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Monday, March 4, 2019

Overcoming Childhood Trauma With Experiential Therapy: What You Fear Now Has Already Happened

For adults who were traumatized as children, childhood trauma (also known as developmental trauma) remains active emotionally and physiologically throughout adulthood without help in therapy (see my article: Developmental Trauma: Living in the Present As If It Were the Past).

Overcoming Childhood Trauma With Experiential Therapy: What You Fear Has Already Happened

Adults with developmental trauma often experience the same fears they felt as children, however, they usually don't realize that they're experiencing emotions from the past rather than the present.

When old emotions get triggered in the present, they can be so powerful that they feel like they're related to the here-and-now rather than the past, but they are really old activation.

The trauma has already happened, but the emotional triggers make the emotions feel like they're current (see my article: Working Through Psychological Trauma: Separating "Then" From "Now").

The reason why they feel like they're from the present is that the trauma hasn't been processed in therapy.  In other words, the trauma remains "unmetabolized" (or unprocessed) in the brain and the nervous system hasn't been "updated" yet.

Although an adult with developmental trauma can try to tell himself that the current trigger is from an old feeling in the past, this usually isn't enough to keep him from getting triggered again.  This is because this type of self talk appeals to the logical part of the brain, the prefrontal cortex and not the deeper part of the brain, the limbic system, where the trauma resides.

Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma
As a psychotherapist with over 20 years of experience helping clients to overcome traumatic experiences, I know that experiential psychotherapy is the most effective modality to overcome trauma (see my article: Why Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma).

As I've mentioned in my other articles, regular talk therapy doesn't get to the limbic part of the brain, which is why clients often develop insight (or an intellectual understanding) of their trauma, but their traumatic symptoms don't change.  They continue to get emotionally triggered in the present (see my article:  Coping With Trauma: Becoming Aware of Your Emotional Triggers).

Experiential therapy includes EMDR therapy (Eye Movement Desensitization and Reprocessing), Somatic Experiencing (also known as SE), clinical hypnosis, and AEDP (Accelerated Experiential Dynamic Psychotherapy).  See my articles: How EMDR Therapy Works: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Fictional Clinical Vignette: Overcoming Childhood Trauma: What You Fear Has Already Happened
The following fictional vignette, which is similar to many actual psychotherapy cases, illustrates how experiential therapy helps clients to overcome developmental trauma so they're no longer triggered in the present:

Ann
Ann started experiential therapy to overcome her fear of getting romantically involved with a new man she was dating.

Two months before she started therapy, Ann met John at a party where they immediately hit it off.  When John took her out on their first date, Ann felt excited and happy to be spending time with him.  They talked for hours and it was clear that they had a lot in common and there was a strong sexual chemistry between them.

But as they continued to date and their feelings for each other deepened, Ann began to feel more fearful than happy to see John.  She knew that she still liked him a lot and that he liked her very much.  But she kept imagining scenarios where John would hurt her and stop seeing her (see my article: Wanting and Dreading Love).

The deeper her feelings became for John, the more fearful she became.  After a while, she was so fearful that there were times when she was tempted to cancel dates with John to avoid her fear. At the same time, she knew that her fear wasn't really about John.

So, she tried to reason with herself by telling herself that her fears weren't related to anything that John was doing or not doing.  But her self talk only calmed her for the moment until the fears resurrected again (see my article: Fear of Abandonment Can Occur Even in a Healthy, Stable Relationship).

She recognized her fears about John as being part of her usual pattern with men.  Whenever she met a man that she really liked, she would become infatuated with him, but as they continued to see each other, her fears of getting hurt would increase to the point where she would end the relationship (see my article: Overcoming Your Fear of Falling In Love and Getting Hurt Again).

Ann didn't want to allow her fear of getting hurt to ruin her relationship with John.  So, she talked to her close friend, Sue, about it.  Sue told Ann that she tried for years to overcome similar fears in regular talk therapy, but talk therapy didn't resolve her problem.  She told Ann that she was able to overcome these fears in experiential therapy, and she encouraged Ann to find an experiential therapist.

After the initial consultation where Ann gave the therapist an overview of the problem and the therapist explained how she worked with experiential therapy, Ann gave her family history in the next therapy session.

Ann explained that she had been close to both of her parents as a young girl, but she was especially close to her father ("I was a real daddy's girl").  Every day she waited up for her father to come home from work so he could read her a bedtime story before she went to sleep.  He would tuck her in and wait until she fell asleep before he left her side.

But shortly after her sixth birthday, her father told her that he had to go away for three months "to get better."  When she asked him if he was sick, he explained that he had a disorder that was completely curable if he got help.  He told her that he loved her and asked her not to worry while he was gone.

Ann told her therapist that she never saw her father again, and her mother refused to talk to her about what happened to her father.

She explained to her therapist that it was many years later, as an adult, that she found out from her paternal aunt that her father had a drug problem and he went to rehab.  However, he left rehab shortly after he arrived, no one ever heard from him since that time, and the family presumed that he was either still in the grips of his addiction or he was dead.  She told Ann that the family tried to find him, but there was no trace of him.

With regard to Ann's fears about her boyfriend, John, her therapist used a hypnotherapy technique called the Affect Bridge to get to the earliest memory related to Ann's fears of being left by John.  It was not surprising to the therapist when Ann's earliest memory of this fear was feeling abandoned by her father.

Over a period of time, using EMDR therapy, Ann's therapist helped Ann to process her earliest memories related to feeling abandoned by her father.  The therapeutic work was gradual, but Ann felt better each time she did an EMDR session with her therapist.

Since EMDR uses a three-pronged approach of working on the past, present and future, Ann and her therapist worked on her fears from the past, her current fears, and her fears about the future.

By attending her EMDR sessions regularly, Ann gradually overcame her fear of being abandoned, and her relationship with John continued to deepen without her usual fear.

Conclusion
The fictional vignette in this article illustrates how developmental trauma can get played out in the present.

In the vignette, Ann already had an awareness that she experienced the same fears in her prior relationships, those fears led her to end those relationships, and her fears about the current relationship weren't related to anything that John was doing.

Although she was determined not to act on her fears in her relationship with John, her attempts at positive self talk to overcome her fears weren't successful because they didn't get to the area in the brain where the developmental trauma resided, the limbic system.

The Affect Bridge from hypnotherapy helped Ann and her therapist to trace back the origin of Ann's fear.  EMDR therapy enabled Ann to process the trauma from the past and her fears about the present and future so that Ann was no longer affected by her childhood trauma.

Getting Help in Therapy
If you're struggling with developmental trauma, you owe it to yourself to work with a licensed mental health professional who practices experiential therapy.

Once you've processed the earlier trauma, you'll be free from your traumatic history so that you can live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Emotionally Focused Therapy for Couples, and Somatic Experiencing therapist.

I work with individual adults and couples.

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

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




















Monday, February 11, 2019

What's the Difference Between Healthy Shame and Toxic Shame?

Shame is an emotion that is hardwired in all mammals, including humans, from the time of birth.  But not all shame is alike, and being able to distinguish healthy shame from toxic shame is important to your overall well-being (see my articles: Healing Shame in Therapy and Understanding the Difference Between Guilt and Shame).

What's the Difference Between Healthy Shame and Toxic Shame?

Why is Shame Hardwired in All Mammals?
Being able to experience healthy shame can help us from making mistakes that would otherwise alienate us from our family, friends and communities.  This was true even when people lived in small communities or tribes when an individual couldn't survive outside of the community.

The ability to feel healthy shame when we have made a mistake, especially a mistake that was damaging to another, enables us to feel remorse so that we can make amends to the person who was hurt by our mistake.

An Example of Healthy Shame
For instance, if Bob says something that is unkind to his friend, Joe, and can see that the Joe looks hurt, Bob feels a sense of healthy shame for hurting his friend.  As soon as he sees the hurt look on Joe's face, Bob blushes and feels a pang in his stomach because he really cares for Joe and he would never intentionally hurt him.  Bob's sense of empathy is what allows Bob to put himself in Joe's place to sense how Joe feels.

In addition, these physical cues (e.g., blushing and the pang in his stomach) and the feeling of shame are indications to Bob that he needs to apologize to Joe to repair their relationship.  Bob realizes that he was in a bad mood and he took it out on Joe, so he explains this to Joe and gives him a heartfelt apology.  Realizing that Bob's remark is uncharacteristic of Bob, Joe accepts Bob's apology and they go to lunch.  After the apology, their friendship remains intact and they go on as they had before.

But imagine if Bob didn't feel healthy shame, and he made unkind remarks to Joe without any sense of remorse.  You can imagine that sooner or later Bob wouldn't have Joe or many other friends left because he would have alienated them with his unkindness.  And, worst of all, he wouldn't try to repair things with his friends because he had no sense of remorse.

There are some people, who have narcissistic tendencies, who lack empathy for others, and this makes it difficult for them to sense what others are feeling.  As a result, they often don't have a healthy sense of shame, and this complicates their relationships with others.

An Example of Toxic (or Unhealthy) Shame
Ida is an artist, and she enjoys painting. Her friends often compliment her artwork and encourage her to have a gallery showing.  One of her friends, Marie, owns a gallery and she has really been urging Ida to show her work in her gallery.

Whenever Ida gets compliments from her friends, she feels ashamed, especially when Marie invites her to show her work in the gallery.  When she hears these compliments, Ida blushes and her stomach feels queasy.  Sometimes, she feels numb emotionally.  Her first thought whenever she gets compliments on her work is, "I'm really not a good artist.  I wish they would stop complimenting me because it makes me feel so uncomfortable, and my work feels so unimportant."

One day, Marie brought an art dealer to Ida's art studio without telling Ida in advance.  When the art dealer praised Ida's work and offered to represent her, Ida's shame was so acute that she felt like she was going to faint.

On an intellectual level, Ida knew that the art dealer wouldn't be making this offer unless she really thought Ida's work was superior.  But on an emotional level, Ida felt so ashamed that she wanted to hide.  She managed to pull herself together enough to take the art dealer's business card and tell her that she would call her within the next few weeks.

Afterwards, when Ida and Marie were alone, Marie told Ida that she couldn't understand why Ida was so hesitant to take the art dealer up on her offer, "Ida, I know you want to sell your work, and Susan is one of the top art dealers in New York City.  Why aren't you jumping on this?"

Ida wasn't sure how to respond because she felt confused about her own emotions.  When she explained this to Marie, Marie suggested that Ida seek help from a psychotherapist to find out what was blocking her emotionally.

A week later, Ida began therapy with an experiential therapist, who was recommended to her.

Over time, when Ida and her therapist traced Ida's sense of shame to Ida's childhood history, Ida remembered her mother's reactions whenever Ida tried to show her mother her artwork, "My mother would scold me every time, and she would tell me that there were much more important things in life than doing artwork.  Then, she would tell me about children who were starving in other countries and that my sense of pride about my artwork was shameful in the face of the suffering that other children had to endure.  She told me that I was being a showoff."

As Ida talked about this with her psychotherapist, she remembered feeling mortified that she was excited about her artwork.  She continued to do artwork, but she stopped showing it to her mother and she never felt that sense of joy or pride in it. Instead, she felt toxic shame for working on her art.  And whenever someone complimented her artwork, the toxic shame that developed in childhood got triggered.

Ida was relieved to know that there was a coherent explanation to her toxic shame and that she and her therapist were able to trace it back to its origins.  But she also knew that this toxic shame was so emotionally debilitating to her, and she wanted to know how to overcome it.

As an experiential psychotherapist, Ida's therapist used many different therapy modalities, including AEDP, which stands for Accelerated Experiential Developmental Psychotherapy and EMDR therapy, which stands for Eye Movement Desensitization and Reprocessing.

As part of the AEDP modality, the therapist explained that everyone has a multiplicity of selves, including a here-and-now adult self and all the various selves throughout a lifetime, including a young child part, a teenage part, etc (see my article: Understanding the Different Aspects of Yourself).

Then her therapist asked Ida to focus on her internal emotional world and access her adult self in order to speak to her mother from an adult perspective, as opposed to speaking from the frightened child self (see my article: Looking at Your Childhood Trauma From an Adult Perspective).  She encouraged Ida to imagine her mother in the room and asked Ida what she wanted to say to her mother about how she shamed Ida.

Ida was able to access her adult self and felt righteous anger about how her mother shamed her.  From this perspective, Ida imagined her mother in the chair next to her in the therapist's office and she told her mother, "How dare you shame a child like that!  I was only five years old when you started telling me these things.  I wanted you to be proud of my work and to encourage me.  But, instead, you turned my artwork into something ugly, as if I was selfish. I no longer accept your words of shame."

In AEDP, this is imaginal work is called a portrayal, similar to "chair work" in Gestalt therapy or other forms of experiential therapy.  At first, a client might feel awkward about speaking to an imaginal figure in the room.  But most clients eventually become comfortable and feel a sense of relief after they do a portrayal.  Pent up feelings that have been stored in the mind and body for many years are released.

It often takes more than one portrayal to complete this work, and in our example, Ida did a number of portrayals over time in therapy by speaking to her mother and addressing her anger and sadness about the way her mother shamed her.

Her therapist also helped Ida to do "parts work."  She explained to Ida that, whereas portrayals are inter-relational work between the client and someone else, parts work is intrapsychic work.

In Ida's case, she remained grounded in her adult thoughts and emotions and she imagined her five year old self sitting next to her in the therapy session.  She even brought in a picture of herself at the age of five to show her therapist before they began doing the parts work.

Her therapist explained to Ida that Ida's five year old self was the "container" for the toxic shame, and that this younger self needed the help of her adult self to heal.  So, Ida imagined herself talking to her younger self and soothing her with a hug.  She and her therapist repeated this work a number of times in their therapy session.

Then they did EMDR therapy to work through the traumatic emotions that were stored in the five year old self (see my articles: What is EMDR Therapy?How EMDR Therapy Works: EMDR and the Brain and Overcoming Trauma With EMDR Therapy When the Past is in the Present).

After Ida worked through her toxic shame, she was able to feel joy and exuberance again about her artwork.  She no longer felt ashamed.  Instead, she felt a healthy sense of pride about her work.  This enabled her to show her work at her friend's gallery and contact the art dealer for representation.

Conclusion
Whereas healthy shame is hardwired and a necessary part of functioning well in society, toxic shame is traumatic.  Toxic shame often has its origins in childhood when a child was dependent upon his or her parents to survive and had little in the way of healthy defenses to ward off the shame.

Although toxic shame can be emotionally and physically debilitating, experiential therapy can help people with toxic shame to overcome the trauma which led to the development of this unhealthy shame.

Getting Help in Therapy
Regular talk therapy can help clients to develop intellectual insight as to why their shame is toxic, but it's often unhelpful in terms of allowing these clients to change on an emotional level (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy to Overcome Trauma).

Experiential therapy, like AEDP, EMDR, Somatic Experiencing, parts work, and clinical hypnosis, are modalities that help clients to shift out of toxic shame.

If you're experiencing toxic shame, rather than continuing to suffer, you owe it to yourself to work with an experiential psychotherapist, who can help you to work through your problems so you're free of toxic shame.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Emotionally Focused therapy (EFT for couples)  See my article: The Therapeutic Benefits of Integrative Psychotherapy.

I work with individual adults and couples.

I have helped many clients to overcome toxic shame so they could live happier, more fulfilling lives.

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

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


























Thursday, January 31, 2019

Learning to Become More Emotionally Responsive to Your Partner in EFT Couple Therapy

Couples often feel frustrated by recurring negative cycles in their relationship.  Even couples who really love each other and want to be there for each other get stuck in these negative cycles (see my article:  What is Emotionally Focused Couple Therapy (EFT)?)

Learning to Become More Emotionally Responsive to Your Partner in EFT Couple Therapy
Emotionally Focused Therapy for couples provides couples with an opportunity to identify their negative cycles and, with the help of an EFT-trained couple therapist, learn how to restructure their interactions with each other (see my articles:  EFT Couple Therapy: Working Together to Overcome the Negative Pattern in Your Relationship).

Emotional responsiveness is an essential part of a loving relationship.  But a common problem in many relationships is that each individual in the relationship has a different concept of what being emotionally responsive means, and this is one of the problems that can perpetuate a negative cycle.

Fictional Vignette: Learning to Become Emotionally Responsive to Your Partner in EFT Couple Therapy:
The following fictional vignette is typical of the dynamic that often occurs in couples when there are problems with emotional responsiveness.  Even though this vignette is presented with the woman and man having particular dynamics, these dynamics can occur with either a man or a woman.  In addition, these dynamics also occur in same-sex relationships.

Sam and Nina
Several months into their relationship, Sam asked Nina to move in with him.  Although she loved Sam and she knew he loved her, Nina told him that she was hesitant to take the relationship to the next level because she felt he wasn't as emotionally responsive to her as she would like him to be.

At first, Sam was surprised to hear Nina say this and he asked her to give him examples of when this occurred.  Nina gave Sam several examples of when she needed his emotional support and, instead of being emotionally present with her, Sam overlooked how upset she was and gave her suggestions on how to "fix" the problem.

Sam listened carefully as Nina spoke, but he couldn't understand why Nina thought he wasn't being emotionally supportive by recommending ways to "fix" her problem.

Nina tried to explain to Sam that she wasn't looking for him to "fix" her problems, which included longstanding complex problems with her parents.  Instead, she just wanted him to listen and be emotionally present with her as she talked to him about these problems.

No matter how Nina tried to explain what she felt she needed from Sam emotionally, he remained confused.  By the end of their discussion, Nina felt frustrated that Sam didn't understand, and Sam felt irritated that Nina couldn't see that if she used some of his suggestions, she wouldn't have these problems anymore, "Isn't it better to have a solution?"

When Nina told Sam that she thought this problem between them was significant enough for them to go to couple therapy, he told her that he thought she was making things unnecessarily complicated between them and he didn't see why they needed to go to couple therapy.

But as the weeks passed and they were both feeling emotionally distant from each other, and Nina expressed doubts about the relationship, Sam told Nina, reluctantly, that he would agree to go to couple therapy to try to work things out between them.

Since Nina's friend told her that she and her spouse had a very good experience in Emotionally Focused Therapy for couples (EFT), Nina sought an EFT couple therapist.

Initially, Sam was sure that the EFT couple therapist would take Nina's side and blame him for their problems, especially since the therapist was a woman.  But he was surprised that the therapist was evenhanded with each of them and she understood and was able to reflect back Sam's and Nina's individual points of view about their problems together with empathy.

Nina and Sam were both pleased that the EFT couple therapist was able to help them to identify the negative cycle where they got stuck as a couple.

Specifically, the therapist assessed that when Nina told Sam that she wasn't getting what she needed from him, Sam felt criticized and blamed, which caused him to withdraw from Nina.  And when Sam withdrew from Nina, she became angry and frustrated and she would become more strident in her efforts to try to get Sam to understand (see my article: What Happens During Stage One of Emotionally Focused Couple Therapy (EFT)?.

Nina's reaction, in turn, caused Sam to withdraw even further, and the negative cycle went on and on (see my articles: How EFT Couple Therapy Helps "Pursuers" to Become Aware of Primary Emotions to Improve Their Relationship and How EFT Couple Therapy Helps "Distancers" to Become Aware of Primary Emotions to Improve Their Relationship).

Both Nina and Sam agreed that this was their negative cycle.  Sam asked the therapist, "It's great that we know what our negative cycle is, but how do we fix it?"  Hearing him say this, Nina rolled her eyes in anger and frustration and turned to the therapist, "You see?  This is what I have to deal with.  Right away, he wants to know how to 'fix' it" instead of trying to get a deeper understanding of it."

When Sam saw Nina roll her eyes, he folded his arms defensively and slumped in his chair.  It took several more sessions for Nina to stop criticizing Sam and for Sam to understand that therapy, including couple therapy, is a process.  She told them that she felt confident that they would eventually both learn to be more emotionally responsive to one another.

When Nina got to the point where she understood in couple therapy that Sam genuinely wanted to be emotionally responsive to her and improve their relationship and, at the same time, his earlier family experiences were an obstacle for him, Nina became much more open and compassionate towards Sam.

When Sam experienced Nina as more open and compassionate towards him, Sam was more willing to see how Nina's family background had a negative impact on her in their relationship.  He also became much more patient with the couple therapy process.

They both came to understand that an intellectual understanding of their relationship dynamic was not enough and to achieve the changes that they each wanted, the shift would have to occur on an emotional level.

With the help of their EFT couple therapist, Sam and Nina began to restructure their dynamics in their couple therapy sessions by allowing themselves to be emotionally vulnerable with each other to say what they each needed (see my article: What Happens During Stage One of Emotionally Focused Couple Therapy (EFT)?).

At first, when they learned to do this in their couple therapy sessions, they thought they were done with therapy.  But, as their EFT couple therapist told them, they discovered that, at that point, it was difficult to do this on their own without the help of their therapist.  They needed a lot more practice in their sessions to begin to have success on their own.

Like most dynamics in therapy, Nina and Sam found out that their individual progress in couple therapy was often two steps forward and one step back.  But over time, they each became more comfortable being emotionally responsive to each other when they were on their own.

Sam learned how to listen to Nina in an emotionally present and responsive way.  Most of the time, he was no longer focused on "fixing" things between them.  And Nina learned to stop criticizing and blaming Sam when he occasionally slipped up and reverted back to trying to "fix" the problem.

They both learned that, even though they were bound to make mistakes with each other, as everyone does, the most important thing was that they knew how to turn towards each other (rather than away) to emotionally repair their interactions with one another.

Conclusion
In every couple, each person brings a family history that impacts how s/he relates in an adult romantic relationship.

Having compassion and empathy for one another and being willing to change a negative cycle is key to a successful relationship (see my article: EFT Couple Counseling: New Bonds of Love Can Replace a Negative Cycle in Your Relationship).

Learning to Become More Emotionally Responsive to Your Partner in EFT Couple Therapy

How each person in a relationship defines and thinks about being emotionally responsive might be different.

Emotionally Focused Therapy (EFT) for couples is a well-researched, powerful tool to help couples to learn to recognize their negative cycle and change it with the help of the EFT couple therapist.

The EFT couple therapist helps the couple to learn new ways of interacting in their sessions so that, eventually, they can interact in a more emotionally responsive way with each other when they're on their own--instead of remaining stuck in a negative cycle.

Getting Help in Emotionally Focused Therapy (EFT) Couple Therapy
Rather than struggling on your own, you and your partner could benefit from Emotionally Focused Therapy so that you can have a more loving and emotionally satisfying relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Emotionally Focused therapist for couples.

I have worked with individuals and couples for over 20 years.

I work with heterosexual, lesbian, gay, transgender and queer couples.

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

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















Monday, December 17, 2018

Overcoming Your Discomfort With Asking For Emotional Support

There is a Swedish proverb that says, "Shared joy is double joy; shared sorrow is half a sorrow."  This proverb reminds us that we're hardwired for attachment with others, including sharing our joy and sorrow with people who are close to us, and that joy and sorrow are affected in a positive way by the emotional support that we receive (see my article: Overcoming Your Fear of Asking For Help).

Overcoming Your Discomfort With Asking For Emotional Support

Sharing joy is usually easier for most people than sharing sorrow.  Many people think that if they share their sadness, they will be judged critically by others.

Often, this is because they were judged harshly in their family of origin, and they received the message from an early age that no one wants to hear about their sadness.

As a result, they learn to pretend to be happy when they're not, they keep their sadness to themselves and don't receive the emotional support that they need (see my article: How to Stop Pretending to Be Happy When You're Not).

Clinical Vignette: Feeling Uncomfortable Sharing Sadness With Loved Ones
The following clinical vignette, which is a composite of many different cases with all identifying information omitted, illustrates how difficult it can be to share sadness as an adult when, as a child, someone is told that he isn't entitled to feel sad:

Tom
After going through a series of significant losses, including the breakup of a relationship and the loss of a close friend who moved away, Tom decided to start therapy because he felt overwhelmed by sadness, which he didn't understand.

After his psychotherapist heard from Tom about his losses and normalized his sadness, Tom told her that he still couldn't understand why he felt so sad.  He told her that he knew several other people who were going through more difficult problems than he was, and he felt it was "selfish" to feel sad, "Why should I feel sad when so many other people have it much worse than I do?"

Since she had a lot of experience working with clients who didn't think they were entitled to feel sadness, his psychotherapist asked Tom to tell her how his parents handled his sadness when he was a child.

Tom responded, "I stopped trying to get comfort from my parents when I was sad after my father told me when I was five that he would give me something to really feel sad about if I didn't stop saying that I was feeling sad" (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).

Tom explained to his therapist that both of his parents had been through many serious hardships when they were children and they grew up to be "stoic" people ("They didn't believe in feeling sad.  They just believed that, rather than dwelling on your sadness, you needed to do whatever you could to resolve your problems, and that was the end of it").

When his therapist asked Tom if he sought emotional support from his close friends when he was feeling down, he said that it would never occur to him to talk about his sadness--except in therapy--and even then, he usually looked for "a solution" rather than dwelling on his sadness in therapy.

As he thought about it, Tom said that his girlfriend ended their relationship because she didn't like that he couldn't express his sadness to her.  He said that she told him that it bothered her that, after three years, he still wasn't comfortable confiding in her when he was sad.  She also said that it made her feel uncomfortable to share her own sadness, so she ended the relationship.

Before coming to therapy, Tom told his therapist, he tried to "find solutions" to overcome his sadness, but nothing worked, and this confused him.

In response, his therapist provided Tom with psychoeducation about why it's important to share emotions, including sadness, with people who are part of his emotional support system (see my article: Emotional Support From Your Family of Choice).

Over time, Tom was able to see that he held himself to a much harsher standard than he did for his close friends.  He had no problems listening to his friends when they were sad, but he didn't feel entitled going to them with his sadness.

He began to understand in therapy that his experiences with his parents affected how he related to friends and romantic partners.  He also began to see that he felt much more emotionally vulnerable sharing his sadness with loved ones.

Gradually, Tom learned to allow himself to be more emotionally vulnerable with his close friends. Several months later, when he entered into a new relationship, he began to open up more to express his sadness so that he would be more emotionally authentic with his girlfriend.

As he received positive feedback and emotional support from his friends and girlfriend, Tom felt more comfortable opening up more to express the sadness that he never felt entitled to before.

He also realized that when he shared his sorrow with people close to him, he had such a sense of relief because his sadness diminished as he shared it.

Conclusion
Early childhood emotional experiences often affect adult relationships.

If a child receives a message from his parents over and over again that expressing sadness isn't acceptable, this child will grow up to be an adult that has problems expressing sadness.

Since emotional support is important for our overall well-being, when someone has problems expressing sadness, he doesn't experience the emotional relief that comes with getting emotional support.

Getting Help in Therapy
Being unable to express certain emotions, like sadness, is more common than most people think.

Well meaning parents, who have problems feeling their own sadness, can unwittingly create emotional problems for their children by not allowing them to express their full range of emotions.

Most experienced psychotherapists, especially trauma therapists, have experience helping clients to overcome feelings that they're not entitled to express certain emotions.

Working through this problem is usually a big relief for most clients because it allows them to ask for and receive emotional support from loved ones when they need it.

If you're having problems asking for emotional support, you could benefit from working with an experienced psychotherapist, who can help you to overcome this problem.

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

I work with individual adults and couples.

One of my specialties is helping clients to overcome trauma so they can feel and express their full range of emotions.

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

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














Wednesday, December 5, 2018

Working Through Painful Emotions in Therapy

People often start therapy because they can no longer cope with painful emotions related to the past or to current events in their life.  In many cases, initially people avoid dealing with painful emotions for a period of time because they hope that these emotions will go away on their own over time.  But as I mentioned in a prior article, time often doesn't heal all wounds (see my article: Time Doesn't Heal All Wounds).

Working Through Painful Emotions in Therapy


So, when people see that they can no longer bury these emotions and that, in fact, these emotions are having an adverse impact on their life, they decide to come to therapy.

As I mentioned in an earlier article, it's common for most people to feel some degree of anxiety and ambivalence as they anticipate the start of therapy (see my article: Starting Therapy: It's Not Unusual to Feel Anxious or Ambivalent).

Often, people are afraid that they will feel overwhelmed in therapy by the painful emotions that they tried to avoid for so long.  However, psychotherapists who are trained to work with emotional trauma usually know how to titrate the work so that it isn't overwhelming for the client.  In addition, they are usually trained to help the client to de-escalate emotions so that these emotions are more manageable, as opposed to being overwhelming.

Most trauma therapists also prepare clients beforehand to deal with painful emotions that come up, so that they can usually manage their emotions between sessions.

Of course, this doesn't mean that working on a traumatic history will be completely pain free.  But once they begin therapy with a trauma therapist, most clients notice that, in addition to working on trauma in a titrated way, most emotions come in wave patterns with a beginning, middle and end within the same session.  So, the experience usually isn't unrelenting pain.

Also, many trauma therapists will include time to debrief to make sure that clients are feel relatively put together to face the world outside the therapy room after the session is over.  So, even though clients might anticipate that whole sessions will be intolerably painful, they are often surprised to discover that the sessions aren't as painful as they originally anticipated.

Part of the problem for many clients is that they remember what they felt when they were going through the traumatic event and they think they will feel the same way again.  But this usually isn't the case, especially in the case of unresolved childhood trauma.

One of the reasons for this is that, as adults, most people have a greater emotional capacity to deal with difficult emotions as compared to when they were children.

Also, when they're working on unresolved trauma, they are doing it in the presence of a therapist who is empathetic and trained to help the client to maintain dual awareness, which means that while clients are remembering the past, they are also aware that they aren't still in the past--they know that they're sitting with a skilled therapist in the present.  So, the past, even if it's the recent past, usually isn't experienced as being as disturbing as when the trauma originally occurred.

Clients will often comment that working through painful emotions in therapy is a relief because a heavy burden has been lifted from them.  They also begin to notice over time that they are gradually feeling better, experiencing themselves in a new way, and interacting with their loved ones and their environment in a better way.

Many clients have remarked in our sessions that if they had known that dealing with unresolved trauma wasn't as painful as they anticipated, they would have come to therapy much sooner rather than avoiding these issues.

Getting Help in Therapy
While it's understandable that no one wants to feel the pain related to unresolved trauma, these emotions rarely, if ever, resolve on their own and, in fact, these emotions often manifest in other ways, including in physical symptoms.

Working through painful emotions in therapy is a healing process, and healing helps to restore you to your true self (see my article: Becoming Your True Self).

If you have been avoiding dealing with a traumatic issue, you could benefit from working with an experienced trauma therapist.

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

I specialize in working with trauma.

I work with individual adults and couples.

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

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






Monday, November 5, 2018

Learning Not to Jump to Conclusions and Personalize Other People's Behavior

One of the most challenging lessons to learn in life is to not jump to conclusions and personalize other people's behavior, which is the topic of this article (see my article: How Psychotherapy Helps You to Understand and Change Distorted Thinking).

Learning Not to Jump to Conclusions and Personalize Other People's Behavior

Why Do We Jump to Conclusions and Personalize Other People's Behavior?
When people feel rejected, criticized or neglected in some way, they often feel insecure or anxious and this can trigger other earlier traumatic experiences that made them feel the same way.

Most people won't recognize that their earlier experiences are getting triggered and assume that what they're feeling has to do exclusively with the current situation.

Other people have difficulty distinguishing their feelings from objective facts (see my article: Discovering That Your Feelings Aren't Facts).

How to Keep Yourself From Personalizing Other People's Behavior
It's so easy to jump to conclusions about what's going on with someone else and what it means about you.

But before you personalize someone else's behavior that feels hurtful to you, it's important to stop your thoughts from getting ahead of you so that you don't distort the situation and project your insecurities onto the situation.

It's also important to consider that whatever this person did (or didn't do) might have nothing to do with you.

Fictional Clinical Vignette:  Learning Not to Take Other People's Behavior Personally
The following fictional clinical vignette illustrates how personalizing someone else's behavior represents distorted thinking and how to handle this type of situation better:

Ann
After being broken up for over a year, Ann decided to contact her former boyfriend, Alex, after she heard from mutual friends that he was having some medical problems.

On the one hand, just the thought of contacting Alex was enough to make Ann feel anxious and insecure with regard to how Alex would respond to her.  But on the other hand, she knew Alex was kind to her and, when she could be objective about it, she thought he probably would respond well, especially since they were on relatively good terms when she broke up with him.

After she left a message on his voicemail, she waited to hear back from him.  But after several days went by, she began to think that Alex might be angry with her after all, and he might not want to talk to her.

When she checked with a mutual friend, Ann found out that Alex had recuperated, he was doing relatively well, and he was back to work again.  This only fueled even more of Ann's insecurity and anxiety.

As each day passed, Ann became even more convinced that she had made a mistake by leaving a message for Alex.  She felt ashamed about reaching out to him. Her thoughts veered to earlier situations when she felt rejected and ashamed, including times when her father pushed her away as a child when she tried to hug him when he came home from work.

After two weeks had passed, Ann confided in her close friend, Rina, that she was feeling ashamed and angry that Alex hadn't returned her call.  Rina, who knew Alex, told Ann that there was probably a good reason why Alex wasn't calling.  She said she doubted that Alex was angry with her, and she advised Ann not to personalize Alex's lack of response.

By the third week, Alex called Ann and apologized profusely for not getting back to her sooner.  He told her that he had lost his phone with all his personal contacts, and he had only recently found it.  He said he really appreciated hearing from her and he was feeling much better.

Conclusion
Jumping to conclusions and personalizing other people's behavior is a common problem for many people, especially people who have an early traumatic history of being neglected or abused.  When people are triggered, it can be difficult to distinguish the current issue from the past.

It helps to develop the ability to stop your thoughts, which might be distorted, and question the conclusions that you've jumped to about the other person and the situation.

Being patient and getting more information is also helpful so that you don't automatically feel anxious or insecure when, in fact, the other person's behavior might have nothing to do with you.

This applies to personal situations as well as work-related situations (e.g., where a supervisor might seem angry with you but, in fact, is angry because of personal problems).

Getting Help in Therapy
If you find that you have a tendency to personalize other people's behavior due to your own early history, you could benefit from seeing a skilled psychotherapist who can help you to make distinctions between the past and the present and also assist you to work through your early traumatic history.

Getting help in therapy for this issue can help you to have a more fulfilling and meaningful life without the distorted thoughts that can cause so much angst.

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

I work with individual adults and couples.

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

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
















Saturday, October 20, 2018

The Psychotherapist's Role in Holding Open the Possibility for the Client's Transformation

Aside from creating a holding environment where the client feels safe and comfortable with the therapist and the therapeutic process, an experiential therapist also holds open the possibility for the client's transformation.

Transformation

What Does It Mean For the Therapist to Hold Open the Possibility for the Client's Transformation?
Many clients come to therapy feeling doubtful and pessimistic about making positive changes.  There is obviously a part of them that hopes they can change, but there is often a bigger part of them that fears they won't change and they'll be exactly where they started before they began therapy.

A skilled experiential therapist creates a space first in her own mind and then intersubjectively between the client and the therapist for the possibility of positive change--and not just any change but a transformation that makes a significant difference for the client (see my article: Psychotherapy: An Intersubjective Experience Between the Client and the Psychotherapist and A Psychotherapist's Beliefs About Psychotherapy Affects How the Therapist Works With You).

The therapist can often see possibilities even when the client cannot.  This isn't a Pollyanna notion or something that is "woo-woo."  This is based on the therapist assessing the client's personal strengths and history as well the signs of resilience in the client (see my article: Discovering Your Personal Strengths in PsychotherapyHow Experiential Psychotherapy Can Help You to Develop Your Personal Strengths and A Strengths-Based Perspective in Psychotherapy).

Fictional Clinical Vignette: The Psychotherapist's Role in Holding Open the Possibility For the Client's Transformation
The following fictional vignette, which is based on many different cases with no identifying information, illustrates this particular aspect of the psychotherapist's role:

Sam
After he relapsed on alcohol after five years of sobriety, Sam began psychotherapy.

During his first session, Sam expressed the despair about achieving sobriety again.  He talked about his relapse, which occurred while he was on a recent company retreat, "I allowed my colleagues to persuade me to drink after our meeting, even though I knew it was a mistake.  I convinced myself  that I could control it and have just one beer.  Then, I was off to the races and one drink turned into five and then I drank the whole weekend.  When I got back from the company retreat, I spoke with my A.A. sponsor and he recommended that I get into therapy.  So, here I am, but I feel like a total failure and I don't think I can get back to where I was in terms of my sobriety."

Listening to his history of struggling with alcoholism from the time he was a teenager, his long family history of drinking, childhood emotional abuse, and Sam's five year history of recovery, his therapist could tell that Sam had a lot of personal strengths (see my article: Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Seeks Help in Therapy?).

Not only did Sam begin attending Alcoholics Anonymous on his own in his mid-20s, even though his family tried to dissuade him from going, he also successfully worked the 12 Steps with his sponsor and felt he benefited from doing it.  He was also an active participant on his A.A. meetings in terms of providing service for the meetings and he welcomed newcomers who were struggling with alcoholism.

As a teenager, despite his drinking, Sam achieved above average grades and got a college scholarship, even though his family placed little value in education and tried to persuade him not to go because they thought it was a waste of time.

When his therapist asked Sam if he had emotional support from anyone else in his family or from a mentor or coach, Sam said he had no one.  But he said he was determined to move out of a dysfunctional family environment where his father and older brothers drank heavily and he knew that a college education was necessary for him to realize his independence.

After he graduated college with honors, despite heavy drinking, he went onto law school and landed a good job in a top law firm.

Right around the time that Sam began his new job, he realized that he couldn't continue to drink heavily if he wanted to succeed, and he sought help in Alcoholics Anonymous.

He explained to his therapist that it was especially challenging for him to get sober because, similar to his family, many of the attorneys at his company, including the partners, drank heavily.  In fact, drinking was part of the culture in his company, and the attorneys were expected to take out their clients for drinks.

Sam said he knew that he wouldn't stand a chance of achieving sobriety without the support of a sponsor, so he jumped at the chance to talk to an A.A. member with many years of sobriety who was among the members who stood up at the beginners meeting and offered to be an interim sponsor.

His sponsor, who was also an attorney, helped Sam to work the 12 steps and become aware of his triggers to drinking.  He also helped him to navigate the tricky situations at work where there would be heavy drinking with partners and clients.

Sam explained to his therapist that, looking back on it, he realized that his alcohol relapse began even before he picked up his first drink.  He said it began when he cut back on the number of A.A. meetings he was attending and stopped talking as frequently to his sponsor.  Then, it culminated in not using the tools that his sponsor helped him to develop and in believing that he could have just one drink to be "one of the guys" at the company retreat.

When she heard about his family history, his psychotherapist could see that much of Sam's self doubt and fear were rooted in his history with a father who constantly criticized and belittled Sam.  Even though Sam struggled against his father's emotional abuse, there was a part of him that internalized and believed what his father said about him.

During the initial stage of therapy, his therapist sensed that Sam wasn't ready to hear her assessment that he had a lot of strengths and that if she said it at that point, he would deny it and might even leave therapy.  So, instead, she asked him if he was willing to work hard in therapy to see if he could become sober again.  When he told her that he was willing, they set up a treatment plan, which included increasing his A.A. meetings and talking to his sponsor daily as well as once a week therapy.

As his therapist formed a therapeutic alliance with Sam and felt that he was comfortable with her, she began to point out and praise him for the positive steps that he was taking.  She also pointed out his positive qualities that helped him to begin making changes.

Since his therapist was an experiential therapist, she was actively engaged in the therapy and expressed her genuine delight as he got back on track with his sobriety because she knew that this corrective emotional experience was necessary, especially given the history of emotional abuse in his family (see my articles: With Experiential Psychotherapy, There Are No Blank-Slate Psychotherapists - Part 1 and Part 2).

At that point in therapy, Sam was able to take in his therapist's emotional support and her view of him as someone who had the personal strengths to achieve an emotional transformation.

After Sam had a few months of sobriety, his therapist introduced the idea of EMDR therapy to work on the underlying trauma that was a factor in his relapse (see my articles:How Does EMDR Therapy Work: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Over time, Sam's confidence increased and he was able to acknowledge that he had many personal strengths that he could use to cope and maintain his sobriety in addition to therapy and his sober support system.

By the time Sam completed therapy, he realized that his therapist had believed in him all along and that this was a big part of his being able to sustain his sobriety and transform his life.

Conclusion
A skilled psychotherapist is able to hold open the possibility for clients' transformation even when clients are at a low point in therapy.

Being able to assess clients' personal strengths, as well as their challenges, and keeping in mind that with help most people's inclination is to move towards health and well-being, an experienced psychotherapist can hold open a space for positive change--especially when clients cannot see it for themselves.

Even when this holding open of a space for transformation isn't articulated by the psychotherapist, I believe that it is transmitted unconsciously in the intersubjective space between clients and their therapists.

Many clients recognize in hindsight that the therapist's role of holding onto the possibility of positive change was instrumental in helping them to achieve these changes.

Getting Help in Therapy
Experiential psychotherapists tend to be more present and actively involved in therapy.  They have seen clients' transformation against all odds and recognize the signs and signals that clients have the personal strengths necessary to make positive changes (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy).

If you're struggling with problems that you have been unable to overcome on your own, you could benefit from working with an experiential psychotherapist who can help you to achieve a transformational experience in your life.

About Me
I am a licensed NYC experiential psychotherapist who uses contemporary psychodynamic psychotherapy, EMDR, Somatic Experiencing, clinical hypnosis, and emotionally focused therapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to overcome their history of trauma as well as their own self doubts to achieve transformational experiences in their lives.

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

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