PLOT
A New York City ballet company is preparing for the production of Swan Lake, choosing to cast a new lead to replace current star Beth MacIntyre (Winona Ryder) as the Swan Queen. However, the lead must maintain an adequate portrayal of both the White and Black Swans. Nina Sayers (Natalie Portman), a dancer, is picked to compete for the part alongside several other young dancers, including newcomer Lily (Mila Kunis). Nina lives with her caring but overbearing mother Erica (Barbara Hershey), a failed dancer turned amateur artist who tries to control much of Nina's life.
The ballet director Thomas Leroy (Vincent Cassel), is reluctant to cast Nina; he claims that she is the perfect White Swan, with perfect technique, but that she lacks the passion of the darkly sensual Black Swan. During a confrontation over the role, Thomas kisses her, and she bites his lip, surprising and exhilarating him; directly after, he casts her in the lead. He presents her as his new star during a benefit gala.
Nina displays a number of psychotic symptoms, including strong delusions and elaborate visual hallucinations. She begins to feel paranoid that Lily, her understudy, is determined to take the lead away from her. Thomas, meanwhile, becomes increasingly critical of Nina's "frigid" dancing as the Black Swan, and tells her that she should stop being so perfect and simply lose herself in the Black Swan role.
One night, Lily appears at Nina's door and pressures Nina to go out on the town with her. Nina is at first reluctant, but after her mother's pushiness to get rid of Lily, she quickly leaves to escape her controlling mother. During the night out, she takes drugs and becomes more interested in Lily than the men at the bar. Upon returning to Nina's apartment with Lily, the two have sex after Nina and her mother have an enraged argument. Nina wakes up alone the next morning, and rushes to make it on time to rehearsal. When she enters the studio, she finds Lily dancing as the Swan Queen in her absence. Furious, Nina confronts Lily, and asks her why she did not wake her up in the morning. Lily states that she spent the night with a man whom she met at the club, and teases Nina for fantasizing about her.
The night before the ballet's opening, Nina is rehearsing late and continues to experience strong visual hallucinations, such as her reflection acting independent of her and of Lily and Thomas having sex together backstage. When she returns home, she sees her mother's paintings speaking and mocking her. She also notices that the rash on her shoulder has worsened, with little black barbs poking through her skin. Nina pulls one of the barbs from her skin, and it appears to be a black feather. Nina's eyes appear to turn into reddish swan eyes and her legs violently contort into the shape of a swan's. As she tries to steady herself, she falls and knocks herself out on her bedpost.
Nina awakes the night of the opening performance, locked in her bedroom with her mother. Nina's mother tells her that she called the company and informed them that Nina wasn't feeling well and will not be able to perform. After violently forcing her mother to let her leave, Nina arrives at the theater and immediately prepares herself as the White Swan.
The first act is less than desired; the Prince drops Nina while dancing onstage. Distraught, Nina returns to her dressing room and finds Lily there, dressed in the Black Swan costume. As Lily announces her intention to play the Black Swan, she changes form into Nina herself. Nina and her duplicate wrestle, with Nina shoving her into a full-length mirror, and during the ensuing scuffle, takes a shard of the mirror and stabs her duplicate, killing her. Upon realizing what she has done, she sees that the body is Lily's. After hiding Lily's body, Nina returns to the stage and dances the Black Swan (the third act of Swan Lake), passionately and sensually, growing black feathers all over her body as she dances, her arms becoming black wings as she finally loses herself and transforms into a black swan; at the end of the act, she receives a standing ovation. When she leaves the stage, she finds Thomas and kisses him with seductive power for the first time.
Back in her dressing room, she is interrupted by a knock at her door and opens it to see Lily, who has come to congratulate her. Nina realizes the fight was another hallucination; however, the mirror is still shattered. She notices a wound on her body and realizes that she apparently stabbed herself as the White Swan, not Lily. Back on stage, Nina dances passionately and seamlessly in the fourth and final act as the White Swan. In the last moments of the ballet, when the Swan is supposed to kill herself by jumping off a cliff on the stage, the audience erupts in thunderous applause while the cast discovers Nina lying on the safety mattress backstage. After Thomas enthusiastically congratulates her on her performance, Lily gasps in horror as she, Thomas, and the cast see that Nina is covered in blood. Though Nina lies wounded and perhaps dying, she feels content that everything she went through helped her to achieve a perfect performance. The film draws to a close with Nina reveling in the audience's applause as she whispers "I felt it. Perfect. I was perfect," and the screen fades to white.
