Category Archives: Personality Disorder

Do you trust your intuition?

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Intuition. Photo courtesy of Pixabay.

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

Intuition makes up half the decision-making system in your brain.

People who study brain functioning have investigated two different ways in which people make decisions. This is sometimes called the dual-process theory. One system, the deliberate decision-making system, is slow and requires a lot of information to arrive at a decision. The other system, intuition, reaches a conclusion rapidly, often based on very little conscious information. Relying on only one of these two systems can get you into trouble. The challenge is to decide when to use the slow, deliberative decision-making model and when to use the fast, intuitive model.

When might ignoring intuition get you into serious trouble?

You’re in the big city, walking across the street. You glance up and suddenly realize a bus is speeding towards you and you are about to get hit. Which decision-making model do you think you ought to use?

If you’re a very logical person, you might want to think this over a bit. How many feet away as the bus? How fast is the bus traveling? You look ahead and see how many feet it is to the other side of the street to get out of the way of the bus. You might also want to look back to estimate if you turn around and jump back onto the sidewalk; how far must you go? While you’re gathering all this information, the bus driver is slamming on the brakes, and you are betting your life on whether he will stop before impact.

What if you decided to use your intuition?

People who use an intuitive decision-making model would leap one way or the other without thinking. If you pick the right direction, this improves your chances of survival. Of course, you could choose the wrong direction and run directly into the path of the bus. Or you might decide to turn around and run back for the sidewalk you just left. One of these decisions, maybe both, might save your life.

Are there other situations in which you might want to use your intuition?

Social situations are a time when you want to rely on your intuition. You meet someone, and they say hello. If you stand there too long thinking over what the proper greeting would be, you’re going to appear socially inept. In the pre-Covid days, if someone put out their hand, you wanted to put your hand out and shake. Now your automatic response might be to bump elbows or perform some other gesture. What you don’t want to do is stand there staring blankly.

Making good decisions in life involves using both decision-making systems.

Relying too much on one decision-making system and not enough on the other are characteristics of two specific mental illnesses. Research on decision-making tells us that people on the autism spectrum rely heavily on thinking things over. They are high on rational decision-making, but that leaves them unable to make automatic decisions based on their intuitive systems.

On the other end of the spectrum are people who make almost all decisions emotionally or using the intuitive method. Relying solely on the intuitive decision-making system is one of the characteristics of schizotypal personality disorder.

You can improve both decision-making systems.

Some people believe that they are using logic to make their decisions, but their decision-making is so full of logical errors and flaws that it’s not very useful. Studying logic and how to make better decisions can improve the slow, deliberative decision-making system.

Many people don’t realize that the fast, intuitive decision-making system can also be improved. In some upcoming posts, I want to talk to you about improving your intuitive decision-making and deciding when to trust those fast decisions and when to use the slower logical decision-making system.

Other posts on related topics can be found under the following categories.

Overthinking               Rumination                 Worry              Finding Yourself

Personality                  Inner Child                  Intuition             Personality Disorders             

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 seems 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 Paranoid Personality Disorder (F60.0)?

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

Grim Reaper

Paranoia.
Photo courtesy of Pixabay.

There’s more than one kind of paranoia.

When you hear the word paranoid, most people think of the expression “paranoid schizophrenic.” Paranoia can be a part of several mental illnesses. Among the mental illnesses that include paranoia as a symptom of Paranoid Personality Disorder is the most common. According to the DSM-5, estimates for the prevalence of Paranoid Personality Disorder range between 2.3% and 4.4 %. The estimate for all types of schizophrenia is between 0.3% and 0.7%. Since there are several types of schizophrenia, my rough estimate tells me Paranoid Personality Disorder is probably 10 times as common as paranoid schizophrenia.

Paranoia can also be a part of several other mental illnesses including, depression, bipolar disorder with psychotic features, other psychotic disorders, delusional disorder persecutory type. Suspicion and even paranoia may also be features of cognitive dementia and substance use disorders.

There is also a condition known as “Subclinical paranoia” in which the person has milder forms of trust issues, suspicion, or paranoia. Symptoms that may cause them problems, but doesn’t quite meet all the criteria to be diagnosed as a specific mental illness. Professionals are beginning to believe that paranoia can exist on a continuum from occasional mild symptoms to the more persistent and serious symptoms that we see in those people diagnosed with Paranoid Personality Disorder.

Many cases of paranoid personality disorder do not get diagnosed. People with this disorder, whether in a mild form or more serious one, distrust others and believe people are out to harm them. As a result of these beliefs, they tend to avoid others, professionals in particular. Those with paranoid personality disorder are likely to only be diagnosed when they are involuntarily hospitalized for mental health issues or forced to be seen by professionals because of criminal or legal issues.

How is Paranoid Personality Disorder diagnosed?

To receive the diagnosis of Paranoid Personality Disorder someone would need to exhibit the presence of at least four symptoms from a list of 7 possible symptoms. These symptoms involve suspiciousness, trust issues, beliefs that others are deliberately trying to harm them. The DSM calls for the symptoms to begin by early adulthood and happen in multiple contexts. This leaves us with a gray area in diagnosing paranoid symptoms which develop in senior citizens.

It’s easy to see that there can be a large mathematical number of combinations of having or not having the seven symptoms. My math tells me that there are over 5000 possible combinations of these symptoms with 840 of those combinations meeting the criteria for a diagnosis of Paranoid Personality Disorder. Since we don’t have laboratory tests such as blood tests or x-rays to detect the symptoms, they are evaluated using symptom check-lists either from the patient’s reports or observations by others. Depending on how the client describes their feelings and the mood of the therapist that day it’s easy to call a particular symptom either in or out resulting in fuzzy diagnoses.

Many of these possible symptoms can vary in intensity. Deciding if someone has 3, 4, or 5 symptoms present can be very much a judgment call. Using more objective screening tools and checklists result in a large number of people who show some symptoms, but not enough to make the cut off for having Paranoid Personality Disorder. One commonly used instrument is the 20-question questionnaire, Paranoia Scale by Fenigstein and Vanable. Results from this scale vary from very low, occasional, symptoms of paranoid to extremely high and constant levels. In future posts, I want to talk about those people who fall in the middle of the score range on the paranoid scale, enough that they frequently experience trust issues and suspicion but don’t quite meet the cut off to be diagnosed with Paranoid Personality Disorder.

What are the 7 symptoms that may be present in Paranoid Personality Disorder?

  1. Being suspicious without good reason that others are trying to harm them, lie to them, or take advantage of them. The presumption here is that the person can’t accurately perceive the actions of others. It can be difficult for the professional to determine whether these beliefs about other’s actions are accurate.
  2. They spend a lot of time thinking about their beliefs that others are not trustworthy, disloyal, or have bad intentions.
  3. They do not trust anyone and avoid talking about their fears because of a belief that others will use what they say against them.
  4. They interpret normal, everyday events as threats or personal attacks.
  5. Holds onto the perceived attacks, may have grudges, and be unwilling to forgive even accidental injuries because they believe others are deliberately trying to harm them.
  6. Gets angry and fights back because they believe others are attacking their character or reputation. The things they’re angry about most other observers don’t see as intentional attacks.
  7. Have unjustified suspicions that their regular sexual partner is unfaithful.

How does Paranoid Personality Disorder disrupt lives?

People with Paranoid Personality Disorder assume that others are out to get them. Sometimes these thoughts are totally unreasonable but other times there a matter of opinion or even experience. If someone has harmed you in the past, it’s not unreasonable to be on the lookout for other people seeking to harm you.

If your partner has cheated on you before, it’s hard to trust them again. Sometimes the mistrust makes sense but other times the injured spouse develops a persistent sort of paranoid jealousy, and no amount of checking will convince them that their partner is faithful.

People with varying levels of paranoid thoughts spend a lot of time doubting and worrying about whether the people around them are trustworthy and loyal. When you’re high in paranoia, you find it difficult to believe you can trust anyone.

Paranoia makes it harder to trust others and makes you reluctant to share personal information with others for fear they will use that information against you. They may be reluctant to answer personal questions and when asked to fill out forms may refuse to give answers to some questions saying that these things are “nobody’s business.” This high level of distrust leads them to believe that accidents were deliberate and that routine jokes were meant as personal criticism. The paranoid person is likely to take compliments as veiled insults.

There are some other characteristics of paranoia that aren’t included in the diagnostic criteria but are listed as associated features. It’s really hard to get along with people who have even moderate levels of suspicion and distrust. People who are high in paranoia are likely to be control freaks and have difficulty getting along with others.

Paranoid Personality Disorder is part of the “Cluster A Personality Disorders.” It’s common for people who are diagnosed with one of the Cluster A personality disorders to also have symptoms of several other personality disorders from this group.

Not everyone with trust issues gets diagnosed with Paranoid Personality Disorder.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities, or cause you personal distress. Otherwise, you may have the issues, but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines, or because of some other physical or medical problem, this fear needs to be more than your situation would warrant. These other issue needs treating first; then if you still have symptoms, you could get this diagnosis.

In upcoming posts, we will look at the overlap between paranoia and substance use disorders, some possible causes for paranoia, some of the milder variations of fearfulness and trust issues as well as ways to reduce the impact of your trust issues on your ability to have a satisfactory life.

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.”

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

Shiny outside, dark side within – the narcissist.

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

a narcissist

Narcissist.
Photo courtesy of Pixabay.com

Narcissists are dazzling at first.

In psychology, there’s an idea referred to as trait narcissism. This trait is closely related to self-esteem and measures how good you feel about yourself. As your narcissism rises, you feel better about yourself. Generally, this is considered a good thing. As your self-esteem rises you take better care of yourself. You may dress better and exhibit more self-confidence. The problems begin when the narcissist loses the ability to empathize with others, and it becomes all about them. At that point, high trait narcissism, or self-esteem, can become a destructive pathological narcissism we call narcissistic personality disorder.

Too much narcissism quickly turns repulsive.

People who have dated pathological narcissists report that in the beginning, the narcissist was extremely attractive. They often dress well, have expensive cars, and appear successful. Pathological narcissists have attracted fields where they can run the show and be in control of others.

When you first meet them, Narcissists are charming. Romantic partners find themselves swept off their feet. In romantic relationships, the problems begin to appear about the seventh date. In business contexts, it may take many months to recognize the destructive aspects of the narcissist.

In narcissism confidence becomes arrogance.

Confidence is a good thing when it comes from a high level of skill and talent. What makes the narcissist dangerous is that their confidence is the result of overvaluing their abilities. Narcissists are good at boasting that they can’t produce the result. What looked like competent turns out to be arrogance. They overestimate themselves and underestimate everyone else.

The narcissist’s overconfidence turns out to be a lack of insight.

Narcissists seek evidence that they are always right and superior to others. Consequently, they discount the opinions and contributions of others. They lose the ability to understand how their actions are affecting others. Narcissists, the pathological kinds, just don’t care about other people. Their view of the world is unrealistic they are unable to accept that they are less than perfect.

The Charming narcissist becomes manipulative and impulsive.

When you first meet a narcissist, they turn on the charm. This is easy for them to do because they fully believe that everyone worships them and that they are superior to others. Because of their unrealistic self-confidence and don’t think things over and act impulsively. These impulsive actions based on the belief that they are always right in their actions should always be admired.

