Sharp Objects mental health check in: Milk

Episode 8, debut 8/26/18: Amy Adams.photo: Anne Marie Fox/HBO. Acquired via HBO Media Relations site.
Episode 8, debut 8/26/18: Amy Adams.photo: Anne Marie Fox/HBO. Acquired via HBO Media Relations site. /
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The brilliant Sharp Objects finale raises a whole host of questions about nature versus nurture. Spoilers. Obviously.

Hello there. Are you watching Sharp Objects on HBO? Are you curious to learn more about mental health and addiction? Well, you’ve come to the right place. Sharp Objects will delve into some serious territory when it comes to women and mental health issues. As a therapist focusing on substance abuse treatment for over a decade, my hope is to sherpa us all through this limited series by providing some real-life context for the disorders and behaviors seen on screen. Ready to dive in? Let’s go. This week, our focus is on nature versus nurture and Cluster B Personality Disorders. 

After so many weeks of atmospheric moodiness, Sharp Objects delivered on all of its promises with a finale that left me breathless and woozy. Funny thing is, I had read the book prior to watching the series, but I was still shocked and thrilled by the way in which showrunner Marti Noxon and director Jean Marc Vallee set up that final, electrifying beat.

But we’ll get to that. The episode kicks off with Camille (Amy Adams) returning home to a Norman Rockwell nightmare after finding out about her dear sister Marian’s cause of death. Despite knowing the truth, Camille decides to play things out for a bit. As she settles into her place at the lavish family dinner, she preps for battle. She telegraphs her willingness to be nurtured by her mother by switching out her usual booze for a tall glass of wholesome (mother’s) milk.  Initially, she tries to act like things are normal, but the mood is skewed by Amma (Eliza Scanlen). The girl – clearly out of her mind with whatever poison Adora (Patricia Clarkson) has been feeding her all day – is wearing a giant floral headdress and going on and on about how she’s Persephone, queen of the underworld.

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When Camille brings up the idea of Amma moving in with her, Adora quickly spirits her youngest away for more of her treatment. Camille has an urge to protect her sister, so she feigns illness instead, leading Adora to switch her focus to the daughter that got away.

What follows is a horribly disturbing series of scenes in which Adora slowly poisons Camille under the guise of nurturing her back to health. When Adora isn’t in the room, Camille attempts to find her cell phone, which her mother has hidden. It’s all just so sinister.

Camille’s efforts to out Adora’s poisonous ways are punctuated only by bouts of vomit and unconsciousness. Slurring and foggy, Camille is forced to listen as her mother attempts to explain away this abhorrent behavior by invoking her own disturbing childhood. Adora juxtaposes her current behaviors with her own mother’s distance and cruelty, but what she doesn’t realize is that she’s just perpetuating a caustic cycle. Because Adora was never nurtured, she doesn’t know how to properly nurture. The nature of Adora’s lineage dictated her demented understanding of nurture.

The argument of nature versus nurture has been a central tenet of psychology for ages. Does our biology or our environment dictate who we are? Well, it’s definitely a combination of both. People can have genetic coding predisposing them to all sorts of diseases, but environment also plays a role in the expression of that biology. The threshold for certain traits depend on certain aspects of both nature and nurture tipping the scales. For example, a child can be born with a proclivity for addiction but, if they grow up in a household where drugs and alcohol are readily available, they’re far more likely to develop issues with substances down the line.

Dysfunction begets dysfunction, and so it’s no surprise that as Camille begins to succumb fully to her mother’s poison concoction, memories of sweetness and light begin to float through her mind. Her purest memories are triggered by the poison, illustrating that after a lifetime of abuse from her mother, she’s conflated love with physical pain and suffering.

No wonder Camille escapes from the world by inflicting pain (cutting) and poison (binge drinking, drugs) on her own body.

As Camille starts to float away in world full of wistful reveries, Curry (Miguel Sandoval) and Richard (Chris Messina) burst in to the house, swooping in to revive Camille and apprehend Adora. Problem solved, right? Nope.

After Adora’s arrest, the episode treats us to a brief respite as Camille tries to break the cycle of dysfunction in her family. Amma moves in with her and even starts making friends. They go to a family dinner at Curry’s house, and the gathering is the polar opposite of the ham dinner disaster that topped the episode. Before sitting down to eat, Curry and Camille review her pending article . Her central thesis ponders the very question of her own nature having an impact on how and why she enjoys nurturing Amma. Is the hardwiring she inherited from her mother giving her a sick thrill when she cares for her little sister? Or is her joy in caring for Amma rooted in kindness? Camille leans towards kindness.

