Overcoming Guilt and Shame About Feeling Depressed: Part 3

This article is Part 3 of a series about overcoming guilt and shame about feeling depressed.  Part 1 and Part 2 of this series introduced the topic by discussing the symptoms and common misconceptions about major depression and how these misconceptions can create or exacerbate shame and guilt.

Overcoming Depression:  Overcoming Guilt and Shame About Feeling Depressed

Fear of Showing a Vulnerable Emotional Side Can Lead to Guilt and Shame in People Who Are Depressed

Many people who feel guilt and shame about being depressed feel that they're the only ones who feel this way.

Often this occurs because they feel too vulnerable emotionally to talk about their depression and they isolate themselves from others who could be helpful to them.  

Many people who are depressed are also painfully aware that, despite all we know these days about depression and brain chemistry, a stigma about depression and mental health problems in general still exists among certain people who aren't informed about depression.

Men who are depressed were often raised to feel that "big boys don't cry" and they need to be "strong" when they're men.  The implication is that to be considered "strong," they can't show their more emotional or vulnerable side, and they especially can't show that they're feeling depressed.

Women who are depressed, especially women who are in male-dominated professions (like law enforcement, medicine, engineering and so on) often get the message that if they want to excel in their profession, they have to "act like men," which means that, like men, they also shouldn't show their more vulnerable side and they shouldn't reveal that they're depressed.

Feeling Depressed and Alone: Social Isolation

People who feel depressed often isolate themselves from others, especially when they're at the point when they can't pretend any more to be happy around others because it's just too emotionally and physically exhausting.

Social isolation often makes people who are feeling depressed feel worse because they're not getting the  emotional support they could be getting from loved ones who could be helpful.

Social isolation can also make them feel that they're the only ones who have ever felt depressed which, of course, isn't true.

Getting Help in Therapy

Educating yourself about depression and becoming aware of the symptoms are the first steps in getting help.

If you've tried on your own to overcome depression and you haven't succeeded, continuing to feel ashamed and guilty will only make your situation worse.

It's important to seek out the help of a licensed mental health professional who can help you to overcome depression as soon as possible. 

A licensed mental health professional can help you to overcome depression so that you can lead a more fulfilling life.  

About Me

I am a licensed New York City 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.

Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 2

In my prior article,  Overcoming Guilt and Shame About Feeling Depressed - Part 1, I began this discussion by discussing the most common depression that people experience.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

In this article, I'm focusing on how guilt and shame about feeling depressed is often based on misconceptions about depression and how these misconceptions can get in the way of your recovering from depression.  Some of these misconceptions are popular in our Western culture.

Let's start by looking at some of the misconceptions about depression.

Misconceptions About Depression:

• If people really want to overcome depression, all they need to do is "snap out of it" to feel better.
• If people are depressed, they don't want to feel better.
• If people who are depressed just "stayed busy," they'd stop feeling depressed.
• People who are depressed aren't trying hard enough to get better.
• People who are depressed have "no reason" to be depressed.
• Other people, who have it worse, aren't depressed.
• People who are depressed have only themselves to blame for their depression.
• People who are depressed are "lazy."
• People who are depressed are "failures."
• People who say they're depressed are just trying to get attention.
• People who are depressed are self centered.
• There's no such thing as depression.  There are only people who say they're depressed and who are faking it.
• You're life is good--what do you have to be depressed about?

I'm sure you could come up with many other misconceptions about depression and people who are depressed.

The point is that these misconceptions, whether they're coming from the person who is depressed or people around him or her, serve to exacerbate the depression and often cause the person who is depressed to feel guilty and shamed.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

If you're feeling depressed, blaming yourself will only make you feel worse.

Becoming aware that these ideas are misconceptions is the first step in overcoming guilt and shame about feeling depressed.

If your loved ones are the ones who are talking to you about your depression by trying to convince you about one or more of these common misconceptions, you need to take care of yourself and stop giving credence to these ideas.

Overcoming Guilt and Shame About Feeling Depressed

If you're the one who is engaging in negative self talk about your depression, be aware that you're doing the equivalent of kicking yourself while you're down.

You need to recognize these thoughts for the distorted thoughts that they are and get professional help from a licensed mental health professional.

In my next article, Part 3, I'll continue this discussion.

Getting Help in Therapy
In the meantime, if you or someone you love is suffering with depression, it's important to take it seriously and seek help from a licensed mental health professional as soon as possible.

Getting Help in Therapy

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:  Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 3

Overcoming Guilt and Shame About Feeling Depressed - Part 1

It's not unusual for people who are feeling depressed to feel guilty and ashamed about their depression, as if they're to blame for their depression and they remain depressed because they want to feel this way.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

For many people, who are depressed, this is one of the most frustrating aspects of depression.

Unfortunately, these feelings are often unwittingly reinforced by well-meaning friends and family members who make tactless comments to the person who is depressed, like "Why don't you just snap out of it?" or "Why are you depressed--do you want to feel this way?" or "You don't have any reason to feel depressed" and other similar comments.

We also live in a society that is sustained by the myth that everyone, no matter what's going on with him or her, "should pull themselves up by their bootstraps" and overcome their problems on their own, and if they can't, they're "weak" (see my article:  Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").

What is Depression?
At some point, anyone can feel "blue," but that's different from being depressed, so before we go any further, let's define depression.

The most common form of depression is major depression, which affects a significant percentage of the population at any given time.

