Tag Archives: Behavioral Health

5 motivation skills you should learn

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

Motivation.

Motivation.
Photo courtesy of Pixabay.com

Attitude will only get you so far – you need skills to stay motivated.

When people talk about motivation we hear a lot about some people having motivation and others not having it. Having a positive, motivated attitude is good, but that will only take you so far.

To get motivated and stay motivated you need some skills and these are abilities you can learn. Research suggests that simply wanting something is not enough; you need to develop the skills needed to make those dreams a reality.

1. Self-motivated people challenge themselves.

People who are high in motivation have learned how to learn new things. To them, a new situation is a challenge they know they can overcome because whatever information is needed they believe they can acquire it.

Self-motivated people seek out these challenges because they have the belief that if they try something they can accomplish it. This belief is built up over time by trying small things and being successful at them.

Self-motivated people may like applause or recognition from others, they may enjoy the money or recognition that comes their way, but they also are extremely pleased when they are able to do something that they have set out to accomplish.

2. Motivated people make a consistent effort.

Sprints won’t win any distance races and life is essentially a long-distance race. Being highly motivated one day and getting a lot done pales next to the person who day in and day out does a little of what is needed to get the task done.

Lots of people start new projects, new businesses, schools, or relationships, but they fail because they think that you can do it all in the beginning and then no more effort will be required.

To be successful you need to keep doing a little or more every day, whether you feel motivated or not.

Do some work on your goal and it will produce motivation, not the other way round. Every writer hears the way to write is to sit with your rear in the chair and pound some keys. Eventually, you will get something done. The rest of life is like that also. Do a little each day and watch the results add up.

3. Manage your time.

Enough time for that great achievement will never come. Big projects get done one step at a time. Motivated people create a time budget just as they create a money budget. Each day includes some time for working on reaching your goal.

Don’t wait till you have extra time to write that book or start that business. Begin doing the footwork now. If all you have is thirty minutes a day, spend that on moving towards your goals and see what progress you can make.

4. Have a plan to reach your goal.

Great achievements rarely happen by accident. Yes, motivated people can make good use of opportunities when they appear, but they recognize those opportunities because they are already on the path to their goal.

Any achievement becomes more probable when you can break the task up into small steps and work on a little step each day. Make a plan and keep on the path towards your goal.

5. Continue to monitor your progress towards your goal.

If you follow a bad map you can get really lost. Some of us created plans for our lives and left steps out. This does not mean your life needs to be a failure. Any good plan needs frequent monitoring and revision. Keep an eye on the goal but keep checking your map to make sure you are headed in the right direction.

Work on these five skills and you will become a lot more motivated and can keep that motivation strong over the long course of life.

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

What sense of smell – odors – tells us about mental illness?

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

Sense of smell.
Photo courtesy of pixabay.

Is there a connection between the sense of smell and mental illness?

There is a body of research that tells us that there is a connection between the sense of smell, your ability to recognize and identify odors, and the chance you have or will develop a mental illness. There are also cases of olfactory hallucinations; smelling things that everyone else is sure is not there.

While this research suggests some connections, to me the articles I have read are short of conclusive.

An altered sense of smell has been linked to disorders as divergent as Schizophrenia, Bipolar disorder, autism, and eating and feeding disorders.

Smelling it does not mean you can identify the smell.

One thing we do know is that the ability to identify an odor is not the same thing as the ability to detect one. People are more likely to like a smell they can identify and unknown smells are more likely to be considered unpleasant. Memory and its connection to smells are important for many reasons.

Smells trigger memories.

This is significant because smells are powerful memory cures. People who have a poor ability to notice smells or to remember them are at a disadvantage in remembering things that might be associated with those smells.

Schizophrenia and odors.

The disorder most cited as having olfactory (odor or smell) impairment is Schizophrenia. More interesting yet is the repeated observation that males with schizophrenia are far more likely to have olfactory disruption than females (Nguyen et al, 2010.) These males with schizophrenia had disruption of odor identification, memory, odor detection abilities, and poor odor discrimination, the ability to tell one smell from another.

Females in these studies rather than not being able to recognize or identify smells were more likely to smell foul or unpleasant things that were in fact not detectable to others. The conclusion was that women have more olfactory hallucinations and men more loss of ability to smell.

