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Wednesday, May 13, 2026

What is the Difference Between Psychotherapy and Psychiatry?

Psychotherapy and psychiatry sound alike, so it can be confusing to know what the differences are and when to see a psychotherapist versus when to see a psychiatrist.

The Difference Between Psychotherapy and Psychiatry

What is the Difference Between a Psychotherapy and Psychiatry?
While the two terms might sound interchangeable, there are important key differences:

Psychotherapy
Psychotherapists tend to focus on thoughts, including unconscious thoughts, emotions and behavior.

The Difference Between Psychotherapy and Psychiatry

Psychotherapists have at least a two year Masters degree and many of them also have an additional four years postgraduate training from postgraduate institute (like the Institute for Contemporary Psychotherapy, National Institute of Psychotherapies and other institutes).

Aside from traditional talk therapy, psychotherapists who go on for advanced training also provide specialized therapy including (but not limited to):
Depending upon their skills and training, many psychotherapists can help clients to:
Couples Therapy
And many other behavioral and interpersonal issues.

Most psychotherapy sessions occur at least once a week for 45-60 minutes.

Psychiatry
Psychiatry focuses on the medical side of mental health.

Psychiatrists are mental health professions who are medical doctors (MDs or DOs). They provide differential diagnoses, prescribe psychotropic medication such as antidepressants, anti-anxiety medication, antipsychotic medication and other similar medications.

In the past, psychiatrists provided traditional psychotherapy, like Cognitive Behavioral Therapy (CBT), psychoanalysis and psychodynamic psychotherapy. However, these days most psychiatrists provide medication management. 

Some specialized psychiatrists also provide Electroconvulsive therapy (ECT) for severe mental health conditions such as treatment-resistant major depression, ADHD, schizophrenia and  catatonia (a state where someone is awake but unresponsive to other people or the environment).

After the initial evaluation session, psychiatry sessions tend to be shorter in duration (15-20 minutes) to assess how a client is responding to medication management. After a client has been stabilized on medication, sessions might occur every 3-4 months unless the client needs help with medication.

Integrating Psychotherapy and Psychiatry
Clients, who need medication management, benefit from integrating both psychotherapy and psychiatric treatment and many psychotherapists and psychiatrists collaborate to integrate both treatments (see my article: Medication Alone Isn't As Effective As Including Psychotherapy).

For instance, a psychotherapist who is helping a client with anxiety will often be in touch with the client's psychiatrist to provide feedback on what she has observed in therapy sessions and to get information about medications prescribed. This is only done with a written consent from the client.

While some clients choose to only take medication, research has shown that combining psychotherapy and psychiatric treatments is most effective (when psychiatric treatment is needed) rather than just relying on medication because clients learn coping skills and strategies to deal with their mental health issues. 

Psychotherapy can get to the underlying issues that cause the mental health issues and if worked through in therapy, it's possible that medication won't be necessary for certain clients. 

In addition, when clients stop taking medication for certain mental health issues, they often go back to having the same problems they had before they took medication. For instance, if they never learned to manage anxiety symptoms or get to the root cause of their anxiety in therapy, once they stop taking the medication, they are back to where they were before they stopped taking the medication.

At the same time, there are certain mental health conditions that require medication such as schizophrenia, some forms of ADHD or bipolar disorder to mention just a few.

How to Choose Between Psychotherapy and Psychiatric Treatment
Making a decision about mental health treatment can be a big step, especially if you are new to it.

Consider what you need:
Are you looking for help with understanding yourself, improving your relationships, dealing with situational anxiety or working on unresolved trauma or are you dealing with more complex long-standing psychiatric problems?

If you are dealing with a mental health issue that requires medication (e.g., ADHD, bipolar disorder), starting with a psychiatrist is a good first step. Then, once you are stabilized on medication, you can see a psychotherapist to help you to make the behavioral changes that medication alone won't do.

How to Discover What is Right For You
It's easy to get confused about the differences between psychotherapy and psychiatry.

The Difference Between Psychotherapy and Psychiatry

You're not a broken machine that needs to be "fixed". You're a human being which means that, like everyone else, you have messy, complicated and wonderful parts of yourself. We all do.

Rather than focusing on being "perfect", the goal is developing a better understanding of yourself, practicing self compassion, finding the right tools and strategies to deal with life's inevitable ups and downs and living a meaningful life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:
























































Tuesday, May 12, 2026

How Can Your Dreams Help You to Develop a Deeper Understanding of Yourself?

Dreams are an internal bridge to your unconscious mind.

