Loving yourself is OK.

By David Joel Miller MS Licensed Therapist & Licensed Counselor.

Loving others requires loving yourself.

Proud

Self-esteem.
Photo courtesy of Pixabay.com

People in a positive, loving relationship need to develop a skill which we used to call Healthy Narcissism, today we might call this high self-esteem. Researchers in the mental health field, believe that a thing called healthy narcissism exists in mentally healthy people. Freud said that our love for others develops from the way we feel about ourselves.

Parents who feel good about themselves can share that love with the children. Parents who feel inadequate find it hard to approve of anything their children do. The more you judge yourself, the more you judge others. High self-esteem or health narcissism is quite different from the unhealthy narcissism we see in people who develop Narcissistic Personality Disorder.

When you don’t feel good about yourself, it’s hard like other.

People with low self-esteem find it difficult to have good relationships with others. A negative view of yourself carries over into negative attitudes towards other people, the world, and the future. Having good relationships with others bolsters your self-esteem. Taking good care of yourself increases your ability to care about others.

Developing an extremely narcissistic personality is one way people protect themselves when they have low self-esteem. Feeling yourself with positive feelings creates a surplus that you can share with others. When you see the world the lens of negativity, everything looks dark and unhappy.

How do you tell healthy self-esteem from pathological narcissism?

Healthy self-esteem results in good mental health. People who feel good about themselves have less anxiety and are more positive and optimistic. People with pathological narcissism, have shaky self-esteem. Someone with narcissistic personality disorder needs to feel superior to others to feel okay about himself.

If you are high in self-esteem, you have plenty of love to share. When your self-esteem is fragile and is based on the beliefs that you are the superior person, and that others should admire you for your greatness, your ability to love and care for others is limited. A pathological narcissist does not love other people; they see others as things they are entitled to use to meet their needs.

Narcissists think they are better than others. People with high self-esteem can see their good points and the good characteristics of others. Narcissists always believed they are better at things that they are. People with high self-esteem feel good about their accomplishments and can see the areas that need improvement.

Narcissists are selfish and believe they deserve the best of everything. People with high self-esteem take good care of themselves so that they will be able to take care of others. People with high self-esteem what their relationships to be caring. Narcissists have little interest in warm, close relationships and see their connections with others as tools they use to get what they want.

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.

Narcissistic relationship partner.        Relationships.

Self-esteem.                                        Narcissistic Personality Disorder.

Posts about having a happy life will be found in the category – happiness.

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

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

Sasquatch.

Wandering through a hole in time they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time but the Sasquatch wants to kill them.

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

Books are now available on Amazon, Kobo, iBooks, and many other online stores.

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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The meaning changed again – concept creep.

By David Joel Miller.

Problems increase when the definitions expand.

man creeping

Creeping.
Photo courtesy of Pixabay.com

Recently psychologists have been studying an idea called concept creep. The principle involved is that once we have identified a problem, more and more things are included in the definition we are using. This expanding definition can be either good or bad depending on your point of view. It’s possible that once we recognize the existence of a problem we begin to find more cases of that problem. Problem recognition is related to the expert effect; if you don’t know what something is, you may not recognize it when you see it.

It’s also been suggested that having once created a category of problem, additional things which used not to be considered a problem get defined into the category. Besides expanding a problem category by adding things to the category, our view of problems may increase as milder things get defined as problems. Expanding categories creates the impression that there is an “epidemic” and that we are all now at risk to experience this problem.

When a concept expands, what used to be normal, is now a part of our definition of problems. I am not arguing here that these changing definitions are a bad thing. But what we need to look at is how these definitions have changed over time and how these words may have very different meanings to different people. Remember that looking words up in the dictionary will not help us here. Various dictionaries will have different meanings for the same word, and the dictionary creates its definition based on the way people have been using the word.

Let’s look at some categories of problems that have expanded.

Mental illness used to be rare.

The term mentally ill used to be roughly equivalent to the label crazy. Today professionals don’t use the term crazy because it implies the condition is not treatable, and this labeling appears to be a case of blaming the victim. Originally mentally ill people were labeled psychotic. The kinds of emotional problems normal people had, were defined as neurotic. Today’s list of mental illnesses includes over 400 separate conditions with an additional 400 or so issues included in a list titled “conditions for further study.”

Increasingly mental illnesses are seen as falling along a continuum from mild to moderate to severe. Mild clusters of symptoms are now considered cases of illnesses where in the past these symptoms might have been attributed to the person’s personality. A person who in the past was described as having a sour, negative attitude might today be diagnosed with Persistent Depressive Disorder or even as having a case of Major Depressive Disorder – mild.

Is that self-abuse?

Our definitions of abuse, both abuse of the self and others, have not just changed, some of them have been turned upside down. Masturbation was once the poster child for the evils of self-abuse, a practice parents frantically sought to contain before this behavior sent their children to the torments of hell. Today masturbation is seen as a normal expression of sexuality.

Beating yourself with whips and chains along with cutting your skin and crawling across broken glass has moved in the opposite direction. These kinds of self-inflicted pain used to be viewed as “mortification of the flesh” a positive spiritual behavior. Today pretty much any episode of self-inflicted damage to the body is viewed as “nonsuicidal self-injury” a symptom of a serious mental disorder.

Sometimes abuse of others doesn’t involve abuse.

Abuse of someone else used to be extremely clear-cut and easily recognizable. Abuse back then referred to beating someone, resulting in visible physical harm. Hitting children with a small stick was considered disciplining that child, a parental responsibility. Such beatings were often accompanied by the old biblical adage “spare the rod and spoil the child.”

Today we are all reasonably clear that any hitting of a child that leaves marks meets the criteria for child abuse. Some people will even argue that any corporal punishment is child abuse. Please don’t misunderstand me here; I’m not suggesting that abuse is okay. What I’m trying to do here is chart the way in which our understanding of the concept of abuse has changed.

Abuse now includes not just physical beatings but also includes neglect and emotional abuse. The concept of abuse as also been expanded to include spousal abuse, elder abuse, and animal abuse. When it comes to elders, financial abuse is also a recognized form of abuse that triggers reporting by a mandated reporter.

“Goldsmith and Freyd (2005) considered emotional neglect, or “emotional unavailability,” to be a form of emotional abuse.” Quoted in Haslam, 2016.

Some of these expanded definitions of abuse spilled over to inform the next example of concept creep, bullying.

Would you recognize bullying if you did it?

I looked up the word bully in my trusty old “Century Dictionary and Cyclopedia” from 1898. It gives us two separate definitions of the word bully depending on whether the word is used as a noun, the person doing the bullying, or it is used as a verb, the act of bullying.

The root of the word bully comes from an older word which means noisy. Bullies were people who were blustering, quarrelsome and overbearing. A Bully was someone who was trying to dominate others. In common usage, back then a “bully” was a term for a pimp, someone who lived off the earnings of a prostitute.

The thing a bully did, when he was bullying, was to be overbearing, blustering, or menacing. A bully got what he wanted by making others fear him.

The concept of bullying is exploding. In the 20 years, 1990 to 2010, annual production of research articles on bullying increased 100 times, (Olweus (2013) Quoted in Haslam, 2016.)

Today the definition of bullying has expanded. Bullying now includes cyberbullying, actions not only to intimidate but to make people feel bad and which happen in the online world. The concept of bullying has also expanded into the workplace were things that used to be considered typical workplace politics may now be construed as “a hostile work environment.” Some researchers have suggested that excluding someone from the social group, or efforts to get others to exclude that person should also be included in our definition of bullying.

Why are they calling the police about that?

Media reporting on crimes, conspiracy theories, and a rash of calls to police reporting things that don’t meet most people’s understanding of crime may all be examples of concept creep in the area criminal behavior in public safety. More on these topics in an upcoming post.

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

High self-esteem or narcissism?

By David Joel Miller.

Trait or State Narcissism.

Proud peacock.

Narcissist?
Photo courtesy of Pixabay.com

In the field of psychology, there has been a good deal of study of a personality dimension which psychologists call narcissism. The way the term trait narcissism is used is very different from the way mental health describes Narcissistic Personality Disorder. This difference has caused some problems when people look at the results of personality tests, theirs or other people’s, and see that there is a score for narcissism.

Trait narcissism is meant to be a measure of how good you feel about yourself. For most people, this trait will be relatively stable over time. State narcissism is how much you are thinking about your own needs now and can vary with the situation. Sometimes you should think about your needs first, and other times you need to include others needs in your calculations.

This difference between the way psychology defines narcissism and the way it is described in mental health and recovery literature has created a good deal of confusion.

High trait narcissism is mostly a good thing.

People with low self-esteem, score low on measures of trait narcissism. As your self-confidence and self-esteem rise, your scores on the narcissism inventory rise. People with high trait narcissism are likely to be extroverted, emotionally stable, and mentally healthy. High trait narcissism correlates with improved functioning and an increase in life satisfaction.

Only those at the extreme high-end of the scale begin to resemble those with malignant, pathological narcissism or Narcissistic Personality Disorder. How much is too much may be open to interpretation but in the tradeoff between low self-esteem and being highly Narcissistic being in the middle, balancing your needs with the needs of others is the healthiest place to be.

Trait narcissism is rising.

Worldwide there appears to be a rise in the levels of trait narcissism. This principally reflects the shift from Eastern collectivist cultures to the Western competitive, individualistic society. We have encouraged everyone to feel good about themselves by bolstering self-esteem, but despite these efforts, there is more depression, anxiety, and suicidal thoughts. When you keep raising the standards for what you expect from people the result is not universal high self-esteem but a society where no one can measure up.

The concept trait narcissism is chiefly studied using verbal questionnaires and tests. This raises the question if everyone responding to these questionnaires understands the concept in the same way. To refine the research results, the trait of narcissism is often studied by separately analyze various subscales, each of those subscales is defined using other words.

The subscales of narcissism.

These various factors are used in measuring the level of narcissism a person has and the components of this condition. There has been some debate about whether these are all distinct factors or how much these concepts may overlap. Here are my thoughts, not specific diagnostic criteria.

Authority.

When do you take command, insist on leading, and assume you are correct, and how much do you defer to the judgment of others. Do you always think you are right?

Self-sufficiency.

Do you think you can do everything? Do you always need someone else’s help? Can you balance self-sufficiency and cooperation?

Superiority.

Feeling better than others is not the same thing as confidence. No one is the best at everything, but highly narcissistic people think they are inherently superior.

Vanity.

More focus on looking good than on substance.

Exhibitionism.

Balancing the search for applause with a tendency to do things specifically for attention.

Exploitativeness.

Is there give and take in your relationship or are you all about getting what you need.

Entitlement.

Do you accept that you need to work for what you get or do you feel that you are superior to others?

One interesting study examined the difference between people in the community who are high in trait narcissism and a group of prison inmates also high in narcissism. The subscale of Exploitivness mostly predicted which of those people who were high in trait narcissism would end up in prison.

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

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How to avoid pathological liars.

By David Joel Miller.

A pathological liar can ruin your life.

Truth or lie

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

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

Avoid letting pathological liars into your life.

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

If someone consistently lies cut them out of your life.

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

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

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

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

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

When in doubt double checked the story.

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

Move slowly in new relationships.

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

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

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

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

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Is your paranoia showing?

By David Joel Miller.

Increasing paranoia – the mental health challenge of this millennium?

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

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

The problem of paranoia frequently gets ignored.

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

There’s no specific diagnosis for paranoia.

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

Humans are often poor judges of danger.

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

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

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

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

Why have we all become more fearful?

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

Belief in conspiracy theories has become more common than not.

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

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

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

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

Your increased dependence on technology put you at risk.

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

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

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

The future is not all bleak.

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

For more on these topics see:

Paranoia

Anxiety

Happiness

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Can you spot the paranoid person?

By David Joel Miller.

Paranoia comes in many shapes and sizes.

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

How paranoia looks depends on the group of people you’re looking at. Researchers who study paranoia believe it may have had an evolutionary advantage. Those who were too trusting did not survive. “It is important to ask why paranoia might be so common in the general population. One possible explanation is that paranoia is a trait that was selected and distributed in humans due to its adaptive value” (Ellett & Chadwick, 2003, 2007).

In many situations, it’s better to be suspicious and cautious, even if your wrong then to be trusting and end up harmed in some way. Being suspicious when in doubt kept our ancestors alive to reproduce. Trust issues seem to run on a continuum from mild suspicion to unhealthy, pathological paranoia. Recent research tells us that mild to moderate paranoia is a lot more common among nonclinical populations than has been recognized in the past. Most of these people who experience an episode of paranoia do not go on to develop a serious mental illness.

According to the Freeman brothers “paranoia is on the rise, fueled by disproportionate media coverage of the dangers we face from others; by increasing urbanization; and by a range of other social factors including fear of crime.”

Paranoia also depends on your viewpoint. If you have been the victim of violence or trusted when you shouldn’t have, you become less trusting. Groups who have historically suffered prejudice and violence, become more suspicious. Suspiciousness in women is likely to be diagnosed as anxiety. Wariness in men is more likely to suggest they will become violent and be diagnosed as some form of psychosis. Both Psychosis and Paranoia are much more likely to be diagnosed in males, particularly African-American males.

Definitions of paranoia.

Wikipedia defines paranoia as “an instinct or thought process believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory, or beliefs of conspiracy concerning a perceived threat towards oneself.”

Google defines paranoia as “a mental condition characterized by delusions of persecution, unwarranted jealousy, or exaggerated self-importance, typically elaborated into an organized system. It may be an aspect of chronic personality disorder, of drug abuse, or of a serious condition such as schizophrenia in which the person loses touch with reality.”

“Paranoia is defined as false beliefs that harm is occurring to oneself which is intended by a persecutor (Freeman and Garety 2000).”

The meaning of the word paranoia has changed over time. The Century Dictionary and Cyclopedia from 1890 defines paranoia as, “a chronic form of insanity developing in a neuropsychopathic constitution, presenting systematized delusions of more or less definite scope, while in other directions there may appear a fair amount of mental health. The prognosis is extremely bad.

Today in the field of psychology, paranoia is treated as a personality characteristic which can fall along a scale from extremely mild and rare to very high and constant. Ways psychologists measure paranoia are by using the Paranoia Scale (Fenigstein and Vanable 1992) or the Paranoia Suspiciousness Questionnaire (Rawlings and Freeman 1997.) When studying personality characteristics, it’s important to differentiate between traits, how paranoid a person is generally, and state paranoia, how paranoid the person may be thinking, feeling, and acting, at the moment.

In common usage, today when most people say someone is “paranoid” they are describing someone with excessive or unwarranted fears and beliefs that others dislike them, are out to get them or will betray them.

Paranoia along with excessive fear and suspiciousness are commonly associated with some of the more serious mental illness. Anyone with difficulty understanding what’s happening around them is likely to become fearful, suspicious, possibly even paranoid.

Subclinical paranoia.

Counselors see many clients with excessive, unreasonable fears. When those fears interfere with everyday functioning, they need to be treated. How much fear is warranted depends on your point of view. When someone has experienced infidelity, the belief that their partner may be cheating again may be very reasonable. If you have been the victim of violence, a heightened wariness is understandable. Life experiences, from your earliest years to the present taught you whether to be trusting or suspicious. Having been neglected or experiencing bullying increases the chances you will see the world as hostile and people as unreliable.

If, as far as you know, your partner has never cheated, but you spend hours each day checking their cell phone or social media for signs they are cheating, if you follow them or demand to know where they are every moment of the day, it’s likely your fears are about you rather than about their behavior.

According to paranoidthoughts.com, “around a third of the population regularly has suspicious or paranoid thoughts. In fact, paranoia may be almost as common as depression or anxiety.”

Subclinical levels of paranoia are associated with the anxiety disorders, depression, and with cognitive impairment. Excessive jealousy can become so severe that it needs to be treated as a “delusional disorder.”

Paranoia among people with substance use disorders.

There’s a significant presence of paranoid symptoms among people with a substance use disorder. Some substances increase the level of anxiety and cause paranoia. The substance using lifestyle includes people who are untrustworthy and can result in traumatic experiences. Using illegal substances involves criminal activity. Telling whether extreme fearfulness and the beliefs that others are out to get is paranoia or reasonable is difficult when you have a substance use disorder. The belief that the police are following you and people are watching you may not be paranoia when you have a kilo of dope in the trunk of your car.

The way you think about yourself affects your risk of developing paranoia.

High self-esteem, feeling good about yourself, has been shown to reduce your risk of developing paranoia. Several other personality characteristics such as optimism and pessimism are also related. There is still the question of whether paranoia causes low self-esteem and pessimism or whether paranoia is the result of those personality characteristics.

In upcoming posts, we will talk about clinical, mental health disorders which may involve paranoia, some of the substance use disorders which involve paranoia and those subclinical problems, which lie on a continuum between trust issues, suspiciousness, and diagnosable paranoia. We should also explore some of the personality characteristics which impact your level of trust issues, suspiciousness, and paranoia.

For more on this topic see:

Trust

Paranoia

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Dextromethorphan and paranoia.

By David Joel Miller.

Sometimes over-the-counter medications cause paranoia.

