plan. It involves another surprise visit to a cat lady’s home.
Rejected at the door, Alex enters through an upstairs window while his droogs wait outside. The cat lady has already called the police. Alex bashes her with her colossal phallic sculpture and leaves. When he joins his droogs, Dim smashes a full bottle of milk on Alex’s face and he goes down. He is apprehended, told that his victim is dead, and sentenced to fourteen years in prison. Two years into his sentence, Alex becomes interested in the Bible. He fantasizes about whipping Jesus and enjoys the stories of torture. Alex is chosen by the Minister of the Interior to participate in a two week experimental reform technique, and is transferred to the Ludovico Medical Facility. Alex is injected with a substance that makes him feel sick while he is forced to watch a montage of vicious scenes involving brutality. Later films are accompanied by classical music, more specifically, Beethoven. As he comes to associate sickness with violence, the whole idea of violent behavior becomes so overwhelming that he would rather die than consider it. Alex returns home to discover that his parents have rented his room to a lodger.
A victim from his past recognizes him and attacks him. Two police officers intervene. The officers are Alex’s old droogs, Dim and Georgie. They drive Alex to a country road and take him to a low water tub, where they hold his head under water and beat him. Left alone, Alex stumbles up the road to a house of a past victim, Mr. Alexander. He recognizes Alex from the newspapers, but not initially as the person that raped his late wife and put him in a wheelchair. Alex is drugged and slowly regains consciousness in a locked room upstairs. Mr. Alexander and his affiliates are downstairs, blasting Beethoven’s 9th Symphony. Alex leaps out of the window because of the distress it induces. He awakens in a hospital bed a few weeks later. Alex is welcomed by his parents, the government’s “cure” has been blamed for the repercussions, Mr. Alexander has been put away, a good paying job is lined up for Alex, and the Minister of the Interior expresses regret by giving Alex a new stereo.
The stereo is playing Beethoven’s 9th Symphony, but it does not agitate Alex. It appears as though Alex has regressed to his former disposition, before he was “cured”. According to the DSM-IV-TR (2000), Conduct Disorder consists of a “repetitive and persistent pattern of behavior in which the basic rights of others or major age appropriate societal norms or rules are violated”. The person must exhibit actions that include aggression to people and/or animals, destruction of property, deceitfulness or theft, or serious violation of rules. In addition, significant impairment in academic, social, or occupational functioning due to this conduct must be present. Alex has a variety of destructive traits that are diagnostic characteristics of this disorder. There is not enough information given about Alex’s history to know the onset of these behaviors. Judging from the severity of his actions, I would have to guess that these types of behaviors started occurring at an early age.
Alex’s aggression can be seen throughout this movie. He initiates the assault of the homeless man and the fight with the rival gang. He carries weapons for these occasions. Alex also engages in physical violence without a weapon. While approaching Mr. Alexander for instance, he kicks him in the face. The rape of Mrs. Alexander is a further portrayal of his aggression, as is his assault of the cat lady. In addition to his physical cruelness, Alex steals from his victims. The DSM-IV-TR (2000), says that “aggressive individuals with this disorder frequently misperceive the intentions of others as more hostile and threatening than is the case and respond with aggression that they then feel is reasonable and justified.” This is illustrated in the scene where Alex ambushes Georgie and Dim. This is his way of asserting his dominance within the gang after Georgie appears to be taking charge. There are few depictions of Alex damaging property that I can recall. I can imagine that the stolen car was left in poor condition after Alex’s carelessness on the road.
He flips a desk containing Mr. Alexander’s personal items and then knocks over a large bookcase. While violating Mrs. Alexander, Alex cuts her garment off with a pair of scissors. Alex displays an enduring trait of deceit in the course of this film. Alex is the type of person who seeks personal gain through misrepresentation. He is dishonest with his parents about having a job and feigns sickness so he does not have to attend school. He finds a way to penetrate several unfamiliar homes. Originally, he attempts to trick the resident by pretending to be in danger. This goal is achieved at the Alexander home. When this ploy fails, he finds a way to break-in. Another great illustration of Alex’s fraudulence is his interest in the Ludovico technique. The only reason Alex finds it enticing is because it gives him an opportunity to shorten his prison sentence. Under false pretenses, Alex is chosen for the treatment and he achieves his objective. Alex violates rules regularly.
He is frequently absent from school, yet continues to stay out late at night. Alex’s Conduct disorder may have developed due to his parents providing a lack of supervision and his association with a delinquent peer group (DSM-IV-TR, 2000). Initially, I thought Alex should be given a diagnosis of Antisocial Personality Disorder. A diagnosis of ASPD is not given to individuals under the age of eighteen and Alex is only fifteen in the beginning of the story. According to the DSM-IV-TR (2000), individuals diagnosed with Childhood-Onset Type Conduct Disorder and receive inconsistent discipline from their parents are at greater risk of their Conduct Disorder evolving into Antisocial Personality Disorder. Although Alex’s position in the end of the movie is left ambiguous, it is implied that he has returned to his former state. Since he is eighteen by the end of the story, had an early onset of Conduct Disorder, and fits the criteria, I believe it’s safe to say that Alex has developed Antisocial Personality Disorder.
The Ludovico Technique is a fictional treatment that resembles Aversion therapy. The goal is to suppress a behavior by associating it with an aversive stimulus. This technique is controversial. Are these individuals “cured”, or are they incapable of acting on free will based on a new disposition that creates fear? The priest in the film expresses his concern with the individual’s lack of choice. I don’t believe this to be an effective treatment for Conduct Disorder. The root of the problem is not addressed, only symptoms are. A treatment that I would suggest for this disorder is Multisystemic therapy. “This therapy is used mainly to treat adolescents who are antisocial and delinquent. It combines strategies from cognitive behavioral therapy, parent management training, and various family therapies” (“Options for managing conduct disorder”, 2011).
Treatment is subjective because MST acknowledges that manifestation of this kind of behavior varies. I think it’s important to look at every factor while treating a patient because everybody is different. Sometimes medications are prescribed, but not often. Perhaps a combination of different therapies and medication would be sufficient. I think MST is the still the best option. It appears to tackle the issue from all angles and is a personalized apparoah. “Studies have concluded that this therapy is effective at reducing delinquent behavior and drug use, and at preventing incarceration or hospitalization” (“Options for managing conduct disorder”, 2011).
Although I believe this is a good treatment option for Conduct Disorder, I’m not sure if Alex would respond to it as well as some individuals. Family support is vital and his parents are not very active in his life. Additionally, in order for a person to get better, they have to trully want to get better. I’m not certain that Alex feels that his “ultra-violence” is a problem. In my opinion, MST may be a more effective treatment for somebody younger, with a later onset of CD. I have not researched treatment options for Antisocial Personality Disorder because it is only my assumption that Alex has regressed in the end of the movie. Much more information would be needed in order to consider treatment options.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. Options for managing conduct disorder. (2011). Harvard Mental Health Letter, 27(9), 1-3.
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