Intergenerational Family Dynamics

Intergenerational family dynamics is an important factor in understanding yourself as well as understanding your family.  This includes developing an appreciation for intergenerational trauma in your family and how it affects you (see my articles:  Psychotherapy and Intergenerational Trauma and Overcoming Dysfunctional Ways of Relating in Your Family).

Intergenerational Family Dynamics

What is a Genogram?
One of the best ways for seeing and understanding intergenerational family dynamics is to draw a genogram.

A genogram is a diagram of your family for at least three generations.  It is a graphic representation with symbols for repetitive intergenerational dynamics in your family.

A Genogram is a Family Tree Where Repetitive Intergenerational Dynamics Are Added 

The diagram above shows an ordinary family tree.  To make a family tree into a genogram, symbols are added to reveal repetitive intergenerational dynamics (see below: Drawing Your Own Genogram).

One of the best books for understanding genograms is Genograms in Family Assessment by Monica McGoldrick and Randy Gerson.  This book is often used in social work graduate programs when graduate students study family dynamics.

This book also provides the symbols most used for showing family dynamics like estrangement, divorce, death, suicides, fused relationships, conflictual relationships and so on (due to the limitations of this blog, I'm unable to provide these symbols, but they are readily available online).  But you can make up your own symbols.

Understanding Intergenerational Family Dynamics From Genograms
A genogram is a useful tool when clients come to therapy to change longstanding dynamics that have played out in their family.

Genograms capture dysfunctional patterns, life changes, trauma and family triangles as well as successful and positive patterns for multigenerational families.

In Genograms in Family Assessment, one of the examples used to show intergenerational family dynamics is a genogram for Eugene O'Neill's family (see my article about O'Neill's play: Denial and Illusions in the Iceman Cometh).

These dynamics are also captured in O'Neill's most autobiographical play, Long Day's Journey Into Night.

The genogram for the O'Neill family is a graphic representation of repetitive intergenerational patterns, including alcohol abuse, drug abuse and other destructive patterns.

It also reveals a generational pattern of marital instability.  In addition, there is an intergenerational pattern of the oldest sons dying young in that family, which is depicted in that genogram.

There was also an intergenerational pattern of estrangement between fathers and sons in the O'Neill family as revealed in the book's genogram for the O'Neills, which is also captured in Long Day's Journey Into Night.

Why Use Genograms to Understand Intergenerational Family Dynamics?
As mentioned earlier, genograms are graphic representations of a family tree for at least three generations.  They include symbols between generations to show intergenerational patterns.

One of the values of using genograms in psychotherapy is that they provide a succinct picture which reveals how complex repetitive patterns evolve in a family over time.  This provides a more in-depth appreciation of why some individual and family patterns are so entrenched and difficult to change.

Drawing Your Own Genogram
A genogram is a tool.  There is no agreed-upon method for drawing a genogram.

You can start by drawing a family tree of both sides of your family and then choosing your own symbols to mark intergenerational patterns for major life events, behavioral patterns and other repetitive patterns.

You can also look at the book, Genograms For Family Assessment, where, aside from the O'Neill family, the authors provide genograms for other well-known families like the Roosevelts, Gandhi's family, Freud's family, Katherine Hepburn's family, the Bronte sisters, the Kennedy family and many others.

There are also some online programs that allow you to draw genograms.

When you have marked the intergenerational patterns in your genogram, you will have a better understanding of your family, a new appreciation of how these repetitive patterns occur over time, and why these patterns might be so difficult to overcome.

If you're in therapy or you're thinking about starting psychotherapy, bringing in your genogram to your psychotherapist will serve as a valuable shorthand to illustrate the dynamics in your family.

There are also some therapists who will draw a genogram in your therapy sessions, based on the information that you provide, to help both you and her to understand your own and your family's history.

Getting Help in Therapy
Whether you use a genogram or not, if you have been unable to resolve your problems on your own, you could benefit from seeking help from a skilled psychotherapist (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

When you have worked through the problems that are holding you back, you can live a more fulfilling life unburdened by your history.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

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 email me.

When You Shut Down Emotional Pain, You Also Shut Down Potential Pleasure

There are many people, who have a history of traumatic experiences and who could benefit from psychotherapy, but they never come to therapy.  Instead, they do whatever they can to try to suppress and avoid feeling their feelings, but what they usually don't realize is that when they shut down their emotional pain, they're also shutting down the potential for feeling pleasure (see my article: What Happens When You Numb Yourself Emotionally).

When You Shut Down Emotional Pain, You Also Shutdown Potential Pleasure

In addition, what many of people don't know is that a skilled trauma-informed psychotherapist knows how to help clients to develop the ability to expand their "window of tolerance" so they can work through their traumatic experiences in an emotionally-safe therapeutic environment (see my article: Expanding Your Window of Tolerance in Psychotherapy).

What is the Window of Tolerance?
In my prior article, I explained that, according to Dr. Dan Siegel, the window of tolerance is a term that refers to the optimal level of arousal or the optimal zone.

When clients are in their optimal level of tolerance, they are neither hyper-aroused nor hypo-aroused.  They are able to deal with problems as they come up because they're at their optimal level of arousal.

During times of extreme stress, if clients are experiencing hyperarousal, they're in the flight/flight mode, which includes hypervigilance, anxiety, racing thoughts and possibly panic. If they're experiencing hypoarousal, they're in the freeze mode, which includes emotional numbness, feelings of emptiness or emotional paralysis.

Fictional Clinical Vignette: When You Shut Down Emotional Pain, You Also Shut Down Potential Pleasure
The following fictional vignette illustrates how suppressing emotional pain also suppresses pleasure:

Rena
After Rena's mother died in a car accident, Rena would wake up each morning feeling that she had nothing to look forward to and she lacked purpose and meaning in her life.

She told her new psychotherapist that everything felt "blah" and no sooner did she wake up in the morning than she felt like hiding under the covers (see my article: Coping With the Loss of a Loved One: Complicated Grief).

When You Shut Down Emotional Pain, You Also Shut Down Potential Pleasure

She explained to her therapist that she didn't always feel this way.  For most of her life, she looked forward to the joy that each day would bring and she was able to take emotional challenges in stride.  But she was very close to her mother and after her mother died in a car accident, her grief was unbearable.

Rena realized that she had never experienced such raw sadness and anger before.  Her new psychotherapist explained to Rena how emotional numbing numbed joy as well as pain.  She recommended that they use EMDR therapy to help Rena overcome her trauma (see my article: How EMDR Therapy Works: EMDR and the Brain).

Over the next several months, as Rena worked with her therapist on the unresolved grief, her therapist titrated the work so that it was manageable for Rena.

Rena's psychotherapist worked in a way that was within Rena's window of tolerance so that, although Rena still felt very sad when she processed her grief, she didn't feel overwhelmed.

Gradually, Rena was able to expand her window of tolerance so that she could tolerate dealing with deeper levels of emotion without feeling overwhelmed.

Psychotherapy Can Help You to Overcome Traumatic Experiences 

Over time, Rena felt as if she was coming back to life again.  Although she continued to feel sad, she also had moments of happiness.  She felt like she was coming out of a period of time when everything felt gray.  Now, she was beginning to notice colors, nature, music--all the things she enjoyed in her life before her mother died.

She memorialized her mother by writing short stories about her from the time her mother was a young girl up until the time she died so unexpectedly.  This felt healing to Rena (see my article: Writing About Your Mother After Her Death).

Conclusion
Shutting down often occurs when people feel overwhelmed by emotion.  It starts as a protective defense mechanism.  Over time, it can develop into an emotional and physical numbing that shuts out pleasure as well as pain.

When this occurs, some people feel their life has no meaning.  The more they try to avoid feeling, the more exhausting it becomes to try to suppress their feelings.

There is no quick fix for overcoming an overwhelming traumatic event, but trauma therapy can help.

Getting Help in Therapy
While it's understandable that people who have experienced trauma want to protect themselves from feeling the emotional pain, avoiding feeling emotions only makes it worse.

A skilled trauma therapist knows how to work with trauma in a relatively manageable way.

This doesn't mean that there is no emotional pain involved, but an experienced trauma therapist can work in a way to minimize a client getting overwhelmed by working within the client's window of tolerance and helping the client to expand that window of tolerance (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

If you're feeling stuck with unresolved trauma, you could benefit from seeking help from a licensed mental health professional who has an expertise in helping clients to overcome trauma.

Working through psychological trauma allows you to work through the emotional pain so that you can feel like yourself again and you can lead a more meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma-informed psychotherapist who works with individual adults and couples.

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

Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma: A Clinical Vignette

In my prior article, Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone, I began a discussion about experiential therapies like EMDR therapy, Somatic Experiencing and clinical hypnosis and why experiential therapy is more effective than talk therapy (psychodynamic or cognitive behavioral therapy) alone.  As I mentioned in my last article, I'm providing a clinical vignette to illustrate these points in this article.

Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma

Fictional Clinical Vignette: Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma:

Tia
Tia began psychotherapy with an experiential psychotherapist after having been with prior psychotherapists who practiced psychodynamic psychotherapy and cognitive behavioral therapy (CBT).

Although she felt she gained valuable insights in her therapy with a psychodynamic psychotherapist and she learned some helpful tools with her CBT therapist, she felt that her core problem, which was a fear of being sexual with her current boyfriend as well as, in the past, with her previous boyfriends.

In her prior psychodynamic psychotherapy, she learned that her fears stemmed from early sexual molestation by her maternal uncle.  Prior to attending this therapy, she had always known about the sexual molestation, but she never connected it to her fear of being sexual.

Although this insight was valuable to her, Tia still got emotionally triggered in her relationship with her boyfriend, John, especially when they made love.  She loved John and she had no doubt that he loved her.  She felt close to him most of the time, but when they had sex, she felt numb and there were times when she had to ask John to stop making love to her because she felt overwhelmed with fear.

Even though she understood the origin of her fear of making love with John, it didn't help her to overcome the emotional and physical numbing that she experienced when he touched her sexually.

After being with her psychodynamic psychotherapist for several years, she went to a therapist who practiced CBT.  Her CBT therapist provided her with tools for anxiety and tried to use desensitization  techniques to help Tia overcome her fear of being sexual with John.

But when Tia was with John and they attempted to be sexual, she continued to feel fearful and then numb, even though she tried using the tools that she developed in CBT.  The CBT desensitization also didn't help her outside the therapy room.

Since Tia wanted to overcome her fear of being sexual, she decided to try experiential psychotherapy after hearing from a friend that it was helpful to her.

After several sessions of providing the history of her problem, family history, and preparation to do trauma work, Tia's experiential psychotherapist recommended that they use EMDR therapy (see my articles: EMDR Therapy - When Talk Therapy Isn't Enough, How EMDR Therapy Works: EMDR and the Brain, and EMDR Therapy For Big T and Smaller T Trauma).

As they worked on Tia's problem using EMDR therapy, Tia's therapist did a "float back" (similar to the affect bridge in clinical hypnosis) to see if there were any earlier memories (also called "feeder memories") that were affecting Tia.  

