Relationships: Asking Your Partner For Emotional Support

Many people in relationships have problems asking for their emotional needs to be met because it requires intense vulnerability and it also triggers deep fears of rejection, judgment or fear of abandonment.

Asking Your Partner For Emotional Support

In addition, our American culture treats emotional self reliance as a strength which causes many people to view their normal human needs as character flaws or signs of weakness.

Childhood Conditioning

Childhood conditioning can also play a role:

• Early Childhood Emotional Neglect: If someone's childhood emotional needs were minimized, ignored or punished, their nervous system learned that asking for their emotional needs to be met was emotionally and physically unsafe (see my article: What is Childhood Emotional Neglect?).

Childhood Emotional Neglect

• The "Easy" Child Trap: Many people learned as children that they had to earn love and approval by being low maintenance, quiet and overly accommodating and this belief often persists on an unconscious level in adulthood in their relationships.

• Hyper-Independence: Childhood emotional neglect often forces children to become overly self sufficient beyond their developmental capacity, but this is a pseudo-independence because it's a survival mechanism driven by fear and neglect rather than a natural, healthy stage of development. This builds thick emotional walls against relying on anyone else. This pattern continues into adulthood which makes it difficult to ask for emotional support in a relationship (see my article: Masking Vulnerability and Shame By Pretending You Don't Need Anyone).

Fears and Psychological Barriers

• Fear of Being a Burden: People frequently convince themselves that their feelings will overwhelm, stress out or inconvenience their partner. 

Fears and Psychological Barriers to Asking For Emotional Support

• Shame of Being "Needy": Internalized shame makes people worry they will be perceived by their partner as being too "needy", dramatic, high maintenance or emotionally unstable. They have learned from early childhood, often on an unconscious level, that their normal emotional needs were "too much". This often occurs because their parents were overburdened with just trying to survive. For example, the parents  might have working two or more jobs just to be able to meet basic needs. In many cases, the parents also didn't have their emotional needs met and this emotional neglect is part of a long line of intergenerational trauma (see my article: What is Intergenerational Trauma?.).

• The Mind Reading Myth: Many individuals have an unspoken belief that if their partners really loved them, they would automatically know what they need without being asked (see my article: Are You Expecting Your Partner to Be a Mind Reader?).

• Emotional Disconnection: Decades of suppressing feelings can leave someone fuzzy or completely unaware of their own emotional needs.

Relationship Dynamics

• Fear of Rocking the Boat: When a relationship is going relatively well, individuals might remain silent about their unmet emotional needs to protect the harmony in their relationship and avoid conflict.

• Past Experiences of a Partner Weaponing Vulnerability: Some people avoid asking for what they need emotionally because their emotional needs and vulnerabilities in prior relationships were used against them as leverage or ammunition during arguments.

What Are Practical Strategies For Asking For What You Need From Your Partner?

Focus on Your Internal State

• Identify Your Feelings: Pinpoint your emotional need (loneliness, feeling invisible, feeling overwhelmed) before speaking to your partner.

Locate Physical Sensations Related to Emotions

• Locate the Physical Sensation: Notice where the tension is located in your body to help you to connect with what you need. 

• Name the Core Deficit: Figure out if you need reassurance, physical touch, focused attention or validation (see my article: What is Emotional Validation and Why is It Such a Powerful Skill in Relationships?).

• Learn to Separate the Past From the Present: Acknowledge whether your current emotional reaction is being driven by old unresolved childhood wounds or prior relationship experiences (see my article: Learning to Separate Past Experiences From Your Current Experience).

Use Specific Communication Techniques

• Lead With Vulnerability: Use "I feel" statements rather than "You make me feel..." statements.

Asking Your Partner For Emotional Support

• Say the Hard Truth: If you feel afraid to express your needs, start with a phrase like, "It's really scary for me to admit this, but..."

• Describe Your Internal State: Feel into your internal state and become aware if you're telling yourself a story that might not be true. For instance, recognize if you're telling yourself something like "He's bored with me" or "He doesn't love me anymore" when this isn't true. Then, tell your partner, "I'm telling myself that you're bored with me" (or whatever you're feeling) and allow your partner to respond.

• Make Requests That Are Actionable: Ask for specific behaviors instead of vague concepts. For example, instead of saying "I need you show you care more", say "I need you to hold my hand while I'm talking to you about my feelings."

Asking Your Partner For Emotional Support

• Ask For a Specific Time: Ask your partner something like, "Can we find 20 minutes tonight to talk about something that has been weighing on me?" If it's not the right time, schedule another time that works for both of you. If you have children, choose a time you won't be interrupted.

• Remove All Digital Distractions: Turn off and put away phones, turn off the TV, put away the computer and other distractions and sit face-to-face before diving into your discussion.

• Reassure Your Partner in Advance: If they haven't done anything that is making you unhappy, reassure them that they're not in trouble--you just need to share your feelings.

• Keep the Conversation to a Manageable Length: Focus on a specific emotional need rather than listing months or years of unmet emotional needs (see my article: How to Stop "Kitchen Sinking" Your Partner).

Responding to Your Partner's Reaction

• Appreciate Your Partner's Willingness to Listen and Communicate: Thank your partner for listening--even if the conversation is awkward and uncomfortable. Recognize that your partner is experiencing their own emotional vulnerability by just listening.

Express Appreciation to Your Partner

• Validate Your Partner's Perspective: Acknowledge your partner's response. For instance, if your partner is opening up to hearing your unmet needs and you recognize that your partner is tired, acknowledge this to them by saying something like, "I realize you're tired and I appreciate that you're hearing me out."

• Allow Room For Pauses: Give your partner time to emotionally process what you are saying without rushing in to fill in the silence.

• Schedule a Future Check In: Propose circling back in a few days to see how the new approach to communicating your needs is working for you and for your partner.

Get Help in Couples Therapy

Communicating your emotional needs to your partner can be challenging especially if you never learned to do it before.

Get Help in Couples Therapy

A skilled couples therapist who is a licensed mental health professional can help you to learn to express your emotional needs and work out problems in your relationship.

Rather than struggling on your own, seek help from an experienced couples therapist so you can have a more fulfilling relationship.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, IFS, Emotionally Focused Therapy for couples, 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.

Before setting up an appointment, I provide a free 10-15 minute telephone call, so you can call me at (917) 742-2624 during business hours or email me.

What is Somatic Resonance in Therapy and How Is It Healing?

In everyday encounters, somatic resonance occurs when two or more people connect with each other and influence each other on a nonverbal, physical and nervous system level.

Somatic resonance is often called "body to body" dialog. It occurs when your body unconsciously mirrors, tracks or synchronizes with the physiological states of another person. 

Somatic Resonance in Psychotherapy

The physiological state includes heart rate, breathing and muscle tension.

How Does Somatic Resonance Work in Everyday Experiences?

Somatic resonance relies heavily on the nervous system's capacity for interpersonal co-regulation.  This includes:

• Biological Entrainment: When people are in close contact, their heart rates and respiration patterns align.

• Mirror Neurons: Brain networks translate the observed movements and emotions of others into internal physical sensations within your own body.

• Micro-Movements: The body picks up on subtle shifts in posture, vocal tone and facial expressions beneath conscious awareness.

What Are Common Everyday Examples of Somatic Resonance?

You have probably experienced somatic resonance in your everyday life without even being aware of it including experiences like:

• "Truth Chills": Feeling a wave of goosebumps, warmth or tears when someone else shares a deeply vulnerable story 

• Absorbing Stress: Walking into a room and immediately feeling your stomach knot or chest tighten when someone else is anxious

• Contagious Calm: Feeling your heart naturally slow down just by being around a calm, grounded person

What is Somatic Resonance in Therapy and How Is It Healing?

