Psychology at Sweet Briar
A DSM-IV look at Sesame Street
Melissa Bellan '00
Note: Please understand that we have the greatest love and respect for all things muppet. It is hoped that no one takes this all that seriously.
The children’s television program Sesame Street has been a staple of households worldwide for nearly thirty years. It was originally conceived as a way to bring educational programming to disadvantaged households, by making it apart of regular public broadcast television. The creators made a lovable cast of muppet characters they believed children would relate to, and learn from. Over time these characters have evolved to better fit these goals, but also have characteristics that are often overlooked. When examined from a psychological perspective, the characters of Sesame Street have many disturbing and serious disorders.
Big Bird is known as "The Friendliest Fowl on Sesame Street," and is described by the creators of the show as a very curious six-year old creature, who makes friends easily, and shares his nest with Radar, his teddy bear (The Children’s Television Network Interactive Site). Big Bird sees his world through rose colored glasses and likes to be a part of everything and everyone’s lives.
Big Bird has the most serious and, as leader of Sesame Street, the disorder that has actually come to be a part of the rest of the cast, crew and guests. Schizophrenia, of the undifferentiated type, is a disturbance that lasts for at least six months and includes at least one month of active-phase symptoms (DSM-IV, 273). In the case of Big Bird, his delusions and hallucinations have lasted for twenty-nine television seasons.
The essential features of Schizophrenia are a mixture of characteristic signs and symptoms (both positive and negative). A diagnosis must include two or more of the following:
Delusions (A large part of Big Bird’s affliction)
Hallucinations (The other manifestation for Big Bird)
Grossly disorganized or catatonic behavior
These signs, or symptoms, are associated with marked social or occupational dysfunction. For Big Bird the disruption in his social behavior has decreased over time with the gradual acceptance of his main hallucination by the populace of Sesame Street. The disturbance is not accounted for by other disorders, and it is not due to the direct physiological effects of a substance or a general medical condition (DSM-IV, 274-285). (It is assumed by this researcher that Big Bird and the rest of the Sesame Street cast have not been partaking in illicit and hallucinatory drug use for the last twenty-nine years).
As defined in the DSM-IV, delusions are erroneous beliefs that usually involve a misinterpretation of perceptions or experiences (DSM-IV, 275). The original delusions of Big Bird centered on the idea that he/she (the gender issue will be discussed later; Big Bird will subsequently be referred to as he) thought he was being ridiculed by others for speaking to his hallucination. Hallucinations may occur in any of the five senses, but auditory hallucinations are the most common form for schizophrenia (DSM-IV, 276). For Big Bird, the hallucination has taken on characteristics of all five senses. Snuffaluphagus, thought by some to be the less dangerous imaginary friend type, is actually a schizophrenic hallucination. He did not exist outside of Big Bird’s brain for the majority of his time on Sesame Street.
Schizophrenia involves dysfunction in one or more major areas of functioning such as inter-personal relationships. Big Bird responded in this dysfunctional way when his hallucination became his best friend, and also when he could not relate to others because they insisted that they could not see Snuffaluphagus. Development may also be impaired through schizophrenia, which may explain why Big Bird has never progressed beyond his six-year-old mentality.
Perhaps the most disturbing part of Big Bird’s power over Sesame Street is that he has made Snuffaluphagus real to others. Shared Psychotic Disorder (Folie a Deux) involves the transference of a delusion (in this case a large brown creature) from one, who already has a psychotic disorder (the primary case), to others who are involved in a close relationship with the delusional person (DSM-IV, 305). Usually the primary case in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person(s). Big Bird is the undisputed ringleader of the "Street", and thus, has convinced the rest of the cast that Snuffaluphagus does indeed exist. They can now see, hear, and interact with this character that was originally only a part of Big Bird’s imagination (The Children’s Television Network Interactive Site).