As Tia focused on whether there were any earlier memories where she had the same emotions and negative beliefs about herself that she had related to her memory of her uncle sexually molesting her, she remembered that when she was a few years younger, an older cousin sexually molested her and threatened to hurt her if she told anyone about the sexual abuse.

Tia's psychotherapist explained to her that, based on feedback from Tia, her earlier psychodynamic therapy provided Tia with insight and helped her to understand the unconscious emotions that were affecting her.  And CBT provided her with some tools, but that therapy remained superficial.

As a result of both therapies, Tia could talk about her problem, but her understanding remained intellectual.  Neither therapy helped her when she froze in fear physically and emotionally when she and her boyfriend tried to have sex.

In addition, and this was important--neither therapy got to the earlier memory of the sexual molestation and threats by her cousin.

After they discovered that there was an earlier memory of sexual molestation when she was younger, Tia's psychotherapist focused on that memory first and when they completed the work on that memory, they focused on the later sexual molestation involving the uncle.  This took several months.

Since EMDR therapy focuses on the past, present and future, after they worked through both memories, they focused on Tia's fear and numbing in the present with her boyfriend.

Why Experiential Psychotherapy is More Effective Than Talk Therapy Alone to Overcome Trauma 

Having worked though the earlier memories of abuse, the present and future/anticipated situations were easier.  And Tia reported to her therapist that she was no longer feeling fearful and numb when she had sex with her boyfriend, and they were enjoying an active sex life.

Conclusion
In this particular scenario, I used an example of EMDR therapy, but the same could apply to clinical hypnosis, Somatic Experiencing, Coherence therapy, and Ego States therapy (also known as Parts Work).

Some people respond better to one type of experiential therapy than another.  For the sake of brevity, I used a scenario where the client responded well to EMDR, but I could have also given a scenario where the therapist either switched to one of the other types of experiential therapies or used these experiential therapies in combination as many integrative psychotherapists do.

As I mentioned in my prior article, there are many reasons why experiential psychotherapy is more effective than talk therapy alone, including the fact that talk therapy tends to remain on a cognitive level whereas experiential therapy gets to the root of the problem on a deeper (limbic brain) level where the problem exists.

Also, both EMDR therapy and clinical hypnosis have particular methods to discover whether there are "feeder memories," which are earlier memories that are affecting the trauma.  In clinical hypnosis, the method is called the affect bridge and in EMDR the method is called the float back technique.

Unless the earlier feeder memories are worked on, the problem will only be partially solved and the client is still likely to get triggered.

In the scenario above, if the psychotherapist had not looked for feeder memories, Tia and her therapist would only have worked on memory that Tia came in with, but that earlier feeder memory would have continued to affect her when she was sexual with her boyfriend.

Although experiential psychotherapy tends to be more effective and work faster in helping clients to overcome trauma as compared to talk therapy alone, experiential therapy isn't a quick fix, and everyone processes their problems differently with experiential psychotherapy.

Getting Help in Therapy
If you have been suffering with unresolved trauma, you could benefit from getting help from a licensed mental health professional who practices experiential psychotherapy.

To overcome trauma, you need more than just insight.  You need psychotherapy that will get to the root of the trauma in the limbic brain, which is what experiential therapy does (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

After you have overcome your traumatic experiences, you can be free from the emotional burdens of your history and live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma-informed experiential psychotherapist who works with individual adults and couples.

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

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

Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma

I have discussed the use of experiential psychotherapy for overcoming psychological trauma in prior articles.  In this article, I'm focusing on comparing talk therapy alone to experiential therapy and discussing why experiential therapy tends to be more effective than talk therapy alone for overcoming psychological trauma (see my article: Experiential Psychotherapy Helps to Achieve Emotional Breakthroughs).

Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma 

My Background as a Trauma-Informed Psychotherapist

As I have stated before in prior articles and in my biographical information for this blog, my original training from almost 20 years ago was in psychoanalysis.  Back then, after completing graduate school, I was a psychoanalytic candidate in training and I used psychodynamic psychotherapy and psychoanalysis with clients from the institute's center, including clients with psychological trauma.

While I loved my training and still like applying contemporary Relational psychoanalytic concepts, especially Winnicottian concepts, over the years I discovered that psychoanalysis by itself was not as effective in helping traumatized clients to overcome their problems as compared to experiential psychotherapy or the combination of contemporary psychoanalysis and experiential therapy (see my article: Contemporary Psychoanalysis and EMDR Therapy: A Powerful Combination to Overcome Trauma).

In those early years of my training to be a psychoanalyst, it was frustrating to see that clients in developed insight into their problems, which was an important step, but it often didn't change their problems.

My experience in those early days was that many clients "felt better" and that psychoanalysis was useful, especially back then when clients came multiple times per week.  But I wasn't satisfied that most clients, who experienced trauma, made significant experiential shifts.

After my psychoanalytic training, the mental health field was changing rapidly, and I decided to find out what other types of psychotherapy were being used effectively for PTSD (posttraumatic stress disorder) and trauma.  That's when I heard about EMDR therapy, which stands for Eye Movement Desensitization and Reprocessing (see my articles: How EMDR Therapy Works: EMDR and the Brain and What is Adjunctive EMDR Therapy?).

Since being trained in EMDR in 2004, I have used it regularly and found it to be an effective therapy for helping clients to overcome trauma, including PTSD.  I was fascinated to see that clients were overcoming their traumatic symptoms faster than most clients in talk therapy alone, and the results lasted over time.

In subsequent years, I obtained training in other forms of experiential therapy, including clinical hypnosis, Somatic Experiencing, Ego States therapy and Coherence therapy, which has been invaluable in helping traumatized clients to overcome their problems.

Using these experiential therapies over the years has been pivotal in becoming a trauma-informed psychotherapist who has been able to help many clients who have a traumatic history.

At this point, after using these experiential therapies consistently for several years, I consider myself to be an integrationist who often combines these therapies when it is most effective to do so based on the needs of each client.

Why Experiential Psychotherapy is More Effective Than Talk Therapy to Overcome Trauma

There are many reasons why experiential psychotherapy is more effective than talk therapy alone to overcome psychological trauma:

• Whereas talk therapy alone tends to help clients to develop intellectual insight into their problems, experiential therapy, by definition, uses the mind-body connection so that clients experience their emotions on a physical as well as an emotional basis which allows access to the unconscious mind (see my article: Experiential Psychotherapy Offers a Window Into the Unconscious Mind).

• With talk therapy alone, many clients remain "in their heads." If they have been in talk therapy before, they know the psychological lingo and can explain their problems well, but they might be cut off from their emotional and physical experiences.  Since experiential therapy focuses on clients' embodied experiences, there is a more integrative experience that combines intellectual insights with embodied experience.

• Whereas clients in talk therapy alone can gloss over their emotions by intellectualizing, experiential psychotherapy helps clients to slow down to get deeper into their embodied experience.  Slowing down to experience the felt sense of their emotions allows clients to make deep psychological connections that they often don't make with talk therapy alone.

• Whereas certain forms of talk therapy can pathologize clients' problems, experiential psychotherapy is nonjudgmental and compassionate.  Rather than making judgments about the clients' problems, experiential psychotherapy tends to have a strengths-based perspective.  It also helps clients to become aware of their internal experiences in more body-mind integrated way (see my article: A Strengths-Based Perspective in Psychotherapy).

• Experiential psychotherapy focuses on healing clients as opposed to talk therapy alone which, as previously mentioned, tends to focus on helping  clients to develop intellectual insight.

• Experiential psychotherapy provides clients with skills and tools that they can use on their own without the psychotherapist.  As previously mentioned, it doesn't rely solely on insight as talk therapy alone tends to do.

• Experiential psychotherapy helps clients to go beyond their "story" about themselves.  This is especially important for clients who have had a lot of therapy before and who have developed a particular narrative about themselves which they tell each therapist that they work with.  Rather than keeping clients stuck in an old "story," experiential psychotherapy helps clients to experience their shifting sense of self on a profound level.

• Experiential psychotherapy tends to facilitate transformational and breakthrough moments for clients in therapy in a more timely manner than talk therapy alone.

Conclusion

Talk therapy like psychodynamic psychotherapy, including psychoanalysis, and cognitive behavioral therapy (CBT) are effective types of therapy for many clients.  However, for clients who want to overcome traumatic experiences, including PTSD, experiential psychotherapy used on its own or in combination with talk therapy is more effective.

In my next article, I'll give a clinical example of how experiential psychotherapy is more effective than talk therapy alone in helping clients to overcome trauma (see my article: Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone - A Clinical Vignette).

Getting Help in Therapy

If you have been struggling on your own with emotional problems, you could benefit from working with a licensed mental health professional with the experience and skills you need to overcome your problems (see my article: The Benefits of Psychotherapy).

The first step in getting help in therapy is calling a psychotherapist for a consultation.  During the consultation, you can ask the therapist about her background, training, skills and how she works with your particular type of problem (see my article: How to Choose a Psychotherapist).

Effective psychotherapy helps to free you from your history of problems so you can lead a more meaningful and fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who uses integrative psychotherapy in a contemporary, dynamic, interactive and collaborative way (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

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.

Making a Change Requires Taking Action: Psychotherapy Can Help When You Feel Stuck

Developing insight into your problems is a necessary part of psychotherapy.  But if you want to make changes in your life, you also need to take action.  In most cases, insight alone isn't enough to bring about lasting change (see my article:  Common Myths About Psychotherapy: Therapy is "All Talk and No Action" and Common Myths About Psychotherapy: Going to Therapy Means You're Weak).

Making a Change Requires Taking Action: Psychotherapy Can Help

Making a Change Can Be Challenging
There's no doubt that making a change can be difficult, especially if it's a significant change from what you've always done in the past.

People usually experience some ambivalence, even for changes that they really want to make, and this ambivalence can play out in your psychotherapy (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent).

Making a Commitment and a Plan to Change Usually Helps
Having a strong commitment to change can be helpful to overcome your ambivalence.

As opposed to having some vague idea of what to accomplish, having a plan can help you to start taking steps.  This plan doesn't have to be carved in stone.  It can be flexible enough to change with your developing sense of self, what you want, and your circumstances.  But you want to have the sense of moving forward rather than stagnating.

Overcoming Unconscious Saboteurs Within You
Progress, especially personal progress, is rarely linear.  Usually, along the way, you take two steps forward and one step backwards.

When you're ambivalent, it can be very helpful to give each part of yourself that has different feelings a "voice" to express the ambivalence--whether you do this with your psychotherapist using Ego States therapy or you do it on your own at home by writing (see my article: Having a Dialogue in Writing With the Different Parts of Yourself).

There might be unconscious parts of yourself that are sabotaging your progress.  For instance, there might be a part of you that feels, "You don't deserve to change" or "You don't deserve to have anything good in your life."

These unconscious parts can act as internal saboteurs and get in your way.

Once you've discovered the part or parts of yourself that are holding you back, you can address those parts to find out why they're afraid of making the change.  Then, you can find out from them what they need to feel reassured--whether it involves taking small incremental steps to accomplish your goals or taking care of that part of you, which might be traumatized, in therapy.

