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Monday, March 20, 2017

Discovering Your Personal Strengths in Psychotherapy

People have many misperceptions about psychotherapy (see my articles: Common Myths About Psychotherapy: Therapy Takes a Long Time and Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").  Another common misperception is that psychotherapy tends to be negative, but an integrated contemporary approach to psychotherapy also focuses on clients' strengths (see my article: A Strengths-Based Perspective in Psychotherapy).

Discovering Your Personal Strengths in Psychotherapy

Many clients who come to therapy, especially clients who are anxious or depressed, are unaware of their personal strengths either because it hasn't been their focus or because they're so immersed in their current problems that they forget that they have strengths.

When new clients begin therapy with me, especially when they want to work on unresolved psychological trauma, after I find out the presenting problem and get their personal history, we focus on reinforcing their internal resources and healthy coping mechanisms.

Discovering Your Personal Strengths in Psychotherapy

Often, it's a matter of perspective.  Even when clients come in thinking that they have little in the way of personal strengths, as we explore these issues, many of them are surprised and happy to discover these strengths.

Even clients with severe trauma, who feel they're lacking in internal resources, have strengths just based on the fact that they survived their ordeals.  But they often overlook this.

How I Work With Clients in Psychotherapy
I've been helping clients overcome psychological trauma since 1996, and over the years I've discovered that taking the time to reinforce internal resources as well as external resources is well worth the time spent (see my article: Coping Strategies in Mind-Body Oriented Psychotherapy).

It's not unusual for clients, who have a history of trauma, to want to delve immediately into the trauma.  The feeling is often something like,  "The sooner we get to the bottom of this, the sooner I'll be rid of these bad feelings."

But delving directly into the trauma without taking time to reinforce internal resources is a mistake.

Discovering Your Personal Strengths in Psychotherapy

Clients, who have significant trauma, need to have their internal resources reinforced and available to help them deal with working through the trauma.  Aside from having the therapist as a resource, these internal resources act as their "safety net," something to fall back on if they get triggered in session as well as between sessions.

Working on internal resources also helps clients to get a more complete picture of themselves.  They realize that they have many aspects of themselves as multidimensional human beings (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

In the early days of psychotherapy, there was more of an emphasis on looking at clients' problems rather than looking at their strengths.

In fact, we need to do both.  We can't ignore either the strengths or the problems.  There needs to be an integrated approach.

Getting Help in Therapy
If you've been procrastinating about going to therapy because you're concerned that it will be a negative experience that is too daunting for you, you could benefit from working with a psychotherapist who uses a strength-based approach to psychotherapy.

By working with a psychotherapist who uses an integrated approach, you're bound to discover parts of yourself that you've been overlooking.

Rather than struggling on your own, consider setting up a consultation with a psychotherapist who is an integrationist and who will incorporate the positive aspects of who you are (see my article: How to Choose a Psychotherapist).

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.

Sunday, March 12, 2017

Is It Time to Reevaluate Your Friendships?

As I've discussed in a prior article, Friendships: Emotional Support From Your Family of Choice, close friendships are usually an important source of emotional support.  Longstanding friendships add to the quality of your life and you add to the quality of theirs. But sometimes it's necessary to let go of toxic people in your life who are causing you pain, so it's necessary, at times, to reevaluate your friendships (see my article: Letting Go of an Unhealthy Friendship and Do You Feel Overwhelmed By Your Friend's Problems?).

Is It Time to Reevaluate Your Friendships?

Reevaluating Your Friendships:
  • Your friend, who is narcissistic, tends to focus almost exclusively on herself when you're together, but when you need support, she's "too busy."
  • Your friend engages in a monologue about herself and doesn't even ask you how you're doing.  You're just there to witness how "wonderful" she is.
  • Your friend has been gossiping about you behind your back, including revealing very personal things you confided in him (see my article: Coping With a Close Friend's Betrayal).
  • Your friend has been flirting a lot with your wife.
  • Your friend tends to put you down and humiliate you in front of others as a way to make herself look superior.
  • Your friend criticizes you a lot.
  • Your friend tells you you're "too sensitive" after you tell her that she hurt your feelings.
  • Your friend is more interested in what you can do for him than he is in you.
  • Your friend keeps borrowing money from you and not paying you back, even when she has the money to pay back.
  • Your friend cancels plans with you when someone else asks her to do something else.
  • Your friend always needs to be the center of attention when you're with a group of people, and this ruins the evening for everyone.
  • Your friend tends to sulk if she doesn't get her way in every situation.
  • Your friend lacks empathy for you about problems that you're having.  She tells you to "get over it."
  • Your friend is easily offended, so you have to "walk on eggshells" with her.
  • Your friend is so self centered that you feel alone when you're with her.
  • Your friend likes to "one up" you when you and he are around other people.
  • Your friend keeps giving you "advice" about how to "improve" yourself, even though you've told her that you don't need advice (see my articles: When to Give Advice and When to Just Listen and Friendships: Losing a Friend After Giving Advice).

Is It Time to Reevaluate Your Friendships?

Is It Time to Reevaluate Your Friendships?

I'm sure there are dozens more examples of things a so-called friend can do that would make you question whether or not you want this person to remain in your life.

Friends Growing Apart:
Aside from the problematic behavior that I've outlined above, sometimes friends grow apart.

The two of you might have been close at an earlier stage in your life, but you might have each gone in different directions.  This isn't anybody's fault.  It just is.

It might not be a matter of letting go of this friendship completely, but more a matter of recognizing that you're not going to be as close as you were.

For instance, it might be fun to see each other periodically to reminisce about your high school days but, other than that, you no longer have anything in common.

Challenges in Letting Go of a Friendship:
Many people find it difficult to let go of a friendship, even when they recognize that the friendship is unhealthy for them.

Sometimes it's difficult to let go of someone who has shared an important part of your life, especially if this person has been a childhood friend.

You might want to keep giving your friend "one more chance" to see if the friendship can be salvage, but as Maya Angelou once said, "When someone shows you who they are, believe them."

Then, again, your own sense of self worth might be so low that you might not feel you deserve to be treated any better.  Often this is an unconscious feeling.

You might also be at a point in your life where you feel emotionally vulnerable and you don't have it in you to end a friendship.  But you'll need to weigh whether keeping this person in your life will make you feel better or worse.

Getting Help in Therapy
Letting go of people in your life isn't easy.

If you allow people to remain in your life who are hurting you, you might need to help to understand the underlying reasons for this so you can take better care of yourself.

A skilled psychotherapist can help you to learn if there are unconscious reasons related to an earlier time in your life as to why you can't let go of someone who is hurting you.

Rather than struggling alone with this problem, you could benefit from working with a licensed therapist who has experience helping clients to work through these types of issues.

About Me
I'm 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.

Monday, March 6, 2017

How Psychotherapy Helps You to Open Up to New Possibilities in Your Life

All too often people are held back from accomplishing their goals because they are hindered by their personal history.  Struggling on their own, they're unable to overcome these obstacles. But psychotherapy offers an opportunity to free yourself from a history that has been holding you back (see my article: The Benefits of Therapy and What's Holding You Back From Achieving Your Goals?).

How Psychotherapy Helps You to Open Up to New Possibilities in Your Life

Usually, people don't understand how problems from the past affect them now because these underlying issues are unconscious and it's difficult, on your own, to make the connection between what happened before and what's happening now.

People, who feel stuck, tend to berate themselves for being "lazy" or "stupid" when the actual cause of the problem is unresolved emotional trauma.

While it's generally well known that the past can affect the present, it's often difficult to see this in your own personal situation.  And, even if you're able to see it, it can be difficult to overcome the underlying issues on your own.

Let's take a look at a fictionalized scenario which is representative of these issues:

Max was in a dead end job with little to no possibility of moving up or getting a raise.

He wanted to start his own business as a website developer.  He had developed websites pro bono for his friends and for nonprofit groups, and he received high praise for his skills, so he decided to develop his own website offering his skills to others for a fee.

How Psychotherapy Helps You to Open Up to New Possibilities in Your Life

Max knew there would be lots of competition because there were already many other businesses that already offered the same services, but Max wanted to give it a try.

After he developed the website for his business, he was ready to launch it, but he delayed because he had a terrible sense of foreboding.  He didn't know why he felt this way, but he decided to hold off for a while until he felt more comfortable with the idea of starting his own business.

A week turned into a month and a month turned into six months.  And, before he knew it, Max delayed launching his website for a year--even though he couldn't think of any logical reason why he was putting it off.

Whenever his friends would ask him how things were going with the launch of his website, he would tell them that he was still working on it. But his friends knew that Max was very talented and that something else had to be going on.

Finally, his best friend, John, asked Max what was going on and why wasn't he getting started with his business idea.  John knew that Max would be successful if he advertised his services, so he realized that something else had to be going on.

Max and John were friends for many years, so he felt more comfortable talking to John about it than anyone else.  He explained to John that when he was about to launch his site, he had a terrible sense of foreboding and he couldn't go ahead with it.

They talked for a long time over dinner.  John tried to convince Max to "just do it" and tried to bolster Max's confidence.  But he realized that nothing he said was having an impact on Max.  So, he suggested that Max see a therapist.

Max had been in therapy several years ago to deal with the loss of his grandmother when she died.

At the time, Max, who was very close to his grandmother, thought he would never overcome this loss, but his therapist helped him to work through his grief, so Max had a good experience of being in therapy before.  But he wasn't sure how therapy could help him now.

How Psychotherapy Helps You to Open Up to New Possibilities in Your Life

After he thought about it for a while, Max decided to return to his former therapist to see if she could help him to overcome his fear and procrastination (see my articles: Overcoming Procrastination and  Returning to Therapy).

Max told his therapist that he couldn't think of any rational reason that he was procrastinating launching his website.  He knew he had the skills and the business savvy to do it.  He also knew that he would enjoy this business.

Then, he described the sense of foreboding that came over him when he was about to launch his website.  He had no words to express the sense of foreboding that he felt in his stomach.

How Psychotherapy Helps You to Open Up to New Possibilities in Your Life

His therapist worked with the mind-body connection in therapy and she asked him to stay with the sensation as long as it was tolerable to him.  In response, Max said that, although it was uncomfortable, it was tolerable.

His therapist asked Max to just notice what happened next.

At first, Max didn't notice any change, but then he realized that the tension that was in his stomach was moving up through his chest and into his throat.  He said it didn't hurt and it was still tolerable, but it seemed odd to him.

Using a clinical hypnosis technique called the Affect Bridge, his therapist asked him to stay with the sensation and the emotions and go back to the earliest time that he could remember feeling these same sensations and emotions (see my article: Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious Mind).

At first, Max was skeptical about this, but he stayed with it and a memory came to him.  He said, "I don't know why this memory is coming up now and I don't know if it's related to what we're working on, but I'm remembering a conversation I had with my grandmother when I was four or five years old."

