Posted by Joseph A Barrett, M.D. on February 24, 19100 at 12:23:13:
I have some thoughts on alcoholism based on observations made on a
dual disorder unit here. We are often confronted with a situation in
which the alcoholic patient is mired in a circuit of repetition that not only
includes compulsive drinking, but also cognitive processing in
general.
I have always been fascinated by the phenomena of progressive
alcohol dementia and Korsakoff's syndrome. These conditions are
characterized by several layers of cognitive dysfunction. However, as means of this
discussion, the role of reiteration and memory impairment are
particularily interesting. For how the alcoholic's mind mind
decomposes is via memory impairment. But, this memory impairment is to a
certain extent consistent with the overall defensive structure of the
patient.
His brain has effectively lost the capacity to retain many details
that communicate trust and other interpersonal feelings.
The result is constant reiteration. The patient has limited
capacity for meaningful connection with another. His fear of abandonment is now
manifest by cognitive dysfunction. What may have started out as a
defensive expression of poor self esteem is now hard wired. The
comorbidity of OCD may have some overlay here too.
Have others thought along similar lines?
Joseph A. Barrett, M.D.
Psychiatry and Behavioral Sciences
University of Washington