NYC Psychotherapist Blog

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Wednesday, November 25, 2009

Relationships: Oxytocin, Trust and Empathy

After I wrote my post yesterday about psychotherapy, gratitude and balance, which was in keeping with the Thanksgiving holiday, I read a fascinating article by Nancy Angier in the Science Times section of the NY Times that piqued my interest. The article is called 
The Biology Behind the Milk of Human Kindness.

Relationships: Oxytocin, Trust and Empathy

Research Links Oxytocin to Increased Levels of Trust and Empathy
Ms. Angier discusses new research linking the hormone, oxytocin, to increased levels of trust and empathy. (Oxycotin is a naturally-occurring neurotransmitter in mammals--not to be confused with the drug, Oxycodan).

Relationships: Oxytocin, Trust, Empathy

Prior to this research, researchers have long known that oxytocin has aided in child birth (many doctors inject women in labor with oxytocin to induce labor), breast feeding, and that it usually increases naturally during sexual arousal and orgasm.

Oxytocin Facilitates Bonding and Has Implications For Relationships
Researchers have also known that increased levels of oxytocin facilitates bonding between mothers and babies in humans and other mammals. It is also generally accepted that when there is sexual chemistry between two people, there are high levels of oxytocin and when there is a lack of sexual chemistry, there are lower levels of oxycotin.

Oxytocin Facilitates Bonding and Has Implications For Relationships

However, this new research, which links increased levels of oxytocin with a greater capacity for trust and empathy has important implications for our relationships.

If you haven't read Ms. Angier's article in Science Times, I recommend that you take a look at it to understand the connection between oxytocin and our ability to feel trust and empathy in our relationships (see link that I have provided at the top of this post).

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

One of my specialities is helping individuals and couples to enhance their personal and work-related relationships.

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.

Tuesday, November 24, 2009

Balance, Gratitude and the Evolution of Contemporary Psychotherapy

A common myth about psychotherapy, especially among people who have never been in in-depth psychotherapy before, is that clients primarily "complain" to their psychotherapists about their families and their lives or come in to "fix" a particular problem. 

Balance, Gratitude and the Evolution of Contemporary Psychotherapy

This is a very narrow view of psychotherapy and does not take into account the full richness and experience of the in-depth psychotherapy process as a place where clients, in addition to resolving particular problems, often find balance and gratitude in their lives, their relationships and for themselves as well.

During this Thanksgiving season, when we tend to be more aware of the people and things in our lives that we are grateful for, I'd like to focus in this post on how in-depth psychotherapy often leads to a greater sense of balance and gratitude.

Often, when people first begin psychotherapy, they either come for a particular problem or they have a sense that "something is wrong" in their lives, but they don't know what it is. In our culture, our tendency is to approach problems in a logical, linear way: identify the problem, analyze the various options, chose an option, fix the problem, and the process is finished.

There's nothing wrong with this approach and, in many instances, it works very well. It also often works well for some specific problems in psychotherapy and hypnosis, like smoking cessation or overcoming a particular fear or phobia. However, in-depth psychotherapy can be so much more than this for people who are interested in finding a greater sense of balance and contentment in their lives.

How Contemporary Psychotherapy Has Evolved Over the Years:
As psychotherapy has evolved over the years, there has been more of an emphasis on cultivating and building a more balanced sense of self. As opposed to more classical ways of working in psychotherapy where the emphasis was primarily on uncovering and working through problems, contemporary psychotherapists also help clients to build a stronger sense of self.

This is done, in part, through the development of clients' internal resources. These internal resources can take many different forms. Sometimes, they're coping abilities that clients have had all along but have been overlooked and under utilized. Often, they're internal resources, or parts of ourselves, that are discovered and developed during the psychotherapy process.

When people are depressed or anxious, it's common to focus on what's wrong or missing in their lives. This is understandable. Often, under these circumstances, their view starts out being narrow until they begin to feel some relief from their anxiety-related or depressive symptoms in a supportive psychotherapy treatment environment.

In contemporary in-depth psychotherapy, clients can begin the process of building a stronger sense of equanimity: a greater capacity to soothe themselves, love and value themselves more, appreciate subtle and richer aspects of themselves, and develop a stronger sense of identity.

With a greater sense of balance for themselves often comes an increased capacity to value and have a greater sense of gratitude and compassion in their relationships, their work, and other important areas in their lives. So, what might have started as a narrow view at the start of psychotherapy begins to open up and broaden to include a more holistic and nuanced view of themselves and others: Not just what's wrong--but what's right too.

Keeping a Gratitude Journal:
I often recommend to clients that they keep a gratitude journal as a way to start developing a greater awareness and appreciation for the positive things that occur in their lives on a daily basis. 

The gratitude journal can be a simple list of two, three or more things that you feel grateful for each day. Over time, cultivating a sense of gratitude, even for the small things in life, can help to create a greater sense of balance, appreciation, and compassion in how we see our world as well as how we see ourselves.

About Me
I am a psychotherapist and hypnotherapist in NYC. I have helped many clients to develop a greater sense of self and an increased sense of balance and gratitude in their lives.

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, November 12, 2009

Getting the Most Out of Your Psychotherapy Sessions

As a psychotherapist in New York City, I often see clients who are coming to psychotherapy for the first time or clients who have been in therapy before where they didn't have a positive outcome.

Getting the Most Out of Your Therapy Sessions

Participating in psychotherapy involves a commitment of time, effort, and money. If you've never participated in psychotherapy or if your prior therapy experience was not a positive one, you might not know what to expect from your therapist or what your therapist expects of you. So, I usually like to talk to new clients about this so they can understand the treatment frame and they can get the most out of their sessions with me.

Choosing a psychotherapist:

A Good Therapeutic Relationship:
If you're trying to find a psychotherapist in a large city like NYC, you usually have many therapists available to you, especially if you have the ability to go outside of your managed care network.

Generally, the most important factor in choosing a psychotherapist is whether or not you feel a rapport with him or her. This might not be evident immediately. It takes time to build a professional rapport with your therapist. Having a good therapeutic working relationship is usually the best predictor of whether or not your therapy will be successful.

It's important to feel that your therapist has empathy and cares about you within the bounds of the professional treatment relationship.

Not every therapist is for every client. Someone else might really like a particular therapist and establish a good rapport with that therapist, whereas you might feel that you're not connecting with that same therapist. It doesn't mean that there's anything wrong with you or necessarily wrong with the therapist. It means that we're all unique and what works for one person might not work for someone else. Usually, after a few sessions, you can tell intuitively if you're connecting with a particular therapist.

Establishing a good therapeutic relationship doesn't mean that you're always going to "feel good" in your psychotherapy sessions. After all, the change process can be challenging and you might be discussing topics that bring up uncomfortable emotions. So, it's important to distinguish between those feelings and the overall rapport you feel with your therapist.

Different Types of Psychotherapy:
Aside from feeling a rapport with your therapist, there are also many different types of psychotherapy.

As a psychotherapist, I work in many different ways, depending upon the needs of the client: psychodynamic psychotherapy, cognitive behavioral treatment (CBT), EMDR (eye movement, desensitization and reprocessing), clinical hypnosis (also known as hypnotherapy), and Somatic Experiencing are among the different treatment modalities that I use.

You might find that you like and respond best to certain forms of psychotherapy and not others. Obviously, you're not responsible and cannot be expected to know about these different forms of psychotherapy before you start therapy, but you can ask any prospective therapist about them, and he or she should be able to explain in plain English any treatment modality that he or she uses.

Choosing A Licensed Psychotherapist:
It's important that whoever you choose is a licensed mental health professional.

There are people who call themselves counselors or therapists who have no professional training, expertise or psychotherapy background. They might be very nice people but, in most states, including New York State, if they're not licensed, they're not psychotherapists.

Knowing that your therapist is licensed lets you know that he or she mets the basic professional requirements in his or her profession.

It doesn't guarantee that he or she will be a good therapist or the right therapist for you, but it demonstrates that the minimum requirements stipulated by your State have been met. It also means that the therapist is governed by a State professional licensing bureau and is ethically bound and accountable to that bureau.

