Tag Archives: By David Joel Miller

What does “an expectation not an exception” mean when applied to co-occurring disorders?

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

Mental illness and addiction go together.
Photo courtesy of Pixabay.com

Are Co-occurring disorders to be expected? – Morning Question #24

Most substance abusers also have some form of mental illness. The two are seen together so often we need to begin by assuming the client could have both and then assess as if both disorders were present. Many substance users had a mental illness before they began using drugs or alcohol. Depression, Bipolar Disorder, and Anxiety are all common among those with an addiction.

People who use and abuse substances are at risk of developing mental health issues as a result of the using experience.

Substances can also alter the brain, resulting in mental illnesses while under the influence, while withdrawing, or after use. Mental illnesses that are the result of drug or alcohol use are called drug-induced illnesses.

Anyone who works with the mentally ill or substance abusers should expect that they will see both of these problems and others on a frequent basis.

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

Are creative people anti-social?

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

Original

Creative.
Photo courtesy of Pixabay.com

Are highly creative people, writers, and artists, also anti-social?

Some occupations require lots of time working alone. Artists and writers, in particular, need to spend a lot of time by themselves. Do these occupations attract people who want to avoid people?

Is there a mental health problem or personality type that is over-represented in the creative fields?

From a counselor’s perspective, people who work alone or prefer to spend time by themselves are not anti-social. We reserve the label of anti-social as in Anti-social Personality Disorder for people who have no empathy for others. An anti-social person takes advantage of others because they don’t care. They are the ones who get the label of psychopath or sociopath.

People who prefer to avoid others may have some form of anxiety as in social phobia or they may have an attachment style that results in avoiding others but neither of those personality features involves harming others on purpose.

An avoidantly attached person does not expect others to meet their needs and seeks to get their needs met by solitary activities. A creative person might be avoidant and prefer to avoid all contact with people but that is likely to be rare. To be successful at a creative activity as an occupation they will need to go out and spend time marketing and promoting their efforts. Avoidant people are not likely to be willing to do that and are likely to believe that others will not like them anyway.

Someone with social phobia would like to be around others but because of fear, they are unable to be in situations that trigger their anxiety.

Anti-social personality, avoidant attachments, and high levels of anxiety are not conducive to the risk-taking the artistic person needs to genuinely create something novel.

But an artist and those of an artistic temperament are more likely to have one particular emotional issue. Many artists are moody.

One mental health issue does appear to be correlated with creative temperaments. Kay Redfield Jamison in her book “Touched with Fire” describes the connection between Bipolar disorder and creative endeavors. Those episodes of above-average energy and times when the person is “in the zone” fuel creativity. Uncontrolled these episodes can turn into manic or hypomanic episodes and result in the creative person losing control and engaging in risky dangerous behaviors.

There are plenty of stories of famous artistic and creative people who had periods of high energy sometimes coupled with risky behavior followed by periods of deep depression. The energetic periods may fuel creativity but in the full-on manic episodes, the person is no longer able to stay focused long enough to complete projects.

The artistic fields have had a disproportionate share of individuals with mood swings who became alcoholics, addicted, or suicidal. The really productive artists, in the long run, learn to manage their moods with or without help and they keep their emotions in bounds.

See also posts on Hyperthymic Temperament, Bipolar Disorder, and Mania.

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

Why men fear marriage counseling.

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

Couple

Why men fear marriage counseling.
Photo courtesy of Pixabay

Why men would rather ship out to a combat zone than go to marriage counseling.

There are a whole lot of reasons that men cringe in terror when they hear those dreaded words “we have a problem” or “we need to go for marriage counseling. They have good reasons to be terror-struck. I would want to avoid it also if I were in their shoes, except that I am a Licensed Marriage Therapist and have to do this sometimes. Here are some of the reasons men avoid marriage therapy.

Men do not talk about problems, they fix them.

Men, many of them, come from a culture that does not talk about feelings. When they feel sad or frustrated they do not talk – they do.  No young boy is taught that when he misses a shot in basketball he should sit and have a good cry and talk about it for a while. He is told to shake it off and get back in there and try again.

If he stopped to engage his feelings even his own mother, a man’s blueprint for how to be around women, might call him a sissy and tell him to knock it off and be a man. Then he gets married and his wife wants him to be more like a woman and have feelings and sit and talk about them.

For most men experiencing feelings, like crying in front of others is the equivalent of being asked to cut off a couple of inches. The man’s answer is if the board is too big, let’s just make the shelf longer, but I am not cutting off anything.

Marriage counseling traditionally was a tag-team sport and the man got the beating.

Most marriage therapists are women. In California, the typical marriage counselor is a 55-year-old woman, who works 20 hours a week in private practice and mostly focuses on children and women’s issues. When I graduated there were only three men and row upon row of women getting their marriage counseling degree.

There are some great women therapists, unfortunately, there are also some who became therapists to fix themselves and they have the view that the problem is always the man.

A lot of men have come into my office and told me that the last “Marriage therapist kept telling their wife that the man was the problem and she should just leave him. You can take just so much of this tag team beating before you need to draw the line.

A good marriage counselor should never take sides. But under the circumstances, it happens way too much. The man is already being asked to be more sensitive, use his intuition, and talk about his feelings.

They expect to hear that who and what they are is not acceptable.

When a man gets an email that the boss needs to see him for a talk, what he hears is that he is about to get chewed out.

Women do not “invite” men to marriage counseling for fun. By the time it is said it is because the problem has reached the crisis stage. This request is likely to sound more like an invitation to a flogging than a request for a problem-solving session.

Most couples, members of both, even multiple sexes, want to find a solution to a problem for which there is no solution. Gottman found after studying what couples fight about, that the majority of things over which couples are fighting about are things that can’t be changed.

She liked how “exciting” he was, only now she wishes he would be more “responsible.” He liked how “stylish” she was; now he is complaining about how much she spends on makeup and clothes.

When one party in the relationship says we have a “communication problem” what they really mean is you are not doing what I want you to do.

Men, most of them, do not have a strong tradition as good communicators. No NFL player stops the talk over the possession of the ball.

Men are more accustomed to the idea that the more they talk over a problem the more they will lose.

The idea that there can be win-win solutions, activities, and exercises that help both parties get their needs met rather than one winning and the other losing is not something men expect to find in marriage counseling.

Even their mother wouldn’t do this to them.

Mothers, the good ones that inhabit myths and legends, love their sons unconditionally. They watched him grow up and know his weaknesses. Mom gave up trying to get him to stop burping at the table and leaving his dirty underwear on the living room floor a long time ago.

The wife is sure she married a fix-it-up-project and has begun from day one to try to make changes in her new acquisition.

Men can’t understand why that woman who loved him unconditionally a few weeks ago is now on the way home from the honeymoon trying to change every nook and cranny of her new possession.

Does this mean it is over?

By the time the couple gets to the marriage therapist’s office many times one or the other party has already decided that they want out. What the man may be hearing is that she set this up so she could have a witness to how unreasonable he is and why she should leave him.

Now what?

How do you get the man or woman in your life to go for relationship counseling before the train wreck? Is there really a way to get that man to come and talk to make things better?

Yes, there are ways to find a professional who can help you work through those issues and help make your relationship happier. The key is to find the right marriage counselor for you and your partner.

In an upcoming post, we will explore how to find a marriage counselor that can help you both find ways to meet your needs by staying in the marriage instead of running for the exit.

See also: Will marriage counseling help?

Finding a marriage counselor who can 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

What is State Dependent Learning? Memory problems?

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

Is it State-Dependent Learning or Forgetting?

State-dependent learning.
Picture courtesy of pixabay.

The way we feel emotionally and the things in our systems, drugs, medications, and general health all influence what we remember and what we forget. State-Dependent Learning is about times we remember and times we forget – the very same facts.

Say you go to a party or a bar after work and you have a few drinks. During the course of the evening, you talk to a lot of people. Let’s say for this example you have a lot of fun, it was a great time.

You have a few drinks but you are sure, positive, you are not drunk.

Next morning you look in your pocket or purse and there are a couple of business cards, only you can’t remember who these people are. Are they potential clients? Were you supposed to do something for them? Or did they try to sell you something? You just can’t remember. So you stick those cards back where they were and go about your day.

