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NYC Psychotherapist Blog

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Sunday, January 27, 2013

How Psychotherapists Listen to Their Clients

Psychotherapists in training often feel they should immediately know and give advice to clients who present in therapy, especially with clients who are upset during the first session.  In situations where new clients come in very upset, sometimes even demanding, "Tell me what to do!,"it's better to help clients to get emotionally grounded, and not fall into the trap of giving advice with potentially disastrous results.  

Psychotherapist Listening to Client

The Therapist's Experience of Getting Comfortable with "Not Knowing"
Fortunately, for most therapists, getting comfortable with "not knowing" during the initial stage of treatment gets easier with time and experience.  Rather than assuming that they're supposed to know immediately what's best for clients, skilled therapists know that they need to listen and learn about the client from the client rather than adhering to any particular theoretical orientation.

Even though the client might not get "the answer" from the therapist, this doesn't  mean that the client doesn't experience emotional relief during the initial stage of therapy. A skilled therapist knows how to create a therapeutic "holding environment," which often, in itself, brings emotional relief.

When the Therapist is Tempted to "Rescue" the Client 
When therapists feel pulled to "rescue" the client, who is not a danger to himself or others, this urge to "rescue" is potentially important information about what might be going on unconsciously in the consultation room with the therapist and client as individuals as well as dynamically between them.

This can happen to even to the most seasoned therapist.  Experienced therapists usually recognize it more readily than psychotherapists in training.  If a therapist finds it happening a lot with particular clients, it's best to obtain clinical supervision, talk to experienced colleagues or address the issue in her own therapy or all of the above if it's a big problem.

It's also important to recognize that not every therapist is for every client (see the link below for my article on "How to Choose a Psychotherapist").

Listening, Learning and Becoming Attuned to the Client
It takes more than one or two sessions for a therapist to get to know and become attuned to a client.  No matter how experienced, a therapist can't assume that she knows what's best for the client without first listening to and learning from the client, except, of course, in cases when a client is in a dangerous situation or a harm to himself or others.  (Then, it's important to know how to handle a psychiatric emergency and determine if the client is in the right level of care.)

Clients Are Looking For Answers
Clients are, understandable, looking for answers to their problems.  Why else would they come to therapy?  If they've never been in therapy before, they might equate the therapy session to a medical exam with their doctor.

During medical exams, unless further tests or consultations with specialists are needed, a doctor often gives a diagnosis and prescribes a course of treatment in one session.  In a day or so, the client might be feeling better.  But the human psyche is much more complicated than taking a pill, and it's rare that a therapist can help a client to resolve a psychological problem in one or two sessions.

What new clients might not understand, and what therapists need to help clients to understand, is that the therapist isn't there to give advice or tell the client what to do.  And even if the therapist was willing to give advice to a new client, who's to say this advice would be right for the client without the client participating in the process?

What Does the Therapist Do, If She Doesn't Give the Client "Answers"?
As mentioned before, the new client often comes looking for answers to her problems.  It might be disappointing to hear that the therapist can't provide immediate answers.

No matter what type of therapy the contemporary therapist practices, basically, the skilled clinician is trained to help the client, in collaboration with the client, to develop greater insight into her problems and work through the problems--rather than telling the client what to do.  Over time, the client, who has never been in therapy before, learns to become more open and curious about her process.  She also learns to become more resilient.  And, the healing process continues unconsciously for the client between sessions.

Mistakes, Ruptures and Repair in Therapy
Of course, therapists are human and make mistakes just like anyone else.  As I've written before, when a psychotherapist makes a mistake with a client, the most important first step is for the therapist to acknowledge the mistake to the client, and make an effort to repair the rupture with the client as soon as possible (see link below for my article, "Psychotherapy:  Ruptures and Repairs in Treatment").  Hopefully, the mistake isn't egregious, the therapeutic relationship remains intact, and the work continues.

Thank goodness, the days when therapists and doctors were assumed to be almost infallible are gone.  These days, many clients are better educated about the psychotherapy process, and they're more likely to approach it as informed consumers.  They know that during a psychotherapy consultation, they're interviewing the therapist and asking questions just as much as the therapist is interviewing the client.

Patrick Casement's Book:  Learning From the Patient
When I was in my first year of psychoanalytic training in 1996, I read Patrick Casement's book, Learning From the Patient.  It wasn't part of the curriculum in the first year.  At the time, the reading list for first year psychoanalytic students was mostly works by Freud.

While I enjoy reading Freud (especially his papers that read almost like poetry) and admire his genius, as a first year psychoanalytic student in training, I didn't always find his papers helpful when I was in the psychotherapy consultation room with a new client.

Somehow, during my first year in training, I came across Patrick Casement's book and, along with the guidance of seasoned clinical supervisors, I found it enormously helpful.

Some of the concepts that Casement writes about are now incorporated in current training programs in the first year, rather than waiting for the second or third year.  I'm sure it's a relief for first year psychotherapists in training, as it was for me, to realize that it's okay, and even not helpful, to think they should know the answers immediately, and it's more important to listen and learn.

Since my early days of training, I've learned other therapeutic ways of working, aside from talk therapy, including EMDR, hypnosis and Somatic Experience.  Whichever method I use, I value listening to and learning from the client.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work in a contemporary, dynamic way in collaboration with the client.

I work with individual adults and couples.

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.

A New Relationship: Understanding the Loyalty Dilemma for Someone Whose Spouse Died

In today's Sunday New York Times Modern Love section, there's an article by Eve Pell about her relationship with her husband (see link below).  One of the things that she mentions is that when they were dating, her then-boyfriend was hesitant about making a commitment to their relationship because he still felt loyal to his deceased wife, who had died several years before.

Understanding the Emotional Dilemma For Someone Whose Spouse Died
Reading this article brought to mind how common this experience is.  Rather than getting competitive with a deceased spouse, Ms. Pell, who sounds like a wise woman, understood her boyfriend's emotional dilemma and let him know.

