Tag Archives: Licensed Therapist & Licensed Counselor

Ca. Professional Counselors – CALPCC and LPCC’s

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

October CALPCC board meeting.

This year California became the 50th state to license Professional Counselors. The official designation in California is “Licensed Professional Clinical Counselor” LPCC for short. Other states had some form of professional counselor’s licensure before California, so we are still finding our way as this profession matures and adapts to California.

CALPCC, a non-profit organization, is the statewide organization for this new profession. Last weekend was the annual “retreat” for CALPCC’s board of directors which I was able to attend.

CALPCC has seen fit to appoint me to that board to fill out an open board member term. I am excited about this opportunity.

Some short recaps of what we talked about are below. Remember that as a new board member these are my impressions and that I can’t speak officially for the board. So any sentiments expressed are purely my own. Here are some of the questions that came up.

1. Why are Marriage and Family Therapists (MFT’s or LMFT’s) becoming LPCC’s also?

At least 4 of the CALPCC board members, myself included, are also licensed as LMFT’s so there was some discussion of why LMFT’s might want to also become LPCC’s.

My belief is that there are things that each profession does that the other does not do and to best serve my clients I needed to be trained in both areas.

Most LMFT’s work with couples, families, and sometimes children. Since I see some children, couples, and families I need to stay licensed, active and up to date in the LMFT field.

Much of my private practice is in individual counseling, particularly something I loosely call “men’s issues.”  LPCC’s are specially trained in things like career counseling and mediation. Sometimes this shades over into the area of life coaching. I approach these issues by trying to help clients solve problems that are causing social or occupational problems or interfering with having a happy life.

2. Why should someone join CALPCC?

Lots of counselors are already members of one or more professional therapist or counselor organizations. They asked why they should join another group.

My view is that if I was solely an LMFT I would need to belong to the one or two organizations in that field. Since I am also an LPCC I felt the need to join the organization that is specific to LPCC’s, which would be CALPCC. I chose to be a member of organizations in both fields and would recommend that to other people who are dually licensed.

3. What are the benefits of being a member of CALPCC?

CALPCC maintains a website. There is information on the website for anyone who is interested in the new Professional Clinical Counselor profession. There is also a member’s only area with additional information that is useful to LPCC’s that may not be of interest to non-counselors. Other professional associations also use this member’s only format for some of their website content to encourage those who use the resources to help pay the cost.

I recommend that if you are licensed or seeking licensure as an LPCC, you want to be a member of CALPCC and get access to the members-only content on the website.

4. Can LPCC’s bill Medi-Cal?

Not yet, but we believe this is coming and coming soon. At this point, there are only a few LPCC’s licensed in California. The last license number I heard was about LPC200. Those who are getting licensed now are people with previous other licenses who are getting a second license.

We were told that there is a huge pile of applications for the LPCC license that were mailed on the last day of 2011. BBS will be working on that pile for a while. By the time those licenses are completed and the BBS moves to issuing new licenses to people who did not have a previous license we hope that the Medi-Cal approval will be completed.

There are other federally funded programs in which LPCC’s are already being hired.

5. Can LPCC’s open a private practice and take private insurance?

Yes, they can. Who the insurance company place on their panel is up to each individual insurance company. I am on several panels and each one that I have looked at will take LPCC’s.

That does not mean that if you are newly licensed as an LPCC the insurance company will automatically add you.  Most insurance companies want to know they are sending their customers to someone who is reliable. They require providers to have a certain length of time in the profession before they add you to their panel. They also look to see if they have too many or too few counselors on their list for your area.

This is not insurance companies picking on the new LPCC profession. These rules have also been applied to existing LMFT’s and LCSW’s.

Most insurance companies I have looked at require you to have been licensed for 2 to 5 or even 6 years before they will consider you for their panel unless you have a particular skill they need on their list. So if you speak Russian and Swahili you may get on insurance panels sooner.

6. Should students join CALPCC now or wait till graduation?

I recommend that you join while still in school and read the members-only updates while you are preparing for your exams. This keeps you up to date on the latest events and trainings in your field.

Also – the CALPCC student member price is VERY reasonable.

Consider that the really good counselors and therapists do not stop learning when they graduate. If you want to be the best possible therapist or counselor you can be, stay active and up to date in your field.

If you are a client or an out of California professional forgive the very California LPCC specific post. The last two weeks have been extra busy for me. Shortly I will return to my posts on recovery, resiliency, and having a happy 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

How does Marijuana affect memory?

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

Marijuana’s effect on memory.
Photo courtesy of Pixabay.com

Does Marijuana use result in State-Dependent Learning?

In a previous post, I wrote about the concept of State-Dependent Learning (SDL), how things learned while you have a drug in your bloodstream may be better remembered when you have that same drug in your body. Readers have asked if Marijuana use results in SDL and what other effects does marijuana have on memory?

If Marijuana causes state Dependent Learning then we should advise people who learn things while smoking Weed to also smoke weed while or shortly before needing to use that information.

Will smoking marijuana just before a test help students who smoke while studying remember the facts better for the test?

Clearly, a great many things, mood states, drugs in the system, even the general health of the individual can affect memory. Unbiased information about the precise effects of Marijuana on memory and learning has been difficult to find.

There are a number of reasons for the contradictory reports of health benefits and harms of Marijuana we read in the media. I have been reading the research since my last post on SDL and here are some of the things that I have found.

Marijuana is more like a stew than a vegetable.

Marijuana contains over 600 chemicals including 60 to 70 Cannabinoids (another article listed 116). Two of the Cannabinoids have some research data but a lot of the other chemicals are poorly understood and have little research. All of the possible combinations of these 600 chemicals create unlimited possibilities for effects. That is not the only reason we know so very little about the effects of marijuana on memory.

How does it work?

For a long time, we knew that marijuana was doing something, we just could not find any receptors for the Cannabinoids in the nervous system so we did not know exactly what Marijuana was doing to the nervous system. Starting in the late 1980s and the early 1990’s receptors for Cannabinoids were found. But there are multiple kinds of receptors and they are located in some parts of the body and not others.

Many of the nerve cells that make up our “brain” are not in the head. When you are hungry the nerve cells in your stomach tell your brain that the stomach wants food. The same thing happens with Cannabinoids. Many of the Cannabinoid receptors are located in places like the spleen and the tonsils. So marijuana might affect memory for pain in the throat differently than memory for the history test.

Worse yet as we study the various Cannabinoids they don’t all do the same things. The two most widely studied Cannabinoids delta-9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) appear to do opposite things. THC seems to produce thinking distortions. The younger you start using THC the more likely you are to develop psychosis. CBD, however, has been proposed and tested as a treatment for psychosis.

One theory, on this contradiction, postulates that young marijuana plants have more CBD and less THC. As the plants mature they form more THC and the CBD is reduced. So if there is high THC, which is the cannabinoid that gets you high, then it has low medicinal properties. Plants with lots of CBD and that might be more medicinal don’t get you high. But most medical marijuana users want the kind that gets them high. What the other Cannabinoids are doing we are not really sure.

It depends on who makes the stew and how long you cook it.

One other problem with the research on Marijuana is that the concentrations of all the chemicals change depending on how Marijuana is grown and how it is processed or dried after harvest. Various studies on Marijuana may really be studies of all sorts of different chemicals, not just the Cannabinoid.

Recent research has tackled this problem by using pure synthetic Cannabinoids so when testing THC or CBD that is the only chemical being tested.

There are different types of memory and memory operations.

Short-term memory is info that is held in memory for a minute or less. Drugs, emotions even attention can interfere with the ability to take in information. Ever read something in a book and a second later realize you don’t remember what you read? This is a failure to encode information into short-term memory.

Marijuana, particularly THC, has been implicated in the failure to encode the information.

Working memory is information being processed. Some information can be distorted while in processing by the drugs in the system. Alcohol especially can make the drunken person think things are happening that in fact did not happen.

I have not found studies that suggest that marijuana (THC) is altering information processing but it is altering some other memory events.

Long-term memory is information held in storage.

The inability to find, access, and retrieve information is what State-Dependent Learning is all about. With SDL it is easier to retrieve previously stored information when the drug that was present during storage is again present.

Marijuana use has not been shown to affect memories formed prior to the use of Marijuana. It is not likely to help reduce PTSD symptoms or unpleasant memories of the past for more than a short time period.

So far no studies I have found indicate that THC improves the ability to locate the material that was previously stored.

Retrieval is the ability to find and pull up information.

If the information that you retrieve is inaccurate or incomplete this is a retrieval error.

THC appears to reduce the encoding of information so less gets into short-term memory and less is stored away.

THC is also reported to interfere with the retrieval of information.

Smoking marijuana while studying results in learning less. Smoking marijuana just before taking the test interferes with remembering what was learned.

Marijuana use (THC) does not create State-Dependent Learning and further use will not help recover memories of information learned while under the influence of marijuana.

There are plenty of people who smoke a lot of Marijuana and remember things just fine and there are people who do not smoke weed and have a poor memory, clearly smoking or not is not the whole answer.  But smoking weed has not been shown to improve memory or help retrieve previously learned information. It has been shown to interfere with the encoding and decoding of information.

Under the influence of THC, you will learn and remember less than you would without the weed.

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

Should I tell my therapist about Porn? Morning Question #21

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

Should he tell?
Photo courtesy of Pixabay.com

Talk to the counselor about porn?

Why? I would think they already know about it. The better question is – are you or your partner having a problem with porn? If this is something that is causing you problems then yes, by all means, tell the counselor about it.

Another reason to disclose the use of porn is if you and your partner are having relationship problems. Even if one partner does not think porn is a problem the other partner may. Viewing sexually explicit materials can create a false sense of reality. Internet porn is about pixels, not people. So if one partner in a relationship looks at porn and there are problems, sexual or otherwise, between the two of you, that porn watching activity is very relevant to individual and couples counseling.

Don’t be afraid or ashamed to talk about anything relevant to your problem. If you are having relationship issues of any kind then what you see portrayed as relationships in any media is relevant. If your therapist is unable to talk with you about this or is excessively moralistic or judgmental, then you just might have the wrong therapist for you.  See also Counseling as a novel relationship and posts about What the counselor can and can’t tell. The post about threesomes was written about bringing an addiction into your relationship but it is very relevant to porn or internet addictions also.

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

Do medications or drugs cause mania or Bipolar disorder?

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7

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

Drugs.

Drugs.
Photo courtesy of Pixabay.

A connection between taking medication, abusing drugs, and Bipolar Mania?

The question of connections between “drugs” and various mental illnesses is a huge concern.  We have known for a long time that there is a connection between some chemicals and Mania. The connection to Bipolar Disorders, formerly called Manic Depressive Disorder, is more problematic.

People seem to think that because a medication is prescribed by a doctor or can be purchased over the counter, it is safe. The huge increase in abuse of prescription medication has made us question that. Now there is evidence that not just street drugs but prescription medications may be setting off episodes of mania.

We all pretty much intuitively know what depression looks like. But Bipolar Disorder that is something else. The official definition of Bipolar disorder requires a lot more than just moodiness.

To get the diagnosis of bipolar you need to have had an episode of mania or hypomania. But the DSM excludes from diagnoses symptoms caused by drugs of abuse. For Bipolar Disorder this includes Bipolar symptoms that were caused by prescribed medications.

Do prescribed medications cause Mania or Hypomania? They sure do.

The creation of Manic symptoms by the taking of medications is so common that some researchers have proposed a separate “type” of Bipolar Disorder, Bipolar III, for those times when taking a medication causes manic symptoms (Akiskal 1999, 2003, Williams 2006.)

Here is the Bipolar medication dilemma.

Most people who get diagnosed with Bipolar Disorder have had one or more episodes of depression first. Then they have an episode of mania or hypomania and the diagnosis gets changed. Taking antidepressants is well known to result in propelling some people into a manic episode. This happens to about 10% of all people prescribed some antidepressants. Also if someone has EVER had an episode of mania or hypomania that risk of sudden switching increases to 20% (Breggin 2010.)

That drug or medication-induced mania is specifically excluded from the diagnosis under the DSM-4.

In practice, it has come to be common that a person who has a sudden extreme reaction to an antidepressant is a likely candidate for a Bipolar Diagnosis despite the DSM-4 exclusion.

If it was only antidepressants that created mania things would be simple. Lots of other drugs and medications can result in manic or near manic episodes.

There is a huge difference between someone being “maniacy” when under the influence or while withdrawing and those people who take a medication one time and are propelled into recurring bouts of mania or hypomania.

We see manic-like symptoms in people who use and abuse stimulants. Even excess of caffeine can create those sorts of symptoms. But medications that we do not think of as stimulants can cause manic and hypomanic episodes.

Antibiotics have been shown to induce manic episodes. So have anti-anxiety meds and some over the counter medications. Other medications like steroids, both prescribed and abused have been suspected of creating this effect also. That connection remains uncertain.

So the question becomes, “Do prescribe medications create a manic episode?” It looks like the answer to that is yes, sometimes they do. Does that mean this is just an allergic reaction or side effect of that medication? This is iffier as some people have that response and others don’t.

Is it possible that people who have an undiagnosed Bipolar Disorder are likely to be propelled into a manic or hypomanic episode when they are exposed to a medication to which they are sensitive?  I am inclined to think so.

We also see a huge overlap between substance abuse disorders, especially alcohol abuse, and Bipolar Disorders. Does alcohol abuse cause a Bipolar condition? Are people with undiagnosed Bipolar Disorder more likely to abuse alcohol?

Does this medication-induced mania matter? Williams says it does and reports that the rate of suicide attempts by people who switch to mania as a result of taking an antidepressant is even higher than for those with Bipolar II.

But there is more

People with anxiety are sometimes treated with an antidepressant. They also can experience an episode of mania or hypomania.

All this points out to me that with all we know about Bipolar Disorder there is still a lot more we don’t know and a lot more research is needed in this area.

It also suggests that there may be multiple types of Bipolar or even several different disorders currently being lumped together under one name.

For more on Bipolar disorders see:

Hyperthymia and Bipolar Disorder

Do drugs cause mental illness?

Bipolar – Misdiagnosed or missing diagnosis?

Bipolar or Major Depression?

Bipolar doesn’t mean moody    

Or the category list to the right.

Anyone have the experience of taking or doing something and then having an episode of Mania which resulted in the diagnosis of Bipolar Disorder that you would care to share?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

Which border is Borderline Intellectual Functioning on?

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20

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

Crossing the border.
Photo courtesy of Pixabay.com

What is Borderline Intellectual Functioning?

Borderline Intellectual Functioning (BIF) is one of several totally unrelated conditions that are officially or unofficially called borderline only because they are on the edge or junction of some other condition. BIF is in no way related to Borderline Personality Disorder.

Borderline Intellectual Functioning is a designation for some individuals who find it hard to learn some information. It sometimes gets confused and mixed up with several types of ADHD or the older label ADD.

The definition of BIF is totally determined by the person’s IQ score. Stay with me here as I explain this. I will give you the exact numbers as we go.

There is also a lot of prejudice about anyone with a low I.Q. score even though some low I.Q. scoring people are extremely talented in areas that are not captured on an I.Q. test.

When discussing I.Q scores we need to be very careful. First, they do NOT mean what many people think they mean, and since they are mathematical numbers being somehow attached to non-mathematical people we need to talk some statistic-number-stuff to explain this one. I will keep the number stuff extra simple.

The companies that make the tests try to improve the test over time but there is only so much you can do in trying to give a test that somehow is meant, to sum up, a person’s abilities. We believe that  I. Q. is made up, not of one single ability, but a whole host of talents. Verbal and mathematical talents are easy to capture with a written test, musical, artistic, and athletic talents may not show up so much.

There is also evidence of something called E. Q. (Emotional intelligence.) We all know someone who is very bright in school but is no good with people and there are those individuals who are good with people or animals but can’t pass a written test.

Many, but not all I. Q. and related tests, are biased towards how many words you know. Want to score well on a lot of ability tests – learn all the words you can.

The scores are designed to measure how someone’s test score compares to other people. We still can’t find any “normal” people to compare others to so we create an imaginary “normal” person by averaging all the scores we get and saying that average (or mean or mode) is somehow the “normal” person.

I.Q. tests are set up so that the “average” score is 100. Theoretically, if you test enough people the most common score is 100. But scores vary an awful lot. So is someone with a 99 really less smart than someone who scores a 101? Not very much.

If you take this kind of test many times you will get many scores. So some days you, one single individual will be “smarter” than on others.

One day the average person scores a 95. We could call that below normal. The next day they get a 105 and are above average. So we learn to use ranges of scores, not just the number.

Turns out that the largest group of people will score between 85 and 115 on most tests. (For the math people the standard deviation here is 15.) This group will contain just under 70% of all humans.

We consider this whole range of people 85-115 more or less the same. Since scores of one person may move up or down 5 points from day-to-day we need to look at the people just outside that range.

So are people above 115 really smart, geniuses maybe? Not that often. It may be easier for someone with an I.Q of 125 to get A’s in school but we all have heard of very bright people who fail school and less smart people who study really hard and get good grades.

For most purposes, we don’t see a lot of differences in individuals till we get out to two standard deviations. People who score between 70 and 130 all fall within the “average” group. This group covers about 97.5 % of all people. Only those below 70 and above 130, start to get extra special labels.

