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Saturday, July 7, 2018

EFT Couple Counseling: New Bonding Can Replace a Negative Cycle in a Relationship

I began discussing EFT couple therapy in my previous two articles (see my articles: EFT Couple Therapy: Overcoming the Negative Dynamic in Your Relationship That Keeps You Both Stuck and How EFT Couple Therapy Can Help Improve Your Relationship).  In this article, I'm focusing specifically on how EFT couple therapy can help couples to replace negative cycles with new ways of bonding.

EFT Couple Counseling: New Bonding Can Replace a Negative Cycle in a Relationship

Negative cycles are often difficult for a couple to see on their own. But when an EFT couple therapist assesses a couple, she can eventually identify the negative cycle and help the couple to change it so that they can learn new ways of bonding together.

Fictional Clinical Vignette: Developing New Ways of Bonding in EFT Couple Therapy
The following fictional clinical vignette illustrates how an EFT couple therapist can help a couple to recognize the negative cycle that they're stuck in and help the couple to stop the negative cycle so they can develop a new way of bonding together:

Ann and Tom
After 10 years of marriage, Ann and Tom were locked into an ongoing emotional battle where each of  them felt unloved and unappreciated by the other.

Ann explained to their EFT couple therapist that they had talked about the possibility of divorce, but they wanted to try to see if they could salvage their marriage, especially since they had two young children.

She said that problems began about five years into their marriage when their first son was born.  Tom had just started his own consulting business, and Ann had taken off time from her career to raise their son.

With stressors related to a new business and raising a young child, they began to drift apart.  They were frequently exhausted and their sex life had waned.  Tom said that Ann was a wonderful mother to their son, but she hardly ever wanted to take time for just the two of them.

He said he tried numerous times to persuade Ann to leave their son with her mother so they could go on vacation together and rekindle their relationship, but she refused to do it.  Eventually, he got tired of trying to persuade her, he threw himself into his work, and they continued to drift apart (see my article: Telltale Signs That You and Your Spouse Are Drifting Apart).

A few months prior to coming to couple therapy, Tom told Ann he felt like he was living with a roommate.  He told her that they were still young enough to start their lives over, and he broached the topic of divorce.  Shocked and upset, Ann told Tom that it would be devastating for their children if they got a divorce, and she wanted to see if they could save their marriage, which was what brought them into EFT couple therapy.

As the EFT couple therapist listened to each of them talk about their relationship history, it was clear to her that, in the past, Tom had been the pursuer in the relationship, and Ann had been the withdrawer.  Tom had been the one who was reaching out to Ann earlier in their marriage, and Ann withdrew emotionally from Tom.

By the time they came for couple therapy, they both appeared to be withdrawn and exhausted.  The EFT couple therapist noted that they hardly looked at each other when they spoke and neither of them made an effort to connect with a look or a touch.  And yet here they were seeking help in therapy.

When the EFT couple therapist asked what attracted each of them to the other  when they first met, Tom said how attracted he was to Ann when they first met in a college class.  He was drawn to her passion and enthusiasm in the class, and he eventually asked her out on a date.  Ann said she was drawn to Tom's good looks and how he made her laugh when they went out.

As they spoke about their relationship history, the EFT couple therapist noticed each of them come alive momentarily, and she commented on it.  For the first time in the session, Tom reached over to Ann, but Ann looked away and Tom withdrew his hand.

When the EFT couple therapist pointed out this interaction and asked Ann how she experienced it, Ann said that she felt emotionally numb.  She said it had been so long since they had touched one another in any way that she felt uncomfortable.  She said, even though she wanted her marriage to work out, she felt a sense of helplessness and almost hopelessness about it.

As the EFT couple therapist helped Ann and Tom to identify their negative cycle, which included Tom making gestures for connection and Ann pulling away, they both agreed that this was their negative dynamic, and they didn't know how to change it.

Over time, with the EFT couple therapist's help, Ann began to express her emotional vulnerability with caution, and Tom listened and felt more compassionate towards Ann.  She said that, after their first child was born, she felt Tom was making emotional demands of her that she couldn't fulfill, and she felt like a failure as a wife.

After their second child was born, Ann said, she felt that Tom's suggestion that they take time apart from their children felt impossible for her.  At the time, she didn't want to leave them in the care of her mother to go away with Tom, and this was the source of frequent arguments between them--until Tom buried himself in his work and Ann became more involved in their children's activities.

They were each able to see how they had gotten to this point after Ann withdrew emotionally and Tom became more resentful, distant and stopped trying to get closer to Ann.

With the help of the EFT couple therapist, each of them began to take small steps to allow themselves to be more open and vulnerable with each other and, slowly, things began to change as they developed a new emotional bond.

Conclusion
In most relationships where the couple is having problems, there is often a negative cycle in the relationship where there is a pursuer and a withdrawer.  After being immersed in this negative cycle for a while, the pursuer might also eventually withdraw emotionally until the couple drifts apart.  Without help, a couple who is stuck in a negative cycle often continues to drift apart until the relationship ends.

With help in EFT couple therapy, a couple can begin to identify their negative cycle and make small gestures to change.  It can take a while for each person in the relationship to trust again to be able to be emotionally vulnerable.

The role of the EFT couple therapist is to help the couple see their negative cycle and develop new ways of bonding.

Getting Help With EFT Couple Therapy
Many couples who are stuck in a negative cycle are helped by EFT couple therapy to learn new ways of relating so they can bond emotionally again.

If you and your spouse are having problems in your relationship, you owe it to yourself and your relationship to get help.

Rather than continuing to drift apart, getting help in EFT couple therapy could save your relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and EFT couple therapist.

I work with individual adults and couples, and I have helped many people to improve their relationships.

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, July 2, 2018

How EFT Couple Therapy Can Help Improve Your Relationship

In my prior article,  EFT Couples Therapy: Overcoming the Negative Dynamic in Your Relationship That Keeps You Both Stuck, I began a discussion about how Emotionally Focused Couples Therapy (EFT) helps couples to overcome the negative cycle that they're stuck in.  In this article, I'm continuing the discussion about EFT and how it can help to improve your relationship.

How EFT Couples Therapy Can Help Improve Your Relationship

EFT couples therapy recognizes that couples often get caught up in a negative cycle and that they are often unaware of this cycle.  During the initial stage of EFT couples therapy, the EFT therapist is assessing, among other things, the type of negative cycle that the couple is stuck in.

EFT Couples Therapy and the Negative Cycle
The negative cycle usually involves each individual in the relationship aware of their secondary emotions (e.g., anger, frustration), but unaware of their primary emotions (e.g., sadness).  The secondary emotions usually function as defenses against experiencing the emotional vulnerability involved with the primary emotions.

For instance, many people feel more comfortable experiencing the secondary emotion of anger rather than allowing them to experience the primary emotion of sadness, which underlies their anger.

It's not that the secondary emotion isn't real--far from it.  The anger is real, but if each individual in the couple only allows him or herself to experience the anger, s/he will remain stuck in anger rather than recognizing the sadness s/he feels about problems in the relationship.

Getting to the primary emotions in EFT allow the couple to move beyond arguing and blaming so that they can express their unmet emotional needs to each other.

At that point, the couple usually feels more motivated to work on their relationship.  They also have something more substantial to work with to make changes in their relationship rather than just blaming each other or getting stuck in a blaming/withdrawing negative cycle (more about this below).

In order to get to the primary emotions, the EFT couples therapist needs to develop a therapeutic alliance with each person in the couple so each of them feels comfortable enough to open up.  Developing this alliance can take a while, and it will be different for each person in the relationship.

Once the therapist and the clients have a good therapeutic alliance, the couple is usually more willing to look at their negative cycle.

Roles in a Relationship: Pursuer/Blamer and Withdrawer
As I mentioned in my prior article, a common dynamic in relationships is for one person to be the pursuer/blamer and the other person to be the withdrawer.

The pursuer/blamer is usually the one who is most vocal about the problems in the relationship.  After the couple has been in a negative cycle for a while, the pursuer/blamer often comes across as being angry and critical.  The more s/he feels ignored by the spouse, the more the pursuer escalates the pursuing and the blaming in order to get his or her partner's attention.

The pursuer's intention is usually not to blame or cause an argument--although that's what it usually looks like to the other spouse.  His or her intention, as previously mentioned, is to change the dynamic in the relationship, but his or her emotions are being expressed in a way that usually alienates the spouse.  As a result, the other spouse often withdraws emotionally and, at times, physically.

As part of the cycle, when the other spouse withdraws, the pursuer will pursue/blame even more to try to reach the spouse who has withdrawn.  This, of course, usually leads to the person who has withdrawn to withdraw even further, and the cycle continues to perpetuate itself.

Often, from the pursuer's perspective, if s/he hopes that if s/he escalates his or her demands and says it loud enough, the other spouse will hear it and respond. But this usually doesn't work.

From the perspective of the person who withdraws, s/he feels frustrated.  Frustration is his or her secondary emotion, the emotion that is closest to the surface.

Often, the louder and more blaming and persistent his or her spouse becomes, the more helpless and hopeless the withdrawer feels.  After a while, the withdrawer might feel that the spouse thinks s/he can't do anything right--so why even try?

As the withdrawer continues to withdraw even more, usually, from the pursuer's perspective, the withdrawer doesn't care.  S/he interprets the withdrawal to mean that the withdrawer is emotionally indifferent because this is how it appears from the outside.

But the withdrawer's internal emotional experience is usually very different.  Far from being indifferent, s/he might feel afraid and hopeless.

Obviously, not every couple fits neatly into the pursuer/withdrawer roles, but the vast majority of couples do.

This negative cycle is unsustainable long term.  It often leads to divorce--even in couples who, underneath it all, really love each other.  After a while, one or both of them finds the cycle unbearable and, not knowing what else to do, want out of the relationship.

Aside from the damage which this cycle does to each person in the relationship, without help, each individual usually brings his or her part of the dynamic into the next relationship and it starts all over again with the next person after a while.

In my next article, I'll provide a fictional clinical vignette which shows how EFT couples therapy helps couples to recognize their negative cycle and find healthier ways of relating to each other.

Conclusion
Over the last 30 years, Emotionally Focused Couples Therapy (EFT) has been a well-researched form of couples therapy that gets to the underlying issues that are causing problems in a relationship.

Rather than focusing on skills, like communication skills, EFT couples therapy recognizes that each couple that comes for help has a negative cycle which keeps them stuck, and they're unable to get to their unmet attachment needs satisfied in the relationship.

How EFT Couples Therapy Can Help Improve Your Relationship
Identifying the cycle and helping each individual in the relationship to discover the primary emotions that aren't being expressed is a significant part of the EFT couples therapist's role in couples therapy.

It's important for each individual in the couple to feel safe with the EFT therapist in order to allow him or herself to be emotionally vulnerable enough to move beyond surface emotions.

As part of developing emotional safety, the EFT couples therapist helps each individual in the couple to develop a therapeutic alliance with the therapist.

Another way that the EFT couples therapist helps the couple is by stressing that there are "no bad guys" in their relationship.  So, rather than blaming each other, they focus on the negative cycle and how they can change it with the help of the couples therapist.

EFT couples therapy has various stages that the therapist helps each individual in the couple to get through until they're able to meet each other's emotional needs.

Like most therapy, progress in EFT couples therapy isn't a linear process.  Even after each individual allows him or herself to be vulnerable enough to express his or her unmet emotional needs, one or both individuals often initially go back to old ways of relating that were part of the negative cycle--until the change is consolidated in couples therapy.

Getting Help in EFT Couples Therapy
There are no "magic bullets" in couples therapy (or in any therapy), but EFT couples therapy has been proven to be an effective form of couples therapy based on 30 years of research and follow up with couples after therapy has ended.

Admitting that there is a problem in your relationship and being willing to get help is the first step in improving your relationship.

Rather than remaining stuck in a negative cycle that's destroying your relationship, you and your spouse owe it to yourselves to improve your relationship with EFT.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individuals and couples, and I am trained in Emotionally Focused Couples Therapy (EFT).

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.
















Saturday, June 30, 2018

EFT Couple Therapy: Overcoming the Negative Dynamic in Your Relationship That Keeps You Both Stuck

So many couples get stuck in a negative dynamic in their relationship that keep them stuck.  A big part of the problem is that many couples blame each other rather than seeing that the problem is the negative dynamic that they get caught up in.

Overcoming the Negative Dynamic in Your Relationship That Keeps You Both Stuck
In Emotionally Focused Couples Therapy (also known as EFT) couples learn to stop blaming each other and focus on their negative dynamic so they can change the dynamic.

Fictional Clinical Vignette: Overcoming the Negative Dynamic That Keeps Couples Stuck:
The following fictional clinical vignette illustrates how a couple can learn to stop blaming each other as they begin to see the negative dynamic and learn to change it with the help of an EFT couples therapist:

Alice and Sam
After five years of marriage, Alice and Sam were nearly ready to get a divorce when they started EFT couples therapy.

During the initial therapy consultation, Alice explained to their EFT couples therapist that she was at her wits end because whenever she tried to tell Sam what was bothering her, he withdrew from her emotionally and physically.  She said she felt alone and lonely in their relationship and she didn't know how to get through to him.

Sam sat in the therapist's office looking away from Alice with his arms folded.  When it was his turn to talk about his perspective of the problem, he shrugged his shoulders and said, "No matter what I do, it's never right."

When their EFT therapist prompted Sam to say more, he said that Alice tended to blame him for all the problems in their relationship and he gave up more than a year ago.  He said he didn't like to argue, so he preferred to go to his home office and shut the door when Alice yelled at him.  He said he was tired of being blamed and he dreaded coming home from work.

While Sam was speaking, Alice seemed as if she could barely contain herself, and she turned to the therapist and said, "You see? This is what I have to contend with. He just shuts down like he doesn't care, and I can't get through to him no matter what I do or say."

When the therapist asked Sam for an example of a typical argument, he brought up an argument that they had a few days earlier.  He said Alice got angry with him after he forgot their wedding anniversary.  He told the therapist that he understood that Alice was upset, but he felt that her reaction was "over the top."

From his perspective, Sam realized that he made a mistake, but when Alice kept criticizing him even after he apologized, he didn't see the point in discussing it, so he went to his office and shut the door.  But rather than allowing things to cool down, Sam said, Alice pursued him into his office and continued to berate him, which he couldn't stand, so he left the apartment.

When it was Alice's turn to speak, she said she didn't understand how Sam expected her not to be angry when he forgot their anniversary.  To her, this meant that he didn't care about her or their marriage.

As the couples therapist listened to Alice and Sam describe their arguments, she could see that they were stuck in a negative dynamic and this dynamic tended to get played out repeatedly with Alice being the pursuer and Sam being the withdrawer in their relationship.

Being stuck in a negative dynamic can be difficult for a couple to change on their own--especially if the couple has been in a particular negative cycle for a while.  But, over time, the EFT couples therapist helped Alice and Sam to see that there were "no bad guys" in their relationship--there was only a negative dynamic that they could learn to change.

Gradually, over time, the couples therapist helped Sam to become emotionally reengaged in the  relationship.  Then, she asked him to describe what he felt like when Alice blamed him for their problems.  In response, he thought about it and then said, "I feel like I'm worthless and that our relationship is hopeless, so why should I even try?"

As Sam said this, he choked back tears, and Alice, who seemed moved by Sam's sadness, reached over to touch his hand, "I didn't know that this was how you were feeling.  I thought you didn't care about me anymore.  I didn't mean to make you feel worthless."

Sam looked over at Alice, squeezed her hand and said, "Of course, I still care about you. I thought you were completely fed up with me, so I withdrew from you to protect myself emotionally."

The couples therapist asked Alice to talk about the emotions she experienced underneath her anger, and Alice responded, "I'm hurt and afraid that I'm losing Sam.  I don't want to lose him.  I don't mean to yell and blame him.  I just get so desperate that I don't know what to say or do.  I want our marriage to work out."

As Alice and Sam began to identify their underlying emotions, they began to see that they both still cared about each other, but the negative dynamic that they engaged in kept them stuck.

Overcoming the Negative Dynamic in Your Relationship That Keeps You Both Stuck
After Sam became more emotionally engaged in the couples sessions and talked about his emotional vulnerability, Alice's attitude toward Sam softened.  Rather than blaming him and yelling at him, she was able to say what she needed from him emotionally, which allowed Sam to open up to give Alice what she needed and express what he needed from Alice.

By rebuilding trust and being more emotionally vulnerable with each other, over time, Sam and Alice were able to change their dynamic so that they could express their underlying emotions rather than allowing anger and avoidance keep them stuck in a negative cycle.

Conclusion
The fictional clinical vignette is a common negative dynamic in relationships where one person is the avoidant withdrawer and the other person is the blamer/pursuer.

Each person in his or her role of withdrawer and blamer/pursuer makes the dynamic worse and reinforces continues to reinforce it.  The more the pursuer/blamer blames and pursues, the more the withdrawer avoids and withdraws.  Even though the couple might know that what each of them is doing isn't working, they don't know how to change this negative cycle.

In the fictional example above, which is brief and simplistic since this is a blog article, the EFT therapist assesses the couples' negative dynamic and the role that each person plays in it.  Over time, she helps each person to identify the underlying emotions that are often not apparent to the other person in the relationship.

For example, when Sam withdrew from Alice, Alice assumed that this meant he didn't care about her anymore.  All she could see was that Sam was withdrawing emotionally and physically.  Not knowing what else to do, Alice continued to pursue and blame Sam and he withdrew even more.

In EFT couples therapy, the EFT couples therapist creates a safe therapeutic environment which helps the withdrawer to feel safe enough to reengage emotionally so s/he can identify the underlying emotions and tell the other person in the relationship what s/he is experiencing.

When the person, who is in the role of the pursuer, hears that the withdrawer feels sad, helpless and hopeless (or whatever emotions s/he might be experiencing), this often comes as a surprise and a relief that the withdrawer still actually cares.

Once the withdrawer becomes emotionally engaged again and can communicate what s/he actually feels, the pursuer often softens his or her stance so that s/he can communicate what s/he is really feeling underneath all the blaming.

The example above is a simply illustration of how EFT couples therapy works.  Each relationship is, of course, different, and there can be other complications in the relationship, especially if the negative dynamic has been going on for a long time.

Sometimes, the withdrawer needs more time to feel emotionally safe enough to say what s/he feels.  Similarly, the person who is in the role of the pursuer/blamer might not trust that that the withdrawer will remain open enough to hear how hurtful things have been for him or her.  So, it can take time.

One important difference between regular couples therapy and EFT couples therapy is that there are "no bad guys" in the relationship.  The focus is on changing the dynamics that aren't working in the relationship rather than assigning blame.

More Information About EFT Couples Therapy
To find out more about EFT couples therapy, you can read Hold Me Tight by Sue Johnson, a clinician and researcher, who developed EFT couples therapy.

See my article: How EFT Couples Therapy Can Help to Improve Your Relationship.

Getting Help in EFT Couples Therapy
When couples are stuck in a negative dynamic, it can be hard to see a way out.

Research has shown that EFT couples therapy is an effective form of couples therapy that gets lasting results.

Rather than feeling helpless and hopeless, you owe it to yourself and your spouse or partner to get help to overcome the negative cycle that keeps you both stuck.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist, who is trained in EFT couples therapy.

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
















Thursday, June 28, 2018

Feeling the Need to "Be Strong" to Avoid Feeling Your Unmet Emotional Needs

People who grew up in families where their emotional needs weren't met often feel they must "be strong" in order to deny their emotional needs to themselves and to others.  This denial of their emotional needs was part of their emotional survival strategy as children and they continue to use this strategy in their adult relationships--even though it's no longer helping them (see my articles: Understanding Your Emotional NeedsWhat is the Connection Between Unmet Childhood Emotional Needs and Problems Later on in Adult Relationships?, What is Childhood Emotional Neglect? and Emotional Survival Strategies That No Longer Work: "I Don't Need Anyone").

Feeling the Need to "Be Strong" to Avoid Feeling Your Unmet Emotional Needs
Whether they received an explicit message when they were children to "be strong" or whether it was an unspoken understanding in the family, as adults, these individuals often feel ashamed of their emotional needs--shame that developed when they were children.

Denying their unmet emotional needs as children was a way of compartmentalizing those needs so that they didn't feel overwhelmed that there wasn't someone to comfort them.  In that way, the defense mechanisms of denial and compartmentalization helped them.  But, as an adult in a relationship, denying emotional needs gets in the way of having a healthy relationship.

Fictional Clinical Vignette: "Being Strong" to Avoid Feeling Unmet Emotional Needs
Jan
Growing up in a home where her parents were usually preoccupied with their own relationship and careers, Jan learned at a young age to deny her emotional needs.

Instead of her parents accommodating Jan's emotional needs, Jan learned to accommodate her parents by never asking them to comfort her or listen to her when she was scared or feeling doubtful.  She learned that she had to "be strong" on her own, and she became a pseudo "independent" child who appeared, externally, to be emotionally self reliant.

Her parents expressed their pride in having a child like Jan who never asked for anything from them and who was seemingly able to take care of her own emotional needs.

But behind this exterior of pseudo independence, Jan was a frightened, sad child who felt ashamed of having emotional needs.  At a very young age, whenever she felt the need for love or comfort, she told herself that she was  "being a baby."  In effect, she internalized her parents' attitude towards her and she shamed herself.

Years later, when she entered into her first serious relationship, she continued to deny to herself and to her boyfriend that she had any emotional needs that he needed to attend to, but she was willing to pay attention to his emotional needs.

Her boyfriend, who was an warming, affectionate, caring person, knew that Jan had lived her entire life denying her emotional needs because of her relationship with her parents, and he found it difficult to be the nurturing person that he really was in his relationship with Jan.  So, he talked to her about getting help in therapy.

Initially, Jan was offended by her boyfriend's suggestion that she get help in therapy.  She thought he was implying that she was a "weak" person (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").

As far as she was concerned, there was nothing wrong with her, and she couldn't understand why he would recommend therapy.  But she wanted to be open minded, so she made an appointment to see a psychotherapist.

During the initial psychotherapy consultation, Jan apologized for taking up the therapist's time when there was really "nothing wrong" with her.  She told the therapist that her boyfriend thought it would be a good idea for her to come to therapy, and she wanted to keep an open mind about it.

As Jan talked about her family history, she was so emotionally detached from the details about her relationship with her parents.  It was as if she was giving a news report.  It was only when the psychotherapist asked Jan to slow down that Jan heard herself and she began to feel sad and anxious about what she was saying.

After a while during the initial psychotherapy consultation, Jan told the therapist that when she slowed down and reflected on her relationship with her parents, she felt uncomfortable.  She thought about the children that she knew now that were the same age as Jan was when she was a child, and she realized that her family life "wasn't normal" (her words) because, of course, it's normal for children have emotional needs.

Over time, Jan's psychotherapist helped Jan to put words to her emotions by using Somatic Experiencing.  When Jan had difficulty identifying her emotions, her therapist asked her to sense what she felt in her body in order to put words to her emotions (see my article: Using Somatic Psychotherapy When the Client Has No Words to Express the Problem).

Initially, this was difficult and frightening for Jan because she spent her life, until now, denying her emotions.  But her therapist titrated the work so that it wasn't overwhelming for Jan.

Once Jan was able to express her emotions and accept that her emotional needs were "normal," she and her therapist used EMDR therapy to help her to resolve the trauma related to her early emotional neglect (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

This work was neither quick nor easy but, over time, Jan grieved for what she needed and didn't get as a child.

As she worked on resolving her childhood trauma, she became more emotionally engaged in her relationship with her boyfriend.  She was able to accept love and nurturance from her boyfriend, who was happy that Jan was growing emotionally and more present in their relationship.

Conclusion
Emotional survival strategies that were helpful during childhood often get in the way of adult relationships.

Someone who spent their childhood denying his or her emotional needs often doesn't recognize, as an adult, that this is what they are doing.  Often, their spouse or romantic partner is the one to point out that there is a problem.

Trauma therapy, like Somatic Experiencing and EMDR therapy, helps to overcome unresolved trauma.

Getting Help in Therapy
Trying to overcome these type of traumatic problems on your own is very difficult (see my article: The Benefits of Psychotherapy).

A skilled trauma therapist can help you to overcome emotional survival strategies that are no longer working for you so you can replace them with healthy ways of relating and coping (see my article: How to Choose a Psychotherapist).

Admitting to yourself that you have a problem and contacting a trauma therapist is often the hardest part of trying to overcome trauma.

The first step is having a consultation to explore these issues further and to see if you feel comfortable enough with the therapist to continue to work with her.

Once you're free of your traumatic history, you can lead a more meaningful and fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

One of my specialties is helping clients to overcome traumatic experiences.

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.


















Friday, June 15, 2018

Experiential Therapy: Learning to Sense Emotions in Your Body As Part of Trauma Therapy

One aspect of experiential psychotherapy that's different from regular talk therapy is sensing emotions in the body.  Sensing emotions in the body helps to deepen the work, get to unconscious emotions, and keeps the work in therapy from being just intellectual.  But some clients have difficulty sensing their emotions, especially if they have experienced significant trauma.  So, as part of the preparation phase of trauma therapy, the trauma therapist helps the client to learn to sense their emotions (see my article: The Body Offers a Window Into Unconscious Mind and What's the Difference Between "Top-Down" and "Bottom-Up" Approaches to Trauma Therapy?).

Experiential Therapy: Learning to Sense Emotions in Your Body as Part of Trauma Therapy 

Fictional Clinical Vignette: Learning to Sense Emotions the Body:
The following fictional clinical vignette shows how a client in experiential therapy can learn to sense emotions in the body:

Ellen
After numerous experiences of trying to work through unresolved childhood trauma in regular talk therapy, Ellen decided to try experiential therapy.

Ellen's psychotherapist provided her with psychoeducation about the different types of experiential therapy, including EMDR therapy, Somatic Experiencing and clinical hypnosis, and how each of them used the mind-body connection as part of the healing process.

As part of the preparation phase of trauma therapy, Ellen's therapist asked her to talk about 10 memories where she felt good about herself.  As she thought about it, Ellen had no problem coming up with the 10 memories from all different times in her life where she felt good about herself.  But as she and her psychotherapist went over each memory and her therapist asked her what emotions she felt in her body, Ellen was unable to identify the emotions or where she felt these emotions in her body.

Based on Ellen's traumatic history, as part of her defense mechanisms to protect herself when she was growing up, she learned to numb her emotions.  Unfortunately, as she discovered in her therapy, she not only numbed her anger, fear and sadness, she also numbed her positive emotions.  As a result, she wasn't sure what she felt.

Since experiential psychotherapy is based on being able to identify and experience emotions, Ellen's psychotherapist helped her to begin to sense her emotions in her body by starting with non-threatening situations.

For instance, Ellen had a puppy that she was very attached to from the day that she got him.  Whenever she held her puppy, she could feel how much she loved him and the puppy's unconditional love for her.

Using Ellen's experience with her puppy, Ellen's therapist asked her to close her eyes and imagine that she was holding her puppy.  Then, she asked Ellen to tell her what emotions came up for her and if she was aware of where she felt these emotions in her body.

Ellen had no problem imaging herself holding her puppy and sensing her emotions.  She told her therapist that she felt tremendous love for her puppy, and she felt protective of him.  She could also sense how affectionate her puppy was when he cuddled with her.  When she thought about where she felt her emotions for her puppy, she said she felt them radiating in her chest near her heart.

Over time, as Ellen and her therapist continued to work on other non-threatening experiences where she felt comfortable, she got better at identifying more emotions and sensing where she felt these emotions in her body.

After they had worked on a number of similar experiences, Ellen was ready to work on the 10 positive memories where she felt good about herself as part of the preparation phase of trauma therapy.

But Ellen was concerned that she might be unable to experience the negative emotions associated with her unresolved childhood trauma.  So, her psychotherapist recommended that they start by working on less threatening negative emotions.

She asked Ellen to come up with several memories that were mildly unpleasant.  She suggested that Ellen come up with memories that, on a scale of 0-10 (with 0 being no disturbance and 10 being the most disturbance Ellen could imagine) that were a 3 or 4 on that scale.

In response, Ellen came up with a memory of feeling mildly annoyed when she had to wait on line at the grocery store.  She was able to sense her annoyance and, on a scale of 0-10, she thought that memory was a 3.  Sensing where she felt the annoyance in her body was more difficult.

Her psychotherapist helped Ellen by suggesting that Ellen sense in her body to see where she was holding onto tension.  She also recommended that Ellen first focus on the area between her throat and her gut.  It took Ellen a while before she was able to detect that she felt mild tension in her upper stomach when she thought about that memory.

After they worked on a number of memories that were a 3 or 4, they gradually worked up to memories that were a 5 or a 6 in terms of how disturbing they were.

One such memory was when Ellen and her puppy ran into her neighbor in the elevator, and the neighbor complained that she didn't think the building management should allow dogs in the building because she was allergic to dogs.  Ellen told her therapist that she tried to be pleasant to her neighbor, who was being unpleasant to her, but she felt annoyed with her neighbor.

When Ellen re-experienced that memory and sensed into her body, she felt a constriction in her throat.  She told her therapist that she thought the constriction in her throat was probably related to wanting to argue with her neighbor but holding back.

Gradually, Ellen and her psychotherapist continued to work on increasingly difficult memories to help Ellen to identify and sense the emotions related to these memories in her body.  She was also expanding her window of tolerance for unpleasant emotions.

Experiential Therapy: Learning to Sense Emotions in Your Body As Part of Trauma Therapy

After a while, Ellen felt comfortable enough to be able to handle the difficult emotions that were associated with her unresolved childhood memories, and she and her psychotherapist used EMDR therapy to do trauma therapy (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Conclusion
Experiential psychotherapy involves identifying emotions and sensing where these emotions are in the body.  This deepens the work and keeps the therapy from being just an intellectual exercise.  It also helps to get to underlying emotions.

Many people, who have unresolved trauma, are unable to identify and sense emotions in the body related to traumatic memories.  This is due to the protective nature of the defense mechanisms they used as children, including emotional numbing, which was useful at the time to keep them from being overwhelmed, but isn't useful as an adult.

Usually, the more traumatic the memories are and the more defended these individuals had to be at the time, the more difficult it is to identify emotions and to be aware of the body.

As part of the preparation phase of trauma therapy, a trauma therapist can help clients to begin to identify non-threatening emotions, at first, as they gradually work their way to more challenging emotions.

By being aware of emotions in the body related to traumatic memories, clients in experiential psychotherapy are better equipped to gradually work through these difficult emotions to resolve the trauma.

Getting Help in Therapy
Unresolved traumatic experiences will remain a part of your experience to be triggered at any time.

Getting help from an experienced trauma therapist can free you from your traumatic experiences, so you can live a more fulfilling life (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than suffering on your own, you owe it to yourself to get the help that you need.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples, and I have helped many clients to overcome their traumatic experiences.

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, June 11, 2018

Trauma Therapy: Why Establishing Safety For the Client is So Important Before Processing Trauma - Part 2

In my prior article, I began a discussion about the importance of establishing safety for clients in trauma therapy before trauma is processed. One of the requirements that I discussed in the last article for establishing safety is that the client's life must be currently stable.  In other words, s/he is not currently in a crisis or creating new crises.  I'm discussing this topic further in this article.

Trauma Therapy: Why Establishing Safety For the Client is So Important Before Processing Trauma

As I discussed in the prior article, clients who are currently in a crisis need help to out of the crisis and keep from creating new crises before they can process traumatic memories.

For instance, if a client has a parent who is in hospice with only a short time to live, the client will need help to get through this crisis and the grief following the parent's death before s/he processes unresolved traumatic memories from childhood.

Likewise, if a client is continuing to create chaos in his or her life, this would need to be addressed and resolved before any processing of traumatic memories from the past can be done.

Fictional Clinical Vignette: Trauma Therapy: Establishing Safety Before Processing Trauma
The following fictional clinical vignette addresses the issue of establishing safety for a client who wants to process traumatic memories but who is still in crisis:

Ann
After a tumultuous breakup in what she described as an on-gain/off-again emotionally abusive relationship, Ann, who was in her late 30s, started therapy to deal with the emotional aftermath of the breakup.  She requested EMDR therapy to deal with the trauma of that relationship (see my articles: How EMDR Therapy Works: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

During the initial consultation, Ann explained to her psychotherapist that she ended the relationship three months ago and, as far as she was concerned, the relationship was really over this time. She was fed up with the name calling and the way he tried to shame her in front of other people a lot of the time.

Trauma Therapy: Why Establishing Safety For the Client is So Important Before Processing Trauma
Ann talked about her history of emotionally abusive relationships that began when she was in high school and continued into adulthood.  She explained that, immediately after she ended her last relationship, she began dating someone new.  She said her new boyfriend seemed nice at first, but lately he was verbally abusive with her too.

When her psychotherapist asked Ann to tell her more about the abuse in this new relationship, Ann told her that he wasn't nearly as abusive as her former boyfriends.  She explained that, although she was aware that she was in another abusive relationship, she was worried about getting too old to have children. Since her new boyfriend also wanted to have children, she wanted to try to have a child with this man before she got any older.

She said she feared that if she broke up with him, she might not meet anyone else and she might miss her opportunity to have a baby.  As a result, she would rather put up with his verbal abuse than breakup with him to find someone new (see my articles: Do You Have a Pattern of Creating Chaos in Your Life?How to Stop Creating Chaos in Your Life, and Remaining in Therapy Beyond the Immediate Crisis).

The psychotherapist explained to Ann that they could not begin EMDR therapy to deal with prior trauma because Ann was in another emotionally abusive relationship where she was likely to be traumatized again.  She explained that it was important for Ann to be in a stable situation before they could do EMDR therapy.

Ann said she understood the rationale for not beginning to process a history of trauma while she was in another relationship where she would probably be traumatized again, but she was not ready to give up her current relationship.

She told the psychotherapist that the thought of ending the current relationship and facing the possibility that she might not meet anyone new was too frightening to her. She said she didn't want to wait much longer to have children, and she would rather have a child with her current boyfriend than risk getting too old to have children.

Even though they could not do EMDR therapy due to Ann's current circumstances, the psychotherapist offered to work with Ann with her current relationship and her difficulty with taking care of herself in terms of choosing men who were emotionally abusive (see my article: Are Your Fears of Being Alone Keeping You in an Unhealthy Relationship?).

Since Ann was not interested in this, she decided not to come for any other sessions.  The psychotherapist gave her information about domestic violence. She explained that domestic violence was emotional as well as physical.  She recommended that Ann contact the New York City domestic violence hotline to deal with this issue.

Two years later, Ann contacted the same psychotherapist.  She told the therapist that she never contacted the domestic violence hotline.  Instead, she had a baby with the boyfriend that she was with at the time when she came for the initial consultation, and the abuse escalated from emotional to physical abuse.  She said she ended that relationship several months ago, and she moved back in with her parents, who were helping her to raise the baby.

When Ann returned to see the psychotherapist, she told the therapist that she regretted remaining in the relationship with her baby's father.  She said that, once the stressors involved with raising a baby increased, the baby's father was unable to handle it.  As the stress increased, his abuse escalated from emotional abuse to physical abuse, and she feared for their child's safety.

Ann explained that, after she left the baby's father and filed for child support, the baby's father disappeared and she didn't know where he was.  As a result, she received no child support from him and she couldn't afford to support the baby on her own, which is why she moved back in with her parents, who took care of the baby while she worked.

When she returned to therapy, she was not in a relationship.  She said that, since she had the baby, she was more aware than ever that she made poor choices when it came to relationships, and she didn't want to jeopardize her baby's well-being by getting into another abusive relationship.  As a result, she wasn't dating at the time.

Although Ann was clearly unhappy, she was safe in her parents' home, and she wasn't in a current crisis.  Since she didn't seem likely to get into another abusive relationship at that point in time, her therapist agreed to do EMDR therapy with her, and they began the preparation work to begin processing her history of trauma.

Conclusion
Some clients, who seek help in trauma therapy, are still either in a current crisis or they are creating new crises in their lives--sometimes knowingly, like the example above in the fictional vignette, and sometimes without their awareness.

The fictional example that I gave is just one possible situation where safety and emotional stability must be present first before EMDR or any type of trauma therapy can be done.  In the prior article, I gave other examples.

A trauma therapist can assist a client who is in crisis to overcome the crisis, but she cannot begin to do trauma therapy until the client's life is stable.

Even after the client's life is stable, every client who does EMDR therapy must go through the history taking and preparation phases of EMDR before the client and therapist can begin processing the trauma.

Since EMDR therapy is more experiential than talk therapy, the preparation phase of EMDR therapy helps to ensure that the client has the necessary internal and external resources to deal with the strong emotions that can come up when working on traumatic memories.

Getting Help in Therapy
Too many people who need help in therapy don't come because of they feel ashamed or they're concerned about the possible stigma of being in therapy.  They mistakenly believe that going to therapy means they're "weak" (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak".

If you've been struggling on your own with an unresolved problem, you owe it to yourself to get the help in therapy that you need (see my article: The Benefits of Psychotherapy).

Once you have worked through your unresolved problems, you can be free from your traumatic history and live a more fulfilling life (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples, and I have helped many clients to overcome traumatic experiences.

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.






