Schizophrenia is characterized by negative symptoms, which are the loss of some abilities others have, as well as positive symptoms such as hallucinations. Someone with schizophrenia will likely have or experience social withdrawal, attention problems, difficulty making decisions, and perceptual problems.

People with schizophrenia also have high rates of olfactory identification problems, discrimination of smells, olfactory memory, and olfactory detection errors, principally in males. Poor olfactory discrimination is also found in close relatives of people who have been diagnosed with schizophrenia even when those relatives have not received the diagnosis themselves.

Olfactory identification problems do not appear to be found in people with Bipolar disorder, Major depressive disorder, other related psychosis, or anorexia nervosa.

Alzheimer’s, and Parkinson’s diseases and smells.

Olfactory hallucinations and discrimination deficits are seen in those with Alzheimer’s, and Parkinson’s diseases in addition to Schizophrenia.

One researcher reports that people with Bipolar Disorder have some olfactory impairment but that they are less bothered by unpleasant smells that those people who have Schizophrenia (Cummings et al., 2010.)

Autism and odors.

In Autism olfactory identification is reported as impaired. Individuals who had been diagnosed with Autism preferred Lemon and Orange smells, to lavender. They disliked most other strong smells. In Autism strong smells are linked to perceptions of taste and result in high rates of food refusal and selectivity (Hrdlicka et al., 2010.)

Olfactory hallucinations.

One condition of note is olfactory hallucinations. Some patients reported a foul-smelling order coming from themselves. This odor was not detected by staff. This olfactory hallucination is referred to as Reference Syndrome and was reported in patients with temporal lobe epilepsy. Other olfactory hallucinations have been reported in clients with substance-induced Psychotic Disorder, Hypomania with Alcohol dependence combined with hypomania (Luckhaus et al., 2003.)

There does not appear to be any connection between depression and olfactory dysfunction (Scinska et al., 2008.)

Migraines and odors.

Olfactory dysregulation has also been linked to people who have frequent migraines, with over 45% of people experiencing migraines reporting odors are triggers for those migraines. In migraine suffers, almost 25% had a fear of a particular odor, and an equal number reported taste abnormalities when having a migraine episode. MRI’s showed that women were eight times more likely to have brain activation from odors. This makes one wonder if many of the issues with odor detection, memory, and discrimination are more linked to gender than to a particular psychiatric diagnosis.

Other studies have reported significant episodes of visual hallucinations during migraine attacks and make the point that visual and auditory hallucinations are so pronounced and readily identifiable most people are not asked about and do not report either olfactory (smells) or gustatory (taste) hallucinations.

In people with schizophrenia, 75% reported auditory hallucinations, 37% reported somatic hallucinations while olfactory hallucinations were reported by 18% of the patients which is slightly more than the 14% who reported visual hallucinations. Despite being so common, few clients report olfactory hallucinations and clinicians are not generally looking for them.

While people with schizophrenia may experience hallucinations in all modalities, providers frequently stop asking about hallucinations after the first or second reported hallucinations.

Stress and hallucinations.

Researchers find that people who report being under “stress” are more likely to have experienced olfactory hallucinations and one study concludes that stress may lower the threshold for hallucinations of any type.

Because the major part of the olfactory sensing part of the brain is on one side of the brain researchers have suggested that there may be a difference in the way in which left-handed and right-handed people experience olfactory hallucinations.

While olfactory hallucinations are readily identifiable in people who have migraines they are less identifiable but more likely to be described as unpleasant in those with epilepsy.

While we still can’t use olfactory or gustatory hallucinations or dysfunction as makers for a particular mental illness, we know abnormalities in the sense of smell and taste may be factors in the development of a mental or emotional problem.

Have you experienced an alteration in your sense of smell or taste and no medical reason has been found? Care to share?

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

Money and Friendships can cost you – ethical loophole #3

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

Ethics

Ethical loopholes strangle.
Photo courtesy of Pixabay.com

Dual relationships get a lot of counselors and clients into trouble.

Having multiple relationships can mess up therapy.

The big obvious one is sex, we will talk about that one later, but there are a bunch of other dual or “multiple” relationships that can cause problems. Here are some examples.

The client doesn’t have money to feed her kids; can I pay her to clean my house?

