What About Bob Sparknotes

Movie Summary
“What About Bob?” is about a man named Bob Wiley, who has “problems.” Bob is referred to Dr. Leo Marvin by his colleague because he is leaving his practice and getting out of town, probably due to Bob and his neurotic nature. Dr. Leo Marvin is a well established psychologist who has a book coming out called “Baby Steps.” When Bob goes to his initial session, he is given this book, which he takes very seriously. For the first time in his life, Bob feels like he found someone who can truly help him, which initiates Bob’s attachment to Dr. Marvin. Their next session will be in a month after Dr. Marvin’s vacation, but Bob has no intention of waiting that long.
Bob tries to find out where Dr. Marvin is vacationing by lying about his suicide. Bob faces his fears of going on a bus by taking “baby steps.” When Bob arrives at Lake Winnipesaukee, he searches for Dr. Marvin by yelling frantically in public.
Bob charms Dr. Marvin’s family with his witty personality and humor. To the family, Bob is fun, kind and sensitive, but Dr. Marvin sees him as a crazy man. Bob bonds with Dr. Marvin’s daughter over sailing, teaches Dr. Marvin’s son to dive and compliments Dr. Marvin’s wife. Dr. Marvin feels like he is losing his family to Bob. He tries to get rid of Bob, but he keeps returning back to the house. Bob is given a

prescription of “taking a vacation away from his problems” from Dr. Marvin, so he starts his vacation at Lake Winnipesaukee. Dr. Marvin mentally spins out of control as he tries to get rid of Bob.
Dr. Marvin’s important day comes when he has an interview with Good Morning America about his new book, but Bob took the spotlight on the show as the successful patient using the “baby step” therapy. Later that day, Dr. Marvin tries to commit Bob to a psychiatric facility, but Bob ends up charming the staff with psychiatric jokes, which made Dr. Marvin look bad to his colleagues. On the way home, Dr. Marvin ditch Bob in the middle of nowhere, but Bob thinks it was “isolation therapy.” Bob gets a ride from a stranger, while Dr. Marvin receives a speeding ticket and his car breaks down. As Dr. Marvin arrives home after fixing his car, he walks into his surprise birthday party thrown by his wife. Dr. Marvin is at his breaking point when he sees Bob puts his arm around Dr. Marvin’s beloved sister. He attacks Bob in front of everyone.
A doctor evaluates Dr. Marvin and thinks the attack was due to stress from the book and appearance on Good Morning America. As the doctor wrote a prescription for Prozac, Bob suggests him to prescribe Librium for the symptoms of mania that Dr. Marvin is exhibiting. The doctor and sister is impressed with his input. When everyone is outside of his bedroom, Dr. Marvin sneaks out of the house and breaks into a store to steal explosives and a rifle. His family searches for him when they find out that he is not in his room. Dr. Marvin finds Bob wandering on the road, points a rifle at him and leads him to the woods. He ties Bob up with ropes and places 20 pounds of explosives around Bob’s neck with a timer. Bob thinks this is “death therapy” and talks his way through the “therapy.” He concludes that he is all tied up inside with emotional knots (as represented by the ropes), and if he doesn’t untie those knots, he will explode (as represented by the explosives). Bob uses the “baby steps” technique and unties the knots, which frees himself physically and emotionally from the ropes. As he runs back to the house with the bombs still around his neck, he realizes that he is now cured.
Meanwhile, Dr. Marvin thinks he is free of Bob and hugs his family by the lake. However, Bob comes out of the house with a cake and candles while the house explodes since Bob left the bombs inside the house. Dr. Marvin ends up in a catatonic state until his awakening at the wedding of Bob and Dr. Marvin’s sister. Bob is now Dr. Marvin’s brother-in-law. He goes back to school to become a psychologist and writes a huge best seller called “Death Therapy”. Dr. Marvin is suing him for rights.
Diagnosis
After his initial session with Bob, Dr. Leo Marvin describes Bob as “almost paralyzed multi-phobic personality that is in a constant state of panic with acute separation anxiety and extreme need for family connection.” This is true on some levels.
In the beginning of the movie, Bob shows a few symptoms of obsessive-compulsive disorder (OCD).