You are positive you were not that drunk, this is no alcoholic blackout. But it is frustrating anyway to not be able to remember why you have those business cards.

Later that day some of the people from your office are off to lunch, lunch with a client and you need to be there. So during this lunch, you have a drink or two. Suddenly you have a thought about those business cards in your pocket. So you pull them out and – yes now you remember the whole conversation and why you saved those cards.

You have just experienced State-Dependent Learning.

In State-Dependent Learning it is as if your brain uses different filing cabinets for information depending on how your system is functioning. With alcohol in your bloodstream, the brain files the information away in a “file needed when drinking” and locks it away. To get the file cabinet open and find that information you need the right key, in this case, alcohol, in your system to reopen the locked file cabinet.

Alcohol is not the only drug or medication that results in State-Dependent Learning and lost file keys are not the only problem that can happen when filing information or trying to retrieve it.

Memories can get lost or distorted when they are filed away. Sometimes, as with alcoholic blackouts, the info is misplaced before going into the file. In that case, the brain, on discovering the file is empty, makes something up. This is called Confabulation.

Problems can happen when the information is stored and some drugs affect storage. The info can also be hard to find if it is stored in the “high” cabinet and you look for it in the “feeling normal” file space.

The size and nature of the information also matter. Say you need to remember a long list of words. If the words are makes of cars, types of seafood, and tools sold in a hardware store, telling you those categories at the time we read the list to you will help you remember them. If the list is long, has words from many categories, and we don’t tell you the categories, the words will be harder to remember.

The brain has filing systems for category lists and for jumbled lists. Different drugs can affect different kinds of information storage and memory so the research can drive you nuts trying to figure out which drugs result in State-Dependent Learning all the time and which only cause State-Dependent Learning part of the time.

Alcohol appears to result in State-Dependent Learning and other memory problems a lot.

Students who use a lot of caffeine to stay awake all night and study for finals appear to have a similar problem. Things learned under the influence of stimulants are very dose-dependent. So if you take a little of the stimulant you may learn more, take too much and it may block memory retention at all.

Methamphetamine users not only don’t learn a lot but begin to lose previously learned material. This makes us wonder how much amphetamine is helpful and how much of an ADHD med you can take before it impairs memory.

So our student, who studies all night, using stimulants to stay awake, may find two problems facing them the next day. State-Dependent Learning may require them to have the same stimulant and amount of stimulant in their system as when they learned it. This will be more or less of a problem depending on the type of memory involved. Picking out the correct answer from a multiple-choice list will not be so much affected. Remembering a list of things that are not on the paper may be harder. So will recognizing the correct answer if the instructor uses a different word to describe the same concept.

The student may also find that the things they could remember easily when wide awake on the stimulant, those answers can’t be found now that the brain is looking in the I am “so-o-o” tired file cabinets. Your physical condition and mood can also affect learning and memory as can the context.

Frankly – no drug appears to improve your memory over a long time and using drugs or alcohol runs the risk of getting the facts you need, lost in a wrong file cabinet, and not available when you need them.

Other drugs and prescribed medications can also cause memory problems and or State-Dependent Learning. Watch for more on this topic to come.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Bipolar Disorder or Borderline Personality Disorder?

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

personality disorder

Bipolar or borderline personality disorder?
Photo courtesy of Pixabay.com

Bipolar Disorder or Borderline?

There are several differences between these two disorders. But it is important to remember that it is possible for someone to have both problems which greatly confuses the issue.

The largest differences between the two are sleep and time. Ego strength and character structure also play roles in this choice of diagnoses. I have exaggerated the differences to make the distinction clearer.

Sleep matters.

To be Bipolar you must have had a Manic or Hypomanic episode. The key characteristic of those episodes is long periods (time) of above-average energy and decreased need for sleep.

In hypomania, the person may be able to get by on a few hours of sleep, 3 or 4, and they feel fine. In full-out mania, they may even go all night without sleeping and still be just fine. At least they think they are fine. Others around them may notice they are irritable from lack of sleep but they think they are just fine.

