NYC Psychotherapist Blog

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Saturday, June 28, 2014

Psychotherapy Blog: Finding Moments of Joy While Coping with Trauma

Anyone who has ever dealt with emotional trauma, including posttraumatic stress disorder, knows how challenging it can be.  So, it might seem like I'm trivializing the anxiety and despair that many people feel when they're coping with trauma by suggesting that there can also be moments of joy along the way.  However, as a psychotherapist in NYC who specializes in working with trauma, I also know that finding moments of joy can help with the healing process.

Finding Moments of Joy While Coping with Trauma

What is Joy?
Joy is a state of being.

Joy can include feelings of great happiness, bliss, exhilaration, or pleasure.

What is Joy?
It can be evoked by beauty, feeling good about oneself, feelings of transcendence in art, music, poetry or spiritual practice.  It can also be evoked during play (see my article:  What is Happiness?).

Coping with Trauma:  From Emotional Numbing to Emotional Openness
These moments of joy often come after the person, who has been traumatized, begins to open up in the healing process.

It's not unusual for people coping with emotional trauma to shut down emotionally because the trauma was too overwhelming at the time.

In many cases, shutting down when the trauma occurred helped them to avoid feeling completely overwhelmed.

Coping with Trauma
But, unfortunately, shutting down not only protects them the uncomfortable feelings--it can also block feelings of happiness, joy, and love because they're emotionally "frozen" or numb to all emotions.

So, what was once, possibly, an emotional defense that helped is now a hindrance.

The initial stage of opening up, whether this occurs in therapy, meditation or in a yoga class, can feel unfamiliar and scary.

But most therapy clients that I have worked with also describe a feeling of relief that the emotions that were suppressed for so long can be released so they can start to feel more authentically like themselves (see my article: Reclaiming a Lost Part of Yourself).

When I work with clients who have been traumatized, I'm mindful that the therapy often needs to be titrated so it is emotionally manageable and it feels safe for clients, which is why, in many cases, I use a mind-body oriented therapy approach (see my article: Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious).

Often, as clients begin to open up to their fear, sadness and anger, they also begin to notice that they're opening up to moments of joy, even very simple things, like noticing a beautiful flower or colorful bird flying overhead (see my article:  Small Wonders All Around Us If We Take the Time to Notice).

Finding Moments of Joy While Coping with Trauma

These sights might have been around them all along, but when they were emotionally numb, they probably didn't notice them.

Once they've started to open up, people coping with trauma often discover that these moments of joy can help to balance their emotional pain.

And, over time, rather than waiting to notice these moments, they seek them out and find ways to create them (see my article:  Recapturing a Sense of Aliveness).

The Way Out of Emotional Pain is Through It
As Mark Epstein mentions in his book, The Trauma of Everyday Life, the way out of emotional pain is through it.

We cannot avoid the emotional pain or trauma that is a part of life, but we can learn to work through it and find a sense of well being.

Getting Help in Therapy
If you're suffering with emotional pain, you're not alone.

Getting Help in Therapy

You can get help with a licensed mental health professional who specializes in working with trauma so you can work through your trauma and experience a sense of emotional well being.

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

One of my specialities is helping clients to overcome trauma.

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

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

Monday, June 23, 2014

Nurturing Your Relationship

Being in a relationship can be one of the most loving, gratifying and fulfilling experiences of your life. It can also be challenging.  Every relationship has its ups and downs.  Whether you're going through a good time or a challenging time, it's important to remember that all relationships need nurturing.

Nurturing Your Relationship

Often, people who are in relationships, especially long term relationships, forget that their relationship needs love and care.  Nurturing each other can make the difference between a relationship surviving a rough patch or not.

Here are some tips for nurturing your relationship:

Communicate in a Tactful and Honest Way
In the heat of an argument, it's easy to forget to be tactful.  And, yet, you might regret something that you say that you can't take back once it's out.  Even if you need to take a break from a heated argument, it's important to treat your spouse with respect and care.
See my article: The Challenge of Keeping Small Arguments From Developing Into Big Conflicts in Your Relationship

Provide Each Other with Emotional Support
Listening with empathy can make all the difference even if you can't change whatever your spouse is going through.  You both need to be there for each other.

Show Compassion
During difficult times, your relationship can degenerate fast if you're each blaming each other for your problems.  Put yourself in your spouse's shoes and think about how you would want him or her to respond in a similar situation and then show the same compassion that you would want.
See my article: Relationships: Moving Beyond the Blame Game

Express Gratitude
It's easy to take each other for granted, especially in a long term relationship.  No one wants to feel taken for granted, so express your gratitude to your spouse for the things s/he does or says
See my article:  Relationships: The Importance of Expressing Gratitude to Your Spouse

Persevere Through Difficult Times
Along with providing each other with emotional support, it's important that you both remain committed to each other when things start to get rough.  Of course, this doesn't mean that you should put up with abusive behavior.  But, under normal circumstances, when life presents challenges in your relationship, your attitude to see it through together is important.

Admit When You're Wrong
If you realize that you've made a mistake, it's important to admit it, make amends and move on.  Holding onto an attitude of "I'm right" when you know you made a mistake will only make matters worse
See my article:  Relationships: The Courage to Admit You're Wrong

Have a Sense of Humor
In many situations, seeing the funny side of a situation can help lighten the mood and help you and your spouse to deal with a difficult situation.

Share Common Goals
One of the signs of a happy, healthy relationship is that both people share certain common goals.  This helps to make your relationship more meaningful.

Create Special Times Together
It's very easy to get bogged down with responsibilities and family obligations, but you and your spouse need to have time together for just the two of you.
See my article:  Creating Special Times Together to Enhance Your Relationship

Nurturing Your Relationship:  Creating Special Times Together

Be Open to New Shared Experiences
It's easy to get into a rut in a long term relationship, so being open to new shared experiences can keep your relationship alive and fun.
See my article:  Being Open to New Experiences

Getting Help in Therapy
There are times when couples go through tough times when they're unable to work things out for themselves.  During those times, it can be helpful to seek help from a licensed mental health professional who has experience helping couples to work through their problems.

When you seek help, you're acknowledging to each other that your relationship is important enough to make the commitment to attending couples counseling.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals 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, June 16, 2014

Having Compassion for the Child That You Were

In a prior article, Psychotherapy and Compassionate Self Acceptance, I discussed some of the challenges that people often face when they start therapy.  In this article, I'm focusing on having compassion for yourself for who you were as a child.

Many people come to therapy feeling ashamed of their problems, even when those problems started when they were children.   Rather than having compassion for what happened to them as children, they have a chronic sense of shame and harsh self judgment.  Often, they believe that whatever happened to them was their fault.

Having Compassion for the Child That You Were

Shame and Self Criticism Often Develops in Childhood
Young children are naturally egocentric, and these feelings of shame and self judgment often develop during childhood and continue into adulthood.

Having Compassion for the Child That You Were: Self Criticism and Shame Often Start in Childhood

As a therapist, when I ask adult clients who feel this way about themselves if they would be as judgmental about a close friend who was struggling with the same issue, they usually say they would not.  Instead of being judgmental, they often say they would feel compassion and would try to help their friend to be more self compassionate.

And yet these clients are often unable to muster the same compassion for themselves.  They're stuck in chronic shame and self criticism.

Often, when I'm working with a client who is feeling such chronic shame that originated in childhood, I help him or her to remember and feel again what it was like to be that young child.

Usually, when a client is able to experience those feelings of sadness, disappointment and anger, as he or she felt those emotions as a child, an emotional shift takes place.  Instead of being ashamed and judgmental, the client feels a certain tenderness for the child self.

The following scenario, which is a composite of many cases with all identifying information changed, illustrates how this emotional shift can take place:

Mike came to therapy because he was struggling with crippling shame and self judgment.

To hide his negative feelings about himself from others, he put up a good front.  But putting up this front often left him feeling exhausted and disingenuous.  It also felt it was getting harder to do over time.

As he described his problems, I could feel that Mike was "reporting" his history without emotion as opposed to feeling it.  He recounted one childhood trauma after another, which included physical abuse from an alcoholic father and neglect from a mother who was emotionally disengaged.

Over and over again, Mike blamed himself for not being able to overcome his problems on his own, saying, "I should be able to get over this on my own" and "I'm just too weak to be able to handle my problems."

Gradually, as we worked together in therapy, Mike realized that his negative feelings about himself originated when he was a child.  Many of the negative things he said about himself now were said to him by his father when he was a child.  Without realizing it, Mike had taken on these critical feelings about himself, which made him feel ashamed.

Before we processed the early trauma, I helped Mike to develop the emotional resources that he needed to deal with his traumatic feelings.

After he developed these resources, I helped Mike to slow down and, instead of just "reporting" what happened, to feel what it was like as a child to experience the abuse and emotional neglect.  At that point, Mike was able to say and feel how disappointed and sad he felt that his parents were unable to give him what he needed as a child.

When he was able to experience himself as a child, he was no longer dissociated from his emotions, and he developed a sense of compassion for himself.  This was the beginning of a healing process for Mike.

From there, we went on to work through the trauma in therapy so that he could let go of the shame and harsh self judgment.

Getting Help in Therapy
Developing a sense of compassion for yourself can be challenging, especially if you developed a harsh, judgmental attitude towards yourself and you feel ashamed.

Having Compassion for the Child That You Were

Rather than suffering alone, you can get help in therapy with a licensed therapist who has experience in helping clients to overcome this problem.

Developing a sense of compassion for yourself can help you to lead a happier, more fulfilling life.

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 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:
Healing Shame in Therapy

Monday, June 9, 2014

Are You Acknowledging or Avoiding Your Trauma?

As I mentioned in an earlier article, The Trauma of Everyday Life: The Buddha's Loss of His Mother,     I recently finished reading Mark Epstein's book,  The Trauma of Everyday Life.  One of the themes in his book is that trauma and suffering are a part of everyone's life and there's no way to avoid it.  Dr. Epstein discusses how Buddha came to accept trauma as something that happened to everyone and, rather than try to avoid dealing with it, it's better to deal with the emotions through mindfulness.

Buddha's First Noble Truth:  Life is Suffering

Buddha's First Noble Truth:  Life is Suffering
According to Dr. Epstein, Buddhist philosophy centers around Buddha's Four Noble Truths.  The First Noble Truth is that life is suffering.  According to the First Noble Truth, we can't live life without enduring some type of suffering, whether it's physical, emotional, psychological and, ultimately, death.

It's understandable that no one wants to suffer, and most people are inclined to try to avoid dealing with their unpleasant feelings.  But when we try to completely avoid dealing with suffering, the effect is usually that we prolong it.

We can find all different ways to try to distract ourselves from our suffering, and we have many more ways now than ever before:  the Internet, TV, smart phones, computer games, etc.  But no matter how much we try to avoid emotions related to suffering, the feelings are still there.

Working Through Trauma in Therapy
Many people are afraid to go to therapy because they fear that they won't be able to tolerate dealing with their emotional trauma.

Rather than dealing with trauma in therapy, they keep pushing down their uncomfortable feelings so they don't have to deal with them.  Often, by pushing down these feelings, the feelings actually intensify and get worse.

Aside from distracting themselves, some people try to alter their mood by drinking excessively, using drugs, gambling or engaging in other mood-altering activities.  This only creates more problems for them.

Creating a Safe Place in Therapy to Deal With Trauma
When a psychotherapy client has a good rapport with the therapist and the therapist creates an emotionally safe place, the client is often surprised that the working through of trauma can be less painful than they expected (see my article:  The Creation of the "Holding Environment" in Psychotherapy).

Why is this often the case?

Well, people who have been emotionally traumatized expect that they will feel as badly in the working through process as they did when they experienced the original trauma.  But, often, during the original trauma the client had to deal with the trauma by him or herself.  Even if there were other people around who wanted to help, they might not have known how to help.

Creating a Safe Place in Therapy to Deal With Trauma

Also, if you're working with a therapist who has an expertise in trauma, the therapist usually knows how to titrate the working through process so that it can be worked through in a way that is more manageable for the client.

This doesn't mean that the client won't feel upset.  It means that, with help from an experienced trauma therapist, the client can work through the trauma so that they usually don't experience the same anguish they did during the original trauma.

An experienced trauma therapist can also help the client to separate emotions from the original trauma versus emotions that he or she feels now (see my article: Working Through Emotional Trauma: Learning to Separate "Then" From "Now").  This is very important because many people assume that they'll be retraumatized in therapy.

Getting Help in Therapy
The first step in working through trauma is getting help from a licensed mental health professional who is a trauma expert.

Getting Help in Therapy

My experience as a psychotherapist, who has an expertise in working with trauma, is that regular talk therapy doesn't always help people to heal from trauma and a mind-body oriented approach to trauma, like EMDR, Somatic Experience or clinical hypnosis is often more effective.

Emotional trauma can lie dormant for a while before it is triggered by an event in the present.  Then, it's often hard to distinguish between the old trauma and the current event.

If you've been avoiding dealing with your emotional trauma, you probably realize that it's not going away by itself.   So, you owe it to yourself to get help so you can work through the trauma and lead a more fulfilling life.

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 emotional trauma.

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

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

Monday, June 2, 2014

The Trauma of Everyday Life: The Buddha's Early Loss of His Mother

I just finished reading Dr. Mark Epstein's book, The Trauma of Everyday Life.

Mark Epstein is a psychoanalytically trained psychiatrist in private practice in NYC.  He is also a practicing Buddhist.

Statue of Buddha Under the Bodhi Tree

The theme of The Trauma of Everyday Life is that, "dukkha" or suffering, isn't just something that happens to an unlucky few.  It's a basic part of life.  It affects all of us at some point in our lives, whether it's the death of a loved one, experiencing a shocking event, our own serious health issues or the natural decline of old age and anticipation of death.  No one is exempt from experiencing trauma.

One of the themes of the book is Buddha's early loss of his mother.

Before we discuss this early loss further, it's important to understand how memory works and the difference between implicit and explicit memory.

Implicit vs Explicit Memory and Trauma
Many people mistakenly assume that children have no memories of their experiences before the age of two.  If this were true, then babies wouldn't have any memories of traumatic losses that occurred to them.  They would also have no good memories of being held, cared for and loved.  However, we now know that infants are capable of storing memories from birth, including happy as well as traumatic memories.

To understand how this is possible, we need to know the difference between implicit memory and explicit memory.

Implicit memory is what we use when we walk, dance, throw a ball or engage in similar activities.  So, for instance, when we walk, we don't have to be conscious of taking a step one foot and then the left foot or how to balance ourselves.  We just do it.  Implicit memory is unconscious.

Implicit memory is what we all have before we have verbally based memories, which are explicit memories.  Until about 18 months, implicit memory is the only memory that we have.

"Relational knowing," which includes expressing affection and the ability to form friendships and relationships, is based on implicit memory.

On the other hand, explicit memory is what we normally think of when we talk about memory.  Explicit memory allows for conscious recollection.

Explicit memory is also called "narrative" or "declarative" memory.  It involves conscious thoughts and language that enables us to symbolize and make sense of what's happening to ourselves and the world around us.

We now know that traumatic experiences, including early loss for infants, are held in implicit memory.  These memories exist in the body at an unconscious level.

Early traumatic memories, although not explicitly remembered, are dissociated and remain unprocessed until they are either emotionally triggered or worked on in therapy.

The Buddha's Early Loss of His Mother
According to Mark Epstein, the Buddha lost his mother when he was only seven days old.

Statue of Queen Maya of Sakya, Buddha's Mother, at the Temple of Swayabhuncth

As a psychotherapist, who has a psychoanalytic background, I'm very aware of how this type of traumatic early loss can affect a person as a child and later on as an adult.

The early days of bonding between a mother and an infant are very important for the infant's development as well as the quality of interpersonal relationships that he and she can have later on (see my article:  How the Early Attachment Bond Affects Adult Relationships).

Based on stories of his life, after his mother's death, the Buddha was well cared for by his aunt and his father, and every effort was made during his early days to keep him from explicitly knowing about the traumas of everyday life, including sickness and death.

But, according to Mark Epstein, even though Buddha was surrounded by joy and wealth, as well as a caring family, as a young man, Buddha felt that "something was missing."

We don't know if Buddha's feelings of estrangement or alienation stemmed from his confrontation as a young man with the realities of sickness and death or if it stemmed from the early loss of his mother, which would have been an unconscious feeling for him.

But we do know that the Buddha was able to create for himself an inner emotional attunement to process his feelings.  He did this, according to Mark Epstein, through the practice of mindfulness.  Rather than trying to escape his suffering, he acknowledged it, accepted that trauma is a part of everyday life, and he taught himself to balance and contain his suffering through mindfulness.

Working Through Early Trauma in Mind-Body Oriented Psychotherapy
As a psychotherapist, who specializes in working with trauma, I've worked with many clients who lost their mothers at an early age.  Even though they had no explicit memories of their mothers, they all had an inexplicable sense of loss that was hard for them to define.

Many people who have lost their mothers at an early age feel ashamed of their traumatic feelings.  Since they have no explicit memories of their mothers or of the loss, their implicit feelings feel amorphous and illogical.  And for those who were told by people, who don't know about implicit memories, that they couldn't possibly feel this loss, their shame feels even worse.

For many therapy clients, who have tried to work through early trauma in regular talk therapy, their experience is often that they have an intellectual understanding of their experience, especially once they learn about implicit memory and how they're carrying around the trauma on an unconscious level.

But having an intellectual understanding isn't the same as healing.

Mind-Body oriented psychotherapy, like clinical hypnosis, EMDR and Somatic Experiencing can help clients to access the unconscious experiences so that they can be worked through on an emotional level, and not just on an intellectual level (see my article:  Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious).

Getting Help
Unresolved trauma often takes a toll on the person with the trauma as well as his or her loved ones.  If you are suffering with unresolved trauma, you owe it to yourself and your loved ones to get help.

When choosing a therapist, make sure that he or she is a licensed mental health practitioner in the state where you live.  I've included links below for directories of therapists who use either EMDR, Somatic Experiencing or clinical hypnosis.

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 website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

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