Not for nothing, but the bit about “leaning towards kindness” is the final sentence in Gillian Flynn’s novel. It’s telling that Camille chooses kindness even after what happens next.

You’ve seen the episode. You know. Amma is the killer. She’s Persephone, the queen of death. She’s a girl who will kill for sport and then nonchalantly use her victim’s teeth for a crafting project.  I’m all for creative upcycling, but I think even Martha Stewart would be appalled at Amma’s behavior.

When I first read Sharp Objects, all the bells for personality disorders went off in my mind, and I wasn’t the only one. Before the series premiered, I even stumbled upon a lively Reddit thread devoted to the discussion of Borderline Personality Disorder and the characters in the series. Personality disorders have their very own section in the APA’s Diagnostic Manual, and there’s a reason why.

what happened at the end of Sharp Objects
Episode 8, debut 8/26/18: Eliza Scanlen.photo: Anne Marie Fox/HBO. Acquired via HBO Media Relations site. /

Individuals with personality disorders are generally identified as people with inflexible and unhealthy patterns of thinking. There are several different types of personality disorders, and many – excepting Antisocial Personality Disorder – are marked by an overwhelming need to be nurtured.

In the novel, Amma eventually explains to Camille that she killed all three girls out of a concern that they would divert attention away from her. Her murderous ways can directly be attributed to Adora, a woman who abused her children and called it love. Such a twisted brand of nurturing is certain to have side effects.

The idea of Adora stealing her daughters’ lives to suit her own maladaptive patterns of behavior is reflected in Amma’s choice to play Persephone at dinner earlier in the episode. Persephone was the daughter of Demeter, goddess of the harvest. Enamored with the young girl, Hades, the god of the underworld, stole her away and made her his bride. (#MeToo: Greek Myth Edition.) As poor Persephone sat and waited for her mother to rescue her, she mindlessly snacked on six pomegranate seeds, sealing her fate. Once Demeter reached her daughter, Hades demanded that Persephone stay with him for six months out of the year as an exchange for those innocently eaten seeds. And that’s why we have winter, y’all.

In Amma’s personal Greek tragedy, Adora tried to play both parts simultaneously. She was the loving, rescuer of a mother, but only when she was also the harbinger of death. As long as crisis loomed, Adora was a perfect, doting mother. But within those manufactured moments of crisis, Amma changed. Her mother stole her health away for her own gain, unaware of what Amma would pick up in the deepest reaches of her poison-addled brain. Through no fault of her own, Amma ingested proverbial pomegranate seeds of dysfunction in order to survive, and the door to an underworld of death and destruction opened wide.

While it’s clear where Amma’s murderous impulses originated from, diagnosing her is no simple task. Many individuals with personality disorders have experienced childhood trauma, but the DSM does not allow most PD’s to be diagnosed until a person has turned eighteen. Amma certainly has a severe case of PTSD, and may also be diagnosed with something called Oppositional Defiant Disorder or Conduct Disorder. Both of these diagnoses are placeholders for teens who exhibit antisocial behaviors but who are too young to be officially diagnosed with a personality disorder.

But even though diagnoses can help people in myriad ways such as connecting to a community with the same issues, and giving direction to care providers, we’re all so much more than numbered codes. For everyone, the real work begins when we confront the issues of our past and work at resolving them with our present. Often the issues that most impact us are rooted in childhood, and will continue to affect our well-being unless we confront them head on with the help of trusted confidants. Whether those confidants are friends, family, or a medical professionals, that’s up for each individual to decide. (Note: Looking for a therapist? Try online databases at Therapy Den or Psychology Today.)

Sharp Objects was not only a portrait of a family in suspended crisis, but it was a bold and eerily beautiful illustration of how family dysfunction – a combination of both nature and nurture – continues to trickle down and mutate with each generation. In the end, Camille is actually the unsung heroine of Sharp Objects. She’s a woman who is trying so hard to break the cycle in order to create a better future for herself. And isn’t that all we can do? If we’re kind to ourselves and each other, change will hopefully follow.

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Please Note: If you feel as if you need to reach out after watching a triggering event on TV, please contact the National Suicide Prevention Hotline at 1-800-273-TALK or the SAMHSA Treatment Referral Hotline at 1-877-SAMHSA7. If you or someone you know are in immediate crisis, do not hesitate to call 911.

The entirety of ‘Sharp Objects’ can be seen on HBO Go and HBO NOW.