Big Bird, as alluded to earlier, also has gender issues and possibly Gender Identity Disorder. There are two components that must be meet in order for a diagnosis of gender identity disorder to be made. First, there must be "evidence of a strong and persistent cross-gender identification, which is the desire to be, or the insistence that one is, of the other sex." Secondly, there must be evidence of "persistent discomfort about one’s assigned sex role or a sense of inappropriateness in the gender role of that sex" (DSM-IV, 532-533). The main problem in diagnosing Big Bird with gender identity disorder is that his/her original gender is undetermined. The Children’s Television Workshop has begun referring to Big Bird as a he for simplicity, but the original conception of the character was not gendered. Big Bird performs many acts stereotypical of both genders, which makes a reliable diagnosis impossible. If he is indeed a he, he performs female behaviors such as sitting on a nest. The conclusion here that Big Bird has some gender issues, mostly that he/she does not clearly identify with either gender, and therefore may be better described as "nonconformity to stereotypical sex role behavior" (DSM-IV, 536). The DSM-IV also points out that in schizophrenia there may be delusions of belonging to the opposite sex (DSM-IV, 537). Big Bird’s gender issues possibly stem from the schizophrenia that is controlling and altering his life.
Overall, Big Bird has the most serious and dangerous disorders of the Sesame Street characters largely because his disorders have come to effect so many others around him.
Beyond being a shared hallucination, Big Bird’s imaginary friend "Snuffy" has problems of his own. This figment of Big Bird’s creation is at first glance, severely depressed, but through careful examination, Snuffy’s diagnosis is more accurately Dysthymic Disorder. He is often quoted saying "Oh, dear" in a very slow and deliberate way, and his greatest dislike is listed as: "When nobody believes I exist" (The Children’s Television Network Interactive Site).
The essential feature of Dysthymic Disorder is a chronically depressed mood that occurs for most of the day, more days than not, for at least two years. During the period of depression, at least two of the following criteria must be present:
Poor appetite or overeating (look at the size of Snuffy!)
Insomnia or hypersomnia (In the beginning Snuffy had a form of narcolepsy and would fall asleep as soon as someone other than Big Bird would appear)
Low energy or fatigue (Snuffy is a slow mover and often complains about being tired)
Low self-esteem (Her self esteem has improved over the years, but still becomes concerned when others claim that she is not real)
Poor concentration or trouble making decisions (Not a characteristic for Snuffy)
Feelings of hopelessness (This was a past characteristic, but has been phased out over the years, could be considered a recovery or remission)
The associated feature of dysthymic disorder are similar to those of a major depressive episode, but those with dysthymic disorder can still carry on their everyday activities, and their symptoms are often thought of as "the way I have always been" or just "part of their personality." In Snuffy’s case, Big Bird seems to be at blame for Snuffy’s problems, since he created him.
Over the years, Snuffaluphagus has exhibited narcoleptic behavior as a manifestation of being Big Bird’s hallucinations. Originally, whenever another cast member would approach Big Bird and Snuffaluphagus, he would simply fall asleep. This conveniently explained his absence to others, but frustrated Big Bird. If another cast member claimed that they could not see Big Bird’s enormous friend, he would ask Snuffaluphagus to say something. Unfortunately, he would be so asleep that Big Bird could never get him to wake up and prove that he was real. As Snuffaluphagus slowly became apart of the other character’s belief system, his narcolepsy receded, and he no longer falls suddenly asleep in public.
Oscar the Grouch
Oscar is known for being disagreeable, and for loving rainy days and arguing. He dislikes everything, and lives by the philosophy "Leave me alone, and I'll leave you alone" (The Children’s Television Network Interactive Site).
The DSM-IV defines the essential feature of Oppositional Defiant Disorder as " a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures that persists for at least six months" (DSM-IV, 91). Oscar the Grouch displays this sort of behavior toward authority figures, the experts and guest stars of Sesame Street, and his fellow cast-mates. Over the show’s twenty-nine years, his anger and outbursts have been tempered considerably, but The Grouch is still a grouch. The DSM-IV also outlines further characteristics of Oppositional Defiant Disorder as having at least four of the following behaviors with regular and frequent occurrence:
(1) Losing temper (the essence of Oscar),
(2) Arguing with adults (he argues with everyone),
(3) Actively defying or refusing to comply with the requests or rules of adults (Oscar generally complies with request, but only after receiving what he considers a "good reason"),
(4) Deliberately doing things that will annoy other people (The original Oscar pulled many practical jokes and still likes to push the other characters’ buttons),
(5) Blaming others for his or her own mistakes or misbehaviors (This criteria is not typical of Oscar, who is usually very willing to take credit for his misdeeds),
(6) Being touchy or easily annoyed by others (Again, an Oscar-esque description)
(7) Being angry or resentful,
Or (8) being spiteful or resentful (Like criteria 3 and 5, this is not typical of Oscar the Grouch)
(DSM-IV, 91-94 & The Children’s Television Network Interactive Site)
Further, these behaviors must occur more frequently than is typical for others of comparable age and developmental level, and must lead to significant impairment in social (Oscar’s downfall), academic, or occupational function.