Fearfulness

Paranoia.
Photo courtesy of Pixabay.com

Dextromethorphan is a common antitussive (cough suppressant) medication found in over-the-counter medications. It is a common ingredient in over 140 over-the-counter medications. Unfortunately, Dextromethorphan has become an increasingly abused substance among those in the 18 to 25-year-old range. Abuse by younger teens is reported to be on the rise.

Because dextromethorphan can be purchased over-the-counter or stolen from grocery stores and pharmacies, many users have underestimated the serious, long-term effects of dextromethorphan abuse.

When taken according to directions most over-the-counter medications are relatively safe. Any medication, including over-the-counter medications, may result in side effects or allergic reactions. Abuse of Dextromethorphan can have some serious health consequences.

When Dextromethorphan is taken in larger than recommended amounts it can produce psychoactive effects. “Use in amounts exceeding those recommended, a practice which is known as “Robotripping,” may result in a toxidrome of psychomotor agitation, hallucinations and paranoia best characterized as Intoxication Delirium (Stanciu, C. et al., 2016.)

Dextromethorphan shares pharmacologic and neurobehavioral properties similar to opiates and phencyclidine (PCP.) Because of its cough suppression action is like the opiate codeine, as the dose increases it can produce dreamlike states and hallucinations somewhat like the “pipedreams” of opium smokers. As the dose increases significant unpleasant and health impairing results occur. At very high doses Delirium and misperceptions occur, resulting in paranoia and violent behavior similar to PCP intoxication.

“Intoxicated excited delirium describes the most serious and potentially deadly DXM-induced medical condition involving psychotic behavior, elevated temperature, and an extreme psychomotor agitation fight-or-flight response by the nervous system. Due to extreme violence frequently encountered such presentations, typically encountered in the emergency room setting with law enforcement involvement, have resulted in sudden death secondary to cardiac or respiratory arrest, an outcome associated with the use of physical restraints” (Stanciu, C. et al., 2016.)

One online user bulletin board, I will leave the website name out, included a number of user warnings. Users report tolerance to dextromethorphan happens rapidly, often after a single dose. Reports of paranoia were common, both paranoia caused by taking dextromethorphan and users reports of high anxiety which they called “paranoid” about the many other negative results from use.

Users have reported impaired daily functioning for as long as six years afterward.

On the way to psychosis and paranoia, users may experience a variety of alterations in perception. Commonly reported are auditory, visual, and tactile hallucinations. That may pass through a period of excitability and pressured speech which can easily be mistaken for bipolar mania. Nervousness, confusion, and disorientation can occur. A variety of physical symptoms are also likely, including tremors, slurred speech, and occasionally seizures. Some less pleasant symptoms include nausea, vomiting, respiratory depression, coma, and even death.

The particular gene responsible for metabolizing dextromethorphan is polymorphic meaning there are a number of different mutations of this gene in humans. Because of this a new user never knows just how dextromethorphan may affect them. Some people need to take a large amount to feel the effects while other people can have a serious adverse effect even at doses only a little above the label recommendations (Stanciu, C. et al., 2016.)

There are antidotal reports of serious interactions between dextromethorphan and commonly used substances such as alcohol and marijuana. In medical settings, life-threatening interactions between prescribed psychiatric medications and intentional overdoses of dextromethorphan-containing products.

Dextromethorphan is not the only drug of abuse which has been connected to an increased risk of developing paranoia. Reports of paranoia among drug users are common. Paranoia can be difficult to identify and diagnose. It is often only considered in the context of diagnosing the paranoid type Schizophrenia or Paranoid Personality Disorder. Recent studies have suggested that paranoia falls on a continuum and paranoia has rarely been studied outside the seriously mentally ill. Many things about the drug using lifestyle increase the risk of paranoia. Another reason for the shortage of information about rates of paranoia and its treatment among drug users has been the systematic exclusion of those with a substance use disorder from psychological research. Given the large overlap between those with a substance use disorder and a diagnosed mental illness, there’s a lot we haven’t learned about trust issues, suspicion, and various levels of paranoia among those with a co-occurring disorder.

I’ll continue to watch for and read research about the trust to suspicion continuum so watch for future posts on this topic.

Staying connected with David Joel Miller

David Joel Miller MS is a Licensed Marriage and Family Therapist (LMFT) and a Licensed Professional Clinical Counselor (LPCC.)  Mr. Miller provides supervision for beginning counselors and therapists and teaches at the local college in the Substance Abuse Counseling program.

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.