Monthly Archives: August 2012

What are V and Z codes? – Things insurance doesn’t cover

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Why are there counseling things that insurance does not cover? V and Z codes.

There are lots of life’s problems that need attention, but they don’t fit neatly under our definition of a mental illness. As a result, most insurance providers won’t pay for treating these problems or if they do there are severe limits on the amount of counseling that you can get for these issues.

These everyday problems that can derail someone’s life get a “V” code. That does not mean they are not important, but it does mean that generally, we don’t see them as an illness, more like a challenge the person must face and overcome. There are over 20 of these “V” codes. (In the DSM-5 this list has gotten longer.)

Some of these are the kind of issues that make the news, the partners who kill each other, and the extreme cases of child abuse. They need treatment but we can’t say that every couple who fights is mentally ill. What we can say is that killing your spouse is not normal or acceptable.

Conflicts with other people are a big part of this, Partner Relations problems, sibling relational problem, parent-child relational problem. These conflicts can cause a lot of damage and they need treatment. Marriage, family, and child counselors specialize in just these issues. The list of relation problems goes like this:

Partner Relations problem

Sibling relational problem

Parent-child relational problem

Relational Problem related to medical or mental disorder

Other Relational Problem

There are life-stage issues we all need to navigate. Some of us move through these concerns with no problem. Other people struggle with one or more of these issues. Each of these can become a reason to see a counselor and they do not mean there is anything wrong with you.

Occupational Problem

Academic Problem

Acculturation Problem

Phase of life Problem

Religious or Spiritual Problem

Bereavement

Borderline Intellectual Functioning   

People who injure others need treatment. Sometimes they are required to go for treatment and may even be made to pay for that treatment. Victims of abuse, neglect or violence get a special status in the DSM and their treatment is found under the 995.xx codes, which are almost always paid for by society. The person doing the abuse or neglect gets the “V” code and mostly has to pay for their own treatment. The categories of misbehavior towards others that may be the focus of treatment include:

Neglect of a child

Sexual Abuse of a child

Physical Abuse of a child

Physical Abuse of Adult

Sexual Abuse of Adult

The last group of things that may need attention but don’t get counted as full mental illnesses are things that people do, other than abuse or neglect, that we as a society do not like. This includes things like career criminals who know what they are doing but do the crime anyway. The term “Behavior” is used here to differentiate those who don’t know that what they are doing is wrong or can’t control themselves as in Antisocial Personality Disorder vs. those who know it is wrong and do it anyway, as in Antisocial Behavior. These items include:

Adult Antisocial Behavior

Child or Adolescent

All these things and many more may be good reasons to see a counselor or therapist even if you don’t have a diagnosable mental illness.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What if you go to the hospital drunk or high?

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What if you go to the hospital drunk or high?
Photo courtesy of pixabay.

By David Joel Miller.

Hospital emergency rooms are filling up with people under the influence.

This is causing a whole lot of problems for hospitals, the emergency room staff, and society in general. There is no special reason why someone needs to go to a hospital because they are drunk or high unless they also have a medical or psychiatric emergency.

They end up there because of the other problems drug and alcohol use cause to the person and to society. Often this happens because there is just no other place to send them. Hospitals do not function as an extension of law enforcement and patient privacy is strongly enforced so unless you are in prison when the emergency occurs don’t worry about seeking help because of the legal consequences.

People who are drunk or high are a lot more likely to slip, fall, or otherwise injure themselves. The emergency room staff is used to this and unless you broke some major law like hitting someone while driving drunk and you are already in custody, their goal is to get you patched up and out of there.

Some under-the-influence people really really need to be in the hospital.

If someone has the Delirium Tremens (DT’s), they need to be in the hospital, this is life-threatening. But most drunks are just a pain to the workers in the ER. They argue, try to go places, and do things that just get in the way.

Heroin and other opiate abusers need an injection to reverse the effects of the overdose, but most enlightened emergency responders carry the injection to do this on the ambulance so that by the time the patient reaches the hospital the emergency is over.

Drunks are most problematic because the alcohol impairs their judgment. They are often suicidal or violent. No not everyone who drinks gets suicidal or violent but many suicidal people abuse substances. A binge drinker is 55 times more likely to attempt suicide than a non-drinker.

Substance abusers make up a significant proportion of admissions to psychiatric facilities. While they are under the influence they are prone to be violent and irresponsible. Some of them are still suicidal or violent after the drugs and alcohol wear off and need further treatment.

Since we don’t know if the current psychiatric problem is only a result of the substance or do they have these issues at other times. Most suicidal, self-harming, or violent people who are under the influence end up staying until the drugs and alcohol wear off and they can rationally answer questions about their behavior and intent.

One very effective approach to this overflow of under-the-influence people filling up the hospital ER’s has been the creation of sobering centers.

Situated close to the hospital and under the supervision of medical staff, trained Para-professionals such as substance abuse counselors and mental health professionals can screen patients for medical necessity and supervise detoxification. These systems have worked well. Unfortunately, when budgets get tight, detox, as well as other services for substance abusers and the mentally ill, get cut.

At the time the need is the greatest detox and sobering centers are the most likely to get cut and throw their work back on the already overused ER’s.

Hospitals are also seeing a surge in irrational people as a result of synthetic drug use. (See 7 new drugs parents should be aware of.) Sometimes that psychosis goes away once they detox but other times it seems to be long-term and results in a psychiatric hospital admission.  Professionals are debating whether the new drugs are creating the psychosis or just a stressor that causes the first occurrence of the disorder.

I am convinced that drug use is damaging some brains and creating mental illness which would not have occurred without the drug use. I understand that not everyone agrees with this position.

So the conclusion to all this is that if you or someone around you is drunk or high and there appears to be a medical or psychiatric emergency you should go to the hospital and get checked out and do not worry about the police finding out about this as a result of your visit. If there is no medical or psychiatric problem and no past history of problems most people do not need to go to the hospital. When in doubt call 911, the doctor or hospital first, not your therapist or the social worker.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What if a client tells you they had sex with their last psychotherapist?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Couple

Sex?
Photo courtesy of pixabay.

Sex is not the cure – Morning Question #19.

Ethically this is never considered acceptable. If the client was a child we would report this as child sexual abuse. If they were adults they need to report this to the licensing board. In California, we have a nifty little book called “Professional Therapy Never Includes Sex.” We are supposed to keep this book handy and give it to anyone who tells us they had sex with a previous therapist. What they do about the situation is up to them.

One reason sex with patients is not considered acceptable is the trust clients put in their therapist to help them sort out emotions. Getting into a relationship other than the therapeutic one is likely to result in the therapist taking advantage of the client.

What to do about this situation generally is up to the client, not the new therapist. Laws could, of course, be different where you live but second relationships with clients are considered unethical most everywhere.

More on this is here and info on what counseling should be is at Counseling as a novel relationship.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Pink elephants kill – Dangers of Delirium Tremens (DT’s)

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Inebriated people.

Alcoholism.
Photo courtesy of Pixabay.

Seeing bugs when drinking?

There are lots of jokes about people seeing things while drinking. Having Delirium Tremens (D.T.’s) is no joke.

Withdrawal from alcohol can be fatal. When we mention withdrawal from drugs most people think of the physical symptoms of heroin withdrawal. Kicking Heroin can make someone wish they were dead, but alcohol withdrawal is far more likely to kill.

Deaths directly related to alcohol each year exceed all the deaths from other drugs, legal and illegal.

DT’s occur when the drinker is withdrawing from alcohol as the blood level is declining. Before modern medicine was available up to one-third of alcoholics with DTs died during withdrawal. Modern medical treatment has cut that rate dramatically but people do still die while sobering up.

If the drinker has EVER had hallucinations or a seizure when drinking or detoxing they need medical attention and should be detoxed in a hospital.

