How to create job burnout.

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

Match on fire

Burnout.
Photo courtesy of Pixabay.com

Some of the things you’re doing can increase burnout risks.

Life can be stressful. Some jobs are more stressful than others. In recent years, job burnout has become extremely common. Once people reached the point of burnout they are likely to quit their job, get fired, or moved to a new equally stressful position. Some people become so burned out they must change careers or may not be able to work at all. While you can’t always control the stresses in your life some of the things you’re doing may be increasing the risk that you will burn out or have a nervous breakdown. How many of the things on this list are propelling you towards burnout?

Sleep less, and you can burn out more rapidly.

People under stress frequently try to do too much. You can’t continue burning the midnight oil for very long before the lack of sleep will wear you out. Not getting a full night’s sleep increases your risk of burnout. If you think you’re too busy to get a full night’s sleep just wait until you crack under the stress. Once you have a breakdown you will have plenty of time to stay home from work.

Increased alcohol consumption leads to burnout.

In the short term drinking alcohol or doing drugs seems like a way to cope with stress. Anesthetizing yourself with chemicals doesn’t allow you to rest, it creates one more stress for your body to recover from. Drinking alcohol does not improve sleep. When you drink alcohol, you end up unconscious rather than sleeping. Your brain does not get a chance to recover. When your liver detoxifies the alcohol, you will wake up. Frequently people who use alcohol to sleep have disrupted sleep, wake up early, and can’t get back to sleep.

Using stimulant drugs to increase your work abilities does not give you an unlimited supply of energy. When the drugs wear off, you crash, and your need for rest becomes even more acute. Abusing tranquilizers and pain medications will catch up with you eventually. You can only walk around with anesthetized pain, physical or emotional, for so long. Eventually, you will collapse into burnout from physical and emotional exhaustion.

Isolating leads to burnout.

Humans are inherently social. People who have a good support system, feel like a part of the team, can cope with stress. As people become physically and emotionally worn out, the early signs of burnout, they often isolate. The more you cut yourself off from other humans, the more rapid the journey toward burnout. If you find yourself too busy to spend time with your family and friends, you are traveling the dangerous road to an emotional breakdown.

Being a perfectionist will burn you out.

B students are happier than straight A students. When a straight “A” student gets even one “B,” they feel like a failure. The “B” student is delighted with the occasional “A.” If your way of coping with stress is to try to do everything perfectly, you are turning up the intensity of your stress and cooking yourself into a burnout. There is such a thing as “good enough parenting” if you do more things right than wrong your children will think you’re a wonderful parent. Try to get everything right, and insisting they be perfect is a recipe for conflicted relationships at home.

Many people who develop job burnout come to work in the morning already emotionally exhausted from relationship problems at home. If your relationships are not supportive, work on improving your home life. Consider counseling, for you, for your relationship, or for your family, before your stress at home destroys your work life and your emotional health.

Having few job prospects leads to burn.

People who feel trapped in a high-stress job convinced themselves they have no other options. If you’re unhappy while at your job, spend some time deciding what is causing this unhappiness. Is it the job you’re unhappy with? Would moving to a different company actually relieve your stress? Or have you trapped yourself working in a job you don’t enjoy, with few prospects of finding another job? The best time to look for a new job is when you have one.

If however, the problem is not the job, but that what you’re doing for an income doesn’t match with your values, life goals, and ambitions, the way to avoid job burnout is to work on yourself and become the best possible person.

Limited job skills increase the burnout risk.

Lack of variety in anything can take all the pleasure out of what you’re doing. If you have only one skill, that will be all you will ever do. The day you can’t earn a living doing that one skill is the day you become unemployed. Learning additional skills gives you the opportunity to have a more varied day and to be more useful to your employer. Look for opportunities to identify skills you have, but which have not been developed. Growing as a person opens up more opportunities and reduces your risk of burning out doing that one thing you know how to do until you can do it anymore.

The things you are doing may be making the stresses you’re under worse. Your current actions, or inaction, may be accelerating your journey towards burnout and an emotional breakdown.

Check out the other counselorssoapbox.com posts about stress and burnout.

Staying connected with David Joel Miller

Three 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.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Why pay a therapist when you can just talk to a friend?

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

Therapist

Therapist.
Photo courtesy of Pixabay.com

Therapist or friend – what is the difference?

1. Friends may keep your secrets; therapists are required to keep them.

Some friends are so close you can tell them anything. Well, almost anything. Most of us have secrets which we were sure we could never tell anyone. Friends are usually friends because we have things in common. If you tell them everything can they, will they, keep the secret? What effect might their knowing the secret have on your friendship? What if you two have a falling out? Some things are just too embarrassing to tell a friend.

There are two concepts that keep a therapist from revealing secrets. Confidentiality, which means that they can’t talk about what you say unless it fits those very few exceptions like you are suicidal or talk about abuse of a child. Other than that what you say there stays there.

Also, there is what is called patient-provider privilege. That means some things may be protected even if police or lawyers come around asking questions. Friends don’t get legal protection to keep your secrets.

You are only as sick as your secrets – Friends shouldn’t have to carry some secrets

2. Friends can help you solve today’s problem – counselors can help you learn to solve your own problems.

Counselors often work with clients to help them learn skills to solve life’s problems. Friends may tell you what to do in a given situation but that does not help you with the next problem.

You want help that will help you become more independent not more dependent. Therapists are taught they should help you be independent not foster dependency.

3. Friends may not want to hurt you but sometimes you need to hear the truth.

A profession person can give you their honest opinion. You paid for it and you deserve it. Friends may be afraid to tell you the truth for fear of losing a friend.

4. Friends get tired of listening to your problems, therapists do this for a living.

Ever meet someone who was really needy. Every time you talked to them it was all about their problem of the day? When you are going through something difficult you need to talk about it. Friends can get talked out. Don’t burn out friends and damage friendships by asking friends to become very involved in your problems.

5. Friends have a good heart. They want to help with your problems. That doesn’t mean they always known how.

Therapists have many years of schooling and specific training in how to help people like you with problems. They study not only diagnosis and treatment but how to help with particular problems.
It is that kind of expertise that you need in your corner when that problem overwhelms you.

6. Friends can play the game with you, but counselors and coaches can help you improve your game.

When the team is losing all the players are going to talk to each other. They know what it feels like to lose. What they don’t always know is how to change that losing streak. That is where a new coach can come in and help turn a team around. Counselors, therapists and professional coaches can do that for your life problems.

That does not mean you should avoid friends or peer support groups. Both are vital parts of your support system. Millions have recovered from alcoholism in A.A. But if you find that when you talk to your friends about your problem, that they don’t know how to help you or that the solutions they offer are not helping, consider that you may have a second problem, a mental health problem and seek professional help.

Those are some reasons that you might decide to see a therapist rather than talk with a friend. What if your friend is a therapist? What if you are a counselor? In the next post, I want to talk about reasons to keep that friendship and that professional relationship separate.

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.

Goodbye to Drugs ritual – Breaking up with an addiction

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

Writing a goodbye letter to your drug.
Picture courtesy of pixabay

Is it hard to let go of your addiction?

When the courtship began it was all good. That drug, the alcohol, the gambling they were fun. Your drug of choice stays with you no matter what.

People come and go in our lives but that addiction we develop it stays with us. Women come and go, Sherry is always waiting, along with Bud and Jose and their friends. Crystal will take you in when no one else wants to see you. It can be hard to say goodbye.

We have ceremonies for starting things, marriages, births of children, graduations. There are ceremonies for ending things also, divorce decrees and funerals and the retirement dinner. How do you say goodbye to that drug?

Do you remember the first time you tried the drug, that first drink and the feelings that your drug of choice gave you? In the beginning was it good? Did it make you feel excited, happy and successful?

Then did bad things start happening? Did the drug take you places you didn’t want to go? Did it send you to jails, institutions, homeless shelters or to lonely places?

It is easy sometimes when all looks bleak to remember the good times if only you could reach that same high again. But you know that it takes ever more and more drug to reach the same high and then one day even the drug can’t get you high. Then it takes more of your drug just to get well, just to feel normal.

It is hard breaking up with someone you have been with for a long time, even when the relationship has gone bad. You remember those good times, long ago when the relationship was new and you wonder how you could live without that drug.

Ending a romantic relationship is often done with a goodbye letter, the “Dear John” or “Dear Jane’ letter. If you want to be free of your drug you may need to write it that same letter.

Dear Methie, Dear Alcehol, we had some good times way back when, but you done me wrong. You said you could make me rich and famous, but you took my money and put my picture on the wanted list. You said you would be my friend, but then you left me alone in jails, prisons, and hospitals. Now you have taken my life and left me looking for ways to end it. It’s time for me to say good-bye ole drug of mine.

Once that letter is written read it over. Have you said it all? Is it clear that you and the drug are through? Or did you leave the door open, breaking up and still wanting it to call again? Rewrite the letter if you need to. Make this one final. The relationship is over. Then send the letter the way your drug of choice will understand.

