by Lida Prypchan
When
a normal individual (normal being the term for average, not a value
judgment) gets drunk, he displays a statistically average form of
behavior, called normal or simple inebriety. This
is characterized by a change in mood (which becomes expansive or, less
frequently, depressed), behavior, attention, and in motor function. It
has three phases. The first shows a pattern of hypomania: the
individual is euphoric, abnormally talkative, care free, mentally agile,
and intellectually hyper productive, but this is accompanied by a
decrease in self control, as well as in attention and vigilance, which,
together with the release of his inhibitions causes him to speak
tactlessly. In a second stage there is incoherence of speech, the
faculty for self-criticism decreases or disappears completely, motor
coordination is impaired (difficulty in articulation, unsteady gait and
clumsy gesticulation), swings in mood increase: he is easily offended,
flies into rages, sings, and displays general sensory hypoesthesia. In
the third phase the subject collapses, vomits, his breathing becomes
labored, his breath smells of acetone, his reflexes diminish, his body
feels anesthetized and he may become incontinent. After sleeping for
several hours he wakes up quite normal, unless ingestion was excessive,
in which case he passes from a coma to complete collapse – or a better
life. Preceding these phases is the pre-clinical phase, where
alcoholemia reaches 0.80 gr/l. In this phase the individual does not
display symptoms, but if tested psychometrically, alteration in sensory
function and decrease in sensory motor activity can be observed.
The
difference between simple and complicated inebriety is in the intensity
of the latter, namely a quantitative difference, since complicated
inebriety presents the symptoms of simple inebriety but in a more
exaggerated form.
Biochemically,
the pre-clinical state is considered to occur between 0.5 to 1 gr/l of
alcohol; inebriety at 1 gr/l; between 1 and 1.5 gr/l signs of
intoxication are evident; between 1.5 and 2 gr/l there is a state of
intoxication; above 2 gr/l intoxication is deep, the lethal dose between
4 and 5 gr/l.
Pathological
intoxication, as differentiated from the simple and complicated forms,
is displayed in individuals whose constitution is so predisposed,
suffice to say that it is typical among neuropaths, hysterics,
schizophrenics, epileptics and psychopaths. It can also, however, be
caused by abuse of alcohol (in chronic alcoholism), by
cranioencephalitic traumatism, severe cerebral illness, syphilis etc.
There are six main characteristics of pathological intoxication: 1)
the insignificant amount of alcohol which is necessary to unleash it; 2)
the almost immediate surrender of oneself to the consumption of
alcohol; 3) its duration, either very short or very long (up to 24
hours); 4) extreme violence, which is why homicidal assaults, pyromania,
rapes, exhibitionism and pederasty are frequent; 5) almost entire lace
of recollection afterwards of what has happened) tendency for relapses.
Pathological
intoxication can be classified into three types: excitomotory,
hallucinatory, and delirious. In the excitomotor type, the individual
is possessed for several hours by an uncontainable fury, he brushes
everything aside, strikes out in any direction, gesticulates
threateningly, and displays great anguish on his face with bulging eyes
and fixed stare.
In
the hallucinatory form, the subject lives his visual or auditory
hallucinations, confusing them with reality, as is the case in delusions
of flagrant infidelity, of massacres, threatening gangs, with the
possibility of impulsive homicidal reactions. The third form is the
delirious form. Here confabulation preponderates, with four main
themes: self-accusation, megalomania, jealousy and persecution. In
delirious self-accusation, the drunkard goes to the police station to
denounce himself for a crime which is currently in the headlines. In
these cases it is necessary to guard the individual from suicidal
impulses. In megalomania the drunk presents himself at the presidential
mansion, demanding entry because he is the President. When the theme of
his delirium is jealousy, the victim can see and hear his wife’s
lovers. In these cases the person to be protected is the wife, since he
may kill her (and since all this can happen so quickly, it would be
advisable for the wife to have a scooter around the house too). When
the delirium is persecutory, the individual seeks protection desperately
from the police, since he feels threatened by a gang of crooks that
wants to trash him, and he may in his panic have defensive and
aggressive reactions.
This
article is not entitled “Drunk with Love” by chance, since as I was
writing it I found similarities between the stages of falling in love
and the phases of drunkenness. In a love affair the conscience recedes
into the background, resembling a pattern of hypomania: the individual
is euphoric, abnormally talkative, carefree, mentally agile (unless
revealing severe mental retardation), intellectually hyper-productive
(works and thinks better), but at the same time self-control is reduced
(saying inappropriate things like “if I ever stop loving you I will give
you an income for life”), attention and vigilance diminish (he doesn’t
notice that his future mother-in-law is intolerable and will make life
impossible for him). In a second stage after marriage, two things can
happen: either compatibility or mutual tolerance prevail in the
relationship or, what happens in the majority of cases, incompatibility.
If the latter occurs, one observes verbal incoherence, decreased or
zero facility for self-criticism in both persons, impaired motor
coordination (stammering, prolonged silences, staggering gait upon
arriving home at dawn and clumsy gesticulation during explanations), and
increased swings in mood (morning irritability and evening
irascibility) interspersed with periods of reconciliation which again
suggest a pattern of hypomania.
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