Other symptoms of DT’s can include fever, shakes, and formication. Tactile hallucinations, bugs or snakes crawling over the skin are commonly associated with the DT’s. These symptoms are sometimes worse at night and can begin to occur days after the last drink as the body attempts to adjust to the absence of alcohol.

Any unusual symptoms that occur when an alcoholic stops drinking should be checked out by a medical professional.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

One problem limit – rationing emotional help

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Can you have too many problems to get help?

Ever feel like you are standing in the wrong line? You go to a place and ask for help only to be told we can’t help you with that problem you need to go someplace else. If you have a few too many problems you might get discouraged and stop trying before you found the place that could help you. You might die while waiting for help.

Systems used to be designed as if people only had one problem. You go to the specialist who handles that one thing. That almost never works, people have multiple problems.

So the system would try to sort people out by their problems. All the people with substance abuse problems go over there. You people with a mental illness you need to stand in that line. We had a line for everything. Lots of places still do.

People with co-occurring disorders, combinations of a substance use disorder and a mental health issue got used to this. You go to a treatment place for substance abuse and they tell you to go see mental health. You go to mental health and they tell you they can’t see you till you stopped using drugs. I would like to do that if only the depression and the voices in my head would shut up. So around and around you go.

So we set up a system where the mentally ill stand in line 1 and the substance abusers you stand in that line over there. The homeless go to another building and the unemployed go somewhere else. If you have a physical illness we send you to this doctor but if it is your heart you see the heart doctor and so on.

Most of us would like to think we are not like those people. We are not homeless or criminals. Until that day when you lose your job and then can’t find a new one.  If you stay out of work too long you might run out of money and have to choose between making the house payment and paying the registration and insurance on your car. But if you get stopped while driving to that job interview with no insurance or registration you might suddenly find yourself as a criminal. That might make you depressed and you might have a drink or two, maybe too many.

See how quickly these problems begin to add up. Multiple problems can be overwhelming to the person with them. They can also be too much to handle for the person who is trying to help them. I would like to help you but the agency I work for has rules and if you don’t do what I say you will not get any help.

One woman told me she was sorry for missing her therapy appointment last week, could I still please see her. Seems she was told by her welfare worker that if she did not come in that day they would cut off her welfare. The same day she got a call from the principal at the school telling her that her son was in trouble at school and if she did not come for a conference this afternoon they would be expelling her son.

Can’t understand why a kid who was sleeping on the floor at a friend of his depressed mother would be grouchy and argue with his teacher or end up in the office after talking back to that principal.

Now I don’t want to sound all negative, though some days that is more likely than others.

Some systems are making strides towards being more helpful and less territorial about controlling the clients. Substance abuse providers are offering mental health treatment and physical health facilities are providing substance abuse and mental health treatment.

Still, we have a long way to go before people who need help can get it wherever they go. As many of us have seen during this last economic downturn, anyone can be closer than they think to a whole list of problems.

SAMHSA talked for a while about the concept of “No wrong door.” That no matter which place you went, they should be able to help you and they should get you connected with the help you needed.

Then came this re-depression and we started locking doors.

Have you and yours been able to get the help you needed?

Care to share? What help have you needed? Has that help been easy to access or have you had to run from place to place and try to meet each program’s differing requirement to get services?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Hoarding – Could the brains of hoarders really be different?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Brain

Memory.
Photo courtesy of Pixabay.com

Hoarding is about to become a recognized mental illness.

Hoarders just can’t make decisions when it comes to their own stuff. They don’t have trouble evaluating other people’s things, just their own, according to a study funded by the National Institute of Health.

There has been a lot more publicity about this than in times past but I have to believe that there have always been hoarders. People who lived through the “Great Depression” (1929 not 2008) tended to keep lots of stuff because if you ran out of wire or nails there might not be money to buy more. That is not the sort of saving that gets diagnosed as hoarding.

There seems to be something uniquely different about the way the mind of a hoarder works. Even when outsiders come in and reorganize the place, dispose of the garbage, the problem is not solved. The hoarder faced with new stuff, today’s mail or leftover napkins and condiment packets from fast food, can’t make a decision about what to keep and what to save. The result is they keep everything.

