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Tuesday, April 30, 2013

Another Study Reveals There's a Seasonal Pattern to Mental Health

Many clients that I see in my psychotherapy private practice in NYC tell me that they notice a seasonal pattern to their mood and that they tend to feel happier in the spring and summer when there's more sunlight as opposed to the winter when there's less sun.  


A Seasonal Pattern to Mental Health

Most of these psychotherapy clients who report a seasonal pattern to their mood don't meet the criteria for seasonal affective disorder.

Seasonal Pattern to Mental Health
There have been studies before that show a seasonal pattern to mental health.  A New York Times article by Nicholas Bakalar discusses yet another study with similar findings (see link below for the article).  The full research study is reported in the American Journal of Preventive Medicine.


It's great to have the research to back up what has been reported to most therapists for a long time.


Getting Help
Whether you notice a change in your mood due to seasonal changes, current circumstances in your life, longstanding problems or for reasons unknown, rather than suffering alone, you could benefit from getting help from a licensed mental health professional.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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 at: josephineolivia@aol.com


A Seasonal Pattern to Mental Health - Nicholas Bakalar - NY Times


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Monday, April 29, 2013

Encouraging Medical Doctors to Be More Creative

In a recent New York Times article, Dr. Danielle Ofri raises important issues about encouraging doctors to be more creative in their approach to medical issues (see link below for the article).


Encouraging Medical Doctors to Be More Creative

In my psychotherapy private practice in NYC, I hear many clients complain that their doctors continue to prescribe medications or recommend the same procedures that aren't working for their medical issues.

Now, in all fairness, there can be many reasons for this.  Being a doctor today is different from how it was 25 or more years ago.

We know that doctors, especially doctors who still take managed care insurance, often have large medical practices in other to stay in business.  Their time is often very limited with each patient.  If you're one of the last patients of the day, you might be seeing a very tired and overworked doctor.

Doctors Are Often Pressured to Spend Less Time With Patients, Which Affects Creativity

Even when they want to spend more time with patients, doctors who are part of group practices, are often pressured by the administration to work faster and spend less time with patients so the administration has more billable hours so they remain a viable facility.

In addition, doctors are often limited to what they can prescribe or recommend based on the patient's insurance.  He or she might have creative solutions to medical problems, but if the insurance company won't pay for these solutions and the patient can't afford to pay, the doctor is often forced to use medications or recommendations that are approved by the insurance, which might not be the most creative or optimal solution to the problem.

There are many good reasons to have what are considered "best practice" protocols, but often one-size- fits-all protocols don't work, and doctor's hands need to be untied so they can be more creative.

In any case, according to Dr. Ofri, many medical schools are now recognizing that doctors need to be more creative in their approach.  This recognition has led to interesting changes at medical school.  According to Dr. Ofri, many people scoff at these changes, but she sees the advantages to these changes that encourage doctors to be more creative in their approach.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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: josephineolivia@aol.com

How Creative Is Your Doctor? by Danielle Ofri, MD - NY Times


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Sunday, April 28, 2013

More Seniors Are Attending Psychotherapy These Days

More senior citizens are attending psychotherapy these days, according to Abby Ellin of the New York Times (see link for the article and a video below).  For many seniors, the stigma that once was associated with attending therapy no longer exists.  They've seen their children and grandchildren attend therapy and they're aware now that a person doesn't have to be "crazy" to attend therapy.  Also, people are living longer these days, and many of them don't want to live an unexamined life for their remaining years.


People Are Living Longer and Many of Them Don't Want to Live an Unexamined Life

My Internship Experience With Senior Citizens at a Local Nursing Home
When I was in graduate school, I was a clinical social work intern at a local nursing home.  At the time, the thinking was that all these senior residents needed was someone to talk to and keep them company because they were lonely.

So, I was assigned to meet with a few of the residents on a weekly basis, and as I met with them, I discovered that they had unique problems at this stage of their lives that weren't being addressed.

More Seniors Are Attending Psychotherapy These Days 
Recognizing that senior citizens have unique issues that are often unaddressed might seem like commonsense now, but back then, this wasn't the thinking in the administration.  They were quite surprised to hear that residents were interested in talking about their personal histories and how it affected their lives, unresolved family issues, their emotional and social isolation, their fear of dying, and many other related issues.

A Positive Shift in Perspective For Administrators:  Seniors Can Benefit From Psychotherapy
The administration was surprised at how open these residents were to talk about themselves and their problems.  Rather than just "keeping them company,"the residents and I were addressing important, sometimes longstanding, issues in their lives.

I was very happy that by the time I left the internship, the administration had changed their views, and they hired a therapist to provide psychotherapy sessions to these residents.

Many Seniors Can Work Through Trauma
There is one area where I disagree with Ms. Ellin.  At one point in the video, she says she thinks that most seniors probably will not make big changes in their lives.

Many Seniors Can Work Through Unresolved Trauma
Of course, a person's ability to make changes, no matter what the age, is different for each person.  But, contrary to what I understood Ms. Ellin to say, I have worked with senior citizens using EMDR to work through longstanding trauma.  So, contrary to what many people think, many seniors can, indeed, make big changes in their lives.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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: josephineolivia@aol.com


How Therapy Can Help in the Golden Years - by Abby Ellin - New York Times


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Saturday, April 27, 2013

Support Groups For Fathers Widowed Due to Cancer

A recent newspaper article, A Lifeline For Widowed Fathers - by Jane E. Brody - New York Times addressed an important need for fathers who are widowed due to cancer.  According to Ms. Brody, more fathers are widowed due to cancer more than any other illness.


