Fear and anxiety not the same thing.

By David Joel Miller.

Confusing fear and anxiety cause you emotional pain.

When is fear real?

Fear, Anxiety, and Worry.
Photo courtesy of Pixabay.com

Many people are high in anxiety. They report that they are afraid of a great many things. To conquer anxiety, you need to learn the difference between the things you are afraid of, the ones you really should be afraid of, and the things that make you anxious for very personal reasons.

Recent research suggests that we may have been getting two different things confused.  While fear and anxiety may look a lot alike, the kind of behavior we do to defend ourselves, the circuits in the brain for these two things are quite different.

Fear is about an immediate danger.

Defensive behaviors are controlled in the human brain stem. The brainstem controls automatic reactions to things. It’s the part of the brain that keeps your heart beating when you fall asleep. Many fears are hardwired into the brainstem and function to protect humans from harm.

If you are too close to the edge of a cliff, and about to fall off, fear kicks in and tells you to step back. For most people avoiding falling off a cliff or from another high place keeps them from getting injured or even killed.

If you’re out in the wilderness, it is a good thing to be afraid of bears and lions, tigers and other wild animals. Most primates are instinctively afraid of snakes. Some steaks are poisonous and can kill you. Having an automatic fear eliminates the need to study the snake in front of you to determine if it’s poisonous. Experts, those who work with snakes on a regular basis, learn the difference between poisonous and non-poisonous snakes. Avoiding snakes, especially the poisonous ones, can save your life.

Anxiety is about distant possible dangers.

While fear is about a current immediate danger, anxiety is about future. The majority of things that anxious people worry about are things that are unlikely to happen. Often anxiety is related to rumination.

The part of the brain that appears to be involved in anxiety are the structures that should be used for thinking and planning as well as memory. People who are high in anxiety will attempt to improve results and keep themselves safe by trying to imagine all the things that could possibly go wrong.

The more you sit and try to think of things that might go wrong in the future, the more things you’ll find to be anxious about. It turns out that most of the things that we worry about will never happen. Anxiety is about trying to predict low probability events.

Planning for the future and for contingencies is a good thing. But if you find that you are spending a large amount of time trying to foresee everything that could possibly go wrong, you have moved from planning to trying to be a fortune teller.

The more you try to be perfect and never make a mistake, to create a life in which nothing can ever possibly go wrong, the more you will worry. Unfortunately, the belief that you can somehow protect yourself from every possible catastrophe turns out not to be true.

Whenever you find that you’re worrying about something and it’s making you anxious, the first question to ask yourself is how close am I to this potential danger? Is this something that could happen in the next minute? The second question you should be asking yourself is how likely is this bad outcome to be.

Ask yourself do you want to give up 99% of your life to avoid the things that have a 1% chance of happening. Living, and having good things happen in your life, requires doing lots of things. Unless you really love your anxiety, consider adding more spontaneous, exciting things to your life. Try more things and pay special attention to the things that go well not the few things that don’t turn out the way you want them to occur.

Learning the difference between realistic fears and the high anxiety that worrying brings can result in a much happier life.

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books

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Feeding your worry.

By David Joel Miller.

Are you feeding the anxiety monster?

Scary fearful monster

Anxiety Monster.
Photo courtesy of Pixabay.com

The more you feed your anxiety, the larger grows. It’s easy to miss the connection between worry and anxiety.

Some dictionary definitions of worry are:  to give in to anxiety or decrease, to let your mind dwell on your troubles and difficulties.

Continuing to worry increases your uncertainty and grows your anxiety until it takes over your life. How many of these ways are you feeding the anxiety monster with your worry?

Stay up all night keeping worry company.

When there is lots of uncertainty, potential problems ahead, many people hold on tightly to their worries. Often after a good night sleep, things look differently in the morning. A certain way to expand your anxiety is to sit up as long as possible, thinking through every possible negative outcome. Ruminating about low probability bad outcomes is just the sort of worry-food the anxiety monster craves.

You won’t let anyone else babysit your worry.

People who have their anxiety under control learn to use experts to manage their risks. One way to increase your anxiety is to keep all your worries to yourself, and never share them with anyone who might be able to put your mind at ease. Have financial challenges? You should talk to a financial professional. If you have medical issues, you need to see your doctor. For emotional issues, a good counselor can be helpful.

Some people become so attached to their anxiety that they would never consider allowing anyone else to babysit their anxiety monster. If you become unwilling to share your worry with anyone who might be able to help reduce the risks, you’ve taken on the care and feeding of an anxiety monster.

