Rewards gone wild

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Need to change

Time for you to make a change?
Photo courtesy of Pixabay.com

Changing others part 3.

By David Joel Miller, LMFT, LPCC.

Sometimes positive reinforcement goes wild. Instead of increasing desirable positive behaviors, positive reinforcement incorrectly applied can create more negative behaviors. Let’s look at some examples.

It is Super Bowl Sunday. Dad wants to watch the game. The kids who are bored to death start getting loud and thrashing around. Dad decides to get this to stop and gives the kids some money and sends them to the store. They don’t interrupt the big game. But then over time, something begins to happen. Dad notices that now every time he wants to watch a game on T. V., the kids get loud and rambunctious. He brings them to the therapist because they are “disrespectful.” What has gone wrong?

It is way too easy to positively reinforce bad behavior. Once you reward bad behavior it begins to expand. Often we do this without noticing that this is what we have done.

Another example. The child, in the store, begins to wine. Mom is getting tired and so she decides she has had enough. She leaves the store and goes home. The problem of whiny kid solved, for now. But over the years mom notices she has a very whiny kid. She can no longer go anywhere the child does not want to go or the whining begins. Another example of how a quick response to a misbehaving child can result in positively reinforcing bad behavior.

A more adult example. Dad can’t find his keys. He is late for work. He begins to swear and yell. Mom goes running and helps dad find the keys. Problem solved for today. But over time if mom runs every time dad is frustrated and yells, dad will yell and swear more. Mom is unknowingly training dad to yell and swear. Sometimes these cases end up in counseling. More of them should. After a while, we start to believe that it is others that are making us mad and of course when mad we should vent our frustration. Anger management classes which include cognitive-behavioral methods may be needed to break the cycle of anger, yelling, and swear words.

But it can get worse. Even if you do not reinforce bad behavior in your child other people may. I worked with one client who had older sisters. They lived in a poor part of town where there were lots of gangs. They used to dress their little brother up as a gang banger. At three it looked “cute” when he reached thirteen and became a real gang banger they were surprised. They shouldn’t have been. They had positively reinforced his looking like and acting like a gang member so much it was natural for him to become one.

This is one reason it worries me when people dress little girls in sexy or “trampy” outfits. Then when she gets to be a teen they try to clamp down on her clothes and behavior. She has been so thoroughly positively reinforced for acting in a sexualized manner why would she change? Besides she is not home now for you to change her behavior. She is out on an overnight date with that “cute” gang banger.

But other people, sometimes with good intentions, also undo our efforts to help children. A child who is shy and feels lonely often begins to avoid others and hide in the corner. So all the staff starts going over to talk to the child. Soon the child is getting lots of attention, which is what the child wanted. So does the child come out of their shell and start being less shy? Not on your life. All that attention for the “shy behaviors” was so completely positively reinforced that the shyness increases.  The right approach would have been for all staff to have watched the child and when they looked over to smile. Positively reinforce any outgoing behavior no matter how small and it might increase. But one staff member can unintentionally undo the work of all the others. So in the home how often do family members, knowingly or unintentionally undo the change efforts of the rest of the family?

It is very important that all the adults in a child’s life be on the same page when it comes to behavior modification. It is also important to be consistent.

Here is hoping that this series is helping you in your efforts to change both yourself and those around you. More to come.

For more on the process of change see the blog post series “Stages of Change”

There is also a series of posts on helping others change, under the heading of “Changing Others.” and “Creating the Change you need.”

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

Improving Relationships – Changing Others Part Two – Encouragement

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

Couple

Relationship.
Photo courtesy of Pixabay.com

Using Encouragement to create change.

One way to improve relationships is to encourage others to do the things we want them to do. This is true whether the relationship we are talking about is a romantic one or the parent-child type. Last time we started to talk about the use of rewards to increase positive behavior. Professional behavior modifiers call this approach the use of positive reinforcement. When we say rewards, lots of people think of tangible things. But positive reinforcements include lots of things that are not physical, like praise and encouragement.  There are some guidelines for using positive reinforcements. Correctly used they are powerful but incorrectly applied they will disappoint.

Marriage counselors stay busy with couples whose main ways of trying to change their partner is to argue, fight, and complain. Researchers like the Gottman’s tell us that for a relationship to be satisfying the positive interactions need to outweigh the negative by a wide margin. But not all positives are created equal.

For positive reinforcement to work, you have to pick the right reward. Chapman wrote a book applying this principle to couples called “The Five Love Languages.” The premise is that different positive rewards say love to different people. So if your partner feels loved when you praise them and you try to make them feel good with gifts, you two are speaking different “love languages” and as a result, your positive reinforcement is not going to work. For the full list of languages and applying them, you might want to read the book.