Proposed for inclusion in the new DSM-5 the new “Hoarding Disorder” is a fairly straightforward diagnosis with only a few characteristics needed to make the diagnosis.

The characteristics needed, in my oversimplified explanation of this one are:

1. Can’t bear to throw things away whether they are worth saving or not.

2. They feel like they must keep it and get upset if forced to part with the item.

3. As a result of the hoarding, they run out of room, and can’t use parts of their home for what it should be used for.

4. Hoarding is causing them problems with jobs, friends, making them unhappy, or creating an unsafe situation.

5. No other reason, medical, etc., for this behavior, is found

6. This is not caused by another mental illness like depression or anxiety etc.

Points one to three are what makes this disorder different and points four to six are standard conditions for almost all diagnosis to look for other possibilities and make sure this really is a problem before making the diagnosis.

There appear to be two types of hoarders.

Those who are indiscriminate collectors and go out of their way to get new stuff, buying, stealing, and scavenging things even when they have no use for the item.

Those hoarders who do not go out of their way to get things but can’t figure out what to keep and what to toss after they get things.

Whichever type of hoarder you or a person close to you are, the hoarder needs help. Cleaning out a hoarder’s collection is a short-term temporary fix. Hoarders need help from a profession to change their thinking or the whole process of accumulating just keeps repeating its self.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

m.

Criticizing, complaining and asking for change.

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Talking to yourself

Communication.
Photo courtesy of Pixabay.com

Criticizing, complaining, and asking for change.

Communication skills part 3.

When something bugs us what should we do? When we are unhappy we are likely to react in one of a very few ways. Will you say nothing, become angry, or take a middle road and try to talk about the issue?

Some people say nothing and suffer in silence. For those people, we recommend assertiveness training. If you do nothing about a problem then you become part of the mechanism perpetuation the problem not part of the solution.

Some people react to annoyances by becoming angry and acting out. Even if the violent approach works in the short run it is likely to result in long-term undesirable consequences. An excessive response to a problem may wind up in you having to do an Anger Management class, going to jail, or permanently damaging the relationship.

In between is the “let’s talk about it” approach. Some ways of talking with the other person are more effective than others.

Criticizing is not communication.

Criticizing is the method most often used and least likely to be helpful. This method attacks the other person. You call them names for not doing what you think they should. Statements get made like “you don’t respect me, you are a slob or other personal attacks.

Criticizing does not make any friends. When we are criticized we are likely to become defensive and reply with our list of all the things the other has done. Criticize someone too often and they may stop listening altogether.

Criticizing cuts off communication rather than improving it or getting things to change.

Complaining does not help communication.

Complaining involves talking about how the issue is affecting you.  While a slight improvement over criticizing it rarely gets anything to change.

This is a recurring behavior in work settings where people complain about how they have to too much to do and saying others do not help and so on. It can become the standard operating procedure in some settings.

People who work as professionals in a complaint department know, or should know, the importance of listening to the customer’s complaint. Until the person feels their complaint has been heard nothing much is likely to happen to resolve that complaint. But eventually, the process needs to move beyond complaining.

Some relationship skill building programs suggest combining the complaining behavior with the next step, problem-solving, or asking for change. While complaining may be a way to tell the other person what is upsetting you, moving to the next step and stating the specifics you want to change are most likely to improve the situation.

Asking for change improves communication.

Of all the ways of dealing with problems, this is the most likely to improve the situation despite seeming to be the hardest thing to do.

Use good problem-solving skills. Ask for change and stay on the problem and how to solve it. The greatest chance for improvement is to find a solution in which both parties win rather than a win-lose situation. There needs to be genuine two-way communication, hearing, and being heard.

Making things better.

Make sure that when you have a problem with another person that you avoid the name-calling and the personal attacks.

Clearly, state the problem as you see it. Ask for specific changes such as not interrupting you when you speak rather than global things like being nicer.

Listen while the other person describes how they see the problem. Work towards understanding their point of view. Look for a solution that meets both of your needs.