Also in Bipolar when they are up they feel great, expansive. The same person may have episodes of depression and during those times they may sleep too much or too little but the telling point is that in the up times they will tell you they are on top of the world, full of energy, and can just do so much without needing to sleep like lesser people.

With those Bipolar manic episodes comes tons of energy. They like to go up in the attic and swing from the rafters. They might work all day then go to the casino and gamble all night only to go back to work the next day like nothing has happened.

Time.

People with Borderline have many moods within a day. The can be “touchy” easily set off and others may hurt their feeling without meaning too or even knowing why. People with Borderline Personality disorder are full of pain and rarely have a good day. They can be so bruised that a look or word can hurt them.

People with Bipolar have longer periods of up or manic feelings. When times are good for them they are really good. They may go weeks, months, or even years when they are on top of the world. But eventually, the crash comes and there will be long periods of time when they are depressed, possibly unable to get out of bed. Recurring episodes of depression is a common feature of Bipolar Disorder.

Ego strength.

Borderline Personality Disorder is pain based. Many borderlines were abused, neglected or deserted. They are needy in relationships but always distrustful that the person they are with will leave them.  Borderline may threaten to kill themselves if you leave them.

Bipolar people mostly don’t care what you think of them, at least not when they are manic. They know they are smarter than Einstein and better looking. They believe they can work miracles. This overvaluation of themselves and their abilities gets them in trouble a lot. The take excessive risks not because they want to hurt themselves like the borderline but because they really believe they will win.

Borderlines are anxious, Bipolar people could care less. Let this one leave and they will find another.

Sex.

People with Bipolar Disorder are often hypersexual. They can’t seem to get enough. This will lead to sexual indiscretions that ruin their established relationships. When manic they just can’t seem to stop themselves. When you’re manic the whole world looks good.

Borderlines are rarely secure in a relationship, fearful that if this partner leaves them, that confirms their fear, they don’t deserve a partner. They will stick with a partner, often an unworthy one, because they fear that if they were to break up they just could not take it.

Who loves their disease?

Someone with Bipolar disorder resembles a Vegas Gambler when they are on a winning streak they want to ride it forever. When the crash they hate themselves and can’t face the wreckage they have created. Bipolar people like being manic. They frequently quit taking their meds just so they can feel manic again. Mania is seductive like a new lover, but one who keeps treating you wrong. Still, you want to recapture that allure.

Borderlines are more like characters from a soap opera, bad stuff keeps happening to them and they wish the pain would end. They live in a world of pain and hurt. They wish they could find a way to get things to change. They are often angry and feel others don’t treat them right. Frequently they are correct. They have been mistreated by someone somewhere and they keep trying to find a way to make it right, to make the pain go away.

Do they ever not have symptoms? – Character structure.

Someone who has Bipolar disorder has a “Mood disorder.” They have specific times (Periods) when they have mania or Depression but at other times they have no mood symptoms. These times of apparent “normal” behavior may last for months or years and then something kicks off another episode of mania or depression.

Someone with Borderline Personality Disorder has a “Personality Disorder.” The presumption here is that they learned to be this way and are like this most of the time. They learned to protect themselves, store their anger, and release it in bursts and other survival techniques. The trouble is that the way they handle emotion makes them and those around them miserable.

The younger you were when you learned basic ways of being with others the harder it is to change. Most people with Borderline Personality Disorder continue to have some symptoms even after treatment, though with good care they can and do get much better.

Please check out my other posts on Bipolar disorder and Borderline personality disorder the list of categories is to the right.

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

Side effects by being impregnated by a Methcathinone user? – Morning Question #20

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Should you worry if you get pregnant by a Methcathinone user?

Anything that damages an egg or the sperm could result in birth defects, age, the physical health of either party, and so on. There is always a risk of spontaneous mutations and genetic damage. I have not seen much good research that indicates that one drug is better or worse than another when used by the father.

ANY drug use by the mother during pregnancy is risky. Sorry ladies. Doctors even take pregnant women off some prescribed medications. Alcohol is the biggest risk factor for preventable birth defects we know of. The only fully safe amount of alcohol a woman should consume during pregnancy is NONE!

If you are worried about the drug use of the father of your child you have more to worry about than possible birth defects. YOUR BABY’S DADDY MIGHT BE A DRUG ADDICT.

Pick your baby’s daddies and mamma’s wisely, you can break up with your partner but your child’s other parent is forever.

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 if a client tells you they had sex with their last psychotherapist?

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

Couple

Sex?
Photo courtesy of pixabay.

Sex is not the cure – Morning Question #19.

Ethically this is never considered acceptable. If the client was a child we would report this as child sexual abuse. If they were adults they need to report this to the licensing board. In California, we have a nifty little book called “Professional Therapy Never Includes Sex.” We are supposed to keep this book handy and give it to anyone who tells us they had sex with a previous therapist. What they do about the situation is up to them.

One reason sex with patients is not considered acceptable is the trust clients put in their therapist to help them sort out emotions. Getting into a relationship other than the therapeutic one is likely to result in the therapist taking advantage of the client.

What to do about this situation generally is up to the client, not the new therapist. Laws could, of course, be different where you live but second relationships with clients are considered unethical most everywhere.

More on this is here and info on what counseling should be is at Counseling as a novel relationship.

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

Pink elephants kill – Dangers of Delirium Tremens (DT’s)

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

Inebriated people.

Alcoholism.
Photo courtesy of Pixabay.

Seeing bugs when drinking?

There are lots of jokes about people seeing things while drinking. Having Delirium Tremens (D.T.’s) is no joke.

Withdrawal from alcohol can be fatal. When we mention withdrawal from drugs most people think of the physical symptoms of heroin withdrawal. Kicking Heroin can make someone wish they were dead, but alcohol withdrawal is far more likely to kill.

Deaths directly related to alcohol each year exceed all the deaths from other drugs, legal and illegal.

DT’s occur when the drinker is withdrawing from alcohol as the blood level is declining. Before modern medicine was available up to one-third of alcoholics with DTs died during withdrawal. Modern medical treatment has cut that rate dramatically but people do still die while sobering up.

If the drinker has EVER had hallucinations or a seizure when drinking or detoxing they need medical attention and should be detoxed in a hospital.

Other symptoms of DT’s can include fever, shakes, and formication. Tactile hallucinations, bugs or snakes crawling over the skin are commonly associated with the DT’s. These symptoms are sometimes worse at night and can begin to occur days after the last drink as the body attempts to adjust to the absence of alcohol.

Any unusual symptoms that occur when an alcoholic stops drinking should be checked out by a medical professional.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

What is Borderline Personality Disorder?

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

personality disorder

What is borderline personality disorder?
Photo courtesy of Pixabay.com

Bipolar or Borderline Personality Disorder?

People with Borderline Personality Disorder (BPD) experience intense emotional pain and lots of loss in their life. They never feel the faint breeze or the warmth of the sun in the springtime. For the Borderline the world is a place of hurricanes and scorching heat. Life is one horrific storm. They experience terrible loss. BPD may result in interrupted education, ruined or unstable relationships, and frequent job loss.

BPD can look like Bipolar Disorder but while the Bipolar person may have months of depression and long periods of elevated mood or irritability the BPD person has all those mood changes in a single day.

Borderline Personality Disorder (BPD) is an often overlooked and misunderstood mental health issue that gets placed under the heading Personality Disorders. BPD is coded on Axis II and viewed as long-standing and difficult to treat. Personality disorders often co-occur with other mental health challenges such as depression and Bipolar disorder. Because of the notion that a personality disorder is difficult, if not impossible to treat, there is a reluctance to give clients this diagnosis.

Untreated BPD is viewed as a “pervasive” or inflexible pattern in life and includes four characteristics, unstable relationships, fuzzy self-image, impulsivity, and lots of negative emotions. The DSM lists 9 “criteria” or symptoms the client might have but only requires 5 of those nine symptoms to make the diagnosis. In practice, this means a lot of judgment calls.

Most people with Borderline Personality Disorder have some but not all of the “criteria” for the disorder. Gunderson suggests in his book that there are three distinct Levels of Borderline Personality Disorder based on the nature of your relationships with others.

Children experience some mood instability as a normal part of growing up. We expect some BPD characteristics that will go away as they mature. As a result, children are almost never given a personality disorder diagnosis. When the BPD picture seems to be developing, the child may be described as having “Borderline traits.”  Those with untreated BPD generally do not get better with age, the pain they experience grows.

