NYC Psychotherapist Blog

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Monday, August 31, 2015

Overcoming Impostor Syndrome

Impostor syndrome is a psychological phenomenon in which a person feels that s/he is a fraud, despite many possible accomplishments and accolades.  S/he has a problem internalizing his or her accomplishments and awards, and s/he is afraid of being "discovered" as a fraud.

Overcoming Impostor Syndrome

People who suffer with impostor syndrome usually develop this problem during childhood, especially if the they feel (rightly or wrongly) that they have been a disappointment to their parents.  These children feel a deep sense of shame.  

Many people who suffer with impostor syndrome find out later in life that they had a distorted view of how their parents and others saw them, and it was only their perception that they were a disappointment--not anyone else's perception.

The underlying issues related to impostor syndrome are often unconscious, so these issues are outside of the person's awareness.  

People who want to overcome impostor syndrome usually don't overcome this problem with cognitive-behavioral therapy (CBT) where the therapist tries to help the client to see the distortions in his or her thinking.  

Overcoming Impostor Syndrome

While a client might recognize logically that there is a distortion, this recognition usually doesn't change the way that s/he feels.  Often, this makes matters worse because the client can see the distortion, but s/he feels powerless to change it.

People who want to overcome impostor syndrome benefit from seeing a psychotherapist who uses a type of experiential therapy that gets to the unconscious underlying issues (see my article:  Experiential Therapy Helps to Achieve Emotional Breakthroughs).

The following fictional vignette, which includes typical problems associated with impostor syndrome, illustrates how this problem can be overcome with experiential therapy: 

Alan came to therapy because he was having problems at work.  

He recognized that, as a manager, he was irritable with his subordinates and felt resentful that he had to constantly prove himself to his superiors.  

Alan knew that he could barely keep his irritability and resentment under wraps, and he was afraid that he would say or do something to jeopardize his position, a position that he worked hard to get.

Overcoming Impostor Syndrome

When asked if anything had come up recently to make him feel irritable and resentful, Alan couldn't think of anything.  He was aware that he had been feeling this way for a long time but, when asked, he couldn't pinpoint when it started.  He just knew that the problem was getting worse.

Using a combination of clinical hypnosis and Somatic Experiencing, I asked Alan to think about the last time he remembered feeling irritable and resentful, to notice if any other emotions came up, and to also notice where he felt these feelings in his body (see my article:  The Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Alan remembered being in a staff meeting with his boss and subordinates a week ago and how irritable and resentful he felt at the time.  He sensed these feelings in his chest and stomach.  

I asked Alan to continue sensing into those emotions and where he felt them in his body.

As he explored how he felt during that meeting, he also realized something that surprised him--he was fearful that everyone in the meeting would realize that he was "a fraud" and he didn't know what he was doing, which is common for people with impostor syndrome.

Alan explained that he didn't know why he was feeling this way because he was well educated, he was a seasoned professional, and he was chosen over many other well-qualified candidates for the job.  

In fact, his boss often went out of his way to praise him for his work, and his subordinates looked up to him, so he didn't know why he felt like he had to prove himself.

He recognized that nothing happened in the meeting that day to make him feel like he was a fraud or to undermine his confidence.

As he continued focusing on his emotions and where he felt them in his body, it suddenly dawned on him that he had been feeling like a fraud for a long time, but he still didn't know why.

He was surprised that he had been carrying around these underlying emotions without even realizing it. The relaxing state facilitated by clinical hypnosis and Somatic Experiencing allowed Alan to access these unconscious emotions.

I helped Alan to use a hypnotherapy technique called the Affect Bridge where he could go back to his earliest memory of feeling this way (see my article: Clinical Hypnosis: Bridging Back to Heal Old Emotional Wounds).

As he went back in his mind to his first job, college, high school, and even grammar school, Alan became aware that his feelings of being inadequate were old feelings that had a long history.

His earliest memories of feeling this way were during a time when his father, who was an avid sportsman, coached Alan's Little League team.

Fiercely competitive, Alan's father placed a lot of emphasis on winning every game.  His father's competitiveness made Alan feel anxious and ashamed because, although he made the team, he was a mediocre player, and he felt he was a constant disappointment to his father.

Alan remembered one particular day when his father heaped praise on the team's star player, a boy who was in Alan's class at school.  

Watching his father praise this boy was hurtful enough to Alan, but then his father added insult to injury by saying to Alan, "You see?  Johnny is a great pitcher.  Why can't you be more like Johnny?"

Although that memory was more than 20 years old, it felt fresh and very much alive for Alan.  He felt the hurt, shame and resentment as if it was yesterday.  

Overcoming Impostor Syndrome

He remembered silently telling himself, "You suck at this game.  You let dad down. You better work as hard as you can to show him that you can be a star too." As Alan remembered these feelings now as an adult, he broke down in tears.

Alan remembered that, from that day on, he practiced everyday.  He suppressed the shame and anger he felt as his father criticized him, and he did eventually get better.  

One day during a tense game with a tied score, he was next up at bat.  Even though he wasn't looking at his dad, he could feel his dad's eyes on him. He was so anxious that he could barely hold the bat without shaking.  

As the ball approached, he hit it as hard as he could.  Then, he ran before he knew what had happened and made it to first base.  Then, he heard his teammates screaming and saw them jumping up and down.  His father was signaling him to keep running.  It was only at that point that he realized he hit a home run.

As he ran, he had a surreal feeling, as if he was dreaming.  He ran as fast as he could around the bases.  When he slid to home plate, he was shocked that his whole team ran out into the field and picked him and carried him around the field.  He saved the game.

His dad was also standing in the field beaming at him.  It was the first time his father had ever looked at him that way during a game.

