NYC Psychotherapist Blog

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Friday, September 25, 2009

Feeling Empowered to Make a Career Change

Most people like to feel a sense of power, a degree of autonomy and an enthusiasm in their work. Feeling empowered, appreciated, creative, and fairly compensated are all important factors that usually contribute to overall work satisfaction.

As a psychotherapist in New York City, I hear many stories from clients who are not satisfied with their work. They feel unappreciated, stifled, and stuck. Even though they feel uninspired by their current work, they're not sure what else they would like to do, and they come to see me to explore and overcome these issues.

Feeling Dissatisfied With Your Career

A Desire for Career Change

Sometimes, the desire for change might begin with a vague sense that work is not as satisfying as it once was. If this feeling continues to grow over time, it can lead to a certain malaise and inertia, especially if you don't take steps to at least explore other options.

Often, clients will tell me that they were once very happy with their work, but they're no longer satisfied. In many instances, the work is the same, the boss is the same, the colleagues remain the same, but something in these clients has changed.

Exactly what has changed in them is not always clear to them at first. But, often, on some level, they have outgrown their job and they want "more" or "something different."

Career Change Over the Span of a Life Time
It's not unusual these days to change careers several times over the span of a life time. Someone might start out in one type of career after college, often influenced by family or friends and, as time passes and they develop other interests, they desire something new. They might return to college or get a certification at a continuing education program to transition to another type of career.

Often, people in their 40s and 50s find that doing the same type of work that they've done for most of their lives no longer suits them. They want to continue to work and feel productive, but not in their current careers. They want something new that they can feel enthusiastic about. This doesn't necessarily mean that they're going through some sort of "mid-life crisis," as many people might say. It's just a common occurrence as people change and outgrow their current careers.

Retirement is Different Nowadays
It used to be that most people retired and that was that. They stayed home, rested, took it easy, and played with their grandchildren. And if that's what you want, that's okay.

But these days, many people, who retire in their 60s, 70s or later and who are in good health, don't usually want to stop working.

They want to work and feel productive in a career, but not doing the same type of work that they did for most of their lives. Maybe they stuck with a certain career because it afforded them a certain lifestyle, it paid for the mortgage and their children's college tuition or for other important reasons.

But for many people, now that they've retired from that career, they finally have the opportunity to do what they've always really wanted to do but couldn't do for whatever reasons.

For instance, I hear many stories about corporate executives who retire and decide to teach, teachers who retire and decide to go into sales, salespeople who retire and decide to start their own business, business owners who retire and decide to indulge their artistic side, and so on. If you're in good health and you no longer have the financial pressures and responsibilities that you once had, why not?

Feeling Stuck and Uninspired in Your Career?
Whatever your current career situation might be, if you're feel stuck and uninspired in your current work, you owe it to yourself to explore other options.

Networking and talking to other people about their work, especially if their work is different from what you do now, can give you some ideas. Doing some soul searching about what's important to you and what you could see yourself doing is also essential.

Start Taking Steps
The important thing is to start taking steps, no matter how small, to get yourself "unstuck" from your current situation.

Feeling Empowered to Make a Career Change

Getting Help in Therapy
For many people, who feel stuck in their careers and feel the need for career change, talking to a licensed mental health professional who has expertise in this area can be helpful in terms of getting unstuck.

About Me
I'm a licensed NYC psychotherapist, hypnotherapist, EMDR, and Somatic Experiencing therapist who is a former human resource manager.  

I work with individual adults and couples.  

I have helped many clients to get motivated so they can find fulfilling careers.

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

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

Thursday, September 24, 2009

Learning to Trust Again After a Major Setback or Loss

"We have no reason to mistrust our world for it is not against us. Has its terrors, they are our terrors; has its abysses, those abysses belong to us; our dangers at hand, we must try to love them. And if only we arrange life according to that principle which counsels us that we must always hold to the difficult, then that which now seems to us the most alien will become what we most trust and find most faithful. How should we be able to forget those ancient myths that are at the beginning of all peoples, the myths about dragons that at the last moment turn into princesses; perhaps all the dragons of our lives are princesses who are only waiting to see us once as beautiful and brave. Perhaps everything terrible is in its deepest being something helpless that wants help from us."
   ~ Rainer Maria Rilke, poet, 1934, Letters to a Young Poet

Learning to Trust Again After a Major Setback or Loss

Learning to Trust Again After a Major Setback or Loss Can Test Us
Learning to trust again after a major setback or a loss can test us in ways that we might not have ever been tested before. When we feel lost, confused, helpless, and disempowered, where do we find the courage to stand up again to face whatever challenge is before us? This is a question that we all face at one time or another. We are challenged to find ways, sometimes without even knowing how or where we'll find the personal strength, to get through the crisis and continue living our lives.

For some people, it's like walking through a dark cave, feeling the wall next to them, taking one small and unsure step at a time, not knowing where it might lead, and hoping that each step will bring them closer to the light, safety, and warmth outside the cave. Without any assurances or guarantees, they keep taking one step at a time, sometimes stopping, sometimes falling down, but getting back up again and continuing to move forward.

Sometimes life presents us with a loss or disappointment, often unexpected, catching us off guard and flat footed. It might be the breakup of a relationship, the death of a loved one, the loss of a job, the betrayal of a spouse or a friend, or a sudden accident or illness. At those times, it might feel that we will never get over the loss. We might feel that we never want to open our hearts again to feel this kind of vulnerability and pain. It might feel unfair that life goes on, time passes, other people are experiencing new joy in their lives, getting married, having children, experiencing success in their lives and we feel stuck in this place of despair.

Sometimes We Disappoint Ourselves
Sometimes we disappoint ourselves when we revert to old behavior that we thought we had overcome, only to find ourselves back again in that same place that we hoped we would never find ourselves in again. This might mean losing our temper when we thought we had overcome our problems with anger management, relapsing on alcohol or drugs after years of sobriety, picking up a cigarette after years of not smoking, choosing an unhealthy relationship again after promising ourselves and others never to do that again, or engaging in other self-sabotaging behavior. At times like this, we might feel that we can't even trust ourselves as we struggle to overcome our own inner demons.

