1. Character source: Movie "Leaving Las Vegas" Leaving Las Vegas (1995)
2. Case description:
Ben, male, middle-aged, divorced, used to be a playwright. After being dismissed from the company due to long-term alcoholism and financial distress, he became a seller and went to Las Vegas, intending to commit suicide and die of alcoholism. There he met the prostitute Sera and had a relationship, but Sera couldn't help him quit drinking at all. Eventually, he fell ill and died in Las Vegas.
3. Diagnosis: Substance Use Disorder (Alcohol)
4. Case symptoms
Ben's alcohol use disorder is severe and meets the criteria for both substance abuse and substance dependence.
(1) Interpersonal relationship
Ben was married and had children, but his ex-wife left him with the children. "I've forgotten that I lost them before I drank, or I drank before they left me," he said.
At the beginning of the film, Ben goes to his friend's table to borrow money, and his friend gives the money, but asks Ben to never come to him again.
Ben was fired from the company. He immediately changed his business and left his original city.
Ben clumsily approached different women at the bar, and was rejected and beaten. He develops a relationship with the prostitute Sera, which begins when he pays Sera, but doesn't ask for sex, but wants Sera to listen to him. One thing Sera did that really moved him was giving him a bottle of wine that he carried with him, and he felt totally accepted.
As you can see, Ben's relationships are pretty bad. Because of his alcoholism, his links with family, friends, and colleagues were disconnected one by one. He's quite lonely, so he keeps hitting up, but no one responds to him except Sera. When he met Sera, he was in the late stage of alcoholism, and Sera could not shake his addiction to alcohol. He could choose between wine and Sera. He would choose wine.
(2) Emotion and thinking
Spending a lot of time drinking alcohol every day presents a certain emotional and mental numbness and sometimes hallucinations. His wedding ring, which was important to him, had been stolen by a prostitute while he was drunk, reminded him from time to time, but he didn't do anything, not even look angry or regretful. When I was in the casino, I gambled while drinking. Because I had the illusion that the passerby was my ex-wife, I suddenly made a scene. He fell in love with Sera, but first emphasized "you can never ask me to stop drinking" before agreeing to move in and live with her. Later, he was kicked out of the house by Sera because he was drunk and recruited prostitutes.
(3) Behavioral and physical symptoms
When he's not drinking, Ben is lethargic and shaking. After drinking, he became hyperactive and talkative. He has no control over the amount of alcohol he drinks, and consumes a lot of alcohol every day. He knows that this is not good for his health, but he does not intend to quit drinking. Instead, he intends to commit suicide slowly and drink himself to death. In the end, he did die early.
5. Diagnosis basis
Meets substance use disorder criteria. The ones marked with √ are the criteria that the movie character Ben meets.
Improper use of the substance causes functional impairment. Two or more of the following criteria must be met for a duration of one year:
Unable to perform duties; √
Even if the substance is harmful to the body, the substance is still used repeatedly; √
Ongoing interpersonal problems; √
Use the substance even if it has caused a problem; √
Drug resistance; √
Withdrawal reaction; √
Substances are used for longer or longer than originally planned;
Inability to reduce or control substance use; √
Spend a lot of time acquiring substances; √
Cancellation or reduction of social, professional and recreational activities; √
Continue to use the substance even if it is known that the use of the substance has caused harm; √
Strong desire for material things;√
6. Cause analysis (possible reasons)
At the beginning, Ben may have used alcohol to suppress his depression and anxiety (family disharmony) and inspire his own inspiration (playwrights need to create), but later he could not control himself and became addicted to alcohol, which made the effective links with others disconnected one by one , and made him more dependent on alcohol. Lack of effective interpersonal connections and alcohol addiction are mutually reinforcing.
7. Treatment ideas and treatment methods
(1) Hospitalization: Because Ben's condition is serious, hospitalization is recommended. Use drugs and other coercive means to help with alcohol addiction.
(2) Team and Family Therapy: Contact Ben's ex-wife and children, invite his children and Sera to participate in Ben's alcohol-abstinence therapy, and provide motivation for Ben to stop drinking. Invite Ben to join a local alcohol mutual aid organization and establish effective interpersonal links in the mutual aid organization.
(3) Cognitive-behavioral therapy: Helps to correct Ben's misconceptions and expectations about drinking. Find the psychological causes of Ben's substance use disorder, and avoid Ben's relapse in negative moods by teaching healthier ways to relieve stress and improve positive moods.
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