Every morning pick worry back up.

Should you ever get a good night’s sleep, make sure you pick up where you left off worrying the night before. Mentally healthy people can set aside their worries and engage in work and play and positive social relationships with others.

Some people come to view anxiety as their best friend. Their hope is that by worrying enough, they might be able to prevent something bad happening. If you’ve adopted this thought, you’re likely to find that even when the danger is past, after being able to do something enjoyable with others, as soon as you can, you will pick your worries back up and cuddle them tightly.

Stay angry to grow anxieties.

When you’re angry at someone, you’re likely to expect the worst from them. If you’re angry at others, you expect them to be angry back. Your anger at others and your anticipation of their retaliation are certain to feed your anxiety monster.

Indulge negative feelings.

Negative feelings are a super food for anxiety monsters. Indulging yourself in every possible negative feeling is guaranteed to increase your worry and anxiety. Should you ever chance to spot a silver lining, search carefully for the black cloud behind it.

People who are high in the ability to worry and make themselves anxious, are often skilled at seeing the worst in every person, place, or situation.

Remind yourself that it is your fault.

If you want to stay anxious and fearful all the time, take on the responsibility for the whole world. Tell yourself that you should have foreseen that earthquake and moved somewhere else. If something breaks, believe that it’s your fault. When others treat you badly, look for what you must’ve done wrong to create their bad behavior.

If someone you know abuses drugs or alcohol or gets in trouble with the law, ask yourself what you must have done wrong to make them misbehave. This constant believing that everything that goes wrong in the world must somehow have been the result of your failure to foresee it is guaranteed to keep you unhappy and anxious.

Search for evidence to grow your fears.

Whenever there is a doubt, do your best to find evidence to prove that the thing you’re afraid of is dangerous. If you can’t find reliable scientific evidence, post you worry on social media and ask people to tell you why you should be afraid of something. When there’s no evidence, believe that your fear is justified just because it feels scary to you.

The human brain has a bias towards negative information. Let ten good things happen, followed by one bad thing, most people will remember only the one problem. Say you get a job interview, and the interview goes well, you get the new job at a very good salary, but on the way home, you get a flat tire. Continue for the rest of your life to remind yourself nothing good ever happens to you “every time” you try to drive; you get a flat tire.

Especially worry about things you can’t change.

People with a well-developed anxiety monster rarely think about things they might be able to control. Nothing expands anxiety like focusing exclusively on things that are out of your control. To maximize anxiety don’t worry about working overtime and paying your electric bill, focus your worry on the possibility this will be an unusually cold winter, and there might be a worldwide shortage of fuel.

Have you had enough anxiety?

I tried to exaggerate all these ways in which people can increase their anxiety. I hope you can see that there may be thoughts you are practicing which are increasing your anxiety. Consider trying to have more helpful thoughts. Change some of the ways you’ve been dealing with life’s challenges and see if you can’t reduce your anxiety.

If your anxiety, worries, and fears have grown so large, that they are taking over your life, consider that now be might be the time to seek professional help. A good counselor or therapist can help you learn to manage and reduce your anxiety and fear.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books

Therapy can make stress and anxiety disorders worse.

By David Joel Miller.

Traditional talk therapy may make your problems worse.

Pain, Anxiety, Depression, Stress

Pain, Anxiety, Depression, Stress.
Photo courtesy of Flickr (marsmet481)

Don’t get me wrong; talk therapy has been helpful to a large number people.  But occasionally I encounter a client whose condition has been made worse, not better, as a result of being in therapy.  One predictor of whether therapy will work for you is the fit between you and your therapist. If the kind of therapy they’re doing or the way they’re doing it is not helpful, begin by talking with the therapist about this. A good therapist will work with you to find helpful solutions. If you find you therapy making things worse, you may end up needing to switch to a new therapist. Below are some ways I have seen therapy be unhelpful and some suggestions for making it more helpful.

Repeated talking about it can retraumatize you.

Some therapists were trained that the way to be helpful to people, was to do a thorough biopsychosocial assessment before they began treatment.  This historical approach often means beginning with the first event in your life and move things forward one event at a time.  Therapists with this orientation may well believe that the key to fixing your current problems, is to thoroughly deal with your childhood issues first.

More than one client as told me that their therapist’s insistence that they needed to talk about past abuse in detail, became so painful they had to discontinue therapy. We often hear from victims of trauma that the having to go over and over the details was more painful than the initial experience.

