NYC Psychotherapist Blog

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Monday, February 29, 2016

Psychotherapy Blog: An Emotional Problem You Thought You Resolved Gets Triggered Again

It's not unusual for people to revisit emotional problems in therapy that they thought they had already worked through at an earlier time in their life.  Different life stages and events can trigger these problems in new and different ways.  Rather than feeling disappointed or discouraged, it can be an opportunity to work through an issue in a deeper, more meaningful way.

The following fictionalized scenario is an example of this type of phenomenon:

Alice came to therapy to work on fears of being abandoned in her current relationship (see my article: Overcoming Fear of Abandonment).

An Emotional Problem You Thought You Resolved Gets Triggered Again Later in Life

She knew logically that there was no objective reason to believe that her boyfriend of three years would leave her, but she still felt overwhelmed by this fear.  But, on an emotional level, she was constantly worried that her boyfriend would leave her no matter how many times he reassured her.

When this happens, it's often the case that there are underlying emotions, usually related to memories, that are getting triggered.

By doing an "affect bridge," which is a technique used in clinical hypnosis, we were able to trace back her fear to an earlier loss that she thought she had already worked through in a previous therapy--the loss of her father when she was 10 (see my article about the affect bridge technique:  What is the "Affect Bridge" in Clinical Hypnosis?).

Alice knew that she missed her father and she often wished that he was still alive, especially now that she and her boyfriend were talking about getting married.  But she said that, without doing the affect bridge, she never would have made the connection between her current fear and her earlier loss.

In a sense, Alice was relieved to know that her current feelings "made sense" in terms of the earlier loss, especially since there were no signs that her boyfriend would ever abandon her.

But, in another sense, she felt disappointed and frustrated that she had to revisit a problem that she thought she had worked through earlier.

As we explored her feelings, it became evident that she had worked through her grief in her last therapy for that time in her life.  But the intensity of her feelings for her boyfriend and their talk about getting married brought her to a deeper level, which she had been unaware of before.

Symbolically, for the sake of simplicity, we can think of the unconscious mind as if it had different layers.  Very often, when we work through an emotional problem, like a big loss, we work through it as best as we can at that time given our emotional development, life experience, and whatever is going on at that time.

Later on, at a different stage in life or with a different life event, like the possibility of getting married, this problem can resurface at a deeper layer, so to speak, of the unconscious mind that we were unaware of before.

In Alice's case, although she grieved for her loss earlier, she was not aware of feeling abandoned at that time.  Those feelings remained unconscious until the affect bridge made her unconscious feelings conscious (see my article: Psychotherapy: Making the Unconscious Conscious).

We started by separating her feelings related to her earlier loss from her current situation (see my article:          Working Through Emotional Trauma: Separating "Then" From "Now" in Therapy).  This helped to ease some of her fears so that she didn't feel the need to keep asking her boyfriend for constant reassurance.

Then, using EMDR therapy, we processed Alice's feelings about feeling abandoned by her father when he died (see my articles:  What is EMDR?How EMDR Works: EMDR and the Brain, and How EMDR Works: Overcoming Emotional Trauma).

Initially, she talked about knowing, logically, that her father loved her and he didn't want to leave her.

As we continued to process her feelings of being abandoned, Alice realized on a deeper emotional level that her feelings "made sense" on an emotional level, especially since she was only 10 when her father died.

The sudden and unexpected nature of her father's death contributed to her feeling abandoned.  She also realized that these feelings of abandonment were on a deeper level of her unconscious mind and they were inaccessible to her during her last therapy.   These feelings didn't surface until this time in her life when she felt emotionally vulnerable with her boyfriend as they talked about making a life commitment to each other.

EMDR therapy enabled Alice to work through her feelings of abandonment so that she was no longer getting triggered in her relationship.

An Emotional Problem You Thought You Resolved Gets Triggered Again Later in Life

Alice still missed her father, especially on her wedding day, but she was no longer vulnerable to fears of abandonment.

As human beings, we are complex emotional creatures.

At different stages of life, old emotional wounds can resurface in new and unexpected ways, even emotional wounds that we thought we had worked through at an earlier time in life.

Often, if we're unaware of what is going on unconsciously, we don't know what is at the root of the problem.

Using experiential types of therapy, like clinical hypnosis, Somatic Experiencing, and EMDR therapy, usually helps to get to deeper, unconscious levels in a shorter period of time than regular talk therapy and also helps to work through the problem at a deeper level (see my article: Experiential therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
If you've been unable to work through your problems on your own, you could benefit from seeing a licensed mental health professional who has expertise in your problem.

I usually recommend that people work with psychotherapists who are trained to work experientially to get to these deeper levels.