As Alan sat in my office, he remembered that, rather than feeling proud of himself, he felt like a fraud that day.  He felt as it was someone else who hit the home run, not him, and it was all a mistake.   

During this therapy session, Alan realized for the first time that on that day when he hit the home run, he wasn't able to enjoy his accomplishment because he felt like an impostor.

He also realized for the first time that, even though he graduated at the top of his class in high school and he had a straight A average in college, he continued to feel like an impostor no matter what he accomplished in his life.  

But he had never really allowed himself to let these emotions come to the surface.  Until then, these emotions got played out in other ways, like feeling that his boss and his subordinates though he was inadequate, which made him feel irritable and resentment.  

But he also realized that his boss and his subordinates had admired and respected him.  So, the emotions that came up for him at work were really from his history and not related to anything going on now (see my article:  Reacting to the Present Based on the Past).

This realization stunned Alan because he had no idea that this is what was happening to him.  

In future sessions, we used Gestalt techniques where Alan imagined himself talking to his father and expressing his hurt, anger and resentment to his father.  

During one of those sessions, Alan realized that his father no longer felt disappointed in him and that Alan was living his life stuck in his memories from 20 years ago.  He realized that he was the one now who felt this way about himself--not his father.  

His father had told him many times in recent years how proud of him he was but, until now, Alan never connected this to his underlying distorted feelings that he continued to be a disappointment to his father and that, no matter what he accomplished, he felt like a fraud and an impostor.

But as we continued to explore these issues, Alan realized that he didn't completely feel this way all the time.  Only a part of him felt this way.  

So we did "parts work" (also called Ego States work) for Alan to experience the part of him that felt like an impostor and the other parts of him that didn't.  

Parts work, which is another experiential type of therapy, allows for emotional integration so that, over time, the part of him that felt like a fraud and an impostor softened.  

Overcoming Impostor Syndrome

As we continued to do parts work, Alan no longer felt like an impostor.  He felt genuinely confident in himself.

People who experience impostor syndrome are often highly accomplished men and women who, despite their accomplishments and praise from others, feel like they're a fraud.  They often live in fear of being "found out" and "exposed" by others.

Impostor syndrome is usually unconscious and can begin at a young age.  

People who suffer with impostor syndrome might be able to recognize that their thoughts about themselves are distorted, but knowing this usually doesn't change it.  In fact, it can often create more angst as they try to reconcile what they know logically to what they feel emotionally.  

This is why cognitive-behavioral therapy (CBT) is often ineffective in helping clients to overcome impostor syndrome.  CBT doesn't get to the underlying unconscious experiences that are at the root of this psychological phenomenon.

Experiential therapy, such as clinical hypnosis, Somatic Experiencing, EMDR and other experiential types of therapy allow clients to access these unconscious experiences and to work through these issues.

Getting Help in Therapy
Impostor syndrome isn't listed in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM), but it is a real experience, and it is more common than most people realize.

If you feel like "a fraud," despite objective evidence to the contrary, and you fear being found out, you might be suffering with impostor syndrome.

Rather than continuing to live with this burden, you could benefit from getting help from a licensed mental health professional who has an expertise in experiential therapy so that you can live free yourself from this psychological phenomenon.

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.


Monday, August 24, 2015

Learning How to Stop Creating Chaos in Your Life

In a prior article, Do You Have a Pattern of Creating Chaos in Your Life?,  I began a discussion about people who unconsciously create chaos in their lives, and I  gave some examples in everyday life with regard to relationships, money issues, family problems and other related issues.

Learning How to Stop Creating Chaos in Your Life

As I mentioned in the prior article, most people who develop self awareness that they're creating chaos in their lives want to stop, but they don't know how.

In this article, I've given a fictional vignette, based on many different cases, and describe how therapy can help.

The following is a fictional vignette based on many different cases:

By the time Ed came to therapy, he was ending an on again/off again relationship for the fifth time and considering reconciling with his girlfriend once again (see my article:  The On Again/Off Again Relationship).

Learning How to Stop Creating Chaos in Your Life

He was considering reconciling with his girlfriend once again even though nothing had changed between them, they disagreed about important fundamental areas in their lives, and they frequently argued.

Despite their problems, Ed felt very lonely without his girlfriend and a part of him would have rather remained in this dysfunctional relationship than spend time alone (see my article:  Are Your Fears of Being Alone and Lonely Keeping You in an Unhappy Relationship?)

He was also behind in his bills and he was receiving delinquency notices.

Ed acknowledged that he made a good salary and he had the money to pay his bills, so he wasn't sure why he allowed his debts to pile up.

Ed felt that his life was out of control and completely unmanageable, but he didn't know what to do to change things.

During the first therapy session, Ed was flooded with anxiety and needed constant redirection because his anxiety caused him to jump from one topic to the next.

As he discussed his family history, he revealed a highly dysfunctional family and he had many of the traits that are usually associated with people from dysfunctional families (see my article:  Dynamics of Adult Children of Dysfunctional Families), including:
  • Fear of angry people and personal criticism
  • Fear of authority figures
Each of his parents also came from highly dysfunctional families and they seemed to unknowingly repeat patterns from their families just as Ed was also unconsciously repeating patterns from his family.

Not only was Ed deeply ashamed of himself and his family background, but he was ashamed to be coming to therapy.

He felt like he must be "weak to need therapy" (see my article: Overcoming Shame: Is Shame Keeping You From Starting Psychotherapy?).

He was very surprised when I told him that people who seek help in therapy are often the healthiest people in their families (see my article:  Why It's Often the Healthiest Person in a Dysfunctional Family Who Comes to Therapy).

Ed felt so overwhelmed by his problems that he didn't know where to begin, so we began by breaking down his problems into manageable pieces so that he could begin to tackle the most pressing issues, including paying his bills.

Deep down, Ed knew that his relationship with his ex was very unhealthy for him.  He also admitted that he knew nothing would change and they would just end up breaking up again because they were basically unsuited for each other.

So, he agreed not to contact his girlfriend and, if he felt like contacting her or he felt lonely, he would call a friend instead for emotional support and he would discuss his feelings in his therapy sessions.

We also worked on helping Ed to develop coping skills so that he would be able to calm himself when he felt overwhelmed (see my article:  Developing Internal Resources and Coping Skills).

Once Ed was able to begin tackling some of his concrete problems, like paying his bills on time, and he developed techniques for managing his stress, we began to work on the unconscious issues related to his family of origin that he was recreating in his life (see my article: Psychotherapy: Making the Unconscious Conscious).

As we discussed how he was leading his life from one crisis to the next and the chaotic patterns in his family of origin, Ed was able to see the similarities.  But, at first, he couldn't see how he was creating these patterns.

This was a new concept for him.  Until then, he experienced the chaos in his life as things that "happened" to him--not that he was creating these situations.

As we went over each situation that had occurred in the recent past, Ed began to develop clarity about his role.  But rather than feeling self compassion, he was self critical, judgmental and hard on himself (see my article: Self Blame and the Internal Critic).

Being critical was another pattern from his family, and it caused Ed a great deal of shame.

Not only was this self blame not helpful in the present, it was also getting in the way of his understanding the origin of his problems from the past.

We had to work on helping him to distinguish taking responsibility and being compassionate towards himself and being critical and self blaming.

As we continued to explore his current relationship to his family, who continued to be dysfunctional, Ed realized that one of the underlying issues to his repeating the pattern of creating chaos in his life was that it enabled him to commiserate with them and to continue feeling connected to them (see my article: Overcoming Trauma: When the Past Affects the Present).

This was an aspect of his problems that Ed had never recognized before, and he worried that if he got his life together that he would be, in effect, moving away from his family on an emotional level.  He had a deep sense of family loyalty, and he felt conflicted about this (see my article:  How a Distorted Sense of "Family Loyalty" Can Affect Your Therapy).

At the same time, Ed recognized that he couldn't keep living his life in the same way as he had been--he had to change if he wanted to be happier in his life.

The next step in our work was to do trauma work in order for Ed to work through the emotional trauma that he experienced in his dysfunctional family and for him to accept that he might not feel as connected to them in the same way if he wasn't creating chaos in his life.

I often use different types of mind-body oriented therapy to help clients with emotional trauma and choose the type of therapy that is best suited for each client.  In Ed's case, I used EMDR to help him work through his childhood trauma (see my articles:  What is EMDR? and How Does EMDR Work - Part 1 and Part 2).

Learning How to Stop Creating Chaos in Your Life

After Ed worked through his experiences of childhood trauma in his dysfunctional family, he no longer felt drawn to creating chaos in his life and to choosing unhealthy romantic relationships.  He was able to live a more stable and meaningful life.

People who have a pattern of creating chaos in their lives usually do so on an unconscious level.

Often, they come from families that are dysfunctional where they experience childhood trauma.

Without realizing it, they usually recreate the dysfunction and trauma that they experienced as children in their adult lives, including choosing unhealthy relationships.

Developing self awareness about this pattern and how they're perpetuating it is usually the first step in therapy to help people to change.

Since many people who create chaos in their lives have never developed healthy coping skills, developing coping skills is also essential.

Therapists often help clients, who are creating chaos in their lives, to break down problems into manageable parts so they can begin to deal with these problems.

In order break the pattern of creating chaos, it's also essential to do trauma work about unresolved family of origins issues.

Often, people who have taken these steps no longer feel drawn to creating chaos in their lives and they often no longer feel compelled to get into unhealthy relationships.

Getting Help in Therapy
If you think that you are creating chaos in your life and you want to change, you can overcome these problems by working with a licensed mental health professional who has expertise in this area (see my article:  How to Choose a Psychotherapist).

Once you've stopped living your life from one crisis to the next, you can lead a happier life with new meaning and purpose.

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

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.

Sunday, August 23, 2015

Psychotherapy Blog: Do You Have a Pattern of Creating Chaos in Your Life?

People who have a pattern of creating chaos in their lives often do it unconsciously.  They usually don't realize that they're doing it themselves and, because they have no self awareness about how they're generating the chaos, they see the problems as external or as if it's "happening to" them rather than self generated (see my article:  Hooked on Emotional Drama: Getting Off the Emotional Roller Coaster).

Do You Have a Pattern of Creating Chaos in Your Life?

There is also often a lot of denial involved when it comes to taking personal responsibility for the chaos.

Everyone has times in their lives that are chaotic, so I want to emphasize that what I'm referring to in this article is a pattern of chaos that is the result of actions taken (or not taken) by the individual involved in the chaos.

Examples of Creating Chaos:
  • Pursuing someone who has told you repeatedly that s/he isn't interested in you
  • Trusting someone who has constantly hurts, betrays and disappoints you
  • Maxing out credit cards for unnecessary purchases to the point where even minimum payments are unaffordable
  • Getting a shut off notice due to an overdue electric bill and spending the money on going out instead of paying the bill
  • Smoking heavily with an asthma condition
  • Drinking heavily despite a damaged liver
  • Getting a DWI and blaming "bad luck" for the arrest
There are many other examples, but I think you get the picture.