Really high scores might get the label “genius.” But some of them still do some dumb things. It may be a lot easier for the person who has an I.Q. of 125 to do a book report and someone with a score of 90 may struggle on a math assignment or vice versa, but we think anyone in that range, with a good education, can do this stuff.

Now back to Borderline Intellectual Functioning. The definition of BIF is an I. Q. Score of 71-84. The person with this score is on the low end of what we would consider an “average” or “normal” person.

Telling someone they or their child has a low score on an I. Q. test is likely to upset them. They want us to do something.

Most of us understand when a kid is too small or skinny to be good at football. We accept that a really short kid will not do so well in basketball. Most of us get this. Except sometimes parents want their kid to be good at a sport so badly that they push this kid unmercifully to grow more and get taller. Don’t get me started on the long-term damage wanting your kid to be something they are not can do to that child.

Not very many parents want to accept that their kid has fewer math or spelling circuits in their brain. So when they get the results of the I.Q. test they want something to make their kid smarter. Lots of kids in the lower normal I.Q. score range get low grades, get discouraged, and stop caring about school work. Then they get diagnosed with ADHD and given a stimulant medication. It may boost their test scores a little, for a while, but it does not make them develop a higher I.Q.

Many people with BIF do graduate from school, get jobs, and have happy productive lives. The task for them is to find the other areas in life for which they have abilities and then accept that some school type things may be harder for them than for people with more skill in another area.

My belief is we need to stop telling our kids that they need to be on the football team and get straight A’s and begin to accept that everyone has different talents. What are your talents and what are you doing with them?

For more on the Mental Health treatment of Borderline intellectual functioning see the post on V codes.

There, I will climb down off my soapbox, — for now.

Did that help you understand Borderline Intellectual Functioning?

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 are V and Z codes? – Things insurance doesn’t cover

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

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Why are there counseling things that insurance does not cover? V and Z codes.

There are lots of life’s problems that need attention, but they don’t fit neatly under our definition of a mental illness. As a result, most insurance providers won’t pay for treating these problems or if they do there are severe limits on the amount of counseling that you can get for these issues.

These everyday problems that can derail someone’s life get a “V” code. That does not mean they are not important, but it does mean that generally, we don’t see them as an illness, more like a challenge the person must face and overcome. There are over 20 of these “V” codes. (In the DSM-5 this list has gotten longer.)

Some of these are the kind of issues that make the news, the partners who kill each other, and the extreme cases of child abuse. They need treatment but we can’t say that every couple who fights is mentally ill. What we can say is that killing your spouse is not normal or acceptable.

Conflicts with other people are a big part of this, Partner Relations problems, sibling relational problem, parent-child relational problem. These conflicts can cause a lot of damage and they need treatment. Marriage, family, and child counselors specialize in just these issues. The list of relation problems goes like this:

Partner Relations problem

Sibling relational problem

Parent-child relational problem

Relational Problem related to medical or mental disorder

Other Relational Problem

There are life-stage issues we all need to navigate. Some of us move through these concerns with no problem. Other people struggle with one or more of these issues. Each of these can become a reason to see a counselor and they do not mean there is anything wrong with you.

Occupational Problem

Academic Problem

Acculturation Problem

Phase of life Problem

Religious or Spiritual Problem

Bereavement

Borderline Intellectual Functioning   

People who injure others need treatment. Sometimes they are required to go for treatment and may even be made to pay for that treatment. Victims of abuse, neglect or violence get a special status in the DSM and their treatment is found under the 995.xx codes, which are almost always paid for by society. The person doing the abuse or neglect gets the “V” code and mostly has to pay for their own treatment. The categories of misbehavior towards others that may be the focus of treatment include:

Neglect of a child

Sexual Abuse of a child

Physical Abuse of a child

Physical Abuse of Adult

Sexual Abuse of Adult

The last group of things that may need attention but don’t get counted as full mental illnesses are things that people do, other than abuse or neglect, that we as a society do not like. This includes things like career criminals who know what they are doing but do the crime anyway. The term “Behavior” is used here to differentiate those who don’t know that what they are doing is wrong or can’t control themselves as in Antisocial Personality Disorder vs. those who know it is wrong and do it anyway, as in Antisocial Behavior. These items include:

Adult Antisocial Behavior

Child or Adolescent

All these things and many more may be good reasons to see a counselor or therapist even if you don’t have a diagnosable mental illness.

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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1

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