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 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 a nursing home, 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

The Challenges of the "Sandwich Generation": Raising Children and Taking Care of Elderly Parents

Coping With the Loss of Loved Ones - Common Reactions 

The Many Layers of Grief 

You Continue to Have an Internal Relationship With Your Parents After They Have Died

Coping With the Loss of a Pet

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:

Relationships: Understanding the 4 Cs of the Attachment Behavioral System

Understanding the Impact of Early Attachment Issues on Adult Relationships

What is Emotionally Focused Therapy For Couples (EFT) 

How Can EFT Couples Therapy Help to Improve Your Relationship? 

How to Get the Most Out of EFT Couples Therapy  

Learning to Ask Your Partner For What You Need

Surviving the End of a Relationship

Ending a relationship is often a challenging experience with many complex, non-linear emotional reactions (see my article: Overcoming the Heartbreak of a Breakup).

Surviving the End of a Relationship

Each person's reactions to a breakup vary at different stages, but there are some common reactions, including a mixture of all the feelings mentioned below:

Common Emotional Reactions

• Sadness: Most people experience sadness after a breakup whether they were the ones who wanted the breakup or not. This often involves crying, social withdrawal and a deep sense of loss. For some people it also includes a period of depression.

• Seeking Explanations: Most people have a strong need to understand why the relationship ended, often replaying past events in their mind to try to find answers.

• Shock and Denial: If the breakup was unexpected, many people have a difficult time accepting it at first because the breakup is a shock. This can lead to a sense of denial that the relationship is over or to a sense of numbness.

• Bargaining: Many people will try to regain control by promising to change or plead for another chance. 

• Anger and Resentment: Many individuals feel angry and resentful if they didn't initiate the breakup. This can lead to lashing out against their ex or self destructive behavior.

• Relief: If the relationship was a high-conflict or unhealthy relationship, an individual might experience a sense of relief.

Common Physical and Psychological Reactions

In addition to the emotional reactions, a breakup can affect the body and daily functioning:

• Brain Chemistry: As a result of a breakup, an individual can experience a loss of the "feel good" hormones like dopamine and oxytocin which can lead to withdrawal-like symptoms. This can also create cravings for the ex-partner.

• Physical Symptoms: An individual going through a breakup can experience increased cortisol which can result in muscle tension, headaches, sleep disturbance and changes in appetite.

• Cognitive Symptoms: It's not unusual to experience a temporary decrease in concentration, memory and decision-making abilities.

Recovery Behaviors

Each person has their own individual recovery behaviors that work for them. Some people prefer to get active again and others prefer to spend time on their own in solitude to recover (see my article: What is the Difference Between Loneliness and Solitude?).

• Going No Contact: Many individuals prefer to go no contact with their ex rather than rehashing their feelings, engaging in bargaining or ongoing discussion about anger and resentment.

Surviving the End of a Relationship

• Spending Time in Solitude: There are some individuals who prefer to spend time on their own to deal with a breakup. They might spend time meditating, journaling or doing other solitary activities they find self affirming.

• Re-engaging in Hobbies and Social Activities: Some people find they prefer to immerse themselves in activities that are meaningful to them including engaging in hobbies and social activities. 

• Reframing the Loss: Being able to reframe a loss usually doesn't happen immediately because it can take time to work through some of the more difficult feelings about the breakup. If someone tries to "reframe" too soon in the grieving process, it can mean that they are avoiding dealing with difficult emotions and they just want to fast forward the process too quickly. For individuals who have allowed themselves to go through the stages of grief about the breakup, reframing can mean seeing the loss in terms of a period of self growth and a time to reinvest in themselves by exploring new interests and build resilience.

• Seek Support: Reaching out to supportive friends and family members as well as to a mental health professional can help to deal with the sense of grief, loss, shock or denial which is often involved in a breakup.

How Can Therapy Help to Deal With a Breakup?

Working with a skilled licensed mental health professional provides a safe, supportive and structured environment to process intense emotions and practical changes involved with a breakup.

Surviving the End of a Relationship

Working with an experienced psychotherapist can help to accelerate the healing process by offering an objective perspective as well as tools and strategies that family and friends often cannot provide.

Well-meaning friends and family members often urge individuals who are going through a breakup to "move on" and "get out there and meet someone new" before the person going through the breakup might be ready. 

Aside from providing a supportive environment, a skilled therapist can also help with:

• Normalizing Common Reactions to a Breakup: An experienced therapist knows that there are common reactions to a breakup and won't try to push you to "move on" before an individual is ready. At the same time, if someone is stuck and unable to grieve, a skilled therapist can help the individual to overcome the obstacles that might be getting in their way.

Surviving the End of a Relationship

• Helping With Emotional Regulation and Coping: Experienced therapists can teach clients skills like grounding techniques, mindfulness, breathing exercises as well as other skills to manage intrusive thoughts and emotional distress.

• Restoring Daily Functioning: If a breakup has disrupted sleep, appetite and ability to function in other ways, an experienced therapist can help you to re-establish your routines and regain focus on daily activities.

• Rebuilding Identity: Many people lose their sense of self when a relationship ends, especially a long term relationship. 

• Breaking Relationship Patterns: By looking at past relationship dynamics, you can identify unhealthy patterns and set healthy boundaries in future relationships.

• Regaining Confidence: If the breakup has caused a loss of confidence, a licensed mental health professional can help an individual to regain their confidence. 

About Me

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

As a Trauma 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:

When Love Doesn't Conquer All

Coping With a Breakup When Closure With Your Ex Isn't Possible

How to Be Open to New Possibilities After Healing From a Breakup

Coping With the Death of an Abusive Parent

One of the most complicated experiences of grief is coping with the death of a parent who abused you.

This is especially true if there were times when this parent was kind and caring and, at other times, abusive or just abusive most of the time, which can create confusion for the child being abused. And that confusion often continues into adulthood.

Coping With the Death of an Abusive Parent

In a prior article, Unresolved Trauma: Coping With a Passive Parent Who Didn't Protect You From Abuse, I wrote about an example of this issue in the vignette in that article.

Under these circumstances, it's common to feel a mixture of feelings including relief, sadness, grief, guilt and shame.

Since the parent who abused you is dead and if they didn't express remorse, this means that they can no longer express their remorse and ask for forgiveness. For many adult children, this is its own form of loss.

How to Process Your Emotions While Coping With the Death of An Abusive Parent

• Acknowledge All Your Feelings: It's important to acknowledge all of the mixed feelings you might have towards your dead parent--all the messy feelings like relief, grief, sadness, anger, resentment, guilt and shame.

Coping With the Death of an Abusive Parent

• Be Aware of Your Personal Survival Strategy: Whether your brain and body are numbing or your mind is overanalyzing, recognize that these are your coping strategies for the moment. Grounding techniques and breathing exercises can help you to stay relatively calm. Exercise, even walking, can help you to release some of this "stuck" energy.

• Grieve For the Lost Potential: You might find yourself grieving for the parent you wish you had and deserved to have in addition to any grief you might feel for your actual parent.

Why is Grieving Under These Circumstances So Complicated?

• Biological Paradox: Your brain's attachment system, which seeks connection, and your threat system, which detects danger, are both activated simultaneously. This can lead to internal chaos for you.

• If There Was No Reconciliation: Death removes any chance for the parent to understand, acknowledge and make amends for the abuse. You are left with many unresolved and complicated feelings that you need to work out on your own or, preferably, with the help of a licensed mental health professional who has an expertie in this area.

• Fragmented Memories: It's not unusual for a parent to be warm and loving at one point and threatening and abusive at other times. This can make it very difficult to understand who this parent was to you and how you feel about them. If the abuse occurred when you were young, you might even experience this parent almost as if they are two different people in your life.

• Lack of Validation: Other people might praise your deceased parent at a funeral or memorial service which can feel isolating because it doesn't match your reality. Even close relatives who might know your parent's abusive nature might tell you, "Don't speak ill of the dead" which can also make you feel alone and lonely in your experience.

What Can You Do to Heal?

• Validate All Your Feelings: Accept that it is normal and common to feel many contradictory feelings at the same time. 

• Prioritize Your Peace of Mind: You are not obligated to place your deceased parent who abused you on a pedestal, nor are you obligated to attend their funeral if it will compromise your peace of mind. Others might not understand or agree, but you have to do what is right for you.

• Externalize Your Emotional Pain: Writing a no-holds-barred letter, which you do not send, or writing in your journal can help you to express all your contradictory feelings and begin to process any unfinished business between you and your deceased parent.

• Get Help in Trauma Therapy: Grief counselors often don't have specialized training in how to deal with complex grief like this. Working with a trauma therapist, a licensed mental health professional who is trained in complex trauma, can help you to work through your mixed feelings and overcome the unresolved trauma. There are various modalities of trauma therapy including:

• EMDR (Eye Movement Desensitization and Reprocessing)

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Somatic Experiencing 

• Parts Work Therapy (IFS and Ego States Therapy)

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.

As a Trauma Therapist, I have helped many 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 (917) 742-2624 during business hours or email me.

Also See My Articles:

Grieving For a Parent Who Wasn't There For You

Coping With the Loss of a Loved One: Common Reactions 

Coping With Complicated Grief 

Mourning the Loss of a Father You Have Never Known 

Letting Go of Resentment

Unresolved Trauma: Coping With Resentment For a Passive Parent Who Didn't Protect You From Abuse

Coping with resentment towards a passive parent for their role in childhood abuse or neglect is usually a difficult process (see my article: Letting Go of Resentment).

Coping With Resentment For a Passive Parent

When you were younger, you might have seen this parent as the "safer parent" or the "nice parent" as compared to the parent who was mistreating you.  However, as an adult, you might come to the realization that the parent you thought was safer or nicer didn't protect you from the parent who mistreated you.

Coping With Resentment For the Parent Who Didn't Protect You

Resentment is often a signal that your boundaries were violated and your need for safety was ignored.

Shifting from a child's view to an adult view often includes:

• Allowing the Pedestal to Fall: Shifting from idealizing the passive parent to a realistic understanding of their complex role is a first step in recognizing and coping with your anger and resentment. While it's understandable that, as a child, you might have seen the passive parent as the "good one" compared to the abusive parent, now that you're an adult, you can develop a more mature understanding of why they prioritized the abusive parent's comfort over your well-being. There can be many complex reasons for their passivity, but being aware of this parent's role in your mistreatment is essential to your healing.

• Understanding Responsibility vs Blame: There is a difference between blaming versus responsibility. The passive parent had a responsibility for your safety and well-being when you were a child. This is often a trap that many traumatized individuals get stuck in because they want to be empathetic towards the passive parent and yet they feel resentment towards them.

• Considering the Passive Parent's Humanity: At some point, as an adult, when you have worked through some of your resentment, as part of your healing, you can consider that your passive parent wasn't infallible. Acknowledging your passive parent's flaws, including their own fear, conditioning and their possible unresolved trauma, can help you to see them as a flawed peer.

What Steps Can You Take As An Adult to Deal With Your Resentment?

• Validate Your Reality: Your feelings of resentment and betrayal are real and valid. In many instances, the passive parent tends to minimize your experience in order to keep the peace with the mistreating parent. This might involve the passive parent telling you as an adult, "This happened a long time ago. Why don't you let it go?" or "You turned out alright so why are you still resentful about this?" Rather than allowing the passive parent to minimize your experience, you don't have to participate in the gaslighting as you reclaim your power (see my article: Self Validation).

• Set Firm Boundaries: Boundaries are for your own well-being. They are not meant to hurt your parents. Start by affirming your right to be treated with respect and prioritize your healing and personal growth (see my article: How to Set Boundaries Without Guilt).

• Learn to Stop Self Abandoning: In situations like these, many adult children learn to abandon their own needs to placate the passive parent, so it's important not to self abandon (see my article: What is Self Abandonment?).

• Expect the Possibility of Resistance: If you have changed your role with the passive parent, you might encounter resistance in terms of being described as someone who has been "brainwashed" or, from their point of view, they might say you are unnecessarily resentful. Try to remain calm and firm in your stance.

• Consider Their Limitations: You cannot force the passive parent to change or leave their situation. Each of you must make your own decisions. You also need to prioritize your well-being.

• Get Help in Trauma Therapy: Untangling these complex situations can be difficult to do on your own. You could benefit from working with a trauma therapist who can help you to heal and grow (see my article: How Trauma Therapy Can Help You to Overcome Unresolved Trauma).

Clinical Vignette

The following clinical vignette illustrates the complexities involved in terms of coping with resentment towards a passive parent and how trauma therapy can help with unresolved trauma:

Ann

As an adult, Ann revealed to her mother that had her father touched her inappropriately multiple times when Ann was 10 years old. In response, her mother remained silent for a long time. Then she said, "You're 25 years old. These things happened a long time ago. Why can't you just let it go?" 

Coping With Resentment For a Passive Parent

Ann was stunned. When she could find her voice, she told her mother that the of sexual abuse by her father was traumatic and, as an adult, it impacted her sexual relationship with her boyfriend as well as her prior relationships with other men.

Ann's mother looked uncomfortable, "You know your father was drinking at the time. He probably didn't even know what he was doing. Now that he's dead, let him rest in peace."

Suddenly it dawned on Ann that her mother might have known about the sexual abuse when Ann was a child and her mother didn't stop it, "Did you know what he was doing to me?"

Her mother left the room quickly and Ann realized that her mother did know and she didn't protect her.  Ann felt enraged and followed her mother into the living room, "You knew, didn't you?"

Her mother looked upset, "You don't understand what it was like. When your father got drunk, he would threaten me. I was terrified that if I confronted him, he would hit me. And I wasn't working so I had no money. What was I supposed to do? Where was I supposed to go?"

"So you didn't do anything!" Ann shouted at her, "You just let him do it!"

"You were so young. I thought you wouldn't remember what happened when you got older" her mother responded.

Ann was speechless and she froze in the moment. But when she reconnected with her body, she left her mother's home and drove back to her apartment (see my article: Understanding the Freeze Response Related to Trauma).

On the way home, Ann was in tears. She recalled, as a child, hearing her parents arguing when he was drunk. At the time, she thought of her mother as an angel and her father as a devil.

Now she realized that, as a child, she had idealized her mother. But, as an adult, she now realized that her mother didn't protect her or try to get help to make the abuse stop--even though she knew about the abuse.

After several months of trauma therapy, Ann became aware that of just how angry she was that  her mother didn't take responsibility to protect her from her father.

She told her therapist that, when she was 15, a few months prior to her father's death, she confronted her father about the abuse. Her father told her he couldn't remember what he did when he got drunk and said, "Let's just put this behind us."

Her therapist used a combination of EMDR Therapy and Parts Work Therapy (IFS) to help Ann work through the unresolved trauma including Ann's feelings of resentment and betrayal towards each of her parents.

She and her boyfriend, Mike, also attended sex therapy to work on their relationship. Initially, when they first met, their sex life was good, but as their relationship became more emotionally intimate and Ann felt more emotionally vulnerable, Ann would freeze whenever Mike touched her.

During her treatment, Ann's trauma therapist and her sex therapist collaborated for the benefit of Ann and Mike's therapy.

Eventually, Ann's mother began her own individual therapy to deal with her role as the passive parent.

After a year in her own therapy, Ann's mother told her that she was ashamed that she didn't try to protect Ann and she apologized. She realized she needed to take responsibility for not doing her part to stop the abuse. She had profound regret and shame and she wanted to work towards reconciling her relationship with Ann (see my article: Understanding the Barriers to Reconciliation in Families).

Her mother also revealed to Ann that she had also been sexually abused as a child by her father and, in hindsight, she realized that her own experience complicated her feelings about her husband abusing Ann. She said she didn't want to make excuses. She just wanted Ann to understand.

Ann had a lot of mixed feelings towards her mother, but she wanted to forgive her. She also had mixed feelings about father because there were times when he was sober when Ann was a child that he was mostly a kind and loving father. 

She continued to work in trauma therapy to reconcile her feelings towards each of her parents. Since her father died, Ann had no way to reconcile with him directly, but she realized that adult children continue to have an internal relationship with their parents even after they are gone.

In the meantime, Ann and Mike continued to work on their relationship in sex therapy so that Ann could separate her traumatic experiences with her father from her sexual experiences with Mike.

Conclusion

The first step in these situations is to look at your childhood history with adult eyes.

Get Help in Trauma Therapy

Each person has to decide whether they are willing to reconcile with their parents or not. 

Some people decide that what happened when they were a child was unforgivable and others try to reconcile with one or both parents. 

Others decide to maintain a superficial relationship as opposed to being completely estranged (see my article: Family Estrangements: Understanding the Barriers to Reconcilation).

There is no right or wrong decision. There is only the decision that is right for you as an individual.

Trauma therapy can help you to free yourself from your traumatic history so you can live 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.

As a trauma 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.

 

The Cycle of Perfectionism, Procrastination and Paralysis

In my prior article, Intergenerational Trauma: What is the Link Between Perfectionism and Unresolved Trauma?, I looked at perfectionism through the lens of trauma that is passed on from one generation to the next.

The Connection Between Perfectionism, Procrastination and Paralysis

In the current article, I'm discussing the cycle of perfectionism, procrastination and paralysis (also known as avoidance).

Cycle of Perfectionism, Procrastination and Paralysis

Perfectionism, procrastination and paralysis form a cycle where an obsession with perfection is the driver leading to avoidance (procrastination) and ultimately resulting in inaction (paralysis).

This self-sabotaging loop occurs because impossible standards create anxiety which makes starting or finishing tasks feel overwhelming and risky (see my article: Overcoming Self-Sabotaging Behavior).

Understanding the Cycle of Fear

• Perfectionism (The Driver): Striving for impossible results, setting impossibly high standards and using all-or-nothing thinking.

• Procrastination (The Behavior): Delaying work or some other action because of a fear that the outcome won't meet the impossibly high standards. This inaction or avoidance can be disguised as "waiting for the right time".

• Paralysis (The Result): Becoming stuck and unable to start or finish a task, project or other commitment due to the pressure of wanting it to be "perfect".

How to Break the Cycle

• Be Aware: "Done is Better Than Perfect": Focus on starting and completing tasks rather than making them "perfect".

• Break Down Tasks: Divide tasks into more manageable and less intimidating parts.

• Set Time Limits: Limit the time you spend "polishing" and trying to make something "perfect".

• Practice Self Compassion: Work towards calming down your inner critic and accept that mistakes are inevitable and part of the learning process (see my article: Making Friends With Your Inner Critic).

• Work on Underlying Issues: The cycle of perfectionism, procrastination and paralysis often develops at an early age related to unresolved psychological trauma. Working through these underlying issues with a licensed mental health professional can help you to get to the underlying issues and resolution to the problem.

Clinical Vignette

The following clinical vignette, which is a composite of many different cases, illustrates the cycle discussed above and how psychotherapy can help.

Jean

Ever since she was a child, Jean approached all tasks and projects with a lot of anxiety. Her parents made her do her homework over and over again until they assessed it was "perfect" (excellent penmanship, no erasures, etc).

When she got to college, Jean had problems getting her papers in on time because her need to make everything "perfect" would cause her to either rewrite her papers many times before she could turn them in or her fear of the papers being less than "perfect" caused her to procrastinate and get the papers in late. There were times when she felt so anxious that she wasn't able to even start the papers.

Cycle of Perfectionism, Procrastination and Paralysis

One of Jean's professors, who recognized that Jean was intelligent and hard working, suggested that Jean get help in therapy to overcome these problems.

Working in trauma therapy, Jean gained insight into the origin of her problem and used the tools and strategies her therapist provided to get her papers in on time.

As part of her therapy, her therapist, who used Internal Family Systems Parts Work Therapy (IFS), helped Jean to work through these issues by getting her inner critic to soften and step aside so she could complete her tasks. Jean also learned to strengthen her Core Self so she was no longer influenced by the parts of herself that strove for "perfection".

Get Help in Therapy

If self help techniques haven't helped you to overcome perfectionism, seek help from a qualified mental health professional.

Get Help in Therapy

Overcoming the root cause of your problem can help you to work through these issues so you can lead a more fulfilling 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.

As a Trauma Therapist, I have helped 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.