Most people who create chaos in their lives grew up in dysfunctional families that were chaotic.  So, they usually don't see the chaos they create in their adult lives as being dysfunctional because it seems "normal" to them.  And it seems "normal" because that's how they've always lived their lives.

Breaking the Pattern of Creating Chaos in Your Life
In order to break this pattern, a person must first be able to see the pattern.

There must be enough self awareness to step back and think about why s/he is having so many problems.

This isn't easy to do, especially if chaos has been a lifelong experience.

Do You Have a Pattern of Creating Chaos in Your Life?

The person who creates chaos often doesn't see that s/he is unconsciously recreating their dysfunctional childhood in their adult life.

Very often what happens is that life gets so out of control that the person who creates chaos is either forced to seek help (i.e., court mandated) or his or her life becomes to unbearable that s/he seeks help in therapy.

In my next article, I'll provide a vignette to show how this pattern develops and how therapy can help.

Getting Help in Therapy
On a conscious level, most people don't want to live a chaotic life.

For people who are stuck in this pattern of creating chaos, they often see problems that they unknowingly create as things that "happen to" them.

Getting Help in Therapy:  Learn to Stop Creating Chaos in Your Life

If you know or suspect that you might be creating chaos in your life and you're ready to change, you could benefit from seeking help from a licensed mental health professional who understands the underlying unconscious dynamics and who can help you to change longstanding patterns.

Psychotherapy can help you to develop a greater sense of self awareness, new coping skills and a new way to live your life so that's stable and fulfilling.

By getting help in therapy, rather than living your life from one emotional crisis to the next, you could be leading a happier 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.

Saturday, August 22, 2015

Discovering the Unconscious Emotions at the Root of Your Current Problems

As Sigmund Freud once said, "Sometimes a cigar is just a cigar."  For clients in therapy this can mean that the presenting problem isn't overly complicated by unconscious factors that would get in the way of working through the problem.   But it's often the case that there are unconscious factors that are at the root of the current problem, making it difficult for clients in therapy to overcome their presenting problem.  When the client is ready, a skilled psychotherapist, who knows how to help clients to discover these unconscious issues can help clients to get to the root of the problem so it can be worked through and resolved (see my article: Making the Unconscious Conscious).

Discovering the Unconscious Emotions at the Root of Your Current Problems

Psychological Defense Mechanisms Are Unconscious
As I've discussed in other articles, psychological defense mechanisms, which are unconscious, often serve to protect clients from feeling overwhelmed by emotions that they're not ready to handle.

Defense mechanisms often help clients to cope with overwhelming emotion and trauma.  They can be useful in helping clients during a certain period in their life to temporarily get through a rough time.

But unconscious psychological defenses that were once useful (for instance, helping a client deal with overwhelming emotion as a child) often get in the way later on in life.  What was once useful is now a problem.

So, for instance, a child, who dissociates when she is experiencing verbal abuse from a rageful parent, protects herself emotionally by distancing herself from feeling the full impact of the parent's rage.  But this defensive strategy, which was useful as a child to keep the child from being overwhelmed, becomes a problem when, as an adult, this individual dissociates with an angry spouse.

Recognizing that psychological defense mechanisms serve a purpose for clients, most skilled psychotherapists work in a way that is respectful and empathetic when helping clients to discover these underlying unconscious aspects.

Rather than trying to uncover these unconscious aspects prematurely, most psychotherapists will assess a client's strengths to determine whether s/he can do psychological discovery work and, if not, work with a client to develop the internal resources necessary to do the work.

Psychological Methods to Discover Unconscious Emotions
Sometimes, clients come to therapy knowing that there are underlying issues that are driving their current problems.  Maybe they've been in therapy before and they've gained some insight into this but, despite their insight, nothing has changed.

In other cases, clients who are psychologically minded, can intuit that unresolved childhood trauma might be triggering them in their adult life (see my article: Psychotherapy to Overcome Your Past Childhood Trauma).

Discovering the Unconscious Emotions at the Root of Your Current Problems
Psychological Methods to Discover Unconscious Emotions

Often, clients come to therapy with no idea that there are any underlying issues, so it's up to the therapist to help them to uncover these issues and work through them.

Psychotherapists, who are trained to help clients with this problem, have many different ways of working to help discover these latent issues.

All of these psychotherapeutic methods can be used alone or in combination with each other.

Affect Bridge from Clinical Hypnosis and EMDR
I've discussed the use of the affect bridge in a prior article using clinical hypnosis, also known as hypnotherapy (see my article: Bridging Back to Heal Old Emotional Wounds).  In EMDR (Eye Movement Desensitization and Reprocessing) the same method is called the Float Back technique.

In both clinical hypnosis and in EMDR, the idea is the same:  The client uses the emotions that she feels in the current situation as well as where she feels those emotions in her body.   Then, in a relaxed hypnotic state, allows her mind to wander back to the earliest time that she felt that way.

Clients are often surprised with their discoveries, especially when they discover latent thoughts and feelings that are, seemingly, unrelated to the current situation.

The idea isn't necessarily to discover earlier events that are the same as the current problem (although they could be the same).  The idea is to use the emotions and sensations in the body to tap into the unconscious emotions that have been stored in the body as memories to the earliest time when the same emotions and body sensations were present.

In other words, the emotions and body sensations will be the same, but the type of problem from the past might be different.

Overt Statements:  A Gestalt and Coherence Therapy Technique
This method is used in Gestalt therapy and Coherence therapy, and it usually involves doing imaginal work.

The client, who is already in touch with the emotions involved in the current situation, imagines that he is speaking with a significant person in the situation.

For instance, if the client is upset with his father, he could imagine that his father is sitting in a chair near him.  Then, the therapist encourages the client to tell "his father" what's on his mind.  This can be done either out loud or in the client's mind.

Some clients feel a little awkward at first, but most clients settle into the imaginal work and feel as if the father is there.  They often express emotions that have been unexpressed and pent up for many years.

This often leads to the discovery that there are other underlying emotions that the client was unaware of before doing this work.

For instance, the client might start out being angry with his father and then discover that, underneath the anger, there's a lot of sadness.  Or, if he tells his father that he knows he has been a disappointment to the father, he might suddenly realize that this is just a projection:  His father isn't really disappointed with him--the client is disappointed in himself and he has projected his own feelings onto the father.

Imagining Yourself Without the Problem: Symptom Deprivation from Coherence Therapy
Symptom deprivation is another technique used in Coherence Therapy where the therapist asks the client to imagine her situation without the symptoms (e.g., emotions, thoughts, body sensations, etc) that are part of the problem now, and then asks the client how she experiences this.

Discovering the Unconscious Emotions at the Root of Your Current Problems
Imaginal Work: Coherence Therapy

For instance, if a client is feeling guilty about a particular situation, the therapist would ask the client to imagine the situation without feeling guilty.  If the client is able to do this, she will usually discover that underneath the guilt there are other thoughts and emotions.  At that point, the client might also discover that another emotion, like fear, and that she has been holding onto the guilt in order not to feel a subjectively "worse" emotion, fear.

In Coherence Therapy, which is a nonpathologizing therapy, the therapist helps the client to understand that holding onto the guilt has served a purpose, namely, to keep the emotion of fear at bay.

So, when the client realizes that she has been maintaining the guilt to avoid feeling fear, she feels a sense of empowerment and agency:  If she is the one who is maintaining it, then she can let it go with help from a psychotherapist.

Free Association/Sentence Completion from Psychoanalysis and Coherence Therapy
Another way to tap into the unconscious is through a form of free association involving sentence completion.  This is a method is often used in both psychoanalysis and Coherence Therapy.

Discovering the Unconscious Emotions at the Root of Your Current Problems
Sentence Completion and Free Association

A therapist provides the stem of a sentence to the client.  For instance, if the client is having a problem with procrastination with regard to completing a dissertation, the therapist might provide the following stem of a sentence for the client to free associate to:

"If I complete my dissertation ________________________."

The client completes the sentence by saying the first thing that comes to her mind without thinking about it.  So, the first thing that might come to her mind might be, "If I complete my dissertation, then my professors will realize that I don't know anything and I'm a fraud."

The therapist will then ask the client to keep free associating with that same stem to see what else comes up.

Often, what comes from the unconscious mind will be surprising to the client.  So, in the example I just gave, before coming to therapy, the client might have thought she wasn't completing her dissertation because she was "lazy."

After she free associates and discovers the unconscious reasons for not completing the dissertation, she will have a better understanding and be able to work on the underlying issues in therapy.

Parts Work From Ego States Therapy, Gestalt and Internal Family Systems
I wrote about parts work (also known as ego states work or as a method in Gestalt therapy and Internal Family Systems therapy, IFS) in a prior article).

Parts work is also nonpathologizing.  It's especially useful when a client is feeling ambivalent about a problem, which is common.

Discovering the Unconscious Emotions at the Root of Your Current Problems:
Parts Work, Ego States Therapy, Gestalt Therapy and IFS

So, with the example that I gave above about the client who is procrastinating about completing her dissertation, the therapist can help the client to get in touch with her ambivalence about completing the work.

This would often involve tapping into the part that is procrastinating as well as other parts, including a part that feels competent and knows that she can do it.

Until the client learns to differentiate between the many aspects of herself that are involved in this problem, she might only be aware of the part of herself that doesn't want to do it or fears that she can't do it.  After she does parts work, she will be aware that this part is only one part and that there are other parts of herself that can be helpful.

By having a dialog with that part, she can also discover what that part of her needs so that, once that part's needs are met, it won't become activated in a negative way.

In my next article, I'll provide a scenario to demonstrate how these methods work.

The methods that I've outlined are some of the different psychotherapeutic methods that a psychotherapist can use to help clients to discover the unconscious emotions that are at the root of their problems.

Discovering these latent issues helps the client to realize that there is more to the problem than what initially meets the eye.  It also helps her to be more compassionate towards herself rather than blaming herself and, often, to recognize she has strengths that she wasn't aware of before doing this work.

Getting Help in Therapy
If you've been struggling with a personal problem and you've been unable to work it out on your own, you could benefit from seeing a licensed mental health professional.

Discovering the Unconscious Emotions at the Root of Your Current Problems
Getting Help in Therapy

You might discover that you've been unable to resolve your problem because of underlying issues.

Working with skilled psychotherapist who knows how to help you to discover the unconscious emotions at the root of your problems can be life changing.

Aside from helping you to discover the root of the problem, she can also help you to discover your strengths, and help you to resolve your problems so you can 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.

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.

Saturday, August 15, 2015

Psychotherapy Blog: Resentment as a Defense Against Feeling Deep Sadness

People who hold onto resentment for many years often don't realize that holding onto their resentment is a defense against feeling the deep sadness that is underneath the resentment (see my article: Letting Go of Resentment).

Longstanding resentment can become like a hard shell that seals over sadness that would feel too overwhelming to experience.

Resentment as a Defense Against Feeling Deep Sadness

This is often the unconscious function of holding onto resentment--it keeps people from feeling the depth of their sadness.  Often, people who experience longstanding resentment don't even realize that they're carrying around this sadness because it's so well hidden by the resentment.

Even though, on an unconscious level, people with longstanding resentment would rather feel the resentment than the sadness, carrying around the resentment takes it's toll physically and emotionally (see my article: Holding Onto Anger and Resentment is Like Drinking Poison and Expecting the Other Person to Die).

Let's take a look at a fictionalized scenario, which is based on many different cases, to see how resentment is used as a defense mechanism to ward off deep sadness, and how this problem can be overcome in therapy:

Ed came to therapy because he sensed that the ongoing problem that he had with male authority figures at work was related to his unresolved childhood problems with his father (see my article: How Unresolved Childhood Trauma Affects Adult Relationships).

Although Ed was much sought after in his field, he had problems with male authority figures at work which caused problems for him in his career.

Resentment as a Defense Against Feeling Deep Sadness

He would usually start out well on a job until he and his manager disagreed about a business decision, especially if he felt that his manager wasn't hearing him.  Then, Ed would feel such rage and resentment that he barely could contain it.

Since he was very good at what he did, most managers would overlook Ed's resentment.  But Ed knew that he was having an increasingly difficult time containing it.  He also realized it was only a matter of time before he exploded and placed his job in jeopardy.
Resentment as a Defense Against Feeling Deep Sadness

When Ed started therapy, he approached it like a pragmatic business problem.  He wanted to define the problem and find the solution.

Since he had never been in therapy before, I provided Ed with psychoeducation about psychotherapy and how it was different from finding a solution to a work problem (see my article: The Benefits of Psychotherapy).

It was very helpful that Ed already had some insight into his resentment and that he knew it was related to his problems with his father when he was growing up.  Rather than blaming each manager that he had ever worked for, Ed realized that it was his problem and not theirs.

As we talked about his resentment towards his father, who was authoritarian and lacked empathy for Ed as a child, I asked Ed what kept him holding onto his resentment after more than 25 years.

At first, Ed wasn't sure why he still felt resentment.  He admitted that he had a very different relationship with his father now, who had become a lot more emotionally available for Ed over the years and who was not the same father that he was when Ed was growing up.  In fact, Ed said, they had a good relationship now.

I recognized that Ed had never processed the childhood trauma, and he was stuck emotionally in that earlier time (see my article:  Reacting to the Present Based on Your Traumatic Past).

I also sensed that Ed had an unconscious reason for holding onto the resentment and that until we got to these unconscious feelings, he would have a hard time letting go of the resentment.  And, as a result, he would continue to have problems with male authority figures at work.

We began by using EMDR Therapy to process the childhood trauma (see my articles: EMDR Therapy and the Brain and How EMDR Therapy Works).

Over time, Ed was able to reduce the emotional effects of the trauma significantly.  But, at a certain point, the EMDR therapy stalled and, as an EMDR therapist, I recognized that we were dealing with a "block" in therapy that needed to be addressed before we could go on.

I also recognized that, although Ed was able to feel anger and resentment during the EMDR processing, the one feeling that he wasn't in touch with was sadness.

This was significant because anyone who experienced what Ed experienced with his father when Ed was a child would have felt sad.  But Ed wasn't in touch with this feeling at all.

Based on my experience as a therapist, I knew that if I asked Ed directly about the sadness or any other underlying feelings, he would deny it because he wasn't in touch with it at all.

So, I used a technique from Coherence Therapy, which is also used in psychoanalysis, to have Ed free associate about letting go of the resentment.

I gave Ed a part of a sentence and then asked him to free associate to the rest and to keep going for a while.

The stem of the sentence was:  "If I let go of my resentment, _____________________________."

At first, Ed seemed self conscious, but as he continued to free associate to sentence, he went from surface to depth as his unconscious feelings eventually came to the surface.

Initially, he responded by saying things like, "If I let of of my resentment, I would be happier," "If I let go of my resentment, I would get along better with my boss," and so on.

After about five minutes of free association, without even realizing it, Ed said, "If I let go of my resentment, I'll be overwhelmed by sadness."

Discovering that Resentment is a Defense Against Feeling Deep Sadness

At that point, he stopped and looked at me with surprise.  Although he didn't say anything at first, the look on his face said, "Did I really say that?"

Then a few seconds later, Ed began to sob.

After a few minutes when he was able to talk again, he said that this was the first time that he was aware that underneath the resentment was deep sadness.

Although he was surprised and a little confused, he said he also felt a lighter just being able to acknowledge the sadness and cry.  He also began to feel an internal emotional shift.

This was a real emotional breakthrough for Ed.

After that, we were able to continue to work on Ed's resentment and sadness for his unmet emotional needs as a child using EMDR.

Working Through Resentment and Sadness to Lead a More Fulfilling Life

Eventually, he was able to work through his resentment and sadness, and he was no longer affected by his childhood trauma (see my article:  Experiential Therapy, Like EMDR Therapy, Helps Achieve Emotional Breakthroughs).

It's not unusual for people to hold onto anger and resentment as a way to ward off feeling deep sadness.

The problem is that they aren't aware that they're doing this because the sadness is unconscious.

What often occurs is that, as children, they allow themselves to feel the anger and resentment because those feelings aren't as scary as sadness.

It can also feel more "powerful" to children and adults to feel anger as opposed to feeling sadness, which can leave a people feeling emotionally vulnerable.  This is especially true for children that don't have an adult around to help soothe them and process their emotions.

So, the sadness goes "underground," so to speak, and remains unconscious even when they become adults.

They don't realize that their anger and resentment have become like a protective shield that keeps them from feeling the sadness.

They also don't realize that, as opposed to when they were children, they now have a greater emotional capacity to deal with difficult emotions as adults, especially if they are in therapy with a therapist who has experience working on these types of unconscious issues.