There’s some truth to the idea that you can’t heal injuries, physical or emotional, that you deny exist. The problem comes from efforts to dig up the graveyard to get at the root causes before the person is even able to cope with life today.

What is often more helpful is a “solution-focused” approach to your problems. This approach means beginning at the top with the problem that is affecting you today. If today’s problem is unemployment or a bad relationship, that may need working on right now. Keep in mind that early life experiences may be impacting today’s issues. As you get today’s problems under control, you may decide you want to work on those old long-term problems, or you may decide that having solved today’s problems you need to move on with your life.

Talking in therapy can turn into co-rumination.

Sometimes therapy can perpetuate problems.  It’s easy to stay stuck, week after week, reviewing the exact same problems.  When this is done with a friend, it is sometimes described as co-rumination.  The same process can be harmful when done with a therapist or counselor.

Narrative therapists described this as staying stuck in a problem-saturated story. Repeating the same story over and over can magnify its control over you. The challenge is to stop the pain and begin to create a story of how the future can be better than the past.

Being in the wrong group therapy can make your problems worse.

We see this often in substance abuse treatment.  A young adult gets caught with some marijuana, which is illegal in his particular jurisdiction.  This person gets referred to drug treatment and placed in a group made up largely of heroin addicts.  Not only is this group not helpful, but there is an increased risk that this person will develop a worse problem than before.

An equally bad problem can be created when a woman with a history of domestic violence ends up in a PTSD group with some returning military veterans. Group therapy can be extremely powerful, but only if you’re in the right group.

Sometimes the symptoms become the problem.

Many of the things that are described as symptoms of a trauma-related disorder are in fact ways that people adapt to having survived that trauma. When therapy focuses too much on ending symptoms, it can become unhelpful.

For example, a victim of trauma may begin drinking, trying not to have to remember the painful experiences. Someone notices the person’s drinking, maybe because they’re drunk at work or they get a DUI. They may end up in treatment for alcohol use disorder. The difficulty here is that for this person the alcohol is not their problem, it is their solution. The problem is the recurring intrusive memories of the trauma.

Using “unhelpful” behaviors to manage your current symptoms can become a habit. Rather than focusing too much on the unhelpful behaviors, many therapists will work with you on creating new helpful behaviors. Under stress, humans tend to revert to their habitual way of behaving. The therapist will want you to continue to practice your new helpful behaviors until they become your new automatic way of coping.

Don’t give up before the healing miracle happens.

I hope this post will help you understand the ways in which therapy can be helpful, and the times it may not be. If you’re currently coping with the results of trauma and stressors or you have high levels of anxiety that are interfering with your day-to-day life, know that there is therapy out there that can make your life better. If you have been for counseling in the past and it was not helpful, seek out a therapist you can feel comfortable working with. If you’re currently working with someone and it’s not helping, talk to them about this issue.

One other thing you need to keep in mind is that when you’re in severe emotional pain, you may feel like you’re stuck and nothing is getting better. It’s very common for people to make large amounts of progress and not realize they’re getting better. Sometimes your counselor, family or friends will see the changes in you long before you do. Please don’t give up.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books

Which kind of sensitive are you?

By David Joel Miller.

Are you too sensitive or not sensitive enough?

Eye

How sensitive are you?
Photo courtesy of Pixabay.com

There are at least two kinds of sensitive. One is generally considered good and the other is thought of as bad. Some people are just way too sensitive.  You know the kind of person I mean.  Other people are extremely insensitive. Have you ever thought about the two kinds of sensitive and why you need more of one and less of the other?

Some people are just too sensitive.

Have you met people like this?  With people who are way too sensitive, any little thing you might say they take as an insult. They are always experiencing slights and they are often looking for ways to get even for these slights, real or imaginary.  You have to be careful what you say around people who are so very sensitive.

I think of these people as being like someone who has been in a car crash, covered in blood and broken glass. The wounds need cleaning but even when you try to be helpful, in the most caring manner, they scream in pain.  You reach the point where you are just afraid to interact with them because of their extreme sensitivity

People who are extremely emotionally sensitive are like that, hard to be around. You are always on edge when near them. Say the wrong thing and you set them off. They are constantly touchy. You wish they were just not so sensitive. Their life is the center of the emotional hurricanes eye. Every day brings more drama and if you are not well grounded you can get swept away in their drama.

In fact, if they want to stay connected to you what they really need to be is – well just be more sensitive, sensitive in a good way.

Some people are just naturally very sensitive.