A diagnosis of Operational Defiant Disorder is not made if these behaviors occur exclusively during the course of a Psychotic or Mood Disorder, or if the individual meets the criteria for Conduct Disorder or Antisocial Personality Disorder (DSM-IV 91). Fortunately Oscar does not meet the criteria for any of these disorders. Although the layman use of the term "Antisocial" has been used to describe Oscar, he does not meet correct use of the diagnostic.
Oppositional Defiant Disorder is associated with low self-esteem, mood liability, low frustration tolerance, swearing, and the precocious use of alcohol, tobacco, or illicit drugs. ADHD, Learning Disorders, and Communication Disorders also tend to be associated co-morbidities. In a significant proportion of cases, the disorder is a precursor to the more severe Conduct Disorder (DSM-IV, 92).
In conjunction with operational defiant disorder, schizoid personality disorder involves a pervasive pattern of detachment in social relationships and a restricted range of emotions in interpersonal settings (DSM-IV, 638). For Oscar, he exhibits one emotion, that of grouchiness, the majority of the time.
Individuals with schizoid personality disorder do not seem to desire intimacy, are indifferent to most social situations, have few if any close relationships, and do not appear to find satisfaction from family or social groups. Most people (or Muppets) with this disorder, like Oscar, are socially isolated, may be termed "loners," and almost always choose to live in isolation (hence the can: DSM-IV, 638 & The Sesame Street Interactive Network).
Those with schizoid personality disorder often seem indifferent to the approval or criticism of others, and do not appear to be bothered by what others think of them. This may result from the fact that they are oblivious to such criticism, and they often have trouble reading cues from others (DSM-IV, 639). Oscar somewhat differs from the classic definition of schizoid personality disorder, in that those with the disorder are often described as having particular difficulty expressing anger. Oscar's grouchiness is a form of anger, but is not, per say, pure anger.
Oscar also has a rather severe case of Agoraphobia, and has not left his house (can) for an extended period of time in 29 years. He has at times, attempted to deal with this phobia, by taking short excursions, but it is clear that he is more comfortable and prefers to be in the can at all times. Additionally Oscar has some of the characteristics of social phobia, most specifically hypersensitivity to criticism, negative evaluation, irritableness, and lack of a social support network (DSM-IV, 413).
Individuals with these disorders are more likely to develop major depressive disorder, which often co-occurs with schizotypal, paranoid, and avoidant personality disorders (DSM-IV, 639). Oscar the Grouch meets some, but not enough, of the criteria for each of these disorders. It seems unlikely that after twenty-nine years of stability within his disorders that he would now begin to develop new ones. It is probable that Oscar will keep his current "issues," continue to express them, but not develop any new ones.
The Count manifests the most obvious affliction of all the Sesame Street characters. This caped creature will count anything at any time, which sometimes tries the patients of others. He dislikes calculators and the concept of zeros, and according to his creators, "tries to maintain the perfect balance between obsession and sanity" (The Children’s Television Network Interactive Cite).
The essential feature of Obsessive-Compulsive Disorder (not to be confused with Obsessive Compulsive Personality Disorder) are recurrent obsessions or compulsions that are severe enough to be time consuming, cause marked distress or significant impairment. At some point, the person has recognized that the obsessions or compulsions are excessive (DSM-IV, 417). The Count seems to realize this each time he begins counting, his maniacal laugher is an admission, but also a dismissal of these feelings.
Obsessions are "persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress" (DSM-IV, 418). The Count’s specific obsession has not been revealed. We do not know if he counts to rid things of contamination (a common obsession), or that he doubts his own ability and therefore must continue to count everything, or if there is some other self-created reason. An individual attempts to ignore or suppress these obsessions with some sort of compulsory ritual; for The Count it is by counting everything he encounters.
