In an addiction state of mind.

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

Hands with pills

Addiction.
Photo courtesy of Pixabay

Addiction is a mental illness.

As difficult as it is to withdraw from some drugs you would think that the primary thrust of addiction treatment would be detoxification facilities. When it comes to curing addiction, Detox programs are an almost universal failure. The majority of people who undergo detox, somewhere near 90% relapse in the first year after detox treatment.

We have been taught to think of addiction as a terrible physical craving, a drug sickness of the body when the user tries to stop. The physical part is the smallest part of addiction.

After 72 hours of detox, the standard treatment in many places, the addict should be past the cravings. Most drugs pass out of the body in hours, days at the most. How then do we explain the high rate of relapse among addicted people?

Some of the hardest to kick drugs have little or no physical withdrawal symptoms. We should expect that the highest rates of relapse would occur in the first few days after cessation. Despite the widely held opinion that addiction is a physical dependence on drugs, recovering people continue to relapse mouths, years, even decades after treatment. The inescapable conclusion?

Addiction is in the mind not the body!

Many efforts to treat addiction fail because they look in the wrong place, in the body. We see programs that include lots of diet and exercise, health farms, and sanitariums they used to be called. They had only limited success.

One way to describe addiction is that the addict’s brain has “gone over to the other team.” The alcoholic develops an alcoholic mind. Efforts to treat that condition with detoxification or drug replacement do not result in the “head change” that is needed to recover.

The psychological cravings persist for a long time after the physical urges have dissipated.

The core problem of addiction is the mind’s determination to obsess over getting a substance, any substance, to change the way we feel.

Once the mind convinces the addict to try a little, just a little, of their drug of choice, the body produces the cravings that continue the use.

Long-term recovery requires stopping those thoughts that an addict can ever safely use even a little of a drug and replacing those using thoughts with positive thoughts.

Recovery from addiction is a long-term process of changing your thinking to change your life.

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 “Happy Emotional Life Plan” – H.E.L.P.?

By David Joel Miller.

What is “Happy Emotional Life Plan” – H.E.L.P.?

In my counselorssoapbox.com post last night I mentioned H.E.L.P. but forgot to explain what H.E.L.P. is.

The Happy Emotional Life Plan “H.E.L.P.” is a curriculum I developed for a training a few years back. It included a lot of material about wellness, recovery and relapse prevention.

Currently, H.E.L.P. is being revised and updated with new material, handouts and worksheets from other classes and trainings I have conducted.

The plan is to release H.E.L.P. late this year or early next, probably as an eBook. If you are interested in more on the book, seeing some excerpts from the work in progress or want to be added to the mailing list for my other writing projects please email me or leave a comment.

Getting some recovery – preventing relapse

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

Urge Surfing Prevents Relapses.

Urge Surfing Prevents Relapses.
Photo courtesy of Pixabay.com

How do you get this recovery thing?

Moving from being “in the problem” to being “recovered” is a process. Many of the things that will take you from the pain to the solution are simple. That does not mean they are easy. Sometimes healing from the past can be painful also.

In past posts, we have talked about Defining Recovery and how recovery is possible for anyone, and that recovery means having the best life possible not necessarily a cure for your condition.

In another post we looked at Why giving up the drugs and alcohol might not make you any happier. Just trying to not do the negative or dysfunctional behaviors will not be enough. Recovery literature talks a lot about using “recovery tools” (see: Getting your tools dirty) and things like internal and external triggers.

What may be missing are the blueprints for creating recovery.

Reader Sue made the following comment.

How exactly should one get their recovery tools dirty? Giving up something that is bad for one, you do expect to feel better but when you don’t you feel disheartened. What’s left is yourself and your problems. So you read all the self-help books and try and work on yourself but how do you connect the practice to the theory? All those learned responses and ways of coping are very hard to unlearn – is it about keeping a record, making new goals, or just trying to get through without going backward?

There are a lot of recovery processes in use today, 12 step models, CBT & REBT therapy, counseling, and so on. They all have their place and they all have some common elements. Here are some basic steps for transforming your life from being hopeless and suffering to having a healthy recovery.

