"Will & Grace" Character Karen Walker a Substance Abuser?

Another paper I wrote for a psychology class. It was kind of a fun assignment. We had to pick a fictional character and give them a possible diagnosis and treatment plan for an abnormal psychological condition. I chose Karen Walker from "Will & Grace" as my fictional character because I am a huge fan of "Will & Grace", and the character Karen Walker, played by Megan Mullally, has some obvious problems. Just remember this is about a fictional character, not the actress who played the character.

Alcoholism and drug abuse are serious problems. They not only affect the one who is abusing the substance but they also can affect those who have a relationship with the abuser. According to a recent study on alcoholism in the United States, about 1 out of 3 adults have had unhealthy drinking habits concerning alcohol at one point or another (Bower). Also, serious alcohol problems occur in about 5 to 10 percent of American adults while problems with illegal substances occur in about 2 percent ("Alcohol and Drug Abuse Prevention at Stanford"). Along with illegal drugs, some have problems with prescription drugs. Substance abuse can eventually lead to substance dependence. Karen Walker from the TV show "Will & Grace" uses substances, like alcohol and prescription drugs a lot and once in a while illegal drugs, it is possible that she could be abusing these substances, and maybe even dependent on them.

According to the DSM-IV checklist for substance abuse, one must have an unhealthy pattern of substance use that leads to significant impairment or distress, and also either substance use that often results in being unable to meet obligations at work, school, or at home, substance use that occurs repeatedly in situations where it can be physically harming, substance-related legal problems, or continuing substance use even though it causes social or interpersonal problems, within one year (Comer 281). This checklist allows one to determine if someone is abusing substances or not. If one meets the criteria on this checklist, then they are abusing a substance.

The criteria on the DSM-IV checklist for substance dependence is an unhealthy pattern of substance use that causes noticeable impairment or distress, and also at least three of the following: tolerance, withdrawal, taking larger amounts of the substance over a longer period than was intended, constant wanting for a substance or not being able to control substance use, spending a lot of time trying to obtain, use, or recover from the substance, using the substance instead of important activities, or continuing substance use even though it causes social or interpersonal problems (Comer 281). This checklist allows one to determine if one is dependent on substances or not. One who meets this criterion is dependent on substances.

Karen Walker often has a martini in her had or another kind of alcoholic beverage, and when she doesn't have a glass of alcohol in her hand, she has some kind of drugs, like prescription drugs. Karen is rich and a socialite. Some of her best friends are Grace Adler, Will Truman, and Jack McFarland. She works as Grace's assistant at Grace Adler Designs, even though she is rich enough that she doesn't need to work. Will is Karen's lawyer and Jack and Karen are like bosom buddies, always shopping together and hanging out. Karen has some rough times with her marriage to Stan, her second husband, and she has step-children from the marriage that she barely sees because her house staff usually takes care of that. Stan has an affair, and he dies. Karen is upset, but eventually falls in love with a man named Lionel. They get married but at the wedding reception Karen realizes she wants a divorce. Stan really faked his death and Karen feels extremely betrayed, and wants to forget about Stan, when he admit he faked his death, but eventually she gets past that and forgives him. Karen also has had a rough past with her mother. Her mother was a con artist and involved Karen in her cons when she was young; Karen despised her mother for this for years, but with the help of Jack, Karen and her mom were reunited but their relationship was still a little rocky. Also, Karen has had a rocky relationship with her younger sister, Ginny, who always blamed Karen for her accident, even though it was really Ginny's fault. Karen's main maid, Rosario, is also a big part of Karen's life; Rosario goes with her almost everywhere and helps Karen out a lot even if Karen is mean to her, but Rosario and Karen really do care about each other. Karen can be a bit insane, but she is a true friend. Her life seems to be good for her for the most part, despite some marital problems, but she almost always seems to have an alcoholic drink in her hand or she's popping prescription drugs into her mouth and sometimes washing them down with alcohol and occasionally she mentions the use of other drugs.

