4 types of addiction

Posted on July 3, 2013 by David Joel Miller

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

Addiction.
Photo courtesy of Pixabay

Not all addictions are created equal.

The word addiction and the whole concept of addiction have taken on a number of meanings. The result is that when we talk about addiction we are not all meaning the same thing.

As a counselor, I have come to see 4 different classes or patterns of addictions.

The meaning of the word addiction has changed so much it becomes difficult to know when to use the word addiction in one way and when it is being used in another.

My favorite dictionary, a real physical, book type dictionary, is the Century Dictionary from 1889. It defines addiction as “A state of being given up to some habit, practice or pursuit; addictedness; devotion. This definition explains why so very many different patterns of behavior have come to be called addictions.

Modern on-line dictionaries have inserted a first meaning of drug dependency and reduced the notion of devotion to something to a secondary position. Both meanings bring people to the counseling room.

Here are 4 primary types of addiction that may call for treatment or recovery.

Physical tissue dependency on a substance is an addiction.

Doctors might refer to this form of addiction as “Chemical Dependency.” We all know about addictions to chemicals which result in severe withdrawal symptoms when the user stops. The Heroin or opioid user gets violently physically ill when they are without their drug for a period of time. Alcoholics may experience the DTs if they are without a drink for a period of time.

Psychological dependence on a substance is addiction.

This manifests when the addict goes through a rehab, 28 or 30 days, and then, when they leave rehab, they return to drug or alcohol use. Clearly, this form of addiction is in the mind, not the body.

One reason we might develop this variety of addiction is the belief that we should be able to handle our alcohol or that we need substances to have a good time. The idea of heavy alcohol or drug uses is almost synonymous with the concept of a party and with having fun.

When people develop problems, DUI’s or similar issues, from drug use, they think it is their fault, that they should be able to handle their alcohol. We are mostly reluctant to admit that drugs, including alcohol, are inherently problematic.

By the way – it is quite possible to have fun, enjoy yourself – without resorting to drugs or alcohol. And this is one case where more is not better, more is a bad thing.

Process addictions, when doing takes control of the doer.

Some processes are psychologically rewarding and become so reinforcing that people find themselves unable to stop an activity or to regulate the time they spend on this behavior.

Slot machines and gambling are one activity that can form a process addiction. Video games, sexual activity, and shopping can all become repetitive patterns that a person can give themselves over to. The result is an addiction, a loss of control of your life, as a result of over participation in this activity.

Overeating may well be a form of process addiction. Other eating disorders anorexia or bulimia may fall into the psychological dependency category.

Lifestyles can become addictions.

The dope game or criminal behavior can also be addicting. Dope dealers get caught up in the game. The lifestyle provides large amounts of money, status, and recognition within a subgroup. The lifestyle also provides many other personal benefits. Every dope man knows there are plenty of customers willing to trade sex or other illegal activities for more dope.

The great fallacy of this game is that because you can make a lot of money in a short time it is very profitable. Careful studies have shown that many a young man thought he had it made; the cars, women, the bling, and the cash. But when we factor in the fines, the legal fees, and the time locked up and making nothing, it is not unusual for the dope man to make less than minimum wage. The catch is that he makes thousands in a weekend and then nothing for the years he spends in prison.

No doubt I have left out listing examples of other items that might fit these four categories. Have you experienced an over-dependence, a devotion to something that has affected your life? Have you been chemically or psychologically dependent on a substance or developed an excessive reliance on a process or a lifestyle?

If you have any of these issues help is available.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

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

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

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

Planned Accidents The second Arthur Mitchell and Plutus mystery.

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

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

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

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

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

For videos, see: Counselorssoapbox YouTube Video Channel

4 Reasons counselors don’t say they like you

Posted on May 23, 2013 by David Joel Miller

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

Counseling.
Photo courtesy of Pixabay.com

Does my counselor like me? Why won’t they say they like me?

Counselors are reluctant to tell clients they like them and for some very good reasons. Most of the time I do like the clients I work with, but there are lots of reasons I don’t say so.

1. We want the client to learn to like themselves.

Many clients report they have “low self-esteem.” As often as I hear that expression you would think it was a specific diagnosis. It isn’t.

One reason for this low self-esteem problem is that too often all of us are looking to outside things to establish our self-esteem. If you need someone, anyone, to tell you that they like you, then your self-worth is dependent on doing and saying things so they will like you. This is a risky place to be.

I do not tell the client I like them. Most of the time I do not encourage them to even worry about what other people think about them. There is a huge danger in basing your self-worth on ratings or other’s opinions.

It is worthwhile to watch and see how you are affecting others. We call this self-monitoring. If lots of people are getting irritated with you, then you may need to take a look at yourself and see what you might improve. What you do not need to do is base your self-worth on what they think. Improve what you can and accept the parts of you that you can’t change.

What I do tell a client is that I think they are worthwhile people. They are the unique them just like everyone else on earth is a unique person. They do not need to do or be anything to be worthwhile. What they need to do is to do those things that will make them happy and that they can be proud of. If they do estimable things they can feel good about themselves regardless of what others think about them.

2. Counselors should not foster dependency.

Counseling is a helping relationship. It is not helping when someone else does everything for you. Rather than doing for clients, we want to teach them to do for themselves.

Rather than being in need of a friend, which increases the risk of becoming a needy person, you should become your own best friend. Once you learn to like yourself, you will find that you are much more likable to others.

Coming every week to see your counselor for another booster shot of self-esteem is not the same thing as recovering from whatever you chose to call your problem.

3. You need to develop an outside support system.

Counselors are professional people but we can’t be there every hour of every day. Yes, professionals are a part of a person’s support system, but we should not be the whole thing.

If you are in recovery, and who among us is not recovering from something or someone, you need a strong support system that is positive and in your corner.

There are a few people who have become conditioned to use the psychiatric hospital and professional therapists as their one and only support. They are sometimes surprised to find they do not have to go on doing that forever.

Having a positive friend you can call in the evening before bedtime or when you are feeling a little low, beats the heck out of having to call the psych hospital every night before bed for some reassurance.

Providers who create peer lines, which are places people with problems can call and talk to other peers, find there are more people who can function without needing psychiatric hospitals. Those communities that rely on hospitals to provide all the services need more hospital beds.

Peers are an important part of the recovery process.

4. There is a danger of developing a second or dual relationship.

The counseling relationship is special. It should not get mixed up with any other relationship. Counselors who forget those boundaries are at risk to get into friendship, financial or even romantic relationships with their clients. That is very likely to harm the client.

If someone says they like you there is that natural tendency to say you like them back. For a week or vulnerable person, there is the risk of trying to feel that way even if that is not how you really feel. The net result is an unwanted unprofessional relationship.

These second or dual relationships harm clients and they can cost counselors their licenses. Best to avoid this from the start.

Hope that explains this odd behavior we counselors feel obligated to observe with our clients.

David Joel Miller, LMFT, LPCC

Can you force a teenager to go for therapy? (counselorssoapbox.com)
What if your Therapist loses their cool? (counselorssoapbox.com)
4 Ethical Loopholes strangle therapists (counselorssoapbox.com)
What will the therapist tell me about trust? Trust issues (counselorssoapbox.com)
What do you do if your therapist cancels? (counselorssoapbox.com)
Will the Counselor, therapist, psychologist keep your secret or tell? (counselorssoapbox.com)

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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 do you find a counselor for Depression or Dysthymia?

Posted on May 22, 2013 by David Joel Miller

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

Counseling questions.
Photo courtesy of Pixabay.com

Looking for help with your depression.

Reader question thought I should share this with all counselorssoapbox.com readers as you might miss it as an answer to an older post. This was a comment on the Dysthymia post.

“I have a question: How do you find a professional who specializes in the treatment of Dysthymia? Someone who is really good. Searching for such a person in Michigan. Medications, by the way, are a waste of time. They don’t work for me. Can you suggest someone for me? Thanks!”

Great question. Let me make some suggestions. I am out in California and do not know professionals back there in your area. But the process is likely the same everywhere.

1. If you have not done so see a medical doctor first, there are some medical conditions that can look like depression or Dysthymia.

2. If you have a history of substance abuse, alcohol, or drugs, get that treated first or concurrently with the Dysthymia Even after people stop using they still have the old thinking and it does not change without help.

3. Interview the counselor you are considering seeing. Picking a therapist is kind of like dating, you may find the right person the first time, but you need to get to know them a little before you make the commitment. Progress in therapy is all about the relationship.

4. Look for someone who treats depression. The process is very similar in treating Depression or Dysthymia If the depression comes from a recent bad event this is more like an adjustment disorder. If you are depressed because you lost your job you need someone who can work on career counseling. Dysthymia is generally more long-term and you may need to look at things you learned as a child that no longer are helpful. I prefer to work from a Cognitive Behavioral or Rational Emotive perspective. Narrative therapy can also work.

5. Avoid a counselor who advertises things that do not fit you. Men should generally avoid a therapist that advertises they use a “feminist” perspective. Don’t see a Muslim counselor if you are a Christian or vice versa. Most good counselors work with everyone and do not put that sort of thing in their advertising.

6. Expect to do a lot of work on yourself. A good therapist is like a good tour guide, they can tell you about the trail but you need to take the hike.

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.

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

Addiction, substance use disorder or chemical dependency

Posted on April 25, 2013 by David Joel Miller

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

Addiction.
Photo courtesy of Pixabay.com

What is the difference between addiction and chemical dependency?

A lot of different terms are applied to the usage of substances and problems that arise when people begin to experience difficulties with their use.

Various professions use different terminology to describe the same or similar problems and we don’t all use the same severity points to identify problems.

One way of understanding these differences is to think of substance use as being on a continuum. Let’s start with something most people are familiar with, alcohol use, and then add various drugs to the picture.

Alcohol use might range from no use to chronic daily drinking to the point of passing out. Fully 50% of the people in the U. S, who are old enough to drink, did not have a drink in the last 30 days. Clearly not everyone drinks and among those who do, not everyone has a problem.

Heavy Drinkers.

At the other end of the scale, the 10% heaviest drinkers consume 60% of all the alcohol drunk. The top 20% heaviest drinkers consume 80% of the alcohol sold in America. People at the high end of the drinking scale develop more and more serious alcohol use problems than those who consume less.

Among those who do drink, some people have one or two drinks on a special occasion such as a wedding or New Years’. People who drink at this level rarely have any problems. It is possible however to drink only once a year on New Year’s and end up drunk every time resulting in DUI’s or arrests.

The labels that will be attached to the person as their consumption of alcohol increases and problems begin to arise will vary with the profession and the reason the person is being given the label.

The person who has one drink and no ill effects would be considered by most of us an alcohol user but nothing more. The person who only drinks occasionally but when they drink has problems might be thought of as abusing alcohol.

The chemically dependent.

The medical profession often has special units which are called “Chemical Dependency units.” The people who reach these units have the most severe form of substance use disorder. They have reached the point of physical dependence on their drug of choice. Those who are chemically dependent on alcohol are at risk to die during withdrawal.

If someone has ever had a stroke, seizure, or experienced the D.T,s if there are any hallucinations occurring when the level of alcohol in this person’s bloodstream begins to drop, this person is at high medical risk and should be detoxed in a hospital or other medically managed facility. People can and do die from alcohol withdrawal.

People who are chemical dependent on other drugs may have severe physical withdrawal symptoms. The heroin or opioid user, for example, will have diarrhea, nausea, vomiting, shakes, and goosebumps. The withdrawals from opiates may feel like the person will die but deaths from opiate withdrawals are rarer than from alcohol. Overdose deaths are another issue.

Short of physical withdrawal is a form of substance use disorder that is called Substance Dependence. Clearly, not all cravings for a drug of choice are the result of physical withdrawal.

Someone goes through a 30-day treatment program, they have not used for over a month but the day they are discharged they use again. The craving is not a result of physical or chemical dependency but is a psychological need. Therapists would diagnose this as Substance Dependency. For the Therapist, this would include both physical and psychological dependency.

Alcoholism and addiction.

Twelve-step programs draw a different distinction. They would call this problem use of substances, addiction, or alcoholism. This addiction level of problem use may be reached even before psychological dependency has occurred. Addiction may begin at the point of wanting, craving, and thinking about the drug of choice even before the person has lost the ability to control usage. If you are struggling to control your usage then you have already reached a point of problem usage and probably would fit the description of an alcoholic or addict.

Substance abuse.

The lowest level of problem use would be referred to as substance abuse. This might be binge drinking, drinking more than planned or doing something dangerous after having consumed alcohol or another drug. The person who has a few too many drinks and then drives may be abusing alcohol but may not yet have developed alcoholism.

If this alcohol abuser can realize they have a problem and stop drinking to excess, they may be able to stop their progression to alcohol dependence, alcoholism, or chemical dependency.

Substance use disorder makes its debut.

The newer trend, now reflected in the DSM-5, is to avoid making fine distinctions between substance abuse, dependency, addiction, and chemical dependency and call all problem relationships with drugs including alcohol simply a substance use disorder.

Substance use disorder can come in mild, moderate, or severe forms.

Wherever the substance use disorder starts, it needs treatment long before it becomes an addiction or chemical dependency.

Whatever happens (It has happened with the DSM-5 and the new OCD-10 as of 10/1/15) with the DSM-5, expect the various professions and the recovery community to cling to their own special perspectives and their preferred terminology.

Did that explanation help with understanding the differences between Substance use, abuse, dependency, addiction, alcoholism, and chemical dependency?

Best wishes on your journey towards a happy life.

David Joel Miller, LMFT, LPCC

Mental illness and substance abuse only strikes certain zip codes (counselorssoapbox.com)
6 Myths about alcoholism (counselorssoapbox.com)

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

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

Story Bureau.

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

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

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

11 signs you crossed the addiction line. Is it partying, drinking and using or addiction?

Posted on April 12, 2013 by David Joel Miller

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

No Drugs.
Photo courtesy of Pixabay.com

How do you know when your drug or alcohol use has become a problem?

Some people report that they can drink a few drinks now and then and they have no problem. There are those rare individuals who are able to try a drug a few times and then put it away with no apparent bad result. But many people discover that what started out as all fun has progressed to becoming a problem. Here are 11 signs that your partying has moved from being fun to being a problem, maybe even an addiction.

1. You are trying to control your use.

One of the first signs of an addiction gone wild are the efforts to control use. Normal people, people without a problem, do not try to control their use. They do not need to control anything because they can take it or leave it. If you find that when you drink or use you end up doing more than you planned on doing if you start needing to control your usage, then you are on your way to a problem.

2. You arrange your life around chances to drink or use.

People with an abuse problem begin to arrange their life around getting and having their drug of choice. They pick restaurants based on the bar, not the food. They avoid social settings where there will be no drugs or alcohol or they will not be able to drink and use.

They also begin giving up friends who do not use or drink.

3. It takes more of the drug or alcohol to get the same high.

This is called tolerance. If you need to drink more alcohol to feel the same effects, you are developing tolerance. If the same amount of a drug produces less and less of an effect on you, then your body has begun to develop tolerance. You are headed for problems. Those who can “hold their liquor” are not safe from alcoholism. They are already on the way to becoming an alcoholic.

4. You have symptoms of sickness when you suddenly stop getting your drug of choice.

This is called withdrawal or sometimes abstinence syndrome. Hangovers when you drink. Other physical symptoms, headaches constipation, diarrhea, changes in sleep, or appetite directly tied to your use are indicators of problems. So is needing more of the thing you did in the morning to recover. Taking some of the hair of the dog that bit you means you have been both bitten and infected with the addiction germ.

5. You get angry when people try to talk to you about your drug or alcohol use.

People who drink or use in responsible ways do not have people talking to them about their use. If your use has reached a point where people need to talk to you about it, then you have gone past the point of casual use and are headed for problems.

6. You have begun to accumulate negative consequences as a result of your use.

If you get in fights, verbal or physical, with people, are getting DUI’s or lose your job as a result of drinking or drug use then it has become a problem. If your relationships are suffering or you are fighting with your partner about your drug or alcohol use then the drug has entered the relationship and you are now in a threesome with that drug. This is not likely to turn out well. Both Sherry (alcohol) and Crystal (Methamphetamine) are jealous lovers and they do not want you to see your current partner.

7. You feel guilty about things you have done while under the influence.

Most times you can drink too much or do a little drugs and the next day you can think I wish I hadn’t done that and everything is fine. But it is not always like that.

Some people find the first time they drink they end up blackout drunk, the may drive drunk and kill someone, do something violent or even commit rape while under the influence. The little things are easier to hide than the big ones. No one knows when they will cross that line.

One warning sign is if more than once you wake up the next day having done things you wish you hadn’t and things that you need to pay for, make right, or worse yet things you can’t take back or fix.

If you feel guilty for things you do when under the influence of drugs or alcohol then you are headed towards addiction. You may already be there.

8. Most of your life involves getting the drug, using, and getting over the effects.

This is a classic sign of addiction. The addict finds that most of the day is spent thinking about their drug of choice, getting it, doing it, and then getting over the effects.

9. Drinking or using interferes with the roles you need to fill in life.

It affects your job, your relationship, and your parenting skills. When you stop seeing your friend or family, when you let your kids or spouse down all because of the things that drugs or alcohol are now requiring of you, it has passed from being fun to being a problem.

10. When you wake up one morning and this is no longer fun.

When you wonder how you ever got started. When you wish you had never taken that first drink or hit, you have reached the point where you don’t need to ask if this is a problem, you already know.

11. When what used to be your solution has become your problem.

If you move from thinking that a little alcohol or weed would mellow you out and make you happier or help you have more fun, and then after a long time using you need this substance to help you wake up, this is a problem. When you decide that this drug is your problem you have crossed the line by then it has become too late. You are now way past the point of return and have arrived at addiction.

Remember not all addictions are physical, getting sick kinds. The psychological addictions are often harder to kick than the physical ones.

If you are seeing some or all of these eleven signs in your life, then consider if it is time for you to give it up. There is help out there but you need to reach out for the help. Some professionals, counselors, and therapists, have been trained to help. There are substance abuse programs in almost every place. If those options do not work for you there are plenty of twelve-step groups and a few other peer self-help groups, all full of people who would like to help you as a part of their recovery.

If your fun has turned into your problem please consider asking for 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.

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

Can you force a teenager to go for therapy?

Posted on March 23, 2013 by David Joel Miller

By David Joel Miller.

How do you get a teen to go for help?

Can you force a teenager to go for therapy? Photo courtesy of pixabay.

The question of getting a teen, or any other person for that matter, to go for mental health treatment is always problematic. With teens, you sort-of can and sort-of can’t. Let’s see why.

First, it depends on what you mean by “force.” With children and teens no matter what they may think, they are still minors and under someone’s supervisor. So technically yes parents can most of the time require a child to go for any kind of treatment even if the child does not want to go.

From here on out let’s call teens “children” because parents have responsibilities for the child regardless of the child’s wishes and teens are for most legal purposes still “minors” until they turn 18. I will let you know if there are reasons to separate teens from children.

Exceptions to making a child go for treatment would come from legal issues. Are you divorced? What does the custody agreement say? Is there legal involvement? What do the courts and Child Protective services say?

Even if the custody order says you can make those decisions for the child, most therapists will want both parents to sign giving consent for treatment. We, professionals, like to stay out of court as much as possible, and seeing a child without one parent’s permission opens you up to all sorts of legal risks that may not be worth taking if you do not have to.

One aside here, the child may consent for themselves if there are crisis issues or if they say you are abusing them, then they can seek outpatient treatment with or without parental approval in some places. This all gets complicated and most times the counselor will already be on the phone with someone for legal advice before they start seeing this child. If the child was suicidal whoever has the legal authority to put them on an involuntary hold and send them for evaluation or treatment can also do that whether you want your child’s suicide attempt treated or not.

Back to our original question. You want this teen to go and they do not want to go. How far can you go to force them? Physical force is not a good idea. For counseling to work the person receiving the treatment needs to talk and they need to think that there is some reason that this person can help them.

People forced to treatment do not get as much work done and it takes longer. Any good counselor will spend the first few sessions trying to build a relationship with this teen so the teen decides that this might be a good thing. At that point please do not start asking the counselor to betray the teen’s trust and tell you everything they have been up to.

I hope it does not surprise you that teens who are abusing drugs and alcohol and those who are very violent and oppositional do not show up for treatment a lot of the time.

Rather than call this treatment “forced” I like to think of it as encouraged.

One rule of parenting I like to tell clients about is that “Parents need to be parents and children need to be children.” Letting kids decide if they need counseling or any other treatment procedure may violate that principle. How can an emotionally disturbed teen make a good decision about going for treatment?

Do you let drunks drive your car? That would be risky for you regardless of who they were. So if you suspect that your child is abusing drugs or alcohol you may find it difficult to get them to go for treatment but one way to motivate them to attend sessions is to take away or restrict their use of the car, or something else they care about if they will not go for counseling. This making the cost of not going higher than the cost of going for treatment works some of the time but not all the time.

If they refuse even with the car taken away, you will need to go to more drastic measures. Also if once you take the car keys away and they do take the car and drive you may be forced to call the police and report the car stolen. Either that or explain to your insurance company and the police why you let a child you suspected of abusing drugs or alcohol take your car and then you did nothing about it.

If you have any reason to think your teen or younger child for that matter, needs to see a counselor or therapist and it is legal for you to take them in, by all means, have them go. The best case is that the counselor will tell you they do not see anything out of the ordinary and what your teen is going through is just a normal part of being a teen. So you spend a little money on an office visit for some peace of mind.

But if after that visit they suggest that your child needs to keep coming, make a serious effort to get that teen to the appointment.

If the teen refuses to go you will need to enlist the help of anyone and everyone who can get that kid into treatment before they get in serious trouble. Try to do this before you need the help of his parole or probation officer and before he has harmed himself or others.

Ignoring mental health problems does not make them go away. In plenty of cases, people saw that there was something wrong with a teen or younger child and yet the child did not get treatment until they did something that ended up on the news.

A few early interventions with teens in distress could save a lot of pain for them and for other people down the road.

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.

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

When Mindfulness makes you feel worse – about pain.

Posted on February 21, 2013 by David Joel Miller

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

Coping with pain.
Photo courtesy of Pixabay.com

What are you doing to avoid feeling pain?

The question came up in a discussion of mindfulness about people who feel unable to be mindful, to meditate, because every time they do they become overwhelmed by extreme pain.

What do you do if you would like to use some of these introspective self-examinations approaches but when you stop what you are doing, even for a moment, you begin to suffer from painful memories of the past?

Here is the dilemma. I am not one to think that to have a happy life we need to excavate every trauma and pain you have experienced. I do in fact see times when cross-examining clients about past trauma can be harmful. The last thing I want to do in therapy is to re-traumatize someone who is suffering. But there is value to cleaning out the wreckage of the past.

One recovery saying that often rings true is “we are only as sick as our secrets.” Lots of dysfunctional behavior, substance abuse, excessive spending, sexual addictions, and other compulsions are ways of trying to avoid having to feel those feelings which are so unpleasant.

Depression, PTSD, anxiety, and a whole host of mental and emotional problems are also maintained by wounds from the past that have not healed.

We know that if you are feeling physical pain, just ignoring that pain is not a good idea. Athletes can sustain long-term injuries if they do not listen to their bodies and stop playing when they are in pain.

My take on this is that if when you try to meditate or be mindful and all that comes up is an overwhelming pain, you need to seek professional help to process and work through that pain. Otherwise, you are at high risk to keep running from the pain until one day your escape mechanism stops working.

Plenty of alcoholics and addicts will tell you that one day their drug of choice stopped working. Any effort to deny the pain can only work for so long and then eventually you will have to face the problem you have been running from.

Drugs and alcohol are common ways of trying to escape feelings but there are others. Using drugs in this way is a very dangerous habit. The relief from the pain is short-lived. When the drugs wear off the pain returns, only now it feels even more overwhelming. So you use again. The intervals between uses get shorter and the amount you need to use gets larger and there you are one day at your upper limit and still feeling the emotional pain.

Most of us are not good at reading our body sensations. We humans often confuse thirst and hunger, resulting in consuming excess calories and weight gain. We also confuse physical and emotional pain. Physical pain may be managed by medication but emotional pain, most of the time you need to feel it, in a safe environment, in order to heal it.

America is currently facing an epidemic of prescription drug abuse.

One reason for this abuse is that people are using prescription pain medications, designed to treat physical pain, for treating emotional pain. The short-term relief results in long-term addiction. If you describe your pain to the doctor as all over in your body he may prescribe medication. If you tell the truth that you have felt this way since you lost your job or partner, the prescription will be some counseling.

The technical term for this is prescription drug abuse. It is easy to get addicted. Pills are quick and easy. They work for a while, then the pills create other problems like addiction. Counseling takes time but it helps you recover.

Mindfulness is meant to help with this, but it can be hard to just sit and stay with a pain for a while and really find out what this pain is all about. Sometimes we need to work on this emotional pain a little at a time.

I have heard this approach to reducing emotional pain described as “peeling the feelings onion.” You peel off a little, tell your helper about what you are feeling, and why then you cry. When the crying is done go back to the peeling. Repeat until all the pain is peeled away.

If you find that when you are alone or you try to clear your mind the only things that race in are those old memories of pain and hurt then you need to start healing those old wounds.

We humans have a bad habit of continuing to hold onto negative emotions long after those emotions have had any benefit. Not being able to release stress or regret can keep the torture of the past alive long after the incident should have been forgotten.

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.

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

Drug programs are not about treating addiction

Posted on January 30, 2013 by David Joel Miller

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

Drugs.
Photo courtesy of Pixabay.

Did you think drug treatment programs were designed to treat addiction?

Drug treatment efforts in the United States are generally not about treating addiction. If we really cared about reducing addiction we would be doing things differently.

There has been a fair amount of criticism surrounding drug treatment programs and why there are so many people who have been through a treatment program and still use drugs. The reason this situation looks so bleak is that the majority of these programs were never designed to treat addiction despite what the program may be called.

Addiction is not the only area where programs are designed to do one thing despite being sold to the public and called by a name that implies they are supposed to solve that problem.

Having angered half the world with my posts on prayer and the role of spirituality in recovery I might as well anger the rest of the world with some comments about the defects in our political system.

Most drug treatment programs are not meant to get addicts off drugs!

Does that surprise you? It is only very recently and among a very small number of people; that addiction, alcoholism, and related impulse control disorders like compulsive gambling have come to be regarded as diseases.

The traditional approach to addiction was to consider those people criminals and lock them up until they quit doing drugs. Alcoholics were considered crazy and got confined to psychiatric facilities called “sanitariums.” The high prevalence of repeat DUI’s (Driving under the influence sometimes called DWI, driving while intoxicated) and rearrests for drug use confirms that more than just locking them away is needed to solve this problem.

Some examples of possible treatments

Methadone maintenance for Heroin Addicts.

Methadone maintenance is not designed to cure addiction. It is designed to reduce crime. The goal in this and most other drug and alcohol treatment programs is now and always has been on crime prevention.

The Heroin Addict with a $200 a day habit has to come up with that money every day or become very sick. There are ways to put the bill off, like getting an advance from the dealer, but that works for a very short time unless you are very, very wealthy. Eventually, you need cash. Drug connections are not charitable institutions, they want the cash.

Many Heroin users resort to stealing to cover their costs, burglary is a common way. To get $200 a day for drugs the addict needs to steal $2,000 worth of property. Fences do not pay retail. In the process of stealing $2,000 a day to cover their drug needs the addict may do $20,000 in damage. They do not care if they break a $1,000 window to steal a $1 item.

Giving the addict a $2 dose of “narcotic replacement therapy” will save as much as $20,000 in burglary and vandalism costs. What shocks me at this point is that the insurance companies are not lining up to fund this kind of crime prevention effort.

Remember that Heroin was discovered back in the 1800s and has been way out of patent protection for a long time. The only reason it is so expensive is that it is illegal. Doctors are not even allowed to prescribe it for clients who are addicted.

The replacement drug, most often Methadone, is not less addicting but more addicting than heroin. It is also not easy to get off. So the system does not treat the heroin addict. We get them hooked on another even more addicting drug.

Please do not misread this as my arguing for the legalization of Heroin or the end of methadone clinics. Keeping as much heroin as possible off our streets may reduce initial cases of addiction. Putting more Heroin on the streets will likely increase cases of addiction. I also know of many cases of people whose lives were changed by the use of narcotic replacement therapy (mostly methadone.) Some people need that drug to get out of the illegal lifestyle and on to a legitimate job.

What I am pointing to is that this program like so many other government programs is not meant to help the people with the problem.

Drug treatment programs are designed to reduce crime not cure addiction.

Prop 36 or SACPA.

The “Prop 36” program in California which sent tens of thousands of addicts to treatment resulted in a number getting off and staying off drugs. The program has since been in large part “defunded.” The official title of the program was SACPA, short for Substance Abuse Crime Prevention Act. Clearly, the emphasis was on crime prevention, not addiction treatment.

Drunk Driving programs.

Further evidence for this hypothesis comes from Drunk Driving programs. Drunk driving programs do NOT treat alcoholism despite the high number of alcoholics with chronic medical problems who are driving up the cost of medical care for all of us. Programs forbid their instructors from talking about alcoholism.

Drunk driving programs are focused on teaching you how to drink more and still not get a DUI. Things like designated driver programs and spacing your drinks so you can continue drinking, the more the better, and still not get a DUI.

It is possible with the expansion of health care we will get serious about treating addiction, alcoholism, and mental health issues. I remain hopeful but skeptical. Past experience has made me that way.

Sorry to spoil your illusions. Drug treatment never was about the addict. But then you are not one of those people who believe in fairy tales like the tooth fairy or that food stamps are meant to reduce hunger are you?

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.

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

Will I remember my Black out? Reader Question # 3

Posted on January 27, 2013 by David Joel Miller

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

Alcoholism.
Photo courtesy of pixabay.

Will I remember my Blackout?

Reader Question # 3

No! If you truly had a blackout you will not remember it. If no memory is stored then there is nothing to recover. Think of it like playing a brand new blank DVD. Nothing recorded, so nothing to play.

Brownouts can happen also.

Sometimes bits and pieces of information were saved. It is often referred to as a brownout. That information may come back a little, bits by bit and piece by piece.

My guess, and it is only a guess, is that the brownouts happen when there was a trauma, like rape and the brain tried to protect you or when the levels of alcohol or other drugs in the bloodstream fluctuated.

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.

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

Not all addictions are created equal.

Physical tissue dependency on a substance is an addiction.

Psychological dependence on a substance is addiction.

Process addictions, when doing takes control of the doer.

Lifestyles can become addictions.

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Does my counselor like me? Why won’t they say they like me?

1. We want the client to learn to like themselves.

2. Counselors should not foster dependency.

3. You need to develop an outside support system.

4. There is a danger of developing a second or dual relationship.

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What is the difference between addiction and chemical dependency?

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The chemically dependent.

Alcoholism and addiction.

Substance abuse.

Substance use disorder makes its debut.

Substance use disorder can come in mild, moderate, or severe forms.

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How do you know when your drug or alcohol use has become a problem?

1. You are trying to control your use.

2. You arrange your life around chances to drink or use.

3. It takes more of the drug or alcohol to get the same high.

4. You have symptoms of sickness when you suddenly stop getting your drug of choice.

5. You get angry when people try to talk to you about your drug or alcohol use.

6. You have begun to accumulate negative consequences as a result of your use.

7. You feel guilty about things you have done while under the influence.

8. Most of your life involves getting the drug, using, and getting over the effects.

9. Drinking or using interferes with the roles you need to fill in life.

10. When you wake up one morning and this is no longer fun.

11. When what used to be your solution has become your problem.

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How do you get a teen to go for help?

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What are you doing to avoid feeling pain?

America is currently facing an epidemic of prescription drug abuse.

Share this:

Did you think drug treatment programs were designed to treat addiction?

Most drug treatment programs are not meant to get addicts off drugs!

Methadone maintenance for Heroin Addicts.

Prop 36 or SACPA.

Drunk Driving programs.

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Will I remember my Blackout?

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