Patient # 13627
S is what you would call a more "difficult" patient. She is in her late 60s and suffers from alcohol dementia which basically means that she acts like a spoiled teenage girl when things don't go her way. She sometimes seems to live in a world totally her own, walking a path with blinders on like a horse trots down the road. However, when an obstacle rears its ugly head and prevents her from continuing on her path she does not respond with the refined sophistication you would expect of a matron her age but rather in a violent, ugly outburst that is designed to maximise discomfort in the person/thing that stands in her way.
S scares me, not directly by her actions but by what she has become. I wonder if I myself could become like that and I honestly believe I may turn from a rather passive, easy-going person to one who can't take even an ounce of stress. To me S is really kind and talkative, it is a crazy juxtaposition that I see in a lot of persons that I've encountered with alcohol dementia. There is a normal, sweet person usually sitting behind the veneer of the person who insists that her seat is the furthest most right one on the couch or who insists that she always sits in the front of the bus or that her non-alcoholic drinks be poured into a wine glass.
I am writing about S today of all days because it is a very sad one for S. Today is the birthday of S's son, also an alcoholic, who killed himself approximately 6 years ago. In fact, S's son had been in this very same rehab facility years ago trying to get better. I would surmise that her son's death may have been the catalyst for her conversion into full-blown alcohol dementia. When she speaks about her son you can tell that she just can't grasp why he choose the route he did and it is really heartbreaking to here her talk about him as if he were still alive and well.
Rubbing her back and listening to her talk about him this morning was really tough. It made me think of my own parents and their worries about me and how losing a child must be the worst thing imaginable that could happen to somebody. It makes me feel horrible for all the petty times I rolled my eyes at her antics; seeing her pain today and sitting with her listening to her wistfully recount her beloved son put a knot in my stomach. I felt guilty for even the few pleasurable seconds when the morning sunlight glinted off my back in warm, sunny pat on the back. It felt wrong that the sun should shine today, but that's how life it, it just goes on and we as people can either choose to move on or not. Unfortunately S seems as though she has not or cannot.
Her antics are a defence mechanism to keep intact a very constricted narrative of her life that helps her cope with the tragedy she has had to endure. In this narrative her life is still fine; she is a well-to-do person for whom life has provided nothing but bountiful fruit. She surely is not a chronic alcoholic with onset dementia who spends most of her year in a rehab facility because she can't survive without alcohol in her day-to-day. Woe be upon the person who may point out that she actually needs the therapy that she seeks. That is just not the case; if anything, she is here on "vacation" or as a "retreat" from the stresses of everyday life, but surely not to rehabilitate. No, to concede that she is in the process of rehabilitation would be conceding that her narrative of a perfectly constructed life is a sham.
And you know what? It is hard to blame her for living such a fantastically constructed life. We are constantly indoctrinated by movies and books where people "get better" one thing I have seen in real life is that this is just sometimes not the case no matter how much we want it to be. The real fact of the matter is that there are many people like S for whom life does not just magically get better. Instead, a narrative of a perfect life is woven in such person's head that allows them to cope with the trauma that they have endured. The violent reactions/outbursts to perceived threats to this narrative are just a defence mechanism that keep the house of cards intact.
If anything S has shown me that I need to let go of my agitation (a very common side effect of withdrawal and recovery from alcohol is that you have little to no patience for anything whatsoever) and see the bigger picture. That when S is having a full-blown toddler tantrum about not getting what she wants, thereby holding up the entire rest of the group, she is not doing this as a personal affront to me or the others, but that she is a person in deep pain who just so desperately wants everything to be okay again. But the sad reality is that life will not be okay again, she will probably never "awaken" in a sense and that is reality; just the really sad side of it.