More on communication skills can be found at:

Communication is not what you think

Just Being Honest        

Criticism, complaining, asking for change.

How are your communication skills? Are you criticizing, complaining or asking for change?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Just being honest – 5 times telling the truth is a bad thing

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Telling the truth.

Truth.
Photo courtesy of Pixabay.com

Not all “truth” is created equal – Communication Skills part 2.

As children most of us were taught we should always tell the truth, even when we knew the adults around us were not being truthful. In relationship counseling, we spend a lot of time on communications but improving communication does not always improve the relationship.

People who say they are “just telling the truth” find that their relationships suffer. Truth and honesty can build trust in a relationship but there are times when telling the truth can be both harmful and misleading.

Some people can say the most hurtful things, only to excuse what they have said by reporting “I am just being truthful.” People who use the truth defense are usually not so very receptive to having their partner reply with similar truths.

While telling the truth is a very desirable characteristic here are sometimes when the truth may damage relationships and may not be the “whole truth and nothing but the truth.”

When your version of the truth is an exaggeration.

Common statements, especially during arguments are “You always – You never, you are totally.”

Categorical statements are rarely, if ever, true. This way of saying things is meant to put the other person down and is criticism for criticism’s sake.

Criticism is a way of being hurtful and may cause permanent damage to the relationship. You don’t get to do this and then play the “I was only being truthful” card.

When you say it out of anger the truth is you are angry.

Things said out of anger are meant to hurt. Even if you avoid the exaggeration trap you are likely to say things laced with sarcasm and personal attacks. “Truths,” said in anger, are going to damage not improve the relationship.

Having hurt the other person they have no incentive to work on changing anything. When you are saying things in anger you are lashing out not looking for constructive resolution. Even if the statements were true, when you are full of anger, this is not the time to have that frank talk.

The truth-telling was all about you.

Sometimes “being honest” is about pointing out all the possible flaws in the other person in order to make yourself feel better about you.

Being honest is one thing, but there is no reason to blurt out every single defect you see in the other person. No one needs or wants that much honesty all at once. Think about the purpose behind telling someone the things you see wrong with them.

Is your honesty really about helping them improve or is it coming from a place of selfishness on your part? Honesty like meals needs to be spaced out over time as the need arises.

If you really want to be helpful talk only about as much of the person’s faults as they are ready to hear. Be sure you are not just doing these things to make yourself feel superior.

If the Honesty talk is all about the other person’s faults and you are not ready to own any of the faults this is not real honesty.

You can’t sleep at night or have an emotional hangover after truth-telling.

If after a binge of “ruthless honesty” you find you are unable to sleep at night. If you are emotionally drained for a while after the conversation then you might be experiencing an emotional hangover.

Telling someone off, like drinking too much, may feel good at the time but it is likely to come with the cost of an emotional hangover.

If you find you regret what you have said after an episode of “being honest” You know that the reason is the damage that what you said has caused to the relationship.

Excess of negative emotions, especially anger and fear will lead you to do things while emotional that you may regret afterward.

“It was true” may be a defense in a court of law but it will not make for happy relationships.

The other person is not ready to hear it – you need to use compassion.

Yelling at the deaf and showing pictures to the blind don’t aid communication. Telling someone more truth than they are ready to hear is only going to harm your relationship.

If you really want to end the relationship you don’t need to catalog the other person’s faults to justify your decision.

Remember to practice your compassion skill first and the honesty will have a place to grow when needed.

More on communication skills can be found at:

Communication is not what you think

Just Being Honest        

Criticism, complaining, asking for change

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Is stress a diagnosable reason for time off from work?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Stress person

Stress.
Photo courtesy of Pixabay.com

Stress and time off from work – Morning Question #18

Short answer – Yes, no, and maybe.

Yes. – Stress is diagnosable – IF the person’s reaction to the stress is extreme and they are unable to work, have relationship problems, or are upset about the way the stress is affecting them. It could be Acute Stress Disorder, Posttraumatic Stress Disorder, or possible an Adjustment Disorder.

