Category Archives: Mental Health

What causes Mental, Emotional or Behavioral illness? We have been wrong.

Posted on by
Reply

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

Sad child

Sad.
Photo courtesy of Pixabay.com

Looks like a lot of the theories about what caused mental illness are wrong.

What causes mental illness? What do we know and what do we think we know?

Many of the things we thought were causing mental illness turns out to not be causes. In the process, we missed a lot of things that are impairing the mental health of our society.

There have always been people who were clearly mentally different from others. We have seen explanations for what causes mental illness to come and go. Today we know more than ever before about the human brain, how it works and some of the problems it may develop, still we are less sure than before about what is causing that thing we call mental illness.

There is hardly a day now when you can turn on the T. V. or read the news online and not hear about someone with a “mental illness” and some terrible thing they have done. This media coverage is leaving more out than they put in and the result is less, not more, understanding about mental illness.

The mentally ill and violence.

As an aside here, the mentally ill, those with serious long-term illnesses, are more likely to be victims of crime than the perpetrators. They get beat up and robbed on a daily basis. This rarely gets on the news unless the perpetrator is a police officer, and even then the sense is that the mentally ill somehow deserved it.

Personally, experience has taught me that I have more to fear from the person who was just served with divorce papers or found out their spouse is cheating and has shown up at a worksite with a gun, than from someone who has a long-term mental illness.

Emotional problems in someone who has not been identified as having a serious and persistent meant illness are the larger threat. It is easy to see in retrospect that there “had to be” something wrong with the person who came to a school with a gun. But if you follow all the people who are diagnosed with schizophrenia, for example, very few of them ever get a gun and shoot up someplace.

Parents and gun violence.

Gun violence at schools and public sites is a huge problem. We need to do something about this. but for the record, for every child killed at a school site by a gunman, 25 to 50 children will be shot and killed at home by a biological parent with a gun. The cure seems simple. Do not let bio parents raise children or own guns. See how simple solutions turn into complex problems and do not always work the way they were intended?

There have been a lot of theories, most of them very simplistic, over the years about the causes of mental illness. Some people continue to cling to the over-simplistic views despite overwhelming evidence to the contrary. But then the flat earth society and those who doubt that some form of evolution has occurred are also still in existence.

In this post let’s look at some of the things that have been suggested as causes for mental illness in a necessarily oversimplified way.

First, the things we now doubt are true about or are not causes of mental illness.

1. Are there are two kinds of people, normal and the mentally ill?

We used to separate emotional problems into two categories, Neurosis and Psychosis. That was it. So people were seen as having a psychosis, they were in effect “crazy” or they had neurosis, problems of living that might respond to talk therapy.

The more this has been studied the less reliable it has become. First, we found that there were people who sort-of had both. They got the label of “Borderlines” then we found there were a whole lot of different kinds of neurosis, like anxiety and depression and OCD. And people with psychosis can also get depressed. You can have two or more problems.

From that two problem view, we continued to study symptoms and the result in the DSM-4 was over 400 recognized mental illnesses.  Even more, possibly another 400 disorders were proposed (the DSM-5 was supposed to simplify this but we still know way less than we would like.) Today we are seeing that some of this splitting up is the result of people moving on a continuum from one level of symptoms to another. People’s illnesses can change over time and they can have more than one illness.

2. For a while we blamed the victim, some people still do.

There was that belief that mental illness was from God or the gods. Some thought that God had caused the mental illness as a punishment for the person’s sins, or the sins of the father or grandfather.

There are still people who take this approach, avoiding the mentally ill or insisting that they should just snap out of it as if being ill was a choice.

We do know that this fallacy like every good lie has some grains of truth embedded in it.

Parents provide both the environment and the heredity. Some life events, like age and use of drugs or alcohol, may increase the risk of a gene mutation. But a risk factor is not a cause, and so we find that some very poor home environments produce some mentally healthy people while “normal” homes produce some very dysfunctional people.

More on the environment versus heredity issues to come.

If the problem is that God is punishing this person somehow then the cure should be a religious conversion. The prescription for mental illness used to be, and in some circles still is, prayer, fasting, self-control or self-abuse, and the like.

Some of the evidence to challenge the “its Gods will” concept of mental illnesses comes from the sudden miraculous improvement in some mental illnesses that medication produces; that and the cases where a person lives a good part of life, often in a “Godly way,” and is suddenly struck by a mental illness. Some of these appear to be the result of the changes our bodies undergo as we age.

3. People said, “It is the mother’s fault.” Occasionally this is read “it is the father’s fault.”

This was popular for a while under the guise that the cause of psychosis was “refrigerator mothers.” We found that there was some truth to emotional problems that resulted from early life experience; we now refer to this as attachment theory.

The idea that a lack of love or poor mothering skills was primarily the cause of serious mental illness has been largely discarded. We now think that there is such a thing as “good enough” parenting. Do a halfway good job and your child should turn out fine. Abuse or neglect can increase the risk of mental or emotional problems but risk is not result.

One new area of study is the role of “complex trauma.” A number of traumas or ongoing trauma change the brain in ways that are different from what we were looking for in the past. This complex trauma can cause more problems than the sum of its parts.  More on Complex Trauma in some upcoming posts.

4. It is just the way they are

There was a school of thought, back when the psychologists seem to offer us answers to all these issues, that mental illness was the result of “personality factors.” Again some truth here, but in my view, not nearly the whole story.

Some children are born “fussy” they are hard to soothe, cry a lot, and get on their parent’s nerves. Those kids may have a fussy temperament or they may have a physical illness. Either way, fussy kids get less care or upset the parents. Maybe the stressed parents yell at the child more. Their life experiences are different from the “naturally happy child.”

Personality can and does change over the lifetime. We can debate how much or why but the fussy child may grow into a contented child and the good child may at the onset of puberty suddenly become the problem child.

All these factors, to me, argue against the idea that mental illness is caused solely by personality.  It points in the direction of gene expression, genes act differently at different points in our lifetime. It also points out the ability of all of us to learn from life and as a result our personality shifts.

Sorry, this ran long. More on the causes and by implication the cures for our mental emotional and behavioral illnesses in some upcoming posts.

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

Will the therapist say I am crazy and lock me up?

Posted on by
2

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

Psychiatric hospital.
Photo courtesy of pixabay.

Being locked up is a fear of some people coming to therapy.

The chances of this happening are very close to zero. The fact that you came in on your own means this is highly unlikely for many reasons.

This idea of the upset person who gets “put away” in a mental hospital, usually called an insane asylum, makes for great T. V or a good novel, but in real life that does not happen, at least not very much and particularly not here in the United States.

Here are the reasons why you are not going to get locked up just for going to see a counselor.

Professionals just do not think of mental illness that way anymore.

The old notion was that there were two kinds of people, normal and crazy. If that were true we would need to lock everyone up because I do not see any normal people in my world. Some people may be more normal or less normal than others, normal being a statistical concept. Being different does not make you crazy.

Mental illness is not the same thing as being crazy.

Mental illness is on a continuum, people get unwell, then they get sick, then they move back in the other direction as they recover. Most people have times in their life when they are anxious or depressed. If someone is shooting at you please get anxious. If a family member dies, I hope you get sad. Do not let that anxiety or depression control you for the rest of your life.

People we call mentally ill get stuck at that “too sad” or “too anxious” and do not seem to get back to a better place without help.

There is a big argument about why. Watch for an upcoming post on the causes of mental illness as I see them.

The therapist expects you to have some problems, so no they are not likely to think you are over the edge just because you came for a little emotional help.

There are only three special reasons you can be confined to a psychiatric hospital against your will.

Holds for involuntary psychiatric hospitalization in this area are only written if the client is a danger to themselves, a danger to others or they are so disabled they can’t feed themselves or clothe themselves. Being poor, or homeless, does not count. I hand you a cookie and you eat it, I offer you a sweater and you put it on, you pass this test.

If you say you are planning to kill yourself then you may be detained until those thoughts pass and you recant that thought. Professionals are suspicious if you were saying you would kill yourself to the police just a few minutes ago and now you are saying that you won’t.

Saying you have thoughts, usually will not get it. You need to also have a plan for when and how you will do it or a history of attempts or some other reason for the official placing you on an involuntary hold to believe this is something you might do.

Being under the influence of drugs or alcohol is a risk factor. People who binge drink or are drunk are 55 times more likely to attempt suicide than sober people. So if when drunk you say you are going to kill yourself and the police are called you may end up in a psychiatric hospital for a very short stay.

Say you are planning to kill someone else, say you also have a gun and you may end up in a hospital or a jail for a while longer. Even then the law just does not let the police or the psych hospital keep people who might someday hurt someone else all that long.

Once the person sobers up or changes their mind, the chances are that they will have to be released even if the police still think that this person may in the future hurt someone.

While this lets some people out who may harm others it also keeps a lot of people from being locked up just because they scare someone else.

The psych hospitals are pretty full and they charge a lot of money.

The hospitals do not want to keep anyone there one minute longer than they have too. The days of years in an asylum are over and gone. Most stays now are a week or less. Stays beyond 30 days are rare.

In crisis units, the stay around here is most often less than a day.

Yes, I know the involuntary hold says 72 hours, but in practice, not many people stay that long. That 72 hours or 3 days is a maximum, not a for-sure.

Most of the complaints I hear are that people were discharged from the hospital before they felt ready, not that they were kept too long.

As soon as someone appears able to cope with life they get let out even if they will need meds or therapy to be able to cope in the future.

Counselors, in most places, are not authorized to write involuntary holds.

Even if a counselor works for the government and writes holds in their day job, they are not able to write them in their private practice. So unless your treating professional is a psychiatrist with treating privileges at the hospital there is a low chance they have that little card that lets them write holds, especially one that would let them write the hold in their private office.

What could happen is if you said you were going to kill yourself or others and you convinced the therapist that you were serious about this, he or she might call the police and get you detained until you change your mind.

There you have it. The things that bring most people to counseling are miles away from the things that might get you locked up in a psych hospital. Stop worrying about this and go get the help you need before you have to live your life in the place of unhappiness.

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 is an addiction?

Posted on by
2

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

Hands with pills

Addiction.
Photo courtesy of Pixabay

How many addictions are there?

More and more things seem to be getting labeled as addictions.  This mushrooming of addictions has resulted in a lot of skepticism about whether all these items are real addictions or just excuses by people who do too much of one thing or another.

The mental health professions don’t typically use the word addiction. We use other terms to help explain why what is commonly called an addiction may look so different in different people.

Let’s explore this problem by starting with the best known of all addictions, drug addiction, and then see what other things might qualify as addictions.

Drug addiction.

Most drugs, legal and illegal, result in two specific reactions in the body, tolerance, and withdrawal. Tolerance means that over time your body builds up a resistance to the drug so that it takes more and more of the same drug to get the same effect.

Physically addicting drugs all result in tolerance in the body.

Withdrawal is the phenomenon of symptoms that occur when the level of the drug in the bloodstream begins to drop. As many an alcoholic knows if you can keep the level of alcohol in the bloodstream up, you can hold off the hangover for a while. Eventually, you fall asleep or more precisely pass out, and then the blood alcohol level drops.

The drop in the level of drug in the bloodstream, not the absolute level is what is causing the withdrawal symptoms, sometimes also referred to as “abstinence syndrome.”

When someone has been abusing drugs, including alcohol, we take them to a detox. They go through a lot of symptoms, some very unpleasant, as the drugs leave their system. So after 3 days or so, defiantly in a week, almost all drugs (except marijuana) are out of the system.

The carvings problem.

No drug (alcohol) in the system, the hangover, or other withdrawal symptoms go away. In the case of heroin, the shakes, diarrhea, vomiting, goosebumps, and all the other classic symptoms of opiate withdrawal end, and the person, now with no detectable drugs in their system are discharged to go home.

The majority of all people who go through detox, somewhere over 90%, will relapse or use again in a month or so after the detox.

If the drugs are all out of their system why are they still exhibiting addictive behaviors?

The problem with addiction is not the chemical dependency in the body, as awful as that can be. The real problem of addiction is that it is a problem of the mind.

We might call this manifestation of addiction a psychological dependency on the drug to differentiate it from a physical addiction. Even when no drugs are in the body the cravings remain in the brain.

Behavioral Addictions.

So can people really be addicted to things like shopping, sex, or compulsive spending?

My belief is that these kinds of activities can also be addicting but are not automatically addiction.

Each activity produces thoughts, those thoughts move through the brain chemically. Change your thinking and your brain chemistry changes. Some experiences, falling in love, having sex, can produce chemical changes in the brain that can be like an addiction.

One key criterion for addiction is the loss of control, if you lose control of an activity you are approaching addiction land.

Continued use of a substance or continued repetition of a behavior despite negative consequences, loss of control over a behavior fits this pattern.

Hypothetical example.

A client says she is “addicted to poodles.” She has poodle skirts, poodle statues, and pictures all over her house. Her husband gripes about all these poodle things but they are still together after 25 years. She says she is “addicted to poodles.” I think she has an unusually large interest, even an obsession with poodles, but so far it does not sound like an addiction.

Let’s say she also has 25 live poodles in the one-room apartment and that she has spent all of their money on poodle stuff this month leaving them with no money for rent and food. Now has her poodle addiction crossed the line?

So while excessive involvement in many things might possibly reach the level of being an addiction the more strongly rewarding things like drugs, alcohol, sex or risk-taking (gambling) produce such high levels of chemicals in the brain that many people might become “Addicted” to these behaviors. Most people are not likely to develop an addiction to poodles. The internet on the other hand –

Let’s leave that for now.

So in many ways, I see addiction, to drugs or other things, as a special case of OCD. The person can’t stop thinking about the object of their addiction and with chemicals or behaviors like gambling once they start they lose control over the substance or the activity.

Most recently we are recognizing that it is possible to have a problem with a chemical or behavior way short of developing an addiction. We might call this a “Use Disorder” or with behaviors we might think of it as an impulse control problem.

However you see this, loss of control over a chemical or an activity can cause someone a lot of life problems and needs treatment.

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 is secondary trauma?

Posted on by
Reply
Injury

Trauma.
Photo courtesy of Pixabay.

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

Can you be traumatized by something that did not happen to you?

Secondary trauma.

Secondary trauma is the traumatic result of watching someone else be injured or their life threatened.  It is just as real as if the incident happened to you and can last long after the incident is over.

One place where we saw a lot of secondary trauma, this might also go by the name of vicarious trauma, were the incidents of September 11th. Children who watched the planes fly into the towers over and over on Television became frightened even though the events were thousands of miles away. They believed, because of the repeated showings, that thousands of planes were hitting thousands of buildings and that any moment the planes might hit buildings in their neighborhood.

This points out that events do not need to happen to you to be traumatic.  Watching a close family member be injured or killed can be as traumatic as if it happened to you. One reason there seems to be more Post-traumatic Stress Disorder among military veterans is the number of horrific incidents they witness during a tour of duty.

Watching others you are close to being killed or injured has a traumatic effect on you even if you are far enough away to escape injury.

Humans are endowed with very vivid imaginations. This raises the question can people be traumatized by fictional things, things that never happened?

As we grow older our ability to distinguish reality from fiction should improve. Young children are not always able to tell the difference. Plenty of children develop fears, night terrors or long-term phobias because adults watch horror or other graphic entertainment. They allow the kids to watch along with them since the adults are not overly frightened they expect the child to be able to understand the difference.

Unfortunately many young children these days are not able to tell the real from the imaginary especially in video format where great effort has been expended to make the horror as realistic as possible.

So whether the trauma was real or imagined, whether it happened to you or someone you know and care about, those traumas can and do traumatize people. We call this trauma, secondary traumatization because the victim of the physical attack may not be the person who suffers the most or the longest.

If you have been traumatized by watching someone else be harmed, there is help available. If your child develops fears or phobias after watching a video, talk with them about reality and fiction. If the problems continue, get professional help.

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

Emotional problem or mental illness

Posted on by
8

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

Confused brain

Mental illness.
Photo courtesy of Pixabay.com

What is the difference between an emotional problem and a mental illness?

Emotions and mental illness Is there really a difference?

Back in the Freudian days, they tended to think that there were two kinds of problems, Neurosis and Psychosis. Those with Neurosis had problems of living; they were too sad, too anxious, or worried too much. Those with psychosis were clearly mentally ill. The heard voices saw things did things that looked irrational. We sent them away to the sanitarium, now called the state hospital. We also tended to mix the mentally ill in with those with an intellectual disability.

Then this nice neat system began to crumble.

Medication can reduce the symptoms of “mental illness.”

First, they discovered a medication that stopped or reduced the voices and other hallucinations. If a med could shut off voices, was the person with a psychotic disorder really “crazy” or did they have a treatable illness?

Then we found that voices were not an all or nothing phenomenon. They did not happen all the time to some of the people who had them. Sometimes hearing voices happen to the “normal” people. Very depressed people might hear voices sometimes and not others. Talk with them, watch their depression recede and the voices shut up.

Also, we found that most teenagers hear voices now and then. You hear a sound; do not know what it is and the brain interprets it as something you know well, like your own name.

Additionally, a lot of otherwise normal people hear angels or a religious figure; some people see or hear loved ones who have died. If it was a religious vision we were reluctant to call that psychosis.

The walls between emotional problems and mental illness began to get thin. In places, we thought we saw people crawl through the cracks in our system designed to keep the normal’s in one place and the mentally ill in the other places. We started calling those that crawled through the fence “borderlines” and other “personality disorders” because they seemed to live in the land between normal and not normal.

Recovery moments happen.

Then came various assorted recovery movements. There was recovery from alcoholism, addiction, and gambling. There was also the consumer movement and then we saw that people with serious and persistent mental illness can and do recover.

People, prominent, important people, came forward and talked about their struggles with mental illness and their own very personal stories of recovery.

The newest trend is to talk in terms of wellness and recovery. That life’s emotional problems are on a continuum. You may have times when you are stressed or depressed and your emotions get out of control. There are other times that your emotions are on a par with the best of them.

Acute versus chronic mental illnesses.

Clearly, for some people, life is more challenging than others. Some people have hereditary predispositions to having more of one problem or another. Some people have multiple problems to deal with. Some people’s problems are chronic and other people’s problems may get better or worse and then better again.

Some of those conditions we have come to call “mental illnesses” have an underlying structural difference in the brain. Some emotional problems are the result of difficult experiences in life. The brain rewires itself based on experiences. Not everyone has or should have all the same skills or the same challenges.

What we continue to see is that these things that bring the majority of people for mental health treatment are not those long-term underlying differences. What most trips folks up are the everyday problems of living, the unemployment, the relationship conflicts, and the times of loneliness.

The line between those with a serious and persistent mental illness and those with a current emotional problem is becoming harder to find.

The truth is that everyone has times of emotional difficulties and everyone can recover and have a happier, better life.

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

Systematic desensitization – conquering fear.

Posted on by
11

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

Anxiety provoking.

Fear and Anxiety.
Photo courtesy of Pixabay.com

Anxiety can be a stubborn foe.

It is tempting to avoid the things you fear and to find ways to numb those unpleasant feelings. Some people use alcohol or sleeping pills other people use avoidance. But eventually, you have to face that fear or be taken prisoner by your fear.

You can’t get over something you don’t face. Sometimes the only way out of a burning building is through the door that is on fire. To begin with, we won’t ask you to walk through the flames, just to look at the door and see how your fear that it might be on fire on the other side is keeping you a prisoner in that room.

Systematic desensitization reduces the impact of fears.

One way of domesticating the anxiety monster is a technique called systematic desensitization. This is an especially effective technique for taming fears or anxiety when those anxieties are a fear of one very specific thing.

Some of these item fears are so specific we name them Specific Phobias. Meaning you are deathly afraid of one particular thing even if you are never around that thing.