His therapist encouraged Max to stay with the memory, sensations and emotions and tell her what was coming up for him.

Max remembered that he used to see his grandmother everyday during that time because she lived in the apartment upstairs from where he lived with his parents.  Usually, he would have his afternoon snack with his grandmother at the same time every afternoon and they would talk.

He remembered on this particular day that his grandmother was reminiscing about her father when she was a little girl in her native country.  She had loved and admired her father very much, and she spent a lot of time with him while he worked in his workshop.

At the time, she thought her father was a genius, especially when it came to fixing things.  He had such a good reputation at what he did that people from their town and the surrounding towns would come with broken appliances or radios, after they had been to other people who told them that it couldn't be fixed, and her father fixed it without a problem.

Although he was admired by most people, there were a few people who had similar businesses who were angry and jealous because they felt he was taking business away from them.

His grandmother told Max that her father invented a farm tool that he was very proud of at the time.  He had hoped that tool, which was unique, would interest local farmers and that he would become financially successful as a result.

When word got out about her father's new farm tool, the men who were jealous of him began to spread malicious gossip about him.  They also maligned his invention.

Although people in the town generally liked her father, for some reason, they believed the gossip and began to stay away from his shop.

At first, her father didn't understand why his business had dropped off so much.  Then, word got back to him about the stories that were circulating about him, and he was stunned.

He realized that his competitors were jealous about his invention and they were behind the vicious rumors.  He also knew that the rumors wouldn't stop until he stopped trying to promote his invention, so he quietly put it away.  And, sure enough, the gossip stopped and people gradually came back to his business.

Max's grandmother remembered this time as being a very humiliating and sad time for her father, for her and the rest of the family.  When she spoke about it, she talked about her father and the rest of the family being powerless to stop what was happening at the time.

Then, she looked directly at Max and she told him, "It's better to remain humble than to be proud and try to rise above where you are or people will try to destroy you."

Max remembers feeling shocked and anxious as a child after he heard his grandmother's story about her father.  At the time, he knew that, even though this was an old memory for his grandmother, she was still very affected by it.  He could see the sadness and fear in her eyes and, as a child, he thought about it for a long time, although he didn't completely understand it because he was so young.

When Max discussed this memory further with his therapist, he had the sudden realization that this was what was holding him back.  He wasn't sure why or how, but he felt it in his gut (see my article: An Unconscious Identification With a Loved One Can Create an Obstacle to Change).

Then, he remembered many other times that his grandmother gave him similar advice based on her traumatic experiences as a child.

Although he knew that his grandmother had been traumatized and she was only trying to protect him, he also felt annoyed that he had been burdened with these ideas at such a young child.

"But how could such a memory from so long ago still be affecting me?" Max asked his therapist.

His therapist responded by telling Max that although this memory wasn't in the forefront of his mind, it had remained in his unconscious and had made an emotional impact on him at an early age, especially since his grandmother had such a big influence on him.

His therapist explained that the memory got triggered, without his realizing it, when Max was about to launch his website to advertise his services.  Even though his grandmother told him this story a long time ago, the memory remained in his unconscious mind and became the impediment to his going forward (see my article: Freeing Yourself From Family Expectations and Beliefs That Are Harmful to You).

Using EMDR Therapy, his therapist helped Max to work through this obstacle (see my articles: How EMDR Therapy Works - Part 1How EMDR Therapy Works - Part 2: Overcoming Trauma and How Experiential Therapy, Like EMDR Therapy, Can Help to Achieve an Emotional Breakthrough).

Over time, Max was able to separate his experience from his grandmother's experience (see my article: Working Through Emotional Trauma: Psychotherapy Helps You to Separate "Then" From "Now").

Gradually, he became comfortable with the idea of launching his website and he also became open to new possibilities in his life, including that he could be a successful business owner.

How Psychotherapy Can Help You to Open Up to New Possibilities in Your Life

By the time he launched his website, he had no fear, conscious or unconscious.  He anticipated that he would enjoy his business and he would be successful.

Often, people are stuck for reasons that they don't understand because the reasons are unconscious.

The Affect Bridge from clinical hypnosis is one of many ways that skilled therapists, who are hypnotherapists, help clients to overcome unconscious obstacles so that clients can become open to new possibilities and new ways of seeing themselves.

Getting Help in Therapy
Clients are often surprised to discover that unconscious memories that are creating obstacles for them.

Getting to these unconscious memories on your own would be very difficult.

If you're feeling stuck and you've been unable to move forward on your own, rather than suffering alone, you can get help from a licensed mental health professional who can help you identify the obstacles and work through them.

The first step, which is often the hardest, is making a call for a consultation, but it can make all the difference between remaining stuck and freeing yourself from your history (see my article: How to Choose a Psychotherapist).

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.

Monday, February 27, 2017

Psychotherapy is More Than Just Venting: Understanding the Importance of Balancing Content and Process in Therapy

If you've never been in therapy before, you might not know what to expect, which is why I've written several articles to educate people about starting therapy (see my articles: Starting TherapyPsychotherapy and Beginner's MindThe Benefits of Psychotherapy and How Talking to a Psychotherapist is Different Than Talking to a Friend).  One important concept in psychotherapy is the importance of balancing content and process.

Psychotherapy: Understanding the Importance of Balancing Content and Process in Your Therapy Sessions

Psychotherapy is More Than Just Venting
Many people who have never been in therapy before think that their therapy sessions will be a place for them to vent about their problems and nothing more.

They think that they can use their therapy sessions to just release whatever is on their mind, so they can empty themselves of what's bothering them.

While venting is an important part of therapy, it's only one part.  If therapy were solely about venting, it would be of limited value since you can vent with a friend, family member or a spouse.  Why pay a psychotherapist if you're only going to vent?

Understanding the Importance of Balancing Content and Process in Therapy
Psychoeducation is an important part of therapy, especially for people who haven't been in therapy before.

Understanding the difference between content and process in therapy is important, and it's essential to balance both in order to have a successful therapy.

Content is just what you would think it is--you talk about what's on your mind: What happened during the week and other things that are on your mind.

Many people who begin therapy only focus on content.

Often, people provide so much content in therapy sessions that there's little time for processing, which is another very important part of therapy.

Processing in therapy is stepping back from the content, experiencing your feelings about what you're talking about, and telling your therapist about your feelings.  For example:
  • What is it like on an emotional level for you to talk about these issues with your therapist?
  • How is the content that you shared with your therapist meaningful to you?  
  • How does it relate to your past, present or wished for future?  
  • How does it relate to other things that you and your therapist are working on?  
and so on.

Let's take a look at a fictionalized scenario that illustrates the importance of balancing process and content in psychotherapy sessions:

Ida started therapy after her breakup with Sam.

She had never been in therapy before, and she started therapy because she was afraid that she would alienate her friends if she kept talking on and on about the breakup.

After the consultation with her therapist, Ida had her first therapy session.  During that session, Ida started venting non-stop about what happened in the relationship.

Since it was Ida's first therapy session, her therapist realized that Ida needed to vent and allowed her to talk.

During the next session, Ida was talking non-stop again about the relationship, but she wasn't talking about her feelings.

When Ida stopped to take a breath, her therapist gently and tactfully pointed out to Ida that she was providing a lot of information about the relationship and the breakup, but she wasn't talking about how she was feeling.

Her therapist explained to Ida why it's important to not only relay information in therapy but also to talk about her feelings--in other words, to balance content and process.

Her therapist asked Ida to slow down rather than try to get in as much information as possible in their hour together.  She told her that by slowing down, Ida would be able to sense into her feelings and process them.

Ida wasn't sure she understood, but she knew how to slow down.  So, rather than racing ahead to her next thought, she focused on what she had just said, which was that she felt betrayed by Sam, her ex.

At first, Ida didn't feel any particular emotions.  Then, her therapist asked Ida to focus on her body and sense if she was holding onto any emotions (see my article: The Body Offers a Window Into the Unconscious Mind).

Ida felt a tightness in her throat and, as she focused on that tightness, she began to cry.

After she cried for a few minutes, Ida felt an emotional release and she realized that she had been holding onto this sadness in her throat.

From that session on, Ida was much more mindful of the importance of both process and content.  Rather than speaking quickly to vent, she slowed down and allowed herself to feel her emotions.

Ida realized that she had been speaking quickly as a way to not feel her emotions.  She was racing from one thought to the next because, without realizing it, she thought it was just a matter of purging herself of these thoughts so she could let them go.

But as she took the time to process her thoughts and emotions, she began to feel more emotionally integrated.

Psychotherapy: Understanding the Importance of Balancing Content and Process in Your Therapy Sessions

A common misconception about psychotherapy is that therapy is just about venting, but this is only a part of what therapy is about (see my articles about other common myths about therapy: Common Myths About Psychotherapy: Therapy Takes a Long Time and Common Myths About Psychotherapy: Going to Therapy Means You're Weak).

Many clients who are new to therapy think that they will use their psychotherapy sessions to just talk and purge themselves of their thoughts.

Psychoeducation is an important part of psychotherapy, especially for people who are new to therapy.

When therapists provide clients with psychoeducation about the importance of balancing content and process in their therapy sessions, clients usually realize how essential this combination is to their healing process.

Rather than just venting about what happened, they're also taking the time to feel how they are affected and make connections to the past, present and their wishes for the future.

The emotional integration of balancing content and process is an important part of what is healing in therapy.

Getting Help in Therapy
A skilled psychotherapist knows how to provide psychoeducation to assist clients to use both content and process in therapy (see my article: How to Choose a Psychotherapist).

Like any other skill, it can take clients time to develop these skills.

As a psychotherapy client, with the help of your psychotherapist, you learn as you become more experienced in therapy.

Although it might seem contradictory, going slower to process thoughts and feelings moves the therapeutic work along faster than just venting.

Venting without any processing is a superficial way of talking about  "the story" of what happened and not about your related emotional experience.

If you're feeling stuck or you're having difficulty overcoming your problems, you could benefit from attending therapy with a skilled psychotherapist.

You're not alone.  Help is available to you.

After you've worked through your problems in therapy, you'll have an opportunity to live a more fulfilling life.

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.

Tuesday, February 21, 2017

Relationships: Thinking of "Starting Over"? Ask Yourself, "What's Changed?"

Before you consider "starting over" in a troubled relationship, it's a good idea to ask yourself, "What changed?," especially if, as a couple, you haven't reflected on what needs to change and how the two of you are going to bring about that change (see my article: Love: Is It Really Better the Second Time Around?)

Relationships: Thinking of "Starting Over"?  Ask Yourself: "What's Changed?"

Many couples, who have having problems in their relationship, decide that telling themselves they're "starting over" means they've changed their problems.

But without introspection by each individual, an understanding of what went wrong in the past, and a plan to make changes, in most cases, the same problems continue--no matter how many times these couples vow to "start over."

Some couples might say that they've talked about their problems and they've decided not to repeat the same mistakes.  But with complex relationship problems, if you don't understand the underlying issues at the root of these problems, a simple declaration to not repeat your mistakes won't resolve the problems.

Let's look at a fictionalized scenario that illustrates these issues:

Jane and Bob
Bob and Jane were dating for two years when they moved in together.  Both of them were divorced and had not dated in a long time before they met each other.

Relationships: Thinking of "Starting Over"?  Ask Yourself: "What's Changed?"

Initially, things were going well and they were enjoying their time together, but several months later, Jane discovered that Bob secretly engaged in online gambling.

One night, she woke up in the early hours of the morning to find Bob at their computer in the living room playing poker online.

When he heard Jane come into the room, Bob tried to hide what he was doing by switching to another website, but Jane had already seen what he was doing and she confronted him (see my article: Are Toxic Secrets Ruining Your Relationship?)

They stayed up all the night to talk about Bob's gambling.  At first, he told Jane that this was the first time that he had ever gone onto this gambling site.  But when Jane looked at the browser history, she saw that he was regularly on various gambling sites.

At that point, Bob had to admit that he would frequently gamble online, and he had been gambling online for several years, but he didn't want Jane to know about it because he felt ashamed about it.

Although Jane felt compassion for Bob, she was also shocked and angry that Bob hid his problem from her.

Over the next few days, as Jane and Bob continued to discuss his gambling, Jane found out that Bob had withdrew a considerable amount of money from their joint checking account.

When Jane confronted Bob about this, he told her that he had planned to replace the money before Jane found out about it, but he was having a "bad streak of luck."  He admitted that he was also gambling on sports and he had lost a lot of money.

By now, Jane was very upset.  She was beginning to realize that Bob's gambling problem was a lot worse than she had originally suspected.

After thinking it over for a few days, Jane told Bob that she couldn't live with a gambler, especially since her father gambled away her family's savings.  Then, she asked Bob to move out.

Relationships: Thinking of "Starting Over?" Ask Yourself: "What's Changed?"

Bob pleaded with Jane to give him a chance to overcome his gambling problem.  He knew he would be miserable without Jane and he felt deep remorse for putting their relationship in jeopardy.

Jane wasn't sure what to do at that point, so she asked Bob to move out for a few weeks so she could think about what she wanted to do.

During the weeks that Bob and Jane were apart, they agreed to no contact.  They each missed each other a lot, and Jane wondered if she had made a mistake by asking Bob to move out.

After their separation period was over, they agreed to talk.  Bob told Jane that he wanted more than anything for them to get back together.  He asked her if she would consider "starting over" and he promised he would never gamble again.

Jane told Bob that their weeks apart had been very hard for her, and she missed him a lot.  She made Bob promise that he would never gamble again and, when he did, she agreed that they should "start over."

They both agreed that they wouldn't discuss his gambling or this painful period in their lives again, and they would resume their relationship "as if nothing had ever happened."  They both wanted to "put it behind" them (see my article: Overcoming Your Emotional Blind Spots)

Relationships: Thinking of "Starting Over"?  Ask Yourself, "What's Changed?"

Initially, they were so glad to be back together again that they went on a romantic vacation together to rekindle their relationship.  They had a wonderful time, and when they got back, they were more resolved than ever to be together.

But a month or so later, Jane couldn't help wondering if Bob was secretly gambling again.  She wanted to trust him, but she began to have doubts.

Whenever she began to have doubts, Jane tried to put these doubts out of her mind, but they kept coming back.

Then, one day, when Bob was out, Jane decided on a whim to look at the browser history, which had been cleared of the previous history, and she saw that Bob had resumed gambling again.  She felt completely betrayed.

When Bob got home, he discovered that Jane had packed his things and put everything by the door.  He realized immediately that Jane had discovered that he started gambling again.

He pleaded with Jane to give him another chance, but she was adamant that he needed to move out.  She didn't want to live her mother's life with a gambler.

A few weeks later, Bob began therapy with a therapist who specialized in addictions.

Over time, he learned about the emotional triggers that triggered his compulsive gambling.  His therapist told him that, in addition to attending therapy, he needed to attend a 12 Step program for gamblers, Gamblers Anonymous and also get a sponsor in that program.

Bob attempted to bargain with his therapist, telling the therapist that he thought he could cut back on his gambling so that it would be less of a problem--rather than abstaining completely from gambling (see my article: Starting Therapy: It's Not Unusual to Feel Anxious and Ambivalent).

But his therapist told Bob that he had a serious problem and explained that if Bob gave into his compulsion to gambling, even if it was less frequently than before, he would be reinforcing this habit and wouldn't stop.  He also explained the brain chemistry involved with gambling and other addictions.

Bob decided to leave therapy (see my article: When Clients Leave Therapy Prematurely).

He felt he could handle his problems on his own, so he made a promise to himself that he would only gamble once a week and he would set a limit on how much money he would allow himself to lose

For the first month, this appeared to work for Bob and he was proud of himself.  He kept to his promise to himself to only gamble once a week and to stay within certain monetary limits.

Bob felt so good about what he saw as progress that he told himself that he was able to control himself and he could gamble twice a week and increase the limit of what he allowed himself to lose.

As time went on, Bob felt bored and he kept bargaining with himself and this resulted in his gambling more often and losing much more money than he had ever lost before (see my article: Overcoming Addiction: Boredom as a Relapse Trigger).

Before he realized it, Bob had gambled away much of his savings and he was tempted to borrow money from his parents.  But at that point, Bob stopped himself.  He knew that he had sunk to a new low and his denial about his problem was only making it worse.

Bob went back to therapy and made a commitment to remain.  He also began attending Gamblers Anonymous (G.A.) and he got a sponsor that he called several times a week, especially when he felt a urge to gamble.

A year later, Bob celebrated his one year anniversary of abstaining from gambling.  He knew his triggers, and he knew he needed to talk about his habit in his individual psychotherapy sessions and in G.A. groups and with his sponsor.  He also knew that he needed to be aware of not becoming complacent.

Throughout this time, Bob continued to miss Jane.  He had thought about calling her many times, but he was afraid that she would hang up on him.

After celebrating his one year anniversary, Bob called Jane and hoped for the best.  He had already discussed this with his therapist and his sponsor, so he was prepared if she rejected him.  But, to his surprise, she sounded glad to hear from him, and they decided to meet for coffee.

Relationships: Thinking of "Starting Over"? Ask Yourself: "What's Changed?"

Coffee led to dinner.  Jane was happy to hear that Bob hadn't gambled in a year.  She sensed his sincerity and commitment to his recovery. He also offered to have her come to a therapy session with his therapist.

After that, they decided to go to couples counseling (see my article: Starting Couples Counseling).

They both knew that simply saying that they would "start over" wasn't the answer, and they needed help from a licensed mental health professional if they were going to get back together again.

A couple's decision to "start over" is usually well intentioned.  But if the couple doesn't address the issues in a meaningful way and with professional help, especially if they have serious problems, it's usually a misguided strategy.

Without realizing it, many couples tell themselves that they will "start over" as a form of denial--a way to avoid dealing with their problems on a deeper level.

In most cases where there are serous problems, it's magical thinking to think that their problems will automatically vanish because they've decided to "put it behind" them.

Many relationships that could be salvaged with professional help end permanently after many efforts to "start over" don't work.

Getting Help in Therapy
While it might be tempting to put aside problems by vowing to "start over," this is usually a doomed strategy.

Acknowledging and understanding the problems on a superficial level is only the first step.

Rooting out the underlying, unconscious issues requires the skill of a licensed mental health professional.

If you and your significant other have been struggling with relationship problems and "starting over" hasn't worked for you, you could benefit by seeking help from a licensed psychotherapist.

It could make the difference between salvaging your relationship or ending it.

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.

Monday, February 13, 2017

Common Myths About Psychotherapy: Therapy is "All Talk and No Action"

As I've mentioned in prior articles, there are many common myths about psychotherapy (see my articles: Common Myths About Psychotherapy: Therapy Takes a Long Time and Common Myths About Psychotherapy: Going to Therapy Means You're Weak).  In addition to the myths that I mentioned in my prior articles, there's also a myth that therapy is all about talking and not taking action.

Common Myths About Psychotherapy:  Therapy is "All Talk and No Action"

I believe this myth survives because of old stereotypes of psychotherapy where a client comes to therapy for many years and nothing changes.

The type of contemporary psychotherapy that I practice focuses on helping clients to achieve transformation, which includes taking action to change.

There can be many obstacles to transformation, so clients often have to work through those obstacles, including early emotional trauma, including their own ambivalence about change, before they can make changes in their lives (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious and Ambivalent).

Let's take a look at a fictionalized scenario that addresses these issues:

Rick came to therapy because he felt stuck in almost every area of his life.

He was in a marriage where he had been unhappy for many years, and he was also in a career that he had come to dislike intensely.

Rick was in therapy before when his anxiety about these issues was especially acute, but he never remained long enough to make changes (see my article: When Clients Leave Therapy Prematurely).

After he turned 45, Rick's fear of remaining stuck became worse than ever.  He was afraid he would complain for the rest of his life about his unhappiness, but he wouldn't make any changes.

When he started therapy again, Rick wasn't very hopeful that it would help him, but he knew that his friends and colleagues were getting tired of hearing him complain, and he and his wife were barely speaking to each other, so he couldn't count on her for emotional support.

Common Myths About Psychotherapy: Therapy is "All Talk and No Action"

Having low expectations of therapy, Rick said he wanted a place to "vent" and to "let off steam" so that his anxiety and dissatisfaction wouldn't overwhelm him.

His therapist addressed these issues in the first session when she asked him what he wanted to accomplish in therapy.

When she heard that he had little expectation of changing, she explained that she worked with clients to help them overcome the obstacles to change and she hoped to be able to help Rick with whatever challenges were getting in his way.

During one of their early sessions, his therapist asked Rick to do a sentence completion exercise in their session through free association, which means to say whatever comes to mind.

Free association is a psychoanalytic technique and using free association in this way is a technique used in Coherence Therapy (see my articles: Discovering the Unconscious Emotions at the Root of Your Problems and Experiential Therapy Helps to Achieve Emotional Breakthroughs).

The therapist gave Rick the following sentence stem for Rick to complete:

"If I could make the necessary changes to be happy in a relationship and in a career, then ________."

Initially, like most people, Rick's first few answers for filling in the blank were somewhat superficial (" life would be easier," "...I would feel better about myself," and so on.

But by the time he did it for the tenth time, he was shocked to hear himself say, "...then I would be afraid that something terrible would happen."

It took a few minutes before Rick could reflect on his words because he was so surprised.  But once he could think about it, he said this felt true to him--although he never realized he felt this way before.

