Social or anti-social drinker? Dangers of emotional drug use.

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Using drugs to regulate emotions is a high risk behavior.

A Kranz (wreath) of Kölsch beer.

We have all heard and seen the use of drugs, especially alcohol to alter mood. Media has bought in to this and it is a common perception. If you feel badly then you need a drink.

This is the worst possible way to use any substance.

People who are sad drink, to cheer themselves up. The angry person has a few to calm down why doesn’t this work?

Absolutely drinking and other drugs can change the way you feel. You feel a little down so you have a few. For a while you feel better. That drinking makes you forget why you were down in the first place. Then it wears off.

As the alcohol wears off the feeling returns only now you have the consequences of drinking, money spent, maybe a hangover, maybe just an empty feeling that you are sad and nothing is getting better. So you need to drink again.

Each time you drink you feel a mood swing. When it wears off your mood moves back where it came from. Once you learn the mood swing that accompanies use of your drug of choice it is reliable. Too reliable.

Over time, as tolerance builds it will take more of that drug to get the same feeling. Or the same amount will do less. Either way the tendency is to do more, drink more to try to change the way you feel. Each time the drug wares off you end up lower than where you were before you used.

Eventually you need to drink or use all the time if you want to keep feeling good or stay out of that blackness. Then something changes.

You find that when the drug wears off you feel worse than before. You need to drink a few now just to get back to where you started. Eventually you will need to drink just to feel normal. Whatever normal is for you and for many of us that normal was the reason we started to drink or use in the first place.

At this point no amount of use will get you back to the feeling ok place. If only using and drinking could help you cope but at some point that substance that promised to be your solution, it has become your problem. Now you are drinking and using just to get by. You may reach a point where you can’t get back to normal anymore. Now you need some of that hair of the dog that bit you just to be able to function at all.

 People who use alcohol because they are angry find that once drunk they lose the control of their emotions. That alcohol, it reduces inhibitions. A couple of drinks makes you social in the beginning but later a few drinks can make you antisocial. Under the influence, disinhibited, you may do things that you never would have done sober.

That person who needs as few to get up the courage to say what they think is now acting on that suppressed rage. One survey concluded that the vast majority of people in prison were drunk or high in the 24 hours before they committed the crime that sent them away.

That supposed friend that was helping you cope, your drug of choice, has it become the reason you are in jail or homeless?

 People who are sad. Who drink to cheer themselves up, find they can forget their troubles for a while but eventually those troubles find them. And now those troubles have become worse because of failed responsibilities and things done and said while under the influence.

We know that people who are sad and depressed who drink are 55 times more likely to attempt suicide. Often with completed suicides and overdose deaths there is alcohol in the bloodstream that reduced the inhibitions and permitted the act that brought this life to an end.

A single drink on a social occasion may make for fun. But if you find you need that drink to have fun, that without the drink or the drug your life is full of emotions that you just can’t stand, then that drink or drug is not your friend any more, it has become your tormentor.

Having to drink or use to regulate emotions places you at high risk for addiction. Alcoholism, suicide or homicide. It also can induce mental and emotional illnesses or make a preexisting mental health problem significantly worse.

You can’t learn much when unconscious and those emotional regulation lessons you learned while under the influence, there is a strong chance that you got those emotional lessons wrong.

Drinking and using for emotional reasons can take you in a really bad direction. 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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Emotional Chameleon or naturally empathetic?

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Do you soak up others emotions like a sponge?

Emotional Chameleon

If you find that the way you feel changes when you are around certain people you may be an emotional chameleon.

Emotional chameleons have difficulty identifying what they feel and as a result they are at risk to assume the feelings of those they are around. They were feeling fine when they entered the class room but within a few minutes they have adopted the sad feelings as well as the behaviors of someone who came to class depressed.

We are all affected by the feelings of others around us but the emotional chameleon is unaware that they are changing emotional state throughout the day as they move around others and adopt the feelings of those around them.

Be careful who you hang with, you might catch their emotions as well as their behaviors.

Some people are naturally empathetic. That is not the same thing as an emotional chameleon. The empathetic person can see and sense what others around them are feeling. The can understand what that person is feeling and behave appropriately.

Some people just are not good at empathy. Someone comes up to you and there are in tears, you might ask what is wrong. They tell you that a family member just died.