Understanding the Loyalty Dilemma for Someone Whose Spouse Died

Instead of feeling like his love for his deceased spouse meant more to him than his love for her, she spoke to him about it with a lot of empathy.  She acknowledged that she understood, respected his feelings for his former spouse, and reframed the issue as there being enough room in his heart for both of them.  According to Ms. Pell, her boyfriend appreciated this and, eventually, they got married.

Working Through the Loss of a Deceased Spouse
There are times when people haven't worked through the loss of a deceased spouse and it keeps them stuck.  Each situation is different.  But reading Ms. Pell's article reminded me of how conflicted a person can feel with a new love, especially when the former relationship ended because of a death.

People, who are widowed, who are still in love with their deceased spouse, often feel that it's an act of disloyalty to begin a relationship with someone new.  Their spouse might be gone, but their feelings are still very much alive.  They might feel confused and not know how to reconcile the fact that they can fall in love with someone new while still loving their former spouse.  If the new love gets jealous and makes emotional demands too soon, it can create an even bigger conflict and ruin an otherwise good new relationship.

Reframing the Love and Loyalty Dilemma
Like Ms. Pell, it's often better to take an empathetic step back, try to understand your romantic partner's emotional dilemma and talk to him about it.  When the dilemma is reframed as there being room for both the deceased spouse and the new partner, it can reduce a lot of tension and offer options that your partner might not have seen before.  Your partner doesn't need to completely bury his feelings for his deceased spouse, which wouldn't be possible anyway.  It's really not an either/or question.  He can still honor the feelings he feels for her and make room for you.

Some people, who have lost a spouse, never get over it, and they're unable to make a commitment to a new relationship.  For other people, this issue works itself out with understanding on both sides.  Sometimes, the person who is widowed needs help in individual therapy to work it out.  Other times, it helps for both people to come into couples counseling to negotiate this problem.

Either way, I found Ms. Pell's approach to this common dilemma to be a mature and refreshing approach.  Thank you, Ms. Pell, for a heart warming article.

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

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.


The Race Grows Sweeter Near Its Final Lap--Modern Love, NY Times by Eve Pell (1/27/13)

Is That All There Is? When "Having It All" Leaves You Feeling Empty

For many people, the meaning of "success" and "having it all"means making a lot of money, buying a big house, having a new car, and being married to an attractive spouse (not necessarily in that order).  For other people, "having it all" might mean being smart, having a graduate degree, and the prestige of being published and recognized as an expert in a particular field.  

Is That All There Is?  When "Having It All" Leaves You Feeling Empty

"Having It All," But Feeling Something is Missing 
But, more often than not, people who have attained their definition of "having it all," are surprised to discover that, instead of making them happy, after a while, they feel empty inside.  They're confused because they feel like there's something missing, but they can't understand what it is since they already have everything they set out to get, so what else could there be?

What Does It Mean to "Have It All"?
How we define "success"' and "having it all" usually determines our focus and the direction we take in our lives.  Early on, we're given implicit, and often explicit, messages about what it means to be successful.  In school and the world around us that usually means striving to be competitive and to get excellent grades so you're at the top of your class with the end goal of getting a well-paid job so you can have monetary success and prestige.

Is That All There Is?  When "Having It All" Leaves You Feeling Empty

Most people would agree that having a certain degree of financial comfort is better than struggling financially.  And while there's certainly nothing wrong with being smart and striving to have monetary success and prestige, if that's all you want, more than likely, when you get it, you'll be wondering, "Is that all there is?," like the song with the same title.  This can be a tremendous letdown, especially if you've invested years of your life to attain these goals.

When Disappointment Leads to Striving For More of the Same
Often, people respond to feeling this disappointment by striving even harder to have more...more money, more prestige, a bigger vacation house, a more expensive car, and so on.  They become even more competitive with their colleagues, friends, loved ones, and neighbors.  But the problem with this is that there will always be someone who is smarter, richer, and more powerful than you are, so where does this end?  For someone people, it ends with deeper disappointment. For other people, it ends with sudden cardiac arrest.

Getting Help When "Having It All" Leaves You Feeling Empty
At about this point, people who might never have come to therapy, seek help.  Striving more, working harder, being bigger and better, smarter and faster hasn't brought lasting happiness, and they're in emotional crisis.  They've done everything they've been told and everything they know how to do to be happy, but happiness eludes them, and they don't know why.  They often come to therapy feeling that their lack of happiness is, somehow, their fault.  

What Is a Meaningful Life to You? 
Rather than looking for a place to cast blame, when "having it all" leaves you feeling empty inside, it's important to take a look at how you're defining success.  Although it might sound like an old cliche, when your definition of success is only narrowly defined by the external things in your life, after a while, these things become less meaningful to you.  If you haven't broadened your definition of success to include a rich inner life and contributing in a meaningful way to the world around you, more than likely, if you're at all in touch with your emotions, you'll feel empty inside. 

Whether you call this empty feeling inside "a spiritual crisis," "a mid-life crisis" or a crisis by any other name, usually, when you get to this point, you can feel desperate because, along the way, you might not have learned any other ways for being happy other than to be more and to get more.  Perhaps you've also surrounded yourself with like-minded people.  And, when you compare yourself to them, they seem to be happy with their lives, so you might ask yourself, "What's wrong with me?"

Psychotherapy:  A Place to Explore and Discover New Aspects of Yourself
Psychotherapy is a place where you can explore and discover what it would mean to you to have a meaningful life.  In the privacy of a therapy session with an objective therapist who is empathetic and with whom you have a rapport, you can start to focus on your inner world, as opposed to being exclusively focused on your external world.  

Whereas friends and loved ones might have their own views of what it means to have a meaningful life, a skilled clinician can help you develop your own new definition of what it means to be successful in a much broader sense without judging you or imposing his or her own views.

Psychotherapy: A Place to Explore and Discover New Aspects of Yourself

Your psychotherapy session is a time and place dedicated to you where you have uninterrupted time to develop and discover aspects of yourself that you might not have even known exist.  It's a chance to discover and experiment with new possibilities of who you are and what might make you happy.

