Married

Yesterday I was thinking about alcohol. I saw A who has Alzheimer's. But she drinks. She's always been a heavy drinker. Her daughter and son-in-law were here with her yesterday. They mentioned that they would find alcohol bottles in the apartment. There is nothing that can be done about this. She is still independent and goes to the store. She lives alone. But alcohol, especially heavy use, is very bad for the memory.
I have another patient who thinks he has Alzheimer's. He came yesterday afternoon. He has alcohol-related memory loss. I can tell the difference between the two, but he and his wife like to think he has Alzheimer's. His son, I think, believes me that it's from too much alcohol. He drinks two glasses of bourbon each evening. Each glass is about four to five ounces of bourbon. So that's a lot of alcohol. That's what he's had every day for over forty years. So it adds up.
I've seen him for a while now. But it was yesterday that he told me he drinks because of "marital discord". He actually said that his wife is "mean". He has a difficult time having to be with her. It came up because I've actually gotten him to cut down on his drinks from two to one recently. I gave him xanax to take, which is not a great trick but often works. It's a different way of calming down. In any case, it's worked well because he lost eight pounds in a month (the weight is killing him, and that's another reason I need him to drink less - it's about 800 calories per day of bourbon). But he complained that now he has to listen to his wife more. They've been married for forty three years.
I see people who have challenging relationships. There are marriages that are mutually destructive. The psychiatry people like to use the word "co-dependent". I suppose that's a useful concept. But I like the concept of "co-destructive". People hurt each other. Then, they withdraw from each other. During the withdrawal, they seethe in anger. Then they hurt each other again. It's a cycle. They think there's love in there somewhere, but it gets very hard to get in touch with it. It wears people down. They adjust, but something just slowly slips away. Year after year they lose a piece of their strength.
I've been in a situation just like that. So I know how it affects a person. But I don't have a solution. I'm in a different place now. I'm married in a way that makes me grow. Every day my wife is there to care for me. Of course, every once in a while, I get hurt by something that she does. But that's more likely my overly-sensitive nature than anything that she's actually done wrong. She is very dedicated to making sure that I'm well in every way. I do the same. So we're in a mutually helpful relationship: "co-growing". It makes life wonderful. It makes me strong and happy. Being in both situations, I can't say that I'm able to survive well in the co-destructive marriage. So I empathize with him.
Alcohol used to reduce pain from this type of situation is not going to be easy to cure. After forty-three years of hurt, I doubt that healing is much of an option. Some patients are hard to treat, after all.
My other patient, A, is newer to me. I don't even know what's led to her alcohol use. So she is even harder to treat.