Fathers Widowed Due to Cancer Often Experience Social and Emotional Isolation

Fathers Widowed Due to Cancer Often Experience Social and Emotional Isolation
In her article, Ms. Brody discusses the social and emotional isolation that these fathers experience after their spouses die.  Not only are they dealing with their own loss, but they must also help their children to deal with the loss of their loss, raise the children on their own, and try to maintain some semblance of normalcy in the household under traumatic circumstances.

A Support Group for Fathers Widowed Due to Cancer 
Ms. Brody indicates that a medical doctor, Dr. Donald Lee Rosenstein and a psychologist, Dr. Justin Michael Yopp, of the University of North Carolina (Chapel Hill) formed a support group for fathers who are widowed due to cancer.

Fathers Who Participated in the Support Group Found Hope

Fathers Widowed Due to Cancer Found Hope and Support
According to Ms. Brody, fathers who had been suffering on their own found mutual support among other fathers who were going through many of the same emotions and everyday challenges that they were facing.  It also helped these fathers, according to Ms. Brody, overcome the loneliness that people experience when they lose their spouse.

The article indicates that Dr. Rosenstein and Dr. Yopp are hoping to expand the support groups to other area of the country.



Fathers Widowed Due to Cancer Can Find Moments of Joy Again

To Find Out More About Support Groups for Widowed Fathers Due to Cancer
If you or someone you know might be interested in finding out more about these support groups, click on this link for more information:  Single Fathers Due to Cancer.

You can also look into support groups at the American Cancer Society.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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: josephineolivia@aol.com


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Friday, April 26, 2013

Discovering a Father's Secret Life After His Death

I recently went to see  Before and After Dinner, a wonderful documentary about actor and director Andre Gregory, which was made by his wife Cindy Kleine.  Many people will remember Andre Gregory from the film, My Dinner With Andre.  One of the themes in Before and After Dinner is that Mr. Gregory discovers information in a book that implicates his late father, a Russian Jew, as a Nazi collaborator.  Mr. Gregory begins a search to discover if his father was leading a secret life.

Unraveling the Mystery of a Father's Secret Life
Most of us can only imagine how painful it could be to try to unravel and piece together such a mystery about one's own father, and how many questions this would raise, especially after a father's death when he's no longer around to answer questions.  The film, which will be released in other cities in the US soon, is worth seeing, so I don't want to give it away.

Although most of us will never have to deal with a mystery of this magnitude about our fathers, it's not unusual for questions to arise after a father's death about some aspect of his life, and for adult children to search for answers about his life.

There's also a book that was recently published, After Visiting Friends: A Son's Story, written by Michael Hainey.  I haven't read the book, but it sounds intriguing.  According to the reviews that  I've read, the author was told when he was a child that his father died "after visiting friends," which was a euphemism for a secret aspect of his father's life.  So, Mr. Hainey sets out to discover what really happened to his father.

The Adult Child Must Be Emotionally Prepared to Discover the Father's Secret
I've worked with clients in my psychotherapy practice in NYC who had reason to believe, after their fathers died, that their fathers led secret lives that these clients felt compelled to discover.  This type of search can become an all-consuming endeavor because of the amount of effort that's often required to find out "the truth."  And, at times, even with an exhaustive search, the results of the search might be ambiguous.  Also, the child, who is now an adult, must be emotionally prepared to learn whatever there might be to discover about his or her deceased father.

Discovering a Father's Secret Life After His Death

In many cases, just knowing that there were possible secrets can be jarring for the adult child, as described by Andre Gregory in the film, Before and After Dinner, to find out that the father you thought you knew while he was alive isn't who you thought he was--or you didn't have the whole story.

Often, this type of search about one's deceased father is not only about trying to discover information about who the father really was, but also an effort to try to understand what this means with regard to the father-child relationship.

This type of search can evoke many different kinds of emotions, including sadness, anger, and feelings of betrayal and abandonment, depending upon the father's secret and why a part of the father's life was kept secret from the child.

It can cause the adult child to wonder about the meaning of a father's secret life and how it might reflect on his or her relationship with the father when the father was alive.

Ultimately, whether an adult child decides to initiate such an investigation about a father is a very personal choice.  There are some people who would rather not know.

In any case, I highly recommend the documentary, Before and After Dinner, which is both funny and poignant.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  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: josephineolivia@aol.com






Thursday, April 25, 2013

Fathers and Sons: Coming Out to Your Father as a Gay Man

Coming out to your father as a gay man can be emotionally challenging.  In many families, there's a real risk that you'll be rejected.  I've worked with many gay men of all ages in my psychotherapy practice in NYC who have struggled with this issue.

Of course, I've also known both gay men with heterosexual parents who didn't have a problem when they came out to them.  But if you're on the fence about coming out to your father or you've already come out and it has placed a strain on your father-son relationship, you already know how emotionally challenging this can be for both you and your dad.

The following vignette is  a composite of many cases with all identifying information changed to protect confidentiality:

Alan
Alan knew from the time that he was about 12 years old that he was gay.  Growing up in a traditional family in the Midwest, he didn't feel he could talk to his parents or brothers about it and he felt lonely and confused.

Alan felt especially worried about what his father would think if he knew Alan was gay.  His father was a kind man, but he was also conservative in his values.  Alan didn't want to be a disappointment to him.

When he was in his teens, Alan tried dating girls, but he knew he wasn't interested in girls.  He had crushes on boys, but he didn't dare tell his friends.  He didn't know anyone who was gay, so he continued to have a lot of questions about his sexual orientation until he moved to NYC to go to college, and he met other gay young men.

Fathers and Sons: Coming Out to Your Father as a Gay Man

It was such a relief to meet other young men who felt the same way that he did.  He went out on dates, but he was too afraid to get sexually involved with any of the young men he dated.

He kept his gay social activities a secret from his family.  He thought his mother might understand because she tended to be more open minded than his father.  But it was all so new for him that he wasn't comfortable with his sexual orientation himself, so he decided to start therapy.

After we started working together for a few months, Alan began to feel more comfortable as a gay man.  He realized that before he felt more accepting of himself, it would have been hard to come out to his parents.

To make it easier for Alan, we developed a plan where he would start with the person he thought would be the most accepting and easiest to talk to.  Alan chose his younger brother, who tended to be more liberal than the rest of the family.  And his younger brother was encouraging, supportive and happy that Alan came out to him.

One by one, Alan called his brothers and, to his surprise, each one of them told him that, even though they might not understand it, they loved him and wanted him to be happy.

Feeling a little more confident, he spoke to his mother, who told Alan that she had sensed from the time he was a young boy that he might be gay.  She was tearful and told him that she worried about him getting HIV.  Alan told her that he had not been sexual with a man yet, but he assured her that he would be careful.

Then Alan asked his mother how she thought his father would react if he came out to him.  His mother was silent, and then she said she didn't know.  She thought that his father might need time to get used to the idea.  But she thought, ultimately, he would come around.

Until then, Alan's experience of coming out to his family had been mostly positive.  He knew that coming out to his father would be the most challenging part of coming out as a gay man.  Although  his mother never pressured him about it, Alan knew his father wanted him to get married to a woman, have children, and lead a traditional life.

Rather than coming out to his father over the phone, Alan decided to do it in person when he went home for a visit.   Before he went home, Alan had several sessions to talk about his fears about his father rejecting him.  This caused Alan a lot of emotional pain.

Before he went home, Alan purchased a copy of the book, Now That You Know: A Parent's Guide to Understand Your Gay and Lesbian Children, which is written for parents of gay children.  The original plan was for Alan to have the talk with his father on his third day at home. But the day came and went and Alan was too afraid to talk to his father.

So, that night, he wrote his father a letter telling his father how much he loved him and how much he valued their father-son relationship.  He also told him that he was happier than he had ever been now that he could be himself and he hoped his father would understand.

The next day, when they were alone sitting on the porch, Alan handed his father the letter and asked him to read it.  His father hesitated, at first, to open the letter.  Alan's heart was pounding in his chest and his hands were sweating, but he urged his father to read it.  Then, he watched a frown come over his father's face as he read the letter, folded it back up again, and walked away silently into the garden.

Alan continued to sit on the porch.  He felt numb and frozen in place.  He didn't know how to interpret his father's reaction.  He was afraid his worst fears had come true and that his father was upset.  He watched the sun go down, and continued to sit in the same spot until early evening.  When it was time for dinner, Alan's mother told Alan and his brothers that their father wasn't feeling well and he wouldn't be coming down to dinner.  Alan felt tears stinging in his eyes, and he decided he would pack his things after dinner and leave a few days early.

As he was packing that evening, he heard a knock on the door.  When he opened the door, he saw his father standing there, eyes averted, looking at the floor.  Alan didn't know what to expect, but he let his father in.  They sat together on Alan's bed, silently, for what seemed like a long time.  Then, his father spoke in a hoarse voice and said, "I don't understand it.  I'm going to need time, but you're my son and I'll always love you."  He reached over and gave Alan a big hug.  Then, he left before Alan could respond.

Alan left the book for his father to read.  He continued to work in therapy on his coming out process. He realized that it had taken him a while to feel comfortable with being gay, so he knew it would be a process for his father too.

Getting Help
The coming out process is different for everyone.  If you're struggling with your own feelings as well as your fears about how your family will react, you could benefit from getting help from a licensed mental health professional who has expertise in this area.  It could make all the difference in your process.  I've included resources below for gay organizations.

I am a licensed NYC psychotherapist, hypnotherapist and EMDR therapist.  I work with individual adults and couples, and one of my specialties is working with lesbian, gay and bisexual clients.

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  send me an email: josephineolivia@aol.com

Resources
LGBT Center - NYC
Gay and Lesbian National Help Center - Hotline
Parents, Families and Friends of Lesbians and Gays

Tuesday, April 23, 2013

Fathers and Daughters: "Daddy's Little Girl" is All Grown Up Now

When your daughter was a young child, she might have been your precious "little girl," looking up at you with adoring eyes.  Maybe her first word was "da da," which moved you to tears.  But when your adoring daughter who was "daddy's little girl" becomes around 13, she's not a little girl any more.  And, you'll need to adjust to a change in your relationship.

Daddy's Little Girl

Father's Confusion and Sadness About a Change in the Father-Daughter Relationship
There are many fathers who feel confused and sad about the change in their relationship with their daughters when their daughters become teenagers.  Your daughter might have loved spending time with you engaging in sports or hobbies when she was younger.  But, often, when girls become teens, their focus changes and they prefer to spend time with their peers.  She also might not like to do the same things you used to do together any more.

"Daddy's Little Girl" is All Grown Up Now

It often comes as a surprise to fathers when their daughters go through this change.  For some girls, it's a gradual process.  For other girls, it can seem sudden.  If you're not prepared for this change and you try to treat your daughter as if she's still a younger child, you'll likely have problems in your relationship with her.

Fathers Often Find Their Daughter's Adolescence to Be Confusing

Tips For Fathers of Teenage Daughters:


Respect Your Daughter's Right to Her Own Views, Even If You Don't Necessarily Agree with Them
You're still the parent, but it's important that you keep the lines of communication open with your daughter.  It's also important that you listen to what she has to say with an open mind.  

Allow Your Daughter to Participate in the Decision-making Process
Adolescence is a time (for both girls and boys) when teens want more independence.  They might not necessarily be ready in terms of their emotional development for all the independence that they want.  As the adult, it's better to allow her to participate in the decision-making process, if possible, rather than dictating terms to her.

Don't Try to Continue Treating Your Daughter Like She's a Little Girl
This will backfire on you and might alienate your daughter.  Accept that she's not a young child any more, and try to remain flexible in your approach. There might be days, as your daughter comes to grips with all the changes she's going through on a physical, emotional and cognitive level, when she might behave like the "daddy's little girl" that you adore.  But this is all part of the change and it won't last.

Let Your Daughter Know That You're There For Her and Keep the Lines of Communication Open
Right now, you and her mother might be taking a backseat to your daughter's friends.  This is a normal part of teenage development.  Rather than trying to compete with her friends, which is a mistake that many parents make, let your daughter know that you're available to talk to her if she wants to talk.  Don't try to force it.

Find Other Ways to Bond With Your Daughter--When She's Ready
If you have established a good foundation in the father-daughter relationship as she was growing up, chances are that once she goes through this phase of adolescence, she'll want to re-establish her father-daughter relationship with you on a more mature level.  You can't force it.  But you might find other ways, when she is ready, to bond with her.

Even though your daughter's adolescence might feel like it sneaked up on you and caught you by surprise, recognize that you might have a blindspot because you want your daughter to remain young.  But it's inevitable, if all goes well, that your daughter will be independent of you one day.

Learning to let go is never easy, but you'll get through this period feeling a lot better if you maintain your sense of emotional balance as well as your sense of humor.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist. 

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 send me an email: josephineolivia@aol.com






Monday, April 22, 2013

Looking Back on Your Relationship With Your Dad Now That You're a Father

How many times did you hear these words from your father, "You'll understand after you have children"?  At the time when your father told you this, you probably felt annoyed and frustrated with him.  But now that you have your own children, you might have a different perspective.

Looking Back on Your Relationship With Your Father
Although it may be hard to admit, looking back on things our parents said to us when we were growing up that was annoying to us back then often makes a lot of sense now.  This is often especially true after you have your own children.  Since I'm focusing on a series of blog articles about fathers, my focus will be on fathers and sons in this article but, of course, women can relate to this too.

When boys become teenagers it's common for them to have a contentious relationship with their fathers.  Being neither a young child nor an adult, being a teenager can be confusing and frustrating for the teenage boy as well as his father.  It can be a time when the father-son relationship becomes strained.

Often, after men get married and have their own children, they gain a new perspective about what it means to be a father.  And, the same men who rebelled against their fathers when they were teens often come to have a new appreciation for the complexities of fatherhood.  They usually develop more of a sense of compassion for their fathers than they had when they were younger.

Looking Back on Your Relationship With Your Dad Now That You're a Father


The following vignette is a composite of many different cases with all identifying information changed to protect confidentiality:

John
When John was a young child, he and his father had a close relationship.  But when he became 15, his relationship with his father became strained.

John wanted to go stay out late with his friends, but his father gave him a curfew of 10 PM, which John resented.  He had other friends whose parents allowed him to stay out later than 11 PM, and John felt resentful towards his father.

From John's perspective, his father was treating him like a baby.  He couldn't wait to be old enough to leave home and go to college.  His father would usually tell him, "You'll understand after you have children of your own."   Whenever John heard this, he would roll his eyes.

When John Was 15, He Often Felt Annoyed With His Father

Years later, when John and his wife had their own teenage son, John realized why his father was so worried about him when he went out.  John's son, Joe, also wanted to stay out late with his friends when he was 15.

But, now that he was a parent, John was very aware of all of the dangers that were out there that his son brushed off.  He also knew what it was like to be 15 and to feel hemmed in by your father.  On the one hand, he wanted his son to have a good time and not resent him.  On the other hand, he knew that Joe lacked the maturity to make good decisions for himself and there was reason to be concerned about his safety.

John gave Joe a curfew knowing that Joe would resent it and that, possibly, Joe would rebel against it.  But John knew that, in the long run, he was doing what was best for his son, even though Joe couldn't appreciate it at the time.

Having to deal with these issues with his own teenage son, John now had a new perspective and appreciation for what it was like for his father back when John was a teen.  He felt a new sense of compassion and love for his father.  He realized now that his father was setting limits for him because he loved him and not because he wanted to be mean, which is what John thought when he was a teenager.

Looking back on his relationship with his father, John realized that many of the things he didn't understand with regard to his father's decisions were much clearer to him now that he had to face many of the same decisions.  So, the next time he called his father, John told him, "I hate to admit it, dad, but you were right.  Now that I have my own son, I understand what you went through as a father."

Being able to talk to his father as one father to another made John feel closer to his father than he had ever experienced before.  From then on, he sought advice from his father about raising children because he realized now that his father really was a loving dad.  And, he was glad his father didn't just allow him to do whatever he wanted to do like his friends' fathers.  He could look back now and appreciate that.

Looking Back on Your Relationship With Your Father With a New Understanding
With maturity and life experience, sons often look back on their relationships with their fathers with a new sense of gratitude and compassion.  Going through this process can bring you and your father closer together.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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: josephineolivia@aol.com

Also see:  Fathers and Sons: Improving Your Relationship With Your Dad










Saturday, April 20, 2013

Fathers and Sons: Improving Your Relationship with Your Dad

In an earlier blog article, I wrote about relationships between mothers and daughters.  In this blog article and in a series of upcoming articles, I'll be focusing on fathers, including many psychotherapy clients' desire to improve their relationship with their father. 

More Men Are Coming to Therapy Now Than in Years Past
There was a time when most clients in my psychotherapy private practice in NYC were women.  Things have changed, and men represent about half of the clients in my practice.  

Improving Your Relationship With Your Father
Of course, men come in for many different reasons, including problems in their relationship or career.  Many men come in because they want to improve their relationship with their dad.  For other men, this issue might not have started as the presenting problem, but it will emerge as an underlying problem, often with men who are having problems with self esteem.

    Improving Your Relationship With Your Father

My experience has been that, generally, people tend to come to therapy after a problem has been brewing for a while and their attempts to try to deal with it themselves haven't worked.  This also applies to men who have problems in their relationship with their father under a variety of circumstances.

Wanting to Improve Your Relationship With Your Father, But Not Knowing How
Even in circumstances where the father-son relationship is strained, generally, clients usually say that they would like to improve the relationship, but they don't know how.  Often, their prior efforts to improve the relationship haven't worked out.

Wanting to Improve Your Relationship With Your Father, But Not Knowing How
A Vignette About a Father-Son Relationship
It isn't possible to address every permutation of problems between fathers and sons, but I'll address one particular problem that I often encounter with psychotherapy clients in the following fictionalized vignette, which represents a composite of many different psychotherapy cases with all identifying information changed to protect confidentiality.

Joe
Joe, who was in his mid-30s, came to therapy because he was having problems with self esteem.  He also had a history of having problems with male bosses, which created problems for him in his career.

When he began therapy, his problems with self esteem created problems for him in his two year relationship with his girlfriend, Alice.  Although he knew there was no objective reason for feeling the way he did, he still struggled with his feelings that Alice would eventually leave him for another man.  

Despite Alice's reassurance that she loved him and she didn't want to be with anyone else, Joe couldn't shake this feeling.  He knew his feelings of insecurity were creating tension in his relationship and that they might bring about what he most feared--the demise of his relationship.

With regard to his career as a sales representative, Joe was successful and he was well liked by his colleagues and his clients.  His boss often praised him for his work, but Joe had a particular problem with his boss:  He had problems accepting constructive criticism.  His initial reaction was to tense up and become defensive. 

Later on, Joe often realized that his boss had a point, and his comments were meant to help Joe, not to hurt him.  But, try as he might, Joe couldn't overcome his feelings  of insecurity and his initial reaction to become defensive.  He knew that, in the long run, this would be a problem if he wanted to move ahead in his career.

Joe's family history was that he was the older of two sons.  His mom stayed at home to raise Joe and his brother and, later on, when Joe was in his teens, she worked as a real estate agent.  Joe's father had his own construction business.

Joe's mother was the more nurturing parent.  Joe described his father as being a man of few words.  He wasn't outwardly demonstrative with his affection.  He was more likely to show his affection by spending time with his sons shooting hoops in the backyard or showing them how to fix things around the house.

Joe remembered that, as a child, even though he always wanted to please his father, he felt like he continually disappointed his father.  His father loved all kinds of sports, but Joe had little interest in sports.  He played hoops in the backyard with his father and brother and joined the Little League to please his father.  

Joe remembered many afternoons where the family drove home in stony silence after a Little League game where Joe missed every pitch in the game.  Joe could feel his father's disappointment, and he felt deeply ashamed.  

It was even more embarrassing for Joe because his younger brother was such a good athlete and loved playing all kinds of sports.  Joe's father and brother bonded over sports, and it was painful to Joe because he felt like such a disappointment to his father.  He wanted desperately to bond with his father the way his brother did, but he didn't know how.

The situation got worse when Joe was in his teens.  At the time, Joe and his brother would often help their father in his construction business.  Whereas his brother really enjoyed learning about the business, Joe wanted to be helpful, but he was bored.  His father assumed that both sons would join him in the business after they graduated college.   Joe didn't know how to tell his father that he had no desire to become part of the family business.

After Joe graduated college, he spoke to his mother about wanting to strike out on his own rather than  becoming part of his father's business.  His mother was understanding and she encouraged Joe to talk to his father about it.  But Joe couldn't face seeing his father's disappointment, so he asked his mother to talk to his father about it.  

After his mother talked to the father, Joe's relationship with his father became even more strained.  He could see that his father was deeply hurt.  The business was passed on from Joe's paternal grandfather and Joe's father was disappointed that Joe, as his older son, wouldn't be a part of it.  Joe and his father never talked about it directly.  

By the time Joe came to therapy, his relationship with his father was strained and awkward.  Joe dreaded going home to visit his parents.  He attended the obligatory family holidays, but he would leave soon after dinner. He and his father barely spoke or even made eye contact, which was painful for Joe and he was sure it was painful for his father too.  He wanted to be able to talk to his father, but  he just didn't know how.

It was clear to both Joe and I that his problems with his girlfriend and the problems he had at work accepting constructive criticism were linked to his history with his father.  Using a combination of clinical hypnosis and Somatic Experiencing, Joe was able to remember a time in his life when he and his father had a better relationship when Joe was about four or five.  

Memories of that time were very poignant for Joe, and being able to access the positive feelings he felt for his father allowed him to write his father a heartfelt letter about how much he loved him and wanted them to have a better father-son relationship.  

To his Joe's amazement, his father was very moved by Joe's letter and told him so.  This began a long process of Joe and his father opening up to each and getting closer.  It wasn't easy to overcome years of tension.  And Joe's father was especially awkward talking about his feelings, but they began the process of repairing their relationship.

As Joe's relationship with his father improved and he began to realize how much his father loved him,  his self esteem improved.  He felt less insecure in his relationships with his girlfriend and his boss.  His only regret was that he wasn't able to improve his relationship with his father sooner.

Getting Help
If you're struggling with your relationship with your father, you could benefit from working with a licensed mental health professional who has experience working with these issues.  Many people don't realize that problems they're struggling with now originate in their early relationships.  Rather than continuing to struggle with these feelings, your life could be so much more fulfilling if you got help.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  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: josephineolivia@aol.com

Friday, April 19, 2013

Trying to Understand Your Father

Historically, psychological theories have placed a lot of emphasis on the relationship between the mother and the child.  This is understandable due to the important role that the mother has from the time the child is in utero, through the formative years of emotional development, and throughout the course of life.  But, in my opinion, until recently,  there has been relatively little attention paid to the role of the father.  

Trying to Understand Your Father


Despite the relative lack of attention to fathers in psychological theory, psychotherapy clients have been coming to therapy to try to understand their fathers for as long as people have been coming to therapy.  So, in my opinion, this is an important topic for many people, and I will be discussing this issue over the course of several blog articles.

Trying to Understand Your Father
Over the years, many clients that I've seen in my psychotherapy private practice in NYC come to therapy because they have unresolved emotional issues about their father.

In many cases, as adults, these clients are trying to develop a better understanding of their father.  In some cases, their father is still alive and they're trying to develop a better relationship with their father.  In other instances, their father is deceased and they're trying to understand who their father was to them and who he was out in the world with others.

Trying to Understand Your Father

In other cases, clients never knew their father at all because he wasn't around when they were growing up.  In some instances, the father was physically present but he was emotionally remote.

Other clients were raised by a single mother and the father was in and out of their lives.  Or, in some cases, the man they thought was their father was not their father, and these clients are shocked to discover this later in life.  Often, these clients don't find out about this family secret until their fathers are deceased and they regret that they have lost the opportunity to have a relationship with the father while he was alive.

As Men Become Fathers, They Often Face Unresolved Emotional Issues About Their Father
For many men, who are now fathers themselves or who are about to become fathers, emotional issues about their own fathers come up.   Some of these issues might not have seemed important before.  But now that they are at the stage of their lives when they are fathers, unresolved emotional issues about their own father are now important.

Unresolved Emotional Issues With a Father

For instance, if they grew up with a father, they might have feelings about who their father was to them and whether they want to be like their father with their own children.  Or, if they never grew up with a father, they might be particularly aware of wanting to spend time with their children because they know what it's like to miss having a father.

When we consider all the possibilities that are involved with father-child relationships, we begin to see the complexity of this topic.  There are so many different types of father-child relationships, including heterosexual and gay fathers and children.

Getting Help in Therapy
Many people want to understand and improve their relationship with one or both parents, but they feel stuck and don't know how to overcome this problem.

If you need to help to work through your problems with one or both of your parents, you could benefit from seeing a licensed mental health professional who has expertise in this area.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.

I've helped many men and women to work through emotional issues about their father.

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 send me an email: josephineolivia@aol.com

Also see articles: 
 Fathers and Sons: Improving Your Relationship With Your Dad
Looking Back on Your Relationship With Your Dad Now That You're a Dad
Fathers and Daughters: Daddy's "Little Girl" Is All Grown Up Now

Thursday, April 18, 2013

Do You Know Your Rights as a Hospital Patient Under the HIPAA Privacy Law?

According to Paula Span of the New York Times, some health care professionals are misinterpreting the HIPAA (Health Insurance Portability and Accountability Act, 1996) privacy law (see link below).

New York Times Blog Article:  What Happens When Privacy Laws are Misinterpreted?
In her New York Times blog article, Ms. Span writes about a woman who is not allowed to accompany her sister even though the sister is asking her to come with her because an ER nurse didn't understand the HIPAA privacy law.

Do You Know Your Rights as a Hospital Patient Under the HIPPA Privacy Law?

These types of misunderstandings can have important implications for patients and their families.  In the example that Ms. Span gave, it was pretty straightforward that the sister who wasn't feeling well was giving permission for her sister to be present.

No doubt there are other situations where it's not as straightforward as this.

It's important to know your rights, especially in a hospital setting.

What Happens When Privacy Laws Are Misinterpreted? - by Paula Span - New York Times

I've included a link for for more information about the HIPPA law below.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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: josephineolivia@aol.com


HIPAA - US Department of Health and Human Services



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Wednesday, April 17, 2013

"Lesbian Bed Death"

The term 'lesbian bed death" was originally coined by Pepper Schwartz and Philip Blumstein who wrote the book, American Couples.  In their book, they wrote that lesbian bed death refers to a phenomenon that occurs in some long term lesbian relationships where one or both women lose interest in having sex with each other.


Lesbian Bed Death: A Myth or Reality?


While it's true that loss of interest in sex can also occur in long term heterosexual relationships, according to the authors of American Couples, it seems to occur with more frequency in lesbian relationships.  However, after their research results were published in the 1980s, their methodology was challenged.

Obviously, there are many happy lesbian relationships where couples continue to have sex and have a healthy relationship. Many lesbians remain in long term relationships, have children, and with the new law in New York that finally allows gay couples to get married, go on to get married.  So, it's understood that many lesbian couples lead happy lives together.


There Are Many Lesbian Couples Who Have Happy, Full Lives Together

But, for the purpose of this blog article, I'm focusing on a particular issue.  And, rather than debating whether lesbian couples' sex lives fizzle out more frequently than heterosexual couples, I'd like to discuss a particular phenomenon that I've observed with lesbian couples who come to see me in my private practice that often leads to lesbian bed death.  I've observed this phenomenon among lesbian couples more frequently than in heterosexual couples or gay male couples.

Given that this is a complex topic, one blog article can't be as comprehensive as this topic deserves. And my observations aren't part of any research, so I can't say that they are generalizable to the lesbian population as a whole, but I think this phenomenon does occur in many lesbian relationships, and it's worth, at least, opening up a dialog about it.

Obviously, the lesbian couples, and couples in general, who come to see me in my psychotherapy practice are couples that are having problems in their relationships, so I can't say they're representative of most long term lesbian relationships because I generally don't see the couples who are in happy relationships.

Long-Term Lesbian Relationships


The following vignette is a composite of many cases, to protect confidentiality, where a lesbian couple in a long term relationship has stopped having sex due to a particular dynamic in their relationship:

Sue and Ann
When Sue and Ann came to see me, they had been together for 10 years.  They came because they had not been sexually intimate with each other in the last three years.  They were familiar with the concept of "lesbian bed death" and, whether it was a myth or not, they were concerned that they had lost the sexual passion that was once so important to each of them.

At first, they both thought they no longer had sex due to long work hours and the pressures of everyday living.  But even when they went on vacation and they had time to be sexually intimate, they no longer felt sexual with each other.

As we explored their relationship dynamic, it became apparent that they were living together as if they were mother and daughter.  Even though they were both the same age (in their late 30s), Sue related to Ann as if Ann was her mother.  Sue liked Ann to behave in a maternal way towards her.  Ann didn't really like being in this role, but she went along with it to make Sue happy.

The problem is that when two people in a relationship relate to each other like mother and child it can feel incestuous to have sex.  So, it wasn't surprising that they weren't feeling sexual with one another.

Now, this phenomenon of a couple behaving as if they are parent and child doesn't just happen with lesbians.  It can occur in heterosexual relationships and in gay men's relationships.  But I've seen it most in lesbian relationships--although, once again, I don't know if we can extrapolate from what I've seen in my psychotherapy practice to make any general statements about lesbian relationshps or lesbian bed death.

What's more important is that couples like Sue and Ann need to be able to communicate with each other about this and decide it they want to change.

While it's true that most long-term romantic relationships have an element of reparenting in them, when this becomes the predominant dynamic, it can have a big impact on the couple's sex life.

Sue and Ann had already decided that they wanted to rekindle their sex life.  So, Sue began her own individual therapy (with another therapist) to work out early childhood issues of emotional neglect.  She had to grieve the loss of not having an emotionally available mother when she was a child.  Over time, this allowed her to treat Ann more like her girlfriend instead of like her mother.

Sue and Ann also became more comfortable in couples counseling talking about what they each wanted in terms of their sex life together.  Over time, they introduced novel ways of relating to each other sexually so that they were able to rekindle the passion in their lives.

Lesbian Bed Death: A Myth or a Reality?
Rather than getting into the debate about lesbian bed death, what's more important is what's going on in your relationship.

Lesbian Relationships:  What's Important is What's Happening in Your Relationship


If you feel that the passion has gone out of your relationship, the first step is to communicate with your partner about this.

There can be so many factors that might be affecting the sex life in your relationship, including internalized homophobia, unresolved family of origin issues, old resentments, health concerns, and numerous other issues.

Getting Help
If you find that you're unable to resolve this problem on your own, you and your partner could benefit from seeing a licensed mental health professional who has experience working with lesbian relationships.

You Can Work Out the Problems in Your Relationship



Marriage Equality


I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who has an office in Greenwich Village.

I work with individual adults and couples, both heterosexual and gay.

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:  josephineolivia@aol.com


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photo credit: Marc Love via photopin cc

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Tuesday, April 16, 2013

The Challenges That Many Gay Men Face at Midlife

Steven Petrow wrote an article for the New York  Times in which he gives advice to gay men in midlife who feel "invisible" in the gay male community (see link below).

As a psychotherapist in NYC, who specializes in working with the LGBT community, I've heard many older gay men talk about the social isolation they feel in the gay male community because they say there is such an emphasis on being young in that community and, as older men, they feel like outcasts.

Add to this that older gay men have often lost many friends and lovers to AIDS and you can begin to understand the challenges that they face.

The Challenges That Gay Men Face in Midlife

Older Lesbians, in General, Tend to Have More of a Social Network
As compared to older gay men, older lesbians, in general, tend to have more of a social network because there isn't such an emphasis on being young, and lesbians aren't as affected by AIDS as gay men.

I would be interested to hear from older gay men, who have experienced this type of social isolation, especially with regard to any useful strategies you would recommend for your peers.

I've included resource links below.

A Gay Man at Midlife Ponders Being Lonely and "Invisible" - by Steven Petrow - New York Times

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

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 send me an email: josephineolivia@aol.com

Resources:

Lesbian Gay Bisexual and Transgender Center - NYC

National Gay and Lesbian Task Force


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Monday, April 15, 2013

Journal Writing Can Help Relieve Stress and Anxiety


Many people find that writing about their thoughts and emotions in a journal helps them relieve stress and anxiety.    Why is this?

Journal Writing Can Help You to Organize Your Thoughts and Balance Your Emotions
When you're under a lot of stress or experiencing anxiety, you can feel overwhelmed by the thoughts and emotions that you might be experiencing.

Journal writing can help you to organize your thoughts and balance your emotions.  Rather than feeling overwhelmed and, possibly, confused, you can capture these feelings in writing and, as you do, the act of writing them down can help you organize your experience.

Journal Writing Can Help You to See the Meaning in Your Experiences
Often, when you write about your experiences in a journal, you begin to recognize that these experiences have meaning for you.  Rather than seeing them as just random experiences, you can begin to understand what meaning they have for you in your life.

When you can see the meaning of a particular experience, even if it's a painful experience, you might begin to understand it's significance in the context of your life.