This sounds harmless enough. Counselors want to help people, that is why they became a counselor in the first place. So they might try to help out. Maybe give the client a little money. What about bus fare home? What about hiring the client to do a part-time job around the house? All this sounds good until it goes wrong.

You give that client bus fare once. They tell some friends who all ask you for bus fare. You have to start saying no. Now you have to tell that first client no. Then they all complain to your boss. Why does client X get bus fare and I don’t? Why did you give it to me and then take it away when I did not do what you wanted? See how that good deed can come back to get you?

What about paying them to help you? They could mow the lawn or clean your house. What if the lawnmower goes missing right after they cut that lawn? What do you do if your jewelry is missing? Can you make a police report on a client? Doesn’t that violate confidentiality? How can you explain that away?

The client is new to the city and does not have any friends. The counselor invites them, to attend church with them. The counselor goes and picks the client up and takes them to church. What could be wrong with that?

You are their therapist; you have power over their life. They are in a weak vulnerable position and you tell them they need to attend church and you are taking them to yours. Can they really say no? Will you withdraw care, stop seeing them if they say no?

What if their religious or spiritual tradition is one you do not approve of? Will you pressure them to convert? What if they consider your religion a “cult” will they be able to say no?

Think this doesn’t happen? Clients tell me, they have been told that their child protective services worker wants to be sure that their children are being raised in a “good Christian home.”  Does that constitute bias? Can the client say anything if they risk having their children taken away or if they have a mental health issue or substance abuse problems? Could those problems be used against them?

Revealing your religious preference to a provider can result in discrimination, loss of jobs, denial of promotion, or even make you the victim of physical violence. That’s why in this day and age members of some religious traditions still need to use the “decline to state” response to the question about religious preference.

I am not saying that all discussions of religious or spiritual values should be off the table in therapy. People with a spiritual connection do better in recovery. What is a problem is when the therapist crosses the line from listening to the client about what the client believes to doing a sales pitch or enabling the client to follow the counselor’s religion.

Encouraging them to practice a religious or spiritual tradition is a yes. Telling them they need to come to Zoroaster is a no.

Counselors do not have to stop going to church or another religious gathering place because their client attends, but they need to be very careful about transporting or arranging to meet clients there. It is probably an ethical boundary violation to be seeing someone in therapy that you also sit in a religious service and socialize with.

Wow! That new client just told me about this great money-making deal.

Money and client relationships, what a dangerous mix. Yes, we have to think about money. We need to get paid. But when we start thinking about money or other things first this can be a trap.

Investing money in a client’s business or investment opportunity or asking them to invest in one of yours, these are all bad ideas.

Lending money to your therapist is an absolute NO! If your counselor asks to borrow money run as fast as you can. Consider lodging a complaint on your way out to the appropriate person.

Think also about insider trading issues. Do you want to end up in court because you made an investment based on a tip from a client? Clients, do you want your therapist testifying in court about your therapy session and how this investment idea came up in the first place?

All of these ethics issues can start with just that little finger through the ethical loophole. Giving someone bus fare out of your own pocket, paying them a few bucks to mow their lawn, becoming involved in their religious or social activities, all of these can lead to trouble.

Client, I know that you may like your therapist, want to do something nice but remember that their ethics code like a priest vow of poverty may preclude them from accepting gifts, stock tips or other offers by you to do things for them.

For me, as a therapist, the best gift a client can give me is to tell me that something we did in session has helped them have the happy life they want. Hearing that I have been able to help, that makes my day.

Sorry if we can’t hang out or attend some social events together. I like you as a person but I respect our professional relationship and you as a client too much to mess this up by getting into another dual relationship with a client.

Next Friday ethics part 4 – the bad news for all you romantics at heart. Why falling in love with clients or your therapist so often ends so very badly.

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

Do therapists tell parents what kids say?

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By David Joel Miller.

How much confidentiality should children get?

Do therapists tell parents what kids say?
Photo courtesy of pixabay

This can be a very touchy issue. Nothing more infuriates a parent than the sense of loss of control over their child’s care. Parents routinely want to know all about what their child is talking about in therapy. Children often ask “Do you have to tell my parents,” before they will disclose something. There are no simple answers.

Two primary questions here.

1. How much should the parents be told?

2. How much are they legally entitled to know?

There are good reasons why parents need to know what is going on with their children. There are also some equally good reasons why they should not be told. Let me try to explain both.

