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Sunday, January 30, 2011

Dreams and Embodied Imagination

NIP Annual Conference: "New Worlds of Psychoanalytic Dream Work"

Dreams and Embodied Imagination

I attended an intriguing annual conference at NIP (National Institute of Psychotherapies) called "New Worlds of Psychoanalytic Dream Work" here in NYC. 

Their first speaker was the world-renown Dutch Jungian psychoanalyst, Robert Bosnak. Mr. Bosnak has developed a very exciting and innovative way of working with dreams that he calls Embodied Imagination.

During the conference, Mr. Bosnak explained Embodied Imagination and then gave an amazing live presentation of his work. The woman who volunteered to present her dream was someone who Mr. Bosnak had worked with mostly through Skype, since she lives in NYC and he currently lives in California, for a short time, as preparation for the conference. He was not her primary therapist.

Borrowing from the early Greek healing arts involving healing incubation, where people who wanted healing went to the Temple of Aesklepius, prior to the conference, Mr. Bosnak asked this volunteer to focus every day on certain health symptoms that she was experiencing in order to "incubate" a healing dream.

As you may know, the early Greeks went to the Temple of Asklepius hoping that they would meet the healing god in their dreams so that they could be cured of their medical problems. In those days, people didn't think of their dreams as being symbolic--they believed that if they had a dream where they saw the healing god, Aesklepius, it was as real an experience as any waking experience.

During the conference, Mr. Bosnak demonstrated his phenomenological technique of Embodied Imagination while he induced a hypnogogic state in the dream volunteer. (The hypnogogic state is the state between waking and sleeping.) His work is a very big departure from traditional or even contemporary psychoanalytic traditions of doing dream work.

Dreams and Embodied Imagination

As he went over the dream with the dreamer, he asked her not only to embody her dream self in her imagination, but also to embody other people and inanimate objects in her dream. 

Rather than experience these people and objects as if they were parts of herself, as she might in parts work or in Gestalt therapy, Mr. Bosnak asked the dreamer to use her imagination to become each of these people and objects in the dream and related their experiences, including inanimate objects like a car.

Notwithstanding the fact that there were at least 300 psychoanalysts and psychotherapists in the room, Mr. Bosnak and the dream volunteer did amazing work, which appeared to be healing for the particular type of medical problem that she was having. 

It is noteworthy that Mr. Bosnak didn't know anything about the dream beforehand. He was hearing it for the first time with the rest of us.

We could see how they both got to material in the dream that they probably would not have accessed if they approached the dream in the conventional manner. It was very exciting, to say the least, to observe this. For most of us in the room, it was a challenge and an invitation to consider how we work with dreams.

Mr. Bosnak has moved away from the conventional idea that dreams have a defensive structure. He also does not work with what is often described as manifest (what is obvious) and latent (what cannot be readily seen) content in his work with Embodied Imagination.

If you have been reading my blog, you are probably aware that I'm very interested in the mind-body connection in my work, so I'm always interested in hearing new techniques for working in this way. Some of Mr. Bosnak's methodology reminded me of Somatic Experiencing, which is a modality I already use in my psychotherapy private practice

Most people who are familiar with Jung's work know that he worked with what he called Active Imagination. He also used Active Imagination in his Red Book. However, Mr. Bosnak seems to have gone beyond Active Imagination.

Robert Bosnak has traveled all over the world, and he has witnessed many different ways of working with dreams phenomenologically, including working with dreams shamanically. He reminds us that how we perceive dreams is very much tied to our cultural understanding.

Just before going to sleep last night, I began to read Robert Bosnak's book, Embodiment - Creative Imagination in Medicine, Art and Travel. I got up to Page 5 when I dropped off to sleep and I had the following dream:

I'm talking to Mr. Bosnak about his method of working with dreams. We're sitting face-to-face at close range. I'm mostly listening to him very intensely and thinking about how I can use this method of doing dream work with my clients. As I take in this new way of working with dreams, I feel very excited and slightly frustrated. Then, I realize and think to myself, "Time is the key. He slows everything down and gives the work lots of time."

When I woke up, I wrote down this dream as well as several other dreams that I had last night.

After I wrote down my dreams, I picked up Mr. Bosnak's book, Embodiment, and began reading again. I was surprised and delighted to find that when I resumed reading and got to the next page, Page 6, he talks about time and the slowness of time when transitioning from the dreaming to the waking state. I felt as if Mr. Bosnak and I had an actual conversation about Embodied Imagination and the nature of time in this work, and here it was confirmed when I resumed reading his book.

It's a fallacy when some people say that they either don't dream or they rarely dream. Everyone dreams at least five dreams a night, but not everyone remembers their dreams.

Whether or not you remember your dreams has a lot to do with how you wake up. If you're someone who takes a while to transition from the sleep state to the waking state, transitioning slowly so that you still retain the feeling state that you were in while you were sleeping, you're more likely to remember your dreams. However, if you tend to wake up suddenly without making that slow transition, you're less likely to remember your dreams.

If you're interested in learning more about your dreams, which are often a rich source of information, I recommend that you keep a pad and pen by your bed. Having a strong intention and telling yourself that you want to remember your dreams before you go to sleep helps to give your unconscious the message that dreams are important to you.

When you wake up, rather than jumping out of bed, take a few moments to stay immersed in the dream state. Especially, do not change your position. So, for example, if you're lying on your left side, don't turn around right away. Remain like that for a few moments and allow the details of the dream to emerge.

Then, write down your dreams in the present tense as if you're still in the dream. Even if it's a fragment of a dream, write down whatever you remember. Usually, you'll find that, as you begin to remember your dreams from the night before, you'll remember them in reverse order, with the last dream first (the dream closest to waking up) and then the next to the last dream, and so on.

Dreams and Embodied Imagination

Very often, if you write down your dreams, over time, you begin to see interesting synchronicities between your dreaming and waking states. I believe that this isn't as unusual as most people think and that, over time, most people can tap into this inner resource. I believe it's a natural ability that most of us have if we're willing to develop it.

Several years ago, when I was working on my dreams every day, I saw very interesting synchronicities. I also had precognitive dreams where I dreamt about certain things happening before they actually happened. I didn't have any earth-shattering premonitions about world events--they were mostly personal incidents in my life. My point is that I saw a connection between paying attention to my dreams and the ability to tap into an inner precognitive resource.

