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Case study I: Mira’s story
Mira, a 23-year-old who identified as female, was transferred into her local AOD service’s opioid treatment program following her recent release from prison. She had been imprisoned for six months for assault and had been receiving methadone while in prison. Upon her release, Mira was living with her older sister. Prior to her incarceration, Mira had been using a range of substances, including heroin, amphetamines, benzodiazepines, cannabis, alcohol and tobacco. Her physical health was visibly poor.
During the assessment, Mira told her AOD worker that she had been raised by her mother and grandmother; her mother had experienced several episodes of depression that had led to hospital admissions. It also became clear that Mira’s mother had experienced domestic violence by her partner. Mira eventually told her AOD worker that this man had also sexually abused her, with some of the abusive episodes occurring before puberty. Over the course of her teenage years, Mira displayed episodes of anger and, although she made some close friends, she very quickly alienated them with either outbursts of anger or becoming ‘too close and clingy.’
Although Mira had several short-term relationships with men, she quickly realised that some of these relationships were the same as those formed by her mother and involved domestic violence. Despite this realisation, Mira experienced intense feelings of rejection at the end of her relationships, which led to her self-harming by cutting. She had multiple episodes of hospitalisation from self-harming and suicide attempts, the most recent of which was shortly before she went to prison. Mira told the AOD worker that while she was in prison, she had been diagnosed by a forensic psychologist as having BPD.
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