No – not everyone who has stress at work should get a diagnosis. Everyone has some stress, even good things like a new job or a promotion can be stressful. So just having stress is not enough for the diagnosis.

Maybe – Maybe you can take stress time off with pay, maybe you won’t get paid for time off.

Time off from work is a legal issue. If you have leave coming or qualify for disability then you might get paid time off. Sometimes a counselor will suggest it would be good for you to take some time off even if you do not qualify for paid time off. Self-employed people probably will not get any paid time off but the counselor may recommend it anyway.

Check the laws in your jurisdiction and the rules for your workplace regarding the issue of the time off being paid.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Communication is not what you think

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Talking to yourself

Communication.
Photo courtesy of Pixabay.com

Why communication is not getting you anywhere.

Ever feel like “We just can communicate?” Ever say that? The old standby in counseling, especially relationship counseling, is to teach people to be better communicators. Usually, the clients are disappointed with the results.

Everyone communicates all the time. If someone gives you the cold shoulder you know what that means, right? The stone wall and the icy silence speak more than words could ever say.

It really is impossible to not communicate. Most of us are pretty good at communicating angry, hurtful messages. It is the happy, helpful messages that get lost between people.

The problem lies in what people mean when they say they can’t communicate.

Most of the time people who say they can’t communicate mean one or more of the following things, sometimes all of them.

The other person does not do what you want them to.

Good communication does not mean the other person will give in and do what you want. Improving your communication skills will not suddenly have you winning all the arguments. What it might do is increase the chances you could have a discussion with the other person and you could find a solution to a problem that works for both of you.

If there are fundamental differences in what you want or believe, better communication is not likely to change one of you. What it will do is to help you understand why the other person thinks and feels the way they do. But after all that understanding you two may still not find a way to agree.

Religious differences are a common example of this. You may think communication about your beliefs will change the other person. Occasionally it does. Most of the time this conversation highlights how we put off these conversations as long as possible and then get disappointed when the other person does not come around to our way of thinking.

They don’t like the message they are receiving.

Lots of communication is sabotaged by having so many negative messages included in the communication no one in their right mind would want to listen to this conversation.

Verbally beating your partner up and then excusing that behavior in the name of “communicating” is guaranteed to result in more problems down the line. Just being Honest is no excuse for deliberately hurting someone else and it is not a communication style that is likely to improve a relationship.

Communication is all about the way in which we send and the other person understands the message. If there is an underlying message of “you are no good” or some other negative evaluation, improving communication will likely lead to a realization that the real problem is not the communication but the feelings behind it.

There are immense differences between Criticism, complaining, asking for change. If what you are hearing about yourself from the other person is hurtful, it is hard to hear much else.

They never hear anything good.

We tell parents that they need to “catch their children doing something right.” The principle applies to adults also.

If the only messages we hear are negative, we tune out. The surest way to reduce communication is to only communicate when there is a negative message. A constant stream of negative messages makes the other person stop trying. There is such a thing as “learned helplessness.” When you begin to think that no matter what you do it will never be good enough you stop trying.

Good communication includes small talk.

Human relationships are built by time together, positive time. It is not in the huge weighty matters that relationships are built but in the small day-to-day conversations where you come to know the other person.

Small talk is not a waste of time. It is one way to make relationships closer and more intimate. We grow fond of others not because they are of the correct political party or have the correct view of the world but because we share common interests.

Take time to talk about the colors and textures of life. The best communication comes when you are able to open yourself up and talk about who you really are as a person, way down inside.

Communicate to the other person that they are important enough for you to want to spend time with them. Try to do this without the distraction of other activities that need to be done. Make sure that your time together is not one where you divide your attention between the other person and the T. V. or a computer.

What do you think? As always comments are welcome. Look for more posts on communication and relationship skills in the near future.

More on communication skills can be found at:

Communication is not what you think

Just Being Honest 

Criticism, complaining, asking for change

How are your relationships, how are your communication skills, and for you are the two related?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel