About David Joel Miller

David Miller is a California Licensed Marriage and Family Therapist, Clinical Counselor, faculty member at a local college, certified trainer and writer.

Cocaine and methamphetamine-induced paranoia

By David Joel Miller.

Stimulant-induced paranoia isn’t exactly a diagnosis.

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

Paranoia is common among drug users. It’s especially common among stimulant users. When crack cocaine users first began to show up in hospital emergency rooms, there was a lot of confusion between drug-induced psychosis and the onset of schizophrenia and other psychotic disorders. For a while, it looked like there was an epidemic of new cases of schizophrenia. Then picture emerged, something was very different about these new cases of psychosis.

The key features of psychotic disorder, schizophrenia, and some other related disorders are delusions, hallucinations, disorganized thought and speech, and grossly disorganized or abnormal motor behaviors. Some loss of normal functioning called “negative symptoms” is also part of psychosis. People with drug-induced psychosis don’t show those same levels of “negative symptoms.”

What most of us think of as paranoia fits generally under a couple of types of delusions, persecutory delusions, and referential delusions. These are the beliefs that people are out to get them and that what others are saying and doing is directed at them. Researchers have discovered that symptoms of paranoid can fall on a continuum from some mild suspiciousness and trust issues to potentially dangerous psychotic paranoia.

Psychosis and presumably paranoia can occur at multiple points in the drug using experience. For any drug of abuse, we expect to see one set of symptoms while the user is under the influence and another set of symptoms during withdrawal. Some conditions will persist, sometimes for years, even after the drugs have left the users system. These conditions are called drug-induced. It’s also possible that a drug user had a particular mental illness before they began using or had a risk factor for an illness and the drug use was enough of a stressor to result in the appearance of that illness.

I should also mention here all these descriptions are based on the idea that mental illnesses are categories. That’s the way the diagnostic manual is designed. You either have the illness, or you don’t. Increasingly research has been suggesting that most of the things we are calling symptoms are on a continuum. You can have more or less of a symptom such as paranoia. This implies that counseling and the ways people think can result in changes in symptoms of something like paranoia, regardless of whether the person with paranoia has a diagnosable mental illness or not.

Paranoia among cocaine users.

Cocaine-induced paranoia is primarily reported during cocaine intoxication. It involves extreme hypervigilance for possible danger in the environment. Up to 70 percent of cocaine users exhibit temporary paranoia even after ruling out mental health diagnosis which would include paranoia. Cocaine users on average report developing paranoid symptoms after about three years of using cocaine. The quantity that was used or the patterns of use do not seem to affect the onset of paranoia (Rosse, et al., 1994.)

Methamphetamine-induced paranoia.

Studies of paranoia among methamphetamine users are generally newer than the ones involving cocaine. One noteworthy difference was that methamphetamine users who became paranoid were more likely to get a weapon and to attack someone. Meth users had typically been awake for 48 hours or more when the paranoia began. The majority experienced auditory and visual hallucinations. Almost 40 percent of the methamphetamine users also reported tactile hallucinations. These results not only overwhelmingly reported paranoia but fit more closely with the diagnosis of psychosis in the studies I found of psychosis in cocaine users (Leamon, M., et al., 2010.)

Other drugs probably cause paranoia also.

Most of the early research on stimulant psychosis was done using patients who had been addicted to crack cocaine. In the years since that research, it has become clear that other stimulants, methamphetamine and the so-called “bath salts,” also produce psychotic episodes and an increase in paranoia. Studies of paranoia among cocaine users were largely done in psychiatric settings while the studies of methamphetamine and paranoia were mainly done in outpatient drug treatment which leads me to believe that paranoia is probably much more common and more likely to lead to violence among those who develop severe methamphetamine use disorders.

Paranoia and hallucinations occur among users of dextromethorphan.

Since most drug users use multiple drugs as well as drink alcohol and many also have mental health issues, it’s hard to be sure about causes. One thing does seem certain almost all drugs of abuse and excess alcohol use result in an increased risk that you will develop some level of paranoia.

For more on this topic see:

Trust

Paranoia

Dextromethorphan and paranoia.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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How to avoid pathological liars.

By David Joel Miller.

