Patient James B presented with a 15 year history of alcohol abuse, starting at age 15 when in high school.
James B is a gay male, aged 30, single, with no children. He is American, English speaking, employed as a waiter at a gay bar. He is an agnostic.
James B was referred by his family doctor, who thought his drinking was getting excessive and may be affecting his health.
Iv. Patient Medical and Mental Health History
James B denies any psychiatric problems, but says when he was younger he did have problems adjusting to his sexual orientation. He was teased about it at school, and he had problems with his parents when they found out, resulting in him leaving home as soon as he finished school and was able to get a job to support himself. He says he vaguely thought of suicide when he was in high school, but never seriously enough to do anything about it. It was just a vague thought. He has never taken psychiatric medicatinns because he is into holistic health and does not believe in them. He has never been hospitalized for more than an overnight stay after an automobile accident, and an emergency room treatment for a cut hand after breaking some glasses at the bar in an accident.
James B began using alcohol in high school along with friends there. Many of the boys in the school drank, according to James B, and he began slowly experimenting with it but became a serious drinker by about age 15. He says he drank for several reasons: to be sociable, to try and prove himself to others, and to just forget the usually stresses of teenage years.
As he got older and became part of the gay bar scene, he began to drink much more because he was unsure of himself in that scenario, and he needed to boost his self-confidence. Once he left home and worked in a bar it became easier for him, as customers bought him drinks, and he wou
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