Where does the Bipolar spectrum begin and end?

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Thoughts on Bipolar spectrum.

My understanding of Bipolar Disorders, like many other “mental illnesses” has changed over the time I have been involved with this field. Not all professionals agree on some of these things so it is only fair I tell you some of my biases first.

When I first learned the technical part of diagnosis we had to study the diagnostic manual (the DSM.) The assumption here is that a really good clinician can distinguish between those with a mental illness and those without and further that those with a mental illness are in some specific way different from the normal ones.

Neither of those assumptions is necessarily true.

In school, it was really important to learn to distinguish the niceties of the diagnosis. I spent a lot of time on things like the differences between Schizophreniform disorder, Schizophrenia, and Schizoaffective disorder. This is very important in school and in taking your exams for licensure. In the real world, it is not so important. Both the meds and the talk therapy are likely to be the same for all of these.

Some of our view of the “Bipolar disorder spectrum” is distorted by the need to rule people in or out and to state which things are normal and which are diagnosable. The ruler you use can alter the results. Our venerable rule books on diagnosis in the mental health field fluctuate between the categorical approach, putting people into pre-sized boxes, and the continuum approach where we line them up from well to sick. Here are my beliefs on this.

1. There are NOT two groups, the “normal” and the “mentally ill.”

With some medical disorders, you either have it or don’t. Mental illness is not like that.

We are coming to recognize that there are not two distinct groups, the well and the unwell, but in fact, there is a continuum between being well and unwell. Something bad happens to you, then you should be sad or anxious. All of us have some days we feel better and other days that we feel less well.

Most of the things we count as symptoms are in fact normal human behaviors. It is just that the unwell person has more symptoms or more severe symptoms than the less unwell person. When the symptoms add up to enough to make a diagnosis is largely a judgment call.

People do not move directly from a healthy weight directly to obese. The move comes on slowly one ounce at a time. The same thing happens with mood disorders. It is not just the number of symptoms but also the severity of symptoms that cause a professional to assign a diagnosis. Two different professionals and you may get two different diagnoses even in research studies using “strict diagnostic criteria.”

2. Counting symptoms is not an exact science.

Each mental health disorder has a list of symptoms that are believed to make up the disorder. The client needs to have some number of symptoms to get the disorder. Say a disorder requires the majority of the list of symptoms, 7 of 13 possible symptoms, look at all the ways we could add this up. The mathematicians among us will recognize this as a factorial problem, the number of outcomes of 13 things taken 7 at a time. Email me if you do the math and get a number. Take my word for it the number of combinations is huge.

So as the clinician talks to you he considers, do you have enough characteristics of a symptom to count that one? Then he adds them all up and if you get enough you win the diagnosis.

Lots of judgment calls in this process.

So what about the spectrum of bipolar disorders?

I think this is a long spectrum and a lot of it does not deserve a diagnosis. The most severe cases can and should be diagnosed because if you have that many symptoms you need help.

Are birds Bipolar? Are other animals? I think they are a little. Every spring the days get longer, there is more daylight and they are awake more. They become interested in the opposite sex. Here in the northern hemisphere birds start looking for mates by Valentine’s day in February and by Easter, they have bred, created nests, and are hatching out chicks. People do this same thing.

We humans, tend to fall in love in the spring and marry in the summer. It takes a little longer for the children, but not that much longer.

There is also a seasonal decline in activities for all animals in the winter. Bears eat all they can and then go sleep for the winter. In humans, we call this atypical depression. So some change from active, even hypomanic behavior occurs naturally with the seasons. These mood changes are normal human behavior.

We probably should not give every teenager a Bipolar diagnosis, though most of the time their parents are sure that their preoccupation with sex and their moodiness should qualify.

People who have diagnosable Bipolar disorder do not really have different symptoms. What they have is a difference in the severity of symptoms. They also have different outcomes.

With all spectrum disorders, we should not make our decision based on the presence or absence of symptoms, which alone is not enough. The key factor is what effect do those symptoms have on the person.

If the increased interest in sex during the manic or hypomanic phase damages their relationships, gets them fired for sexual harassment of causes other disruptions in their work and relationships then they get the diagnosis. Also if the symptoms of the mood swings become unmanageable and they upset the person with those symptoms, then they should be treated.

So yes there is a spectrum of Bipolar-like symptoms from almost unnoticeable to debilitating severe. The thing we professionals should be looking at is not our judgment of the severity of the symptoms, but how are these symptoms, these problems in living life, affecting the client.

If the problems interfere with having a happy life then it has become severe enough we need to give it a diagnostic label and begin treatment.

Personally, I think there are a lot of people with less severe mood swings than what would be diagnosed as a Bipolar spectrum disorder that would benefit from some counseling. But as long as they can maintain the choice is up to the client.

Thanks to reader Dr. Charan Singh Jilowa for suggesting this topic. For more on this topic check the list of posts to the right or the post list on Bipolar disorder and mania.

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

How do the mentally ill feel? About feelings.

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

Man with feelings

Managing feelings.
Photo courtesy of Pixabay.com

Can you describe how the mentally ill feel?

This question actually comes up, both in-person and as search terms. Despite the difficulty of answering such a general question, I will take a stab at this.

Speaking for any group of people is always problematic. I am an old white guy. So I should be able to tell you how old white guys feel right? Trying to speak for any group is beyond difficult. How old white guys feel would depend on whether that old white guy was a homeless veteran living alone under a bridge or a Wall Street executive who was paid millions for running a company last year that lost billions. I really can’t describe how all old white men might feel about anything.

But I will try to tell you how the mentally ill feel.

It might be easier to describe how the mentally ill do NOT feel, though that begs the question of how they do feel.

The mentally ill don’t feel happy. Occasionally they may feel mania. They may run without stopping and not need to sleep but even then they will probably tell you they are not really happy.

It is hard for positive emotions like happiness, contentment, and peace to co-exist with active symptoms of a mental illness.

One reason I feel so sure that I can describe the way the mentally ill feel is that they are so much like those of us who would like to think we are not suffering from a mental illness – not at this moment anyway.

In the course of any one year, 25 % of Americans will have symptoms of a mental illness so severe they should be diagnosed. Over half of all Americans will have at least one episode of a mental illness during their lifetime. So they will feel a lot like the rest of us – only more so.

The rest of the world has similar prevalences of mental illness. What you call it may vary from place to place. What symptoms people may exhibit may vary from culture to culture, but most any of us can tell when people are not happy and when they are suffering from dis-happiness.

Most people with a mental illness feel flooded, overwhelmed with negative emotions. When they are anxious they feel really, really anxious. When they are sad they are down in the bottom of the hole sad. Their depression does not go away when they watch a sitcom. Their night of dark feelings is really, really black.

It would be reassuring to think that somehow the mentally ill are different from the rest of us. If only they somehow have a different temperament or had done something so wrong they deserved their misery.  But the truth be told, bad things can happen to good people and we all are at risk to have an experience that overwhelms us.

Sure once they develop mental illness they may act differently from the way they did when they were well. They will smoke more and maybe drink and drug more. They may lose the ability to care for themselves or to show up for work.

But tell the truth, if tomorrow you were to lose your job and your home, if your family and friends turned their back on you – wouldn’t you feel depressed, anxious, and like giving up?

So for those of you who wonder how the mentally ill feel, take a look at how you feel when things go wrong, and then you will know how you might feel if one day you woke up and discovered you had contracted a mental illness.

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

How does my therapist know that? Isn’t counseling confidential?

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

Is counseling confidential?
Picture courtesy of pixabay.

Did my last therapist tell?

This comes up a lot when people move from provider to provider. It especially happens when you see multiple people in the same agency. No not everything you told your old therapist will be kept secret from your new one. WHY?

Laws about confidentiality make a distinction between “Use” and “Disclosure” of information. If you are in the hospital anyone who is treating you needs to be able to look at your record and see what medications you are on, what procedures you have had, and what allergies you may have. Anyone who treats you in the future at that agency probably has the right to look at your old record and see what was done to you. The same applies to psychotherapy.

Everyone at the hospital does not get to look at anyone’s medical record just because they want to see it. The only reason to access a medical record should be for the purpose of treatment. People have gotten fired for looking up someone’s medical record just because they were curious. Even looking in medical records to see if a famous or infamous person was treated at your hospital can get you fired. But if you are treating a client you may need to know what is in their record.

Psychotherapists do and can share records and that is considered “use” not “disclosure.” Laws about confidentiality primarily relate to disclosure. Some of this has to do with law, for that see a lawyer. As a therapist though, I find this is an important issue to many of my clients and they need to understand how our system works.

It is considered good practice to separate psychotherapy notes from your general medical file. Everyone who treats you in the emergency room for an accident does not need to know about your marital problems.

We also don’t need a list of the names you or your spouse call each other. What the counselor wants to know is that you two are having conflicts and that you resort to name-calling with each other rather than problem-solving. One or two examples will suffice here. Long transcripts of the argument might be interesting in a movie script but they don’t need to be in psychotherapy notes.

Clients sometimes move from therapist to therapist. Sometimes clients want a new counselor, some therapists are known to “fire” clients for a variety of reasons. Ethically we should suggest a change of provider if we feel that we are not able to help a client. If your counselor retires, you may be assigned a new one.

When the client changes therapist, we do not, as a rule, start a new file. Would you want to go through all those tests and lab work every time you saw a different doctor? Same with taking a life history. It should be in your chart. The new provider should review your chart so they should have some knowledge of what your last therapist was treating you for and why.

Charts are needed to provide continuity of care as well as other reasons. Clients have told me they resent that the new therapist knows things they had not told them. They probably read this in the chart though they may have been briefed on the case by the last provider also. If the file moved to a new agency there probably was a release of information but at the same agency, the old paperwork still applies.

Personally, I like to meet the client first and form my own opinion about them, then review the chart. The risk is that the client will have to tell me something they just told the other counselor last week. The benefit is that in telling me again they may say something they did not say last time or I may ask a different question. A fresh set of eyes can sometimes see something new.

More than once after doing a new assessment I looked at the file and can see why the last counselor came up with the diagnosis they did, but having new facts I don’t necessarily agree with that opinion.

So yes, the new therapist may know something you did not tell them. That they were filled in by your previous provider is not a violation of confidentiality. Did you really want to have to retell your whole life history to a new person before getting down to the work of solving life’s problems?

The bigger question is why you would want to hide things from the therapist you are seeing now?  They will have trouble helping you if you don’t tell them what the situation really is.

The most important person for you to trust and get honest with is you. Some clients hide things from their counselor because they don’t want to face the fact that they have a particular problem.

The results of counseling are mostly about the relationship. We try to spend time upfront getting to know clients and building trust. Some clients have more trust issues than others. If you are not sure you trust your therapist, ask them questions. The names of their kids and their spouse are not important but their views on how to raise a child or have a good relationship might matter to you.

You should be able to rely on your provider to maintaining your confidentiality and not disclosing your information to someone who has no reason to know. Don’t expect one doctor or therapist to try to hide your symptoms from another professional who is treating you.

The bottom line? If you want help in recovering from your issues, whatever they are, you need to get honest with yourself and your counselor or find a provider you feel you can trust.

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

The question why? – In therapy

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

The question why in therapy.
Photo courtesy of Pixabay.com

Does it help to know why?

More than half the time in most therapy sessions is spent on the question why? Most of the time the focus of the why question, is not on the client but on some other person in their life. Clients spend a good deal of time asking me why their partner did this or that, why did their parents do something, and so on.

It would be reassuring to know why. Most of us think if we just knew why then we could prevent something bad from happening. The great illusion of most relationships is that we can somehow control the behavior of others. Most of the time we can’t control the others in our life, and except for teaching our children good behavior, controlling others is probably not healthy.

The questions we should be asking are not about others. More helpful questions are the ones we ask about ourselves. What do I really want out of life, what are my values? How much am I willing to invest in reaching my goals? Can I accept this situation? What am I willing to do to change?

Sometimes we focus on others to avoid looking at ourselves. It is easy to upset yourself about things happening in the next apartment, across the street, or across the country. Looking at what is happening in your own life is more productive. It is also more challenging.

People like to vent about their partner, their boss, or their children. It would be easy to devote a lot of therapy time to talking about others. Conversations between friends often turn to talking about others. We call that practice gossiping. It is easy to do. We may even think that by discussing others we can gain some insight into the situation, some way to improve our outcomes.

One thing we tell clients in therapy is that it is not productive to talk about people who are not in the room. Taking about your conflicts with your partner may make you feel better, temporarily, but it won’t change the situation. There are two ways to improve this relationship situation, get the other person in the therapy room, or change yourself.

Marriage, Child, and Family Therapist’s work from a “systems” perspective, to change a family situation it helps to get all the people involved in the room. Often the “identified patient” is not the one with the problem. Let’s look at some examples of this situation.

Mother comes in with her teenage child. The child has a severe weight problem. The child has become depressed as a result of being overweight. Despite mom’s best efforts to put this teen on a diet, make them exercise; the teen continues to gain weight. The teen comes to therapy; they don’t want to talk about their weight. What is on their mind is the way their parents have been fighting and every time they go to visit grandma, she runs mom down the whole visit.

Turns out that because of the marital conflict, every time dad takes this teen out they stop somewhere for something to eat. Dad always says “don’t tell your mother, she is way too hard on you,” which the teen tries to respect.

When the teen visits grandma she does the same thing, makes excuses for why the teen does not need to lose weight, and rewards the teen with food treats. Grandma does not like her daughter-in-law and gets even with her by being the teens “friend” and sabotaging the mother’s plans for the teen to lose weight.

Working with the teen around weight loss may not be very effective. One approach is to get the whole family together at once and talk about how they are all colluding to use the teen’s weight as a way to try to control or get even with other family members.

Sometimes we can’t get the whole family to therapy. We have to work with the teen on what they really want. If the teen is impacted by this weight issue we may need to help them to learn how to say no to dad and grandma’s efforts to sabotage their diet. Some teens can’t resist the family dance and are stuck.

Boys escape this family dance by joining the military or running away from home. Girls try to escape by getting pregnant, moving in with a man, or some other way of having to leave the family. Both genders may also use drugs and alcohol to escape the intolerable conflicts.

Another situation that results in a lot of talk about a person who is not in the room is the spouse of the alcoholic or addict. They are likely to want to spend a lot of time on how to make their partner stop or on what they did to make them drink and use.

The spouse did nothing to make their partner abuse substances.  A bad relationship may have contributed but it is not the cause. People drink and use to change the way they feel, eventually they lose the ability to cope without the substances. Some people can use and drink a little or even drink a lot and then stop when they want. Other people find that when they try to stop they can’t. We consider this an example of the disease of addiction.

There is not much the non-using partner can do to stop the other person’s substance abuse.  They have a choice. End the relationship, say that this is more than they signed on for and they are done, or they can accept that the other person is the way they are and go on from there. Spending time talking about the person who is not in the room is not helpful here either.

Do you spend a lot of time asking why others do what they do? How much time have you spent in looking at yourself? What do you really want? What can you accept or not accept?

Don’t waste time on the why; work on the “what and how” of the changes you need to make to have a happy future.

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 addict, mentally ill labels help or hurt?

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

Mental Health or Mental Illness

Mental Health or Mental Illness?
Photo courtesy of Pixabay.com

Do most people accept labels like “addict” or “mentally ill?”

The use of labels to identify clients keeps coming up. Does having a label, a name, for your problem help you find answers, or does it stigmatize you?

The recovery movement often uses labels, usually self-applied to define the nature of their issue. Saying you are an Alcoholic helps you to understand the problem and what you need to do to overcome it. In this case, if you are really an alcoholic you should not drink.

In A.A. they don’t give out the labels. They present information and let people decide for themselves if the designation fits. This approach has a lot to recommend it.

Some people feel that giving out labels can be a barrier to recovery. If you say you are an addict then, of course, you will use drugs, the use of the label could be interpreted as a reason to stay in your problem rather than move towards a solution.

Personally, if I have a cough it makes a lot of difference to me whether I have an allergy or tuberculosis. I am frankly a lot suspicious of a doctor who wants me to take medication for my cough but does not want to tell me what is wrong with me for fear of labeling me.

People are not defined by their disorders. We should not refer to them as “the schizophrenic” or the “depressive.” We know that there are times the person with schizophrenia or another psychosis may not be experiencing symptoms or the symptoms may be milder. This sometimes is referred to as periods of lucidity. People with depression can get better.

Most people, in my experience, embrace these labels. They help define the challenge the person is facing. It is reassuring to know that you have a treatable disorder rather than to think that you are crazy or that there is something so wrong with you and there is no hope. What most people find is that there are lots of other people who are struggling with the same illness.

As a professional, I feel I owe it to a client to tell them what I think they are struggling with. Knowing the problem can suggest solutions. I don’t find it useful to argue with clients overdiagnosis. Whenever possible we start by working on the things the client thinks are problems for them. Help them find a job and the depression just may go away.

Sometimes people put too much trust in a diagnosis. What if the person who gave you that one was wrong? Learn to use that information, their view of what you are struggling with, and go from there.

Now if you have been given medication, I recommend you take it as prescribed. If it is not working or you are experiencing side effects, talk with the prescribing doctor before you make a sudden change, and please do not take a med only on the days you think you need it, unless the doctor prescribed it to be used that way.

Feel free to add other helpful things, like therapy, meditation, and a strong support system to your medication. Medication can only take you so far. Working on your recovery includes learning and practicing the skills you will need to maintain that recovery.

So as far as diagnosis or labels go, if they help your recovery, use them. If your label is getting in the way of your recovery don’t worry about what it is called and focus on your recovery skills.

My view – for most people labeling the problem is helpful, labeling yourself is not. You are, after all, much more than any one problem you may be struggling with.

For more on this whole label-diagnosis thing see also the posts on:

What is wrong with me?

5 Axis diagnosis esoterica

Is it a medical problem or a mental health problem?

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

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Discovering Happiness

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

Happy faces

Happiness.
Photo courtesy of Pixabay.com

The search for Happiness.

Of the thousand goals, you might have in life, finding happiness sums up that one thing most people are looking for. You might label it love or contentment, success or achievement but whatever you call it we all appear to have the hope if we can just find that one elusive thing we are looking for we will finally be happy.

As a professional counselor and therapist, I like to think that basically what I do involves being in the happy life business. I try to help people create a happy life.

What a happy life means to you and what it might mean to me are probably quite different things. The hardest part of helping people find happiness is being able to not know what they should do to find their happiness and still participating in the journey to help them find that happiness.

Cultivating that “not knowing” attitude rather than imposing our version of happiness on others takes practice. Daily I have to think that I know very little about this person and what will make them happy.  I need to create a safe place for them to explore that landscape and find what happiness would be for them.

Generally, I know the landscape of happiness. I have found some things that make me happy, but the journey of discovery continues. I am honored when a client tells me that our time together has helped them find that place of success, love, or whatever they call their happiness.

I have written some blog posts on things I have learned about the search for happiness and they are listed below. Would you care to share some of the things that have led you to your happiness or the things that take you away from that place of fulfillment?

