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Tuesday, October 16, 2018

Emotional Vulnerability as a Pathway to Greater Emotional Intimacy in a Relationship

Being in an emotionally intimate and loving relationship is a desire that most people have.  But achieving emotional intimacy in a relationship can be scary for many people because it involves being emotionally vulnerable (see my article: The Emotional Vulnerability of Being in a Relationship).

Emotional Vulnerability as a Pathway to Greater Emotional Intimacy in a Relationship

The wish to remain "safe" and avoid danger, rather than being vulnerable, is something that many people struggle with, especially if their emotional needs weren't met as children.

These people often experienced criticism, emotional neglect and shame when they sought love as children, so it's understandable that they fear getting close to someone in a relationship--even though closeness is what they really desire (see my article: An Emotional Dilemma: Wanting and Dreading Love).

When children are emotionally neglected, they hide the more emotionally vulnerable parts of themselves in order to protect themselves.  This was an adaptive thing to do as a child because to continue to allow themselves to yearn for what they weren't getting as children would only bring more emotional pain.

Allowing Yourself to Be Emotionally Vulnerable in a Romantic Relationship
If you were emotionally neglected as a child or if you had bad experiences in prior relationships, you don't suddenly become comfortable with emotional vulnerability (see my article: What is Childhood Emotional Neglect?).

That self protective part of you that took care of you as a child or in a prior emotionally abusive relationship continues to operate in the same way--until you take steps to make room for emotional vulnerability.

Sometimes the pain of being alone and lonely is greater than the fear of being emotionally vulnerable, and this creates the impetus for opening up to a romantic partner (see my article: Overcoming Loneliness and Social Isolation).

But allowing yourself to be emotionally vulnerable can still be daunting.

The truth is, whether you realize it or not, to be human is to be emotionally vulnerable.  You can try to protect yourself and avoid emotional intimacy in a romantic relationship, but you're still vulnerable in other relationships with loved ones.  It's just a part of life.  

The first step in overcoming your fear of emotional vulnerability is to become aware of your fear.

Noticing the physical and emotional cues to your avoidance can take practice because, when your fear has been longstanding, your avoidance is so automatic that you don't notice it. 

As I have mentioned in a prior article, becoming aware of your emotions usually starts with noticing what's going on in your body.  

Being present and aware of your body takes practice.  A "body scan," where you have quiet time and privacy to sense into your body to see where you're holding onto tension, is a good start.

Start from the crown of your head and slowly descend from the crown to your face, throat, chest and down to your gut.  Along the way, notice if you're holding onto tension in any particular area and then try to identify the emotion that goes with the tension.

The book, The Power of Focusing: A Practical Guide to Emotional Self Healing, by Ann Weiser Cornell is a simple how-to book on developing a "felt sense" of what's going on for you physically and emotionally.  She has practically exercises to help you develop your ability to become aware of your emotions.

Using these exercises, you can check in with yourself periodically during the day to sense what's going on for you.

Once you become more experienced with sensing your emotions, you'll discover when your fear of emotional vulnerability is operating and getting in your way.

Then, it's a matter of consciously making room for emotional vulnerability in romantic relationships with a person you can trust.

How do you know if you can trust someone enough to be emotionally vulnerable?  You need to get to know them over time and, if s/he feels safe enough, you can begin to take a risk of opening up emotionally to this person.

Getting Help in Therapy
Past trauma, including emotional neglect or abuse as a child as well as traumatic experiences in prior relationships, can make it difficult for you to achieve an emotionally intimate relationship because it feels too frightening to you.

A skilled trauma therapist can help you to work through the earlier traumatic experiences so you can gradually learn to be emotionally vulnerable to have the love and emotional intimacy that you long for in your life.

Rather than vacillating between hope and dread, you can get help in trauma therapy to feel hopeful and secure enough to take the emotional risks to achieve emotional intimacy.

About Me

I work with individual adults and couples.

One of my specialties is helping clients to overcome their traumatic experiences so they can live more fulfilling lives.

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, October 11, 2018

How Experiential Therapy Can Help You to Discover Your Personal Strengths

In my prior article, Discovering Your Personal Strengths in Therapy: You're Much More Than Your Traumatic History, I began a discussion about seeing beyond your traumatic history to discover your personal strengths (see my article: You're Not Defined By Your Diagnosis and Discovering Your Personal Strengths in Psychotherapy).

How Experiential Therapy Can Help You to Discover Your Personal Strengths
As a trauma therapist in New York City, many clients come to see me to overcome their history of trauma.  As I'm helping them to overcome their trauma, I'm also assisting them to discover their personal strengths (see my article: A Strengths-Based Perspective in Psychotherapy).

As I mentioned in my prior article, it's important to be able to appreciate the personal strengths that got you through difficult times as well as that you can use these same strengths to cope with whatever challenges you're dealing with now.

Fictionalized Clinical Vignette: How Experiential Therapy Can Help You to Discover and Use Your Personal Strengths:
The following fictionalized clinical vignette, which is representative of many cases in therapy, illustrates how an experiential therapist can help a client to explore and use his personal strengths:

Ed
Before Ed began experiential therapy, he had been in conventional talk therapy for several years trying to overcome the effects of the childhood trauma he experienced as a young child.

Ed explained to his new therapist that he was grateful for the work he did with his prior therapist in talk therapy, but he felt no relief from the traumatic effects of childhood emotional neglect and abuse.  This is why, at the suggestion of a friend, he was willing to try experiential therapy.

From the very first session in experiential therapy, Ed noticed the difference in the way his new psychotherapist interacted with him.  Whereas his former therapist, who practiced conventional talk therapy, said very little in his sessions, his new therapist, who was interactive and dynamic.  She also talked about working in a collaborative way so that the therapy would be meaningful and effective for Ed.

In addition, she explained the different types of experiential therapy that she did with individuals, which included EMDR therapy (Eye Movement Desensitization and Reprocessing) therapy, AEDP (Accelerated Experiential Dynamic Psychotherapy), Somatic Experiencing, and clinical hypnosis.  She also explained that her original training was in depth psychotherapy so she had an ability to work deep and do brief therapy at the same time.

Ed could tell from his new therapist's facial expressions, gestures and demeanor that she already seemed to care about him, even though they were just having their initial consultation.  This surprised him because he never experienced this before in therapy.

His therapist emphasized that, in addition to helping him to resolve the effects of his traumatic history, she thought it was equally important to help Ed to explore and experience his personal strengths on an emotional level.

When Ed thought about it, he realized that he never really thought about his personal strengths.  He knew, on an intellectual level, that he had somehow survived the effects of his parents' abuse and neglect, but he never explored how he was able to do this in his prior therapy.

As he thought about it more, he told his new therapist that friends and other relatives who knew him often commented to him that, considering his family history, he accomplished a lot in terms of his success at college and in his career.

But Ed only experienced their praise as mere words.  He knew they were sincere, but he didn't know how to relate to what they were telling him.  He didn't think he had done anything out of the ordinary with regard to surviving his childhood history and being successful.

After his therapist heard his traumatic history, she said she was amazed that he had accomplished so much, and she asked him how he did it.

Ed seemed confused at first, and he said that he didn't know what he did to succeed at college and in his career, "I just did it.  I didn't think it was such a big deal."

Even though, at that point in therapy, Ed couldn't identify his personal strengths, he began to get curious.

In order to help Ed to appreciate that he had personal strengths that helped him, his therapist recommended that he think of his early history and his subsequent successes as if they were about someone else.

After thinking about it for a few minutes, Ed said that he had a close friend, who had a similar family history and similar accomplishments.  Ed told his therapist that when he thought about his friend, he admired his friend for being able to overcome his early challenges so that he could succeed in his career.  But when he thought about his own history and accomplishments, he wasn't able to appreciate them as much as he appreciated his friend's, which made him curious as to why he couldn't appreciate his efforts.

Over time, Ed talked about how both of his parents, who were physically abusive, also told him repeatedly from a young age that he would never amount to anything.  Although on some level, he believed them, he said, he was also determined to be independent of them.

As a result, even though he had low self esteem, he persevered in his studies as if his life depended on it.  And, in many ways, he felt that his life did, in fact, depend on being able to get a good job so he could move out of his parents home.

Since he did well in high school, despite the ongoing abuse and neglect, he was able to get a scholarship to an out of state college where he excelled.  From the time he moved out to go to college, he never moved back home.  He only went for brief visits.

His therapist helped Ed to see that two of his personal strengths were his determination and perseverence despite the challenges at home.  She helped him to appreciate these personal strengths as well as his other strengths, on a visceral emotional level by having him identify the emotions that he felt when he was able to feel good about these strengths and where he felt these emotions in his body.

Initially, this was difficult for Ed because he was so accustomed to minimizing his strengths and accomplishments as being "no big deal."

But one of the things that made it easier for him to eventually appreciate his personal strengths was how his therapist reflected back to him, on a emotional level, how delighted she was that he had these strengths to help him to excel.  He was able to see in her eyes and in her face the genuine caring and delight--something he never experienced with his own parents.

Over time, Ed had what is called a "corrective emotional experience" with his experiential therapist (see my article:  What is the Corrective Emotional Experience in Therapy?).  In contrast to his early experience with his parents, who were angry, abusive and neglectful, Ed experienced his therapist as being genuinely caring, warm and empathetic.  Compared to his prior therapist, his new therapist was emotionally accessible and enthusiastic about his well-being.

In addition, rather than just having an intellectual understanding of his problems and his personal strengths, Ed was able to develop an ability to actually feel these experiences on a core emotional level. He learned that, in order to make positive changes, being able to experience his innermost, primary emotions was essential for transformation.

These experiences in therapy were new and exciting for Ed, and he looked forward to his therapy sessions with his experiential therapist as he continued to make progress in therapy.

Conclusion
Many clients, who have a history of trauma, are almost exclusively focused on the effects of their trauma and their emotional problems.

While, ultimately, the goal of therapy is to help clients to overcome their trauma, along the way, as part of experiential therapy, it's important for clients to also recognize their personal strengths that allowed them to survive and, in many cases, to thrive despite the obstacles.

Not only does it help clients to appreciate how their strengths helped them in the past, it also helps them to recognize that they have these internal resources to call on in the present.

An experiential therapist is focused on helping to undo the aloneness that clients experienced during their traumatic history by being emotionally accessible to clients as they work through their trauma. She also helps clients to access their personal strengths.

In addition, she strives to help clients to have a new corrective emotional experience in therapy that is healing to clients.  All of this helps clients to overcome trauma and make positive changes in their lives.

Getting Help in Experiential Therapy
If you have been unable to resolve your problems on your own or you feel frustrated by intellectual insight that doesn't lead to a healing experience, you owe it to yourself to get help in from a licensed psychotherapist who practices experiential therapy (see my article: How to Choose a Psychotherapist).

Experiential therapy, like AEDP, is an evidence-based therapy that is effective and can lead to a transformation in your life.

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

I work 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, October 9, 2018

Discovering Your Personal Strengths in Therapy: You're Much More Than Your Traumatic History

In a prior article, You're Not Defined By Your Diagnosis, I discussed how clients, who have been in prior therapy, often think of themselves as defined by their diagnosis ("I'm depressed" or "I'm anxious") rather than seeing the totality of who they are, including their strengths.

Similarly, when clients come to therapy to deal with a traumatic history, their self concept is often defined by their trauma--rather than also seeing their resilience and personal strengths (see my article: A Strengths Based Perspective in Psychotherapy).  This is especially true of clients who have been in conventional talk therapy.

Discovering Your Personal Strengths in Therapy: You're Much More Than Your Traumatic History

As I mentioned in the prior article, it's not a matter of being in denial about the client's negative experiences.  It's more about seeing their problems as well as seeing beyond those problems to include everything that's positive about them.

As a psychotherapist in New York City, who specializes in working with trauma, I take a holistic view of clients and want to help them build on their strengths as well as helping them to overcome unresolved trauma.

Clients, who have been in prior therapy, are often accustomed to being pathologized to the point where all they see about themselves are the "negative" parts that they want to overcome.

While I understand a client's need to focus on the trauma and trauma therapy is one of my specialties, I also want the client to appreciate the parts of that helped him or her to get through the traumatic experiences and excel in other areas of life.

As part of AEDP therapy (Accelerated Experiential Dynamic Psychotherapy), which is an experiential therapy, I help clients to take the time to really internalize their experiences of their strengths at the same time that I help them to overcome their traumatic experiences (see my article: Why Experiential Therapy is More Effective Than Talk Therapy).

Part of AEDP therapy is helping clients to have a deep sense of their personal strengths, which can feel unusual, at first, for clients who are so focused on their problems.

This might mean slowing things down experientially when a client talks about an obstacle s/he overcame or a courageous stance that s/he took. Interestingly, slowing things down experientially actually helps to speed the work up in the long run.

By slowing down the work at that point, I'm helping the client to have more than just an intellectual understanding of their strengths.  Instead, in addition to their intellectual understanding, I'm helping the client to have an embodied experience of his or her strengths.  In doing so, I'm helping the client to have a more integrated mind-body experience.

You might ask, "Why is this important?"

Well, it's an important part of helping a client to have a transformative experience in which s/he recognizes that the trauma history is only one part of who s/he is and there is so much more than the trauma.

It also helps the client to see that they have internal resources and coping skills that s/he can call upon when faced with adversity.  This is a crucial part of the way I work with clients who have been traumatized.

Anyone who has survived a traumatic history has personal strengths that got him or her through.

Being able to recognize and value those strengths is a part of AEDP work in therapy and in all experiential modalities that I use, including EMDR therapy, Somatic Experiencing and clinical hypnosis.

In my next article, I'll provide a clinical vignette that illustrates how I work with clients' strengths while helping them to overcome trauma.

Getting Help in Therapy
Being pathologized in therapy by psychotherapists who only focus on diagnosis or "the problem" makes overcoming trauma more difficult and can diminish your sense of self.

If you have been struggling with unresolved problems, you owe it to yourself to seek help from a skilled licensed psychotherapist who has a strengths-based perspective.

Freeing yourself from your traumatic history and, at the same time, recognizing that you have strengths can help you to lead a more fulfilling life.

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

I work 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.






Saturday, October 6, 2018

With Experiential Therapy, There Are No Blank-Slate Therapists - Part 2

In my prior article, I began a discussion about how experiential psychotherapy is different from conventional psychotherapy.  I discussed that some therapists in conventional therapy still work with their clients from a stance of neutrality with little to no self disclosure.  This is in contrast to experiential therapy where the psychotherapist is a dynamic, empathic, emotionally accessible, and a collaborative presence in the therapy session with the client (see my article: Why Experiential Psychotherapy is More Effective Than Conventional Talk Therapy).

With Experiential Therapy, There Are No Blank-Slate Therapists

Fictional Clinical Vignette: With Experiential Therapy, There Are No Blank-Slate Therapists
The following fictional clinical vignette, which is representative of the issues being discussed in this article, illustrates the difference between experiential psychotherapy and conventional psychotherapy where the therapist takes a neutral stance with the client:

Alan
Attending therapy twice a week, Alan endured long silences in his therapy sessions with his conventional talk therapy psychotherapist.

Alan dreaded these silences because it reminded him of the times when he was a young child and he and his parents sat in stony silence at the dinner table.  During those days, when he attempted to talk at the dinner table about things that went on at school, his father would reprimand him, "Be quiet and eat your food" (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).

Afterwards, his mother would oversee his nightly ritual of washing up and putting on his pajamas before he went to bed.  He often wished that his mother would read him a bedtime story, which is what his friend, Tom's mom would do when Tom went to bed.  But having asked his mother for a  bedtime story in the past, Alan knew that his mother would reject his request and just tell him to go to sleep.

As he lay on the couch in his therapist's office for his second session of the week, he stared at the ceiling as he became increasingly uncomfortable.  From behind him, Alan could hear his therapist shift slightly in his chair, but that was the only sound that Alan heard.  He knew from his prior sessions that his therapist could go nearly an entire session without saying anything if Alan didn't know what to say.  Alan dreaded those long silences and he hoped this wouldn't be one of those sessions.

Clearing his throat to speak, Alan said in a low voice, "I'm not sure what else to talk about.  We have discussed so many times before how I feel like I'm an unlovable person and how lonely that is for me.  I don't know what else to say about it" (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

From behind him, Alan heard his therapist writing, but his therapist didn't respond to Alan's remark.  Alan thought about how he had been coming to therapy with Dr. Walsh for three years, and he felt he wasn't making any progress.  In the past, when he mentioned this to Dr. Walsh, he told Alan that it would take many years of therapy for Alan to see progress (see my article: Common Myths About Psychotherapy: Therapy Takes a Long Time).

Alan, who was about to turn 35, didn't feel like he could endure his emotional pain without relief for several more years.  Whenever he told his therapist this in the past and asked his therapist what he thought was getting in the way of his progress, his therapist turned the question back on Alan and asked Alan what he thought.  But Alan didn't know what he thought, and this was frustrating to him.

After enduring another session where they were mostly silent, Alan left feeling worse than before the session.  As he walked to meet his friend, Ed, for coffee, Alan thought about how he knew nothing about Dr. Walsh even though he had been attending twice-a-week sessions with him for three years.

At one point in an earlier session, he asked Dr. Walsh if he had ever experienced feeling as insecure in his life as Alan was feeling, but Alan didn't get an answer.  Dr. Walsh, once again, turned the question back on Alan and wanted to explore the question rather than answer it.  This left Alan feeling like he had done something wrong by asking the question, and he felt ashamed.

On the rare occasions when Alan looked back to see Dr. Walsh, he saw a very serious, authoritarian look at Dr. Walsh's face similar to the look that his father used to give him.  During those times, Alan wondered if Dr. Walsh even liked him or thought about him when they weren't in session.

In the coffee shop, Alan shared his frustration with Ed about his therapy sessions, "I just feel like I'm getting nowhere in my therapy, and I worry sometimes that my therapist might not even like me.  He's kind of distant and impersonal in the sessions so it's hard to tell."

Ed looked surprised.  He said his therapist was completely different--she was emotionally engaged, supportive and dynamic in their therapy sessions.  He told Alan that she was active in helping him to get to the underlying emotions (also called primary emotions) that were at the core of his problems, and this helped him to start making changes.

In addition, Ed explained, she occasionally shared stories that let Ed know that she understood his problems.  There were also times, he said, when they laughed in session, and Ed felt how this helped to release tension and open him up to the therapeutic process (see my article: Humor Can Be Effective in Therapy).

Alan was shocked to hear that Ed's experience in psychotherapy was so different from his own, and he asked Ed, "What type of therapy are you doing?"

Ed responded, "My therapist is an experiential therapist who does all kinds of therapy, including AEDP, EMDR, Somatic Experiencing and clinical hypnosis.  Maybe you should have a consultation with an experiential therapist." Alan thought about it for a minute and then asked Ed to get a referral from his therapist to another experiential therapist.

By the following week, Alan was sitting in an experiential therapist's office having a consultation.  He noticed the big difference in how he felt with this therapist immediately.  Not only was she warm and emotionally accessible, she sat facing him (rather than behind him) and he could see that she was emotionally attuned to what he said (see my article: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Rather than coming across as a blank screen, Ed realized, this therapist allowed Ed to see that she was intensely engaged in their session.  She also shared with Ed how she experienced him in the session which felt heartfelt and genuine.

In addition, she explained how experiential therapy was different from conventional talk therapy (see my article: What's the Difference Between "Top Down" and "Bottom Up" Approaches to Therapy?).

During his next session with Dr. Walsh, Alan revealed that he had gone for a consultation with another psychotherapist who did experiential therapy.  Hoping that Dr. Walsh would respond, Alan waited in vain.  After several minutes had passed, Alan told Dr. Walsh that he felt the other therapist was more attuned to him, but Dr. Walsh said nothing, which brought back more memories of his silent childhood dinners with his parents.

Alan knew from his prior therapy that there was a termination phase before ending therapy, so he told Dr. Walsh that he would like to have a few more sessions to end therapy and then he wanted to move on to work with an experiential therapist.

During the next three sessions, things remained basically the same in Alan's sessions with Dr. Walsh. He encouraged Alan to talk about what he felt he had gained from their therapy together, and Alan told him that he felt he had gained some insight into his problems.  But what Alan didn't tell him was that, even though he had gained intellectual insight, he felt nothing had changed or shifted in his life. He felt his problems remained the same (see my article: Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

At the end of the last session with Dr. Walsh, Alan wasn't sure what to do, so he offered to shake Dr. Walsh's hand as he was about to leave.  He noticed how reluctant Dr. Walsh was to extend his hand, which hurt Alan's feelings.  But Dr. Walsh did, reluctantly, extend his hand, shook Alan's hand and told him that he could return to therapy with him in the future.  His words sounded pro forma to Alan, as if Dr. Walsh had said these words many times before.  Then, it was over, and Alan walked out feeling empty.

During the initial stage of experiential therapy, Alan was surprised that his new therapist was so dynamic.  She was so engaged in their conversation that, for the first time in his experience with psychotherapy, Alan didn't feel alone with his problems, which was such a relief to him.  He felt like his new therapist actually cared about him and his well-being.

Not only that.  When he was ready, she helped him to access the underlying emotions involved with his feeling like an unlovable person.  They talked about his relationship with his parents, but the difference, compared to his prior therapy, was that she explained the importance of the mind-body connection and she helped him to connect to his emotions in his body about those experiences (see my article: Experiential Psychotherapy: Learning to Sense Emotions in the Body).

After a while, Alan began to understand that "talking about" his problems only provided him with intellectual insight.  But since experiential therapy used the mind-body connection, in addition to insight, he also had a deep sense of something shifting for him at a core level.  Even more important, he felt a sense of hope that he could change.

Over time, he realized that for him to make the kind of changes that he wanted, he had to make those changes based on his primary emotions, which his new therapist was helping him to access.

Gradually, Alan began to sense a shift in how he felt based on his shifting emotions and the positive regard he felt from his therapist (see my article: What is the Corrective Emotional Experience in Therapy?).

Conclusion
As illustrated in the clinical vignette above, rather than taking a neutral, impersonal stance, the experiential therapist is attuned to the client and emotionally engaged.

Along with her clinical training and expertise, the experiential therapist uses her own emotional experience to attune to the client and help the client to access the primary emotions that lead to change.

The experiential psychotherapist is aware of the brain's neuroplasticity, the brain's ability to change based on learning and experience.

There are many problems with the neutral stance in conventional psychotherapy, including the triggering of earlier emotional experiences of emotional neglect.  This, of course, isn't the intention of the neutral stance, but if often occurs.

In addition, experiential therapy, which uses the mind-body connection, tends to be faster than conventional talk therapy (see my article: Experiential Psychotherapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Getting Help in Experiential Therapy
If you have been struggling with unresolved problems, you could benefit from working with an experiential therapist.

Experiential therapy tends to be more effective and work faster than conventional therapy.

Rather than struggling on your own, you could begin to get a sense of emotional relief as you work towards freeing yourself from problems that keep you stuck.

About Me
I am a licensed NYC experiential therapist, who works with individual adults and couples.

I work in an dynamic, interactive and collaborate way using cutting edge modalities, including EMDR therapy (Eye Movement Desensitization and Reprocessing), clinical hypnosis, AEDP (Accelerated Experiential Dynamic Psychotherapy), Somatic Experiencing, contemporary psychodynamic psychotherapy, and Emotionally Focused Therapy for Couples (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

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.





















Wednesday, October 3, 2018

With Experiential Psychotherapy, There Are No Blank-Slate Therapists

When I was training to be a psychotherapist in postgraduate training, we were taught that the ideal stance for a therapist was neutrality.  From the neutral perspective, the therapist should not convey what is going on internally, make any unnecessary gestures and, in general, remain as a blank slate (see my article: What's the Difference Between "Top Down" and "Bottom Up" Psychotherapy?).

Experiential Psychotherapy: There Are No Blank-Slate Therapists
Because of my background and temperament, this was especially hard for me.  I was raised in a family that was warm, gregarious and effusive.  There were no blank slates.

I also found that it was better for my patients for me to be an accessible human being in the therapy session, and the less my supervisors knew about my human response to clients, the better.

Of course, I was always careful not to cross any ethical boundaries or provide more information about myself than was necessary or warranted.  The focus was still very much on the client.

Since that time, we now know how emotionally depriving it is for psychotherapists to try to be a blank slate.  I say "try" because no one is ever a blank slate.  We are all always reading and picking up on what's going on with each other all the time.  So, the notion of a "blank slate" is a fallacy.

I'm not sure where the idea of being so impersonal came from.  It certainly wasn't part of Freud's practice.  He regularly walked clients around his garden at his home and had them over to his house.  From everything that I have read, he was rather engaging.

It seems like it was more of an overreaction by American psychiatrists, who were the psychoanalysts of their day, during the early days of psychoanalysis when there were few rules and some analysts were acting out with their clients.

The one thing that Freud didn't like was to be looked at directly by the client when he was with them in his therapy room--even though they looked directly at him when they were in his garden or in his home.   So, he came up with the idea that the therapist should sit behind the client out of the client's sight so he could listen with "evenly hovering attention," ostensibly, without the distraction of looking at the client.

Over time, most therapists discovered that there is a lot that is missed when a therapist isn't looking at the client directly or when the client isn't looking at the therapist.  The therapist isn't picking up on body language, facial cues, gestures and, in general, the intersubjective experience of being with a client.  This is certainly a lot to miss.

There have been certain times when I have had a client who preferred for me to sit behind him so the client couldn't see me and I could only see only the back of his head.  While I honor this request, I also explore the meaning of it with the client.  For some clients, it's easier for them to talk if they don't watch the therapist's face or gestures.  I get that, and I want my clients to be comfortable, so I will arrange to sit behind that particular client.

But the vast majority of clients want the therapist to be human, collaborative, interactive and dynamic rather than a therapist who is trying to be a blank slate.  This suits me fine since it feels most natural to me to work in that way.

There Are No Blank-Slate Therapists With Experiential Psychotherapy
Experiential therapy, including EMDR Therapy (Eye Movement Desensitization and Reprocessing), AEDP (Advanced Experiential Dynamic Psychotherapy), Somatic Experiencing, clinical hypnosis, Emotionally Focused Therapy for couples and other types of experiential therapies emphasize the importance of the therapist being relatively open and emotionally accessible.

How did this change from the blank slate therapist?  Through research and clinical experience, researchers and clinicians discovered that change occurs when psychotherapists and clients are emotionally engaged with each other in therapy.

Some of the research is extrapolated from Ed Tronick's still face experiments between mothers and babies.  Other research from AEDP and Emotionally Focused Therapy also reveals that the therapist and client need to be emotionally engaged for change to take place.

Having a cognitive understanding of their problems is an important part of therapy but, in terms of change, it's limited (see my article: Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

In order to make changes, clients need to be able to get to their underlying emotions (also called primary emotions), and this is difficult to do with a therapist who is sitting there like a mannequin.

In the next article, I'll provide a clinical vignette to illustrate how experiential therapy is different from older forms of conventional psychotherapy and psychoanalysis (see my article: With Experiential Therapy, There Are No Blank-Slate Therapists - Part 2).

Of course, much has also changed in psychoanalysis, especially Relational Psychoanalysis and other contemporary forms of psychoanalysis so there is more of a collaborative approach and more self disclosure on the part of the therapist.  However, unfortunately, there are still some therapists who try to be blank slates.

Getting Help in Psychotherapy
As previously mentioned, these days most clients want a collaborative, interactive and dynamic psychotherapist.

Experiential therapists provide this experience to clients in a supportive and empathic environment.

Experiential therapists also help clients to connect with the mind-body experience.  This is different from conventional talk therapy, which provides more limited insight-oriented experiences.

We now know, based on research and clinical experience, that getting to the core of emotions is what brings about transformation (see my article: Experiential Psychotherapy Helps to Achieve Emotional Breakthroughs).

If you have been struggling with unresolved problems and conventional talk therapy hasn't helped you to resolve these issues, you owe it to yourself to contact an experiential psychotherapist.

Experiential therapy can help to free you from unresolved problems so you can live a more satisfying life.

About Me
I am a licensed NYC experiential psychotherapist who uses clinical hypnosis, EMDR therapy, AEDP therapy, Somatic Experiencing and Emotionally Focused couple therapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work 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, October 1, 2018

Relationships: In Love But Not Compatible With Your Partner

It's so easy to get caught up in the passion of a relationship, especially when you're in love and things are new and exciting.  But, as many couples find out, being in love and being compatible aren't the same things. They discover that the relationship isn't going to work out--despite the fact that you're both in love with each other (see my article: All You Need is More Than Love).

Relationships: In Love But Not Compatible With Your Partner
Of course, when we're talking about compatibility, it matters whether we're referring to relatively minor issues where there can be negotiation and compromise or if we're discussing core values that are non-negotiable with each person.

When the incompatibility involves core values, many couples, who love each other, keep hoping for the best because they don't want to lose each other.  But if they remain together, get married and have children, it can be even more heartbreaking to have ongoing conflict, tension in the home and, possibly, an eventual breakup.

Fictional Clinical Vignette: In Love But Not Compatible
The following fictional vignette, which is representative of many actual cases, illustrates the problems  involved when two people in a relationship are in love but not compatible:

Alan and Jennifer
Alan and Jennifer met at a local dance club in Manhattan when they were both in their 20s.  Instantly attracted to one another, they began dating regularly and, after several months, they were both in love with each other, sex was amazing, and they decided to remain monogamous.

After dating for a couple of years, they talked about the possibility of moving in together and eventually getting married.  Neither of them had ever felt so in love and committed to a relationship before.

The problem was that when they talked about getting married, Jennifer said she wanted to have at least two children, and Alan said he didn't want to have children at all.  Although Jennifer was concerned about this, she didn't want to breakup with Alan.  So, she decided to move in with him and wait to see if he changed his mind.

Two years after they moved in together, each of them was even more committed to the relationship than before.  But the question about children remained an issue.  Alan still maintained that he didn't want children, and Jennifer wanted children more than ever.

At the same time, Jennifer was concerned about her "biological clock" and, if she was going to have children, she wanted to start trying to get pregnant within the next year or two.  They talked about this issue many times, but they couldn't come to an agreement, and they were both feeling increasingly anxious about what this meant for their relationship.

Soon after that, they decided to come for couple therapy to see if they could work out this issue.  As Jennifer explained it, she felt like she was caught in a dilemma:  She didn't want to be with anyone else, except Alan, but she didn't want to regret not having children later or feel resentful towards Alan about it.

Alan explained to the couple therapist that he also felt like he was in a dilemma:  He loved Jennifer and he wanted to marry her, but he felt he would be unhappy having children.  He said he thought about going along with Jennifer about having children, but he was also afraid that he would resent her eventually if he acquiesced to her and he was unhappy later on.

Jennifer expressed her deep sorrow and frustration.  She had been raised to believe that if two people love each other, they could work anything out.  She thought "love conquers all," but their problem seemed intractable.

Furthermore, from a practical point of view, she feared that, even if she was willing to leave Alan, which she didn't want to do, there was no guarantee that she would meet someone else that she would fall in love with and who wanted children.  She didn't want to give Alan up, and Alan also didn't want to break up.

Fortunately for this couple, they began to spend a lot more time with Jennifer's sister, Ann, who just had a baby.  Jennifer adored her niece, and Alan was very surprised that he also loved being with the baby.  He said he began to enjoy imagining himself being a father and raising a child.

After that, Alan told Jennifer that he changed his mind--he would like to have at least one child, and this allowed them to take the next step to get engaged.

They remained in couple therapy until after their first child was one years old. In their couple therapy sessions, they talked about how challenging it was to have a new baby and how tired they often were. Having a child turned out to be a lot more work than either of them had imagined. But both Alan and Jennifer were happy that they decided to have a child.  Since everything else in their marriage was going fairly well, they ended couple therapy at that time.

Occasionally, over the years, they returned to couple therapy whenever issues came up.  But, overall, they were getting along very well and their child was thriving.

Conclusion
In this particular scenario, the problem worked out because circumstances changed and they both ended up on the same page about having children.

Unfortunately, for many couples, whether the issue is having children or some other core issue, things don't always work out so well.

If Alan and Jennifer had not come to an agreement about children, like many couples, they would have had to decide whether to stay together or not.  This is a big dilemma to have to face and, obviously, there's no right or wrong answer.

In addition, so many of us were raised with the idea that "love conquers all."   It can be so disappointing and disillusioning when you and your partner are in love, but you disagree about important issues, and it seems like your relationship isn't going to work out, despite how much you love each other.

Getting Help in Couple Therapy
Being in conflict about a core value can put a very big strain on your relationship, especially if you're both procrastinating about dealing with it--whether it's about having children or any other important issues.

Sometimes, couples can come to an agreement--whether it's to stay together or break up--with the help of couple therapy.  It can be a relief to make a decision even if it's a very difficult one (see my article: What is Emotionally Focused Couple Therapy (EFT)?

Your problems probably won't go away on their own, so it's better to face them together with the help of a couple therapist.

If you've been putting off dealing with core issues in your relationship, whatever they might be, you could benefit from working with an experienced couple therapist.

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

I work 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.













Saturday, September 29, 2018

Infidelity: How to Save Your Relationship After You Have Had an Affair

In my last article, I focused on how an injured partner can cope with intrusive thoughts and emotions after finding out about a spouse's affair.  In this article, I'm discussing what the unfaithful partner can do to try to save the relationship (see my articles: Coping With Infidelity).

Infidelity: How to Save Your Relationship After You Had an Affair
Research on infidelity reveals that 20-40% of all marriages experience some form of infidelity.  In my opinion, this is a very high number and more research needs to be done to determine why so many people cheat on their partners and what, if anything, can be done in terms of prevention.

Generally, the research reveals that men tend to cheat more than women, but women also cheat.  This article assumes that either a man or a woman is capable of cheating.

After an affair has been discovered, if the relationship is to survive, the partner who cheated has certain responsibilities, especially during the initial stage of this process.

For the Partner Who Cheated:
If you're the partner who cheated, at a minimum, you need to be willing to do the following:
  • Be Honest With Yourself About the Infidelity: If you have been minimizing the fact that you are or were having an affair, be honest with yourself about what's going on for you.  Was this a one-time sexual affair, an emotional affair or some combination of the two?  Or, are you someone who has multiple or serial affairs?  Although all infidelity is damaging to a relationship, there is an obvious difference between getting drunk on a business trip and going to bed with someone you met once vs. going online and seeking multiple or serial affairs.  If your behavior is compulsive, you might have a problem with sexual addiction that needs to be addressed (see my article: Infidelity: Married, Bored and Cheating OnlineSexually Compulsive Behavior as a Split Off Part of Yourself and Understanding the Healthy Needs Underlying an Addiction).
  • Be Honest With Your Partner About the Infidelity: Assuming that you want to save your relationship, with time and effort, a relationship can survive infidelity if both partners are willing. What often ruins a relationship is when the partner who cheated lies about it--even when his or her partner shows evidence that the affair has been discovered.  If you want to save your relationship, rather than lying or having the truth come out piecemeal over time, answer your partner's questions honestly, thoroughly and patiently.  This isn't the time to get defensive or to become avoidant.  You owe it to your partner to be open about what happened and answer whatever questions s/he might have. If, on the other hand, you no longer want to be in your relationship, then, as difficult as it might be, you need to be honest about this and communicate this to your partner.  Sometimes, people who cheat do it unconsciously as a way to getting out of the relationship because they don't know how to tell their partner that they no longer want to be in the relationship.  Instead of communicating directly with their partner, they "act out" by having an affair.  Rather than "acting out," you need to be honest, direct (although considerate and tactful) and talk to your partner as soon as you realize you no longer want to be in the relationship.  
  • Take Responsibility For the Affair: Rather than making up excuses, take full responsibility for having the affair--regardless of the state of your relationship at the time.  Making excuses, blaming your partner or being defensive will only exacerbate the problem.  
  • Show Genuine Remorse: You have caused your partner a lot of pain and put your relationship at risk.  Don't expect to be forgiven the first, second, third or tenth time that you apologize for the affair.  You might need to apologize many, many times.  Also, your partner might not be ready to accept your apology for a while.  Surviving infidelity is a process and you will need to be sincere in showing your remorse and commitment to the relationship.  This can take months or years.  
  • Be Attuned and Empathetic to Your Partner's Pain: If you want to save your relationship, you need to show that you're attuned to your partner's feelings and that you care.  This will probably mean that you're going to be on the receiving end of your partner's rage, hurt and sadness for however long it takes your partner to forgive you--assuming that s/he does eventually forgive you.  Be willing to take in your partner's emotions.  This is not the time to try to sweep your partner's feelings under the rug or rush him or her to "move on."  Infidelity is a serious breach and a betrayal.  Unless you can show that you're emotionally present to your partner's pain, your relationship probably won't work out.  
  • Don't Dismiss Your Partner's Emotional Reaction: Related to being attuned and empathetic, don't dismiss your partner's reaction to discovering the affair.  Don't tell your partner that s/he is overreacting.  This will only reveal that you're not attuned to your partner's feelings.  Likewise, telling your partner that the "other woman" or "other man" meant nothing to you and you don't understand why your partner is so upset, will make you sound like you're being dismissive.  Even if it's true that the other person meant little or nothing to you, you have to understand that this sounds like you're making excuses and minimizing your partner's emotions. Your partner's response to this could rightfully be, "If she [he] meant nothing to you, why did you do it and risk our relationship?" If, on the other hand, your partner asks you about  your feelings towards the person you had the affair with, that's different--you can respond honestly about that.  In that case, you're responding to your partner rather than trying to minimize the affair.  Remember: Everyone is unique in terms of how s/he reacts to discovering infidelity and how long it takes (if ever) to forgive.
  • Cut Off All Ties With the Person You Cheated With: If you're serious about saving your relationship, you must cut off all ties with the "other woman" or "other man."  This is non-negotiable.  No exceptions.  You can't try to salvage your relationship while you maintain a connection with the other person.  If the other person contacts you about reconnecting to resume the affair or "to be friends," you maintain your stance that there can be no contact.  You must let your partner know that the other person contacted you so that your partner doesn't discover this on his or her own.  That would make matters worse because it would look like you're trying to hide things.
  • Deal With Triggers That Lead to Cheating: As part of your self reflection about your behavior, consider whether there are certain triggers that lead to your cheating.  For instance, if you know that drinking or drugging lead to cheating on your partner, get professional help for these issues.  If you continue to indulge in substances that usually precede cheating, you will leave yourself vulnerable to cheating and possibly lose your relationship.  Boredom is another possible trigger.  Another example is that if you know that going to certain places makes you vulnerable to cheating, avoid those places if you can or, if you can't, make a plan as to what you will do to avoid cheating and stick with that plan.  Ditto for certain online sites.  Don't delude yourself into thinking that you can be "strong" and deal with triggers.  You will only be kidding yourself, and there's too much at stake to put yourself and your relationship at risk (see my article: The Allure of the Extramarital Affair).
  • Be Willing to Demonstrate Your Accountability to Your Partner: Whether this means that you allow your partner to have access to your phone, email or other online accounts, you need to show your partner that you're willing to be an open book.  If your partner wants you to call him or her when you're working late at the office or on a business trip, do it.  Do whatever is necessary to try to regain your partner's trust (see my article: Learning to Trust Again After an Affair).
  • Work Actively to Repair and Rekindle Your Relationship: Beyond everything else that has already been mentioned above, you need to be willing to do major work on your relationship if it is going to survive.  You need to find meaningful ways to show your partner that you love him or her and that s/he is the most important person in the world to you.  If the two of you have been emotionally disconnected, find ways (once your partner is ready and willing) to reconnect emotionally.
Recognize that, ultimately, even if you're very committed to salvaging your relationship, it will be up to your partner to decide if s/he wants to remain in the relationship.  For many people, infidelity is beyond what they can forgive, and you might have to accept this as the consequence of your behavior.

Sometimes couples rush to put the pain behind them without going through the necessary emotional process of dealing with the betrayal and breach of trust.  Then, later on, they discover that just telling each other that they're "moving on" or "starting over" isn't enough.  The problem might have been swept under the rug, but it's still there.

Getting Help in Therapy
Depending upon the underlying issues that caused you to cheat, you might need individual therapy and, if and when your partner is ready, couple therapy.

Coping with the guilt and shame about an affair as well as triggering behavior can be very challenging on your own (see my article: Healing Shame in Therapy and Learning to Forgive Yourself).

Don't underestimate how easy it would be to resume an affair or start a new one, especially if you're not dealing with the root cause of your problem.  

A skilled psychotherapist, who has experience working with partners who cheat, can help you to get to the root of your problem and develop the necessary skills to remain faithful in your relationship.

Many couples, who decide they want to remain in their relationship after an affair, don't make it because they get stuck in a negative cycle and they don't know how to change it.

A skilled EFT therapist (Emotionally Focused Therapy) can help you and your partner to overcome the negative cycle so that you can rebuild trust and rekindle your relationship.

Getting help in therapy could make the difference between saving your relationship or breaking up.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Emotionally Focused (EFT) therapist for couples.

I have helped many individuals and couples to survive infidelity.

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

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