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Monday, December 5, 2016

Is It Time to Reevaluate Your Therapy?

I've written many articles for this psychotherapy blog about how to find a psychotherapist that's right for you, and how you know if your therapy is working for you (see my articles: How to Choose a Psychotherapist,  Psychotherapy: Psychotherapists Listening and Learning From ClientsPsychotherapy: How Talking to a Psychotherapist is Different From Talking to a Friend and Being Honest With Your Psychotherapist).  In this article, I'm focusing on how you know if you need to reevaluate your therapy and recognizing some of the possible signs that your therapy might not be working for you.

Is It Time to Reevaluate Your Therapy?  Warning Sign:  Therapist Frequently  Falls Asleep in  Session

Consider Reevaluating Your Therapy Under the Following Circumstances:
  • Your therapist misrepresented his or her skills, which you discover after you begin therapy.
  • Your therapist lacks the professional skills to help you and is working outside the scope of his or her expertise.
  • Your therapist lacks empathy for your problems.
  • Your therapist doesn't respect your ethnic, religious, racial or cultural background.
  • Your therapist talks too much about him or herself in your sessions.
  • Your therapist hardly talks at all and you feel alone.
  • Your therapist frequently falls asleep during your sessions.
  • Your therapist can't remember basic information about you from one session to the next, and you have to keep repeating your story.
  • Your therapist tries to be your friend instead of your therapist.
  • Your therapist doesn't like that you're developing other sources of emotional support among healthy family members and friends.
  • Your therapist frequently takes non-emergency calls during your sessions.
  • Your therapist often misses appointments or shows up late.
  • Your therapist has a belittling or dismissive attitude towards you.
  • Your therapist uses your sessions to try to get advice from you during your sessions (e.g., you're a financial advisor and therapist tries to get financial advice).
  • Your therapist thinks that his or her method of doing therapy is "the only way."
  • Your therapist doesn't continue to develop his or her professional skills at seminars, workshops or online.
  • Your therapist pressures you to confront family members when either you're not ready or you know it would be dangerous to do so.
  • Your therapist promises you that you will be "cured" of your problem by seeing him or her.
  • Your therapist breaks confidentiality by naming other clients.
  • Your therapist breaks confidentiality by providing information about you without your permission or without a mandate.

Recognize even more serious "red flags" about your therapy under the following circumstances:
  • Your therapist crosses boundaries by being seductive or trying to initiate a sexual relationship with you (see my article: Boundary Violations and Sexual Exploitation in Psychotherapy).
  • Your therapist's license has been revoked.
  • Your therapist has no license at all and never had one.
  • Your therapist tries to borrow money from you.
  • Your therapist appears to be emotionally unstable.
  • Your therapist appears to be impaired on alcohol or drugs during your sessions.
  • Your therapist attempts to push his or her religion on you.
  • Your therapist becomes too emotional when you talk about your problems.
  • Your therapist is frequently late or doesn't show up for your appointments.

Serious "Red Flags" in Your Therapy: Sexual Boundary Violations

Under the first category of items, if you've expressed your concern and your therapist hasn't changed his or her behavior or attitude, it's your right to tell your therapist that the therapy isn't working for you and you'll be seeking other help.

Under the second category of items, the "red flag" items, these problems in therapy are serious enough for you to discontinue therapy and look for someone else, especially in cases of serious boundary violations.

It's not always easy to recognize these problems, especially when you're in a vulnerable state, which is why I hope this article will be helpful to clients who aren't sure if they need to reevaluate or leave their therapy.

I have been a psychotherapist for over 20 years and I've known many therapists.  I believe that the vast majority of therapists are caring, qualified and ethical professionals.  Most therapists enter the field because they feel a calling to help clients and use their expertise in an appropriate and professional manner.

But, just as there are unethical people in any profession, there are cases where some therapists shouldn't be in the profession.

Even if none of these circumstances apply, if you think you're not making progress in therapy after a reasonable time, you've discussed this with your therapist and you still don't know how your therapist is going to help you to overcome your problem, consider that you and your therapist just might not be a good fit or your therapist lacks the skills to help you.

Making a change in your therapy can feel daunting, but continuing to work with a therapist when the therapy isn't right for you is a waste of your time and money.

If you find yourself in one of these unfortunate circumstances in your therapy and you're not sure what to do, it might be wise to have a consultation with an experienced, objective therapist to talk over your concerns so you can make a decision about what to do.

Finding the Right Therapist Can Make All the Difference For Your Emotional Healing

Once you've found a psychotherapist that is the right therapist for you, it can make all the difference in your journey toward healing.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Also, see my articles:
The Therapist's Empathic Attunement in Therapy
Asking For What You Need in Therapy
Empowering Clients in Therapy - Part 1
Empowering Clients in Therapy - Part 2: Clinical Issues
Beyond the "Band Aid" Approach in Therapy
Ruptures and Repairs in Therapy
Psychotherapy and the Erotic Transference: When You "Fall In Love" With Your Therapist
What is EMDR Therapy?

Thursday, November 24, 2016

Is It Possible to Feel Gratitude Even When You're Sad?

