Hallway of transitions
Photo courtesy of Pixabay.com

Life is choked with transitions.

By David Joel Miller, MS, Licensed Therapist, Counselor, and Certified Life Coach.

Over the last few years, my practice as a therapist and counselor has shifted. Some of that is because of COVID and learning to work remotely online, doing telehealth. I’ve found that my practice has shifted from working mainly with young people starting out in life to serving an ever-increasing number of older people.

I hesitate to call these people elderly since most of them are younger than me, but I’m sure that I am the exception that proves the rule. I feel fortunate that, despite being 77 years old, I can still work and be productive.

Two things stand out in my online practice, which are different from what I saw when I worked for the county or in an office in private practice. I am seeing far fewer children or couples, and many more single adults and older adults. While the specific mental health diagnoses vary a great deal, what I see most often is people struggling with life’s transitions.

When the challenges life throws at you are overwhelming, you’re very likely to develop high anxiety, severe depression, a substance use disorder, or some kind of dysfunctional behavior.

For better or worse, I have personally gone through a pretty large number of life transitions. I tell my clients that I have learned a lot more about life’s problems, particularly aging, than I ever wanted to know. I’ve spent a lot of time studying the challenge of transitioning from one thing to another, both by reading the research and by living the experience.

I mentioned these things not because I want anyone to feel sorry for me, but because I’ve developed a special sensitivity to the role that transitions play in all our lives.

There are certainly developmental transitions, and some people experience difficulty navigating those. Progressing through school involves its share of developmental challenges. Graduating, whether it’s from high school or college, and then entering the workforce can be a major transition for many people. In my role as a clinical counselor, I have studied career counseling and the challenges of finding the right job. That task deserves an entire series of posts.

Getting into and out of relationships involves a great many painful as well as joyous transitions. I believe that the increasing lifespan has led to more people ending one relationship and starting another than at any other time in human history. I intend to talk about the changing nature of human relationships in an upcoming post.

At some point, most of us will go through conflicts with our spouses, and some people will experience breakups or divorces. If you live long enough, you may experience the death of a spouse. An increasing number of family members are struggling with a loved one who is in Hospice and dying, or living in a long-term care facility. There’s also the transition of the person who loses individual functioning. Dementia has become more common and causes a great deal of suffering both for the person with dementia and for those who encounter the dementia sufferer.

For something to be considered a mental illness, it has to affect a person in four basic areas. If your problem interferes with social functioning, your ability to have relationships with family and friends, including your romantic partner, then it’s a reason for your problems to be considered a mental illness. Any problem which is severe enough to interfere with occupational functioning is also diagnosable. By occupation, we don’t just mean paid employment. We also would include school or the duties of parenting if that were a full-time activity.

The third criterion for diagnosing someone with a mental illness is that it causes them subjective distress. If something is so upsetting to you that you just can’t stand it, and the pain of this event or condition is unbearable, then we call that a mental illness. And lastly but not least, if what you’re dealing with interferes with your ability to function in some other area that is important to you, even if it is a hobby or a recreational activity, it may qualify as a mental health diagnosis.

From that brief description of reasons why something might be diagnosed, I think we can all see that transitions or changes in any one of those areas can be overwhelming.

Eventually, I will probably get around to discussing most, if not all, of these issues. But being very action-oriented, I thought I’d start with a brief description of what I understand to be the main ways in which people cope with and sometimes overcome the challenges of life’s transitions.

The next stop in our journey of understanding the nature of life transitions and how to overcome them will be a brief review of the two major theories about how to navigate life transitions.

Does David Joel Miller see clients for counseling and coaching?

Yes, I do. I can see private pay clients if they live in California, where I am licensed. If you’re interested in information about that, please email me or use the contact me form.

Recently, I began working with a telehealth company called Grow Therapy. If you’d like to make an appointment to work with me, contact them, and they can do the required paperwork and show you my available appointments. The link for making an appointment to talk with me is: David Joel Miller, LMFT, LPCC 

Life coaching clients must be working toward a specific problem-solving goal. Coaching is not appropriate if you have a diagnosable mental health problem. Also, life coaching is not covered by insurance. If you think life coaching for creativity or other life goals might be right for you, contact me directly.

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