These sort of folks just always seem to know exactly the right thing to say. They intuitively know how you are feeling and are supportive in every way.  Everyone needs a few people like this in their life.

Don’t you just wish your friend or partner could be more in tune with your feelings, if only they could be more sensitive?  Especially more sensitive to you and how you’re feeling each day.

What is the difference between the two forms of sensitivity?

If In the first variety, the too sensitive form, the person’s sensitivity is focused inward. They see everything as if it pertains to them. “Why did you say that to hurt me” is their mantra.  That other people have feelings and matter is beyond their understanding.

In the second form, the intuitive and sensitive, the sensitivity is turned outward. They are looking to see how what they are doing is affecting others. This kind of extra sensitive person is empathetic and attuned to others.

Which kind of sensitive are you?

Are you focused inwardly, expecting others to always say and do the right thing to make you happy? Or do you stay focused on others,  looking for ways you can be of service and helpful to them?  The topic of sensitivity justifies some thought.  Consider how you might work on becoming more sensitive to the needs of others and less sensitive to everything they say and do that might affect you

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books

Lessons Anxiety teaches you.

By David Joel Miller.

What are your fears teaching you?

Anxiety and Fear

Lessons Anxiety teaches you.
Jimee, Jackie, Tom & Asha

Are you someone who suffers from high anxiety?  Have you learned the lessons that your anxiety is trying to teach you?  Anxiety can be a kind of bully, trying to scare you away from anything new and keeping you from the parts of life that might be beneficial. Or anxiety can become a good teacher and help you learn life lessons.

Below is the list of some lessons that anxiety might be able to teach you and ways that you could develop those lessons.

Just because it scares you does not make it dangerous.

A well-functioning anxiety system helps you identify risks and warns you of danger.  Some people’s anxiety system is turned up way too high.  Overly sensitive anxiety systems give off warning sounds and flashing lights even when the danger is minimal.

An important lesson you should learn from your experiences with anxiety is that not everything that makes you fearful or scares you is in fact, that dangerous.  Learn that your anxiety is a source of information, not an absolute life ruler.

It is OK to feel scared.

Some people believe they should never feel scared.  One of the lessons about anxiety it is important to learn is that it is possible to feel scared and still have nothing bad happened.  Let anxiety teach you this lesson.  Just because you’re scared does not mean that anything terrible or awful will necessarily happen to you

It is OK to feel what you feel.

Are you one of those people who was taught that you shouldn’t feel whatever it is that you are feeling?  A valuable lesson that anxiety and many of our other feelings has to teach us is that humans use feelings as a source of information.  Information is neither good nor bad in and of itself.  Was is important is for you to feel what you’re feeling, decide what that means, and then decide what you wanted to do with that information.

Feelings can be your friends.

Feelings are not automatically your enemies.  They can be your friends.  Sometimes anxiety and fear are friends warning you of danger.  What you need to decide is how real and how important that danger it is.  Every so often the danger is very real and very imminent.  During those times you will need to do something about it.  Other times your anxiety is detecting something new and unfamiliar and you’ll need to learn how you are going to respond to that new and novel situation.

Walking towards fear makes it shrink.

Fear is a natural-born bully.  Fear wants to have its way.  The more you give in to your fear the larger the fear grows.  Many things that look scary and are fearful at first sight become far less scary as you begin to do them.

If you walk towards something that scares you, what you will often find is that it is far scarier from a distance than once you get up close.

The first time is always the scariest.

Many people are afraid of something new that they’ve never experienced, but once they’ve tried it for that very first time that may discover that they enjoy it.  Don’t let your fears and your anxieties keep you from trying something that might turn out to be a great deal of fun.

Scary experiences create lasting memories.

Despite the fact that many people avoid things that make them anxious or scare them, most of us are also fascinated by the scary.  Scary movies draw large audiences.  Haunted houses are perennial Halloween favorites.

Because of the heightened level of hormones in the body during scary events the brain thinks that it is important to remember these times.  In thinking about the times that some event made you anxious it is important to remember the times that despite the anxiety those things turned out very well.

You can’t be calm and scared at the same time.

Ever notice when there’s a loud noise everyone turns to look at it and ignores everything else that is happening?  Anxiety and fear are like that.  They distract your attention from what else is going on at the same time.

One way of reducing anxieties impact on you is to learn ways to calm yourself.  Stress reduction techniques like deep breathing, mindfulness, and meditation can all be very helpful in reducing your anxiety.  What you will quickly learn, if you try these techniques, is that it’s not possible to be calm, relaxed and scared at the very same time.

Learn to make this fundamental rule of emotions work for you.  Opposite sets of emotions don’t like to live together.  It’s difficult to laugh when you are sad.  People don’t seem to be able to be both excited and relaxed at the same time.  If you have found that your anxiety has gotten out of control, a quick way to reduce that anxiety, if is to learn ways to self-sooth and calm yourself.

The more skills you have the more you can handle.

In all aspects of life it is important to develop a good set of skills.  While initially it may be uncomfortable to work with strong emotions such as anxiety, the more you do this work the better you get at it.  Repeatedly putting yourself in situations that create a small amount of anxiety, which you discover you are able to handle, can result in increasing your ability to handle increasingly difficult anxiety provoking situations.

Whenever the size of your comfort zone, if you spend too much time cramped inside it, that comfort zone will prevent your personal growth.  Gradually work on stretching out that comfort zone.  Before long you will have the skills to handle situations they used to seem impossible.

When you do good self-care less overwhelms you.

Another lesson than anxiety will teach you is the importance of good self-care.  With poor self-care it’s easy to get stressed out and have everything overwhelmed you.  When you concentrate on taking good care of yourself you will be able to handle situations that you never thought possible.

You will handle most things better than you thought you would.

It’s normal to be very scared before something that you have never experienced. What surprises so many of us is how often we are able to handle far more than we ever believed possible.  Anxiety teaches you that you are capable of much more than you would have believed had you not been in those anxiety provoking situations.

Most of the things we worry about turn out better than we thought.

Many people discover that the majority of things they have worried about turn out better than they expected.  It is a human failing to expect the worst.  Let your anxiety teach you that many good things can happen.

You almost always have more options than you think.

One bad habit that makes anxiety far worse than it needs to be is artificially limiting your options.  Often we only see a couple of alternatives.  Make sure that you look for other options.  People will tell themselves they have to get something done by a deadline or they’re going to lose their job. Only seeing those two options results in not making use of the many more options that might have resulted in a better outcome.  Besides not finishing the report or getting fired, you may also have the options of discussing the deadline with your boss or requesting additional help in completing the project on time.

If you make anxiety your friend you may find that it’s a wonderful teacher.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books

What is Separation Anxiety Disorder (F93.0)?

By David Joel Miller.

Separation Anxiety Disorder used to be strictly a children’s condition.

What is? Series

Separation Anxiety Disorder
Photo courtesy of Pixabay.com

In the past Separation Anxiety Disorder was listed in the section of the Diagnostic and Statistical Manual (DSM) under the category of Disorders First Diagnosed in Infancy, Childhood, and Adolescence.  Recently in the reorganization of the DSM, this disorder was moved to the chapter on anxiety disorders.

Increasingly we recognize that there are adults who suffer from Separation Anxiety Disorder.  In children, if they have the symptoms for four weeks or more, that meets criteria.  But when we see this disorder in adults we expected it to last at least six months.  This is a disorder which may come and go throughout the lifespan.  It is likely to begin after, or to be triggered by, stressful events.

Separation Anxiety Disorder is about a fear of losing the major attachment figure.

In Separation Anxiety Disorder there is a fear of leaving home or being separated from a major attachment figure.  This is very different from people who are simply afraid of going out of the house, being around crowds, or meeting strangers.  In Separation Anxiety Disorder it is the fear of losing that significant person which causes them extreme distress.

This fear is clearly far more than life circumstances would warrant.  People with this disorder need to know where that important person is it all times.  And they may have an excessive need to stay in constant contact with their major attachment figure.  These people may be given to constantly texting, and may become quite upset if they’re communications are not immediately responded to.

You may also fear being taken away.

Separation Anxiety Disorder is also the fear that something will take you away from that major attachment feature.  People with this disorder worry about an illness, kidnapping or being forcibly taken from a major attachment figure. Some people with this disorder are unable to be in a room by themselves.

Separation Anxiety Disorder can make you refuse to leave home.

The classic example of this is the child who is terrified of leaving their mother to go to kindergarten on the first day of school.  In normal children, if we expect them to get over this fear after a few days.  But in those with Separation Anxiety Disorder that fear continues for long periods of time. We may continue to see this behavior as children get older.  They may have frequent illnesses which keep them at home with their important attachment figure.

Like most other anxiety disorders, Separation Anxiety Disorder typically begins in childhood, but it may well continue throughout adult life.  In diagnosing this disorder the professional looks at the developmental stage of a person to see if what they are going through is appropriate.

Some adults are so afraid of leaving their significant family member that they are unable to venture out into society alone.  They will only be willing to go outside the house, to the store or an appointment, if that major attachment figure accompanies them.

That huge fear of being alone maybe Separation Anxiety Disorder.

An abiding characteristic of Separation Anxiety Disorder is the extreme level of fear of being alone.  Any time this person is separated from their major attachment figure, they become anxious and may even become terrified.

In children, the attachment figure is likely to be their parents or caregiver.  In adulthood people with this disorder are likely to become very anxious when separated from their spouse, partner or their children.

If that important person is not home, then you can’t sleep.

People with Separation Anxiety Disorder find that they are unable to sleep when the major attachment figure is not in the house.  They may stay up all night on those occasions when that person they’re attached to needs to be gone overnight.

The person with Separation Anxiety Disorder will have a constant need for reassurance.  This need may result in frequent phone calls or other efforts to contact the attachment figure who is not there.  This constant need for reassurance may begin to interfere with their partner’s ability to work.

Separation Anxiety Disorder causes nightmares about being separated.

In this disorder, the content of the nightmare is that the important person will be taken from you or you from them and that you will never ever be able to see them again. These nightmares can be recurrent and play a role in maintaining the other symptoms.

Separation Anxiety Disorder can make your physically ill.

Symptoms of this disorder can look just like a physical illness.  These symptoms may include headaches, inability to eat, nausea, or even vomiting if there’s a chance that you’ll be separated from this major attachment figure in your life.

People with Separation Anxiety Disorder are likely to be described by others as needy and insecure.

There is help for Separation Anxiety Disorder.

While this condition often begins in childhood and may continue well into adulthood, someone with this issue does not have to continue to suffer.  There are treatments available.  If you or someone you love suffers from this condition, consider getting professional help.

More on this and other anxiety disorders see:  Anxiety

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

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Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books

What is Selective Mutism (F94.0)?

By David Joel Miller.

Selective Mutism is the failure to speak at times when speech is necessary.

Can't talk

No speech. Selective Mutism.
Photo courtesy of Pixabay.com

Selective Mutism is an interesting disorder. It is one of the less common anxiety disorders and one which commonly first appears in childhood.  This disorder often co-occurs with Social Anxiety Disorder.  As with all the anxiety disorders, Selective Mutism may continue well into adulthood.

Selective Mutism is not the inability to speak or the willful refusal to speak.  Selective Mutism occurs when someone chooses not to speak in a particular situation even when not speaking may cause them difficult.  Children with this condition will avoid starting a conversation with other children.  When spoken to they will fail to respond.

Selective Mutism gets noticed when children begin to attend school.

Children with Selective Mutism do poorly in school because they do not respond verbally to the teacher and do not read out loud.  Those with this disorder may use other ways of communicating rather than speaking.  Sometimes they will point, grunt or used personally significant gestures.  They may also be willing to engage in social activities when speech is not required.

Children with Selective Mutism are able to speak normally at home with their parents or primary caregivers.  They may be unwilling to speak in the presence of close relatives including cousins, aunts and uncles, and grandparents.

Risk factors for Selective Mutism.

Children who are shy are at extra risk to develop this disorder.  Having parents who are withdrawn or growing up in a socially isolated environment may also be risk factors.  It is possible that having overprotective or controlling parents increases this risk.  There’s some evidence that children with this disorder have difficulty understanding the things that are said to them.  Having Social Anxiety Disorder or a family history of it may also increase the risks.

Other problems may accompany Selective Mutism.

People was Selective Mutism also frequently are shy and experience social embarrassment.  They may be isolated and withdrawn.  Children with Selective Mutism may be clingy and become easily upset.  They many also exhibit temper tantrums and oppositional behavior.

Having this disorder early in life and not getting treatment for it puts the child at extra risk for poor development and failure to learn needed social skills.

Things that are excluded from a Selective Mutism diagnosis.

To get this diagnosis, this condition of not speaking even when you need to speak must go on for at a month or more.  If the thing keeping you from speaking is the result of not knowing the English language or being bilingual in some way, this is not a case of Selective Mutism.

Also excluded from the definition of Selective Mutism are things related to speech fluency.  If the person involved is experiencing an episode of hearing voices, if being psychotic, or a schizophrenia-like condition, this also is outside the definition of Selective Mutism.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

More “What is” posts will be found at What is.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – 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 the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s 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. A list of books I have read and can recommend is over at Recommended Books