Where happiness hides.

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

Happy faces

Happiness.
Photo courtesy of Pixabay.com

How happiness becomes invisible.

Happiness is so much harder to find than pain for the majority of humans. This is not a result of some personal failing. Turns out that this bias, to see the bad and the dangerous and to miss the happy and the pleasant, is a built-in feature, a part of the design of humans.

One particular psychological principle explains a lot about the inability of so many people to see happiness even when it is right in front of you. That principle is the “expert effect.”

Let me explain the expert effect and how it hides happiness with a story from my past.

I once had a friend who was into antiques. We decide to meet up for lunch and check out a few antique stores downtown. After walking through one especially well-stocked establishment we paused outside to talk about what we had seen.

“Did you see that Fenton glass? And the shelf of carnival glass over in the corner?” She asked.

I had to admit I hadn’t noticed either of these glass items. They were right there in plain sight.” She commented.  “How could you have missed them?”

I had to admit I had missed them. There was a good reason why. At that point in my life, I could not have told you the difference between a piece of Fenton glass and a fence. I could easily spot the shelves of old books but the glass, not so much.

So after that experience and not wanting to appear so stupid I determined to solve this problem. The next week I went to the library and checked out, and read, some books on antique and collectible glass.  The next time we went antique hunting I did indeed see all sorts of previously invisible collectible glass.

Not only did I see it, but now I slowed down to take a close look and tried to remember what I had read about this particular type of glass. When we did finally talk about what we had seen there was so much more to the conversation.

The principle here is the “expert effect.” If you don’t know what something looks like it is hard to spot. The more you learn about a subject the faster you will identify it and the more meaning it will have when you see it.

Most of us are hard-wired to spot pain but we have never learned to see happiness. This makes the good things in life invisible even when they are right in front of us.

Most of us are naturally able to spot the unhappy, the painful, and the dangerous. You don’t need to be eaten by a lion to know that avoiding lions is a good thing to do. We can learn from others by seeing them get eaten. We might even learn from hearing others tell tales about lions eating people. Getting eaten has a high importance if you live around lions. In my town, we avoid gang members with guns in the same way.

It is much harder to spot others who are happy. And we don’t often hear stories about other’s happy moments. Even when we do see and hear happiness stories they don’t stick in our brains the way lion stories do. This is called a negativity bias.

Rick Hanson author of Buddha Brain, has written and talked about our ability to learn about the negative quickly and our lack of skill in learning to spot and remember happiness. With time our brains can learn most anything but the less you know about the topic the harder it is to learn and the more we will be biased to learning only scary things we need to know to keeps us alive.

So his prescription for learning about happiness? How do you become a happiness expert so you can spot it at a distance and learn to run toward happiness instead of from lions? Hanson suggests that a positive memory needs to be held and savored for 20-30 seconds before it will sink in unlike pain that registers straight off. He calls this 3 step process “taking in the good.”

The brain does not do a good job of storing facts, especially small or unimportant facts.

Did you know that the bulk of all learning, maybe 80% or more, is emotional, not intellectual?

Want to remember something? Turn it into an emotional experience, not a fact. Here is a happiness example.

You are walking along at a fast clip, trying to get your exercise done before sunset. Nice sunset. Nice flower I just passed. Glad when this jogging stuff is over and I can rest. Is that the way many of us do this exercising thing?

What would happen if you stopped and looked at the sunset? How long can you stare at your neighbor’s flowers before she calls the cops? If you pause and look, for as little as twenty to thirty seconds, give this experience time to soak into your brain, you will greatly increase the likelihood of remembering this experience as a pleasant one. Let a few of these 30-second experiences accumulate and you might become a happiness expert.

What – you too busy to spend 30 seconds collecting happiness?

But wait there is more. Hanson also said that besides slowing down and turning the facts into an experience, holding the feeling for the 30 seconds we also need to make a conscious effort to save the experience.

So if you set out to become a happiness expert, invest the time, feel the feeling when it comes, and plan to hold on to it and capture it in your brain.

You too can become a happiness expert and prevent happiness invisibility.

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 face of bullying is changing

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

Crying child

Youth mental health.
Photo courtesy of Pixabay.com

As bullying changes so should our response.

Most kids will be bullied sooner or later.  We used to think that there was something that the victim was doing. It would make us feel safer to think they had done something wrong and if we teach kids to avoid that mistake then our kids will be safe. Like blaming the rape victim, blaming the victim of bullying has not helped reduce the number of incidents. The amount seems to be growing. So is the type.

Our fear of violence in the school has led to crackdowns on violence. We have zero-tolerance policies. Bring a weapon to school and you get kicked out. Hit someone and you will be suspended maybe even expelled. There is no such thing as a “normal” fight between kids anymore. This has reduced the rate of physical bullying – somewhat. It has not reduced the rate of emotional bullying.

Bullying is not always from outside the family. The most devastating form occurs when family members, those who should have protected you, become the bullies. Relentlessly harassing a family member, the name-calling and the feeling of rejection all take their toll.

Kids have come into the psychiatric facilities as a result of a suicide attempt and they tell me their family has called them fat and dumb for years. They finally just gave up. This form of emotional bullying is also emotional abuse. It can and probably usually should be reported to the Child protective services as child emotional abuse. Besides intervening in the family we need to help the victim to get past the trauma of the abuse. But bullying is everywhere.

The new face of bullying is the anonymous face of the internet, cyber-bullying. It is also the acts of kids rejecting and excluding other kids. There is a lot more name-calling and cruel posts online.

Recently Psychotherapy Networker presented a webinar on bullying featuring Stan Davis as part of their parenting skills series. I try to catch as many of their presentations as possible. Most of the programs are designed for professionals and include continuing education units (CEU’s.) They also make some presentations available free of charge, but only for a short time. For more information on Psychotherapy Networker and their webinars see: http://www.psychotherapynetworker.org/

Davis tells us that the old approach to bullying is not working. Education for bullying, as in education for drug abuse does not solve the problem. Kids know they shouldn’t bully, with or without an education component.

The kids who tell me at age 8 that drugs are bad and they learned in school that you should never do drugs; I see them again in their teens after they have had an overdose. Same thing with bullying.

If we really want to create a climate without bullying, or less of it anyway, we can’t excuse or alibi bullying when it happens. We need a consistent message that there is zero-tolerance for emotional bullying just like zero tolerance for physical violence. So far society is not consistent with this message at home or at school.

Drugs are cool in movies and on T. V. so are in your face put-downs of others. Kids are learning to bully from what they see others do and lacking any amount of self-control they imitate the reality shows and the movie and video game bullying.  Like the way, drunk driving stopped being OK as a result of a concerted campaign by MADD we need a campaign to make bullying a not acceptable activity.

Davis also mentioned that the best antidote for bullying is friends. The more a child belongs and feels like a part of something the less likely they will be affected by bullying. The most victimized are the most alone and once they become the victim they are more likely to be shunned by others, who are afraid to become victims also.

Connection reduces the impact of trauma whether it is from bullying or from a natural disaster. We know from other sources that people with a serious mental illness, like schizophrenia, which have partners at home that support them are half as likely to end up in the psychiatric hospital. Kids who have friends are less likely to be permanently harmed by bullying.

Resiliency is also a source of protection when someone is bullied. Resilient people seem to be able to screen out the verbal insults and the put-downs  Screens, says Davis, keep out the injury, but we need help from our friends to keep the screens of protection clean and repaired.

So the summary here is that more bullying today is non-physical like insults and rejection and to protect against this, more friends and resiliency are what is needed.

See also: Bullying, Families, and Resilience 

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 Eating Disorder – the other side of Anorexia and Bulimia

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

What is

Binge Eating Disorder – the other side of Anorexia and Bulimia
Photo courtesy of Pixabay.

Eating yourself to death – Binge Eating Disorder.

We used to ignore Binge Eating and only pay attention to eating disorders that involved inappropriate ways to control weight. Anorexia and Bulimia are well-recognized eating problems that were covered in previous posts.

Other posts about eating disorders and the new DSM-V proposals will be found at:

Binge Eating Disorder – the other side of Anorexia and Bulimia 

Middle class and starving to death in America – An Eating Disorder called Anorexia

Love-Hate Relationship with food – Bulimia Nervosa

Eating Disorders and Substance abuse  

Avoidant Restrictive Food Intake Disorder

Recently we have started to see how the overeating part can be a major issue even without the effort to control weight. In Binge Eating Disorder the emotional eating component takes place but it is as if the person with Binge Eating Disorder gives up and stops even trying to control their weight.

As in Bulimia, the food is consumed in a relatively short period of time, two hours or less. One episode of this behavior does not make for the diagnosis; Binge Eaters do these behaviors on a regular basis. The strict diagnostic criterion calls for at least one episode a week for at least three months.

Loss of control is a hallmark of this as well as other impulse control problems. It is not simply that the person likes to eat but that they are driven to eat. Even when they try to avoid the excess calories they are unable to control themselves.

Binge eaters eat faster than everyone else, they wolf the food down. And the Binge eater does not stop when full. They are unable to realize they are full until it becomes impossible to eat more. Even when not hungry the Binge eater will continue to eat for the emotional values of the experience rather than for the nutritional ones.

This eating disorder like other eating disorders is characterized by secrecy and avoiding others seeing what the Binge Eater is doing, they will eat surreptitiously to avoid notice. After a binge episode, the Binger may become sad, anxious, and have feelings of guilt. They can begin to hate themselves.

Binge eaters are not comfortable with what they are doing, they wish they could stop but efforts to control their food intake are unsuccessful.

Binge eating is not a simple case of overeating, laziness, or unwillingness to exercise. It is a specific psychiatric problem that includes the uncontrollable urge to eat even when full and the lack of any energy to attempt to lose weight.

Binge Eating may lead to depression or may accompany a mood disorder. Gradually the pounds are packed on; the Binge eater becomes isolated from family and friends and may begin to hate themselves but still can’t stop without help. This condition requires professional treatment. Treatment for Binge eating may be less widely available than therapy for other eating disorders because the health damage occurs more slowly, but untreated the ill effects on health will certainly occur.