When continuing to do more of the same of what you've been doing continues to leave you disappointed, you owe it to yourself to work with a skilled clinician who can help you expand your definition of success and happiness.  

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

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: josephineolivia@aol.com.

Saturday, January 26, 2013

Can't Stop Looking at Your Ex's Social Media Pages? Here Are Some Reasons to Stop

On some level, most people know that continuously reading their ex's Facebook page can be very upsetting, especially if you discover things about your ex--like he has a new girlfriend or, worse still, he got married--that you're not prepared to face.

Can't Stop Looking at Your Ex's Social Media Pages?

Over and over, I hear from psychotherapy clients as well as people in my personal life that they can't stop themselves from looking at their ex's Facebook page, even when they know it's really over.  For many people, it becomes an obsession.  They want to know what's happening in their ex's life and, more importantly, has s/he found someone new?

Although it might be tempting to keep looking at your ex's Facebook page because you feel that you just can't resist, there are some very good reasons to stop:
  • You're going to find it very hard to move on if you keep looking at your ex's Facebook page.
  • It can be a form of emotional self torture to find out that your ex is with someone new. And, anyway, what can you do with this information, aside from making yourself miserable and upset?
  • If you see her looking happy with someone new, it can make you feel awful about yourself, wondering why she wasn't happy with you (even though the pictures you see on the Facebook page might not reflect reality).
  • Like any obsessive habit, the more you do it, the more you want to do it, making it very difficult to stop.
Here are some tips that might help you the next time you feel the urge to look at your ex's Facebook page:
  • De-friend your ex.  As hard as it might be, it will help you not to have such ready access to your ex's Facebook page.
  • Try waiting 20 minutes, when you feel the urge to look, to see if the urge passes.
  • Ask yourself, "What do I hope to accomplish by looking at his Facebook page?"
  • Go out for a walk or distract yourself by doing something else.
  • Talk to a supportive friend who knows how to listen attentively to your feelings.
  • Take a break from social media and go out and do something nurturing for yourself.  
When You Don't Want to Let Go of Your Ex
Continually looking at your ex's Facebook page might mean that you're not ready to move on yet, and you might be harboring wishes, no matter how unrealistic, that the two of you might get back together again.  Be honest with yourself and ask yourself if this is what's going on with you.

Are You Avoiding Feeling the Emotional Pain of the Breakup?
Nobody likes to go through the emotional pain of a breakup.  But if you're holding onto unrealistic fantasies of rekindling your romance with your ex, part of this might be an unconscious wish to avoid feeling the pain.  Unfortunately, there's no way to avoid going through the pain in order to get to the other side so you can move on.

Getting Help in Therapy
Mourning the loss of a relationship is hard, but you can make it harder on yourself by holding onto what you know deep down is really over.  Everyone is different and every situation is different when it comes to mourning this type of loss.

No one can tell you how long it should take.  But if you find that, over time, it's not getting a little easier for you, you might consider consulting with a licensed psychotherapist who can help you get over your obsessive reading of your ex's Facebook page and also help you through the mourning process.

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

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.

Also see my article:
Stalking Your Ex on Social Media








Friday, January 25, 2013

Psychotherapy Daily News - 1/25/13

Psychotherapy Daily News for today, 1/25/13, has articles from Psychiatric Times, American Psychological Association (APA) Help Center, Good Therapy.org, New York Times Health, Harvard Business Review, Psychotherapy Networker, Science Daily, and this psychotherapy blog, among others, about mental health issues, science, health, the environment, and leisure issues.

Here are a list of just some of the articles, which represents the latest and most interesting news stories:

  • Your Relationship:  Should You Stay or Should You Go?
  • Relationships:  Covert Belittling
  • Overcoming Trauma with Somatic Experiencing
  • The Joy of Being Attuned to Your Inner Child
  • Working with the Borderline Client
  • Can a Sense of Control Increase Your Lifespan?
  • Red Explosions:  Secret Life of Binary Stars is Revealed
  • Scientists Discover How Epigenetic Information Could Be Inherited - Mechanisms of Epigenetic Reprogramming Revealed
  • Parenting - The Art of Benign Neglect
  • Getting Naked:  It's Not Just About Sex

Subscribe to Psychotherapy Daily News
You can subscribe to get your daily copy in your in box by going to Psychotherapy Daily News and clicking on the "Subscribe" button.  Your information will be anonymous (even to me) so you don't have to be concerned about getting SPAM.

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

I work with individual adults and couples.

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

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

Psychotherapy Daily News






Thursday, January 24, 2013

Psychotherapy Daily News - 1/24/13

Psychotherapy Daily News features articles about mental health, science, health, education plus more from various sources, including New York Time, Yoga Journal, the Harvard Business Review, GoodTherapy.com, Psychiatric Times as well as some of my own psychotherapy-related articles.

Here are a list of some of the articles in today's Psychotherapy Daily News:
  • Interpersonal Neurobiology in the Consulting Room With Dan Siegel
  • Psychiatrists With Ethics Training Less Likely to Push Brand-Name Drugs
  • Managing Suicide Risk of Clients With Borderline Personality Disorder
  • Emotional Demands:  The Exhaustive Effect on Technology Workers
  • Sugar Addiction and Mental Health:  America Needs Rehab
  • Does Religion Help You Quit Smoking?
  • Find Your Authentic Self and You Just Might Find Your Next Career
  • Starting Therapy--and Ending It Too
  • Reasons for Substance Use Predicts Treatment Outcome in Adolescents
  • EMDR Self Help Book:  Getting Past Your Past
  • Feeling Lonely in a Relationship
  • Can You Read the Face of Victory?
  • Th 28-Day Meditation Challenge Returns on February 1
  • Why You Should Emphasize Your Potential Rather Than Your Achievements on Your CV
  • It's Time to Cut Back on Social Media
  • What Capitalism Can't Fix
  • May I Be Happy?
  • Long Term Effects of Life Expectancy From Smoking
  • Addiction in the Home:  Healing Lives, Families and Communities
  • It's My Job and I'll Tweet If I Want To
  • Tips For Managing and Preventing Stress
  • Science News From Around the Web
  • Krishna Das Nominated For Grammy Award
  • Stop Underage Drinking - Gateway to Federal Resources
  • Study Links Cognitive Deficits and Hearing Loss
  • Positive Psychology News Daily
You can subscribe for free by clicking on this link:Psychotherapy Daily News and clicking on the word "subscribe" so you don't miss an issue.