The symptoms of major depressive disorder, as outlined in the Diagnostic and Statistical Manual (DSM), can include five or more of the following symptoms for at least two weeks or more where at least one symptom is depressed mood or loss of interest and pleasure:

• depressed mood most of the day and nearly everyday
• a significant decrease in interests or activities that were once pleasurable
• a significant decrease in appetite and weight loss 
• insomnia or oversleeping almost every day
• agitation
• fatigue or loss of energy nearly every day
• feeling worthless or excessively guilty
• feeling helpless or hopeless
• problems with concentration or indecisiveness
• recurrent thoughts of death, suicidal ideation or suicide attempt or specific plan

To be considered major depression, the source of these symptoms cannot be otherwise accounted for by a general medical condition.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

In my next article, I'll continue discussing this topic.

Getting Help in Therapy
If you think you're depressed, especially if you're having thoughts about suicide, you're not alone and you should get help from a licensed mental health professional as soon as possible.

Many people who have suffered with depression have been able to recover from their depression in therapy with a licensed psychotherapist who has expertise in this area.

If you're unsure about how to go about finding a psychotherapist, see my article:  How to Choose a Psychotherapist.

Depression:  Getting Help in Therapy

If you're close to someone who is feeling depressed, you can help your loved one, who might feel too hopeless and helpless to seek help, by helping him or her to find a qualified therapist in your area (see my article: Are You Concerned About Your Husband's Depression?)

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 regular business hours or email me.

Also, see:  Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 2.

Psychotherapy Blog: The Counterphobic Defense

In my prior articles, What is the Counterphobic Defense? and The Counterphobic Defense and Hypersexuality, I discussed a particular type of counterphobic response, hypersexuality, which I defined and gave a fictionalized scenario to describe how childhood sexual abuse could lead to hypersexuality.  As I mentioned in my prior article, this fictionalized account is not about any one client--it is a composite of many different cases with all identifying information changed.

Fictionalized Scenario About Hypersexuality as a Counterphobic Response:

When we last left off in the prior article, Marie, who had been sexually abused as a child by her stepfather and who, subsequently, acted out sexually in a hypersexual manner, met a man, Tom, whom she really liked.

The Counterphobic Response:  Getting Psychological Help

But, unlike her other encounters with men, which were sexual but non-intimate and where she felt "in charge" and empowered due to her counterphobic response, Marie felt emotionally vulnerable and ambivalent about this relationship.

Her fear of being emotionally vulnerable troubled her so much that, at times, she was tempted to break off her relationship with Tom.  At the same time, she knew that this was the only healthy relationship that she had ever had and she knew she needed psychological help to overcome her fears.

Marie went to several different psychotherapists.  Each time they would get close to the core of her problems, including the early childhood loss of her father, the guilt she felt for her father leaving, the emotional abandonment by her mother, and her feelings of helplessness when her stepfather sexually abused her as a child, Marie would find a way to sabotage the treatment.

Either she would stop going to her therapy sessions or she would find faults with whichever therapist that she was seeing and then she would leave.

In her treatment with a male therapist, she attempted to seduce him, and when he set limits with her, she left treatment (see my article:  Boundary Violations and Sexual Exploitation in Therapy).

All the while, her boyfriend, Tom, tried to be patient with her ambivalence and moodiness towards him.  He knew that they loved each other, but he couldn't understand why Marie would be kind and loving to him one day and then annoyed and dismissive with him on another day.  And whenever he asked her what was wrong, she had no answer for him.  She only knew that she was terrified of being in this relationship, but she was too afraid to tell him this, so she gave him no answer.

Finally, he gave her an ultimatum:  Either she get psychological help for whatever was affecting her or it was over between them.

Faced with the possibility of the end of their relationship, Marie would have thought she would be relieved.  It would have put an end to her fears.  But, instead, she realized that she was more afraid of losing him and the relationship that they had than she was of being in the relationship, so she knew she had to get psychological help and stick with it.

When Marie came to see me for her first therapy session, it was obvious that she was very frightened.  She seemed like she was going to bolt out the door.

During the consultation, I explained how I worked and told her that I usually start with psychological resourcing (e.g., developing coping skills and mechanisms) before I deal directly with the trauma, and we would go at whatever pace she felt comfortable with because I could titrate the work so she would not become overwhelmed.  Marie seemed relieved about this.

I also explained that, given her significant childhood trauma, this would not be short-term therapy, so she would need to know that it required a commitment to do the work involved with trauma therapy.

Once she was in therapy and Tom realized that she was committed to getting psychological help this time, he agreed to remain in the relationship as long as she remained in treatment.

Marie and I worked on resourcing to help her develop coping mechanisms that she never developed before.  There were many times that Marie wanted to leave therapy, but she remained.

After a few months of her developing internal resources to do the trauma work, she and I agreed that she was ready to deal her counterphobic response and the underlying trauma.

We used EMDR (Eye Movement Desensitization and Reprocessing) therapy to deal with her early childhood losses and sexual abuse as well as her feelings of sadness, anger and helplessness.

Despite her trauma, Marie had a lot of strengths  She also came to her weekly sessions regularly.  The coping tools that she developed during the initial stage of therapy helped her to deal with her fear and ambivalence about her relationship with Tom.

The Counterphobic Response:  Getting Psychological Help

As she continued to work through the trauma and used her coping skills to deal with her fears, she was able to allow Tom to get closer to her.  She was no longer tempted to act out sexually with other men when she felt afraid.  Instead, she was able to communicate her fears to Tom, and they were able to talk it out.

