What is Dissociation?

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

Confusion.

Confusion.
Photo courtesy of Pixabay.com

Does Dissociation really happen? What causes it?

Personally, I think there is more misunderstanding around this condition than most other mental health issues. First off Dissociation is way more common than most people realize. It comes in varying intensities; much of it is mild and goes unrecognized, denied and undiagnosed.

Dissociation, particularly Dissociative Identity Disorder has so much stigma around it that when we see it in clinical practice, I believe most clinicians call it something else more acceptable, like stress or Posttraumatic Stress Disorder, and let it go at that. This leaves people with more severe cases of dissociation with less than adequate treatment.

My view is that milder forms of dissociation are a normal protective behavior for most vertebrates, humans included. Under stress, the brain stem engages the “F’s” and takes over the functions of the brain to ensure survival.

Dissociation in its milder forms is, as I understand it, a functional survival mechanism. It is a close cousin to daydreaming and alcoholic blackouts.

Some simple examples of Dissociation.

I am driving along, I am thinking about something I need to do tonight. In my mind, I am picturing a set of slides that I want to create for the power point. I realize all of a sudden that I am miles past my freeway exit and I have no memory of driving this way. My mind has blanked out.

At this point, I turn around, drive as fast as I can and reach my destination. Do I tell everyone about my “zoning out?” Not a chance. I make some lame excuse about traffic and getting off work late.

Next example, more severe

A woman who was gang-raped in the past is walking around downtown. She sees some men who are wearing gang colors and look kind of like the men that assaulted her. She becomes frightened and crosses the street, she begins walking fast to get away. A few minutes later she slows down. Her panic is subsiding. She looks around and finds she is walking through a neighborhood and she has no idea where she is or how she got here.

So now we can see a mechanism by which someone who is upset might do actions like run away and be functioning essentially on autopilot. High levels of stress, like high levels of alcohol in blackouts, might shut off the connection between current functioning and memory.

Does that mean this woman has some form of Dissociative Disorder?

Maybe, maybe not. The new DSM-5 lists five major kinds of Dissociative Disorders plus some specifiers and or sub-types.

This woman, now upset because this past problem, memories of the rape, is messing up her life and also a lot worried because she ended up in a strange neighborhood with no memory of how she got there comes to see a therapist.

She begins to talk about her experience. She had an experience that brought back memories of her rape (Intrusive thoughts.) She tried to avoid things, ran away (avoidance, yes.) She has been anxious for several nights since and has lost sleep over this. Maybe even had a nightmare and this has been affecting her home life and her relationship.

At this point she gets assessed, a treatment plan created and treatment begins.

She was embarrassed so she left out the part about walking for a while and having no memory how she got there.

Her diagnosis – it’s likely to be Posttraumatic Stress Disorder.

In clinical settings, the stress-related disorders get diagnosed a lot more than the dissociative disorders. Sometimes it is a judgment call. Which disorder are this woman’s symptoms more like? But I think we professionals may be overlooking a lot of dissociative symptoms. The result may be that in outpatient settings we are under-diagnosing Dissociative Disorder and over-diagnosing PTSD.

In carefully controlled research the prevalence of Dissociative Disorders of all 5 types exceeded 5% of the population. That makes dissociation up to 17 times more common than Schizophrenia.

Dissociative Disorders are the next chapter over in the DSM-5 from stress-related disorders. We see a huge overlap between those two groups. There is also an overlap with Borderline Personality Disorder another misunderstood condition.

If we think of all these conditions as reasonable responses to stress given the person’s biology and experiences we can see how some of the things that occur to a person with dissociation make sense.

Dissociative Disorders are most commonly found in the aftermath of traumatic events. Some of the symptoms of dissociation are embarrassment, confusion and a desire to hide the existence of your symptoms. If you are the victim of trauma and let on how much the trauma affected you, this might put you at risk to be revictimized.

People under stress will have gaps in their memory. People with dissociation may also not know they have those gaps until someone asks about something they can’t remember. This is referred to in the literature as “amnesia about the amnesia.”

Dissociative Disorders, all 5 of them according to the DSM-5, include both positive and negative symptoms. In the past the only other disorder that I remember being described that way was Schizophrenia, but as I think about them other disorders have both also.

Positive and negative symptoms do not mean they are good and bad. What this means is that people with a disorder lose the ability to do some things others can do. This loss is called negative symptoms.

