Do people with problems not want to change?

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

Need to change

Time for you to make a change?
Photo courtesy of Pixabay.com

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

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

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

Binging on food – Binge Eating

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

Food.
Photo courtesy of Pixabay.com

Out of control eating is officially a mental illness.

With the advent of the DSM-5, Binge Eating Disorder (307.51 F50.8), is officially a recognized mental illness. Reading through the description of this newly recognized disorder it occurs to me that this is not what most non-professionals have been thinking of when they talk about people who overeat. What follows is my oversimplified explanation of how I understand this and how it might affect clients I see. For the full official description, you would need to read the APA’s DSM-5 text.

Why does Binge Eating Disorder matter?

Given the APA’s estimates, the number of people in the U. S. who currently have or meet the criteria for Binge Eating Disorder would run from 2 ½ to 5 MILLION people. A look at the criteria also indicates this is a lot more serious condition than we might first think. A lot of the criteria remind me of the features we see in alcoholism. This is more than just liking to eat. Binge Eating Disorder goes all the way to losing control.

First, some things that do not appear to be included in the definition of Binge Eating Disorder and then the things that might define the disorder.

What Binge Eating Disorder is not:

Binge Eating disorder is not being overweight or obese.

We think that excess weight is a medical problem. There are a lot of reasons someone could be overweight or even obese that have nothing to do with binge eating. Mental Health and obesity have a lot of connections but Binge Eating Disorder is not the only one. (More on how mental illness may be making you overweight in an upcoming post.)

Binge Eating Disorder is not Holiday Eating.

That Thanksgiving dinner is a good reason to gorge yourself. It is almost Un-American to eat lightly on that holiday. Lots of families have other traditional family or holiday celebrations and the food is a major part of that celebration. We do not count social eating events as Binge Eating Disorder even if after the holidays you find you have packed on some pounds.

Snacking all day is not Binge Eating Disorder.

Some people have told me that eating small amounts of food at many small meals a day is healthier than a few huge ones. I am also told that eating lots of food is healthy if you can do it all day long. (I am skeptical of that argument.) There was a time when low weight people died every winter and a fat baby was considered a healthy baby. Modern healthcare has severed that connection, but I know new parents often worry if their child is not gaining weight as rapidly as they expected.

Eating because you are chronically hungry is about poverty, famine, or bad nutrition.

If someone is low in body weight and eats a lot that is probably not Binge Eating Disorder. If they are staying low body weight because they do other “compensating” behaviors that is a different kind of eating disorder most likely Bulimia Nervosa.

Eating frequently because you are growing, expending energy, or just plain hungry is not Binge Eating Disorder. Binging is sneakier than that.

What factors do make it Binge Eating Disorder?

 The Binge eater feels bad when they do it.

People with Binge-eating Disorder may eat alone so others do not see how much they eat. This behavior reminds me of the alcoholic sneaking drinks. The Binge Eater does not want others to see them binging. They may eat in solitary, hide the evidence, and feel guilty or ashamed of what they do.

Eventually, that shame and or guilt become a separate problem that needs treatment and may be the thing that keeps the binging behavior going even if they want to stop.

Binge eaters lose control of their eating.

This loss of control takes many forms. The binge eater eats fast, very fast. They eat more than they want. They can’t stop eating even when they are overfull. They may keep on eating to the point of feeling sick to their stomach.

One of the defining features of this disorder is the tendency to eat huge amounts of food in a short period of time. A binge eater will eat enough food for two or three people and do it in 2 hours of mealtime or less.

Binge Eaters do these behaviors a lot.

This is not something that the binge eater does occasionally. To get this new diagnosis a person would need to binge at least 13 times over a three-month period.

The Binge Eating Disorder diagnosis allows for a range of severity.

The minimum is 13 times in three months. Extreme Binge Eating Disorder is binging two times a day all 7 days a week. To meet the 3-month rule and have extreme Binge Eating Disorder would require over 180 episodes of binging with no compensating efforts to lose the calories.

Emotional Eating does not automatically count as a Binge.

Most counselors have heard clients describe times they “emotionally eat.” You have a fight with your partner and there go the whole two gallons of ice cream. Those uses of food to make yourself feel better are more likely a part of depression, anxiety, or that often overlooked but sometimes fatal Adjustment Disorder.

The Binge Eating conclusion?

If you are overweight or obese see your doctor and work on your physical health. If you occasionally use food as a drug to treat your emotional problems work on those problems. But if you find that you or someone you know is repeatedly binging on food, feels shame and guilt about this behavior, or has lost control of how much they eat, it is time for some professional help.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel