Do people with problems not want to change?

By David Joel Miller.

Why do they say that people with problems want to be that way?

Disabilities

Not want help?
Photo courtesy of Pixabay.com

Lots of people, with varying problems and disabilities, seem to be dismissed with the expression that the reason for their problems is that they do not want to change. Is there any truth to these claims and why do we hear this so often?

First, let me give you a list of the things I have heard recently. Some of this comes from professionals, some from the news media and some from just average people. After the list let me tell you why I think we are hearing this more these days and lastly what we should be doing about this.

People with depression are using this illness to avoid doing anything.

Fat people don’t really want to lose weight.

There is no such thing as mental illness, those people just want to get on disability.

People who say they have anxiety are just trying to get other people to take care of them.

The homeless prefer to live out on the street.

Drug users do not quit because they want to use.

The unemployed are unemployed because they do not want to work.

There are many other forms of these statements, but mostly they seem to me to be ways of dismissing people with problems by blaming them for having those problems and then saying that they are unwilling to change.

So why if obesity, homelessness, unemployment, loneliness, drug addiction and mental illness cause all that pain, do people seem to so strenuously avoid doing exactly the things that would change their situation? Doesn’t it look sometimes as if people with problems really do not want to change or they would?

Turns out that change is far harder most of the time than doing nothing.

I can see why society and people who work in the helping fields could start blaming the people with the problems for their lack of progress. As long as we can blame them we do not have to think that our programs and policies might be letting the suffering down. It is easier to think that the homeless like to be out there in the cold, the rain or the snow, than to really try to tackle those issues.

Why do we blame those with problems for those problems?

Turns out that change is hard for humans. We learn a certain way of coping and then we continue that coping style over and over. Even when we come to believe that what we are doing is not working, deciding to do something different and then carrying through on that decision is difficult. People in these situations sometimes have to give up everything they have to reach for something else. Here are some examples.

Unemployment is rarely a choice.

If I think that unemployment is caused by a lack of jobs, I might get scared I could end up out of work. If I can convince myself it is because they don’t want to work I can pretend it won’t happen to me.

For a huge stretch of time since World War II here in the United States, we have had growth and expanding employment. There have been ups and downs but overall more people work as time goes on. There was a time when any able-bodied person who wanted to work could find a job. Recently we have seen a trend, there are jobs available, but those jobs require advanced skills and are often in distant places.

Many who are unemployed lack the skills needed to get a good job, they may live in places with high unemployment and as a result become seriously depressed. When you are depressed doing anything can be at the limits of your abilities.

For the homeless shelters may mean giving up all you have.

If you are homeless, most of your friends and partners are homeless also. If you have a boyfriend or girlfriend you need to leave them behind. Your pet? That dog that kept you warm and comforted you on that cold night? That animal goes to the pound. There are few places a homeless person can take their partner or their pet.

While in the homeless shelter you need to be there in the early afternoon and leave in the early morning. Getting to and from the shelter takes up the whole day. Your life begins to revolve around being a recipient of a place to sleep.

When you have next to nothing you use what tools you can find to cope. Many homeless people drink to dull the pain, physical and emotional. Without an address, it is hard to get into medical or psychiatric services.

Homeless programs often require that the people they house stop alcohol and drug use altogether to get housed. It is easy to say that the homeless do not want housing and harder to recognize that they may not be willing to give up friends, relationships, pets or other coping mechanisms to fit into the requirements of a given program.

Obesity is about more than just eating less.

Once upon a time, we idolize the person with some meat on their bones. When food was scarce the healthy, those who were not emaciated, made it through the winter to live another year. Then times change, food became instantly available, and the ideal change.

Weight loss has become big business. Despite a quizillion diet books and weight loss programs, the rate of obesity in America continues to climb. Food is available on every corner. Fast food and food available 24 hours a day in any season. The result of this increased availability of food has not been better health but more unhealthy food.

Most dieters learn all too rapidly that the minute you relax your diet the weight returns and brings a few pounds of extra fat with it. With the weight gain comes physical ailments. Exercise is harder the more weight you need to lose. The modern solution? Surgery to reduce the body’s ability to hold and process food.

The mentally ill are likely to be told to just snap out of it.

For most people who have a mental illness snapping out of it is only slightly more difficult than growing a few inches because you should be taller.

When you have depression, severe major depression, getting out of bed in the morning is an all-day task. This is not laziness, it is horrific work to make yourself do something that you lack the ability to do.

If you have an anxiety disorder, the most common mental disorder in America, you are likely to be told to just not worry about it. If you go for treatment those of you who have social anxiety can look forward to spending hours in crowded waiting rooms with people you do not know and with whom you wish you did not have to spend time.

I know there are exceptions. Programs to treat anxiety that are small and personalized. But all too often treatment programs are organized to meet the needs of the system, not the individual.

The truth is that those with problems no not always use programs, not because they like things the way they are but because they are being asked to do more than they are able to in order to access those helps that most of the rest of us take for granted. We need to stop blaming the sufferers for their illness and look for solutions that work rather than create more programs that fail the people they are designed to serve.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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Under-housed and almost homeless in America

By David Joel Miller

Sometimes homelessness wears disguises.

Homeless and Under-housed

Homeless and Under-housed.
Photo courtesy of Flickr (waferboard)

We here in America have slipped into a shared fantasy. There are the homeless and then there are the rest of us. It would be reassuring if there were only those two kinds of people and if we could somehow pretend that the majority of us would never be homeless.