Develop a Deeper Understanding of Yourself Through Dreams

Dreams help you to process your emotions, problems-solve and confront unresolved fears and desires. This is why they are such a rich source of information about your internal world.

How Can Dreams Help You to Develop a Deeper Understanding of Yourself?
Since dreams bypass the logical part of your waking mind, you can gain a deeper understanding of your unconscious mind in the following ways:
  • Emotional Processing and Regulation: Dreams can help you to identify emotions and work through unprocessed emotions which helps with emotional regulation.
  • Identifying Blindspots: Since dreams bypass your logical conscious mind, they can reveal aspects of yourself that you're not aware of during your waking state including blindspots (see my article: Overcoming Emotional Blindspots).
Develop a Deeper Understanding of Yourself Through Dreams

  • Creative Problem Solving: Dreams can provide you with a fresh perspective on challenges you are trying to resolve. They can provide ways to practice responses to these challenges that you might not think of when you're awake.
  • Highlighting Unresolved Problems: Recurring dreams are often signals about ongoing stressors or unresolved conflicts. 
How Can You Remember and Use Your Dreams For Self Discovery?
Here are some practical tips that can be helpful:
  • Set a Pre-sleep Intention: Before going to sleep, tell yourself that you will remember your dreams.
  • Stay Still When You Wake Up: When you wake up, don't move or open your eyes immediately.  Physical movement and sensory input (light) can make it more difficult to remember dreams.
  • Dream Delving: Dream delving is also called reverse recall. If you only remember a fragment of your dream, focus on that fragment, image or emotion and work backwards. Ask yourself, "Where was I?" and "What was I doing in the dream?". It's also helpful to be aware of the emotions you're experience upon waking up to see if these emotions are related to your dreams.
  • Keeping a Dream Journal: Recording dreams in a dream journal on a consistent basis can help improve dream recall and help you to see growth patterns over time.
  • Active Dream Participation: Techniques like rewriting nightmares after you wake up allow you to consciously interact with the dream material to face fears directly and allow you to work through unresolved issues (see my article: Transforming Nightmares Through Creative Dreamwork).
How Can Psychodynamic Psychotherapy Help You to Understand Your Dreams?
Psychodynamic psychotherapy can help you to understand your dreams by providing a collaborative framework with your therapist to identify symbolic imagery, emotional patterns and unconscious conflicts and desires.

Psychodynamic psychotherapy can help:
  • Identify Themes: Psychodynamic therapists can help you to spot recurring symbols and emotional patterns that might signal unresolved issues.
Develop a Deeper Understanding of Yourself Through Dreams
  • Help With Emotional Regulation: Psychodynamic therapists can help to unpack dreams, including nightmares or scary dreams which can help you to manage your emotions.
  • Provide a Safe Place For Exploration: Therapy provides a safe space to explore difficult feelings that can surface in dreams. 
  • Help With Behavioral Change: When you gain a better understanding of your dreams, this understanding can provide a catalyst to make changes in your life.
There are many different ways of doing dreamwork (see the links below other articles).

About Me
I am a licensed New York psychodynamic psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles:















Sunday, May 10, 2026

How to Develop a Curious Mindset

Being curious has emotional, psychological, social and health benefits.

Developing a Curious Mindset

Being curious also strengthens relationships by promoting active listening and empathy.

Curiosity can also lower anxiety because seeking new information is a "feel good" stimulator that can keep the brain from focusing on worst case scenarios.

What Are the Key Benefits of a Curious Mindset?
The following are some of the benefits of being curious:
  • Enhanced Learning and Memory: Curious people tend to learn faster and retain information better because curiosity activates the brain's reward center and hippocampus
Developing a Curious Mindset
  • Stronger Relationships: Curious people are usually viewed as being warmer and more approachable. They tend to build deeper connections by genuinely engaging in others' ideas and perspectives.
  • Increased Mental Health and Resilience: A curious mindset, which is similar to a growth mindset, helps individuals to adapt to challenges and reduce stress, resulting in greater life satisfaction.  
  • Professional Growth and Creativity: Curiosity drives innovation, boosts career performance, and helps to find solutions to problems.
  • Improved Cognitive Health: Curiosity keeps the mind active and engaged, which strengthens mental capacity.
How to Become a More Curious Person
Becoming a more curious person is a skill that can be developed by shifting from a "know it all" to a "learn it all" mindset.

Curiosity is like a muscle. It requires regular exercise and a willingness to embrace uncertainty.

    Habits to Develop a Curious Mindset
  • Ask "Why" and "How": Move beyond simple facts. Instead of just learning what something is, ask why it originated and how it works so you can gain a deeper understanding.
Developing a Curious Mindset
  • Adopt a "Beginners Mindset": Approach topics that you already know with fresh eyes. Get comfortable with saying "I don't know" or "I don't understand" to keep your mind open to new information. Then, get curious (see my article: Beginners Mind).
  • Keep a Curiosity Journal: Collect ideas, quotes and random questions that pop into your mind throughout the day.
  • Read Outside Your Field: Explore topics, books or articles that are entirely unrelated to your area of expertise.
  • Change Your Daily Routine: Take a different route or try a new hobby to expose your mind to new stimuli.
  • Travel or Explore Locally: Visit new places including museums and other areas where you live that you have not been to before.
  • Connect Unrelated Ideas: Look for bridges between unrelated topics. This type of networked thinking can lead to creative insights and a more engaging way to view the world.
  • Slow Down and Notice: Pay more attention to your immediate surroundings. Simple activities like walking without a set path or people-watching can stimulate a sense of wonder.
    Habits to Enhance a Curious Mindset
  • Listen Without Judgment: Practice active listening where your goal is to understand the other person rather than just waiting for your turn to speak.
Developing a Curious Mindset
  • Ask Open Ended Questions: Instead of asking questions with "yes" or "no" answers, ask questions like, "What is it about ______________ that is so fascinating to you?" 
  • Surround Yourself With Curious People: Join book clubs, discussion groups, volunteer groups or online communities where learning is valued. Curiosity can become "contagious" in the right social setting.
How to Overcome Barriers to a Curious Mindset
  • Face Your Fear of Being Wrong: Many people suppress their curiosity because they're afraid of being wrong or making mistakes. Reframe being wrong as a valuable step in the learning process (see my article: Overcoming Your Fear of Making Mistakes).
  • Replace Judgment With Curiosity: When you feel annoyed or judgmental about someone else's behavior, challenge yourself to come up with alternative explanations for their actions.
  • Experiment and Be Playful: Give yourself permission to try new things--even if you're not good at them--to break out of rigid routines and ways of thinking.
How Psychotherapy Can Help to Develop a Curious Mindset
Therapy helps individuals to become more curious by helping them to shift from an automatic state of judgment and "knowing" to one of open investigation. 

Therapists encourage clients to explore their inner world by modeling curiosity, using open ended questions, and fostering a safe environment:
  • Modeling Compassionate Curiosity: Therapists demonstrate curiosity by asking open-ended questions ("What are you noticing within yourself right now?) instead of making assumptions.  The therapist's "not knowing" stance encourages clients to mirror this openness towards their own thoughts and feelings.
Developing a Curious Mindset
  • Developing Interoceptive Awareness: Therapeutic practices that encourage somatic awareness help clients to pay attention to their bodily sensations--such as tension or a feeling of lightness in the body--which can open the door to curiosity about their emotional, psychological and physical state.
  • Challenging Rigid Narratives: Therapy challenges rigid narratives. It also helps clients to explore discrepancies between goals and behavior. Instead of clients asking themselves, "Why did I do that?", they can learn to get curious and say to themselves, "What lead me to do that?"
Developing a Curious Mindset
  • Reducing Defensiveness: Curiosity is incompatible with judgment. Shifting from a judgmental state to a curious state activates the logical part of the brain and calms the reactive part of the brain.
  • Breaking Stagnation: In relationships, curiosity helps reignite intimacy by encouraging partners to keep asking questions rather than assuming they know everything about each other.
About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles 







Saturday, May 9, 2026

Coping With Ambiguous Loss

The term ambiguous loss was coined by Dr. Pauline Boss in the 1970s. She is an internationally-recognized American educator, researcher and family therapist.

She has written a few books on the topic of ambiguous loss:
  • Ambiguous Loss: Learning to Live With Unresolved Grief
  • Loving Someone Who Has Dementia: How to Find Hope While Coping With Stress and Grief
  • The Myth of Closure
What is Ambiguous Loss?
Ambiguous loss is defined as a loss that lacks closure or a clear understanding. 

Dr. Boss classified two types:
  • Physically Absent But Psychologically Present: A loved one is gone physically but remains present in the minds and hearts of family and friends (e.g., a missing person, estrangement, giving up a baby for adoption, separation). The experience is: Gone but no certainty if they are alive or dead, which often leads to a search for answers.
Coping With Ambiguous Loss
  • Physically Present But Psychologically Absent: In this type of loss a person is physically present but they are emotionally or cognitively absent (e.g., dementia/Alzheimers; traumatic brain injury; chronic depression; an intense preoccupation with work, technology, etc.) The experience: "Here but not here" which leads to grief for what is missing.
Ambiguous loss is considered the most stressful loss because it usually doesn't allow for typical grieving rituals and closure.

Coping With Ambiguous Loss
Coping with ambiguous loss involves accepting that complete closure may not be possible.

Strategies for coping include:
  • Finding Meaning: Acknowledging the ambiguity and that the situation is not within your control but finding personal meaning for yourself
  • Balancing Emotions: Managing the tension between hoping for a return/recovery and accepting the current reality
Coping With Ambiguous Loss

  • Seeking Support: Utilizing therapy or a support group for emotional support and to validate your experience
Clinical Vignette
The following vignette, which is a composite of many different cases, illustrates how someone can cope with the ambiguous loss of a loved one being physically present but psychologically absent:

Gina
When Gina's mother, Ann, was diagnosed with Alzheimer's disease, Gina felt crushed. Her mother had always been an intelligent, active and loving person who held a responsible job as a hospital administrator for many years before she retired.

Coping With Ambiguous Loss

Several years after Ann retired, she complained to Gina that she was getting forgetful and confused. When Gina discussed this with her brother and sister, they decided to take their mother to a neurologist to get evaluated. That's when they were told that their mother was in the middle stage of Alzheimer's.

The neurologist provided them with resources for their mother and support groups for them, including the Alzheimer's Association. 

They talked about the diagnosis as a family and realized they had different views. Gina and her sister felt their mother should be told because they knew she would want to know what was happening to her and be part of the planning. However, their brother, who was the eldest, said their mother would only get upset if she knew so she shouldn't be told.

After going back and forth about this decision for several weeks, the brother relented and said he would go along with what Gina and her sister thought was best.

When they told Ann, they weren't surprised to hear that she already had a feeling that she might have Alzheimer's because her mother and maternal grandmother had it (although people don't always inherit Alzheimer's).

Knowing that she would decline over time, Ann was very sad, but she was also a practical person. She asked her children to arrange for visits with a geriatric social worker and an elder care attorney to advise them.

Gina and her siblings each had different reactions. Gina's brother tended to be stoic and he didn't want to discuss his feelings. Gina and her sister supported each other in their grief. They talked frequently. They also joined an online Alzheimer's support group and felt relieved to hear that other adult children were going through the same emotional ups and downs as they were experiencing.

Gina also sought help in individual therapy because she wanted the privacy to talk about things she didn't feel comfortable talking about in the support group.

She told her therapist that she had always relied on her mother for emotional support and advice whenever she had to make big decisions and the thought of not being able to do that made her feel tremendous grief.

As her mother declined, Gina's therapist recommended that she work on a family photo album with her mother. So, Gina gathered together the loose family photos her mother kept in a box, bought a photo album and went through the pictures with her mother as they placed the pictures in the album.

She and her mother laughed and reminisced about the events in the photos for hours. Her mother told her she hadn't thought about some of the people and events in the photos for a long time.

They also listened to some of her mother's favorite music which she enjoyed when she was younger. This also stimulated certain memories for her mother.

While her mother was still able to garden, Gina's sister and Ann spent time planting in the mother's garden, which they both found relaxing.

Gina's brother took Ann for walks around the neighborhood and pointed out places that Ann knew from years ago. 

Although the medication the neurologist prescribed helped to slow Ann's decline, eventually, Ann could no longer be maintained at home with a home health aide, and Gina and her siblings had to make tough decisions.

At that point, their mother had declined so much that she only remembered her children intermittently. She was also frequently agitated, which was so different from how Gina and her siblings had always known Ann to be prior to the onset of Alzheimer's.

Gina and her sister wanted to explore nursing homes, but their brother refused to even consider the idea. The thought of putting their mother in a facility was beyond what he could bear. So, he decided to take time off from work and, with the help of an aide, took care of Ann full time.

He soon discovered how exhausting this was--even with Gina and her sister relieving him for a few days out of the week and the help of a home health aide.

When Gina's brother needed to return to work, they spoke with the geriatric social worker who helped them to find facilities that were suitable for their mother. They visited several places, which were good but left each of them feeling very sad.  These facilities had memory units to help patients with dementia and Alzheimer's, patients were well taken care of, but the sight of many elderly impaired patients was upsetting.

At that point, Ann was no longer able to make decisions for herself. Gina and her siblings had already consulted with an elder care attorney to establish a durable power of attorney with Gina in charge. Then, they chose a facility close to where they all lived so they could visit Ann frequently.

At each stage of her mother's decline, Gina felt, at times, that her sadness and grief were unbearable. But she continued to discuss her feelings with her therapist and in the Alzheimer's support group because this was unlike any loss she had ever experienced before.

Over time, even though she felt tremendous sadness and grief, she accepted she couldn't control what was happening to her mother. 

There were some days when her mother seemed content to be participating in activities at the facility and other days when Ann glared at Gina and her other children and said, "Why did you put me here?"

Every time Gina felt she had come to accept her mother's condition, she had to contend with the next stage of her mother's decline. 

Gina's friends, who had older parents who were still functioning well, seemed to want to avoid talking to Gina about how she felt. Gina felt frustrated about this, but she understood that they had their own fears for what might eventually happen to their parents.

In addition to therapy and the Alzheimer's support group, Gina also felt some comfort in journaling

After her mother died, Gina felt a mixture of sadness, grief and relief that her mother was no longer suffering. 

She told her therapist she felt guilty that she felt relief and her therapist normalized what Gina was experiencing. She told Gina that it's common for adult children to experience a mixture of emotions including relief.

Gina learned to accept that her grief and sadness would come in waves so that she could feel better for a period of time but, seemingly out of nowhere, she felt tremendous sadness.

Over time, Gina learned to live with her grief. There were even days when she felt hopeful and grateful for what she had in her life. 

She also volunteered to be a peer group leader with the Alzheimer's support group so she could help others to deal with their loss and provide them with a sense of hope.

Conclusion
There are two types of ambiguous loss. I focused on the physically present but psychologically absent because this type of loss isn't addressed as often as the physically absent but psychologically present.

The vignette presented a daughter with a mother who had Alzheimer's. This type of loss could also involve someone coping with a sick or cognitively impaired spouse.

Coping With Ambiguous Loss

Both types of ambiguous loss are difficult, but with help there is hope.

Getting Help in Therapy
Loved ones can be well-meaning but often say and do things that are unsupportive.

A licensed mental health professional, who has an expertise with helping clients to cope with ambiguous loss, can help you to navigate the stages of loss.

Rather than struggling on your own, seek help from a qualified mental health professional so you can learn to cope with ambiguous loss.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years with grief, loss, trauma and many other issues.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles












Friday, May 8, 2026

Relationships: Looking at Your Partner Through an Attachment Lens Instead of an Enemy Lens

In prior articles I have discussed insecure attachment styles including anxious attachment, avoidant attachment and disorganized attachment (see links for these articles at the bottom of this article).

Looking at Your Partner Through an Attachment Lens

Even if you're familiar with attachment styles, including your own style and your partner's, it's easy to slip into looking through an enemy lens when things get tense between you.  

When you look at your partner through an enemy lens, you might feel like things they say are meant as a personal attack against you or proof that they don't care.  

When you switch your focus to an attachment lens, you can see your partner's behaviors as being either a cry for connection or a cry for space if they are overwhelmed.

Looking at Your Partner Through an Attachment Lens Instead of an Enemy Lens
Here are some examples of how you can switch your focus:
  • From Controlling to Anxious: Instead of seeing your partner's frequent texts or calls as controlling behavior, looking at their behavior from an attachment lens, you can consider that your partner, who feels insecure, might need reassurance from you that you're there for them.
Looking at Your Partner Through an Attachment Lens
  • From "Indifferent" to "Overwhelmed": Instead of seeing your partner's silence as being indifferent or cold, consider that your partner might be overwhelmed and they might feel the need to "shut down" in order to avoid escalating a conflict between you or they might be feeling like a failure.
  • From "Picking a Fight" to "They're Reaching Out": Your partner's critical comments can be clumsy, desperate attempts to get your attention because they feel lonely or unimportant to you.
The Negative Cycle is the Enemy--Not Your Partner
In Emotionally Focused Therapy for Couples (EFT) neither partner is "the bad guy". 

Instead of making your partner the villain or making yourself the problem, see your interactions in terms of the negative cycle you both get stuck in (see my article: Breaking the Negative Cycle in Your Relationship With EFT Couples Therapy).

Looking at Your Partner Through an Attachment Lens

When you stop blaming each other, you can recognize that you each have underlying fears that drive the negative cycle between you.  This allows you to move from a combative or defensive posture to a compassionate stance.

Getting Help in EFT Couples Therapy
If you and your partner have been struggling, you could benefit from working with an EFT couples therapist.

Getting Help in EFT Couples Therapy

A skilled EFT couples therapist can help you to improve your dynamic so you can have a more fulfilling relationship.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples over the years.

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

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Articles: