• Read Case Study The Law Student
• This case is an example of a client who just entered treatment and is filled with defense mechanisms.
• Your task is to analyze this case, identify the client's defense mechanisms, and describe which theoretical orientation/orientations you would utilize as a counselor to counter these defenses.

Case Study: The Law Student

A 31-year-old white male law student in his fourth year of law school had a long history of experimental drug use including alcohol (his first drug), marijuana, and LSD, but at no time had he abused a psychoactive drug. Approximately two years ago he was introduced to cocaine in a social setting by a group of friends and fellow law students. He became a regular recreational user of cocaine and in a social setting during an evening would chop up and snort between 10 and 20 lines of cocaine in the usual fashion. (Often, as with this case, cocaine is used in a recreational setting along with alcohol and marijuana.) With this law student, the pattern of recreational cocaine use continued for some time, but moved to a more daily pattern when he found that the inhalation of cocaine stimulated his performance and ability to study at night, something he found desirable because he had begun to prepare for the bar examinations.

One evening, a female friend with whom he was periodically having sexual relations produced a needle and syringe and indicated that the injection of cocaine produced a pleasurable, orgasmic-like "rush." The law student injected the cocaine simultaneously with his female sexual acquaintance and found the orgasmic "rush" quite desirable. Over a several months basis he escalated his intravenous cocaine use on a daily basis, injecting from approximately 10 p.m. until 7 a.m., on a 15 minute to 1 hour repeated schedule, using approximately 2g of cocaine per night. Despite the fact that the law student was independently wealthy as a result of a family inheritance, he found that he was rapidly consuming his inheritance as his cocaine habit was costing him $50-150 a day. As a consequence he began dealing his own cocaine to his friends in order to help support his own habit. While the injection of cocaine involved both male and female figures, he would almost invariably inject with a woman in sexual context, although he reported that as he became deeply involved with cocaine, his libido dropped dramatically; for both he and his female sexual partners, the orgasmic effects of the cocaine injection became a substitute for actual sexual experience One evening, he injected a female friend in his usual fashion (he would first inject the woman and then himself). She suddenly had a series of seizures, became comatose, required mouth-to-mouth resuscitation and was subsequently transported to an emergency room. During this particular cocaine run, he also experienced the first evidence of cocaine psychosis, with auditory and visual hallucinations and extreme paranoia. The negative effects both to himself and to his girlfriend were quite shocking because he had believed cocaine to be as free of adverse consequences as marijuana. Because of these two episodes, he decided to quit cocaine use and seek treatment.