Marie became increasingly aware that there was no "quick fix" for her problems, but she remained motivated in treatment, even though it was difficult at times.

When Marie divulged her history to Tom, including her hypersexuality, he was understanding and willing to be supportive in any way that she needed.

As she became psychologically healthier, Marie began to understand what it felt like to feel genuinely empowered as opposed to the pseudo empowerment she felt, which was related to her former counterphobic response.

The Counterphobic Response:  Getting Psychological Help

By the time Marie completed her treatment, she was more emotionally open and vulnerable with Tom than she had ever been with anyone.  They made plans to move in together and talked about getting married.

Getting Help in Therapy
Overcoming the counterphobic response, whether it involves hypersexuality or other counterphobic responses, is challenging but it is possible.

If you think you're affected by a counterphobic defense in your life, you could benefit from getting help from a licensed mental health professional.

Getting psychological help could make the difference between you living a life where you are constantly trying to quell your fears through compulsive or dangerous behavior and living a fulfilling and meaningful life with a genuine sense of empowerment.

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.

The Counterphobic Defense and Hypersexuality

In my prior article, What is the Counterphobic Response?,  I began discussing the counterphobic defense mechanism by defining it and giving some general examples of it.  In this article, I'm focusing specifically on the link between the counterphobic response and hypersexuality.

The Counterphobic Response and Hypersexuality

As I mentioned in my prior article, there are many different ways that the counterphobic defense mechanism manifests.

It's easier to understand the counterphobic response and denial involved in situations where people, who are fearful, deny their fears by becoming daredevils about the very situations that they fear.

The counterphobic response is more difficult to see in situations where a man or a woman is hypersexual.

What is Hypersexuality?  
Hypersexuality, also known as sexual addiction, is defined as a dysfunctional preoccupation with sexual fantasy or in combination with obsessive pursuits of casual/non-intimate sex.  It can involve pornography, compulsive masturbation, romantic intensity or objectification of a sexual partner.  Usually, it occurs for at least six months or more.

Hypersexuality affects both men and women.

Like most addictive behavior, this adult obsessive pattern of thoughts and behaviors will continue despite the person affected by hypersexuality:

• making attempts to stop this problematic sexual behavior
• making promises to him/herself and significant others to change sexual behavior
• experiencing significant negative life consequences

Let's take a look at common situation in a fictionalized scenario where early childhood trauma leads to hypersexuality as an adult:

Marie
When Marie was five, her parents split up and Marie and her older siblings didn't see their father again for many years.  Neither their father nor their mother talked to them about the separation.  They learned about it when they came home from school one day and their father, who was normally there, was gone.

Marie felt responsible for her father leaving the family

When Marie asked her mother where her father was, her mother, Ann, slapped her and told her not to be disrespectful by asking her this question.  Then, her mother told her to go to her room and do her homework.

As most children at her age would react, Marie assumed that she did something "bad" and her father went away.  She believed that she was the cause of the problems in her family and she prayed every night that she would become a better person so that her father would return.

Neither her mother nor the other adult relatives would talk to her or her siblings about why her father "disappeared."  It became the "family secret."

Marie felt so ashamed of what she thought her role was in this that she felt too guilty to talk to anyone else about it, so she kept her fear and sadness to herself.

A year later, Marie's mother, Ann, began seeing a man she met at a party, John.  A few weeks later, John moved into the household and Marie and her older siblings were told that he was their "new father."

John tended to be irritable and bossy.  He expected the children to adhere to his demands without any back talk.  When Marie's teenage brother protested that he didn't want to do a chore that John demanded that he do, John knocked him to the ground and told him to never disobey him again.  When Ann came home and Marie brother told her what happened, Ann sided with John.

After that, Marie and her siblings were more afraid of John than ever.  They tiptoed around him and hoped not to experience his rage.

Marie became to anxious that she began wetting her bed at night, which angered John and brought on the first of many spankings from him.

When Marie turned six, John came into her bedroom late after Ann and the other family members were asleep and he began fondling her breasts.  Marie was shaking with fright, but she pretended to be asleep because she didn't know what to do.

John knew that she wasn't asleep and began taunting her, telling her that she was a "bad girl" and she "liked it."

When he told her to open her eyes, she was too afraid not to do as he said, so she did and, as she did, she saw his leering smile and penetrating gaze.

She began to feel very confused about what was happening.  On the one hand, she felt terrified and helpless.   She knew that what he was doing was "bad."  But, on the other hand, no one else in the household paid any attention to her, and she liked the attention.

John told Marie that if she told anyone about it, no one would believe her.  And, if they did, he would her mother and siblings and he would beat her.

Having already felt responsible for her father leaving the household, Marie didn't want to cause any more problems, so she kept quiet about it.  Whenever she heard his footsteps as he approached her room, she close her eyes and pray.  Then, when he began touching her, she went into a traumatic dissociated state to the point she felt she could look down on herself from the ceiling and see what was going on.

Afterwards, she always felt "dirty" and would go into the bathroom and scrub her body hard with a towel until it was red.

These nightly visits continued for several months until Marie couldn't stand it anymore.  So one day, when she was alone with her mother and no one else was around, she told her mother about John touching her.  She just wanted to make it stop.

Ann reacted by getting angry with Marie and telling her that it must be Marie's fault if John is behaving this way.  She told Marie to lock her door at night and to stay away from John.  She refused to confront John and told Marie that she was being selfish.  After all, wasn't John helping to support the family?

Marie felt devastated that her mother wouldn't help her.   But she also believed that, if her mother said it was her fault, it must be true.  Even worse, she felt frightened, powerless and lonely.

When John realized that Marie locked her door, he got angry and jimmied the lock to get in.  Feeling helpless and frightened, Marie submitted to John and escaped into a dissociated state whenever he touched her.

The sexual abuse continued into Marie's adolescence.  By that time, Marie felt angry about feeling helpless and developed a counterphobic response to John's sexual advances.  She was tired of feeling like he was the predator and she was the victim.

So by the time she was 17, without realizing it, on an unconscious level, she decided that she would be in charge in the situation--no longer behaving like a powerless victim.

One night when John came into her room, Marie told him that she wanted to have sex with him.  Shocked at first, John had sexual intercourse with Marie.  Marie was sure that her mother, who was next door, heard them having sex, but she chose to ignore it.

After that, John seemed to lose interest.  He preferred when Marie was childlike and frightened.  He seemed confused and a little frightened by Marie's boldness, so he stopped coming to her room.

But because Marie was experiencing the counterphobic defense mechanism, she didn't want John to feel he was in charge any more about if they would be sexual, so she would be seductive around him when no one else was around, taunting him for being "less than a man" for ignoring her.

Each time after she seduced him and they had sex, he always blamed her for being "a tramp," but she didn't care--she felt she was the powerful one in the situation.

When Marie was 18, she became pregnant.  By that time, she was having sex with John as well as several other older men that she met in the neighborhood, so she didn't know the identity of the father of the baby.

She had an abortion without telling anyone and, by the time she was 22, she was had two other abortions.  Her hypersexuality included seducing many men that she didn't know.  Each time that she seduced a different man, she felt empowered.

When she was 25, she met a man her own age, Tom, that she liked.  She realized that her feelings for him were different and she felt frightened and emotionally vulnerable, which she didn't like.  When she tried to seduce him, she was surprised that he told her that he really liked her and he thought they should wait rather than crossing that boundary too soon.

Even though she liked him a lot, Marie felt confused by how he treated her and how she felt.  To alleviate her fears, she continued to sneak around with other men without Tom knowing.  These other experiences continued to make her feel empowered, but she also felt guilty about seeing these men behind Tom's back.

The Counterphobic Response and Hypersexuality

When Marie and Tom became sexual, Marie felt very uncomfortable and she couldn't understand why. She prided herself in being sexy and attractive, and she knew that Tom really liked her.  But, unlike how she felt with other men, she felt increasingly frightened by the feelings that she was developing for Tom.

Marie was tempted to break it off, but she knew she would also miss Tom and he was different from other men that she was with.  At the same time, her emotional vulnerability in this relationship made her feel like a helpless child.

Marie knew that she couldn't deal with her ambivalence on her own, so she sought psychological help.

Getting Help
The counterphobic response, as an unconscious defense mechanism, can manifest in many different situations where a person is in denial about their fear and trauma and wants to feel empowered.

This sense of "power" isn't really empowerment.  It's a way to deny the underlying fear by moving towards a feared situation or person as a defense against the fear.

If you feel that you're caught up in a counterphobic response and you want to get help, you could benefit from seeing a licensed mental health professional who can provide you with the psychological help that you need to overcome this problem.

Confronting underlying fears isn't easy but, in the long run, once you've overcome the counterphobic response, you have an opportunity to live a more meaningful and authentic life.

About Me
I am a licensed New York City 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.

What is the Counterphobic Defense?

The counterphobic defense is an unconscious defense mechanism that some people use to fend off anxiety.  It's the opposite of the avoidant defense mechanism (see my article:  Changing Coping Strategies That No Longer Work For You: Avoidance about the avoidant defense mechanism).

What is the Counterphobic Defense?

When people use a counterphobic defense, instead of moving away from something that they fear, they move towards it.  They seek out what they fear.

The following list gives some examples of the counterphobic defense:

• a woman, who was traumatized as a child due to domestic violence between her parents, has an unconscious pattern of seeking out romantic relationships as an adult where she will be abused
• a person who dreads heights seeks out dangerous situations that involve heights as a way to deny that he has this fear
• a veteran, who was traumatized in combat, seeks out dangerous missions as a soldier during war and dangerous situations as a civilian to deny his fears
• a person, who has fears of being sexually intimate, engages in hypersexual activity to deny his or her fear of closeness and sexuality
• a person who compulsively engages in daredevil activities, as a form of denial about these activities, with the hope of feeling a sense of power and control 
• a teenage boy, who has anxiety about his social environment, engages in acting out behavior at school as a form of denial about his fear

What is the Counterphobic Defense?

There are many other examples of the counterphobic defense, but the list above gives you a sense of how people who use the counterphobic defense actively and often compulsively seek out the very types of people and situations that they fear the most.

This is not to say that everyone who does mountain climbing, rides a motorcycle or engages skydiving or other similar activities is using a counterphobic defense.

The key to understanding this defense mechanism is to understand that there is an underlying fear that the person is defending against.

The counterphobic defense mechanism, which might seem counterintuitive at first, isn't as common as the avoidant defense mechanism.  And, yet, many of us know of people who actively seek out dangerous or anxiety-provoking situations or relationships as a way to deny that they have these fears.

What is the Counterphobic Defense?

As I mentioned earlier, as a defense mechanism, it's usually, for the most part, unconscious, so the person who uses this defense mechanism often doesn't realize that they are in denial about what they're doing and why.

In the next article, I'll give more detailed examples of the counterphobic defense and how facing up to the underlying psychological causes can help people, who use this defense, to overcome their fears.

Getting Help in Therapy
If you are behaving in ways that are self destructive, you could be unconsciously using a counterphobic defense as a way to deny underlying traumatic issues that are at the root of your problems.

Rather than continuing to place yourself in dangerous situations, you could benefit from seeking help from a licensed mental health professional.

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.

See my article:  The Counterphobic Response and Hypersexuality.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

This is the third article in a series of articles that looks at the effect of growing up with a parent who had borderline personality disorder.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

In my first article I gave an overview of borderline personality disorder, and in my second article I provided a fictionalized scenario of a young woman, Karen, from the time she was an infant until college, who grew up with mother who suffered with borderline personality.

In this article, I'll discuss how this fictionalized character, Karen, was affected by her mother's problems and how she was able to get psychological help in therapy to overcome these problems.

Karen
As I mentioned in the prior article, Karen grew up in a chaotic home environment with a mother who exhibited many of the symptoms of borderline personality disorder.

Karen often felt anxious because of her mother's anger, depression and unpredictable moods.  She wished that she could help her mother, especially after many of her mother's frequent breakups with men and a suicide attempt.  But Karen was too young, and she often felt helpless.

Fortunately, she had a schoolteacher who took Karen under her wing.  This teacher liked Karen, and she motivated and inspired her to look forward to a future that included college.  This was a new perspective for Karen.

Karen had a lot of inherent strengths and, with the help of this teacher, who helped to mitigate the chaos that was going on in Karen's home, Karen worked hard in school and she eventually got a scholarship to attend an out of state college.

Karen was happy to be away from home.

Initially, Karen's time at college went well.  But in her third year, after a relationship with a young man that she had been dating got serious, she became anxious and ambivalent about the relationship.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

Karen knew that her relationship with Dan was a loving relationship.  Even though they were both young, deep down she knew that they could be happy together--if only she didn't feel like running away when she felt emotionally vulnerable and scared.

She knew she needed to get psychological help before she ruined things between her and Dan so, although she felt hesitant, she went to the student counseling center.

After hearing about Karen's family background, the school counselor, who was an empathetic therapist,  knew that Karen needed more than the short term therapy that the counseling center provided.  So, she provided Karen with psychoeducation about trauma and why it was important to get psychological help (see my article:  Untreated Emotional Trauma is a Serious Issue).  Then, she referred her to a trauma therapist who had an office nearby.

Karen's only experience with therapy was in family therapy when she was a child, after her mother made a suicide attempt.  She remembered liking the family therapist, so she had a favorable memory of family therapy.  But she had never been in individual therapy.

Karen explained to her therapist that she couldn't understand why she was feeling so afraid of being in a relationship with Dan.  After all, Dan treated her well and she knew they loved each other.  She explained that whenever she felt so frightened that she wanted to run away from him, she felt like she was going crazy.

Her individual therapist helped Karen to understand that her current reaction to Dan was being triggered by her early childhood experiences.  She told Karen that she would help her to separate "now" from "then"(see my article:  Working Through Emotional Trauma: Learn to Separate "Then" From "Now" in Therapy).

Her therapist began by helping Karen to develop internal resources to deal with her fears and to cope with working through her early trauma.  These resources included mindfulness meditation, breathing exercises and safe place meditation.

Once Karen developed and used these resources to cope with her fears, her therapist spoke to her about EMDR (Eye Movement Desensitization and Reprocessing) therapy, which is a trauma therapy that has helped many clients who are suffering with trauma.

Karen processed her traumatic memories and fears in EMDR therapy over time.  Gradually, using the EMDR float back technique, they were able to get back to Karen's earliest traumatic memories.

At the end of each EMDR therapy session, her therapist used the last part of the session to help Karen to debrief and to do a meditation to help her to feel calm and safe.

During this time, Karen continued to see Dan and she was feeling much less anxious about the relationship.  Knowing that Karen was getting help, Dan was also patient and understanding.

EMDR isn't a "magic bullet," especially when a person has had the kind of underlying trauma that Karen experienced.  But, over time, Karen was able to work through her trauma and her fears.  She was also able to have a stable and happy relationship with Dan.

Getting Help in Therapy
Growing up with a parent who had borderline personality disorder can be traumatizing and have a negative effect on your adult relationships, especially romantic relationships where core issues tend to surface.

EMDR is one form of therapy that is used by EMDR therapists to help clients to overcome trauma.  Other forms of trauma therapy include Somatic Experiencing and clinical hypnosis, also known as hypnotherapy.

Getting Help in Therapy

If you have underlying trauma that is getting in the way of your having a more fulfilling life, you could benefit from getting help from a licensed mental health professional who is an experienced trauma therapist.

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

Psychotherapy Blog: The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder - Part 2

In my Part 1 of this topic, I began a discussion about the effect of growing up with a parent who had borderline personality disorder.  In this article, I'm continuing the discussion with a fictionalized scenario as an example of this dynamic.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

Borderline personality disorder, which I defined in the prior article, is a disorder that is a catchall for many similar traits, including chaotic relationships, unpredictable emotional reactions, a fear of abandonment, and a strong ambivalence about close relationships, including a longing for closeness at the same time as the person with this disorder experiences a fear of being rejected, hurt or abandoned.

As I mentioned in the prior article, there are some people who don't necessarily meet the full criteria for borderline personality disorder diagnosis, but they have certain borderline traits.

As I also mentioned in Part 1 of this topic, even though a primary caregiver (usually the mother) might have borderline personality disorder and this usually has a detrimental effect on a child, if a child is lucky, there can be mitigating factors, like other close relationships (another loving parent, a loving sibling, a nurturing grandparent, caring teacher or mentor, concerned coach or so on) that can help to temper the detrimental effect.

We also know now that, due to the neuroplasticity of the brain (the ability of the brain to change), even when there's no one in the child's life to help mitigate the effect or the child doesn't have a particularly resilient nature, as an an adult, s/he is often helped later on in life by having a loving, secure relationship or by getting help in therapy.

The following fictionalized scenario, which is composed of many different cases with all identifying information changed, illustrates how someone who had a parent with borderline personality disorder can be affected as a child and later on as an adult.

Keep in mind that this scenario is only one possible result of this dynamic and there can be many other results.

Karen
Karen's mother, Alice, gave birth to Karen when Alice was only 16.

Alice lived with her single mother, Betty, and Alice's six siblings.  When Betty found out that Alice was pregnant, she became enraged.  She hit her, cursed at her and called her "a whore."

Alice dropped out of high school after her pregnancy became more obvious, and she hoped, eventually, to get her GED.

Alice was confused and had mixed feelings about her pregnancy.  She had some resentful towards her unborn child because she knew her life would be changed forever.  Instead of going to parties with her friends, she knew she would be home taking care of the baby.

At the same time, she didn't want to have an abortion because it was against her and her family's religious beliefs.  So, she grudgingly accepted that she made a mistake and baby was her responsibility.

The baby's father, who was also only 16, was sent away by his parents to live out of state, so Alice was completely dependent upon her mother during her pregnancy and after Karen was born.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

In the meantime, she and her mother were both reliant on public assistance to get by, and life was tough.

When her friends went out, Alice felt left out and lonely because she had to stay home and take care of Karen.  On the one hand, Alice loved Karen.  But, on the other hand, she also resented her because she wanted to be a normal 17 year old by going out and having fun.

Alice also had a lot of resentment towards her mother, Betty, for her verbal abuse and they would often argue.

Even though Alice told herself that she would never treat her daughter, Karen, the way that her mother treated her, she had no awareness of how she (like most children) internalized this dynamic on an unconscious level.  And, as Karen got older, without realizing it, Alice was just as verbally abusive with Karen just as her mother was with her.

Karen grew up to be an anxious child.  As a four year old, she never knew when Alice would fly off the handle and scream at her or slap her.  There were times when Alice would be sweet to Karen and then, for a minor issue (like Karen dropping an ice cream cone) Alice would explode and startle Karen.

Alice had several boyfriends during Karen's childhood.  She had very chaotic on-again/off-again relationships with men.  Karen would start to get close to whomever Alice was seeing at the time, and then he was gone.  This was significant losses for Karen.

Whenever Alice went through a breakup, she became depressed and angry and she would drink a lot.  Without realizing how damaging it was, while, drunk and upset, Alice would tell Karen that men were "no good."

Alice Became Depressed and Angry Whenever She Went Through a Breakup

Karen was very anxious and she wished that she could do something to help her mother.

During one particularly bad breakup, Alice made a suicide attempt by taking a handful of sleeping pills.  Betty called 911 and Alice was rushed to the ER.  Alice was kept in the hospital for observation for 72 hours and, after she assured the psychiatrist that she wasn't going to hurt herself or anyone else, she was released.

While Alice was in the hospital, Betty refused to talk about it with Karen.  She tried to distract her with books and TV, but Karen knew that something was wrong and not knowing made her feel scared.

Alice, Betty and Karen had to attend family counseling after the hospital contacted the bureau of child  welfare.

Things improved for a while during this time.  After they completed family therapy, the counselor recommended that Alice attend individual therapy, but Alice refused and her case was closed.  Then, things went downhill again.

When Karen's elementary school teachers told Alice that Karen was an anxious child, despite their assurances that they were not criticizing her, Alice took their comments personally and felt they were saying that she was a bad mother.  Alice got very angry and moved her to another school.

When Karen was 11, Alice got her GED and got a job where she could support them, so she moved out of Betty's household.  At first, things seemed to be going well.  Alice and the landlady became friends.

But several months later, when the landlady made a comment about Alice not recycling properly, Alice became enraged and moved back in with her Betty until she found another apartment.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

Throughout Karen's childhood, she and her mother moved numerous times because of the arguments that Alice would have with the landlords.  Each time that this happened Alice would uproot Karen from  the neighborhood, her school and the few friends that Karen made.

When Karen went to junior high school, one of her teachers saw something special in Karen and took Karen under her wing.  She spent time with Karen as part of the after school program, helped her with her homework, and took an interest in her.  She encouraged and motivated Karen.  She also gave Karen a sense of hope about the future--something that Karen never had before.

Gradually, Karen came out of her emotional shell and began to enjoy her talks with her teacher.  She never told her mother about this relationship because she was afraid that her mother would get angry and try to come between her and the teacher.

By the time Karen was in high school, she dreamed of going away to college and being on her own.  She worked hard, got good grades and, despite the chaos at home, she was able to go to the college of her choice out of state with a scholarship.

Karen did well in college.  She made friends and dated casually.  She felt happier than she had ever felt.

Growing Up With a Parent With Borderline Personality Disorder

Then, in her last year of college, her relationship with a young man, Dan, at college began getting serious and she felt anxious and scared.

Even though she knew she cared about him and he cared about her, the anxiety and emotional vulnerability that she experienced was so overwhelming that, at times, she wanted to end the relationship just to avoid feeling these emotions.

Karen knew that she needed to get psychological help or she would ruin her relationship with Dan.

In my next article, I'll continue discussing this scenario and how Karen was helped in therapy.

Getting Help in Therapy 
Growing up with a parent who has borderline personality disorder can be traumatic, but working with a licensed mental health professional can help you to free yourself from emotional trauma so you can go on to live a meaningful and fulfilling life.

If you're struggling as an adult with the impact of childhood trauma, you're not alone.  Rather than continuing to struggle alone, take steps to contact a licensed therapist who can help you to overcome unresolved trauma.

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.

See my article:  The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder - Part 3

Psychotherapy Blog: The Effect of Growing Up With a Parent Who Has Borderline Personality Disorder - Part 1

In a prior article,  Coping With a Spouse Who Has Borderline Personality Disorder, I discussed the challenges of living with a spouse who has borderline personality disorder.  It is one of the most popular articles on my blog site.  In this article, I'm focusing on the affect of growing up with a parent who has borderline personality disorder.

The Effect of Growing Up With a Parent Who Has Borderline Personality Disorder

Before we go further, let's define borderline personality disorder.

What is Borderline Personality Disorder?

Borderline personality disorder is characterized by a pervasive pattern of unstable interpersonal relationships, self image and emotions.

It is also characterized by impulsivity beginning by early adulthood with five or more of the following:

• frantic efforts to avoid real or imagined abandonment
• a pattern of unstable and intense relationships, alternating between idealization and devaluation
• an unstable self image or sense of self
• impulsivity, including self harm, overspending, substance abuse, binge eating, etc.
• recurrent suicidal behavior, gestures or threats or self mutilation
• highly reactive and unpredictable mood 

As I mentioned above, for someone to be diagnosed with borderline personality, s/he doesn't have to have all of the above traits--they only need to have five or more.

The Effect of Growing Up With a Parent Who Has Borderline Personality Disorder

Even when someone doesn't meet the full criteria for borderline personality, a person can have significant borderline personality traits.

How Does Borderline Personality Disorder Affect Attachment Between the Primary Caregiver and a Child?

A loving bond between a primary caretaker (let's assume for this article that it's the mother) and an infant is crucial for the healthy physical and emotional development of the infant.

There's no such thing as a "perfect bond" between mothers and infants.

The bond between most infants and their mother tends to be "good enough" so that the infants develop a secure attachment (see my article:  Early Bonding Between Mother and Infant).

Secure Attachment Between Mother and Child

A secure attachment generally develops if the mother is receptive to the infant by engaging in caregiving responses like touching, holding and soothing as well as being emotionally in sync with the infant.

As part of healthy, secure attachment, there is a reciprocal relationship between the infant and the mother as they each respond to each other emotionally and physically.

However, infants who are raised with a mother who has borderline personality disorder tend to develop insecure attachment.

As opposed to secure attachments, mothers with borderline personality disorder tend to develop unresolved, preoccupied and fearful attachments with their children.

With insecure (unresolved, preoccupied and fearful) attachment, the person with borderline personality longs for closeness but is also fearful of dependency and rejection at the same time.  T

his ambivalence is communicated to the infant on an unconscious level and it is detrimental to the infant's healthy physical and emotional development.

The Effect of Growing Up With a Parent Who Has Borderline Personality Disorder

For the mother with borderline personality the vacillation between longing and fearing emotional intimacy is an emotional dilemma (see my article:  An Emotional Dilemma: Wanting and Dreading Love).

The infant who is raised by a mother with borderline personality disorder experiences unpredictable emotions, including unpredictable rage.

A mother with borderline personality disorder might also be emotionally and physically abusive with the infant or neglectful.

Children who grow up under these circumstances often have difficulty developing trusting relationships  as children and as adults due to the unpredictable nature of their early childhood experiences.

The negative affect of growing up with a parent who has borderline personality disorder can be mitigated by the loving presence of another adult, like the other parent, an older sibling, a grandparent and so on (more about this in a future article).

In Part 2 of this article, I will continue discussing the affect of growing up with a parent who has borderline personality disorder.

Getting Help in Therapy
You don't need to be psychotherapist to know that growing up in an emotionally unpredictable and chaotic home has a profound effect on you.

Getting Help in Therapy

Many people, who grew up with one or both parents who had borderline personality disorder, fear that they will develop similar dynamics with their children or in their adult relationships, even though they don't want to do this (see my article:  Discovering That You Developed the Same Traits You Didn't Like in Your Parents).

As I will discuss in a future article, the emotional effects of growing up in chaotic and abusive or neglectful household can be overcome in therapy if you work with a licensed mental health professional who understands these dynamics and knows how to help people to overcome them.

It's often hard for people who grew up in unpredictable households to trust coming to therapy, but for those who get psychological help with an experienced therapist, they can learn to live a more fulfilling and meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist and EMDR 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:  The Effect of Growing Up With a Parent Who Has Borderline Personality - Part 2

Psychotherapy Blog: Are You Using Your Idea of "Positive Thinking" to Deny Your Problems?

As a psychotherapist, I'm all for people having a genuinely positive attitude about themselves and life.  I think that people who have a genuinely positive attitude, especially people who can reframe unfortunate things that happen to them as being meaningful, tend to be more resilient.

A Genuinely Positive Attitude About Life Can Help You to Be Resilient

While positive thinking can be a valuable tool to deal with life's challenges, using positive thinking to deny your problems is just another form of denial and is counterproductive (see my article:  Changing Coping Strategies That No Longer Work For You: Avoidance).

Using "Positive Thinking" as a Form of Denial and Avoidance

Over the years, I've seen many instances where psychotherapy clients use their idea of positive thinking as a form of denial, which keeps them from acknowledging and being proactive about their problems.

Rather than acknowledging and coping with their problems, they use their version of positive thinking to deny that they have problems or that they need to be proactive.

For many of them, it's as if acknowledging that they have problems makes them a "negative person," which, understandably, they don't want to be.

"Putting on a Happy Face" Doesn't Help When You're Life is Falling Apart

But "putting on a happy face" while your personal or work life is falling apart doesn't help.

No one would expect you to tell everyone you know about your problems.  But so many people come into therapy and, instead of being honest with themselves, they want to learn how to be "positive" in order to avoid coping with problems.

This isn't what adherents of positive thinking had in mind.

The following composite scenario is an example of how the idea of positive thinking can be used as a form of denial:

Ted
When Ted came to therapy, he said he wanted to learn to be a more positive person.  He felt that if he could learn to be positive, he wouldn't feel so filled with "negativity."

After hearing about his personal life, I could understand why Ted was feeling so badly:  He was burdened with high debt, and not only did he stop opening his mail, he also avoided taking the collection calls to his home phone.  He was heading down a slipper slope without even realizing it.

He felt that all he needed to do was to be positive and "the universe would provide."

When I inquired as to what he thought he could do, aside from whatever the universe might or might not provide, he didn't know what to say.

It became clear rather quickly that Ted's problem wasn't that he needed to be positive.  His problem was that he wasn't being realistic.  Instead, he wanted to pull the covers over his head, avoid dealing with his problems, and hope that "positivity" would take care of things.

In other words, Ted was so frightened by his problems that he only wanted to find a magical solution, like being positive, to make everything all right in his life.

Are You Using Your Idea of "Positive Thinking" to Deny Your Problems?

As Ted continued in therapy and we began to explore the difference between being confident and resilient while taking action to resolve problems  vs. just trying to be "positive," being passive, and hoping that his problems would disappear.

As time went on, Ted began to see that his fears were paralyzing him, and he wanted to take flight into a magical world where he could delude himself rather than being proactive and taking steps to deal with his problems.

As is often the case, Ted's fears stemmed from childhood memories of his family struggling to keep their heads above water financially.  This family history and the emotional trauma that went with it left their psychological marks on Ted.

Over time, Ted was able to work through his childhood trauma so that it no longer got triggered in his current situation.  This took time.

At the same time, he began to take steps to deal with his financial problems:

• He hired an attorney to help him negotiate with his creditors.  
• He went to Debtors Anonymous, a 12 Step program for people who spend compulsively and get themselves into debt.  
• He also continued to come to his therapy sessions regularly.

As he took steps to deal with his problems, he felt reinforced and empowered to take additional steps.

This work wasn't easy or fast because Ted's sense of denial as well as his fear were strong.  There were times when he still longed for a magical solution to make all his problems go away.

This wish was understandable.  Would we all wish that someone could wave a magic wand and make problems go away?

The difference lies in seeing the wish for what it was.  In Ted's case it was a childlike wish from a time when he was younger and felt overwhelmed by his family's problems.

As an adult, when he felt gripped by this fear, he felt that all he needed to do was to recite affirmations and "be happy," and his problems would take care of themselves.

Whenever he would backslide, we would talk about whatever was getting triggered in him from the past and work through that issue.

Each time that this happened, we would explore what was underlying his magical wish, work through it, and then Ted would continue to make progress.

At the same time, instead of berating himself for having the wish, Ted learned to develop self compassion for the younger part of himself that was holding onto this wish.

Although he was learning in therapy to be compassionate for that younger part of himself, at the same time, he was also learning not to allow that younger part of himself to be in charge.

He learned that the adult part of himself had to be in charge at the same time that he acknowledged the hurt and pain of his younger self.

Progress in therapy is usually not like a straight arrow that begins and keeps going straight forward.

Progress is usually more like a spiral with two steps forward and one step back.  This is part of the therapeutic process.

Over time, as Ted learned to cope with his fears and to take action, he realized that he was feeling genuinely positive about himself.  His positive feelings were no longer a defense--they were real, and they were based on his experience of being proactive, feeling capable, and taking care of himself.

As Ted became more confident in himself and his ability to deal with his problems, he saw the real power of being positive.

Getting Help in Therapy
Understanding that the "power of positive thinking" doesn't mean being passive or hoping that something external will resolve problems is often a difficult concept for people, who use this defense mechanism, to see because the wish for something magical is so strong.

Without the help of a licensed mental health professional, people who use this defense mechanism often double down and think they just need to "try harder" to make positive thinking work for them.  But, in the meantime, their problems, left unattended, get worse.

Getting Help in Therapy

If there are times when you can see that you're using your idea of positive thinking as a way to avoid dealing with your problems, you could benefit from working with a licensed mental health professional who can help you work through the fears underneath your denial.

A licensed mental health professional can also help you to learn to be compassionate with yourself so you can start being proactive to overcome your problems and feel genuinely positive about yourself.

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.