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Wednesday, May 22, 2019

Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy

May is Mental Health Awareness month.  As part of Mental Health Awareness month, The National Alliance of Mental Illness (NAMI) has chosen the theme of reducing the stigma of mental illness, "Cure Stigma" as its theme this year to acknowledge that a stigma still exists for people with mental illness as well as a stigma for getting help in therapy. In addition, NAMI also to provides information, encourages people to get help, and provides advocacy for people with mental health problems.

Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy
Treating Physical Symptoms Instead of the Underlying Emotional Problems at the Root of the Problem
Research has shown that one in every five Americans has a mental health problem, but many of these same people suffer in silence and never get help.

As a result their symptoms often get worse or develop into physical symptoms.  For instance, a person with untreated anxiety might develop headaches, backaches, digestive problems, insomnia or other physical problems.

Whereas this person might feel ashamed to get help for his anxiety, he feels much more comfortable seeing his primary care doctor about his physical symptoms because there's no stigma about the physical symptoms.

What Are the Consequences of Treating Physical Symptoms Instead of Treating the Underlying Emotional Problems at the Root of the Problem?
With regard to the example above, it's this person's doctor might treat only the anxiety-related physical symptoms without ever treating the underlying anxiety.

The doctor might provide this person with anti-anxiety medication for insomnia, which might help the insomnia, but then the underlying anxiety can manifest in another symptom--like irritable bowel syndrome (IBS).

At that point, the primary care doctor might refer the patient to a GI doctor, who might send this same patient for a CT scan to rule out any serious internal problems.   Finding none, the GI doctor will probably prescribe a different type of medication for the IBS to control the symptoms.

This can go on for quite some time as the anxiety-related symptoms manifest in all different physical symptoms because none of the doctors are dealing with the underlying emotional problem, which is anxiety, that is at the root of the physical problems.

But if someone with similar problems happens to have a primary care doctor who is trained to know that psychological problems are often at the root of medical problems, after the doctor has ruled out more serious physical problems, the doctor will advise the patient to get help in therapy.

Why is There Still a Stigma For Getting Help in Therapy?
Although it's now somewhat more acceptable for people to get help in therapy, many people, who need help, are afraid to seek the assistance that they need for a variety of reasons related to the stigma of going to therapy:
  • They judge themselves harshly for needing help and feel ashamed.
  • They believe they should just "get over" their problems.
  • They believe they would be "self indulgent" or "too self centered" if they went to therapy.
  • They believe only rich people attend therapy.
  • They think that only "crazy" people seek help in therapy.
  • They believe, far from being real, their problems are only in their imagination.
  • They feel they don't deserve help.
  • They believe that they must be "weak" if they need help (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").
  • They believe they will have to remain in therapy for a long time to overcome their problems (see my article: Common Myths About Psychotherapy: Therapy Takes a Long Time).
  • They're worried about what their family and friends might say if they found out that went for help in therapy.
  • They believe the therapist will judge them.
  • They don't know about Federal confidentiality laws, so they believe that their therapist might tell their employer or other people about the problems they discuss in therapy.
  • They believe that going to see a therapist means they're paying the therapist to be their "friend," which makes them feel ashamed because they believe a therapist couldn't actually care about them.
What Can You Do to Reduce Your Fear of Getting Help in Therapy?
  • Know that you're not alone.  There are skilled mental health professionals who can help you.
  • Know that a skilled therapist has experience helping other clients with similar problems to yours and she won't judge you for your problems.
  • Know that a licensed psychotherapist can't divulge your information under Federal law without your written consent unless you're an active harm to yourself or others (you have a thought, intent and plan to hurt yourself or someone else and you refuse to make an agreement with your therapist not to take action) or you're engaging in child abuse (psychotherapists are mandated reporters and must report child abuse to the state).
  • Know that seeking help in therapy doesn't mean you're "weak."
  • Know that seeking help in therapy doesn't mean you're "crazy."
  • Know that everyone needs help at some point in their lives and everyone is deserving of help.
  • Talk to trusted family and friends who would be supportive of your getting help.
  • Know that you can see a psychotherapist for an initial consultation to see if you feel comfortable with her and to obtain psychoeducation about how therapy works (see my article: Why It's Important for Psychotherapists to Provide Psychoeducation About How Therapy Works).
  • Know that you decide what your therapy goals are, you're in charge of your therapy and you can go for as long as you want to go.
  • Most psychotherapists are empathetic towards their clients' suffering.  You're not paying them to be your "friend."  You're paying them for their expertise and time to help you to help yourself.
Conclusion
There are many reasons why people avoid going to therapy even though they would benefit from it.

Although it's considered much more acceptable to go to therapy now than it was in the past, there is still a stigma among some people about going to therapy.

Psychoeducation about psychotherapy is important, and you can consult with one or more psychotherapists to get this information and see which therapist is right for you.

Rather than suffering on your own and risking that your problems will get worse, you would benefit from getting help from a licensed mental health professional so you can resolve your problems and lead a more fulfilling life.

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

I work with individual adults and couples (see my article: How to Choose a Psychotherapist).

I use Emotionally Focused Therapy (EFT), recognized as the leading couples therapy, when I work with couples.

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

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

































Tuesday, May 14, 2019

How Past Psychological Trauma Lives on in the Present

A history of psychological trauma often lives on in the present.  Among other problems, it can create problems with trusting others.  As a result, people with a history of trauma often have internal conflicts about entering into a romantic relationship.  Many clients come to therapy when their conflict between their fear and their longing for love becomes unbearable (see my article: An Emotional Dilemma: Wanting and Dreading Love).

How Past Psychological Trauma Lives on in the Present
Most people want to form loving relationships, so conflicting feelings of dread and longing for a close relationship pose a painful dilemma.

When the source of the fear involves unresolved psychological trauma, people can't work it out on their own.  They need the help of a skilled trauma therapist.

Fictionalized Scenario: Overcoming Psychological Trauma
The following fictionalized scenario, which is a composite based on many actual psychotherapy cases (with no identifying information), illustrates how trauma therapy can help:

Ann
Ten years after she was sexually assaulted while she was on a date, Ann sought therapy to overcome her fears of socializing and developing relationships with men.

During the initial consultation, Ann told the trauma therapist that she was sexually assaulted while she was a senior in college.  All she remembered from that night was going to the local bar near the college on her first date with Ed.

Her next memory was of waking up in her dorm room feeling groggy, achy and bruised around her legs and genital area.  She had no recollection of anything that happened between arriving at the bar and waking up in her bed.

She said that when she confronted the Ed about about her bruises and her grogginess, he was very anxious around her.  He also gave her a vague apology but, despite her insistence, he refused to say anything more.  After that, Ed refused to talk to her anymore.

Ann told the therapist that she knew she had probably been drugged and raped by Ed, but she was so ashamed about the incident that she never spoke to anyone about it.  She was afraid that others would blame her for the assault. She imagined them telling her, "You should have been more careful" or "Maybe you drank too much."  As a result, she told herself that she would put the incident behind her and try not to think about it anymore.

But far from being able to put the incident behind her, from time on, Ann was fearful of meeting and dating men.  She only went out with men when she knew she would be in a group setting where she felt safe.  But even though Ann felt fearful of being alone with a man, she also felt lonely and she wanted to eventually get married and have children.

A couple of weeks before she came for the therapy consultation, Ann celebrated her 31st birthday with her women friends.  Although she had a good time, Ann was also aware that after her birthday celebration, each of her friends was going home to a boyfriend or a husband, and she was going home alone.  She was also aware that, at 31, she was facing her "biological clock" in terms of having children.

During the next several sessions, Ann and her therapist talked about Ann's conflicting feelings about getting involved with men.

They also talked about EMDR therapy, a therapy that was developed in the early 1980s by Francine Shapiro, Ph.D. specifically to help clients to overcome psychological trauma (see my articles: How EMDR Therapy Works: EMDR and the Brain).

After the preparation phase of EMDR therapy, they targeted the memory of Ann waking up after the date where she was assaulted. While doing this work, Ann discovered that her negative belief about herself was "I'm powerless," which was how she felt that day and also how she felt whenever she thought about going out with men that she was currently attracted to in the present.

Over the next few months, based on the EMDR protocol, Ann and her therapist processed her past memories, her current fears and her anticipated fears about the future.

The work was neither quick nor easy, but it delved deeper and was quicker than talk therapy would have been.

After several months of EMDR therapy, Ann no longer felt traumatized by her memory and she no longer feared going out with men (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Overcoming Psychological Trauma With EMDR Therapy
A few months later, she was able to enter into a dating relationship with a man that she met at a professional meeting.  A year after that, she and her boyfriend got engaged.

Conclusion
The fictionalized scenario above was about a sexual assault, but there are many other types of trauma that pose obstacles in terms of feeling safe enough to develop a romantic relationship, including physical and emotional abuse, early loss of and unresolved grief for a parent, early abandonment, a prior history of infidelity or betrayal in a relationship, and other similar situations.

Usually, people don't make the connection on their own between their traumatic history and the obstacles that are getting in their way, and they discover the effect of their trauma once they begin therapy.

Experiential therapies, like EMDR and other trauma therapy, are usually more effective than regular talk therapy for overcoming trauma (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy to Overcome Trauma).

Getting Help in Therapy
If you're struggling with a history of unresolved trauma, you owe it to yourself to get help from an experienced trauma therapist (see my article: How to Choose a Psychotherapist).

By overcoming unresolved trauma, you can free yourself from your history so that you can lead a more fulfilling life.

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

I work with adult individuals, and I use Emotionally Focused Therapy (EFT) for couples.

One of my specialties, as a trauma therapist, is helping clients to overcome psychological 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.