Consider this a general answer and deliberately vague, lots of factors play into this situation and these vary widely from location to location. So the legal practice in one state may not apply in another. From the therapist’s point of view, there are something’s the parents need to know and other things that will interfere with the process if the therapist tells them.

The exact legal requirements are another issue that varies with the jurisdiction.

The parent, therapist, and the child may also discuss ahead of time just what things will be told to the parent and what should be kept confidential.

Some parents want to know everything the child says. They want the counselor to pry those secrets out of their child. They ask us things like “Is he doing drugs?” “Is she having sex?” The great illusion of some parents is that if they knew all their children’s secrets they could better control the child’s behavior and “Keep them from making mistakes or doing something wrong.”

Let me give you a real-life example of a parent’s effort to control their child’s behavior and how it backfired. This particular example is based on a news story, not my clinical practice so parents, if I have seen your child, relax this is not your kid. I have imagined a few things that were likely to happen after the news account left off.

Dad was worried about his daughter staying out late and was suspicious she was having sex with one of the boys from her school. Dad wants to put a stop to this behavior. He gets an adult this girl trust to talk with her. Have that sex talk. She reveals that yes after going to a local hangout she and this boy did go off and have sex. The girl is 17 the boy is 18. So this sex, in my state, would have been illegal as statutory rape but not reportable by the counselor as child sexual abuse.

Dad is told. He becomes enraged. Dad pressures the police and the local D. A. to arrest this older boyfriend for statutory rape. Dad also files a lawsuit against the hangout where the two of them met for endangering the morals of children. Let’s not worry about the merits of a suit like this just now. The boy is in jail, the hangout is fighting to stay in business and now checks all the kid’s ID’s and no longer allows anyone under 18 to enter. Everyone in this small town knows who had the sex that caused the problems for all of the other teens.

The result?

This Girl, now furious with her father, sneaks out her window, goes to another spot, and hooks up with a couple of older guys. She is going to get even with dad. She is now having sex with lots of older guys, not just the one cute potential boyfriend who is away in jail.

A better approach would have been to talk with the girl about love, relationships, and the dangers of unprotected sex.

Parents make the mistake of thinking that they need to control children’s behavior to keep them safe. So very often that “protected” child turns 18 and now all bets are off.

Parents, at some point in your child’s life, probably in the teen years, your role should move from protecting your child to teaching them how to make good choices. That learning to make choices part scares most parents. What if they make a mistake?

Parents fear this because frequently those parents have made all those mistakes themselves.

We all need to live our lives, learn to make choices, for better or worse, and sometimes in the process, we fall down and get hurt.  A good parent can loosen their grip enough to let the child make some decisions and learn from them before they reach the point of having to face those huge, life-altering, decisions all alone.

Lots of teens ask me to not tell their parents things because they know they have messed up. Often the parents are very understanding and can help the teen solve the problem. Embarrassment and the keeping of secrets are not helpful to the teen.

Some reasons parents should not be told what their child says.

If there is a danger the parent will overreact, or harm the child then the counselor may be ethically bound to keep things from the parent.

More than one parent was concerned about what the child was saying because the parent was engaged in illegal activity, used drugs, or had some other secret they wanted to hide.

If you are the parent whose child is in therapy, trust the therapist to tell you what needs to be told, to report what legally has to be reported, and to try to help your child through the process of learning to make their own decisions.

If you are that teen in therapy, have this conversation with your counselor. Ask them what sorts of things they will be telling to your parents and what is confidential. Unless there is a safety issue involved it is generally best to let your parents know what problems you are dealing with and the counselor can help you with the process of telling them. Don’t let embarrassment keep you from getting help. We all make mistakes in life. The smart people know they need to fix those mistakes and sometimes that means asking for help.

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

Desperate for friends? – Signs of a destructive friendship.

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

group of friends.

Friendship.
Photo courtesy of Pixabay.com

5 Ways to evaluate a friendship.

Some friendships are destructive; some drain the life out of you. Why then do we hold on to those friendships even when there is something inside of us telling us this is not right?

Certainly one quality we want in a friend is someone who cares about us and likes us all the time. It is not much of a friendship if their feelings towards us are dependent on us being a certain way or doing a certain thing for them.

If we expect that kind of total acceptance from a friend then we might tell ourselves that we need to be there for them even when it is painful or has its emotional price. How then do we decide if this friendship has become toxic? When do we need to let friends go?

Some of us stay with unhealthy friends out of guilt or duty. We feel we owe it to them to continue the friendship. Others stay in unhealthy relationships because of an inner fear that if we did not have this friend then we might have no one.

It takes courage to look at this relationship and realize that this “friendship” is not healthy. When you spend time with this friend how does this make you feel?

1. Friends should be uplifting.

You should part company with a friend feeling better than when you met. That conversation you had with the friend should make you feel happy and good about yourself.

If you leave your time with that “friend” feeling drained, down or bad about yourself then you should reconsider this relationship.

2. How do you feel when away from this person?

Do you feel relieved that the visit is over? This is clearly a bad sign. Do you dread seeing them again but feel you owe it to them to visit?

A clear sign of a toxic friendship is the dread you get when you think about going to see them.

3. What do you do when you are together?

If the time together is all about the other person, when you are there to cater to their wants and needs, then this is a one-way friendship and they are on the taking end.

Some people are ill. We may take care of them. When we leave this person we may feel a sense of joy at having been able to be helpful. But if that person seems to constantly demand more, then this is not a healthy relationship.

4. What does this person like to do when you are not around?

If this friend’s primary interest is in doing things that make you uncomfortable then this is not a healthy relationship.

People who like to drink, get drunk, or do drugs, want those around them to do those same things. Is there pressure to be like them?

Does being around them place you at unnecessary risk? Are they involved in an illegal lifestyle? Then how healthy is it for them to involve you in their problems?

5. Do you feel pride or shame when you see how they treat others?

If how this person is treating others makes you feel bad, then consider that they are probably treating you that same way but you are avoiding looking at those behaviors.

Positive friends should make you proud, not ashamed of their behavior.

Take a look at your friendships, and the other relationships in your life, look at the unhealthy ones and consider how you can cut these off or limit your contact with people who are harmful to you and 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

Going nowhere fast? When you want something and you’re not getting it.

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

Ball recovery

Recovery and Resiliency.
Photo courtesy of Pixabay.com

Questions to ask – things to do when your dreams are not happening.

Some people seem to be able to make everything come their way. Others of us seem to keep struggling, the only thing coming our way is an oncoming truck. Here are some things to look at if you just can’t get things to happen.

1. How bad do you want it?

For several years now I have been saying I wanted to lose some weight. Every time the choice between exercising and sitting down to read a good book or write another post comes up – the weight loss goal losses out. I am just not that committed to losing the weight.

Motivation plays a role here and later this year there will be a series of posts on motivation, how you motivate yourself, and others. But no amount of motivational efforts will help if you just don’t want it enough to put in the effort.

2. Do you believe in yourself and in your ability to reach this goal?

This is really about two different things. Do you deserve to be successful? If you have doubts in this area you need to do some work on that issue. I believe that we all deserve success and happiness. What success means to you, that is a different question.

The second part of this is do you think that if you set out to accomplish something you will be able to do it? If you have doubts about your abilities, you need to get more skills training. Work with a good counselor or coach may help establish or improve the skills you will need to get where you want to go.

3. Have you identified your objectives, short and long-term?

Saying you want a more successful, productive, or happier life is a start, but we need to operationalize those goals. What will it look like when you get there? How will we know you are headed in the right direction? Are there any markers along the way that will tell us we are headed in the right direction?

4. Are you taking action?

All progress begins with taking action. You cannot succeed at something if you do not try. The first step in reaching more goals in your life is taking more action.

No one hits one hundred percent of the shots they take but you have to keep putting the ball up in the air to make any baskets.

5. Are you cheering yourself on?

People who keep telling themselves they can, they often do. Tell yourself that you can’t do this, that this will never happen and you create the failure. Are you urging yourself on or holding yourself back? Positive self-talk contributes to success, negative self-talk ensures failure.

The highly successful keep telling themselves they can. They also look at results that fall short of their mark as improvement opportunities rather than failures.

6. Have you learned the technology of success?

Success is rarely the result of some sudden stroke of luck. Some people do win the lottery but we have repeatedly seen winning does not produce happiness. There is a process for technology, involved in moving from wishes to results.