A pathological liar can ruin your life.

Truth or lie

Separating truth from lies is hard work.
Photo courtesy of Pixabay.com

Anyone who has ever had to deal with a compulsive, pathological, liar can testify to the way this can disrupt your life. You shouldn’t have to put up with someone who can’t or won’t tell the truth. When you first meet a pathological liar, they may be hard to spot. Some people lie about almost everything. A pathological liar will like to you even when telling the truth might have been more effective. The best way to deal with pathological liars is to avoid them whenever possible.

Avoid letting pathological liars into your life.

If you have questions about somebody’s truthfulness, exercise extreme caution. Don’t make excuses for them or try to change them. Once you identify somebody, who can’t be trusted to tell the truth, avoid them when possible.

If someone consistently lies cut them out of your life.

Having to constantly verify everything someone says is exhausting. If you have trouble believing things someone tells you to avoid having to listen to them. If possible, get them out of your lives altogether. If you must have contact with them because of work or family connections do everything you can to minimize both conversations and contact.

Don’t get angry with people who tell you the truth.

We tend to teach people how to treat us. If you become angry when people tell you unpleasant things they are likely to stop telling you the truth. Don’t force the people you interact with to lie to you to spare your feelings.

Encourage people to tell you the truth even when it’s uncomfortable.

If you want the people in your life to tell you the truth, you must go even further than withholding your anger. People must be encouraged to be truthful. That means thanking people for their honesty even when they tell you things you wish you hadn’t heard. It’s not fun having your flaws pointed out, but if you want to improve yourself, you will need to accept some honest feedback.

When in doubt double checked the story.

Before you rely on something, it is wise to double-check the facts. Don’t take everything you told at face value. Some people will tell you things, which they honestly believe, but which later turned to be inaccurate. I don’t consider factual errors to be lying. It’s up to you to decide what to believe. But if you discover that someone is telling you things that are inaccurate, and they know that they are lies, you should stop trusting them. Liars often lie to manipulate you and get you to behave the way they want you to. Before you take any action, consider the consequences of acting on what they told you and later finding out that it is a lie.

Move slowly in new relationships.

At the beginning of a new relationship, particularly romantic ones, people want to be liked. Almost all people practice “impression management.” It makes good sense to put your best foot forward. It’s not a good idea to point out all your flaws and problems to everyone you meet. Often we are misled in new relationships because we want to like that person and believe what they say.

It takes a good amount of time to get to know somebody. It can take even longer to find out whether that person is someone you can trust with your secrets. Don’t expect everyone to tell you all their faults. As a relationship progresses, both people should feel more comfortable about being who they genuinely are. The longer you know someone, the more trust you should have for them.

If you find that the longer you know someone, the less you trust them, there is probably something in your gut telling you this person is not to be believed. Don’t dismiss those thoughts without careful examination. Better to find out that someone is less than fully honest when their only casual acquaintances than to wait till you’re involved in a romantic relationship, possibly with children, or in an economic relationship where you stand to lose a lot of money.

Keeping pathological liars out of your life is an ongoing process.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Friends.

Sunday Inspiration.     Post by David Joel Miller.

Friends.

“Good friends, good books, and a sleepy conscience: this is the ideal life.”

― Mark Twain

“It takes a great deal of bravery to stand up to our enemies, but just as much to stand up to our friends.”

― J.K. Rowling, Harry Potter and the Sorcerer’s Stone

“It is one of the blessings of old friends that you can afford to be stupid with them.”

― Ralph Waldo Emerson, Emerson in His Journals

Wanted to share some inspirational quotes with you.  Today seemed like a good time to do this. If any of these quotes strike a chord with you, please share them.

Becoming more resilient.

By David Joel Miller.

Resiliant

Resilient. 
Photo courtesy of Pixabay.com

How do you get back up when life knocks you down?

Resiliency is the key to getting back up when life knocks you down. Resiliency is a skill that you can learn, but it requires practice. When you’re going through difficult times, it can be hard to imagine life getting better. Here are some tips for improving your resiliency and learning to bounce back from adversity.

Shift your focus from where you are to where you’re going.