I've written prior articles about gratitude for this psychotherapy blog (see: Psychotherapy, Balance and Gratitude,  Keeping a Gratitude JournalThe Importance of Expressing Gratitude To Your Spouse and Being in the Present Moment).  I'm focusing on a particular topic relating to gratitude in this article, which is a question that often comes up in therapy:  Is is possible to feel gratitude even when you're sad?

Is It Possible To Feel Gratitude Even When You're Sad?

It might sound pollyanaish or naive to talk about feeling grateful when you feel sad.  But cultivating an attitude of gratefulness on a regular basis helps you, especially during the times when you're not at your best.

Why is this?  Well, when you develop the ability to find things in your life that you can be grateful for, you're developing a particular skill that will help you during good times and bad.

In many ways, it's easier to focus on the things that aren't going well in your life and, at any given time, you might have numerous challenges.

But if you have developed a habit of looking for the positive things, the things that are going well in your life, no matter how small, it helps to alleviate some of the emotional pain that you might be going through.

Is It Possible to Feel Gratitude Even When You're Sad?

Developing a habit of noticing things to be grateful for doesn't mean that you're trying to deny that you have problems or that you're upset or depressed (see my article: What is the Difference Between Sadness and Depression?)

It's a way of getting a bigger perspective about your life and the people in your life that includes the challenges as well as the positive aspects.

So, how to you do this?

How to Begin to Develop the Ability to Notice Positive Aspects of Your Life:
If you've never tried to develop the ability to find the positive things in your life to be grateful for, you can start in small ways by jotting down things that were positive each day.  

Make a List:
This list can be as simple as the smallest things:  
  • Someone smiled at you and lifted your spirits for a moment.
  • You heard your favorite song.
  • You remembered a happy memory.
  • You heard from a friend.
  • You noticed a job online that you could apply for to get out of your current job.
  • Someone complimented you.
  • You found a parking space easily.
  • The sales assistant in the store was helpful to you.
Keeping a Gratitude List

And so on.

Getting into the habit of noticing the positive aspects of your life each day helps you to begin to be attuned to these experiences on a regular basis.

It can also help you to realize that, even though you might be sad, life is complex and good feelings can still coexist with sad feelings.

Developing a Sense of Gratitude

Once you've begun to notice that there are usually at least one or two things that make you feel good and that you can appreciate, you can learn to deepen these feelings by using the mind-body connection.

Using the Mind-Body Connection to Deepen Your Sense of Gratitude
It's not unusual, especially if you're feeling sad, to notice positive aspects of your day and experience them in only an intellectual way.

Experiencing something in an intellectual way is very different from feeling it on an emotional and physical level.

One way to go from experiencing these positive aspects from purely an intellectual perspective to deepening the feeling to an emotional and physical level is to use the mind-body connection.

Using the Mind-Body Connection to Deepen Your Sense of Gratitude

One method that I use with my therapy clients when they're starting therapy is called "internal resource building."

When we're engaged in internal resource building (also known as developing coping skills), I ask clients to bring in 10 positive memories from their life, no matter how long ago it was and no matter how fleeting the memory might be.  If they can't come up with 10, I'll use whatever they bring in and that's just fine.

I ask the client to close her eyes, get back into the memory and notice what emotions and sensations she feels in her body.  Then, we use some form of what is called "bilateral stimulation" (from EMDR Therapy) to reinforce that feeling.

The bilateral stimulation can be done with "tappers" (one tapper in each hand) that provide alternate or bilateral buzzing in each hand.  This is done for only a few seconds to focus on the positive aspect of the memory and to try to prevent negative aspects from coming up so the memory remains positive.

Since you won't have tappers, you can use another EMDR therapy technique, which is alternate tapping.  Alternate tapping, which is a form of bilateral stimulation can be done by using your hands to gently tap, and it can be done in several ways:  

  • Alternate tapping of your leg--right leg, then left leg, back and forth (see Laurel Parnell's Book, Tapping In).
  • The "Butterfly Tap" where you cross your arms in front of your chest and do alternate taps of your upper arms
  • Bilateral music that goes from one ear to the other (see Bilateral Music).

The idea is that you're focusing on the positive emotion that you're feeling in your body, and this helps to strengthen the positive feelings.  

By strengthening the positive feelings, your experience of gratitude usually goes from an intellectual experience to a felt sense of gratitude.

It also provides you with a reprieve from your sadness.

So, to answer the question that I posed at the beginning of this article:  Yes, it is possible to feel both sadness and gratitude, but it can be challenging to feel gratitude when you're overcome with depression or unresolved trauma.  At that point, you might need the help of an experienced psychotherapist.

Getting Help in Therapy
There's a difference from feeling sad and feeling depressed.

When you're depressed, it's harder to access positive feelings and gratitude and you could benefit from seeking help from a licensed psychotherapist who has an expertise is helping clients to over come depression.

Depression is episodic and you can have multiple episodes throughout your life.  Getting help from a mental health professional can help you to overcome these depressive episodes so that they are shorter than they would be without help.

Getting help in therapy also helps you to develop the necessary coping skills to help you lead a more fulfilling life (see my article:  How to Choose a Psychotherapist).

If you've tried to cultivate an ability to feeling grateful, but emotional problems or a history of trauma are hindering you, rather than suffering alone, find a skilled therapist to help you through these challenges.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and adults.

I have over 20 years of experience as a therapist and I helped many clients to overcome their problems.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, November 21, 2016

Are You in a Codependent Relationship With Your Ex?

In a prior article, Is Your Boyfriend Stuck in a Codependent Relationship With His Ex?, I explored this dynamic from the perspective of someone who is in a current relationship with someone who is still codependent with his ex.

I've also written other articles about codependency (see my articles: Overcoming Codependency: Taking Care of Yourself FirstHow to Stop Being the "Rescuer" in Your Family of Origin and Exploring Secondary Gains of Codependency).  In this article, I'm looking at the same issue from the perspective of the person who is stuck in a codependent relationship with his or her ex.

Are You in a Codependent Relationship With Your Ex?

We all know that breakups are hard, especially at the beginning.  They're even harder when codependency is involved.  Codependency can be emotional, financial, sexual or any other form of dependency that two people can get into together.

When two people have been codependent upon one another, it's especially difficult to end the relationships because neither person has learned to be independent.

This is often the result of childhood emotional neglect or abuse where emotional needs weren't met (see my article: Understanding Your Emotional Needs).

This dynamic can also be the result of growing up in an enmeshed family that fostered codependent relationships (see my article:  Enmeshed Families and Shame).

For the person who is doing the "rescuing," s/he often believes that the ex can't survive alone.  Except in the most dire circumstances, this is usually not the case.  But it's a way for the "rescuer" to delude him or herself into thinking that s/he must remain involved, even if it's not a romantic involvement.

One of the problems with this is that the "rescuer" is so focused on the ex's needs that s/he doesn't look at his or her own needs to continue to be involved.  The "rescuer" looks like the "strong one," but s/he is just as dependent as the ex, if not more so.

Continuing to "rescue" the ex doesn't allow the "rescuer" to grow as an individual or to develop a new relationship.  And even if s/he does manage to get involved in a new relationship, the codependent dynamics with the ex can interfere with the new relationship.

This sets the stage for triangulation between the "rescuer," the new partner and the ex with all the problems engendered in that dynamic.

Often, this is a way of the "rescuer" from being fully committed in the new relationship.  Most of the time this isn't a conscious choice.  It's usually unconscious.

Let's take a look at a fictionalized scenario and see how these dynamics play out:

Bill, Meg and Ellen:
After being in a tumultuous relationship with Meg for over three years, Bill ended the relationship with much difficulty.

Bill was exhausted from trying to help Meg through constant emotional crises, and he knew he couldn't remain in the relationship anymore.

Initially, when they met, Bill thought Meg was an intelligent, charming woman who "had it all together."  He admired her passion for her business and how knowledgeable she seemed about the industry.

But within a few months of their dating, Meg called late one night in tears to tell him that she was heavily in debt and unable to meet her basic personal or business expenses. She was crying hysterically and she didn't know what to do.

Bill was completely taken off guard because this was the first time that Meg had revealed that she was in trouble.  Before this, she had led him to believe that she was doing very well.  But in this phone call she told him that she was too ashamed to tell him, at first, that she was in trouble and it was now to the point where she might be evicted from her home and her office.

Bill helped Meg go through her bills, and he agreed to lend Meg the money to get on her feet, and Meg gratefully accepted his loan.

Are You in a Codependent Relationship With Your Ex?

Little did Bill know that this was the beginning of a slippery slope where Meg was in constant crisis and Bill was her "rescuer."

During the next three years, it was one thing after another:

  • Meg was having problems with the IRS because she didn't file her income tax, so Bill paid for a tax accountant to bail her out.
  • Meg had an argument with her mother, who had lent Meg money and now wanted it back, so Bill intervened as a mediator and paid Meg's mother back.
  • Meg's top salesperson walked out on Meg because she felt that Meg was verbally abusive, so Bill intervened to smooth things over.
  • Meg couldn't sleep at night, so she would call Bill at all hours of the night and he would calm her down.
  • Meg went to the ER numerous times with chest pains and each time the doctors told her that it was anxiety and she should see a therapist, but she refused to get help in therapy and insisted each time that Bill accompany her, which he felt obligated to do it.
By the third year, Bill was emotionally and physically exhausted from all the chaos.  He knew that he was in an unhealthy relationship with Meg.  He pleaded with her to see a therapist, but she refused. She felt that all she needed was Bill.

He thought long and hard about breaking up with Meg, but he didn't know how she would get along without him.  Finally, he started therapy because he felt conflicted about whether to stay or leave the relationship.

Even though Bill wanted to focus on Meg, his therapist helped Bill to keep the focus on himself and his own need to be in this relationship.

At first, he was very uncomfortable looking at his own dynamics in the relationship.  He had been taught as a child that it was "selfish" to think about yourself first and that others should always come first.

Bill's therapist helped him to develop the internal resources before going deeper into his own personal history and how it affected him in his current relationship (see my article: Developing Internal Resources and Coping Skills in Therapy).

When his therapist thought he was ready, she used a technique in clinical hypnosis called the Affect Bridge to help Bill make an emotional and physical connection to the current situation and his childhood history.

His therapist wasn't surprised when Bill discovered that he had a similar relationship with Meg as he did with his mother.

From a young age, Bill became a "parentified child" as his mother got into one crisis after another and Bill tried to help his mother overcome her problems.  It was as if he was the parent and she was the child.

It became very clear to Bill that he couldn't continue in his relationship with Meg, especially since she refused to get help, because it was affecting him physically and emotionally and it was a repetition of a childhood trauma.  So, he and his therapist talked about how he would end the relationship with Meg.

It took a few more months before Bill could summon the courage to tell Meg that he wanted to end the relationship, but when he did, Meg became enraged.  She was no longer the charming, loving girlfriend.  She became angry and vindictive.  She threatened to call his boss and tell him lies to get Bill fired.  She left voicemail messages on Bill's cellphone with all kinds of other threats.

Bill was shocked to see this other side of Meg, and he kept his distance.  But he also felt very guilty and wondered how Meg would get along without him.

In the meantime, he continued to see his therapist and worked on maintaining his resolve not to call Meg.

A few months later, Meg stopped calling Bill.  He was still worried about her, and he felt guilty, but he didn't call her.  Soon after that, he met another woman, Ellen, whom he really liked and began dating.

His relationship with Ellen was warming, loving and harmonious.  It had none of the emotional drama that was involved in his relationship with Meg (see my article: Hooked on Emotional Drama: Getting Off the Roller Coaster).

Even though he had not spoken with Meg in several months, Bill still wondered how she was doing.  Since Meg was no longer calling him and threatening, he thought it wouldn't be a problem to call her briefly to find out how she was doing.

His therapist was away, so he couldn't discuss it with her, so he decided to give Meg a friendly call.  But as soon as he got Meg on the phone, she began yelling and threatening him again.

Are You in a Codependent Relationship With Your Ex?

He told her that he had only called to find out how she was doing, but he was going to hang up because she was becoming abusive.

Then, Meg broke down in tears and told Bill that she was sorry for everything, that she was miserable without him, she was lonely and she had no one to turn to.

A few weeks later when Bill talked about this phone call in his next therapy session, he told his therapist how he felt himself irresistibly pulled in again, and he began to meet Meg for coffee to listen to her problems without telling Ellen.

But Ellen soon found out and she ended their relationship because he kept his visits with Meg a secret from her.  Bill pleaded with Ellen to take him back but, inwardly, he felt caught between his Ellen and Meg.  He knew that he loved Ellen and his relationship with her was a healthier relationship, but he also felt compelled to continue to help Meg.

Bill's therapist helped him to see his own codependent emotional needs at the point when he called Meg again, and he took responsibility for recreating this problem in his life.  He wanted to be with Ellen, but he just didn't know how he could "abandon" Meg (see my article: Why Understanding Your Problems Isn't Enough to Change Them).

After working on this issue for several months and working through the original childhood trauma with EMDR Therapy, Bill felt ready to let go of his role as Meg's "rescuer" (see my article: What is Adjunctive EMDR Therapy?)

Deep down, he also knew that by continuing to bail her out of situations, he was enabling Meg to continue to get into one crisis after another and she would never take responsibility for her life.

After a few weeks, Meg's desperate calls stopped and Bill breathed a sigh of relief.  For the first time, he felt that, even though he felt compassionate towards Meg, he wasn't responsible for her and she would have to work out her own problems without him.

When he recontacted Ellen and told her about the work he did in therapy, she agreed to meet with him so they could talk.  After meeting a few times to talk, they started dating again and resumed their relationship.

The fictionalized scenario about Bill, Meg and Ellen demonstrates that the roots of codependent relationships are usually found in early childhood relationships.

This is often what makes these relationships so compelling--not only are you experiencing the emotions related to the current situation but, on an unconscious level, you're also experiencing old childhood wounds.

The combination of the conscious emotions and the older unconscious emotions can be very powerful.

This is why it's so important to work through the earlier childhood trauma--otherwise, you can get out of one codependent relationship and go right into another one without even realizing it.

It's not always obvious from the start of a relationship that it will turn into a codependent relationship.  Often, people put their best foot forward at the beginning and only later reveal their need to be "rescued."  And often you don't feel the need to "rescue"at the beginning of the relationship, but it can develop with time.

The most important step you can take, if you find yourself in a codependent relationship, is to put the focus back on yourself and recognize how you're being affected by the relationship (see my article: Losing Yourself in a Relationship).

While it might seem that your partner (or your ex) is the "needy one," this is an illusion.  The person who is doing the "rescuing" has an emotional need to be in this dynamic just as much as the person who is living a crisis-oriented, chaotic life.

These relationships are often hard to let go of by yourself because the emotions can be so overpowering.

Even when you have managed to end a codependent relationship and you're in a healthier relationship, it's not unusual to feel compelled to go back to the former relationship or get involved with "rescuing" again.

Getting Help in Therapy
Getting help from a licensed mental health professional, who has experience with helping people in codependent relationships, can make all the difference between remaining in an unhealthy relationship which is draining you emotionally and physically and living a healthier, happier life.

Getting Help in Therapy

Take the first step to get help by setting up a therapy consultation.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

I have helped many people overcome codependent dynamics.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, November 14, 2016

How Narcissism Develops at an Early Age

In a previous article, I wrote about people who have narcissistic personalities (see my article: Narcissism: An Emotional Seesaw Between Grandiosity and Shame).

How Narcissism Develops at an Early Age

In this article, I'm focusing on how narcissism develops in childhood.

No one is born with a narcissistic personality, although some children seem to be more vulnerable than others.

Children who develop a narcissistic personality are usually overvalued by their parents.

Rather than the parents expressing warmth and love, they tell their children that they're "perfect" or "the best" or "the most attractive" and so on.

This overvaluation is beyond just average complimenting or praising of a child.  It's usually ongoing, over-the-top and exaggerated praise about how special the child is compared to other children.

This exaggerated praise usually comes from parents who are themselves narcissistic and who want to feel that their child is "special."  Having a "special" child reflects on their own specialness.

Narcissistic personality isn't a monolithic diagnosis.  Individual children and adults can have varying degrees of narcissism.  Some are more grandiose with an inflated sense of themselves and others are more narcissistically vulnerable and easily wounded.

Like narcissistic adults, children who have narcissistic personalities are often charming, intelligent and creative.  They can be a lot fun--as long as they're getting their way.

They often have problems when they interact with other children when things don't go their way.  Having been raised to feel that they're entitled to special treatment, they can become enraged when they don't get it.

Since they're raised with an exaggerated sense of entitlement and, often, without a sense of empathy for others, they usually insist on having their way, even when it's to the detriment of other children.

The following scenario is a fictionalized vignette that illustrates the problems that children with narcissistic personality often have:

Anne was raised as an only child who was raised primarily by her mother.

Anne's parents were divorced shortly after she was born.  The father moved to the West Coast to take a job and only saw Anne when he visited NYC every few months.

Anne began having problems in school soon after she began Kindergarten.  Although she was intelligent, outgoing and charming, she often got into arguments with other children when they were playing.

How Narcissism Develops at an Early Age

Anne insisted on dominating the other children during playtime, and she would have temper tantrums when she didn't get her way or if she couldn't be the center of attention.

Anne's teacher, Sally, had a meeting with Anne's mother, Joyce, to talk to her about Anne's behavior.

Before Sally could explain the problem, Joyce began telling her how "special" Anne is and that it was important for Sally and the other children to recognize this.

When Sally tried to explain to Joyce that Anne wasn't learning how to interact with the other children because she was so insistent on having her way, Joyce had a hard time understanding why this was a problem, "Why not just let Anne have her way?"

By the end of the conversation, Joyce was angry and told Sally that Sally wasn't perceptive enough to see how special Anne is and Sally shouldn't be a teacher.

Soon after that, Joyce removed Anne from the school and decided to home school her.

Anne made some friends in the neighborhood, but she had a hard time keeping friends.  If she didn't get her way, Anne would argue or hit the other children until she alienated them.

Even though Anne spent much of her time alone and lonely, her mother continued to tell her how special she was and that if other people couldn't see that she was entitled to special treatment, it was their problem.

When Anne was 10, Joyce was diagnosed with pancreatic cancer.  She died within nine months of her diagnosis and Anne had to go live with her father, his second wife and their children.

Sad, angry and resentful, Anne didn't respond well to the boundaries and limit setting imposed on her by her father and stepmother.

When she was asked to do household chores, like the other children, she refused and got into power struggles with her father and stepmother.  She also showed disdain for her step siblings.

Her father and stepmother could see that Anne was suffering and that, despite her air of superiority, she was really a vulnerable, insecure child.

They decided to take her to see a child therapist, which also enraged Anne.

Initially, Anne refused to participate in play therapy but, after a few weeks, she allowed the child therapist to engage her.

Through play therapy, after several months, Anne began to learn to have empathy for others.  She also developed better social skills.

Her father and stepmother also met with the child therapist once a month to learn how to cope with Anne and how to enhance the skills that Anne was learning in therapy.

As Anne began to feel more comfortable in therapy, she looked forward to attending her sessions.  She also grieved for the loss of her mother.

At that point, Anne was back in school and attempting to negotiate relationships with other children, which was very difficult for her.

Her father, stepmother and child therapist knew that Anne had turned a corner when Anne found out that one of her classmates lost her father and Anne felt genuine concern for this classmate.  She went out of her way to spend time with her and comfort her.

Anne was also getting along better with her half siblings at home and accepting her share of responsibilities in the house.

By then, Anne was also making friends with other children in her school.  She still had to fight off the feeling that she should be the center of attention all the time and get her way.  But she was making progress and her father and stepmother felt hopeful for her.