After a loss or a major setback, rebuilding trust in ourselves, in others, and in life in general is a process. It can feel slow and unsteady at times. Often, we might feel like we'd like to give up, abandon hope, keep our heads down, make ourselves small, and hide out somewhere. But most of the time, after a temporary retreat, we might not have that option. The father with small children whose wife died must continue to care for his children, go to work, take care of daily responsibilities and go on with life. Even though part of him really doesn't want to because he's grieving for his loss, he knows must learn to trust again that life will get better for himself and his children. The single mother who lost her job again, maybe for the third or fourth time in a row, must go out and try to find another job and trust that there's a prospective employer who will see her talent, hire her and keep her on as a valued employee. The victim of a car accident who has become disabled faces the choice of giving up or engaging and persevering in physical therapy with the hope that his health will be restored.

Remembering Challenges We Have Overcome Gives Us a Sense of Hope
Remembering other difficult times in our lives where we've overcome personal challenges can give us a sense of hope that we can overcome whatever we're faced with now and learn to trust again. Reading and learning about what other people have done to regain trust in themselves, others and in life, can help to inspire us and give us hope. As an example, I'm thinking, in particular, of Franklin Roosevelt, who was disabled by polio during his presidency, but who persevered and, according to Eleanor Roosevelt, never gave up hope that he would overcome his illness.

Getting  Help in Therapy: You're Not Alone
It's important to realize that, even when you feel that life has dealt you a terrible blow, making you feel alienated and isolated from the rest of the world, you're not alone. Many people have gone through what you're experiencing and have come out on the other side. It's important to stay connected to supportive friends and family, and if you're still unable to see light at the end of the tunnel, to seek professional help from a licensed psychotherapist.

About Me
I'm a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.   I work with individual adults and couples.  

I have helped many clients to learn to trust again and find hope and meaning in life.

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

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

Wednesday, September 23, 2009

Learning to Trust Again After an Affair

In the last article I introduced the general topic of  Learning to Trust Again - Coping with Betrayal.

In this article I would like to focus on a particular topic related to learning to trust again: Finding out that your spouse or partner is having an affair.

Trust is the foundation of any relationship:
Trust is the bedrock of any relationship. Without trust, few relationships survive and those that do survive in some form are often filled with suspicion, recrimination, anger, resentment, and sadness. There are few things more shattering to trust in a relationship than finding out that your partner is having an affair. Regaining trust, once it has been breached, is a major challenge.

Learning to Trust Again After an Affair

Partners who discover affairs often talk about their feelings in terms of "before I found out about the affair" and "after I found out about the affair":
The feelings associated with the discovery of the affair become an emotional dividing line for the spouse who feels betrayed. 

Typical comments are "Before I found out about the affair, I thought we were happy and that we'd be together forever, but after I found out about the affair, I felt like my whole world was turned upside down" or "Before I found out about the affair, I felt so secure in my marriage, but after I found out that he was having an affair, I felt like I didn't know my husband any more, I didn't know myself, and I questioned everything after that" or "Before I found out that my wife was having an affair, I thought I was such a lucky guy to have such a great wife who loved me, but after I found out that she was cheating on me, I felt like a fool."

Discovering infidelity has become more common with the advent of cell phones, email and other forms of communication that have been developed in the last 10 or 15 years:.
Spouses can find out about affairs inadvertently by stumbling upon the information by accident or, if they're suspicious, by actively searching telephone numbers and pictures stored in cell phones, looking at cell phone bills, reading their spouse's email, listening to their spouse's saved telephone messages, looking at a computer browser's history or finding other common telltale signs of infidelity. Once the spouse discovers signs of infidelity, it then becomes a question of what to do about this discovery.

Emotional reactions to discovering infidelity vary, but there are some common reactions:
Shock and denial are two common reactions: "This must be a mistake," "I must be imagining things--he would never do this," "There must be some other explanation." Anger and profound sadness are also common reactions. Many people confront their partners with whatever they've found, often hoping that their partners will give some explanation that will confirm that it's all a mistake. In most cases, this is no reflection on the intelligence of the spouse who has discovered the information. Most often, it's a deep wish, in the face of everything, to preserve his or her own emotional security as well as to save their relationship.

If the spouse having the affair lies about it, the betrayed spouse might go along with it, colluding in the lie, at least on the surface. But often, deep down, he or she really knows that it's a lie. Another common reaction is for the spouse to say nothing to the partner and to continue to "monitor" the situation by snooping and policing the partner's activities until he or she has gathered enough evidence to confront the partner. For other spouses, it becomes a matter of evening the score by going out and having their own affair. This is usually a misguided attempt to get revenge and to feel that they're attractive and sought after by others. Not only does this not work, but it makes the situation worse.

Whatever the initial reactions might be, both people have decisions to make:
If the partner continues to lie about the affair or blame the spouse, if there are no feelings of remorse, most relationships don't last. Trust cannot be regained under these circumstances. At the very least, the partner needs to admit that he or she made a mistake, feel genuine remorse about it, and end the affair for there to be any hope of regaining trust in the relationship. Then, the couple can decide individually and as a couple whether they want to pick up the pieces of their relationship and try to put them back together again.

For some couples, once trust is shattered, it's so damaging that even if they both decide to work on their relationship, they can't get passed what happened. For them, it becomes a very painful emotional crisis in the relationship that cannot be overcome.

Even if they move on to other relationships in the future, if each partner doesn't work through what happened in the relationship where there was infidelity, they often carry this emotional baggage into their next relationship in one form or another or it becomes so damaging that they're unable to have new relationships.

