Case Study - rain in my heart

https://www.youtube.com/watch?v=lwv7Utcf-gM

Mark has had a long unhealthy relationship with alcohol, he is featured in a powerful 2006 documentary ‘Rain in my Heart'. At various times he has come close to death due to the hazardous amount of alcohol he has consumed. At age 29 his physician gave him a 50% chance of dying in the hospital, yet he resumed drinking soon after leaving the care of the medical staff. Because of his liver disease Mark does not appear to be a good candidate to resume the W.H.O sensible drinking limit. His only chance is to find a way to abstain from drinking at all. Mark is aware of his situation and the medical practitioners have warned him of the reality he faces. Mark has managed to not drink for three weeks, but like many people who have developed a dependency, he is prone to slipping back to his addictive drinking. His ‘on/off' relationship with booze has reached a point of severe ‘tissue damage'. It is important that Mark demonstrates a commitment to change so that he may one day be a candidate for a liver transplant. Mark does have family and friends that care about him but his obsession with alcohol has a strong hold .Like the other three alcohol dependent ‘patients' focused on in the documentary, two of whom died during the filming (Vanda died not long after, despite cutting down on the alcohol), Dr Smith-Laing holds out little hope that Mark will survive.However, Mark falls in love with awoman called Louise and starts to turn his life around.

Mark fathered a child when he was only seventeen, but alcohol has interfered with his ability to be a good dad. Mark did not have a particularly traumatic childhood, and there is not strong evidence that he was genetically predisposed. He does however seem to have a very strong bond with alcohol. He reports that alcohol helps him cope with his boring existence and paradoxically enables him to draw a sickness benefit and to some extent stop him searching for employment. The pain of detox does not seem to have ‘taught' Mark to avoid drinking again. His attitude to alcohol is evident with his defense of George Best(a famous footballer who drank away his new liver)!

Mark is a great example of having the knowledge but not applying it to his own situation. He describes how the addiction was for him a vicious cycle.... "it is like a little ride I can't get off" Mark described his addiction as a disease a habit an illness. Mark also describes how he could swear he had nothing to drink and lie to his partner constantly. He blamed his partner for letting him have a can of beer, (he states that he needed her to threaten to leave him if he drank!). People who are as hooked as Mark is on alcohol will often look for things outside of themselves to blame.

Dr Smith-Laing talked about his frustration at the lack of support for his patients when they left hospital. He asserted that governmental policy was only getting worse. Towards the end of the YOUTUBE clip Mark managed to stop drinking for eight weeks, therefore he demonstrated that he had the ability to abstain. Unfortunately, he was unable to prevent a slip turning into a full-blown relapse. His family was dismayed that he started drinking again and ended up as an inpatient at a psychiatric facility. His family described mark as totally unmotivated. Some of his family did not want him back home ruining their happiness. It was clear that Mark was on the verge of becoming a homeless ‘drunk'. The family had reached a point where they would only offer help ‘more remotely', as his drinking behaviour was too disruptive on the family. The impact on the family of people like Mark, is always profound.

Mark also self-harmed by cutting himself, but wanted to hide the problem from his mum to save her pain. He reported feeling dirty, a person who lets people down, and did not want to be that way. He became very tearful when talking about his daughter....."She is the first one in my thoughts". He seemed to use alcohol or cutting to address his bad temper. The documentary maker Paul, asked him how long he could keep hiding from people, as Mark drank and vomited, and drank. According to Mark's mother he saw the world as a dark lonely place, and he was without social skills. Drinking helped him avoid having to have social skills. Mark described himself as prone to panic attacks (when sober). It appears that the way he solved his problems when NOT boozing was cutting himself. The self-sabotaging, demonstrated the ‘madness', or as the twelve step movement calls it , the insanity of addiction. Indeed Mark saw himself as the perfect example of why alcoholism is so devastating, and that his addiction was a form of slow suicide.It was clear that some promised state assistance simply did not happen, and that Mark's family had become very frustrated at the lack of mental health services available. "If only someone would cut me a break", Mark said at the end of the documentary....... Louise appears to be the break he was hoping for.

What is your causation hypothesis for Mark?

Screen and assess using the instruments covered in class: DSM IV and V criteria met by Mark.

Possible co-existing disorders Mark may have?

Examples of three LEVELS of intervention for Mark and significant others in his life.

Case study , it consists of a case study video of mark, and we need to use mason durie and also 12 steps model.

Attachment:- Assignment.rar