Are you the Passive Aggressive type?

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

Couple fighting by not fighting

Passive-aggressive.
Photo courtesy of Pixabay.com

Who is the Passive-Aggressive?

There has been some discussion recently on the internet and elsewhere about people who are “Passive-Aggressive” how you deal with someone who is Passive-Aggressive and so forth.

What exactly is a “Passive-Aggressive Person” and how might this passive-aggressive personality be affecting you?

Turns out there are at least two somewhat different activities going by the name of Passive-Aggressive behavior.  On the subject of Passive-Aggressive Personality, psychology and mental health are not on the same page. There are not just separated and divorced on this one but living in different time zones.

Psychology has studied the way people may behave and do they have Passive characteristics or Aggressive characteristics. They used to think of these two as on opposite poles of the same axis.

Then it was suggested that some people combine both into a Passive-Aggressive style of dealing with conflicts. There were also some studies of whether these were stable traits, people did this all the time, or were these states, that the person might use a particular way of behaving in response to a specific situation and at one time but not another.

Mental health started looking at this as a potential mental illness, Passive-Aggressive Personality Disorder, which was causing problems in people’s social lives or in their work settings. The result of these two different perspectives is that the two fields came to differing views about Passive-Aggressive personality.

How did we get to a place where some professionals are writing about Passive-Aggressive people as if we all know what that is and why, while other groups have told us to drop the idea altogether?

Is a passive-aggressive person all bad or are there times when this is a useful way of behaving?

The idea that there are “Passive-Aggressive people” seems to have originated during World War Two when officers noticed, and then they complained, that they might give orders but the men just did not get around to doing what they were supposed to do. The result of this behavior was that the men got out of doing things and sometimes they communicated to a superior officer that they did not like that officer.

One example of this might be an officer who had the men dig a ditch one day and then had them fill it in the next. I suppose that the officer could argue that this is teaching discipline and is keeping the men active and fit, but the men soon caught on and found that there was no reason to put much effort into this ditch to nowhere.

This concept, of the person who is told to do something but then deliberately does it poorly or not at all, has also been applied to employees in the work setting. Some bosses like to think of themselves as generals or in other military terms. They talk about commanding their employees. You can make a good argument for the need of people in the military to carry out an order regardless of whether they agree with the order or not. It is harder to see why bosses give some orders that just make life harder for their employees and do not create any extra production.

The result of these irritating directives from management can be work slowdowns, stoppages, or people who just forget to do things. Sometimes it is hard to tell the difference. Some jobs take longer to do than planned. Sometimes people do forget. So the interpretation of “is this a Passive-Aggressive act” has to do with the motivations or intent of the employees, not with the resulting action or inaction.

This Passive-Aggressive idea was expanded to include children who did not do what adults asked. I still see this version in articles about our educational system. The student is told to move something but they drop and break it. Or they get the instructions wrong and go to the wrong place. Sometimes is as simple as them saying yes to doing something but then just sitting in their seat and doing nothing. The complaint by teachers is that the student may be saying yes but their actions are sabotaging the outcome.

One other place this is coming up, and here we are bordering on the mental health arena is in the field of marriage counseling.

One partner will refer to the other as passive-aggressive. Say the wife has a job interview the next day, she is busy getting ready and she asks the husband to stop at the grocery store on the way home.

He gets home late that night and reports he had a problem at work and “forgot” to stop at the store. This may lead to an argument and then either they eat leftovers or he goes to the local fast food for dinner. She is annoyed.

Next morning she goes to use the car for the job interview and finds that the gas tank is empty. She is now furious at him. Her conclusion is that he was late and left the gas tank empty to sabotage her efforts to get a job. Before long both partners may be “not doing” and “forgetting” to get their revenge on the other partner.

So from these examples, we can see why some people may do things that look Passive-Aggressive and that this can be really annoying if you are on the receiving end of this behavior.

This is also a hard thing to cope with because the person who is behaving in a Passive-Aggressive manner has all kinds of excuses for why they did not get things done or why they made a mistake.

Does that mean that someone who is acting in a Passive-Aggressive manner has a mental illness? Why do they do this and how can you get them to stop? And can Passive Aggressive behavior sometimes be a good thing, at least for the person who is using it?