When life has knocked you down, avoid wallowing in the mud. When your down, it is tempting to spend your time thinking about how bad things are and how unfair it is. It’s inviting to look for someone to blame. Don’t make the mistake of believing that there is something inherently wrong or defective about you. Don’t become paranoid and believe your difficulties are caused by others who are out to get you.

Do spend your time planning for and working to become the best person you can. Learn from your mistakes. Change what you can. Do the work you need to do to change where you are.

Strengthen or develop a support system.

Humans do best when they are part of a group. When times are tough, you will find out who your real friends are. If there are ruptures in your support system, try to repair those relationships that you can fix. Evaluate the people you spend your time with. Hang out with negative people, and you will become more negative. To be a healthy, happy person, you need to have positive people in your life.

Stay connected to family, friends, faith, support systems, and your community. When times are hard, your connections are vital. Friendships cannot be one-way streets. If someone only takes from you but never gives, that’s not a friend. If you have a particular faith or religion, make sure you stay connected. Stay involved in positive things in your community.

Contribute to the world around you.

Doing things to make the world a better place will improve your self-esteem and self-confidence. Do what you can. It’s not necessary to donate large amounts to causes. If you can afford to, give small amounts of money. More important than the money you give, is the time and the giving of yourself.

The smile you give some may be exactly what they needed. If you give a smile, you may get one in return.

Identify the areas in your life you can control.

Sometimes bad things happen, and they are out of your control. You may have an illness. You didn’t pick that sickness. Pretending you’re not ill will not help. Suffering in silence is not a virtue.

What you can do may be significant. You can see a doctor. You can take your medicine as prescribed. You can illuminate unhealthy habits. Quit smoking, give up or reduce your drinking. Get plenty of sleep. Get up off the couch and move around as much as you are able.

When you start looking for the things that are in your control you may find many opportunities to improve your life. Small improvements here and there can add up.

Identify and develop your skills.

The situations in your life will change. The skills you learn in one situation may be useful in the next situation you encounter. Don’t focus on what you can’t do. Identify the strengths you have and build on them.

Develop the good parts of yourself.

Begin by identifying the good parts of you. If you have trouble thinking of those parts right now, ask yourself what a good friend might say about you. Maybe you’re creative. Some people are naturally curious, and they love to learn new things. Perhaps you are a kind person or someone who cares about fairness. Do you have a good sense of humor? Whatever your qualities look for ways to strengthen them and to build on them to create a better future.

Learn to manage stress.

Stress is a part of life. As long as you live, you will experience stress. Even good things can be stressful. Learn some simple stress reduction techniques. You may find that deep breathing can slow down the floods of emotion that can overwhelm you. Many stressful events have both good and bad features. Avoid focusing on only the distressing parts of the situation.

Practice coping with adversity.

Use the small, everyday problems as an opportunity to identify your strengths and to practice your coping skills. Coping with everyday irritations develops your coping skills for the big challenges in life.

Increase your self-confidence.

In parenting education, we tell people to build resiliency in children by catching them doing something right. Hopefully, you had people in your early life who gave you praise for the things you did well. If you didn’t get that praise, start today to recognize and acknowledge your accomplishments. If you have difficulty accepting, compliments learn to compliment yourself and receive the gift of a compliment rather than returning it as being of no value.

Avoid shaming and guilt tripping yourself.

The field of positive psychology tells us that shame and negative motivation does not spur people to do better. Recognize what you can improve on but don’t fall into the trap of believing that calling yourself names and beating yourself up will result in doing better. Making a mistake does not make you a “bad person.”

Try to fix the things you can and accept the things you can’t. What other ways have you found to increase your resilience? What will you start doing today to create a better future?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Coping with life’s regrets.

By David Joel Miller.

Don’t let regrets about the past ruin the present and future.

Regrets.

Regret.
Photo courtesy of Pixabay.com

Do you have regrets? Maybe they are small ones; you wish you bought the other color or model. Maybe your regrets are big ones, actions that caused you or others pain, things you wish you could go back and change. But you can’t change the past. Almost everyone has regrets, some small, some large, a few even gigantic. So, what to do with those regrets? How do you get past the pains of your past?

Fix the things you can.