Somatic resonance in therapy is the therapist's ability to use her own physical body and nervous system as a diagnostic and healing tool.

Rather than just listening to words, the therapist tracks her own internal physical sensations to understand the client's unconscious, unspoken emotional states:

• Somatic Attunement: The therapist attunes to her own bodily responses as a way to understand the client's unexpressed emotions and unspoken trauma.

Somatic Resonance in Psychotherapy

• Implicit Communication: Client and therapist communicate through non-verbal cues like micro-expressions, posture shifts, vocal prosody (tone of voice, melody of the voice and vocal inflection). 

• Nervous System Co-regulation: The therapist maintains a grounded, regulated autonomic nervous system which acts as a biological anchor to help the client's dysregulated nervous system safely return to a calm state.

What Are Typical Examples of Somatic Resonance in Therapy?

Somatic resonance manifests through immediate physical tracking during a therapy session which might include:

• Uncovering Hidden Anger: A client speaks with a calm, pleasant voice, but the therapist suddenly feels tightness in her throat or stomach which signals the client's suppressed rage. While the therapist is sensing this, she checks first to ensure that these sensations are not related to anything that might be going on due to her own issues.

• Identifying Dissociation: The therapist suddenly feels an overwhelming fogginess, drowsiness or a sense of "spacing out". After she has checked in with herself internally and she determines that these feelings are not due to something that is going on for her personally, she becomes aware that this is the client's defense mechanisms against painful feelings (see my article: What is Trauma-Related Dissociation?).

• Gauging Grief: The therapist feels an unexpected ache in her chest or a sudden urge to cry just as the client touches upon a seemingly minor memory. Once she has checked in with herself and she has determined that these feelings are not related to anything that is going on personally within herself, the therapist becomes aware that these feelings are due to the client's unacknowledged grief (see my article: The Many Layers of Grief).

What Are the Benefits of Somatic Resonance in Mind-Body Oriented Therapy?

When a mind-body oriented psychotherapist is trained to use somatic resonance, it provides unique therapeutic benefits that traditional cognitive behavioral therapy (CBT) cannot provide. 

Working with somatic resonance shifts the therapy from a conversation about the past to a live in the moment experience. It provides a live physiological transformation in the here-and-now.

The healing benefits include:

• Correcting the Client's "Invisible" Somatic Narrative: Clients often enter therapy with stories that contradict their physiology. For instance, a client might talk calmly about a traumatic event without much, if any, emotion, but the therapist might respond with a sudden spike in adrenaline or chest tightness. This resonance alerts the therapist to hidden, unintegrated trauma. This allows the therapist to address the client's unspoken experience instead of just relating to the client's words. 

Somatic Resonance in Psychotherapy

• Accelerating Physiological Co-Regulation: Traumatized clients often lose their ability to self soothe. They can remain stuck in chronic states of fight, flight or freeze. Using somatic resonance, the therapist's stable, regulated nervous system acts as a biological pacemaker. Sitting with an emotionally regulated, anchored therapist allows the client to safely down-regulate using the therapist's calm state.

• Resolving Transference and Countertransference Safely: In traditional psychotherapy countertransference (the therapist's emotional reaction to the client) can cloud judgment. Somatic resonance transforms these reactions. By tracking her own physical sensations, the therapist can differentiate between her own experiences and the client's unspoken experiences. This prevents clinical blind spots.

• Allowing Survival Energy to Discharge Safely: Trauma survivors often fear their own internal sensations. This often leads to emotional numbing. However, when a therapist uses somatic resonance, she can pace the therapy session by micro-tracking the client's physical activation. This precise pacing ensures that the client can touch upon traumatic memories and safely discharge trapped survival energy without becoming overwhelmed or retraumatized.

• Re-establishing a Body-Based Sense of Safety: Healing from trauma requires that the body know that the danger is over. Since somatic resonance operates below the level of thought, the felt experience of feeling deeply met, mirrored and kept safe by the therapist updates the client's threat detection center (the brain's amygdala). This helps to rewire the client's baseline so they can feel genuinely safe again.

Which Mind-Body Oriented Therapy Modalities Use Somatic Resonance?

Somatic resonance is a basic part of several mind-body oriented therapies including:

• Somatic Experiencing

• Somatic IFS (Internal Family Systems Therapy)

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

About Me

I am a licensed psychotherapist, hypnotherapist, EMDR, AEDP, IFS (Parts Work), EFT (for couples), Somatic Experiencing and Certified Sex 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.

How Does Happiness Change With Age?

I have been focusing lately on the topic of happiness (see my articles: What is Happiness? and Why Chasing Happiness Doesn't Work).

In the current article, I'm focusing on how happiness changes with age.

Happiness as a Teenager vs Happiness as an Adult

According to social psychologists, how we experience happiness changes with age.  

When I was a teenager, happiness meant going out on the weekend with my friends to a noisy dance club.

Happiness Changes With Age

These clubs were known as "juice bars" because they served non-alcoholic drinks for teenagers. 

Since we were underage and not interested in alcohol, we didn't care about drinking.  We were there to meet boys our own age and have fun on a noisy dance floor. It didn't matter to us that the music was so loud that, even when we met someone, we had to go outside to talk.

Before the weekend, we spent all week talking to each other about what we would wear and who we hoped to meet at the club. We would visit each other's homes to help each other choose outfits and accessories--all in anticipation of our Saturday night out.

As compared to my teenager self, my experience of happiness today might involve going to a quiet restaurant with friends and loved ones or staying home to read a book or watch a classic movie.

If my teenage self had been told that my adult self would be going to quiet restaurants or reading a book on a Saturday night, she would have been shocked and disappointed. She also would have thought I had become "boring." 

But my current adult self can look back on those dance club nights with nostalgia as having been fun and exciting for the time. I'm glad I did those things at a time when they were new and exciting to me.

When I talk to friends in my age group now, they agree that who they are now and what makes them happy is a lot different from what made them happy as teenagers. 

How Does Happiness Change With Age?

Researchers from Northwestern University have used the term "promotion mindedness" to describe experiences of the young. 

Happiness Changes With Age

It's a time for focusing on hopes and dreams for the future before you have a lot of responsibilities. Even though you know intellectually that you're not immortal, you feel immortal and you hink you can do anything. 

As you get older and you have more responsibilities, these illusions change. Instead of dreaming about endless possibilities, you're trying to maintain what you have worked so hard to achieve, possibly a marriage, children, a house or a career.  So, your priorities change as you get older and what makes you happy also changes.

Teenagers and young adults are typically looking for excitement--like their first experience of sex, finding love and dreaming about a successful career. 

But by the time you become a mature adult, you have achieved many of those things and, aside from maintaining what you have achieved, you want to feel peaceful, relaxed and calm. Dance clubs and raucous parties are probably not high on your list.

What is the U-Shaped Curve of Happiness?

Over the lifespan, happiness follows a u-shaped curve.

Based on psychological and economic studies, the u-shaped curve indicates that happiness tends to be greatest during youth and old age:

• The Youth Peak (early 20s): Young adults typically start with high levels of life satisfaction which is fueled by optimism, fewer responsibilities and freedom to explore.

• The Midlife Low Point (40s to early 50s): Generally, life satisfaction tends to steadily decline, bottoming out at around ages 47 to 49. This slump is usually driven by peak career stress, financial burdens, childcare, caring for elderly parents and unfulfilled youthful expectations.

• The Golden Rise (50s to 70s): After age 50, happiness tends to rebound for most people. Many studies indicate that age 70 is the pinnacle of lifetime satisfaction. Many of these individuals report fewer stressors or career anxiety and greater emotional stability.

Why Do Older Adults Score Higher in Happiness Studies?

According to studies, all other things being equal, emotional well-being thrives in later life for the following reasons:

• The Positivity Effect: According to neurological and psychological studies from institutes like the Stanford Center on Longevity, older brains naturally filter out negative stimuli, choosing instead to focus on positive memories.

Happiness Changes With Age

• Socioemotional Selectivity: Realizing that time horizons are short, older adults tend to let go of superficial social networks and focus more on high-quality, meaningful friendships and family bonds.

• Emotional Regulation: Most older adults have decades of life experience so they usually develop better coping skills as compared to when they were younger. This helps them to handle stress and daily anxieties much better than teenagers or young adults.

All of these findings assume that basic needs like food, shelter, good health and the other necessities of life are taken care of which isn't the case for everyone.  

For instance, these days there are more retirees who are returning to work in order to have the basic necessities of life. 

In addition, if you live in an expensive city, like New York City or San Francisco and you weren't a high earner, your life satisfaction will be different from people who are more financially secure.

Conclusion

Happiness changes with age and, for most people, it tends to develop in a u-shaped curve with happiness being at its highest levels in youth and old age.

So, if you're young, enjoy the excitement and time of new discovery during this phase in your life. If you're older, you can still be open to new experiences and approach life with a sense of wonder and curiosity, but your interests might be different from when you were younger.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT couples therapist, IFS, Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples of all ages 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:

Why Are Close Friends Important? 

How to Develop a Healthy Relationship to Joy and Pleasure

How to Develop a Curious Mindset 

Striving to Be a Lifelong Learner

Seeing Small Wonders All Around Us If We Take the Time to Notice

What is Happiness?

In a prior article, Why Chasing Happiness Doesn't Work, I discussed why happiness remains elusive for so many people who pursue it relentlessly. This raises the age old question: What is happiness?

What is Happiness?

Rather than being a permanent state of euphoria or the complete absence of pain, happiness is a subjective state of well-being. It's characterized by a combination of frequent positive emotions, overall life satisfaction and a deep sense of meaning and purpose.

What is Happiness?

Psychological experts who study happiness see it as an ongoing balance where positive feelings outweigh negative ones and includes a sense of optimism.  

What is the Psychological Breakdown of Happiness?

Positive psychology researchers use the term "subjective well-being" instead of the word "happiness".  They break this down into three main areas;

• Enjoyment: The passing moment-to-moment feelings of pleasure, joy or fun in daily activities.

What is Happiness?

• Satisfaction: The cognitive evaluation of your life as a whole including how well you feel you are progressing towards your goals and values.

• Meaning: A sense of purpose, feeling connected to something larger than yourself and believing your life matters.

Two Philosophical Paths

The debate about what makes a good life goes back at least as far as the ancient Greeks. The two philosophical paths are:

• Pleasure: Pleasure is often derived from what feels good in the moment. It includes indulging in sensory pleasures, self care and immediate gratification. Although the feelings are pleasurable, they are often short lived.

What is Happiness?

• Meaning: Meaning making includes aligning your values, thoughts, choices and actions as well as a sense of purpose in your life.

What is the Connection Between Happiness and Health?

Physical health is directly influenced by your emotional well-being and, at the same time, your well-being influences your physical health.

Medical data from the Harvard T. H. Chan School of Public health indicate that emotional well-being acts as a protective shield for your health and chronic negative emotions place a heavy toll on your major organs.

Health and Happiness

In terms of longevity, happiness can actively protect your heart, decrease stress-induced damage and promote healthy daily choices. As a result, it is a major driver of a longer life. 

Data collected over decades has revealed that, in general, happier individuals have a lower risk of premature death.

How Can You Live a More Meaningful and Purposeful Life?

Happiness researchers have found that long term well-being is influenced by how you structure your daily routine, nurture your relationships and how you respond to stress:

Nurture Deep Social Connections

According to the Harvard Study of Adult Development, deep, high quality social connections are the strongest predictor of life-long happiness and longevity. This includes:

• Practice Helping Others: Spending time and resources on helping others trigger your brain's internal reward system. 

What is Happiness?

• Perform Random Acts of Kindness: The term "random acts of kindness" was coined by Anne Herbert in 1982. Random acts of kindness are selfless, unexpected gestures you make toward others without prompting, expectation of reward or ulterior motives. These gestures can be made towards loved ones, acquaintances or strangers as a way to brighten their day (see my article: What is Kindness?).

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT couples therapist, IFS, 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.

 

Why Chasing Happiness Doesn't Work

People often feel discouraged in their pursuit of happiness because the more they chase it, the more elusive it feels.  

Chasing Happiness Doesn't Work

Chasing happiness creates an emotional paradox which often pushes true well-being away. 

Psychological research reveals that transforming happiness into a rigid, primary goal often creates stress, disappointment and exhaustion instead of fulfillment.

The Illusion of a Final Destination to Happiness

• The Hedonic Treadmill: People often assume there is a fixed finish line--like achieving a specific career rank or purchasing a luxury item. But the truth is that once this kind of goal is achieved, the brain quickly adapts to the new baseline. This, in turn, can spark never-ending desires in the hopes of achieving happiness.

• Time Scarcity: Actively working toward a vague goal of "being happy" makes people extremely aware of time. This causes people to feel they never have enough time in the day which can cause panic and dissatisfaction.

• The Perfection Standard: Treating positive emotions, like happiness, as the default sets unrealistic and unmanageable expectations. When life inevitably brings real challenges, an "expectation gap" forms leading to severe disappointment and discouragement (see my article: Coping With Life's Inevitable Ups and Downs).

Flawed Emotional Management

• Constant Self-Monitoring: Chasing happiness forces people into a constant state of internal evaluation. Constantly asking, "Am I happy yet?" pulls people out of possible immersive, joyful experiences--also known as a flow state (see my article: What is a Flow State?).

Chasing Happiness Doesn't Work

• Suppression of Reality: People often mistakenly try to push negative emotions under the rug. But natural human experiences, like grief, sadness and frustration, are meant to be felt. Trying to suppress these feelings creates an unstable, exhausting psychological foundation.

• The Achievement Deficit: High achievers frequently replace true life enjoyment with strict struggles to achieve success. They treat hobbies or relaxation as a waste of time, which leaves them feeling empty.

Evolutionary Hurdles

• Survival Over Satisfaction: From an evolutionary standpoint, the human brain didn't evolve to be constantly happy. It evolved to survive, reproduce and scan the environment for threats.

• An Inability to Predict What Will Create Happiness: Researchers have discovered that humans have an inability to accurately predict what will make them feel fulfilled in the long run.

A Shift in Focus
To reduce a sense of discouragement, shift your focus away from direct happiness. Instead aim your focus on meaning, resilience, gratitude and deep emotional connection which can allow contentment to happen naturally.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), IFS, 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:

What Are Peak Experiences?  

A "Happy Life" vs a Meaningful Life 

Becoming Your True Self 

Healing From Moral Injury

Moral injury is the profound psychological, social and spiritual distress that occurs when someone perpetrates, witnesses or fails to prevent acts that violate their deeply held moral beliefs and values.

Healing From Moral Injury

Moral injury was originally studied in military veterans returning from war. Now, it's seen as a widespread phenomenon affecting healthcare workers, first responders and everyday individuals.

The consequences of moral injury is that it has a negative impact on a person's conscience, shatters their sense of self worth and erodes their trust in institutions or leaders. 

What Are Core Causes of Moral Injury?

A moral injury is triggered by a Potentially Morally Injurious Event (PMIE) which usually break down into the following categories:

• Acts of Commission: Doing something that actively violates your moral code (e.g., a soldier either accidentally or following orders to harm civilians in a combat zone).

• Acts of Omission: Failing to act or prevent harm when your ethical compass dictates that you should (e.g., as a bystander you fail to stop an assault).

Healing From Moral Injury

• Betrayal: Witnessing individuals in authority or institutions act against what is moral and just, especially in high stakes situations (e.g., an executive ordering employees to hide serious defects in a product that can do harm to consumers).

• Bearing Witness: Observing atrocities, extreme cruelty or systemic injustices without the power to change the outcome (e.g., care workers or visiting relatives witness bed-bound residents suffering from severe bedsores, malnutrition and prolonged isolation due to corporate understaffing and regulatory failures).

What Are the Symptoms and Manifestations of Moral Injury?

When an individual's ethical boundaries are crossed or when they are placed in a situation where they violate their own moral beliefs and values, it alters their worldview.

Common symptoms include:

• Sustained Guilt and Shame: Feeling a persistent sense of remorse or believing "I am a bad person."

• Social Isolation: Withdrawing from loved ones, peers or community activities due to feeling unworthy or that they will "contaminate" others.

Healing From Moral Injury

• Loss of Trust: An inability to trust authority figures, organizational leadership or systems.

• An Existential or Spiritual Crisis: Questioning long-held religious or spiritual beliefs, faith n a higher power or the fundamental goodness of society.

• Anger and Disillusionment: Directing profound bitterness toward a system or the people that forced an impossible choice.

What is the Difference Between Moral Injury and Posttraumatic Stress Disorder (PTSD)?

While moral injury and PTSD often co-occur, they are distinct psychological concepts:

Whereas moral injury is primarily a guilt, shame and values-based condition, PTSD is a mental health condition after experiencing of witnessing a deeply traumatic, terrifying or ife-threanting event or ongoing events. 

Primary Triggers

• Moral Injury: Ethical transgressions or a betrayal of core values

• PTSD: A life threatening, psychological event (or series of events) that overwhelms an individual emotionally and psychologically

Core Emotions

• Moral Injury: Guilt, shame and deep remorse

• PTSD: Fear, horror, helplessness or panic

Biological Impact

• Moral Injury: Identity disintegration (i.e., a shattering of a person's core sense of self, moral identity and personal narrative)

• PTSD: hypervigilance, visual replay (e.g., visual replay, present-moment distortion, flashbacks, body memories and so on) and a heightened startle response

Clinical Status

• Moral Injury: Recognized as a moral problem and clinical focus, but not a separate diagnosis

• PTSD: A formal psychiatric diagnosis

What Are Current Examples of Moral Injury in Everyday Life?

There are many current examples including but not limited to:

• Healthcare Resource Triage: A doctor or nurse is forced to triage care by rationing ventilators or critical ICU bed during a pandemic which, effectively, determines which patients will live and which will die.

• Family and Caregiver Burnout: A family member caring for a relative with severe dementia becomes completely exhausted and places the relative in an understaffed nursing home. This results in a deep sense of abandonment.

• Navigating Marital Separation and Divorce: A parent files for divorce to escape an unhappy marriage, but they experience profound guilt over the emotional distress and disruption caused to their children.

How to Heal From Moral Injury

Since moral injury is a wound of the conscience rather than a fear-based disorder (like PTSD), conventional trauma treatment focused only on anxiety reduction might not be enough.  Recovery requires specialized multi-dimensional support including:

• Meaning Making: Processing the event to contextualize actions within a chaotic or impossible situation.

• Self Forgiveness: Moving away from persistent self punishment and developing self compassion.

Healing From Moral Injury

• Communal Recognition: Speaking the truth to a supportive group of peers who understand the unique pressures of the situation.

• Moral Repair: Engaging in altruistic actions, volunteerism or advocacy work to reaffirm personal values.

• Psychotherapy: Therapy helps to heal moral injury by providing a structured, nonjudgmental place to process guilt and shame, deconstruct impossible standards or responsibility and rebuild a functional moral identity.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, IFS, EFT (for couples), 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.