Without the benefit of working out these issues in psychotherapy, spouses who felt betrayed in the prior relationships often have difficulties trusting in future relationships. This can result in their mistrusting their own judgment, mistrusting others, closing themselves off emotionally and, in some cases, isolating themselves and deciding to remain alone. Or, they can carry their emotional wounds and feelings of betrayal into the next relationship. They might continually look for signs of infidelity where there are none and ruin an otherwise good relationship.

If the partner who cheated moves on to other relationships in the future without any self exploration about why he or she was unfaithful in the prior relationship, he or she runs the risk of cheating again in the next relationship. So many factors might have contributed to his or her infidelity, including growing up in a dysfunctional home where one or both parents were unfaithful to each other, fear of getting close in his or her primary relationship, a lack of empathy for his or her partner, and so on. Working through these issues in either couples counseling or individual psychotherapy can help prevent a repetition of these same mistakes over and over again.

For other couples, regaining trust is a challenging process but, over time, they're able to rebuild and regain the sense of trust, step by step, in their relationship, usually with the help of an experienced psychotherapist. In other situations, a couple might establish somewhat of a truce, but anger and suspicion remain. In those situations, the affair might temporarily recede into the background, but it's still there, just under the surface as a point of contention, waiting to be resurrected in other arguments.

Each relationship and each person in the relationship is unique, and it's hard to say with any degree of certainty what enables one relationship to survive infidelity and another to end:
Often, couples who survive infidelity have a sense that they've invested too much emotionally and they have too much at stake not to try to work it out, especially if they have children. They're willing to look at the dynamics of their relationship to understand how each of them might have contributed to their problems. 

Some couples even come out of this experience with a stronger commitment to their relationship. If the spouse who feels betrayed can forgive and if the partner who had the affair does some soul searching and genuinely recommits to the relationship, the affair might become a part, albeit a painful part, of their history and they can move on to strengthen their relationship.

Couples who are in crisis can benefit from participating in couples or marriage counseling with a licensed psychotherapist if they seek help early on:
An experienced psychotherapist can help couples in crisis to either work through the crisis or to decide to end the relationship in a healthier way than they might be able to do on their own.

Often, the key to working through problems in a relationship is not to wait until it's too late. This might sound self evident, but many people don't realize this or don't recognize the period of time in their relationship when couples counseling would be optimal. It's not unusual for couples to come to marriage counseling as a last ditch effort when one or both of them really know that it's over. Or, they wait too long and one of the partners wants to save the relationship and the other partner really knows deep down that it's over but doesn't want to appear uncooperative so he or she goes along with the counseling for a while, but it's really too late.

Getting Help in Therapy
If you've discovered that your partner has been unfaithful or if you are the one who has been unfaithful, regaining trust in your current relationship, future relationships and in your own judgment is challenging but, with professional help, it's often possible.

About Me
I'm a New York City psychotherapist, hypnotherapist and couples counselor. 

I have helped many individual adults and couples to work through times of crisis in their relationships to regain trust and confidence.

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

To set up a consultation, call me at (917) 742-2624 during business hours or Josephine Ferraro, LCSW - NYC Psychotherapist.

Tuesday, September 22, 2009

Learning to Trust Again: Coping with Betrayal in a Relationship

Learning to trust again after discovering a major betrayal in a relationship can be a challenging process. Whether the betrayal involved infidelity, lying, discovering that your partner has an addiction or some other form of betrayal, if you choose to stay in the relationship, it can be a long road back to trusting your partner again once trust has been breached. And there are no guarantees that trust can be regained.

Learning to Trust Again After a Betrayal

Initially, you might be shocked into emotional numbness, denial, anger, profound sadness, isolation, self doubt or all of the above. It can be especially hard if you've had a long history of being with people who have betrayed you in one form or another, possibly starting with your family. 

Aside from blaming your partner, you might blame yourself for not recognizing the signs of the betrayal before. You might start having feelings of worthlessness: "If I was good enough, he wouldn't have cheated on me" or "If I was good enough, he wouldn't be abusing drugs." You might blame other people who might have known about the betrayal and didn't tell you. If you're a spiritual person, you might have a temporary crisis in faith, blaming God for "allowing this to happen."

At some point, after the initial shock, you have some hard decisions to make. Whether you choose to stay and try to work things out with your partner or whether you decide to go and move on with your life, learning to trust again is a challenge. 

The alternative to learning to trust again is closing yourself off emotionally, mentally, physically or even spiritually. Anger and bitterness can set in, making it almost impossible to try again in your current relationship or in future relationships. When you feel that you can't trust others or that you can't trust yourself, you're stuck and there is little hope for healing.

Getting Help in Therapy
If you are in that stuck place where you feel that you can't go back, but you feel that you can't move forward either, you're not alone. Many other people have experienced what you are experiencing and have overcome these feelings.

If you're having difficulty coping with this on your own, you could benefit from working on these issues with a licensed psychotherapist.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist. 

I work with adult individuals and couples.  I've helped many clients heal and learn to trust again in themselves and others.

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

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

Also see my article:
Learning to Trust Again: After the Affair

Monday, September 21, 2009

Coping with Frustration

All of us have experienced times when we've either not gotten what we wanted or we've had to deal with something that we didn't want. When we're forced to deal with these types of situations, we often feel frustrated, annoyed and disappointed.

Coping With Frustration

Learning to Cope with Frustration as Part of Personal Development:
Learning to cope with feelings of frustration is an important part of personal development. Without the necessary coping skills to overcome frustration and disappointments, we get stuck, and this adds to our emotional pain. So, how do people learn to tolerate frustration?

How We Learn to Cope with Frustration:
Ideally, we begin learning to cope with frustration as infants. Under normal circumstances, if we've had good enough parenting, we learn early on in small, manageable doses that we can't always get what we want and we sometimes have to do things that we don't want to do. If you've ever seen an infant who wants to continue playing when his mother says it's time to eat or sleep, you've likely seen an infant's reaction to frustration. There may be crying, angry flailing about, kicking, and screaming. It's a situation that certainly tests a parent's tolerance for frustration.

Over time, in small ways, if the baby is exposed to small doses of frustration, he learns that he's not always going to get what he wants but, under optimal conditions, he gets what he wants enough times so that he is satisfied.

However, if a caregiver is inconsistent and arbitrary, this can create confusion and even greater frustration for the baby. Or, if the parent doesn't set limits with the child and allows the child to have whatever he wants, whether it's good for him or not (perhaps because the parent is unable to tolerate the baby's reaction to not getting what he wants), then that child often grows up without the skills for coping with frustration. This creates problems later on when, as an adult, he has to deal with other adults who won't always accommodate him. Since he didn't learn to tolerate frustration in small doses as a child, when he doesn't get what he wants or gets what he doesn't want, it seems overwhelming. So, in other words, either neglect (and certainly abuse) as well as overindulgence can lead to low frustration tolerance in adults.

Of course, nobody can control what their parents did or didn't do when they were growing up. So, if you didn't learn to develop coping skills to deal with frustration along the way, here are some suggestions:
  • When something doesn't go your way, try not to personalize it: Most of the time, when circumstances come up that frustrate you, it's not meant to be personal. So, if the grocery clerk packs your grocery in a way where the eggs break, they make a mess, and your bag breaks, most likely, he didn't do it on purpose. Or, if you're in a hurry to drive to an appointment and someone is taking a long time to cross the street, which is delaying you, maybe he's handicapped and not purposely trying to make you late for your appointment. Or, if a client is rude to you on the phone, maybe he's having a bad day that has nothing to do with you. Learn to step outside of the situation and consider that it's often not about you, even though it might be affecting you.
  • If you encounter an obstacle in your path, try to find another way to approach the situation: Rather than giving up or taking it as a sign that you're a failure, try a different approach. Talk to other people who have gone through what you're going through. What did they do? Can you learn something from them? Think of it as a challenge rather than as a defeat. Think about other situations where you have overcome obstacles, recognize that you've had successes in the past, and you'll have successes in the future.
  • Learn to keep things in perspective: When you're feeling frustrated, it can seem like a big deal at the time. But sometimes, depending upon the situation, a little light hearted humor can go a long way. Does it really help you to get angry, tense and miserable when things don't go your way? Usually not. So, learn to put things in perspective.
  • Learn to reframe the situation for yourself: Often, how you perceive things and your attitude about circumstances can have a bigger impact on the situation than someone or something else. So, for instance, rather than feeling frustrated and fuming that your flight is delayed, take the time to do something that you wouldn't have had the time to do if the flight was on time: call your children, get caught up on your email, go to the gift shop and look for that birthday gift for your sister that you haven't had time to get yet. So, rather than seeing the delay as an obstacle, see if there are any opportunities that you can create.
  • Develop a sense of confidence in yourself: If you lack confidence, this can be one of the more challenging steps, but it's an important step. Often, the difference between someone who is able to tolerate and overcome frustrating situations and the person who can't is a matter of confidence, optimism, and resilience. When you feel confident and optimistic, you're more likely to see setbacks as temporary rather than permanent obstacles in your way. Confidence and resilience can give you the extra mental, emotional and physical energy that you need to overcome a frustrating situation. If you read about some of our greatest inventors, like Thomas Edison, you'll discover that they were very persistent and resilient, overcoming one obstacle after the next to meet their goals.
  • Develop positive outlets to deal with stress and maintain emotional balance: Tension and frustration are an inevitable part of life. Whether you choose to meditate, take a yoga class, go to the gym, take a brisk walk, talk to friends--whatever you choose to do, find ways to release tension and frustration rather than bottling it up, allowing it to build up, or losing your temper with the people around you.
  • Learn to accept change: Learning to accept change can go a long way to helping you to cope with frustration. (Of course, I'm not talking about accepting abuse or unhealthy situations.) There is very little in life that is permanent. Relationships change, friendships change, jobs change, almost everything changes. When it's a change that we like, it's easy to accept change. But when it's a change that we don't want, it's a lot more challenging. Change is a big part of life and learning to be flexible is important to coping with some of the frustration involved with change.
  • Learn to accept what you can't change: Sometimes, no matter how hard you try, there are situations that are not under your control. If you know you've done your best, sometimes, you have to accept that there are some things that you just can't change, no matter what you do. This can be a humbling experience but, in most cases, it doesn't have to be devastating. Making peace with the things you can't change is far better than wasting time and effort railing at them in vain or continuing to make fruitless efforts when you could be directing your time and energy towards more attainable goals.
Getting Help in Therapy:
Sometimes, despite your best efforts, learning to cope with frustration can be overwhelming. 

If your inability to cope with frustration is affecting your relationships or getting in the way of your leading a fulfilling life, you might benefit from psychotherapy with a licensed psychotherapist.

About Me:
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist. 

I work with individual adults and couples.

I have helped many clients to learn to cope with frustration so that they lead happier lives.

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

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

Friday, September 18, 2009

Assertiveness: Learning to Say "No"

Do you often find yourself in situations where you said "Yes" where you wish you had said "No"?

Do you feel you would be "rude" or "unkind" if you turned down other people's requests?

Are you able to say "No" in certain situations, but then feel you have to apologize or say something like, "I hope that's okay" because you're afraid that people won't like you if you say "No"?

Assertiveness: Learning to Say "No"

Do you avoid taking calls from certain friends or family members when you know they're calling to ask a favor of you that you know you either can't or don't want to do?

Do you agree to do certain things for people and then seethe silently with anger and resentment?

If you answered "Yes" to any of the above questions, more than likely, you're having problems asserting yourself enough to be able to say "No."

Many people have problems saying "No." They feel uncomfortable and think it would be either too hurtful to the other person or they worry that if they say "No," they'll be seen as mean or uncaring. They often lack the self confidence to feel they are entitled to say "No." They will often go to great lengths to accommodate others to the detriment of their own health and well-being. Under certain circumstances, if they know that someone is about to ask them to do something that they really don't want to do, they might avoid that person, which causes other problems when that person feels ignored.

Although both men and women have this problem, it tends to come up more with women. Women are often raised to feel that they must accommodate others, no matter what the consequences are for themselves. In our society, women are also seen as the "nurturers," "caregivers," and encouraged to be "people pleasers," so there's often pressure to take care of other people's requests and problems.

Here are some typical examples of situations where people have problems asserting themselves enough to say "No." See if you can identify with any of them.

Scenario 1:
Mary is the second oldest adult child in a family of five children. She's also the oldest daughter. She and her brothers and sisters live about the same distance away from their aging parents. Whenever her parents need help, they call Mary. Whether it's a matter of taking them to doctor's appointments, grocery shopping, helping them to set up their computer, whatever they need help with, they expect Mary to help them. Their way of thinking is that she's the oldest daughter and this is her role. Mary loves her parents very much, but she's often exhausted after a week of working full time and, as a single mom, taking care of her teenage children. She never turns down any of her parents' requests, but lately she's been feeling irritable and resentful whenever they call. She feels too guilty to say "No" or to ask her brothers and sisters to pitch in, so she seethes in anger instead. Lately, she's been having tension headaches, and during her last doctor's visit, her doctor warned her that her blood pressure was a little high and she needs to reduce her stress. She knows she needs to find a way to change the dynamic with her parents, but she doesn't know how.

Scenario 2:
Bob and Dan are colleagues in the same company. Over the years, they have become friends. Bob enjoys Dan's company and they and their wives often socialize on the weekends. Over the last few years, Dan has borrowed a few hundred dollars from Bob, but he hasn't paid him back. Initially, Dan was apologetic and said he would pay Bob back, but lately Dan has not mentioned the money at all. Bob is annoyed about this, but he tells himself that Dan has had several unexpected financial setbacks, so he doesn't want to ask him for the money. But Bob's wife recently lost her job and now they're trying to get by on just one salary until she can find a new job. Finances have been tight. They've had to cut back on certain expenses, like sending their daughter to the dance classes that she loved. Lately, Bob's wife has been pressuring him to ask Dan for the money he owes them. But Bob feels that if he asks Dan for the money, he wouldn't be a good friend. Then, one afternoon, Dan leaves Bob a familiar voicemail message at work, "I'm in a jam. I need to talk to you. Can we have lunch?" Bob recognizes the familiar words and tone as a sign that Dan wants to borrow more money. Rather than calling him back, Bob avoids Dan for the next few days because he doesn't know how he can say "No" to Dan's request, but he also knows that he can't afford to lend him any more money. So, he doesn't know what to do.

Scenario 3:
Nancy is a writer and she works from home. She loves her work and she has been getting more frequent and interesting assignments lately from her editor. Nancy knows this is a sign that her editor really likes her work and she is progressing in her career. She wants to continue to do well so she can get more of these types of projects. These interesting assignment also come with more stringent deadlines. She's disciplined about how she does her work at home and she has never missed a deadline yet. Her latest assignment has been the most exciting one so far. She knows it will be a challenge to get the piece to her editor on time, but she thinks she can do it if she stays focused. However, the problem lately is that she has an elderly next door neighbor who lives alone and who is lonely. She likes to "drop by" Nancy's apartment to chat. Nancy likes her neighbor very much and also feels sorry for her because her children never come to visit her. Sometimes, when she's coming up against a deadline, Nancy feels irritated when her neighbor rings her bell. Most of the time, Nancy lets her in and hopes that she won't stay too long. But lately, the elderly neighbor's visits have really been interfering with Nancy's work and she's afraid that she's going to miss her deadline for this new project. She doesn't want to hurt the neighbor's feelings, but she can't miss her deadline. She doesn't know what to do.

Scenario 4:
Alice has a stressful full time job. She and her husband are also raising three young children who are in elementary school. Alice is also involved in the PTA and other local community groups. Lately, several colleagues have been laid off at work, so Alice has been asked to take on additional work assignments. By the end of the day, after helping her children with their homework and putting them to bed, she's exhausted. Now that Alice is working longer hours, her husband has taken on additional household duties, including cooking, picking up the children from school, doing the laundry and grocery shopping. They have a good marriage, and he has always shared in household responsibilities. He's also working extra hours at work due to company cutbacks. So, they're both stretched to the max. One day, Alice receives a call from the PTA president, who tells Alice that she found out the school will be cutting out several after school activities. These are activities that parents and children have come to rely on. The PTA president is worried and upset about this. She has received numerous calls from parents who don't know what they'll do if these programs are cut. She tells Alice that, in addition to what Alice normally does for the PTA, she needs extra help over the next four weekends from Alice for a fund raising event so they can raise the money to save these programs. Inwardly, Alice cringes because she doesn't know where she'll find the time, but she's caught off guard and she says "Yes." After Alice hangs up the phone, she feels annoyed with herself for taking on this extra work. She also doesn't know how she'll tell her husband, who would have to take on even more responsibilities over the next few weekends because of this new commitment that she has made to the PTA president. She doesn't know what to do.

Do any of these scenarios sound familiar to you or can you see yourself in similar predicaments? Can you think of other ways that each of these people can handle their situations where they don't have to compromise themselves or those close to them and where they can tactfully say "No"?

Fortunately, saying"No" in a tactful way is a skill that can be learned. If you have problems asserting yourself in similar situations, there are certain things that you can do to learn to be more assertive:

Talk to a trusted friend and ask him or her to do role plays with you where you can practice standing up for yourself. As a start, you can use the scenarios presented above and also come up with some of your own that are relevant to your life.

So, for instance in Scenario 1, you can practice how you can speak to your brothers and sisters to ask them to share in the responsibilities of helping your parents. You can also practice with your friend how you would talk to your parents to tell them that, while you want to help out, you can't always be available and explain the reasons why.

In Scenario 2, you can practice telling your friend and colleague, Dan, that while you empathize with his financial problems, you're also having financial problems. So, you can't lend him any more money and you and he need to work out a payment plan for the money that he currently owes you.

In Scenario 3, you can practice talking to your friend as if she were the elderly neighbor and tell her that, while you enjoy her company, there are times when you can't socialize with her because you have work deadlines that must be met. Suggest other times when you can get together to chat.

In Scenario 4, you can practice taking the time to think about what you'd say to the PTA president before automatically saying "Yes" and then regretting it. Since the person in this scenario was caught off guard, you can practice a certain technique that will give you time to think when you're caught off guard. This technique is restating the president's request in a tactful way ("So, let me make sure I understand what you're asking: You're asking me if I can spend about five hours each weekend working on the fund raiser? Is that right?") This gives you time to think of a tactful answer. After your friend, in the role as PTA president, restates her request, you can practice telling her that you can't help out this time because you're already over extended at home and at work. You can also practice stating what you can and can't do. You can also practice from the standpoint of having said "Yes" initially and then calling back the same day and telling her that you've thought about it and regret that you can't do it. This not an ideal way to handle this type of situation. Most of us like to honor our commitments most of the time. We feel that once we've committed ourselves that we want to be true to our word. While I'm not advocating that you go back on your word on a regular basis, there might be certain times when you realize that it's going to be impossible for you to fulfill your commitment. Of course, it would have been better not to have made the commitment at all. But sometimes we make mistakes and we have to learn, when the circumstances are not dire, how to handle these types of situations without feeling completely stuck.

Practice asserting yourself by saying "No" in real life situations that are not so emotionally charged for you.

For instance, if you normally accept every leaflet that people are handing out in your neighborhood, whether you're interested or not, because you feel sorry for the person giving out the leaflets, practice saying "No thanks" in a tactful way. Or if you have a hard time getting telemarketers off the phone, practice saying "Thank you, but I'm really not interested. I would appreciate if you would take me off your list."

Practice writing down in advance what you want to say before you say it.

So, if you have to call a friend to turn down her request, write down what you want to say to her. Of course, you're not going to read it to her, but it's helpful to have the words in front of you if you begin to stumble on the phone.

If you still have a hard time asserting yourself so you can say "No" or you have difficulty setting healthy boundaries with the people in your life, there might be other underlying emotional issues that practicing might not resolve. In that case, you could benefit from dealing with these issues in psychotherapy.

If you have a hard time asserting yourself, you're not alone. This is a common problem that many people have. It's important for you to know that you don't need to suffer in silence. And, remember that there's a big difference between being assertive and being aggressive.

Being Assertive
Being assertive and standing up for yourself doesn't mean you're being aggressive. And, you can learn to develop the self confidence to become more assertive.

About Me
I'm a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

I have helped many clients to learn to assert themselves in healthy ways.

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

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

Thursday, September 17, 2009

Making Changes One Step at at Time

"The journey of a thousand miles begins with a single step." said the Chinese sage, Lao-tzu.

Making Changes One Step at a Time

One of the major obstacles for people who want to make major changes in their lives, but who don't, is that they think about everything that they would need to do to make the change and they become overwhelmed and discouraged before they even start.

Change is a Process
While it's important to know the process and the steps that we need to take to make changes in our lives, often, if we focus on the entire process at once, it can seem too daunting to accomplish. For major transitions that might take months or even years, it's usually so much more beneficial to think about the change in terms of incremental steps. 

Breaking down a major transition into a step-by-step process is a lot less stressful than focusing on everything at once from beginning to end. Focusing on one step at a time also provides us with markers along the way where we can see progress. Usually, seeing incremental progress along the way gives us the incentive to keep going to the next step.

For example, as a psychotherapist, I've seen many clients who have considered either going back to college or graduate school to complete their degrees, often after having been out of college for many years. 

For most of these clients, furthering their education would mean maintaining a full time job and taking classes at night, which is no easy task. For most of them, the usual reaction to considering such an endeavor is something along the lines of, "I would love to go to graduate school and get my Masters degree. It would really open doors for me in my career. But when I think about working full time and taking classes at night, I feel too overwhelmed."

I empathize with these feelings because I attended most of my college classes at night while maintaining a full time job. I also worked full time while getting my graduate degree and postgraduate training. Anyone who has ever worked and taken classes at night knows that it can be challenging on so many levels. 

However, the long-term rewards can be tremendous. The other comment that clients often make in this type of situation is, "But I'll be 45 by the time I complete my degree in three years" to which I usually respond, "But you'll be 45 any way in three years, either with or without your degree."

In the above example, what if instead of focusing all at once on the three years of working full time and going to classes at night, the client were to break down the process into manageable steps? So the steps might be: get the college brochure, find out what would be required, enroll in one class and see how that goes, etc. At each step along the way, there is a decision point as to whether or not to continue.

Making Changes: Along the Way You Have Choices
It's important to realize that at any step along the way you can stop and decide whether to go to the next step. The alternative, feeling that once you start it will be like a runaway train that keeps going, does make it all seem too daunting. 

More importantly, it's not the reality of the situation and these feelings are often fueled by anxiety. For most people that I have helped with this issue and similar issues, they enjoy each step along the way, which encourages them to decide to take the next step. Then, before they realize it, time has passed, they've accomplished what they set out to do, they feel proud of themselves, and new opportunities become available to them.

The same principal would apply to changing certain habits or addictive behavior. As a hypnotherapist, I help clients to stop smoking. I also help clients with alcohol abuse, eating disorders, sexual addiction and other addictive behaviors. 

It's not unusual for clients to tell me, "When I think about not drinking for the rest of my life, it's too overwhelming. I don't think I can do it" to which I often respond, "So, what if you didn't think of it like that? What if you took it one day [or one step] at a time? " For most people, it's such a relief not to have to focus that far ahead. Then, as days, weeks, months and years pass, they build a sense of competence in themselves. The cravings often subside and, over time, they usually realize that they're able to do it, day by day.

Are There Changes You Would Like to Make?
Are there changes that you'd like to make in your life, but you feel too overwhelmed to even start? If so, you could benefit from working with a psychotherapist who is able to help you to break down your goals into manageable steps and provide you with the tools you need to succeed.

About Me

I'm a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.   

I have helped many individual adults and couples to overcome obstacles that have kept them from accomplishing their goals.

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

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

Wednesday, September 16, 2009

Coming Out as Lesbian, Gay, Bisexual, Transgender or Queer

The coming out process as a gay, lesbian or bisexual person is a very individual process. There is no one right way or particular age to come out. For many people, it's a challenging process that can take years and for others it's an exhilarating process that frees them to be who they are naturally without having to pretend to be heterosexual.

Coming Out as Lesbian, Gay, Bisexual, Transgender or Queer

Some people say that they knew that they were gay from the time they were children or teens. Many others say that they dated the opposite sex for a while, had satisfying romantic relationships as mature adults, and even got married and had children before they realized that they were gay, lesbian or bisexual.

There seems to be a misperception that most gay, lesbian and bisexual people come out in their teens. While this is true for some people, it doesn't appear to be the case for the vast majority.

Another misperception is that once a person comes out, it's a linear process that ends with that initial coming out. But, in reality, for most people, the coming out process is a life long process that changes over time as they accept their own identity, come out to friends and family, meet new people, start new jobs, and encounter new situations.

For most gay or bisexual people, new people who meet them will assume that they're heterosexual. So, each time it's a matter of choosing whether or not to come out with new people and in new situations. This is very different from being heterosexual where you don't have to think about this or explain your sexual orientation. The other possibility is that a person might come out and then go back and forth, in and out of the "closet" a few times before acknowledging (or not) his or her sexual orientation.

Usually, the coming out process starts with coming out to yourself. If you're fortunate enough to know other lesbian, gay or bisexual people or if you live in a large city where there are resources, you can usually find supportive people to talk to that won't have a negative reaction. (I've listed some resources below for people in the NYC area as well as a national hotline, if you live in other areas.) I

If you don't know anyone and you live in an area where there are either limited or no resources, it might be a matter of calling an LGBT (lesbian, gay, bisexual, transgender) hotline to talk. It's important to know that you're not alone. There are many other people who have gone through this same process and are continuing to go through this process. And it's important not to isolate. Finding support and places to socialize in your area can be affirming to your identity and emotional well-being.

The next challenge is usually coming out to family and friends. It's easier to come out to supportive family and friends first before considering coming out to others who might not be as supportive. Of course, this is always a judgement call and you might be surprised, for better or worse, how people react.

It's important to realize, too, that if coming out is a process for you, it might also be a process for your family and friends to see you in a new way. They might need time to understand what this means to you and to your relationship with them.

Coming out on the job can present a particular challenge for many people. Even if you live in a city like New York, where there are laws against discrimination based on sexual orientation, it doesn't mean that you won't be discriminated against, sometimes in subtle ways, or that your employer will feel comfortable with your sexual orientation. Your employer should only be taking into consideration your work performance, but the law doesn't control people's personal likes or dislikes. And actually proving discrimination, of any kind, can be difficult.

If you're in a relationship, there's the question of how to talk about your partner or how comfortable you feel inviting your partner to company events. Again, this is another choice and what you decide can have repercussions for your relationship. Some people have the attitude that they're out to everyone and they feel this makes their life easier because they don't want to have to think about it all the time in each situation. As previously mentioned, other people choose when and where to be out.

Coming out is a complex issue and one post cannot possibly cover all the topics involved. I've touched on some of the main coming out issues. If you need further assistance, please see the resource list that I've provided towards the end of this post.

If you're gay or bisexual and you're thinking about seeing a psychotherapist, whether it's specifically for coming out issues or not, it's important to find a therapist who is gay affirmative and has experience working with gay, lesbian and bisexual clients.

If you're not sure, you can ask. You don't want to see a therapist who has an agenda to "change" your sexual orientation or who views being gay or bisexual as a disorder. Even though the American Psychological Association removed homosexuality from their list of mental health disorders more than 25 years ago, there are still a minority of therapists who either don't understand or, for their own reasons, continue to see homosexuality as a psychological disorder.

Some people want to know if their psychotherapist is gay or bisexual and others don't want to know anything about their therapists. Usually, therapists don't divulge a lot about themselves because the therapy is supposed to be focused on you and not them, but if it's important for you to have a therapist that you know is either gay or bisexual, ask prospective therapists that you meet for consultations.

Hopefully, your coming out process will be a happy and meaningful experience. But if you need help, don't be afraid to ask.

The following is a resource list primarily for gay, lesbian, bisexual and transgendered individuals as well as a national organization called PFLAG for families and friends.

Gay, Lesbian, Bisexual and Transgender Resources:


The Lesbian, Gay, Bisexual & Transgender Center:

Identity House:

Gay Men's Health Crisis:

Audre Lorde Project:

Senior Action in a Gay Environment (SAGE):

Parents, Families and Friends of Lesbians and Gays (PFLAG):

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

One of my specialties is working with lesbian, gay and bisexual individuals and couples, including people who are going through the coming out process.

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

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

Friday, September 11, 2009

September 11, 2001

Today is the eighth anniversary of the September 11th World Trade Center attack. For most of us, especially those of us who live in NYC, it's a time to remember where we were that day and to reflect on the many lives that were lost and the people who survived and who are dealing with those losses.

On September 11, 2001, unlike today, it was a clear, sunny day. The sky was beautifully blue. I was in an office two blocks away from the World Trade Center's South Tower. I had arrived in my office at about 8:30 AM and was at my desk when I heard and felt a loud booming noise that sounded like a construction accident. A couple of colleagues came by and we turned on the radio to find out what might have happened. But there was no news during those first few minutes. Then, we saw tons of paper mysteriously floating in the air outside our windows. Eventually, the news about the plane crashing into one of the towers came over the airwaves, but there was still no news about a terrorist attack. Then, there was the second plane crash and a call from building management to evacuate the building.

I'm aware of how lucky I was that day to get out of the building safely and, eventually, get home. I'm also aware that I was fortunate not to have lost anyone at the World Trade Center that day. A week or so later, I listened to many accounts from clients who were not as lucky as I was and who lost husbands, wives, family members, and coworkers in the towers that day.

My heartfelt wish for healing and peace goes out to all families and friends who lost someone on September 11, 2001. My thoughts are with you.

Developing Internal Motivation to Change

Making changes in our lives, even when it comes from an internal sense that we need to make a change,  can be challenging enough. But when the call for change comes from our partners, families, friends, employers, or all of the above, it can be very difficult to hear what they have to say and find the internal motivation to change, especially when we might not see the need to change.

Developing Internal Motivation to Change

Being Open to Hearing What Others Have to  Say
Being able to stay open, listen and really hear what we're being told, and consider the possibility that, perhaps, there is some kernel of truth to what others are telling us can be hard. It's much easier to become defensive and dismiss what others are saying. After all, it can be hurtful to hear that our partner or a family member isn't satisfied with something about us. But after the initial reaction of surprise, hurt or anger, can we take the time to consider that, most of the time, the people who are confronting us with the need to change are people who care about us and that it's usually not easy for them to tell us things that they know we don't want to hear? That doesn't mean that they're automatically right, but can we take the time and make the effort to think about what they're saying and see if it resonates with us in some way?

External Motivation in Seeking Therapy
As a psychotherapist, it's not unusual for me to get calls from prospective clients who say, "I'm calling because my wife says I'm too irritable" or "I'm calling because my family did an intervention last week and told me that I have a drinking problem" or "I'm calling because my boss said, 'Either get help with your anger management problem or you'll be terminated" or "I'm calling because my boyfriend, my mother, my father and my sisters have all told me that they're worried that I'm a compulsive overspender, but I don't think I have a problem. "

Developing Internal Motivation to Change in Therapy

At the point when these prospective clients are calling, they're often not sure they need to change. Sometimes they're angry. Sometimes they're attempting to comply with what's being asked of them but they feel that it's not their problem--it's the other people's problem. Or they're hoping to come for one session so I can tell them that they don't have a problem and they can go back to family or friends with that information. And, of course, there are times when it's apparent that this person doesn't need to be in therapy and only comes in for a few sessions.

Developing Internal Motivation to Change in Therapy
When there seems to be some truth to what others are telling a client, I try to help the client to put aside the initial resentment or anger and develop the ability to look into his or her own internal world to see if, maybe, deep down, he or she has some awareness that there is a problem. It might start out as a small and vague sense of awareness, which is fine because most change is a process and it takes place over time. As this awareness develops and grows, the next step is usually some form of acceptance and ownership for the presenting problem, aside from what others may or may not be saying. This step takes courage. And, as you might expect, this isn't a linear process and people often go back and forth in their process between acceptance and denial.

Finding the internal sense of motivation to change when the call for change comes from the outside and it's in an area where we might have a "blind spot" about ourselves can be a daunting process for some people. And, yet, for other people, it can be very liberating to finally admit that there's a problem and feel good about taking steps to change it. They feel that they've had a breakthrough and now they can open up, let go of their denial and free themselves of traits or habits that have been holding them back, often, for many years.

About Me
I'm a licensed NYC psychotherapist, hypnotherapist and EMDR therapist.

I work with individual adults and couples. 

I have worked with many clients who, initially, start with only external motivation and learn to develop their own internal sense of motivation to change.

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

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

Wednesday, September 2, 2009

The Power of Starting the Day with a Positive Intention

How you start each morning often sets the tone for the rest of your day. Starting the day with a particular intention that is meaningful to you is a powerful way to begin your day.

The Power of Starting Your Day With a Positive Intention

What is Meaningful to You?
Your intention can be whatever is meaningful to you--having a peaceful day, opening up to new possibilities, feeling more confident, improving an aspect of your relationship, developing your intuition, enhancing your creativity or taking a step towards realizing one of your goals.

Often, people have only a vague sense about their intentions. They might need inspiration to help them get clear about what they want.

Starting the day by reading an inspirational passage in a book, reading poetry, listening to music, meditating, praying, taking a yoga class, exercising, or taking a walk can help to inspire you to set an intention for your day.

Writing down your intention can also help to define and clarify your intention.

Find Ways to Act Upon Your Intention
As you go through your day, think about your intention and find ways to act upon it. So, for instance, if your intention for the day is to bring more serenity into your life, ask yourself what you can do to make that happen on this day.

If this is your intention, can you take a few minutes at lunch time to close your eyes and pay attention to your breathing? Can you pay attention to the quality of your interactions with others and ask yourself if you're communicating in a way that creates the serenity that you want in your relationships?

Reflect Upon Your Intention At the End of the Day
It's also helpful at the end of the day to reflect on your intention and ask yourself if you were able to manifest what you wanted. If you did, that's great. And if you didn't, rather than berate yourself, think about what you might have done without judging yourself harshly.

Having a sense of meaning and purpose in your life can enhance your sense of self and help improve your relationships. Starting each day with an intention that is important to you can help you to achieve your goals, feel more empowered, and improve your overall sense of well being.

About Me
I am a licensed NYC psychotherapist, hypnotherapist and EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.  I have assisted many clients to discover their intentions and develop more meaningful lives.

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

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