NYC Psychotherapist Blog

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Monday, October 30, 2017

Comfort Objects From Infancy Through Adulthood

In prior articles, I've discussed Donald Winnicott's contributions to the field of psychology (see my articles: The Creation of the Holding Environment in PsychotherapyBooks: Tea With Winnicott at 87 Chester SquareUnderstanding the False Self and On Being Alone).  As a pediatrician and psychoanalyst, Winnicott also contributed the idea of the child's need for comfort objects (also called transitional objects).  But comfort objects are not only for babies--they play an important role throughout our lives.

When Donald Winnicott discussed transitional objects in the mid-20th century, there was little understanding of these concepts among pediatricians and mental health professionals.  The field of child psychology was still relatively new and many people saw children as little adults rather than children who had their own emotional and developmental needs.

According to Winnicott, the baby is comforted by an object, usually a blanket or a soft toy (like a teddy bear)) that is soothing to the baby to hold.

The transitional object helps to soothe the baby when the mother is not holding the baby.

These transitional objects also help the baby, as the baby is developing, to create a transitional space between the times when the baby is with the mother and other times when she is not.

As I mentioned before, transitional objects are usually associated with children, but we all benefit from having transitional objects throughout the life cycle.

Let's explore these concepts further in a fictionalized vignette:

As a baby, Alan liked to hold onto his favorite blanket as he was falling asleep.  Sometimes, his mother would watch him fall asleep while he was gently chewing on the blanket or a soft toy.

Comfort Objects From Infancy Through Adulthood

Whenever Alan's mother tried to take the blanket from him to wash it, Alan would cry so hard that she would give it back to him.

When she asked Alan's pediatrician about this, he told her that this is a common reaction that babies have at this stage.  He explained that the baby likes to hold, smell, and chew on the blanket (or whatever comfort object the baby prefers) and likes it just the way it is--smells and all.  So, he told her not to worry about it.

When Alan was about three years old, he had a teddy bear that was his comfort object.  He dragged that teddy bear all over the house with him.

When he was in his room, Alan would listen to his mother in the kitchen washing the dishes and talking to her friend.  At this stage of his development, it was enough for Alan to hear his mother and know that she was only a short distance away even though he couldn't see her.  He had his teddy bear to comfort him.

Alan did well when he started school.  He got along well with the other children and he really liked his teacher, Ms. Jones.

Towards the end of the school year, Ms. Jones began talking to the children about all the wonderful things they would learn next year.  She also told them that they would have a different teacher.

Until then, Alan hadn't thought about not being in the classroom with Ms. Jones and the idea of not being with her frightened him.

When he got home, he told his parents that he didn't want to go to the next grade because he wanted to remain with Ms. Jones.  His parents understood that this was a common reaction that children have, especially if they really like their first teacher, so they tried to comfort him by telling him that Ms. Jones would still be around and he would see her in school.

Ms. Jones also knew that Alan and many of the children in her class were unhappy about not having her as a teacher the following year, so they continued to talk about this in school.  She assured them that she would be around and told them where they could find her during the day.

On the last day of class, Ms. Jones took pictures with each student and allowed them to keep them.

Alan carried around his picture with Ms. Jones throughout the summer.  He also kept it in his shirt pocket on the first day of class.  Even though he missed Ms. Jones, he felt comforted by looking at the picture.

As Alan matured into a young adult, he made friends and he became more independent from his parents.  Although he continued to be close to his parents, he spent more time with his friends.

Like most people, Alan had other transitional objects throughout his lifetime.  After he graduated college, he wore his college ring.  And after his grandfather died, Alan wore his grandfather's watch.

Comfort Objects From Infancy Through Adulthood

Eventually, Alan got married.  His wife took a temporary assignment out of state for a few months.  Whenever he felt himself missing his wife, he would look at a picture of her that he kept on his nightstand and that helped him to feel a little better.

People use comfort objects, also known as transitional objects, throughout their lifetime.

Comfort objects help to soothe people during times of transition or stressful times.

A comfort object is a very personal thing and each individual will choose the objects that are most soothing to them.

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

I work 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 send me an email.

Monday, October 23, 2017

The Therapeutic Benefits of Integrative Psychotherapy

Integrative psychotherapy is a client-centered approach to therapy that combines various forms of psychotherapy depending upon the needs of each client and the skills of the psychotherapist (see my article: The Benefits of Psychotherapy).

The Therapeutic Benefits of Integrative Psychotherapy

Psychotherapists, who use integrative psychotherapy, choose the types of therapy that they combine for each client.

As a psychotherapist, I combine a psychodynamic approach with various forms of mind-body oriented psychotherapy, including EMDR therapy, clinical hypnosis, Somatic Experiencing and Ego States work.

The benefit of using integrative psychotherapy is that the psychotherapist has many different ways that she works so that she can find the approach that is best suited for each client.

Integrated psychotherapy can be used together or separately at different points in therapy.

Let's take a look at a fictionalized vignette to see how integrative psychotherapy can be used:

Pat came to therapy to work on unresolved childhood trauma that was affecting her in her relationships.

She had heard from a friend, who was in EMDR therapy, that EMDR was effective in helping her friend to overcome emotional trauma, so Pat requested EMDR therapy.

Pat chose a psychotherapist who practices integrated psychotherapy, which included EMDR therapy, among other treatment modalities.

The Therapeutic Benefits of Integrative Psychotherapy

After the initial consultation and the history taking sessions, her therapist discussed the preparation phase of EMDR where the therapist assists the client to develop internal resources to deal with whatever might come up in EMDR therapy.  This is called the resourcing phase of EMDR therapy.

Since the therapist was also trained in clinical hypnosis, after discussing hypnosis with Pat, the therapist helped Pat to imagine a relaxing place (see my article: Safe Place Meditation).

While Pat was in a relaxed hypnotic state, she imagined herself on the beach and, using hypnosis, her therapist helped her to engage all her senses (sight, sound, smell, taste, physical sensation, hearing) to make the image as vivid as possible.

Afterwards, Pat said she felt very relaxed and she could use this image of the beach if anything came up in EMDR therapy that was disturbing to her.

Using clinical hypnosis, her therapist also helped Pat to imagine various friends and loved ones that had qualities that she liked (a nurturing person, a wise person, and a powerful person).  These are called imagine interweaves and they are also part of the resourcing phase of EMDR therapy.

Pat and her therapist talked about touchstone memories that related to the unresolved trauma, so Pat chose certain memories that reflected how emotionally neglected and invisible she felt as a child (see my article: What is Childhood Emotional Neglect? and Growing Up Feeling Invisible and Emotionally Invalidated).

Pat chose a memory that was emblematic of her parents neglecting her emotionally, and her therapist asked her, as part of the EMDR Therapy protocol, what negative belief she had about herself as it related to this memory.

Pat thought about it for a moment, and then she said, "It makes me feel unlovable, and I've felt this way my whole life" (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

As Pat and her therapist began working on the memory using EMDR, they came to an obstacle in the work.  Although Pat made clinical improvements until then, she was unable to get beyond a certain point in the therapy.

This is a common problem in trauma therapy, and her therapist helped Pat to explore if there was a particular belief (called a blocking belief in EMDR) that kept Pat from making further progress in their work.

Using Somatic Experiencing, her therapist helped Pat to explore what the blocking belief might be.

At first, Pat couldn't come up with anything.  But when her therapist asked Pat to sense into her body and see what she felt when she thought about the trauma being resolved, Pat said that she felt a tightening in her stomach (see my article: The Body Offers a Window Into the Unconscious Mind).

Her therapist helped Pat to describe this tight feeling in her stomach and to put words to this feeling.  Pat responded by saying, "I don't deserve to be loved."

As soon as she said this, Pat wanted to take it back.  She said, "I'm surprised that this is what came up because I don't feel this way completely."

Pat's therapist helped Pat to understand that we all have different aspects that make up who we are, and that there can be parts of ourselves that feel a certain way and other parts that don't (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

In Pat's case, there was a significant part of her that felt that she didn't deserve to be loved, and until her therapist could work with this part, their work together would remain blocked.