With a narcissist, a dramatic life turns into attention-seeking histrionics.

Because of their grandiose beliefs, narcissists tend to live drama-filled lives. They live larger than life adventures. In their minds, they should be the stars of their own reality show. If others interested in him should lag, they’re likely to behave in histrionic ways.

It’s not unusual for people with pathological narcissism, technically called narcissistic personality disorder, to also qualify for diagnoses of histrionic personality disorder and antisocial personality disorder. When you believe, you are that wonderful; it’s easy to believe that everything should be about you and that the rules that apply to ordinary mortals don’t apply to you.

With the narcissist, imaginative becomes odd, even bizarre.

People who are high in self-confidence are often imaginative and creative. When self-esteem moves into being feelings of superiority, that creative streak can become bizarre thinking and behavior.

More about Narcissists.

As we move through our series of Narcissism posts, feel free to ask questions, and leave comments. To help you find these posts, below are some links to point you in the right direction. Keep in mind that all the posts about narcissists appeared in the narcissism category but links to future posts will not be live until future posts appear.

Narcissism category.                          Personality disorders.

Narcissistic traits.                               Psychology. (coming soon)

Narcissistic relationship partner.        Relationships.

Self-esteem.                                        Narcissistic Personality Disorder.

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

Surviving a Narcissist.

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

a narcissist

Is he a Narcissist?
Photo courtesy of Pixabay.com

Some narcissists you just cope with.

It may be hard, but there are plenty of times in life when you are going to have to get along with difficult people. Narcissists turn up everywhere you go. Some occupations, business management, politics, and other high-pressure jobs attract people who are high in narcissistic traits. I’m beginning to believe that some jobs turn vulnerable people into pathological narcissists. Sometimes, for your own peace of mind, you must find ways to work with them.

If you are in a close, romantic relationship with the narcissist, or if they are a relative you may decide that you just have to accept them the way they are. Sometimes it’s not worth the conflict to upset your narcissist.

Here are some suggestions for surviving that narcissistic encounter.

Give that narcissist lots of praise.

Narcissists expect, need, frequent praise and compliments. The best way to get along with a narcissist is to give them lots of approval. Some narcissists are insecure, and they crave praise. If you don’t give it to them, they are offended. Other narcissists believe they deserve your appreciation and will feel cheated if you don’t express your admiration. Hand out that verbal recognition in front of others to maximize its effects.

If you must criticize a narcissist, do it in private.

Narcissists expect to be praised and admired. Saying anything negative or disagreeing with them in public is likely to be taken as a personal attack. If you are forced to disagree with a narcissist or give them bad news, do it privately so that their public persona remains undamaged.

Make the narcissist the center of attention.

The higher that someone in your life is in narcissism the more they believe they should be the center of attention. If you take the spotlight off the narcissist, expect an all-out war. When they are in the room, let them shine. Your time comes with a narcissist is off stage. If you want to earn extra points, make sure you mentioned their contribution favorably whenever you get recognized.

Get clear on the narcissist’s rules.

Narcissists believe they are superior to others. If you want cooperation, make sure you know what their rules are and follow them. They may have a distorted understanding of truth, lies, and loyalty. You need to develop an understanding of when leaving negative things out will be considered lying and when not telling them your criticism will be considered loyal.

Do not cross a narcissist.

Because of the narcissist’s sense of entitlement, they are very likely to take everything personally. Before you take action, consider carefully whether the narcissist will agree with what you said and did. In making choices, your primary consideration will be making the narcissist happy. Make sure what you do will make them look good.

Keep your narcissist laughing, use humor.

Don’t get heavy or serious with the narcissist. They expect to be the source of all important ideas. Keep it light. Look for ways to keep them laughing. When you make the narcissist happy, they like you. Avoid being the one to bring them the bad news. Narcissists are likely to blame the messenger. They tend to reward people who tell them what they want to hear even when it’s untrue. Narcissists are equally likely to punish people who bring them bad news even when it is a necessary truth.

More about Narcissists.

As we move through our series of Narcissism posts, feel free to ask questions, and leave comments. To help you find these posts, below are some links to point you in the right direction. Keep in mind that all the posts about narcissists appeared in the narcissism category but links to future posts will not be live until future posts appear.

Narcissism category.                          Personality disorders.

Narcissistic traits.                               Psychology. (coming soon)

Narcissistic relationship partner.        Relationships.

Self-esteem.                                        Narcissistic Personality Disorder.

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 are personality disorder clusters?

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

What is

What are personality disorder clusters?
Photo courtesy of Pixabay.

What are the three main groups of personality disorders?

The newest edition of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders divides personality disorders into three categories based on their similarities.  Personality disorders are long-term or enduring patterns of behavior.  The old way of thinking about these issues was that this is just the way someone is and treatment was not likely to be successful.

Recently treatments for many of the personality disorders have become available.  Currently, we think of many of these personality disorders as problems of living which may occur in varying degrees.  Someone who is low in self-esteem might be described as low in narcissism.  If they were high in narcissism they might be lacking in the ability to empathize with others.  Below is a list of the clusters of Personality disorders with brief descriptions of the disorders in that cluster.  For longer discussions of the personality disorders see separate posts on the specific personality disorder.

Cluster A personality disorders.

This group of personality disorders includes people who appear odd or eccentric.  Among the Cluster, A personality disorders, are Paranoid Personality Disorder, Schizoid Personality Disorder, Schizotypal Personality Disorder.

Paranoid Personality Disorder involves people who are more fearful of people, life, and events that would be warranted.  They are especially likely to think that other people are out to get them.

Those with Schizoid Personality Disorder are detached from others and seem to have little desire to have close personal relationships. They have less ability to express emotions.

In Schizotypal Personality Disorder, people are very uncomfortable in close relationships, have eccentric behavior, and may have thinking or perceptual difficulties.

Cluster B personality disorders.

Cluster B personality disorders include things like Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder, and Narcissistic Personality Disorder.

Those with antisocial personality disorder seem to have little regard for others and their rights.  They don’t mind taking advantage of people around them.  This is different from those people who may make a living out of crime and intentionally steal from, or harm others.  Career criminals get a diagnosis of Adult antisocial behavior Z72.811.

People with Borderline Personality Disorder are likely to have a poor self-image, low self-esteem, fluctuating emotions, and often are very impulsive in their relationships.  Those with Borderline Personality Disorder may also self-harm.

Histrionic Personality Disorder might be described as the typical “Sarah Bernhardt” actress.  Someone with histrionic personality disorder is excessively emotional and is always looking for more attention.

Cluster C personality disorders.

Cluster C personality disorders include disorders related to relationships with other people.  These personality disorders in Cluster C are thought to begin in early childhood. They include unusual ways of relating to close people in their life. This includes Avoidant Personality Disorder, Dependent Personality Disorder, and Obsessive-Compulsive Personality Disorder.

People with Avoidant Personality Disorder avoid other people, feel that they’re inadequate, and are often very sensitive to criticism.

Those with Dependent Personality Disorder are the people likely to become co-dependents.   They are often submissive, clingy, with an excessive need to find someone who will take care of them and control their lives.

Obsessive-Compulsive Personality Disorder is different and separate from Obsessive-Compulsive Disorder.  When the pattern of being obsessive-compulsive becomes a preoccupation with orderliness, perfection, control, having everything exactly the way they need it to be at all times, this moves from a single obsessive-compulsive behavior to the level of a continuing personality disorder.

In addition to the three personality disorder clusters, two other personality disorder characteristics are described in the DSM-5.  Sometimes a personality disorder can be the result of medical conditions.  The DSM-5 also allows for other specified personality disorder or other unspecified personality disorder when one exists that does not fit this list.

Each of these personality disorders is described more completely in other “What is” posts about that specific personality disorder.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships your enjoyable activities, or cause you personal distress.

Having mild forms of these disorders does not qualify unless it causes you problems.  In that case, you may have the issues, but you will not get the diagnoses. If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem these characteristics need to be more than your situation would warrant. These other issue needs treating first, then if you still have symptoms you could get this diagnosis.

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 also Recommended Books.    “What is.” and Personality Disorders

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 you have Borderline Personality Disorder?

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

personality disorder

What is borderline personality disorder?
Photo courtesy of Pixabay.com

What are the signs and symptoms of Borderline Personality Disorder?

Problems with identifying Borderline Personality Disorder.

Borderline Personality Disorder formerly called Borderline conditions has received a lot of attention recently. It is one of those troubling conditions that looks different to different people.

If you have Borderline Personality Disorder you know the suffering having this disorder can cause. If you have lived with someone who has Borderline Personality Disorder you know how frustrating this can be. This difference in perspective is one of the problems with the increased attention to the disorder.

Many of the symptoms of Borderline Personality Disorder overlap or are the same as symptoms of other disorders. So when should someone get a Borderline diagnosis and when should we call it something else? Sometimes those iffy cases get a notation put on their chart “Borderline traits” rather than the full diagnosis. Electronic medical records are making it harder to leave notes like that and this may result in more people getting the full diagnosis.

For the record, diagnosis is not a do it yourself project. Mental Health, as well as physical health diagnosing, should be done by a professional. But so many people out there are being called Borderline these days and talking about it is so common, it is worth looking at the whole “what is Borderline Personality Disorder?” question.

There are efforts to come up with some kind of definitive test for borderline and other mental health conditions. At this time we can read research reports of “markers” and risk factors for many mental illnesses but we can’t be sure what is causing them. For example over 95% of people with Borderline Personality Disorder also have a sleep disorder.

Lacking a good test, mental conditions are diagnosed by looking at symptoms and seeing if someone has enough symptoms and if they are severe enough to need treatment.

With so many Borderline symptoms overlapping or look just like symptoms of other mental illnesses, what name something gets called may depend on which symptoms are seen at any given appointment and the perspective of the viewer. We want to avoid normal problems of life being called diseases but this causes another problem.

Many mental illnesses are caused by identifiable life events. PTSD and other stress disorders need an identifiable stressor to get diagnosed. Many, but not all, people with Borderline Personality Disorder can point to some life event that started their symptoms.

As more people know about Borderline Personality Disorder more people are coming to believe that they have the condition. Family, Friends, and relationship partners are likely to blame all the interpersonal or relationship problems on someone having Borderline Personality Disorder. I suspect that professionals are going along with this and giving the diagnosis out more often.

Is Borderline Personality Disorder an illness or a lack of mental wellness?

Symptoms of Borderline personality disorder can vary from person to person and they may vary in intensity. This has resulted in an increasing amount of discussion, and a past counselorssoapbox blog post about whether there may be Levels or Types of Borderline Personality Disorder.  There has also been some professional discussion about whether some clients have been given the diagnosis because they angered the treating professional.

Some of you have noticed from my other writings that I believe strongly in Wellness and Recovery. (See post on Mental Illness or Mental Health.)

Many of the things we call “Mental illness” are on a continuum. Those problems get better or they get worse. Sometimes in life, we get sad. When that sadness keeps you from working or enjoying life we call it depression and it deserves to get treated. The same thing is true of Borderline Personality Disorder. Many people with this condition do get better.

As we look at the symptoms of Borderline Personality Disorder below I will comment on some of the questions you might have about each one of the symptoms. This discussion is based on the SAMHSA publication titled An Introduction to Co-Occurring Borderline Personality Disorder and Substance Use Disorders. This publication was written primarily for professionals but I include it here in case any of you want to see the original source. The SAMHSA publication draws on the –DSM-5 (DSM is a registered trademark of the APA,) which some of you may also want to consult. The paraphrasing and comments are mine, so let’s hope I get this right. If you have or think you may have this condition please see a professional in your area.

Below are some of the typical features of Borderline Personality Disorder.

Borderline Personality is not common except in psychiatric hospitals.

Estimates of how common Borderline Personality really vary. In the general population, it is estimated at around one to two percent. In inpatient psychiatric facilities the rate of Borderline Personality Diagnosis can reach 20%. That suggests to me that this is a very impairing condition.

Notice as we go through these symptoms that many of these are things that have been considered “female” characteristics. Turns out that three out of every four people who get the Borderline Personality Disorder Diagnosis are female. Also, many of these symptoms are exactly what we would expect in someone with a Stress or Trauma-Related Disorder as in Posttraumatic Stress Disorder or a Dissociative Disorder.

Borderline Personality Disorder is not simply a matter of being overly dramatic or wanting attention. Most, about 80%, attempt suicide and they die from suicide attempts at about 50 TIMES the rate of the general population. This does not need to happen as there are effective treatments for Borderline Personality Disorder available. Additionally about 80 percent of those with this diagnosis cut on themselves, which is often called Non-Suicidal Self Injury. Some people with this condition both cut and attempt suicide.

Symptom – Intense fear of abandonment and efforts to avoid it.

Many, not all, people with Borderline Personality Disorder were abused or neglected as children. Some had this experience in adult life. This suggests that these fears are both rationally based on experience and learned. If you learned to be fearful you can learn to not be fearful. But lessons learned very early in life may be much more difficult to unlearn. For many this fear of abandonment makes sense.

Borderline symptom – troubled, vacillating relationships with others.

In a single session with a therapist, someone high in borderline traits may tell the therapist that they love them and they are the only on that ever understood them and then later they will say that they hate the therapist and “you just don’t understand at all.”

The same thing happens in their personal relationships. They fall in love quickly and they fall out just as rapidly. They have overinflated views of their potential partners and then they feel tricked, deceived, and angry. Relationships with someone who has Borderline Personality Disorder can include fabulous sex followed by violent fights.

Don’t know who you are and who you are keeps changing.

People with borderline conditions have more difficulty than others in telling you what they like, who they are and they look to others to define themselves.

Impulsive acts are common in Borderline Personality Disorders.

Risky sexual behaviors are the most commonly noted behaviors. Over-spending and reckless driving are also included in this definition. Frequent conflicts with others are common.

Suicidal Behaviors or Self-Mutilation.

People with borderline personality disorder are often overwhelmed by emotion and then hurt themselves rather than express their anger towards the person that angered or hurt them. This kind of sudden flip in their feelings towards others and then their impulsive behavior can look a lot like Bipolar and turns out that many people get both diagnoses or they are moved back and forth. It is of course very possible for someone to have more than one disorder.

Borderline makes people feel empty.

Since people with Borderline do not know who they are and they fear being abandoned, this makes sense. If you look for your self-worth from others and then feel empty or nothing at all when you are not getting positive interactions from those others you can feel empty. Some of these characteristics may sound like an immature or selfish person. If you did not get enough food as a child you may be physically stunted. If you are abused or neglected as a child or abused drugs and alcohol, then you may not have learned the lessons you need to learn back then. The result is continuing to use coping strategies that may have kept you alive or got some of your needs met as a child but they are not working now. This is true of some people with Borderline Personality Disorder but not all.

Remember that these explanations are ideas about how things could happen but not precise formulas for how it did happen to any one particular person.

Episodes of strong, excessive anger.

There is no specific diagnosis for “anger issues” despite how common referrals to therapy for “Anger Management” are. Anger is a symptom reported in many other mental or emotional issues. What further clouds this picture is the high rate of Bipolar Disorder and Substance Use Disorders among those with Borderline Personality Disorder. Depression can also lead to irritability and then anger. What is looked for in Borderline Personality Disorders is sudden explosive anger often with fights and violence, that come on unexpectedly with someone who shortly before was a close friend or loved one.

Borderline may include Stress-related Dissociation or Paranoia.

This can be a problematic symptom in practice. Part of the way we identify paranoia is that the fear is excessive. Men are taught to approach things they fear. Kill it if possible. This results in men getting acting out, violence-related diagnoses. Women are taught to avoid danger and if you have been victimized in the past you recognize danger coming. So if you have been abused once the fear that your new boyfriend will abuse you sounds reasonable, not paranoid. See how this can be an issue?

It is also possible that “dissociation” gets pathologized. Some dissociating or “spacing out” is normal in children or those who are overwhelmed. People who suffer trauma may well dissociate. So it seems to me that cases of excessive dissociation may get swept into the Borderline Personality Disorder category rather than being recognized for what they are. As before someone could have both Borderline Personality Disorder and Dissociative Disorder.

Those are my thoughts on recognizing Borderline Personality Disorder and how it and other conditions may be getting mixed together. If you or someone you care about may have this condition consider professional help. If they do not have this problem please stop calling everyone you dislike Borderline. You may also want to check out other counselorssoapbox posts on Personality Disorders.

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 are sleep disorders listed as mental illnesses?

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

View of dreamland.

Dreamland.

What are Sleep-Wake Disorders?

Are problems with sleeping or staying awake making a mess of your life? Then you may have a sleep-wake disorder on top of all your other problems. Why does this matter? Because an untreated sleep-wake disorder will make all your other problems worse.

These issues turn up in the therapist or mental health counselor’s office when people start talking about their concerns with both the quality and the quantity of their sleep. Often this is because those sleep issues are impacting their wide-awake life. When sleep issues start interfering with your job, relationship, or just plain making you not care anymore it needs attention.

This group of disorders sits at the intersection of mental and physical problems and reminds us that the distinction between body and mind is not all that clear-cut. The nervous system connects with the limbic system so your thoughts and feelings impact your immune system. Your body’s physical ailments affect your mood.

With the introduction of the DSM-5 clinicians in the mental health, area are getting a chance to take another look at the connections between sleep and mental health. One rule for therapists is to not be practicing medicine. If a therapist has any doubts, they should refer you to a medical doctor to get a purely medical cause of your issues ruled out or treated before using a primarily talk method to help you.

Some sleep disorder problems can best be determined by sleep specialists. These issues look differently when you try to describe them the next day versus when you are being monitored in a sleep lab and they can be detected right then and there. Your diagnosis may depend on whether the problem occurs during REM sleep or non-REM sleep. Even medical doctors can’t get this part sometimes without sleep tests. The International Classification of Sleep disorders – 2 is far more exhaustive than the DSM or other possible lists, but it requires a sleep specialist to run tests to get this right.

Poor sleep can be a symptom of a mental disorder. Changes in sleep and appetite are one of the things that professionals look for in diagnosing depressive disorders. But poor sleep is not specific to depression or any one particular mental disorder. Sleep-wake cycle disorders affect a host of mental, emotional, and behavioral disorders.

Poor sleep, especially distressing dreams, bad dreams, and nightmares have been connected to depression, anxiety disorders, panic attacks, ADHD, borderline personality disorder, dissociative disorders, substance use disorder, substance withdrawal, an increase in suicide risk, PTSD, and non-suicidal self-injury also known as cutting.

While poor sleep is found in conjunction with a lot of mental illnesses, it has also been suspected to cause mental illnesses. For example, nightmares are a key factor in maintaining Posttraumatic Stress Disorder (PTSD.) Having frequent distressing dreams in childhood predicts the development of an anxiety disorder 5 years later. While nightmares and bad dreams may change and decline as you age, the majority of people who will get diagnosed with an anxiety disorder will have symptoms in middle school at just the time disturbing dreams are at their worst.

Sleep problems are also connected to behavioral problems. Children who are treated for behavioral issues also have nightmares or bad dreams on a regular basis. People with insomnia are at risk to have more nightmares and more nightmares increase the risk of developing a stress-related disorder like PTSD.

It is easy for a therapist or counselor to overlook sleep-wake disorders. If you have depression or anxiety, those sleep issues may be considered symptoms of your depression or anxiety. Make sure you mention the sleep problems to your therapist. If you have sleep-wake cycle problems, whether they are caused by another mental illness or not, if they bother you they should get diagnosed and treated along with the other issue.

Some Nightmares are harder to treat than others. The ones found in PTSD about things that have really happened to you are harder to get rid of than other bad dreams, but there are treatments for these nightmares that do work. Bad dreams based on generalized anxiety have been treated in children with as little as one therapy session. There will be more on treatments for sleep-wake cycle issues in upcoming posts.

Here is the list of Sleep-Wake disorders based on the DSM with their most current numbers.

Scary list isn’t it? For a full discussion, you would need to check out the APA’s book DSM-5. I will try to give you the short plain language versions of these issues in upcoming posts.

Sleep-Wake Disorders

Insomnia Disorder 780-52 (G47.00)

Hypersomnolence 780.54 (G47.10)

Narcolepsy (subtypes/specifiers have different numbers.)

Breathing-Related Sleep Disorders

Obstructive Sleep Apnea-Hypopnea 327.23 (G47.33)

Central Sleep Apnea (subtypes/specifiers have different numbers.)

Sleep-Related Hypoventilation (subtypes/specifiers have different numbers.)

Circadian Rhythm Sleep-Wake Disorders (subtypes/specifiers have different numbers.)

Parasomnias

Non-Rapid Eye Movement Sleep Arousal Disorders

Nightmare Disorder 307.47 (F51.5)

Rapid Eye Movement Sleep Behavior disorder 327.42 (G47.52)

Restless Legs Syndrome 33.94 (G25.81)

Substance/Medication-Induced Sleep Disorder (you need a number chart for this one)

Other Specified/ Other unspecified – Insomnia/ Hypersomnolence or Sleep-Wake Disorder (6 total)

Which sleep-wake disorders are mental health issues?

Some of these disorders are pretty straightforward, some are medical issues, some are psychological and a few are mixed, other sleep-wake disorders are even more complex. Nightmare disorder is a good example of the confusion. In common speech, nightmares are those bad dreams you have that upset you. In technical terms, bad dreams, nightmares, night terrors are all different things, sometimes. Even the researchers use different definitions in their articles.

In coming posts let’s look at the various sleep-wake disorders and treatments for them. Until then sleep well or consider getting help.

You might want to take a look at other posts on:

Sleep

Dreams and Nightmares 

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

Nonsuicidal Self Injury – Cutting to stop pain

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

Cutting – nonsuicidal self-injury.
Photo courtesy of Pixabay.com

What is cutting – Non-suicidal Self-Injury?

Non-suicidal self-injury often called cutting, is another of those troubling conditions that send people to hospitals, physical and mental hospitals. Intentional self-burning, head banging, hair pulling, hitting yourself, and repetitive skin picking are other examples of this thing we call Non-suicidal self-injury. Non-suicidal self-injury causes a lot of suffering for those who do it and for those around them, and yet this problem, like anger, does not get the recognition of a separate diagnosis. FYI Hair pulling has gotten its own diagnosis called Trichotillomania.

Deliberate self-injury is a behavior. Like many behaviors, it can be misunderstood. If someone waves at you, they may be calling you over, they may be telling you to get away from where you are or it may be a way to say hello. It might even have another meaning. Self-injury is like that, a behavior, which may have different meanings.

Non-suicidal self-injury is a condition that has been researched and has been proposed for inclusion in the DSM as a recognizable mental illness. Currently, it is not a “stand-alone diagnosis.” Non-suicidal self-injury is listed in the back of the DSM-5 as a “condition for further study.”

If someone engages in non-suicidal self-injury, the kind we think is a mental illness, the most likely way it gets categorized is as a symptom of Borderline Personality Disorder. Sometimes it is a symptom of Borderline Personality Disorder or Borderline traits, sometimes not. Borderline Personality disorder is the only mental health condition that lists both suicide and Nonsuicidal self-injury as symptoms despite the high or increased rates of self-harm in other disorders like depression, bipolar, and alcohol use disorders. First, the things Nonsuicidal self-injury is not and then what we or I think it is.

What Non-suicidal self-injury is not.

Non-suicidal self-injury is not simply a teen thing.

The kind of thing we mean when we talk about Non-suicidal self-injury, the one that gets diagnosed and treated is not a fad or a rite of passage. I know there are those who cut, tattoo or brand themselves because they want to scar their body to look cool or to impress their friends. This is not what we are talking about when we say Non-suicidal self-injury – the disease.

Nonsuicidal self-injury is not a request for attention.

Yes, some people do this behavior to get noticed or to get something they want. One way to differentiate this is to ask where they self-injury. Most people who seek attention cut in places that are clearly visible. Those who do it as a result of an emotional or mental issue cut or otherwise self-injure in places that are not visible, the stomach or the thighs and they often wear long sleeves, even in the heat of the summer, to cover the cuts. The distinction is that those who develop the illness Non-suicidal self-injury often try to hide their cutting.

What Nonsuicidal self-injury is.

A way to cope with emotional pain.

Transforming emotional pain into physical pain can seem like a way to escape that emotional pain. While it does work, at least some of the time it is not a desirable way to cope. Good coping mechanisms need to be not only effective but safe also. Treatments for Non-suicidal self-injury include lots of learning and practice of alternative coping skills sometimes referred to as recovery tools.

A way to cope with dissociation

Some people report they self-harm to feel or to feel real. This numbing out is a symptom of dissociation and related disorders. Dissociation is not always recognized for what it is. Dissociation needs treatment for what it is not just for behaviors like anger or cutting.

If you live in chronic emotional numbness then the only time you may be able to feel anything is when you substitute physical pain for the constant numbing emotional hurts.

Non-suicidal self-injury is a way to regulate emotions.

Some people have difficulty regulating their emotions. They may have suffered traumas, grown up in a dysfunctional home, or have personality characteristics that make them more prone to be overloaded with emotions. Take a look at the post Emotional Avalanches and Feelings Landslides which discusses how people can be suddenly swept away by feelings floods.

Cutting or other types of non-suicidal self-injury is one way some people cope with these feelings avalanches. Violent outburst is another way. The topic of violent outbursts and emotional regulation is covered in the series on “Anger Management.”

Rumination plays a major role in depression, anxiety, and anger as well as in causing emotional landslides.

Some of the links above may not be active yet. The bold-underlined terms mean that a post is up or will be coming shortly. I will try to get the links in here as the new articles post. If any links (the ones in blue) do not work let me know and I will work on fixing them.

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 do people act in Passive Aggressive ways?

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

Passive-aggressive.
Photo courtesy of Pixabay.com

Why must they act Passive Aggressive?

Passive Aggressive Personality Disorder used to be a recognized mental illness. Then in the DSM-4, it was reduced to a condition that may need more study, and most recently it has simply disappeared from our way of thinking of mental illnesses.

Remember that there are times when a person gets criticized for adopting this form of behavior, maybe even referred for psychiatric care and then other people may be praised for adopting some form of passive reaction to an injustice.

So let’s look at why some people may adopt Passive Aggressive Behavior and why we are no longer so sure that it should qualify as a mental illness.

There are legitimate reasons people do not just come out and say what they mean. There are also reasons people may choose to say nothing but fail to carry through on things they were told to do. Passive-Aggressive behavior can be the result of some of those reasons.

People become Passive Aggressive when they have no power or control.

Children, especially if they are in an abusive or non-loving home, may not feel they can say no to their parents. They get out of things, not by saying no or discussing things but by taking excessive time or doing things wrong. If they break enough dishes mom may stop asking them to do the dishes.

The same behavior makes sense in the boss and employee situation. Sometimes you can’t tell the boss no, so you just do not get around to doing things that would be a waste of time anyway. Not everyone does this. Some employees are very conscientious, but the worse the boss in terms of giving arbitrary orders and not allowing people to disagree the more likely this becomes.

Some people use Passive Aggressive behavior more often than others.

If you came from a family where it was not acceptable to disagree with the parents or worse yet where you were not supposed to have any feeling unless they were sanctioned by the adult, you are more likely to hide your anger and then express it in Passive Aggressive ways.

Mental health clinicians used to think that there were things we called “Personality Disorders” and the presumption was that people who had these were always like that and that they were hard to treat and never changed. These premises have recently been called into question. Turns out that people can change their behavior when the situation changes.

One other thing that cuts against the validity of there being such a thing as Passive-Aggressive Personality Disorder is that it is mostly used in situations where there is a weaker person who is unable to disagree with a stronger person or in a close situation like a marriage where sometimes we want to avoid both doing what the other person told us to do and also avoid making this into an argument.

One characteristic that has been used to differentiate Passive Aggressive behavior from something like passive nonviolence is the level of anger or hostility that the person using passive-aggressive behavior is experiencing.

When the non-doing stops being a way of avoiding conflict and becomes a way to harm someone else without having to accept the responsibility that hidden or veiled aggression can drive the most rational person to open hostility.

One aspect of Passive-aggressive behavior that has received a lot of attention is the times when it appears to be motivated by contrariness or oppositional motives. When a youth adopts the position that they will avoid doing whatever the adult asks them to do just for the sake of asserting that the adult cannot control them this can escalate to severe problems.

Frankly, much of what was getting called Passive-Aggressive Personality Disorder looks way more like Oppositional Defiant Disorder when we see it in youths.

Passive Aggressive Personality Disorder shared so many features in common with other personality disorders and with depression and anxiety most professionals only used it when a parent or spouse said that was what the client was doing.

Most of the things we have been thinking of as personality disorders include a lot of antagonism towards others. Sometimes this is because the person’s life experiences tell them that they will not be treated fairly if they openly disagree or resist the will of others.

So while you will still read about Passive-Aggressive people, mental health has largely concluded that this is not a mental illness but is a way that some people cope with not being able to express disagreement. In other words, Passive Aggressive behavior is a symptom of some other problem rather than being a particular treatable disease.

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

Are you the Passive Aggressive type?

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

Couple fighting by not fighting

Passive-aggressive.
Photo courtesy of Pixabay.com

Who is the Passive-Aggressive?

There has been some discussion recently on the internet and elsewhere about people who are “Passive-Aggressive” how you deal with someone who is Passive-Aggressive and so forth.

What exactly is a “Passive-Aggressive Person” and how might this passive-aggressive personality be affecting you?

Turns out there are at least two somewhat different activities going by the name of Passive-Aggressive behavior.  On the subject of Passive-Aggressive Personality, psychology and mental health are not on the same page. There are not just separated and divorced on this one but living in different time zones.

Psychology has studied the way people may behave and do they have Passive characteristics or Aggressive characteristics. They used to think of these two as on opposite poles of the same axis.

Then it was suggested that some people combine both into a Passive-Aggressive style of dealing with conflicts. There were also some studies of whether these were stable traits, people did this all the time, or were these states, that the person might use a particular way of behaving in response to a specific situation and at one time but not another.

Mental health started looking at this as a potential mental illness, Passive-Aggressive Personality Disorder, which was causing problems in people’s social lives or in their work settings. The result of these two different perspectives is that the two fields came to differing views about Passive-Aggressive personality.

How did we get to a place where some professionals are writing about Passive-Aggressive people as if we all know what that is and why, while other groups have told us to drop the idea altogether?

Is a passive-aggressive person all bad or are there times when this is a useful way of behaving?

The idea that there are “Passive-Aggressive people” seems to have originated during World War Two when officers noticed, and then they complained, that they might give orders but the men just did not get around to doing what they were supposed to do. The result of this behavior was that the men got out of doing things and sometimes they communicated to a superior officer that they did not like that officer.

One example of this might be an officer who had the men dig a ditch one day and then had them fill it in the next. I suppose that the officer could argue that this is teaching discipline and is keeping the men active and fit, but the men soon caught on and found that there was no reason to put much effort into this ditch to nowhere.

This concept, of the person who is told to do something but then deliberately does it poorly or not at all, has also been applied to employees in the work setting. Some bosses like to think of themselves as generals or in other military terms. They talk about commanding their employees. You can make a good argument for the need of people in the military to carry out an order regardless of whether they agree with the order or not. It is harder to see why bosses give some orders that just make life harder for their employees and do not create any extra production.

The result of these irritating directives from management can be work slowdowns, stoppages, or people who just forget to do things. Sometimes it is hard to tell the difference. Some jobs take longer to do than planned. Sometimes people do forget. So the interpretation of “is this a Passive-Aggressive act” has to do with the motivations or intent of the employees, not with the resulting action or inaction.

This Passive-Aggressive idea was expanded to include children who did not do what adults asked. I still see this version in articles about our educational system. The student is told to move something but they drop and break it. Or they get the instructions wrong and go to the wrong place. Sometimes is as simple as them saying yes to doing something but then just sitting in their seat and doing nothing. The complaint by teachers is that the student may be saying yes but their actions are sabotaging the outcome.

One other place this is coming up, and here we are bordering on the mental health arena is in the field of marriage counseling.

One partner will refer to the other as passive-aggressive. Say the wife has a job interview the next day, she is busy getting ready and she asks the husband to stop at the grocery store on the way home.

He gets home late that night and reports he had a problem at work and “forgot” to stop at the store. This may lead to an argument and then either they eat leftovers or he goes to the local fast food for dinner. She is annoyed.

Next morning she goes to use the car for the job interview and finds that the gas tank is empty. She is now furious at him. Her conclusion is that he was late and left the gas tank empty to sabotage her efforts to get a job. Before long both partners may be “not doing” and “forgetting” to get their revenge on the other partner.

So from these examples, we can see why some people may do things that look Passive-Aggressive and that this can be really annoying if you are on the receiving end of this behavior.

This is also a hard thing to cope with because the person who is behaving in a Passive-Aggressive manner has all kinds of excuses for why they did not get things done or why they made a mistake.

Does that mean that someone who is acting in a Passive-Aggressive manner has a mental illness? Why do they do this and how can you get them to stop? And can Passive Aggressive behavior sometimes be a good thing, at least for the person who is using it?

Let’s take a look at all those issues in an upcoming post about the reasons people might adopt passive-aggressive behavior.

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.

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

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