Eventually for Laeddis, the dream sequences start to dominate his conscious-real moments, which results in everything shown onscreen becoming provisional. If this poses a lot of challenges to the audience to keep up with the plot, one can only imagine the mental turmoil that Laeddis would have suffered. In other words, both the audience and the lead character are confronted with temporal and spatial uncertainties. But for the nursing student the film offers insights on the predominant therapeutic practices of the 1950s. In some ways, the fundamental questions facing the psychiatric profession have hardly altered in the half a century since. For sure, mental pathologies themselves have not undergone any great changes over the years. (Alleva, 2010) The anatomy of mental suffering remains more or less the same, one might claim, through the breadth of recorded history. Di Caprio’s own experience in playing this overwhelming role underscores this point:
“I also watched a lot of documentaries on the different forms of treatment done in those days and what people went through. The mood helped feed the over-the-top paranoia of the movie. But it was also hard to shake off. Shutter Island took such an emotional toll that there were times I wondered whether I would finish the picture…my character was going through extreme emotional trauma and it’s hard for those types of things not to rub off on you…” (“Scorsese Saved Me from,” 2010)
Laeddis’ condition is identified to be a split personality, which his mind concocted to negotiate feeling of acute guilt. But Dr. Cawley’s attempt to resolve this dichotomy by simulating the hallucinatory world fails. Upon this realization, the film makes an important statement about ‘living as a monster’ or dying as a hero’. This is interpreted by some as a willing suicide thus freeing Daniels of the guilt over killing his wife. Here, Fairburn’s concept of the moral defence is seen to be at play. Through this, Laeddis’ question can be interpreted as ‘Which is best, to live as someone who is unconditionally bad or die as someone who believes that he is conditionally good?’ The split between the law-upholding officer and the husband guilty of neglect manifests in Laeddis’ divided personality. His frequent flashbacks that accompany his migraine headaches are an attempt to reconcile these two aspects of his life. These represent “aspects of the internalized bad objects that his being an upholder of the law is unable to repress.” (Gilbey, 2010, p. 44) Daniels would prefer to die with the comforting belief that he is a good man (even if illusory), than confessing to his immoral tendencies and tend toward restitution. In terms of Fairbairn’s understanding
“of the balance between shoring up inner reality by reinforcing the ego-ideal versus releasing and learning to cope with the repressed bad objects, it seems as if the ‘defence of guilt’ has gone too far and the internalized bad objects can never be released, faced and understood.” (Clarke, 2012)