Some of these specific phobias are so terrifying to the people with that particular specific phobia that I can’t even write the word out or they would stop reading. So let’s start with an exaggerated and somewhat humors example of how this specific desensitization could work.

Say there is this person that is deathly afraid of crackers. (The little packaged edible kind.)

If you know who I am talking about here please do not let on. That person’s family laughed at him.  But try as he would he just could not bear to eat at a table where there were crackers. Eventually, this got so bad that I – I mean he – could not eat with his family when they were having soup for fear there would be crackers present.

This fear became progressively worse. Soon eating out was impossible because there might be crackers all around. Eventually, even commercials for crackers or the mention of the word might provoke a panic attack. Something needed to be done.

The cure for cracker or saltine phobia? Systematic desensitization.

So off to the therapist this sufferer from cracker phobia went. Here are the steps in recovery from cracker phobia.

First, you need to be willing to talk about this fear and develop a scale of fear. Something like if we just talk about that fear I – I mean he – had by referring to this as the fear of “You know what.” That would be a 1 on the fear scale.

Actually using the name “Cracker” that scored a two. To see a picture of some crackers in a magazine that would rate a fear factor of 4. Entering at a restaurant where there might or might not be crackers present, that was a 5. Seeing actual crackers, that would be a 6, and witnessing someone eat one that would rank an 8. To have to physically touch a cracker that would rank a 9. To personally eat a cracker that would rate a 10.

Now having developed our scale we would begin to work our way up the scale all the while with the therapist reassuring the client.

Along the way, the therapist might teach the client some relaxation techniques, deep breathing, and so on. The theory here is that you can’t really feel two contradictory feelings at the same time. The more you concentrate on your relaxation the more likely you are for the fear, or anxiety if you prefer, to subside.

So over time, the exposure to the dreaded crackers becomes more and more frequent and closer, all the while practicing the relaxation skills.

At the end of treatment, the goal would be for the client to actually open a package of crackers and to eat one while the counselor watched.

Now neither I nor anyone I know has really suffered from a cracker phobia. This cracker fear has been a long time joke in the family. But I hope this has demonstrated how a counselor could help a client overcome a specific phobia that may sound funny to the client’s family and friends but has been causing the client some very real distress.

What are some of the specific phobias that this method is known to work on? Well the number one fear in America, more severe than the fear of death, is the fear of public speaking. Also up there on the list are phobias to snakes and spiders.

Fear of snakes is no big thing for most city dwellers, but if you needed to live and work outdoors this could be a trial. If you worked at the zoo in the reptile house, a fear of snakes could cost you your job.

So whatever your fear or specific phobia there are treatments to help you turn that anxiety or fear control back down to a manageable setting.

Similar to systematic desensitization, at least in my book, is the use of exposure and response prevention. People with Obsessive-Compulsive Disorder (OCD) develop rituals or routines that they feel the need to perform to reduce the anxiety. If we can expose the person to the thing that they fear and prevent the ritual, then over time the fear diminishes. Combine some relaxation techniques with the exposure and response prevention and you move close to the systematic desensitization approach.

Best wishes on taming those pesky excessive anxiety and fear monsters.

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

Anxiety is a good thing

Posted on by
1

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

Anxiety provoking.

Anxiety.
Photo courtesy of Pixabay.com

Some anxiety is a good thing.

A little anxiety some of the time may be helpful. It is only when the volume on your anxiety control gets turned up too loud that it becomes a problem.

Dictionary definitions of anxiety include such things as nervousness about something that is going to happen and something that causes you to worry.

In these troubled economic times, worry about your job and job security makes sense, especially if you work in an industry or company that has been having economic difficulties. Even those government jobs that used to be the height of security don’t seem immune from danger these days.

But if you spend needless hours in worry that you might get laid off or fired when there is no basis in fact for that worry, then your anxiety control might have its volume turned up too high.

Anxiety can protect you.

Some anxiety is actually protective – if and only if, you are in a dangerous situation that warrants that anxiety. This is another case of a little is good and too much is harmful. The challenge is in knowing which is which. If you see someone with a gun shooting, it is wise to be nervous, even scared, and to duck behind something for cover.

Anxiety can help you avoid risks and in certain situations, like when someone is shooting at you, that anxiety might save your life.

Anxiety can take control of you.

If when sitting at home on your couch you hear the noise from a car door slamming a block away and you jump behind the couch to take cover, this level of anxiety is a problem.

People become anxious in dangerous situations for a reason. If the stress they are under triggers an excessive response that may be an “Acute Stress Disorder” but if those over-reactions to past stress continue long enough, they can morph into something more serious. Post-Traumatic Stress Disorder is just such a problem.

This was first recognized in servicemen returning from the war and the hallmarks are intrusive thoughts of what happened in the past that are still interfering with your life today and recurrent nightmares that involve memories of things that happened to you in the past or efforts for you to avoid those situations. We now realize that these problems also are prevalent in children and adults who have been abused or molested.

Disrupted sleep from nightmares about past anxiety-producing situations predicts that you will have mental health symptoms in the future. IRT can help reduce nightmares. 

Treating PTSD is a complex subject. There are many theories but the research is less than convincing. What I feel fairly sure about is that taking sleeping pills or drinking alcohol are not a good solution. If you have intrusive thoughts or nightmares you need some counseling to get this under control.

Running and hiding from our fears gives them extra chances to grow.

But what if you do not have a case of PTSD but your anxiety is off the hook? Do your friends tell you that you are an overly anxious person? Do you sometimes think that you are just too scared and worried?

If your anxiety volume control is just turned up too high, if the affairs of everyday living are making you want to crawl out of your skin, then you need treatment.

What kind of treatment? Well, there are several, but one, systematic desensitization is especially helpful if you have fears that do not make sense to others but you find are interfering with your life.

Too much anxiety? Try some systematic desensitization (done with a therapist or counselor) and see if you can’t get that anxiety volume turned back down.

In tomorrow’s post, we will talk about systematic desensitization.

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

You can recover from your mental illness

Posted on by
15

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

Woman crying with alcohol

Mental illness
Photo courtesy of Pixabay.com

Recovery happens – Does that surprise you?

Mental and emotional illnesses are relatively common.

Some of you are denying that you have or could ever get a mental illness. Half the population at some time in their life will have a mental illness. Depression and anxiety problems are the most common but many other emotional problems can throw you for a loss.

Among those who do develop a mental or emotional disorder, the conventional wisdom has been that they are “seriously and persistently” mental illness. The implication, all too often, has been that once you get a mental health diagnosis then life is over for you.

Recovery happens.

The truth is that many people do recover from their mental illness. Some by using professional help and others recover in spite of the obstacles the system puts in the way of recovery.

Before the discovery that medications could help with mental illness, the prevailing thought was that the mentally ill were “Crazy” and that once you “lost your mind” it was unlikely you would regain it. This has turned out to be untrue.

Medication can help.

For some, but not all, medication has completely changed the prognosis of mental illness. If a few days on medication can restore someone to functional behavior then it is clear that having a mental illness is not an incurable condition.

We have also discovered that many of the things we used to consider mental illnesses were the result of a lack of skills. People who did not learn good social skills in childhood find it difficult to have good relationships in adulthood. The good news is that anything you learned incorrectly can be unlearned and that the human brain is never too old and rarely to sick to preclude the chance of learning new material.

The consumer movement emphasizes recovery.

One other factor has challenged the notion that once mentally ill, forever sick. Because of the stigma, the mentally ill have traditionally faced many people hid their diseases. More and more of those who have had a mental illness have come forward to talk openly and honestly about their struggles. This openness is sometimes referred to as the consumer movement.

It has become clear to me and to others that there are many highly functional individuals who have at one point or another in their lives have struggled with a mental, emotional, or behavioral illness.

Unfortunately, discrimination against the mentally ill continues to keep people away from treatment.

In truth, half of all Americans are likely to experience one or more episodes of mental illness in their lifetimes. Those fortunate enough to have a strong support system and willing to seek treatment can and do recover.

