Case Study About Coprophilia and Substance Abuse

Running head: CASE STUDY ABOUT COPROPHILIA AND SUBSTANCE ABUSE

Exploration in to a possible linkage between coprophilia and substance abuse.

Micael Johansson

Pierce College

Abstract

This case study attempts to explore the correlation between coprophilia and substance abuse. The research seeks to determine the cause, effect, and treatment options for persons diagnosed with co-occurring disorders involving a paraphilia and substance abuse. The research is based on several interviews over a period of two months culminating in the hypothesis being created stating that “Persons acting out in paraphilia is of high risk for substance abuse.” The conclusions were drawn based on the answers given by the subject and the assessments done creating a time line that appears to suggest a correlation of the acting out behavior in early adolescence.

Exploration in to a possible linkage between coprophilia and substance abuse.

I - CASE HISTORY

1 - Background Information

Andrew is a 37 year old Caucasian heterosexual male. Andrew is currently working in the field of aerospace engineering having procured a masters degree from Embry Riddle Aeronautical University in Arizona in 1997. Andrew stated having had no past or current medical problems and states having no known allergies. Andrew grew up in Tucson, AZ and moved to California after completing studies to gain employment. Andrew's parents divorced when he was 8 years old and he reports being a single child. Andrew grew up in his mother's house and he reports being close with both of his parents today. Andrew states he is not aware of any mental health issues in his family but reports having 2 uncles being addicted to alcohol and his father being an addict. Andrew stated his father is now in recovery. Andrew reported having started to use marijuana and alcohol as a teenager and currently uses amphetamine frequently and reports using 3.5 grams weekly and reports he used amphetamine for the first time in college to be able to study. Andrew stated the main reason he started using drugs was because he felt like a freak being a coprophiliac and using marijuana and alcohol took away those feelings. Andrew states using drugs has now become the primary problem and he has found himself unable to perform work duties. Andrew states he still practices coprophilia but reports having no real consequences from this behavior. Andrew gave permission for his case to be studied and submitted himself for questioning to be able to gain insight into the cause of his presenting problems.

2 - Presenting Problem

Andrew has not been able to stop using amphetamine and is in risk of losing his job as he is not able to fulfill his work duties due to being under the influence at work. Andrew reported having issues with being a coprophiliac and stated he felt “ashamed” and “like a freak” and he has never been able to share this problem with anyone because of the guilt and shame this area of his life has caused him.

Andrew was screened for depression using the Beck's depression survey and scored an 18 and was recommended to attend a therapist or psychologist for further evaluation in regards to possible depression. Andrew completed an addiction severity index (ASI) and was deemed to be a suitable candidate for an intensive outpatient program (IOP) based on the score of 35 of 70.. Andrew stated he will make every effort to be abstinent from all mind-altering substances and will submit random urine analysis. Andrew appears to have been in the contemplative stage based on his own statements and appears to be ready to move into a preparation stage as evidenced by having not used amphetamine for the last 5 days.

3 - Diagnosis

AXIS I

304.40 Amphetamine Dependence

302.90 Paraphilia NOS

311 Depression NOS

AXIS II

V71.09

AXIS III

None Noted

AXIS IV

Impaired Employment, Lack of sober support

AXIS V

48

II вЂ" INTERVENTION

1 - Cognitive-Behavioral Approach

Andrew strive toward becoming congruent in his actions and words. Andrew states he no longer wants to use mind-altering substances or partake in coprophilia but is at present not able to accomplish his goals for treatment. Andrew is to explore the feelings associated and distinguish between rational and irrational beliefs he possesses regarding these two issues. Andrew is to verbalize the feelings and emotions he states have had a negative effect in his life leading him to feel inadequate and turning to the use of mind-altering substances. Andrew has had a hard time accepting himself and interventions has been made to work on attaining a positive self-image and Andrew has been invited to use positive self-affirmations. The difficulties in addressing the two issues simultaneously has been for Andrew to be self-accepting of his coprophilia and to realize the process most likely will be slow. Andrew has agreed to maintain abstinence from all mind-altering substances.

2 - Humanistic Approach

Andrew has expressed an interest in finding out the causes for the two problematic behaviors and has showed a willingness to be an integral part of his treatment planning. Andrew has been asked to self-define abstinence for him in regards to coprophilia and to work on eradicating the behavior if he deems it necessary and proper for him to do so.

III вЂ" Interviews

During two months Andrew and I sat down and Andrew answered questions about his presenting problems to form a time line, overview, and hypothesis.

What time do you remember first doing these behaviors?

“I started the coprophilia when I was 12 and I used marijuana and alcohol that same summer because I felt ashamed