NYC Psychotherapist Blog

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Sunday, January 19, 2014

Untreated Emotional Trauma is a Serious Issue: Part 3: Starting Therapy

In two prior articles, I began a discussion about the effects of untreated emotional trauma:  Part 1, Untreated Emotional Trauma is a Serious Issue With Negative Consequences  and Part 2 of this topic, Understanding the Impact of Untreated Emotional Trauma.

In the current article, I'm continuing the discussion about the case I began discussing the last time about Joe, which, as always, is a composite of many different therapy clients to protect confidentiality.

Joe was considering attending psychotherapy because he was having a hard time allowing people to get close to him.  At that point, he knew that something was wrong because he wanted very much to have close friends and to be in a relationship, but his fear of allowing people to get close to him was the major obstacle for him.

His emotional dilemma was that he felt trapped--his longing for emotional connection and his fear of getting close to others kept him in an internal state of conflict, and he saw no way to overcome this on his own.

Untreated Emotional Trauma is a Serious Issue: Starting Therapy

For years, he had been ambivalent about starting therapy, but when he thought about whether he wanted to be stuck in this emotional dilemma of wanting but fearing closeness, he knew, no matter how fearful he felt about going to therapy, he needed to get help because he didn't want to look back on his life when he was older and regret that he remained fearful, alone and lonely.

His doctor, who had been encouraging Joe to go to therapy for several years, referred Joe to me because he knew that I'm a trauma therapist.

The Initial Stage of the Therapy Consultation
I encouraged Joe to come in for a therapy consultation to see if he felt comfortable enough with me so we could work together.  I also use this first session to get an overview of a client's problems and for the client to ask whatever questions he or she might have about the therapy process, how I work  or about my professional background as a psychotherapist.

Although Joe was anxious, he was comfortable enough to come to weekly sessions.  During the initial sessions, we discussed his his family background, which included a father who had alcohol problems and who was physically abusive.

Psychoeducation About Psychological Trauma
I knew that Joe wasn't making the connection to how his early childhood trauma was affecting him now in his adult life.  Like many people, Joe assumed that, because these problems occurred years before, they weren't connected to his current problems.

So, I started, as I usually do, with providing Joe with psychoeducation about how early trauma can affect people in their adult lives, including the connection to fears about emotional intimacy.

Understanding Psychological Trauma Intellectually vs Overcoming the Trauma
I could tell that Joe understood this intellectually, but it didn't resonate with him emotionally.

I also knew that just talking about his early emotional trauma in therapy wouldn't be enough for Joe to overcome his problems.

In other words, if we only used talk therapy, Joe would make intellectual connections and he would develop insight into his problems, which is important, but his problems probably wouldn't change.

This is the frustrating position that many therapy clients find themselves in when they're in a therapy that uses talk therapy exclusively:  They learn to understand their trauma, but little or nothing changes.

Mind-Body Oriented Psychotherapy
In my professional opinion, Joe needed the type of therapy that would help him to connect his intellectual understanding to a felt sense of his problems.

As a psychotherapist, my experience has been that mind-body oriented therapy works best for most clients who are dealing with psychological trauma.  These types of therapy include EMDR, Somatic Experiencing and clinical hypnosis (also known as hypnotherapy).

Developing Internal Resources
We started, as I usually do, by helping Joe to develop his internal resources, also known as coping strategies or coping skills, to prepare him to start processing the trauma (see my article about Coping Strategies in Mind-Body Oriented Psychotherapy to get an idea of how I help clients develop coping strategies).

Like many people who have been traumatized, Joe relied on dissociation, which is a defense mechanism to "zone out" and numb himself emotionally, whenever he felt uncomfortable.  So, we worked on helping Joe to learn to use positive coping strategies instead of dissociation.

This isn't an all-or-nothing process, but by using the internal resources that he learned in our work together, Joe began to develop enough resilience to begin to tolerate some of his discomfort and enough tolerance to begin working on his emotional trauma.

In my next article, I'll discuss the next phase of therapy, which is processing the trauma.

Getting Help
If you think emotional trauma has been in obstacle to your leading a fulfilling life, you owe it to yourself to get help from a licensed mental health professional who has expertise in working with trauma.

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

One of my specialties is helping clients to overcome psychological trauma.  

In addition to working with clients as a primary therapist, I also do adjunctive trauma therapy for clients who want to remain with their primary therapist, who might not be a trauma 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 during business hours or email me.