I've been dealing with this particular client for about 12 years or so now. He has never really been shy about his alcoholism with me; I had to draw firm boundaries with him years ago so we've settled into a pretty respectful relationship.
His wife has always lived in another state for as long as they have been clients & while we work together just fine via email & phone, she always asks about his drinking. Has he been driving himself to the office? Can I tell if he's been drinking? etc. They no longer speak directly to one another - EVER. In ANY way. A couple of years ago he fell in his bathroom during a binge & it was days before someone found him & got him medical help. He refuses to consider any kind of assisted living because they won't allow him to drink, but he really NEEDS daily help. He's always bruised from constantly falling, tripping & running into things.
Today I came into the office & found a voicemail from him from around 3am this morning. I could hear the difference in his tone - I knew something had changed. He sounded scared, paranoid & confused (he's usually cocky, witty, confident); rambling on about his hired caregivers & being vulnerable, etc. It didn't make much sense..... when I talked to him later in the morning he was still shaky & scared & repeated over & over again that he knows it's him, he's losing his touch with reality & his mind is liquefying faster than he realized it would. I asked him a LOT of questions to determine what had happened - do you think they are stealing from you? (no) -are they aggressive, are you scared? (no) -have they done anything "wrong" to make you feel this way? (no)
He could see that it's all him - these people were referred highly & there is no problem with their work. He's uncomfortable because they are strangers to him & he's not able to suck them into his manipulation because they're just there to do a job. I told him that he sounded paranoid & that seeing how his message was left around 3am I have to take the educated guess that this is all the result of alcohol. He agreed & said, "I've always known my mind would go Fire, I've always known it. I chose this, I know I did... I just didn't understand! I didn't understand how FAST everything would deteriorate once I started to feel it! I expected it to be more gradual, but every day I feel like I'm losing my grip on reality faster & faster.... once it starts, it just GOES! It's GONE! I HAVE to see a familiar face!" Anxiety rising with every word.
Luckily I'm alone at the office today & I could talk "real" with him - hey man, this isn't going to get any better, you know that right? I/we can't run over there every time you get lost in an alcohol fog.... never mind we're not even here in the office to get the message unless it's during business hours. What are you going to do when the next panic/paranoia attack comes over a holiday weekend?
SO sad. He's out of options & has no desire to change even a little, not that it would be easy now in his late 70's after decades of heavy abuse. I absolutely cannot leave the office empty to run over there today because then he will never stop asking & I know that these "spells" are likely to increase in the coming months, as he feels his "grip" or control sliding away.
I'm sick of dealing with addiction in every area of my life.