1. What is the problem?

You don’t get chemotherapy for depression or a drinking problem. Drug and alcohol treatment is not very effective for cancer. Make sure you are treating the real problem.

For most people who come to treatment for an addiction problem, the drugs, and the alcohol is not the problem! The drugs and alcohol are their solutions. The real problem is that their coping method, drinking or drugging to ease the pain, is not working. The problem has become that they don’t know how to live without the drugs and alcohol.

Part of defining problems is to admit that your efforts to control the problem have not been working. This is sometimes referred to as “Powerlessness” which is not the same thing as being helpless. Applying this concept of powerlessness to ways to cope with family members who have the problem was the subject of another blog post.

Mental illnesses can play the same role. Depression, anxiety, and dissociation can all function to avoid a painful life experience. The current problem, the one you need to solve first is how to live life without drugs, alcohol, depression, anxiety, or any other negative coping mechanisms.

Most of the time we think the solution to drugs and alcohol is to just stop doing them. This rarely works. Once deprived of your coping mechanism people just suffer. The most effective treatment is to replace the substances with something positive. With clients that I work with we start by creating a Happy Emotional Life Plan (HELP). As a counselor, I believe I am in the happy life business.

With emotional issues, as with eating disorders, it is a little more difficult. You can’t just give up sadness or anxiety and you have to eat and stay healthy. You need to learn to feel feelings without having them control you.

2. Are you ready to change? What help will you need?

Self-help groups talk about recovery being a “we” program not an “I” program. You need to be willing to accept help and support from any source that is healthy. Counselors, Therapists, 12 step groups all can assist in your recovery.

3. Change requires moving through a process

Twelve-step programs refer to “working” the steps or “taking” the steps. Counseling involves some self-examination. To really change requires a lot of action steps. For a detailed description of the process see the series of posts on “Stages of Change”

Pre-contemplation
Contemplation
Preparation or determination
Early Action
Late Action
Maintenance

4. Even after you have changed there is more work to do.

For change to be lasting you will need to do some sort of maintenance. Our old behavior patterns are deeply grooved into the structure of our life. It takes work to avoid falling back into the same old groove.

5. Progress, not perfection.

People in early recovery try to do everything now. They want to do recovery, get a job, find a new relationship, and generally create the perfect life all in one week. Learn to take things “one day at a time.”

Relapse, in my view, may not be a required “part of recovery, ” but it happens often enough that it is nothing to beat yourself up about. If you relapse on substance or depression, just get back into recovery as quickly as possible and move on.

The goal, as the old saying goes is “progress not perfection.” Keep your eyes on the gains you are making, give yourself credit for anything well done, and try to build on small successes until you create the bigger ones.

Life in recovery is a sort of experiment. We try things and learn from our efforts. Try to avoid experiments that result in a lot of pain or require time behind bars, but you will have to make choices and some of those choices will not work out the way you would have hoped.

This is a real-life, sometimes I like it sometimes I don’t. Learning to sit and feel bad and know this will pass, but I can tolerate this feeling without using my negative coping mechanism.

So, yes Sue, recovery is about trudging forward, trying on new behaviors and sometimes it is hard or painful and sometimes we fall back but always keep track of what works and what doesn’t and keep moving forward.

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

Preventing anxiety and depression relapses.

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

Urge Surfing Prevents Relapses.

Urge Surfing Prevents Relapses.
Photo courtesy of Pixabay.com

10 Ways to avoid a relapse of anxiety or depression.

Anxiety and Depression are treatable, but like other conditions, it is possible to relapse into anxiety and depression. There are some understandable reasons to relapse on anxiety. But what steps can you take to prevent a mental health relapse?

1. Learn and learn again.

Just learning something once is not enough. To learn it thoroughly you need to continue studying even once you think you have it. We call this form of learning “overlearning.” Learn your relapse prevention skill beyond the point of being able to recite it. Learn your relaxation techniques and thought-stopping skills until those processes become automatic.

2. Don’t quit your lessons once you pass the first test.

For substance abuse clients we know that the longer they stay in treatment past the point of getting off the drugs the better their chances of avoiding a relapse. The same is true of anxiety and depression. Fears will return. Life stressors will get you down. Having stayed in treatment will build protection from an emotional relapse.