NURSING FACTS & INFORMATION
Hallucination
A hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space. The latter definition distinguishes hallucinations from the related phenomena of dreaming, which does not involve wakefulness; illusion, which involves distorted or misinterpreted real perception; imagery, which does not mimic real perception and is under voluntary control; and pseudohallucination, which does not mimic real perception, but is not under voluntary control.Hallucinations also differ from "delusional perceptions", in which a correctly sensed and interpreted genuine perception is given some additional (and typically bizarre) significance.
Hallucinations can occur in any sensory modality — visual, auditory, olfactory, gustatory, tactile, proprioceptive, equilibrioceptive, nociceptive, thermoceptive and chronoceptive.
A mild form of hallucination is known as a disturbance, and can occur in any of the senses above. These may be things like seeing movement in peripheral vision, or hearing faint noises and/or voices. Auditory hallucinations are very common in paranoid schizophrenia. They may be benevolent (telling the patient good things about themselves) or malicious, cursing the patient etc. Auditory hallucinations of the malicious type are frequently heard like people talking about the patient behind their back. Like auditory hallucinations, the source of their visual counterpart can also be behind the patient's back. Their visual counterpart is the feeling of being looked-stared at, usually with malicious intent. Frequently, auditory hallucinations and their visual counterpart are experienced by the patient together.
Classification
Hallucinations may be manifested in a variety of forms.Various forms of hallucinations affect different senses, sometimes occurring simultaneously, creating multiple sensory hallucinations for those experiencing them.
Visual
The most common modality referred to when people speak of hallucinations. These include the phenomena of seeing things which are not present or visual perception which does not reconcile with the consensus reality. There are many different causes, which have been classed as psychophysiologic (a disturbance of brain structure), psychobiochemical (a disturbance of neurotransmitters), and psychological (e.g. meaningful experiences consciousness). Numerous disorders can involve visual hallucinations, ranging from psychotic disorders to dementia to migraine, but experiencing visual hallucinations does not in itself mean there is necessarily a disorder. Visual hallucinations are associated with organic dos orders of the brain and with drug and alcohol related illness.
Auditory
Auditory hallucinations (also known as Paracusia),particularly of one or more talking voices, are particularly associated with psychotic disorders such as schizophrenia or mania, and hold special significance in diagnosing these conditions, although many people not suffering from diagnosable mental illness may sometimes hear voices as well. Auditory hallucinations of non-organic origin are most often met with in paranoid schizophrenia. Their visual counterpart in that disease is the non-reality-based feeling of being looked or stared at.
Other types of auditory hallucination include exploding head syndrome and musical ear syndrome, and may occur during sleep paralysis. In the latter, people will hear music playing in their mind, usually songs they are familiar with. Recent reports have also mentioned that it is also possible to get musical hallucinations from listening to music for long periods of time. This can be caused by: lesions on the brain stem (often resulting from a stroke); also, tumors, encephalitis, or abscesses. Other reasons include hearing loss and epileptic activity. Auditory hallucinations are also a result of attempting wake-initiation of lucid dreams.
Olfactory
Phantosmia is the phenomenon of smelling odors that aren't really present. The most common odors are unpleasant smells such as rotting flesh, vomit, urine, feces, smoke, or others. Phantosmia often results from damage to the nervous tissue in the olfactory system. The damage can be caused by viral infection, brain tumor, trauma, surgery, and possibly exposure to toxins or drugs. Phantosmia can also be induced by epilepsy affecting the olfactory cortex and is also thought to possibly have psychiatric origins.[citation needed] Phantosmia is different from parosmia, in which a smell is actually present, but perceived differently from its usual smell.
Olfactory hallucinations have also been reported in migraine, although the frequency of such hallucinations is unclear.
Tactile
Other types of hallucinations create the sensation of tactile sensory input, simulating various types of pressure to the skin or other organs. This type of hallucination is often associated with substance use, such as someone who feels bugs crawling on them (known as formication) after a prolonged period of cocaine or amphetamine use.
Gustatory
This type of hallucination focuses typically on food and is common to individuals presenting persecutory perceptions along with the experience of epileptic aura.
General Somatic Sensations
General Somatic Sensations of a hallucinatory nature is experienced when an individual feels that his body is being mutilated i.e. twisted, torn, or disembowelled. Other reported cases are invasion by animals in the person's internal organs such as snakes in the stomach or frogs in the rectum. The general feeling that one's flesh is decomposing is also classified under this type of hallucination.
