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Tuesday, April 7, 2020

Tips on Getting Along as a Couple During the COVID-19 Crisis

Although being alone and feeling lonely during the COVID-19 crisis is challenging, being in a relationship where you're both staying in your home for long periods of time together can also be challenging (see my article: The Challenge of Keeping Small Arguments From Becoming Big Arguments and Telltale Signs That You and Your Spouse Are Growing Apart).

The sudden shift to all day/all night togetherness can put even the best relationship under a strain (see my articles: Coping and Staying Calm During the PandemicCommon Reactions to the Crisis: Fear and Anxiety and Grieving Losses During the Crisis).

Tips on Getting Alone as a Couple During the COVID-19 Crisis

Depending upon the relationship, couples are responding differently, but most couples are finding it difficult to deal with the shift to being around each other all the time.

Some couples that were already experiencing a strain in their relationship before the pandemic are finding it even more stressful to be around each other.  Other couples have put aside their differences for now to focus on what they need to do to get through the current crisis.

Many couples will go through different experiences at different times.  Couples that are getting along now might not get along well over time due to the ongoing strain of the crisis and vice versa.

It's not unusual for individuals in a relationship to want different things with regard to time together vs time apart, and this is especially true now (see my article: Learning to Compromise About Time Together vs Time Apart).

In addition, when you live together, there are always other issues that need negotiating.

Whether you're currently having problems in your relationship or not, it's a good idea to anticipate and be prepared for possible problems before they occur.

Potential Problems For Couples During the Pandemic:
With the pandemic, there can be unique issues to deal with that affect the health and well-being of both people, including:
  • What to Do If One Person Gets the Coronavirus:
    • In the event that one person becomes infected, both people will need to decide how to handle this.  
    • The dilemma is that the person who is sick would probably need help to get through the illness. But the uninfected person would be fearful of getting the virus.
    • A consultation with your doctor is best.  
  • Whether to Stay in NYC or Leave Temporarily to Go to a Second Home (if possible)
    • Each person might have different feelings about whether to stay or leave, if they're fortunate enough to have a second home that they can go to temporarily. 
    • One person might prefer to stay in New York City and the other person might prefer to leave. They will have to negotiate and might need to compromise about this. 
  • How Much Space and Privacy to Give Your Partner
    • Different people need varying degrees of alone time. Some people like to be with their partner most if not all the time.  
    • If their partner doesn't feel that way, the person who wants to be together most or all the time can feel rejected.  
    • Other people need their own space and privacy to have a sense of well-being.  
    • If you're living in an apartment that's large enough, this can often be negotiated.  But most New York City apartments aren't large so both people might feel too confined in a small space.
  • How to Negotiate Childcare Responsibilities 
    • If a couple is accustomed to normally having childcare either in a daycare or with an nanny whose services are no longer available, they need to figure out how to negotiate childcare responsibilities. 
    • Older children will, obviously, still need parental care and guidance, but they can be more independent.
    • Younger children will need more time and attention, including help with online schoolwork.
    • Will each parent can take turns and give the other parent a break? Will they divide up the tasks or come up with some other way?
    • If a couple already has differences in terms of childrearing, going through this health crisis can highlight those differences and make things worse.
  • Differences in Cleaning Standards Around the Home 
    • Many couples already have differences to negotiate around cleaning standards.  One peron might be neater and want to clean more often, and the other person might be a lot more relaxed about it.  
    • With the current health crisis, there can also be issues around what and how much to disinfect.
  • Whether to Go to the Grocery Store or Order Grocery Online (if possible)
    • Most people are trying to minimize their time outdoors, so one person might prefer to order grocery online and the other might prefer to go to the store.  
    • The person who wants to order online might have concerns about his/her coming into contact with other people in the grocery store as well as having concerns about the partner's exposure to others.
  • Whether to Order Takeout
    • This issue is similar to whether or not to go to the grocery store.  
    • Some people prefer not to cook.  Others feel safer cooking their own food.
  • Whether to Wear Masks Outside or Not (the latest recommendations from the CDC as of the writing of this article)
    • There has been some recent confusion about this.  Originally, people in the US were told that there was no need to wear a mask.  Now CDC is recommending the wearing of masks, but they're not mandating it.
    • One person might feel strongly that wearing a mask is important, while the other person might not want to wear a mask.  This creates a potential problem because the person who feels strongly about a mask might worry that the partner who doesn't want to wear a mask is putting each of them at risk.
  • How to Have Quality Time, Fun and Socialize While Practicing Social Distancing
    • Couples who are accustomed to socializing in person with friends and loved ones might feel at a loss about how to socialize with the new requirement for social distancing.  
    • One partner might enjoy socializing online and the other partner might not.
And so on.

Tips on Getting Along as a Couple During the Pandemic
There are no right answers to the dilemmas that couples face during the pandemic, but here are some tips that might help, which will require some flexibility, compromise and negotiation:
  • Create a Routine and Structure Your Day
    • Since both of your routines have been upended, it's important for a couple to come up with a rough schedule for how they will spend their days.  
    • Each person might have different needs, so that will need to be taken into account.
  • Make Time For Alone Time
    • Make time for time apart to work, nap, talk to friends on the phone or online, read, meditate, watch a program the other person doesn't like or engage in other solo activities.  
    • Try to be respectful of your partner's need for time apart so that when you come together again you'll feel ready to be in each other's company.
  • Learn to Communicate With Each Other Effectively 
    • Over time, nerves can get frayed.  One or both of you is bound to either get inpatient or lose your temper.  Expect it (see my article: Learn How to Communicate More Effectively in Your Relationship). 
    • Learn how to take responsibility for your words and behavior and make amends with your partner as soon as you can.  
    • Pick your battles.  
      • Don't argue over small issues.  It's better to let some things go sometimes rather than arguing about them.
    • Tell your partner if you need time to regroup after an argument. 
      • It's not unusual for one person to want to work things out immediately and for the other person to need time to cool off first.  
      • If you're the person who wants to work things out immediately, recognize that if your partner isn't ready to do it and you push to do it, you'll probably continue to argue, and your partner will resent you.  
      • If you're the person who needs time to cool down before you talk, let your partner know about how long you'll need so it doesn't feel endless to them, and don't stonewall (see my article: Are You a Stonewaller?).
    • Remember to express your love and gratitude to your partner (see my article: The Importance of Expressing Gratitude To Your Spouse).
  • Find Meaningful Ways to Connect
    • One of the biggest complaints that couples often have under normal circumstances is that they barely see each other during the week because of their busy work schedules and then on weekends they feel too exhausted.
    • If you have more time now, talk to your partner about how you would like to spend your time together in a way that's meaningful and enjoyable.
    • This could include:
      • Spending more time having sex and discovering new things that you both want to do sexually, possibly including a willingness to explore new ways of being together and enjoying each other sexually.
      • Redecorating your home
      • Learning a new game
      • Learning a new language together
      • Talking about future plans, including travel plans when it's safe to travel again 
      • Reading aloud to each other
      • Listening to a podcast together
      • Watching a movie you've always wanted to see
And so on.

Getting Help in Couples Therapy
Despite your best efforts, you and your partner might find that getting along during the pandemic
highlights problems that you've had all along that you've never dealt with before.

Even if you got along well before, the stresses and strains involved with too much time together at home, a change in your routine, the loss of things you used to do outside, and the unknowns involved with the pandemic and economy are threatening your relationship.

If you can't work things out on your own, rather than watching the demise of your relationship, you could benefit from atending couples therapy.

Many therapists, including me, are providing individual and couples therapy online (also known as teletherapy, telemental health and telehealth) while they're out of their offices (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Rather than allowing your problems to destroy your relationship, seek help from a licensed mental health professional who works with couples.  It could save your relationship.

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

I have worked with individual adults and couples for over 20 years.

I'm providing online therapy (also known as teletherapy, telemental health and telehealth) during the pandemic.

Emotionally Focused Therapy For Couples (EFT) is the therapy I use to work with couples. EFT is one of the best effective and well-researched therapy to help 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, April 6, 2020

How to Stay Calm and Stop Catastrophizing During a Crisis

During a crisis, like the pandemic we're currently experiencing, it's easy to catastrophize and have thoughts like, "It's the end of the world!" or "We're all going to die" (see my article: Common Reactions to COVID-19: Fear and Anxiety). It's easy to understand how someone might get so panicky and filled with dread because we're in an unprecedented time in modern history (see my article: Are You Catastrophizing?Living With Uncertainty and Tips For Coping With Panic Attacks).

How to Stay Calm and Stop Catastrophizing During a Crisis

What is Catastrophizing?
  • Catastrophizing is an Overreaction to a Current or Anticipated Situation
  • Catastrophizing is More than Just Feeling Afraid or Anxious
    • It goes beyond being afraid and involves persistent worry and heightened anxiety.
  • Expressing Catastrophic Thoughts to Your Loved Ones Can Heighten Their Fears and Anxiety 
    • It's important for your peace of mind and well-being as well as your loved ones to recognize and overcome your distorted thinking.
  • Catastrophizing Clouds Your Ability to Cope and Think Clearly 
    • It makes it difficult to cope, thinking creatively and plan.
    • Depending upon how overreactve you become, it can also psychologically paralyze you to the point where you can't think or act on your behalf or on the behalf of your loved ones.
Tips on How to Stop Catastrophizing
While it's important to take the current pandemic seriously, as previously mentioned, overreacting will get in the way of your coping effectively.  So, it's essential that you get a handle on your distorted thoughts in the following ways:
  • Calm Your Body, Calm Your Mind:
    • Be proactive in terms of calming your mind and your body rather than allowing distorted thinking to make you increasingly anxious.
    • Engage in mindfulness meditation (see my article: Mindfulness Meditation).
    • Do breathing exercises (see my article: Square Breathing).
    • Get physical: Exercise or do yoga based on a level that's right for you. 
    • Use your imagination in a positive way rather than imagining end of the world scenarios (see my article: Using Your Imagination as a Powerful Tool For Change).
  • Maintain Your Perspective: Step Back and Question Your Distorted Thoughts:
    • Write down your thoughts. Be specific so they are clearly defined rather than just nebulous thoughts floating around in your mind.  After you've written them down, take a step back from your thoughts and ask yourself about each one objectively and how likely it is that your worst thoughts will come true.  Once you've written them down and you gain some perspective about your thoughts, you might realize that your fears are exaggerated.
    • If you still believe your thoughts, imagine you can put each thought individually on a large screen 20 feet away from you and examine it. If 20 feet isn't enough, imagine putting the screen further back.  Now that your thought can be viewed at a distance outside of you, how does it seem?  Once again, ask yourself how realistic it is compared to reliable information that you're receiving.  In other words, you're externalizing your thought so you can be more objective.
  • Recognize That Your Thoughts Aren't Facts and You're Not Defined By Your Thoughts:
    • Your thoughts can also shift from one extreme to another.  You might go from catastrophizing to being overly optimistic while you try to get a handle on your thoughts.
      • Remember you might experience your thoughts as very powerful and real, but remember they're only thoughts. Thoughts aren't facts.  
    • Pay Attention to the Sources of Information that You Listen to and How Often:
      • Listen to reliable information.  There's a lot of misinformation circulating around, so use good judgment when you watch, listen or read the news.
      • Don't spread unreliable news because it could have an adverse effect on you and others.
      • Take a break from watching, listen to or reading the news.
    • Recognize That You're Not Powerless:
      • Remember other times when you were in a crisis and you were effective in dealing with the problem at hand. 
      • Remember the sense of agency you had in those prior situations and ask yourself how you can use those same skills in the current situation.
    Getting Help in Therapy
    Social isolation and loneliness can take a toll on most people's psychologicalwell-being.  So if you're feeling overwhelmed, you're not alone.

    Many therapists, including me, are working online to provide you with online therapy, which is also called teletherapy, telemental health and telehealth (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

    Rather than struggling on your own, get help from a licensed psychotherapist, especially if you're having difficulty getting a handle on your catastrophic thinking or you have unresolved trauma that's getting triggered by the current crisis.

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

    I am providing online therapy sessions during this crisis.

    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.

















    Sunday, April 5, 2020

    Self Care During the COVID-19 Crisis: How Mindfulness Can Reduce Stress

    Self care during the COVID-19 crisis is essential to maintaining your health and sense of well-being so you can get through this pandemic and get back to your normal routines when this is over (see my article: The Mind-Body Connection: Calm the Body and Calm the MindCoping and Staying Calm During the COVID-19 CrisisEmpowering Yourself During the COVID-19 Crisis and Self Care: Feeling Entitled to Take Care of Yourself).  In this article I'm focusing specifically on slowing down in a mindful way to notice what's going on in your internal world as well as to pay attention to the environment around you.

    Self Care During the COVID-19 Crisis: How Mindfulness Can Reduce Stress

    Learning to Be Mindfully Aware
    I was talking to a friend a few days ago, and she was telling me about a workshop she took.  She told me the teacher, who was doing the workshop on breathing exercises and Qigong, said that in centuries past, before monks were allowed to learn these exercises from their teachers, they had to spend many years sweeping the steps outside the temple.  We talked about how fortunate we are to be able to learn these exercises through workshops, videos and teaching each other without having to wait years.

    Afterwards, the image of a monk sweeping the temple steps stayed with me.  I thought about the monk performing this task and how, beyond the mundane aspects of it, sweep served to help the monk focus and be more mindful of himself, his task and his environment.

    Just as the monks derived a sense of well-being from living in a mindful way, practicing mindfulness can be a valuable practice to help you reduce stress too.

    Feeling Isolated and Lonely
    Many people feel trapped at home because of the requirement to practice physical distancing. But rather than zoning out in front of the TV or computer, you can use this time to slow down and be more mindful of your body, thoughts, emotions and behavior (see my articles: Coping With Loneliness and Social Isolation During the COVID-19 CrisisUndoing Aloneness: Staying Socially Connected Even Though You're Physically Disconnected and Common Reactions to the COVID-19 Crisis: Fear and Anxiety).

    Tips For Slowing Down and Being Mindful
    So, let's discuss how you can learn to slow down in simple mindful ways:
    • Pay Attention to Your Body
    • Breathe:
      • Most people breathe in a shallow way, which can be anxiety and stress producing. Become aware of your breathing and take full breaths.
      • Take time to do a simple breathing exercise.
    • Do One Thing at a Time
      • Juggling tasks, even if you think you're good at it, is stress producing.  
      • Rather than multi-tasking, do one thing at a time and pay attention to what you're doing so that you can do your task in a mindful way. 
    • Take Breaks During the Day
      • If it's too hard to find the time and space during the day, get up a few minutes early or take a few minutes before you go to sleep to spend some quiet time with yourself  (see my article: Learning to Relax: Going on an Internal Retreat).
    • Maintain Your Perspective
      • Although stressful events, like the COVID-19 crisis, might feel like they'll go on forever, there will be an end.
      • Remember the words, "This too shall pass." 
      • Also, remember other times when you were able to get through very difficult times.
      • Remember that you're probably more resilient than you think (see my article: Resilience: Tips on How to Cope).
    • Take it One Day, One Hour or One Minute at a Time: Try Not to Anticipate What Will Happen in the Future:
      •  Whether you need to take it one day at a time or one minute at a time, try not to project into the future. 
      • Worrying about the future will only make you anxious and deplete your energy (see my article: How to Stop Worrying). 
      • Focus on the here and now (see my article: Being in the Present Moment).
    • Unplug From Your Telephone and Social Media
      • When you're able to take a break, unplug from the TV, your computer, your phone and social media. 
      • Remaining connected all the time is stressful.  
      • You might feel like you have to stay on top of breaking news, but spending a lot of time watching or listening to the news can be stress and anxiety inducing.  
      • Limit how much time you spend plugged in to your cellphone, computer and social media.
    • Focus on What You're Grateful For Each Day
      • No matter how big a crisis you're going through, you can usually find something to be grateful for--even if it's something that you think is small.  
      • That doesn't mean that you ignore the negative things going on or that you don't prepare yourself and your family for what might come.  
      • It means that you also remember that good things are happening.  
      • By writing down at least three things that you're grateful for each day, not only do you feel gratitude and appreciation for the people and things you have in your life, you also train your mind to remember that, even in the darkest hour, there are almost always things to be grateful for (Keeping a Gratitude Journal).
    Getting Help in Therapy
    You're not alone.  Many people are feeling the psychological effects of the pandemic (see my article: Undoing Aloneness: The Client's and Therapist's Parallel Experience in a Crisis).

    Everyone needs help at some point.  There are times when, despite your best efforts to reduce your stress and anxiety, you might need help from a mental health professional.

    A licensed psychotherapist can help you to manage your stress and anxiety by helping you to develop tools and internal resources.

    Many psychotherapists, including me, are doing online therapy (also known as teletherapy, telemental health and telehealth) durng the COVID-19 crisis (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

    Even before the COVID-19 pandemic, there was an epidemic of loneliness, and the social isolation and loneliness involved with practicing physical distancing are making those experiences even worse.

    Rather than struggling on your own, take action and get the help you need sooner rather than later.  In the long run, it could make all the difference in your health and emotional well-being.

    About Me
    I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, 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 emal me.














    Saturday, April 4, 2020

    Doing the Body Scan Meditation to Sense and Reduce Stress

    One of the tools that I usually teach clients in my psychotherapy private practice in New York City is doing a body scan meditation (see my article: Developing Coping Strategies in Therapy).  Breathing and doing a body scan meditation helps to reduce tension in the body and activate the parasympathetic nervous system to help you to relax (see my articles: Common Reactions to the COVID-19 Crisis: Fear and Anxiety and Coping and Staying Calm During a Crisis).

    Doing the Body Scan Meditation to Sense and Reduce Stress

    How to Do a Body Scan Meditation to Reduce Stress
    There are many ways to do a body scan meditation.  Here's what I teach my clients to do:
    • Start By Taking a Few Deep Breaths:  
      • You can close your eyes if you feel comfortable doing this or you can find a spot on the floor to look at so you can begin to narrow your focus to your body.  
      • When you're breathing in, make sure that your abdominal muscles expand.  You can think of inhaling as taking in healing cleansing breaths.  
      • When you breathe out, feel your abdominal muscles contract a little so you're letting out all the air, and think of letting go of all the stress from the day.
      • Continue to do this until you feel yourself starting to become calmer.
    • Focus on the Crown of Your Head
      • After you have taken a few deep breaths, focus on the crown of your head as a starting point to begin scanning your body.
    • Move Your Attention Down From the Crown Slowly to Your Forehead
      • From the crown of your head, move your attention down to your forehead and sense if you feel tension in your forehead.  
      • We tend to hold a lot of tension in the muscles of our forehead, especially when we're stressed or anxious.  
      • If you sense the muscles in your forehead are tense, imagine that you could send your breath to your forehead to allow those muscles to relax. 
      • Continue to do that until you feel those muscles relax.
    • Move Your Attention to Your Eyes
      • After the muscles in your forehead feel relaxed, move your attention to your eyes.  We tend to hold a lot of tension in our eyes without even realizing it because while we're awake, we're using our eyes all the time.  
      • When we're under stress or looking at the computer, our eyes tend to be in a fixed position that can cause eyestrain and fatigue.  
      • Even though your eyes are closed, you can sense if you're holding tension in your eye muscles. 
      • Allow your eyes to relax and let them "drop" down in the direction of your lower eyelid.  
      • Allow the muscles around your eyes to relax.  If you're having a problem getting your eye muscles to relax, imagine that you can send your breath to your eyes so they can relax.
    • Move Your Attention to Your Nose and Checks
      • After your eyes relax, sense into your nose and check muscles, and follow the same steps as you've used above, including imagining using your breath to get those muscles to relax.
    • Move Your Attention to the Temples on the Sides of Your Head:
      • Become aware of any tension that you're holding onto in your temples.
      • Imagine sending your breath to your temples to relax them.
    • Move Your Attention to Your Mouth
      • Follow the same procedure as above. Notice any tension around the muscles in your mouth and allow those muscles to relax. Use your imagination to send your breath to get your mouth muscles to relax.
    • Move Your Attention to Your Tongue
      • The tongue holds a lot of tension.  Allow your tongue to relax at the bottom of your mouth.
    • Move Your Attention to Your Jaw
      • Allow your jaw to relax and follow the same procedures as above with imagining sending a breath to your jaw muscles to allow them to relax.
    • Move Your Attention to Your Face
      • See if there's any remaining tension in general left in your facial muscles.  
      • To help reduce that tension, scrunch up your face as tight as you can for about 20 seconds and then let go and feel the tension reduce.
    • Continue Moving Down Your Body
      • Your throat, chest, abdomnal muscles and use the same techniques as above.
    • Move Your Attention to the Back of Your Neck and Shoulders
      • Imagine that any tension in your neck and shoulders just slides off your shoulders, down your arms and out through your fingers.
    • Move Your Attention to Your Legs
      • Imagine that any tension in your legs just slides down your legs and out through your toes.
    • Move Your Attention to Your Shoulder Blades
      • Focus on your shoulder blades and notice if there is tension there. Imagine that there's a curtain rod across your back that opens up, and as it opens up, feel your shoulder blades opening up and relaxing.
    • Move Your Attention to Your Spine: 
      • Notice if you're holding attention in your spine both the upper, middle and lower level.
      • Imagine that your spine can float in the air and relax.
    • Move Your Attention to Your Hips:
      • We tend to hold a lot of tension and emotion in the hips.  Send your breath to your hips and imagine that your breath can dissolve that tension. 
    • Sense into Your Body and See If There's Any Remaining Tension: 
      • Even after you go through scanning the body parts mentioned above, you might still be holding onto tension somewhere in your body.  
      • Just sense into your body from top to bottom slowly and pay particular attention to any areas where you still feel tension. 
      • Use the same techniques used above, including imagining sending your breath to these areas to help them relax.
    • Bringing Yourself Back to the Here and Now: 
      • After you've gone through all the areas in your body, if your eyes were closed, open your eyes.  Whether your eyes were closed or not, orient yourself to the room where you are (look around) and feel your feet on the ground so you feel grounded.
      • If you still don't feel like you're back, get up, walk around, drink a glass of water or do whatever helps you to feel yourself back in the present moment.
    You Can Do the Body Scan Meditation to Sense and Reduce Stress Whenever You Need to Do It
    You can use the body scan and breathing exercise whenever you want and as often as you need it to reduce your stress.

    Getting Help in Therapy
    If you continue to feel overwhelmed even after your do the body scan meditaton and breathing exercise, you could benefit from working with a licensed psychotherapist.

    An experienced therapist can help you to work through the stress and anxiety that you're unable to overcome on your own.

    Many therapists, including me, are doing online therapy (also called teletherapy, telemental health or telehealth during the COVID-19 crisis due to the recommendations of physical distancing (see my article: The Advantages of Doing Online Therapy When You're Unable to Meet With Your Therapist in Person).

    Rather than suffering on your own, get help from a mental health professional.

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

    I work with individual adults and couples.

    During the COVID-19 crsis, I am providing online therapy.

    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.




















    Friday, April 3, 2020

    Common Reactions to the COVID-19 Crisis: Fear and Anxiety

    Aside from worrying about the COVID-19 crisis, many people are concerned that their reactions make them feel "weak" or "abnormal" or "crazy," but most of the reactions that people are describing are common and many people are experiencing the same reactions.  In a prior article, I discussed the common reaction of grief during this crisis.  In this article, I'm discussing fear and anxiety in an effort to normalize these feelings (see my articles: Coping and Staying Calm During the COVID-19 CrisisAccepting Your Negative Emotions During a CrisisCommon Reactions During the COVID-19 Crisis: Waves of Grief and Empowering Yourself During the COVID-19 Crisis).

    Common Reaction to the COVID-19 Crisis: Fear and Anxiety
    A Common Reaction to COVID-19: Fear and Anxiety
    Many people are trying to make sense of their reactions to the current pandemic.  Since we have never experienced anything like this during modern times, it's sometimes hard to know what to feel or to distinguish one emotion from another.

    First, let's recognize that there's a difference between fear and anxiety.  Briefly stated, fear is about a known event and anxiety is about an anticipated event (for a more detailed explanation, see my article: What's the Difference Between Fear and Anxiety?).

    Some people talk about feeling "strange" or like they're in a "Sci Fi movie."  Many people feel the surreal nature of the experience as they try to grapple with the enormity of the crisis.

    Along with many other common reactions, fear and anxiety are the ones that most people mention.  It's easy to understand why people are fearful and anxious on many different levels due to concerns about their
    • Health
    • Emotional well-being
    • Children and grandchildren
    • Jobs
    • Financial situation
    • Future prospects
    and so on.

    Self Judgment and Self Criticism About Feeling Fear and Anxiety
    People who wouldn't ever think to judge someone else for being fearful and anxious often take a harsh stance with themselves about feeling the same emotions (see my article: Self Blame and the Internal Critic).

    They think they should do better, especially if they grew up being a parentified child where they took care of their parents emotional well-being instead of being taken care of by their parents (see my article: Children's Roles in Dysfunctional Families).

    These are people who, as children, had a heavy burden placed on them which was far beyond their development, so they're accustomed to having unrealistic and unreasonable expectations of themselves.  Unfortunately, these unrealistic expectatons don't stop when they become adults.  They continue to have the same patterns.

    Many of them might have internalized a critical voice from one or both of their parents who might also have been parentified children to their own parents, so this appears "normal" to them.

    Children who grew up being parentified children often just can't give themselves a break.  It's not unusual for them to think they have to do things and react to things in a "perfect" way, and anything that's less than perfect isn't good enough (see my article: The Connection Between Perfectionism and Shame).

    Using Defense Mechanisms to Avoid Feeling Fear and Anxiety
    Many people use one or more of the following defense mechanisms to avoid experiencing their emotions (see my article: Understnding Defense Mechanisms).
    • Denial About Fear and Anxiety: For many people, acknowledging their fear and anxiety makes them feel too vulnerable.  Instead of acknowledging their feelings, they deny them instead, "I don't feel fearful or anxious.  What good would that do me?"  So their feelings get swept under the carpet and often manifests in physical or psychological ailments, like headaches, bodily aches and pains, depression and so on.  
    • Rationalizing Away Fear and Anxiety: Another reaction that I often see is for people, who are harsh with themselves, compare themselves to others who are much worse off than them, "I don't have any reason to feel fearful or anxious.  Look at Mary, she has it so much worse than me."  They don't recognize that Mary's situation doesn't negate their own and that they're entitled to their own emotional reactions.  Instead of allowing themselves to feel their emotions, they minimize their reactions by comparing themselves to someone who is much worse.  However, if we carried this to its logical conclusion, each person could find someone who is much worse off as a way to blame themselves for having what turns out to be a common response (see my article: Rationalization as a Form of Denial and Self Deception).
    • Projecting Their Fear and Anxiety onto Someone Else: Instead of allowing themselves to feel their emotions, people who use projection project them onto someone else, "I'm not feeling anxious or afraid.  You're the one who feels that way."
    • Intellectualizing as a Way to Avoid Feeling Fear and Anxiety: People who tend to intellectualize as their defense against feeling fear and anxiety are usually able to talk about crises in terms of facts, logical, and data.  But they are too uncomfortable to talk about their emotions because it makes them feel too vulnerable.
    How Does a Person Learn to Accept Their Emotions Instead of Defending Against Them?
    One answer to this question for many people is to receive psychoeducation in an article like this that their emotions are a common reaction to the current situation. Also, if they talk to another people about it, they will often hear others say the same thing.

    People who have unresolved trauma will need more help.  They need to work through their childhood trauma first to have some self compassion about their current emotions.

    On a logical level, many people who were parentified children can see that it makes sense (logically) that they feel as they do.  But on an emotional level, they still judge themselves, and that's the old trauma getting triggered, "You should be able to deal with this without feeling afraid of anxious."

    Getting Help in Therapy
    If you have a history of trauma that is getting triggered now, working with a trauma therapist, who can help you to work through the past trauma as well as helping you with your current fears and anticipatory anxiety, will allow you to cope better.

    Many psychotherapists, including me, are doing online therapy sessions (also called telehealth, telemental health and teletherapy) during this period of time (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

    Rather than struggling on your own, seeking help can help to alleviate your fears ans anxiety.

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

    As previously mentioned, I'm currently providing online therapy.

    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, April 1, 2020

    Common Reactions to the COVID-19 Crisis: Waves of Grief

    During the current COVID-19 crisis, many people have told me that their grief about the crisis, which is similar to the grief that you might feel for other losses, comes in waves (see my article: Grieving Losses During a Crisis).  They told me that they might feel fine one moment and then they suddenly feel a wave of grief pass over them.

    Common Reactions to the COVID-19 Crisis: Waves of Grief 

    Waves of Grief During a Crisis Are Common
    Just like any other loss, the grief that people are feeling during this health crisis is real and understandable.  So much of life, including in-person contact with loved ones, has been upended, and this is a significant loss.

    The fact that no one really knows how long this crisis might last can intensify your grief.  For instance, if you knew that the crisis was going to last another 30, 60 or 90 days, you would have an idea of when you might experience light at the end of the tunnel. However, at this point in time, although there are various projections, no one seems to know for sure when this pandemic will end in the United States.  So, it can feel like it's endless and the losses are permanent.

    Emotions often come in waves.  When I'm working with a psychotherapy client and doing trauma therapy, I usually can expect to see the waves of emotion--whether it's sadness, fear, anger, or whatever emotion the client is experiencing.

    Before doing trauma work in therapy, I provide psychoeducation about the work, including how emotions usually rise, reach a peak and subside.  One of things I do while working with a traumatized client is to track these waves of emotion as well as the discharge of these emotions by observing how the client reacts during therapy (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Therapy Works).

    When you cry, sigh, yawn or feel waves of emotion throughout your body, from a Somatic Psychotherapy perspective, you're discharging energy or emotions.  Although it might be unpleasant to go through a wave of negative emotion, it's usually better to allow yourself to feel it and allow it to go through you than to try to stop it because when you feel the emotion and allow it to discharge, you're self regulating your mind and your body.

    Fictional Clinical Vignette: A Normal Response to a Crisis: Waves of Grief
    The following fictional clinical vignette, which is a composite of many different cases, illustrates how grief is felt and discharged during a trauma therapy session:

    Alice
    When Alice learned that her husband, who was a firefighter, had died at the World Trade Center during the 9/11 attack, she was shocked and felt emotionally numb.  All she could think was that she was having a nightmare and any moment she would wake up and she would realize that it had all been a bad dream.

    As her shock wore off a few weeks later, Alice felt very angry because she heard that her husband and the other first responders at the World Trade Center site didn't have the proper equipment to communicate with their superiors.  She felt such rage towards everyone involved because she believed that her husband would have survived if only he had the proper equipment.

    She also felt rage when she heard that there had been warnings at the Federal level about the possibility of a terrorist attack that went unheeded.  From her perspective, she couldn't believe her husband was dead due to the incompetenence at such a high level.

    She received a lot of support from the fire department's counseling unit as well as individual firefighters who worked with him, friends, family and neighbors. But she still felt alone and lonely as waves of grief washed over her.

    A few months later, Alice decided to start therapy because she was feeling overwhelmed by the loss of her husband.  She felt enveloped by grief all the time, and she didn't have a sense of relief from it.

    At the recommendation of a friend, Alice sought therapy with an experiential therapist who was a trauma therapist.  As part of the psychoeducation Alice received in her therapy, she lealrned that, in fact, grief comes in waves and she became more aware of periods of when her grief was heightened and when it had somewhat subsided for a period of time (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy)

    Before this, Alice hadn't paid attention to the wave-like experience of grief that ebbed and flowed.  Her therapist explained that similar to physical pain, emotional pain had a rise, a peak and a reduction similar to a wave.  Her therapist told her that many people who have physical pain can learn in therapy how to detect their waves of pain rather than believing that they have constant intense pain all the time.

    Developing an awareness of the ebbs and flows to grief is an awareness that's similar to mindfulness.  The client learns to maintain a dual awareness of experiencing the pain (physical or emotional) at the same time that s/he is observing her reactions.

    With guidance and practice, being able to maintain this dual awareness is a skill that can be learned in trauma therapy with a therapist who practices experiential psychotherapy.

     At first, Alice struggled with the observing part of the dual awareness.  She felt too immersed in her grief to do anything other than experience it.  But, over time, gradually, Alice learned to be more aware of her waves of grief as well as the dissipation or discharge of it when she cried, which brought emotional relief.

    In learning to be more mindful of the grief she was feeling, it was as if Alice developed another part of her mind that was slightly outside the experience.  In psychotherapy jargon, this would be called "an observing ego."

    Alice learned from her psychotherapist that:
    • When we speak of an observing ego, we're speaking metaphorically.  It's not like we can physically locate an observing ego in the brain.  It represents a healthy split in consciousness where a part of the mind witnesses what's going on for the individual.  
    • The observing ego allows us to perceive change in ourselves, and this is what allows people who are experiencing physical or emotional pain to witness their own experience.
    • Not only does the observing ego allow us to witness our reactions and changes in our reactions, it also grants us a sense of agency and we feel empowered by it because it can guide us to do what's best for ourselves.
    • Most people have an observing ego to a greater or lesser degree.  If you've ever had the sense of observing your reactions to a particular situation, your observing ego was at work.
    • The ability to strengthen the observing ego can be learned in experiential therapy.
    • There is usually a discharge, which can be very subtle, at the end of a cycle of emotion.  This discharge, which is often a letting go of emotion or subtle physical energy can come in different forms, including crying, yawning, sighing or feeling small waves of energy move through the body.
    Being able to observe the ebb of flow of her grief at any given time, Alice no longer felt like she was "going crazy" when a tidal wave of grief came over her for no apparent reason.  Similarly, when she observed that she was feeling a little better or she was able to enjoy a visit with a friend or laugh at a joke, she realized this was also normal and it was part of the cycle of grief that she felt on most days.

    After helping Alice to develop coping skills and techniques, her therapist talked to Alice about EMDR therapy to help Alice heal (see my articles: What is EMDR Therapy?,  How Does EMDR Therapy Work? and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

    As Alice continued with her EMDR therapy sessions, she still missed her husband on most days, but she no longer felt overwhelmed by her grief.  She also realized the periods of time when she felt on an even keel emotionally were getting longer and more frequent.  Gradually, her sense of relief expanded and she had more full days when she felt a sense of well-being.

    Conclusion
    Even though the fictional vignette above deals with the 9/11 World Trade Center attack, the concept of wave of grief applies to other losses and crises.

    People experience grief when they go through major losses, whether it's the loss of a relationship, the loss of a job, a downturn in their finances, and so on.  Grief isn't only about death.

    As mentioned earlier, grief is a normal and common response to loss.  Since the current pandemic encompasses losses on many different levels, both emotional and practical, it makes sense that many people are experiencing grief.

    A wave is like a crescendo.  It has a rise, a peak and a fall.  Developing an awareness of this cycle and the observing ego to recognize it is part of experiential therapy.  

    When a client develops this mindful awareness of their own emotional process, s/he experiences a sense of agency and control over herself and her emotions in situations that are often uncontrollable.

    Getting Help in Therapy
    Although grief is a common and normal response to loss, including the losses that many people are experiencing during this pandemic, attending experiential therapy, like EMDR therapy, Somatic Experiencing, AEDP therapy, and other forms of experiential therapy, helps you to heal faster than if you were to try to overcome it on your own or if you were in regular talk therapy.

    An experiential therapist can teach you the skills and guide you through the grieving process in a way that you can't do it on your own.

    Rather than suffering alone, help is available to you.

    Many psychotherapists, including me, are providing online therapy (also called telehealth, teletherapy or telemental health) during the COVID-19 crisis while we're unable to do in-person therapy in our offices due to the need for physical distancing (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

    Working through grief with an experienced psychotherapist can help to alleviate your emotional pain.

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

    Emotionally Focused Therapy is available for couples therapy.

    I'm currently providing online therapy while I'm out of my office during the COVID-19 crisis.

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

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


































    Tuesday, March 31, 2020

    Empowering Yourself During COVID-19: There Are Things You CAN Control

    During the current COVID-19 crisis, many people are feeling powerless. This is understandable given the suddenness and the unprecedented nature of the crisis. Also, many of the social interactions, activities and diversions that would normally be available to people to support their well-being aren't available to them because people are physically isolated and might be lonely.  There are many unknowns about the future and it can feel like everything is out of your control.  But before you give into feelings of hopelessness and helplessness, let's take a look at the things that you can control (see my articles: Coping and Staying Calm During a CrisisCoping with Loneliness and Social Isolation, and Undoing Aloneness: Staying Socially Connected Even Though We're Physically Disconnected).

    Empowering Yourself During COVID-19: There Are Things You CAN Control

    There Are Things You Can Control During the COVID-19 Pandemic
    The Serenity Prayer, which was written by Reinhold Niebuhr, contains much wisdom and many people, both in and out of the recovery community, find it calming:

    "God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference."

    Regardless of whether or not you believe in a God, a Higher Power, religion or prayer, these words remind you that, if you're worried about things you have no control over, you can redirect your attention to what you can control.

    What You Can Control During the COVID-19 Pandemic
    Rather than focusing on what you can't control, let's take a look at some things you can control:
    • Stay Informed But Don't Spend Too Much Time Watching the News
      • Getting reliable information is important to staying informed. 
      • It's also important to moderate how much time you spend watching or listening to the news.  
      • Much of the news is repetitive throughout the day, and the benefit spending time watching TV or online news is often outweighed by how anxious it can make you feel.
      •  So, you need to figure out what's best for you in terms of how much and when you watch the news.  
      • If you want to maintain your overall sense of well-being, it's especially important that you don't watch the news before you go to sleep.
    • Center and Ground Yourself: 
      • Practice doing breathing exercises to help to calm yourself (see my article: Square Breathing to Manage Stress). 
      • Practice online yoga at a pace that's right for you if yoga appeals to you. If you're not up to doing a vigorous form of yoga, there are online videos or chair yoga.
      • Practice meditation at a regular time. Some people prefer to meditate at night.  Others prefer to meditate when they wake up, and some people do it two or more times a day.  You don't need any special knowledge to quiet your mind to meditate.  You can start by taking a few deep breaths to activate your parasympathetic nervous system, which will calm you down.  There are also many online meditations that you can follow (see my articles: The Mind-Body Connection: Mindfulness Meditation and Calming the Body, Calming the Mind). 
      • Calm your thoughts by taking it one day, one hour or even one minute at a time.
      • Recognize that all things pass.
      • Feel gratitude and appreciation for what you do have right now. 
    • Establish a Routine For Yourself: Chances are good that your normal routine has been interrupted since the current crisis began.  A routine can give you comfort and a feeling of stability, so you can establish a new routine for yourself:
      • Wake up and go to sleep at the same time everyday.
      • Plan your meals.
      • Plan some quiet time for yourself, even if it's just a couple of minutes to breathe.
      • Make a To-Do list for yourself for the next day so you don't spend all day either in bed or watching news
      • A To-Do list can help to organize your day, your week, and your life.
      • Try not to be too ambitious with your To-Do list.
      • Be gentle with yourself. Recognize that you're probably not going to accomplish everything on the list--and that's okay.
      • Appreciate yourself for accomplishing whatever you accomplish on the list.
    • Stay Active: Even though you might be physically isolating, there are still ways to be physically active:
      • You can find many free workouts and yoga classes online.
      • You can also walk or bike outside as long as you take the precautions recommended to stay a healthy distance (at least 6 feet away) from others and follow The Center for Disease Control (CDC) recommendations.
    • Accept the Ups and Downs You Feel as a Common Response to a Crisis: You're living through an unprecedented time in modern history.  Chances are that your mood will go up and down at various times. This is a common experience during times of stress and crisis (see my article: Overcoming Your Fear of Your So-Called "Negative Emotions".
      • If you feel anxious, sad, fearful or whatever emotion you're experiencing at any given time, you're having a common response to a crisis.
      • Rather than judging yourself, accept all your emotions and do whatever you can to alleviate your stress and negative emotions.
      • Recognize that you're not alone.  Millions of other people, who are just like you, are experiencing the same thing. We're in this together.
    • Eat Nutritiously: Eating the right amount of protein, vegetables, grains and vegetables is important to stay physically and mentally healthy.  
    • Get Enough Sleep: Getting proper sleep is essential to your overall health and well-being (see my article: Tips on Improving Your Sleep).
    • Stay Connected Socially: Even though you might not be able to see loved ones now, you can still stay connected to them via: 
      • Phone calls
      • Video chats  
      • Games with friends online.  
      • Video night with a Netflix Party

    Getting Help in Therapy
    Times of crisis can trigger prior trauma and stressors, and it can be difficult to determine what you're reacting to emotionally.  The important thing to know is that you're not alone.

    An experienced psychotherapist can help you to get through a stressful time when you feel overwhelmed.

    Many psychotherapists, including me, are providing online therapy (also called telehealth, telemental health, and teletherapy) during the current crisis when therapists aren't in their office (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

    Rather than struggling on your own, you could get help from a licensed psychotherapist to overcome the obstacles that are hindering you.

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

    I work with individual adults and couples.

    I am providing online therapy during the COVID-19 crisis.

    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.