Therapy and Relapse: a Michael De Santa Headcanon (Grand Theft Auto 5)

Therapy and Relapse: a Michael De Santa Headcanon (Grand Theft Auto 5)


ORIGINALLY WRITTEN: February 2021

DISCLAIMER: I am not a psychiatric professional. I do have a degree and spent years studying the intersection between the mental health and correctional systems, but I am not a clinician or an individual with a lot of clinical knowledge.

CONTENT WARNINGS: Addiction, Alcoholism, Substance Use / Substance Abuse


Reviewing some of the therapy sessions that Michael attends with Dr. Friedlander in the game, there’s an interesting side to these sessions and the history that I really wish was more detailed and discussed.

It’s confirmed in game that Michael, at some point in time after moving to Los Santos, was actually being medicated for his behavior. The game obviously doesn’t go into detail and any medication names would be botched anyway due to the game using “parody names” (e.g. Los Santos = Los Angeles), so upon doing some joint research it was discovered that Michael most likely took Librium.

Librium is a tranquilizer (sedative) and Librium is the brand name for the actual drug chlordiazepoxide. Chlordiazepoxide is classified as a minor tranquilizer, which means that generally speaking it’s, alongside drugs like Valium and Xanax, used to treat general anxiety disorders.

Stronger medications (major tranquilizers) are used for paranoia, schizophrenia, and other stronger disorders which can lead to delusions. In the case of Michael, he ends up describing some side effects to Dr. Friedlander that match up almost identically to those of Librium, including:

But the true headcanon part comes from this idea:

“ Librium is also used to treat symptoms of acute (severe) alcohol withdrawal, and anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic. “

It’s fairly obvious in the game that when he’s stressed, the first thing he does is reach for the bottle (or for cigarettes if alcohol is unavailable). While not explicitly shown in the cutscenes and main storyline though, Michael is a frequent blackout drunk. If you take him to hang out with people, he gets wasted. Granted, they all do, but Michael’s case seems a lot more interesting when you consider some of the things he says in the moment.

The few instances that come to mind are mostly when he’s drunk with Franklin. Their dialogue is always fun to me because of the “wannabe dad” relationship Michael has with Franklin, but it’s especially so when drunk.

One time, Michael’s telling Franklin how he needs to stop getting so drunk and how he’ll never do it again. Another, he’s so drunk he’s actually experiencing the beginning symptoms of alcohol poisoning and believes he’s going to have a heart attack, on top of his entire body hurting and his cognitive functions beginning to fail. It’s also worth mentioning his father was an alcoholic as well, and it’s surprisingly common for that trait to be passed down through the generations.

On top of this though, as it’s relevant and somewhat discussed in his therapy sessions, we also know Michael is a frequent smoker and he has piss poor impulse control when it comes to his actions (hence, getting into messy situations and having to pull heists again).

Michael has an ‘addictive personality’ [EDIT: An ‘addictive personality’ is not a steadfast or concrete concept, but one of many explanations professionals may use to describe the phenomenon of addiction].

From this part forward, I’ll be referencing information from the American Addiction Centers (AAC) website, so if I quote something I will include AAC next to it.

People who have addictive personalities are varied in terms of actual personality, but they have similar and defining traits that hint they may be more likely to develop an addiction, such as:

I’m going to delve into two of these because they’re particularly applicable.

“Being Adventurous and Risk-Taking to the Point of Endangerment”

Individuals who like to take risks and who have little impulse control around experimenting and playing with new experiences and dangerous activities are more likely to try drugs. A study reported by Reuters indicates that this may have to do with the individual’s levels of dopamine and the brain’s sensitivity to it. People with high levels of dopamine in the brain may have a lower sensitivity to its effects, meaning that they need to have more intense experiences in order to feel the pleasure that this brain chemical causes. This, in turn, can be bound into the person’s experience using drugs and alcohol, which directly affect the dopamine system. In this way, the adventure-seeking, risk-taking personality can have a higher likelihood of experimenting with and, later, becoming addicted to these substances (AAC).

This all fits Michael.

Not only because he’s male (this portion of the addictive personality is more common in men, addictive women tend to be cautious and disconnected according to the Scientific American (AAC)), but because of the things he does. He doesn’t try hard drugs, he gets his kicks from crime (e.g., grand heists and cons).

“Unable to Self-Regulate”

As explained in an article from the University of Rochester Medical Center, studies are beginning to show that an inability to regulate behavior around the anticipation of receiving a reward is strongly linked to the development of addiction (AAC).

However, this is not the end of the issue. Individuals who pursue the idea of reward so strongly often do not experience as much pleasure from having gotten the reward as those who do not have this issue. This diminished sense of pleasure leads the person to push harder to win more in the hope that the reward response might be stronger. This, again, is linked with the person’s levels of, and sensitivity to, dopamine and potentially to other neurochemicals as well (AAC).

This is more displayed through his actions in regard to crime and heists. As the plot progresses, they get bigger. More risky and, in turn, more rewarding. This doesn’t help when it’s combined with Michael’s “stuck in the past” mentality. He constantly compares newer jobs to his prime days North Yankton. Michael is constantly trying to relive that high again, whether it’s by robbing the Union Depository, the FIB, or daydreaming about the incident by the pool.