Narcissism often develops at an early age as a result of one or both parents overindulging a child and giving that child an exaggerated sense of entitlement.

Narcissism isn't always apparent immediately because these children are often charming, intelligent and engaging--until they don't get their way or until someone disagrees with them.

A lack of empathy is the hallmark of narcissism, and if a parent raises a child to only think or him or herself to the exclusion of others, this child will have difficulty in interpersonal relationships.

With help, young children can change and develop empathy and a more realistic view of themselves and others.

Usually, the older the child, the harder it will be for the child to overcome narcissism, although for most children there can be improvement.

It's very important for parents of narcissistic children to, at least, participate monthly in their children's therapy.  Ideally, they would benefit from participating in their own therapy to understand their own narcissism and their need to overvalue their children as a way of inflating their own sense of self.

Getting Help in Therapy
It is much easier for a child with narcissistic traits to get help in therapy than it is for an adult with narcissistic traits.

Most adults with narcissistic traits don't ever come to therapy because they lack the self awareness to see that they're having problems.  They often assume that the people around them are the ones who have problems.

However, some adults with narcissistic traits come to therapy after they have sustained serious multiple losses, like the end of a marriage or the loss of close friends.

If you recognize yourself or your child from the fictionalized scenario above, therapy can be helpful, especially if you see a therapist who specializes in working with narcissism.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Also see my article:  
A Romantic Relationship With a Narcissistic Partner Can Be Damaging to Your Self Esteem

Monday, November 7, 2016

The Connection Between Infidelity and the Need to Feel Desirable

I've written about infidelity in prior articles (see my articles: Broken Promises - Surviving InfidelityCoping With the Sudden Feeling That You Don't Really Know Your SpouseWhen Trust Breaks Down in a Relationship: Lies of OmissionRelationships: Coping With Infidelity, and After the Affair: Can You Trust Your Spouse?

The Connection Between Infidelity and the Need to Feel Desirable

In this article, I'm focused on the connection between infidelity and the need to feel desirable.

Esther Perel, a Belgium psychotherapist, who is a relationship expert, writes about this topic in one of her articles.

Most people seem to believe that infidelity occurs mostly because the relationship isn't working out.

But Dr. Perel's article highlights that infidelity can occur in an otherwise happy relationship, demonstrating how the need to feel desirable to someone new can be at the root of the infidelity, even when there aren't other problems in the relationship.

In many cases, the infidelity never becomes physical--it remains on the level of flirting either in person or online or sexting.  The spouse, who is involved in this type of interaction outside the relationship, often enters into a fantasy world with the other individual and, in that fantasy, he or she feels desirable.

This feeling of being desirable can be "intoxicating" and difficult to let go of, even when the unfaithful spouse wants to stop engaging in this behavior.

I would like to expand on these ideas with the fictionalized vignette below, which is representative of many different cases with all identifying information changed:

Ruth and Ed
Ruth and Ed were married for several years when Ruth discovered flirtatious email between Ed and a colleague.

Ruth was devastated.  She had always thought that she and Ed had a good relationship but, as she read email after email in which Ed and another woman engaged in sexual fantasies, she felt shocked, hurt and betrayed.

When she confronted Ed about the emails, he felt deeply ashamed.  He tried to tell Ruth that nothing physical happened between him and the other woman but, at that point, Ruth didn't believe him.  She told him to leave the apartment and check into a hotel for a couple of weeks until she could sort out her feelings.

After a few weeks, Ed persuaded Ruth to go to marriage counseling.

During their marriage counseling sessions, the therapist helped Ed to explore what triggered his infidelity, and he realized that he liked the way he felt when the other woman flirted with him via email.  It made him feel attractive and desirable.

However, he was quick to say that he had no real feelings for the other woman.  In fact, he never anticipated that the flirty emails would develop into anything.

Ed said he realized that it was selfish of him to jeopardize his marriage in this way.

The therapist also helped Ruth to explore her feelings, and Ruth expressed feeling angry, but most of all she felt hurt and betrayed.

During the next few months, both Ruth and Ed became increasingly committed to their relationship and to their marriage counseling sessions.  They both wanted to find out what they could do to get past this chapter in their lives so they could build a stronger relationship.

Ruth expressed that she felt badly that she wasn't the one who made Ed feel desirable and she acknowledged that she might have taken him for granted a little during the last few years (although she and Ed both knew that this didn't excuse his behavior).

They both wanted to explore ways to reignite the passion in their relationship so they could both feel desirable to one another.

Their commitment to the relationship and their willingness to do the necessary work in therapy is what helped them to overcome this traumatic period.

The Connection Between Infidelity and the Need to Feel Desirable

In the end, they each came away feeling that their love was even stronger than it had been before Ruth discovered the emails.

Many people assume that if there is infidelity in a relationship it must mean that there are problems with the relationship.

But, as I mentioned earlier, there are many instances where one or both people in a relationship engage in infidelity not because there is a problem in the relationship but because it makes them feel desirable to someone else.

This is often not readily apparent to either person until they begin to explore these dynamics in couples or marriage counseling.

Depending upon the individuals in the relationship, some relationships can be salvaged under these circumstances and some cannot.

There are couples who say they have gotten past the problem but, in many instances, one or both people never get over it.

For those couples, it can become something that is used as a "weapon" when there are other problems, usually with the person who feels betrayed brings it up at unexpected times.

For other couples, like the couple mentioned in the fictionalized scenario above, working through this problem can be a source of emotional growth that improves the relationship beyond how things were before the infidelity.

A skilled, experience therapist will not have an agenda to either keep the couple together or to see them split up.   This important decision is completely up to both individuals in the relationship.

Getting Help in Therapy
Individual, couples or marriage counseling is a valuable resource to help individuals and couples to understand the underlying cause of the infidelity in their relationship and it provides an opportunity to decide if they want to remain together or not.

If they decide to split up, therapy can help a couple to do it in as amicable a way as possible so that each person can be his or her own "best self" through the process.

If they decide to stay together, each person needs to be committed to seeing the process through in order to benefit from therapy.

If you're having problems with infidelity in your relationship, you owe it to yourself and your spouse to get professional help rather than making decisions that you might ultimately regret.

A skilled therapist who works with couples is objective and experienced in helping couples to understand internal as well as intersubjective dynamics so that each person can make decisions about the relationship.

Taking the first step, which is setting up a psychotherapy consultation, is often the hardest, but it might just be the best thing that you ever do for yourself your relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples.

I have worked with many individuals and couples to deal with infidelity.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, October 31, 2016

Co-Parenting After the Divorce

In a prior article, Talking to Your Young Child About Your Divorce, I discussed how to talk to young children about divorce.  In this article, I'm focusing on co-parenting after the divorce.

Co-Parenting After the Divorce

When a happy, romantic marriage disintegrates, it can be traumatic for the married couple as well as the children.

Most people don't get married with the idea that they'll be getting divorced one day.  There are usually expectations of a romantic, happy life together.

Unfortunately, about half of all marriages end in divorce.  Often, this is due to unrealistic expectations of marriage.

Whatever the reason for the divorce, if there aren't children involved, the two formerly married people need never see each other again.  This allows each person to grieve the end of the relationship and to, eventually, move on.

But when formerly married people have children, they need to find a way to co-parent their children in a mature, respectful way.

Despite their best efforts, many people struggle to find a way to co-parent without doing harm to their children.

Co-Parenting After the Divorce

The worst cases involve one or both parents who lack the necessary emotional maturity and interpersonal skills to co-parent and who end up doing emotional damage to their children.

Here are some basic concepts to co-parenting well:

  • Accept that the marriage is over and don't try to use your children to get your ex back.  Not only is this disrespectful to your ex, but it's emotionally damaging to your children to expect them to function in this way.  Be the adult.  Don't use your children as pawns and don't expect your children to be the adults.
  • Negotiate a plan with your ex, if possible, for how the two of you will speak to the children about the changes in their lives.
  • Speak with the children yourself, if it's not possible for your ex to be there, explain the changes and be prepared for questions.
  • Recognize that co-parenting is a challenge and prepare yourself to handle challenges as they arise.
  • Be prepared for your children to try to get you and your ex back together again, even after you have explained many times why you're not together.
  • Work with your ex, if possible, to get on the same page about basic rules so that your children will have a stable environment in your home as well as in your ex's home, including:  sleep time, when to do homework, curfews, etc.
  • Be respectful of your ex.  Although it might be gratifying on some level for you to hear your children criticize your ex, be sure to foster a respectful environment in your home.
  • Recognize that the situation will be continuously changing over time, including new romantic relationships for you and/or your partner, new marriages, new siblings or step siblings of your children, and so on.

Getting Help in Therapy
Many people who are in unhappy marriages think that they will feel completely better after the divorce.

While it's true that some of the relationship pressure between you and your ex will no longer be an issue, other issues related to co-parenting can be just as difficult if not more so.

Family and friends might be supportive, but they might not be the most objective.  In the worst of cases, they might unintentionally fan the flames of your anger and despair about the divorce and co-parenting issues.

If you're finding it difficult to handle the aftermath of your divorce, you could benefit from seeing a licensed mental health professional who is objective and has the experience and skills to help you overcome the challenges that you're facing.

If you're feeling unsure as to whether you want to go to therapy, it's usually best to think of the first session as a consultation where you're under no obligation to continue if you don't feel comfortable with the therapist.

The best predictor of a good outcome in therapy is for you to feel a rapport with the therapist.

Family therapy can also be helpful to assist you, your children and your ex with the transition.

So, if you're really struggling emotionally, don't wait until you're in an emotional crisis to seek help.  Take the first step today by setting up a therapy consultation.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

I have helped many clients through the aftermath of their divorce and the challenges of co-parenting.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, October 24, 2016

Talking to Your Young Child About Your Divorce

Talking to young children about your divorce isn't easy.  Depending upon what your child has heard about from their  friends, she may or may not understand what the word "divorce" means or might have misconceptions (see my article:

Talking to Your Young Child About Your Divorce

This is why you and your spouse want to be on the same page about how to approach your child, choosing the right time and keeping it simple.

Here are some basic suggestions:

Get Together With Your spouse Beforehand and Present a United Front:  
  • Even though you and your spouse might not be getting along, you both need to put aside your differences for your child's sake.  You might be relieved that the marriage will soon be over, but expect that your child probably will be upset about it, even if she witnessed the marital conflicts.  
  • Decide in advance what you will say and keep it as simple as possible.  If your child asks why you're getting divorced, you can say something simple like, "We're not getting along," but don't say, "We don't love each other anymore" because this could lead to your child thinking that, at some point, you might not love her anymore.

Choose the Right Time and Place and Leave Plenty of Time For This Talk:
  • Choose a time when it's quiet and you'll have privacy to talk.  Also allot enough time for your child's questions or emotional reactions
  • This isn't the kind of talk you want to have with your child in a car, in a public place, before your child goes to school or just before you go to work. 

Remain Calm and Bring Forth Your "Best Self:"
  • You and your spouse need to summon your most mature and "best selves" to have this conversation.
  • This isn't the time to blame your spouse or for your spouse to blame you for things that haven't worked out or to express your grievances about the marriage.
  • It's also not the time to try to get your child to side with you.

Reassure Your Child That It Isn't Her Fault :
  • It's very important to assure your child that the breakup of your relationship isn't her fault.  Young children are naturally egocentric during the early stage of their development and it's normal for a child to blame herself for the divorce.
  • It's also very important to let her know that, even though the marriage will be over, you each will love her always and she'll be safe.

Talking to Your Young Child About Your Divorce

Explain What the Living and Visitation Arrangements Will Be:
  • Once again, due to the early stage of a young child's development, your child will naturally be concerned about where she will live.
  • You need to explain the living and visitation arrangements to your child in a simple way.
  • Anticipate other questions.

Don't Assume That Your Child is Okay Just Because She's Not Reacting:
  • Depending upon your child's personality and level of maturity, she may or may not react immediately.
  • Don't assume that everything is okay because she's quiet.
  • Although she is quiet, there can still be a lot going on in her mind that she's not expressing, so you might need to elicit questions or concerns during and after the initial talk.

Anticipate That Your Child Might Regress or Act Out After the Talk:
  • It's not unusual for a child to regress to an earlier stage of development after you and your spouse talk about the divorce.  Young children usually don't have the communication skills to express their feelings, so their upset is often expressed through a regression or through acting out.
  • A child of five or six might start wetting the bed or start using baby talk or feel the need to be treated like a baby again.
  • This usually passes, but if it doesn't speak with your pediatrician and explain what's going on.
  • Acting out could take the form of testing limits, like refusing to do homework or suddenly not want to go to school.
  • Speaking of school, your child's academic performance and behavior in school might become problematic, so you want to remain in contact with the school.  
  • Try to be as compassionate as you can be and recognize that your child might need further reassurance that she's going to be okay and that you and your spouse will each be okay.

Talking to Your Young Child About Your Divorce

Check In With Your Child From Time to Time After The Talk:
  • It often takes young children a while to absorb all the implications of how she will be affected by the divorce, so it's best to check in with your child from time to time.
  • Anticipate that she might try to bargain with the two of you to try to get you to stay together, so you might have to explain it to her again, keeping it simple.

Try Not to Worry Too Much--Most Children Are Resilient:
  • Although it's normal for your child to be sad, disappointed or angry about the divorce, over time, most children are resilient and eventually bounce back, especially if you and your spouse can be respectful of one another and have an amicable relationship when it comes to the welfare of your child.
  • Change can be challenging for anyone, especially children, who need structure and routine, but most children adjust to new routines, especially if they know what to expect.
  • If your child is having an especially difficult time, consider taking your child to a child therapist for help.

Seek Professional Help If You and Your Spouse Are Having a Hard Time Calm and Respectful Towards Each Other For the Sake of Your Child:
  • Although you and your spouse might be beyond fixing your problems, you will need to co-parent your child until she is at least 21.
  • If you're having a hard time coming together in a respectful, calm way, you could benefit from attending marriage counseling to develop the necessary skills to communicate effectively with your child.
  • It would be better to get help in advance than to have a talk with your child if you can't contain your hostility and anger.
  • Learning how to be mature and respectful when you talk to your child and in the co-parenting process will help your child to process the change in a healthy way.  You and your spouse will also feel better about yourselves in the long run.

Getting Help in Therapy to Co-Parent After the Divorce

Getting Help in Therapy
Most people associate marriage counseling with trying to work out problems in a marriage so you can stay together.  That is certainly one aspect of marriage counseling.  But people also come to marriage counseling to learn how to part amicably, whether there are children are not.

If you have children, you and your spouse owe it to them and to yourselves to be your "best selves," which is often difficult to do when you're getting a divorce.

Being able to put your child first, regardless of your feelings towards your spouse, is important, and seeking help if you're unsure of yourselves can be the best step that you take during this challenging time.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (212) 726-1006 or email me.

Also see my article: Coparenting After the Divorce.