Home » Articles » Alcohol Use Disorder: A Psychological Perspective Case Study
Download PDF version of this article

Alcohol Use Disorder: A Psychological Perspective Case Study

LukeNotes, Fall 2022

Father Bob is a diocesan priest, much loved by parishioners and brother priests alike. He has served in both parish and service positions for the diocese, frequently at the same time.

In the last several years he has noticed feeling both physically and mentally exhausted. He seems to have less patience for the issues and people he must confront. He has also noticed a gradual demise of his spiritual life; he no longer engages in private prayer and is feeling cut off from God.

Others have noticed that Father Bob seems tired, and his smile is not as ready as it once was. He also seems more irritable with parishioners and brother priests. Office staff have had increasing difficulty locating him when needed. At first, they assumed that this was due to his heavy workload, but recently they have found him alone in the rectory in the middle of the day.

The office staff become concerned enough that they approach the bishop, hoping that he might relieve Father Bob of some of his many duties. The bishop is considering his options when things reach a crisis point; Father Bob slipped and fell at Mass and the parishioners who helped him up smelled alcohol on his breath.

Father Bob came to Saint Luke Institute for a psychological and spiritual evaluation. The bishop, concerned that Father Bob might be slipping into depression, wanted to get a complete picture of any mental health issues and recommendations for help strategies. The bishop mentioned the incident at Mass to the evaluation team, but only in passing.

The Saint Luke Institute evaluation team conducted a complete clinical assessment, including screening for symptoms of depression, other mental health disorders, and alcohol misuse. They found that Father Bob did indeed meet diagnostic criteria for a low-grade depression known as persistent depressive disorder. They also discovered that Father Bob’s use of alcohol had been increasing over the years as he dealt with the stress of his ministries and the workload of multiple assignments. The evaluation team diagnosed an alcohol use disorder, mild, meaning that Father Bob had two to three of the eleven possible symptoms. He was not addicted to alcohol but appeared to be headed in that direction.

The Saint Luke Institute evaluation team recommended that Father Bob engage in a course of outpatient psychotherapy in his home diocese with a therapist who was experienced in treating both mood disorders and substance abuse. This therapist practiced Cognitive-Behavioral Therapy, an approach to treatment that has good results for both depression and substance misuse. Together Father Bob and his therapist explored how some of the ways that he thought about himself and his role as a “good” priest might not be realistic, and he reframed his thinking along healthier lines.

Additionally, Father Bob discovered that he had classified some emotions as “good” and some as “bad,” and that he was not allowing himself to express or even recognize the “bad” ones. With the help of his therapist Father Bob improved in recognizing and expressing his full range of emotions. In addition to these recovery tools, Father Bob also made some changes to his lifestyle that included regular exercise, a healthy diet, and time with friends.

Finally, at the recommendation of the Saint Luke Institute evaluation team, Father Bob began regular work with a spiritual director to address the disconnection he had been feeling with God. His spiritual director helped him rebalance his spiritual life so that it was a source of strength and connection with God rather than something that was a source of shame.

Father Bob is like many who are eventually diagnosed with a mental health issue and an alcohol use disorder. His symptoms developed over a long period of time and for many years were not evident to either himself or others. Eventually the combination of symptoms reached a crisis point and others noticed. The diagnosis of both a mood disorder and an alcohol use disorder allowed both to be addressed in treatment. Additionally, Father Bob made lifestyle changes and addressed spiritual issues. Moving forward Father Bob now has a roadmap identifying danger signs that his depression may be returning or that his use of alcohol may be increasing to unhealthy levels. He also has a toolbox of coping strategies that he can use on a regular basis and when danger signs appear.

For confidentiality reasons, names, identifying data, and other details of treatment have been altered.