They also develop symptoms that others do not have. These added symptoms are called positive symptoms.

Since I believe people can and do recover I think that these areas of altered functioning can vary in intensity and can get better or worse depending on time, traumas, conditions, and treatment. More on negative and positive symptoms in future posts.

Another area of concern in talking about dissociation is something called state or trait theory. Trait would imply that once you got it you always got it. So if you dissociate then you are a goner and who wants to believe that. But if dissociation is a state then you can move into and out of it.

One other cause of Dissociative symptoms are efforts to reprogram or expose someone to “thought reform.” This mental reprogramming, like brainwashing, results in a brain that at some level believes two contradictory things. Can you see how that brain could pop in and out of contact with others?

Last, despite all the press about extreme cases of dissociation and the recurrent belief that this is something that only happens to women, the research tells me it is, in fact, more common among men than women. I have some theories about why that might be but that like the rest of this needs to wait till another post.

Dissociative disorders vary from person to person and time to time. Nothing I can say will fit everyone and there is a lot to be said for listening to the “lived experience” of those who have these disorders. More to come on this topic, but in the meantime what do all of you think about this?

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

When should you force a child to go to therapy?

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

Therapy

Therapy.
Photo courtesy of Pixabay.com

Sometimes you need to insist they get help.

Parents seem to be concerned about when to force a child to go to therapy. Making

children go for counseling shows up in search terms to counselorssoapbox.com from time to time. This is an important topic.

In a previous post, I wrote about “Can you force your child to come for therapy.”  Parents know that forcing a child to do almost anything is difficult to do. Sometimes you need to enforce rules and decisions and sometimes the battle is not worth the effort. When it comes to getting your child into therapy which is which?

Most of the Can you force a child to go to therapy post was about the practical problems of coercing someone to go for therapy. Therapy works best when the person in session wants to be there. Sometimes they only “want to be there” because their parents or their parole agent made them come. Either way, if they have some incentive it increases the chances therapy will work.

There are times when you the parent are worried about your child, you can offer to get them therapy but “forcing” the child can make things worse. In a future post, I want to tell you about those times you should resist the urge to force your child to see a therapist.

We also need to look at when, for what problems, parents should be so worried, so concerned that they absolutely insist their child see a counselor.

Here are some of the reasons to put your foot down and insist that your child sees a counselor other professionals outside the family. Families who have a good, open relationship, find their children will talk to them about more, but there are still those things that are just too embarrassing to tell mom or dad about.

Your child says they are suicidal.

Suicidal statements, talking about death or starting to say or acting like they do not want to live anymore are not something to ignore. Children of any age can and do commit suicide. Do not brush this off as just a ploy for attention. Kids get embarrassed and do not tell their parents the truth.

If there is any chance they will try to self-harm get them to go see a professional who can assess for the risk they will carry through on this thought. This is one area where kids will often tell a professional the things they will not tell their parent.

If you suspect your child has been the victim of abuse, rape or molestation.

If you think this your emotions may run the gamut. You will be angry, fearful and just plain want justice. The danger here is that by questioning the child too hard you will scare them, and make them close up and stop talking.

You can also run the risk of asking the wrong questions or asking them in the wrong way and then thinking their answers mean something they did not mean. You can end up taking a wrong action. Repeated questioning can also make a young child think something must have happened even though they did not realize it and they will start “remembering” details to please you. You want the truth not a story made up to please you.

These sorts of problems need professional intervention and please let the authorities deal with identifying and punishing the person who may have done something to your child.

Asking for too many details about abuse can also make the child feel it was their fault. The last thing you should do is to put the child through a second trauma when they are being interrogated about what has already happened.

You see evidence that they are becoming addicted to a drug.

The longer you wait to interrupt a substance use disorder the more likely it is to become a permanent addiction. Seek professional help.

This does not mean that if your child is smoking weed or drinking a few beers that there is someone who can lock them up to prevent them doing drugs.

In most areas, there is no way to detain a kid for very long even when the parents want them locked up. A few places may let you turn them in as incorrigible but the number of places that will do that is getting very small.

Watching a child full-time is a difficult job. If they are abusing substances keeping them locked up and away from drugs is a complicated task. The faculty can’t just hire anyone to do this and paying a professional for 24/7 treatment gets expensive.

For drug treatment, the most effective methods include involving the parent in the treatment. Most treatments are outpatient and the child comes home at night. If you want help with this problem you will need to be part of the solution.

Locking your child up will not take away the desire to do something. The second they get out they will run to do what you tried to keep them from doing. What they need is a “head change” not incarceration.

If there are sudden dramatic behavioral changes in your child.

If they are stealing, need money, cut classes or their grades suddenly drop through the floor, these are all warning signs. Look for help fast. Do not make the mistake of thinking they will “grow out of it.”

This may mean drugs, may mean depression or the beginnings of another mental illness or could just be a problem with a boyfriend or girlfriend. Either way, once the changes are in play it may take the help of a counselor or therapist to find out what is going on and formulate a plan to help your child navigate these issues.

As hard as it may be there are sometimes you need to put your foot down, be the parent and get that child in to see a professional.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How long does the therapist keep your file?

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

Therapist

Therapist.
Photo courtesy of Pixabay.com

Will the therapist have my file from when I was a child?

There are lots of reasons counselors keep client files, legal, ethical and practical reasons. There are also financial reasons such as billing insurance companies and taxes.

Some files get kept a whole lot longer than others.

Just what goes into a file and how long to keep it can vary with the setting. There don’t seem to be any universal rules but there are some guidelines.

For practical reasons, you can’t keep everything forever. Now with electronic records systems, this may change. But when all files were paper, eventually the therapist, after seeing clients for years had so many paper files they had to pay to store them and worry about keeping that storage place safe or they had to start getting rid of something.

What therapy files to keep and what to destroy?

Two ways to cut down on the storage space problem; thin the files or toss some completely.

Some places, especially large agencies, might go through a file and dispose of unneeded pieces of paper while preserving the record of why the client was treated and what was done. These thinned records might get stored away for a very long time.

That same agency, at another facility, might dispose of any records more than a certain number of years old.

One major criterion for keeping files is the legal issues that can arise. If the client sues you for doing a bad job it is nice to have some records to show what you did. The length you might need to keep records can vary with the jurisdiction in which you live.

The usual length of time therapists are told to keep records is 7 years. But there are some legal issues that stay open for 10 years. The trend is to tell new counselors to be safe, keep your files for a least 10 years.

A significant reason therapists need their old records and the insurance company wants you to have them is if the client says you harmed them in some way. Especially if the client alleges you were romantically or sexually involved or that there was money moving between you for things other than for therapy.

What about juveniles therapy files?

These files should be kept till the client becomes an adult, eighteen at a minimum. But at that point, they may want to complain about something that happened to them. Maybe even sue someone. Because of this, it is recommended that files of juveniles be kept for 10 years after the client turns 18. So once they are an adult they have some time to file a complaint about the way they were treated and this can be checked out.

Keep in mind many files don’t always include the kind of details that the client expects.

Say a child was coming for therapy and tells the counselor that he is involved in gang activity. Most of this activity, while illegal will not be reportable as any sort of child abuse. The kid is choosing to do this stuff.

So the child tells the counselor that he was pressured to ride along on the commission of some crimes. Those details of which crimes, the dates and who else was there, are probably not in the file. The counselor was documenting the progress of treating the client’s mental health issues, not his life events.

What will show is, was the client enjoying hurting others or was he feeling guilty and how did the counselor help him with his emotional conflicts.

So while you told the counselor all about those kids that teased you that summer at grandma’s, the chances are that the names and addresses of those kids are not in your old file. What will be in there, if the file still exists, will be, was your response to the teasing a normal response or excessive and what were the things the counselor did to try to help you adjust.

Do old psychotherapy files have to be destroyed.

While there are laws, rules and ethical guidelines about how long a therapist needs to keep a record, I know of no law that says there is a point when they have to destroy old records. What they do have to do is keep them safe from unauthorized views. So if there is some good reason you need info from an old therapist it never hurts to ask if they still have your old file.

Recognize that it may take some time to find the old file or even to find out if it still exists. The information you are looking for may also not be in there.

Writing a note and keeping files is something we therapists don’t spend much time on in school but spend a lot of time on in the work setting. Thankfully in most agencies, there are people other than the counselors who also get involved in doing all this stuff.