There is a fourth category of Eating disorders, Eating Disorders Not Otherwise Specified (NOS) which includes both unusual problems in food and weight loss and those cases that are not quite severe enough to get a diagnosis of one of the three principal types.

Three brief posts to cover four potential problems in the area of food and eating. There is treatment available for all of these issues. If you have experienced an eating disorder and care to share your experience, strength, and hope please leave a comment about anything related to Anorexia, Bulimia Binge Eating Disorder, or any other topic related to recovery.

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

Middle class and starving to death in America – An Eating Disorder called Anorexia

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

Unhealthy food

Unhealthy relationship with food.
Photo courtesy of Pixabay

Anorexia is a killer.

We know Anorexia Nervosa, Anorexia for short, is out there. This eating disorder can be a fatal disease. Most of us can name a famous celebrity or two who suffered and died as a result of Anorexia. But when someone we know, someone in our family develops Anorexia we are likely to look the other way until it is too late.

Anorexia Nervosa, along with Bulimia and Eating Disorder Not Otherwise Specified, mostly binge eating without an effort to lose the weight, these are the three currently recognized eating disorders. There are many misconceptions about Anorexia.

Anorexia is not dieting gone too far. Anorexia’s most recognizable feature is a refusal to maintain normal body weight. It is a distortion in the way the person sees themselves. The person with Anorexia sits in front of me. It is hard for me to look at them. The bones are visible and they look like a skeleton walking. They hid this from people for a long time with baggy clothes, strange secretive eating habits, or other devices.

Anorexia is not a loss of appetite. Even in the presence of extreme hunger, someone with Anorexia will refuse to eat.

I ask the person with Anorexia what she thinks of her weight. She says she needs to lose some weight, she is getting fat. I ask how much weight, she tells me five maybe ten pounds.  If I were to show her the mirror, let her see the bones sticking out, would that change her mind? Not likely. People with Anorexia even when confronted with a look at the bones that stick out will still insist they are too fat; they need to lose more weight. The problem is not in the diet but in the mind. The image in the mirror looks fat to them.

It is not about a lack of interest in food. Many with Anorexia watch cooking shows, own recipe books, and even hoard food. In the early stages, they may develop odd picky eating preferences and habits. Some appear to have Obsessive Compulsive Disorder when it involves food, weight, and dieting. They may refuse to eat in public and insist on taking their food to their rooms. They may have a strong perfectionist inclination.

They know the ingredients in the foods and can tell you more about the nutritional values than most dietitians, only they refuse to eat until they damage some organs. Sometimes the dieting and the other behaviors continue until death.

You don’t see a lot of Anorexia in poor families. It is more likely among the middle class and the rich. All the resources in the richest country on earth and still they starve – on purpose.

The thing that matters most to the anorexic is not the food – it is the control. They may have no control in any other area of their life but you can’t make them eat. Force feed them and they will vomit. The ways a person with Anorexia may reduce their weight are varied and imaginative. They may restrict, purge, use laxatives, or exercise to the extreme.

Anorexia doesn’t just cost weight. It affects a person’s overall psychical health, their psychology, and their social life.

Anorexia is most often not a stand-alone disorder. It like the other eating disorders, Bulimia and Binge Eating, frequently co-occur with anxiety and depression.

Besides the low weight, how can you tell if it is Anorexia and not just a dedicated dieter?

Someone with Anorexia will weigh less than 85% of what is considered normal for their height and age. They become extremely fearful of gaining any weight even when they know that they are thinner than their peers.

In women, they will have missed three or more menstrual cycles.

Someone with Anorexia sees their extremely low weight as a great achievement rather than a life-threatening illness.

Anorexia is not a phase teenagers go through even though many first develop the symptoms in their teen years. It is a life-threatening illness. Without treatment, it is highly unlikely to go away and is very likely to get worse until eventually it impairs health and may result in death.

Dieting is not the only way someone with Anorexia might control their weight. Some people binge eat and then purge, they may develop a ritual around their efforts to vomit and undo the binge eating. Those with Anorexia who binge and purge are more likely to develop other impulse control problems; they may abuse drugs and alcohol and engage in excessive, risky sex. Those who binge and purge are more likely to attempt suicide.

Anorexia Nervosa affects about one in two hundred people. Lots more cases come close but don’t get diagnosed because they don’t get below 85 % of normal weight measures. Most clients with Anorexia are female and this disorder most often starts in the early to middle teenage years, but not always.

Most any clinician can recognize and diagnose Anorexia but very few are willing to treat this condition. Even psychiatric hospitals are likely to refuse clients with Anorexia because of the high risk of permanent medical problems or death. There are effective techniques for treating Anorexia but they are specialized and often treatment occurs at treatment facilities that specialize in eating disorders.

Anorexia is a dangerous sometimes fatal condition. If you or someone you know has signs of this disorder please seek professional help before it is too late.

Other posts about eating disorders and the new DSM-V proposals will be found at:

Binge Eating Disorder – the other side of Anorexia and Bulimia 

Middle class and starving to death in America – An Eating Disorder called Anorexia

Love-Hate Relationship with food – Bulimia Nervosa

Eating Disorders and Substance abuse  

Avoidant Restrictive Food Intake Disorder

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

Love Hate relationship with food – Bulimia Nervosa.

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

Unhealthy relationship with food.
Photo courtesy of pixabay

Bulimia Nervosa a relapsing eating disease.

Bulimia Nervosa is included in the eating disorder category along with Anorexia Nervosa but it is very different from the other eating disorders. Anorexia progresses like a vice, starving the sufferer until their weight reaches a critical potentially fatal low. Bulimia runs its course in episodes of extreme eating and efforts to undo the overeating and lose the weight until it finally does its damage.

If you didn’t hear the person with Bulimia talking about food, should you only hear the emotional component, it would be hard to distinguish Bulimia from the binge drinking form of alcoholism.

Episodes of binging and the resulting guilt can be triggered by many of the same things that trigger addictive binges. Poor relationships and conflicts with others, the feeling of deprivation from excessively strict diets, or feeling out of control all can trigger the binges.

Binge eaters describe these overwhelming obsessive-compulsive urges as emotional eating. Emotional eaters who do not purge develop Binge Eating Disorder. Those who start compensating develop Bulimia.

Most people who develop Bulimia start off at normal or even a little overweight. They are likely to be a little older than the beginning person with Anorexia, perhaps late teens or even early twenties. There may be a period of moderate to strict dieting before the Bulimia strikes.

When they diet they have increasingly intense urges to eat. The tension continues to grow until the individual can’t stand it any longer, then like the alcoholic, the binge is on. At this point, the “just don’t think about it” approach does not work and may make things worse. In a previous post “Don’t think about Elephants.”   I described why the “just not thinking about things” approach does not work and what else can be done in this circumstance.

Binge drinking is defined as 4-5 drinks on a single drinking occasion, enough to get intoxicated. Binge eating is described as eating far more than a normal person during a single food intake episode lasting two hours or less. Bulimics crave food and then when they give in and eat it is not a little, but a lot of food consumed in a short amount of time. This overconsumption results in guilt and regret.

These episodes increase in frequency. Typically the person with Bulimia will have two or more episodes of loss of control, binge eating, and then efforts to purge the food every week for at least three months. The guilt over the episode increases the risk they will binge again.

Often the food of choice is ice cream or cake though no one food type is the choice of all people with Bulimia. They will eat until they reach the over-full point, become uncomfortable, or even painfully full.

The Bulimic then tries to undo the excess calories by deliberate vomiting or other compensatory behaviors. This is not a disease of gradual overeating and excess weight gain. Bulimia may result in sudden swings in weight, both increases, and decreases. The damage comes not from the weight gain or loss but from the radical behaviors used to undo the binge episode.

The emphasis is on the person’s use of “inappropriate” methods to undo the overeating. Someone with Bulimia may vomit so often that the enamel in the teeth is destroyed. They may develop calluses on the knuckles from repeated efforts to force the vomiting.

There can be damage to the throat and esophagus. A great many medical problems develop over time but may go unnoticed as the person’s weight swings up and down rather than moving to an extreme.

Bulimia is more common than Anorexia with up to three percent of women developing Bulimia during their lifetime.

These episodes of binge eating and the resulting efforts to undo the overeating are generally done in secret. The sufferer tries to be inconspicuous and may withdraw from family and friends damaging their relationships.

Self-esteem for the person with Bulimia is dependent on body shape and weight. They often develop intense depression after a period of bingeing and purging. Some have undiagnosed depression before the Bulimia, but Bulimia can also cause depression and anxiety.

Bulimia Nervosa like Anorexia Nervosa is treatable but both require specialized treatment by someone knowledgeable and experienced in treating eating disorders.

Bulimia is not associated with a high risk of suicide or death from medical complications, though some who have suffered from Bulimia can become severely depressed and have thoughts of self-harm.

Bulimia Nervosa is an illness not a case of vain or selfish behavior. If you want to be helpful to someone with this disorder listen to what they have to say in an open and non-judgmental way.

If you have Bulimia, get help now. If you know someone who has this problem encourage them to seek professional help.

Other posts about eating disorders and the new DSM-V proposals will be found at:

Binge Eating Disorder – the other side of Anorexia and Bulimia 

Middle class and starving to death in America – An Eating Disorder called Anorexia

Love Hate relationship with food – Bulimia Nervosa

Eating Disorders and Substance abuse  

Avoidant Restrictive Food Intake Disorder

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

LPC or LPCC? – Brief news update – plus the LPCC gap exam

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Is there a difference between LPC’s and LPCC’s and if so what is that difference, and how hard is the gap exam?

There have been several web searches on this topic and a couple of emails so now might be a good time to explain this. This question primarily applies to California clients and professionals.

Mental health practitioners in California are regulated by the California Board of Behavioral Sciences (BBS). They administer the laws passed by the California legislature and their rules and regulations. A recent news update from CALPCC explained the sudden appearance of multiple sets of initials for mental health clinicians.

The difference between LPC’s and LPCC’s has to do with the BBS computer system not any difference in the licenses or qualifications.

The BBS computer program only allows for three initials in front of the license number no matter what the designation of the practitioner. The correct designations are:

Licensed Professional Clinical Counselors are designated LPCC’s. Their license number begins with LPC.

Licensed Clinical Social workers are designated LCSW’s. Their license begins with LCS.

Licensed Marriage and Family Therapists are called LMFT’s. Their license number begins with MFC.

MFC is a throwback to the days when they (we) were called Marriage, Family, and Child Counselors. MFT’s are the same thing as LMFT’s since you can’t call yourself an MFT unless you are licensed. Marriage and family therapy interns and trainees should be identified as MFT interns and MFT trainees – NOT MFTI or MFTT. Both of these groups are working under the supervision of a licensed clinician.

How hard is the LPCC gap exam?

People have been asking “How hard is the LPCC gap exam?” Personally, I would say based on my experience – well that depends on whether or not you knew the answers. Since the exam is only on the differences between LCSW, LMFT, and LPCC’s, there is a lot of material to cover in a very few questions. If you graduated recently or have been studying LPCC material since graduation you should be in good shape. Some of the material was very specific so if your school covered if you were in luck. If your particular instructor did not cover an item it would have been hard to know what to study.

I would recommend a review course, though it is early for the review classes to know what to teach you. Also, study anything in the BBS booklet that looks unfamiliar. The wider your knowledge base the better you should do.

Hope this helps explain LPC’s, LPCC’s, and the gap exam.

Update on the gap exam and the changes in initials.

The period for grandfathering in as an LPCC has come and gone. No more Gap exam. Also, the new computer system fixed the initial problems. My most recent license renewal shows my licenses as LPCC and LMFT.

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

Meditation for people who don’t meditate

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

Tree.
Photo courtesy of Pixabay.com

Are you a meditator or a non-meditator?

For a very long time now I have been convinced that there are two kinds of people, meditators, and non-meditators. I was sure I was a non-meditator. Turns out I just might be a closet meditator after all.

There are lots of meditators out there. I read about them and the benefits of meditation. I am sure it must be immensely helpful to those who practice it, but like weight loss and exercise it has always on my “to do” list not my “done” list till now.

Meditation fits nicely with all those pleasant eastern religions, but I am a hopelessly western person. How could meditation fit into my life? I have been to a twelve-step meeting where they talk about prayer and meditation but getting into meditation has been an awfully long stretch for me.

One problem with my meditation efforts may have been the tendency to think that somehow I needed to close my eyes and block out the world. That is the way we are supposed to pray in church so that was the way I tried to meditated. The same problem occurs with both prayer and meditation when I close my eyes. First, my mind floods with thoughts about everything in the world. These are important thoughts, creative thoughts and I don’t want to lose them so I keep trying to remember these important ideas while trying to empty my mind. Ever try to empty a large pool of water using a running hose?

This flood of ideas happens at other times, like when I am supposed to be writing my blog post. At those times I use a “capture tool” for those pesky other thoughts. Rather than trying to remember the idea I just got for tomorrow’s post while typing today’s installment, I write it down on a clipboard next to my computer. This “captures” the thought and lets me drop it out of my mind and concentrate on the idea at hand. I tried that with meditation but it seems disrespectful to the meditation leaders to always be writing things down while others are trying to meditate. Seems downright sacrilegious, in a non-religious meditation way.

My training as a counselor has been mostly centered around the western style of cognitive behavioral therapy. Get a head change, change your thinking and the emotions will follow. Meditation might work for some of my really anxious clients but I was a little unsure how to teach them the benefit of something I had always been sure I didn’t do – till now.

Someone recently told me they meditate by watching the leaves in the trees. There was a brief flash of thought, not willing to call it enlightenment just yet, but I started to wonder – could watching the leaves in a tree be a form of meditation?

In counseling, we work on a skill called “attunement” with clients. We try to not only get the meaning of their words but also the feeling behind those words. We try to see the world from the client’s point of view. If we can attune to people why not trees?

It suddenly came to me that the times in my life which were the most peaceful were when I could attune with something in nature. Sitting on the ground staring away at the leaves, watching the wind making its way through the tree and feeling attuned to the tree, that occasion was one of the most peaceful times in my life.

Trees have a lot to tell us. From a distance, they look a lot alike. Close up it is amazing the variation. No tree is perfect but you don’t need to be perfect if you are a tree, you just grow and give shade.

Like most people I have moved all around looking for the place I belong, that tree outside my office has lived in that same spot since the day it was born. In all likelihood that tree will still be here after all the people who work in the building have come and gone.

The tree has its struggles. Last winter there was a wind storm and the tree lost a branch, broke off all of a sudden. The tree lost part of its self and still just kept on growing, reaching for the sun. We humans sometimes stop growing after a loss like that.

Trees aren’t the only non-humans we need to attune with. There are birds that act out their drama while living in that tree. The rain comes and it plays with that tree until drops fall to the ground and flow away.

Watching the river run downstream is also a peaceful centering experience. Water, by the way, does not care if you watch or close your eyes to meditate. If you close your eyes while attuned to a river, it will sing to you.

There you have it. While I will probably never be able to sit quietly staring off into space and meditating, I find great joy and contentment in watching the wind play games with the tree outside my window and the rain run down the stream to the river and eventually the sea.

Could you accept that attunement to nature is a very productive form of meditation?  It’s a version of meditation that works for me.

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 abuse of seniors and the disabled get reported?

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

Older people

Elderly couple.
Photo courtesy of Pixabay.com

Reporting abuse of a senior citizen or a disabled person.

Most people are well aware that child abuse and neglect get reported, but reporting abuse of other vulnerable people gets forgotten. This is a legal and an ethical question. For legal advice please consult with a lawyer or your local statue. There are lots of ifs, and’s and exceptions here. I will keep this simple.

From a California LPCC and LMFT’s point of view here are some things to think about. Every two years when we renew our licenses we have to take a refresher course on Law and Ethics, so we stay up to date and don’t forget things we are required to do. Sometimes we need to check out the fine points of the law also.

There are two types of report categories, mandatory and permitted and then there are categories of victims of abuse, children, seniors, and the disabled.

Mandated Reports.

In most places, there are groups of people called “mandated reporters.” These are people who work with a vulnerable group of people, may learn about abuse or neglect, and are required by law and ethical codes to report abuse and neglect.

In California, mental health professionals (LMFT’s LPCC’s, LCSW’s, etc.) are mandated reporters. In short, if we know or should know about some abuse or neglect, we have no choice, we have to make the call and report this.

This does not mean that we go around the neighborhood looking over fences for a crime. Mental health professionals are not the police. We don’t report crimes and as a rule, are required to keep anything the client says confidential EXCEPT that abuse and neglect stuff.

But if while doing therapy, we are told about abuse or neglect we can’t let that go. We have to make this report.

There are some iffy areas here that can vary from place to place and are open to interpretations. Cruelty to animals and domestic violence are deplorable but most of the time this does not trigger mandatory reports. Some agencies would like to expand the number of things we have to report but if the list swells beyond what is absolutely needed it keeps people from coming to their therapist and telling them things that they need help with.

Because we have to make this report and others, we are supposed to inform our clients of the things that we must report. This along with fees and other stuff like that is called “informed consent.” You can’t very well consent if you have not been informed, can you?  Remember in most counseling settings, the abuse gets reported, like it or not and neither you nor the counselor has a choice in this.

Permitted reports.

Any member of the public can report abuse at any time. Permitted reports can be anonymous. The reporting person is supposed to be kept confidential but sometimes people do things they are not supposed to do like tell the person involved who reported them.

My understanding of this is – if I am a mandated reporter, I can’t make an anonymous report. Some of my colleagues have argued with me about this. But the first thing they ask me on the phone is “are you a mandated reporter?” Once I say yes I can’t very well try to make an anonymous report. Besides if I am required to do this I want a record that I did it. It took a lot of work to get these licenses and I want to keep them.

One difference between mandated and permitted reports may be that mandated reporters have lots of protection if they make a report, whether it turns out to be true or not. We don’t investigate people. We report it once and unless we learn more down the road we are done.

People who make Permitted reports get in a lot of trouble for making too many unsubstantiated reports. In divorce cases, there is this temptation to think your ex should never be allowed to see these kids again. He cheated on you, right? Cheating on a spouse is most likely not abuse of the child. If you make daily reports on your ex, pretty soon the authorities stop listening to you and they may even come after you for false reporting.

So the people who might get abused or neglected are Children, the elderly (seniors), and the disabled.

Child abuse and neglect are the most common by far.

Remember abuse is really bad stuff, not just stuff we don’t like such as strict parents. Lots of parents want their 17-year-old daughter’s 18-year-old boyfriend arrested for them having sex. That may be statutory rape, a crime, but it is not generally child sexual abuse. Counselors don’t report crimes they report abuse or neglect, which just happens to be a crime also.

If that 18-year-old boy is having sex with your eleven-year-old daughter that is pretty much child sexual abuse everywhere and that will get reported to the proper authorities in a heartbeat.

Abuse or neglect of Senior citizens and the disabled are also reported.

It is probably a mandated report if you are a mandated reporter. For sure it is here in California. These are classes of people who because of their age or disability cannot fully take care of and or protect themselves. Society steps in to take care of them.

Besides the types of abuse that apply to children, another type of abuse is common when it comes to the elderly and the disabled, financial abuse.

Now some seniors choose to have relatives live with them or give those relatives gifts. But if that other person does not care for the elderly person and bullies them or cheats them out of the money then it may be a crime. It may also be elder or disabled person abuse.

One warning here

Some people come to therapists and tell us tales of people being abused but they don’t want to get involved or make the report. All that second-hand information may not meet the criteria for a “mandated report.”  Calling a therapist to tell them about your suspicions will not help the person. The therapist can’t go out and investigate. If you think someone is being abused, you should be the one making the report.

Hope this helped to get you thinking about the problem of abuse and neglect in our society and the role of the mandated reporter and the possibility that abuse and neglect could include senior citizens and the disabled.

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

Have you lost your child forever? Parenting after being away.

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

Children working

Parentified child.
Photo courtesy of pixabay

How do you reconnect with your children if you have been away a long time?

Recovering people have often been away from their children for extended periods of time, in jail and prison, in rehab programs, or just gone doing their drug of choice. When you have been away from your children for a while, parenting can be especially difficult. Over time they change, you change and the situation changes also. Here are some thoughts on making the transition back home.

The reunification challenges are greatly increased if your child has been in foster care or their other parent has started a new relationship. You may be the biological parent but someone else has been there raising this child while you were gone.

You need their permission to reconnect.

Just being the biological parent does not give you the right to force your way back into their life. Time changes people. Painful as it may be for you, the process needs to move at the child’s pace, not the pace you would want.

The longer you have been away the more your children will have changed. You can’t expect to pick up where you left off. We tend to remember things the way they were and forget how much they will have changed.

Short separations don’t pose the problems that longer separations do. Several clients, I have worked with were away from a decade or more. That cute five-year-old who was starting kindergarten when you went away, would be a teenager now. Your “little girl” may have a boyfriend, piercings, and a whole lot of habits you wish she hadn’t picked up. She won’t take kindly to you coming back after all this time wanting to change her life.

You need to figure out how you fit into the child’s life, not the other way around.

What they went through left wounds.

You may have changed but the only memory they have of you is the way things were. Drug addicts with three days clean wonder why the family can’t forgive them, after all, they quit right? One way people protect themselves is to hold on to that anger or resentment. For some kid,s that has turned to indifference. You left them, whether you chose to or not. Seeing you again can be like being grabbed where the broken bone still hasn’t healed.

They have had to adjust.

Adjusting for the child means developing new relationships. Someone has cared for them, seen that they were fed, taken care of them when they were sick. They got close to that person. They have come to love that person and trust them. They owe that person some loyalty. Reconnecting with you can make them feel like they are betraying the one who cared for them while you were away.

Now suddenly you want them to forget the person who raised them and follow you blindly?  Why should they trust you? You weren’t there?

This is a huge problem if their other parent has started a new relationship. Papernow has written about step-families and tells us that with blended families the new spouse is always an outsider. The parent and the children had a relationship first and the new spouse came second.

If you have been away for a long time you may be in the position of the new stepparent with your own biological children. The child has developed a relationship with their other parent’s new partner. The one who was there all those years has been the one that went to their school activities and played with them.

Biological parent or not you are the new person in the child’s life, and to make it more difficult you are not even living in the house now.

To rebuild this relationship will take time, lots of time and that time will have to fit into your child’s life and their family’s life, not yours.

Reconnecting needs to be a priority.  Lots of people in early recovery fantasize about having those great relationships with their children, the reality is that it takes lots of work and it will probably not live up to your expectations. Lots of people give up. I commend those who are so determined that they stick with the process even when it is less fulfilling than they had hoped.

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

Therapist, Counselor or Social Worker?

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

Therapist

Therapist.
Photo courtesy of Pixabay.com

LPCC, LMFT, or Social Worker?

Recently a number of people have asked me about the different mental health professions and which they should go to see. Students in my Substance Abuse Counseling classes also ask me about which career they should pursue. It might be helpful to talk about where these professions came from, what they do, and why you would choose to see or become one of these professionals. Many professionals in these fields are in recovery also and they often make excellent helpers.

Here is a brief explanation of my point of view on the subject. Remember that I am licensed as both a Licensed Professional Clinical Counselor (LPCC) and a Licensed Marriage and Family Therapist (LMFT), have taken classes in the Psychology Doctorate program but am a long way from finishing that one and that these are just my opinions.

The titles and what they are allowed to do depend on your jurisdiction.

California was the last of the 50 United States of America (North America) to license Professional Clinical Counselors. Substance abuse counselors in California are registered or certified not licensed and in some states, there are no requirements other than getting hired to do the work. Educational requirements and licensing rules can vary widely and have changed over the years.

These titles and what they may legally do vary from place to place. Check with your appropriate state or national agency to see what the regulations are in your location. Consumer protection agencies can sometimes tell you what the rules are in your locality.

Licenses, Job titles, and Educational degrees are not the same things.

Agencies hire people to work in a particular field. Not everyone who works in a social work agency has either an educational degree or a license in social work. Someone who processes welfare applications or inspects homes for child abuse or neglect may be called a social worker. Sometimes these workers have a degree in the field but not always. This depends on the rules of this agency.

If you are looking for work and have not yet finished your education there are far more entry-level positions for doing social work than any other of the behavioral health professions. There are two-year degrees (AA or AS) in social work and Substance abuse counseling but not much else in the Mental Health field. There are also many social work bachelor degrees that qualify you to work in the field but not to be a clinical social worker.

There is a large difference between a “social worker,” someone with a master’s degree in social work (MSW) and a Licensed Clinical Social Worker (LCSW.) To be an LCSW you would need to complete a master’s degree, complete a number of hours of supervised experience, and pass a test. LCSW’s spend a lot more time working with clients and some specialize in therapy around certain issues, such as foster family and abused or neglected children.

All of the licensed professions also have beginner categories of learners who are being trained and supervised by licensed people.

So what are the primary types of behavior health specialists?

They would be Social Workers, Marriage and Family Therapists, Clinical Counselors, psychologists, and Psychiatrists. Here is my oversimplified description of what each profession does. Let’s take a short look at a scenario that might show us how all these professions may interact with one family.

Police are called to the home where a domestic disturbance is in progress. The adults are both drunk and they are fighting. The kids are scared and under the bed. Parents are out of work and about to be evicted. Mom has a history of depression. Both parents are yelling about wanting a divorce.

So what does each profession do?

Social Workers (LCSW’s or beginners are called ASW)

They might be called to the scene. They will evaluate the home and maybe take the children into custody and place them in foster care. Once the parents are released from jail for the domestic violence charges the social worker might meet with the mother, get her in a battered woman’s shelter, arrange for both adults to attend substance abuse treatment, and enroll them in domestic violence counseling. A Licensed Clinical Social Worker could be assigned to work with the children to see if they have PTSD and need treatment for the effects of living in a violent home.

While an LCSW may do long-term therapy, they are specially trained in policy and referrals. They are likely to be running programs, deciding to leave the kids, or take them and making referrals to long-term treatment.

DV and substance abuse counselors

These professionals often have a short-term, two-year, or less training in their specialty. They are limited to working on one problem only and most often they must work for a licensed agency or under the supervision of a licensed person.

Parents may be required to complete a Substance abuse program and or Domestic Violence or anger management groups before the kids are returned to the home.

Once the parents stop drinking and they have learned how to control their anger, or not get angry in the first place they may decide to try to get back together.

Marriage and Family Therapists

Marriage and Family Therapists (LMFT’s, or MFT’s if they are licensed and beginners are called MFT interns or MFT trainees.)

MFT’s work from a systems approach that says that all humans have relationships and relationships are like dances. If one person changes, the others may change, and then the dance changes. So they would with couples or families on better communication and having a good relationship.  They most often work with the couple or the whole family at once. If they work with one person it is most often about that client’s learning skills to improve their relationship.

They might also have to tackle working with mom on how her depression or dad’s unemployment is affecting the kids and the family.

All the Marriage and Family Therapist programs I know of are 45-60 unit masters degrees. MFT’s often have bachelor’s degrees in all sorts of things unrelated to therapy. They frequently have had some life experiences that pointed them in this direction.

Professional Clinical Counselors (LPC or LPCC in California)

These counselors are specifically trained in mental health and problems solving. They might work with mom on changing her long-standing depression or they might work with dad on how to find a new job.

Should the marriage counseling fail they might also work on meditation and working out custody arraignments.

These three professions, LMFT, LCSW, and LPCC despite having differences in training may do very similar things. Beyond the basic degree or license, they are required to take continuing education classes each year. Some professional counselors or therapists specialize in a particular issue, some are generalists. If clients only had one problem we could all get really specialized but most people have multiple problems and so over time a counselor learns to work with clients on many issues.

Psychiatrists.

Psychiatrists are medical doctors with additional training in psychiatric medicines. Child Psychiatrists are even more specialized and unfortunately, there are never enough of these professionals. Because of the high demand for their services they are very busy. Most psychiatrists see clients for an initial “assessment” which is a medical assessment and very different from the counseling assessments we therapists do. After that first appointment, most psychiatrists will be seeing clients for a ten to fifteen-minute med check appointment every month or even every few months. They are looking for side effects of the medication and to see if they need to change meds or doses.

Psychiatrists generally do not have the time to spend talking with clients that are required for therapy. Most often they oversee the meds and refer the clients to see a counselor or therapist to work on the thought and behavior parts of the problem.

In our example of the couple above, the Social worker, therapist or counselor might refer the mother to a psychiatrist if the depression was severe. Some clients are so affected by their disorder that they can’t benefit from therapy until they are on medication. Some conditions are the result of changes in the brain and that person may need medication for the rest of their life. Meds may stabilize them but they will often need counseling for other problems like relationships and careers.

Psychologists.

This is a doctor’s level degree. I completed 6 units in this program before deciding that I did not have time for another degree and license. What their training appears to be directed towards are long-term problems. They can spend a lot of time studying, testing, and personality structure.

Many psychologists work with clients over the long-term on problems that are slow to change. They are also likely to be called upon to do evaluations for court or disability insurance.

In the example of the couple above the man might be court-ordered to see a psychiatrist who will determine if he should be allowed back around the family. The wife might be evaluated if she puts in for long-term disability saying she is so depressed or traumatized that she is unable to work.

So there you have it, a brief oversimplified outline of what the larger professions in the mental health field do. Whether you are a client or an aspiring professional you need to pick the profession that will be a good fit for you.

Licensed Professional Clinical Counselor (LPCC), Marriage and Family Therapists (LMFT), Social Workers, Psychiatrists, and Psychologists which is the right fit for 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

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