Recognize that it's not at all unusual for old emotional wounds to resurface at different stages of your life.  Working through an old emotional wound at a deeper level can help you to feel more emotionally integrated and fulfilled.

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, February 22, 2016

Being the Different One in Your Family

In a prior article,  The Role of the Family Scapegoat in Dysfunctional Families, I discussed how the family scapegoat is usually made to feel like s/he is "different" from the rest of the family and the cause of the family's problems, even when s/he isn't really the source of their problems.  In this article, I'm focusing on what it's like to feel "different" in a family.

Being the Different One in Your Family

Examples of Being the "Different One" in a Family:
  • A first generation child, whose parents are originally from a different country, not only feels different, but often feels conflicted because s/he can feel caught between the family's traditions from their country of origin and the culture of the new country.
  • A child, who is gay, in a family that has traditional views of what it means to be a man or a woman, can feel different from other family members and, depending upon the family.
  • A child, who has liberal views and who grows up in a family who conservative traditional views can feel different.
  • A child, who is artistic and who grows up in a family that devalues artistic skills and wants their child to pursue a more mainstream career, can feel devalued and question his or her own views.
  • A child, who grows up in a family where the parents and the siblings all abuse alcohol and drugs and who all dropped out of high school, might feel misunderstood because s/he values education and wants to avoid abusing substances.

These are just a few of many possible examples of how a child can feel and be perceived as different from other family members.  There are many other examples.

Of course, there are families who are open minded and who can accept a child who is different.  This can help the child to feel accepted and loved as well as accepting of his or her own values.

The problem arises when being "different" in the family is perceived as being "less than" the rest of the family.  The parents might feel that the child's differences are a threat to the family and, in that sense, the differences feel dangerous to them.

The following scenario is a fictionalized example of how growing up being the "different one" in a family can be difficult and how this problem can be overcome in therapy.

Mark grew up in a traditional religious family.  He was the youngest of five children.

When he was a young child, he never questioned his religion.  But when he was in his mid-teens and he socialized with friends and their families from different backgrounds, he became increasingly aware that there were other ways of seeing the world and he began to question whether he believed the basic principles of the family's religion.

When he told his parents and older brothers that he wasn't sure if he believed in these basic principles, they were stunned.  His father became angry and told Mark that the family's religion is what got them through many difficult times going back to Mark's great grandfather's time and probably before. He felt that Mark's questioning was heresy.  He warned Mark that no good would come of it.

Mark couldn't understand why his father was so upset.  But, after he experienced his father's anger, Mark kept his questions to himself.  He continued to observe the family's religious traditions but, inwardly, he continued to wonder how meaningful, if at all, these traditions were to him.

As Mark entered college, he was encouraged by his parents to take business courses so that he could become an accountant or a business manager.

During his first two years of college, Mark's college required him to take certain core courses where he was exposed to many different subjects and new ideas.

By the time he was a college Sophomore, he was very drawn to art history.  But when he told his parents that he wanted to be an art history major instead of a business major, they were even more upset than when he told them that he was questioning their religion.

His parents talked to him about how financially difficult it had been for both the mother's and the father's families and for them before Mark was born.  They stressed the importance of choosing a major that would be "practical."  They didn't want Mark to struggle financially the way they did or the way their parents did.  They urged him to major in business because, as a business major, he could find a job, whereas as an art history major, he might end up jobless.

Mark considered what his parents told him.  He was aware that his older brothers followed their parents'  suggestions and each of them was doing well financially.  They had secure jobs, and they seemed happy with their choices.

But Mark was becoming increasingly aware that he wouldn't be happy as a business major.  He understood his parents' concerns and their practical advice, so he felt torn.

He was also more and more aware of how different he was from his parents and brothers.  He loved them very much, but he knew he needed to find his own way, which was probably going to be different from the rest of his family.

He also felt that his parents were still traumatized by their experiences of going through difficult financial times.  Even though they overcame their earlier financial difficulties, he knew that, on an emotional level, they never got over their fear and sense of vulnerability.  It was as if they were living in the past.  He knew they couldn't see that he had opportunities now that they never had.

Feeling more and more conflicted and confused between what he wanted and his loyalty to his family, he decided to start therapy.  This was difficult for him because, on a certain level, he felt he was being disloyal to his family by going to therapy (see my article:  When Family Loyalty Gets in the Way of Your Psychotherapy Sessions).  

He didn't tell his family about his therapy because he was sure they wouldn't understand.  He knew that they would think that he shouldn't talk about the family to a stranger, even if the stranger was a licensed mental health professional.

During his therapy, Mark's therapist, who was trained as a hypnotherapist, helped him to have greater access to his unconscious feelings and wishes by using clinical hypnosis.  While he was in a relaxed hypnotic state, his therapist asked him to imagine his future self as he wanted himself to be when he completed college (see my article: Experiencing Your Future Self: The Self You Want to Become).

As Mark became more comfortable with hypnosis, he was able to gradually put aside his conflicts and focus on what he wanted for himself.  As he did this, he felt how deeply he wanted to pursue a career in art history.

Over time, with increasing confidence, Mark became more open to exploring this possibility by seeking out people who were already in the field, including his professor.  With more information from people in the field, Mark realized that he wanted to pursue an art history career, possibly working in an art gallery.

After he graduated with a major in art history, despite his family's disapproval, Mark went on to get a graduate degree in art history.  His degree also included business courses related specifically to the art world so he felt he would be better prepared for the field.

As part of his educational courses, Mark interned at one of the more prestigious art galleries in New York City, and by the time he had his Master's degree, the gallery owner hired him full time.

Although his fear was that he would alienate his family, he came to realize that his family still loved him, even if they didn't understand why he wanted to pursue a career that was so different from what they wanted for him.

Over time, as Mark continued to advance in his career, his parents' and older brothers' disapproval softened and they came to accept that Mark was happy in his field and that's really all that mattered.  Mark also let go of his conflictual feelings about being different and embraced his choice.

Getting Help in Therapy
Being the "different one" in your family can be an emotionally painful and lonely experience if your family members don't understand or accept what you want.

Trying to appease others by sacrificing your core sense of self will only make you unhappy. Although it can be difficult to be an individual who is different from other family members, being true to yourself is the best way to lead a fulfilling life.

If you're struggling with feeling different, rather than struggling on your own, you could benefit from working with a licensed mental health professional who can help you to deal with these emotional struggles, learn to be an individual, and feel more confident (see my article: How to Choose a Psychotherapist).

About Me:
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex 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, February 8, 2016

Overcoming Anticipatory Anxiety

In a prior article, How to Stop Worrying, I addressed a concern that many chronic worriers have.  In this article, I'm addressing a specific type of worrying, which is called anticipatory anxiety.

Overcoming Anticipatory Anxiety

Many people struggle with anticipatory anxiety, which is worrying about something in advance of it occurring.

The thing that you're worried about is something that may or may not occur at some point in the future.

Anticipatory anxiety isn't an anxiety disorder.  It's part of different types of anxiety disorders, including generalized anxiety, panic attacks, posttraumatic stress disorder (PTSD) and other forms of anxiety.

What Are the Symptoms of Anticipatory Anxiety?
Symptoms can include:
  • excessive worrying
  • insomnia
  • muscle aches
  • nausea
  • headaches
  • hyperventilation
  • feelings of dread
  • overeating
  • gastrointestinal problems
  • panic attacks
When, Why and How Does Anticipatory Anxiety Occur?
Anticipatory anxiety can occur at any time and for many people it's a chronic condition.

Anticipatory anxiety can include worrying in advance of anything being wrong about money, job loss, problems in a relationship or any other event or situation that hasn't occurred yet.

The fact that it hasn't occurred yet is key--it is the anticipation that something bad will happen.  It's not necessarily based on anything objective that is going on now.

Anticipatory anxiety can occur based on your past, including early childhood experiences.

For instance, if you grew up in a home that was chaotic where your parents were constantly worried about real and imagined problems, you can grow up feeling that the world isn't a safe place and, generally, anything that can go wrong will go wrong in your life as an adult.  This can develop into generalized anxiety disorder.

Many people who suffer with anticipatory anxiety are unaware that they have become accustomed to this habitual way of worrying.  Their habit of worrying has become automatic.

If you had significant trauma that has resulted in your developing posttraumatic stress disorder (PTSD), you might respond to many events or situations in your life as if they will result in catastrophe (see my article:  Are You Catastrophizing?)

There is no differentiation between traumatic events and normal non-traumatic life events.

How to Overcome Anticipatory Anxiety?
Here are some tips that might be helpful to you:
  • Rather than allowing your thoughts to run away with you, make a conscious effort to step back from worrying and question whether the things you're worrying about are likely to happen.
  • Ask yourself if you're okay now (as opposed to your worries about the future).
  • Think about all the other times when you worried about something and things turned out well.
  • Distract yourself from your worries by focusing on something else.
  • Talk to a friend or loved one to get a better perspective.
Getting Help in Therapy
The tips outlined above work for some people.

Many other people, who try to deal with their anticipatory anxiety on their own find that they need the help of a professional mental health professional, especially if their problems are longstanding and ingrained.