This is a brief, more or less, response to a reader’s inquiry about would the therapist still have their old file from when they were a child. They did not say why they wanted to know so I am not sure if this answered their question but maybe it will help answer someone else’s questions.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

When your mind magnifies your problems

By David Joel Miller MS Licensed Therapist & Licensed Counselor.

Mind magnifies your problems.
Photo courtesy of Pixabay.com

My Magnifying Mind.

Pole-vaulting over dust bunnies.

This recurring human habit to make mountains out of molehills, say it any way you like, but the truth is that my mind can make the smallest inconvenience into a major problem. Does yours?

Do you find that a major part of the stress in your life comes from worry and planning for things that never happen? What if the car won’t start? Do you say to yourself “That would be awful, unbearable, I just couldn’t stand it?”

This habit, to focus on the minute and miss the important, is sometimes referred to as “catastrophizing.” Focus on the risks and your depression and anxiety can expand to fill every moment of your life.

Absolutely it pays to plan for possibilities. You need issuance. Car insurance is a requirement in most places and those who do not have it face dire consequences when they get in an accident. Fire or homeowners insurance is recommended. So is some form of disaster preparedness.

Do you worry about what will happen if—but do nothing about it?

What if you NEVER get a job again? That is a possibility. But rather than stress on what if’s consider what you are doing to find a job. What are you doing to make yourself more marketable?

Did the boss say he needs to see you this afternoon? Do you immediately think that you are going to get chewed out, maybe even fired and you don’t even know what you did?

When your girlfriend or boyfriend doesn’t answer your call, do you start thinking they are out with someone else? Do you imagine that they never want to speak to you again? Do you worry that if this person dumps you then you will NEVER have another lover in your life? You will live the rest of your life lonely.

That is your magnifying mind at work.

Some people worry so much about their lover breaking off the relationship that they anger themselves over this possibility. They may become jealous, violent or very often they break up with the partner first.

Their magnifying mind has turned a small delay in hearing from someone into a major catastrophe.

You are running late to work; there is traffic today, like every day. There is that report you still need to finish and if you are late there may be no coffee left in the break room. What if there are messages and emails to return. And you forgot to take something out to defrost for dinner.

Do you think “Today is sure to be a disaster.”

The repeated piling of one worry on top of another can overload the brain and result in an inability to do anything at all. If you abuse substances you may decide to stop for a drink so you can cope. If you suffer from anxiety or depression you may fall apart and decide to skip work today.

All of these things happen when our mind turns the magnifier on those usual problems of daily living and magnifies them to impossible proportions.

If you have a magnifying mind, turn that lens the other way and shrink those problems back down to their true size. Live today in today and leave the worries of later for then.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Desperate for friends? – Signs of a destructive friendship.

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 that 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

Six David Joel Miller Books are available now!

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

Dark Family Secrets: Some family secrets can be deadly.

What if your family secrets put you in danger?

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?

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Sasquatch. Wandering through a hole in time, they encounter Sasquatch. Can they survive?

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

Books are now available on Amazon.

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

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders, see my Facebook author’s page, davidjoelmillerwriter.

That’s not what I meant – Words can interfere with communication – Denotative and connotative meanings

By David Joel Miller MS Licensed Therapist & Licensed Counselor.

Why what you thought I meant and what I meant to say get so far apart.

Dictionary

Looking it up in the dictionary won’t help.
Photo courtesy of Pixabay.com

Even when we talk with someone in the same language and we think we should both know what the other one is talking about, we can walk away shaking our heads about how far apart our understandings are of the conversation.

These misunderstandings often get attributed to other people lying to us. It is not unusual for two people both engaged in an argument to accuse each other of lying. To the outside observer, it sounds like they are talking about two unrelated topics.

One cause of these disagreements is the different meanings we ascribe to the words we use. The things we say begin as thoughts in our heads. We can make a strong argument that thoughts are largely mental words or self-talk. Those thoughts are strongly influenced by our feelings before they leave our body via speech and action.

Words are symbolic and there is not a direct one to one correlation between thoughts and words. We can and often do disagree about what word best describes a thing or a feeling. Then our thoughts need to be transferred into words sent to the other person and then decoded. There is plenty of room for error in this process.

Consider the common two finger gesture. Sometimes this is interpreted as a “peace sign” and other times as the sign for victory. Words frequently have multiple meanings.

