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Monday, July 31, 2017

Psychotherapy Blog: A "Flight Into Health" as an Escape From Therapy

In a prior article, Overcoming the Urge for "a Flight Into Health," I discussed a particular dynamic that comes up with many clients as they talk about childhood abuse.  In this current article, I'm focusing on childhood neglect, which is often more difficult to detect than abuse, and how it can affect relationship choices as an adult (see my articles: What is Childhood Emotional Neglect?What is the Connection Between Childhood Emotional Neglect and Problems Later on in Adult Relationships? and As an Adult, Overcoming the Effects of Childhood Trauma).

"A Flight Into Health" as an Escape From Therapy

In psychotherapy, the term "a flight into health" implies that the client leaves therapy abruptly out of fear, telling herself that she no longer needs therapy.  This often happens when something comes up in therapy that the person is frightened by and not ready to deal with at that point.

This doesn't mean that the client is lying or trying to fool the therapist.  Usually, the client really believes that s/he is ready to leave therapy but, based on whatever came up just before the client decides to leave, the therapist usually knows that this is a defensive gesture on the client's part that comes from fear.

An astute psychotherapist will try to reengage the client to discuss what came up and what might have frightened the client.

If the therapist and client have a good rapport, the client might be willing to come back for another session to explore whatever might have come up to cause him or her to leave.

If the therapist and client haven't established a rapport, the client might not be open to exploring this further because s/he really believes everything is okay or, even if s/he knows things aren't okay, s/he might feel too emotionally vulnerable to explore it further.

A Fictionalized Scenario
Let's take a look at a fictionalized scenario, based on many cases, which deals with a "flight into health" involving a history of childhood emotional neglect:

Mary
Mary started therapy because she wanted to make healthier relationship choices (see my articles: Choosing Unhealthy Relationships: Bad Luck or Poor Choices?Falling In love With "Mr. Wrong" Over and Over Again and Choosing Healthier Romantic Relationships.

She attended a few sessions with a psychotherapist who was recommended to her, and told the therapist about her tendency to get involved with men who were in and out of life.

The relationships usually started out well.  With each relationship, Mary thought there was a possibility for a long term relationship.  But whenever she and the current man in her life would became more serious, the man disappeared.

Mary was very confused and hurt about these dynamics and wanted to stop choosing men who turned out to be so unreliable.

By the second session, the therapist asked Mary to share her family history, and Mary said she thought she had "a very good childhood."  But when she talked about her parents, she was very vague, and the therapist had to ask questions in order to understand the family dynamic.

A "Flight Into Health" as an Escape From Therapy 

As a result of the therapist's questions, Mary alluded to her father being around sometimes and not around other times.  But as soon as she said this, Mary looked uncomfortable and guarded.

She folded her arms in front of her chest, and said, "He was a very good father, even if he wasn't around all the time.  He had a rough childhood himself and I don't hold it against him that he would sometimes have to disappear for months at a time."

Having said this, Mary appeared upset.  She told the therapist that, until now, she never thought about how similar the dynamics were between her and her boyfriends and her and her father.

Since Mary was the one who made this connection, the therapist asked Mary what it was like to realize this.  But Mary was at a loss for words.

Mary remained quiet for a while, and then she said that she needed to leave the session early.  The therapist tried to help Mary to calm down, but Mary told the therapist that she was "alright"--she just needed to leave.  She said she would come in for her session next week.

But a few days before her next session, Mary left a message on the therapist's voicemail, at a time when she knew the therapist wasn't there, saying she was "feeling better" and no longer needed to come in.

Her therapist knew that Mary was bothered by what came up in the prior session, and she tried to reach Mary a few times, but Mary didn't return her phone calls.

Several months later, after being hurt and disappointed again by another man, Mary resumed therapy with the same therapist.

Initially, she was defensive, saying that she didn't want to talk about her family, "After all, my parents both did the best that they could."

When her therapist asked Mary why she left the last time, Mary didn't respond to the question.  She said she only wanted to focus on her current life and what she could do to find a man who would treat her well.

As soon as she said that, she began to sob and told her therapist, "I don't even know why I'm crying."

Her therapist realized that Mary wasn't ready to make any further connections between her father and the unconscious choices she was making about the men in her life.

She knew she had to develop more of a rapport with Mary.

The therapist also knew that  they would need to go slowly, and she would need to help Mary with the anxiety about these issues--otherwise, Mary would become too anxious again and she might take another "flight into health." And next time, she might not come back.

Her therapist suggested that they begin by working on coping skills and helping Mary to develop internal resources.

Based on their work together, Mary began to meditate for 10 minutes in the morning and at night.  She also started a beginners yoga class.  In addition, her therapist helped Mary to visualize a relaxing place so that whenever she felt anxious, she could imagine herself going there.

As the holidays approached, Mary talked about trying to decide if she wanted to go home to see her family or not.  She still maintained that she had "a very good childhood," but she also expressed her strong ambivalence about going home.

When her therapist asked Mary about this, Mary started getting agitated, so her therapist suggested that Mary visualize the relaxing place, do the breathing exercises she taught her, and then they could resume talking about her family--if Mary wanted to do it.  Her therapist made it clear that it was up to Mary if they talked about the upcoming holiday and her family or not.

After Mary relaxed a little, she said she didn't want to make it sound like there were problems in her family home.  She said, "Far from it..."  But she was unable to articulate why she had mixed feelings about going home to her parents.

By the next session, Mary brought in a dream:  She was five years old and she was waiting for her father by the window that faced the street.

In the dream, every time she saw a man walking towards the house, she got excited because she thought it was her father.  But each time the man got closer, she could see that it wasn't her father and she was disappointed each time. The dream ended with Mary waiting and waiting and her father never showed up.

After she told the dream, Mary burst into tears.  She remembered being that little girl by the window many times, hoping to see her father, but he didn't come.

Her therapist was listening and sensing what was going on for Mary and if she would be able to explore this further.  Rather than push her to go somewhere where she wasn't ready to go, she would take her cues from Mary (see my article: The Therapist's Empathic Attunement and The Creation of the Holding Environment in Therapy).

Mary seemed to be in her own world, as if she was back in the dream, "I don't understand why my father came and went like that.  I know he loved us, but he would just suddenly leave without saying a word and we never knew when he was coming back."

Her therapist remained attuned to Mary and stayed close to Mary's experience, reflecting back to her how difficult that must have been for such a young girl.  Mary nodded her head.

By the end of the session, Mary told her therapist that she felt supported by her and she was grateful for that.  She had never felt so supported in her life before.

During the next few sessions, Mary continued to talk about the dream and how it reflected her childhood experience with her father.  She went back and forth between feeling sad and defending her father vs. telling her therapist what a good man he was.

When Mary felt comfortable, they did "parts work" where Mary imagined her younger self sitting next to her and she spoke to her younger self to soothe and reassure her.

Then, her therapist asked her to switch roles and be her younger self and ask Mary for what she needed.  Mary said she felt soothed by these exercises.

When she came in the next time, she talked about a recent dream where she was sitting on the couch next to her five year old self, holding and rocking her.  She said she felt the sadness from her younger self, but her younger self also felt comforted, and Mary was happy that she could do this for her.

Several months later, Mary came in and told her therapist that she thought she felt a little more comfortable now exploring the connection between her relationship with her father and her relationships with the various men that she dated.

Her therapist said they could do this, but she wanted Mary to tell her if she began to feel like she wanted to leave therapy.  She asked Mary to talk about it, if she could, rather than acting on it.

Mary said she would try to do this, and she said she might feel like leaving, but she really wanted to stay and talk about it, especially now that she felt a stronger bond with the therapist.

A "Flight Into Health" as an Escape From Therapy
Gradually, over time, Mary was less defensive and she was able to express her sadness and anger about her father's erratic behavior when she was a child.

She also began to understand how she was unconsciously repeating these experiences in her current life by choosing men who would behave in a similar way as her father.  Unconsciously, she was repeating this behavior in the hope that there would be a different outcome.  This is called repetition compulsion in psychotherapy.

This was a big step for Mary, and it was the beginning of her healing process.

She admitted that talking about this felt a little anxiety provoking, but her anxiety was no where near what it had been.  She also felt good that she could say this, and it didn't feel nearly as frightening as it did when she first made the connection on her own when she began therapy.

Conclusion
A "flight into health" is a reaction that many people in therapy have when something comes up in therapy that causes them to feel anxious and they're not ready to deal with it.

This is usually an unconscious response.  At that point, the client is often convinced that whatever symptoms or problems brought them into therapy are now gone--they're "better" now.

If clients in this situation remain long enough for the therapist to help them to develop the skills to cope with their fear, they can eventually go back, when the client is ready, to explore together what was too frightening before.

When clients leave therapy, as in the fictionalized vignette above about "Mary," they often return at some point because they become aware that their problems aren't really gone.  It just seemed that way because they convinced themselves of it out of fear.

At that point, the client and therapist can strengthen the therapeutic alliance between them by allowing the client to set the pace.

Most skilled psychotherapists know that it's counterproductive to push clients beyond where they can go emotionally, especially if they're not feeling safe.

It's better to take a step back and help the client to develop the necessary internal resources so that if and when the client becomes ready, s/he can feel more confident to deal with whatever comes up, knowing that the therapist is there for them.

Getting Help in Therapy
It's often comforting for clients to know that if they've taken "a flight into health" that they're not the only ones who have ever experienced this.

If you recognize this dynamic in yourself, you can be assured that an experienced psychotherapist understands this dynamic.

Whether you return to your former therapist or decide to see someone else, you're not alone.  You can think of the"flight into health" as a temporary obstacle that a skilled therapist can help you to overcome.

Being afraid and ambivalent about exploring uncomfortable personal problems is normal.

It's also alright to tell a therapist that you're uncomfortable, and the two of you can work together to help you get to the point where you feel more comfortable.

The first step is making the phone call to get help.

Freedom from a traumatic history allows you to live a more fulfilling life.

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

One of my specialties is helping clients to overcome emotional trauma.

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

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




































Monday, July 24, 2017

The Connection Between Abandonment Issues and Codependency

I've written about fear of abandonment and codependency in prior articles (see my article: Is Fear of Abandonment Keeping You in an Unhealthy Relationship?Abandonment Issues Can Get Triggered When Your Therapist is Away,  How Psychotherapy Can Help You to Overcome Fear of AbandonmentOvercoming Codependency: Taking Care of Yourself First and Exploring the Secondary Gains of Codependency).  In this article, I'm focusing on the connection between abandonment and codependency.

The Connection Between Abandonment Issues and Codependency

Fear of being abandoned usually starts at a young age.  When I refer to being "abandoned," I'm not just referring to being physically abandoned--I'm also referring to the more common experience of being emotionally abandoned, which might be less obvious than physical abandonment.

One common outcome of being emotionally abandoned as a child is that that child grows up to be an adult with codependency issues, which includes going from one relationship to the next, choosing unhealthy relationships or isolating out of fear of being abandoned.

A Fictionalized Vignette
The following fictionalized vignette illustrates how being emotionally abandoned at an early age can lead to codependent relationships:

Ann
Ann was raised by her mother and maternal grandmother because Ann's mother was only 15 when she gave birth to her.  She never knew her father.

Ann remembered her mother being very resentful towards her because her mother felt she missed out on a lot adolescent activities because she had to take care of Ann as a child.

When her mother was especially resentful towards Ann, she would tell Ann that Ann was ugly and no boy would ever be interested in her because of her ugliness.

When Ann was older, she understood that her mother was very young, immature and irresponsible and she was acting out by rejecting Ann.  But even though throughout her life people told her that she was an attractive and kind person, Ann believed her mother's words, which Ann had internalized at a deep level at a young age (see my article:  Dynamics of Adult Children of Dysfunctional Families).

Ann married the first young man who was interested in her, and she believed that she was lucky to find a man who cared about her, despite her being "ugly" in her own eyes.

At 18, Ann had no idea what marriage was about.  She just knew that she was glad that she had someone and that she didn't become "an old maid" like her mother told her that she would be.

Ann didn't know her husband, Tom, very well when she married him.  But within a few months of their getting married, she found out that he was an alcoholic and he got angry and loud when he was drunk.  He also became emotionally abusive calling her names and telling her that she was useless.

The Connection Between Abandonment Issues and Codependency

Since Ann grew up with a mother who was verbally abusive with her and she already had low self esteem, she believed Tom.  She thought it must, somehow, be her fault that he was drinking too much, and he did everything he could to blame her.

She believed that if she tried hard enough, she could help Tom to stop drinking.  She wanted to help him to get sober.  But she was also afraid that if she didn't help him, he would leave her and she was very afraid of being abandoned (see my article: Overcoming the Need to Be Everyone's Caretaker).

She did everything that she could think of to help Tom to stop drinking, but it was futile because he didn't want to stop and he kept blaming her (see my article: How to Stop Being the "Rescuer" With Your Loved Ones and Relationships: Why Emotional Abuse Might Seem "Normal" to You).

When she confided in her best friend, Carla, she told Ann that she wasn't to blame for Tom's drinking.      She said to Ann that if she didn't leave Tom, she was going to have a miserable life.  Carla knew because she watched her father drink himself to death and watched her mother and everyone in the family suffer, including Carla.

After three years of being with Tom and watching him lose one job after another, Ann felt emotionally and physically exhausted.  They barely got by on her salary.

By then, Ann was no longer in love with Tom.  Just the sight of him drunk and lying passed out on the couch made her stomach turn.  But she dreaded being alone, so she stayed, feeling helpless and hopeless about her life (see my article: Fear of Abandonment: Are Your Fears of Being Alone and Lonely Keeping You in an Unhealthy Relationship?).

A few years later, Tom was rushed to the hospital and he was diagnosed with pancreatitis due to his excessive drinking.  The doctor told Tom in front of Ann that if he didn't stop drinking, he was going to die.  But it made no difference.  Once he was discharged from the hospital, Tom resumed drinking even worse than before.

One day, when he was in a drunk stupor, he told Ann that he wanted a divorce.  He continued to blame her for his drinking and told her he wanted out of their marriage.

Ann was stunned and terrified of being alone.  Even though, at this point, she hated Tom, her fear of being alone was much greater than her dislike of her husband.

She pleaded with Tom not to leave her.  Tom took that as a sign that he could bargain with her, so he told her that if he was going to stay in their marriage, he wanted to be able to see other women.  He told her that he was too young when they got married and missed out on sowing his wild oats.

After much arguing, Tom said this was the only way he would agree to remain with her, so Ann agreed.  At that point, she felt she would agree to anything so she wouldn't be alone.  She feared she would never meet anyone again.

Soon after that, Tom began spending most of his time in bars where he met other women.  One night, Ann woke up to the sound of Tom and a woman laughing and having sex in the living room.

Ann was furious that Tom would be so disrespectful of her, but she pretended not to know what was going on.

After that, she knew she had to get out of the marriage, but she was still too afraid to be alone.  She felt desperate to leave Tom for another man because she knew if she had someone else, she could leave Tom.

Fast forward 10 years:  Ann divorced Tom and soon after the divorce, she married Bill, who was kind and gentle to her.  He also had a steady job, so all the financial burdens weren't on her shoulders.

But a few months into their marriage, Ann discovered that Bill was a compulsive gambler.  She also found out that he was heavily in debt, something he never revealed to her and he owed money to loan sharks.

Ann bailed Bill out time after time and hoped that he would stop gambling, but his gambling just got worse over time--to the point where Ann couldn't bail him out anymore.

By the time Ann came to therapy, she was in her late 30s and she had been through several dysfunctional relationships.

As she described her relationships to the therapist, the codependent pattern was the same with each relationship.  Ann was continuously trying to rescue these men and blaming herself for their problems.

Before she ended one relationship, she made sure she had the next relationship lined up so she wouldn't be alone, which she still dreaded.  As a result, she got into relationships without knowing these men well.

Her current husband, Jack, was obsessed with Internet pornography to the point where he spent hours online.  Initially, he hid it from Ann, but then one day she discovered his problem when she saw the browser history (see my article: Sexual Addiction: Is a Compulsion For Viewing Pornography Online Ruining Your Marriage?)

Once again, Ann blamed herself for not being pretty enough and sexy enough to hold Jack's attention. She tried dieting (even though she wasn't overweight), she bought sexy clothes and tried doing everything she could think of to be more attractive, but nothing changed.

She came to therapy because she hoped the therapist could help her to save her marriage.  She knew, on some level, that all of these relationships had the same pattern and that this marriage was probably not going to work out.  But she would do anything to avoid being alone.

She was too afraid to leave Jack and she feared he might lose interest in her altogether and leave her.  She wanted the therapist to tell her what she could do to help Jack.

When the therapist asked Ann to focus on herself, Ann became angry.  From Ann's point of view, she didn't have a problem--Jack had the problem.

The therapist listened to Ann patiently and then explained codependency to Ann.  She also recommended a book that Ann could read about codependency.

Ann wasn't happy about this, but she didn't know what to do, so she began reading the book.  After a few pages, Ann realized that this book could have been written for her.  She recognized herself on nearly every page, and she finished the book in a day.

When Ann went for her next therapy session, she was much more open to exploring her early history and it affected her (see my articles: Understanding Why You're Still Affected By Trauma That Happened a Long Time Ago).

At first Ann felt ashamed but, over time, Ann's shame diminished.  She began to understand the connections between her fear of being abandoned, her codependency and her childhood history (see my article: Healing Emotional Wounds in Therapy and Healing Shame in Psychotherapy).

As she continued to work on herself in therapy, over time, she developed more confidence in herself.  She also began to feel that she deserved to be treated better.

Once she was ready to work on her early childhood trauma, Ann and her therapist focused on her emotionally abusive relationship with her mother, and Ann saw parallels between how her mother treated her, how unlovable Ann felt as a child, and her relationships with men.

She regretted how much time went by before she got help, but she also knew she would have probably continued in the same relationship patterns for the rest of her life if she never went to therapy.  And she was grateful that she was feeling better about herself and working through the earlier trauma (see my articles: Overcoming Emotional Trauma Developing Resilience and Becoming Resilient).

Within a year, Ann left Jack and she decided that she would learn to spend some time alone rather than rushing into another relationship.

Although she still had some fear about being alone, she was no longer terrified by it.  She worked in her therapy to appreciate her solitude and, after a while, she was surprised to discover that she wasn't lonely or afraid of being alone anymore.  She actually enjoyed her own company (see my article: Solitude vs. Feeling Lonely and Abandoned).

The Connection Between Abandonment Issues and Codependency

When she was ready, Ann began dating again.  This time she felt much more deserving in terms of what she wanted from a relationship.

When she met a man that she really cared for and who cared for her, she took the time to get to know him before they moved in together.

Conclusion
It can be very difficult to see the connection between fear of abandonment, codependency and earlier trauma, especially if you're so fearful of being alone that you go from one relationship to the next without really knowing the person.

The desperation to avoid being alone can lead to unhealthy relationship choices.

Becoming aware of this pattern is the first step.  Accepting that you have a problem is the next step, and taking action to get help is the step after that.

A skilled psychotherapist, who knows how to help clients to overcome these unhealthy patterns, can help you to understand and overcome these problems.

Part of the work in overcoming these patterns is preparing you to do the trauma work in therapy.  This means helping you to develop the necessary coping skills to work on the emotional trauma (see my article: Developing Internal Resources and Coping Skills).

Therapy to overcome these patterns also involves working through the original trauma, so that it no longer gets played out in your relationship choices.

Getting Help in Therapy
Rather than suffering on your own and continuing to get into dysfunctional relationships, get help in therapy from a licensed mental health professional who has experience helping clients with these issues (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Being able to free yourself from your traumatic history will allow you to live a much more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, and Somatic Experiencing therapist who works with individual adults and couples (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

I have helped many clients to overcome their fear of abandonment, codependency and history of trauma.