One important rule for using positive reinforcement is to pick the right reward. Say your child really likes playing video games. He hates doing his homework. So you tell him if he does all his homework this week you will get him a gift on your way home from work Friday. One your way home you stop at the toy store and find him a gift, a new book called “Doing Math the Fun Way.” Is this likely to make him happy? Will he be likely to do his work the next time? You picked the wrong reward and it looks more like punishment, more homework, to the child.

Men are particularly prone to falling into this trap when “positively reinforcing their partners.”  If you decide to make her happy by buying her a box of candy, that might work. But if you bring her a gift two days in a row, presumably before she has eaten very much of the first box, will that be positively reinforcing? The second box will get a lot fewer results than the first. Now, what if she is on a diet and just lost some weight, should you bring candy? This is more likely to end in an argument than to increase positive interactions.  Pick the right reward.

Now there are times when a given reward works better than others. A drink of water works better when you are thirsty than when you just finished drinking something. Bars put out salted snacks for just that reason. So if someone has been without the reward for a long time it is more rewarding. After going without their phone for a while a kid is willing to do a lot more to get one than if you just took it away yesterday and they are still mad. The principle here is, don’t overuse a reward and use them at the times they will have the most impact.

You take your child out for a treat, a special time together. That should be really positively rewarding. You go to the mall and walk around. Malls are frequently very positively reinforcing for adolescents. Your child lags behind. As you offer to buy them a particularly popular piece of clothing, they burst into tears.  Trip over. You head home. Once home you set the child down on the couch, time for a talk.

You explain to the child that you can’t understand why they got so upset. You were trying to positively reward them for all that hard work and their good grades. Your child goes storming out of the room, doors slamming. You look over at your partner. What went wrong? “The new report card came in the mail today.” your partner says. “Four F’s this time.”  How did you go so wrong?

Positive rewards have to occur very soon after the action you want to increase. The shorter the time between the action and the reward, the more reinforcing it will be. You should have done the trip immediately after the last report card when there were some good grades to reward. By waiting so long you let other actions good and bad happen in between. Now the reward looks like a punishment. The sooner the reward is given the larger the result.

How long do you have to keep the positive reinforcement up? People are afraid that once they start it they may need to keep it up forever. There are two ways to get past this. Create a set of instructions that the person whose behavior is being changed can repeat to themselves. Kids learn to repeat these instructions as they do the task and then they can positively reinforce themselves with the knowledge that they did the task well. Look for natural reinforcers in the environment. Humans are social animals, we like others to like us. Once a positive behavior is created the positive reinforcement can be changed from a tangible reward to things like verbal praise. Eventually, smiles may be enough to reinforce the new likable behavior.

Positive reinforcement works not only for changing others but also for changing yourself. If you have embarked on a program of self-change remember to give yourself frequent, positive reinforcement for the progress you are making. Sometimes positive reinforcement backfires and creates a huge negative response. Why?

More to come on behavior modification and changing yourself or others.

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

Changing Others – Part One

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

Change

Change.
Photo courtesy of Pixabay.com

Sometimes we really do need to change others.

Now I know I talked to you before about how hard changing others was and how we first need to look at ourselves. We have also looked at the way in which really lasting change happens. But sometimes we do need to try to change other’s behavior especially when it is not us they are harming but themselves and their acceptance in society. If your child is hitting other students you could wait to see if he outgrows it, but by then he may be expelled from school and you may be stuck with an unruly brat in your home all day. So sometimes teaching others to change is for their own good. There is a process for this way of changing others and it is called behavior modification.

Now I know I talked to you before about how hard changing others was and how we first need to look at ourselves. We have also looked at the way in which really lasting change happens. But sometimes we do need to try to change other’s behavior especially when it is not us they are harming but themselves and their acceptance in society. If your child is hitting other students you could wait to see if he outgrows it, but by then he may be expelled from school and you may be stuck with an unruly brat in your home all day. So sometimes teaching others to change is for their own good. There is a process for this way of changing others and it is called behavior modification.

Now I know I talked to you before about how hard changing others was and how we first need to look at ourselves. We have also looked at the way in which really lasting change happens. But sometimes we do need to try to change other’s behavior especially when it is not us they are harming but themselves and their acceptance in society. If your child is hitting other students you could wait to see if he outgrows it, but by then he may be expelled from school and you may be stuck with an unruly brat in your home all day. So sometimes teaching others to change is for their own good. There is a process for this way of changing others and it is called behavior modification.

Behavior modification began as largely experimental methods. It was used to change animals and later was applied to developmentally delayed clients. It has been gradually expanded to include all kinds of groups from kindergarten kids to college graduate students. And the great thing about behavior modification is that it works. But it does not involve what most people think it might include. Behavioral modification is not a shorthand name for brainwashing or manipulation. It is about helping people to change who don’t know then need to change.

Lots of behavior change methods have been criticized as manipulation. I cringe when I hear that expression. Don’t all kids manipulate? It is one way of getting your needs met when a direct method does not work. We need to teach others how we would like them to behave and then encouraging that behavior. For the “spare the rod” crowd I reiterate that physical punishment is the least effective method of teaching most of the time. It produces angry people who hit back or beaten people who stop trying. Real discipline is about training, not punishment.

Some people think the opposite of punishment is bribery. That won’t work either. If you bribe someone, particularly a kid, to do what they should do, next time the amount of the bribe will need to be increased. Eventually, the whole bribery method collapses when you can’t or won’t pay the exorbitant amounts demanded. Not sure about this, check with Washington.

The first step in changing someone else’s behavior is to get crystal clear about what behavior you want to change and why. Let’s take an example.

Mom brings in a child which we will call Clarence for want of another name. Mom is tired of getting calls from the school that Clarence won’t behave. She wants me to fix him. Sorry mom, I am fresh out of parts for that year and model. You want him changed, you as his parent need to do that. I will be glad to teach you how but you will have to do the work.  So mom what is Clarence doing? When you say he does not behave – what exactly does he do or not do?

At this point, mom pulls out her list. He won’t do his homework, does not stay in his seat, makes “mouth noises” did not clean his room, and got in a fight. The fight might be anger management, but the mouth noises, that is a whole nother thing. So I ask the mother what is the one thing, the one most important thing she wants to change about her son. With behavior modification, we need to start on one thing to change and then progress to each item on her list one at a time.

Mom picks “won’t do his homework” I feel myself starting to relax. This is a case of increasing a behavior. We have more and better tools to increase desirable behaviors than we have tools to reduce undesirable behaviors. Also, this is something specific so we should be able to tell when we are making progress.

Sometimes I get things like I want him to be friendlier. What exactly do you mean by being friendlier? Bringing home a girl?  Giving away your stuff? Or would you settle for smiling more? A specific behavior like smiling more is easier to work on than the vague friendly thing.

The fastest way to increase a behavior is to reward someone for doing the thing we want them to do. Someone in the back of the class just yelled foul. You said no bribes. No, I am not saying bribe the kid. I said reward. What is the difference? A bribe comes before someone does the act. A reward comes after and the two things are connected. So my boss pays me if I show up for work for a whole two weeks. He does not give me a bribe first and then hope I will show up. And the amount was clearly understood. It does not go up each time he wants me to show up.

Let me give you a hint here. For many kids, praise for something done well is even more reinforcing than things. Kids who have a close relationship with their families want to please their parents. Just make sure you let them know you are pleased. If my boss were to stop paying me I might get the idea he does not want me working there and I would probably stop showing up. I might also get really mad.

So next time we will need to talk about what things might be rewards and how to use these to increase positive behavior without falling down the bribe trap. Rewards are also powerful motivators in adult relationships. If you do not make each other happy more often than you make each other mad your relationship is headed for trouble. So very soon I plan to write a post about rewarding your partner to keep the relationship alive. Till next time

More on the topic of changing others can be found at:

Changing others part two 

Rewards gone wild

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

Clear Values

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

When you are struggling with life’s problems it is difficult to keep your priorities straight. People who have anxiety disorders find everything is so important they run from task to task with never a chance to rest. People with depression find any and all tasks overwhelming. Sometimes it is hard to take any action. Recovering people are often faced with the need to decide what is really important in their life. What things need to be kept and what things can be let go. We call this process “values clarification.”

“Values Clarification” is also an exercise that we sometimes run in group therapy. It goes something like this. Each member of the group is asked for two things that are important to them. We go around the group and everyone gets a chance to tell us about two things that are important in their life. I like to write this on a board or paper in front of the group as I go. Sometimes we get several things that seem almost the same and need to be lumped together. For example, one person may say my job and another says his career. I make a bigger category of employment.

These lists contain quite a variety of things. Some people nominate material items, a car, money, or a place to live. Other people list self-improvement things like education, sobriety, or achieving a life goal. Many people mention relationships, like with their wife, husband, or children. Some people include spiritual values like God or religion. And there are often nominations for global goods like peace, health, ending pollution, and saving endangered species.

Now I have found that the list I get varies a lot depending on the group involved in this exercise. People in a locked hospital because of psychosis are likely to mention basic needs of life, like food or a place to live. People in substance abuse treatment are more likely to mention things like sobriety and attending twelve-step meetings. They are also more likely to look at internal personal things as important like peace of mind and self-respect.

The next step in the process involves clarifying these values. Son and daughter might be combined to make children and so on. Each member of the group is then given three votes for items on our refined list. This requires them to vote for at least one thing they did not nominate. It also allows people to change their minds and vote for things that they did not think of before. In the process of voting a strange thing takes place.

The list has some items with a lot of votes and others with few or no votes. In almost every case I have ever done this, relationships, family, and friends rose to the top of the list. So did intangibles. Peace, happiness, sobriety, and security, which beat the heck out of money, cars, and pleasure most every time. In recovery, we find that the values we hold drive our actions. It is important to be clear about what really matters.

So if relationships and peace of mind are so important to us – why do so many people spend all their time and effort on making money and getting things?

What is important to you? What do you spend your time pursuing?  Care to comment and share what you value most?

Special thanks to Irene Aparicio, LCSW, an early supervisor in my career who taught me this exercise.

Till next time, David Joel Miller, LMFT, LPCC

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

Bipolar – misdiagnosed or missing diagnosis?

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18

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

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Diagnosing Bipolar Disorder.

Why is it so hard for people with Bipolar Disorder to get diagnosed and treated? For mental and emotional problems, the sooner the diagnosis, the sooner the treatment begins, the less the suffering. The more entrenched the illness the longer and more difficult the recovery. We continue to have difficulty with Bipolar Disorder. Why?

Almost 70% of people with a Bipolar Diagnosis had another diagnosis first. On average they get four other diagnoses before the Bipolar one. Usually, somewhere along the line, they are diagnosed with Major Depressive Disorder, given an anti-depressant. At this point, on an antidepressant, 40% of clients with Bipolar experience an episode of mania or hypomania. Antidepressants given to people with Bipolar disorder also increase the likelihood they will become rapid cyclers.

Our understanding of this condition has changed over the years. To be honest the mental health profession’s understanding of most illnesses has changed a lot over the years. We used to call Bipolar Disorder by another name – Manic Depressive disorder. Clients continue to come into facilities and tell us that they have Manic Depressive Disorder and Bipolar, not understanding that both are the same thing, just a new name.

Currently, there are two principle camps in this debate – those who think too many people are being diagnosed with Bipolar Disorder and those who think that professionals are missing a lot of Bipolar Disorder. The controversy goes back to the first efforts at classifying anything, the lumpers, and the splitters. Some people would like a different name for every possible type of dog; other people are content to consider them all dogs, the same with mental illnesses. So what difference does it make? It could make a lot of difference.

Ira Glick, up at Stanford wrote an article a while back called Undiagnosed Bipolar Disorder: New Syndromes and New Treatments. This is not a really new article but it is important as we think about how the diagnosis is likely to change in the next few years when the DSM-5 comes out. Glick suggests that the true rate of Bipolar may be as much more than what is being diagnosed. We used to expect Bipolar Disorder to run 1% to 2 % of the population; recently it has been diagnosed closer to 7%.

We are starting to think of this condition as a spectrum disorder. So there is a range of symptoms and the ones with less noticeable symptoms are not getting diagnosed.

Does it matter if some mild cases are getting missed and not treated? Yes, it matters and the clients with the less prominent symptoms are not necessarily milder cases. Currently, we separate cases into Bipolar I and Bipolar II.  People who have Bipolar II don’t have pronounced episodes of mania. They do have other significant differences.

People with Bipolar II have way more unemployment. They get divorced more often; have more thoughts of suicide and more suicide attempts. This one disorder, according to Glick, accounts for more suicide attempts than any other mental illness, excluding personality disorders. This is a big problem since Bipolar II looks like Major Depression until the mania or hypomania kicks in.

Many people who eventually get the Bipolar Diagnosis are first seen by their primary care physician. Primary care doctors treat more than half of all the depression and anxiety. There are a lot of medical problems that are especially problematic for people with Bipolar Disorder. People with bipolar disorder are more likely to have migraines, diabetes, or obesity.

Medications for people with Bipolar are especially problematic. People with Bipolar II get antidepressants till they have a manic episode then they may get all sorts of meds. People with Bipolar I have the more pronounced psychosis and may get all kinds of heavy-duty antipsychotics. Sometimes people with depression have distorted thinking and we see psychosis. Sometimes the psychosis in Bipolar II looks a lot like Schizophrenia, Schizoaffective disorder, and a lot of other things.

We are also not sure how much of all this is a result of genetics and how much is learning. Some authors have talked about how personality traits, those supposed unchanging characteristic ways of behaving may be related to Bipolar Disorder.

In fact, there is some question as to which mental health issues are district illnesses and which are symptoms. A cough is easy to notice but what causes the cough can vary a lot from person to person.