Since Karen seems to have alcohol or drugs on her often, here are some examples of Karen's alcohol and drug use. Karen always shows up late to work, usually close to noon, and she is usually drinking on the job. She has made many references about seeing double. In one episode Grace offered to baby sit a friend's kids and Karen came over to help; when Karen got to Grace's apartment she told her she brought juice boxes for the kids, which were really two big boxes of wine. Another time, Will, Grace, and Jack were all in Karen's bathroom at one of her parties, they accidentally knocked open a cabinet and hundreds and hundreds o prescription pill bottles poured out of the cabinet and on to the floor. Karen finds out one of her step-children made the swim team and she has to go to swim meets, so she shows up with a cup filled with an alcoholic beverage. Another time, Will is teaching Karen to drive and she mentions that it is a "flying car" and will questions her, "since when is this a flying car?" Karen replies, "It is when you've smoked as much as I have." There are many times Karen mentions she needs to call "pharmacist". Also, there have been numerous times Karen is seen washing down prescription drugs with a martini. There are many instances of Karen using prescription drugs and/or alcohol, and occasionally other drugs, so it is possible that she is abusing these substances and possibly even dependent on them. To diagnose Karen with substance abuse it is important to follow the DSM-IV checklist for substance abuse, and the same for substance dependence.

Substance abuse is a serious problem. What happens in one's childhood could help lead to substance abuse ("Substance Abuse"). Childhood factors that can lead to substance abuse are things such as poor parenting, hectic environments, overly aggressiveness or shyness in social settings, weak social skills, hanging out with the wrong crowd, and also thinking that the use of harmful substances is okay ("Substance Abuse"). There are also other possible causes of substance abuse besides factors from one's childhood. Some of the other causes may be biological, cultural, environmental, psychological, and also social ("Alcohol and Drug Abuse Prevention at Stanford"). It could be possible that Karen's excessive use of alcohol and prescription drugs could be environmental or social, like her marital problems with Stan.

The first part of the DSM-IV checklist for substance abuse is having an unhealthy pattern of substance use that leads to major impairment or distress (Comer 281). Karen does show signs of this first part of the checklist. She often mentions seeing double, because of all the alcohol she drinks. Also, she mentions being buzzed a lot too. These are both major impairments; they can affect her every day life. She won't be able to see clearly or think clearly with the amount of alcohol, prescription drugs and sometimes illegal drugs she takes.

For Karen to be diagnosed as a substance abuser, she also needs to have at least one of these problems within a year: substance use that results in failure to meet work, school, or home obligations, substance use that can be physically harmful, substance use that causes legal issues, and/or substance use that occurs repeatedly even if it is causing problems socially or personally (Comer 281). Karen does meet at least one of those. She works as Grace's assistant, but she is Grace's worst assistant ever. She is always late and drinking on the job, taking pills too. She sometimes passes out at work and doesn't answer the phone when it rings. Maybe Karen is just lazy, but the way she acts at work could be from her use of alcohol and prescription drugs. Also, Karen does use substances in physically harming situations. Many times she takes prescription drugs with a martini or a glass of gin, which can cause dangerous reactions or cause serious problems; many prescription drugs have warnings about drinking alcohol with them, or directions not to drink alcohol while taking the prescription drugs because it can be harmful. So, Karen does have at least one of the criteria needed for the second part of the DSM-IV checklist for substance abuse.

So, following the DSM-IV checklist for substance use, Karen does abuse substances. She is constantly using them, either drinking alcohol or taking handfuls of prescription drugs. She uses them carelessly and they affect her every day life; either seeing double, or affecting her day at work, or even putting herself physically harmful situations with her use of the substances. Karen Walker is a substance abuser.

Along with abusing substances it is also important to know if one has become dependent on those substances too. Dependence on substances is an addiction to them. When one is dependent on substances, they go through things such as tolerance to the substance and withdrawal (Comer 280). With Karen's frequent use of alcoholic drinks and prescription drugs, her substance abuse, it is possible that she also might be dependent on these substances too.

The first part of the DSM-IV checklist for substance dependence is the same as the first part of the checklist for substance abuse: having an unhealthy pattern of substance use that causes noticeable impairment or distress (Comer 281). Like stated previously, Karen does meet this first part of the checklist. She has mentioned often about seeing double or feeling buzzed, which are impairments that can affect her every day life.

The second part of the DSM-IV checklist that Karen needs to meet to be diagnosed with substance dependence is to meet least three of the following: tolerance, withdrawal, taking larger amounts of the substance over a longer period than was intended, constant wanting for a substance or not being able to control substance use, spending a lot of time trying to obtain, use, or recover from the substance, using the substance instead of important activities, or continuing substance use even though it causes social or interpersonal problems (Comer 281). Karen does experience tolerance to the substances she uses. She never seems to get drunk or have hangovers from her use o substances; at most she sees double, or gets a little buzz. Also, Karen cannot control her substance use; she continually drinks and takes pills. She also spends a lot of time drinking or popping prescription drugs; she does that when she should be working, or sometimes when she should be at work, which is using substances instead of doing important activities. Karen does meet the at least three of the criterion listed for the second part of the DSM-IV checklist for substance dependence.