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

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


































Monday, July 17, 2017

Your Unresolved Trauma Can Affect Your Children

In a previous article, Overcoming Your Emotional Blind Spots, I began a discussion about how your unresolved trauma can affect your loved ones, including your children.  In this article, I'm exploring this further by delving deeper into the affect of parents' unresolved trauma on their children (see my article: Untreated Emotional Trauma is a Serious Issue With Negative Consequences and Overcoming Childhood Trauma That Affects Adult Relationships).

Your Unresolved Trauma Can Affect Your Child
Most parents want the best for their children and would never intentionally overlook a problem that their children are having.  But having an emotional blind spot usually means that the problem is out of your awareness so that you don't see it.  And if you don't see it for yourself, you often won't see it when it involves your children.

When the blind spot involves unresolved trauma, there's an even greater chance that the problem will go undetected.

A Fictionalized Vignette About How a Parent's Unresolved Trauma Can Affect a Child
The following fictionalized vignette is based on a composite of many different cases with all identifying information changed:

Jane
After years of enduring a chaotic family environment, Jane was relieved to move out of her parents' home when she went away to college.  Her family home was a tense, volatile place where Jane never knew when one of her parents would explode.

Your Unresolved Trauma Can Affect Your Child
Jane was dimly aware that her parents had narrowly escaped from a repressive regime in their native country, but she didn't know what really happened because they refused to talk about it.  Their attitude was that, unlike many of their relatives, they were fortunate enough to leave their country and  they wanted to leave behind everything that happened to them.

Even though her parents' traumatic experiences were never spoken about or even acknowledged, Jane sensed that her parents' emotional volatility was related to their unspoken experiences, but she didn't know how or why.  And since her parents' attitude was that they "left it behind" them and they refused to talk about it, there was no way for Jane to bring this up.

Instead of discussing it, without their realizing it, her parents' earlier experiences came out in other unintended ways, including their constant warnings that the "world isn't a safe place."

Not only were they overly protective of her, from an objective point of view, but they would become hysterical with worry over minor issues, including Jane coming home a little late when she saw her friends.  They were highly anxious people and assumed that she had been kidnapped or murdered.

Aside from their anxiety and volatility, Jane's father would often drink too much.  This exacerbated the volatile situation at home because he would become loud and even angrier than usual.  He and Jane's mother would argue more when he was drunk (see my article: People Who Have Alcohol Problems Often Don't Get the Help They Need).

But whenever Jane tried to talk to her mother about the father's alcoholism, Jane's mother made excuses for him and told Jane that Jane couldn't possibly understand what she and Jane's father had been through in their native country, and the father drank to "take the edge off."

After trying to talk to her mother about it several times, Jane gave up.  She realized that, even though her mother didn't like the father's drinking, her mother felt too conflicted about it to address it with him.   She knew it was  futile to try to talk to her mother about it, so she began to "tune out" whenever her father was drunk, and it didn't bother her as much (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).

Jane felt compassionate towards her parents, even if she wasn't really aware of what happened to them.  But after she graduated college, she moved in with her college roommates, and she only saw her parents occasionally because it was too hard for her to be around them.

When Jane got married and had a baby, she was determined to be different than her parents.  She loved her daughter a lot, and she made conscious decisions that were completely different from what her parents did with her, and she felt proud of herself.

Your Unresolved Trauma Can Affect Your Child

When her marriage began to fall apart, Jane was determined that her daughter, Alice, would not experience the kind of volatility at home that Jane experienced as a child.  She refused to argue with her husband in front of her daughter.

And when she and her husband decided to get a divorce, they spoke to their daughter, who was in her mid-teens by then, together.  They assured her that they both loved her and would always remain in her life.  But Alice took the divorce hard, she began acting out at home, and her grades plummeted at school.

At the recommendation of Alice's guidance counselor, Jane brought Alice to therapy so Alice could work out her anger and sadness about her parents' divorce.

Initially, Alice was uncooperative in therapy, but as she developed more of a rapport with her therapist, she opened up more and began to like going to therapy.

As part of Alice's therapy, both Jane and her ex-husband met with the therapist and Alice once a month.  They were pleased with the progress that Alice was making in therapy and they both wanted the best for their daughter.

During the sixth month of therapy, Alice's therapist requested Jane to come to one of Alice's therapy sessions without her ex-husband.  This surprised Jane, and she wondered about it.  But she decided to wait to ask questions until after she had heard what this was about.

As soon as Jane entered the therapist's office, where Alice was already waiting for her, she sensed that Alice was very tense and uncomfortable.  She avoided making eye contact with Jane when Jane came into the room, which concerned Jane.

There was an awkward silence initially, and then Alice began to speak with an anxious voice.  At first, Jane couldn't understand what Alice was trying to tell her.  It was as if she heard Alice saying words, but she couldn't understand what she was trying to say.

Jane could see that Alice looked very frustrated by Jane's confusion, and Alice turned to her therapist in exasperation.  Then, Alice's therapist told Jane, "Jane, your daughter is telling you that she has a drinking problem."

Jane was stunned and speechless.  Her eyes darted from the therapist to Alice and then back to the therapist (see my article: Dynamics of Adult Children of Dysfunctional Families).

Alice began to cry and then she yelled at Jane, "Mom, I've been trying to tell you for the last year that I have a drinking problem, but it's like you just tune out!  You're not hearing me!  And you're still not hearing me!" (see my article: Ambivalence and Codependence in the Mother-Daughter Relationship).

The therapy session felt unreal for Jane.  It was as if she was having a bad dream and that any moment she would wake up from this dream.

She kept thinking to herself:  This isn't real.  I just have to open my eyes, and this will be over.   But why can't I open my eyes? (see my article: Overcoming Your Denial About Family Problems).

Then, she realized that Alice's therapist was telling Jane about a alcohol rehabilitation center for adolescence that she was recommending for Alice.  She offered to make the referral and could have Alice in treatment by the next day.

Alice explained to Jane that she had recently told her father about her drinking problem, and he was able to hear it.  But Alice was angry that Jane wasn't there for her about this.  Alice needed help and she needed her mother to be there for her now more than ever.

At that point, Jane felt like she was going through the motions.  She felt like a robot.  She consented for Alice's therapist to make the referral and drove Alice to the rehab.

Driving home from the rehab, Jane had to pull over because she felt overwhelmed with emotion.  Alone and frightened, she couldn't stop crying.  She couldn't understand how this all happened to her daughter--she thought she did everything right.

During a family visit to Alice's rehab, Jane met with Alice and her rehab counselor.  Alice had calmed down since the day Jane met with her and her therapist.  She was now able to calmly recount the times when she tried to tell Jane that she was drinking, but Jane seemed to almost go into a trance.

Although it was confusing and emotionally painful for her to listen to this, Jane listened attentively.  She felt guilty and ashamed. She would never have hurt her daughter intentionally, so she couldn't understand why she had not heard her daughter's cries for help (see my article: Healing Mother-Daughter Relationships).

The rehab counselor also explained the possible genetic link between Jane's father's alcoholism and Alice's problems with alcohol.  She told Jane that Alice was depressed and she was "self medicating" with alcohol (see my article:  Adolescent Depression).

When she met with the other visiting families in the rehab, she heard similar stories to her own--many mothers and fathers who had emotional blind spots and didn't hear their children's cries for help.

At that point, Jane realized that she wasn't alone, but she wanted to understand why she had this blind spot and what she could do about it, so she began attending her own individual therapy (see my article:  Psychotherapy to Overcome Your Past Childhood Trauma).

During the course of her individual therapy, Jane learned about intergenerational trauma and how it can affect one generation after the next in unconscious ways.

She realized that she was directly affected by her parents' unresolved trauma without realizing it, and that Alice was affected by her unresolved trauma.

Jane also realized that she coped with her parent's volatility and her father's alcoholism by shutting down or, to use a psychological term, dissociating.

She learned that this was her unconscious defense mechanism as a child to cope with an unbearable traumatic situation and that it worked for her at the time.  But this same unconscious defense mechanism was counterproductive later on in life with her daughter.

As Jane began to work on her own unresolved traumatic childhood experiences in therapy, she began to feel like a weight was being lifted from her.  She also started remembering times when Alice approached her to try to talk about her drinking problem.

These memories, which, until recently were dissociated in Jane's mind, were very painful to remember.  As part of her treatment, Jane apologized to Alice, who was much more forgiving of Jane after she heard about Jane's experiences as a child.

Until then, Jane had never spoken to Alice about these experiences because she didn't want to burden Alice.  But Jane wanted Alice to understand that these were longstanding unconscious problems and that she didn't know that they were affecting her ability to be completely present with Alice.

Jane also worked on self compassion for not being as good a mother as she hoped that she would be.  She developed compassion for herself as an adult as well as for the struggling child she had been in her family home (see my article: Psychotherapy and Compassionate Self Acceptance).

Conclusion
Unresolved emotional trauma often has a way of getting played out from one generation to the next in ways that are unconscious to everyone involved.

It's not unusual to trace back this intergenerational trauma for many years, even though it might be very hard to detect by people who don't have psychological training.

This is one of the major reasons why it's important to get treated for unresolved trauma before it has an impact on your children, their children and generations to follow.

Getting Help in Therapy
We know so much more about psychological trauma and intergenerational trauma and how it can be transmitted to one generation after the next (see my article: The Benefits of Psychotherapy).

Trauma therapists are also uniquely trained to help clients with unresolved trauma to overcome the effects of the trauma (see my article: How to Choose a Psychotherapist).

Rather than continuing to suffer with the effects of unresolved trauma, you can get help from a licensed psychotherapist who is a trauma therapist so you and your family can live more fulfilling lives.

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

As a trauma therapist, I have helped many clients to overcome single event traumas as well as longstanding unresolved trauma.

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

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






















Monday, July 10, 2017

Understanding Why You're Affected by Trauma From a Long Time Ago

I've written many prior articles about fear and trauma, including Trauma: How Childhood Feelings of Being Powerless Can Get Triggered in AdultsOvercoming the Traumatic Effects of Childhood Trauma, Looking at Your Childhood Trauma From an Adult Perspective, and Time Doesn't Heal All Wounds.  The question that often comes up for many psychotherapy clients when they start therapy is, "The trauma happened a long time ago, so why am I still affected by this?"  This is often asked with a lot of critical self judgment followed by a statement to the effect of, "I should be over this already."

Understanding Why You're Affected By Trauma That Occurred a Long Time Ago 

When clients come to me for trauma therapy, I provide them with psychoeducation about trauma and why they're still affected by events that occurred, in some cases, more than 50 or 60 years ago.

Whether the trauma involves a one-time event, like shock trauma or a recurring trauma from the past, it's normal to be affected by it many years later because the trauma hasn't been worked through.

Understanding the impact of trauma can be complicated.  Suffice it to say that trauma remains unmetabolized in the mind and might lie dormant for a long time.  Then, seemingly out of the blue, the trauma can get triggered by something that happens in the present, and it can feel like what happened in the past is happening now--even though it's not.

This can be very confusing for someone who is getting emotionally triggered, so this is why it's so important for trauma therapists to provide clients with psychoeducation about trauma.

A fictionalized vignette
The following fictionalized vignette illustrates how trauma that occurred in the past can get triggered in the present:

Rena
Rena, who was in her mid-60s, began dating Larry after they met at a local community meeting in their neighborhood (see my article: Dating Again in Your 40s, 50s, 60s and Beyond).

Understanding Why You're Affected by Trauma That Occurred a Long Time Ago

Initially, they had a wonderful time together.  They both liked to work out at the gym and go on hikes, and they enjoyed outdoor activities together.

But one day, while they were driving to a camping site, Larry got angry with another motorist who cut him off and began yelling at the driver in the other car.

Since Rena had never seen Larry get angry before, she was shocked at his loud, booming response.

Suddenly, she felt confused and afraid.  She began to tremble uncontrollably and, at first, she couldn't speak.  She felt as if she didn't know where she was.  But when she found her voice, she stammered that she wanted Larry to take her home.

By then, Larry had calmed down and he apologized to Rena for losing his temper, but she felt so ill at ease that all she could say was that she wanted him to take her home, and even this was an effort for her.

Reluctantly, Larry drove Rena home.  He apologized repeatedly and asked Rena what was wrong.  But Rena couldn't respond.  She heard his voice as if it was far away and all she could think was that she wanted to go home and hide under the covers.

She barely remembered opening the door to her apartment and telling Larry that he needed to leave her alone.  Then, she got undressed mechanically, got in bed and fell asleep.

When she woke up the next morning, she felt as if the experience she had the day before was a dream or as if she had been in a fog.  She couldn't figure out why she felt so "out of it" and couldn't remember a time when she felt this way before.

Larry had already left several text messages asking her to call him because he was concerned about her.  He wanted to know if she was alright, and he apologized again.

Rena had no desire to contact him, which she thought was odd.  But she didn't want him to worry, so she texted him that she was alright and she just needed some time to herself.

After a few days, when she got very little sleep and continued to feel uneasy, she went to see her medical doctor.  After her doctor ruled out any physical cause, he told her that she should consult with a psychotherapist.

Rena made an appointment to see a psychotherapist the following week.  In the meantime, she felt like she was just "going through the motions" in her life.  She felt oddly disconnected from people she cared about and things she used to love to do, and she wondered if she was losing her mind.

Several therapy sessions later, after hearing about her family history, Rena's therapist told her that she had been emotionally triggered by Larry's yelling.  The therapist explained that Rena's symptoms were a common trauma response to getting triggered (see my article: Reacting to the Present Based on Your Traumatic Experiences From the Past).

Understanding Why You're Affected by Trauma That Occurred a Long Time Ago

After doing the necessary therapeutic preparation, Rena's psychotherapist used a technique that is used in clinical hypnosis and EMDR Therapy to help Rena to go back to the earliest time when she had a similar reaction in her life (see my article: Overcoming Trauma With EMDR Therapy: When the Past is in the Present).

Rena suddenly remembered how frightened she was as a young child whenever her father lost his temper.

Her father was a big man, who frequently lost his temper and would hit Rena's mother, Rena and Rena's younger brother whenever the father got angry.  He had a loud, booming voice, which was similar in tone and volume to Larry's voice when he lost his temper.  This frightened her.

Afterwards, when Rena and her therapist discussed what came up, Rena was surprised that something from so long ago could be still affecting her now.

Before she came to therapy, Rena hadn't thought about her childhood reactions to her father in a long time.  But now, she remembered hiding under the covers whenever her father was abusive.  Her childhood bed was her sanctuary, and she felt the same after the incident with Larry.

Rena's psychotherapist explained how this type of recurring trauma can lie dormant for a long time, but it was still a part of Rena and the trauma was susceptible to getting triggered now (see my article: Coping with Trauma: Becoming Aware of Emotional Triggers).

Rena's therapist helped her to separate what happened in the past from what was happening now (see my article: Working Through Emotional Trauma in Psychotherapy: Learning to Separate "Then" From "Now."

Rena knew that Larry was not like her father.  Before the incident with the other motorist, she never saw him lose his temper or felt afraid of him before.  But since the incident, her feelings for him were conflated with her feelings for her angry father.

Rena knew, on an intellectual level, that she wasn't in any danger with Larry.  But, on an emotional level, she felt afraid.

Her therapist introduced her to EMDR Therapy (see my article: EMDR and the Brain).  She told Rena that there was no "quick fix" for getting over what happened in the past that was still affecting her now.

Gradually, over time, with EMDR Therapy, Rena began to appreciate how damaging her childhood experiences were, and she was able to work through the trauma related to her father.  She also "uncoupled" her experiences with her father from her experience with Larry.

Eventually, a year of so later, she resumed her relationship with Larry, who, from then on, was much more aware of how he came across.  A few months after they reconnected, they got engaged.

Understanding Why You're Affected by Trauma That Occurred a Long Time Ago
But when he did occasionally get a little angry, he was relieved to see that Rena didn't have a big reaction.  Rena was also relieved that she remained calm, she was able to see that Larry's anger wasn't abusive, and she was also able to react to the present rather than getting triggered by the past.

Conclusion
Traumatic memories can get triggered in the present--even when people don't have present explicit recall for those memories.

Trauma reactions can include emotional and physical reactions as well as sleep disturbance, and other common reactions to trauma.

For the sake of simplicity, the example which I gave in the vignette above is a relatively straightforward example.

But triggers aren't always so straightforward or as easy to link to the past.  Sometimes, the trauma that gets triggered can appear to be very different from the present circumstance.

Often, what links the present to the past can be memories that seem to be unrelated to the present.  The original trauma isn't always so easily detectable at first.  It might not even be a complete memory.  It can be a fragment of a memory--like a sound, smell, emotion or physical reaction.

People who come to therapy to work on unresolved trauma often feel guilty and ashamed of their reactions, as if it's their "fault" that they're experiencing these reactions.  So, an important component of trauma work is developing self compassion (see my article: Having Compassion For the Child That You Were).

Getting Help in Therapy
Most survivors of psychological trauma are resilient people.  They often have a lot of personal strengths.

Their resilience and personal strengths can make it all the more confusing as to why they're unable to overcome traumatic events on their own (see my article: The Benefits of Therapy).

People who suffer with traumatic reactions often feel ashamed of their reactions.  As a result, many people, who suffer with traumatic reactions never get the help that they need, which is unfortunate, especially now that there are effective forms of trauma therapy.

If you are struggling with psychological trauma, you're not alone.  Even though many people don't talk about their struggles with trauma, a significant percentage of the population are affected by psychological trauma.

Rather than suffering on your own, you could benefit from seeking help from a skilled psychotherapist who can help you to work through the trauma so that you can lead a more fulfilling life (see my articles: How to Choose a Psychotherapist and How Talking to a Psychotherapist is Different From Talking to a Friend).

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

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

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
























Wednesday, July 5, 2017

A Happy Life vs. a Meaningful Life

In my prior article, Are You Waiting For Happiness?, I focused on the issue of people waiting for a person, event or something else that is external for them to be happy.  In this article, I'm discussing the issue I began to address in my prior article, happy life vs. a meaningful life (see my article: Living Authentically, Aligned With Your Values).

A Happy Life vs. a Meaningful Life

The Difference Happiness and Meaning in Your Life
Although many people have similar values, what's meaningful to one person can be very different from what is meaningful to another person with the same values.

What Research Says
Stanford research study explored the differences between happiness and meaningfulness and discovered the following differences:
  • Satisfying your desires can provide happiness, but it had nothing to do with a sense of meaningfulness.  The example that they gave was that a healthy person are usually happier than sick  people, but sick people's lives don't lack meaning.
  • While happiness is about the present, meaningfulness links the past, present and the future.
  • Interpersonal connections are important to both happiness and meaningfulness.  And, while spending time with casual friends might add to happiness, deep relationships, which require working on challenges, like family relationships, are more meaningful.
  • People who have a high degree of meaningfulness in their lives often encounter negative issues, which can result in unhappiness.  One example given in the study is that raising children can give a sense of joy, but it's also connected to high stress, which can be meaningful but can also lead to unhappiness.  Another example is that while retirement can lead to happiness because people no longer have the pressure of their jobs, a sense of meaningfulness can drop.
  • Meaningfulness is about expressing and defining yourself and your personal identity, whereas happiness is getting what you want.  A meaningful life is connected to a valued sense of self and your purpose your life and community.
  • You can find meaning in life and still be unhappy.
  • You can be happy and yet lack meaning in your life.
  • Happiness without meaning often leads to a shallow and self-centered life.
  • A meaningful life gives you a sense of purpose and direction where you are aligned with your values.
Getting Help in Therapy
Understanding what is meaningful to you is a process--it's not a one-time event that you settle once and for all.

In addition, what is meaningful to you at one stage in your life could be different from what it would be at a different stage as life changes and you continue to grow as a person.

Discovering what is meaningful to you can be challenging at various points in your life and might conflict with what might make you happy at the moment but would provide meaning in the long run.

Working with a skilled psychotherapist can help you to identify what is important to you, help you to develop insight into yourself and work through these issues.

These are issues that most people struggle with at some point in their lives.  Rather than struggling alone, you could get help in therapy so you can lead a more meaningful life.

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

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

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