A licensed psychotherapist can help you to get to the root of the problem that causes you to have anticipatory anxiety.

Rather than suffering on your own, with the help of a licensed therapist, you can overcome this problem 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.

Monday, February 1, 2016

Redefining Happiness and Success For Yourself

Developing your own definition of happiness and success for yourself is part of an important personal growth and development process.

Redefining Happiness and Success For Yourself

Throughout the different stages of your life, you could find yourself redefining what happiness and success means to  you as you grow and change.

It's not unusual for people to change what they want, especially as they approach midlife and reevaluate their lives (see my articles:  Midlife Transitions: Reassessing Your Life and Midlife Transitions: Living the Life You Want).

Sometimes, what seemed important at an earlier stage in your life becomes less important later on in life.

Maturity, life experience, losses, aging, surviving a serious illness and other important experiences can contribute to your need to reevaluate your life and what makes you happy.

The following brief fictionalized scenarios are examples of how people change their minds about what's important to them:

Larry came from a long line of doctors in his family.  His great grandfather, grandfather, father and older brother were all doctors.  So, from an early age, his family urged him to follow in his family's footsteps to become a doctor.

Redefining Happiness Success For Yourself

Although Larry was interested in painting, his father urged him to forget about his artwork and concentrate on science and math.

Fifteen years after Larry graduated from medical school, he was a successful cardiologist at a prestigious hospital, but he was deeply unhappy.  Although he cared about his patients, he was disenchanted with all the changes in the health field and he longed to get back to painting.

Burnt out and at his wit's end, he began therapy to explore what he wanted to do with the rest of his life.  Gradually, over time, Larry realized that he allowed his family to dictate what it meant to be successful and happy because he didn't want to disappoint them.  And, although he was good at taking care of his patients, he wasn't nurturing himself.  So, he decided to cut back on his hours to give himself time to paint.

Once he began painting, he felt more emotionally integrated and approached his work as a cardiologist with a new sense of purpose and devotion.  He also began to think about spending more time painting when he retired.

Mary spent most of her adult life in banking.  She started as a teller and worked her way up to a position as a managing director.  Although the work was financially rewarding, Mary felt that something was missing in her life.  She was two years away from retirement and she found herself daydreaming about running a bed and breakfast in the country.

Initially, she pushed these thoughts out of her head because they seemed so far fetched to her.  But, over time, as this daydream continued to occupy her thoughts, she realized that she needed to pay attention to them.

Redefining Happiness and Success For Yourself
When she approached her husband about it, he was surprised at first because Mary had never mentioned this to him before.  But the idea of moving out of the city, living in the country and running a small bed and breakfast began to appeal to him.  Their children were already grown and on their own.  With their retirement savings, they could afford to do it.

The main challenge for Mary was that, since she was in her early 20s, she had defined herself, to a large extent, based on her career in banking.  She was also very successful in her field and she derived satisfaction from being recognized as successful.  Retiring from banking and running a bed and breakfast would be a big change.

As she discussed her daydreams with her therapist, she began to feel more comfortable with the idea of making plans for this major change.

Martin spent his 20s working as a flight attendant.  Although he loved the travel benefits, he found the work uninspiring.

After a close friend died suddenly from a brain aneurysm, Martin began to reevaluate his life.  He realized that life is short and he wanted to do something that had meaning for him.   But he didn't know what he wanted to do.

Feeling lost and confused, he began therapy to explore these questions.  As he opened up to his internal experience in therapy, he realized that he wanted to help others.  Exploring many options by talking to people in various medical and social service settings, he decided to become a social worker.

Redefining Success For Yourself

Although giving up the travel benefits was hard, as Martin began his first internship in the social services field, he knew that he had made the right choice.  Working with children and seeing the difference that he made in their lives was the most fulfilling experience of his life.

These fictionalized scenarios are just a few examples of how people grapple with a need for change and a process of redefining what is meaningful to them.

These types of changes are often preceded with ambivalence and anxiety.  In many circumstances, it can feel like you're stepping into the unknown, which is why people going through this process often find it helpful to work with an experienced mental health professional who can help them to understand and work through the underlying issues, including deep underlying fears, that might be holding them back.

Getting Help in Therapy
Asking for help isn't always easy.  Anticipating change can also be anxiety provoking.

If you're struggling with your own definition of what it means for you to be successful and happy or you identify with one of the fictionalized scenarios above, you could benefit from seeking help from a licensed mental health professional.

Working with a licensed psychotherapist, you can explore your own anxiety and ambivalence about what it means to be successful and happy, and overcome the underlying issues that might be getting in your way.

Seeing a licensed psychotherapist to help you to discover what makes you happy can help you to 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.