Many a tragedy, personal and public, might be averted if more people could be encouraged to go for treatment rather than trying to hide their symptoms and pretend to themselves and others that they were not struggling with a mental health challenge.

Put an end to the lie – let people know – recovery happens.

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

Why you should judge a book by its cover

Posted on by
Reply

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

Books.
Photo courtesy of pixabay.

Ever heard the old saw “Never judge a book by its cover? Turns out that most of the time we should be judging books by their covers.

Let’s start by considering two literal books, both presumably about economics and how to respond to economic problems.

Book one is titled “How to make money in a bad economy.” The author’s name is “A working girl” and the cover depicts an attractive woman in a negligee holding a large fanned wad of cash.

Book two is titled “The history of recessions, depressions, panics, and commercial revulsion’s in the United States from 1640 to 2008, including the role of government’ policy in precipitating financial collapses.”  This second book is written by a well-known economist from a prestigious eastern school. It comes with a very plain cover with the title, author’s name and credentials, and not much else.

Which book should you pick? Do you really need to open the book and read the first few chapters to figure this one out?

If you wanted a steamy sex book, by all means, pick the first book. But if you are trying to figure out a way to plan your financial future you might be better off with book two.

Turns out that there are plenty of times when we should, in fact, judge a book and a whole lot of other things by their cover, so to speak.

You don’t always get the chance to think it over.

Humans are inherently cognitive misers. We only have so much brain space and if we squander that capacity thinking over things that do not require careful thought we will have nothing left to think about trivial things like what to eat and where to live. Think too much about every decision and you will have trouble getting out of bed in the morning.

Now it is possible that these titles are misleading and that one or both do not live up to the promise made by the cover. If you really want to be sure you might open the book and read the first page or two but by then you should have figured out if this is the book for you.

Turns out that there are a lot of other life decisions where the first impression is the right one.

Yes, first impressions can be wrong, but most of the time we form those first impressions based on past experiences, and as a result, we find it easy to make choices that have a high probability of pleasing us.

Too much time spent thinking things over and checking every possibility to avoid a mistake can result in paralysis and indecision.

One other factor to consider is the costs of either failing to make a decision or making a bad decision.

If you are a college professor who teaches economics, you may well go ahead and buy both. Spending more money may be within your budget. But if you are having trouble paying your bills you may read a few pages of both and then decide to pass on both.

This does not negate the principle that sometimes there are plenty of good reasons to judge a book by its cover.

One last thought. In doing that judging you need to look at what the thing is, not how it looks. I have bought a lot of used books in my time. Some had torn or dirty covers some had no dust jacket at all. Still, I could generally tell from the apparent characteristics, the title, the author, and so on, whether this book had merit.

I think this value of judging books by their cover applies to a lot of other life decisions.

But what about judging people by their looks. By this, I do not mean race, but their dress and self-care. Should you judge a person by their outward appearance?

More on the pros and cons of judging by appearance and why we are all likely to do things that way when we are unsure will be coming up in a future post on counselors soapbox.com.

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

Do people really need to stay on anti-psychotic medications over the long haul?

Posted on by
Reply

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

Drugs

Medications.
Photo courtesy of Pixabay.com

Are psychiatric meds for life?

The conventional wisdom has been that one you were put on an anti-psychotic you were going to be on it for life. People who stopped taking their meds were at high risk for a relapse.

Now comes a blog post, from no other than the director of the National Institute of Mental Health, reporting that we may have been wrong about this.

You can read the full director’s report at the link below.

http://www.nimh.nih.gov/about/director/2013/antipsychotics-taking-the-long-view.shtml

Please do not read my post or even the Director of NIMH and stop taking your meds. Talk to your doctor first.

But consider that meds and meds alone may not be what you or others with a mental illness really need.

You might also want to talk a look at Aaron Beck’s book on cognitive therapy and schizophrenia. The link is below.

Schizophrenia: Cognitive Theory, Research, and Therapy

“Counselorssoapbox is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.” We recommend only books we think are good and maybe occasionally make a buck.

So as with all other treatments, one size, one method is not the right approach for everyone.

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