Let’s take a look at all those issues in an upcoming post about the reasons people might adopt passive-aggressive behavior.

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

4 reasons your self-improvement program will fail

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

Changing your life

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

Self-improvement programs fail when you set wrong goals.

Another year, another bunch of resolutions, and by now most are headed for the same old failures. The reason most self-change programs fail – wrong, fuzzy, and poorly defined goals.

Most resolutions are made with little or no thought about where you are going and how you will get there. If this new you is not worth the trouble to plan, then it probably will not be worth the effort to take action, and next year, long about this time, you will be in the same place you are now.

What are the specific things you need to think about if you want your plan to succeed?

1. What is your goal?

Set the wrong goal and you end up at the wrong destination or you don’t get anywhere at all. Fuzzy goals lead you around in circles.

A common form of resolution this time of year goes something like:

I want to lose weight, exercise more, get in shape, and improve my health.

Some of these goals may conflict. One easy way to lose lots of weight is to get sick, physically, or mentally. Worry enough or get really depressed and you may stop eating. Good for weight loss but not for getting healthy.

Exercising more may result in that fat being converted to muscle. You will be healthier but may not lose any weight.

Improving your health may involve seeing a doctor, getting your flu shot, and a lot of preventative screening tests. Hard to do when you are starving yourself and running marathons. Severe calorie restriction and aggressive exercise may result in a hospital say, not really what you had in mind when you set your goals.

Second goal problems example.

You decide you want to be wealthier. For most people, this means wanting to be able to afford to buy the things that you or your family wants. So you work harder, take a second job, save some money and then you buy your kids that new video game console they wanted.

One problem – now you are broke again and you are working more hours than before. When most people say they wish they were wealthier what they really mean is they would like to be able to spend more. The wealthier goal self-destructs the closer you get to it.

To build real wealth you need to scale back your consumption and save. That is exactly the opposite of what most people mean when they say they want to be wealthier.

Getting really clear on your goals can improve your chances that this year’s resolutions have some chance of succeeding.

2. How big a priority is this goal?

Many people set goals that sound all nice but they are not really committed to getting there. If you would like to lose weight or get richer, as long as you do not have to actually work for that goal, there is little chance of you arriving there.

To make achieving a goal a reality it needs to be something that you want more than you want other things. Do you want that goal enough to give up time on the couch? Will you forego spending or eating something to reach that goal?

Just how committed are you to this thing and what difference will it really make in your life if you get there?

3. Is the goal consistent with your values?

You value time with family, especially those family get together dinners. That time with family is pretty inconsistent with working more, spending less, and improving your finances. Those entertaining times are also inconsistent with losing weight.

Despite these inconsistencies, lots of people will say they want things mostly because they would like the praise of others for getting to this goal even when that goal is in direct conflict with their personal values.

4. Can you see clear benefits in reaching this goal?

Some things are kind of nice to have but really getting them will not change much in your life. Unless you can picture yourself reaching this goal and visualize how your life will be better off for having made the sacrifices needed to get there, you are not likely to be motivated to do the work.

So consider now, as the first month of 2014 is well underway, what happened to those New Year’s resolutions? Did you get clear on what you wanted and how that is influenced by your values? Can you see this goal becoming a reality? And most of all is this change thing something you are doing for you or is it something you think you should do because of what others will think about you?

Are you one of the rare ones who decide to make a change and then does the work to get there? Maybe we will check back in about a year and see who has made a success of their change plans.

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

Wrestling unruly feelings to the ground.

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

Man with feelings

Managing feelings.
Photo courtesy of Pixabay.com

Getting misbehaving feelings under control is a three-step process.

It would be nice if you could keep these pesky feeling-gremlins out of your house and your life in the first place but somehow they keep getting in.

There are techniques for regulating which feeling you let into your place and which you choose to entertain. Those techniques for controlling access to your life are something that we teach and practice in doing Cognitive Behavioral Therapy. More on that later.

Not all negative or painful feelings need to be banished. Some feelings, sadness, anxiety, or loneliness are like distant relatives, fine in small doses, nice to see occasionally just to remind you who they are, but not someone you want moving in and living with you full-time.

But for now what if you discover that some unnecessary negative feeling has taken up residence in your life and you decide this is not cool with you. What do you do?

1. Find the feeling.

This can be a struggle at first. Unhealthy feelings can be like termites. You do not see them but all the while they are eating away at your mental health house.

We often are unaware of what feelings have moved in and taken over our lives until they have begun to be destructive.

Recognize that you are feeling something is the first step in getting these creatures to do our bidding.

Yes, feelings have their purpose. That pain in the neck feeling is telling you that this person is not a healthy relationship for you. Anxiety, that one is trying to keep you safe. If your anxiety tells you to duck when there is gunfire, then it is doing its job. If it tells you to stay home because leaving the house is too scary, tell that anxiety to take some time off.

Makes sure to check all around your body for those feelings. They may be hiding in the pit of your stomach or in your lower back. Not all of those aches and pains are real, physical pain. Some of those are pesky negative feelings that have moved in and are cramping up your nerve cells.

Get those feelings located and you may be able to get them to move to where they can do you some good.

2. Name that feeling.

Women seem to have a genetic advantage here. They have all kinds of feeling words. We men usually are only acquainted with three feelings by their first name. We are “good, bad, or pissed off.”

Learn the difference between excited and anxious. Get to recognize the difference between rage and it’s younger, smaller, sibling irritated.

Getting the right name on the feeling can help you get them to stay where they belong.

3. Apply your feeling control techniques.

There are whole books on how to control or make use of particular feelings. The one that gets the most press is the feeling of anger and its larger relative rage. Those two do a lot of damage.

Learn those ABC techniques for changing the way you interact with those feelings and you will find them better behaved. SAMHSA publishes a cool book on anger management available free from their website. Lots of programs use that book and others.

In CBT therapy we find that it is not always the feeling that is causing the problem. Your beliefs about why people are doing things may be generating lots of extra negative emotions.

Make sure you invite in lots of positive feelings. Having a huge gathering of happiness, acceptance, and patience makes those anger and anxiety feelings uncomfortable enough that they may leave. At least they will hole up in their room and not bother the rest of your feelings.

Are your feelings well-behaved, or do you need to do some work on emotional regulation, getting those feelings back to working for you instead of the other way around?

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

How are children’s substance abuse problems different from adult addiction?

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

sign

No Drugs.
Photo courtesy of Pixabay.com

There are some differences between the substance abuse issues in children from those in adults, but they may be less than we used to think.

There are a lot of people who continue to think of substance abuse, addiction in particular, as an adult disease. That would be way wrong.

Most adults with a substance use disorder began their use at a young age. Seventy-five percent of all disorders, mental health, and substance use, begin before age 24. Half start before age 14.

Kids are getting into drugs and alcohol abuse earlier than most adults realize.

Larger treatment facilities will tell you about children as young as 5 that already are developing signs of alcoholism. Children frequently report that their drug use began as early as age 8.

That’s right folks, as soon as the end of the third grade we are already able to identify children at risk to develop an addiction, going to prison, or both.

Are there “Gateway drugs?”

There used to be much discussion of so-called “gateway drugs.” The idea was that up till you tried the gateway drug you were not at risk of becoming addicted. Once you take the gateway drug you are on the path to addiction. The drug that got blamed the most as a “gateway drug” was marijuana. While I think letting your third or fourth grader smoke some of your “medical marijuana” is a way bad idea, it has turned out that for most adult addicts that was not the gateway drug.

One reason that marijuana was implicated was that it was illegal. That meant that to procure marijuana in the first place you had to be breaking the law. Someone who was selling marijuana illegally and risking jail might also be selling other “harder” drugs. Breaking society’s rules on substance use is a bad direction to start out on, but there is more to the story than that.

For most children, the gateway drugs have been cigarettes and alcohol. Consider the cost to society of a child who starts smoking at an early age. There is good evidence to show that after trying that first cigarette if the child lights up a second one they are going to be smokers for life.

Look around any homeless encampment, any old-time A.A. or N.A. meeting or the public hospital emergency room and you will find a lot of smokers. Nicotine has been reported as more addicting than heroin. I have heard people in recovery from drug addiction say that it was harder for many of them to kick cigarettes than to kick the heroin.

Alcohol is also a severe problem for children.

The younger they start drinking the larger the risk. Some people have argued that there are places in Europe where children begin drinking at a young age and do not develop any higher rate of alcoholism than we do with a legal drinking age of 21. The biggest difference is that in those cultures children learn to drink a small amount with meals and as part of a social occasion.

Here in America, the tradition is that when you drink – drink all you can. These drinking occasions are times when a bunch of people are out to “party” and alcohol is a large part of that. The result is that children, teens, in particular, learn to drink heavily and to drink to get drunk. You do not take your grandparents to the party with you.

Drinking to get drunk, binge drinking is, of course, the riskiest way to drink.

Younger substance abusers go for cheap or easy to get substances. They are more likely to sniff paint or glue. They are also less likely to understand how risky a substance is; hence they go for synthetic drugs because they can get them without breaking a law. What they miss is that these drugs are “not for human consumption” for good reason. Some of these synthetic drugs can cause permanent brain damage.

Back to that gateway argument. It appears that it is not the fact that a drug is illegal, as in the status of marijuana in the past, but the fact that it is “illicit” that the child is sneaking to do something they are not supposed to do, that predisposes them to greater risks down the road.

One thing we miss is the relationship between substance abuse and crime. This is not solely the rule for adults. Children of any age who drink or do other drugs are more likely to do other crimes, behave in anti-social ways, and get into trouble.

One report said that on the order of 80% of all those in prison here in California were drunk or high in the 24 hours before they did their crime.

There is no doubt that being under the influence disinhibits you. Drug use also means you need money and that may lead children to do crimes to pay for their drug and alcohol activities. It is hard to keep asking mom for drug money unless she is also in the drug game.

Drinking and drug use may look different in youngsters than in their older compatriots but addiction and alcoholism start in the young and just keep getting worse.

As a colleague of mine keeps reminding us – any drug use by an eight-year-old is a problem.

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

First night of Drug and Alcohol Classes

By David Joel Miller.

Drugs.

Do drugs cause mania.
Photo courtesy of Pixabay.

Tonight is the first night of classes here at FCC.

One activity in my busy schedule that I thoroughly enjoy is the opportunity to teach Substance Abuse Counseling classes at Fresno City College.

The program here is accredited by the California Association of Drug and Alcohol Educators (CAADE) and leads students towards becoming registered and then certified drug and alcohol counselors.

The program includes 36-semester units of classes in Drug and Alcohol use disorders, recovery, and the work of counselors and social workers. A few students from the 4-year college show up in these classes because this program contains more information about Substance Use Disorders than most Masters or Ph.D. programs.

We see students in this class who want to be drug and alcohol counselors. There are often also social work majors, nursing students, criminal justice majors, and a smattering of people who are in early recovery and know they need more information on Substance Use Disorders to be able to decide what career is right for them.

All these majors are welcome. I try to emphasize that first night that no matter where they work there is a strong possibility that they will encounter people with substance use disorders. They will also if they see substance abusers see mixed in with those clients a lot of people who have emotional or mental health issues.

For those of you, who are not able to take classes of this nature, consider some reading on the topic of substance use disorders, (The A.A. big book is a good place to start.) Also, consider taking a Mental Health First Aid (MHFA) class if one is offered in your area. If there is not one close to you, encourage your local officials to get an MHFA training scheduled for your locale.

Teaching, while enjoyable takes a bit out of my time so the posts may come a little farther apart and the replies to your questions and comments will take a little longer but know that I values all your input and will get back to you all as quickly as I can.

  • Are you a Functional Alcoholic? Do you know someone with an Alcohol Use Disorder? (counselorssoapbox.com)
  • How to control your drinking (counselorssoapbox.com)

    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

How is youth mental health treatment different from adults?

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

Crying child

Youth mental health.
Photo courtesy of Pixabay.com

What are the differences between youth and adult mental health treatment?

There are differences in the way a counselor might work with a child and how they might work with an adult. How to “treat” a mental health problem is a complicated subject. It needs several books to fully describe this, but let me focus here on just a few things that may influence how a professional might try to help with an emotional problem in a child.