Past Posts on the topic of Happiness:

Successes, Happiness, and Contentment

Where Happiness Hides

Buying Happiness

Directions to Happiness

Finding Happiness

Happiness or Misery

How to Be Happy

Happy Enough to Make the Bed?

Should you be happy?

There are lots of posts on my blog and other blogs about unhappiness. It seems unhappiness is easier to find than happiness. One thing I am sure of is that things don’t equate with happiness. Things are symbols. Happiness comes from what things mean to you.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

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

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is Passive-Aggressive Personality?

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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

Are you stuck with a passive-aggressive?

Passive-Aggressive Personality is another one of those things that may be hard to define but you know it when we see it. The Passive-Aggressive Person (PA) doesn’t say much, but they sabotage everyone else. They can be especially annoying if you are confined with one in close quarters, at home, or at work. PA’s are responsible for a lot of organization’s failure to meet goals. They create a lot of family pain.

The PA may smile and nod their head yes, but their behavior says “No! No! No!” Their way of disagreeing is indirect. Sometimes defined as “obstructionist” they seem especially skilled at snatching misery from the jaws of success. Their favorite weapon is inaction.

PA people are known for their hostility, unexpressed hostility which leaks out by getting even with others through “not doing.” They are frequently late and forgetful, resulting in not getting things done that they were expected to do. When you look back at the record you may find they never said they would do it, they just didn’t say no when you asked them.

This failure to express themselves, particularly about emotions results in a lot of misunderstandings. When confronted with the discrepancy between what everyone else thought they would do and what they, in fact, did not do, the PA is likely to deny they ever agreed to do that, assert they forgot, or all too often give the confronter the “cold shoulder” and say nothing.

PA is considered more a trait or a personality characteristic than a mental illness. It is not officially a DSM diagnosis, though it has moved in and out of the list of Personality Disorders over time. As a personality trait, PA can vary from a few rare occurrences to a characteristic pattern that someone uses most all the time.

Most people with PA traits often report “trust issues” but so do lots of people without PA traits. We think that developing PA characteristics is related to growing up in a home that was non-affirming or where it was not OK to express emotions. In this sense, it is like the “Attachment Disorders.”  They have learned to avoid criticism by avoiding action. They are good at excessive procrastination and other forms of learned helplessness. They go along with things but make sure that the project fails by withholding effort at a critical time.

In addition to highly critical parents, the PA person is also likely to have had painful disappointments in life. They have reduced their expectations for themselves and others to avoid disappointment. Setting low sights reduces disappointments. They become so afraid of being told no they stop asking.

People with strong PA traits will fear competition and avoid situations where they will be judged at the same time they avoid dependency. They tend to keep their distance from others and are especially hard to get to know. They often express the feeling that they are unable to please anyone no matter what they do. Others feel that they can’t depend on the person with the PA traits.

Lacking truly close relationships, someone with a lot of PA traits creates a lot of chaos, makes excuses for failure to meet other’s expectations, and chronically takes the victim stance. Rather than direct disagreement they use obstructionism and sabotage to undermine those they resent. Their sabotage is of the indirect “failing to do anything” in the face of an urgent need form.

A key characteristic of the PA person is a lack of assertiveness. Unable to directly confront others they use indirect methods to accomplish their aims.

In the workplace, PA’s can be hard to spot and can rise to the top ranks since they always seem to agree with superiors despite failing to meet goals. They always have excuses for why the goals were not attainable. Management does not always value the worker who openly disagrees even when their productivity is high. Working with someone with PA traits destroys teamwork.

In the home, people with PA traits can be hard to live with and often under function. We know from system theory that when one person in a family under functions another is likely to over function, the result is a dance that is hard to change.

The family member who is PA will be hypersensitive to criticism especially when they have let others down and may resort to telling the rest of the family that their expectations are unreasonable. The result is that the rest of the family takes on the PA person’s responsibilities.

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

So gratefully thankful I might be spoiled – gratitude lists.

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

grateful

Gratitude.

If you are too grateful, might you be spoiled?

This is the time of year that those of us in the United States of America (North) celebrate a holiday called Thanksgiving. Why we need to restrict our thanks to one day escapes me. I know that those of you in other countries may be thankful on other days, some of you may even be thankful on more than one day a year. I think we here in America may have so much to be thankful for we just might be spoiled. I am convinced I am.

One thing that recovering people do is make gratitude lists. They should do this regularly, list out the things that make them grateful, but especially on Thanksgiving, it is helpful to know what we are thankful for.

So often these lists are lists of things we have, not things we are. Do you have to own a lot of stuff to be grateful? How many square feet does your house need to have for you to be thankful?

Here are some of the things that I am thankful for this year, listed in no particular order.

I woke up this morning instead of coming too.

An old-timer told me this one. Any morning you wake up is a good morning. There are people all over the planet who may or may not regain consciousness this morning. I am so lucky to be among those who woke up.

I live in a house.

You don’t have to go very far to see people who are living on the street or under bridges. Here in America, the richest country on earth, we still have homeless. Some of you are unhappy because your house is not the size you want or in the place you want it.  There are days I have felt that way, but seeing people who don’t have any home makes me think I am a little spoiled.

My house has a roof.

There are people whose houses are made of sticks or thatch. That’s not so bad. There are people whose roof is a cheap blue tarp or a freeway overpass.  My roof keeps the rain out. I am so lucky.

I have running water.

My running water does not require me to go to a stream or make a trip to a well. There is no pitcher or jug that I have to pour from to make my water run. I turn the tap and out it comes. Presumably, it is safe and palatable. There are people who don’t have running water and the water they do have is not safe to drink.

I feel so spoiled, having clean water any time I want it.

My house has windows.

I can see out and still the rain is kept out. I know there are houses in this town, not far from mine, who have plywood nailed up on their windows. Some people have cardboard in the holes.

I am told that some people only have holes in the walls to look out if they even have walls. I am so fortunate to have windows.

I have electricity and gas heating.

Not only do I have electricity but it works most days. There are people who don’t have electricity. There are others whose idea of electricity is to run an extension cord over a fence or next door and plug into someone else’s house. I don’t have to do those things and the lights are on anytime I want them, no lighting fires required.

Lots of people had their power interrupted recently by a huge storm. My heart goes out to those who had to wait days, even weeks to get the power back. All that while I was safe and warm in my home with the power on.

I feel so ungrateful that any morning I want I can turn those lights on. Sometimes I realize I did not give thanks today for having electricity and heat. How spoiled can I be?

I can read and write.

In places all around the earth, there are people who are not able to read or write. The prisons are full of those who can’t read at grade level. We here in America take education for granted until we see someone in another country who is willing to risk their lives for the chance to learn to read.

I even own some books and a computer so I can surf the web and read things whenever I want. Some people only get to read what their government wants them to read.

I am blessed with so much to read that it would be easy to complain that I have too much – until I think that too much is a better alternative than too little.

I am free to come and go as I please.

I am not incarcerated. I have freedoms other people on earth only dream of. When I think of how valuable these freedoms are and how rarely I think about them, I feel like I must be spoiled from having so much.

If I don’t like the rules or the rulers I can vote.

My vote does not always go to the winning side. Sometimes I wonder if my vote makes any difference.

But I keep reminding myself there are people who are not allowed to vote, for whom the outcome of the election is decided before they ever go to the polls.

I have a job and they pay me to do what I do.

Sure I would like to be paid more. I don’t like the idea of pay cuts any more than anyone else. But think of this, each day I get to go do something I like to do and they pay me for doing it.

There are lots of people out there today that wish they had a job, any job. I feel so spoiled by the idea that they pay me money for the work I do.

I can pay taxes.

It would be easy to complain about my taxes. Lots of us do. No one likes to have high taxes, but the alternative, to have a government that can’t do the things we want it to do, which is not acceptable to me.

So while I don’t like ever-higher taxes, I feel blessed that I make enough to be able to pay some taxes and still have enough left to get by on.

I have people in my life who care about me.

I will keep this short but every friend in my life is a blessing for which I am grateful. You know who you are. I include all my readers in this also, you like what I write enough to keep coming back, which makes me feel privileged to have your ear from time to time.

I could go on and on but enough is enough. Those are some of the reasons I feel blessed, grateful, thankful, and yes even a little spoiled on this one day of the year we are supposed to be thinking of things that make us thankful.

Do you have things on your gratitude list that make you feel blessed, thankful, or even a little spoiled?

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

Does a little alcohol make you more productive?

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

Bottles of alcohol.

Alcoholic Beverages.
Photo courtesy of Pixabay.com

Alcohol’s effect on productivity – Morning Question #28

Alcohol is not likely to make you more productive. People used to believe that alcohol was a stimulant and increased your productivity. It is not a stimulant, it is a depressant.

What alcohol does do is reduce the function of parts of the brain; as a result, people lose their inhibitions. So people who put things off and avoid things because of anxiety and shyness may do things while they have alcohol in the bloodstream that they otherwise would not do.

Taking more chances can be good if it helps you overcome inhibitions and gets you to try something for the first time. But it can also be bad if the thing you try that one time has harmful consequences, like sex with a new partner or drugs. Having to use chemicals to overcome anxiety also increases the risk you will become dependent on that chemical to cope with that problem the next time it arises.

This false belief in alcohol’s ability to increase productivity resulted in a lot of authors, newspaperman, and other creative types abusing alcohol and resulted in a lot of alcoholism.

There is no magic substance to make you more productive or creative.

Good health practices, some exercise, and reducing the internal censor that inhibits you from trying new things can go a long way towards increasing your productivity.

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

Is your inner child missing?

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

Child walking with adult

Inner child.
Picture courtesy of pixabay

What would happen if you were able to find your inner child?

Most of us have some hurt and pain from things that happened when we were young. Some people have deep wounds and traumas, others have regrets and disappointments. Much has been written about working on your inner child issues. Some of us are looking to find that little child in us that needs loving and nurturing. Why is this process so hard?

Behaviorally oriented therapists and mindfulness practitioners might both agree there really is no inner child in us, though they conclude this for very different reasons. There is that sad, anxious wounded, and immature part in many of us, which seems to say that there was something missing in our childhood, something we long for and need to be complete. Why can’t we find that inner child and give them a hug or a swift kick in the pants and solve this problem?

Behaviorists might tell us that there really is no inner child. Yes, I know that if you x-ray me there is no little creature lurking in there. They tell me that all I have are those memories of what it was like when I was a child. Not very accurate memories, I am told, as I was really young and got those facts wrong. That explains things sometimes, for a while.

Then something reminds me of that thing that happened that Christmas when I was 5 or the hurt from middle school and suddenly that little child part in me wants to cry.

Scientists assert that sometimes just trying to look at things changes them. Try to photograph a subatomic particle, start to measure it and you might change it. Looking for things alters them. I know that turning on the light in that old warehouse, the one full of cockroaches, results in them all scurrying for hiding places. The more light you shine in there the harder the roaches are to find.

Is my inner child like that? Does looking for him somehow change him?

The mindfulness people remind me there really is no “me.” No-self they call it. There are lots of past selves and hopefully some future selves but right now the only me is the one I perceive and I know that this me will certainly change. The me of 1970 is not the me from 1990 and so on. Why is it so hard to let go of the notion that there is this one immutable me and become open to getting to know all the possible “me’s”?

So that friend from elementary school, she doesn’t exist anymore. Her place has been taken by a senior citizen with the same name and some of the same memories, but not the same body. My child is an adult now and my cat; she is not the same cat from way back when.

So while looking for an inner child may be tempting, it may be a whole lot more productive to spend some time getting to know the person you are today before another day passes and you find you are changing again.

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