You can repair some things. You said or did something that damaged a relationship. Sometimes you can apologize, say you’re sorry. If you owe somebody money you can pay it. Sometimes an apology is not enough. Maybe you need to do something to make it right, to make your amends to the person you have injured.

Undo yes and no decisions.

You can undo some decisions. You said yes to a job or attending a party and now you wish you hadn’t said yes. You’re entitled to change your mind. Call that person, send them an email. Maybe you said no to something or someone, and now you wish you had said yes. Check it out; sometimes it’s possible to change your mind.

Pick a new alternative from life’s menu.

Sometimes changing your decision is no longer a possibility. For example, you wanted to attend a concert but didn’t buy the tickets in time. Look for other options. Maybe the person or group you wanted to hear is performing somewhere else nearby. Maybe there’s some other event you would enjoy instead. Don’t stay stuck in regret over the relationship that didn’t work out, maybe it’s time to meet someone new.

Only take responsibility for your part of the problem.

A lot of life’s regrets are about relationships. Maybe it was an argument with a family member or friend, that conflict cost you a relationship. Take responsibility for your part of the conflict. You can’t take responsibility for what the other person did or said. If you can fix it do so, but not at the cost of ignoring the other person’s part in the problem.

Reevaluate the alternatives. You may have picked the best alternative you had.

Sometimes you must pick between two bad choices. Don’t be so hard on yourself. You may have made the best choice you could under the circumstances. Be careful of hindsight. If you would have had the information you have now back then, you might have made a different decision. But you didn’t have that information, and you had to choose. Don’t spend the rest of your life stuck in regret.

Learn from your mistakes.

Don’t be one of those people with tons of regret who keeps doing the same things over and over. Stop piling up new regrets by learning from your mistakes and making improved decisions in the present.

Practice extreme acceptance.

Staying stuck in regrets can use up a lot of energy. Practice accepting that what happened is in the past. Avoid ruminating and allowing your mind to enlarge the pain. Shift your focus from regrets about the past to opportunities for better future.

Stop looking over your shoulder at the past.

The past is gone. Don’t keep looking back at the things that can’t be altered. When the thought of that regret comes up, practice shifting your focus to the future. As long as your alive there will be more events ahead on the road of life. Look forward to making your future the best it can be. If you only look for the bad in life, you will find it. It’s quite possible that all around you are opportunities for happiness here in the present and in the future.

Do some psychological repair.

Make healing from life’s regrets a priority. Sometimes you will have a close friend with whom you can talk it through. You may need to be careful about who you tell what. Telling family or friends about things you regret may damage your relationship. If you are not sure how someone will react to hearing about your regrets, that person may not be the one to talk with. Once you tell that secret, it can’t be untold. Some people find it useful to journal, write out how they feel in a document meant for only them to see.

If you’re having trouble processing and dealing with regrets, you may need to seek professional counseling help. Don’t stay stuck in a life dominated by regrets. Use some of these approaches to change what you can, and accept what you cannot change.

You find more about this topic under Regret.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Is your paranoia showing?

By David Joel Miller.

Increasing paranoia – the mental health challenge of this millennium?

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

The growing problem of paranoia is gone unrecognized for very long time. Currently, anxiety disorders are the number one diagnosed mental illness. The category of anxiety disorders has grown so large that recently professionals separated this family of disorders into two groups, the disorders of excessive anxiety, called anxiety disorders, and the disorders caused by real-life events, now referred to as trauma and stressor-related disorders. What has often overlooked is the prevalence of Paranoia.

The problem of paranoia frequently gets ignored.

Many people describe themselves as paranoid, or “a little bit paranoid.” Professionals often dismiss these labels as exaggerations. Over the last 25 years, as there has been more study of paranoia, professionals are starting to recognize how common paranoid symptoms are in the general population. Recent studies conclude that among the general population, people who have never been diagnosed with a serious mental illness, the rates of paranoia may run between 15 and 20 percent.

There’s no specific diagnosis for paranoia.

When we say paranoia, most people immediately think “paranoid schizophrenic.” We have come to understand that not everyone who has schizophrenia is paranoid. Paranoia can also be part of several other serious mental illnesses. Paranoia is also a part of paranoid personality disorder, delusional disorder, and may even be a feature of severe major depressive disorder. Many drugs of abuse can cause paranoia. Paranoia in its less extreme forms may go under the label “excessive suspicion” or “trust issues.” In it’s more dangerous form; paranoia can be a feature of delusional jealousy.