Someone with low empathy might make a joke about the funeral home should be running a two for the price of one sale with all the deaths going around. A more empathetic person might respond with some conversation about how this person was handling the loss and how can we all be supportive. The emotional chameleon will start crying and tell this person all about the deaths in their family going back to the turn of the century.

Counselors are trained to be empathetic, that skill of being with the other person and picking up on how they must be feeling. Humans have mirror neurons that help us understand what the other person must be feeling. This helps us to behave appropriately and promotes social connection if you pay attention to the other.

The empathetic person can understand what the other person is feeling without being swept away by the feelings.

Not so for the emotional chameleon. They quickly take on the feelings of the others. It is as if they have no feelings of their own and they need to absorb others emotions to know how and what to feel.

If you find that you are particularly sensitive to others feelings there are several things that you can do to keep yourself grounded and avoid emotional contagion.

Learn to identify what you feel and distinguish this from what others around you are feeling. This process of work with feelings begins by noticing that you are feeling something, find the place in your body that you feel this thing. Next identify that feeling. This means studying feelings and developing a vocabulary to identify them when you have them. Lastly learn to vary you responses and behavior depending on what feeling you are having.

Having strengthened you own feelings system you will be at less risk of catching someone else’s emotion. The more you know about you feelings the better you will be at being empathetic and understanding what others are feeling without having to catch your feelings from others in order to feel.

This also allows you to be with someone who is having a negative feeling without having to take that feeling as your own and take it home with you.

Are you high in natural empathy or are you an emotional chameleon who is at risk to catch another feeling from someone else every time you change locations?

David Joel Miller, LMFT, LPCC

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

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What is Alcohol and Drug tolerance?

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Illegal Drug Addiction and Substance Abuse

Illegal Drug Addiction and Substance Abuse (Photo credit: epSos.de)

 

When it comes to drugs and alcohol tolerance is not a good thing!

 

If your doctor, psychiatrist or counselor has begun to talk with you about tolerance and your drug use this is a bad sign. The concept of tolerance when applied to drugs, and alcohol is a drug also, is a very different idea than when applied to civil rights.

 

Alcoholic tolerance does not mean that you are OK with a drunk sleeping on your lawn. It also does not mean that you are good with sleeping on other people’s lawns on the night you are too drunk to get home. Tolerance for the ill person is a commendable thing. Building up tolerance to a drug of choices is not.

 

If your body develops tolerance for the drug, that is a serious problem.

 

From here on we will use the definition of drug as “anything that goes into your body and changes functioning or thought that is not food.” So yes Alcohol is a drug and so are prescribed medications whether you have the prescription or not. Remember also that this is written from a counselor’s perspective so if you have questions of a medical or legal nature ask your doctor or lawyer.  

 

Alcoholic tolerance is about the ways in which your body and your mind become accustom to the presence of alcohol or another drug of choice. As a result of having lots of this drug in your system you begin to change from the inside out.

 

Tolerance along with Withdrawal are two of the hallmark, identifiable characteristics of addiction or alcoholism. Doctors might define this as chemical dependency but the concept is essentially the same.

 

Tolerance is that natural adaptive skill your body has to resist things in you that are not normally there.

 

So the first time you drink you will have low tolerance. Once the liver has experienced the presence of alcohol it will ramp up and begin to produce more of the enzymes that break down the alcohol. Each successive time you drink you will need more alcohol to feel as drunk as last time. Over time you will develop a tolerance that means you can “hold your liquor” better and better.

 

This ability to “Hold your liquor” or other drug is not a good thing. It indicates that your body is already changing as a result of use.

 

As you develop higher tolerance you will feel less drunk or high than before resulting in a need or desire for more of the drug to get that same effect that you used to get.

 

For some drugs this is described as “chasing the high” as users find that they can never recreate that first using experience. Over time you will need more and more drug to get the same or similar effect and the same amount you used to use will produce less and less of an effect.

 

This does not mean that the danger from use is declining. Just the opposite.

 

 I have worked with clients whose blood alcohol content (or level) was above .32 (read as point 32). Since .08 is legally drunk in this sates that person is drunk enough for four people.

 

They were talking and walking around just like any normal person, or close to it. How? Because this person practiced drinking on a daily basis. Does that mean that they were ok? Not a chance.

 

While they may be able to talk coherently and even walk a line close to the way a non-intoxicated person would, behind the wheel they would hit anything that was out there, on the road or not. In that condition a person who is driving has been known to drive right in to the tail lights of a parked car not recognizing that the car was not moving.

 

People in this state of high tolerance can and do die without ever realizing the risks.

 

Lots of heroin overdose deaths are a result of this tolerance phenomena.

 

A person has a certain level of Heroin use, overtime they need to increase the amount they use as their body builds tolerance. One day they get arrested. They are in jail for a while, say thirty days. Over that time the body resets. Their tolerance to their drug of choice goes down.  

 

Now they get released from jail. When they get home they find that packet of drugs they had tucked away. They use exactly the same amount of the same drug as they were using the day before their arrest. They overdose and if medical attention is not fast enough they die.

 

Why did this happen. Because over the time in jail while they were not using their tolerance declined.

 

So if you stay off the drugs for a while then your tolerance will decline and you can start over using a small amount occasionally? Lots of alcoholics think this way. Give them a year of not drinking and they think they are cured and can safely drink again.

 

What we are told is that once the body increases its ability to neutralize that drug of choice that increased capacity may take a vacation but it is still there. An alcoholic who has not had a drink for 5 years can develop the same tolerance and use pattern they had before they quit in days rather than the years it took the first time.

 

Tolerance even after a long period of not using comes back fast and strong.

 

The moral here is that if you have begun to develop tolerance or have used long enough to have this result you will probably never return to safe use.

 

This tolerance effect explains why some prescribed medications need to be increased in dosage after a period of use. Sometimes doctors have to switch meds if you build up too much tolerance to one medication.

 

Not every drug results in tolerance at the same rate. Some drugs can be used for years and little or no tolerance develops. Other drugs the tolerance develops so rapidly that if you use the drug one day it will have no effect on you the next day. I won’t tell you which drug that is but those of you who use it know what I am talking about.

 

I should also point out that most street drugs, drugs of abuse, are much more likely to produce rapid tolerance and the resulting addiction than most prescribed medications but there are exceptions to that rule.

 

When in doubt about the physical signs and symptoms of tolerance consult your doctor. If you are having behavioral or emotional issues as a result of using to the point of tolerance then consider treatment or counseling. 

 

This discussion about tolerance has focused on changes in physical tolerance. There are also characteristic mental and emotional changes that can occur as a result of drug use. For more on those mental health issues look under co-occurring disorders in the list of topics this blog covers.

 

David Joel Miller, LMFT, LPCC 

 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

 

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Finding the recovery door

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Why this time recovery just might take

Recovery Door

Recovery Door

“This program has really helped me” the client said. I had to wonder why. They had been in several programs before and none of them had worked. I thought of all the usual reasons.

We like to think that every client needs to be ready. The old way of thinking about that was to say that people need to “hit bottom.” The assumption here was that until things get really, really, bad you might not be willing to give up that familiar problem.

This hitting bottom idea is most often applied to people in substance abuse recovery but experience has taught me that the same process of looking for and finding recovery happens to those people who have a mental or emotional issue. Sometimes people have both.

One person’s bottom may be getting arrested for a DUI or being so anxious they miss work again and lose their job. For another person their bottom may be total loss of family, friends and job. Some people find recovery when they are homeless, some not even then.

So when I see someone who has been through various programs I always wonder what will be different this time. 

“I knew there was recovery out there” the client replied, “but every time I got to the recovery door I just didn’t go in.” I knew they weren’t talking about programs or even about the number of therapists they had seen. That list was in the file and there were plenty.

“What door?” I asked.

“The recovery door.” The client said again. I knew there was recovery behind that door but I was just afraid to open the door and go through it. That would mean changing my life and when I got there I was just afraid of what else might change so I never walked through and entered recovery.” They explained.

In recovery it takes whatever it takes for someone to be ready to walk through that door. It doesn’t do any good to try to pull them through the door kicking and screaming. The best I can ever do is hold the door open and let them catch a glimpse of recovery. Maybe they will build up some desire for this thing called recovery, especially when they see others who look like them who have found recovery.

I have heard other ways of saying this. The metaphors may be different but the sentiment is the same.

People go to programs and they get a set of “tools” then they don’t take those tools out of the package and get them dirty. They don’t use the recovery tools to solve their problems.

We get close to that door to a new life and then out of fear of the unknown, we are afraid to make that last step and walk through the door into a new happy life.

Is there some life change you need to make to find your recovery? Do you need to reach out for help? Should you be attending a program or a self-help group?

What do you need to be walking away from and what should you be moving towards?

No matter how long it takes to get there are you finally ready to walk through the recovery door?

Here is wishing you a happy, recovered life.

David Joel Miller, LMFT, LPCC  

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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Armed Forces Day – today is one of 52 Armed Forces Days

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Today is Armed Forces Day here in the United States of America.  

Fifty Two different countries celebrate Armed Forces Days, though on different dates. In the U.K the date moves around, mostly late June, and so does the places of celebration. Australia and New Zealand celebrate a similar day on April 25th.

In some places Armed Forces Day is merged with Veterans Day or Memorial Day.

The purpose of Armed Forces Day is to honor those who serve in the often difficult job of protecting and defending their countries.

Our American Armed Forces Day was created in 1949 when days devoted to the various branches of the military services were merged to create one overall day the whole country could celebrate.

In times of war it is easy for us to remember our Armed Forces. When we are under attack they rise to the front of public view.

Unfortunately we have learned that as soon as the crisis passes the public quickly loses sight of the role of the Armed Forces. While the public quickly forgets the members of the Armed Forces will remember their time in the service throughout their lifetime.

In times of peace members of the armed forces are active in many ways. They are present in times of hurricane, flood, earthquake and all manner of natural disasters. They fight fires and keep the peace, both at home and at times in other lands.

Those who serve often pay a heavy price. The images of things they have seen may persist for a life time. Service can leave them changed forever. Some wounded warriors bear the marks of service on the outside and some carry those wounds internally.

Some wars are popular and some have been unpopular, either way the service and those who served can quickly fade from the popular mind.

For this one day, Armed Forces Day, regardless of where you live or when you celebrate the day, we all should seek to remember those who chose this path of service.  

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Why love and counseling don’t mix – ethical Loophole 4

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This time love is not the answer

We thoroughly enjoy our romance. Everyone can connect with the story of Cinderella and the price, wouldn’t it be nice if every commoner girl could find and marry her prince charming?

There is a whole category of books devoted to romance. There are plenty of films that script out the story of someone who finally meets this wonderful person who makes their life complete, and they live happily ever after. It is when we try to bring that fantasy into the real world that things go wrong.

Men, particularly older men have this fantasy, that should some woman, usually a beautiful younger woman, enter their life, they will have wild passionate sex and live happily ever after. As long as this stays in the world of fiction this may cause few problems.

When these fantasies make their way into the counseling room this looks less like a flowery romance and more like a fatal car crash viewed in slow motion.   

It is not unusual for a client to find they are falling in love with their therapist. They may be weak, vulnerable and needing love and affection. Clinicians are taught to be aware of this and to work on helping the client learn to love again without taking unfair advantage of the client and becoming that new romantic partner.

Some codes of ethics say that a therapist or counselor should never date or become romantically involved. Some set limits, 2 years, five years or more. The thought here is that after many years of not being in a professional relationship, then should you meet a former client on a cruise or at a school function you might establish a relationship. Even here the counselor is supposed to make a note in the chart indicating they thought about this, that enough time has passed and they believe this will not harm the client.

This is critical; will falling in love with former client harm them? By the way, ending therapy and giving the client a love letter saying call me in two years on date X and then we can date. That is just as bad as starting up the relationship while the counselor is still seeing them.

Given all these warnings why do counselors still engage in romantic and sexual relationship with clients?

Every time the new professional magazine arrives we see a list of professionals whose licenses have been suspended or revoked. Counselors who started using drugs or abused alcohol is always a big one. But right up there, sometimes in first place, are the reports of therapists that engaged in sex with a client.

Why does this happen? What is the ethical loop-hole that people stick their heads through that ends up straggling them?

Frequently this ethics issue begins with the counselor entertaining the notion that yes sometimes it is possible to fall in love with a client and live happier ever after. No they would not do it, but they can see how it might be all right sometimes for some counselors and clients.

This can also start with the idea that it is possible for a counselor to develop an outside social relationship, or friendship without it becoming sexual. Sometimes it starts with attending a social event, going to a movie or having dinner together. There are all the usual excuses, the client needs to feel safe going out, we are helping them learn to make friends or socialize.

But having once said that it may be OK to have some dual relationship with a client that sometimes it might be OK for some counselors and clients to fall in love and have a romantic sexual relationship, it becomes possible that this time, they and this client, that is one of those exceptions to the rule.

Once we start making exceptions, looking for loopholes, sooner or later we are at risk to put our heads through that hole. Why should we care if an occasional therapist has sex with a client, maybe the code of ethics is two strict?

We should care because those relationships are inherently unequal and have a serious potential to harm the weaker party, commonly this weaker person is the client.

Falling in love with a client, that one is always a bad idea. Beware the tendency to look for loopholes. Many an unwary counselor has tried to put their head through this one and ended up hung.

David Joel Miller, LMFT, LPCC

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

Should an addict take psych meds?

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Vincent van Gogh, The Starry Night. Oil on can...

How safe is it from someone in recovery from drugs or alcohol to take psych meds.

Many recovering people are worried about the effects of taking psychiatric meds on their recovery. The recovery community has long been divided on this issue. Here is some background on the topic and my thoughts as a professional counselor.

Any decision to take, start or stop any medication should be talked over with your doctor. There can be side effects, withdrawal effects and the effects of the medication can change over time as your body adjusts to the effects. Never make sudden changes to meds without talking to your doctor.

Unfortunately not all doctors are equally informed when it comes to the area of addiction and psychiatric medication. You need to be an informed consumer. Ask questions and talk these issues out with your doctor. Here are some things to consider in making your decision about taking psychiatric meds.

One long standing belief in some recovery circles is that if you are talking medication then you are not clean, you are still using a drug to alter the way you feel. I think this is a bogus argument.

If you have a medical condition and there is a med that will help you by all means take that med. Diabetics need insulin and using that should in no way interfere with or compromise your sobriety.

The more important question is not should you take them but are you taking your meds AS PRESCRIBED!

Two med compliance issues arise for people in recovery. One they tend to play doctor and one day they take the med then the next day when they feel better they skip the meds. Most meds and psychiatric meds are especially in this group; need to be taken every day. You need a certain level in your bloodstream to be effective. Taking them some days and not others can result in developing tolerance more rapidly, or can prevent building tolerance and can result in them not working correctly when you start taking them again.

Do not do the on and off thing with prescribed meds. Take them as prescribed.

Second problem – If one is good 30 should work better right?

If you find yourself boosting the dose, taking more than was prescribed, this is the dangerous path to addiction and problems. First most psych meds do not work that way. More is not better. The correct dose is what you need and only you and your doctor working together can figure that one out. If taking more of most psych meds makes you feel better, then this may be more a placebo effect than the meds. Talk to your doctor and your counselors about those issues.

As a counselor what can I tell you about psych meds and their risk for recovering people? Here are my thoughts based on experience for whatever they are worth. If this gets you thinking for or against, please talk this over with your doctor.

There are four main categories (based on use not chemical formula) of psych meds, Antidepressants, Mood stabilizers (anti-mania), antipsychotics and Anti-anxiety meds.

Let’s look at these one at a time and let me tell you what clients who have taken them tell me about the effects they have had on their recovery. I will sneak in a few things from the effects of drugs and alcohol on the body and the brain class I teach. For more on this topic check either “Drug Use and Abuse, Maisto, Galizio and Connors” or “Uppers Downers and All Arounders, Inaba and Cohen.” Any recent edition has good information.      

1. Antidepressants

These are NOT happy pills. The need to build up slowly over time and it can take 30 or 45 days to have an effect. You must take them every day as prescribed.

No self-respecting addict will take a pill today to feel better a month from now. No one in recovery has told me they had any problem with an antidepressant. If you don’t need them they just don’t do much and pass out of your system.

Occasionally someone will have sudden, week or ten days, response to an antidepressant this makes me think that the person may have bipolar disorder or that this is a medication induced hypomanic episode. If that happens talk it over with your doctor. This is rare in my experience though I suspect psychiatrists see this more than a recovery counselor hears about it.

Either way I don’t worry about clients in substance abuse recovery talking an anti-depressant.

2. Mood stabilizers (anti-mania)

Mood stabilizers are used to treat Bipolar and other mood instability problems. I am told they do not make you feel any particular way. They seem to just take the edge off.

Some of these have side effects that people find unpleasant. If you need them you need them if not you will not want to take them. Either way there is not a lot of abuse potential for recovering people.

3. Anti-psychotics

There are two main kinds of anti-psychotics the older ones or typical and the newer atypical. Some of the older ones are very sedating and they tended to be over used in prisons and institutions to keep people “zombie out.” If you like being stoned and nodding out all the time then you may want to discuss with your doctor taking the newer atypical anti-psychotics.

The newer atypical ones, no one has said they like how it feels enough to abuse it. Mostly they do not like the risk of weight gain that comes with these. If you take an anti-psychotic invest some time in diet and exercise and try to keep the weight off.

All in all anti-psychotics do not seem to be a big issue for those who are in recovery.

Not taking an anti-psychotic if you need one, is a major risk for relapse if you are in recovery.  Getting rid of or managing hallucinations or delusions are best done with prescribed medication and counseling not street drugs.  

4. Anti-anxiety meds

This one seems to cause the most problems for people in recovery.

If you need them, you really need them, and prescribed meds are a whole lot better than alcohol or street drugs for managing anxiety.

The worry with this group of meds is that many, (probably most) are tranquilizers. People can and do abuse these. So if you are one of those “the more pills the better” people, you will need to have that hard talk with your doctor about the risks and benefits of these meds. Let that doctor know you are in substance abuse recovery and that you are concerned about the effects of meds on your recovery.

Also with anti-anxiety meds take them EXACTLY as prescribed. Do not take extras unless the doctor has said it is OK and if they are to be used when needed try to get through as many things as possible without “needing” to take them.

Anxiety disorders are a time when social supports may be absolutely essential to your recovery. Whenever possible reach for the phone and talk with your support system before you reach for a pill.

There you have it, my opinion on psych meds. Most help and have low risk of abuse. If you need them, you need them, and do not be afraid to take them as prescribed. If you find yourself abusing them talk with everyone on your treatment team, the doctor and the therapist about these issues.

One last aside, those who do the best in recovery use every resource they can. Meds help but they will not do the whole job. You need a head change, a change in your way of thinking, and you need a good support system if you want to go the rest of the way in recovery.

Best wishes on your happy life.

David Joel Miller, LMFT, LPCC 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

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Pretending to be happy?

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How much effort does it take to try to be happy?

Happy Cactus

Are you one of those people who grew up trying to be happy, trying to look happy for a parent, for friends or those around you? Were you pretending to be happy but you never really felt it?

After long periods of trying to be happy, of pretending so that you don’t make others sad, you lose touch with how you really feel.

You may have despaired of every really feeling happy. Happiness for you was something you faked for others, but deep down inside you never really felt it. You began to wonder if you would ever genuinely feel happy the way others appeared to experience it every day.

For this effort to try to feel the way you should, the way others tell you that you should feel, you pay a high price. You lose touch; become disconnected, from how you are really feeling. You begin to doubt that you will ever have a genuine happy experience the way others do.

You may give up on happiness and opt for not feeling so much pain. You may use drugs or alcohol to numb out or you might disconnect from your feelings altogether.

One cause of this disconnect between your feelings and you, and there can be many causes, is those adults who did not validate your feelings. When you said you were sad they said you had nothing to be sad about. You began to question what you felt and what you should feel.  

Most of us know what anger feels like. But you may have been told that it’s not acceptable to feel anger, so you tried your hardest to feel an approved feeling. Before long you need others to tell you what it is you are feeling as you struggle to feel the way you should feel, rather than the way you do feel.   

Some of you gave up on the idea of feeling happy or content or accepted. Those positive feelings were beyond your reach. You opted instead to avoid feelings and to try to feel the way those around you told you to feel. You may have thought that you would never get there and tried to accept your lot as one whose role was to make others happy, not to find those feelings for yourself.

Over time this trying to feel the way you should and the denial of what you are truly feeling in favor of pretending to experience the feelings others ascribe for you, these behaviors extract a heavy price. You become increasingly disconcerted from feelings and your inside becomes empty.

There are solutions. You can find happiness. Acting in happy ways, doing things that you find enjoyable can help, but only if you stop pretending and let yourself feel what it is that you truly feel.

The road to happiness runs through you. It requires getting to know you, that fearless and patient path of self-exploration. Finding happiness also requires developing a palate of feelings that bring the color back into your life. With the joy and pleasure there will also be some pain and discomfort. But accepting that this is a real life and sometimes you will not like it is part of finding out who you are.

Be very cautious when other people tell you who you are, especially family members and those misery-loves-company friends. What they say is only their opinion. You do not have to create the things they tell you.   

Other people’s opinions of who you are and what you should feel are things they hand you, nothing more. Like things that they might pass to you in a restaurant, some are worth eating and some are already destined for the garbage. You don’t have to keep everything you are handed in the restaurant for the rest of your life. Some of it goes in the trash on the way out. Some things you use for a while and leave behind. Let others opinions of you be like something they pass to you over dinner. You decide if you want this or you will trash it.

Some things others tell us, like a napkin given at the dinner, may indicate they have seen a part of us that needs cleaning up. If two or more people tell you that same thing you may need to look at this part of you. Think about this for a while and see if they are right. But just because they hand you a napkin to wipe the ketchup off your face does not mean that you will have a dirty face forever.

Consider that you determine who you want to be and how you will get there. Along the way you are entitled to feel and think anything you want, as long as you don’t try to impose those thoughts on others.

Get to know yourself, accept yourself as just fine the way you are, but with the potential to be and do more and you will find that you just might discovery that true happiness, the kind you do not have to fake for anyone, around the next life corner. 

Are you ready to stop pretending to be happy and begin the hunt for a life worthy of the person you can become?

David Joel Miller, LMFT, LPCC

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

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5 motivation skills you should learn

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English: Handwritten words: "Motivation &...

English: Handwritten words: “Motivation & Emotion” (Photo credit: Wikipedia)

 

Attitude will only get you so far – you need skills to stay motivated

 

When people talk about motivation we hear a lot about some people having motivation and others not having it. Having a positive, motivated attitude is good, but that will only take you so far.

 

To get motivated and stay motivated you need some skills and these are abilities you can learn. Research suggests that simply wanting something is not enough; you need to develop the skills needed to make those dreams a reality.

 

1. Self-motivated people challenge themselves

 

People who are high in motivation have learned how to learn new things. To them a new situation is a challenge they know they can overcome because whatever information is needed they believe they can acquire it.

 

Self-motivated people seek out these challenges because they have the belief that if they try something they can accomplish it. This belief is built up over time by trying small things and being successful at them.

 

Self-motivated people may like applause or recognition from others, they may enjoy the money or recognition that comes their way, but they also are extremely pleased when they are able to do something that they have set out to accomplish.

 

2. Motivated people make a consistent effort.

 

Sprints won’t win any distance races and life is essentially a long distance race. Being highly motivated one day and getting a lot done pales next to the person who day in and day out does a little of what is needed to get the task done.

 

Lots of people start new projects, new businesses, school or relationships but they fail because they think that you can do it all in the beginning and then no more effort will be required.

 

To be successful you need to keep doing a little or more every day, whether you feel motivated or not.

 

Do some work on your goal and it will produce motivation not the other way round. Every writer hears the way to write is to sit with your rear in the chair and pound some keys. Eventually you will get something done. The rest of life is like that also. Do a little each day and watch the results add up.

 

3. Manage your time

 

Enough time for that great achievement will never come. Big projects get done one step at a time. Motivated people create a time budget just as they create a money budget. Each day includes some time for working on reaching your goal.

 

Don’t wait till you have extra time to write that book or start that business. Begin doing the foot work now. If all you have is thirty minutes a day, spend that on moving towards your goals and see what progress you can make.

 

4. Have a plan

 

Great achievements rarely happen by accident. Yes motivated people can make good use of opportunities when they appear, but they recognize those opportunities because they are already on the path to their goal.

 

Any achievement becomes more probably when you can break the task up into small steps and work on a little step each day. Make a plan and keep on the path towards your goal.

 

5. Continue to monitor your progress

 

If you follow a bad map you can get really lost. Some of us created plans for our lives and left steps out. This does not mean your life needs to be a failure. Any good plan needs frequent monitoring and revision. Keep an eye on the goal but keep checking your map to make sure you are headed in the right direction.

 

Work on these five skills and you will become a lot more motivated and can keep that motivation strong over the long course of life.  

 

David Joel Miller, LMFT, LPCC 

 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

 

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What sense of smell – odors – tells us about mental illness?

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Is there a connection between sense of smell and mental illness?

Improving memory

There is a body of research that tells us that there is a connection between sense of smell, your ability to recognize and identify odors and the chance you have or will develop a mental illness. There are also cases of olfactory hallucinations; smelling things that everyone else is sure is not there.

While this research suggests some connections, to me the articles I have read are short of conclusive.

An altered sense of smell has been linked to disorders as divergent as Schizophrenia, Bipolar disorder, autism and eating and feeding disorders.

One thing we do know is that the ability to identify an odor is not the same thing as the ability to detect one. People are more likely to like a smell they can identify and unknown smells are more likely to be considered unpleasant. Memory and its connection to smells are important for many reasons.

This is significant because smells are powerful memory cures. People who have poor ability to notice smells or to remember them are at a disadvantage in remembering things that might be associated with those smells.

The disorder most cited as having olfactory (odor or smell) impairment is Schizophrenia. More interesting yet is the repeated observation that males with schizophrenia are far more likely to have olfactory disruption than females (Nguyen et al, 2010.) These males with schizophrenia had disruption of odor identification, memory, odor detection abilities and poor odor discrimination, the ability to tell one smell from another.

Females in these studies rather than not being able to recognize or identify smells were more likely to smell foul or unpleasant things that were in fact not detectable to others. The conclusion was that women have more olfactory hallucinations and men more loss of ability to smell. 

Schizophrenia is characterized by negative symptoms, which are the loss of some abilities others have, as well as positive symptoms such as hallucinations. Someone with schizophrenia will likely have or experience social withdrawal, attention problems, difficulty making decisions, and perceptual problems.

People with schizophrenia also have high rates of olfactory identification problems, discrimination of smells, olfactory memory and olfactory detection errors, principally in males. Poor olfactory discrimination is also found in close relatives of people who have been diagnosed with schizophrenia even when those relatives have not received the diagnosis themselves.  

Olfactory identification problems do not appear to be found in people with Bipolar disorder, Major depressive disorder, other related psychosis or anorexia nervosa.

Olfactory hallucinations and discrimination deficits are seen in those with Alzheimer’s, and Parkinson’s diseases in addition to Schizophrenia.

One researcher reports that people with Bipolar disorder have some olfactory impairment but that they are less bothered by unpleasant smells that those people who have Schizophrenia (Cummings et al., 2010.)

In Autism olfactory identification is reported as impaired. Individuals who had been diagnosed with Autism preferred Lemon and Orange smells to lavender. They disliked most other strong smells. In Autism strong smells are linked to perceptions of taste and result in high rates of food refusal and selectivity (Hrdlicka et al., 2010.)

One condition of note is olfactory hallucinations. Some patients reported a foul smelling order coming from themselves. This odor was not detected by staff. This olfactory hallucination is referred to as Reference Syndrome and was reported in patients with temporal lobe epilepsy. Other olfactory hallucinations have been reported in clients with substance induced Psychotic disorder, Hypomania with Alcohol dependence combined with hypomania (Luckhaus et al., 2003.)

There does not appear to be any connection between depression and olfactory dysfunction (Scinska et al., 2008.)

Olfactory disregulation has also been linked to people who have frequent migraines, with over 45% of people experiencing migraines reporting odors are triggers for those migraines. In migraine suffers almost 25% had a fear of a particular odor and an equal number reported taste abnormalities when having a migraine episode. MRI’s showed that women were eight times more likely to have brain activation from odors. This makes one wonder if many of the issues with odor detection, memory and discrimination are more linked to gender than to a particular psychiatric diagnosis.

Other studies have reported significant episodes of visual hallucinations during migraine attacks and make the point that visual and auditory hallucinations are so pronounced and readily identifiable most people are not asked about and do not report either olfactory or gustatory (taste) hallucinations.

In people with schizophrenia 75% reported auditory hallucinations, 37% reported somatic hallucinations while olfactory hallucinations were reported by 18% of the patients which is slightly more than the 14% who reported visual hallucinations. Despite being so common, few clients report olfactory hallucinations and clinicians are not generally looking for them.

While people with schizophrenia may experience hallucinations in all modalities, providers frequently stop asking about hallucinations after the first or second reported hallucination.

Researchers find that people who report being under “stress” are more likely to have experienced olfactory hallucinations and one study concludes that stress may lower the threshold for hallucinations of any type.

Because the major part of the olfactory sensing part of the brain is on one side of the brain researchers have suggested that there may be a difference in the way in which left-handed and right-handed people experience olfactory hallucinations.

While olfactory hallucinations are readily identifiable in people who have migraines they are less identifiable but more likely to be described as unpleasant in those with epilepsy.

While we still can’t use olfactory or gustatory hallucinations or dysfunction as makers for a particular mental illness, we know abnormalities in the sense of smell and taste may be factors in the development of a mental or emotional problem.

Have you experienced an alteration in your sense of smell or taste and no medical reason has been found? Care to share?

David Miller, LMFT, LPCC 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog there is also a Facebook authors page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. 

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