The way a counselor works with clients is sometimes referred to as our “theoretical orientation.” How I see your issue determines how I might try to help you. I can’t speak for therapists of other theoretical orientations but I would describe my approach as largely Cognitive Behavioral Therapy, that with a dash of learning theory and occasionally a pinch of narrative therapy.

This stuff is largely “skills-based.” I figure that the client is trying the best they can but that there are things they may not know and if they knew them they could do better. I could try to tell them, sometimes that works but mostly they need some help it trying on new behaviors and seeing what works for them and what does not.

Lots of people have “stories” they tell themselves about them. By story I do not mean that this is either true or false, it just is the way that person explains themselves and their life.

That story might sound like “I am such a loser.” Or “I can’t do anything right.” Kids get one thing wrong and they may start saying that they are a failure. See how having a single story that describes you rather than the thing you were not able to do could color your life experiences?

So adults have more experiences in life and may have more ways of thinking of new stories for their life than a younger person. What I am saying is that I would try as much as possible to tailor my approach to the individual, not some specific category or label.

In career counseling, the approach would be very different in working with a person who had worked at lots of jobs and was just downsized than it might be with a client who was very young and had never had a job.

What are some considerations in creating a treatment for a specific client?

Age is only a small part of the picture.

I would want to know in addition to the client’s age something’s about their abilities and their life experiences. Age, I.Q, and developmental stages are all in the mix. So might things like learning disabilities, intellectual disabilities, and other developmental issues.

The approach for someone who has a form of Autism Spectrum Disorder might be different from a younger person who had a less severe challenge. The key, for me, is really getting to know the person and match my efforts to them rather than memorize a particular formula for a given age, I.Q. or disorder.  Here are some things a therapist might do as the child moves through the lifespan and becomes a young adult, a mature adult, and evenly an older adult.

1. Activities build relationships.

With adults, it is often possible to sit down and have a talk with them. The younger the child, the more the anxiety or the more “inside themselves” they are the more we need to work on forming a relationship.

One way to create that relationship is to do things with the client. (Yes even with a five-year-old I think of this person as a “client.”) How would I have wanted to be approached when I was that age? If I can’t remember ever being that age, I take a guess at what that might have been.

So the counselor might play a game, not to waste time but to get the client to feel comfortable. Even with very adult clients, I find they will say more about their lives when we are doing something than when they are sitting in a chair and I am cross-examining them.

2. Pictures versus words in therapy.

Very young people and some adults are better at seeing than describing, they just do not have the words to tell me their story. I ask them to draw me a picture. A rainbow tells me one thing and a tornado-like creature in black and red tells a very different story.

3. Skills training is important.

You need to practice skills if you want them to be there when you need them. Adults practice golf swings. Younger people may need to practice introducing themselves, making friends, and sharing appropriately. A whole lot of people tell me right up front they have an “anger management problem” they do not seem to understand that managing anger is a skill like most other things in life and you can learn that skill.

The younger or more impaired the person the more they need help in learning appropriate skills.

4. Involvement of your support system makes a difference.

With children or youths, I like to know the involvement of the support system. The more people on your side the better your chances. Some people have a parent or caregiver that can help the client through things. Other young clients have no one on their side.

Sometimes I am working on helping the caregiver to learn to help the youth and other times I am helping the client learn how to cope with their less-than-perfect caregiver.

There are a whole lot of specialized treatments for all sorts of mental, emotional, and behavioral problems that a child may experience. This post has not even begun to look at all those possibilities but I hope it has given you some small idea of the ways in which a professional counselor might be able to help a child or their caregiver through a child’s emotional problems.

If you work with children consider taking the Youth Mental Health First Aid training when it is offered in your area.

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 the mental health problems in children different?

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

Crying child

Youth mental health.
Photo courtesy of Pixabay.com

Age impacts mental health.

A reader asked “You keep mentioning children in your posts, how are their problems like or different from adult mental illness?

There are some differences between the issues children have and adults, but my experiences tell me that there are a lot of similarities.

We used to have a separate section for “Disorders usually first diagnosed in Infancy, Childhood, and Adolescence, in the DSM-4. In the DSM-5 those disorders get moved around. One problem with the old approach was that many clinicians missed the “Usually” part. We tended to think of these problems as something children get and adult problems as something only adults got.

That just is not so.

Some of these early-onset problems get missed or continue to plague people throughout their lives. Stress-related issues are a good example of this. Reactive Attachment Disorder may be easy to see in a small child but the after-effects can result in a bunch of problems that in adults we usually call by other names.

Just like the child develops, the mental health problems of that child may develop and change with time.

Also, it is very possible for children to develop problems that we used to think were only the providence of adults. Remember that “Happy childhood” myth. There must have been a few people with happy childhoods but there were a lot of people who did not get their ration of that one.

So children can and do suffer from depression, anxiety, stress, trauma, and a host of other adult looking problems.

We currently believe, I think for good reason, that the earlier in life we recognize some of these problems and treat them the better the chance that the person will not grow up to have a severe emotional disorder. That treatment, by the way, need not be medication or prolonged therapy.

Lots of other things can help these children. Anger Management and Parenting classes for unprepared parents also help. So do supportive environments like quality preschool or even grandparents or other supportive adults.

A disclaimer here – my perspective on working with children may be a bit different from other clinicians. My work with children has been largely in crisis settings, these kids were brought in because they said they were suicidal or they were way out of control. The other groups of children I worked with were substance abusing or those brought in for an assessment because someone believed this child has a serious emotional problem or a serious mental illness.

My experiences were with a group of children that may be more seriously affected by society’s problems. As a result, some childhood problems were probably not represented and others were way over-represented.

The problems that bring children to the attention of professionals change as they get older. The 3-year-old who is not talking is a way different problem than a 17-year-old girl who has been abusing drugs and is now suicidal because she found out she is pregnant by her 24-year-old boyfriend.

Both may have been the victims of abuse or neglect, so these very different “symptoms” may stem from the same or similar roots.

As a child gets older the way we should be assessing and the way we treat this “child’s” issues should get more and more like the way we treat adults. Mental health has had problems here for years as I see it. Some clinicians continue to treat adult clients as if they were mentally retarded or little kids.

One day you are 17 and you get the “now little girl” treatment and the next day you are 18 and you get the “grow up” lecture.

One other thing to consider when talking about the difference between adults and youth mental health issues is how to tell the difference between normal adolescent issues and those problems that could be the beginnings of a serious mental health issue. Just being a teen is, in and of itself, not a diagnosis.

Recently I attended a training to get certified as a Youth Mental Health First Aid trainer. I can’t begin to cover all that info here. If the issue of how to recognize mental health problems in young people interests you, you might want to check out that training.

The question about how the treatment approaches may differ between a young person with a disorder and a person who has accumulated more years, presumably an adult, that topic needs a whole other post.

Till next time, David Miller, LMFT, LPCC

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Why do so many substance users have mental illnesses?

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

Drugs.

Drugs.
Photo courtesy of Pixabay.

Why are co-occurring disorders so common?

We used to talk about addiction and think there were just a handful of people with that problem; we blamed them for their disorder. We now know that long before someone becomes addicted they can have serious problems in their relationships with substances. We now are talking about substance use disorders.

We talked for a long time about the “seriously and persistently mentally ill” as if they were somehow different from us. We now know that mental illness is on a continuum. Those emotional problems, depression, anxiety, stress-related issues, can overwhelm anyone.

Is it really that common to have both problems?  Why do we say now that co-occurring disorders are an expectation, not an exception?”

So far in my career as a therapist, I have worked with substance abusers. I have worked in locked psychiatric hospitals with those on an involuntary hold for wanting to kill themselves or others. I have also been able to work with adolescents in crisis.

In every one of these settings, the number of clients who had both issues was large. Why do the two problems so often exist in the same person? Here are some of the reasons that both disorders so often co-exist in the same person.

1. Two issues, substance use disorders, and a mental or emotional illness are relatively common in our society.

Far short of addiction there are plenty of people who attend DUI School, lose days of work, or get into arguments with their spouses as a direct result of substance misuse.

Most families have one or more person in them who has been so depressed or so anxious that they missed work or stopped participating in family and social activities.

2. Having a mental or emotional problem increases the risk of using and abusing substances.

People who are depressed or anxious often start drinking. At first, this works but over time the alcohol makes them more depressed and when it wears off they become more anxious.

The result of using substances to manage your emotions is that over time you need more and more and eventually, you develop a substance use problem.

Many people in substance abuse treatment will report emotional problems including being the victim of abuse or neglect before they developed the substance abuse problems.

The seriously mentally ill find the effects of smoking very soothing. They become heavy smokers. This increases the risk that they will develop health problems, end up homeless, and that their lifespan will be cut short.

3. Using or abusing substances increases the risk of developing a Mental illness.

Alcohol is a depressant. Not everyone who drinks becomes clinically depressed but some people do. The more you drink the more depressed you become. The more depressed you get the more you drink. This can be a rapid downward spiral.

There are connections between many other abused substances and developing mental illnesses. Stimulants increase the risk of psychosis and can increase sexual behaviors. The younger you are when you begin to smoke Marijuana the more likely you are to develop certain mental health issues.

I am not trying to take sides here on the “medical marijuana” debate, but note that smoking anything, dried lettuce or incense included, is bad for the lungs. There is also a developing body of research that says that CBD is better for medicinal use and THC is not. If you are smoking marijuana to “get high” you are at risk to develop problems with its use no matter what story you are telling others. (I think I wrote some posts on that one, note to self-see if those articles got posted.)

4. Substance abuse issues or mental and emotional problems results in a lifestyle where it becomes hard to get your basic needs met.

Both groups have an increased risk of homelessness. They are both at risk to become alienated from family and friends.

You have to do what you have to do.

The result of these lifestyle changes is that the substance abuser is likely to become depressed, anxious, or to be abused. The mentally ill person, to cope with their isolation or homelessness, may turn to alcohol or drugs to cope.

What you go through with either problem increases the risk that you will develop the other disorder.

5. There are emotional consequences to entering recovery.

The substance abuser often gets closer to their drug of choice than to others in their life. When they stop using or abusing they have to go through a grieving process that can be just as severe as a divorce or death in the family.

Users have told me that “women come and go but crystal is always there for me.” People let me down but (fill in the name of liquor here) is always waiting for me. Losing this one support can be a major obstacle in creating a new life.

People in recovery very much need a new support system.

The conclusion?

Having either a substance use disorder, or a mental-emotional problem, increase the risk of having the other. It is easy to get locked in a pattern when no one is supporting your recovery and your environment is supporting you staying sick. Change can be difficult but change – recovery is very much worth the effort.

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

Spiritual but not religious

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

Waterlily

Mindfulness and meditation.
Photo courtesy of Pixabay.com

What exactly does “Spiritual but not religious” mean?

A very large number of people here in America are describing themselves as “Spiritual, not religious.” There is a growing disconnect between religion and people’s day-to-day life.

As a result of this disconnect we are gaining some things, I hope, such as a wider appreciation of our differences, but we are also losing some things.

In secular programs, those run by government agencies, we try to accommodate people of all faiths and those with no faith. Sometimes this is a challenge. We have to ask people what their religious or spiritual belief is without implying that they need to have one or that the belief they have is not acceptable to the agency.

An example of accommodating faiths and other spiritual beliefs

There are a whole lot of people who are vegetarians, do not eat meat variety vegetarians, not because of religious or health reasons but because they view the killing animals for human food as morally wrong.

Our society seems to be doing a better job of accommodating this particular moral belief. More events are offering vegetarian meals.

It gets harder when we take into account that some faiths do not eat pork, some decline beef and some require particular diets as in kosher.

Beyond dietary restrictions, it gets progressively more difficult to accommodate other spiritual beliefs within our increasingly multicultural society.

During intake processes, we are supposed to ask about the client’s race or ethnicity. An increasing number of clients are finding it difficult to answer that question. Some people are reporting 5 or more different ethnicities in their background.

When talking with clients I try to make it a practice to ask about their spiritual or religious beliefs.

Say the client reports that they are African-American. This tells me nothing about their spiritual beliefs. We need to try to stay open to all manner of possibilities.

More and more people are finding it impossible to answer questions about their faith. We have to tread lightly here. I do not want to imply that they need to have a faith or that any particular faith is preferred, but I do not want to completely disregard their spiritual practices in designing their treatment.

Those few who do answer are resorting to one of two responses. I am a Christian or Spiritual But Not Religious. Most who say Christian do not self-identify with any particular denomination. They are not Catholic; they are not Protestant and so on. Some few report attending Non-denominational churches.

Most who self-describe as Christians are reporting, at least in my experience that they do not attend any particular church.

A very large number are reporting as Spiritual but not religious.

So why does all this matter? From a practical standpoint those who self-identify as believing something do better in treatment than those who have no faith. This benefit includes those who self-identify as Atheists if they also report some particular higher law or principle, say right and wrong, that helps them guide their life and is reassuring in times of stress.

One of the gains from this spirituality moment has been sets of values that people take with them day by day in all areas of their lives. I am suspicious of any faith that requires you to be a believer for a couple of hours each week, while in a particular building, but you are free to spend the rest of the week on raping, pillaging, and burning.

One of the things we are losing as a result of this increased emphasis on spirituality and the disconnect from religion is the loss of meaningful shared rituals.

Rituals give meaning to things that would otherwise be everyday actions.

Rituals are not solely the providence of the religious world. Court proceedings, with that robe, the bailiff, and the ritualized language, make the whole process seem more meaningful and as a result, are intended to increase respect for the law and the workings of the court. The ritual gives the process meaning. Occasionally the system debases the meaning when they do not follow the principles of justice these rituals imply.

Graduation ceremonies are a ritual we can all share to make the transition to another life stage. Marriages used to be a way to make the transition from being two separate dating people; to one committed couple. We still have the ritual despite the loss of meaning that a wedding has after having the parties have several children.

Funerals are also a ritual we all share that helps us negotiate the loss of a person who had some meaning in our life.

In places where there is one dominant faith, rituals are shared by virtue of people’s participation in that faith. With the decline of active participation in a particular religion and an increase in self-identified Spiritual But Not Religious, what has been missing are the rituals that used to accompany life events.

Creating new rituals.

People in recovery have resorted to creating new rituals that may help them to share the emotions and resolve the changes in status without invoking a particular religion.

Addicts may write a “Goodbye Letter” to their drug of choice. There are traditions of sponsorship that may replace the “rite” of confession in certain religions. People celebrate the anniversary of their embarking on the road of recovery.

One remaining challenge has been how to create meaningful shared rituals that do not impinge on people’s particular religious faith and allow full participation in the ritual.

Whatever your spiritual or religious tradition, here is wishing you the best possible life.

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

Top 10 Mental Health Blog posts of 2013

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

Counselorssoapbox.com

Here are the most read mental health blog posts from 2013, at least the most read posts here on counselorssoapbox.com

With over 700 posts now available here on counselorssoapbox.com, a few continue to be read and reread each and every day.

In case you missed any of these Mental Health or Substance Abuse posts the links are below. There are also a whole parcel of other posts, some of them very specialized. You might want to look through the library of past posts or try the search feature to look for things that are of interest to you.

Many of the posts over the last year were inspired by questions that you readers sent in and the comments you left at the end of posts. Keep those comments and questions coming. It helps me to know what you would like me to talk about next.

Every question or comment deserves a reply and please know that I wish I could get back to you all right away but this schedule, having to work and trying to write does not always allow me to post responses as quickly as I would like. Just know that I really want to tell you things that are accurate and that means some time researching things and thinking about them before I post that reply.

The work on the book I have been writing is accelerating and I hope to have more to tell you on that topic in the near future.

Without further delay – the top Mental Health posts on counselorssoapbox.com for 2013 are:

1. How much should you tell a therapist?  

2. Levels or types of Borderline Personality Disorder 

3. Do therapists have to report a crime? 

4. Do people really forget what happened when drinking? – Blackouts   

5. Which border is Borderline Intellectual Functioning on? 

6. Are you Hyperthymic?

7. Hyperthymia, Hyperthymic Personality Disorder and Bipolar Disorder

8. Is nicotine a stimulant or a depressant?  

9. Why can’t we forget the painful past?

10. 6 ways to recover from Complex Trauma or Complex PTSD

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