3. Face your problems as they come.

Using avoidance and distraction only makes the challenge larger. Putting things off, using substances, or not thinking about your challenges may seem like a way to avoid the fear in the beginning, but fear avoided grows. Seeking out pleasure as a way to avoid anxiety or depression works for a while but eventually, you will have to face your problems.

4. Practice and train for many possible relapse triggers.

If you are afraid of snakes practice looking at and talking about many kinds of snakes. If your fear is public speaking make as many small presentations as possible with as many different groups as possible. Practice speaking on several topics. The more potential cues for fear you practice on the better prepared you will be for an unexpected fear.

5. Practice your relapse prevention skills in multiple locations.

It is easier to manage your fear of snakes when looking at a picture book in the library than to avoid that fear in the woods. Practice in the yard, on walks in the neighborhood, and as many other places as you can find to be outside and think I can handle seeing a snake if one should cross my path. Practice public speaking in more than one place.

6. Practice relapse prevention skills at times you are slightly uncomfortable.

You don’t develop skills if there is no challenge. Your anxiety relapse prevention exercises need to create a little anxiety. Training when you are very anxious is setting yourself up for failure. Gradually increase the challenges, keeping the anxiety at a manageable level.

7. Self-improvement programs work better with a little homework.

Set some homework projects for yourself. Ask your counselor or support system for suggestions. Don’t put homework off. You grow by repeated practice.

8.  Not all homework has to be done involving real danger.

Mental rehearsals for challenges can be helpful in increasing your ability to cope with an anxiety-provoking situation. What should you do if the situation occurs? What do you wish you were able to do? Picture yourself doing the thing you most would like to be able to accomplish.

9. Use “I can” self-talk.

Telling yourself that you will be able to cope increases the likelihood you will be able to cope. People who repeatedly tell themselves they can’t find they are right. Use coping language and stories to help you picture being successful and competent.

10. Avoid emotional reasoning.

Just because something feels scary does not make it dangerous. Examine the connection between your fears, anxiety, and sad thoughts and the things that cause them. You likely will find that it is the view of the situation that is causing the negative emotion.

There are 10 Ways to avoid a relapse of anxiety, depression, or other negative emotion.

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

Relapse on anxiety, depression or another mental illness?

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

Urge Surfing Prevents Relapses.

Urge Surfing Prevents Relapses.
Photo courtesy of Pixabay.com

Can you relapse on anxiety, depression, or another mental illness?

Relapse is a concept that has been borrowed from substance abuse treatment. It is easy to think in terms of an alcoholic drinking again as a relapse, but do people with a mental illness relapse? What would a relapse for anxiety or depression look like and what can we do to prevent a mental health relapse?

We are starting to view mental health and wellness as a continuum so people can move from well to less well to unwell and back again. In that respect, a mental health relapse seems to make sense.

A lot of people experience a mental illness at least once in their lifetime. Estimate run from 25% in any one year to 50% at some point in a lifetime. For an Anxiety Disorder, the estimates run from 10% to 20% and may even be higher than that when we consider the increase in PTSD.

In a previous post, we talked about Bob and Ellen who were treated for anxiety disorders, social phobia and specific phobia using systematic desensitization sometimes called exposure therapy. This is a proven effective treatment for specific phobia. As we last saw Bob and Ellen, after getting better they had both relapsed and were having symptoms of anxiety again. This is not surprising.

From one-third to two-thirds of everyone treated for anxiety disorders relapses, despite the fact that we know why this happens and how to prevent it.

Anxiety is fear-based.

It shrinks when approached. We tend to avoid scary things but the more you avoid them the harder they become to face the next time. Once people complete treatment they tend to stop thinking about the thing they feared. Over time the gains they made fade away. Substance abuse treatment tries to avoid this problem by encouraging people to continue with self-help groups to maintain the growth that has happened. Self-help groups for emotional issues are much harder to find.

Treatment for fear in the office does not equal less fear out in the backyard.

A recovery skill needs to be practiced in many settings so that it is usable at any time or place. Fear is worse in new novel situations. Learning, to be useful, needs to “generalize” into many settings. People who are in treatment for an anxiety disorder need to practice their skills in as many situations as possible.

Many people use medication to reduce or manage symptoms.

