What if talk therapy isn’t working?

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

What should you do if counseling doesn’t seem to be helping?

Talk Therapy.

Talk Therapy.
Photo courtesy of Pixabay.com

Some people come to counseling for a couple of sessions and then drop out saying that counseling doesn’t work for them.

Other people come for therapy over a very long period, and while they feel counseling is helping them, other people don’t see any change. How do you evaluate the progress you’re making in therapy?

If you don’t feel you’re getting the results, you would like to see in therapy your progress, or lack of progress should be the primary topic you talk about with your therapist. Here are some questions to ask yourself and some of the factors that impact the effectiveness of therapy.

Is your problem acute or chronic?

Some problems are acute. Something has happened, and you can tell your counselor what happened and when. Treatment for acute problems can be very brief. You decide you need to change something in your life, or you may need to accept the change which has happened. What you may need is an empathetic person you can tell about what happened you.

The problem some more chronic you’ve always been common anxiety, or you don’t ever remember being happy. Treatment for these problems is like treatment for a chronic medical problem. Managing long-term mental health problems can be like managing high blood pressure or type II diabetes.

The professional may be able to help you initially, but a significant part of the process will be your learning life skills to manage your problem over the long term.

How long have you been in therapy?

When you’re in pain, whether it’s emotional or physical, you want it to stop. Go to the doctor he can give you pain meds, or he can look for an underlying cause and treat that issue. If you have gone to therapy for a while but aren’t feeling better discuss with your counselor how long treating your condition should take. Many people have unrealistic expectations for talk therapy.

Treating emotional problems is a process. How long this process will take depends on your specific diagnosis and your personal characteristics.

How good is your relationship with your therapist?

Most of talk therapy is done through conversation. The best predictor of success in treatment is the relationship you have with your counselor. If you feel uncomfortable discussing certain things with that therapist those unsaid things could be holding back your progress. Ask yourself if the problem is your difficulty in talking about what you need to deal with or in your lack of trust of the counselor. Not every counselor is a good fit for every client. If you have been working together for a long time and don’t see progress, you may need to try working with a different therapist.

Are there some problems you’ve avoided discussing?

The issues you don’t deal with are the ones likely to be keeping you sick. Sometimes people go to counseling and talk about the surface day-to-day events. Every time you go you feel a little better. But if you never get down to the real core of your issues, each session is like a Band-Aid placed on a deep wound.

Therapy can involve treating deep emotional pain. Looking at your core issues can be uncomfortable. The process can be like peeling an onion. You go as deep as you can and then you cry little. When you have process that material fully you go a little deeper. Over time you can heal all these deep wounds.

Are you working on your problem between sessions?

Your problems are with you between sessions. Talk therapy can be very instrumental in healing past wounds are in clarifying values and goals. For things to change in your life, you need to start making changes. For every one-hour a week of therapy, there will be 167 other hours when you’re not in therapy.

If your counselor is teaching new skills in session, you need to practice those skills outside of the therapy hour. The students who learn most in school not only attend class but also do homework outside of class. You can’t become a great musician by taking a weekly lesson. You need to practice your music between lessons. As you learn new emotional skills, you need to practice those skills between therapy sessions.

You’ll make more progress if you have clear therapy goals.

When reason people don’t make good progress in the therapy is fuzzy goals. Think about your goals for treatment. Discuss these goals with your counselor and make sure the counselor is working towards the same goals.

Consider adding medication to talk therapy.

Medication has not been shown to cure any mental or emotional illness, but medication can be very effective at managing symptoms so that you’re able to work on the causes. I’ve had lots of clients tell me they don’t want to take medication because they don’t want to become dependent on drugs. Unfortunately, many of those same clients are using alcohol, marijuana, gambling, or sexual addictions as ways to manage their problem. Newer psychiatric medications are much safer than the medicines that were available in the past. Discuss medication with your medical doctor and your mental health provider. Medication and therapy together are often more effective than either separately.

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.

SasquatchWandering 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 intends 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, Barnes & Noble, Google Play, 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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Authenticity.

Sunday Inspiration.     Post by David Joel Miller.

Authenticity.

Authenticity.
Photo courtesy of Pixabay.com

Authenticity.

“The privilege of a lifetime is to become who you truly are.”

― Carl Gustav Jung

“Beauty of style and harmony and grace and good rhythm depend on simplicity – I mean the true simplicity of a rightly and nobly ordered mind and character, not that other simplicity which is only a euphemism for folly.”

― Plato

“No man who values originality will ever be original. But try to tell the truth as you see it, try to do any bit of work as well as it can be done for the work’s sake, and what men call originality will come unsought.”

― C.S. Lewis, The Weight of Glory

Wanted to share some inspirational quotes with you.  Today seemed like a good time to do this. There are an estimated 100,000 words in the English language that are feelings related. Some emotions are pleasant, and some are unpleasant, but all feelings can provide useful information. If any of these quotes strike a chord with you, please share them.

Look at these related posts for more on this topic and other feelings.

Emotions and Feelings.

Inspiration

What is a Drug Video.

When we say drug what do we mean? Drug education video #1 is now live on YouTube.

Why are you writing that?

By David Joel Miller, MS, Writer.

The why changes the way you write.

Writing.

Writing.
Photo courtesy of Pixabay.com

Writing is an awesome skill. The ability to write allows us to save information for later use and it enables us to transmit that information to someone in a distant place. Writing also gives us access to the thoughts and expressions of people were no longer with us. Writing is such a useful human skill that the meaning of “writing” has expanded well beyond the use of paper and pen.

Writing also implies a related skill, which we generically call “reading.” Today under the category of writing we include alternative recording methods such as typing and dictating. Reading also includes listening to audio “books.” The boundary between writing words and delivering messages through video content is becoming less distinct.

Writing can play a great many roles in your day. What you write can be utilitarian, the recording of information and data. What you write can be very personal or can be designed to inform or entertain people you will never meet.

Creative people often explore a variety of mediums searching to find the best method to express whatever it is they are seeking to communicate. Both the process and the techniques they use change depending on the piece that they are writing. Here are some of the reasons a person might be writing and how that purpose would affect the process.

Utilitarian writing needs the facts.

Utilitarian writing might be anything from making out a grocery list to recording the instructions for assembling a table. If it’s written just for you, there will be a minimum of elaboration, and you may use terms that have personal meaning. Your grocery list might include the notation “lasagna fixings” if you are planning to cook dinner, or it might say “pasta isle” if you are restocking shelves in a grocery store.

Writing can be for personal exploration.

In mental health and recovery, people are encouraged to write about their thoughts and feelings, a process often described as journaling. Personal writing can be an opportunity to write about things you don’t want other people to know. Writing your thoughts and feelings can help you sort out what’s going on. If you Journal over an extended period and then go back and look at your earlier writings, you can often see how your emotional states and your plans have changed over time.

Writing to express strong feelings.

Poetry is an especially useful medium to explore intense feelings. Poets spend a lot of time in a relatively short work, searching for precisely the right word to convey a meaning. Poetry is often included in high school English classes the most people don’t consciously read poetry after high school. I’m sure there are some exceptions, but most published collections of poems reach an extremely limited audience.

The principal use for poetic techniques these days is to marry the poem to music. The great modern poets have been mainly songwriters. The more commercial use of poetry has been the writing of commercial jingles.

You are writing because you have a story to tell.

Good writing tells the story. Fiction storytelling includes short stories, novellas, the novel, and epic stories. In the short attention span digital age the trend seems to be towards the novella and shorter length novels. Short stories used to be popular in magazines. In the digital age, those short stories attempt to find new homes on the Internet. Electronic publishing and the proliferation of video materials have expanded the opportunities for telling stories in new ways.

Storytelling is not limited to fiction. Nonfiction books, particularly creative nonfiction, either tell a story or may use those stories to illustrate the points the author is trying to make. Traditional non-fiction stories include history, biography, and military genre.

Writing is a part of your creativity.

The drive to be creative underlies a lot of human effort. Some people primarily express themselves visually, and others do their art verbally. Some creative people like to try their hand variety of mediums. If you’ve done a lot of original work in one field, you may want to write a book about those creative endeavors.

You are writing because you’d like to make some money.

Most creative people hope to make some money from their efforts. In a capitalist society, the primary way we measure the value of things is by how much people are willing to pay for it. Many writers goal is to be able to make enough from the writing to be able to quit their day jobs and write full-time. Many people work day jobs, so they can make enough money to support themselves doing their writing.

There’s nothing wrong with writing what people want to read. Popular writing, the writing that sells a lot of copies of a book, must also be good writing. If you are writing with the idea of becoming rich, you will probably be disappointed. Monetary results are the result of both the writing and the marketing functions.

Don’t fall into the trap of thinking that you need to suffer for your art. Jeff Goins has written an intriguing book titled Real Artists Don’t Starve. These days many indie writers are earning good incomes from their writing and related activities.

These are some of the reasons why you may feel the urge to write. I feel sure there are other reasons some of you are writing. One reason is not necessarily better than another. As a writer, you may be writing for multiple purposes and writing different pieces for different reasons. What is critical, I believe, is that each time you set out to write something you get clear on why you are writing this particular piece.

This piece was inspired by a question/comment from a reader. Thanks for that inspiration. If you enjoyed this piece, please leave a comment. If you have a question for me, you can ask it through the comment form or use the contact me form. Thanks for reading and I wishing you the happiest life possible.

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.

SasquatchWandering 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 intends 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, Barnes & Noble, Google Play, 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.

Counselorssoapbox videos

Today marks the first counselorssoapbox video.

Future videos will cover the topics of mental health and wellness, drugs and drug use disorders, psychology, and life skills to have a happy life. I hope you will join me for future videos. David Joel Miller.

The first series of videos will cover basic drug education.

 

 

Learning about alcohol and drugs.