If you're not sure, you can ask your therapist. You can also check with the State professional licensing board. In New York State, you can go to the Office of the Professionals - NYS Education Department: and go to the section for verifications.

Choosing a Psychotherapist Who Stays Up-to-Date With Current Practices:
Aside from meeting the minimum requirements for licensing, you should ask any prospective psychotherapist that you're considering about his or her background and training. Generally, you want someone who has stayed up-to-date with current practices.

Choosing a Psychotherapist

Often, clients who would be concerned about these issues when choosing a doctor, don't think about it when they're considering a psychotherapist.

So, for instance, if you needed surgery, you would want to make sure that your surgeon continued to get training beyond his or her medical school training and stayed current with state of the art medical and surgical practices, especially for your particular medical problem. You wouldn't dream of seeing a surgeon who said, "I've never done this type of surgery before, but I'm happy to try it out on you" or "It's been a long time since I've performed this surgery. I might be rusty, but I think I can muddle through."

It's no different with psychotherapy. If a prospective therapist has not continued to train beyond graduate school, in my professional opinion, this isn't a good sign.

Ethical Considerations in Psychotherapy:
Ethical considerations in psychotherapy is a vast topic. There have been many books and articles written about it. I cannot possibly do justice to this topic in one posting. 

I think the vast majority of psychotherapists are ethical and caring people who want to help their clients. However, unfortunately, there are instances where there are boundary violations which are detrimental to the client. I will touch on some important factors:

"Dual Relationships" in Psychotherapy Are Unethical:
The psychotherapeutic relationship is unlike most relationships. It's different from a friendship or a familial relationship, even though you're talking about very personal things about yourself. Your therapist is not going to be your friend, not even after you stop therapy with him or her.

Psychotherapists' code of ethics considers it a boundary violation for therapists and clients to be in "dual relationships." That means that your relationship with your therapist will be strictly professional and limited to your therapy

Even though your therapist might have a warm and friendly manner, as a mental health professional, he or she is responsibile for maintaining clear and consistent boundaries.

Getting romantically or sexually involved with clients or taking advantage of clients in other ways is strictly forbidden. If a therapist seduces you into a romantic or sexual relationship, he (or she) can lose his license. You have the right to report the therapist to his or her professional board of ethics sessions (see my article:  Boundary Violations and Sexual Exploitation in Psychotherapy).

The therapy should be focused on you. An ethical therapist will not be discussing his or her own personal problems or focusing on him or herself.

This is another way that the psychotherapeutic relationship is different from most other relationships. Depending upon the psychotherapist, most therapists do not disclose a lot of personal information, especially if the therapist works in a psychodynamic way. The primary reason for this is, once again, to keep the focus on you.

That doesn't mean that the therapist might not selectively disclose certain things about him or herself if it's in the service of furthering the treatment.

Therapists' self disclosure is also another vast topic. Generally, even the most conservative psychoanalysts today no longer believe that they are "blank screens" for clients to project their thoughts and fantasies on. However, it's important to understand that if a therapist is not disclosing personal things about himself or herself, it's usually in the service of providing the best possible treatment for you.

Ethical Issues Regarding Managed Care Fees:
If your therapist is an in network provider on your managed care insurance panel, he or she should not be asking you to pay additional money, beyond your copayment, to bring your fee in line with his or her non-managed care fee structure.

When your therapist is on a managed care panel, he or she signed a contract with the managed care company to accept their fee. The contract also stipulates how to handle missed or broken appointments. If your therapist asks for additional money beyond what is allowed in the insurance contract, this is insurance fraud and is reportable to your insurance company and your therapist's professional board of ethics.

Also, most managed care companies don't allow your psychotherapist to charge the insurance for your missed or broken appointments. This is a contractual issue between your therapist and your managed care company.

That means that, in most cases, you are often responsible for the entire fee (not just the copayment) when you have a broken appointment with your therapist. This is a topic that should be discussed at the first sssion so that you're clear about your responsibility with regard to missed appointments. If you're not clear, you can call your insurance company and ask.

Some therapists bill the managed care company for broken appointments, even though it's against their contract with the insurance company. Possibly, they feel that they're being nice to clients by not charging them or they're trying to preserve the therapeutic relationship. However well intentioned this might be, you should know that, unless an insurance contract allows for this (and I don't know of any that do) this is insurance fraud and your therapist can lose his or her license for this.

Doing Your Part in Psychotherapy:
Usually, the therapeutic hour is somewhere between 45-60 minutes per week for individual therapy, depending upon your therapist and the type of therapy. An hour out of a week is not very much time. So, if you want to get the most out of your therapy, it's important that you know what is expected of you in therapy.

Doing Your Part in Therapy

Showing up for your appointments:
This might seem obvious, and most clients don't start therapy with the intention of not showing up for their appointments. However, it's not unusual to feel ambivalent about going to therapy. Clients will often start therapy saying that they want change, but the process of change is sometimes diffiicult, and when a client and therapist begin to discuss topics that are uncomfortable, some clients begin missing appointments.

They might not even realize that they're missing appointments because of their discomfort. Emotional discomfort and ambivalence can show up in many different guises: "forgotten" appointments, missing therapy because you feel "tired," and other reasons that might mask an unconscious wish to avoid change. Clients might also begin arriving late for their appointments as an unconscious way to avoid dealing with the process of change.

Thinking About What You Discussed in Therapy Between Sessions:
As I've mentioned, the therapeutic hour is brief compared to the rest of the time in your week. If you want to get the most out of therapy, it's important to think about what you and your therapist have discussed. That means taking time during the week to think or journal about the issues and feelings that come during and after your session.

It's also important to apply whatever you've learned in your every day life. Your therapy will be of little value to you if you have insights in your therapy session, but you forget them once you've left the therapist's office. Also, pay attention to whatever emotions come up between sessions and let your therapist know, even if you might feel uncomfortable. Chances are, if you're seeing an experienced, licensed mental health professional, he or she has already dealt with these issues before.

Doing Homework:
As a psychotherapist, I usually don't give a lot of homework to most clients between sessions. However, at times, I might recommend reading an article or a book, practicing something that has been learned in the session (like meditation or self hypnosis) or I might ask a client to journal or reflect on a particular issue or emotion. I might recommend attending a 12 Step meeting, getting a sponsor, etc.

I might also come to an agreement with a client to take a particular step or action to further the process.

For instance, if a client has problems with procrastination, it's important to talk about it and try to understand it but, ultimately, the client needs to take certain steps in order to overcome this problem. So, we might come to an agreement about what the next step might be to further the process along. Among other things, doing homework between sessions helps to bridge one session with another. A week might not seem like a long time, but in psychotherapy, it can be very long--enough time to forget or put out of your mind what you and your therapist have discussed. So, finding ways to bridge that time can be very valuable.

One posting about how to get the most out of your psychotherapy sessions is not enough to cover all the relevant topics. However, if you're thinking about starting therapy or if you're already in therapy, I hope this posting will be a good start for you and get you thinking about it.

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

I have helped many clients to lead more fulfilling lives.

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.

Friday, November 6, 2009

EMDR Therapy for "Big T" and "Smaller t" Trauma

As a New York City psychotherapist who is an EMDR therapist, I see clients for EMDR treatment for both "Big T" and "Smaller t" trauma. I will clarify what I mean by "Big T" and "Smaller t" trauma below.

What is EMDR?
First, as I have written about in earlier posts, I want to reiterate that EMDR (Eye Movement Desensitization and Reprocessing) is a form of psychotherapy which has been found to be effective for healing trauma. Francine Shapiro, Ph.D., who is a psychologist, developed EMDR in the late 1980s.

EMDR Therapy For "Big T" and "Smaller t" Trauma

Since that time, EMDR has been one of the most well-researched forms of psychotherapy for posttraumatic stress disorder (PTSD) and other types of trauma. It has been recognized as a safe and effective form of treatment by the Veteran's Administration, the American Psychiatric Association, the International Society for Traumatic Stress Studies, the Israeli National Council for Mental Health and the United Kingdom Department of Health, among other mental health organizations.

EMDR uses bilateral stimulation of the right and left brain hemispheres (through eye movements, alternate taping, bilateral music, and other similar methods) to activate the brain's "information processing system" to heal trauma.

When we are overcome by experiences that produce overwhelming emotional and physical reactions, often, our minds are unable to process these experiences.

Under certain circumstances, which are unique to each person, these overwhelming experiences can produce adverse reactions, like debilitating depression, anxiety and other psychological difficulties. EMDR allows clients to reprocess these experiences, allowing us to get to the root of these emotional processes, and usually produces a long-term cure.

EMDR therapists, who have advanced training, know how to work with clients in a way so that they are not overwhelmed with the EMDR reprocessing. Each client's experience is unique.

Generally speaking, high levels of emotional reaction tend to dissipate with EMDR treatment. Also, an experienced EMDR therapist makes sure that clients are well prepared for EMDR processing before the actual processing begins by working with clients to develop internal resources (coping skills) to deal with any uncomfortable reactions that might take place during the reprocessing of emotional trauma.

What is the Difference Between "Big T" and "Smaller t" Trauma?
EMDR is usually associated with what is referred to in psychological literature as "Big T" trauma. However, it seems that it is less well known that EMDR is usually very effective for "Smaller t" trauma as well.

"Big T" Trauma
When we refer to "Big T" trauma, we are usually referring to trauma that occurs during war or natural disaster, rape, kidnapping, physical attack, and other similar types of trauma. These types of trauma are usually so overwhelming for most people that they are unable to cope.

An example, of this is the Vietnam or Iraqi veteran who has witnessed atrocities during war and who comes home, relives these atrocities through flashbacks, where it adversely affects his or her ability to function in every day life.

Another example of "Big T" trauma is when a woman who has been raped continues to have nightmares about the rape; she ruminates about what happened, reliving the event over and over again in her mind.

She might be too afraid to start new relationships or to even go outside.

Generally, "Smaller t" trauma is trauma that is more subtle than "Big T" trauma.

An example of "Smaller t" trauma can occur when we're children and we witness events that are upsetting and overwhelming to us because our child-like minds are unable to understand or process these events.

An example of a "Smaller t" trauma could be when a child witnesses loud arguments between his parents and he fears that they are going to get a divorce. As a child under these circumstances, it's normal to be concerned about his safety and well-being. After all, he worries about what will become of him and who's going to take care of him if his parents are not together.

These kinds of experiences can leave a mark on a child's psyche, leaving him vulnerable to feeling anxious, depressed, or insecure later on in life.

There are many other everyday examples of "Smaller t" trauma that people often don't recognize at the time when they're occurring. The emotional damage that has been done often does not show up until later on in life. Sometimes the events that led up to these problems later on are apparent and, other times, they're not. Either way, EMDR is usually an effective form of therapy to overcome the effects of "Smaller t" trauma.

Since most literature focuses on "Big T" trauma like PTSD, I would like to focus on "Smaller t" trauma in this post to illustrate its effects and how EMDR can help. The following vignette is a composite of many cases with all identifying information changed to protect confidentiality:

When John first came to treatment, he was in his late 30s. He worked as an attorney in a large corporate law firm. Like most attorneys in his law firm, John hoped to become a partner one day in his firm.

Generally, he liked corporate law and enjoyed working with his clients. However, he felt very anxious around his boss because his boss was a bully. Whenever his boss felt that John fell below what was considered an acceptable rate of "billable hours," he berated him in the most demeaning way.

John understood the importance of "billable hours" and knew what was expected of him. He felt that, overall, he was a knowledgeable and capable attorney. However, whenever his boss berated him, John felt emotionally paralyzed.

John felt his confidence plummet and he would ruminate for days about whatever his boss told him. His colleagues experienced the same bullying from the boss and, although they were concerned about it, they were not as affected by it as John.

John recognized this and he knew he needed to get help or his boss's tirades continued to be detrimental to him. He realized that his reaction to his boss's comments were out of proportion to the current situation.