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

I work with individual adults and couples.

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

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

Visit Psychotherapy Daily News for the latest information about mental health issues.




Wednesday, January 23, 2013

Psychotherapy Daily News - 1/23/13

Today's Psychotherapy Daily News, which has articles from my psychotherapy blog as well stories and videos from 
other psychotherapy sources, includes the following stories and videos:

  • Psychotherapy:  Healing Your Emotional Wounds
  • Psychotherapy and Beginner's Mind
  • Resilience:  Bouncing Back from Life's ChallengesEMDR Self Help Book:  Getting Past Your Past
  • Memory Experiment
  • Update on Adolescent Mood Disorders
  • Planck's Law of Generations - Psychiatric Times
  • Family Habits:  The Key to Controlling Childhood Obesity
  • Video:  Stories of Hope and Recovery - Jordan's Story
  • Video:  Hurricane Sandy - Dr. Steven Southwick (Psychiatric Times)

You can subscribe to Psychotherapy Daily News by going to the site and clicking on the "Subscribe" button.

I am a licensed NYC psychotherapy, hypnotherapist, EMDR and Somatic Experiencing therapist.

I work with individuals adults and couples.

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

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

Visit:  Psychotherapy Daily News


Monday, January 21, 2013

The Dreamer and the Pragmatist

I'm reading Adam Phillips' book, Promises, Promises - Essays on Psychoanalysis and Literature. In Chapter One, "Poetry and Psychoanalysis," Phillips discusses, among other things, the difference, generally speaking, between two different types of clients, the Dreamer and the Pragmatist.

Psychotherapy Clients - The Dreamer and the Pragmatist:
According to Adam Phillips, the client who is a Dreamer wants to free associate in therapy and go wherever his thoughts lead him, and the Pragmatist is focused on resolving his problems in therapy.  Whereas the Pragmatist wants to achieve things, the Dreamer is focused on the experiential.

The Dreamer and the Pragmatist

Adam Phillips says the Dreamer wants the therapist to help her get back into her reverie, and the Pragmatist wants the therapist to help her find a solution to her problem.

The Pragmatist wants to know, in a practical way, what to do.  The Dreamer wants to discover the way and see what happens.

Of course, these are generalizations, and most clients don't fall neatly into one category or another.  People are often a combination of the two.

I've worked with both Dreamers and Pragmatists in my psychotherapy practice in NYC and both types of clients appeal to the different aspects in me that I identify with.

Psychotherapy with the Pragmatist
In many ways, I'm a Pragmatist and I like helping clients in a down-to-earth manner, especially clients who come in for brief therapy, assuming that brief therapy is the appropriate form of treatment for them.  

Brief therapy is appropriate where a client has a specific problem, with no major trauma, that lends itself to brief solution-oriented therapy.  Often, this client just needs some direction or guidance, an objective mental health professional to check in with, and they can often come up with practical solutions to their problems.  Long-term treatment isn't necessary, unless, over time, the client becomes curious and interested in exploring more about his inner world.

Psychotherapy with the  Dreamer
I also have a side of me that is a Dreamer or Seeker, and I also enjoy working with clients who are more interested in discovering their inner world and more focused on the "journey" rather than the "destination."


My original training is in contemporary psychoanalysis.  I'm fascinated by the unconscious, including dreams.  When I work with dreams, I have different ways that I work, including contemporary psychodynamic dream work and Embodied Imagination dream work, which is a post-Jungian way of working developed by psychoanalyst, Robert Bosnak.  This type of psychotherapy is more open ended than brief treatment and, as in all therapy, the client decides when s/he has completed treatment.

Many Different Types of Psychotherapy - Many Choices for Psychotherapy Clients
Whether you're someone who seeks brief therapy, more open-ended psychodynamic treatment or something in between, there are so many different types of therapy today that you have many choices, including psychoanalysis, psychodynamic therapy, solution-focused therapy, cognitive behavioral treatment (CBT), EMDR, hypnotherapy, and Somatic Experiencing, to name just a few.

I usually recommend that people looking for a therapist trust their gut instincts when choosing a therapist.

See the link below for my article, "Psychotherapy: How to Choose a Psychotherapist" for more information.

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

I work with individual adults and couples.

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.


Psychotherapy: How to Choose a Psychotherapist

Promises, Promises - Essays on Psychoanalysis and Literature - by Adam Phillips













Friday, January 18, 2013

People Who Abuse Alcohol Often Don't Get the Help They Need

People who abuse alcohol or who are alcohol dependent frequently don't get the help they need to overcome their alcoholism for variety of reasons.  For one thing, people who abuse alcohol are often in denial about their alcoholism.  They often don't admit their problem to themselves or to others who can help them.  Shame is a major factor in their denial.  They often tell themselves, "I can stop whenever I want to," which keeps them from admitting their problem or from getting help.

People Who Abuse Alcohol Often Don't Get the Help They Need

People with Alcohol Problems Are Often Good at Hiding Their Drinking
Even when people who abuse alcohol admit to themselves that they have a problem, they're often very invested in hiding their problem from loved ones, their employers, and even their doctors.

People With Alcohol Problems Are Often Good at Hiding Their Drinking


Doctors usually don't have the time and many are not knowledgeable enough about the signs of alcoholism to ask the right questions during routine exams (see link to article below).

Families Often Collude and Enable People with Alcohol Problems
Families often, either knowingly or unknowingly collude in the problem by enabling the person who is abusing alcohol.

People Who Abuse Alcohol Often Don't Get the Help They Need:  Family Problems

More than one spouse, who was married to a husband who abused alcohol, has told me that she would rather buy him the alcohol and maintain peace in the household rather than have the husband create havoc because he's craving alcohol he doesn't have.  One person told me, "Once he has his beer, he goes in the den, drinks, and he doesn't bother anybody."  Often, this sad state of affairs can go on for many years.

Employers Often Collude and Enable People with Alcohol Problems
It's not unusual for employers, who might recognize that an employee has a drinking problem, to look the other way.  When I was a human resources manager and I asked managers why they allowed a certain employee to continue to come to work drunk, I was often told something along the lines of, "Well, Joe is a good guy.  I didn't want to get him in trouble."

Untreated Alcoholism Can Cause Serious Medical Problems
What people often don't realize, and this includes the person who is abusing alcohol and the people in his or her life, is that untreated alcoholism can cause serious medical problems.  It can even be fatal.  Late stage alcoholism can include severe memory problems and other cognitive impairments.

Alcoholism can lead to heart attack, stroke, and kidney and liver failure.  Alcoholism also often destroys families.  It is also one of the main causes of car accidents and vehicular homicide.  It costs companies millions in lost productivity.

Alcoholism is a Medical Condition--Not a Moral Issue
Even though we now know that alcoholism is a medical condition, many people, including people who abuse alcohol, still see alcoholism as a moral issue.  They think that it's a moral failure and a failure of will on the part of the person with alcohol problems.   But this couldn't be further from the truth.  We don't moralize about other medical conditions--like diabetes.  But people with alcohol problems are still blamed, and they blame themselves, for their medical condition.  This creates a great deal of shame, which keeps the person with alcohol problems from getting help.

Getting Help:  Alcoholics Anonymous (A.A.)
Rather than blaming themselves and trying to "white knuckle it" through, people with alcohol problems need to talk to other people who understand what they're going through.  I am a big proponent of Alcoholics Anonymous (A.A.)

Sober people who attend A.A. understand the challenges involved with giving up alcohol and leading a sober life.  They're there to offer support when the person who is contemplating sobriety takes his or her first tentative steps to getting sober.  They know it's hard, but they also know that it can be done.

I usually recommend that people who are new to A.A. attend a beginner's meeting.  There are often people there who volunteer to be interim sponsors to people who are new to the program because they know that it's hard for newcomers to ask for help.  They can help new people to work the 12 Steps, starting with the first step, often the hardest for many people, to admit powerlessness over alcohol.

Sometimes, A.A. isn't enough and the person who wants to get sober might need to go to either an intensive outpatient program or an inpatient program.  In NYC, I've found, over the years, that both the Parallax Center, which also does outpatient detox, and Inter-Care are both very good outpatient programs.  Both of them offer intensive treatment.

If you have an alcohol problem, don't wait until you've "hit bottom" and you've lost everything.  Get the help that you need.  I've included resources below that you might find helpful.

Resources:
Alcoholics Anonymous:  http://aa.org

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

Thursday, January 17, 2013

Your Workplace Could Feel Like a Dysfunctional Family

Workplace dynamics often mimic dysfunctional family dynamics.  It's no wonder that employees are often emotionally triggered by what goes on at work.

At Work:  Feeling Powerless and Like a Child Again
Over the years, I've heard many psychotherapy clients complain that the dynamics at work, especially  with difficult supervisors, often make them feel that they're back home again when they were children being chastised by their parents.

Your Workplace Could Feel Like a Dysfunctional Family

In many ways, workplace relationships can feel like familial relationships in both positive and negative ways.  When workplace relationships are positive, they can be a source of mutual support in much the same way that siblings support each other.

But when workplace relationships are negative, they can be as competitive and contentious as dysfunctional family members.

When employees come from family backgrounds where there was emotional or physical abuse, they can get emotionally triggered when they work for a difficult supervisor, especially a supervisor who is verbally abusive, demeaning or a bully.

Getting Emotionally Triggered at Work:  Re-Experiencing Childhood Trauma
Most of the time, people who get emotionally triggered at work don't realize it because this is often an unconscious process.

When they get emotionally triggered, they're not only dealing with the current situation but, without realizing it, they're also re-experiencing the emotions from the past.  If these feelings are especially overwhelming, they might realize that they're overreacting to the present situation, but they might not understand why or what's happening to them.

Some employees, who are emotionally triggered by the dysfunctional dynamics at work, might feel anxious or panicky.  They might feel powerless to deal with the situation at work in much the same way that they might have felt powerless when they were children.  If the situation goes on long enough, they might feel depressed.

If it's possible to get out of a dysfunctional work setting, it might be the best recourse.  But it's not always possible to leave.  And there's no guarantee that the next place won't have its own dysfunctional dynamics.

Getting Help in Therapy:  EMDR and Somatic Experiencing
Psychotherapy, like EMDR or Somatic Experiencing, can often help people to overcome the original trauma that is being triggered by the situation at work.

Both EMDR and Somatic Experiencing also help clients to develop emotional resources to deal with the stressors they're experiencing in the here-and-now and differentiate these stressors from the past.

Rather than getting triggered over and over again, if you're in a workplace environment that mimics a dysfunctional family, you could benefit from working with an EMDR or Somatic Experiencing therapist to help you overcome the trauma in your history as well as developing the emotional resources you need for your life now.

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

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, January 15, 2013

Living Fully in the Present Moment

Why is living fully in the present moment so hard?  Everyone has different ideas about this.  I believe that most of us tend to focus our thoughts mostly in the past or in the future and relatively little time living in the here and now.

Living Fully in the Present Moment

Living Mostly in the Past or in the Future
For people who live in the past, they often dwell on how life was for them during particular times in their lives.  They might focus on times when they thought life was better.  There's often a yearning to get back to that time, if it was a special time in their lives.  Or, especially when there's been emotional trauma, they might focus on emotional upsets from the past and dwell on them.  Trauma often keeps people stuck in the past if the trauma hasn't been worked through in therapy.

For people who live in the future, they often dwell on thoughts of how they would like to live their lives.  They might spend a lot of time fantasizing about a new relationship, a better job and, overall, living a happier life.  Conversely, they might spend most of their time worrying about the future.

Of course, there's nothing wrong with thinking about your past or your hopes for the future.  It's important to learn from the past and to plan for the future.  But the problem is that when you tend to dwell on these thoughts most of the time, you're not living fully in the present moment and you're missing out on what's going on around you right now, including  your relationships and your environment.  And, by dwelling mostly on the past or the future, you're probably not in touch with your inner emotional world as it is right now.  And dwelling on the past or the future can be a way of escaping from the here and now.

Precious Moments - Even During Difficult Times
I believe that even during difficult times, there can be precious moments that we can miss if we're not attuned to what's happening in the here and now.  It's very easy (and understandable) that when times are tough, we tend to focus on our worries.  Our thoughts might run wild about all the things that could go wrong.  We can get distracted and disorganized, which creates its own problems.  Then, we miss out on what might be precious gems of moments even during an otherwise turbulent time.

Living Fully in the Present Moment

Recently, a close relative was rushed to the emergency room because he was having a heart attack.  Like most people, as I was rushing to the hospital, my first thoughts went to the worst case scenario.  I hailed a cab and told him how to get to the hospital, which was about 30 minutes away from my home.  Instead of following my directions, the cab driver told me he knew of a faster route, so I agreed to go his way.  But, instead of being a faster route, he got lost and, worse still, we were going in the wrong direction.  Then, we got caught in a lot of traffic.

It took all the self discipline that I could muster to stay calm and not lose it with this taxi driver.  All the while, I was worried about getting to the hospital too late.   I had to continually bring my mind back to the present and remember to breathe.  I knew that getting upset wasn't going to help me or the cab driver.

Finally, he was able to turn around and follow my original suggestion for getting to the hospital and we were soon there.  As I reached into my wallet to pay the driver, he looked back at me with kind eyes.  He apologized for getting us lost and told me that he wouldn't charge me for the ride.  In that brief moment, when we made eye contact, I could see that he had a lot of compassion and I sensed from his few words that he understood what I was going through.  It was just a moment in an otherwise chaotic situation, but it was meaningful to me, and I was grateful for it.

During the days when my relative was in the cardiac care unit (CCU), there were other special moments in an otherwise distressful situation, including the care and kindness of the nurses and doctors on staff.  Most of them had worked together as a team on CCU for many years and they seemed to have such a camaraderie among them, which I was very grateful for.  They were very compassionate and skilled in their work.  They also took the time to explain things carefully and in simple terms.  Each night I left the CCU when visiting hours were over, I was able to console myself with the thought that my relative was getting the best of care from people who were concerned about his well being.

There were other moments where friends and a relative that I hadn't seen in many years visited the CCU and brought poignant moments of laughter and comfort.  Getting caught up and feeling rooted in a strong emotional support system gave comfort to my relative who had the heart attack and to me.  It reminded me that, even during very difficult times, there can be precious moments that we could miss if we remain distracted in our thoughts and not living in the present moment.

Fortunately, my relative is on the road to recovery, and he has a very good medical team in place for after care.  His medical emergency was another reminder of how precious life and our relationships with our loved ones are, and how easily we can forget this when we're stuck in our particular default mode of going through life.

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

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 or email me.

Monday, January 14, 2013

Letting Go of Unhealthy Relationships: Unrequited Love

One of the most difficult things to do is to let go of an unhealthy relationship where there is unrequited love.  When you're in a relationship with someone that you love, but who doesn't love you, it's emotionally painful and eroding to your sense of self.  The other person might have his or her own reasons for remaining in the relationship with you but, for you, the focus becomes hoping and doing whatever you can to try to get your partner to love you.  

Letting Go of Unhealthy Relationships:  Unrequited Love

For many people, being part of a relationship where their love is unrequited is an unconscious repetition  of a childhood dynamic with either emotionally absent or narcissistic parents.  The unspoken message from childhood as well as in adult relationships in this dynamic where you love, but the other person doesn't love you, is "You're not good enough."

Achieving clarity about the unhealthy nature of this type of adult relationship is hard because the person who wants to be loved is often completely focused on how to get the other person to love him or her.  Rather than putting him or herself first, this person places the other person's emotional needs first, to his or her own detriment.

A person can become so locked in this dynamic that he or she doesn't see it.  Friends and family often see it before he or she does.

Knowing this, the person whose love is unrequited not only feels the shame of not being loved by the person s/he loves but also feels ashamed that others are making judgments about it, even if loved ones never say anything about it.

When someone, who is involved in a relationship where his or her love isn't returned, comes to therapy to deal with the pain of this dynamic, it's the therapist's job to help this person become aware of the dynamic without being in denial about it.

With awareness comes the ability to make a choice about what to do.  Whether you make a choice to stay or leave, you're no longer a victim because you're consciously making a choice.

An article in yesterday's New York Times, in the Modern Love section, by Hannah Selinger, reminds me of this dynamic (see link below).

Getting Help in Therapy
There are few things sadder than looking back towards the end of your life and regretting that you wasted time with someone who doesn't love you or who doesn't treat you well.  You might realize, at that point, that if you had let go of that relationship earlier, you might have found someone who would have loved you.  But life is short and there aren't any "do overs," so this realization often doesn't help you.

If you're in a relationship where you're the one who is in love, but you know your partner doesn't love you, you know how much this hurts.  If you can get to the point where you can admit to yourself that this has become too painful, you could benefit from seeing a licensed mental health professional, someone who can be objective and nonjudgmental about your situation.

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

To find out more about me, you can 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.

New York Times: Modern Love - "Friends Without Benefits" - by Hannah Selinger

Tuesday, January 8, 2013

Research Study: We're Not Good Predictors of Who We'll Be in the Future

According to a recent New York Times article by John Tierney, a study finds that even when we're able to look back and see that we've changed over the years, we're not good predictors of what we'll be like in the future (see link below).  According to the article, which was conducted with 19,000 people between the ages of 18-68, people expect that, in the future, they won't change much from who they are now.

Research: We're Not Good Predictors of Who We'll Be in the Future

The End of History Illusion
The researchers who conducted the study called this phenomenon "the end of history illusion" because people tend to underestimate how much they'll change in the future, despite how much who they are now changed from the past.

People who participated in the study were asked about current personality traits and preferences (favorite foods, vacations, hobbies, etc) as compared to the past.  They were also asked to make predictions about their personality traits and preferences for the future.  The article indicates that people tended to play down the potential of their changing in the future, assuming that they would be pretty much as they are now.

In the Future, How We'll See Who We Are Now
According to the New York Times article, one of the study's authors, Daniel T. Gilbert, Harvard psychologist, indicated that most people in the study didn't realize that, in the future, they'd look back on who they are now with the same amusement or chagrin as they currently look back on their former selves.

Speculating as to why this phenomenon occurs, the researchers hypothesized that one reason might be that people feel a certain comfort with feeling that they've already reached the peak of their personal evolution, so they don't think they will change in the future.

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

I work with individual adults and couples.

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.

Why You Won't Be the Person You Expect to Be - 
New York Times - by John Tierney



Monday, January 7, 2013

When Our Emotional Attachment to Our Possessions Becomes a Problem For Our Loved Ones

During the last few years, there have been many more articles, books, and even a TV program about hoarding.  There have even been articles about how children of hoarders have been affected by a mother's or father's hoarding. 

All of these stories serve to highlight our emotional attachment to our possessions and how possessions can become imbued with personal symbolic meaning.  Even when our emotional attachment to our possessions doesn't reach the level of hoarding, it can be a psychological problem that causes distress for the person with the problem as well as loved ones who live with him or her.  But this problem can be worked through in  therapy.

Emotional Attachment to Our Possessions Become a Problem For Our Loved Ones


The following fictionalized scenario, which is a composite of many cases with all identifying information changed to protect confidentiality, is an example of how one person's emotional attachment to his possessions can be a problem that can get worked through in therapy:

Joe:
Joe became depressed after his girlfriend of 10 years, Mary, broke up with him.  The breakup occurred four years before, but Joe still missed her everyday.  When they were living together, Mary was the neat one and Joe tended to be more messy.

But after Mary left, Joe went from being messy to accumulating clutter.  The things he accumulated in the house were mostly clothes, books, and mementos from the relationship.  Other than that, he cleaned the house and never accumulated any garbage, the place was habitable, and he had people over.  It never reached the level of "hoarding," but it was still becoming a problem and he feared that this problem might get worse.

Our Emotional Attachment to Our Possessions Becomes a Problem

When he began therapy, he talked about other big losses in his life, including losing both of his parents at an early age.  Prior to Mary leaving, Joe didn't think about their deaths as much as an adult.  But after Mary left, Joe began having dreams of himself as a child searching for his parents.

It became apparent in therapy that the loss of his relationship with Mary triggered this early childhood trauma, and his emotional attachment to his possessions took on a new meaning for him with the triggering of this early trauma.  His possessions became imbued with a personal meaning that he never felt before.  It was as if his possessions were like beloved friends and family members, and he couldn't bare to part with them.

On the one hand, having them around him gave him a certain amount of emotional comfort.  But, on the other hand, the clutter increased his anxiety.  He also felt ashamed about it.  His bedroom closet was filled with clothes that he no longer wore, but they had come to have meaning to him because they were purchased for him by Mary.  His desk and his floor were littered with books and papers that he also associated with Mary.

During his therapy, Joe mourned the loss of his relationship and the loss of his parents.  He learned to nurture the "inner child" in him that he had ignored for years and who was feeling emotionally deprived.

Joe Learned to Mourn His Losses and Nurture His Inner Child So He Could Let Go 


Gradually, he started letting go of the possessions he was accumulating.  In order to let them go, he did a simple ritual in which he thanked each possession for what it "gave" him on a symbolic level.  It was still hard for Joe to let them go, but he did.  Although it was sad for him, he also began to feel less anxious because he could now relax more in his environment.  He also began to take steps to meet other women.

When Possessions Take on a Personal Symbolic Meaning and You Can't Let Go of Them:
In the above scenario, the accumulation of possessions never reached the level of hoarding as we've come to define it.  I think it's important to recognize that people can go through stages in their lives where they develop an emotional attachment to their possessions that isn't hoarding per se but is still problematic.

I believe there's a difference between clutter and hoarding, and it's important to recognize the symbolic meaning of possessions.  Often, possessions take on a symbolic meaning of being like a friend or loved one that provides comfort after a loss.  Under these circumstances, the person usually has mixed feelings about these possessions because, even though they provide a degree of emotional comfort, the clutter also creates anxiety.

Mourning and Problems with Letting Go of Possessions that Belonged to a Loved One
Many people go through a similar feeling when someone close to them dies and they have to get rid of  clothing and other possessions.  Sometimes, they have to wait a while before they can do it because it's just too hard.  They might spend time holding and smelling certain items of clothes that still have the scent of their deceased loved one.  But, eventually, they usually let go of these things because they know they have to do it or they'll remain stuck emotionally.  It's part of the mourning process.

Not Just "Messy" - The Importance of Understanding the Meaning of Holding On
It's not unusual for possessions to take on this symbolic meaning without the person who is affected  realizing it at first.  

A person who begins to accumulate clutter might just see him or herself as "messy" at first without realizing that the possessions have taken on a new meaning.  At that point, it becomes hard to get rid of these things  because who wants to throw out a "loving friend" or "family member"?

This problem is a lot more common than hoarding.   Overcoming this problem isn't easy.  It begins with an awareness that the possessions have become imbued with emotional meaning that goes beyond their functional status.  Then, overcoming the problem involves working on a deeper level, as in the scenario above.

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


Children of Hoarders on Leaving the Cluttered Nest

Sunday, January 6, 2013

Pets Can Help Improve Your Mental Health

Psychological research has shown that people with pets, generally speaking, tend to be happier and healthier.  Our pets, whether they are dogs or cats, provide us with emotional support.  They bond with us, and most people see them as family members.

Pets Can Provide Emotional Support for People Who Are Socially Isolated
People who might be experiencing social isolation, often fare better if they have a pet.  Our pets usually love us unconditionally (and how often do you experience that!) and we love them.  They're a source of comfort and can be a source of joy.

Pets Can Improve Your Mental Health


Pets and the Elderly
Assisted living and nursing home facilities have found that the elderly respond to dogs and cats even when they might not respond to other residents or staff.  They enjoy the pet's company, including their physical and emotional warmth, and the tactile sense when they pet them.

I was very moved to hear a story about a cat in a senior residence who instinctively knew when a resident wasn't feeling well.  He would lie on the bed with the resident, providing comfort.  This cat was also attuned to when a elderly resident was about to pass away, and he would stay with the resident until he or she died.  The staff said it often helped the resident to have a peaceful passing.

Pets Can Help Us to Relax and Shift into a Good Mood
Even when you're not around your pet, just thinking about your cat or dog can help you to relax and shift your mood.

I love both cats and dogs, but I'm especially partial to cats.  I had my cat, Hecate, from the time she was about seven weeks old until she died at the age of 19.  Contrary to what people often say about cats, she was very sweet, loving, and cuddly.  When I first got her, she would drape herself across the top of my head at night like a fur hat.  She was also very smart (I know, I know--everyone thinks his or her pet is the cutest and smartest!)

In the morning, Hecate would pat my mouth with her paw to let me know she wanted her breakfast.  She was also very playful.  Once I was looking for her all over the apartment.  

Usually, she would come when I called her name, but this time she wasn't responding, so I was starting to get worried.  Then, as I was standing by the refrigerator wondering where she might be, I felt a tap-tap-tap on my head.  I looked up.  She was standing on top of the refrigerator, giving me a mischievous look. Then, she jumped back to hide again, and slowly creeped to the edge and peered over the side to see if I would play with her which, of course, I did.

Hecate passed away more than 10 years ago now, but all I have to do to shift my mood is to think of her and she still brings a smile to my face and a warm feeling.

Although pets can improve your mental health, they are also a responsibility and not everyone can afford or provide care for a pet.  

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

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.

Also, see my article:  Coping with Pet Loss




Saturday, January 5, 2013

Narcissism: An Emotional Seesaw Between Grandiosity and Shame

The grandiosity that is associated with narcissistic behavior is often a cover up for a great deal of shame.  For people who exhibit narcissistic traits, what appears to others as over confidence or even arrogance is really a thin shell that protects a deeply deflated and hollow sense of self.  Often, people with narcissistic traits are on an emotional seesaw between grandiosity and shame.  

Narcissism: An Emotional Seesaw Between Grandiosity and Shame

A Need for Ever Greater "Narcissistic Emotional Supplies"
To hide their sense of shame, people with narcissistic traits often need to constantly keep themselves pumped up emotionally or expect that others will pump them up.

If they're in high positions of authority, there are usually subordinates who are willing to engage in this charade for whatever they expect to gain from the situation.

Behind the scenes, these subordinates might be secretly laughing at their boss, especially if they see through the boss's grandiose cover up.  But in front of the boss, they're all too willing to continue providing narcissistic strokes.

The problem is usually that, eventually, the pendulum swings the other way and the person with narcissistic traits confronts his or her own deep seated shame and emotional hollowness.

If people with narcissistic traits are unwilling to acknowledge and take steps to overcome the deep sense of shame that fuels this dynamic, they often find themselves in a never-ending quest for more "narcissistic emotional supplies."

This can take many different forms, including an obsession with making more and more money, a craving for ever greater expensive possessions, an obsessive focus on appearance (e.g., a need to appear physically "buff" or having plastic surgery to hide the signs of aging), the need to have a lot of power over others or the need to be surrounded by very attractive  romantic partners.

These so-called "narcissistic emotional supplies" provide only temporary gratification.  Sooner of later, the shame that might have been temporarily kept at bay rises to the surface.

Narcissism:  An Emotional Seesaw Between Grandiosity and Shame

Often, people who are caught in this emotional seesaw between grandiosity and shame don't get help unless there is a significant emotional crisis in their lives.  This could take the form of a spouse getting fed up and leaving, the realization that this dynamic has alienated other close family members like one's children or  losing one's job and thus losing career status.

When people with narcissistic traits go through these types of losses that they cannot assuage in other ways, they're often in a lot of emotional pain, and they don't have the emotional resources to deal with it.

These deeply humbling experiences and the shame that cannot be pushed down any more sometimes brings them to therapy.  For others, who don't get help, they often feel impotent rage or depression.  They might turn to alcohol, drugs, gambling, sexual acting out or other mood-altering behavior to bury their feelings.  This often leads to a further emotional spiraling down.

The origins of shame are as varied as the people who suffer with it.  This kind of deep seated shame, which is covered over by grandiosity, often starts early in life.  It might start as early as the preverbal stage of life.  It can begin with emotional neglect or the lack of emotional attunement or mirroring between the infant and the primary caregiver.

Getting Psychological Help
Getting help to overcome shame takes courage, especially for someone who has spent most of his or her life trying to hide it.

Shame often keeps people with narcissistic traits out of treatment so that the people who usually need the most help never seek it.

If they do seek help, they must be willing to make a commitment to stick with it, and treatment is often long.

These are ingrained characterological traits and require a willingness on the client's part to do in-depth psychological work and the willingness on the therapist's part to do the work with challenging clients.

For those willing to do the work with a skilled clinician, freeing oneself from the emotional seesaw of  grandiosity and shame can be a life changing experience.

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

I work with individual adults and couples.

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,