The opening scene shows Bob sitting in apartment saying "I feel good, I feel great, I feel wonderful" to himself over and over again as he rubbed his temples. He repeats this to himself whenever he is nervous or in a new situation. He also uses tissues to open doors or to touch anything outside of his apartment that may have germs from other people. He is constantly worrying about diseases. According to the DMS-5, his compulsion (of talking to himself into everything he does) paired with the obsession (with germs) makes it clear that he has OCD (APA,

2013).
Bob shows many signs of agoraphobia, such as not wanting to leave his apartment, telling Dr. Marvin that he fears his heart will stop beating, or he will not be able to find a bathroom and his bladder explodes. He also avoids getting on the elevator and is reluctant to get on the bus to go visit Dr. Marvin. He has problems moving when he is not at his apartment. When he is outside, he gets “weird.” His symptoms include dizzy spells, nausea, cold sweats, hot sweats, fever blisters, difficulty breathing and swallowing, blur vision, involuntary trembling, dead hands, numb lips, finger sensitivity, and pelvic discomfort. Bob meets 2 criterias in the DSM 5: fear of using public transportation and being outside of the home alone (APA, 2013).
Besides OCD and agoraphobia, Bob shows major signs of dependent personality disorder (DPD). The following are symptoms of DPD according to DSM-5 and the examples that he has shown to fulfill DPD criteria (APA, 2013). Bob has difficulty making everyday decisions as shown by having trouble leaving his house. He has difficulty expressing disagreements with others as shown when Bob doesn’t argue with Dr. Marvin about their meeting even though he has to sit and wait for hours. Bob has difficulty doing things on his own, so he participates in all of their vacation activities instead of planning his own, eats dinner with them, takes part in Dr. Marvin's interview with Good Morning America, and even stays with the Marvins. He goes excessive lengths to obtain nurturance and support from others because he constantly tries to do things for Dr. Marvin’s family. He feels uncomfortable or helpless when alone, so he is always at Dr. Marvin’s house. He urgently seeks another relationship as a source of care and support when a close relationship ends. When Bob’s therapist leaves him, he becomes extremely attached to Dr. Marvin very quickly, calling him day and night, begging for his help and assistance. Lastly, Bob is unrealistically preoccupied with fears of being left to take care of himself. When he learns that Dr. Marvin is on vacation and can no longer be contacted, he goes so far as pretending to be Dr. Marvin's sister, calling with an emergency, as well as faking his own suicide, which finally gets him Dr. Marvin’s vacation address and therefore not be alone. He is dependent on Dr. Marvin for everything, from psychiatric aid to everyday decisions.
Client Map
Bob’s diagnosis would be dependent personality disorder with OCD and agoraphobia. The objective of treatment is to improve social and occupational function, self-esteem, develop appropriate sense of responsibility, reduce anxiety, reduce thoughts and compulsive behaviors, and improve stress management. Assessments that will be used are Millon Clinical Multiaxial Inventory, Yale-Brown Obsessive Compulsive scale, and client self-report logs of panic. The clinician should be patient, calm, reassuring, consistent, able to set limits, able to manage transference and countertransference, able to communicate acceptance and empathy in face of dependence and resistance and comfortable with slow progress. The location of treatment is outpatient setting. Interventions to be used are cognitive behavior therapy, schema therapy, and mindfulness based cognitive therapy. There is a strong emphasis on establishing a therapeutic relationship, present orientated, balance between supportive and exploratory, and fostering client’s responsibility. The patient should have weekly individual therapy and then taper off to biweekly and monthly. Also group therapy is highly recommended because it has been found to reduce the number of crisis visits and use of medication. This is a long-term therapy, gradual but steady pace. There is no medication for personality disorder, but anti-anxiety and SSRI medication would be useful for Bob. Adjunct services for Bob are group counseling for DPD, career counseling, mindfulness, meditation, relaxation and assertiveness training. The prognosis for DPD is relatively good because Bob is capable of establishing and maintaining relationships. People will DPD are trusting and are able to make commitments and keep them, they want to please, and they ask for help, which are attributes for more positive treatment outcome than other personality disorders (Reichenberg & Seligman, 2016).