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Monday, April 30, 2018

Feeling Alive Again After a Period of Stagnation

In Elizabeth Strout's book, Olive Kitteridge, one of the characters named Harmon has a realization that he is feeling alive again after a long period of emotional stagnation (see my article: Recapturing a Sense of Aliveness).

Feeling Alive Again After a Period of Time

His realization happens one day when an older customer, Bessie, comes into his store and she tells him how lonely she feels.  The author describes Harmon's awakening experience as "some skin that had stood between himself and the world seemed to have been ripped away, and everything was close, and frightening."

It seems that Harmon's empathy for Bessie's loneliness touched him deeply.  After he overcomes his anxiety, he realized that he needed to make certain major life decisions (I don't want to give away the specifics because the book is worthy reading without having any spoilers from me).

As a psychotherapist, I have seen this type of awakening many times, and Elizabeth Stout gives a sensitive, insightful and realistic portrayal of how people often come to this realization.

Feeling Alive Again After a Period of Stagnation

Similar to Harmon's experience, people often realize retrospectively that they're feeling alive again.  This realization can come from simple experiences, like being able to listen to music again after a period of not being able to tolerate hearing certain music or feeling like dancing again or the experience of falling in love again.


Feeling Alive Again After a Period of Stagnation

The renewed feeling of aliveness, however it happens, is a reminder of what aliveness feels like.  For people who haven't had this sense of aliveness before, it's a new experience of how vibrant life can feel.

In retrospect, people who recapture a sense of aliveness often say that they remember feeling alive before a period of stagnation set in.

Often hard to describe, a feeling of aliveness is usually an integrated mind-body experience that can also feel transcendent.

Getting Help in Therapy
People often come to therapy because they feel that, somewhere along the way, they lost their zest for life and they want to capture a sense of aliveness again (see my article: The Benefits of Psychotherapy).

Somatic Experiencing can help people to feel alive again (see my article:Why Experiential Psychotherapy is Often More Effective Than Regular Talk Therapy).

Rather than struggling on your own, you could get help from a psychotherapist who is an experiential therapist and who uses Somatic Experiencing (see my articles: How to Choose a Psychotherapist).

Feeling alive again makes life much more meaningful and fulfilling.

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

I work with individual adults and couples, and I have helped many clients to recapture a sense of aliveness.

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, April 29, 2018

Movies: Lou Andreas Salome - The Audacity to Be Free

Lou Andreas Salome, who was born in 1861 in St. Petersburg, Russia, became one of the few women psychoanalysts in Sigmund Freud's inner circle.

Movies: Lou Andreas Salome - The Audacity to Be Free*

At a relatively young age, she was known for being an intellectual with unconventional ideas for her time.  Throughout her life, she had many intellectual pursuits, including psychoanalysis, and she prized her freedom and spoke up for what she believed in, which was unusual for women in her day.

The movie, Lou Andreas Salome - The Audacity to Be Free, traces her life from early childhood until old age.  Although the title of the movie emphasizes Salome's lifelong pursuit of individual freedom and creativity, it actually focuses on her role as a muse to various famous men in her life, including Rainer Maria Rilke and Friedrich Nietzsche and less on her accomplishments, which were many.

The movie focuses only briefly on her accomplishments as a psychoanalyst during the early days of psychoanalysis and her relationship with Sigmund Freud.  As a psychotherapist who is psychoanalytically trained, I would have liked more of an emphasis on her life as a psychoanalyst, especially considering that a career in psychoanalysis in her day was mostly pursued by men.

In many ways, Salome was ahead of her time with regard to understanding the importance of culture, which we take for granted now.  But in her time, the focus in psychoanalysis was on the patient's inner world, the Oedipus Complex and Freud's psychosexual model of psychoanalysis.

It's unfortunate that such an outstanding psychoanalyst, who was well-known and highly regarded internationally in her time, has been all but forgotten these days, except in some psychoanalytic circles and, even there, her books and papers go mostly unread.

Even though the movie focuses mostly on her personal relationships with men, hopefully, it will arouse curiosity about this accomplished woman who was ahead of her time.

For a more comprehensive understanding of Lou Andreas Salome, I recommend Julia Vickers' book, Lou von Salome: A Biography of the Woman Who Inspired Freud, Nietzsche and Rilke.  Although the title emphasizes her role as a muse to some of the most famous men of her time, it also gives an in-depth exploration of her childhood background, how her background influenced her lifelong intellectual pursuits, her accomplishments, and her need for freedom and equality as a woman.

Salome also wrote her own memoir called Looking Back: Memoirs where she gives her own account of her life.  This book is more of a meditation on her life than a chronological account of her life history.

There is also a book, Salome: Her Life and Her Work by Angela Livingstone, that provides a more of a history of Salome's life.

It's important to remember women psychoanalysts like Lou Andreas Salome and Karen Horney for the important contributions that they made to psychoanalysis and psychotherapy in general.

Getting Help in Therapy
If you have been feeling overwhelmed by your problems, you're not alone.  Help is available in psychotherapy (see my article: The Benefits of Psychotherapy).

Working through your problems in psychotherapy can free you from your traumatic history and allow you to live a more meaningful and fulfilling life (see my article: How to Choose a Psychotherapist).

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

I work with individual adults and couples.

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.


*Photo Credit: Shutterstock: A romantic Slavic woman in vintage dress (this is not Lou Andreas Salome).






Rediscovering in Psychotherapy What You Thought Didn't Exist

Psychotherapy often provides clients with an opportunity to rediscover in therapy what they thought didn't exist in their lives.  This is especially true in experiential therapy, like Somatic Experiencing, EMDR (Eye Movement Desensitization and Processing) therapy, and clinical hypnosis (see my articles: How EMDR Therapy Works: EMDR and the BrainWhat is Adjunctive EMDR Therapy? and Overcoming Trauma With Somatic Experiencing).

Rediscovering in Psychotherapy What You Thought Didn't Exist

Clients who come to therapy to work on unresolved traumatic experiences are, understandably, focused on the negative experiences they had, especially if those traumatic experiences go back to childhood.

But in experiential psychotherapy, they often rediscover that there were also positive, life affirming experiences that they have forgotten because of the preponderance of traumatic experiences that overshadowed everything else.

Rediscovering these positive experiences doesn't negate the traumatic experiences that need to be resolved in therapy.  But it gives clients a broader perspective of their lives.  It can also help them to see that they have internal resources that they didn't know they had.

As a psychotherapist, I have been delighted to witness this experience many times with clients in therapy.  Often in the mist of processing a traumatic memory, a client will suddenly remember that there was someone who did something that helped him or her at that time--whether it was a teacher, mentor, a relative or a friend. Or they will remember a transformative experience that helped them while they were enduring the trauma.  When a client has forgotten these positive memories, the rediscovery of them in therapy can be an epiphany.

These rediscovered positive memories aren't necessarily dramatic experiences, but their rediscovery often leads to advances in the processing of the traumatic memories.

Fictional Clinical Vignette
The following fictional clinical vignette illustrates the healing effect of rediscovering positive memories within the context of processing traumatic memories:

Sandy
After a particularly difficult family visit, Sandy began psychotherapy to deal with longstanding unresolved trauma related to her childhood experiences in her family and the emotional triggers that were set off by the last family visit (see my article: Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Seeks Help in Therapy?).

She explained to her psychotherapist that she had a contentious relationship with her parents from an early age.  She said parents often belittled her and physically abused her when she was a child, which resulted in her low self esteem and anxiety.

Rediscovering in Psychotherapy What You Thought Didn't Exist

Since moving to New York City, Sandy limited her contact with her parents because their interactions were still contentious.  But, generally, she went home a couple of times a year during the holidays to try to maintain some type of connection with them, even though these visits often left her feeling disappointed and hurt.

During the holidays in 2016, she went to visit her parents for Christmas, and she found this visit to be the most challenging of all.

She and her parents never agreed on politics, and she tended to stay away from political conversations because she knew they would lead to arguments.  But, on the first day of her visit, her parents were so elated that their candidate won the presidential election that they could barely talk about anything else to Sandy, who voted for the candidate who lost (see my article: How to Cope With Difficult Family Get-Togethers).

Sandy was already reeling from the results of the presidential election, and she wasn't prepared to deal with the usual tension in her relationship with her parents as well as hearing them gloat about the election.  Tactfully, she suggested that they change the subject because it was upsetting to her.  But, as usual, her parents paid no attention to her feelings and her mother told her that she was being "too sensitive" and a "spoiled sport."

Sandy told her therapist that hearing those two phrases triggered childhood memories when both of her parents tended to disregard her feelings by telling her that she was "too sensitive" and a "spoiled sport" (see my article: How to Cope With Getting Emotionally Triggered During Family Visits).

Even though she was an adult, she said she felt like she was a helpless child again in her family home where she could neither fight back nor flee. As a child, she would stay in her room and fantasize about the day that she would be old enough to move out.  When she graduated high school, she was relieved to go away to college, and she never moved back into the family home.  

During the family visit that occurred shortly after the presidential election, Sandy told her parents that  if they didn't stop talking about the election, she would leave.  In response, they were dismissive and continued to disregard her feelings, so she packed her things and took a cab to the airport where she spent the Christmas holiday waiting to get a flight back to New York City.

She told her psychotherapist that it was a miserable Christmas for her.  But she felt she had to take care of herself by doing what she was unable to do when she was a child--leave her parents' home.  She explained that since that visit, she was flooded by childhood memories of her mother hitting her with a belt and her father taunting her for being "a crybaby."

That's when she decided that, in addition to coping with her current problems with her parents, she needed to work through her traumatic childhood memories so these memories wouldn't continue to get triggered.

Over the next several sessions, after Sandy and her psychotherapist talked about her family history and did the preparation work for trauma therapy, they began trauma therapy using a combination of Somatic Experiencing and EMDR therapy to work on past trauma as well as current difficulties with her family (see my article: Integrating EMDR Therapy and Somatic Experiencing).

During the trauma therapy, Sandy told her psychotherapist that her childhood was one long, bleak, lonely experience with no one to help her.  Not only was she an only child, but she had little contact with other relatives, who lived out of state.  Since her parents didn't allow her to invite friends over or to go to friend's homes, Sandy often felt lonely and unlovable as a child (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

Then, one day in therapy, after they did several sets of EMDR, Sandy suddenly remembered a high school teacher, Ms. Scott, who took Sandy under her wing.  She spent time with Sandy after class and encouraged her to open her mind to possibilities beyond their town, including applying to out of state colleges (see my article: How One Person Can Make a Difference in a Traumatized Child's Life).

Sandy was moved in her therapy session by remembering the impact of her former high school teacher, "How could I have forgotten how much Ms. Scott helped me?"

She said that if it had not been for the encouragement of Ms. Scott, she probably would have never applied to colleges--much less colleges out of state--because her parents didn't believe it was necessary for her to go to college.  They told her that what was most important was for her to get a job, any job, so she could contribute to the household.

Ms. Scott helped Sandy to see that a whole new world was waiting for her.   And, when Sandy's parents refused to help her with the college application process, Ms. Scott helped her with that process as well as the financial aid process when Sandy was accepted into a college in New York City.

Sandy's psychotherapist noticed how Sandy's face lit up and how alive she seemed after she remembered Ms. Scott, so they used these experiences as internal resources to help Sandy through the processing of the trauma.

Sandy said that she had forgotten how kind and generous Ms. Scott was to her.  Looking back now on those memories, she realized that there was someone who made her feel she was worthwhile and lovable at that time.  Recapturing those feelings facilitated the processing of the past trauma as well as the current difficulties with her family.

Soon after that, Sandy contacted Ms. Scott, who had since retired but who continued to live in the same town.  Ms. Scott, who now asked Sandy to call her Betty, was delighted to hear from Sandy and they planned to get together for lunch during Betty's next visit to New York City.

Conclusion
A long history of trauma can overshadow positive experiences in a person's memory.  But experiential psychotherapy can create the therapeutic environment that leads to the rediscovery of positive, life affirming experiences even in a traumatic childhood.  The rediscovery of these memories can facilitate the processing of traumatic memories.

Getting Help in Therapy
Unresolved traumatic memories often get triggered by current experiences, which is why it's so important to work through the unresolved trauma (see my article: The Benefits of Psychotherapy).

Experiential therapy, like EMDR, Somatic Experiencing and clinical hypnosis, is usually more effective than regular talk therapy to process trauma (see my article: Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone).

Along the way, it's not unusual for clients in trauma therapy to rediscover people and experiences that they forgot about who were helpful to them in the past.  Combined with trauma therapy, those past positive memories can provide the client with the much needed internal resources to work through the trauma.  

Rather than continuing to get triggered, you owe it to yourself to get the help you need from a skilled trauma therapist (see my article: How to Choose a Psychotherapist).

Once you have worked through unresolved trauma, you can live a more fulfilling 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, and I have helped many clients to overcome 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.

























Thursday, April 26, 2018

Understanding Internal and External Psychological Defense Mechanisms - Part 2

In a prior article, I began a discussion by describing internal and external psychological defense mechanisms.  To illustrate the points that I made in that article, I'm providing a fictional clinical vignette:

Fictional Clinical Vignette: Understanding Internal and External Psychological Defense Mechanisms
The defense mechanisms in the following fictional vignette will be identified and italicized in parenthesis to make it easier for the reader to identify (to see a full list of defense mechanisms, click on this link for the prior article):

Ted
After his girlfriend threatened to end their relationship if Ted didn't get help in therapy, Ted contacted a psychotherapist and reluctantly began psychotherapy.

Understanding Internal and External Psychological Defense Mechanisms

Ted explained to his psychotherapist that his girlfriend of two years, Amy, told him that he was too defensive and this was causing problems in their relationship.  He said that Amy indicated that she felt frustrated with him because he couldn't admit when his behavior caused problems between them.

His psychotherapist noticed that as he talked to her, Ted frequently looked away as if he was uncomfortable (non-verbal tactical defense mechanism: lack of eye contact).  He also spoke about his problems in the relationship in a vague way so that she would need to ask him to be more specific (verbal - tactical defense mechanism: vagueness).

She also noticed that Ted was sitting slumped with his arms folded across his chest and with legs crossed looking uncomfortable (non-verbal tactical defense mechanism: posture and body language).

Since Ted was only talking about what Amy thought were the problems in the relationship, the psychotherapist asked him about his opinions.  In response, after thinking about it for a minute or so, he responded by saying in a sarcastic tone, "I think things are perfect between us. (verbal - tactical defense mechanism: sarcasm).

Then, when he saw that the therapist was still waiting for his answer, he cleared his throat and said, "I'm just kidding.  Of course, I think we have problems, and I acknowledge that I can be defensive, but I think she's too hard on me" (verbal - tactical: dismissive/blaming).

Seeing that Ted was uncomfortable and highly defended, the psychotherapist realized that this was probably what Amy was dealing with in their relationship.  So, with much empathy, she decided to tactfully bring up Ted's discomfort and defensiveness in the session with her.

"I know it's difficult to begin therapy, especially during the first few sessions before you're comfortable with me.  I wonder if you've noticed that your defensiveness as we are talking," she said.

At first, Ted denied being defensive (regressive - intrapsychic: denial), so his psychotherapist pointed out the defense mechanisms that he had used so far in the therapy session at the same time that she reiterated that she understood that it's difficult to talk to a stranger about personal problems.

Ted thought about what the psychotherapist said, and he responded by beginning to talk about something unrelated to what they were discussing (verbal - tactical: changing the subject).

His therapist responded by bringing Ted back to the issue that they had been discussing and telling him that she thought it would help him to use the therapy sessions to begin to become aware of his defensive behavior.

When she asked him if he wanted the dynamic between him and Amy to improve or if he was ready to allow the relationship to end, Ted looked at her directly and said, "I don't want to lose Amy.  That's why I'm here.  I know I've been screwing up in our relationship.  It's just hard to face it."

His psychotherapist acknowledged that change is hard, especially if Ted's defensive behavior was an emotional survival strategy he learned to survive when he was younger.  In response, Ted acknowledged that he had a hard time in his family when he was growing up because both of his parents were perfectionists and he was made to feel ashamed when he made a mistake.

Over the next few sessions, the psychotherapist helped Ted to appreciate how important it was for him to use an emotional survival strategy when he was younger because it was the only way he knew how to survive with punitive parents, but that same survival strategy, defensive behavior, was no longer working for him as an adult.  In fact, she said, it's causing problems for him.

Gradually, Ted became more aware of how often he used defense mechanisms to ward off his uncomfortable feelings in the therapy sessions.  This helped him to bring that awareness to his relationship as well, so he was less defensive.

As Ted became more comfortable with his therapist over time, they worked on his unresolved childhood trauma that was at the root of his defensive behavior.  There were still times when he occasionally engaged in defensive behavior, but when he did, he was aware of it and acknowledged it to his therapist and to Amy.

Over time, Ted felt more comfortable being open with Amy and so he was less defensive.  He was able to communicate in an honest way about his feelings without being afraid that there would be the kind of repercussions that he experienced when he was a child.

Conclusion
Defense mechanisms are usually a life-saving emotional survival strategy when children are in an abusive and/or neglectful home and they have no other options.  These defense mechanisms help to ward off emotions that would have been overwhelming to a child.

But when that child becomes an adult, a propensity for defensive behavior causes problems.  The adult needs to first become aware of his defensive behavior and then learn new ways of relating and communicating.  If he has unresolved childhood trauma, he and his psychotherapist also need to work on resolving that trauma.

Getting Help in Therapy
Defensive behavior is often unconscious so the the person who engages in it is usually unaware that he is doing so.

A skilled psychotherapist, who is tactful and empathetic, can help a client become aware of his defensive dynamic and help him to learn new ways of relating (see my article: The Benefits of Psychotherapy).

A psychotherapist, who is a trauma therapist, can help the client to work through underlying unresolved trauma that is at the root of the defensive behavior (see my article: How to Choose a Psychotherapist).

If you have been experiencing the negative consequences of defensive behavior, you owe it to yourself to get help in therapy so you can free yourself of this problem.  Once you have learned healthier ways of relating and you have worked through unresolved trauma, you can lead a more meaningful and fulfilling 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, and I have helped many clients to overcome 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, April 23, 2018

Understanding Internal and External Psychological Defense Mechanisms - Part 1

I have discussed defense mechanisms in prior articles, including:
Understanding Internal and External Psychological Defense Mechanisms

In this article, I'm beginning a discussion about internal/intrapsychic and external/interpersonal defense mechanisms by identifying them.

In my next article, I'll discuss the consequences of using these defense mechanisms that alienate you from yourself and others.

Generally speaking, defense mechanisms are either directed inward against your own uncomfortable feelings or they are directed outward to avoid closeness or meaningful contact with others.

As I've mentioned in prior articles, defense mechanisms are often perceived as being negative.  But they can be life-saving for a child and living in a home where s/he is being abused or neglected (or both).  They serve as an important emotional survival strategy (also known as defense mechanisms) to keep the child from feeling overwhelmed in a situation where s/he can neither fight nor flee.

But, unfortunately, as that same child becomes an adult, these emotional survival strategies get in the way of having healthy relationships with oneself and others.  In order to maintain emotional distance, the adult ends up paying a high price by staying in a "bubble" (see my article: Emotional Survival Strategies That No Longer Work For You: "I Don't Need Anyone").

If you have been using defense mechanisms extensively in your life, they become so much a part of you that they are difficult for you to see without the help of a psychotherapist.  A skilled psychotherapist can help you to see how these defenses are "protecting" you and, at the same time, how they're also getting in the way of your relationship with yourself and others.

Of course, it's all a matter of degree.  No one would survive emotionally if s/he didn't use defense mechanisms at certain times to a degree.  But defense mechanisms become a problem when they alienate you from yourself and others.  I'll write more about this in my next article.

Common Intrapsychic/Internal Psychological Defense Mechanisms
Intrapsychic/internal defense mechanisms are used between you and your inner world to ward off what would be uncomfortable for you to experience.

These include both repressive and regressive defense mechanisms.

The repressive defense mechanisms serve to hold back uncomfortable feelings, thoughts, fantasies or impulses.

The regressive defense mechanisms are child-like mechanisms that were used at a younger stage in life that are used again as an adult.  These defense mechanisms are usually unconscious and, as previously mentioned, difficult for the individual who uses them to see.

Repressive:
  • Intellectualization
  • Rationalization
  • Worrying
  • Rumination
  • Minimization
  • Displacement
  • Reaction Formation
  • Ignoring
  • Avoidance
  • Procrastination
  • Externalization
  • Distraction
  • Self-attacking thoughts
  • Addictive Behavior

Regressive:
  • Projection
  • Denial 
  • Acting Out
  • Repetition Compulsion
  • Imitation
  • Identifying with the Aggressor
  • Passive-Aggressiveness
  • Isolation of Affect
  • Somatization

Common Tactical/External Defense Mechanisms
Tactical/external defense mechanisms are character defenses that are used between you and others.  If you habitually use tactical defense mechanisms, they're ingrained in your personality.

In effect, these defense mechanisms provide a wall between you and others to avoid closeness or to keep others at a distance.

Aside from personal relationships, these defense mechanisms are also used unconsciously by many clients in psychotherapy as a way to avoid developing a therapeutic relationship with their psychotherapist.  Since the behavior is unconscious, clients don't realize that they're doing it.  But, at the same time, using these defense mechanisms hampers the work in therapy because a positive outcome in psychotherapy is dependent upon a good working alliance between the client and the psychotherapist.

