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Wednesday, January 31, 2018

Movies: Infidelity, Triangulation and Betrayal in "Lover For a Day"

The last film of the Philippe Garrel's French trilogy, Lover For a Day, deals with many of the same themes of his prior films, including emotional intimacy, infidelity, triangulation, jealousy and betrayal (see my articles about these topics, including: The Connection Between Infidelity and the Need to Feel DesirableRelationships: Coping With InfidelityCoping With Secrets and Lies in Your Relationship and Getting Involved in a Love Triangle).

Movies: Infidelity, Triangulation and Betrayal in "Lover For a Day"

After a breakup, Jeanne, portrayed by the filmmaker's daughter, Ester Garrel, who also appears in Call Me By Your Name, leaves the apartment that she shared with her boyfriend.  Distraught, she heads to her father's nearby apartment because she needs a place to stay.

When she arrives at her father's apartment, Jeanne assumes that her father, Gilles, is alone. She tells Gilles, portrayed by Eric Caravaca, about the breakup.

Then, she is surprised to see a woman's makeup case on her father's kitchen table.  A little thrown by this discovery, she asks her father if she has come at an inconvenient time.  Gilles, a loving father who is a philosophy professor, responds by with reassurance that she is not disturbing him, he makes up the couch for her and tells her to try to get some sleep.

The next morning after Gilles leaves for work, Jeanne meets Gilles' girlfriend, Adriane, portrayed by Louise Chevillote, who is a student at Gilles' college.

Both Jeanne and Adriane are the same age, 23, and Adriane asks Jeanne if she minds that her father is with a woman who is the same age as she is.  Although Jeanne says she doesn't mind, this questionable based on her actions later on in the film.

Adriane tells Jeanne how she seduced Gilles, even though he resisted at first.  She also reveals that she has been living with Gilles for a few months, and they are keeping their relationship a secret at the college where Gilles is a professor.

Thus begins a triangle between Jean, Gilles and Adriane that raises questions about gender issues, infidelity, family loyalty, betrayal, secrets, and infidelity.

Both Jeanne and Adriane keep each other's secrets from Gilles in what appears to be a friendly alliance between the two women.  But appearances are deceiving.

Are the betrayals in the film conscious or unconscious on the characters' parts?

It's difficult to say, and the characters in the film might not know themselves.  Such is the power of the unconscious mind that motivates behavior that might only be clear after the fact, and maybe not even then.

I won't give away the rest of the plot because I think this movie is worth seeing.

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

I work with individual adults and couples.  

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, January 29, 2018

How to Avoid Last Minute "Doorknob Comments" at the End of Your Psychotherapy Session

In prior articles, I discussed common issues in psychotherapy, including: How to Make Your Psychotherapy Sessions a Part of Your Life Between Sessions,  Psychotherapy as a Co-Created Process Between You and Your Psychotherapist and How Psychotherapy Helps You to Expand Your Inner Emotional Awareness.  In this article, I'm discussing another common issue, "doorknob comments" at the end of the therapy session, the problems with these comments, and how to avoid them in order to get the most out of your therapy (see my article: Getting the Most Out of Your Psychotherapy Sessions).

How to Avoid Last Minute "Doorknob Comments"

What Are Doorknob Comments?
Doorknob comments got their name from clients who literally have their hand on the doorknob as they're leaving their psychotherapist's office when they make a last minute comment, which is sometimes a "bombshell" comment ("I've decided to end therapy, so today is my last session" or "I was fired from my job and lost my insurance, so I can't continue in therapy").

Sometimes these comments are things that clients say at the end of their session in a vague way when there's no time to talk about it.

Why Do Clients Make Doorknob Comments?
Client who make doorknob comments are often too anxious or ambivalent to talk about these issues when there's time to discuss it, like at the beginning of their session, so they bring it up at the last minute as a parting comment.

Some clients, who make doorknob comments, are either consciously or unconsciously testing the boundary of treatment frame to see if their psychotherapist will give them more time beyond the therapy hour.

How Do Psychotherapists Handle Doorknob Comments?
There's no one standard way for psychotherapists to handle a comment that the client makes as s/he is walking out the door.  That being said, most experienced psychotherapists will recommend that they discuss the issue at the next session, including an issue about ending therapy.

There are a few very good reasons why it's best to maintain the treatment frame by not extending the therapy session:
  • On a practical level, many psychotherapists see clients in back-to-back sessions, so if they extend the therapy hour for one client, they would keep all subsequent clients waiting for their sessions.  This isn't to say that there aren't rare instances when a therapist might exceed the time limit but, for the most part, it's not fair to the other clients.
  • On a clinical level, it's not helpful to the client making the doorknob comment to extend the therapy hour because s/he doesn't get an opportunity to talk about a topic that requires more time.  Also, the client doesn't learn to communicate in an effective way with his/her therapist.
  • Equally important, the psychotherapist and client need time to explore the underlying issues which led to the client waiting until the last minute to bring up something important:
    • Was s/he anxious or afraid to bring up the topic?
    • Is there a problem in the client-therapist relationship? Is this problem a pattern in other relationships?
    • Is there a connection to the client's family of origin issues?

How to Avoid Last Minute Doorknob Comments
  • Think About the Issue Before the Therapy Session:  If you know you have a topic to bring up in therapy that you feel uncomfortable talking about, think about the issue beforehand.
  • Prepare to Talk About Issue in the Therapy Session: If it's an especially difficult subject for you, you would probably find it helpful to make notes before the session and bring your notes to the session.  You might not need the notes, but they're handy to have in case you get too anxious and forget what you want to say.
  • Bring Up the Topic at the Beginning of the Therapy Session:  You're spending your time and money to attend psychotherapy, and you deserve time to discuss an issue that's important to you rather than shortchanging yourself by bringing it up at the end of the session when there's no time to talk.  If it's a big issue ("I just found out that my mother has cancer"), you might be discussing this issue for many sessions.  If it's a matter of you're wanting to end therapy, there is such a thing as the "termination process" where, depending upon how long the client has been in therapy with his or her therapist, the client and therapist spend at least one or more sessions talking about ending therapy, summarizing the work, talking about whether the client met the goals that s/he might have set at the beginning of treatment, discussing the therapeutic relationship, and so on.

Conclusion
Last minute doorknob comments are common in therapy, especially with clients who are anxious or ambivalent about the topic.

