The case of White Rabbit of Alice in Wonderland

The name of the client is White Rabbit from Alice in Wonderland of the 1951 movie. He is
literally a rabbit. The assigned sex of White Rabbit is male, his gender identity is male, his gender is
expressed in masculine way and there was no mentioned of his sexual orientation since he didn’t have a
relationship at all to any man or woman. Also, there was no mentioned of his age but we can surmise
through his occupation and physical appearance (e.g. poor eyesight) that he was already on his middle
adulthood. Also, there was no mentioned of his religious affiliation, he has no children but he has a maid
on his house named Mary Ann (although we didn’t see her in the entire movie, he just mistakenly called
Alice as his alternative to his maid, Mary Ann). And lastly, he worked as a herald-like servant on palace
of the King and Queen of Hearts.

In the movie, the client - White Rabbit has been showing an excessive anxiety and worry in most
of his activities or situations especially on the time or for being late. It seemed that the White Rabbit was
always in the hurry that he had no time already to say “hi” or “good-bye” anymore personally to someone
he just passed by (especially when he met Alice for the first time). It seemed that he was worrying a lot
whenever he saw his clock that he used to bring with him everytime. The worry on his face has seemed
that there would be a possible danger or threat that he might acquire. Having said this, along with this
excessive anxiety and worry, he also felt restless, irritable and some physiological manifestations due to
his excessive anxiety and worry and that he can’t control it and it impaired his daily functioning already.
And as such, we can surmise that in this particular scenario, the client – White Rabbit is looking for help
on how to handle excessive anxiety and worry that he is experiencing that gave him an impact on his
daily functioning. In the movie, there was no relevant history that was explicitly mentioned on the
character’s problem.

Accordingly, the client – White Rabbit of Alice in the Wonderland is consistent with the
diagnosis of Generalized Anxiety Disorder 300.02 (F41.1). Additionally, here are the justifications in
diagnosing the client – White Rabbit with Generalized Anxiety Disorder 300.02 (F41.1). Firstly, he met
criterion A, “which is the excessive anxiety and worry (apprehensive expectation), occurring more days
than not for at least 6 months, about a number of events or activities”. This is very evident on White
Rabbit wherein he was always worried about his being late to his appointment or destination. He always
stated “I’m late, I’m late” everytime he saw his watch and that his face really looked so worried that
something might happen badly. Adding to this, when he first met Alice, he didn’t just say hi or good-bye
personally to her. What he was thinking then was just his being late. This continued when Alice met him
on his house, it seemed that White Rabbit was again in a hurry and looked so worried. Additionally, he
was also worried on the things inside his house and carrots he planted beside his house. And even if there
wasn’t mentioned on the number of days, we can still surmise that this anxiety and worry has occurring
for more days that not for at least 6 months.

Also, the client – White Rabbit has met criterion B, “wherein there’s a difficulty to control the
worry”. Again, in relation with criterion A, White Rabbit has a difficulty controlling his worry. He cannot
control this everytime he thought that he was late. He just can’t stop running on his way out there and the
thoughts on his mind would not be relaxed. He also had difficulty controlling his worry especially on
what might happen on the things inside his house. Also, White Rabbit is consistent with Criterion C
which states that, “anxiety and worry are associated with three or more of the following six symptoms of
the disorder – with at least some symptoms having been present for more days than not for the past 6
months”. In here, he is consistent with Criterion C-1 wherein, “there is restlessness or feeling keyed up or
on edge”. As we noticed, it was apparent that in the entire movie, White Rabbit felt uneasy from forest, to
his house and finally to the palace. He cannot keep calm because of worrying on so many things
especially his lateness. The client also showed the Criterion C-4, “wherein there is irritability”. This was
apparent when he was angry to Mary Ann (referring to Alice) for she was just standing outside the house.
He shouted to Mary Ann (referring to Alice) while blowing his horn in order for her to find his gloves
since he was already late. Also, this was apparent especially when Alice became big and the only way that
she can get out of his house is to burn it .And also when Mad Hatter was fixing his clock as well. Also,
the client is consistent with Criterion C-5, “wherein there is muscle tension and associated with it is
trembling, twitching, feeling shaky, and muscle aches or soreness”. In here, we always noticed that White
Rabbit was always trembling, twitching and feeling shaky not only because of his worry on lateness. But,
there was also when Mad Hatter fixed his clock, when Alice became big on his house or even his meeting
with the Queen of the Hearts, White Rabbit showed these symptoms as well.

Also, there was, “worry or physical symptoms cause clinically significant distress or impairment
in functioning”, and that means he met Criterion D. This was apparent especially on meeting with people
or his social interaction with them. White Rabbit cannot talk to people personally already because he
worried too much. And as such, he can’t even talk to Alice in a genuine way or personally in the entire
movie and this impaired his social aspect in daily functioning. He can’t even find or get certain things in
his house like his gloves because of those anxiety and worry that he faced. In addition to that, he also met
criterion E, “the disturbance is not attributable to the physiological effects of a substance (e.g., a drug of
abuse, a medication) or another medical condition (e.g., hyperthyroidism)”. In the entire movie, the
White Rabbit did not use any drugs like nicotine, caffeine and whatnot. He didn’t also drink excessive
alcohol intake or there wasn’t medical condition that had appeared on his condition and this was
consistent throughout the movie. And lastly, he met criterion F wherein, “the disturbance is not better
explained by another mental disorder”. To rule out other anxiety disorders, White Rabbit did not exhibit
panic disorder because there was no recurrent unexpected panic attacks in the movie. Also, we cannot
diagnose White Rabbit of having social anxiety disorder since if he has, then he would be experiencing a
marked fear or anxiety about one or more social situations in which the individual is exposed to possible
scrutiny by others. Also, this is not agoraphobia since there was no fear and anxiety on two or more social
situations like being in an open spaces, enclosed space or being in a crowd. This is not also specific
phobia, since White Rabbit did not exhibit a phobia in a particular object or situation. And lastly, this is
not an obsessive-compulsive disorder since in this disorder the obsessions must be an inappropriate ideas
that take the form of intrusive and unwanted thoughts, urges, or images. In generalized anxiety disorder
the focus of the worry is about forthcoming problems, and it is the excessiveness of the worry about
future events that is abnormal.

One of the theoretical frameworks that we can use to explain the cause of this is Cognitive
Behavioral Perspective. The said perspective was founded by Aaron Beck during 1960s (“The story of
Beck”, 2016). And according to Beck (1967; Beck & Weishaar, 2000; Beck et al., 2004; Beck et al.,
2005; as cited in Butcher, Hooley & Mineka, 2015), “different forms of psychopathology are
characterized by different maladaptive schemas that have developed as a function of adverse early
learning experiences” (p. 100). The schemas that are maladaptive would turn into the distortion on the
way people think that are characteristics of disorders like anxiety and depression (Butcher et al., 2015).

Accordingly, there are several assumptions that rest upon on Cognitive Behavioral Perspective
(McLeod, 2008). First, this perspective is believed that abnormality arises because of the faulty cognition
about others, our world and us. Hence, the faulty thinking is maybe because of the cognitive distortions or
cognitive deficiencies. Second, the said cognitions have caused distortions in seeing or viewing things
around us. And lastly, it is said that we used mental representations in interacting with the world. If our
mental representations are inaccurate then it may lead to distortion of our emotions and behaviors. Just
like in the case of White Rabbit, he might have a cognitive distortion on too much worrying on certain
situations like being late (since it is the most apparent worry that he has in the entire movie) and at the
same time had made certain associations or learning between stimulus like being late and negativity.

In order to be specific with the Cognitive Behavioral Perspective, one of the models of this theory
that could better explain the case of the client is the Cognitive Model of Anxiety that was first proposed
by Beck, Emery and Greenberg (1985; as cited in Beck & Clark, 1997). This model is, “a schema-based
information processing perspective that considers the erroneous or biased interpretation of stimuli as
dangerous or threatening to an individual's physical or psychological well-being, a core feature of anxiety
disorder” (Beck & Clark, 1997, p. 50-51). In these model, there are three stages in explaining the cause of
anxiety. The first stage is the initial registration, is also known as orienting mode (Beck, 1996; as cited in
Beck & Clark, 1997). Accordingly, “the first stage of processing threat information involves a very rapid,
automatic recognition of a stimulus” (Beck & Clark, 1997, p. 51). On this stage, anxiety may contain a
biased initial registration or orienting mode by selecting to negative, personally relevant information. It is
stated that, “the problem in anxiety is that the orienting mode is excessively tuned to detect negative
stimuli” (Beck & Clark, 1997, p. 51). On this stage, we can say that the client – White Rabbit has
excessively selected and recognized negative rather than positive stimuli. As an example, excessive
anxiety and worry about being late (since this is the most apparent worry that he has in the entire movie).
Through this stage, it explains that White Rabbit has registered or recognized negativity on the stimulus
(clock) or being late rather than giving it positivity.

After the recognition of the relevant negative stimulus by the initial registration or the orienting
mode, it will now lead to the processing of threat. The second stage is also called as the immediate
preparation. During this stage, “there is an activation of the primal mode, a cluster of interrelated schemas
embodying more primitive and immediate cognitive/affective/behavioral/physiological patterns” (Beck,
1996; Beck, Shadicks, Hopkins, 1990; as cited in Beck & Clark, 1997, p. 52). In here, two products of
primal threat appraisal are important in the experience of anxiety. The first one is the activation of the
primal mode and this causes of narrowing or constriction of cognitive procession that will result to biases
and inaccuracies. In here, anxious individuals tend to become hypersensitive to the potentially harmful
aspects of a certain activity or situation but ignoring the positive features of it. The second product of the
primal mode activation is the occurrence of negative thoughts, and these involve threat and danger as
themes (Beck & Clark, 1997). In relation with the client – White Rabbit, after he recognized the stimulus
as a negative one and avoiding positive one, he might try to narrow his cognitive processing that will
eventually result to inaccuracies and might also incorporate danger and threat for this.

The final stage in the cognitive model of anxiety is the secondary elaboration. This stage would
occur after the activation of the primal threat mode. In here, there is a full activation of elaborative
semantic processing. On this stage, information processing is characterized by slow, effortful and schema
driven (Beck & Clark, 1997). But, the cognitive processing of threat will still continue to be involuntary
because of the activation of the primal mode. In the secondary elaborative stage, there are two aspects
involved. The first aspect is about worry. And according to Borkovec, Robinson, Pruzinsky and DePree
(1983; as cited in Beck & Clark, 1997) worry is defined as a, “chain of thoughts and images, negatively
affect-laden and relatively uncontrollable and it relates closely to fear processes” (p. 10).
 It is said that the elaborative process involved in worry may lead to adaptive response and the
reduction of anxiety, but pathological worry that characterizes anxiety disorders like generalized anxiety
disorder leads to an acceleration of anxiety since there is a domination of primal mode of thinking. The
second aspect of this elaborative processing is focused on the safety signals. In here Rachman (1984; as
cited in Beck and Clark, 1997) stated that disorders such as generalized anxiety disorder involve an
interplay between the search for safety signals and the avoidance of threat or danger. Relating this again
with White Rabbit, since there is already an activation of those inaccuracies of cognitive processing and
perceived threats and danger, there would already be an acceleration of anxiety due to pathological worry
thus leads to mental disorder like the Generalized Anxiety Disorder. And this might prevail as well once a
person does not know how to cope with safety signals and does not know how to avoid threat or danger.

Additionally, here are possible helpful treatments for White Rabbit with his GAD:

 The first helpful intervention for White Rabbit is Cognitive Behavioral Therapy a form of
psychotherapy (Mayo Clinic, 2010; McLeod, 2008). For this therapy, it is said that thoughts, feelings
and behaviors are intertwined together and that means that changing one aspect could lead to a change
of another. This help reduce cognitive distortions and the learning or associations between negative
stimuli. This includes relaxation, scheduling specific ‘worry time’ as well as planning activities and
controlled exposure to thoughts and situations that are being avoided.
 Under Cognitive Behavioral Therapy, we can also have mindfulness since it is also effective in
treating patients with GAD (Evans, Ferrando, Findler, Stowell, Smart, & Haglin 2008).
 Also, we can have medications (Mayo Clinic, 2010) and these medications include antidepressants like
medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake
inhibitor (SNRI) classes. The examples of antidepressants used to treat anxiety disorders include
escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil,
Pexeva). But, we need to be careful combining psychotherapy and medications since they might be
contraindicated.
 Also, one way to help the excessive worry and anxiety of White Rabbit is through making a good
relationship with their Queen of Hearts. We can surmise that one factor that has caused this was
because of his occupation as the Herald. If the Queen of Hearts would be more polite and gentle then,
it is possible that it would be lessened (Jacob, 2015).
 And since White Rabbit has no family, it is also good that he could have a good circle of friends where
someone can cheer him up from his worries and have some time interacting and talking with him. By
this, it could lessen down the worry and anxiety (Goldsmith, 2012).
References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th
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Beck, A.T. & Clark, D.A. (1997). An Information Processing Model of Anxiety: Automatic and Strategic
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Butcher, J. N., Mineka, S., & Hooley, J. M. (2015). Abnormal Psychology 16th edition. Pearson Educa
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Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008). Mindfulness-based
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Goldsmith, Borton. (2012). Top 10 Tips to Reduce Anxiety. Psychology Today. Retrieved from
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Jacoby, Sarah. (2015). How Basic Politeness Can Reduce The Effects Of Stress. Refinery29. Retrieved
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mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/basics/treatment/con-20024562.

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