Compulsions are "repetitive behaviors or mental act (counting is considered a mental act), the goal of which is to prevent or reduce anxiety or distress (DSM-IV, 419). The obsession or compulsions must be time consuming, or interfere with the individual’s normal routine. Because the counting behavior has come do define his routine, it is hard to determine if it actually interferes, or if the behavior is The Count’s routine. One deviation from the classic definition of obsessive compulsive disorder that The Count has is that he seems to get true pleasure out of the activity.
Bert, more famously of the duo Bert and Ernie, is very serious when it comes to some things, especially keeping control and order in his life. He dislikes being asked what he considers to be silly questions, and hates being bugged or having practical jokes played on him (The Children’s Television Network Interactive Site).
Bert displays the essential features of obsessive-compulsive personality disorder. This disorder is marked by a preoccupation with orderliness, perfection, mental and interpersonal control, and neatness, at the expense of flexibility, openness, and efficiency (DSM-IV, 669). Bert is a compulsive cleaner and organizer, is dominant in his relationship with Ernie, and has very set patterns of behavior. He becomes agitated when his (and Ernie's) bedroom or bathroom's usual order is disturbed, and often becomes upset until Ernie cleans it up (The Sesame Street Interactive Network).
Individuals with obsessive-compulsive personality disorder attempt to maintain a sense of control through painstaking attention to rules, trivial details, procedures, lists, schedules, or form to the extent that the major point of the activity is lost (DSM-IV, 669). In Bert's case it is usually the fun that is lost, at least according to Ernie. He is oblivious to the fact that other people tend to become annoyed at the delays and inconveniences that result from this behavior.
Obsessive Compulsive Personality Disorder individuals may also be excessively conscientious, scrupulous, and inflexible about matters of morality, ethics, or values. They may force themselves and others (possibly Ernie) to follow rigid moral principles defined by the society, and to meet very strict standards of performance (DSM-IV, 670). This criterion, if met by Bert, would bring about Ego-like tendencies in the Freudian sense, and could also discount the much-repeated theory about an intimate relationship between Bert and Ernie.
Cookie Monster quite obviously has an appetite for everything in sight. He prefers to be eating at all times, and his creators list his hobbies/obsession as "eating lunch, eating dinner, eating snacks, eating telephones, eating Ws, eating umbrellas, and of course, eating cookies (The Sesame Street Interactive Network).
The essential features of binge eating are recurrent episodes associated with subjective and behavioral indicators of impaired control over, and significant distress about, the binge eating and the absence of the regular use of inappropriate compensatory behaviors (such as self-induced vomiting, misuse of laxatives and other medications, fasting, and excessive exercising) that are characteristic of Bulimia Nervosa (DSM-IV, 729). Indicators include impaired control include eating very rapidly, eating until feeling uncomfortable full, and eating large amounts of food while not hungry. It is quite clear that Cookie is not eating for the purpose of nutrition. His habits, including eating foods and non-foods with no nutritional value (Telephones, umbrella, etc.), demonstrate his inability to control the binge impulses.
The diagnosis of binge eating is contingent on whether further evidence about Cookie’s disorder is learned. Thus far there is not evidence of purging or methods to remove the food from his system after he binges. However, no Sesame Street character has ever been shown using or even mentioning a bathroom, so this lack of evidence may not be telling the entire story.
These beloved characters of Sesame Street are not the fun loving teaching aids that the public is lead to believe they are. These Muppets obviously have some severe and far-reaching disorders that have changed the chemistry of the show and its cast. This trend suggests that other characters will also be found to have disorders, based on the seriousness of the disorders explored. The influence these main characters of an educational children’s program may be having on children must also be examined in future research. Sesame Street and its characters are a staple of households worldwide, but its influence may be greater than previously thought. The proper diagnosis of the characters is essential to further understanding of the phenomenon, and will lend itself to the examination of other children’s programming.
The American Psychological Association (Eds). (1996). Diagnostic and statistical manual, 4th ed. Washington DC: American Psychological Association.
Barlow, David H., & Durand, V. M. (1995). Abnormal psychology: An Integrative approach. Pacific Grove: Brooks/Cole Publishing Company.
The Children’s Television Network Interactive Site. http://www.ctw.org/sesamestreet. Accessed April 15, 2000.