Recently, Valve released the “Meet the Pyro” video and more pieces were added to the very incomplete puzzle of the pyro. So this time, I examined the Pyro, from the Team Fortress 2 game, and attempted to diagnose and treat him. For this I will be using the DSM-IV and the Axis diagnosing method. For simplicity, I am assuming the pyro is a man and that these symptoms have been consistent for an extended period of time.
(DSM-IV - Source http://allpsych.com/disorders/dsm.html)
DSM-IV is the “Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition”, it is the current manual (US) used to diagnose and treat the mentally ill by psychologists and mental health workers. I am using this DSM version, as opposed to the one in the time frame of the game because current mental health issues are better understood and treated as opposed to 1968.
The Axis system:
Axis I: Clinical Syndromes (eg. bipolar or depression)
Axis II: Developmental Disorders and Personality Disorders, mental disorders (eg. paranoid or borderline personality disorder)
Axis III: Somatic Issues related to the mental illness (eg. brain injury)
Axis IV: Psychosocial Stressors (eg. job loss or dearth in family)
Axis V: Global Assessment of Functioning (GAF) (100 to 0 Scale)
GAF is the score used to rate patient’s level of function, higher the number, the more functional a person is.
Short Version: The Pyro is f*cking crazy.
Axis I: Schizophrenia
(NC- normal control, SZ- Schizophrenia. These brain are measurably different, the pyro’s brain might look like the one on the right.)
The pyro is shown in the video as suffering from severe delusion and hallucinations. He believes that he is not causing any harm, and believes he is playing with or helping those around him. People with delusions tend to hold onto their beliefs strongly, regardless of the evidence to the contrary. His delusions are backed up by his hallucinations. He is suffering both auditory and visual hallucinations; however he may not be suffering from tactile hallucinations. In the video the Pyro is still wearing a flame retardant suit and gas mask while in pyrovison. Thus, he can feel the pain of the fire and the effects of the smoke. In game, the pyro makes sounds when in pain. Also, this disorder creates major social problems for the Pyro as most people fear and actively avoid him, making real social relations difficult. He may suffer alogia, however it could be the mask, though it is possible to talk clearly though a gas mask. I am assuming that these symptoms have been present for a long time, well over the minimum 6 month requirement.
Lastly, I don’t think the Pyro is suffering from pyromania. Pyromania is a disorder where a person is deliberately and compulsively setting fires. In the pyro’s delusional state I doubt that he even realized that there is fire around him. For example he views his flame thrower as a musical device of some kind that shoots rainbows and bubbles. In the pyro’s happy world, the presence of fire would be a bad thing, something to seek protection from, thus the suit. Pyromaniacs would, also, be obsessed with fire, almost worship it, however, the perceived items that the pyro (pyrovision) is holding are not related to fire. (I am not considering hats as evidence, as they no longer follow theme and accurately represent the characters.)
(This is a very happy world, with no fire to be seen anywhere)
Axis II: Schizoid personality disorder
As mentioned before, the pyro is often seen as isolated and feared by his peers. He rarely talks or interacts with other characters. His primary play style is ambush or hit and run, where the player is often hidden alone or with a few other players. Also, often people with this disorder will have extravagant external worlds, as seen in the video, which is made real by the delusions and hallucinations. This disorder is a Schizophrenia related social (personality) disorder.
Axis III: N/A
His suit is made of asbestos and the pyro may have respiratory illness, though this is not related to the mental health of the pyro and without more information on the pyro, it is hard to know if there are any other health issues.
Axis IV: Occupational hazards
His job is relatively dangerous and due to the lack of tactile hallucinations, the pyro can feel and perceive pain. Also, nothing is known about the pyro’s private life and other stressors may exist.
Axis V: 1 to 10
While the pyro seems to be able to care for himself, he is a substantial danger to other, prompting the extremely low score.
(GAF guidelines chart)
Short version: Lots of bullets and explosives
Long version: Treatment using a combination of medicine, psychological therapy and immediate institutionalized, for everyone’s safety.
Step 1 Medication: There are a number of antipsychotic drugs that can be used for treatment, though traditional medicines usually have significant side effects. Luckily, there are new atypical medications, such as SSRI, that have been proven effective and have fewer side effects.
Step 2 Psychotherapy and Cognitive behavioral therapy (cbt): Psychotherapy can be used to overcome the pyro’s delusions, once the medication has helped reign in the hallucinations, and allow the pyro to identify what is reality and what is not. CBT can be used to help with symptoms and gradually change the pyro’s behavior, particularly social issues.
Step 3 Electroconvulsive therapy: Commonly known as electroshock therapy, is usually a last line of treatment and in is used in cases where medication is not effective. It has been shown to help patients on occasions, by providing a controlled shock to the brain that is thought to “reset” the brain and restore normal function. Though, extended use can lead to problems such as memory loss and motor control issues.
The pyro is severely impaired; it will take a very long time for the pyro to recover, if ever.
Admittedly I am happy the pyro is not getting better any time soon, as he is my favorite class. The pyro video is very well done, however I think it rewrote the pyro into a new light and may have ruined some of the pyro’s “cool” as this shifts him from being evil insane to just very clinically in need. As always, thanks for reading and constructive feedback is always appreciated.