Using a combination of clinical hypnosis and Ego States work (also called Parts work), her therapist helped Pat to give a voice to this part who felt undeserving of love.  It turned out to be a very young part that had internalized her parents' emotional neglect and believed that Pat was unlovable.

By asking Pat to imagine this young aspect of herself sitting next to her, her therapist helped Pat to understand this part.

Using Ego States work, her therapist helped Pat to embody this young part so she could express what this young part needed.  Then, her therapist asked Pat to switch back to her adult self and to imagine her adult self holding and nurturing the younger part.  Then, she asked Pat to embody the child part and to feel the love that was coming from the adult part of her.

Since this was a very ingrained blocking belief, Pat and her therapist continued to do Ego States work  for several sessions until the younger part felt nurtured and deserving of love.

The Therapeutic Benefits of Integrative Psychotherapy

At that point, the blocking belief was resolved, and they were able to go back to doing EMDR therapy without any further problems.

Integrative psychotherapy combines various forms of therapy based on the client's needs and the psychotherapist's knowledge and skills.

The fictionalized vignette above demonstrates how various forms of therapy, including EMDR therapy, Somatic Experiencing, clinical hypnosis and Ego States work can be combined based on the needs of a particular client.

Not every therapist uses integrative psychotherapy.  So, in the case above, for a psychotherapist who only does EMDR therapy, she might have to use another approach to overcome the blocking belief.

In my experience, using integrative psychotherapy offers the therapist the best possible tools to help the client overcome problems that come up in the work, and it is more effective than just using one treatment modality, especially since there is no "one size fits all" form of therapy that works for every client.

Getting Help in Therapy
If you've decided that you could benefit from attending psychotherapy, it's good to be an informed consumer, which means educating yourself about the various forms of therapy (see my article: How to Choose a Psychotherapist).

When you see a psychotherapist for an initial consultation, you can ask the therapist how she works and what treatment modalities she uses.

In my professional opinion as a psychotherapist, an integrative approach that includes various mind-body oriented therapies is the most effective approach for most clients.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I use an integrative approach that combines mind-body oriented therapy with psychodynamic therapy.  

I work 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 or email me.

Monday, October 16, 2017

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client

In a prior article, I began a discussion about the holding environment in therapy (see my article: The Creation of the Holding Environment in Therapy).  As I mentioned in that article, the idea that the psychotherapist creates a safe therapeutic holding environment for the client was developed by British psychoanalyst, Donald Winnicott (for more on Winnicott, see my article: Books: "Tea With Winnicott" at 87 Chester Square).  In this article, I'm focusing on a particular aspect of the holding environment, which is the therapist's ability to keep the work emotionally manageable for the client.

The Holding Environment in Therapy

As an example, it's often the case that clients come to therapy because they're not feeling good about themselves.  This can be a lifelong problem or a new development for a client.  Either way, the client might focus on the aspects of himself that he is unhappy about and miss the fact that he has many strengths.

A skilled psychotherapist will usually see the client's strengths, even when the client is unaware of these strengths.  

The challenge for the psychotherapist is when to talk to the client about his strengths.

Timing is everything.  If the therapist brings up the client's strengths too early in therapy, the client, who has a particularly negative view of himself, will often minimize or dismiss the idea that he has these strengths (see my article: Overcoming the Internal Critic).

Some clients, who are focused on what they perceive as emotional deficits in themselves, might even think the therapist is being disingenuous when she tries to talk to them about their strengths (see my article: A Strengths-Based Perspective in Psychotherapy).  

In many cases, on an unconscious level, these clients are too afraid to consider the possibility that they have strengths.  Rather being overwhelmed by their fear, they protect themselves emotionally by remaining stuck in their denial.

It's important that the psychotherapist not interpret the client's reluctance as "resistance."  This comes across as judgmental.  It would only make the client feel uncomfortable and it's not helpful to the work.

If the therapist doesn't know how to handle the client's fear,  this could lead to the client leaving therapy prematurely to avoid dealing with uncomfortable feelings (see my article:  When Clients Leave Therapy Prematurely).

So, the skilled psychotherapist, who is aware that it would be premature to talk to the client about his strengths, must keep these observations to herself until the time is right.  This requires the therapist to be emotionally attuned to the client (see my article: The Psychotherapist's Empathic Attunement).

Even with self critical clients who are willing to explore the possibility that they have strengths, they might perceive their strengths on an intellectual level but not on a deeper emotional level.

For these clients, the therapist might broach the topic of the client's strengths, let the client know that she (the therapist) sees these qualities and will hold a space for them until the client can accept this on an emotional level.

This is a way for the therapist to create a safe holding environment for the client because the client knows that the therapist holds onto these observations until the client is ready.

Let's take a look at a fictional vignette that illustrates these points:

John had been in and out of therapy for many years.

He usually attended a few sessions with a therapist, and then he aborted therapy because he felt the therapist didn't understand him.

John struggled with depression, including low self esteem, since he was a child.  He grew up in a household where both parents were mostly preoccupied and paid little attention to John, who was an only child.

John's father often criticized him and told John that he would never amount to anything.  His father's critical comments were so frequent that John internalized them and, over time, believed them.  John's mother was depressed and withdrawn, and she was emotionally unavailable to him.

When he was in school, his teachers often told John that he had a lot of potential, but he was not trying.  From John's depressed perspective, he didn't see a reason to try since he believed his father that he wouldn't ever amount to anything.

As an adult, John drifted from one job to another.  Since he never expected to do well, he put little effort into his work, which resulted in disappointment for him.

John also had very low expectations about relationships.  He had a few close friends, but his romantic relationships didn't last beyond a few months.

He would go through long periods when he didn't even try to meet anyone, but then his loneliness caused him to try again with the same low expectations.  It was an ongoing cycle.

By the time John came to therapy again, he felt he was at a low point.  He was already in his mid-30s and he felt he had nothing to look forward to in his life.

The Holding Environment in Therapy

He told his current therapist at the start of therapy that he left his prior therapists because they were unable to see him as he was.  He felt that each of them saw him as they wanted him to be, which frustrated him.

He appreciated that his former therapists were "nice people" and they tried to speak to him about his personal strengths, but he didn't believe what they were saying.  He wasn't sure if they were mistaken or if they were intentionally trying to boost his confidence in a false way.  

Either way, whether the therapist was well-meaning but wrong or whether the therapist was only trying to boost his confidence and didn't really believe he had strengths, John found these discussions intolerable and he would abort therapy.

John's current therapist could see how self critical he was.  She also saw that he had many strengths.  But she also heard John loud and clear that he was unable to even consider that he had strengths, and she knew, based on what he was telling her, that if she tried to broach this with him, he would leave therapy, as he did in the past.  So she waited until he was ready.

Until then, his therapist remained attuned to John's experience and reflected back to him what he told her.  In doing this, she showed John that she understood how he felt about himself, and for the first time in his life, John felt that he was finally seeing a therapist who understood him.

In the meantime, his therapist held onto her perception of the many strengths she saw in John over time.  She waited until she saw a possible opening to explore this with him.

Gradually, as John felt more comfortable with his therapist, he opened up more with her, and she continued to let him know that she understood how he felt by mirroring back to him.

One day, John came to therapy in an agitated state.  He told his therapist that his new supervisor complimented John on a project.

John's first reaction was to get angry because he thought his supervisor was lying to him or he was trying to manipulate John in some way.

But as he thought about it, John said that he knew his supervisor wasn't a manipulative person, so he doubted that this was the reason for his compliment.  He said that maybe his supervisor was just trying to make him feel good--like some of John's prior therapists.  

Whatever the supervisor's intentions, John found it difficult to sit there and listen to his supervisor's compliments.  He said nothing to his supervisor but, for some reason, John realized, it brought up a lot of shame and sadness for him.

During the next several sessions, John continued to talk about this because his supervisor came to him again and told him that he really liked his work.  This continued to baffle John.

Over time, John became more open to exploring this issue and his own sadness and shame.  He was able to connect his negative feelings about himself to his critical father.