Often, it's a matter of the client not knowing how to bring up the topic and waiting until the end of the session to blurt it out.  This is especially true for clients who are new to therapy.

Some clients, knowingly or unknowingly, try to test the boundaries of the treatment frame with regard to the end time for the session by making last minute vague comments or dropping "bombshell" comments.  In most cases, when this occurs, experienced psychotherapists will usually recommend that they talk about the issue at the next session.

When you wait until the end of the session to bring up an important issue, you're shortchanging yourself by not allowing enough time to discuss the issue at length.

Often, aside from anxiety and ambivalence, there can be earlier underlying issues for the client that are related to making last minute comments.

These underlying issues need to be explored by the client and therapist to understand the origin of the problem and how best to resolve it.

Getting Help in Therapy
Asking for help can be difficult (see my articles: Tips For Overcoming Your Fear of Asking For Help).

Psychotherapy provides an opportunity to free yourself from problems that are preventing you from maximizing your potential.

If you've tried on your own to resolve your problems and you've been unable to do it, you could benefit from working with a licensed mental health professional who can help you to work through your problems (see my articles: (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

When you have worked through the problems that keep you stuck, you can lead a more fulfilling and meaningful life.

About Me
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.





















Sunday, January 28, 2018

How to Make Your Psychotherapy Sessions a Part of Your Life Between Sessions

In an earlier article, Getting the Most Out of Your Psychotherapy Sessions, I addressed certain issues related to starting therapy, including: different types of therapy, how to choose a psychotherapist, ethical issues in therapy, and so on.  In this article, I'm expanding upon a topic that I began discussing in that article and a subsequent article, which is how to make your psychotherapy sessions a part of your life between sessions.

How to Make Your Psychotherapy Sessions a Part of Your Life Between Sessions

What Comes Up in a Psychotherapy Session Doesn't End When You Walk Out of Your Therapist's Office
Psychotherapy is a process.  It's not like taking a pill to make your headache go away.  Things unfold over time.

Many psychotherapy clients, especially clients who are new to therapy, leave their psychotherapist's office at the end of the session and immediately divert their attention to something else.   As a result, they become distracted and forget what they discussed in their session.

When clients forget what was discussed in their therapy sessions, the therapy sessions are relegated to a specific time and place rather than being a part of the rest of their life.  They leave behind whatever "pearls" they gained in therapy, and they will probably need to go over the same material again and again to remember those "pearls."

While I understand that people are busy these days, I recommend that clients take time after each session to reflect on what came up in session and any thoughts, feelings, memories, dreams or daydreams that might come up as a result of the session.

One way to keep your therapy sessions alive and to integrate it into the rest of your life is to write in a journal soon after the session is over.

This doesn't have to be a time-consuming process and the journal entries don't need to be long.

How to Make Your Psychotherapy Sessions a Part of Your Life Between Sessions

Writing After Your Therapy Sessions:
  • Enables You to Reflect on Your Session:  A therapy hour is a relatively short period of time as compared with the rest of your life, especially if you're attending therapy once a week.  It's easy to lose awareness of whatever you gained in that session if you don't take the time to reflect on it and write it down.  There might also be things that come up for you between sessions--a memory, a dream, a question about what your therapist said, something you didn't understand or something that bothered in you in the session (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).  If you don't write these things down, you're likely to forget them.
  • Creates an Increased Awareness of How You're Changing (or Not Changing):  When you spend time reflecting on and writing about your therapy sessions, you can develop an increased awareness of how you're changing (or not changing) in therapy over time.  This doesn't mean that you can expect big transformations in only a few sessions but, over time, you would benefit from assessing your progress in therapy.
  • Enables You to See Where You Might Be Creating Obstacles For Yourself: It's common that when people come to therapy because they want to make changes in their life, they experience a certain amount of ambivalence about making those changes.  Change can be challenging, even if people really want it--especially if people really want it because there's more at stake.  Due to their fear of change, many clients often unconsciously create obstacles for themselves in therapy and in other areas of their life.  By capturing thoughts and feelings in a journal, clients can see over time if they're repeating certain self defeating patterns that are getting in the way of their psychological growth (see my article: Making Changes: Are You Creating Obstacles For Yourself in Therapy Without Even Realizing It?).
  • Allows You to Take Your Share of the Responsibility For Your Therapy:  As I mentioned in an earlier article, psychotherapy is a co-created process between the client and the therapist.  There are certain parts of therapy that your therapist is responsible for including providing an emotionally safe environment for you to open up in therapy (see my article: How Psychotherapists Create a "Holding Environment" in Therapy).  But there are also aspects of your therapy are your responsibility. As mentioned above, if you're creating obstacles for yourself by not doing your part in therapy, like doing homework between sessions (if your therapist gives homework), then you're not taking responsibility for your part in therapy.  If you're keeping a journal, you can see how often this occurs, own it, discuss with your therapist, and change it.
  • Increases Your Awareness of How Your Unconscious Mind Continues the Process :  Even when you don't consciously reflect on your psychotherapy sessions, the work continues to be done between sessions in your unconscious mind.  You might dream or daydream about something you spoke about in therapy or a thought suddenly pops into your mind, not so coincidentally, that is related to a discussion you had with your therapist.  Your dreams, daydreams, thoughts and feelings are important.  They reveal how your unconscious mind is continuing to process the material.  If you don't journal about it, you will have a harder time making these psychological connections.  
  • Increases Your Awareness of the Different Parts of Yourself: In an earlier article, I discussed self states as parts of yourself that are constantly shifting. When you spend time writing in your journal between therapy sessions, you can see how the various parts of yourself affect you, which parts come to the surface in different situations and how these parts interact to help or hinder you (see my article: How Your Shifting Self States Affect You For Better or Worse).
  • Helps You to Develop Increased Awareness About How Life Around You is Always Changing: There's an old saying by the ancient Greek philosopher, Heraclitus, which is "You could not step twice in the same river."  The significance of that quote is that, just as the river is ever flowing and never the same, life is ever changing.  If you take the time to write about it, you will gain a new perspective and appreciation for how life is constantly changing.
Heraclitus: You Cannot Step Twice in the Same River
  • Provides You With a Personal Record About Yourself Over Time:  It's easy to forget how you were when you began therapy.  Your therapist can help you to gain insight into how you were at the start of therapy as compared to how you are now.  In addition, if you keep a journal about your experiences in therapy, you will have a personal record about yourself over time.