Like intrapsychic conflicts, these defense mechanisms are usually unconscious so they are difficult for you to detect on your own without help from a psychotherapist.

Verbal:
  • Vagueness
  • Speaking in generalities
  • Contradictory statements
  • Sarcasm
  • Changing the subject
  • Argumentativeness
  • Dismissiveness and blaming
  • Distancing
  • Passivity
  • 3rd person speech
  • Playing games
Non-verbal:
  • Body language
  • Physical presence
  • Eye contact/lack of eye contact
  • Fake smile and laughter
  • Weepiness and crying
  • Acting out
  • Posture
  • Voice and tonality
  • Speed of talk
  • Withdrawal
  • Detachment
  • Grooming and appearance
  • Weight and physical shape

Most people who tend to use defense mechanisms to ward off uncomfortable feelings internally and/or externally to keep others at a distance, don't seek help until they're experiencing significant consequences either within themselves or in their relationships or both.

See my next upcoming article for a continuation of this discussion.

Getting Help in Therapy
If you think your defensiveness causes problems in your life, you could benefit from seeking help in therapy (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist can help you to identify the defense mechanisms that you use either internally and/or externally.  Also, over time, a skilled mental health professional can help you to feel safe enough to relate to yourself and others in a healthier way (see my article: How to Choose a Psychotherapist).

As I mentioned before, defensive behavior is usually longstanding and ingrained by the time you become an adult, so the work in therapy isn't easy or fast.

A psychotherapist can assist you to expand your emotional window of tolerance so you can gradually tolerate emotions that were once too uncomfortable for you.  An expanded window of tolerance can allow you to come out of the "bubble" that you've kept yourself in (see my article: Expanding Your Emotional Window of Tolerance in Psychotherapy).

Once you're free of the kind of defensive behavior that is keeping you alienated from yourself and others, you can live a fuller, more meaningful life.

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

One of my specialties is helping clients to overcome developmental and shock trauma.  

I have also helped clients, who used defensive behavior for self alienation as well as alienation from others, to gradually feel safe enough to expand their emotional window of tolerance, so they could change.

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, April 20, 2018

Relationships: The Ideal vs. the Real

When people fall in love, they often fall in love with their idealization of their lover rather than the reality.  At the beginning of the relationship before they know each others' habits, doubts and fears, each partner tends to see the best in the other and fills in the missing pieces with fantasies of who they want their partner to be.  But after they have been living together or married for a while, the ideal tends to fall away as reality sets in.  There is, inevitably, some disillusionment, but how each partner navigates his or her disappointment often predicts if the relationship will survive and thrive or end.

Relationships: The Ideal vs. the Real

Some people, who become disillusioned, leave the relationship and continue to look for their ideal mate.  Little do they realize that they will probably go through the same experience again with the next person.  For these people, searching for their "soul mate" can become a lifelong quest that is never fulfilled.

Fictional Clinical Vignette: Relationships: The Ideal vs. the Real
The following fictional vignette illustrates how the initial idealization can turn into disappointment and disillusionment and how psychotherapy can help to get to the underlying issues to resolve the problem:

Cassie
After living together for six months, Cassie realized that her boyfriend, Steve, wasn't the person she thought he was when they first met at an outdoor photography class a few months before.

When she first met Steve, Cassie was struck by his good looks, his kindness, humor and intelligence.  From the moment they started talking, she was immediately drawn to him.  She had just gotten out of a one year relationship with another man, who turned out to be a different person from who she thought he was during the first few months together.

After the photography class, over dinner later, they spoke for three hours and continued the conversation the next day for several more hours.  Since their first day together, they spent time together everyday until Steve eventually moved in with Cassie.

She expected there would be things that annoyed her about Steve and that annoyed him about her.  But she didn't expect him to be so different from the person she originally fell in love with.

When she first met him, Steve was living temporarily with a friend because he was new to New York City.  At the time, he was living out of boxes and suitcases, so when he moved into her apartment, Cassie made room for Steve's things in her closets and drawers.  She also made sure to buy things that she knew he would like to eat.  She wanted him to feel comfortable.

But after a few days, Cassie realized that, unlike her, Steve was sloppy.  He left his clothes and things all over the apartment--dirty socks on the floor, newspapers piled up in the living room, his toiletries taking up all the space on the bathroom counter they shared, and puddles of water on the floor after he took a shower.  And the worst thing for Cassie was that he didn't seem to mind living this way.

The first few times, she tried to be tactful when she spoke to him about his sloppiness, hoping that he would be neater.  She didn't want him to feel that her apartment wasn't his place too or that she wanted to boss him around.   But, even though he apologized and said he would try to be neater, he continued to be sloppy, which angered Cassie.

She also began noticing other things that bothered her: He tended to drink from the milk carton and leave it on the kitchen counter so it spoiled.  She also saw that if she left for work earlier than he did, Steve got up and left for work without making the bed or tiding up in the kitchen.  He also left his dishes and coffee cup in the sink.

Finally, Cassie suggested that they talk, and she mentioned the things that were bothering her.  Steve told her that he would try to be more considerate, but he also felt that Cassie was being picky about certain things.

Relationships: The Ideal vs. the Real

During their talk, Steve reminded her that the few times when he did make the bed, she wasn't happy about the way that he did it because she had a particular way that she preferred.  Cassie admitted that she tended to be somewhat of a perfectionist and she realized that she would have to let go of some of her perfectionism if the relationship was going to work.

Later that week, when Cassie spoke with her two close friends about Steve's sloppiness, both of her friends told her that their husbands were the same way. They said they used to argue about these things a lot in the beginning, but they gave up after a while.

With a long sigh, Cassie hesitated before she brought up what she was thinking.  Then, she told her friends that she felt disillusioned about Steve and their relationship.  She said he seemed so different when they first met.  She wondered if she had made a mistake in getting into a relationship with him. Her friends suggested that she talk to a psychotherapist first before she ended the relationship precipitously.

A few weeks later, Cassie felt so troubled about her relationship that she contacted a psychotherapist to be able to talk things out.  She didn't want to break up with Steve, but she wasn't sure she could stay in the relationship either.

As Cassie spoke with her psychotherapist about what was going on at home, she began to cry.  She said that, when she and Steve first met, they had sex all the time.  But, she said, shortly after they moved in together, they had sex once a week or less, and she didn't feel as attracted to him as she once did.  All she could think about was his sloppiness.  She also wondered if he felt less attracted to her because she criticized him for being sloppy.

When Cassie spoke with her psychotherapist about her family, she said that her mother also tended to be a perfectionist.  Her mother told Cassie that she had to "put her foot down" when she and Cassie's father got married because he tended to be sloppy.  After that, Cassie's mother controlled things in the relationship, and the father became much more passive.

Cassie told her psychotherapist that she didn't want to be controlling or have Steve become passive.  She said she just wanted the man she met when they first got together.  Then, she cried.

Her psychotherapist explained that almost every couple starts their relationship with an idealized image of each other.  Then, after they get to know each other, that idealization falls away and reality sets in and the couple has a chance to develop a more realistic relationship.

She asked Cassie questions about whether she and Steve had shared values and still enjoyed the same things together.  Cassie responded that their values were the same.  She also said that, lately, since things were strained between them, they weren't enjoying the same things together as much as they used to before.  She said she noticed that Steve was more apprehensive around her at home, and she realized that he probably expected her to be critical about the things he did or didn't do things at home.

As her psychotherapist normalized Cassie's experiences in her relationship, Cassie realized that she didn't know if she was ready to let go of the "idealized Steve" that she thought she was in a relationship with in order to accept the "real Steve."  She said that as she heard herself say these words, she felt immature.

Over the next few weeks, Cassie talked in therapy about being a perfectionist and how unhappy it made her--even before Steve was in her life.  She felt like "perfection is my norm."  They talked about how much shame there was underneath her perfectionism, and worked on helping her to overcome her shame (see my article:  The Connection Between Perfectionism and Core Shame).

Over time, Steve became more self aware and he was more conscientious about being neat and considerate.  He even told her that he realized that he preferred it when the apartment was neat and tidy.  Cassie could see that he was really trying, but she still felt like she missed the "idealized Steve," even though she realized that he never existed--except in her head.

In her psychotherapy sessions, Cassie talked about all the prior relationships that had a similar pattern where she thought each boyfriend was "wonderful," only to find out later that each of them had flaws that she couldn't stand, which led to her ending those relationships.

But now, at age 30, she was trying to focus on what was more important, and she realized, on an intellectual level, that the fact that she loved Steve and he loved her--although not in the head-over-heels way that they did at first.  She also realized that he was a good person, which was more important than some of his habits than annoyed her.

Casie told her psychotherapist that she just wished she could feel this on an emotional level and not just on an intellectual.  She kept thinking about what her mother might say if she knew how sloppy Steve was.  She knew her mother would disapprove and she would expect Cassie to control him, like her mother controlled her father (see my article: Ambivalence and Codependence in Mother-Daughter Relationships).

The more Cassie and her therapist talked about it, the more they both realized that Cassie was still seeing things from her mother's perspective and still trying to please her--rather than developing her own perspective.

Relationships: The Ideal vs. the Real

Over time, Cassie and her psychotherapist worked in therapy to help Cassie distinguish her own views from her mother's views.  As they did this, Cassie felt more like an adult.  Over time, she felt on an emotional level (and not just on an intellectual level) that she was satisfied in her relationship with Steve and, if anything, their love was growing in a more mature way.

Conclusion
It's normal to idealize the person that you're with when you're first in a relationship.  Over time, both of you get to know the "real" person you're in a relationship with and not the ideal.

Some people have problems accepting anything less than the ideal.  Often, this has to do with unconscious underlying issues, including still trying to live up to parents' expectations.

By letting go of your concept of the ideal and re-evaluating your relationship and what's most important to you, you have an opportunity to see your partner and your relationship in a more realistic light so that your love can mature and grow.

Getting Help in Therapy
Many people, who have problems with the disillusionment that reality is different from the ideal, are helped in psychotherapy (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist can help you to discover the underlying issues that are getting in your way and help you to make decisions about your relationship and your life (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, you owe it to yourself to get help in therapy.

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.  One of my specialties is helping client to overcome traumatic experiences and deal with unresolved 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.
















Wednesday, April 18, 2018

Understanding How an Avoidant Attachment Style Affects You and Your Relationship

In my prior articles, How Your Attachment Style Affects Your Relationship and How Early Attachment Bonds Affect Adult Relationships, I discussed attachment styles in general and the affect they can have on relationships.  In this article, I'm focusing specifically on the avoidant attachment style, its origins, and how it can affect a relationship (see my article: An Emotional Dilemma: Wanting and Dreading Love).

Understanding How an Avoidant Attachment Style Affects You and Your Relationship

Relationships: From Passion and Excitement to Fear of Emotional Intimacy
While relationships often start with passion and excitement, each person's core vulnerabilities can emerge as the relationship becomes more serious, the couple becomes more attached, and the emotional intimacy increases.  If both people are emotionally secure because they grew up in loving and secure homes where their emotions needs were mostly met, when issues , they can usually be worked out more easily than one or both people have an insecure attachment style.

But people who developed an insecure attachment style, like avoidant attachment, as a coping strategy when they were children, can become increasingly uncomfortable as the relationship becomes more emotionally intimate.  With greater emotional intimacy, they become aware that they are more emotionally dependent upon their romantic partner, which can make them feel emotionally vulnerable.

People with an avoidant attachment style are often unable to put their fear into words.  Depending upon how threatened they feel by the emotional intimacy of the relationship, they will often dissociate and become estranged from their own feelings and from their partner because this is the emotional survival strategy that they developed in childhood.

They will often shut down emotionally.  Although they might appear from the outside as if nothing much is going on, internally they are in a state of turmoil and often unable to express their feelings.

They appear as if they are deliberately stonewalling their partner but, in most cases, they have really "checked out" or dissociated because they're overwhelmed, and the more the other partner insists that they talk about what's happening, the more dissociated they can become (see my article: Relationships: Are You a Stonewaller?).

How Do People Develop an Avoidant Attachment Style?
The avoidant attachment style usually begins in early childhood due to consistent neglect or abuse.  If the parents are unable to provide the baby with an emotionally safe home environment, the baby, who is unable to fight or flee, goes into "freeze" mode, which is another term for dissociation, as a last resort to cope with the abuse or neglect.

As adults, these individuals continue to be disconnected from their emotions.  Without the necessary help in early childhood about how to identify and tolerate uncomfortable emotions, these adults continue to engage in maladaptive coping strategies to avoid experiencing uncomfortable feelings.  So, a strategy that saved them as infants becomes an obstacle to their knowing themselves and connecting with others.

Fictional Clinical Vignette: Understanding the Avoidant Attachment Style
Ken
During the first three months of his relationship, Ken, who was in his mid-30s, was in a state of bliss whenever he was with Ann.  They met at a party and they were instantly attracted to one another.  Soon, they were dating a few times a week and enjoying each other's company.

By the fourth month, Ken realized how deeply he cared for Ann, and he began to feel anxious. He wasn't sure what made him feel anxious, but he knew that he was feeling different from before.  Whereas he felt loving and carefree whenever he was with Ann before, he now felt ambivalent about seeing her.

Rather than feeling carefree and in a state of bliss, he now experienced anxiety just before they got together.  He tried to think of what changed, but he couldn't think of anything.  Nothing had occurred that would account for his anxiety.

Sometimes, he wondered if he just didn't care for her anymore, but he knew this wasn't true.  If anything, he cared for her more now than during their few couple of months dating, so none of this made sense to Ken.

Ken had been in two other serious relationships before, and he experienced a similar pattern--feeling happy during the early stage of the relationship and then increasingly uncomfortable as time went on.  In each case, he assumed that his feelings had changed or they had "grown apart" and he ended the relationships.  But there was something different about how he felt this time because, even though he felt anxious, he knew he still cared for Ann.

When Ann brought up that he seemed to be more distant around her lately, she asked him if there was anything wrong.  Ken didn't know how to answer her, so he remained quiet for a while.  Then, he assured Ann that he cared for her a lot and wanted to continue to see her.  This response seemed to satisfy Ann, but Ken knew it was just a matter of time before this issue came up again.

As he became increasingly concerned about what was going on for him, he contacted a psychotherapist to try to understand himself. When his psychotherapist asked Ken to talk about his family history, Ken talked about being an only child in a household where his mother was emotionally distant and his father was emotionally and physically abusive.  He had few specific memories of his childhood, but he knew that he was happy to go away to college, and he never moved back in with his parents again.

Ken discussed how emotionally distant he was becoming when he was around Ann.  He also spoke about being concerned that if he didn't get help, he might be jeopardizing his relationship.

After his psychotherapist assessed Ken over the next several sessions, she provided him with psychoeducation about attachment styles.  She told him that due to his traumatic childhood, he developed an avoidant attachment style which surfaced when relationships became more emotionally intimate and threatening to him.

His psychotherapist explained that their work in therapy would be neither quick nor easy, but if he stuck with therapy, he had a chance of overcoming his fearful, avoidant attachment style.

She began by helping Ken to identify his emotions.  Initially, this was very hard for Ken when he thought about his relationship with Ann.  He knew that he was happy at first when they were first getting to know each other.  He also knew that he felt anxious around her lately, but he didn't know why.

His psychotherapist taught Ken how to sense his emotions in his body.  She told him that the body offers a window into the unconscious mind and that if he could sense into his body, over time, he might be able to identify more specifically what he was experiencing (see my article: The Body Offers a Window Into Unconscious Mind).

At first, Ken had difficulty sensing into his body.  It took a while for him to be able to sense tension in his neck and chest.  Then, gradually, he was able to identify other emotions, like fear, when he thought about getting together with Ann.

Over time, Ken also noticed in therapy that as he focused on an emotion in his body, like fear, that it eventually dissipated.  So, after a while, he realized that emotions often come and go and that he was not identified by his emotions.

Ken's psychotherapist paid particular attention to what Ken was able to tolerate with regard to uncomfortable emotions.  She knew that his window of tolerance for emotions that made him uncomfortable was narrow, so she was careful not to have Ken dwell on uncomfortable emotions longer than he could tolerate.

Over time, Ken's window of tolerance expanded so he could tolerate uncomfortable emotions for longer periods of time.  Using Somatic Experiencing, this allowed them to explore what thoughts, memories of physical sensations came up for him as he experienced these emotions.

Over time, Ken had expanded his window of tolerance significantly.  Then, his therapist recommended that they work on the root of his problem, which was the childhood abuse and neglect, using EMDR therapy (see my articles:  How EMDR Therapy Works: EMDR and the Brain).

In the meantime, Ann, who knew that Ken was in therapy working on his problems, was patient.  She mentioned to him that she noticed some progress.  Specifically, she sensed that his ability to remain emotionally connected to her had improved somewhat.  She noticed that he wasn't as emotionally distant with her as he had been before.  This was encouraging to both of Ken and Ann.

Understanding How an Avoidant Attachment Style Affects You and Your Relationship

Over the next year, Ken continued to work with his psychotherapist using EMDR therapy to resolve his traumatic past.  EMDR therapy helped Ken to make emotional connections between his current fear and the fear that he experienced when he was a child.

He also began to develop an ability to separate his fear from childhood from what was getting emotionally triggered in his relationship (see my article:  Overcoming Emotional Trauma: Separating "Then" From "Now").

He understood on an emotional level that, whether he was in a close relationship with Ann or with someone else, this fear would get triggered (see my article:  Coping With Trauma: Becoming Aware of Emotional Triggers).

Eventually, Ken worked through his early trauma, he became more connected to his internal world and more connected to Ann.

Conclusion
Attachment styles are developed early in childhood.  If a child grows up in a secure, loving home environment, all other things being equal, s/he will usually develop a secure attachment style.  If a child grows up in an abusive and/or neglectful home environment, s/he will probably develop an insecure attachment style.

The avoidant attachment style is one form of insecure attachment.  It becomes more obvious in a relationship as the relationship becomes more emotionally intimate.

At that point, what usually happens is that, on an unconscious level, the person with an avoidant attachment style uses the same emotional survival strategy that s/he used as an infant--s/he dissociates, which creates an internal emotional estrangement as well as creating distance from a romantic partner.

Although this is a maladaptive coping strategy as an adult, it keeps him or her from becoming overwhelmed.  However, it also creates the kinds of problems which I described in the vignette above.

Since the root of the problem is in childhood, this is where the therapeutic work needs to be.  However, the psychotherapist must make sure first that the client can tolerate feeling his or her uncomfortable emotions.  If the client can't tolerate uncomfortable emotions, which is usually the case, the therapist needs to help the client to expand his window of tolerance first so that, gradually, s/he can tolerate difficult emotions.

Once the client can tolerate difficult emotions, then the therapist can help the client to overcome the original traumatic experiences which are at the root of the problem using a form of trauma therapy, like EMDR (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
It can be very confusing to realize that your feelings have changed from bliss to anxiety during the course of a romantic relationship which has become more emotionally intimate.

A skilled psychotherapist, who uses experiential therapies, like Somatic Experiencing and EMDR therapy, can help you to expand your window of tolerance and, eventually, help you to work through the root of your traumatic experiences (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than suffering alone, you owe it to yourself to get help in trauma therapy.

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

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

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

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












Saturday, April 14, 2018

Overcoming Your Fear of Allowing Yourself to Feel Your Sadness

Many people have a fear of allowing themselves to feel their sadness.  Their fear is if they allow themselves to feel sadness or grief that they will drown in it, so they use various defense mechanisms to avoid feeling sadness or grief, which prolongs their discomfort (see my articles: Grief in WaitingCoping With GriefDiscovering that Sadness is Hidden Underneath Your Anger, and Allowing Yourself to Experience Your Emotions in a Healthy Way).

Overcoming Your Fear of Allowing Yourself to Feel Your Sadness

Usually people who fear feeling sadness or other feelings that cause them discomfort had experiences as young children where left alone with their emotions, so they were forced to soothe themselves with the limited capacities available to them as children (see my article: Overcoming Your Fear of So-Called "Negative Emotions").

Sometimes, this is related to experiences of childhood abuse and/or neglect where one or both parents were either emotionally unavailable to soothe them or where the parents were the perpetrators of the children's emotional distress (see my article: What is Childhood Emotional Neglect?).

In other cases, the parents weren't dealing with their own emotional discomfort and, as a result, they didn't know how to soothe themselves or their children.  Often, this becomes an intergenerational pattern unless people get help in therapy to cope with their fears of experiencing uncomfortable feelings (see my article: Intergenerational Family Dynamics).

People who fear dealing with sadness or other emotions that are uncomfortable for them usually don't seek out help in psychotherapy for the same reason why they don't allow themselves to feel their full range of their feelings--fear of being overwhelmed by their emotions.  Instead, they might keep themselves distracted and "busy" to ward off uncomfortable emotions (see my article: Are You Constantly "Keeping Busy" to Avoid Uncomfortable Feelings?).

The various forms of trauma therapy, including Somatic Experiencing and other experiential forms of psychotherapy, can be helpful to these clients because the work is titrated to the needs of the client after the psychotherapist assesses the client's ability to tolerate emotions that are uncomfortable to him or to her (see my article: Experiential Psychotherapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Fictional Clinical Vignette: Overcoming the Fear of Allowing Yourself to Feel Your Sadness
The following fictional vignette illustrates how a trauma therapy, like Somatic Experiencing, can help a client to gradually develop the capacity to tolerate sadness so that the problem can be worked through and resolved:

Gene
Gene decided to begin psychotherapy after his medical doctor ruled out any medical cause for his headaches.  Since all tests were negative with regard to a physical cause to his problems, his doctor explained the mind-body connection and how psychological problems can create physical symptoms if these psychological problems are not dealt with and resolved.  The doctor recommended that Gene attend psychotherapy to deal with the underlying emotional reasons for the headaches.

Gene was reluctant to attend psychotherapy, but he also didn't want to continue to have headaches or develop other physical ailments, so he contacted a psychotherapist for a consultation.  During the consultation, Gene told the psychotherapist, "I don't believe in psychotherapy, but my doctor recommended that I begin therapy, so I'm willing to try it."

When his psychotherapist asked Gene about his family history, Gene, who was in his late 30s, said he didn't have clear memories of his childhood.  He provided basic information that he was the oldest of three children and grew up with both his parents in New York City.

He said he remembered that when he was a child, he spent most of his time alone because his parents were preoccupied with their own lives.  He also mentioned that he was not close to his parents or his young brother and sister.  They all lived in the same household, but they were each living a separate life (see my article: Disengaged Families).

With regard to his current relationship with his family, he only saw them a couple of times a year on holidays when Gene and his siblings visited his parents, who now lived in Florida.  He said that family relationships were strained, and he was always glad when he was on his way back to New York.

Gene told his therapist that he had been in one romantic relationship when he was in his late 20s.  He said it ended after a year because his then-girlfriend told him that she didn't feel he was emotionally available to her.  He said that, after the initial stage of passion and excitement in the relationship, he didn't want as much emotional intimacy as his girlfriend did.  He said, vaguely, that he thought they just "grew apart," but he didn't really understand what she meant when she said he was emotionally unavailable.

He also said that, although he dated "here and there," he didn't especially miss being in a relationship because he thought a relationship would demand more from him than he could handle.  He would see friends occasionally, but he spent most of his time alone, which is what he preferred.  Overall, he considered himself to be "a loner" (see my article: Seeing Yourself as a "Loner" vs. Experiencing the Shame of Feeling That You Don't Belong).

As his psychotherapist listened to Gene talk about himself, she could see how tense and uncomfortable he was feeling.  Towards the end of the consultation, she asked him how it was for him to talk about himself and history.  Gene thought about it for a moment, and then he said he wasn't sure how he felt about it but, in general, he never felt comfortable talking about himself.

She explained to Gene that she tended to work experientially and she developed treatment plans in collaboration with each client depending upon their needs.  She also told him that she worked in a way that respected each client's capacity to tolerate dealing the emotions that came up regarding his or her presenting problem.  Then, she provided Gene with basic psychoeducation about experiential psychotherapy (see my article: Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone).

His psychotherapist could tell that Gene was cutting off emotions that were uncomfortable for him and that he probably spent a lot of his childhood using the defense mechanism of dissociation in order to deal with his aloneness and lack of emotional support, which is why he had so few memories from childhood.

When Gene came to his next psychotherapy session, he asked his therapist what he needed to do to "fix things" so he didn't continue to get headaches.  His psychotherapist told him that she would need to get to know him better to assess the problem, and he would need to see if he felt comfortable enough with her to do the work.  She explained that the therapeutic alliance between the therapist and the client takes a while to build, and there would need to be a therapeutic alliance before they did any in depth psychological work.

In other words, there was no "quick fix" for his problems (see my article: Beyond the "Band Aid" Approach to Psychotherapy).

Gene was displeased with this answer.  He wasn't accustomed to the idea of an emotional process and that there would be a process in therapy where he and his psychotherapist would need to develop a relationship.  He thought it would be similar to going to the doctor where he would receive either medication or a shot to deal with his problems.

So, his psychotherapist provided him with more information about the psychotherapy process and how, if there was a good fit between the client and the psychotherapist, the client would learn to trust the therapist over time.  In the meantime, they could continue to explore the timing of his headaches and if these headaches coincided with something that was going on in his life.

At first, Gene said that he didn't see the connection between his headaches and anything that was going on his life.  So, his therapist asked him if he remembered what was going on when his headaches started.

Initially, Gene said he didn't remember anything in particular.  But then, he remembered that his headaches started after his maternal uncle died last year, but he didn't see the connection between his uncle's death and his headaches.  When his therapist asked Gene how he felt about the loss of his maternal uncle, Gene was confused by this question.  So, she asked him specifically how he grieved for the loss.

Gene still didn't understand what his therapist meant by "grieved."  He said he wasn't aware that he did anything in particular other than going to the funeral and paying his respects to his aunt and cousins, which was something that was "expected" of him.  He said he wasn't aware that there was anything more to do about his uncle's death.

His psychotherapist provided Gene with psychoeducation about the rituals that many people perform in order to grieve this kind of loss, but Gene still didn't understand.  He said that, although he cared for his uncle and they were close at times when he was a child, he went to the funeral out of sense of obligation to his aunt and cousins.

As they explored Gene's reaction to his uncle's death, it became apparent to his psychotherapist that Gene was defending himself against his uncomfortable feelings about the loss.  As she watched Gene fold his arms across his chest and look away with barely any eye contact, she could see that he was defending against feeling his sadness.

At one point, as he was talking about the loss of his uncle, Gene became irritated and told the psychotherapist that he didn't see how talking about his uncle's death was going to help him to get over his headaches.  He thought this was a waste of time.

His psychotherapist asked Gene what he was experiencing in that moment, and he said he was feeling annoyed.  Then, she asked him if it would be tolerable for him to stay with that feeling for a moment to see what happened next.  Gene didn't see how this would be helpful, but he agreed to try it.

After a minute, Gene said he was surprised that, as he focused on his feeling, he felt his annoyance starting to dissipate.  His therapist explained to Gene that, often when a person focuses on an emotion, it changes because emotions tend to come and go.

She also explained that each person has a particular capacity to deal with uncomfortable emotions.  She called it their "window of tolerance" (see my article: Expanding Your Window of Tolerance in Psychotherapy So You Can Overcome Emotional Problems).

As they continued to work together, Gene was beginning to discover that he had a narrow window of tolerance, which was why it was so difficult for him to relate to emotions that made him feel uncomfortable, especially sadness.

Over time, Gene also discovered that he was warding off much of his sadness for his uncle's death because he was afraid that he would drown in his sadness if he allowed himself to feel it.  Using Somatic Experiencing, his psychotherapist helped Gene to experience his sadness in a manageable way, rather than dwelling on it for a long period of time in therapy.

Gradually, Gene began to develop a greater capacity to tolerate sadness and he allowed himself to grieve in his psychotherapy sessions.  Having his psychotherapist there to help him with his sadness and grief was an experience that he had never known before because he grew up in an environment where he was alone with his feelings almost all of the time.

As Gene mourned the loss of his uncle, his headaches dissipated.  He realized that when he was warding off his sadness in the past, he was placing himself and his body under a lot of stress, which is what was causing the headaches.

He also realized that, prior to allowing himself to feel his sadness and grief, he feared that his emotions would be overwhelming and he would drown in his emotions.  But, with the help of his psychotherapist and the titration of his emotional experiences so that they were manageable, he was able to cope with whatever came up for him emotionally.

As he opened up to experiencing his emotions more, Gene also realized that he was feeling lonely, but he had not allowed himself to experience that feeling until this point in his therapy.  The loneliness and his increased openness to other people allowed Gene to open up to connecting emotionally with women and the possibility of finding a relationship.

Conclusion
When people shut down emotions that are uncomfortable for them (whether it's sadness, anger or any other emotion), they usually don't realize that this is what they're doing because they're often out of touch with their emotions in general.

Fear of experiencing uncomfortable emotions usually begins at a young age when the child is overwhelmed by emotions that aren't mediated by his parents.  Since children need their parents to help them to cope with uncomfortable emotions, they don't develop the emotional capacity to deal with these emotions, and this continues into adulthood where they have a fear of uncomfortable emotions.

Getting Help in Therapy
Experiential therapy, like Somatic Experiencing, is usually much more helpful to overcome fear of allowing yourself to feel uncomfortable emotions.  The problem with not allowing yourself to experience uncomfortable emotions is that these emotions remain and continue to come up from time to time and get in the way of connecting emotionally with yourself and others.

It usually takes more and more effort to  avoid these feelings, which can develop into physical symptoms, like headaches, irritable bowel syndrome (IBS), stomach problems, and other medical issues.

A skilled experiential psychotherapist will help the client to begin experiencing uncomfortable emotions in a manageable way a little at a time.  During that process, the therapist helps the client to develop and expand their window of tolerance so s/he has a greater capacity over time to experience and eventually let go of these emotions (see my article: How to Choose a Psychotherapist).

If you think you might be avoiding emotions that are uncomfortable for you, you owe it to yourself to get help from a skilled psychotherapist who uses experiential psychotherapy.

Once you have expanded your window of tolerance for experiencing uncomfortable emotions, you might be surprised that you can experience and let go of these emotions over time.

With a greater capacity to feel a range of emotions, you can live a more fulfilling life.

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

I work with individual adults and couples, and I have helped many clients to expand their window of tolerance so they can overcome their fear of their emotions and live a fuller life.

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, April 13, 2018

How Do You Know If You're in an Unhealthy Relationship?

How do you know if you're in an unhealthy relationship?  Being objective about whether or not your relationship is healthy for you can be complicated when you're in love and sexually attracted to someone.  You might overlook certain red flags in your relationship.  This is especially true if you were raised in a family where there was a high level of dysfunction and conflict (see my articles: Relationships: Are You Attracted to People Who Hurt You?Are You in a Toxic Relationship? and Choosing Healthier Relationships).

How Do You Know If You're in an Unhealthy Relationship?
To avoid getting into an unhealthy relationship, it's important to date someone long enough to get to know him or her before you both decide that you're in a committed relationship (see my article: Dating vs. Being in a Relationship: Taking the Time to Get to Know Each Other).

Signs That You're in an Unhealthy Relationship
Here are some red flags to be aware of:
  • Excessive Jealousy:  If you know that you've been faithful to your partner, but your partner exhibits excessive jealousy or s/he is accusing you of cheating, this is a significant red flag that your partner is insecure and possessive and that you're in an unhealthy relationship.  This type of problem rarely, if ever, gets better on its own (see my article: Overcoming the Jealousy and Insecurity That's Ruining Your Relationship).
  • Controlling Behavior: Related to excessive jealousy, your partner might not exhibit controlling behavior at first, but this can develop later on in the relationship.  Controlling behavior includes your partner telling you where you can go, who to socialize with, when to come home, what to wear, and so on.  This type of behavior tends to get worse over time, so if your partner is trying to control you, you know you're in an unhealthy relationship (see my articles: Relationships: Is It Kindness or Controlling Behavior?).
  • Problems With Anger Management: If your partner has problems controlling his or her temper, this is a sign that you're in an unhealthy relationship, especially if your partner refuses to get help.  Problems with anger management include problems with verbal and/or physical aspects of anger management (shouting, making demeaning remarks, breaking things, threatening you, threatening people who are close to you, and so on).
  • Emotional Blackmail:  If your partner uses emotional blackmail to control you, this is a sign that you're in a dysfunctional relationship.  For instance, if you and your partner get into an argument and, to get back at you, s/he stops speaking to you, this is emotional blackmail.  This is not the same as when a partner needs a temporary time out to regroup and then comes back to discuss whatever you were disagreeing about.  This is a deliberate form of manipulation to punish you or to get his or her way (see my article: Breaking the Cycle of Emotional Blackmail).
  • Gaslighting/Manipulation: When someone uses gaslighting, s/he is attempting to deliberately manipulate you to make you think that you're the problem.  When someone engages in gaslighting, s/he knows that s/he is attempting to manipulate.  It's not just a matter that s/he has a different opinion from the partner.  People who engage in gaslighting are often narcissistic and some of them are sociopathic.  This is a sure sign that you're in an unhealthy relationship (see my article: Are You Being Gaslighted?).
  • Addiction: If your partner is abusing substances or engaging in other addictive behavior and s/he refuses to get help, you're in an unhealthy relationship.  Addictive behavior includes excessive drinking, abusing drugs, compulsive gambling, compulsive overspending, sexual compulsivity, compulsive overeating, and so on (see my article: Recovery: Understanding Cross Addiction - Substituting One Addiction For Another).
  • Codependent Behavior: Codependent behavior occurs when one or both partners enable the other's unhealthy behavior.  A typical example of this would be if a partner makes excuses for his or her partner's addictive behavior.  This is a sign of an unhealthy relationship and both people need to be willing to work on their issues in therapy to develop healthier ways of relating to each other (see my article: Overcoming Codependency: Taking Care of Yourself First).
  • Infidelity: If your partner is cheating on you and s/he refuses to get help in therapy, you're in an unhealthy relationship.  Aside from the emotional pain that infidelity causes, it also creates mistrust and it's often hard to get trust back.  This is not to say that everyone should leave a partner who cheated.  Some couples are able to work through infidelity in individual therapy or in couples therapy.  But if your partner refuses to get help, there is little to no chance that your trust can be restored (see my article: Gaslighting and Infidelity).
  • Physical, Emotional and Sexual Abuse: Any form of physical, emotional or sexual abuse is unacceptable and a definite sign that you're in an unhealthy relationship.  Abuse often escalates and gets worse over time.  Your primary concern should be your own safety and well-being.
The items on the above list are some of the most significant signs that you're in an unhealthy relationship, but there might be other signs as well.

Conclusion
I believe that most people know deep down when they're in an unhealthy relationship, but they choose to overlook red flags for any number of reasons.  Denial can also be a strong defense mechanism with regard to not wanting to see the red flags.

Sometimes, people who overlook red flags don't feel good about themselves and they believe that if they let go of the relationship that they're in, they won't find another relationship.  Other people engage in wishful thinking that things will get better on their own, but that rarely happens without help (see my article: Wishful Thinking Often Leads to Poor Relationship Choices).

Getting Help in Therapy
If you think you're in an unhealthy relationship and you're having problems recognizing it or taking steps to preserve your own well-being, you could benefit from working with a licensed mental health professional (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Getting help in therapy from an objective clinical professional is an important first step to taking care of yourself and making important decisions for yourself.

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.