Four discrepancies in the way we attach meanings to words can result in garbled communication even when we think we are being clear and that we understand what the other person is saying. Those four communication traps are the differences between “denotative” meanings and “connotative” meanings, personal idiosyncratic meanings and slang.

What slang words mean.

Slang words require both people using them to attach the same meaning to the expression. They change over time and vary between subcultures.

Consider the word “hot.” To a weatherman, it could mean an above average temperature or a day in the hundreds. To the scientist, this may be a statement about the amount of energy the item contains. To someone else, this may mean something that is new, in fashion or desirable.

So the person in the shop points to an item on the table and says “that new part is really hot.” The apprentice quickly picks it up and then screams in pain. He expected this new part to be something novel that he might want. His coworker was warning him about the items temperature and potential to harm. See how using a word in multiple ways can obscure communication?

Denotative meanings.

Denotative meaning is what the dictionary says the word means. Look up most words in a dictionary and you will find that there are multiple definitions for the same word. Check many dictionaries and you get alternative meanings.

Most of us have learned a large number of words from hearing others use them in speech. We haven’t looked up every word and while we can feel pretty sure we know what we mean when we say the word we can’t be sure someone else has the same meaning in mind.

If I were to say that someone had been staring at the moon too long – what might you think I meant? That they are in love from too much time in the moonlight? That they had gone crazy as in becoming a “lunatic.” Or do we mean that they and their friends have been exposing their naked rear ends a lot? It would make a lot of difference in our conversation.

What is a connotative meaning?

Connotation is when a meaning is implied or attached to something in addition to its basic denotative meaning. For a long time, black has been attached to bad, evil or another negative opinion. If I describe someone’s character as black, it makes a lot of difference whether I am talking about someone from the African-American community who exemplifies what an African-American should be or if I were describing a Caucasian who is doing some evil things.

Idiosyncratic meanings.

Sometimes words develop a specific meaning for a person or group of people because of a particular experience.

Say a man came from a family that had a dog when he was a young child. For whatever reason he had difficulty saying the word dog and used its name, Spot to called the pet. From then on all dogs became “Spot.”  To this day if someone uses the word spot in a conversation this family will laugh and think of that dog. This has resulted in some embarrassing moments at the dry cleaners.

Other people might hear the word spot and think of a place they had visited, a stain on the carpet or an ad on T. V. The online dictionary I use listed 21 meanings for the word spot.

So when we consider that words can have so many different meanings, is it any wonder that we can have a conversation, think we have conveyed some meaning and then later find that what we said was totally misconstrued.

The real wonder is that with all this confusion we are able to communicate at all.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Can an LPCC practice privately? Reader Question # 2

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

So now LPCC’s are licensed – where can they work?

In California, an LPCC can practice privately if – and only if, they are licensed here in California. So far the only people who meet this requirement are those who already had another license (LMFT or LCSW) here in California and who took the Gap exam to qualify for the LPCC license also. People who were licensed as a Professional Counselor in other states and moved here are beginning to qualify to take exams and become California licensed LPCC’s.

LPCC’s have a special role in working in career counseling, mediation and a few other areas that are somewhat different from other mental health professions. LPCC’s should not treat children, families or couples unless they have had additional training in those areas similar to the training LMFT’s receive.

Interns of any license (MFT interns, ASW and PCC interns) are not allowed to have their own practice and must work under another licensed person. In a for-profit practice, the intern can only work for a limited period (6 years) while gathering supervised hours and testing. Interns and associates who work in governmental settings or other “exempt” settings may be able to work longer than the 6 year period their first intern number is good for.

Because of quality concerns, I expect most employers to limit the time interns who work for them have to get licensed and still work seeing clients.

Some people are attempting to get around this licensing requirement by calling themselves Life Coaches, a profession that to the best of my knowledge is currently not licensed or regulated. If the client’s issue relates to anything that may be caused by a mental, emotional or behavioral disorder then the client should be seen by a licensed mental health professional. Coaches should restrict their practice to clients who do not have a mental illness but want help in accomplishing more in life.

The more promotional material I read and view online from coaches the more nervous I am that they may be stepping outside their scope of competency as well as their scope of practice.

The laws may vary in other jurisdictions but the legal and ethical principles to stay within your scope of practice and scope of competency should be the same everywhere.

Thanks for that question.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

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

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.