Leaving Las Vegas

He lost his family and screenwriting job in Hollywood, because of his non-stop consumption of alcohol.  Ben Sanderson became more and more depressed.  He finally decided to just sell off everything he has got; leave Los Angeles and transfer to Las Vegas.  His intention:  to die drinking alcohol.

As he was driving drunk into Las Vegas he decided to check into a motel that he thought reads:  “The Hole You’re In”  [which actually says The Whole Year Inn].  Ben think wryly and cynically how apt the situation is.  Then he almost runs over a prostitute:  Sera.            They got to know each other because Ben invited Sera to his motel room in exchange for $500.  But Ben did not make love to Sera.  He just wanted to talk.  They became friendly.  They eventually felt enamoured.  However, they decided to create a compact not to change each other’s way and just live happily day by day with no plan for the future.  They both agree.  Ben continues drinking all day long, Sera keeps on being a prostitute.

However, as days go by, Sera starts feeling differently about Ben and becomes really concerned.  So she tries to make him eat.  To which Ben refuses and plays unaffected and just berates Sera to remember their agreement.  To top such frustration of Sera, Ben hires another prostitute and brings her to the house of Sera.  This made Sera more than furious and throws Ben out of her house.

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Patient Evaluation:

Ben Sanderson is prone to depression because the more he indulged in alcoholism because of his life’s failures.  From the onset of the story, he is already experiencing a meltdown, a bridge of no return.

Patients stated reason for problem

What aggravated his high alcohol consumption was his broken marriage and his family disentanglement and his losing his job.

History of Illness

No previous indication of emotional dilemma prior to the family breakup and loss of job.

Past Psychiatric illness, treatment, and outcomes

None as indicated in the story.

Medical History

None as indicated in the story.

Psychosocial History
As a professional in Hollywood, Ben Sanderson is seemingly sociable, well connected and enjoyed a fruitful career at an early stage.

Drug and Alcohol history
Up and until he could not handle the breakdown of his family, he was already an alcoholic.  The more it got worse after his failures in his married life and career.

Behavioral Observation
The loneliness that has enveloped Ben Sanderson has been so imminent from the beginning of the story.  He easily just talks up any prostitute to join him somewhere.  It was also depicted that his financial resources are always at the ebb.  He had to borrow money from friends for his drinking spree.  The gratuity payment he received from his lost job was for purposes of drinking and drinking only.

In one scene with Sera, Ben Sanderson says:  n one You haven’t seen the worst of it. I knock things over… throw up all the time. These past few days I’ve been very controlled. You’re like some sort of antidote that mixes with the liquor and keeps me in balance. But, that won’t last forever.”

Mental States Observation
The mere fact that he openly accepts the termination of his boss from his job, he was even thankful for the gracious severance pay.  This is an illustration of being uncaring for one’s future.  But sine he cannot cope with his failure, so Ben Sanderson openly shows he is suicidal.  His purpose of moving to Las Vegas was to die.

Functional Assessment
The move/story immediately showed a Ben Sanderson already in pieces.  “…….[he] was imploding, rigid in his attempt to maintain control, to smile when he does not feel a smile, to make banter when he wants to scream. He needs a drink. ……. [he is] into the regions of hell. There will be times when he has the DTs, times when he must pour booze into his throat like an antidote to death, times of nausea, blackouts, cuts and bruises. There is a scene in a bank when his hands shake so badly he cannot sign a check, and we empathize with the way he tries to function, telling the bank teller whatever he can think of (“I’ve had brain surgery”). Yes, sometimes, he feels better, and sometimes we can sense the charm he must have had (we sense his boss’ affection for him even as he’s being fired). But for Ben these moments are not about pleasure but about the temporary release from pain.”  (Ebert, 2004)
Strengths

Ben Sanderson is still cognizant of one simple coherent thing in his life:  he needs someone to care for him.  And he needs someone to care for.  Considering, Sera is the one and only human being in his life in the course of the story, he focuses on her.  Yes, he feels a pure love that is needing and grateful.  He did not even have sex as premium in his mind.  He just simply wants a feeling of belongingness and togetherness.  It is somehow an act of humility that inspite of the suicidal nature of his life, Ben Sanderson exuded even a weebit of dignity by being a needing and concerned human being.

Diagnosis
Ben Sanderson is borderline depressed and

Treatment
Psychotherapy will play a major role.  The mere fact that there is still a tinge of lucidness in wanting and needing, Ben Sanderson could very well respond to psychotherapy.  Aid of pharmacological intervention will likewise augment the psychotherapy treatment.

Prognosis
Sera indeed recommended that Ben sees a doctor which of course Ben refused.  However, had there been a way for the said action been taken, there is very good hope that Ben could have surpassed even the extreme condition of his alcoholism.  Considering that Sera has eventually developed a deep sense of concern and a better prospect for their relationship, it will be a tool to bridge the hope for Ben Sanderson.
The DSM-IV Criteria

Ben Sanderson experienced clinical disorder that is substance related.  His anxiety disorder is alcohol induced.  The film illustrated clearly as such and the story simply illustrated the basic paradox in humanness in someone who is terminally hopeless.  No myths about mental illnesses was every portrayed or illustrated.

References:

“DSM-IVTM  Multiaxial System (Made Easy)”.  Psyweb.com

http://www.psyweb.com/Mdisord/DSM_IV/jsp/dsm.iv.jsp

“Leaving Las Vegas:  A Review”.  Roger Ebert.  April 25, 2004

http://www.rogerebert.suntimes.com/apps/pbcs.dll/article?AID=/20040425/REVIEWS08/404250302/1023

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