Humans are often poor judges of danger.

In the 1950’s almost every small child look forward to getting their first bicycle. Kids commonly walk to and from schools which were often a considerable distance away. Today many people do not let their children play outside. One explanation for this is they are afraid something bad will happen to their child.

The statistics tell us that the most dangerous place for most children is at home. Every year in America more children are shot and killed at home by a biological parent who then turns the gun on themselves than all the children killed in school shootings. Absolutely school shootings are a problem that needs to be tackled, but we are fooling ourselves by thinking that it strangers who are the major danger.

America and many other industrial countries are facing an epidemic of childhood obesity. The risk of poor health and shortened lifespan from lack of exercise far outweigh the risk to most children from going outside to play.

Many people worry every time they take to the road that they will encounter someone with road rage will run them off the road or shoot them. These are certainly risks, but the far greater risk comes from people being injured or killed in automobile accidents while not wearing your seatbelt.

Why have we all become more fearful?

High levels of danger are often associated with the big city and crowded urban environments. A hundred years ago less than 5 percent of the world’s population lived in large cities; most people lived in small towns and rural settings. Since the year 2000 more than 50 percent of the world’s population lives in large cities. Today television and the online news are available 24/7 to tell you about every awful event.

Belief in conspiracy theories has become more common than not.

Humans use to accept widespread death from illness as normal increasingly people believe these epidemics must be the result of some government or international conspiracy. Throughout history, there have been plagues which devastated humanity. During the Middle Ages, there were places where as much as 70 percent of the population died. These same epidemics would recur periodically. In the 1800’s epidemics of yellow fever and cholera resulted in death rates of 30 to 50 percent of the population of some towns. In the U.S. Civil War, for every man killed in battle mortality in camp due to illness could run from 5 to 10 men. During World War I, deaths from Spanish influenza ran into the millions. These recurring illnesses used to be blamed on devils and demons, religious minorities and more recently bacteria and viruses. Today, when a new illness is discovered many people’s first thought, is that someone has deliberately created this illness or that there is a cure for it, but someone is withholding that cure.

People who believe in conspiracy theories often believe in mutually contradictory ones. The same person who believes that Jimmy Hoffa was killed by the CIA might also believe that he faked his own death and is currently living in Bolivia. The average person’s willingness to believe a conspiracy theory seems to be growing exponentially.

Some increased trust issues, even paranoia, may be reality based.

Modern society has created dangers that didn’t exist past. With larger numbers of people working for the same employer competition on the job becomes fiercer. Many of the people you work with you may never see outside of work. This has led to more competition on the job and less cooperation. When we were an agricultural society, farmers tended to help each other. Today it’s likely that the person in the next cubicle may be undermining you in the competition for promotion or to avoid the downsizing layoff.

Your increased dependence on technology put you at risk.

Technology is becoming more complicated and more pervasive, growing at an exponential rate. Your personal information is no longer safe because you keep it locked up. Every company you do business with, every detail of your financial and healthcare life may be at risk. Online companies know more about the person you sleep with.

How are trust issues, suspiciousness, anxiety, and paranoia connected?

In upcoming posts, I want to talk to you more about why “trust issues, suspiciousness, anxiety and even paranoia have become so prevalent, how they may be connected and how you can cope with your fears and not let the forces of anxiety and paranoia take over your life. But I don’t want to overwhelm you with the problems without talking about the solutions.

The future is not all bleak.

At the same time psychologists and counselors have been looking at some under recognize problems, things like paranoia, burnout, and the role of the Internet in changing human relationships some positive things have also been recognized. Positive psychology has revealed an entire technology centered around having a happy life. We now know happiness is not the result of constant doses of temporary pleasure but comes from long-term ways of thinking and behaving. We are also recognizing that people have certain inherent strengths. Whether you know it or not, you and your children have some talents and abilities just waiting to be discovered and perfected.

For more on these topics see:

Paranoia

Anxiety

Happiness

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.