BPD begins in early adulthood and those “characteristics” or “traits” need to occur in multiple situations. This disorder, when treated, generally fades as the person gets older. Women make up 75% of those who get BPD diagnosis and frequently had a diagnosis of Bipolar Disorder prior to being diagnosed with BPD. This disorder is probably underdiagnosed in men because men act out, break laws, and get caught abusing substances more often than women. These other problems get diagnosed first and become the focus of treatment.

Treatment for Borderline Personality Disorder is effective in reducing symptoms. Ten years after treatment half of those diagnosed with BPD no longer have enough symptoms to receive the diagnosis though they may continue to have some Borderline “traits.”

There appear to be a number of Causes of Borderline Personality Disorder. Some of the symptoms of BPD are adaptive behaviors that may have worked to protect you and get your needs met when you were younger but as you grow up these behaviors no longer work.

Abandonment is a key issue for those with BPD. They need someone in their life and can’t stand being alone but fear being rejected and abandoned. They are constantly on the lookout for signs of potential abandonment. As a result, they may appear needy and drive people away. Their impulsive behavior creates exactly what they most fear.

Someone with BPD is very sensitive to their environment. When things do not go well in relationships they blame themselves and may “take it out” on themselves. Self-mutilating, cutting, burning, and suicide attempts are common.

Because of their terrible need for a supportive relationship BPD individuals tend to jump into very close intimate relationships without getting to know the other person. As a result, they over-trust people who should not be trusted and expect more from partners than another person can provide. Once disappointed they become furiously angry. They are often demanding in relationships and need lots of time with their partner. They may have violent emotional reactions when their partner attempts to leave for work, school, or errands.

Sudden changes in their opinions of others are common. When let down by those in their life they respond with lots of anger, sarcasm, and bitterness which only drives others farther away.

Many individuals with BPD report they don’t know who they are other than by adopting the values of those around them. They may have sudden changes or difficulty identifying values, goals, or career plans. They often self-sabotage. It is not uncommon for someone with BPD to quit school just before finals or leave a job just as they were about to get a raise or promotion.

Living with Borderline Personality Disorder is a horrific challenge for those with this condition and it challenges those who would like to be in a relationship with the person with a Borderline condition. While treatment is never easy it can be effective and result in creating a happy, fulfilled, and connected life.

Other posts on Borderline Personality Disorder include:

What is Borderline Personality Disorder?

What causes Borderline Personality Disorder?

Levels or types of Borderline Personality Disorder

Treatment for Borderline Personality Disorder

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Can one person be a support system?

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

Support system.
Photo courtesy of Pixabay.com

How many people make a support system?

Morning Question #16

Having a close, significant person as a support system can be extremely helpful. People with a serious and persistent mental illness who are in a long-term supportive relationship are less likely to end up back in the hospital. There are several reasons why a one-person support system is risky for them and for you.

Expecting one person to carry the full load of supporting you is an awful lot to ask. It is too much for someone to care for your needs and to be in a close relationship with you. How does that person get their needs met? If you need a support system, can you be fully present to meet your partner’s needs? Having people other than your partner in a support network increases the support you can call on and avoids pushing that one person who is around you all the time to the breaking point.

More people in your support system spreads the burden around and increases the joy of being able to help each other. Building a support system is important, so is making sure they are supportive.

Support people are often relatives or close intimate partners. Having someone to love and who loves you can be very supportive. No relationship is ever conflict-free. If you and your partner have a disagreement, if there is a fight, you risk your support system being unavailable just at the time you most need one.

We tend to be attracted to and close to people like ourselves. There is no reason why two people who have depression or any other mental illness can’t be in a relationship. If your partner has issues also they may not always be available or able to cope with your issues.

Too many people in your support system may be just as much of a problem, as too few. It is difficult to stay in contact with many people. A support person should be someone you know well and who knows you well.

How many people do you have in your support system? How many do you believe would be ideal?

Other posts about support systems can be found at:

How supportive is your support system?

Support meetings for family members?

How do you develop a support system?

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