During that time, his therapist continued to maintain an open and empathetic stance with John, allowing John to draw his own conclusions (see my article: Why is Empathy Important in Therapy).

She knew that if she intervened prematurely, John would shut down emotionally and he might leave therapy.  She had to wait until he was ready.

Then, one day John came in and told his therapist that his supervisor took him to lunch.  John was surprised that he enjoyed talking to his supervisor over lunch.  He was also surprised to realize that his supervisor liked him and that his praise really was genuine.

As John opened up more emotionally in therapy, he allowed himself to feel his sadness about being a disappointment to his father.  He wished he could have had a father who was more like his supervisor--a kind and generous man.

As he continued to discuss this in therapy, John became aware that his father was a disappointed, bitter man, and his father didn't feel good about himself.

As he looked at his childhood from an adult perspective, he realized that his father was projecting his own negative feelings about himself onto John (see my article: Looking at Your Childhood Trauma From an Adult Perspective).

This led to John questioning whether his father's perceptions about him were accurate, "Maybe I'm not such a loser after all.  What do you think?"

At that point, his therapist realized that John created a small opening for them to be able to discuss the possibility that he wasn't "a loser" and he might have positive qualities.  She also knew that this was a tentative opening that could shut down if she rushed in because John might get overwhelmed, so she had to be cautious.

His therapist said she observed positive qualities in him, and she explored with him whether he would be open to discussing this.  John responded by shifting in his seat and telling her that it felt uncomfortable but, at the same time, there was a part of him that wanted to talk about it.

Gradually, John was able to explore his feelings.  He trusted his therapist enough to know that she wasn't going to lie, hurt him or try to manipulate him.

His therapist relied on John to tell her whether their discussions about his strengths felt too uncomfortable, and he told his therapist when he felt uncomfortable.  In this way, his therapist was able to maintain an emotionally safe environment for John in their sessions.

The Holding Environment in Therapy

Over time, John developed the emotional tolerance to discuss seeing himself in a positive light.  This was new and scary for him at first, but he was starting to feel better about himself.

By being attuned to John, his therapist was able to provide him with feedback about his positive qualities in "manageable doses" for him.  She respected his feedback when he told her that he was beginning to feel overwhelmed, and she would not push him beyond where he could go emotionally.

Working with John in this way, over time, his therapist was able to help John to mourn what he didn't get as a child and to develop more self confidence (see my article: Psychotherapy and Compassionate Self Acceptance).

There are many ways for a psychotherapist to create a therapeutic holding environment for a client.

One way, as I have discussed in this article, is to keep the therapeutic work manageable for the client.

To create a holding environment, the therapist must be emotionally attuned to the client and intuitively sense when the client is ready to explore uncomfortable issues.  She must also ask the client for feedback.

When the client provides a tentative opening, a skilled therapist doesn't rush in.  She helps to facilitate an exploration that is manageable for the client.

In this way, by being attuned and titrating the work, the therapist helps the client to make progress in therapy.  In other words, going slowly in these particular cases, is more effective than trying to get under the client's defenses and overwhelming the client.

From the outside, it might appear that the work is going too slowly, but with regard to the client's internal world the client is developing the internal resources for more in-depth work.  

Not every client has these particular problems, and in many cases the therapist senses that she can make observations early in therapy without jeopardizing the work.  But for clients who aren't ready, premature explorations often lead to premature endings in therapy because the client aborts therapy.

Getting Help in Therapy
Many people, who could be helped in therapy, never come to therapy and struggle on their own without success.

Finding the "right fit" with a particular therapist might be a matter of trial and error as you interview various therapists (see my article: How to Choose a Psychotherapist).  

I usually tell prospective clients to follow their own instincts when choosing a therapist and not to remain with a therapist if their gut feeling is telling them that it's not working out.  However, if you have a long history of aborting therapy prematurely, it might be worth considering that you're avoiding dealing with certain issues in therapy.

Rather than struggling on your own, you could benefit from seeing an experienced therapist who can help you to work through the problems that are keeping you stuck.

By working through problems that are keeping you stuck, you can lead a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and Sex Therapist who works with individual adults and couples.