Some people find it helps to tear the letter up and flush it down the toilet, the way the drug tried to put your life in the toilet. Are your dreams up in smoke? You may need to take that letter to a safe place and burn it. Some people feel that everything about their life has gone downstream; they may wish to tear the goodbye letter up and toss it in the river.

Creating a ceremony marking the end of your relationship with that drug that used and abused you is a good way to start the next chapter of your life.

Some people prefer to do this sort of ritual alone. For others, it is helpful to have a trusted friend, counselor or sponsor to help with the goodbye process.

However, you chose to do this goodbye ceremony, do it and toss that drug of choice out of your life. Stop choosing drugs and start choosing yourself.

Staying connected with David Joel Miller

Three 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.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Posttraumatic Growth (PTG) vs. Posttraumatic Stress Disorder (PTSD)

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

Words about PTSD

PTSD.
Photo courtesy of Pixabay.com

How are PTSD, PTG, and Resilience related?

Is some sort of personal growth possible as a result of living through a traumatic experience? Recently researchers have begun to study the concept of Posttraumatic Growth (PTG.) There has always been a body of literature about how some difficulty might spur changes in a person and lead to a new way of seeing life. But could something that was so severe a stressor as to be traumatic really lead to positive growth? And if that change might happen, why? What characteristics of the person, the treatment they received or their support system might transform Posttraumatic Stress into Posttraumatic Growth?

Zoellner & Maercker defined PTG as “the subjective experience of positive psychological change reported by an individual as a result of the struggle with trauma.” So far studies of PTG have been lacking and those that have taken place include mostly groups of people who are different from the clients we see in therapy who have PTSD. For example, many patients with PTSD also have co-occurring substance abuse disorders. Most studies of PTG have excluded clients with substance use disorders. We know from many individual reports that overcoming substance abuse especially in clients with PTSD can result in the client developing a new way of seeing the world and many in recovery report that they have grown as a result. Clients with suicidal thoughts have also been excluded from studies of PTG despite the recurrence of clients telling us that being hospitalized for a mental illness, especially with suicidal thoughts, can be a life-altering experience.

Hagenaars & van Minnen (Journal of Traumatic Stress, Vol. 23, No. 4, August 2010, pp. 504–508 (c 2010), conducted a study using Exposure Therapy. The therapy included steps beginning with low-intensity experiences such as “Patients were asked to close their eyes and talk about the traumatic event in the first person and in the present tense, recollecting as many sensory details as vividly as possible, i.e., as if the trauma was happening “here and now.” The intensity progressed to real-life situations. This procedure is similar to systematic desensitization procedures in use for specific phobias.

So what did they find? The more PTG the less PTSD and vice versa. Also, the more someone was “emotionally numb” the less likely they were to benefit from the treatment and the less likely they were to have PTG. They concluded that an inability to feel emotions is related to an inability to grow. So the ability to face problems leads to growth and the inability to face problems leads to staying stuck in the problem. Unfortunately, this leads us around in a circle to the place we started. Resilient people can grow as a result of trauma but trauma can make you less resilient especially repeated traumas.

Some clients who have been forced to relive traumatic events become re-traumatized. So sometimes the exposure techniques make you better but the same treatment can also make you sicker. How do you choose? Clients who share about trauma in a safe environment seem to get positive benefits; those who are cross-examined for details get worse. So, in the end, the value or damage of the technique depends on the relationship. This is one reason that group counseling is so appealing. People with similar traumas feel safer in talking about them in a group who has had a similar experience. Counselors who are seen as accepting help and rejecting professionals harm. It is in the case of PTSD as in other therapy – all about the relationship.

One further problem with the concept of PTG, how do we know it happens? Mostly we measure it by the client’s subjective report. They say they grew as a result of the trauma so that is evidence. But how did they grow? Did they take new actions or did they have a change of attitude? Maybe both? People who are spurred to action appear to grow more.

We also suspect that PTG is related to resilience. So do resilient people have more growth as a result of a traumatic event or do people who overcome a traumatic event become more resilient?

We know that PTG reduces PTSD symptoms and that the process of growth is related to resilience somehow. It is also clear that there is a lot more PTSD out there than we wanted to recognize. The challenge is making use of the things we learn in research and theory to help the clients who walk in the door in their journey from Posttraumatic Stress Disorder (PTSD) to Posttraumatic Growth (PTG.)

Do any of you have experiences with Posttraumatic Stress Disorder (PTSD) or Posttraumatic Growth (PTG) you would care to share?

This post was featured in “Best of Blog – May 2012

For more information on Stress and PTSD see:

Posttraumatic Stress Disorder – PTSD and bouncing back from adversity

8 warning signs you have PTSD

Acute Stress Disorder vs. PTSD 

Staying connected with David Joel Miller

Three 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.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

Books are now available on Amazon, Kobo, iBooks, Barnes & Noble, and many other online stores.

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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How safe is your job?

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

Filling out a job application

Job application.
Photo courtesy of Pixabay.com

The story of the Cordwainers, Redsmiths and the disappearing jobs.

Did you get a job once and plan to work at that job, maybe even that company, for the rest of your life? Then one day the company went out of business. When that happens to you what do you do?

There was a time when most people learned their trade from their parents or underwent an apprenticeship and then worked at that trade the rest of their life. Not anymore.

The career landscape has been completely reshaped in recent years. Some people lose their job and no matter how much they look they can’t find another job in their field. Our countries unemployment has continued to stay stuck at an unacceptably high level. Some places have higher unemployment than others, but even when you are willing to relocate – what if you can’t find a job that matches your skills? What if you are approaching retirement age?

It may be because of the Cordwainers and Redsmiths!

As a Professional Counselor, I see clients who are in that situation. I warn them about the Cordwainers and Redsmiths.

Check any help wanted ad. Look through the listings at your state’s employment development office, Can you find a help wanted ad for a Cordwainer? I have looked more than once. I can’t find one. Did you know there was a time when Cordwainer was a common occupation in America?

Cordwainers were leather workers. Mostly they made shoes from leather supplied by the factory owner. They formed one of the first unions in America. The Cordwainers strike in 1805 set a precedent for labor law for most of the early part of American history. It was big news. Today they are almost all gone. Most shoes are massed produced in factories overseas. Over time the old Cordwainers had to take other jobs. Not good paying jobs, not jobs in their trade, but they took whatever work they could find. Not just a job or a company went out of business but a whole occupation essentially ceased to exist.

Does this story sound frightening? Does it sound familiar? What did you say you did for a living? Could that occupation cease to exist also?

What about the Redsmiths?

Have you seen any job openings for them? They have mostly come and gone like the Cordwainers. You have heard of blacksmiths, right? And goldsmiths? Redsmiths worked on red metal, copper, and brass. Some of them made their living traveling around in their wagon to the farmhouses where they repaired broken copper pots and kettles. Fixing copper vessels used to pay. Today we throw those old pots and pans out and buy new ones. The Redsmiths got thrown out also. Like most of the repair and fix-it shops.

Think about someone who lost their job as a Cordwainers and retrained to become a Redsmiths. That had to be a traumatic experience.

Could that happen to you? Sure it could.

The typical skilled worker will need to retrain for a different job 3 to 5 times in their lifetime. That has been getting harder not easier to do.

See also: Degree but can’t find a job?

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.

13 Ways to Make Yourself Miserable.

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

Unhappy emoticon

Unhappy.
Photo courtesy of Pixabay.com

How to create a miserable life – let me count the ways.

1. Require yourself to be perfect.

No matter how well you do at anything, tell yourself you should have done better. Flog yourself repeatedly because you “should have” done better. Carefully avoid ever giving yourself credit for anything you ever do right.

2. Compare yourself to others constantly.

Look for someone who is taller, smarter, richer or better looking. Keep comparing yourself until you find people who were better at something than you. Did you win a gold medal at the Olympics? Was there someone who won two? Did someone win 5 or 7 once? Did a medalist run for Congress? There must be someone out there who was better than you!

3. Discount all your accomplishments.

Did you get the highest score on a test? Well, you should have done better. You were just lucky that day. Tell yourself that your accomplishment is no big thing. Do it right ten times in a row, remind yourself that you might fail next time.

4. Call yourself names.

Remember to call yourself stupid or ugly several times a day. Repeat over and over “I am a loser.” Need help thinking of insults? Call those around you names and encourage them to call you names back.

5. Focus on your disabilities.

Remind yourself that you are too tall or too short. Can you claim to be too dumb or too smart? Anything can be a disability if you can find a way to allow this to hold you back.

6. If someone gives you a compliment toss it back.

Instantly dismiss any compliments. If they really knew you they would not have said that. You know you are not worthy. It was no big deal. Anyone else would have done it better, right?

7. Become indignant when anyone criticizes you.

How dare them to criticize a helpless person like you. Do not ever take any critique in a positive way. If you are not the best at something know it is because you are worthless not because you have something yet to learn. Make no effort to improve yourself and remind yourself that they are just criticizing you because they hate you and think you are worthless.

8. Self-sabotage.

If things start going too good mess it up. Get drunk, do some drugs, gamble it all away. No point in being good if you can’t have fun. No reason to have fun if you can’t take it to revolting extremes.

9. Hang out with negative people who will agree that you should be miserable.

Avoid those suspicious positive people. Look for the Gloomy Gus’s of the world. They know what is up and will not mislead you with any of that happiness stuff.

10. Never do something when you can complain.

Take no action that might change anything. Especially avoid changing you. Make sure you complain often and loudly until someone agrees with you that things are bad and you are worse.

11. Neglect self-care – you don’t deserve it.

Taking care of yourself is a waste of time and money. A miserable person does not deserve anything and you are out to deprive yourself as much as possible.

12. Make lists of things that could go wrong.

Look for misery anywhere you can find it. Catalog all the things that could go wrong. Watch the news and look for the awaiting catastrophes.  Imagine all the failures and diseases you or your family could get and hide from them. Worry about what could go wrong but under no circumstance should you do anything to prevent catastrophes or protect yourself.

13. Work at a job you hate.

Pick a dead-end job and stay there until you die. Carefully avoid any effort to improve your job or career. Never get more education or learn new skills. There is no point in trying as you know that happiness is an illusion and everyone hates their job. If you start to like your job become suspicious and quit. Take a new job that is less rewarding. Good things can’t last so if this is too enjoyable it is bound to go wrong soon.

This blog was inspired by a post of Tim Brownson on Steven Aitchison’s blog CYT (Change Your Thinking)

Tim’s post started as 12 ways but ended as 14 ways. Since I was not sure that would be enough ways to create misery I have come up with 13 more ways. If you need more ways to be miserable check out the list at CYT.

Now should you decide you have had enough misery and want some recovery, try doing the opposite of these suggestions.

Any of you have other ways you have made yourself miserable that you would care to share? What are you doing to move from misery to happiness? What has worked to make your life happy?

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.

Is it Complex Grief, Depression or Bereavement?

Bereavement

Bereavement, grief, and loss.
Picture courtesy of Pixabay.

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

Just what is Complex Grief, compound grief and why have people been asking about them recently?

Complex grief is also called complicated grief, traumatic grief, prolonged grief, chronic grief or extreme grief.

The Idea behind Compound grief and its many other labels is that while most everyone experiences grief at some point in their life, sometimes that grief becomes debilitating and people with these issues need help. The questions become, is this a mental illness and how should people with severe grief issues be helped.

One thing therapy shouldn’t do is turn everyone into a mental patient and start requiring treatment for all. In professional lingo, this is called pathologizing clients. There is plenty to do helping people who genuinely need help so we don’t need to enlarge the number of disorders just to keep counselors busy.

Grief is a normal part of life. People we love die. The loss of a close family member should make you sad. When does this move from a normal part of life to a disorder requiring treatment? And who should pay for this? Insurance companies may cover necessary treatment but they will draw the line if normal human emotions become the subject of treatment. The more diseases we create the more health care will cost. Besides if someone really has an extreme impairment as a result of bereavement that becomes Major Depression and gets treated right? Not exactly.

Currently, grief is excluded from the DSM-4 criteria for depression. The reasoning for this was that if everyone is likely to experience this sooner or later, then it is not a mental illness. Just how much the death of a family member is expected to affect us is mostly a result of culture. Some cultures mourn for a year or more. The widow or widower wears black and is granted time to grieve their loss.

In western society, we limit grief to 60 days. Many other acute life events are limited to 30 days. After that, you are supposed to get back to work and living. Since the DSM guide to mental illnesses is published by the American Psychiatric Association it reflects American and western values. That may not be appropriate for people of other cultures regardless of where they live.

Currently, the loss of a close person is included in the DSM as V62.82 Bereavement. V codes normally are not covered by most insurance plans. At least two factions are working to change this.

Those who are working on the new DSM-5 report that Complex grief is a disorder proposed by groups outside the APA which is being considered. Additionally, people within the APA have suggested removing the exclusion for grief from the definition of Major Depressive Disorder. That would result in more people who have severe symptoms as a result of grief getting treatment under the Depression code. I suspect that in practice most clinicians, after a while, go ahead and give the diagnosis of depression, grief or no, after the client has had problems for a while.

But there is another problem with all this increasing of treatment for grieving people. A specialty is growing up of practitioners who say they specialize in “grief counseling.” The research has not been kind to some of those “Grief counselors.” Some grief counseling seems to do more harm than good.

Personally, I am all for helping people who need help but the idea that we might evolve a subspecialty of counselors who are doing harm not good worries me. Complex grief is not the only area where we have a risk of doing more harm than good.

Some of the treatments for PTSD and other trauma counseling have the potential to make the victim relive the experience, rather than allowing them to heal. The repeated exposure to the trauma may retraumatize the client and makes them worse.

Not everyone who experiences the loss of a loved one has symptoms we might call complex grief. People with a past history of Major Depression are more likely to become depressed again if someone close to them dies. So is this a new disorder “complex grief” or is this a reemergence of Major Depression? Add a second stressor like financial problems, divorce, alcoholism or addiction and the loss of a loved one is more likely to affect people’s functioning.

People with multiple losses are more at risk and so are people who have a loss in early life and then experience a loss again. If you lose a parent as a child, are you more likely to feel sad when someone else dies in your life? Does that make the second loss a mental illness?

Men and women differ in the way they show grief, so do people of different cultures. We would want to avoid creating a mental illness that only one sex or culture gets diagnosed with. But then we already have several that are more likely to be given to woman than men.  Does that mean that there is a difference in the mental health of one sex or the other or only that we are defining the emotions of women and ways they express them as a mental illness?

Professionals don’t all agree on this.

So what do I think will happen? Wish my crystal ball was clearer. My guess is that we will not add complex grief as a new disorder. The APA looks poised to soften the criteria for Major Depression and let some people who are suffering from depression as a result of a traumatic loss get more help.

I also expect to see more peer and self-help groups with or without professional assistance.

So what do you think? Is complex different from normal grief? Should it be a separate diagnosed mental illness or is it a normal human emotion?

This post was featured in “Best of Blog – May 2012

Staying connected with David Joel Miller

Three 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.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

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

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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. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

People are like them trees.

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

Tree

Tree.

“People are like them trees,” the old man said as he pointed out the window. I must have looked at him like he was crazy because he started to explain.

“Ain’t a one of them that grows straight up to the sky, not one! Some of them look straight from far off but when you get to looking right up close they everyone gots their scars.”

“They start off all looking straight; we stake them up nice and neat but sooner or later we takes the stakes off and then the tree has to grow on their own. People try to do that with their kids, stake them up, fence them round and keep them growing up on the straight. But eventually, the parents got to back off and let the kids grow on their own just like we do them trees.”

“Trees grow for a while and then they take off in one direction or other, eventually they end goin off this way or that and then they head back towards the light and grow a different way. Lots of twists and turns in direction we all have.” Had to agree with that one, not many people grow up and grow out in the same direction I thought. “We need to change direction from time to time just like them trees.”

“Sometimes them trees get pruned back, branches cut off. Life done pruned me some, recon it pruned you too” he said and gave me a glance. I had to agree my life had changed direction, been pruned a few times too. Some of that pruning hurts at the time even when it makes you grow straighter, I thought.

“Look at that one there,” he said, pointing to one large tree with a lot of branches going every which way. “He been reaching out for a long time trying to find the sun when all the time it is up there above him. We peoples look all around for happiness and don’t even know it is there like the sun for the taking long as we don’t keep grown after every which way thing.”

The longer I looked the more I could see how he was right. Trees have knots and scars just like us. But they keep on growing, growing towards the light. Trees like people grow up or we die.

“What kind of tree are you?” He asked. I said I didn’t know exactly, just one that kept changing direction looking for the light.

Never thought about it that way I said to the old man. Mind if I share the “people are like trees” idea with some other folks? “Go right ahead,” he said. “Can’t recall who told me.”

Ever since our talk, I have been thinking about the way my life keeps changing direction but keeps reaching for the sky. What will this tree of my life look like when it is done growing?

Say what do you think? What kind of tree are you?

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 self-care?

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

Self-care.
Photo courtesy of Pixabay.com

Do you take care of yourself?

In recovery and resilience literature we talk a lot about self-care, how you do it, what you do and most importantly why it is important. In a previous blog post, we talked about the connection between PTSD and sleep. There is a lot more to self-care than just lying in bed enough hours or eating the right food. Let’s look at some of the areas of self-care that are important for mental and emotional health.

For people in recovery from substance abuse or from mental illness, sometimes from both, self-care is of vital importance. We talk about it but rarely get specific about just what that means. Recovering people often make excuses for a lack of self-care. Good self-care does not have to be expensive. I wrote in a previous post about ways to find help and counseling if you have little income and no health insurance. But let’s be honest here. I see people who have money for their addiction, money for their hobbies or entertainment but say they have no money for self-care. Make self-care a priority. It is extremely important for your recovery.

Keeping your life in balance is the first rule of self-care. An excess of emphasis in any one area is likely to throw your emotional balance and your recovery off. Too much nicotine is a problem. Emotional problems can result in a sharp increase in smoking. I think any smoking is too much, but if you have not yet reached the point of quitting, monitor your consumption and keep it to a minimum.

Physical health.

Your insides are important. Make time to see a doctor and address your physical health concerns.  Sometimes things we worry about turn out to be unimportant. I have never seen a serious illness that got better without treatment. Putting off finding out if you have a disease or condition does not prevent it. Not treating an illness allows it to become more serious.

Physical health is also about having your vision and hearing checked. Children who need glasses and don’t get them are at high risk to fall behind in school and not achieve their full potential. Adults who can’t see or hear don’t succeed as well in jobs or life.

Besides wearing glasses makes you look smarter and cooler!

Outward appearance.

One way recovering people can judge their progress is by their appearance. When you are depressed fixing yourself up does not matter. It may even require more effort than you can muster. A lack of attention to your appearance is an indicator of your low mental state; it can also affect that state. Spending more time on grooming and shopping for new clothes can also make you feel better about yourself.

Nutrition.

Poor nutrition can make your mental condition worse. There is lots of material out there on the internet and in books about diet. Spending some time reading about better health and working to improve that health can improve your outlook on life. Don’t neglect the most vital of all nutrients. Lack of adequate water can make you fuzzy headed. A large number of people think they are hungry when in fact they are thirsty. This leads to weight gain and poor mental health. Diet experts suggest drinking a glass of water and then waiting a few minutes to see if your hunger goes away on its own.

Exercise.

Taking care of your body is more than just maintaining your weight. As we age the percentage of the body that is fat increases and the muscle mass declines. Even if your diet and don’t gain weight, you are becoming less fit. Make sure you get enough physical exercise to keep your muscles working. Feeling healthy will improve your mood.

If you are in early recovery, don’t overdo the exercise either, you can’t undo a long period of neglect by running a marathon on the first day. The key to exercising as with all other recovery activities is to keep your life in balance and build up to doing more gradually. Do a little each day and slowly increase the amount and intensity of exercise.

Improvements in mood and self-esteem come from the trying and appear long before any changes in the body become noticeable.

Time off –vacations and pleasure.

Make sure you plan for some enjoyable events in your life. People in early recovery often try to make up for lost time by working several jobs, going back to school and paying off old debts. If recovery becomes unpleasant it will be harder to sustain. Remember that your illness also has resulted in a deficit of fun and enjoyment. Recovery should be an adventure. Anything that is enjoyable is more likely to be maintained.

Reward yourself.

One way we humans show our affection to others is to give them gifts. Most of us forget to love ourselves as if taking good care of us is not important. Some people were taught that doing nice things for yourself was selfish. Good self-care is not selfish.

Taking good care of yourself is important. One way you can do that is to reward yourself with positive gifts. The key here is to keep your life in balance. A new piece of clothing is one thing a whole new wardrobe is something else. In disciplining children we find that all punishment means the level of punishment needs to keep increasing. All rewards result in ever more reward until it becomes bribery. Discipline yourself in the same way. Give yourself small rewards for things well done and small consequences for things that you could do better. Remember also that harsh parenting can result in abused children. Don’t abuse yourself.

Mental Health.

Recovery is about staying mentally healthy. Sort out your thoughts. Avoid unhealthy thoughts, ruminations, and self-doubt. Whatever you did to begin your recovery, counseling, self-help groups or religious practice, keep doing the things that started you on the recovery road.

Encouragement – self-affirmation.

Being told that you are worthwhile and that what you are doing is good and appreciated is important for self-esteem and self-efficacy. Some of us didn’t get much praise when we were young. If there is no one in your life who tells you they value you it is hard to feel good about yourself.

Give yourself the affirmation you deserve. If you don’t think you deserve it work on improving yourself and work with a professional on these issues.

Some people find it helpful to make up a list of the positive things about themselves. Get help on making this list if you can. Post the list in a prominent place and read it early each day.

Take time for yourself.

Make time for yourself. You are worth it. We all have responsibilities but self-care is also a responsibility. Family members come to me about how to help their loved one who is in some form of recovery. One of the first questions I ask them is what they are doing to care for themselves.

You can’t help others if you are neglecting yourself. Make self-care a priority not a second thought.

Avoiding excess of nicotine – food – soda and caffeine.

It is easy to trade one addiction for another. Problems often occupy a central place in our lives. What would you do if your problem were suddenly solved? Would you find another issue to take its place? Replace problems with positive activities, not new problems.

Finances and savings.

Getting your finances in order is a part of self-care.  How can you be happy if you are stressed by money problems? Get professional help here if you need to. Read about money management.

The difference between the richest half of all Americans and the poorest half is having even a few dollars in a savings account.

Make paying off credit cards and old bills a priority. Getting out of debt can take a lot of worries off your plate.

There is a lot of emotional pain around financial losses. Losing a job or a home in foreclosure is often heartbreaking. Financial events may force drastic changes in your life. We all resist changes. Sometimes change is also an opportunity. Resolve to be happy with or without money but do your best to get your financial life in recovery also.

Quality relationships.

People who have good quality relationships with other people are more successful in recovery than those who don’t. Nurture the positive relationships. Spend time with family members who are positive. Make new friends. Get a sponsor in recovery.

Just be careful not to be so needy that you let unhealthy people back into your life. Part of self-care is avoiding people who are bad for your recovery and increasing contact with people who help build your recovery.

Make good self-care a priority.

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.

Think yourself sick – Nocebo Effect

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

Woman thinking

Thinking.
Photo courtesy of Pixabay.com

The Nocebo Effect.

Did you know that thinking you will get sick, can make it so? Most of us are familiar with the Placebo effect in which someone who thinks they are taking powerful medication will get better even if the pill has nothing in it. There is an opposite but not so equal effect called the Nocebo effect in which we can make ourselves sick when the risk factors say we should not have gotten ill.

In one study of women with a family history of heart disease, women who expected to have heart problems – eventually developed them.  Thinking they were prone to heart disease made them four times more likely to develop the disease than those who did not think they would get it. That difference persisted even when we compared the results of diet, exercise, weight, blood pressure and cholesterol.

This does not mean you should give up efforts to control your weight or improve your health. What it does tell us is that while positive thoughts can make you happier, negative thoughts can kill you.

Doctors have known about the existence of the Nocebo effect for a long time. Surgeons know that people who do not expect to survive an operation are much more likely to die. If the patient has had a loved one who died recently and they want to be with that loved one, the risk of death increases dramatically even when the operation is not that risky. Still, it is hard to measure something that makes the body sick but is centered in the mind, not the body.

Is this a new idea? No, not really. We have all talked or thought about someone who “makes me sick.” Brian Reid wrote an interesting article called The Nocebo Effect: Placebo’s Evil Twin for The Washington Post on April 30, 2002. He is not the only one to tackle this subject. Penny Sarchet discussed research on the ‘Nocebo’ effect in her winning essay for the Wellcome Trust science writing prize in November of 2001. There have been lots of other references to this phenomenon but it hasn’t been widely noticed.

One reason is that we like to give people credit for healing themselves through their beliefs or positive thinking but we are reluctant to criticize someone for having negative thoughts. Depressed people, for example, can’t be positive. Acknowledging the Nocebo effect feels like blaming the victim.

Many of the side-effects reported for medications may be the result of Nocebo effects. Burns, Meichenbaum, and others have talked about the way in which beliefs about the effectiveness of a medication or negative beliefs about the med can change the results of studies even when there are no active ingredients in the pill. For example, always buy multi-colored capsules if you can; they work better than white tablets regardless of what is in them.

Reid also pointed out in his article that doctors don’t like to warn patients about potential side effects because telling the patient about that side-effect makes the patient much more likely to have that side effect.

We know that thoughts are transmitted in the brain chemically. Now with various sorts of brain scans, we can see what happens in the brain. Tell someone that the medication they are taking will have a painful effect and the parts of the brain that process pain will light up.

We also know that what you are thinking, good or bad has an effect not just on your thoughts and mood but also on the production of chemicals that make you better or worse.

Have you ever awakened one morning and thought you were going to have a bad day? Have you known someone who was always negative and expected the worst? How does it usually turn out? Expecting the worst increases the chances that you will experience it.

Thinking is not a substitute for proper medical treatment, but your attitude towards that treatment may influence the effectiveness of the treatment no matter what your doctor does. Your thoughts can influence the results.

So how do you banish Nocebo?

Try to keep your thoughts positive. Read inspirational books. Spend time with friends. Having positive people around you can make you more positive. If you don’t have a positive support system, develop one. Go to religious services, do hobbies and activities where you might see people and make friends. Having good friends can lengthen your life.

Pay more attention to the benefits of things than the negative. Whatever you focus on you will get more of. Constantly worrying about side effects will make them larger. Focusing on any progress no matter how small will magnify that progress.

If something is concerning you, capture that thought, write it down, type it on the computer whatever it takes to get it recorded and then out of your head. Trying to remember for a month all the things you need to discuss with your doctor will keep you focused on your pain and symptoms. Writing it down gets the disturbing thought out of your head and gives you something to take with you when you talk to your provider.

Work with a counselor or therapist on improving your outlook. Self-help groups, religious leaders, and trustworthy friends can also be helpful in banishing negative thoughts.

Be aware of the Nocebo effect and don’t become its next victim.

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.