If you want to find out more about Robert Bosnak's method of Embodied Imagination and his way of working with dreams, you can visit the website for the Embodied Imagination Institute: www.cyberdreamwork.com. You can also read his book, Embodiment, which is written in an accessible way.

Mr. Bosnak also heads up the Santa Barbara Healing Sanctuary, and you can visit their website at: www.sbhsanctuary.com.

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

I work with individual adults and coupls.

I have been fascinated by dreams since I was a teenager and I enjoy doing dream work with my clients. Dream work often helps clients to gain a perspective of themselves and others that they wouldn't ordinarily otherwise have access to in other ways. 

I also enjoy using clinical hypnosis to re-enter the dream state, and I have found this to be very useful to clients.

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.





























Healing Mother-Daughter Relationships

In my prior two blog posts, I provided some background information about life stages in mother-daughter relationships and I also discussed how early infant bonding and attachment affect mother-daughter relationships: Life Stages in Mother-Daughter Relationships and Mother-Daughter Relationships: Early Bonding

Healing Mother-Daughter Relationships

In this blog post, I will discuss how mother-daughter relationships can be healed using a composite vignette, which does not represent any one particular case with no identifying information.

Clinical Vignette
The following vignette is based on a composite of many different cases with all identifying information removed to protect confidentiality:

Ellen:
Ellen was a married woman in her early 50s when she first came to see me. She came because she and her adult daughter, Sandy, had difficulties in their mother-daughter relationship since Sandy was an infant. Ellen felt very sad and frustrated that she and Sandy never had a good relationship, and she felt that they were both stuck in a dysfunctional pattern or relating that neither of them knew how to change. Sandy was her only child, and Ellen wanted very much to heal their relationship.

Ellen had given birth to Sandy when Ellen was 18. She hid the pregnancy from her family through most of her pregnancy because she was ashamed and afraid to tell her parents. By her eighth month, she could no longer hide the pregnancy, despite wearing baggy clothes, and she had to tell her parents that she was pregnant. 

Both of her parents were very upset, and they wanted to confront the boy's parents, but Ellen refused to tell them who the father was. She told me that the father was a young man in his early 20s who was visiting NYC, on leave from the Army, and he left for his home town and never knew about her pregnancy.

Ellen's parents decided that they would raise the baby and, Ellen, who dropped out of school in her eighth month, could focus on getting her GED and going to college. She described this time in her life as being very tumultuous. She was aware that her parents were very disappointed in her and they felt that she had "ruined" her life with this pregnancy.

Since all of her parents' relatives lived on the West Coast, Ellen's parents told them that the baby was Ellen's mother's and that she had kept the pregnancy secret because she wasn't sure she would be able to carry the baby to term due to her age. This was the first secret related to Sandy's birth.

When Sandy was born, Ellen's mother took over. Her mother would hardly allow Ellen to hold the baby and she didn't allow her to breast feed the baby. Ellen said that when Sandy was born, she looked upon her more as a doll than as a live baby. Ellen said she felt a deep shame about having a baby out of wedlock, and it was easier for her to go along with her parents' lies than to deal with the truth.

Before she went away to college, Ellen said she remembered many nights when Sandy cried for hours by herself by herself in her crib. Ellen's mother didn't believe in picking up Sandy when Sandy was in distress because she thought that this would spoil her. Her mother also wouldn't allow Ellen to go to her. So, most nights, Sandy cried until she was exhausted without anyone to comfort her. Ellen said this was excruciating for her, and she was glad to go away to college so she didn't have to hear Sandy cry any more.

While she was in college, Ellen visited home occasionally on weekends. She remembers thinking that Sandy was a sullen, irritable, anxious child. Sandy's basic needs (in terms of being feed, bathed and clothed) were taken of, according to Ellen, but Ellen's parents didn't spend much time talking to Sandy or playing with her. 

 She was left in the crib most of the day by herself. Ellen said that her parents were never overly affectionate people, but their behavior was in stark contrast to how they behaved with her when she was younger. She felt that they were not emotionally prepared to take care of Sandy, and they resented it.

According to Ellen, Sandy grew up thinking that Ellen was her older sister. By the time Sandy was old enough to walk and talk, Ellen said she had also convinced herself of this deception too because it was easier for her to live with. She described the difficulties that Sandy had in school. Although she was bright, Sandy had difficulty making friends with other children and she didn't relate well to her teachers.

After Sandy was evaluated and it was determined that she didn't need a medical intervention, the school recommended counseling. Ellen's parents were opposed to counseling, especially after they heard that the whole family had to be involved in the counseling sessions, so they refused at first. 

 But the school administration continued to pressure them and warned that they would contact the Bureau of Child Welfare if they didn't comply with their recommendations, and Sandy might be taken away from them. The principal felt that Sandy was having basic problems relating interpersonally, and if she didn't get help, this could be a lifelong problem for her. So, Ellen's parents relented very reluctantly.

During family counseling, Ellen's parents finally revealed their secret--that Ellen was really Sandy's mother. Ellen said that her mother broke down one day and told the family therapist the truth. 

 The family therapist helped the family to get through this very difficult time. She told Ellen and her parents that Sandy needed to be told. Ellen and her parents struggled with this for a few months but, with the family therapist's help, they prepared themselves to talk to Sandy in session to tell her, in a way that a child might understand, that Ellen was her real mother.

Ellen told me that she felt retraumatized when she and her parents had to reveal the truth to Sandy. Until then, she had gone into a sort of state of denial about being Sandy's mother, and she felt like she was being confronted with it all over again.

According to Ellen, after she was told, Sandy became very angry and she began acting out in school and at home. She stopped talking to Ellen and she vacillated between clinging to Ellen's mother and pushing her away. 
She behaved in much the same way with Ellen's father. 

During those sessions when Sandy was told the truth about Ellen being her real mother, she was also told that her father lived far away and no one had contact with him. 

Over and over again, the family tried to reassure her that she was much loved by them (even if Ellen's parents had difficulty showing it), but Sandy's school work suffered. Her therapy sessions were increased to three times a week so the family therapist was able to help her get through this crisis.

Soon after that, Ellen moved out of the household to get her own apartment with roommates, and she only went home occasionally to visit her family. She said she made efforts over the years to reconcile with Sandy, but Sandy was very resistant to this. Sandy completed high school and she went on to college. 

She made a few close friends, but she had a lot of problems in her relationships with young men. She tended to choose men who were emotionally unavailable and she was constantly trying to win their affection. According to Ellen, these relationships usually ended in the young men abandoning Sandy.

By now, Sandy was in her mid-30s. As a college graduate, she was underemployed as an office clerk, and she had a succession of roommates over the years. She had not been in a relationship for several years. 

Ellen called Sandy about once every couple of weeks to find out how she was doing, but she said, most of the time, she got Sandy's answering machine and Sandy rarely returned her calls. Whatever she knew about Sandy, she knew from a cousin who moved to NY and who befriended Sandy.

In the early stage of our work together, I helped Ellen to understand what might have gone wrong with Sandy in the early attachment phase when she was an infant. In order for babies to learn how to bond and develop a secure attachment to their primary caregiver (in this case, Ellen's mother), they need to have consist nurturing and care.

Based on Ellen's description of her mother's interactions with Sandy as an infant, it appeared that Sandy's basic needs were taken care of, but there wasn't a lot of nurturing or affection. As a result, Sandy grew up to feel insecure and had difficulties forming relationships. 

I assured Ellen that this didn't mean that Sandy was doomed to continue in this way, but she had to be willing to get psychological help. 

 I told her that the family therapy was probably helpful to her when Sandy was younger, but it seemed, based on Ellen's account, that Sandy probably had a lot of unspoken anger, hurt and resentment towards her. If they were going to heal their relationship, Ellen would have to learn to forgive herself and make amends with Sandy. Sandy would also have to be willing to reconcile.

Our early work together involved helping Ellen to develop emotional resources for herself. Her husband was her main source of external support. She also had supportive, close friends. 

During this period of our work, Ellen grieved for the loss that she felt for not being closer to Sandy when she was a baby. 

She felt that she really missed out on having these early years with her daughter. Ellen also learned to be compassionate with the teenage part of herself who was obviously not equipped on any level to take care of an infant and who had no choice but to go along with her parents' wishes with regard to Sandy.

When she felt ready, she tried to contact Sandy by phone to ask to see her and talk to her, but
Sandy remained unresponsive to her. So, Ellen wrote Sandy a letter in which she expressed her deep sorrow and regret for what happened between them. She asked Sandy to forgive her and told her that she hoped they could develop a better relationship.

Much to Ellen's surprise, Sandy agreed to come in for a therapy session to meet with Ellen and me. It was a very emotional session with lots of anger and tears on Sandy's part and much anguish and pain for Ellen. Sandy agreed to come back for another session a week later. 

Since Ellen had no expectations of how the session would go, she was able to come into her next session with me and talk about how she felt. Even though it was very painful to hear Sandy's anger and pain, Ellen felt that, at least, they were talking in an honest way and the lines of communication were finally open. But she also knew that she could not force Sandy to have a mother-daughter relationship if she was not open to it. At that point, Sandy seemed highly ambivalent.

Ellen and Sandy met with me for several months. It was very rocky at first, but I saw some hope in that they both wanted to continue the process. During our sessions, Sandy developed a psychological curiosity about her own emotional process, and she also began her own individual sessions with a psychotherapist.

Gradually, Ellen and Sandy began to make some progress. 

Just like most psychological changes, it was not a steady line of progress. It was more like two steps forward and one step backwards, but it was progress nonetheless. They began going for coffee after their sessions and, after a while, they were having dinner together. 

Although Sandy was guarded and very cautious at first about opening up, she also seemed, underneath it all, to have a real need for the compassionate, nurturing mother that she never had. By now, Ellen's parents were in their mid-70s and they never really bonded with Sandy.

With Sandy's consent, I also maintained contact with her individual therapist. Her therapist reported that Sandy had formed a rapport with her, and she was making slow, steady progress in treatment. She was beginning to let go of some of her fears about starting to go out with men again, and she eventually met a man that she really liked and who was very interested in her, and emotionally available.

When there is this type of emotional rupture in the mother-daughter relationship, the work tends to be slow. Healing doesn't happen over night, if it happens at all. Trust must be regained over time for both the mother and the daughter.

For mothers and daughters to make amends in these types of situations, there usually needs to be an overarching motivation to transcend their differences. A therapist never knows in advance how this will go in the treatment. 

Healing Mother-Daughter Relationships

Fortunately, for Ellen and Sandy, they were eventually able to develop a belated mother-daughter relationship that they could both feel comfortable with over time. There was nothing magical about it--it involved a lot of sustained, hard work on both of their parts and a willingness to be emotionally vulnerable.

Sandy also tracked down her father who, at that point, was divorced with adult children. After the initial shock of hearing that he had a daughter that he never knew about, he wanted to meet her. Over time, Sandy began taking steps to develop a belated relationship with her biological father.

Conclusion
I hear from both mothers and daughters in this type and other types of relationships. Sometimes, they decide to come in after many years of estrangement. 

Often, mothers and daughters, who might have been reluctant to heal their relationship earlier on, will have a change of heart as the mother ages. Often, they see it as their last chance to reconcile before the mother becomes too frail or before she dies. Other times, as daughters become mothers themselves, they develop more compassion and empathy for what their own mothers might have gone through with them.

There are times when mothers or daughters cannot heal their relationship for a variety of reasons. Sometimes, one or the other of them is not willing or able. Other times, one of them is no longer alive and so the person remaining has to heal her own internal mother-daughter relationship on their own in therapy.

At times, whatever occurred in the mother-daughter relationship might have been so abusive that the relationship is just still too toxic to heal, especially if the mother is unable to own up to the abuse (if she was the abuser) or unable to accept that abuse occurred (if the abuser was someone else). 

Often, these are instances where there was physical and/or sexual abuse that remains unacknowledged and unresolved. At those times, you might need help to overcome the trauma of what occurred without involving the other person.

Getting Help in Therapy
As I've mentioned in prior blog posts, the mother-daughter relationship is the most intense family of origin relationship. This can make it the most rewarding as well as the most painful relationship.

If you and your mother or daughter are having problems healing your relationship on your own, you might consider getting professional help to assist you with this process, whether you decide to do this on your own or with your mother or daughter.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist and EMDR therapist (see my article: What is a Trauma Therapist?).

I work with individual adults and couples.

I have helped many clients to work through mother-daughter issues as well as other family of origin problems so that they can lead meaningful and fulfilling 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.

Wednesday, January 26, 2011

Mother-Daughter Relationships: Early Bonding

In my prior blog post, I discussed Life Stages in Mother-Daughter Relationships from infancy to middle age for daughters and later years for mothers:  Life Stages in Mother-Daughter Relationships. In today's blog post, I'll focus on the early stage of bonding between mothers and daughters.


Mother-Daughter Relationships: Early Bonding


Why is Early Bonding Important?
First, let me say that bonding between infants and parents is extremely important for the infant to grow up to be a healthy, well-related adult.

Even though I'm focusing on mothers and daughters in this blog post, it's important to understand that both parents need to bond with their babies, whether the babies are girls or boys. So, even though the focus is on mothers and daughters, it's understood that fathers need to bond with their children as well.

Bonding between mothers and infants is an intense attachment. When bonding is going well, not only is it gratifying to both mother and infant, but the infant begins to learn in her first intense relationship how to relate.

Mother-Daughter Relationships: Early Bonding

If the mother is responsive to the baby, all other things being equal, the baby will usually grow up with a sense of security and positive self esteem. How the mother responds to the baby affects the baby's social and cognitive development.

Bonding is a process that takes place over time. It doesn't have to be perfect--it just needs to be good enough.

Often, bonding takes place, without the mother even necessarily being aware of it, through the normal caregiving responses that she performs for the baby if the mother is also emotionally attuned and related to the baby.

An example of this is when a mother is changing a baby's diaper and she's talking lovingly to the baby at the same time. The baby often responds by smiling and cooing, which is gratifying to the mother, who responds even more lovingly to the baby. Under ordinary circumstances, this is a natural part of the mother-infant bonding process.

Babies respond to touching (skin-to-skin contact), which they find soothing. They also respond to their mother's voice and the mother's scent. Eye-to-eye contact, where the mother mirrors the baby's expressions and the baby attempts, even at an early age, to mimic the mother's expressions, is a very important aspect of bonding.

Breast feeding is another bonding experience between the mother and infant, as the infant learns to associate the mother with comfort, warmth, love and sustenance. All of these examples are powerful ways for mothers and infants to bond.

Secure and Insecure Attachment:
Most of the time, bonding is a pleasurable experience for mother and infant, and it tends to go well. But there are times when there are problems with bonding for a variety of reasons: mothers might be suffering with fatigue, depressive disorder, postpartum depression, medical issues or other problems that get in the way of their bonding with their infants.

 If there are problems during birth, babies might need to placed in intensive care. Under those circumstances, some mothers are put off by all of the equipment, and if they don't take the time and effort to bond, there can be serious consequences for the baby as well as their primary and other relationships later on.

In addition, aside from problems that the mother might have, the baby's temprement might affect the bonding process.

Attachment Theory:
In this blog post, there won't be time or space to go into all of the complexities of attachment theory. However, some basic concepts can be helpful in our discussion.

When we refer to attachment, we're referring to the quality of the bond between the infant and the caregiver.

Attachment theory was originally developed by John Bowlby (1907-1990), British psychiatrist, psychologist and psychoanalyst. His work was enhanced by his American student and eventual colleague, Mary Ainsworth (1913-1999) who observed mother-infant interactions in her infant research. Through her research, she identified four different types of attachment: secure, avoidant, ambivalent/resistant, and disorganized.

Before going describing the different types of attachment, I want to stress that just because an infant demonstrates a particular type of attachment, which might not be secure attachment, does not mean that this can never change. Scientists have discovered the remarkable plasticity of the brain in terms of people being able to make significant behavioral changes, even in old age.

Based on Ms. Ainsworth's research, secure attachment is optimal. When there is secure attachment, caregivers respond consistently and lovingly to the infants' needs most of the time. Studies have shown that about 65% of infants develop secure attachment.

Avoidant attachment in babies often occurs where the primary caregivers show little or no response to the babies' distress. These caregivers often discourage crying and want their babies to be emotionally "independent" beyond the babies' capacity. Due to these caregivers' lack of responsiveness, these babies often avoid emotional attachments and connections.

When babies show ambivalent/resistant attachment, the primary caregivers are often inconsistent, vacillating between being emotionally responsive and being neglectful or abusive. These babies are often insecure because they cannot rely on their primary caregivers.

Disorganized attachment usually occurs when primary caregivers are too intrusive or abusive with the infant. These infants are traumatized.

Consequences of Secure and Insecure Attachments:
Once again, I want to stress that an insecure attachment does not necessarily become that adult's inevitable destiny. So, what I'm about to say are generalizations about what has been found in research.

When bonding goes fairly well, as it does with 65% of infants, all other things being equal, these infants tend to grow up as secure adults. Of course, there are many other factors to take into account besides attachment, but for the sake of simplicity and brevity, let's just look at attachment and assume that everything else has gone reasonably well for these infants who grow up to be adults.

Generally, these adults, who experience secure attachment with their primary caregivers, tend to be able to trust in their adult relationships. They usually have healthy self esteem; they're empathetic towards others; they feel deserving of love, and they're able to form healthy adult relationships.

Infants who grow up with insecure attachment often have difficulty trusting. Self esteem is often impaired. They might also have a hard time understanding and being empathetic towards others. In addition, they often have difficulties forming healthy adult relationships.

We can already anticipate what the challenges might be in the mother-daughter relationships as well as other adults relationships for daughters who have developed insecure attachments as infants.

Getting Help in Therapy
These problems can be overcome and repaired in psychotherapy. Many people who didn't have secure attachment as infants overcome this problem and are able to form healthy adults relationships. I will explore this as well as the implications for mother-daughter relationships in future blog posts.

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

I have helped many clients to overcome problems in mother-daughter relationships.

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.



Tuesday, January 25, 2011

Life Stages in Mother-Daughter Relationships

In a prior blog post, I wrote about Ambivalence and Codependence in Mother-Daughter Relationships. That blog post presented the complex nature of mother-daughter relationships when there are problems with enmeshment. At this point, I would like to return to the topic of mother-daughter relationships to step back and look at these relationships over the course of the various life stages that mothers and daughters go through.

Life Stages in Mother-Daughter Relationships

Mother-Daughter Relationships - Early Bonding:
There is no doubt that, in general, fathers are more involved with their children than they were a generation ago, which is encouraging. But the primary parental relationship for most girls and women remains the mother-daughter relationship.

During the 1940s and earlier, people believed that babies were born as blank screens, but we now know that from early infancy we're biologically "hard wired" for attachment. That means that infants seek warmth and comfort from Day One: the warmth and scent of her mother's skin, the comfort of her mother's breast, and the sound of her mother's voice. When bonding goes well between mother and infant, the baby feels a secure attachment to her mother. This secure attachment between mother and child makes it more likely, all other things being equal, that the child will develop healthy relationships later on in life.

Under optimal conditions during infancy, the baby and mother are also bonded through the mother's loving gaze. The baby sees herself in the mother's eyes and feels the mother's love. The mother, in turn, sees how comforted the baby feels being mirrored in the mother's eyes and this is comforting to the mother as well. This interaction provides a positive feedback loop between mother and child and reinforces this bond.

Mother and Daughter Relationships - From Early Years (18 months to age 5):
At around the age of 18-24 months, babies begin to learn to separate from their mothers for short periods of time. Margaret Mahler referred to the "separation/individuation" phase when, under optimal circumstances, babies learn that their mothers continue to exist even when they are out of sight. This is also the time when babies begin to assert some of their autonomy by saying, "No!" If the mother is patient and recognizes this as a normal stage of development, babies gradually outgrow this sometimes difficult stage.

From about the age of four or five, most daughters idealize their mothers. They often find their mothers to be attractive and glamorous. At this stage, many girls want to mimic their mothers by putting on the their mothers' makeup or playing dress-up with "mommy's clothes." They often think of their mothers as beautiful and all-knowing.

Some daughters have a hard time separating from their mothers when it's time to start school (this occurs with sons as well sometimes). It's their first time away from the security they feel with their mother to be in a new and strange environment with a stranger (the teacher) who is now in charge. Most of the time, young girls are able to make this adjustment, and the mother remains their primary attachment figure.

Mother-Daughter Relationships - During the Daughter's Adolescence:
While mothers are idealized when children are four or five years old, teenagers often see their mothers as being old fashioned or "out of it." This is another stage where children are learning to separate themselves emotionally from their mothers.

This stage can be bewildering to mothers who often say, "What happened to my relationship with my daughter?" This is a time when teens bond with their peer group, and a friend's advice or opinion is often valued more than a mother's.

Tension and conflict during this period of time can be managed if both mothers and daughters accept and respect each other rather than viewing each other as the enemy. Since they're the adults, mothers have a greater onus for being understanding and fostering good relationships with their daughters. However, daughters must also learn to be open and respectful towards their mothers. Mothers need to learn to allow their daughters an age-appropriate degree of autonomy, but mothers must also provide guidance and support while setting boundaries for their daughters. Daughters will often test these boundaries, but this is also a normal part of adolescence.

Mother-Daughter Relationships - Daughters in Their 20s and 30s:
During their 20s, daughters are no longer teenagers, but some of them, depending upon their level of maturity, might not feel like adults yet. Prior to the 1990s, many daughters were able to go out on their own and live independently after college because apartments were more affordable. Now, with fewer rent stabilized and moderate income housing, many daughters continue to live at home for longer periods of time, depending upon their parents for longer as compared to prior generations.

During their 20s, many daughters often realize that their mothers are fallible and they don't always have all of the answers. During this period, many of them are being challenged by career choices and choosing a mate. Often, they're learning how to distinguish themselves from their mothers while attempting to maintain a bond with them.

During their 30s, many daughters are starting to come into their own with regard to career and their own family. Under ideal circumstances, they are less emotionally and financially dependent on their mothers. They often realize that their ideas differ from their mothers with regard to certain values. At this point, if they are in committed relationships with a significant others, under optimal circumstances, daughters are learning to put their partners first. This can create tension in the mother-daughter relationship, unless mothers understand that this is a normal part of development.

Mother-Daughter Relationships - 40s and Beyond:
Although there are many sons who help to take care of their elderly mothers, traditionally, for better or worse, it has been the daughter's responsibility to take care of elderly parents. For many women, who are "sandwiched" between their own families and their parents, this can be very challenging. During this time, daughters and mothers start to come to terms with the fact that mothers are aging and have more years behind them than ahead. How well they deal with this is often dependent upon how well their relationship has developed until this point.

Life Stages in Mother-Daughter Relationships

This is also often a time when mothers and daughters let go of old resentments in light of the fact that mothers are elderly at this point and time might be short for reconciliation. Under most circumstances, daughters often develop a different perspective of what's important, especially if they now have their own children and they understand better what their mothers went through with them.

In future blog posts, I will continue to explore mother-daughter relationships.

About Me
I am a New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist. I work with individuals and couples.

As a psychotherapist, I have helped many mothers and daughters, individually and together, to improve their relationships.

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.




Sunday, January 23, 2011

What is Intergenerational Trauma?

The topic of my prior blog post was Psychotherapy: Healing Your Emotional Wounds.  In that blog post, I mentioned that when people have unresolved, unhealed trauma, they often pass on their fears and anxiety, unconsciously, to their children and that it's not unusual, under these circumstances to see transgenerational trauma.

Intergenerational Trauma


What is Intergenerational Trauma?
As the name implies, transgenerational trauma are emotional wounds that are passed on from one generation to the next, usually, in an unconscious manner. Most of the time, this passing on of trauma from one generation to the next occurs because there is little or no understanding about how trauma affects the self and others and the trauma has not been worked through by the person who originally experienced the trauma.

The following vignette, which is a composite of many cases with no identifiable information, illustrates how transgenerational trauma gets passed on:

Sonia:
Sonia, who was a woman in her mid-30s, came to therapy because she was extremely anxious and her anxiety was affecting her family.

When we went over her personal history, there were no overt signs of abuse or neglect. She grew up in a loving family in NYC. Based on Sonia's account, her parents were supportive and attentive to Sonia and her siblings. Sonia couldn't see any reason why she felt as anxious as she did: She had difficulty sleeping, she worried about almost everything, and she had a terrible sense of foreboding almost all of the time that something bad was going to happen.

Her husband encouraged Sonia to start psychotherapy because he felt that Sonia's anxiety was affecting their five year old daughter. Their daughter was already showing signs of being an anxious child, even though it was obvious that both Sonia and her husband were loving parents.

"My husband says that I make our daughter nervous," Sonia told me, "but I don't see how I do that. And I don't understand why I'm so nervous myself most of the time."

Based on her account, Sonia seemed like she was a very attentive mother who was emotionally attuned to her daughter. But, it was obvious that she was passing on her own anxiety to her daughter somehow.

When we went over Sonia's parents family history, I could see that both of them had experienced early trauma when they were growing up in their native country. Sonia's father lost his parents in a car accident when he was five, and he was raised by an aunt who was both physically and emotionally abusive towards him and his brothers. By the time he was 18, he left the aunt's household to be on his own. He lead a precarious existence until he came to NYC and met and married Sonia's mother. At that point, his life settled down and he had a more stable life, but he tended to be anxious and he worried a lot.

Sonia's mother, who grew up in the same country, lived through several dangerous hurricanes, one of which destroyed the family home. As a young girl, not only did she see the family home destroyed, she also witnessed the drowning of her beloved uncle when the family was attempting to cross a river during the severe flooding related to one of the hurricanes. From that time on, Sonia's mother had nightmares and panic attacks. She never obtained professional help for her anxiety, and she managed her panic attacks by taking anti-anxiety medication. But her nightmares never stopped.

As Sonia and I continued to work together, I discovered that Sonia's parents tended to be overprotective of her and the other children when they were growing up and, without being aware of it, they passed on her worries to Sonia and Sonia's siblings. Sonia grew up feeling that the world was not a safe place and anything that could go wrong would go wrong.

Until we began talking about it, Sonia never realized that her unnamed fears originated with her parents and she was now conveying her fears to her daughter. I provided Sonia with psychoeducation about the nature of transgenerational trauma. Gradually, we worked through Sonia's anxiety using a combination of EMDR and clinical hypnosis until she worked through her fears.

It was only after Sonia had worked through her anxiety and she realized what it felt like to be calm that she realized how anxious she had been all of this time. During that time, Sonia also took her daughter to see a psychotherapist who worked with children so that her daughter wouldn't grow up with the same anxiety that Sonia experienced.

Often, Without Realizing It, People Who Experience Trauma Pass on Their Fears to Their Children 
It's not unusual for people who experience trauma to inadvertently pass on their doubts and fears to their children. There have been many documented cases of this with Holocaust survivors, even in cases where the survivors never discuss what happened. Without realizing it, they convey their fears on an unconscious level to their children so the children often feel that the world is not a safe place.

Getting Help in Therapy
If you think that your trauma is affecting your loved ones or that you are the one who is affected by transgenerational trauma, you're not alone and you owe it to yourself to get help from a licensed psychotherapist who has expertise in dealing with trauma and transgenerational trauma.

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

I have helped many clients to overcome trauma and transgenerational trauma.

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

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


Healing Your Emotional Wounds in Therapy

Emotional wounds are a source of shame for many people. Often, rather than getting help, their initial inclination is to either suppress or deny these emotional wounds in an effort to rid themselves of the emotional pain. But when we deny or suppress emotional wounds, the result is that they intensify.

 
Healing Your Emotional Wounds in Therapy


When we're physically hurt, we usually don't think about getting rid of the body part that is injured. So, for instance, we wouldn't think of cutting off an arm that was bruised or burnt. We know that, in most cases, there needs to be special care and attention for the arm to heal.

But when it comes to emotional wounds, many people are much more impatient and rejecting of help than they would be for a physical wound. They either don't know or they don't want to know that, often, these emotional wounds have been around for a long time and, no matter how much they might want to banish them, they'll still be there unless they get special attention and care, much the same as a physical wound.

We know that if we have a physical wound and we don't take care of it, it will get worse. Lack of care can create severe or life threatening consequences. In much the same way, emotional wounds can also become worse and, in some cases, become life threatening if a person is very depressed or anxious.

We have choices as to how we relate to our emotional wounds. We can deny, suppress or ignore them, all of which tends to make them worse. Or, we can look upon them with compassion and see them for what they usually are--early childhood aspects of ourselves that either suffered from abuse or neglect and that need professional psychological help.

When we neglect these emotionally wounded aspects of ourselves, we are, unconsciously, perpetuating the original trauma. Not only can we perpetuate it in ourselves, but we can also have a profound traumatic effect on our loved ones. It's not unusual to see transgenerational trauma that is passed down from one generation to the next, unintentionally, because the original trauma remains unhealed.

Making the Unconscious Conscious:
As I mentioned, when we retraumatize ourselves or we pass on the effects of our trauma onto others, this is an unconscious process. So, if it's unconscious, how can we become more aware of it so that we can make the unconscious conscious?

Often, if you observe your thoughts and attitudes towards yourself, you can begin to see where you're being overly critical, judgmental and harsh with yourself. For many people who practice mindfulness meditation, they become aware of their punitive thoughts and attitudes towards themselves and also become aware that they need to develop more self compassion. They begin to see how they're being overly critical of themselves and engaging in negative self talk.

Even if you don't practice mindfulness meditation and you take the time to observe your internal dialogue, you can see if you're being too hard on yourself and you ask yourself where this harshness originates from. Very often, it originates from early trauma that created emotional wounds.

Many people become aware of their own harshness towards themselves when their friends or loved ones observe it and comment on it. These same people, who are being so harsh on themselves, would almost never be as harsh on someone else in similar circumstances. They often reserve their most punishing attitudes towards themselves because this is what they have internalized, in most cases, when they were growing up.

For most people, they learn to make the unconscious conscious in psychotherapy where the psychotherapist has a psychodynamic orientation as part of the treatment modalities he or she uses with clients, and can help clients to heal from their trauma.

Self Compassion for Your Emotional Wounds:
If you think of the emotional wound as an aspect of your inner child, you'll probably have more compassion for that part of yourself. This could be the start of your being more open and willing to seek help to heal.

Getting Help in Therapy 
Taking the first step is often the hardest. When you're mired in hurt and shame, you might feel that you're the only one who is experiencing this. 

But you're not alone. Once you've become aware that your emotional wounds are having a detrimental effect on your life, the next step is accepting this and taking action to find a professional mental health practitioner who specializes in trauma because the healing work that needs to be done cannot be done by you alone.

Rather than spending the rest of your life adversely affected by your trauma, you could benefit from working through these issues with a licensed psychotherapist who has expertise in this area.

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

I work with individuals and couples.

I use a variety of treatment modalities, including mind-body oriented psychotherapy, psychodynamic psychotherapy, and cognitive behavioral treatment, depending upon the needs of the client.

I have helped many people overcome their emotional wounds so that they can lead more fulfilling lives.

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

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

Also see my article:  Psychotherapy and Transgenerational Trauma







The Mind-Body Connection: Can Yoga Improve Your Mood?

According to the Journal of Alternative and Contemporary Medicine, recent studies have demonstrated that yoga has been shown to increase GABA (gamma-aminobuturic acid), a chemical in the brain that helps to regulate nerve activity.  GABA is usually reduced in people with mood disorders, and doctors often prescribe medication to increase GABA to improve mood and decrease anxiety.

Mind-Body Connection:  Can Yoga Improve Your Mood?

According to the journal article, the study, which was conducted by Dr. Christopher Streeter and his colleagues of Boston University School of Medicine, measured GABA levels in people who practiced yoga and found an increase in GABA levels after a yoga session.

Dr. Streeter and his colleagues found these results encouraging and suggest that longer term research studies are needed to continue to explore the benefits of yoga with regard to mood and anxiety.

The study seems to corroborate what many yoga practitioners have been reporting anecdotally for years--that they have a sense of peace and well-being after their yoga sessions.

A word of caution: Although the research findings about how yoga can improve your mood are encouraging, it's always best to consult with your doctor and psychotherapist before you stop or decrease your medication.

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

I work with individual adults and couples.

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

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

Monday, January 17, 2011

Flirting with Disaster: Sex on the Job

The workplace can be an intimate setting where you and your colleagues are working closely together for long hours on projects of mutual interest. It's not unusual for sexual attractions to develop on the job, especially under these circumstances. But acting on those sexual attractions, even if you're both single, is like flirting with disaster.

Flirting with Disaster: Sex on the Job

What might start out as a romantic encounter or a fun and sex encounter can end up costing you your job and, possibly, your reputation in your industry.

The following vignette is a composite account, with all identifying information changed, of what could happen if you get sexually involved at work:

Ray:
Ray was a successful account manager in his mid-30s at a public relations firm. He had a reputation for being smart and creative. He was becoming increasingly visible at his company due to his success with his accounts, and his boss told him on more than one occasion that senior management had their eye on him for future promotions.

Ray was also single and attractive, and many women in the office were interested in him. In the past, he dated a couple of women at work when he first started on the job. But, when he became an account manager, he decided that office romances were too risky because when the relationship ended, there tended to be hard feelings on one or both sides and he had to continue to have contact with these women, which made it very uncomfortable.

When Sally, the new administrative assistant, began working at the firm, Ray felt an instant sexual attraction for her. She was attractive, sexy smart, and single. Ray also sensed that Sally was attracted to him. He thought about what it might be like to go out with her, but he had no intention of asking her out since they worked together.

A few months later, Ray was working on a project with a short deadline and he was working long hours to try to meet the deadline. His boss assigned Sally to assist Ray as the deadline approached so Ray and Sally found themselves working in close quarters, alone, late at night.

When they were alone, they tended to flirt with each other a little but the pressure to complete the project kept them focused on their task. There was a lot at stake.

On the final night of the project, Ray thought they were really working well as a team. Without Sally's help, Ray knew that he wouldn't have completed the project on time. He also knew that Sally was underemployed as an administrative assistant, and she hoped that she might make a good junior account assistant.

When they had put the final touches on the presentation, they both breathed a sigh of relief. It was late at night and they were both tired. Ray was about to call a limousine service to take Sally home when he looked up at her, saw her staring at him with obvious interest and, without thinking, he kissed her.

As Ray described it to me when he came to see me in my psychotherapy private practice in NYC, maybe it was the excitement of completing the project and the sexual tension that was building up between them but, before he knew it, they were having sex on the floor.

When it was over, according to Ray, he felt embarrassed and guilty for initiating the sexual encounter between them. He knew that they couldn't get involved again, and he told Sally this. She told him that she was disappointed and hoped he would change his mind.

After that, Ray found it very awkward to see Sally at work. He tried to pretend that nothing happened between them, but it was hard. He sensed that Sally was hurt and annoyed with him because he only interacted with her when he absolutely had to and he kept it professional.
A few months later, Sally was assigned to help Ray again with another project deadline. Ray tried to get another administrative assistant to help him, but no one else was available. So, once again, Ray and Sally were alone in the office. Ray tried to focus on the project document, but he was very sexually aroused by Sally and he knew that she felt the same way. Since they had already had been sexually involved, it was that much more tempting.

Ray decided to work in another office and to give Sally work to do in her area. He thought if he didn't have to look at her, he wouldn't be so distracted by the sexual attraction between them. But by the end of the night, the forbidden nature of the situation made it even more tantalizing, and Ray went back to Sally's place, against his better judgment, and they spent the night together.

Afterwards, Ray told Sally again that, even though they had fun together, he wasn't interested in dating her because it would be too complicated. Once again, Sally was annoyed and hurt. She told Ray that they could date without anyone knowing about it, but Ray wasn't interested.

Soon after that, Sally applied for a position as an account manager. Ray's boss asked Ray what he thought about Sally for the job. Ray told his boss that he thought Sally would make a good junior account manager, but he didn't think that she was ready for the more senior position. He told me that he based this solely on her skills and experience, and it had nothing to do with his sexual encounters with her.