Getting Help in Therapy
Holding onto resentment is often an unconscious defense against feeling sadness or other uncomfortable feelings.

People are often surprised to discover what a relief it is to let go of longstanding resentment and how much better they feel.  They often talk about having more energy and a greater sense of well-being.

If you've had a problem overcoming your resentment on your own, it's possible that your resentment is an unconscious defense against feeling emotionally vulnerable, and you could benefit from working with a licensed mental health professional who has experience helping clients with this problem.

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

I have helped many clients to discover and overcome unconscious emotional blocks that hindering them from having a more fulfilling life.

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.

How to Stop Being the "Rescuer" in Your Family of Origin

As a psychotherapist in New York City, I see many clients who come to therapy because they feel overburdened by their loved one's problems.  Often, they're the ones who everyone relies on, and they come to  therapy when they feel exhausted from other people's problems.

How to Stop Being the "Rescuer" in Your Family

But often what they don't realize is that they're participating in this codependent dynamic with their loved ones because they're invested in being the "rescuer" and they're unable to set boundaries with their loved ones (see my article: Assertiveness: Learning to Say No).

It's not unusual for this pattern to start early in life.  It doesn't seem to matter if this person is the oldest, the youngest or the middle child.  Early on, they become the ones that everyone turns to when they're in trouble, and they become accustomed to this role--until it becomes overwhelming.

The following vignette is a fictionalized example, which represents many different cases where the client is the "rescuer" in her family of origin until she feels feels overburdened by this role:

Nina was the middle child of five children in a chaotic family.  Since Nina's father was often away as an interstate trucker, her mother was left to take care of the children and manage the household.

Of all the children, Nina was closest child to her mother.  At the end of the day, when the younger children were put to bed and the older children were watching TV, Nina would sit with her mother and at the kitchen table and listen to her mother's complaints:  She was tired. She was worried about her elderly mother's health.  She didn't know how she was going to manage the bills.  And so on.

Nina would listen quietly.  Then, she would try to come up with solutions to her mother's problems.  Afterwards, her mother would praise her for being "mother's little helper," which made Nina feel good (see my article: Role Reversal in Mother-Daughter Relationships and Ambivalence and Codependency in Mother-Daughter Relationships).

How to Stop Being the "Rescuer" in Your Family of Origin

Whenever Nina was upset about anything, she mostly kept it to herself because she knew that her mother was already overwhelmed and she didn't want to bother her.  Sometimes, she talked to her older sister, but this was rare.  More often than not, Nina's siblings, both younger and older, turned to her for help.

This dynamic continued into adulthood with Nina being the one who attempted to rescue her mother and her siblings.  She would listen to their complaints for hours and try to come up with solutions for them.  Sometimes, she also bailed them out financially, even when it meant sacrificing things that she needed for herself.

By the time Nina was in her early 30s, she was exhausted from trying to rescue her mother and siblings over and over again.  Their problems seemed endless.  No sooner would she help them to overcome one problem than they developed another problem.

She loved her family very much, and she wanted only the best for them, but she didn't know how to deal with her increasing exhaustion.

During a rare time when Nina confided in a friend, her friend told her that she thought Nina was part of the problem because she didn't know how to set boundaries with her family.  She suggested that Nina get help in therapy.

Nina was shocked to hear her friend say this.  She never thought of getting help for herself.  She always thought it was her family members who needed help--not her.

But not knowing what else to do, she decided to give therapy a try.

Initially, Nina had a hard time focusing on herself in therapy.  She felt more comfortable talking about her family member's problems.  So, it took a while for her to be able focus on herself and to get in touch with what she was feeling.

She knew that she felt overwhelmed in a general sense.  But she was so unaccustomed to think about what was going on with her that, at first, she felt selfish for thinking about herself.  She also felt guilty for complaining about her family members (see my article:  Overcoming the Guilt You Feel For Not Being Able to Solve Your Parent's Problems).

Gradually, Nina came to see that she was caught in a dynamic with her family that she was actively participating in.  She saw that it wasn't something that was happening to her--she was an active participant.

How to Stop Being the "Rescuer" in Your Family of Origin

She also began to see another underlying dynamic about herself that she hadn't seen before:  Aside from wanting to be helpful, whenever she helped her family members with their problems, she felt like she was in control and, to a certain extent, omnipotent.

Looking back on her chaotic childhood, Nina was able to see why, as a young child, she would want to feel in control and powerful in a household that often felt out of control.

But as an adult, her life was no longer out of control, and she was ready to give up whatever feelings of  omnipotence she still felt in order to gain peace of mind.

Over time, Nina learned in therapy how to set limits with her mother and siblings.  It wasn't easy and, initially, her family resented this change.

But, gradually, Nina felt how much healthier it was for her to focus on herself first instead of being in the role of a "rescuer."  She also saw that her mother and siblings were able to solve their own problems if she didn't jump in to rescue them, and they felt better about themselves because of this (see my article:  Overcoming the Confusion Between Compassion and Responsibility).

Nina also worked in therapy to deal with her own unmet childhood emotional needs that she suppressed in order to be the parentified child to her mother and her siblings (see my article:  What is Childhood Emotional Neglect?).

Whenever there's an ongoing dynamic between "rescuer" and "rescuee," both people are participating in this dynamic.

How to Stop Being the "Rescuer" in Your Family of Origin

On the surface, it might look like the "rescuee" is the only one who perpetuates this dynamic.  But, on closer inspection, it becomes clearer that this codependent dynamic wouldn't continue without both people actively participating.

Since the role of "rescuer" often begins at a young age, it's often difficult to change.  The "rescuer" often feels guilty and selfish, and the "rescuee" often feels letdown and betrayed by any attempts to change the situation.

During the early stages of trying to change this dynamic, the "rescuer" is often tempted to revert back to what is familiar because attempts at changing the dynamic can feel like swimming against the tide.

Some people never get out of the role of being the "rescuer,"even though they're exhausted from it and feel increasingly resentful.

Getting Help in Therapy
If you recognize yourself as being in the "rescuer" role for loved ones and you've been unable to change this dynamic on your own, you could benefit from seeking help from a licensed mental health professional who has experience helping clients to overcome this dynamic.

Not only will you be helping yourself, you'll also be helping your loved ones to see that they can solve their problems without being dependent upon you.

You might be surprised to discover a sense of well-being when you're not continually trying to fix other people's problems.

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

I have helped many clients who are caught up in codependent dynamics to overcome this role so they can lead more fulfilling lives.

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

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

Monday, August 10, 2015

Psychotherapy Blog: A Psychotherapist's Beliefs About Psychotherapy Affect How the Therapist Works With You

Psychotherapists' beliefs about psychotherapy can have a significant effect on the way they practice therapy. The impact of their beliefs can include the therapists' views about clients, diagnoses, the types of therapy that they practice, and length of treatment, among other things.

A Psychotherapist's Beliefs About Psychotherapy Affects How the Therapist Works With You

What Shapes Psychotherapists' Views About Therapy?
Psychotherapists' beliefs are often shaped by their psychotherapy training, their own personal experiences in therapy as well as their professional relationships with supervisors, mentors, colleagues and institutes in their early career.

For instance, psychotherapists, who were trained years ago in traditional classical psychoanalysis and who have not had any other training in contemporary psychotherapy, often believe that psychotherapy takes a long, long time for everyone (see my article: Common Myths About Psychotherapy: Therapy Takes a Long Time).

While it's true that some clients might need a longer time in therapy than others, if this is a therapist's belief for all clients, how she practices therapy and the length of time that most of her clients spend in therapy with her, will conform to this belief, especially if long-term therapy is the only type of therapy that she practices.

Another example is that if a therapist tends to pathologize clients' ambivalence or difficulties in therapy, she will probably see the client as "resistant" or as a "help rejecting client" rather than seeing ambivalence as a normal part of therapy or taking a more nuanced view of the client and the therapeutic relationship, including that the problem might be related to something the therapist is doing or not doing (see my article: Starting Therapy: It's Not Unusual to Feel Anxious and Ambivalent and Reconceptualizing the So-Called "Help Rejecting Client").

If the therapist only focuses on looking for psychological disorders to the exclusion of seeing the clients' strengths, the therapy will tend to be pathologizing.  She will probably see mostly clients'  problems rather than clients'  strengths, resilience and capacity for change.

A Psychotherapist's Beliefs About Psychotherapy Affects How the Therapist Works With You

Working Deep in Therapy in an Experiential Way vs Working Only to Relieve Symptoms
Being able to work deep in psychotherapy is a valuable skill for therapists.

Most therapists who stopped their training in graduate school and never learned depth-oriented therapy tend to work in a way that only touches the surface.  They usually look for ways to relieve symptoms rather than looking beyond for what is transformative for the client.  This is a disservice to clients.

But working deep no longer means that the client must spend many years in therapy.  There are newer types of experiential therapy that can significantly reduce the time in therapy for many clients without sacrificing the depth (see my article: Experiential Psychotherapy, Like EMDR, Helps Achieve Emotional Breakthroughs and The Unconscious Mind and Experiential Therapy: The "Symptom" Contains the Solution).

Some forms of therapy, like certain forms of Cognitive Behavioral Therapy (CBT) and Solution Focused Therapy (SFT), as practiced traditionally by many therapists, sacrifice depth for brevity.

These types of treatment might help to alleviate certain symptoms, but they don't get to the underlying unconscious issues that are at the root of the problem--so that clients who complete CBT and SFT often return when their problems surface again in another way because the root cause was left untreated.

CBT and SFT therapists often ignore the unconscious as well as any transference or countertransference issues because this isn't part of the way they do treatment.  This can lead to many enactments by both the therapist and the client that aren't addressed.

Aside from EMDR, Somatic Experiencing, clinical hypnosis, and Coherence Therapy are also experiential forms of therapy where the therapist works deep and therapy is often shorter than traditional talk therapy.

A Psychotherapist's Beliefs About Psychotherapy Affects How the Therapist Works With You

These experiential forms of therapy are often mind-body oriented types of therapy, which means that the therapist recognizes the mind-body connection as well as that unconscious thoughts and feelings are stored in the body.

So, if a therapist asks clients to focus on where they feel emotions in their body, clients can learn to more easily access the unconscious in a faster way as compared to regular talk therapy (see my article: The Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Getting Help in Therapy
Many clients who seek help in therapy don't know that there are different types of therapy and different approaches to therapy.

If you're seeking help in therapy, it's important to ask any therapist that you have a consultation with how he or she works in therapy and then, after a consultation, decide if that approach is a good fit for you (for tips on how to choose a therapist, see my article:  How to Choose a Psychotherapist).

Look for a therapist who has skills in many different treatment modalities so that if one modality doesn't work for you, the therapist will have a repertoire of modalities to call upon.

Ask questions about a therapist's training, experience, years in practice and treatment philosophy.

Last but not least, trust your gut when you're trying to decide if a particular therapist is right for you.

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

I am trained in psychoanalysis as well as other contemporary experiential approaches like clinical hypnosis, ego states therapy, EMDR and Somatic Experiencing.

Rather than trying to mold the client to fit a particular type of therapy, I work in a collaborative way to develop a treatment plan that suits each client's needs.

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.