SOCIAL HISTORY
Phillip Kozlowski is a well dressed 42 year old male being admitted
to our
alcoholic treatment center on February 13, 1999. Upon admission
Mr. Kozlowski
claimed to have had little to drink; his coordination and his
mannerisms were
that of a sober person but his blood alcohol analysis showed .26.
Mrs.
Kozlowski, the children and his employer were all involved in convincing
Mr.
Kozlowski to freely admit himself to our center. At the time
of admission, Mr.
Kozlowski indicated that he was "tired of the problems drinking had
caused"
him and was "frustrated" that he had to "sink down" to the point of
being
"forced into treatment". Mr. Kozlowski indicated he felt that
everyone was
against him and this was the real reason for his preoccupation with
alcohol.
Phillip was reared in Indianapolis, Indiana where he was an only child.
Accord-
ing to Phillip, his parents seemed to have had constant marital discord.
Phillip's father was a highly skilled repairman for I.B.M. and would
be gone on
long business trips without calling or writing to his wife or son.
Since
Phillip's father was a world traveler, it would not be uncommon for
him to be
away for two years at a time. When Phillip's father returned
, he and his wife
could not control themselves for an hour without getting involved in
a
"knock-down, drag-out fight--mostly yelling but no reall physical contact."
Phillip remembered his mother saying nasty things about his dad when
he was on
business trips. However, with all their marital problems, Phillip
noted that
neither one of his parents were heavy drinkers but did drink alcohol
on social
occasions. He does not remember them ever being intoxicated.
However, he did
remember that his grandfather (father's father) had a severe drinking
problem;
in fact, he died of cirrhosis of the liver. Phillip left home
to go to college
at age 17, and graduated at age 21. By his sophomore year in
college, his
parents were divorced. He has not seen his father since prior
to the divorce
and does not care to see or hear from him again. He still sees
his mother
occasionally (on holidays); however, he rarely writes or calls her
but does send
her money. Phillip indicated that his mother told him she would
never marry
again.
Mr. Kozlowski is married with three (3) children. Mary, his wife,
is three
months his junior. They met while they were students at Ohio
State University
and were wed upon graduation. Both Mary and Phillip were outstanding
students
with majors in Business Administration. Through most of their
marriage there
was little marital conflict. Mrs. Kozlowski indicated that the problem
started
to gradually occur after ten (10) years of marriage. Mr. Kozlowski
had to be
away on short business trips--he would return intoxicated. Gradually,
the
trips became longer. Initially, she thought Phillip was seeing
"another
woman," but after several talks with him she concluded that there was
no other
woman in the picture. During the interview, Mary stated that
the whole problem
was alcoholism.
Their three (3) sons, Phillip Jr. (age 22), Thomas (age 20), and Steve
(age 19)
see little of their parents. Phillip Jr. elected not to go to
college and
lives in Ohio where he sells insurance, while Thomas and Steve are
attending
school at the College of William and Mary. All three sons admitted
to not
knowing their father well. Phillip Jr. indicated that while growing
up, he was
teased by his peers because of his father's effeminate mannerisms.
Apparently,
Mr. Kozlowski's effeminate mannerisms are more annoying to his sons
than the
problem of alcoholism. The three sons were not sure if their
father's
effeminate was related to alcoholism, but it was evident that they
felt their
father was "strange" and needed help. Consequently, they all
said they feel
quite distant to Mr. Kozlowski.
Mr. Kozlowski admitted having homosexual tendencies and was not sure
what to
do. He noted that he might be addicted to alcohol, but indicated
that his
alcoholism evolved from his homosexual behavior. He stated in
a clear and
confident voice that he preferred sexual relationships with other men
more than
with his wife. In fact, he noted that the only manner in which
he could have a
relationship (sexual) with his wife was to first become intoxicated.
He also
admitted to drinking while searching and maintaining homosexual relationships.
He was sure that his wife did not suspect him of his homosexual involvements.
He indicated that it was about time to decide whether to tell his wife
and leave
or to give up his homosexual lifestyle and remain with his wife.
Phillip noted
that the reason for his indecision was purely financial. The
Kozlowskis have
well paying positions, with a combined income of $120,000 per year.
Phillip
works for SouthernBell, while his wife is an executive administrator
for R.J.
Reynolds Tobacco Company. He stated that if he left his wife
to pursue
homosexuality, the standard of living to which he had grown accustomed
would
change significantly and he did not want that to happen. He indicated
that his
wife was a "good woman" and deserved better than him. However,
he said that he
felt "indifferent" toward her and was not sure if his attitudes could
change.
He suspected that his real feelings toward his wife were "drowned with
years of
drinking." Prior to his last drinking binge he believed he had
aquired
syphilis from a homosexual relationship. He said that he did
not know what to
do about his own problem of syhpilis but worse that that, he belived
he had
transmitted the disease to his wife and she, of couse, does not know.
Mr.
Kozlowski indicated he was confused, scared and desperately needed
help.
In addition to problems with his wife and family, Mr. Kozlowski is having
serious problems with his employer. His direct supervisor, Mr.
Harry Locklear,
who has had contact with our alcoholic treatment center, indicated
that Mr.
Kozlowski's job performance has hit "rock bottom" and that he will
be fired if
improvements are not made. Mr. Locklear said that Mr. Kozlowski
was one of the
company's finest employees but that alcohol seemed to have ruined his
effectiveness, and that Mr. Kozlowski's addmission to treatment was
made to
avoid firing him, something Mr. Locklear does not want to do. Both
Mr.
Kozlowski and his employer realize that without good job performance,
he has
no chance of maintaining his employment.
Mr. Kozlowski has Blue Cross/Blue Shield health insurnace which will
pay 100%
of all fees connected with detox up to seven days and 80% beyond seven
days to
30 days with no further coverage for detox. The policy covers
80% of the fees
connected with Inpatient Alcoholic Rehabilitation for a period of 60
days and
40% of the following 60 days with no further coverage for Inpatient
Alcoholic
Rehabilitation. This policy also covers 80% of outpatient treatment
for a
period of 24 months as long as the outpatient program is an extension
to the
inpatient treatment. Blue Cross will not cover outpatient treatment
independent of inpatient treatment for alcoholism.
IMPRESSIONS
Phillip Kozlowski is a 42 year old male with an admitting diagnosis
of Dementia
associated with alcoholim (291.22). He is confused, anxious,
and frustrated,
particularly in dealing with issues of sexuality and communication.
He
projects the image of being aloof to the feelings of his three sons
and wife,
having little if any meaningful communication with them. The
reaction of his
wife and children may have led Mr. Kozlowski to a state of paranoia.
Most of
Mr. Kozlowski's problems seeem to evolve around his addiction to alcohol.
PROBLEMS
1. Can Mr. Kozlowski and/or his insurance pay for treatment?
2. Mr. Kozlowski feels that everyone is against him.
3. Mr. Kozlowski and his three (3) sons have a difficult time
communicating.
4. Mr. Kozlowski has a very high tolerance for alcohol and must
go through a
period of detoxification.
5. Mr. Kozlowski has received the medical diagnosis of alcoholism.
6. Mr. Kozlowski has stated that he feels "indifferent" to his
wife and is not
sure what to do.
7. Mr. Kozlowski believes that he is a homosexual and does not
know what to
do.
8. Mr. Kozlowski believes that he has syphilis and does not know
what to do.
9. Mr. Kozlowski believes that he has transmitted syphilis to
his wife and
does not know what to do.
10. Mr. Kozlowski will be fired from his job if his performance does
not
improve.