CASE STUDY

JORDYN WALSH

GWEN CUMMINGS

APPROXIMATELY 28 YEARS OLD

A. IDENTIFYING INFORMATION AND REFERRAL STATEMENT:

B. PRESENTING COMPLAINT:

C. HISTORY OF PRESENTING COMPLAINT:

D. MEDICAL:

E. PRESONAL HISTORY:

F. FAMILY CONSTELLATION:

G. CLINICAL DESCRIPTIONS, IMPRESSIONS, AND OBSERVATIONS:

H. TENTATIVE DIAGNOSIS:

I. INITIAL TREATMENT RECOMMENDATIONS:

J. INITIAL PROGNOSIS:
 CASE STUDY

JORDYN WALSH

GWEN CUMMINGS

APPROXIMATELY 28 YEARS OLD

IDENTIFYING INFORMATION AND REFERRAL STATEMENT:

Gwen Cummings is a single, big-city newspaper columnist who has just gotten

out of a drug and rehab center. Gwen was given a choice between prison and a

rehab center after ruining her sisters wedding because she was drunk and

crashing a stolen limousine while drunk driving into the front of somebodies yard.

Gwen shows addictive behavior towards alcohol and cigarettes. Addictive

behavior is based on a pathological need for the substance or activity. (Butcher,

J., Hooley, J., & Mineka, S., 2013) Gwen is considered to be an alcoholic. She

states to her counselor on the first day of rehab “She’s not like these other

people at this rehab, that she is a writer and that she knows she drinks a lot but

that is why she does. She has control and could stop if she wanted to, but only if

she actually wanted too.” An alcoholic is a person with serious drinking problem

whose drinking impairs health, personal relationships, and occupational

functioning. The day of Gwen sisters wedding she woke up, and in her bed there

were beer bottles, she drank in the taxi on the way there and when she was late

her sister told her “you make it impossible to love you” and Gwen instantly got a

drink to cope with her sisters feelings towards her. This show dependency when

in need of copping, and this proves alcoholism. Alcoholism is dependence on

alcohol that seriously interferes with life adjustment. The referral source was a

referral by a physician from Gwen rehab facility. (Betty Thomas, (Director),

Susannah Grant, (Writer) 2000)

PRESENTING COMPLAINT:

Gwen has had out of body experiences when trying to escape rehab and jump

out of window to do so. Gwen tells counselor that she “realizes that any normal

person would never risk their live to escape a place” and she has seen herself in

the window saying, “you know you are screwed.” She suffered from withdrawals

on the very first day that include; throwing up, laying on the bathroom floor, and

flashbacks of her mother drunk when playing and raising her and her sister. Her

boyfriend at the time brought her pills and she was caught and almost kicked out

and forced to go to jail. Gwen states, “She knows she needs help and to be able

to be a normal human being that can breathe and sit still without a cigarette or

alcohol. She realizes that she needs to get better.” Gwen’s dependency on

alcohol is absolutely affecting her everyday life, she has admitted to using the

substance everyday in order to “be a normal person”. (Betty Thomas, (Director),

Susannah Grant, (Writer) 2000)

HISTORY OF PRESENTING COMPLAINT:

The onset of Gwen’s alcoholism can come from her old environment. Her ex

boyfriend was really into the drinking and partying lifestyle. During Gwens’ time in

rehab he proposed to her and when saying no because she needs to get herself
better he said he didn’t believe she had anything wrong with her. He, Jasper,

Gwen’s ex boyfriend told her “she does not need to cope with her problems that

she deals with them just fine”. I believe that Gwen’s onset could come from the

history of her mother and watching her mother is an alcoholic when she raised

her. Gwen has experienced flashbacks of almost being hit by a car when

sledding into the road with her mom. Also having to slap her mom in the face to

wake her up after passing out from being so drunk. I believe Gwen learned the

behavior to cope with things with alcohol from watching her mother do it. (Betty

Thomas, (Director), Susannah Grant, (Writer) 2000)

MEDICAL:

Prior to rehab Gwen has never seen a psychiatrist or counselor. She has never

been on any prescribed medications that a doctor has prescribed that to her.

When Gwen was in rehab she was caught getting pills from her boyfriend but it

unknown at this time what medications she was given. Today Gwen has been

clean and sober since the day she got back from her outing when Jasper came.

After getting in trouble with her counselor and almost getting kicked Gwen took

the pills almost once but actually spit them out and has been sober ever since to

the day. (Betty Thomas, (Director), Susannah Grant, (Writer) 2000)

PRESONAL HISTORY:

There is no information on Gwen’s birth or infancy. Her mother died when she

was a young girl. Her mother was also an alcoholic and on the day she died her
and her sister just thought she was passed out from drinking because that had

always happened. When Gwen and her sister, Lilly, were told the news of her

mothers death they said, “don’t worry just slap her, she will wake up, she always

does that”. Gwen and her sister have a very shaky relationship; ever since Gwen

ruined her sisters wedding there relationship has been even worse. At the time

Gwen is still single since Jasper and is really focusing on her and getting better.

(Betty Thomas, (Director), Susannah Grant, (Writer) 2000)

FAMILY CONSTELLATION:

Prior and during rehab Jasper was Gwens only family; Lilly and Gwen did not

have good relationship at all. Her mother was dead and the mention of her father

was never brought up. Gwens father is unknown of and as I mentioned before

Gwens mother was an alcoholic herself; she was a thrill-seeking addict who died

of an overdose when Gwen was about six, leaving both Lilly and herself to be

raised by an aunt. When her sister came to a group therapy session she told

Gwen how she ruined her wedding. Gwen gave a very offending rambling

speech that she does not even remember; in Gwen’s speech she said to Lily

“Her husband was not what she wanted and that she settled because he made a

lot of money.” Gwen also due to intoxication knocked over the cake, which is

what led her to drive the limousine from the reception trying to locate a cake

store. This is when she lost control of the car and crashed into somebodies the

front yard and house. Lily then leaves abruptly saying, “She doesn’t need this,

that she has a life.” However when Gwen’s roommate Andrea is found dead in
their bathroom from an overdose Gwen becomes devastated and possibly was

an eye opening experience to how an addict’s behavior affects other. Gwen then

commits herself to restoring her relationship with her sister Lily. (Betty Thomas,

(Director), Susannah Grant, (Writer) 2000)

CLINICAL DESCRIPTIONS, IMPRESSIONS, AND OBSERVATIONS

Gwen is becoming a functioning adult that does not have to depend of alcoholic

she begins actually participate with her fellow rehab community. She begins to

participate in group therapy sessions. The first time the group gives her a hard

time and she proceeds to tell them to “back the fuck off and that she is trying her

hardest”, this is considered to be good sharing and good progress for Gwen.

When Gwen begins a friendship with a fellow addict Eddie, she is afraid to share

what she has done as a practicing alcoholic for fear for looking bad to him. This

shows to me that she no longer think her drinking problem is normal, that she

now knows that she cannot live that way and what she was doing was wrong.

This shows her first step to recovery; accepting and realizing that her alcoholism

is an actually issue that she now is ashamed of. (Betty Thomas, (Director),

Susannah Grant, (Writer) 2000)

TENTATIVE DIAGNOSIS:

I believe the Gwen Cummings suffers from alcoholism and being an alcoholic

(see section Identifying Information and Referral Statement for definition) they

are both classified as substance abuse and can be known as Alcohol- Related
Disorders. Alcohol has complex and often contradictory effect on the bran; at

higher levels alcohol depresses the brain functioning and at lower levels alcohol

stimulates certain brain cells and activates brain “pleasure areas”. The alcohol

related disorder could cause personality deterioration, impaired reasoning,

depression and chronic fatigue. This all become a factor to an alcoholic when it is

abused and depended on. I also have reason to believe that Gwen suffers from

alcoholism due to biological casual factors such as genetics and learning factors.

Gwen’s mom was a diagnosed alcoholic and with genetic factors is causes

sensitivity to addictive power of drugs like alcohol. Learning factors play an

important factor in the development of substance abuse, greatening the risk and

chance of those who parents were alcoholics. Gwen falls into this category and

gives me even more reason to believe that she does in fact surfer from

alcoholism. (Betty Thomas, (Director), Susannah Grant, (Writer) 2000)

INITIAL TREATMENT RECOMMENDATIONS:

I find that Gwen would abuse alcohol the most when being unable to tolerate

tension or stress. She was emotionally immature and the only parent she had as

a role model was a negative one. There are many treatments and approaches

alcohol-related disorders. There is biological approaches which involve

medications to block desire to drink or lower side effects of acute withdrawals but

I would not recommend using another substance to get over abusing another

one. Instead I would recommend a psychological treatment approach which

includes continuing group therapy, behavioral and cognitive behavioral therapy,

and a continues environmental intervention. (Butcher, J., Hooley, J., & Mineka,

S., 2013) Gwen has already started on her environment intervention when she

broke things off with Jasper. When Gwen leaves treatment and returns to New

York she tries to help Jasper understand what needs to change in their

relationship to support her recovery but she soon learned that he does not take

her sobriety seriously and that is when she comes to terms they are two different

people and her recovery is more important. She then walks away for good in her

first big step to treatment in reconstruction of her environment. (Betty Thomas,

(Director), Susannah Grant, (Writer) 2000)

INITIAL PROGNOSIS:

I predict that Gwen’s alcoholism will not forever hinder her life. I believe her

recovery will be need to be worked on daily and it will be difficult but as long as

she seeks the support she needs and continues to express her feelings talking

about all of her stress and possible desires to drink again. I do believe that due to

Gwen past, family history, and self history with alcohol abuse that she should

stay sober and away from drinking habit for the remainder of her life in order to

stay on track. A major factor to her prognosis is to continue to be a normal

person and keep control of herself and her sobriety. Gwen has worked hard to

get this fair and gain this control on her addiction. (Butcher, J., Hooley, J., &

Mineka, S., 2013) As long as she keeps this motivation and continues behavioral

counseling with myself and group therapy, Gwen should stay on track to “being
that normal more controlled self” she wants to be. (Betty Thomas, (Director),

Susannah Grant, (Writer) 2000)

Citation:

Betty Thomas (Director), Susannah Grant (Writer). (2000) 28 Days [Motion

picture on DVD]. United States of America.

Butcher, J., Hooley, J., & Mineka, S. (2013). Substance-Related Disorders. In

Abnormal Psychology (pp.368-403). New Jersey: Pearson Education.