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

How much do you really know about alcohol and drugs?

drugs and alcohol

Drug and Alcohol problems.
Photo courtesy of Pixabay.com

Despite the prevalence of drugs and alcohol in our society, many people have never had any formal education about drugs or alcohol. Most people get their education in this area the same way they learn about sex, on the street, and by experimentation.

As a society, we have a love-hate relationship with drugs and alcohol. The consensus seems to be that drinking and doing drugs can be enjoyable, but that “losing control” of that habit can be harmful maybe even deadly. Clearly simplistic solutions, just say no, or saying only bad people have problems is not working.

Ignoring the effects of addiction and alcoholism is easy.

Most people try to ignore the problem until it overwhelms them personally, or someone close to them. It’s reassuring to believe that addiction or alcoholism is something that happens to “those kinds of people,” the weak, or the lazy.

Not everyone who experiments with drugs or alcohol develops a problem. We know that young people are likely to try new and exciting experiences. Initially, it all sounds like fun. Most go on to have typical lives. But increasingly we are seeing people of all ages, including the older generation, whose lives are being damaged by substances.

Most people’s conception of an alcoholic is the homeless bum on the street, someone who can’t work and drinks all day every day. The unpleasant truth is that 95% of all alcoholics have full-time jobs. It’s entirely possible that you meet these hidden alcoholics every day. For every person with a drinking problem, estimates tell us that, 5 to 8 other people are harmed by that person’s drinking.

In some hospitals, half of the bed are taken up by people whose illness is primarily caused by or made worse by the direct results of alcoholism.

The problems with alcoholism and addiction are all around us.

In every city in America of any size, and I feel confident this happens everywhere else on planet Earth, we see the harm caused by the misuse of substances. A quick look at last night’s paper shows several people arrested for DUI. Several accidents in which one or both drivers were intoxicated. And an occasional story about someone dying of a drug overdose.

The war on drugs misled us.

American’s have noticed a staggering increase in the number of people who are dying from overdoses of prescribed opiate drugs. Despite a long-running war on drugs, the devastation is worse now than it was before. Several unpleasant facts emerge from studying substances and substance use disorders.

The majority of drug overdose deaths arise from prescribed medications, not street drugs.

Legal or tolerated drugs, nicotine, and alcohol each kill more people per year than all the illegal street drugs combined. Most of the deaths from drug overdoses involve people who have more than one drug in their bloodstream. Mixing alcohol with other drugs, prescription or street drugs, increases the risk of death.

Many professionals lack education about the effects of drugs and alcohol.

Most professionals working in the mental health field have minimal training in substance-related problems. Most counselors and therapists receive from one to three units in substance-related classes in an entire master’s program. Surveys indicate that the majority of people with substance use disorder, 60% or more, also have a co-occurring disorder. Furthermore, many people with diagnosed mental illness, approximately 50%, also have a substance use disorder.

In my own experience, it is extremely common to find someone with severe depression or high anxiety, who is also abusing substances. Use of alcohol or drugs may temporarily mask symptoms but in the long run, using substances as a crutch makes the problem worse.

Therapists who work with couples often find that one or both parties are using drugs or alcohol, and this is contributing to the marital discord. Unfortunately, many counselors who were not trained in substance use disorders ignore the problem rather than ask about it.

Since I started in the counseling field as a substance use disorder counselor, I’m acutely aware of how commonly mental health problems and alcoholism or addiction occur together. Substance abuse counselors, at least here in California, typically go through a 36-unit program with many of the classes specifically focused on alcohol, drugs, and the process of moving from use to addiction.

Very soon school will be back in session, and this semester I will be teaching several classes in the substance use disorder program. While I don’t want to shift the counselorsoapbox.com blog specifically towards drugs and addiction, I thought it might be useful to share with you some of the material I use in my substance abuse counseling classes. Also, in the near future, I am planning to release some of this material as videos on our very own counselorssoapbox YouTube channel. Stay tuned, and I will let you know how the videos are progressing.

If you made it this far, thanks for reading, and please remember to click like if you enjoyed this post and please leave comments. Talk to you again soon.

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.

SasquatchWandering 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 intends 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, Barnes & Noble, Google Play, 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.

Anticipation.

Anticipation.

Sunday Inspiration.     Post by David Joel Miller.

Anticipation

Anticipation.
Photo courtesy of Pixabay.com

Anticipation

“The idea of waiting for something makes it more exciting”

― Andy Warhol

“… We need the sweet pain of anticipation to tell us we are really alive.”

― Albert Camus

Pleasure is found first in anticipation, later in memory.”

― Julian Barnes, Flaubert’s Parrot

Wanted to share some inspirational quotes with you.  Today seemed like a good time to do this. There are an estimated 100,000 words in the English language that are feelings related. Some emotions are pleasant, and some are unpleasant, but all feelings can provide useful information. If any of these quotes strike a chord with you, please share them.

Look at these related posts for more on this topic and other feelings.

Emotions and Feelings.

Inspiration