Following the checklist for substance dependence, Karen meets the points on the DSM-IV checklist, so she should be diagnosed as dependent on alcohol and prescription drugs. Her substance use causes impairment, she is pretty tolerant to the substances she uses, she can't control her use of the substances, and she spends a lot of time using the substances and sometimes uses the substances instead of other activities that are important, or should be important. So, Karen is dependent on alcohol and prescription drugs.

Since Karen has a serious problem with substances she should seek treatment. Therapy is treatment for substance abuse and dependence problems. There are different kinds of therapy, like behavioral, biological, cognitive-behavioral, psychodynamic, and sociocultural (Comer 305). And although there are many different kinds of therapy for treatment, some treatments are often combined together (Comer 305).

One treatment plan for Karen could be psychodynamic therapy. Psychodynamic therapy focuses a lot on finding underlying issues or wants that could have caused the substance abuse and dependence (Comer 305). Since Karen has had some hardships in her life, there may be some reasons that she is unaware of that have led to her substance use. Karen had a rough relationship with her mother, a sister who blamed her for years and years for an accident that wasn't her fault, her marriage to Stan was actually her second marriage, and he also betrayed her, these could all have led to her problem with abusing substances. So, the psychodynamic therapy may help Karen realize what has caused her problems, but it may not be as helpful to stop her from abusing the substances. Psychodynamic therapy is said best to work when it is combined with other therapies (Comer 305). So, this type of therapy may not be the best treatment that Karen needs.

Another type of treatment that could help out Karen is cognitive-behavioral therapy. Cognitive therapy and behavioral therapy are both popular therapies and the combination of the two can help one better control their substance use (Comer 306). In cognitive-behavioral therapy there are a couple approaches; two approaches are behavioral self-control training and relapse-prevention training (Comer 306). Behavioral self-control training helps the substance abuser become more aware of their drinking habits and then they learn how to set limits and control their substance use (Comer 306). Relapse-prevention training starts of similarly to behavioral self-control training and they are also taught to plan ahead (Comer 306). Since Karen drinks so much and uses prescription drugs often, she should learn how to control her use of these substances. While these situations might help Karen control her drinking, it is not as successful with those who are dependent on substances (Comer 306). So, this might not be the best option for Karen either, since she is dependent on substances.

Biological treatments may be better for Karen. Some of the biological treatments can help when people are dependent on substances. Detoxification is a biological treatment that is a supervised withdrawal from substances and sometimes along with the detoxification therapy is also offered (Comer 307). These programs can be motivating to people and slowly help them stop using the substance completely; however, if one does not follow up with therapy or other treatment, relapsing is more likely (Comer 307). Since Karen is always using some substance, it is important for her to reduce the amount she uses and how she uses them, or even stop using them all together. Going through treatment like detoxification can help Karen reduce or stop her use of harmful substances. Another form of treatment that might be one of the better types of treatment for Karen is sociocultural therapy. Sociocultural therapies think problems come from social situations and should be treated that way also (Comer 309). Self-help programs are one of the approaches of sociocultural therapy (Comer 309). One self-help program that could help Karen is Alcoholics Anonymous. Alcoholics Anonymous offers support and guidelines to help people get past their alcohol problems (Comer 310). There are also other kinds of support groups too. There are support groups that are good for drug use too. Support groups like these could help Karen out. They will give her support that she needs to overcome her substance problems. They will help her get on the right track. Another kind of self-help that could help Karen is residential therapy centers. These centers are substance free environments where people can live and work and socialize without the influence of the substances that caused their problems (Comer 310). It is said that many people say these types of self-help programs have helped them change their lives and get them on a good path (Comer 310). Other types of sociocultural therapies are culture- and gender-sensitive programs and community prevention programs. Sociocultural therapies are said to be successful, and the most successful of them is community prevention programs to stop it before it starts (Comer 311). Sociocultural therapy might be the best kind for Karen. It can help her get away from peer pressure o drinking, and from influences, and it can also give her the support and guidelines she needs to help her get over her alcohol problem.

Karen is a substance abuser and is dependent on substances. She needs help. She needs to get treatment to help her with her substance problems before something terrible happens because of it. There are a couple different kinds of therapy options that could work for Karen, like biological, psychodynamic, cognitive-behavioral, and sociocultural. It is said that a combination of therapies is usually what works best (Comer 305). So, depending on exactly what Karen needs to help her with her substance-related problems, a combination of some of the different type of treatment may be what Karen needs to overcome her problems.

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"Substance Abuse." EMedicineHealth. 10 Aug. 2005. WebMD. 13 Aug. 2007 .