Conclusion:
As I mentioned earlier, the therapeutic process doesn't end when you walk out of your psychotherapist's office.

You're spending valuable time and money for your therapy sessions, so if you want to get the most from your therapy, take the time to reflect on your sessions and write down whatever comes up for you.

By taking the time to keep a journal about your sessions and whatever comes up between sessions, your therapy will become integrated in your life and you will get much more out of your sessions.

Not only will keeping a journal between sessions allow you to be more self reflective and aware of your own psychological process, it will also help you to develop new insights into yourself and the direction you want your therapy and your life to take going forward.

Getting Help in Therapy
Attending psychotherapy is a unique experience (see my article: Psychotherapy: A Unique Intersubjective Experience).

It takes courage to seek help in therapy and to change (see my article: Developing the Courage to Change).

Whether you want to gain psychological insight into yourself, make changes in your life or work through a traumatic experience, working with a skilled psychotherapist can be a life-changing experience (see my articles: (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

The first step, which is making a phone call to set up a therapy consultation, is usually the hardest step, but it can also be the first step to transforming your life.

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

I work with individual adults and couples.

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

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











Saturday, January 27, 2018

Developing a Compassionate Understanding of Your Maladaptive Coping Strategies

In prior articles, I've discussed various unhealthy coping strategies (see my articles about changing maladaptive coping strategies that no longer work, including avoidancepassive behavior and controlling behavior).  In this article, I'm focusing on the importance of developing a self compassionate understanding of your maladaptive coping strategies and how psychotherapy can help (see my article: Psychotherapy and Compassionate Self Acceptance).

Developing a Compassionate Understanding of Your Maladaptive Coping Strategies

Why Is It Important to Develop a Compassionate Understanding of Your Maladaptive Coping Strategies?
Maladaptive coping strategies often develop when a child or an adult is in emotional pain, their coping skills are inadequate or poor, and they don't know any other way to relieve their emotional pain.

When people develop unhealthy coping strategies to relieve pain, the main intent is to relieve the emotional pain so it won't hurt so much, even if the strategies are unhealthy.  The main intent is not to develop unhealthy coping skills per se.

The problem with these strategies is that, although they might work temporarily, they don't resolve the problem and they usually add to the existing problems and make things worse.

For instance, if a child is raised in a very punitive environment where his parents constantly punish him for even minor behavior problems and withdraw from him emotionally, he will grow up feeling ashamed.  He will internalize a feeling of being a "bad person" or an "unlovable person," even when that's not the intent of his parents (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

The emotional pain of feeling like a bad person or feeling unlovable is difficult to bear, so he will try to find ways to relieve that emotional pain that might work in the short term, but usually cause other problems in the long term.

For instance, he might numb himself emotionally or use alcohol to blunt the emotional pain.  Because the alcohol "works" temporarily to numb him to his pain, this becomes a powerful reinforcement to keep doing it, even if he knows that it can cause him physical and emotional harm and possibly ruin his interpersonal relationships and career in the long run.

Even though he knows there could be serious consequences if he continues to drink excessively, he might bargain with himself, "I'll stop after New Year's Eve" or "I'll just have one more drink and then I'll stop."  This gives him temporary relief from the fear of long-term consequences to his drinking.

But, as previous mentioned, a maladaptive coping strategy compounds the original problem. For instance, a spouse might threaten to leave the relationship or a boss might give a warning that the behavior is interfering with work.  Then, the person who is using the temporary fix knows he needs to do something else because life is becoming unmanageable.

At that point, the problem is often that shame gets in the way of getting help.  The person is now ashamed of being someone who is a bad person or an unlovable person and, in addition, he is ashamed of what he has been doing to relieve his emotional pain (see my articles: Are You Afraid to Start Therapy Because You Feel Ashamed? and Overcoming Shame).

This is where learning to be self compassionate can help to mitigate the shame so that the individual can seek help rather than continuing to avoid help due to the shame.

It's important to understand that being self compassionate doesn't mean being irresponsible or unaccountable to yourself or to others.  Self compassion isn't an excuse to continue harming yourself or others.  It's a first step in being able to resolve your problems.

A Fictional Vignette: Developing a Self Compassionate Understanding of Maladaptive Coping Strategies
The following fictional vignette illustrates how being self compassionate can allow an individual to overcome shame so he can get help.  Although I'm using alcohol as an example of the maladaptive coping strategy, the strategy could be emotional numbingoverspending, overeating, compulsive gambling, sexual addiction, and so on.

Ron
Ron was the youngest child by far of three children.  By the time he was old enough to go to school, his older siblings were already out of the house so, in effect, he was raised as an only child by two parents who were emotionally neglectful and punitive (see my article: What is Childhood Emotional Neglect?)

By the time he was five, he already knew that he was an unplanned child, an "accident," as he overheard his mother say to a friend one day when she was complaining about how tired and harried she felt from raising a small child at her age.

Ron never told anyone what he heard, but he would often sit by himself in his room feeling sad about being a "burden" to his parents (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).

He tried in every way that he knew how to be a well behaved child, to do well in school, and not to cause problems for his parents.  But both parents had little tolerance anymore for a young child, and minor things would irritate them so that they would punish Ron.

They preferred for Ron to play in his room quietly so he did not disturb them.  But sometimes, when he was playing with his toys, he would get so enthusiastic that he would raise his voice a little.

If his parents were in the dining room, they wouldn't hear him, but if they were in the living room, they could hear him playing and it would annoy them.  At that point, either his mother or father would come into his room and take away the toys he was playing with and tell him to do something where he could be quiet, like reading or drawing.

When he would cry after his parents took away his toys, they would tell him to "Stop being a cry baby" or "You're too sensitive."

As a result, Ron grew up feeling that, in order not to get punished or ridiculed by his parents, he had to make himself "invisible" and also not show his emotions.  Without Ron realizing it, this eventually led to emotional numbing by the time he got a little older.  He numbed himself emotionally to the point where he wasn't sure what he felt at any given time.

By the time he was a teenager, he learned to pretend to feel happy in order to fit in with his peers.  Most teens who knew him thought of him as being a happy person, but Ron really felt empty inside (see my article: How to Stop Pretending to Feel Happy When You Don't).

When he went away to college, he began drinking heavily with other students.  He liked drinking because he felt uninhibited and free.  Since he was shy, the alcohol acted as a social lubricant for him so that he felt free enough to tell jokes at parties or ask young women out on dates (see my article: Overcoming the Temptation to Use "Liquid Courage" in Social Situations).

When his alcohol abuse began affecting his grades, he cut back enough so that he improved his grades and graduated with a high grade point average.  During his senior year, he was recruited by a large corporation in New York City, and he and some of his college friends rented an apartment together.

Developing a Compassionate Understanding of Your Maladaptive Coping Strategies 
Even though alcohol "worked" for Ron temporarily to relieve his feelings of low self worth, he began to realize that he needed to drink more to feel good.  He was intelligent and well informed enough to know that continuing to abuse alcohol could have negative emotional and physical effects.  But he didn't know what else to do not to feel overwhelmed by his feelings of inadequacy.

A couple of his roommates, who were close friends, stopped drinking and urged Ron to get help.  But Ron felt too ashamed.  He thought of his drinking as a "moral failing" rather than a maladaptive coping strategy.

Then, one day, one of his roommates, Tom, invited his Uncle Jim to the apartment to talk to Ron. Jim was a recovering alcoholic.  He told Ron how he started drinking and how he stopped by getting help.

It turned out that Jim's early childhood history was similar to Ron's in that Jim also grew up in a home with punitive parents where he felt he was a burden to them.  He also learned to numb his feelings and eventually developed a drinking problem in college.  But his life turned around after he was arrested for DWI and mandated to therapy.

Since that time, which was 20 years ago, he said, he remained sober.  But he also said that he knew plenty of people with alcohol problems who don't get the help they need and whose lives spiraled down (see my article: People Who Abuse Alcohol Often Don't Get the Help They Need).

Ron listened to Jim tell his story, and he was amazed.  It was the first time that he had ever heard anyone describe problems that were so similar to his.

Jim also talked about how ashamed he was at first when he started therapy.  He said that he was also ashamed of himself from the time he was a young child because he felt he was unlovable.  As a child, he thought to himself, If my own parents think of me as a burden, then I must be a bad person.

After he began therapy, Jim explained, he learned to be more self compassionate at the same time that he was becoming more responsible and accountable for his life.  He realized that no one had ever taught him healthy coping skills so, before he went to therapy, he did the best that he could.

He learned in therapy that his shame contributed to his emotional numbing and drinking and it made him feel even more ashamed of himself (see my articles: How Psychotherapy Helps to Heal Shame and Working in Therapy to Accept Your Emotional Needs).

He also learned to develop healthy coping skills and to work through his early childhood trauma (see my article: Developing Internal Resources and Healthy Coping Skills in Therapy and Resolving Childhood Trauma in Therapy).

Developing a Compassionate Understanding of Your Maladaptive Coping Strategies

Just hearing that someone else could understand how he felt was a relief to Ron.  He accepted Jim's invitation to go to an Alcoholics Anonymous (A.A.) meetings.

Ron also sought out help from a licensed mental health professional to learn better coping strategies and to work on unresolved childhood trauma that was affecting him as an adult.

Conclusion
People, who grow up in punitive families where they feel unlovable, often internalize these feelings and believe them to be true.

If they haven't learned healthy coping skills, they will most likely develop unhealthy coping skills to avoid feeling the emotional pain.

Unfortunately, shame often becomes an obstacle for getting help, including the original shame of feeling unlovable as well as the shame that develops as a result of unhealthy coping skills.

People often feel alone with these problems, especially if they don't know anyone who has had similar problems.  They might feel defective and that they're the only ones who feel this way.

Getting Help in Therapy
As I've mentioned to in prior articles, it takes courage to get help to change (see my article: Developing the Courage to Change).

It's often the case that people wait until the pain of not dealing with their problems outweighs the shame of getting help.  At that point, they might be in an emotional crisis, but a crisis can bring about positive changes in life with help in therapy (see my article: How a Crisis Can Bring About Positive Changes in Your Life).

A skilled psychotherapist can help you to develop healthy coping skills and also assist you to work through the emotional trauma that led to your developing the unhealthy coping strategies in the first place (see my articles:  The Benefits of Psychotherapy and How to Choose a Psychotherapist)

Once you have learned healthy coping strategies and worked through the underlying emotional trauma, you have an opportunity to lead a more fulfilling and meaningful life.

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

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

I work with individual adults and couples and I have helped many clients to develop healthy coping skills and work through emotional 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.
























Friday, January 26, 2018

Self Abandonment - Part 2: A Clinical Vignette

In my last article about self abandonment I defined self abandonment and the circumstances where this dynamic occurs.  In this article, I give a fictional clinical vignette to further illustrate these dynamics.

Self Abandonment: A Clinical Vignette

As I mentioned in my prior article, some of the ways that self abandonment can take place include the following: a pattern of ignoring your well-being to focus on others, placing your well-being in the hands of others and them for your happiness, and judging yourself harshly.

A Fictional Clinical Vignette About Self Abandonment

Nina
Nina started psychotherapy in an emotional crisis.

Her three year relationship with Mike ended a month prior to her starting therapy when Mike told her that he no longer wanted to be in a relationship.

He denied that he was interested in anyone else. He said he felt pressured by Nina to take the next step in their relationship and he wasn't ready to do that.  He said he wasn't sure if he would ever be ready with her or anyone else.

Self Abandonment: A Clinical Vignette

Nina felt devastated when Mike broke up with her.  At 35, she had hoped that they would eventually get married and have children.  Now she wondered if she would ever be married and have a family.

After the breakup, Nina couldn't sleep, she couldn't concentrate at work, and she often cried throughout the day.

All she could think about was Mike and how much she wanted him back.  She tried to reach Mike by phone, text and email to try to reconcile their relationship.  But after he broke up with her, he refused to respond.

Nina felt she couldn't talk to anyone about the breakup because, after they met Mike a few times, her friends warned her that Mike would hurt her.

They thought he was narcissistic, and they disliked that he was openly critical of Nina in front of them (see my article: Could It Be That Your Friends See Things About Your Significant Other That You Don't See? and Belittling Behavior in Relationships).

Her friends also thought he was immature and irresponsible when he told them that he wasn't showing up for work because his boss didn't give him the praise he felt he deserved.  His attitude resulted in his losing one job after another.

Nina defended him to her friends by telling them that they didn't understand him.  She saw a side of Mike that no one else saw and she thought they were being harsh.

After listening to Nina complain to them and then defend him many times, her friends were tired of of it.  They told her that it would be better for her not to talk about it with them anymore.

Before the breakup, Nina continued to see her friends, but she stopped talking about her relationship with Mike and, at her friends' request, she no longer included Mike in their get-togethers because they didn't like him.

Now, Nina felt alone and miserable.  She couldn't believe this was happening to her, and she didn't understand why Mike broke up with her.

It was true, she said, she suggested that they move in together.  But she didn't expect Mike to have such a strong reaction to their conversation, "It's not like I gave him an ultimatum."

Nina's psychotherapist focused on helping Nina to get through this difficult time (see my article: Developing Internal Resources and Coping Strategies).

She taught Nina how to develop a wind down routine before going to bed so she could sleep better.  She also taught her how to do a relaxing meditation, a breathing exercise, and recommended that Nina keep a journal to express her feelings.

Once Nina was more on an even keel emotionally, Nina and her therapist explored the dynamics in her relationship with Mike with an emphasis on Nina's self defeating behavior.

Her psychotherapist explained the concept of self abandonment to Nina and tried to help Nina to develop insight into her own behavior.  But, initially, every time that her psychotherapist talked to Nina about how she didn't take care of herself, Nina would try to talk about Mike and what he said and what he did.

In a gentle, tactful way, Nina's therapist kept bringing the focus back to Nina and pointing out how Nina kept avoiding looking at her own behavior because she was so focused on Mike (see my article: Overcoming Codependency: Taking Care of Yourself First).

Nina wasn't accustomed to focusing on herself.  At first, she felt like she was being selfish and self centered (see my article: Is Self Care Selfish?).

But, over time, Nina began to understand how focusing on Mike was a way to avoid looking at herself and that she wouldn't develop insight into what happened until she was able to look at her own dynamics in the relationship (see my article: Changing Maladaptive Coping Strategies That Don't Work: Avoidance).

Gradually, as the therapy progressed, Nina realized that in her relationship with Mike and in her prior relationships, not only did she focus on her boyfriend, she abandoned her own needs and gave away her personal power (see my articles:  Relationships: Are You Giving Away Your Personal Power? and Taking Back Your Personal Power).

Over time, Nina also realized that she wanted so much to be in a relationship that she avoided the warning signs that were there all along and that her friends could see more objectively (see my article: Are You Ignoring the Early Warning Signs in Your Relationship?).

Nina and her therapist were able to trace back these ingrained dynamics to Nina's family history.  As the oldest, Nina became a parentified child to a single mother who turned to Nina for mothering from the time Nina was a young child.  She also expected Nina to take care of her younger siblings.

Nina worked through the trauma of her emotional neglect as a child (see my articles: What is Childhood Emotional Neglect? and  What is the Connection Between Childhood Emotional Neglect and Problems Later On in Adult Relationships?).

She also talked to her friends about the breakup and what she was learning about herself in therapy.

When she began dating again, she didn't allow her fears to get in the way of being more discerning when she met men (see my article: Choosing Healthier Relationships).

Although it was difficult for her, Nina also learned to like herself more and to take better care of herself.

Conclusion
Self abandonment can occur in many different ways.  It often involves codependency in relationships, as illustrated in the fictional vignette above.

Psychotherapy can help people who engage in this self destructive dynamic to develop insight, learn how to take better care of themselves, and change this self defeating pattern.

Getting Help in Therapy
Self abandonment usually involves unconscious behavior that has its roots in early childhood.

It's very difficult to change this self defeating behavior on your own, even when you're aware of  it, because the early roots of this behavior usually remain out of awareness.

Working with a skilled psychotherapist, you can develop insight into your behavior and change your pattern of relating to yourself and others (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

It takes courage to seek help in therapy to change (see my article:  Developing the Courage to Change).

By taking care of yourself and choosing healthier relationships, you can lead a more fulfilling and meaningful life.

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

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

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

















Thursday, January 25, 2018

Self Abandonment: Part 1: What is Self Abandonment?

In my prior articles, I've written about abandonment in terms of feeling or being abandoned by parents, romantic partners, and friends (see my articles: Fear of Abandonment: Leaving Your Relationship Because You're Afraid of Being AbandonedThe Connection Between Fear of Abandonment and Codependency and How Psychotherapy Can Help You to Overcome Fear of Abandonment).  I'm focusing on self abandonment, a form of abandonment that is not talked about as much, in this article.

Self Abandonment: Part 1: What is Self Abandonment?

What is Self Abandonment?
The following list are signs of self abandonment:
  • Ignoring Your Own Well-Being Consistently to Focus on Others:  Rather than attending to your own feelings and what's best for you, you consistently ignore your well-being to focus on others--family members, friends, romantic partners and others.  Rather than taking care of yourself, you consistently prioritize others' needs over your own, even in relationships where there is little to no reciprocity.  This is codependent behavior.  You avoid thinking about your own feelings of sadness, loneliness or emptiness because it makes you feel too uncomfortable.  After a while, you might become so disconnected from your inner emotional world that you experience emotional numbing and no longer know what you feel.  You no longer know your emotional truth.  You might even see self care as being "selfish" (see my article: What Happens When You Numb Yourself Emotionally?Is Self Care Selfish? and Overcoming Codependency: Taking Care of Yourself First).
  • Placing Your Well-Being in Others' Hands:  Instead of taking care and nurturing yourself, you rely on others to do it for you.  You might be hoping, as an adult, to get from others what you didn't get as a child from one or both of your parents.  Even though you're hoping to get what you've needed for a long time from someone else, you might unconsciously choose people as romantic partners who can't or won't provide you with the love and nurturance that you need.  When you don't get what you need emotionally from your significant other, you interpret this as a sign that you're not worthy of being loved and it becomes a self fulfilling prophecy. Eventually, after several disappointing and hurtful relationships, you give up completely on relationships (see my next description, Judging Yourself Harshly, and my articles: Emotionally Unhealthy Relationships: Bad Luck or Poor Choices? and Choosing Healthier Romantic Relationships).
In my next article, I'll provide a clinical vignette to expand on this topic and discuss ways to overcome a pattern of self abandonment.

Getting Help in Therapy
People who engage in self abandonment often don't realize that they're doing it because the behavior is so ingrained and often unconscious.

Having no recognition of how they betray themselves, they might not seek help until they're in an emotional crisis and in despair.

Once the crisis is over or they enter into a new relationship, they "feel better" and they often don't stick with therapy to change the underlying self destructive patterns--until they're in the next emotional crisis (see my article:Leaving Therapy Prematurely and Remaining in Therapy Beyond the Immediate Crisis).

If you recognize yourself in this article, you could benefit from getting help in therapy, and sticking with therapy to learn to develop a healthier sense of self (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist can help you to recognize and change self destructive patterns that are keeping you stuck in your life (see my article: How to Choose a Psychotherapist).

Once you've become aware of your self destructive patterns and worked through earlier trauma at the root of your problem so you can change, you can lead a more meaningful and fulfilling life.

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

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

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











Wednesday, January 24, 2018

Should You Reveal to Your Spouse That You Cheated in the Past?

Trying to decide whether or not to reveal a past affair to your spouse or significant other can be one of the most challenging decisions that you can make in your life, and no one can tell you what to do (see my articles about infidelity: Infidelity: Cheating on Your Husband Even Though You're "Not the Type"Relationships: Coping With Secrets and Lies in Your RelationshipWhen Trust Breaks Down in a Relationship and The Connection Between Infidelity and the Need to Feel Desirable).

Should You Reveal to Your Spouse That You Cheated in the Past?

Before you confess to your spouse or significant other that you had an affair in the past, there are some important things to ask yourself:

Consider the Following Questions
  • What Are You Hoping to Accomplish By Revealing a Past Affair? Assuming that the affair is truly over and you and the other person aren't just on a hiatus, what are you hoping for by telling your spouse or significant about the affair?  
  • Have You Forgiven Yourself For the Affair? Sometimes people reveal past affairs because they've been unable to forgive themselves and they're hoping that if their significant other  forgives them, they'll feel better about themselves.  The risk, of course, is that their significant other won't forgive them and that, worst case scenario, the relationship will end.  
  • Have You Considered How Your Significant Other Will Feel After You Reveal the Affair?  You might feel better after you confess that you were having an affair.  The pressure of keeping that secret will no longer be part of you.  But, even though you think of the affair as over and in the past, your significant other will be learning about the affair for the first time, and it will probably feel like it's happening now on an emotional level for him or her because the emotions will be so strong and immediate.  Your significant other might also question his or her understanding of the entire relationship, especially if s/he never had any idea that you were cheating or that you were even capable of cheating.
  • Do You Understand Why You Cheated? Have you done the necessary internal work to understand why you cheated in the first place?  Did alcohol or drugs contribute to the problem?  It's important for you to know why you started cheating and, if you reveal a history of infidelity, your significant other will also probably want some answers.  Do the same problems exist for you or your relationship now as they did when you cheated?  If so, what are you or you and your significant other doing to work on those issues? 
  • How Did the Extramarital Affair End? Assuming that the affair is really in the past, did you end it, did the other person end it or was it a mutual decision?  Why the other relationship ended is as important to understand as why you began the affair in the first place.  It's a necessary part of what you need to understand about yourself.
  • Are You Being Honest With Yourself About the Affair Being Over? Some people decide to confess an affair because they're afraid they'll start up with the "other man" or "other woman" again.  They fear that they won't be able to control themselves so they want their significant other to know about the affair so that the confession will be an impediment to resuming the old affair or starting a new affair.  This is more common that people think, and it's not a solution to the problem.  Even if your significant other forgives you and is willing to act as your "conscience" by monitoring your whereabouts and actions, this would be very unhealthy, codependent behavior.  It would be highly stressful for both of you, and it wouldn't solve your problems to have your spouse act as a "parent" to you.  You need to dig deeper within yourself to get to the root of your problem. That gets back to the question: Do You Know Why You Cheated?
  • Are You Trying to Sabotage Your Relationship? Sometimes, when people confess to a past affair, on an unconscious level, they're trying to sabotage their relationship.  The relationship might feel "dead" to the person who cheated and, on an unconscious level, s/he might want out, but don't have the courage to end the relationship.  Instead, they want their significant other to end it.  They think that a confession about infidelity might be the way out for them if the significant other leaves.  This will take a lot of self exploration because it might not be apparent to you.
  • Are You Ready to Deal With the End of Your Relationship? It's often hard to predict how a significant other will react to finding out about prior infidelity.  For some people, infidelity is unforgivable and they will end the relationship.  Other people will try to work on the relationship, even if they are very hurt and not sure if the relationship will survive.  So, some relationships end, some relationships muddle through, and some relationships become stronger after infidelity is revealed.
Getting Help in Therapy
As I mentioned before, no one can advise you what to do in terms of revealing or not revealing prior infidelity, but it's important for you to understand your motivation in revealing the affair and whether you're ready to deal with the consequences, whatever they might be (see my article: The Benefits of Psychotherapy).

There can be compelling arguments on both sides as to whether to reveal the affair or not.  A skilled psychotherapist won't tell you what to do, but she can help you to deal with the questions I posed above and can facilitate your decision-making process (see my article: How to Choose a Psychotherapist).

Rather than struggling alone with this important issue, you could benefit from getting help from a licensed mental health professional, who has experience helping clients with this issue.

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

I have helped many individual adults and couples to work through relationship issues.

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.






Books: Love and Longing in "Enigma Variations" by Andre Aciman

Andre Aciman's book, Enigma Variations, is the story about a life of love and longing.  It is similar in to Aciman's prior book and movie, Call Me By Your Name, in that both books are looking back at an earlier time in life of a young, naive boy.  Both books also have a poetic and musical quality to them.

Books: Love and Longing in Enigma Variations

The book, Enigma Variations, is named after Edward Elgar's musical composition, Variations on an Original Theme Op 36 (1898-1999), which is popularly known as Enigma Variations.

Elgar composed 14 variations on the original theme.  Each variation is a musical composition about people who are close to him, including his wife and close friends.

Books: Love and Longing in Enigma Variations

Similarly, Aciman's Enigma Variations is based on the life and loves of the protagonist, Paul.  The variations allude to the many different selves that are part of Paul and the people he loves throughout his life starting at age 12 and continuing through his late middle age.

Similar to Call Me By Your Name, in the first chapter of the Enigma Variations, "First Love," the narrator, Paul, is immersed in memories of an earlier time.   He is thinking about his 12 year old self when he developed his first unrequited infatuation for a man, the local cabinetmaker, Giovanni, on a small island in Italy, San Giustiniano.

The first words of the first chapter, "First Love," are "I've come back for him" as Paul takes us on a journey back in time.

After being away for 10 years, Paul, who is now in his early 20s, returns to San Giustiniano where the family house burned down to the ground under mysterious circumstances after the family went back to the mainland.

Just as mysterious, Paul's family never returned to what was left of the house or the land.  His parents abandoned the area for reasons that, at first, are puzzling (part of the "enigma").  Eventually, the house was ransacked by the neighbors and nothing is left.

From there, Paul's 12 year old self takes over the story of his unrequited love for Giovanni, who is Paul's father's friend and who is restoring a treasured old table that Paul's mother inherited from her father.
 
Books: Love and Longing in Enigma Variations


Twelve year old Paul marvels at how Giovanni discovers a secret compartment in the table that no one knew about.  Inside that compartment they discover a Pelikan pen that belonged to Paul's maternal grandfather.

The Pelikan pen is the exact type of pen that Paul has been asking his mother to buy him and which she refuses to buy because he isn't doing well in two classes at school.

Interestingly, the pen is inscribed with the grandfather's initials, which are the same as Paul's initials, so his mother gives him the pen.  It's as if the secret and the pen are meant for Paul.

Just as the secret compartment of the table opens up to reveal this treasure, metaphorically a secret compartment in Paul also opens up as he discovers his infatuation for Giovanni.

Back then, the 12 year old Paul had no one to talk to about his feelings, so he struggled with his infatuation and confusion on his own.

Even though he was struggling with his feelings, Paul tried to find ways to get closer to Giovanni physically and emotionally.  He frequently visited Giovanni in his shop and wanted to learn to work the same way that Giovanni did.

When Giovanni, who was a patient and perceptive man, realized that Paul is staring at him with love and sexual longing, he told Paul in the most gentle way that Paul shouldn't stare at people that way.  He also told Paul in a paternal way to "behave" himself.  Then, he gently suggested that Paul go home.

Paul left, but he was filled with anger, sadness and shame for his feelings.

For the 22 year old Paul, who still remembers the love he experienced for Giovanni as a child, these feelings are still close to the surface.  He hasn't forgotten.  But he longs to find out what happened to Giovanni after Giovanni mysteriously disappeared.

As he talks to people who still live in the town and who remember Paul's family and Giovanni, Paul is surprised to learn things about his family that he never knew before.  Now, certain unanswered questions begin to make sense to him.

This first chapter, which is like a novella, sets the tone for the rest of the book about Paul's life and loves from childhood through late middle age.

A phrase from Call Me By Your Name, "We are not written for one instrument," applies to Enigma Variations as well.  Paul loves men and women equally, and he experiences the same fears, doubts and longings in his romantic relationships with men and women.

It seems to me that part of the enigma in Andre Aciman's Enigma Variations is the many variations of Paul throughout his life.  Although he changes over time and has many different selves, as we all do, in many ways, the core remains his 12 year old self, whose romantic yearnings are still poetic and all-consuming.

Andre Aciman has been compared to Proust, and Enigma Variations is a beautiful work of art.

Similar to Proust, the book's surprising twists and turns will make you want to reread the story when you get to the end and your understanding of what you thought you knew about the story is upended.

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

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

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










Monday, January 22, 2018

Psychotherapy as a Co-Created Process Between the Psychotherapist and the Client - Part 2

In my prior article, I began a discussion about psychotherapy as a co-created process between the psychotherapist and the client.  I'm continuing this discussion to delve deeper into this topic, specifically about how the client and psychotherapist co-create the therapeutic relationship.

Psychotherapy as a Co-Created Process Between the Client and the Psychotherapist 

How the Client and Psychotherapist Co-Create the Their Therapeutic Relationship
As I mentioned in my prior article, the concept that psychotherapy is a co-created process is part of contemporary psychotherapy and it's different from how psychotherapy was practiced in the past.

There is now a recognition that each client-psychotherapist relationship is unique--just as any other type of relationship between two people is unique.

It's the psychotherapist's responsibility to provide the client with psychoeducation about psychotherapy and how she works in therapy.

If the psychotherapist uses Integrative Psychotherapy, as I do, she will explain the different therapy modalities that she uses, which can be used individually or in combination.

For instance, if the psychotherapist is trained as a contemporary psychoanalyst and she also does EMDR Therapy, she can explain how these two modalities can be used in combination (see my article: Contemporary Psychoanalysis and EMDR Therapy: A Powerful Combination to Overcome Trauma).

Most likely, she will also explain that if one modality doesn't work for this particular client, she can switch to another modality.

The relationship between the client and the therapist is also known as the therapeutic alliance.  At the most basic level, the therapeutic alliance is based on the therapist being able to provide a safe, trusting relationship, also called the "holding environment"  (see my article: The Creation of the Holding Environment in Psychotherapy).

Contemporary psychotherapy is a two-person therapy.  It's an intersubjective experience between the client and the therapist where the therapist is attuned to the client (see my article: The Psychotherapy Session: A Unique Intersubjective Experience).

Even though the psychotherapist is the one with the expertise in doing psychotherapy, most  psychotherapists also rely on feedback from the client about what's working and what's not working in therapy for the client (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

Ideally, the therapist will ask at various points in therapy and encourage the client to give feedback at other times but, even if your therapist doesn't ask you for feedback, it's important to give feedback to her.

Why is it important?  It's important for the therapeutic process and also for maintaining a good relationship with your psychotherapist that you provide her with feedback as to how the therapy is going (see my article:  Why Being Honest With Your Psychotherapist is the Best Policy).

Many people have problems giving feedback to their therapists because they were discouraged or even punished for giving feedback to their parents when they were children, so even as adults, they still carry that fear.

Other people don't feel entitled to give feedback.  They think of it as "complaining" and they don't want to "offend" their psychotherapist.

So, instead of giving feedback, they might pretend that everything is going well in therapy, and the end result is that the client doesn't get what she needs in therapy, the therapy is an "as if" therapy and nothing changes.

Many psychotherapists recognize when clients are hold back from talking about misgivings in therapy or that a certain aspect of therapy isn't working for them, so they will try to elicit feedback.

But there are times when the therapist doesn't see it, and the therapy becomes ineffective or, rather than express himself, the client leaves therapy prematurely (see my article: When Clients Leave Psychotherapy Prematurely).

The client's trust and sense of safety develop over time.  For some clients, it happens relatively quickly and for others it can take a while, especially if they've had early experiences where they couldn't trust their parents or other close family members.

The therapeutic alliance is also based on there being a good match between the client and the therapist.

Initially, you might not know if a particular therapist is a good match for you.  You might need a few therapy sessions to be able to discern if the two of you are a good match.  This doesn't mean that the therapist isn't skilled or that you're being "resistant."  It might just mean that, like any two people, the two of you aren't a good fit.

Some psychotherapists are better trained, educated and more skilled than others as well as more empathetic than others.

An empathic failure can result from a psychotherapist's oversight, but in a good therapeutic relationship, once the client provides feedback about an empathic failure or other rupture in the therapy, there is an opportunity for a repair (see my article: (see my articles:  Why is Empathy Important in Psychotherapy?What is Empathic Failure in Psychotherapy? and Ruptures and Repairs in Psychotherapy).

But if there are consistent empathic failures on the therapist's part, you would be wise to tell the therapist that you don't think the therapy is working for you and then seek out another therapist.

Even when you think the therapy isn't working for you, it's still important to provide the therapist with feedback rather than just leaving abruptly or disappearing from therapy.

Why?  It's not for the therapist (although it can be beneficial).  It's for your benefit to be able to assert yourself and speak up for what you need, especially if this is challenging for you (see my article: Ask For What You Need in Therapy).

So, if the therapy is going relatively well because you have a good therapeutic alliance with the therapist and you're starting to make changes in your life, does this mean that there will be all smooth sailing ahead?

Not necessarily.  There is the issue of transference, which is unconscious and which can change over time (see my articles:  What is Transference in Psychotherapy?,  Psychotherapy and the Positive Transference,  What is the Negative Transference? and Psychotherapy and the Erotic Transference: Falling "In Love" With Your Psychotherapist).

Having a negative transference at a certain point in therapy isn't necessarily a bad thing.  In fact, it can turn out to be beneficial.  Often, a negative transference is based on earlier relationships with parents where you weren't able to work out these issues with your parents.

But in a good therapy, you have a unique opportunity to work out these issues with a therapist who is receptive to working on issues in therapy that might have triggered earlier unresolved problems.  This can be healing to you and help you to resolve those earlier issues.

Getting Help in Therapy
It takes courage to admit that you have a problem and to ask for help (see my article: The Benefits of Psychotherapy).

Many people start therapy with a sense of ambivalence, especially if they've never been in therapy before (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent).

Getting help in therapy starts with calling for a consultation.

The purpose of the consultation is to talk about your problem in a general way and to ask the therapist questions about her experience, training, history of helping clients with similar problems, and how she works (see my article: How to Choose a Psychotherapist).

Working through your problems in therapy can lead to your living a more fulfilling and meaningful life without the "baggage" from your history.

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

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

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














Psychotherapy as a Co-Created Process Between the Client and the Psychotherapist - Part 1

In prior articles, I discussed some of the myths and misconceptions that people often have about psychotherapy (see my articles:Common Myths About Psychotherapy: Going to Therapy Means You're "Weak"Common Myths About Psychotherapy: Psychotherapy Takes a Long Time and Common Myths About Psychotherapy: Therapy is "All Talk and No Action").  In this article, I'm focusing on another myth that many people, especially if they've never been in therapy, which is that therapy is something that happens to them as opposed to therapy being a co-created process between the client and the psychotherapist.

Psychotherapy as a Co-Created Process Between the Client and Psychotherapist

What Does It Mean that Psychotherapy is a Co-Created Process?
As opposed to going to see a medical doctor or your dentist, good therapy is a collaborative process between the client and the psychotherapist.

In other words, in good therapy the client and the therapist work in an interactive and dynamic way to help the client to define and resolve his or her problems.

In the past, psychotherapy was a more hierarchical process where psychotherapists believed they knew what was best.  They made interpretations about clients' problems and expected the client to either agree with the interpretations or work on the clients' resistance to the therapist's interpretations (see my article: Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy).

There are still some psychotherapists who work this way, and it works for some clients.  But the vast majority of clients want a more collaborative process where the client and the therapist both have input into defining the problem and working on a resolution.

Psychotherapy as a Collaborative Process Rather Than Something That is "Done" to You
Rather than seeing the psychotherapist has someone who has "all the answers," most clients are comfortable with the idea that the psychotherapist has a particular expertise in helping clients to work through their problems, but they also recognize that, as clients, they need to participate in the process (see my article: Why It's Important For Psychotherapists NOT to Have "All the Answers").

Rather than seeing therapy as something that is "done" to them, clients who have experience with contemporary psychotherapy know that the therapist can help to facilitate the process, suggest certain ways of working in therapy, help the client to develop coping mechanisms and internal resources, help the client to develop insight into his or her problems, assist the client to make changes, and point out self defeating patterns or defense mechanisms getting in the way, but the therapist can't tell you what to do or wave a magic wand to make the problems go away.

I'm mentioning this because many clients who have had brief experiences with psychotherapy will often say that they left a particular psychotherapist because the therapist didn't tell the client "what to do."

Similarly, people who have never been in therapy might expect the therapist to give them advice.

It's easy to see why people with no or only brief experience with psychotherapy might think that the therapist is responsible for giving advice or resolving problems.  These clients might have gone to school counselors or other types of counselors in the past where advice is often given.

But psychotherapy is different from counseling in that psychotherapists help clients to explore problems and come up with solutions as a result of that exploration, but they don't tell you what to do.

This is why it's so important for psychotherapists to provide clients with psychoeducation during the initial phase of psychotherapy, especially for clients who have little or no experience with psychotherapy (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

In my next article, I'll discuss further aspects of the co-created process in psychotherapy.

Getting Help
Everyone needs help at some point in life.

Often, family and friends aren't helpful for particular problems and you need the help of a licensed mental health professional.

Many people avoid starting psychotherapy because they have misconceptions about therapy or they don't know what to expect (see my article:  The Benefits of Psychotherapy).

When you see a psychotherapist for an initial consultation, you would benefit from asking questions about psychotherapy, the therapist's background and training, and how this particular therapist works.  You're not only entitled to know these things, you will benefit from knowing it.

Rather than suffering on your own, you could benefit from seeking help from a skilled psychotherapist who can help you to work through your problems (see my article: How to Choose a Psychotherapist).

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

I work with individual adults and couples.

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.

See my article: 
Psychotherapy as a Co-Created Process Between the Client and the Psychotherapist - Part 2