As he and his therapist explored this issue, Rick realized that one of his unconscious core beliefs was that if he allowed himself to be happy, fate would intervene to spoil it for him and something terrible would happen (see my article: Are Your Core Beliefs Keeping You Stuck?)

He didn't have any idea what that "something terrible" would be, but it was a strong feeling that he felt in his chest and in his stomach (see my article: Are You Afraid to Allow Yourself to Be Happy?).

As his therapist listened to his family history, she and Rick discovered the roots to this underlying belief.

Rick talked about how unhappy his parents were, especially his father, who had many unresolved early traumatic experiences.

From the time that Rick was a young child, his father told him that Rick had to remain ever vigilant for the "fickle finger of fate," especially if things were going well and he was happy.

His father had many early losses, including the loss of both parents in a car accident, when he was a small boy.

From his father's perspective, the accident (and other family tragedies) occurred because things were going too well in the family, and fate came along to teach them a lesson.

His father saw each loss and downturn as the direct result of "fate" when things were going well, so that, from his perspective, no one could ever let down their guard, especially when they were feeling happy.

Common Myths About Psychotherapy: Therapy is "All Talk and No Action"

His father told Rick from an early age, "If you learn to expect terrible things when you're happy, you'll be prepared and you won't be taken off guard."

Rick's father's belief were so detrimental to Rick that he feared being happy, which was the obstacle in his way to making changes (see my article: Freeing Yourself From Family Beliefs and Expectations That Are Harmful to You).

It was Rick's unconscious belief that as long as he was in an unhappy marriage and in a career that he hated, "fate" wouldn't be tempted to devastate him.

After he said these words out loud, Rick realized how unrealistic it sounded but, deep down, he also knew that he had come to believe this at an early age.

After his therapist helped Rick to discover this unconscious belief, it made sense to both of them why he remained stuck.  Given his belief, why would he want to "tempt fate" to bring him pain?

As he continued to work in therapy, Rick explored the many times when he was happy in the past and when he wasn't "punished by fate" for it, so he started to understand the fallacy in his unconscious belief.

Over time, his therapist encouraged Rick to begin to explore other career options that might interest him.  Initially, he set up informational interviews, and then he talked about his experiences in therapy.

After one of these interviews, Rick got a call from someone, who met with him for an informational interview, telling Rick about an opening in the company.  This manager had been so impressed with Rick's background that he asked Rick to apply for the job.

When Rick told his therapist about it, he was excited about the possibility.  As she listened to him speak, his therapist asked him to check in with himself to see if he was feeling his old fear that if he allowed himself to be happy that "something terrible would happen" to end my happiness.

Rick reflected on this for a moment, and he was surprised that he didn't feel this old feeling.

As Rick took each step in the process towards changing his career, he would check in with himself to see if his old core belief was getting in his way, and each time he was surprised that it wasn't.

As it turned out, Rick didn't get that job, but he now felt free to explore other options and take the necessary steps to make changes.

The other problem, his marriage, was more complicated because Rick wasn't sure how he felt about his wife.

After talking it over with his wife, they went for marriage counseling and, after a few sessions, they mutually agreed that the relationship had been over for several years and that neither of them were happy.

Soon after that, they spoke to their marriage counselor about how they could end their marriage in a way that was amicable and respectful.

Rick got his own apartment nearby and they began the divorce process.

Even though Rick knew that he wasn't happy in his marriage and the divorce was for best for both of them, he still felt sad about the ending of this long relationship, and he dealt with his grief about it in his own individual therapy.

A year later, Rick wondered if he should start dating, but he had not been on a date in many years, and he felt uncomfortable.

As they explored this issue, Rick checked in with himself again to see if his old core belief was lurking in the background and tripping him up.  But he had no sense of this.

After they had talked about dating for a few sessions, Rick's therapist encouraged him to start taking steps, no matter how small, to start dating.

Rick would have preferred to continue talking about dating rather than taking any action, but his therapist told him that he could do both.  He could start taking steps to date and they could continue to talk about each step.

In this way, step by step, Rick began dating and he developed increasing confidence in the dating process, even though he had not met anyone that he really liked yet.

In a therapy session where he and his therapist looked back at where Rick started and where he was at that point, Rick expressed a sense of empowerment that he was able to take steps to overcome the obstacles that were preventing him from making changes in his life.

Old stereotypes contribute to the common myth that therapy is "all talk and no action."

Contemporary psychotherapy is a combination of self discovery which leads to taking meaningful action to change.

In the fictionalized scenario above, there is a particular longstanding core belief from early childhood that got in the way of the client making changes.

There are many other types of obstacles, conscious and unconscious, that get in the way of people making changes.

Once these obstacles are discovered, they can be worked with in therapy so that clients can free themselves of their effect.

It's important for the therapist to encourage clients to take action, no matter how small, and not to just talk about the problem.

This requires a clinician who has the clinical skills to know when to push the limits and when to hold off and, of course, this will be different with every client.

Getting Help in Therapy
If you have been avoiding therapy because you believe in the old myth that therapy is just about talking and not taking action, you're doing yourself a disservice.

Rather than telling yourself that you've tried to change in the past, but you can't do it, recognize that there are obstacles that you haven't discovered yet but that you can discover with the right therapist.

You might be surprised, as the client in the scenario above, to discover that there are unconscious beliefs that are holding you back.

Very often, once these unconscious beliefs have been exposed to the light of day, they don't hold up.

If you've been feeling stuck, you could benefit from working with a skilled psychotherapist who can help you to bring about the changes that you want.

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.

Monday, February 6, 2017

Coping With a Breakup When Closure With Your Ex Isn't Possible

In an ideal world, couples would work out the end of their relationship in a mutually respectful way that would allow for closure.  While this is possible for some couples, for many couples this isn't possible, for a variety of reasons, and each person in the former relationship has to find closure in his or her own way (see my article: Overcoming the Heartbreak of a Breakup).

Coping With a Breakup When Closure With Your Ex Isn't Possible

In a situation that is volatile or when one or both people feel unable or unwilling to communicate with each other, closure might not be possible for the couple.  But most of the time, people feel a need for closure and it becomes frustrating when this isn't possible.  It can also prolong the grieving process after the breakup.

Let's take a look at a fictionalized scenario which is representative of one of these situations:

Ina and Ted
Ina and Ted were in a relationship for five years.  They lived together for the last three years.

Although they loved each other very much, one of their ongoing problems was that Ted didn't like to talk about his feelings and he became impatient when Ina wanted to talk about her feelings or about the relationship.

Ina felt very frustrated by Ted's refusal to talk about feelings, and he felt annoyed by Ina's need to talk  (see my article:  Are Your Emotional Needs Being Met in Your Relationship?).

Ina was aware that Ted came from a family where the only emotion that was expressed was anger.  Ted's father was especially volatile when he got angry and, although he never hit Ted, Ted was frightened by his father's angry outbursts.

He also grew up being frightened by his own anger or any strong emotions that he experienced.  Whenever he experienced a strong emotion, his first impulse was to push it down.

It took Ted a while to tell Ina that he loved her, and throughout their relationship, it still made him feel uncomfortable.

Since Ted wouldn't allow any strong emotions, after five years, the relationship felt "flat" to Ina.  When she tried to talk to Ted about this, he walked into another room.

Coping With a Breakup When Closure With Your Ex Isn't Possible

A few days later, Ina came home and she was shocked to discover that all of Ted's possessions were gone.  At first, she thought they had been robbed.  But when she saw that many valuable items were still in the apartment and all of her things were still there, she realized that he had moved out without a word.  There was no message--not even a note.

Ina tried to call Ted on his cellphone and at his work number, but he didn't pick up and he didn't respond to her messages.

Although she knew that Ted didn't like to deal with strong emotions, she couldn't believe that he would end the relationship this way.  She still loved him, and she hoped that they would be able to work things out.

After a few days, he sent her a text in which he told her that she needed to "move on" with her life because things weren't working out between them.

Coping With a Breakup When Closure With Your Ex Isn't Possible

Ina was shocked, angry and hurt that, after five years, this is all he had to say to her and that he was saying it in a text message.

She tried, in vain, to get Ted to speak with her, but he resisted all of her efforts.

Not knowing what else to do, Ina started therapy because she felt overwhelmed by the breakup, how it occurred and that Ted refused to speak with her.  She knew he wasn't communicative about his feelings, but she never would have guessed that he would do something like this.

Ina found herself ruminating about what might have happened that caused Ted to break off their relationship in this way.

She felt a rapport with her therapist and felt safe being vulnerable in therapy.  She realized that she really missed feeling heard and understood in her relationship.

After a few weeks in therapy, Ina admitted that the relationship had been on the rocks for a while and it was bound to end.  But she still felt a need to have closure.  She would have preferred to have closure with Ted, but she knew that this wasn't going to be possible.

In her therapy sessions, her therapist asked Ina to imagine talking to Ted about her feelings and to say out loud what she was feeling.

At first, Ina felt awkward doing this, but as she opened up, she felt how freeing it was to express her feelings "to Ted" (even though he wasn't really there).  She told him how hurt she was and how disappointed she felt that he ended their relationship this way and refused to speak with her.

As she expressed her feelings, she had a realization that, all along, she had been asking Ted to do something that he was incapable of doing--to listen to her express her feelings and for him to express how he felt.

On some level, she always knew this, but when she spoke out loud, as if Ted was in the room with her, she had a deep awareness of it.

In time, this helped Ina to inwardly forgive Ted, even though they never spoke again.  Realizing that he was incapable of doing what she wanted and needed allowed her to let go of her anger.

Coping With a Breakup When Closure With Your Ex Isn't Possible

Over the next several months, Ina felt that she was able to have her own sense of closure about the breakup in therapy, and she realized what she needed emotionally in her next relationship (see my article: Learning From Past Romantic Relationships).

There are many reasons why closure isn't possible within a relationship.

The scenario above presents one example, but there are numerous reasons.

Just because you can't have closure within the relationship doesn't mean that you can't have closure within yourself.

Even when two people are able to talk about the end of their relationship, one or both people might still feel that there's no closure.

Sometimes, one person in the relationship can use the idea of closure in order to maintain contact with the other person and this can lead to a form of harassment (see my article:  Breakup: When Closure at the End of a Relationship Leads to Harassment).

Therapy allows for another possibility for closure.

Getting Help in Therapy
Working with a skilled psychotherapist can help you to have closure around the end of a relationship even when you can't have closure with your ex (see my article: How to Choose a Psychotherapist).

This doesn't mean that all the loose ends are tied up in a neat bow or that it will be quick or easy, but it does mean that you can emotionally heal without being in a protracted state of grief after a breakup.

If you're going through a breakup and you need emotional support, you owe it to yourself to get help in therapy.

Friends and family might be supportive, but they're not trained to help you to work through your sadness, anger and grief (see my article: Talking to a Psychotherapist Is Different From Talking to a Friend).

Getting help in therapy can allow you to heal emotionally.

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.