But that's not how Sally saw it. When she heard that Ray didn't think she was qualified for the job, she assumed that he was saying this because he was uncomfortable with her due to their sexual encounters. And she went straight to the EEO (Equal Employment Opportunity Office) officer and filed a sexual harassment complaint against Ray.

There was an investigation, which was very humiliating for Ray. He admitted that he had sex with Sally on two occasions, but he denied that this had anything to do with his opinion that she was not ready for the job. Soon after that, Ray's boss reprimanded Ray for getting sexually involved with a someone at work. He told Ray that, as a manager, he should have known better. He was mandated to attend an EEO training on sexual harassment. He was also told, informally, that, even though he was not being terminated, his future with the company was dim and encouraged to resign as soon as possible.

Due to the recession, it took Ray more than a year to find a comparable job and, in the meantime, he had exhausted his savings.

By the time Ray came to see me, he was doing well on his new job, but he was emotionally traumatized by what he allowed to happen at his former job, which is why he came to therapy.

Ray was lucky that Sally didn't go outside the firm to sue for damages, and he realized this. He had a lot to consider in therapy when he thought about his impulsive behavior on his former job.

Getting sexually involved at work can turn out to be a personal and career disaster. This is not to say that many people don't meet at work and eventually get married without a problem, but for many other people, it creates tremendous problems. Even if your company doesn't have a policy where employees are not allowed to date each other, you would be wise to carefully consider getting sexually involved with someone at work.

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

I work with individual adults and couples.

I have helped many clients with personal and career issues.

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.

Mind-Body Connection: The Source of Our Emotions

Book: Molecules of Emotion by Candace B. Pert, Ph.D.

Molecules of Emotion by Candace B. Pert, Ph.D. (http://www.candacepert.com) is a fascinating read about how our emotions are stored throughout our body.

 
The Mind-Body Connection: The Source of Emotions


Through her research work as a scientist and Section Chief of the NIH (National Institute of Health) in the 1980s, Candace Pert discovered that emotions are not just in the brain, as we might normally think, but that emotions are stored throughout the body, mostly in neuropeptides at every level of the body and mind. 

She uses the phrase "bodymind" to emphasize that the body and mind are one.

Using precise scientific research methods, Dr. Pert and her colleague, Michael Ruff, Ph.D. give scientific credence to what many Eastern gurus have known for centuries--that the mind, as such, is not just in the brain, but all over the body, which is why it's possible for us to have "body memories."

This also explains why mind-body oriented psychotherapy, like Somatic Experiencing, EMDR and clinical hypnosis can be so effective.

At the time, Dr. Pert's work was ridiculed by many in the scientific community because it was considered the "new paradigm" and many in the conventional scientific world found it threatening.

Aside from providing fascinating and accessible information about the "bodymind" and emotions, Dr. Pert gives us a rare glimpse into the hallowed halls of the research establishment and how research gets approved (or disapproved) based on internal politics and maintaining the status quo.

If you're interested in the mind-body (or "bodymind") connection, I recommend that you read Molecules of Emotion by Candace Pert, Ph.D.

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

I work with individual adults and couples.

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

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

Awareness and Acceptance: Being Willing to See Things You've Been in Denial About

Awareness and Acceptance: Being Willing to See Things As They Are:
One of the primary sources of emotional pain is that we sometimes keep ourselves unaware and refuse to see and accept things as they are because we want them to be different. This is a common phenomenon that most of us struggle with at various times in our lives.

Awareness and Acceptance

This refusal to see and accept things as they are comes up all the time in psychotherapy sessions:

"My boyfriend keeps cheating on me, but I'll change him."

"My wife has been drinking too much for years, but she promises that she'll stop on her own."

"My teenage son was arrested again for selling drugs, but I think this is just a phase he's going through."

"My husband hit me again, but I know he feels badly about it and he won't do it again."

"My boss says I'm always late, but I wouldn't be if he would just get off my back."

"I just got my second DWI, but I don't have a drinking problem."

Denial Can Be Powerful:
It's understandable that, sometimes, we don't want to see things as they are because we want things to be different or we're hoping that things will change. This can distort our perception and judgment.

But as long as we cling to how we'd like things to be instead of how they are, we're living in denial, and the likelihood that things will change decreases as long as we're in this state of denial.

What Does Acceptance Mean?
People often have problems with the word "acceptance." They think that if they "accept things as they are" that this means that they don't care or they've given up or they won't take action to change the situation. But this isn't what this means at all.

Accepting things as they are is a starting point where you acknowledge the status of the current situation. You are aware and recognize how things are at that moment. Once you've brought some awareness and acceptance to a situation, then you can decide how or if you want to change it or if it can be changed by you or needs to be changed by someone else or if it can be changed at all.

Being Aware and Attuned:
You must be aware and attuned to yourself and the people and situations in your life first to be able to accept them or, if possible, make changes. If your basic emotional defense is to tune out, you might find yourself continually being surprised by what seems like your own and/or other people's "sudden" behavior--when, in fact, it's not "sudden" at all. It just seems that way to you because you're in denial and tuned out.

By keeping yourself blissfully unaware, which is often an unconscious process, you set yourself up for disappointments and rude awakenings when the situation you've been ignoring or in denial about worsens.

Cultivating Awareness and Acceptance, Then Taking Action:
As I've mentioned in prior blog posts, a regular practice of mindfulness meditation, also called Insight Meditation, helps to develop self awareness as well as awareness of the people and things around you.

Psychotherapy is also a form of self exploration as well as a way to develop insight and take action in the areas that you want to change.

When someone comes to see me for psychotherapy in my private practice in NYC, I work with him or her dynamically to not only help them to be more aware and honest about the situation, but also to take action where they can.

It's not enough just to talk about the problem, which is where many psychotherapy treatments get bogged down. If it's possible to take action, I help clients to feel more empowered to make changes. If it's not within their power to make changes, I also help clients to see the situation for what it is rather than what they want it to be.

If you find that your predominant way of coping is to go into denial or get stuck in wishful thinking, you could benefit from seeing a licensed mental health professional to help you overcome this problem.

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

I have helped individuals and couples to overcome areas where they're stuck in their lives so they can lead more fulfilling lives.

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

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