Learn the technology of success and practice it. Become good at reaching goals, small and large. More on the technology of success in a future post.

7. Keep on the success path.

People who are highly successful are “single-minded” meaning they are not easily distracted. They do not change goals frequently and they do not put reaching those goals aside on any kind of regular basis. They do keep reevaluating their progress, am I on track, am I doing what I need to do, and is this still something I want to accomplish?

Very successful people do reexamine goals and change them from time to time. They also may have several or many goals they are working towards. What they do not do is vacillate. They are either in or out.

8. Enjoy the journey to your goal.

If you hate the process, the things you have to do to reach a goal, then it is not likely to be meaningful when you get there. People who have the greatest success are working at things they enjoy doing. The more you like a subject the better you will learn it. The more you enjoy an activity the more likely you are to repeat that behavior and the better you get at it.

Sure every worthwhile endeavor involves some sacrifice and some difficulty. Remember the old saying “no pain no gain.” I think pain, in that sense, means effort and struggle, not suffering. People who are highly successful learn to enjoy the struggle as well as the result.

Is your life the way you want it to be? Do you have goals that are not coming to pass? How are you doing on goal setting, motivation, and creating your happy life?

David 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

Growing up mentally ill effects every part of your life

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

Confused brain

Mental illness.
Photo courtesy of Pixabay.com

The high cost of growing up with a mental illness.

Lots of attention has been focused on how the severely mentally ill may be different from others. Very little attention seems to be paid to how the experience of having a mental or emotional problem in early life changes who that person becomes.

The prevailing myth is that childhood is a happy time; life problems and the resulting emotional distress come later, the cost of growing up. We would like to hold onto this Peter Pan fiction despite the fact that more than a few of us have our own memories of childhood emotional or mental difficulties.

Who we become as an adult is shaped by our experiences and what we learn about the nature of the world we live in. The life events of the mentally or emotionally challenged child are significantly different from those others undergo. These early emotional experiences create the adult they will become.

The challenge of growing up with a mental illness changes every aspect of your experience. Those life experiences contribute more to who the mentally ill child becomes that the particular emotional illness they have.

For the child with an emotional problem, all relationships are fundamentally altered. The cranky from birth child is hard to care for. Interactions with the caregiver depending on the extent of the child’s mental illness and the age at which the symptoms first develop. The problem child gets labeled and learns the role of Black sheep, the creator of the family’s dysfunction.

Peer relationships are likely to be distorted. The depressed or emotional child is more likely to be bullied and rejected by peers. They grow up alone, unaccepted, and victimized.

Their symptoms call down the wrath of teachers and adult authority figures. They are more likely to be judged by their symptoms than for themselves.

As difficult as the teen years are for the “typical” teen they are extra difficult for a teen who is struggling with mental illness. They may find it difficult to establish supportive friendships and have fewer resources to draw on to navigate the developmental tasks of growing up.

When and if they develop an intimate partner relationship that connection will be heavily influenced by the person’s mental illness. They are more likely to enter relationships with other mentally ill partners or to become the victims of partners who take advantage of their weaknesses. Being involved in relationships with other mentally ill people adds a double strain to the process of establishing healthy relationships.

They also have more difficulty staying in school and finishing their education. As a result, career options are more limited and the emotionally challenged youth is more likely to be unemployed or underemployed.

The mentality ill leave home and school to become a permanent member of an unnoticed minority. Regardless of their race or ethnicity, the emotionally challenged child grows up to be a victim of discrimination.

The mentally ill child is often scapegoated and blamed for the family’s problems. Some of them have grown up as the caregivers of mentally ill parents.

They come to question who they are when they are depressed, when they are manic or when they experience other symptoms.  The question becomes which part of their experience and their behavior is them and which is the result of their illness.

They often experience adults who view their symptoms as a matter of choice rather than illness and who tell them to just snap out of it and act normal. They wonder why others can cope with life and they find it such a challenge.

Growing up mentally ill can result in feelings of self-doubt and negative beliefs about the self. They come to think that they can’t do anything right. Not liking themselves is common.

Even when they enter the system they are likely to be viewed as incompetent rather than uneducated. They are likely to be assigned case managers who see their job as permanently managing these people who form a drain on society’s resources.