Despite all the issues with diagnosis, Bipolar disorder in all its forms causes a significant amount of suffering. It is also a difficult disorder to manage for the client and for the professional. If there is a chance you or someone you know has this disorder get a professional evaluation. If you have Bipolar disorder become a knowledgeable client, and don’t give up hope, the treatment options continue to improve.

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 Inside and Outside of Relapse triggers.

Posted on by
10

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

Relapse

Relapse.
Photo courtesy of Pixabay.com

Relapse triggers, either internal or external, are those things that set off cravings in a recovering person. The failure to do maintenance steps in the process of change increase the risk of giving into triggers.

External triggers are the things outside ourselves that place us at risk to resume old behaviors and give up on the progress of recovery. Shorthand ways of understanding these triggers are people, places, and things.

People are one of the biggest reasons people relapse. There is a huge temptation to look up old friends. Often the only thing that you have in common with an old friend is a history of using drugs or drinking. Sometimes there was a history of other dysfunctional activities, codependency, or abusive relationships. If the people you had around you in the past supported your addiction or if they were not affirming, or made you feel bad about yourself, being around them can take you back there. Avoiding people who are bad for you is not being selfish.it is being self-caring. In early recovery it is suggested you not make a change you can’t take back like changing jobs or relationships. Surround yourself with people who support your recovery.

Places are another important external trigger to pay attention to. Alcoholics need to avoid bars; drug addicts should avoid dope houses. But there are other places to avoid. People with relationship issues should avoid revisiting places they used to go with a partner who is no longer in your life. Should someone on a diet visit a candy store? I wouldn’t recommend it. Think about places that you may need to avoid if you want to be secure in your recovery. Is there a family member or former friend who triggers your issues?

Things can also reignite thoughts of returning to an old lifestyle. Music can be a powerful memory trigger, so can some smells. People with relationship issues, sometimes we call these people love-addicts, find it hard to let a relationship go. They keep the old moments out. They think about the things they did together. One last call to see how that person is doing is likely to set off a new round of problems. Carrying lots of cash can trigger some people, especially gambling addicts and former drug dealers. Sometimes it is a pipe or a lighter you find hard to get rid of. Is there something that reminds you of your issue but which you find hard to give up?

Internal triggers are the other part of the equation. The things going on inside our bodies and our minds are also relapse triggers. The word HALT standing for, Hungry, Angry, Lonely, and Tired is used as a reminder of those triggers.

Hunger, thirst, and many other physical sensations can make you feel restless, irritable, and unleash the cravings. Negative emotions are powerful relapse triggers. Feeling anger fear or resentment, any number of negative emotions can cause someone to catch a case of “who cares.” Loneliness sends people back to their disorder quickly. Being tired is likely to upset recovery also. All of these internal triggers have to do with not taking care of ourselves. It is a short hop from not taking care of yourself to thinking you don’t deserve care, after that why should you hang on? Why not go back to the old life? People who don’t provide good self-care don’t encourage others to care for them. They start believing they don’t deserve to be treated well and then they stop treating themselves well.

Another way of understanding internal and external triggers is to look at the two main causes of relapse, romances, and finances. Romances are all about your feelings, feelings of loving and being loved, self-worth, and self-esteem. Finances, mostly money, is the ultimate thing. Lack of money can sap our will to change. Having a lot of money makes some people feel they are invincible; the rules don’t apply to them. Pay attention to the healthiness of your relationships with things and with people. When one of these relationships gets out of balance, your life is headed out of balance.

These are only some of the things that might cause you to relapse. We each have our own triggers. What are yours? Knowing your triggers and how to defuse them strengthens your 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

10 ways to get emotional help without money

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3

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

Counseling.
Photo courtesy of Pixabay.com

Can’t pay for therapy?

The times you need help the most are likely to be the times you are least able to pay. People with emotional problems often have other problems, no job or a low-paying one, physical health problems, housing issues. If you had those other problems wouldn’t you be depressed or anxious?

Now if this is an emergency, if you or someone close to you is thinking of suicide, has a drug overdose or other critical problem, please call your local emergency number. In my area, we have 911 services and every night many people call that number and end up in hospitals where they can be linked to help. People who chose to not call emergency services can walk into an emergency room and seek services. These days emergency rooms across America are filling with people with mental and emotional problems, people with nowhere else to go.

We continue to hope that the services for the people in need will match the need. So far it isn’t happening. The recent downturn in the economy has resulted in strained budgets and budget cuts. Mental health and substance abuse dollars keep shrinking at the very time the need is growing.

The first place to start of course is your local mental health facility. If you qualify for services they are likely to be covered or offered at extremely low rates. These days the need is so great most public facilities are limited to serving only those with the most severe need, people who are suicidal or have hallucinations. Even if you don’t qualify for ongoing therapy, you may be able to get emergency services or they may be able to refer you to free or low-cost services.