The truth is that many of us are at risk of becoming homeless. Homeless for many does not spring up overnight. It can begin as a slow slide off the cliff and into the deep waters of hopelessness.

Most of us are only 30 days away from being homeless. Lose your job or other sources of income and the eviction proceedings begin. You can try to starve it off as long as possible, borrow from friends, max out the credit cards. You try one thing, then another. But unless the money flows in again the slide to the street begins.

There is this shadow thing here in America – the under-housed.

Many stop off here on their way to the homeless encampments.One reason it is so hard to get a handle on homelessness is because people slip back and forth between being without a home, the out on the street night after night and the short-term stay places.

The slide towards homelessness can begin when suddenly you have to leave the place where you stay. Couples fight and break up. There may be domestic violence or addiction. One partner, often the woman has to leave suddenly. So they go stay with friends and relatives. The intention is to be there for a while until they can find permanent stable housing.

These stays may be temporary. The people who took in their friends or relatives only have so much space, so much money. Eventually the under-housed have to leave and move on.

Couch surfing on the way to being homeless.

Repeated moves can become “couch surfing,” a night here and a night there. You may be able to afford a motel for a night or two. Eventually, this gets expensive. Expensive beyond many people’s means.

Sometimes they are able to stay longer. We find two or more families living together in a house or apartment not designed for much more than a single person.  Not because they want to live in crowded conditions, not because they are cheap, but because they have no income or only limited funds and the cost of permanent housing is beyond their reach.

Families with small children may come apart.

One child stays with grandma, another with an aunt. But there is no place for mother and children together.

Some of you are saying there are programs for the homeless, why don’t they go to the shelters? Plenty of nights the shelters are full. There are waiting lists and programs may need your contact information. Some programs require a background check. Where do you stay while you wait to qualify for those programs?

If they do find logging in a woman’s shelter, dad or child’s father can’t come.

Women are at high risk to hook up with a man, most any man, in order to have a roof over their head and food for them and their children. Most of these relationships do not last. The cycle repeats.

Before we congratulate ourselves on the efforts to place the homeless into permanent housing, we need to be ever aware of the host of almost homeless who on any given night might end up down at the local encampment.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is the Drug of choice among the homeless?

By David Joel Miller

So which drug does the majority of the homeless use?

Day in the life of the homeless

Day in the life of the homeless.
Photo courtesy of Flickr

Being homeless is one problem. Most of the homeless have a whole raft of problems. It would be nice to think that if they just got a place to stay, move them into a shelter, then their problems would go away. It is more complicated than that. Drug use also plays a role. You may be surprised at the relationship between drugs and homelessness.

It is more complicated than that. Drug use also plays a role. You may be surprised at the relationship between drugs and homelessness.

Homelessness, mental illness, and drug use run in packs.

Among the homeless, there is a disproportionate number of the mentally ill. These are people with serious and persistent mental illness. By serious and persistent mentally ill, I do not mean that they are beyond hope and incapable of recovery. Many very seriously impaired people do recover. But being homeless and having a mental illness makes the road of recovery that much more difficult.

The question is “Do we as a society have the collective will to help them recover?” Can we create the path back to society that they need? I fear that as a society most of our efforts are to keep them out of sight rather than to welcome than back to society.

People who are mentally ill, homeless or not, are more likely to do certain drugs. They use them to control or manage symptoms and the use to forget and to cope. The mentally ill use one drug in particular more than the rest of society.

Beyond mental illness, there are other problems for the homeless. Drug use yes that is one. I’ll get to that in a moment. They also have a host of medical problems. The mentally ill die significantly sooner than the people who are not symptomatic. Their most preferred drug shortens their lifespan dramatically.

Note that I did not say the non-mentally ill. (Or the normal, who knows what is normal?)

We know that there are many people with less severe emotional problems who when put under enough stress can show signs of a mental illness.

As I have said before, I do not get fearful working around someone with schizophrenia. What makes me really scared is the “normal” person who is served with divorce papers or has just found out their partner is cheating and then this enraged person shows up at a workplace with a gun.

These adjustment disorders, untreated are a lot scarier than the persistently mentally ill. But I digress.

The homeless, often with a mental illness, and being homeless can cause depression and anxiety in the most stable of people, they have severe medical issues. The only source of treatment for many is long waits in hospital ER’s, at a huge effort for them and a huge cost to society. Their drug of choice makes their medical issues more acute.

By drug, I do not mean prescribed medication. Most homeless have difficulty getting a prescription and if they do have one taking it consistently is unlikely.

The homeless and the mentally ill everywhere are more likely to be the victims of crime than the perpetrators. When they do have prescribed meds they are likely to get lost or stolen during the course of life on the street. Lots of things get lost or stolen when you are homeless.

So which drug is the drug of choice among the homeless?

Tobacco, nicotine is the drug of choice among the homeless, followed arguably by alcohol. They pick these drugs because they are cheap and readily available.

The numbers with respect to smoking are staggering.

Three of every four homeless smoke, you heard that right, 75% of the homeless smoke. Rates of smoking among those with a psychosis are very high.

A homeless person is FOUR times more likely to smoke than someone who is not homeless. The homeless are dying from smoking-related illness at rates far above the rest of the population.

Helping the homeless with smoking cessation, alcohol abuse treatment and treating the health-related problems these two legal drugs are creating might go a significant way towards helping the homeless on their path to recovery.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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

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

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

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

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

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.