As soon as the symptoms are reduced they discontinue the medication. Discontinuing medication too soon is likely to result in relapse.

If there is an actual injury fear is more likely to return.

Getting treated for irrational fear is likely to stick but if you were in an accident you have good reason to be afraid of the same thing happening again. You should expect to use extra caution in dangerous situations if you have been injured in the past. Anxiety is meant to keep you safe. The goal is to manage the anxiety not to completely eliminate it.

If nothing else happens fear tends to return with time.

Treatment for anxiety needs occasional “boosters” to prevent its return.

Other emotional issues increase the risk of a return of anxiety.

An untreated depression greatly increases the risk of a relapse of anxiety, so does substance abuse. If you have multiple problems, anxiety, and depression or anxiety, and substance abuse you need to be working on all the issues at the same time. Leave on issue untreated and the risk of relapse for the others increases.

Continue to work on your recovery to prevent a relapse of anxiety, depression, or another 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

Which alcoholic beverage causes the most hangovers, DUI’s and damage to the body?

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

Liquor

Alcoholic beverages.
Photo courtesy of Pixabay.com

Standard drinks and why they matter.

There are more urban myths and legends around alcoholic beverages than you would find in most children’s storybooks.

People believe that one particular alcoholic beverage is safer or less likely to get you drunk than another. Does drinking shots get you drunk faster? Is wine safer than beer? Can you avoid becoming an alcoholic by sticking to beer and avoiding the hard stuff? Let’s look at the facts behind these beliefs.

All alcoholic beverages share one most significant ingredient – ethanol. Alcohol is produced by the action of yeast fermenting something. Fermenting grains and berries produces ethyl alcohol, which is the only alcohol that can be drunk by humans without fatal results. Wood can be fermented and produces methyl alcohol, but if it is drunk it can be fatal, producing blindness and brain damage before death.

All alcoholic beverages contain ethyl alcohol. When it comes to intoxication – alcohol is alcohol. What varies is the amount of alcohol and the various additives and flavorings. Make no mistake. The more ethyl alcohol you consume the drunker you will get.

To compare one alcoholic beverage with another we have created the concept of a “standard drink.” Correctly served, a standard drink of beer, wine, or a shot of hard liquor all contains precisely the same amount of alcohol.

Beer.

A standard drink of beer is a twelve-ounce bottle.  One small can of beer contains one standard drink. People mislead themselves into thinking that drinking beer is safer because it requires drinking more volume than other drinks to get the same blood alcohol level.

More than once a client has said: “I only had a couple of beers but I got a DUI anyway.” It makes a lot of difference if the beers were 12 ounces or 40 ounces. One beer should produce a blood alcohol level of about .02. Two 40 ounce beers are equal to almost 7 of the little ones and will produce a blood alcohol level of around 0.14.  That is past the point of legally drunk in most any place I know of.

It is also worth noting that in the United States of America more than half of all the alcohol (pure ethyl alcohol) consumed comes from beer. Lite Beers may be as bad or even worse.

Also for the record, your liver may develop tolerance to alcohol but the liver only has one speed. No matter how high the blood alcohol level goes the liver can only detoxify one standard drink of ethyl alcohol an hour and the liver only starts to work once the alcohol is digested and absorbed into the bloodstream. This explains why someone can drink a couple of 40-ounce beers, feel fine, and then suddenly feel drunk an hour to an hour and a half later after the alcohol gets absorbed into the bloodstream.

Malt liquor will get the drinker even higher blood alcohol numbers, up to half again the numbers for beer.

Wine.

A standard drink of wine is one – five-ounce glass of 12 % wine. This number will vary from text to text. Some places measure alcohol by volume and other countries measure by weight. So don’t be surprised if you read elsewhere that a standard drink is 4 ounces of wine.

If you like “fortified wines” as in sherry or port the size of the glass needs to be smaller. A standard drink of port is a 3.5-ounce glass.

It does not count if you open a bottle of wine, pour one glass, and then continue to refill the glass all evening. If you finish off the whole bottle of wine, regardless of the number of glasses you use, you will have consumed 5 standard drinks. Five standard drinks on one occasion for a man or four standard drinks for a woman is binge drinking and does a lot more damage to your body. This is an even bigger problem if you are a binge drinking senior citizen.

Shots – Hard Liquor.

A standard drink of hard liquor is one and one-half ounces of 40% alcohol. Since proof numbers are exactly double percentages that would mean a standard drink of 86 proof liquor should be just shy of 1 ½ oz.

So a person drinking 3 ounces of hard liquor in a small glass gets two standard drinks.

Question?

A beer drinker consumes a forty-ounce bottle of beer; his buddy drinks only one glass with three ounces of 86 proof tequila, who is drunker?

Easy – the beer drinker consumed like three and a half standard drinks, the tequila drinker only consumed two standard drinks, the beer drinker will be way more intoxicated come an hour later when the drink is absorbed into the bloodstream.

See how easy it is to fool yourselves saying you had only one drink when in fact there was a whole lot more alcohol in that one drink than you thought?

In this discussion, we have left out the effects of “tolerance” and “withdrawal” which complicate the math but not the legally drunk part. We also have not talked about drinking something stronger like “151” or “191” and how much closer that could take you to the .60 blood alcohol level where you blackout, organs stop working and you get pronounced legally dead.

Also, you need to know that if every time you drink, you end up drunk, which has less to do with the kind of drink you consumed and more to do with your having counteracted a disease called alcoholism.

So the results of this exercise tell us, it really doesn’t matter if you drink beer, wine, or hard liquor, what matters is how much ethyl alcohol is in that drink and what happens to you when you put ethyl alcohol in your bloodstream.

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

Binge drinking, memory loss, cognitive decline and Alzheimer’s

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

Drinking

Binge drinking.
Photo courtesy of Pixabay.com

Binge drinking your way to Memory loss, cognitive decline, and Alzheimer’s.

Once you get past age sixty-five, it doesn’t take much in the way of binge drinking to impair your cognitive abilities. A recent study by Dr. Lang of the University of Exeter reports that the threshold for memory loss as a result of binge drinking is a lot lower in senior citizens than previously thought.

Seniors who binge drank TWO times per MONTH were 250% more likely to have memory loss and cognitive decline than those who did not binge drink.

The study defined binge drinking in seniors as four or more drinks on one drinking occasion. Given what other studies have found about the declining tolerance of seniors for alcohol, that four drink figure sounds awfully high. See a previous post on binge drinking for more on the effects of substances on the elderly.

This study does not draw a conclusion about any connection between binge drinking and either dementia or Alzheimer’s. But the conclusion that even occasional episodes of four drinks by seniors can impair the memory makes me question the safety of these promotions trying to get seniors to drink a little for their heart.

This study was presented at the Alzheimer’s Association International Conference. A second study presented at the same conference examined the effects of “moderate” drinking on older women. In this one over 1,300 women age 65 and up were studied for twenty years. The result?

Moderate alcohol consumption did not protect memory in older women.

We also suspect that binge drinking coupled with prescription medications increases the risk of blackouts in Seniors.

The drinking by seniors conclusion?

Alcohol consumption by seniors does not protect the memory and even occasional binge drinking, as few as four drinks in one day, maybe less, can result in memory loss for those in the senior community.

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

Can you change a mentally ill family member – Powerlessness?

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

Change

Change.
Photo courtesy of Pixabay.com

What is powerlessness?

Does powerlessness have anything to do with mental illness and family members? The more we move from a model of mental illness that emphasizes permanent disability to a wellness and recovery model the more we see terms like powerlessness applied to the recovery from mental illness process. One blog reader asked about applying Al-anon principles to their problems with mentally ill family members.

Are people really powerless over mental illness and addiction? Doesn’t saying you are powerless just breed an attitude of helplessness, a victim mentality? Not at all.

There are some things in life we have control over, there are a lot of other things that we have little or no control over. The important thing is learning which is which.

This kid was walking along texting on his phone and generally not watching where he was going. He walked straight into a cement wall. The whole situation looked humorous to me, but I am quite sure it was not a laughing matter to that teen. He became quite angry and hit that wall a good one with his fist.

That teen could stand there pounding away at the cement wall but in the end, he is likely to find he is powerless over that wall. Eventually, he may damage the wall but he is going to harm himself seriously in the process.

Now insisting that the wall is wrong, that it needs to get out of his way is unlikely to be helpful. But isn’t that what happens to so many people, especially people in recovery, every day. Despite clear indications that the current approach we are taking is not working we continue to insist that the world change to accommodate us.

Looking at that wall in an objective way it was easy to see that there was a gate only a short distance away. The teen could have taken the gate, or at the other end the wall ended and with a few extra steps he could have gone around, still, he insisted the wall change.

The alcoholic is like that. Every time they drink they end up drunk. They struggle to control their drinking. The anxious or depressed person tries to deny they have a problem. Ignore the problem and it will go away is the universal motto.

Even after untold negative consequences, alcoholics tell themselves they will find a way to keep drinking and not have problems. The sad truth is that if anything has become an addiction in your life you will never be able to control that thing again. You are powerless to make that thing do what you want it to.

We are all powerless over rain. Now anyone can take a few raindrops. But I have never been able to make it rain or not rain on command. Facing a hurricane I can walk into the storm contending that I am not powerless over a little rain but eventually the storm will get the better of me.

The surest course of action when encountering the hurricane is to admit you are powerless over the storm and take cover in as safe a place as possible. Accepting that you are powerless over hurricanes and that the storm will do what it will do is a wise use of thought. Accepting help for your emotional problem is a wise course also.

The safest thing to do when encountering a drug is to admit that the tiny little thing can whip you any day. Struggling to do a little of the drug and still not let it control you is looking for disaster. No one controls their addiction. Learning that you can say no before the first taste, that is power.

We also need to learn that we are powerless over others. All that begging and bribing, the threatening and the use of force, this approach never really gets you control of the person. If your partner is addicted do you really think you can somehow win the battle to control the substance? We are powerless over people and things.

People will struggle for years to not be sick even when an effective treatment for their problem is right in front of them.

So the idea that a family member might by some special effort get their family member to change and presumably not have a mental illness, that is the clearest sort of delusion.

A central message of Al-anon as I understand it is the same as the message to addict’s, continued efforts to pretend that we have control over others, people, or things, are an illusion. Once you admit you are powerless over the mental illness, then the person can stop trying to pretend they don’t have the problem and begin to look for help in living with their issue.

The key to helping others is to first change yourself. The serenity prayer tells us to change the things we can, mostly that is ourselves, accept the things we cannot change, and develop the wisdom to know the difference.

Absolutely spiritual principles like those of A.A., Al-anon, and other 12 step groups apply to mental illness just as they apply to addiction and alcoholism.

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

Dangers of Binge Drinking

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

Drinking

Binge drinking.
Photo courtesy of Pixabay.com

Binge drinking may be more dangerous than we thought.

One drink per day for thirty days, for many people this is no big problem. No drinks for thirty days and then binge drink thirty drinks in one day, that would be a huge, maybe fatal, problem.

Thirty drinks, if consumed rapidly enough and kept down would result in a “theoretical” blood alcohol level of .60 which is enough alcohol in one person to have made seven and a half people legally drunk. At that blood alcohol level, the person would probably not need treatment. They would already be dead.

Blood alcohol levels of .50 to .60 are likely to be fatal. But even lower levels can kill or permanently injure a person. Alcohol kills more people in the United States every year than ALL DRUGS, legal or illegal combined (not counting nicotine.) Even when people die from other drugs, they typically have alcohol in their bloodstream.

To be fair, not everyone who drinks, binge drinks, and gets drunk. About half of all Americans old enough to drink have not had a drink in the last thirty days. Those who drink a lot, damage themselves and others a lot.

The twenty percent of Americans who consume the most alcohol, the frequent binge drinkers, consume 80% of all the alcohol sold. The majority of all the people in prison around here were drunk or high in the 24 hours before they committed the crime that sent them to prison.

People who drink rapidly and reach high blood alcohol levels are likely to have blackouts.

Even at much lower levels, we find that “binge drinkers,” those who consume larger than typical amounts of alcohol on one occasion, are 55 times more likely to attempt suicide.

The damage alcohol does to the body depends on the level of alcohol in the bloodstream. Our way of assessing risk, based on the number of drinks during a single “drinking episode” is biased towards underestimating the extent of binge drinking. Not everyone who drinks gets the same result.

The blood alcohol level is dependent on a number of factors and the number of drinks is only one of those factors.

Body weight influences blood alcohol levels. If a one hundred pound person and a two hundred pound person have the same number of “standard drinks” the one hundred pound person will have a significantly higher blood alcohol level.

Alcohol is soluble in water, the more water in the system the lower the blood alcohol level. Men have more water per pound of weight than women. This means that if a man and a woman of the same weight drink the same amount of alcohol the woman ends up with a higher blood alcohol level.

Liver function also affects the body’s ability to process alcohol. A damaged liver and the drink will stay in your system longer.

Age is a factor. You can put color on your hair but you can’t pretty up your liver. As you age the liver gets old and tired. It won’t process as much alcohol per hour. An old liver will result in higher blood alcohol levels. Studies tell us that the “safe” level of alcohol consumption for an “older person” is maybe half what it was for a younger person.

If one glass of wine a day is good for you at age 30, three glasses a week will be your max at age 80 or so. I know there are exceptions, don’t email about your grandparent who still drinks a tall one every day and is in good health. Studies say that for the elderly, most of them, 3 drinks a week would be all that is safe.

Binge drinking is defined as 4 drinks on one drinking occasion for a woman and five drinks for a man. We have already underscored that for people of low body weight or the elderly or woman these numbers are way too high.

Who is at the highest risk for medical problems from binge drinking? Four groups are at highest risk, the young, the old, the pregnant, and the alcoholic.

The young have more drinking problems.

They don’t know the risks and the results. They can get drunk, hurt someone, be in trouble and there goes the life. Almost all people with a substance use disorder become alcoholics or addicts before the end of their twenties.

The elderly have lots of substance use problems.

These folks are not exempt. In more than half of all hospital emergency room admissions of senior citizens, the elderly person is drunk or high when the accident occurs. One reason seniors are falling down and breaking hips is they are stoned.

Seniors may become depressed when they retire or end up living alone. They may drink; take prescription drugs and even illicit drugs. Put that all together and it is easy to have substance abuse get out of control in the elderly.

The pregnant should not drink.

Any alcohol is bad for the developing fetus, the more alcohol the worse the damage. We can’t always see the damage as it can hide in lower IQs, retardation, and learning disabilities. Alcohol induces “Fetal Alcohol Spectrum Disorder” which is the largest source of preventable birth defects.

The alcoholic will not be able to safely drink.

As many an alcoholic will tell you “one is too many and a thousand is never enough.” The hallmark of alcoholism is the loss of control. An alcoholic has lost control of how much they will drink once they get started. The only “safe amount” for someone with a history of alcoholism to drink is – none.

Many drug addicts get into recovery and then fool themselves by thinking “I never had a problem with alcohol so I can drink safely.” Scratch a drug addict and you will find an alcoholic. The same seems to hold true for anyone who has had any other form of impulse control problem.

Consider for a moment. If you drink multiple drinks, most days or end up drunk when you drink you may have a drinking problem. If you binge drink, drink with the intent to get drunk or buzzed, you are in the highest risk group.

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

Anxiety – fears and phobias can be treated.

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

Fear

Get rid of fear.
Photo courtesy of Pixabay.com

Are you afraid of spiders, snakes, or public speaking?

If you are afraid of a particular thing or situation and go to lengths to avoid that thing you may well have a Specific Phobia. Specific Phobia involves the fear that a particular thing is going to harm you. This fear may be irrationally strong even when you have never been harmed this way before and the risk is low.

There are five types of specific phobias, Animal type, Natural environment type, medical type, places, and “other” type. Other type includes diverse things like a fear of choking and a fear of costumed characters. People with a specific phobia, except very young children, know their fear is excessive and is interfering with their life but they will go to great lengths to avoid the thing that scares them and to avoid getting treatment for their phobia.

Animal type refers to the spiders and snakes as well as any number of other creatures great and small that may scare us. Some animals may really be harmful or dangerous but a phobia is not restricted to only those things we should fear but is enlarged to fear all creatures whether they are likely to harm us or not.

Natural environment phobias include heights, weather, and water. The “medical type” includes such things as blood, needles, and medical procedures. Place phobia is best known for fear of flying and elevator fear.

A closely related anxiety disorder “Social Phobia” includes things like public speaking and eating in public. In social phobia, the fear is not of being physically injured but a fear of doing something that is embarrassing or uncontrollable.

Both social phobia and specific phobia are treatable. For some people, medication can help to manage symptoms in the short run but over time the symptoms of anxiety may reappear. A specific counseling method called systematic desensitization or exposure therapy is especially helpful for treating specific phobia and a related method works well for fear of public speaking.

If the phobia becomes excessive someone may seek treatment. Here is an example of a treatment episode for a mother; we shall call Ellen, who had a terrible fear of snakes. She was practically pushed in the office door by her husband Bob. Her son and her husband Bob both wanted to go camping and she had refused. While on vacation they had wanted to visit a zoo. Both of these activities might involve snakes and snakes terrified Ellen.

The therapist began by teaching Ellen how to relax using deep breathing and other relaxation techniques. It is impossible to be both frightened and relaxed at the same time. Over the next week, Ellen practiced her relaxation methods every time she became anxious, whether it was about snakes or just day-to-day life.

At the second session, they discussed what things about snakes provoked what level of fear. Could Ellen write the word snake on a piece of paper with only modest fear? Could she say “S-N-A-K-E.?”

For each item on the list, they assigned a number from one to ten. The goal was, to begin with, the “snake’ exposures that were the least frightening and progress to the more threatening ones. Her fear hierarchy might come out something like this.

  1. Write the word snake on a piece of paper.
  2. Say snake.
  3. Talk about snakes.
  4. Read a word book about snakes.
  5. Look at pictures in a book about snakes.
  6. Watch a video about snakes on T. V.
  7. Visit a local pet store with her son and look at snakes in the cages.
  8. Touch a snake while the pet shop owner held him.
  9. Visit the local zoo and look at snakes in the Herpetarium with her son and husband.
  10. Go on a camping trip where they might encounter a snake.

After developing the “snake fear scale” Ellen practiced her relaxation. She was then able to write down the list of “snake steps” and read them back to the counselor at the second meeting.

By the third session she was reading an article the counselor had brought in about types of snakes and some of the good things snakes can do.

Her efforts to look at pictures in a book took longer, several times she had to stop, do her relaxation exercises, and discuss her feelings with her therapist.

Ellen watched the snake video in the counselor’s office, being prompted to do her breathing and relaxation as needed. She was able to take the video home and watch it a second time with her family and reported it went well and she did not have to close her eyes even once.

By the time summer came Ellen reported to the counselor she had completed steps one to nine.

This same sort of method can be used for social phobia. A common fear is public speaking. Many people report they are more afraid of public speaking than death. The old approach to fears and phobias was the “throw them in the deep end and they will sink or swim.”  Too many people were traumatized by that approach and never went into the water again.

Turns out that Bob, (Ellen’s husband remember?) was not afraid of snakes, but he was terrified of speaking in public. His company wanted him to make a presentation later in the year at a large convention and Bob was terrified. The counselor worked with Bob for a while on relaxation techniques and then gave Bob some choices.

For those with a fear of speaking there are classes at the local college or adult education and there are clubs whose purpose is to help people overcome their fear of speaking in front of others. Working with a small group of others who are all trying to learn to speak in public can ease the tension. Building up gradually from talking around a table to standing up and speaking to the group and finally to speaking in front of progressively larger audiences can build your confidence.

Bob took the college classes. He was able to complete the class and began speaking to groups his company sent him to speak at. Things were going fine. – Sort of.

Then the counselor got a frantic call from Bob and Ellen. Despite all their efforts and all that progress, Bob was terrified of the speech he needed to give at the convention, he was thinking of quitting his job to avoid it. Ellen had been in the bedroom crying for the last week. She was not going to the convention with Bob, as much as she wanted to be supportive because that meant the camping trip after the convention and her fear of snakes had returned with a vengeance.

Why after all that work had Bob and Ellen had a relapse of Anxiety? We know systematic desensitization works to reduce anxiety.

Stay tuned for a post on what causes an anxiety relapse.

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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