Journal Writing Can Help Relieve Stress and Anxiety
For instance, if you're recovering from an illness that was particularly challenging for you, by writing about it in your journal, you might recognize that going through this experience helped you to realize how precious life.  It can help you to reflect on how you've been living your life, what you want to do with the rest of your life, and who you want in your life.

Journal Writing Can Help You to Make Connections
When you organize your thoughts in writing and you begin to see the meaning of your experiences in the context of your life, it can help you to make connections to other current and past experiences.

The act of writing down your thoughts can help you to see patterns that you engage in that you might not have recognized before.

Journal Writing Can Help You to Make Connections to Current and Past Experiences

For instance, if you're writing down your feelings about an argument you had with your significant other, as you think about what happened and how you reacted, you might recognize that your tendency is to withdraw emotionally for days at a time after one of these arguments.  This insight can help you to see how this reaction is affecting you and your relationship.  It can also help you to decide if you want to change your behavior.

Journal Writing Can Help You to Talk About Something That's Upsetting You
Organizing your thoughts in writing, giving meaning to your experience, and making important connections can help you to talk about what's bothering you.  It can give you the clarity you need to have an important talk with a loved one.

Journal Writing is Low Cost
All you need is a notebook and a pen or, if you choose to keep your journal online, a secure and private site.

The type of journal you use is a personal choice.   Sometimes, a regular notebook or loose leaf book that's not too fancy is best.  Sometimes, when people buy beautiful journals, the beauty of the journal can make it feel too "precious."  They feel that they can only write "important" thoughts rather than just letting themselves write freely.

Some people like to carry a small notebook around with them to jot down their feelings.  Other people prefer a larger book with unlined pages so they can include artwork like drawings or clippings.  The most important thing is that the journal is private so you feel free to write whatever you want.

Journal Writing Between Therapy Sessions
I often recommend journal writing to therapy clients as a way to capture their feelings between therapy sessions.  A lot can come up between sessions and it's easy to forget if you don't write it down.  Writing in a journal between sessions can also help you to reflect on whatever came up in the therapy session as well as how your thoughts and feelings evolve over time.

A Word About Timing
When considering whether to write about a traumatic event, some people find that it's best for them to wait until a little time has passed before they capture their thoughts in writing because they're not ready to face their emotions about the trauma.

Timing Can Be Important When You Write About Traumatic Events in Your Life

Other people find it helps them to write about the traumatic event soon after it happens.  There's no right or wrong about when you write.  You'll discover what's best for you.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  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 send me an email:  josephineolivia@aol.com

Also see my article: Writing Down the Milestones of Your Life

Sunday, April 14, 2013

Writing Down the Milestones of Your Life

Often, when people feel stuck with where they are in their lives, their disappointment has a way of coloring their perspective about all of their life--not just their current state.  Usually, this is a distorted view based on how they're feeling about themselves now.  

When I'm working with a psychotherapy client whose self perception is distorted in this way, I often recommend that she write down the milestones of her life to help her gain a better perspective.

Writing Down the Milestones of Your Life

What Are Milestones in Your Life?
Milestones are memorable markers in a lifetime.  Milestones can be memorable events or accomplishments.  Whether they're happy or sad occasions, they represent important events in your life.

Why Write Down the Milestones in Your Life?
Milestones usually serve to give you a perspective on how your life has changed over time.  So, if you're struggling at the moment because you're feeling stuck and you feel that nothing ever changes in your life, writing down and reviewing the milestones in your life, can give you a different perspective.

Whether you view the important milestones in your life as being positive or negative or some combination of the two, you can see how your life has changed over time.

You can also gain a perspective that your life will continue to change over time.  This can be a useful perspective if you're currently feeling stuck.

Usually, I recommend that clients write down the milestones on a timeline starting with the earliest memories on the left and moving forward to the right on the timeline.

Which Events Should You Choose to Write About?
It's completely up to you which events you choose.  There's no wrong way to do this exercise.  Even two people who seem to have similar lives, at least from an external perspective, will usually have very different feelings about what's important to each of them, so they'll focus on different milestones.

One of them might include milestones about memorable birthdays, anniversaries, and the first time she fell in love. And the other might include certain accomplishments, like graduating college, getting an article published in a magazine and the death of a parent.

The Milestones That Seem Important to You Often Change Over Time
What's interesting to see, if you do this exercise at various times in your life, is that some of the milestones that you choose will be different at various stages of your life.

For one thing, there are new milestones as time goes on.

But, even more interesting is that, often, when you look at the same events at different points in your life, different events will seem more important at any given time.

The Milestones That Seem Important to You Often Change Over Time

Time as a Factor in Choosing Milestones
This makes sense when we realize that what's important to us changes over time, so what stands out at any given time as a milestone is likely to change with the passage of time.

Time is an Important Factor in How We Perceive the Milestones in Our Lives

That's why writing down milestones at various points in your life can be such an eye opener in terms of how you see yourself and your life.

Milestones to Accomplish Your Long-Term Goals
Writing down milestones can be done retrospectively or as a way to set long-term goals for the future.  So, if you have a particular long-term goal that you would like to accomplish, you can write down the milestones that you would need to accomplish in order to achieve your goal.



Milestones to Accomplish Your Long-Term Goals


Over time, you'll probably discover that these milestones change as you go through the process of working on your long-term goals.  So, it's important to be flexible about making changes.
Feeling More Empowered in Your Life
Whether you use milestones retrospectively or to set goals for the future, writing them down and looking at them over time can help you, especially when you feel stuck in your life, to realize that life is always changing over time.

And when you recognize that life changes over time, you can also feel empowered to take steps to make the changes you would like to see in your life.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

I work with individuals and couples.

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

To set up a consultation, call me at (212) 726-1006 or email me: josephineolivia@aol.com


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