The professional that believes in recovery and a full and happy life for the mentally ill has long been the exception rather than the standard.

The cumulative impact of these experiences can easily lead to an adult mentally ill person who has come to accept that they are somehow defective and unwanted. They become marginalized unable to work, dependent on scanty government and family handouts and convinced by years of learned helplessness that they would not be able to succeed if given the chance.

We as a society create these angry depressed and isolated adult mentally ill by our unwillingness to recognize and help these youths who are struggling to overcome an emotional issue.

What is critically needed is more emphasis on early detection and treatment of mental and emotional challenges. We also need social service systems that believe in recovery rather than permanently marginalizing the mentally or emotionally ill.

David Miller, LMFT, LPCC

Related articles

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

Mentally Ill keep Big Tobacco profitable – dying to smoke

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

Cigarette

Cigarette smoking is addictive.
Photo courtesy of Pixabay.com

Mentally ill and substance abusers are major consumers of tobacco products.

Those with a mental or emotional health problem continue to be major consumers of tobacco products.

A recent government study reported that 40% of those with a mental illness smoke cigarettes.

This is almost double the rate of smoking among the general public.

There was a time when the rate of smoking among those with a DSM diagnosis, that is either substance abuse or mental illness was reported as topping 50%. While this most recent study suggests a slight decrease in smoking by the mentally ill their rate of tobacco consumption continues to be far above that of other Americans. This decline however slight may well reflect a change in attitude among providers of services to the mentally ill.

We have discovered that having a mental illness can reduce your life expectancy by twenty years or more. On average those with a mental illness live shorter lives than those without similar challenges. Despite the existence of treatment that significantly reduces the impact of having a mental illness, we continue to have long-term health problems associated with having developed a mental illness.

In the past, many professionals took the position that with all the challenges the mentally ill had why were we trying them to get them to give up smoking or other things they found pleasurable even if those practices were impairing their health. The attitude of professionals is changing.

Recovery includes not only recover from their mental illness or substance abuse problem but from other unhealthy lifestyle choices. It is not the role of professionals to decide for our clients how they will live. Sometimes they make unhealthy choices. But they deserve the same care and advice about the dangers of unhealthy practices that other people receive. Long-term effects of substance abuse can increase mental health symptoms while impairing health.

Some things, like smoking cigarettes and abusing street drugs, are so high-risk any recovering person should consider giving them up. Recovery is not just about giving things up. It should also include positive steps to improve health and activity. Putting away the cigarettes may be a start on your efforts to create a new healthier and happier you.

Till next time, David Miller, LMFT, LPCC

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What’s the big deal if a therapist smokes a little dope? Ethical Loopholes Part 2

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

Cannabis

Marijuana’s effects. 
Photo courtesy of Pixabay.com

What if your counselor does drugs when they are off work?

The series on “Ethical loopholes and why these can strangle you” started in a previous post (last Friday) when I talked about the dangers of counselors talking too much about their clients and then violating confidentiality, this is a violation of most codes of ethics and illegal in most places. I also said there are three other ethical problems for counselors that may be affecting their clients. Here is part two – Counselors who are impaired by drug or alcohol use.

Is it OK to be a casual drug user? Can you just chip a little? Even if someone has a drug problem, should that keep them from working a job?

I think this depends on what that job is and for counselors and therapists, this should be a no.

There are times when working with a client that I do not focus first and exclusively on getting that client to stop drug use. When working with a suicidally depressed client, this is not the time to talk stop smoking, or even about giving up weed.

That is the old approach and it did not work. We used to tell the mentally ill that they had to stop all drugs for 30 days before they could get mental health treatment. Clinicians did not want to diagnose clients until they had a period of sobriety. So they referred them to substance abuse treatment first. The substance abuse treatment provider then refused them saying they were too mentally ill for drug treatment until they got their mental health symptoms under control So the client got ping-ponged back and forth.

The new process is to treat both problems at once and to “meet the client where they are” so if they are not ready or do not want to quit we work on the things they do want to change. So far I am good with this. I believe that any clinician worth their salt substitute can do an adequate assessment on someone who is using, you may have to catch them at a lucid moment but it can be done.

So we help clients work on what they want to work on. But here is where there is a two-part ethical trap.

In being willing to work with clients who are still using we can cross the line into saying that their drug use is OK and that they are entitled to keep doing it. I think we let the client down when we do not at some point mention that their drug use may be causing some of their mental health symptoms and encourage them to stop.

This danger, that accepting their drug use and working with them as they are can turn into advocating for their right to continue to abuse substances.

I am not an advocate of trying to help an airline pilot control their recreational drug use or alcoholism and still keep flying.

The ethical problem for counselors.

Once you begin to advocate for your client’s right to keep getting high and working it is a short hop to thinking that it is OK for the therapist to use and get drunk as long as they do it on their own time.

At what point does this “harm reduction” philosophy move over into it is OK for the therapist to use?

Can you smoke the night before and sleep it off? What if you come to work and are high? What if you come to work and have a hangover?

It is my belief that counselors who started out advocating for the client’s right to keep using can cross the line into being impaired by drugs and alcohol on a regular basis.

Those therapists do not usually get caught because they come to work impaired. They can often hide that. But every time I get my professional magazine it seems like there are more listings for therapists, psychologists, and counselors who got arrested did something violent or delusion while under the influence.

Guess what? Licensing boards do not say “He was off work so the DUI does not count.” Impaired professionals get their licenses suspended or revoked.

Starting to make exceptions for when it is OK to keep on drinking and using includes the risk that the professional will pick up.

I cannot tell you how many times I have seen substance abuse counselor’s crash and burn when they picked up again.

Therapists seem to be able to hide it a lot longer but once they stick their head through that ethical loophole and think that it is OK to abuse substances occasionally when they are off work, then becoming an impaired professional is just around the corner.

Oh my, the word counter is blinking at me again. Seems I have gotten worked up and written more words about this ethical issue than I had planned.

In a future post the dangers of counselors and therapists making exceptions to the “dual relationship” principle.  Getting to be friends with clients and doing things other than therapy with them can hurt clients and therapists. We also need to talk about that sex with counselor thing but we have saved that for last. See you again next time.

David Joel Miller, LMFT, LPCC

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Which you is the real you? Life Roles

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

Hats

How many hats do you wear?

On the stage of life, we each play many parts.

One way we get confused about who we are deep down is the way in which we play many roles in our lifetime, sometimes in the same day. Each and every one of these you’s is the real you even when they can be quite different.

Changing those roles may feel like an actor changing their costume. Roles each come with an imaginary role hat. People in recovery may find it difficult to move from role to role while maintaining their recovery.

We are all children with parents. Even when we reach our senior citizen years, if our parents are still living we will continue to be our parent’s children. For some of us, this is a good thing. For others of you, you would prefer to not fill that role but somehow after one short phone call, we can get right back into the feelings we had as small children.

Five minutes after getting off the phone with your parent you can be yelling at your own child. You are now in the parent role. While these two roles are very different both are the real you. But your roles don’t stop there.

We also are partners or ex-partners or about-to-be-partners depending on the state of our romantic relationships at the time.

We, many of us, also have work roles. Even those who do not work at paid employment may have “welfare recipient” roles that require you to attend sessions and do various activities to continue to receive your assistance.

The critical factor here is to keep your head straight on what your role is now, in this minute, and to be able to meet all these various role requirements.

Recovering people struggle to keep their roles separate. Yes, you are a person with depression, anxiety, or substance abuse issues but you still need to fill those parent, child, partner roles also.

Your disorder does not define you and neither does those other roles.

Learn to be able to slip from one role to another. Remember to change your role-hat when you need to move from recovering person to employee or parent.

Learn that the you that is present when your depression is troubling you is not the same you that will be present when the depression lifts. Accept all these many you’s with equal love and caring.

Realize that sometimes a very small trigger can move you from parent-you to child-you or from loving partner to an angry spouse.

Each of these roles may require different traits. You need to be an affirming parent at home but may need to be a stern boss at work.

The more easily you can comfortably move from one role to another all the while being the real you the better you will adjust to life’s challenges.

The more skills you develop, the more easily you will be able to move from role to role without feeling overwhelmed or being a fake you.

Sometimes these roles may conflict and the challenge is to keep all these roles in balance without them overwhelming the other you’s.

The skills you may use when a part of a group may be very different from the skills you will need for those times in life that you are alone with only yourself.

How many roles do you fill each day and how do you manage to move between roles that require different skills?

Related articles

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