Thursday, June 7, 2018

Trauma Therapy: Why Establishing Safety For the Client Is So Important Before Processing Trauma - Part 1

As a psychotherapist who specializes in helping clients to overcome traumatic experiences, I see many clients in my private practice in New York City who come for trauma therapy, including EMDR therapy, Somatic Experiencing, and clinical hypnosis.  Early on in the therapy process, I provide clients with psychoeducation about why establishing safety for the client is so important before traumatic memories are  processed in trauma, which is the topic of this article (see my article: Why is Experiential Psychotherapy More Effective Than Talk Therapy Alone to Overcome Trauma? and How EMDR Therapy Works: EMDR and the Brain).

Why Establishing Safety For the Client is So Important Before Processing Trauma

How is "Establishing Safety" Defined in Terms of Trauma Therapy?
Let's start by defining what safety means with regard to trauma therapy.

It's the psychotherapist's responsibility to create a therapeutic environment that helps to establish safety in therapy (see my article about the therapeutic "holding environment" and a more detailed explanation below).  There can be many issues that get in the way of establishing a holding environment, including obstacles in the client's current life and traumatic experiences from the past (see more detailed discussion below).

Safety, which is a relative term that recognizes that there are degrees of feeling safe and the client needs to feel safe enough.  This is an important concept in any type of therapy, but it's especially important in trauma therapy because trauma therapy is experiential and without a sense of safety, the client can be retraumatized (see my article: Developing a Sense of Safety and Trust With Your Psychotherapist).

The following is a list of some of the most relevant issues with regard to establishing safety in trauma therapy with a recognition that, due to the fact this is a blog article and not a journal article or a book, this list might not include all issues:
  • The Client Needs to Feel Relatively Comfortable with the Psychotherapist:  In the most basic terms, the client needs to feel a rapport with the therapist and that there is a therapeutic alliance.  The therapeutic alliance between the client and psychotherapist usually develops over time as the client senses that s/he can trust the therapist.  Many clients get a sense of whether they feel safe with a therapist during an initial consultation, even though the therapeutic alliance hasn't developed yet.  The client often intuits whether s/he will get along with the psychotherapist and that the therapist is someone that s/he can work with on whatever the presenting problem might be.  In that case, there is enough of a sense of comfort to at least set up the next appointment.  Assuming that the therapist has an expertise in the area that the client wants to work on and that she feels she can be helpful to the client, they can proceed from there.  If not, it's important for the client and the psychotherapist to recognize that not every client-therapist dyad is a good match.  Every therapist is not for every client, so it's important to recognize that, regardless of the client's motivation and the therapist's skills, sometimes a particular client-therapist dyad doesn't work (see my article: How a Psychotherapist Creates a Holding Environment in PsychotherapyThe Therapist's Empathic Attunement Can Be Emotionally Reparative to the Client, and What is the Corrective Emotional Experience in Therapy?).
  • The Client is Not Involved in an Ongoing Crisis or Creating New Crises in His or Her Life:  It's not unusual for clients who have a history of unresolved trauma to be involved in an ongoing crisis or creating new crises in his or her life--often without even realizing.  This topic warrants its own article and it will be discussed further in my next article.  At this point, suffice it to say the processing aspect of prior trauma cannot be done when the client is still in crisis and needs help with crisis management .  The need for crisis management must take priority over processing trauma that is based in the past.  Likewise, if the client is creating new crises in his or her life, s/he needs to recognize this dynamic so s/he can change it before any processing of historical trauma can be done.  Once the client is no longer involved with a current crisis and s/he is no longer creating new crises or emotional drama, the psychotherapist can assist the client to prepare for the processing of trauma (see my articles: Do You Have a Pattern of Creating Chaos in Your Life?How to Stop Creating Chaos in Your Life and How a Crisis Can Bring About Positive Change in Your Life).
  • The Client is Not Involved in Excessive Drinking, Drug Abuse, Gambling or Other Compulsive Mood-Altering Behavior:  If a client is engaged in mood altering behavior, whether it involves alcohol, drugs, compulsive gambling, compulsive overspending, sexual addiction or compulsive viewing of pornography, including Internet pornography an eating disorder or other compulsive behavior, s/he isn't ready for processing traumatic memories from the past because s/he hasn't developed the necessary coping skills for trauma therapy.  The psychotherapist would need to assist the client to be stable enough without mood-altering behavior in order to delve into traumatic memories.  If not, the client's mood altering behavior will continue or increase because s/he won't be able to cope with delving into the trauma.  So, the mood-altering behavior must be addressed first, and there would need to be a period of "sobriety" before trauma processing can begin.  Without a period of six months or so of "sobriety," the client is likely to relapse into compulsive behavior.  So, as a first step, this might mean that, if the psychotherapist has a background in helping clients to overcome mood-altering behavior, the therapist will assess the client's true motivation.  Specifically, many clients say they want to stop engaging in mood-altering behavior, but they're not ready.  Since there is always some ambivalence, the therapist can help the client to recognize the ambivalence and, if the client is motivated enough, try to help the client to stop the compulsive behavior or refer the client to a higher level of care, like a detox, rehab or residential treatment.
  • The Trauma Therapist Helps the Client to Prepare For Trauma Processing in Therapy: Unlike regular talk therapy, trauma therapy is experiential, as mentioned above.  Whereas in talk therapy, the client and therapist talk about the trauma, in experiential therapy, they revisit traumatic memories and the experience is more immediate.  In order for the client not to be retraumatized by revisiting traumatic experiences from the past, the therapist needs to help the client to prepare for trauma processing.  The preparation phase, which is also called the resourcing phase, is crucial to trauma therapy and no responsible trauma therapist will proceed without first going through this phase of treatment.  To proceed without the preparation phase would be clinically irresponsible and unethical--no matter how much the client wants to jump right into processing the trauma.  Depending upon the individual client's coping skills, the preparation phase can be as little as a few sessions or, where the client has little in the way of coping skills, the preparation phase can be several months or more.  As a result, the therapist needs to assess the client's coping skills first.  At the very least, the therapist needs to assess if the client is able to maintain dual awareness when discussing the trauma.  In other words, when discussing the trauma, the client remains aware that s/he is in the here-and-now as well as remembering a memory from the past at the same time.  If the client gets so immersed in the memory that s/he forgets where s/he is in the here-and-now, the therapist cannot proceed with trauma processing before helping the client to develop the ability to maintain dual awareness--however long that takes.  An example of a client who cannot maintain dual awareness would be a client who loses all sense of the present moment.  S/he dissociates to such a degree that s/he completely forgets that s/he is in the therapist's office and actually relives the trauma as if it were happening now and not in the past.  This is an example of a retraumatizing experience, as opposed to a healing experience.  Assuming that the client is able to maintain dual awareness, the preparation, at a minimum, would include the client learning ways to de-escalate and cope with uncomfortable emotions during the session and between sessions (see my article: Developing Coping Strategies in Therapy Before Processing TraumaEmpowering Clients in TherapyTrauma Therapy: Using the Container Exercise Between Therapy SessionsTrauma Therapy: Using Grounding Techniques Between Therapy SessionsSafe or Relaxing Place Meditation
  • The Client Keeps Appointments and Comes to Regular Weekly Sessions: Due to the intensity of processing traumatic memories in therapy and the psychotherapist's need to continually assess the client's emotional state during trauma processing, clients must be able to come to weekly sessions.  This is an issue that often comes up during initial consultations when the client raises the issue of coming every other week or monthly or randomly.  Between therapy sessions, traumatic memories continue to be processed on an unconscious level, so the trauma processing continues even when the client is not in session. This often means that new material in the form of new memories or current emotionally triggering experiences can come up between sessions where the client needs the therapist's help.  Even the space of one week can be a long time for certain clients who have problems containing emotions that come up between sessions--even though they have gone through the preparation phase of therapy.  Progress in therapy, especially trauma therapy, isn't linear.  Sometimes, the client feels worse before s/he feels better, so weekly sessions are important for the client to maintain emotional stability.  If money is an issue, the client can inquire as to whether the therapist has a sliding scale or, if not, if the therapist can make a referral to a psychotherapy center where sliding scale therapy is available.
  • The Client is in Control During Trauma Processing:  Even the best psychological assessment cannot always predict when a client might need a break during trauma processing.  This is why it's important for the client to tell the therapist when s/he might need to take a break during the processing of a traumatic memory.  In many cases, a trauma therapist will be able recognize when a client is feeling overwhelmed and help the client to de-escalate before going back into processing the trauma or to debriefing.  But some clients have gotten so good at pretending that they are okay because they feel ashamed of needing help that they override their own internal signals that they need a break from the processing.  They need to learn in therapy how to honor internal signals that they need to de-escalate and feel comfortable enough to tell the therapist.  This doesn't mean that the client will necessarily need to stop when s/he is somewhat uncomfortable if s/he is within his or her window of tolerance.  It also doesn't mean that an inexperienced therapist, who has her own discomfort with seeing clients feeling tolerably uncomfortable, should stop the processing.  If the therapist senses that the client is overriding internal signals to stop, she can ask the client if it's okay to continue processing.  Similarly, clients, who are accustomed to people pleasing, need to learn to overcome their fantasy that they are pleasing the therapist by continuing to process a traumatic memory even though they feel overwhelmed.  Based on the issues that are being presented in this section, it's obvious that the client being in control of trauma processing can be complicated (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).
  • The Client Uses Coping Skills Between Trauma Therapy Sessions:  It's one thing to learn coping skills and it's another to actually use them between trauma therapy sessions.  Since, as mentioned above, clients continue to process traumatic memories on an unconscious level between sessions, it's not unusual for the client to have thoughts or dreams about traumatic memories between sessions.  Or, the client can get triggered by something in his or her current life between therapy sessions.  This is why the preparation phase of trauma therapy is so crucial.  If, for example, a highly traumatized client doesn't follow the therapist's recommendation to practice de-escalation techniques between sessions in order to stay calm, s/he might discover that s/he is unable to contain his or her experiences between sessions.  For clients who practice coping techniques between sessions, they are usually more likely to either avoid having experiences which are intolerable or mitigate such experiences (see my article: The Benefit of Journal Writing Between Therapy Sessions).
As I mentioned above, establishing safety in trauma therapy (or in any therapy) is a big topic, and a blog article cannot address every possible issue.

How to Start Trauma Therapy
An exploration as to whether you want to begin trauma therapy (or any therapy) and work with a particular therapist begins with an initial consultation in person.  

As mentioned earlier, it's important to your emotional well-being to get a sense as to whether or not you feel comfortable with a particular therapist.  

When clients come to see me for an initial consultation, I tell them that the consultation is for them to provide me with an overview of the problem, ask questions about the process, my skills and experience, to see whether they feel comfortable enough to come back for another session and for me to assess if they appear to be ready to start therapy and if I have the particular expertise that they need.

Obviously, this is a very tall order for one session, and their comfort level and my assessment will continue, and it will be ongoing if they come back for therapy sessions.  As mentioned before, just like any relationship, it takes time for most clients and their therapists to develop a therapeutic alliance--assuming the therapist-client dyad works well enough for the client to want to return beyond the initial consultation.

It's also important to realize that although psychotherapists might approach the initial consultation in different ways, most therapists recognize that being in therapy involves participating in therapy while clients learn how to be clients in therapy at the same time.  In other words, you don't have to know all the answers before you start.  You learn as you go along with the therapist's help.

Choosing a psychotherapist that you feel comfortable with is important, and you might want to see more than one therapist before you make a decision (see my article: How to Choose a Psychotherapist).

Getting Help in Therapy
Unresolved trauma usually impacts issues in your current life, no matter how long ago the trauma occurred.  Whether the impact is in your personal life, where core issues are most likely to come up, or in your work life or both, unresolved trauma often creates current problems (see my article: Reacting to Your Current Life Based on Your Traumatic Past).

Rather than struggling on your own, you owe it to yourself to get help from an experienced trauma therapist.

If you're already in therapy and your therapist isn't trained in trauma therapy, like EMDR therapy, Somatic Experiencing or clinical hypnosis, you can explore the possibility of adjunctive trauma therapy with a therapist who is trained in trauma therapy.  

Adjunctive therapy means that you continue to see your existing psychotherapist and see a trauma therapist for adjunctive therapy.  It's important to discuss this with your primary therapist first before you begin adjunctive therapy with a trauma therapist.  Also, in most cases, the primary therapist and the adjunctive therapist will ask for your written consent to be able to confer with each other (see my article: What is Adjunctive EMDR Therapy?).

Taking the first step, which is contacting a trauma therapist by phone or email, is often the hardest step.  

Once you have worked through your unresolved trauma, you have an opportunity to let go of your traumatic history so you can lead a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who provides integrative psychotherapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy)

As a trauma therapist, I work with individual adults and couples, and I have helped many clients to overcome their traumatic experiences.

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.