<![CDATA[Jonathan Miller, EdM, LPCC-S - Blog]]>Wed, 15 Jan 2025 12:45:16 -0800Weebly<![CDATA[December 16th, 2024]]>Mon, 16 Dec 2024 16:24:32 GMThttp://millercounselingllc.com/blog/december-16th-2024]]><![CDATA[Why AI can't get us out of grief]]>Wed, 25 Sep 2024 00:45:21 GMThttp://millercounselingllc.com/blog/why-ai-cant-get-us-out-of-grievingThe oldest joke in the book runs:

"Doc, it hurts when I go like this."
"Okay. Don't go like that"


"What I would like to see is the complete and total eradication of grief," says tech entrepreneur Justin Harrison. That's never going to happen. And the better his tech gets, the worse its central problem will be.

Harrison's venture offers mourners the chance to create an AI version of their loved one. You can have conversations with these "versonas" now. Someday, you'll be able to load the AI into a robot you could hug. This video from The Guardian suggests people could use this technology to reach emotional closure. But how many people would say goodbye when they could just start the AI back up again?  A cybernetic ghost is the worst of both worlds. Your loved one is still gone, but there's less reason to move on with your life.

Grief can be agonizing. It's pain with a purpose - to help us accept and adjust to loss. We can put it off all of our lives, but we can't get out of it. Working through the process means wholeness. You know you've reached the end when you find happiness in your memories of your loved one, instead of sorrow.

These AIs won't eliminate grief. They'll help mourners stay trapped in one of grief's earliest stages - denial. Let's have sympathy and compassion for the bereaved. Let's hope the tech industry find ways to help people work through it.

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<![CDATA[You're Coping Better Than You Think]]>Sun, 07 Jun 2020 23:54:33 GMThttp://millercounselingllc.com/blog/youre-coping-better-than-you-thinkWhere’s your focus gone? You have free time, why aren’t you more productive? Where did today go, anyway?
As commercials keep reminding us, these are uncertain times. Any one of 2020's catastrophes would have been the low point for a different year. As traumatic as Sept. 11th was, our new normal set in quickly. Today's protests have no end date. Doctors, politicians and relatives all say different things about the risks of coronavirus, what steps we should take, and how long we’ll have to take them. 
Along with all of this stress has been an avalanche of advice. Clients aren't asking, “How do I cope?” They already know. They're asking, “What else can I do?” Are they getting exercise and a healthy diet? Check. Are they practicing mindful meditation or other kind of relaxation practice? Check. Are they getting seven-to-nine hours of sleep? When insomnia and worry permits.  So why aren’t they feeling better?
Most advice comes with an unspoken promise: “Do this and everything will be fine. Do that and you’ll feel great.” Not “better." Not “good.” GREAT.
Edginess, lack of energy, reduced activity and trouble concentrating are all normal reactions to stress. That stress gets worse when we think we should cope effortlessly with multiple national stressors at once. We’re raised on problem-solving. If you feel bad, you figure out what’s making you feel bad. Fix that problem and then you don’t have to feel bad. This works great for problems that have quick, easy solutions. We’re stuck with several that don’t. It can leave you feeling like a failure.
We have enough information on how to cope.  Let’s talk more of how “coping” isn’t the same as “conquering” or “being completely unaffected by”. Still stressed and uncertain? Look for what other healthy habits you could add to your current routine. If you aren’t exercising, eating healthfully, practicing relaxation skills, limiting your screen time, or reminding yourself we can only control our choices, now’s the best time to start.
You could also go easy on yourself. Chances are, you’re coping better than you think.

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<![CDATA[What exactly is EDMR? ERDM? EMDR?]]>Fri, 04 Nov 2016 20:10:42 GMThttp://millercounselingllc.com/blog/what-exactly-is-edmr-erdm-emdr"Eye Movement Desensitization and Reprocessing" (EMDR) is a mouthful to say. It's a powerful treatment for anxiety disorders, but it's complicated to explain. This short video from the EMDR International Association helps clarify.
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<![CDATA[When to seek help for anxiety? ]]>Fri, 02 Oct 2015 21:56:10 GMThttp://millercounselingllc.com/blog/when-to-seek-help-for-anxietyHealthy New Albany magazine interviewed me about anxiety and when to seek help. It's in this month's issue. Check it out. ]]><![CDATA[Bill Murray on being your best]]>Wed, 23 Sep 2015 23:37:57 GMThttp://millercounselingllc.com/blog/bill-murray-on-being-your-bestIn his Vulture profile last year, comedian Bill Murray said, 
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"Someone told me some secrets early on about living. You have to remind yourself that you can do the very best you can when you’re very, very relaxed. No matter what it is, no matter what your job is, the more relaxed you are, the better you are."

Psychology researchers would disagree. They aren't the illustrious Dr. Peter Venkman. Could both be right?

Strictly speaking, perfect relaxation doesn't help performance. When you're as serene as a yoga instructor with a trust fund, you won't have the motivation it takes to boost sales or production. Performance goes up with stress, but only to a point.

The Yerkes-Dodson law shows we do our best when our stress level isn't too high or too low.*  In this "eustress" zone, there's enough agitation to create drive, but not enough to cause panic. This is where talk-show hosts like to have their guests; just anxious enough to put on great, manic entertainment.
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Performance goes up with stress, but only so far.

Past that point, when arousal levels go too high, performance quality goes down. It's hard to meet quarterly goals when you're rigid with fear. That means companies that take the high-pressure, "purposeful Darwinism" approach are probably sabotaging themselves.
 

Does this mean Murray's wrong? For the sake of Caddyshack, Stripes and Groundhog Day,** let's say no. Life creates tension. It can take regular relaxation practice and self-care to ease our anxieties. Aim for, "very, very relaxed," and you'll reach the sweet spot on the curve without trouble. 


* The ghost of my Psych 101 professor just rapped my knuckles. Yerkes and Dodson said their discovery doesn't apply to simple tasks. I doubt Murray had digging ditches in mind. 

** What About Bob? is sadly inaccurate about therapy and therapists. I almost wish it wasn't as funny as it is. 

@ 2015 Jonathan Miller All Rights Reserved
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<![CDATA[Parks & Recreation & Anger Management]]>Wed, 06 May 2015 00:06:23 GMThttp://millercounselingllc.com/blog/parks-recreation-anger-management
In-between the jokes, this snippet offers solid stress-management advice. 

1. Count backwards from one thousand by sevens: When you focus on a repetitive math problem, your brain increases metabolism in areas such as the posterior parietal cortex (which is involved in planned movements) and the prefrontal cortex (which is involved in decision-making). That means less energy to the areas that handle instinctive, angry responses.  

Not a math whiz? Try counting backwards from three hundred by threes. Math whiz? Try calculating some five-digit prime numbers. You want to pick a problem simple enough you can do it in your head but complicated enough to make you stop and think. 

2. Think of warm brownies: This trick helps because of classical conditioning. Can you remember feeling happy and relaxed when the brownies came out of the oven? Think of their sight, taste, texture and smell. Automatically, your nerves relax some because they associate brownies with safety and calm. 

If an image of brownies doesn't do the trick, think about the times where you felt tranquil, secure and content. Pick an item or image that sums up those times and visualize it in every detail. Depending on the associations you've made, you might picture buffalo wings, a bonfire or your favorite fishing spot. Thanks to classical conditioning, the image will lead your nerves to unwind, just as Pavlov's bell made his dogs' mouths water.

There's a business-management lesson here, too:

1. At high-stress moments, remind your employees of their coping skills.
2. Tolerate their surly attitude until the skills have had time to work.
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<![CDATA[Rescue Your Relationship From the "Four Horsemen"]]>Wed, 11 Mar 2015 22:35:33 GMThttp://millercounselingllc.com/blog/rescue-your-relationship-from-the-four-horsemen"We want to stop fighting," is what most couples say at their first therapy session. "That's never going to happen," is what John Gottman, Professor Emeritus of psychology at the University of Washington, would tell them. So why is he considered one of the most important figures in relationship counseling?

Gottman spent years studying couples and how they communicate. Although he came to see there's no way to avoid conflict, he also found squabbles don't have to spell doomsday. He identified four emotional reactions that shred relationships. He called them the "Four Horsemen", after the Biblical figures who signal the coming end of the world. He also picked out four substitutes to make arguments productive. 
Albrecht Durer Four Horsemen 1497-1498
As illustrated by Albrecht Durer, ca. 1498.
From the least harmful to the most, the four riders are:

Criticism:  "How can you treat me this way?" "You never think about what I want." "Why do you have to be so selfish?"

Criticism is anything that implies something is fundamentally wrong with your partner. If you use words like "always" or "never", it's criticism.  After all, if it happens every time, there must be something lasting about them and their character.

Complaints are more effective: "What you said hurt my feelings." "When you don't do your share, I wonder why I should do mine." "That kind of language gets me really angry."  

This kind of complaint isn't whining. Good complaints are specific about what your partner does, and what you'd like them to do differently. Be careful; if you give anyone a long list of detailed complaints, it might as well be global criticism.

It's worth the time it takes to spell out the problem precisely. Criticism often provokes …
PictureJohn M. Gottman, PhD
Defensiveness: "Have you looked in a mirror lately?" "If you don't like my temper, don't talk like I'm an idiot." "ME? What about you?"

When you feel attacked, you want to defend. It's easy to believe your partner starts all the trouble, and easier to think your actions should be overlooked.

Owning part of the criticism, even a small part, will get their attention: "You're right, I should have done the dishes." "I talk to kids all day, so maybe I don't realize how I sound." "You did say you wanted to leave by 6:00 PM."  

If 90% of what your partner says is flat wrong, start by agreeing to the 10% that's accurate. They'll be more relaxed and open to the other things you want to say. Fight the temptation to rationalize what you've done or to point out your partner's blind spots. They will get the message you don't care about things that are vital to them. That can lead to …

Contempt: "I'm the only one who's being logical here." "If you don't like it, get out." "You're just like your mother and I'm sick of you both."

Contempt includes ridicule, eye-rolls, condescension or any kind of belittling comparison.  It goes far beyond gentle teasing. When partners hold genuine contempt for one another, the relationship is most likely over.  

Cultivate a culture of appreciation in your thoughts about the other person, and it can overgrow the contemptuous ideas: "He works really hard in the yard," "She never keeps me waiting," "He's great with the kids."  You don't have to pretend you aren't frustrated. Write up a list of their good qualities and re-read it. Realistic, appreciative thoughts will balance your thinking and you'll remember they aren't garbage.

You don't want them to think you see them that way. It can result in …

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Stoneware stonewalling.
Stonewalling:  (Nothing is said.)
When people feel overwhelmed by sadness, anger or fear, sometimes they shut down. They may look away, cross their arms or sigh heavily, but they won't communicate.

Stonewalling hurts. It sends the message, "I don't care enough to answer you." Ironically, it's often intended to help.  If your partner grows quiet, it may be they don't want to lose their temper. When one person thinks, "I'm going to keep my mouth shut so I don't make it worse," and the other thinks, "I'm going to keep talking until he shows me he understands," it makes for a long, destructive, one-sided conversation.

To break out of stonewalling, calm yourself and respond. Slow, measured breaths will relax you enough to speak with an even tone. Even if you only say, "I'm agitated and I want a break," you've told your partner you respect them enough to say that much. 

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<![CDATA[Questions Clients Hate (and why therapists ask)]]>Mon, 02 Feb 2015 23:11:25 GMThttp://millercounselingllc.com/blog/questions-clients-hate-and-why-therapists-askAn supervisor once said, "We don't get paid to have the answers. We get paid to ask the questions." Some questions set off heavy sighs and rolled eyes. Here's why your therapist will ask them anyway:  

Question #1: “What do you want to work on today?”

Everyone walks in with the same goal: to feel better. When you're miserable and overwhelmed, it can be disconcerting to be asked where you want to start. Therapists are the ones with a degree - shouldn't we know what comes next? PictureNot again!
Why we ask:

It’s your therapy. You’re the one who knows what you can handle and what’s most important. Too often, we therapists will wear ourselves out on an issue, then learn our too-quiet client didn't want to talk about it at all. By putting you in charge of what to work on, we give you practice in taking charge of your life. 

By the time we ask this question, you should have already have completed a treatment plan and learned how your problems can be treated. Pick from any of the goals you agreed to.  A good therapist will follow you where you're willing to go. 

Question #2: “How does that make you feel?”

This should be obvious, right? If you've just explained your mother needs chemotherapy, you could be tempted to say, “How do you think it makes me feel?” When others ask how we feel, we usually respond with an evaluation like, “Fine,” “Great,” or, “I'm hanging in there." Therapists ask for the specific emotion, and that's personal. 

Why we ask:

1. Identifying emotions is healthy. It’s information that helps you understand what is happening and why. When you let emotions up, that means they're on their way out, and that's what helps you feel better. 

2. Feelings are what you've asked for help with. A mechanic can’t fix your car without a look under the hood.  Since most of us aren't practiced in naming feelings, good therapists will have a list of emotion words handy for your referral. 

3. We don’t know. We know how we would feel if was us, but it's not. Our psychology degrees taught us about people in general, and you are you. Maybe there's a numb feeling that's taken you by surprise. Maybe your cancer-stricken mother made childhood miserable and you’re enjoying the schadenfreude. We ask, because it's arrogant to assume. (Have you watched movies or TV shows where therapists see through clients in seconds? They're a load of bunk.)

Question #3: “Are you thinking about killing yourself or anyone else?”

This one is a little insulting, isn’t it? Especially if you’ve told your therapist you’d never do such a thing. Didn't you say so just last week?
Picturesrsly?
Why we ask:

We know what you said last week. We want to know about this week. 

Anyone who's ever worked in a mental hospital can tell you about a patient who looked fine, said they felt great, and killed themselves a day or two after they left.  People often commit suicide when they’ve been depressed for a long time. You could look the same as you have all along, and be on the edge of finally ending it all. 

Under the law, it's our job to know when a client might hurt somebody, and to prevent it if possible. When a client commits suicide, we're on the hook, legally and emotionally. Even when there's no legal action or licensure-board investigation, we’ll spend months or years wondering how we might have kept them alive. The regrets and second-guessing are worse than any lawsuit. That's why this question is never an accusation; it's a way to settle our nerves by doing our job.

Are there other therapist questions that leave you wondering? E-mail me and I'll address them in an upcoming post.


©2015 Jonathan Miller Counseling, LLC. All Rights Reserved.
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