Ask The Counselor -

Hi... Welcome to my Interactive! page. This is the spot where I answer reader's questions about life, relationships, online counseling services, mental health topics, treatment issues and more- whatever is on your mind or weighing heavy on your heart. This free service is provided as a courtesy to Grace Tree's visitors and is not intended to replace traditional therapy which promotes a much deeper level of personal healing and growth through personalized counseling services. You can always order professional online counseling services at my website if you'd like further personal counsel and encouragement. So, feel free to submit a question for review. You may remain anonymous if you like, and patience is required because there's been quite an overwhelming response here and there are many questions waiting in the wings! If your question is chosen it will be posted here with my response and may be appropriately edited to save space. Just remember, this is a public forum and all questions are subject to screening and approval.

I look forward to reading your questions and helping out as I can. So,CLICK HERE NOW to Ask The Counselor, or click on Comments/Trackbacks below. And, be sure to check back in for weekly updates to start again soon!

Regards!
Carole L. Miller, LCSW-C
Grace Tree Counseling Services

Healing From Past Abuse

I was just wondering roughly how long it take to heal from emotional and verbal abuse if you are in counseling?
Dee


Hello Dee,
Thanks for writing in and asking such an important question. I'm sure it's of interest to many readers. Healing from the pain of any type of abuse is usually a very individual journey and the process is unique to each person. Such healing often takes place over a considerable amount of time, even years, and the level of progress really depends on the person, level of abuse and the circumstances involved.

No one can accurately predict when anyone will 'heal' from past abuse, and many people find that healing and making peace with the past occurs at various times throughout a person's life span. Some people make many gains after a few years of therapy and are able to 'let go' and move on without any further effects. Others report the same gains, but also add that the pain of the past sometimes comes up once in awhile and they need to revisit the grieving-healing process at times. However, this is when they put into practice what they've learned before while in therapy as to help them along. The counseling process can be very beneficial in learning new skills in how to cope and continue to heal when 'stuff' comes up after moving on from therapy. One thing I've learned over the years in my professional practice counseling others is that the healing & grieving process can often be a life long process, which does wane though as time goes on. And, if a person can recognize and accept the healing process as a life journey there is much more serenity and peace found along the way.

Thanks again for your inquiry Dee, and I wish you all the best on your healing journey!

Sincerely,
Carole L. Miller, LCSW-C

Online Counseling Considerations

Ms. Miller,
Mine is not a comment, but rather a question. In your Internet counseling how do you deal with issues of confidentiality, licensure and competence? Do you ever deal with crisis issues?
Christine


Hello Christine,
You asked some very good questions about online counseling and I'll tackle each issue one at a time. First, confidentiality of online clients is maintained just as it would be in a traditional office setting. There, files are kept locked in a filing cabinet and no one has access to them except the treatment team and agency administration for billing purposes. When a client orders e-counseling services at Grace Tree the information included on the Secure Order form is protected by the latest security protocols and cannot be accessed by anyone outside of Grace Tree. The information cannot be intercepted in cyberspace and it isn't stored anywhere out in cyberspace. All safety measures are taken to prevent this and the information comes directly to Grace Tree's server and is stored there. You can tell if a website's order form is secure by checking for the little security logo on the order form's page. This logo tells you that the company processing the order has all safety measures in place. Additionally, our company servers are highly secure, protected by firewalls and encryption codes, and more.

Also, when someone purchases e-mail counseling services they are assigned their own personal secure e-mail account that is accessed right off that company-protected server. They receive their own unique logon ID and password so no one else can access that account. For example, if you set up an e-mail account with Yahoo any mail you get is stored on shared servers and you don't really know who has access to your e-mail or other information. At Grace Tree I am the only individual who has access to clients accounts and information. And, all data is maintained electronically in this fashion and password protected. The security process for this is the highest that is currently available!

You also asked about licensure. I am a Licensed Clinical Social Worker in the state of Maryland, USA. Potential clients can always verify my credentials through the official Maryland State licensing board via a link right on my website. Though I am only licensed in Maryland State, I work with clients around the country and even outside the USA. It is always their choice to contract for services with me. There is much movement among social workers and other mental health professionals to relax or collapse state licensing regulations in an effort to provide some type of national licensing for professionals. Licensing procedures and requirements are very similar in all 50 states and many professionals argue that the time for this is long overdue, especially given the nature and fluidity of services that the Internet and related communications offer people. Many other developed countries do not have regional licensing and offer basic national licensing to their professionals. And e-counseling by telephone has been around for years and years, and has been proven to be one of the best modes of personal counsel for many. Interestingly, it was resisted early on until the success of crisis lines and other venues became very apparent in the mental health field.

As far as dealing with competence, I am very honest with potential clients and all my areas of specialty are listed right on my website. Clients usually know well in advance if I can help them or not by browsing the site. Sometimes I do field e-mail inquiries from people who ask if I can help them. If I feel I cannot help a client with their issues I let them know as soon as it becomes apparent and make recommendations for other services that I think would be more helpful to them. I do sometimes handle e-mails that are crisis oriented, but they are very few. I also think the term 'crisis' can be defined differently by people. As a professional, an example of a pressing crisis such as someone who is actively suicidal would not be something that could be handled well through online counseling. That individual would be encouraged to seek local help right away. However, if someone was faced with making a big decision in life and considered it 'a crisis point' in his/her life, I could help with processing those thoughts and feelings aid the decision making process for that person. In sum, I relate personally to each potential client and work with him/her on deciding if online counseling services are something they may benefit from. It's always up to the individual and I encourage all my clients to communicate the helpfulness of services as we go along. I think issues of competence are very relevant, for both online and traditional face-to-face counseling methods.

I hope this has helped answer some of your concerns Christine. I am a very sincere professional and competent in my areas of expertise. And, I am pleased to say that my clients agree as well.

Warm Regards,
Carole L. Miller, LCSW-C

Coping With Spouse's Eating Disorder

Dear Grace Tree,
My wife has been battling with an eating disorder for about two years and she is getting worse. She has been in an outpatient program and a six-week inpatient eating disorder program. After the programs she appeared to have improved a little but now she has began to do the purging again and she hardly eats. I have tried everything and she refuses to do any more programs. I feel helpless and this is stressing me out because I am watching my wife literally disappear in front of my eyes. What do I do, is there anything I can do as her husband because I think I have had enough and I am on the verge of leaving her.
Thank You,
Chuck


Hello Chuck,
It sounds like your wife is seriously ill, and I truly sympathize with you. Eating disorders are one of the most difficult addictions to overcome. However, it's not impossible though. I think you're feelings of helplessness are certainly understandable and a good descriptor of how you're feeling because you cannot help your wife unless she wants the help. She has to decide that for herself, as you know sine she's been through this cycle before. Unless she is actively suicidal or her health is at a critical point, there is not much you can do for her beyond further encouraging her to seek help if you see her encountering problems as a result of her behaviors and attitude.

Yet, there are things that you can do for yourself which may help her in the long run. You really need to take care of yourself while dealing with this. If she does turn around sometime soon she'll need you to be mentally healthy and responsive. One thing you can do is contact some of the local outpatient programs and ask about support groups for partners of those afflicted with eating disorders and start attending. The mental-emotional support you'd receive there would be a big blessing to you and help you maintain your sanity. It's never good to isolate oneself with the difficult problems that you're facing, even though that's sometimes our human tendency. You may also want to ask them about therapy for yourself at this time to maintain your strength and help you deal with your wife on a daily basis. I would really recommend it.

Short of doing those things and requesting she seek help again, there isn't much you can do for her. And it really sounds like you are frustrated and have exhausted all your efforts. Your care and concern for her is evident too. As far as being in the verge of leaving, no one can make the decision for you to stay in your marriage to your wife. You have to really search your heart and consider things prayerfully. Sometimes if one partner gives the other an ultimatum to get help and threatens to leave the relationship, it can spur movement of the other towards getting some help. But, sometimes it doesn't and there is never a guarantee. I hope your situation takes a turn for the better Chuck, and if I can be of any further service or help please feel free to contact me again.

Sincerely,
Carole L. Miller, LCSW-C

Lessons From Noah's Ark

Hello Readers,
Here is a cute little tidbit of wisdom that was sent to me recently by a good friend so I thought I'd share it with all. I think it cleverly outlines the very important little things to pay attention to and keep in our hearts during life's journey with all its blessings and trials. It's so easy to get bogged down and lost at times, and sometimes we just need to be reminded where a healthy focus lies. There's an emphasis here on both individuality and comunity which I especially like because we all need each other no matter what we may be dealing with personally. And working together is the best way to enjoy life to the full as God is intended for all of us. Enjoy!


"Evereything I need to know I learned from Noah's Ark"

1) Don't miss the boat!
2) Remember that we are all in the same boat.
3) Plan ahead- It wasn't raining when Noah built the boat.
4) Stay fit- When you're sixty someone may ask you to do something really big!
5) Don't listen to critics- Just get on with the job that needs to be done.
6) Build your future on high ground.
7) For safety's sake, travel in pairs.
8) Speed isn't always an advantage- The snails were on board with the cheetahs.
9) When you're stressed just float awhile!
10) Remember, the ark was built by amateurs and the Titanic by professionals.
11) No matter what the storm, when you're with God there's always a rainbow waiting!

Warm Regards,
Carole L. Miller, LCSW-C

Romans Revised For Recovery!

Here's a special holiday message of hope for all my readers who struggle with addiction, codependency and other issues whether its food, alcohol, sex, pornography, work, drugs, religion, cigarettes, people-pleasing, approval seeking, perfectionism, obesessing, depression, anxiety, victimization, childhood pains, deep grief, an empty heart and more. You know, whatever we're recovering from we all fall short at times in our efforts to maintain sobriety or change our old attitudes and habits, but God will always be there for us no matter what. If we pick ourselves up after each fall and 'keep on keeping on', he is ever faithful! In the book of Romans, Paul understood this so clearly and came to rely solely on God's grace for his sustenance, and two millenium later we too have learned to believe in a power greater than ourselves to restore us to sanity. In this New Year remember to rely on his loving kindness and mercy, for it is sufficient for ALL of us! Have a Happy New Year and spend some time reflecting on God's goodness and unbelievable forgiveness by considering his amazing grace and unconditional love!

Much Love,
Carole L. Miller, LCSW-C


Struggling to Recover!

"God’s design is good then. The trouble is not with his desire for me, but with me, because I am sold into slavery with my old ways, my old attitudes, beliefs and behaviors as my master. Sometimes I don’t understand myself at all, for I really want to what is right, what is good, new and healthy, but I don’t do it. Instead, I do the very thing I am trying to recover from! I know perfectly well that what I am doing is harmful to myself and others, and my renewed mind shows that I agree that God’s design for my life is so very good. But I can’t help myself, because it is my old ways inside, those old tapes that play and knee-jerk reactions which make me perpetuate these unhealthy ways.

I know I am sick, through and through, so far as my old dysfunctional nature is concerned. No matter which way I turn, I can’t make myself change! I want to change, but I can’t. When I want to step out in faith and do things differently, as God would have me do them, I don’t. And when I try not to do the same old thing, I do it anyway. But, if I am doing what I don’t want to do, then I am not really the one doing it, the old me within is doing it, not the "recovered me."

It seems to be a fact of life that when I want to do what is healthy and right, I inevitably do what is not, the same old-same old. I love God’s ways with all my heart. But there is another way at work within me that is at war with my desire to change and to grow into his likeness. These ways usually win the fight, and make me a slave to the old ways still at work within me. Oh, what a miserable person I am! Who will free me from this life that is dominated by my old habits and is dying? Thank God! The answer is in Jesus Christ our Lord. So, you see how it is: In my mind I really want to trust and embrace God’s heart, truly he desires my recovery. I so want to break free! But, because of my damaged nature I am often a slave to those same old ways within."

Romans Revised For Recovery - Romans 7:14-25

Infidelity - Rebuilding a Marriage

Dear Ms. Miller,
My husband and I just reconciled after being separated for 18 months. He left our home because he was having an affair, which turned into an ongoing relationship. The problem is that he continues to have anxiety attacks about not seeing the other woman. He says that there has not been any contact on either side in any way for 6 weeks. This makes me feel angry and hurt all over again. What can I do to help us, he says he wants our marriage to work because he loves me and the children. Any suggestions?

Robin


Dear Robin,
It has to be very hard to be in your shoes right now and I am glad you wrote in for support. I can easily see how your husband?s anxiety issues affect you, and I imagine that they stir up all kinds of feelings, thoughts and concerns. And, you are certainly entitled to your feelings of anger, pain, sadness, frustration and more. Though much of your anger is likely (and understandably!) directed toward your husband, it may be counterproductive to expect that you two can work out all the issues involved together. While there are times you?ll both need to address the issue openly together and process things, it would really benefit both of you to allow yourselves time apart to process your unique, individual feelings regarding this intensely painful and emotional matter. Though you certainly need to communicate and work this out as a couple, you need your own space as well and I cannot stress this enough. This may require that you build time away from your family into your schedule to do so and take care of yourself, and if necessary you should seek professional therapy for yourself, and/or marital counseling for you both. It sounds like your husband may also require professional intervention given your brief description of his symptoms. Issues of betrayal and rebuilding are often very difficult for couples to manage on their own and professional guidance and support can be a marriage saver.

Also, it?s very likely that all of your loyalty and trust toward your husband has been severely damaged by this affair. It?s going to take a lot of difficult work to restore it. A lot of people have a tendency to continue to re-persecute their mate every chance they get by continually bringing up the affair and betrayal. Though your husband will have to prove he?s sincerely dedicated to you again, it?s also going to require a true willingness to accept him after what happened and work together. If you want to stay together it?s going to take a lot of grace, time and patience. Your husband should also be willing to address issues of being totally accountable to you and understand how important that is to working things out.

As for your husband?s anxiety issues, the important thing to keep in mind is that you cannot change your husband or make him feel a certain way, and it is unrealistic to expect that his feelings for this other woman will just magically go away right away. However, as he does the work he needs to regarding his feelings and honestly addresses the issue, his anxieties are likely to subside. Just as you have to work out your feelings and concerns, he has to do the same. If he is truly recommitted to you and loves you as he says he does he should be willing to do whatever it takes to heal your marriage. Fully acknowledging and addressing his issues are a big part of doing so. With all the feelings you?re experiencing it?s likely to be hard for you to support him, but the best thing you can do is encourage him to seek the help he needs while not neglecting yourself.

I hope that I have been some help to you Robin, and that you and your husband both find it in your hearts to work things out and save your marriage. Please contact me again if I can be of any further service to you.

Sincerely,
Carole L. Miller, LCSW-C

Help With Eating Disorders

Dear Ms. Miller,

Hi, I am a student currently in my last year at University. I’m 21 years of age. I am suffering from eating disorders and I fear that I might be headed towards a depression. I feel like I am weak, ugly and extremely vulnerable, all of which I am the exact opposite of. I have always been the strong, independent beautiful figure that people use to see. I can't tell anyone. I can hardly admit it to myself. While trying to sleep tonight I realized that I could die from my eating disorders. I want to make it through this last year and have a great life I just don’t know how to go about doing that any more. I feel like everything is a mess. I have no family or friends with me because I changed countries and now I just feel helpless and alone. You’re my only hope. I hope you can help me.
Sarah


Hello Sarah,
You are right to be very concerned about your condition because eating disorders are very serious and can be life threatening. Right now you sound very fragile and desperate Sarah. While you fear you may be headed toward a depression, it really sounds like you are already there. I strongly recommend that you get professional help. It would be very helpful for you to see a medical doctor for a complete medical evaluation and confide in him/her about your mental health needs. Now that the semester year is in full-swing, school stress levels are likely to make you even more vulnerable. It sounds that somewhere inside you, you believe that you are competent, smart and strong, even if it’s a struggle for you to embrace that right now. I encourage you to draw on those strengths from deep inside and seek the help you need. It’s very tough to be in a different country and feel so alone too. But, if you continue to keep things to yourself and remain isolated you will likely continue in your self-destructive patterns and behaviors Sarah.

In addition, Many University campuses have student counseling centers which offer a wide range of services and even specialize in helping students with such personal issues. Student counseling centers are well equipped to deal with such issues because they are fairly commonplace among people your age Sarah. You are not alone. Many college students, young women and men alike, struggle with eating disorders, depression, school stress, achievement issues and expectations, anxiety issues, substance abuse, and more. A University center can be very helpful in guiding you down the right path, linking you with other service providers, suggesting community support groups, and may even provide you with some free services or for a very low fee. A counseling center’s main function is to serve the University’s students, and they always take into account each individual student’s overall health, functioning and financial situation. So, don’t let anything stop you from getting the help you need. Once you get the help you need things will get better.

Sincerely,
Carole L. Miller, LCSW-C