The First Phase of EMDR Treatment: During the first phase of EMDR treatment with John, I obtained a detailed history from John about his background. From his family history, I learned that John's father was very much like his boss. He was hypercritical of John and often berated him, leaving him feeling like he could never please his father. If John came home with a report card with all A's and one B, John's father focused on the "B" and berated him for not getting an "A" in that subject, leaving John to feel badly about himself.

Developing Coping Skills: During that initial phase of treatment, I also helped him to develop basic coping skills. Since he didn't do anything to manage his stress, John began working out and going to yoga class. I also taught John to meditate.

In addition, we developed internal resources that he could use during EMDR processing. For instance, John learned to think about and visualize certain "protective" figures from his life (his grandfather, a kind uncle, his nurturing older sister, as well as a lifelong friend and confidant). Through EMDR processing, we worked to help John to internalize these protective figures in such a way that he could "call on them" (essentially, remember, visualize and sense them) when he felt emotional distress either in the psychotherapy session or outside. Just using these internal resources whenever he had to deal with his difficult boss helped John tremendously.

EMDR Processing: During the next phase of treatment, John chose a particular incident that occurred at work with his boss and we began to process that incident using EMDR eye movements. 

Before the processing, John rated this incident as a "9" out of a possible 10 in terms of how emotionally disturbing it was to him (with 0 being no disturbance and10 being the highest level of disturbance). So, overall, it started out as being very disturbing to him. 

However, as we continued to do EMDR processing, the incident became less and less disturbing. It gradually went down to a 5 for John. He felt relieved, compared to how he felt originally, but it was still disturbing. Further processing of that incident did not decrease John's level of disturbance.

When Processing of Trauma Gets Blocked: When the level of processing gets "blocked" (meaning that it stays at a certain level of disturbance and it won't go down to 0 or 1), it generally means there is underlying trauma that is feeding into the current situation and is making it more emotionally charged than it might normally be. Having already obtained John's family background, I was aware that John's relationship as a boy with his father was probably feeding into his current problems and activating his emotional response.

The Difference Between EMDR and Regular Talk Therapy for Trauma: If we were doing regular talk therapy, we might have discussed John's relationship with his father and how if affected him now.

It probably would have been enlightening to John but, usually, this would only remain as an intellectual insight. In other words, it's interesting and informative to know, but it doesn't produce any change. And therein lies the problem with regular talk therapy and trauma.

In addition to my EMDR training, I'm also trained as a psychoanalyst, so I understand and value psychodynamic treatment for most problems. However, when it comes to trauma, regular talk therapy is often limited in terms of resolving and healing trauma.

Processing the Earlier Trauma that Triggers the Current Trauma: So, knowing that there were probably earlier memories that were feeding into and triggering John's emotional reaction to his current situation, we did what is known in EMDR as a "float back."

During a "float back," the client thinks back to an earlier time when he might have experienced these same feelings. An experienced EMDR therapist might have a sense of what those memories might be, but he or she doesn't make any suggestions about them. The EMDR therapist allows the client to come up with whatever he or she remembers or senses.

In John's case, his earliest memory of feeling the same way as he did in his current situation was when his father berated him during Little League practice. According to John, he struck out each time that he was up at the plate during a big game with a rival team.

Afterwards, he was feeling bad enough, but when his father yelled at him in front of his team mates and the other parents, John was mortified. John rated his level of disturbance as being a "10" for this memory. Gradually, as we continued to process the memory with EMDR, his level of disturbance went down to a "0." When it went down to 0, he, of course, remembered the memory with all of the details, but he no longer felt disturbed by it.

Resolution of the Trauma: After we processed this earlier memory, which was emblematic of his experiences with his father, we went back to the current situation with his boss. As is usually the case, having reprocessed the earlier "Smaller t" trauma produced a "0" in terms of John's level of emotional experience in the current situation.

John was really surprised and greatly relieved. He was able to go back to work, deal with his boss, and when his boss saw that he could no longer intimidate John the way he used to, he stopped ranting at him and chose to bully another more vulnerable attorney instead.

EMDR Follow Up: When John checked in with me several months later, he told me that the results of our work continued to hold. He also said that his self esteem was now higher than it ever had been and his boss told him that he was on track to become a partner, which made John feel very happy.

The above vignette is one brief example that demonstrates how EMDR can work. Everyone's experience of EMDR is unique.

EMDR is an effective treatment for dealing with trauma, and it is usually faster than regular talk therapy.

Getting Help in EMDR Therapy
If you have unresolved trauma, you could benefit from working with an experienced EMDR therapist who is a licensed psychotherapist.

About Me
I am a New York City licensed psychotherapist and EMDR therapist.

I work with individual adults and couples.

I have helped many clients resolve both "Big T" and "Smaller t" trauma.

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.

Wednesday, November 4, 2009

Workplace Issues: Strategies for Dealing With Malicious Gossip

I came across an interesting article in the New York Times by John Tierney called Can You Believe How Mean Office Gossip Can Be?  It was based on a journal article in the Journal of Contemporary Ethnography. 

Workplace Issues:  Strategies for Dealing With Office Politics and Malicious Gossip

Considering the fact the many of us spend at least eight or more hours in an office and gossip is part of most organizations, this is an important issue to explore.

Years prior to my becoming a psychotherapist, I was a human resource manager. In my prior career. I saw, first hand, the negative effects of gossip, which included undermining and, in some cases, ruining people's career.

Workplace Issues: Strategies for Dealing With Office Politics and Malicious Gossip

People engage in office gossip for all sorts of reasons. Some people, who work in organizations where there are reorganizations or layoffs looming, gossip to deal with the stress of the situation, the lack of information, and to try to give and get information. The problem is that the information is often wrong.

Other people gossip to vent about the boss or top management when they feel disempowered in their work environment. The obvious danger with this is that you could lose your job if the boss finds out that you're talking about him/her. The other problem is that this kind of gossip can undermine your entire office, which could have repercussions in how others, including future prospective employers, see you. They could easily say, "If the boss is a incompetent, everyone under him is probably incompetent too.
Workplace Issues: Strategies for Dealing with Office Politics and Malicious Gossip

Even if you don't lose your job because you're gossiping about the boss, frequent malicious gossip can produce a toxic office environment where the group's dissatisfaction grows, festers, and feeds on itself, reducing morale and making it a very unpleasant place to work.

Some people gossip because they're bored or dissatisfied with their jobs. Others hope to form certain alliances among a particular group of employees while alienating other employees.

Gossiping might seem like a harmless diversion and it might bring about a certain temporary cohesiveness within the group where the gossiping is taking place. But there is usually a certain amount of suspicion within the group, "If he's gossiping about her, he's probably gossiping about me too." And, of course, this is often the case.

One situation that was not explored in the article is when employees purposely start a cycle of gossip as a way to intentionally sabotage an employee. If you happen to be that employee, it can be extremely difficult to combat this form of sabotage because you might not be able to find out who started it and you might not be able to control it due to the covert nature of the gossip.

When you're in a work setting where there's a lot of office gossip, it's hard to avoid. John Tierney's article suggests certain strategies if you happen to be part of a gossipy group and you feel uncomfortable.

One suggestion is to say something positive about the person being maligned. This makes it difficult for others to continue to talk negatively about that person. Another strategy is to change the subject, a subtle suggestion that you're not interested in engaging in this gossip. A third recommendation is that you suggest, in a tactful manner, that you and others get back to work.

Workplace Issues:  Strategies for Dealing with Office Politics and Malicious Gossip

In my opinion, one of the most effective strategies for discouraging office gossip is for top management to encourage employees to come forward with their dissatisfaction.

Now we all know that many managers talk a good game about having an "open door policy," but not all of them mean it. Employees quickly pick up on the disingenuousness of this, and it creates more bad feelings. But if employees see that top management is genuinely concerned and problems are addressed and resolved, this can go a long way towards decreasing office gossip.

But what can you do if the boss is the one who is gossiping to you about his/her colleagues, superiors or your coworkers? This situation is not addressed in the article. This is obviously a very ticklish situation where you may be damned if you do and damned if you don't join in the conversation with your boss.

Tact and diplomacy are essential, and you might suddenly "remember" that important call that you need to make to a client or the report that's due today, making it necessary to excuse yourself. If possible, you might also consider looking for another job before it's your turn to be the object of your boss's disaffection.

Whether we like it or not, gossip is a fact of life in most offices. Men and women both engage in it.

Learning to deal with office gossip requires tact and maturity as you balance your need not to participate with the reality that, for as long as you're in this work environment, you still need to work with the worst offenders of office gossip.

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

I have helped many clients deal with workplace and career issues.

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 or email me.

Tuesday, November 3, 2009

Boredom as a Relapse Trigger

As a psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist in New York City, one of my specialities is working with people who have problems with addictions and codependency. Over the years, I've found that one of the most challenging aspects of overcoming addictive and codependent behavior is overcoming boredom as a relapse trigger.

Overcoming Addiction: Boredom as a Relapse Trigger

What is Boredom?
For most people, feeling bored means that they're doing the same things over and over again and not feeling fulfilled. Life feels dull and monotonous. They feel like they're in a rut and can't get out. Life and relationships might not feel as meaningful when someone is bored.

Why Does Boredom Often Lead to Relapse?
For someone who is accustomed to feeling "high" from drinking, drugging, overspending, overeating, bingeing and purging food, gambling, engaging in sexual addiction, cutting, or getting overly involved in someone else's life drama, trying to live a clean, sober and healthy life might feel unexciting and dull.

When you're used to dealing with your problems by looking for stimulation in unhealthy habits, you might feel a void in your life as you let go of these habits, people you used to engage in these habits with, and former places where you used to go.

At that point, if you haven't developed other healthy habits to take the place of addictive behavior, you are at risk for relapse as you begin to think about stimulative and thrill seeking behavior. It's very tempting to revert back to old habits as you bargain with yourself: "I'll just do this one more time, and then I'll stop" or "I can have one drink. I can control it" or other self deceptive thoughts.

How to Overcome Boredom to Avoid Relapse:
First: Realize that you're not alone. Many people who are struggling with addictions and codependence have faced the same challenge as you have and they have successfully overcome having boredom lead to relapse.

Second: It's important to get out, talk to people who have overcome these problems, and get support. Self help groups like A.A., N.A., Debtors Anon, Al-Anon, Sexual Compulsives Anon, Gamblers Anon, Overeaters Anon and other self help groups are often an excellent source of support (see resource list below at the end of this post).

When you listen to other people talk about how they struggled and overcame boredom as a relapse trigger, you'll often hear aspects of their stories that will resonate with you and help you develop your own ideas about overcoming boredom. Get a sponsor to help you work the Steps and navigate through your difficulties with relapse.

Third: Think about activities and hobbies that you used to enjoy that you might have given up after you began engaging in the addiction of your choice. Maybe you used to like to listen to music before. Or, maybe you liked a particular sport, hobby, or other healthy recreational activity. Often, when people get immersed in addictive behavior, they let go of and forget about activities that they used to enjoy. You can recapture the enjoyment that you used to get from these activities.

Overcoming Boredom to Avoid Relapse

Fourth: Be willing to try new and healthy activities to get out of the rut that you're in. If you're out of shape, consult with your doctor and find out if you're up to exercising at the gym, or taking a yoga or dance class. For most people, walking, at a pace that is healthy and right for you, is often a safe form of exercise. Join a book club where you can clear out the cobwebs from your mind, meet new people, and find other ways to stimulate your mind through new ideas.

Fifth: Get involved by volunteering. There are so many organizations that desperately need help: from soup kitchens for the hungry and homeless to reading and mentoring programs in schools. When you help someone else or make a positive contribution to a worthwhile organization, you feel good about yourself and it helps to build your self-esteem. Even if you have a tendency towards codependence, you can learn to help others in a healthy way.

If you find that you're still struggling with boredom as a relapse trigger, you could benefit from working with a licensed mental health professional who has an expertise in helping people overcome addictive and codependent behavior.

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

I work with individual adults and couples.

I have helped many clients overcome addictive and codependent behavior.

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.