So if you are someone who has fallen through the cracks, who needs counseling or therapy but has no insurance, doesn’t qualify for services or your diagnosis does not meet the “medical necessity” for services, how do you get help? Here are a few suggestions, some are more available than others, and some are more painful than others but if you need help and haven’t been getting it these are things you might try.

1. Read the internet

Especially read blogs and sites about recovery. The internet can be had for little or no cost. These days’ even homeless people have email. Most libraries let people use computers for some amount of time. This has brought information to everyone. It has also caused problems. Not all sources of information are helpful. Watch out for sites that are sponsored by a company that wants to sell you something.

Read about recovery. Some writers are in lots of pain; their writing is therapeutic for them. I read those sites but I find it is good to limit readings about pain unless there are also posts about recovery. Read blogs that spread the cure, not posts that spread the disease. Also, avoid reading too many posts about diagnoses. Self-diagnosis is a trap even professionals can fall into. You need an objective professional person to make a good diagnosis. That said, if someone has given you a diagnosis, read about your condition. If the things you read don’t match what is happening to you, ask questions. Not all professionals agree on things and sometimes they get things wrong.

2. Read self-help books.

There are lots of self-help books out there. I wish I could give you a list of the best ones. I am working on that list but so far it is not ready. I asked colleagues for recommendations and at this point, no two therapists have recommended the same book or books. Read a self-help book that speaks to you. What you need to learn may be different from what someone else needs to learn. You can get self-help books for very little money. Libraries have them for loan. Some can be downloaded from the internet for free or at a low price. I have picked up some great ones at thrift stores for fifty cents to two dollars. If you find a great one please leave a comment here and share your find.

Avoid books that require you to be dependent on or give unquestioning loyalty to a person or group. A.A. literature says here are “suggestions” that have helped us. If you find a better way we wish you well. If you have to do things the author’s way chances are the book is designed to help him and not you.

3. Self-help groups.

The old standby of self-help groups are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). The success of A.A. has spawned over 200 self-help groups based on the twelve-step model. There are also specific groups for people with co-occurring or dual diagnosis issues. There are also some groups based on specific needs that do not involve the twelve steps. Please don’t be put off by the twelve step programs talk about a “higher power” even nonreligious people, atheists, and agnostics are welcomed and they often find there is something they can believe in if it is only the ability of the group to be helpful.

4. Colleges and schools

Many colleges have therapy available for students. These services are in addition to the department that does academic counseling. Check with the health services on campus if you are a student. Universities that offer counseling or therapy major often have clinics where new therapists under the supervision of experienced instructors, provide therapy services to members of the community. These university-sponsored programs have low-cost or reduced-cost options. School counselors can sometimes help with family issues, parenting, and child behavioral issues.

5. Community-based resources

Non-profit organizations are sometimes able to provide some services to people in the community who are otherwise unable to access services. Check with charitable organizations. Some areas have a 211 phone service that is able to provide social service referrals.

6. Ask therapists and counselors about sliding fee arraignments

Some practitioners are able to see clients for reduced fees. Don’t be afraid to ask, but expect to have to show proof of income.

7.  Consider group therapy

Group counseling is not second-rate services. Sometimes being in a group with others can be a powerful experience. Group fees can be significantly less than individual counseling. Some practitioners offer large group counseling at extremely low fees. In my area, there have been large groups run by professional therapists that were sponsored by churches or community-based organizations that were free. The therapist donates their time and the organization provides the space. The people who attend get free services that they would otherwise not be able to afford and the counselor often gets referrals for their private practice.

8. Substance abuse facilities

Substance abuse facilities often have outpatient groups that are extremely reasonable. They also may have free or low-cost groups for the family members of clients in substance abuse treatment.

9. Think about your priorities.

How much is your recovery worth? Many a time a person has told me they couldn’t afford therapy but they continue to pay hundreds of dollars each month for hair or nail appointments, home shopping, or their drug of choice. Is it true you can’t afford help or is it that you have not made your recovery much of a priority?

10. Consider Religious counseling.

Pastors, Rabbi’s Priest, Bishops, and other religious leaders often have training in Pastoral counseling in addition to their religious training. Seek out people who seem to care about you and about being of service.

If any of you know of other resources let me know so I can pass the information along. Till next time –

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

Maintenance is a part of change

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12

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

Changing your life

Time for a life change?
Photo courtesy of Pixabay.com

How do you stay changed?

How can maintenance be a part of change? Isn’t maintenance what you do, as needed after the successful results of change are obvious? No, not at all. Not including maintenance as a step in the change process is where many improvement projects, public and private get themselves into trouble. Let me give you a more visual example.

The other day I drove through an older part of town. This part of town, built throughout the Victorian era to the turn of the century was really something once. Today this part of town is a poor neighborhood. While there are still a few houses that reflect the old glory days most of them are getting run down now. A couple of houses are slated for demolition. What happened to those grand old houses? There was no earthquake or fire, nothing dramatic, just the slow process of decomposition.

A roof was torn off, the owner had not bothered to get it fixed and the rain had rotted out the lumber. Another has a porch that has fallen down. Lots of homes have not been painted in a while, broken windows are covered with cardboard, and sometimes there is an old blue tarp over the destruction. Realtors describe these homes as having “deferred maintenance.” Last time I talked with you about relapse as the result of the failure to do a maintenance step. Relapse is a sort of deferred maintenance.

What do we hear from people who relapsed on substances? You hear the story so often it starts to sound like a well-rehearsed poem. The recovering person says they, stopped going to meetings, stopped calling their sponsor, and started hanging out at the old spots. The dieter gets the goal pounds off and then eases up on the diet. The change has been a short-term project and now the deferral of maintenance starts. Eventually, when the change is completely reversed by the relapse the person starts to wonder when they tried to make that change in the first place.

We tell recovering people that whatever you did to get better, you need to keep doing it to stay recovered. Most people don’t want to accept the idea that what was needed was not a quick repair but an ongoing plan of preventative maintenance.

One important component of that relapse prevention plan is learning to provide good self-care. Having a good support system is also vital. People who have positive people in their life, people that want them to do well, are more likely to succeed. Never get to busy to call your support system. One study found that schizophrenics with a warm supportive person in the home with them cut their risk of ending up in a psychiatric hospital by almost 50%. People who attend AA drink less even if they don’t stop altogether. Many weight loss programs include a group component. Being surrounded by others who are also working on their own recovery is likely to strengthen your recovery.

Real lasting change has to include a commitment to a different lifestyle. This does not mean that every self-improvement plan needs to take over your life. If the changes you make are hard to do the chances are that you will stop doing them when the urgency is gone. Urgency is an often-overlooked factor. If your doctor tells you to lose twenty pounds or he can’t do a life-saving surgery, that is motivation. If the judge says to stay off drugs or you will go back to prison that is motivation. But if the diet is a lot of work to keep up it will probably be forgotten way too soon.

The end of this tale is that whatever got you better, diet, meetings, a religious practice, or time with friends, keep doing them. Don’t give up these positive things as you see results from your change efforts.

That is the story of my understanding of stages of change. In future blog posts, I want to talk more about relapse prevention and triggers. We should also talk more about the connection between depression, bipolar, and abuse of a couple of substances. There is a huge connection between mood disorders and substances and not always in the direction you might think. I also want to talk about why it seems there is so much controversy, especially among professionals about the diagnosis of bipolar disorder.

I read your comments and appreciate them. I also try to read as many blogs as I can that are written by recovering people of all types. The things you say remind me of things I need to talk about.

There is a lot of pain out there and we know how to help more than ever before – so why is it hard for people to find the help they need?  Why doesn’t therapy always work? What makes counseling helpful? I will give you my take on these issues and would appreciate yours.

I also want to talk to all of you, very soon, about how you might find help when you don’t have the money to pay for the help you need. Till then, here is wishing you all a happy life.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Is Relapse a part of recovery?

Posted on by
11

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

Relapse

Relapse.
Photo courtesy of Pixabay.com

At some point, every recovery program has to tackle the issue of relapse. Why after losing all that weight do people suddenly put it back on? Do all alcoholics; sooner or later pick up a drink? Once you have depression you will always have recurrent bouts right? The way in which relapses are understood separates the Stages of change model from almost every other model of recovery. I have been told more than once that relapse is a part of recovery. I am not buying that! It doesn’t have to be that way.

So if relapse were a part of recovery, every person signing up for a self-improvement program should get out their calendar on day one and plan for their relapse. Doesn’t AA even say a relapse is a part of recovery? No, it doesn’t. The AA book says that a certain percentage of people get it the first time and don’t relapse. Bill W. estimated that percentage at 50%. In the early days, it appears that a lot of people who really wanted the program and stuck with it got it the first time around. He also said that there were some people, maybe 25% who tried a few times and eventually got it. The rest were better while they were in the program but kept going in and out. The stages of change model agrees with that thinking.

So why do people say that relapse is a part of recovery? Mostly, people say that because relapse happens a lot. And if relapse does happen, rather than giving up, the objective is to pick yourself up and try again. One article I read said smokers typically have to try to quit seven times. Now some people quit on the first try, a few people become nonsmokers in a few tries and there may be some people who just don’t seem to be able to quit. Any self-change is like that. It takes more than trying hard.

It is not the quitting of bad habits that is the problem. Some people quit drinking 5 or 6 times in one day. It is the staying quit that is harder. So how does someone make a change, give up a bad habit, make an improvement in their life, and then stay changed?

The stages of change model says that after all that effort, that process of change, there is one more thing you need to do to stay changed. See change is not a one-time thing. Real lasting change is an ongoing process. Why do people think that they can excessive like crazy, take off a few pounds, and then once they lose the weight they can stop the exercise?  How many days off Heroin before it would be safe to try some drugs again? The truth is that change is not a thing – it is a process. Once you make the change you have to keep doing the process to maintain the change.

The thing you need to do to stay changed is called maintenance. To stay changed you will need to do some maintenance. If you mow a lawn once will it grow back? So if it took an increase in exercise or an improvement in healthy eating to lose weight it will require you to keep doing that work to keep the weight off. The addicted person can’t just put down the substance; they need to keep doing the things that got them sober.  In the stages of change, relapse is not seen as something that is part of change it is understood as a failure to do the one remaining step in the process of change – doing maintenance.

Now, this is easier to see when we talk about weight loss or addiction but what about depression or bipolar disorder? With any of life’s problems, there are things that you can do to make the problem grow and other things that make the problem shrink. Taking good care of yourself is especially important for mental and emotional issues. So if taking good care of yourself makes you less depressed, what might happen if you stopped eating and sleeping well? Your depression might grow. The maintenance step is needed for holding onto any change you made, it is the best antidote to a relapse, whether that relapse is weight gain, addiction, or depression.

Next time we will talk about the last stage of change – maintenance. After that, I want to talk a bit about some related problems like triggers and finding help when you have few resources. Till then –

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

Stages of change – Late Action

Posted on by
10

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

Change

Change.
Photo courtesy of Pixabay.com

Late Action – The change accelerates.

Last time we talked about how I might be full of enthusiasm as my self-improvement program gets going. In the weight loss example, I begin to exercise and maybe even get interested in nutrition and diet. Are deep-fried Twinkies a healthy diet? The diet guru says no. I eat low-fat and lots of greens. I hate greens but I eat them anyway. My efforts at change are taking shape and encouraged by my own persistence I may even expand my efforts.

On days when I can’t get to the gym, workdays, I start walking on my lunch hour. It is a mile around the park. If I walk fast I can make two trips and eat during my lunch period. I discover that if I bring a healthy lunch, a sandwich, and some low-fat yogurt, and I walk around the park fast, some days I lose weight. Even if I don’t actually lose weight, at least those days I do not gain any more. At this point, the intensity of my workouts is increasing. I am really getting into this.

In substance abuse recovery terms, the person involved may not only be attending meetings, but they also have a regular home group they go to every week, maybe even a fellowship they attend every night. Some people “get into service” meaning they make coffee, take out the trash, and so on. We get trainers, sponsors, and a support system. At this point, my change is beginning to be something I tell people about.

For people who have an emotional problem, like depression or anxiety, their recovery action might be seeing their therapist on a regular basis, improving self-care, or journaling. There is a huge connection between emotional issues and eating problems. One of the key issues a professional looks for in making a mental health diagnosis is changes in eating and sleep. Binge eating, overeating or not being able to eat, as well as sleeping too much or too little are all symptoms of problems. They can also be causes. More about that mind-body connection and the relationship between sleep, eating, and other life problems in a future blog.

So in late action, I am getting somewhere on my self-change program. Losing a few pounds, not drinking or drugging and I am no longer so depressed I don’t want to get out of bed. Everything should be going fine. Right?

Then what happens? Why do so many people successfully make a change only to return to the place they were before? Why do most weight loss programs, diet, and exercise, end in putting on more pounds than we lost? Why do so many people get a thirty-day sober chip only to drink again? And how is it that depression and anxiety return after a period of time?

I start wondering, am I fixed? Do I have to give up those quadruple thick burgers with the pound of fries? How long will I need to take these psych meds? Can’t I just have a donut or a glass of wine? What kind of wine goes best with donuts? My mind starts looking for ways out of the change process.

For substance abuse, we call this relapse. For depression or anxiety, we are starting to think in those terms also. For weight loss programs the part that we don’t like to talk about is why after losing twenty pounds, do I put it all back on and then some. Every time I have been on a diet I have needed to get new larger clothes.

This is the point where people start talking to us about maintenance plans.  You mean I can’t just crash diet off ten pounds and then I will be able to eat like other people? Can’t you AA folks just teach me to control my drinking? So my depression is gone. I will never feel that way again. Time to get back to the way things were before my self-improvement program. So next time let’s talk about putting the weight back on, the relapse, and the return of emotional problems.

Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency

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