I work in an empathetic, attuned and respectful manner with clients to help them to overcome their problems and maximize their potential.

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, October 9, 2017

Why Your Child Can't Be Your Best Friend

In my previous article, Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult, I discussed how early dynamics between parent and child often get recreated in adult relationships.  In this article, I'm focusing on a particular dynamic between parent and child where the parent sees the child as his or her "best friend" and the child takes on the parental role (also known as the parentified child) and the parent takes on the child role.

Why Your Child Can't Be Your Best Friend

To explore how this parent-child dynamic develops, it's important to realize that the parent who sees the child as a best friend usually was in that same role with one or both of her parents as a child.  In other words, this is often an unconscious repetition, so it doesn't seem unusual to the parent.  On the contrary, it's very familiar because he or she lived through it as a child and considered it to be "normal."

The parent who treats their child as a best friend often didn't get her emotional needs met as a child because of her own role as a best friend to her parent (I'm saying "her," but this is also true of relationships between a parent and a son).

This dynamic can continue to repeat itself intergenerationally, so there can be three or four generations where the children are expected to focus on the emotional needs of the parent instead of the parent taking care of the emotional needs of the child.

This comes at a tremendous emotional cost to the child because she subordinates her emotional needs to the needs of the parent.  On the face of it, this might seem like an impossible task for a child, but many children learn to sacrifice their emotional needs for  their parent's needs, and they become very good at it--to their own detriment.

So, if this is happening intergenerationally, how can a family break this unhealthy cycle?

Well, it often occurs when the child approaches adulthood and struggles to develop a healthy sense of autonomy.  Although this is a healthy sign for the child, it can wreak havoc between the parent and adult child if the parent isn't willing to allow the child to be more independent.

Let's take a look at a fictionalized vignette which explores these dynamics:

Clarissa and Clara
Clarissa started therapy soon after she began submitting her college applications to out of state colleges.

Why Your Child Can't Be Your Best Friend

Clarissa was an only child who was still living at home.  Her mother, Clara, was a single parent.  At the point when Clarissa came to therapy, they were arguing about the fact that Clarissa wanted to go away to college.  Although Clarissa stood her ground with her mother, inwardly she felt deeply ambivalent about leaving her mother.

Not only did she fear that her mother would be very lonely without her but Clarissa knew that her mother relied on her when Clara felt especially depressed and discouraged.

On the one hand, Clarissa wanted to be away at college to experience more freedom and have the campus experience before she settled down in a career.  On an intuitive level, she knew this was what she needed emotionally and socially.  But, on the other hand, she felt guilty leaving her mother alone.

When they argued, Clarissa tried not to show her ambivalence because she feared that she would cave in to her mother's wishes and sacrifice her own needs.  But, internally, she was struggling with the possibility of letting go of her role as her mother's best friend.

As Clarissa explored her family history with her psychotherapist, she began to realize for the first time that she and her mother had a similar dynamic to her mother and maternal grandmother.

Similar to the maternal grandmother, Clara was in her mid-teens when she had Clarissa.  They both raised their children without the biological father with the help of their mothers. Clara was her mother's best friend and confidant and they usually did everything together.

When Clarissa revealed to Clara that she wanted to go away to college, Clara was stunned.  She couldn't understand why Clarissa would want to leave their town where their family had roots for many generations.

Clara had always hoped that she and Clarissa would have a similar relationship to the one that Clara had with her mother.  She told her that Clarissa that she considered it a form of betrayal that she would want to move away to college for four years.

Clarissa talked to her therapist about how she grew up listening to her mother's problems.  Even as a young child, she tried to help her mother to overcome feelings of helplessness and hopelessness.

Even though she was only a young child, she felt she did a good job of shoring her mother up emotionally.  But now, she wanted something more--something for herself for a change.  She asked her therapist, "Am I being selfish?"

Over time, Clarissa's therapist helped her to work through her ambivalence to see that what she wanted for herself was healthy and necessary for her well-being.

Being able to look at her situation through her therapist's eyes, Clarissa could see, for the first time, that what was expected of her as a child wasn't healthy for her.  At the same time, she had a lot of compassion for her mother.

When Clarissa felt ready, she asked Clara to come to a therapy session with her.  Although Clara said she "didn't believe in therapy," she came to the session with a wary eye on the therapist.

When Clarissa explained to Clara why she wanted to go away to college, Clara burst into tears.  Although they had had this same talk many times before on their own, Clara realized that Clarissa made up her mind and it was final.

Clara explained to Clarissa and the therapist that she wanted what was best for her daughter, but she felt it would be unbearable for her to be home alone, especially since her mother died the year before.  She would have no one.

Clara idealized her relationship with her mother and told them that, from the time Clarissa was born, she wanted the same relationship with Clarissa that she and her mother had.  She was her mother's best friend and she hoped that Clarissa would be her best friend always.

But now that Clarissa wanted to go away, she saw all of this falling apart for her.  She couldn't understand why Clarissa couldn't go to the local college so they could remain together.  The therapist suggested that Clara could benefit from seeing her own therapist, but Clara brushed this off.

When Clarissa came to her next therapy session, she told her therapist that she felt more confident in her decision, even though she still felt guilty about leaving her mother.

Why Your Child Can't Be Your Best Friend

Eventually, Clarissa went off to college.  She continued to work on the emotional separation process from her mother with a therapist at the counseling center.

Her relationship with her mother remained fraught until her mother began developing her own friendships and interests in her church.

Over time, they were able to repair their relationship.  Clarissa enjoyed her new sense of autonomy and she felt that she was finally taking care of her own emotional needs.

When parents have their own unmet emotional needs from childhood, and especially if they were parentified children with one or both parents, they are more likely to try to get their unmet needs through their children.

This is usually an emotional blind spot for the parent.   In most cases the parent is unaware that she is doing harm to the child.  She's just doing what feels right, often based on her own childhood.

Children will often try to extend themselves beyond their emotional maturity and sacrifice their own needs in order to please their parents.

Even when the child attempts to resist being a parentified child, he or she often feels guilty about not being able to meet their parent's needs.

In order for the child to grow emotionally, the child needs to assert his or her own needs by resisting the parent's attempt to make the child their emotional caregiver.  Resisting the parent is usually very difficult and beyond what most children are able to do.

In order for the parent to grow, the parent needs to mourn that s/he didn't get what s/he needed as a child and find other healthy ways of getting emotional needs met instead of depending on the child.

Getting Help in Therapy
It's often difficult for the child to assert his/her needs for fear of losing a parent's love.  Similarly, it's often difficult for a parent to resist depending upon the child emotionally.

For parent and child, psychotherapy is often helpful to overcome these challenges.

If you're struggling with these issues, rather than struggling alone, you could benefit from getting help in therapy.

A skilled psychotherapist can help you to negotiate these emotional challenges so you can change, grow and lead a more fulfilling life.

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

I have worked with adult children and parents, both individually and together, to help them overcome these emotional challenges.

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.

Thursday, October 5, 2017

Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult

People often unconsciously choose a spouse who has similar characteristics to one or both parents (see my article:  Overcoming the Guilt You Feel For Not Being Able to Heal Your Parent's Emotional Wounds and How to Stop Being the "Rescuer" in Your Family of Origin).
Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult
A child, who was the emotional caregiver for a depressed parent, will often unconsciously choose a spouse who is depressed and recreate a similar caregiving dynamic with the spouse.

The following fictionalized vignette illustrates how these patterns are repeated and how therapy can help:

Emma grew up in a loving, nurturing home.  She was the youngest of three children in a close-knit extended family.  Both parents were actively involved in the children's lives, although the father was often away on business.

Emma's mother was well liked by her neighbors for her kindness and generosity.  She was very proud of Emma and Emma's sisters, and she instilled confidence in them.  She encouraged their curiosity and creativity, and she taught them that they could be whatever they wanted to be.

As the youngest, Emma was closest to her mother.  By the time Emma was about to start school, her sisters were already involved in high school activities and out of the house most of the time.  As a result, Emma spent a lot of time alone with her mother.

Emma's Mother: Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult

For a young child, Emma was especially perceptive, and she realized that her mother was depressed--even though her mother was loving and active in Emma's life and she tried her best to hide her depression from Emma and the rest of the family.

Emma worried about her mother, and she spent most of her time at home trying to enliven her mother and make her laugh. There were days when Emma's jokes and funny stories seemed to lift her mother's mood.  But there were other days when it seemed that nothing Emma could do would lift her mother's spirits and Emma felt very sad on those days.

As Emma got older and she developed friendships and outside interests, she continued to feel that her primary responsibility was to lift her mother's spirits. Realizing that Emma felt overly responsible for her, her mother would encourage Emma to pursue her friendships and interests.  She didn't want Emma to sacrifice her happiness.

By the time Emma graduated from high school, she felt deeply ambivalent about going away to college, even though her parents and older sisters encouraged her.  She worried that her mother would sink into an even deeper depression if she wasn't around to try to enliven her.

She had a hard time adjusting to being away from home during her first year at college, and she took every opportunity to go home on weekends to spend time with her mother.  She would also often bring home friends that she thought would be entertaining for her mother.

In her junior year, she met Tom.  She liked that Tom was a serious philosophy major, who was intelligent, knowledgeable and curious.  Soon they were spending a lot of time together.

Emma's friends at college teased her about Tom because they thought he was dour.  But Emma brushed off their criticism and told them that they didn't know him, they were judging him only from his outer appearance, and they couldn't appreciate all of the qualities that she saw in him.

Soon after they graduated college, Emma and Tom got married and began working. Emma found her dream job working as a journalist.  But Tom was unable to find the type of job he hoped for after he graduated college.  Part of the problem was that he had definite ideas of what he wanted and refused to compromise.  As a result, he did temp work.

Emma and Tom: Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult

Emma was very aware that Tom felt depressed and discouraged about his work situation, so she refrained from gushing about her work.  Instead, she tried to be emotionally supportive of Tom, but he didn't respond well to her trying to lift his spirits.  He would become annoyed with her and mostly wanted to spend time alone.

This left Emma feeling lonely and helpless, and when she tried to talk to Tom about it, he refused to address the problems between them.  He expressed his resentment that she was so happy with her work, and he felt miserable.

Soon, Emma was spending most of her free time with her friends because Tom refused to go out.  She was deeply concerned about Tom and their marriage, but there was nothing that she could do.

As time went on, Emma was promoted into a more responsible position with a big salary increase. She was also given more interesting assignments.  But Tom continued to stagnate.  Emma encouraged him to get help in therapy, but he refused to go.

Two years later, their marriage was over.  Tom moved out to live with his parents across the country, and Emma was in despair.

Shortly after that, Emma began therapy to try to understand what happened and to pick up the pieces of her life.  Her psychotherapist helped Emma to see how she had been in a similar dynamic with Tom as she had been with her mother.

Although Emma's mother and Tom experienced their depression in different ways and had their own unique responses to Emma's attempts at caregiving, they elicited similar responses in Emma.

While she was in therapy, Emma also saw her blind spots about Tom.  Looking back with the perspective of time, she realized that there were signs before she got married that Tom was depressed and rigid in his thinking, but she didn't want to see these traits.  She also saw her role in the demise of their marriage and how she infantilized Tom.

Emma grieved in therapy for the loss of her marriage as she went through the divorce process.  She also learned in therapy that she had a propensity to be a caregiver in a relationship due to her early relationship with her mother, and she would need to be much more aware of this in the future so she would not repeat the same patterns.

Emotional dynamics between parents and children are developed at an early age.

As in the fictionalized vignette above, these dynamics are often unconscious for both parent and child.

When a child grows up feeling emotionally responsible for a parent, this often sets up the possibility for similar dynamics in adult relationships on an unconscious level, which often leads to problems in the relationship for both individuals.

Getting Help in Therapy
Both people in the relationship need to be willing to change these unhealthy dynamics to make healthy changes.

It can be very challenging to overcome these dynamics on your own, even if one or both people are aware of them and willing to change, which is why working with a skilled psychotherapist can be helpful.

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 overcome unhealthy emotional patterns in their 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.