This is obviously easier if you're in therapy with a psychotherapist who does Ego States therapy,  some form of parts work therapy or a technique called the Affect Bridge in clinical hypnosis.

Until that unconscious part of you is discovered and addressed, you might keep looping around your goal without understanding what's getting in your way.

Who or What is Holding You Back From Making Changes?  
Aside from your ambivalence or unconscious internal saboteurs, another problem that could be holding you back is if you're working with a psychotherapist who believes that making a change, any kind of change, takes a very long time (see my article: Common Myths About Psychotherapy: Therapy Takes a Long Time).

I've heard this idea again and again from many psychotherapists, especially psychotherapists who tend to work in an outmoded way, spend their time among other psychotherapists who have the same traditional beliefs, and who haven't updated their skills.

This is how they were trained a long time ago, and this is what they continue to believe despite the many changes that have been made in the mental health field (see my article: A Psychotherapist's Beliefs About Psychotherapy Affect How Your Psychotherapist Works With You).

While it's certainly true that change is a process and some changes can take a long time, when a psychotherapist believes that all changes take a very long time, that's how this psychotherapist will approach your problems.  Then, it becomes a self-fulfilling prophesy.

In some cases, it might be true that it's too soon, especially if the client is emotionally fragile and wants to take action that would be emotionally harmful to him or her.  In those cases, the psychotherapist is being a responsible mental health professional.

If you're honest with yourself, you can determine whether you're holding yourself back or if you're in a therapy where you're being held back.  If it's the former, as I mentioned before, it's important to discover what's going on in your inner world that's holding you back whether you do this on your own or with your psychotherapist.  If it's the latter, you might need to find a new psychotherapist, especially if you've been going around in circles for a long time.

Sometimes, it's a combination of the former and the latter--there's an unconscious collusion between the client and the psychotherapist where both of them are unaware that they're getting in the way of the client making changes.

Getting Help in Therapy
When you go for a consultation with a psychotherapist, ask the therapist what his or her philosophy is about psychotherapy and change.

This is not about asking "How long will it take for me to change?" because no one can predict that.  Rather, it's about asking the therapist about his or her general philosophy about therapy and making changes (see my article: The Benefits of Psychotherapy).

If you've been trying unsuccessfully on your own to make changes in your life, you could benefit from working with a contemporary psychotherapist who works in a dynamic, interactive way, as opposed to a psychotherapist who believes that all change takes a very long time (see my article: How to Choose a Psychotherapist).

By being proactive with regard to finding the psychotherapist who is right for you and making the changes that you want to make, you can make greater progress in your therapy and in your life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples in a contemporary and dynamic interactive way.

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 Psychotherapy Can Help Adult Children of Dysfunctional Families: The Golden Child

In my prior article, The Roles of Children in Dysfunctional Families, I discussed the various roles that parents with narcissistic traits assign, consciously or unconsciously, to the children in the family (see my article: Dynamics of Adult Children of Dysfunctional Families).

How Psychotherapy Can Help Adult Children of Dysfunctional Families: The Golden Child

As I mentioned in my prior article, the most common roles for children of dysfunctional families are the following:

• scapegoat (see my article: The Role of the Family Scapegoat in a Dysfunctional Family)
• hero/responsible child (see my article: The Trauma of the Hero in a Dysfunctional Family
• invisible/lost child
• golden child (the focus of this article)
• caretaker/placater (see my article: How to Stop Being the Rescuer in Your Family of Origin)
• mascot/clown

The Golden Child
In this article, I'm focusing on one of the roles, the golden child, with a fictional clinical vignette with a typical scenario to show how psychotherapy can help an adult who was traumatized by being forced into this role as a child.

As mentioned in the prior article, the golden child is usually the parents' favorite child because this child is seen by them as an extension of one or both parents.

He or she is seen as the "perfect" child.  As a result, the parents live vicariously through this child.  Rather than being seen and valued for his or her inner qualities, the golden child is usually valued for physical attractiveness.

As in the other roles, the child's emotional needs are subordinated to the parents' needs.  As a result, one or both parents often establish an enmeshed relationship with this child (see my article: Overcoming Shame: Enmeshed Families).

Fictional Clinical Vignette: How Psychotherapy Can Help Adult Children of Dysfunctional Families - The Golden Child:

Jane
Jane, who was in her late 20s, told her new psychotherapist that she wanted to start psychotherapy because, a few years after she had jaw surgery, she developed sagging skin around her jaw line.

Jane explained to her therapist that she was so upset because, before she had surgery, she had an attractive, youthful appearance.  But shortly after the surgery, she noticed that the skin around her jaw was noticeably sagging and it made her look older and less attractive.

She had a consultation with a plastic surgeon who told her that she could have surgery to lift the sagging skin, but Jane wasn't sure if she wanted to go through another surgery.

Jane told her psychotherapist that she grew up always being praised for her attractiveness by both parents, especially her mother.  Her mother, who seemed to be very conscious of her own looks, often confided in Jane that of her five siblings, she considered Jane to be the most attractive and the most like her.

How Psychotherapy Can Help Adult Children of Dysfunctional Families: The Golden Child

As a child, Jane was aware that she was her parents' favorite child based primarily on her looks.  She felt fortunate to be attractive and to be her parents' favorite, especially when she considered how her other siblings were treated by her parents.  Her mother used to call Jane "my perfect child."

Prior to the surgery, Jane did everything she could to remain young looking and attractive, and she continued to get her mother's praise and attention.  Her mother was extra generous with Jane, as compared to Jane's siblings, and often treated Jane to expensive clothes and spa treatments.

Throughout high school and college, Jane was conscious that she could use her attractiveness and charm to get what she wanted from young men, friends and even college professors.  She felt she also used her attractiveness to excel in her career.

But after the surgery, when Jane and her mother began to notice the change in her appearance, her mother had a strong negative reaction to Jane's sagging skin, which hurt Jane a lot.  Her mother physically recoiled when she noticed the change in Jane's appearance, and she told Jane that she no longer looked as attractive.

This precipitated a change in her mother's attitude towards Jane.  She no longer invited Jane out to go shopping for clothes or for spa treatments.  Instead, her mother invited Jane's younger sister, Beth, and praised Beth for being the most attractive child and the most like her mother.

Whereas Jane and her mother used to spend a lot of time together, now her mother made up excuses for not wanting to spend time with Jane.  This was devastating to Jane, who used to relish the attention she got from her mother.

Her mother's change in attitude as well as Jane's own new self doubts about her appearance caused Jane to lose confidence in herself.  She no longer felt confident talking to men at parties or going out on sales calls for her job the way she used to do.

This resulted in social isolation and problems with regard to her job performance.  After her manager  admonished Jane for not bringing in enough business, Jane knew she had to get help in therapy.

Jane told her psychotherapist that, unlike when she was a child, she felt mature enough now to understand that focusing only on her looks was shallow.  She wanted to feel good about herself regardless of her looks.  But what bothered her the most was realizing that her parents, especially her mother, valued her most for her looks and now that her looks had changed, she felt emotionally abandoned by her parents.

After Jane's psychotherapist listened to Jane describe her presenting problems, she discussed the role of the golden child and how Jane's childhood history reflected that Jane was placed in that particular role in her family.

Looking at pictures that Jane brought in of her appearance before and after the surgery, the psychotherapist also recognized that, although Jane's looks changed somewhat after the surgery, Jane's view of herself was distorted.  Jane's appearance was nowhere near as changed as she believed it to be.

As they continued to work together in therapy, Jane's psychotherapist helped Jane to see how she was affected by the rigid role that she was placed in as a child primarily by her mother.

She also helped Jane to see that, although her mother's extra attention prior to the surgery was gratifying to Jane, it was also very damaging because her mother valued Jane for her outer appearance rather than who Jane was as a person.  Although Jane's view of herself was distorted, it did not meet the criteria for body dysmorphic disorder.

In addition, her psychotherapist helped Jane develop insight into how the focus on her looks kept Jane from developing her inner world.

When Jane's psychotherapist assessed that Jane was ready to work on the affect of her traumatic experiences related to her family, she recommended that they use EMDR therapy to work on the trauma (see my article: How EMDR Therapy Works: EMDR and the Brain).

The work in therapy was neither fast nor easy because Jane was attempting to see herself in a new way and to overcome long ingrained patterns.  But, gradually over time, Jane developed a stronger sense of self as she worked through her traumatic experiences of growing up in a dysfunctional family.

She also realized that the change in her appearance wasn't nearly as big as she originally thought.  In addition, she learned to value herself for her inner qualities rather than focusing on her external appearance.  This gave her the self confidence that she needed in her interpersonal relationships and in her career.

Conclusion
Adult children of dysfunctional families often carry the emotional burden of their childhood trauma into adulthood where it has a negative impact on their sense of self, their personal relationships and, possibly, their career.

The impact of growing up in a dysfunctional family can take many different forms that might not become apparent until adulthood.

Getting Help in Therapy
A skilled psychotherapist can help you to overcome traumatic experiences so that you can live free of the impact of your traumatic family history (see my article: The Benefits of Psychotherapy).

Rather than struggling on your own, you could get help from a licensed mental health professional (see my article: How to Choose a Psychotherapist).

Unburdened by a dysfunctional family history, you can live a more meaningful and fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I am a trauma-informed psychotherapist, and one of my specialties is helping clients to overcome traumatic experiences.

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.

Children's Roles in Dysfunctional Families

Children of dysfunctional families are often placed in rigid roles by parents to meet the parents' narcissistic needs.  These roles don't take into account the children's emotional needs and, as result, these dynamics are traumatic for the children.  As adult children, these same people often continue to function in these roles with their families and in other relationships.  In my next article, I'll discuss how psychotherapy helps adult children of dysfunctional families to overcome these unhealthy patterns (see my article: Dynamics of Adult Children of Dysfunctional Families).

The Roles of Children in Dysfunctional Families 

Roles of Children in Dysfunctional Families

The following are some of the most typical roles of children in dysfunctional families:

• Scapegoat Child
• Hero/Responsible Child
• Invisible/Lost Child
• Golden Child
• Caretaker/Placater Child
• Mascot/Clown Child

• Scapegoat Child:  The role of the scapegoat child is to carry the family shame.  This child is seen as being inferior.  Even though the family often has many other serious problems, he is usually the "designated patient" when the family comes to family therapy.  One or both parents will often tell the family therapist that, except for problems with this child, the family has no other problems which, of course, usually isn't true.  Although this child might spend his whole life trying to get his parents' approval, he can almost never live up to the parents' expectations because his parents won't allow it.  They need him to continue to function in his designated role of being the scapegoat.  This often results in the scapegoat child rebelling because of the emotional burden placed on him to carry the family's problems.  This can lead to real problems outside the home as this child tries to get his parents' attention--whether it's positive or negative attention (see my article:  The Role of the Family Scapegoat in a Dysfunctional Family).

• The Hero/Responsible Child:  Typically, the role of the hero/responsible child is assigned to the oldest child in the family.  This child takes on the role of the parent (often referred to as the "parentified child").  Trying to be "perfect" to meet the parents' expectations, this child will often try to be the best academically or in sports to gratify the parents' narcissistic needs.  This is the child that the parents will often point to when they want to look good to outsiders.  This child is aware that if she isn't "perfect" in her parents' eyes, her parents might make her the scapegoat child, which this child wants to avoid at all costs--no matter how stressful it is for her to try to function in the hero/responsible child.  As a result, she develops into someone who is self critical and critical of others.  She often feels ashamed because she knows deep down that she's not perfect (see my article: The Trauma of the Family Hero in a Dysfunctional Family and The Connection Between Perfectionism and Core Shame).

• The Invisible Child/Lost Child:  The child who is placed in the invisible child role is ignored.  Receiving neither praise nor criticism from the parents, this child is seen as having no value in terms of gratifying the narcissistic parents' needs, which is why she is ignored.  In order to protect herself, this child might withdraw emotionally and isolate.  She often doesn't develop the necessary interpersonal skills to interact effectively with others.  As a result, this child has difficulty allowing others into her inner emotional world.  She usually grows up feeling unlovable and these feelings often continue into adulthood (see my articles: Growing Up Feeling Invisible and Emotionally Invalidated, Are You Feeling Lost? and Overcoming the Emotional Pain of Feeling Unlovable).

• The Golden Child:  The child who is in the role of being the golden child is the favorite of one of one or both parents.  The parents are unaware that this child (or any of the other children in the other roles) has his own subjectivity.  This child is seen as an extension of one or both parents so that they can live through this child.  She is the "perfect" child in the parents' eyes.  Rather than being seen for her inner qualities, this child is often valued for being physically attractive.  This is an emotional burden, especially as this child becomes an adult, ages and no longer is as attractive as she once was as a child.  Since the golden child is valued mostly for outer appearances, she believes that her looks are all that she has to offer.  The parents often establish an enmeshed relationship with this child (see my article: Overcoming Shame: Enmeshed Families).

• The Caretaker/Placater Child:  This child is assigned the role of been the people pleaser and rescuer in the family.  Her sense of self is defined in terms of what she can do for others rather than focusing on herself.  She is selfless and she doesn't ask for help for herself.  She grows up often not knowing her own emotional needs or how to get her own needs met (see my articles:  How to Stop Being the Rescuer in Your Family of Origin, Overcoming Your Need to Be Everyone's Caretaker and Adult Children of Dysfunctional Families and People Pleasing).

• The Mascot/Clown Child:  The child who is in the mascot/clown role is constantly joking and clowning around to divert the family's attention away from their dysfunctional patterns.  Although this child might appear on the surface to be happy, he suppresses his own emotional needs and uses the clowning around as a defense against these needs.  Beyond their humorous facade, these children (and later on as adults) struggle with feelings of loneliness and emptiness.  They are often drawn to become performers as adults (although not all performers were mascot/clown children).

Aside from the roles that I mentioned above, there are other ways that parents in dysfunctional families assign rigid roles to children.

For instance, if there are two daughters, one of them might be designated by one or both parents as "the pretty one" and the other one could be designated as "the intelligent one."

Like the other roles, these rigid roles have nothing to do with whether one child is more attractive or more intelligent.  The designation of these roles are based solely on the emotional needs of the parents.

As I mentioned earlier, I'll discuss how psychotherapy can help you if, as an adult, you continue to struggle with a rigid role in a dysfunctional family.

Getting Help in Therapy
There is a heavy emotional price to pay if you were assigned into a rigid role in a dysfunctional family.

Rather than struggling on your own, you could benefit from seeing a licensed mental health professional who can help you to transcend the narrow role that you were placed in as a child (see my article: The Benefits of Psychotherapy).

Working with a skilled psychotherapist can help you overcome the traumatic experiences of not being seen and valued for who you really as an individual (see my article: How to Choose a Psychotherapist).

By breaking out of a dysfunctional role, you can be more authentic and live a more fulfilling life (see my article: Becoming Your True Self).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

One of my specialties is helping adults to overcome traumatic experiences.

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 Psychotherapy Can Help You to Change Distorted Thinking

In my prior article, I described the various forms of cognitive distortions that often create unhappiness.  In this article, I'm focusing on how psychotherapy can help you to overcome cognitive distortions.

How Psychotherapy Can Help You to Change Distorted Thinking

Psychotherapists are trained to detect cognitive distortions, which, as I mentioned in my prior article, include:

• Taking things personally
• Jumping to conclusions
• Catastrophizing
• Overgeneralization
• Fallacy of fairness
• Blaming or Externalizing
• Emotional reasoning
• A need to be right
• All or nothing thinking
• Filtering

Aside from bringing these distortions in thinking to a clients' attention, a psychotherapist will often help clients to identify the origin of these thoughts and help clients to change their pattern of thinking so that it is healthier and more effective.

Fictional Clinical Vignette: How Psychotherapy Can Help You to Change Distorted Thinking

Sam
Sam began psychotherapy at the suggestion of his wife after they had another argument where Sam insisted that he was right and his wife was wrong.

Subsequently, Sam realized that they each had a different way of looking at the situation that they were arguing about and, as it turned out, his wife was correct, which disturbed Sam very much.

Sam told his psychotherapist during their initial consultation that he hated to be wrong because it made him feel "stupid" and ashamed.  Although he apologized to his wife, he realized that there were many times when he had arguments with his wife when he insisted that he was right and afterwards he realized that his wife was correct.

In hindsight, Sam recognized that none of these arguments were about anything important.  They were about everyday issues, but he had such strong feelings about being right and it disturbed him greatly when it turned out that he had made a mistake (see my article: Overcoming Your Fear of Making Mistakes).

He realized that his need to be right was having a negative impact on his marriage, and he feared that if he didn't overcome this problem, his marriage might not survive.

During his next therapy session, Sam revealed that his need to be right started when he was a young child.  Growing up with two highly critical parents, Sam learned early on that they became upset whenever he made a mistake, especially his father.

Whenever Sam made a mistake, whether it was at school or at home and no matter how small the mistake was, his parents let him know that they were disappointed in him.  They would withdraw emotionally from him, which led to his feeling ashamed whenever he was wrong.

As a result, whenever there was a possibility of Sam being wrong, he would become highly anxious because he didn't want to make his parents unhappy.  He especially didn't want them to withdraw from him emotionally.

Since his childhood, he felt it was unacceptable for him to be wrong.  Logically, he understood that everyone makes mistakes but, on an emotionally level, he would panic if he thought there was even a possibility of being wrong or making a mistake.

Rather than admit that he might be wrong or he might have made a mistake, he would insist that he was right.  It was like a knee jerk reaction that he had, which was preferable to him than considering the possibility that he might be wrong and all that this implied for him.

This created problems for him in his career as well as in his friendships.  Now, it was creating problems between Sam and his wife because she was fed up with it.

Over time, Sam's psychotherapist helped Sam to recognize that panicky feeling by helping him to be aware of what he was feeling physically in his body at those times.

At first, Sam had difficulty with this because he wasn't accustomed to identify where he felt emotions in his body.  But, over time, using the mind-body connection and a recent memory of having an argument with his wife when he insisted that he was right, Sam's therapist helped him to identify that he felt panic in his stomach.

As time went on, Sam's therapist helped him to make the emotional connection between his current panic and how anxious he felt as a child whenever his parents criticized him for his mistakes.

Sam and his therapist also used EMDR therapy to work through his childhood trauma.

Since EMDR therapy addresses the past, present and future, eventually, Sam was able to work through the past and tolerate being wrong in the present with his wife and others.  He no longer had the need to insist that he was always right, and he and his wife got along better.

Conclusion
Cognitive distortions can create personal unhappiness as well as problems in relationships.

The fictional vignette above addresses a particular type of cognitive distortion, the need to be right, and shows how therapy helps clients to work through the underlying issues involved as well as address current and future circumstances.  A skilled psychotherapist can address other forms of cognitive distortion as well.

Getting Help in Therapy
Even when you have insight into your distorted thinking, it's difficult to change these problems on your own (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist can help you to work through the underlying issues that created the distortions and help you to free yourself from a difficult personal history (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, you could benefit from getting help from a licensed mental health professional so you can lead a more fulfilling and meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

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 email me.

How Psychotherapy Can Help You to Become Aware of Distorted Thinking

Psychotherapy can help you to become aware of a distorted pattern of thinking, which could be contributing to your unhappiness.  Prior to beginning psychotherapy, most clients are unaware of their particular pattern of thinking.  A skilled psychotherapist can assist clients to change their distorted thinking (also called cognitive distortions).  In Part 1 of this topic, I'm focusing on the various types of cognitive distortions.  In Part 2, I'll discuss how psychotherapy can help to overcome cognitive distortions.

How Psychotherapy Can Help You to Become Aware of  Distorted Thinking 

Distorted Thinking/Cognitive Distortions
There are many ways that a particular pattern of thinking can create problems without people even realizing it.  These patterns are distortions in thinking and often begin early in life.  Another term for distorted thinking or cognitive distortions is errors in thinking.

Here are some of the most common cognitive distortions:

• Taking Things Personally:  People who tend to take things personally see others' words and deeds as being directed at them when they're not.  For instance, if your boss comes to work in a bad mood and seems annoyed, someone who takes things personally might think that the boss is angry with him.  But, in reality, the boss is looking annoyed because he had an argument with his wife before he came to work, and his mood has nothing to do with anyone else.

• Jumping to Conclusions:  People who jump to conclusions will make assumptions without having objective facts, and they will assume that they're right.  The example that I gave above about the moody boss is one way of jumping to conclusions.  

• Catastrophizing: Simply put, catastrophizing is when a person expects the worst in most situations. His fears are usually exaggerated without sufficient evidence for this type of fear. An example of catastrophizing would be if a person hears a weather report that indicates there will be 1-2 inches of snow and makes the assumption that there will be a gigantic snowstorm where he might not be able to leave the house.  The weather report becomes exaggerated in his mind and he becomes highly anxious when there is no objective reason to believe there will be a storm.

• Overgeneralization:  People who engage in overgeneralization often take one or two instances of something happening and make the assumption that this is how it is always.  For instance, if someone has a negative encounter with a postal employee at the post office and, based on that one experience, he says that all postal employees are rude.  This is an overgeneralization.  

• Fallacy of Fairness:  Many children grow up thinking that the world should be "fair" and, as adults, when they encounter situations which are "unfair," it contradicts their way of thinking.  Without even realizing it, many people carry this belief from childhood into adulthood.  This type of belief can be very subtle, and it's ingrained in our culture that if you are "good," good things will come to you and if you're "bad," bad things will come your way. As an example, someone who believes that he lives in a world where justice prevails might be disillusioned and confused when someone who assaulted him suffers no legal consequences because of a technicality in the law. 

• Blaming or Externalizing:  When people have a tendency to engage in blaming others (also known as externalizing), they don't take responsibility for their own thinking, feelings or actions.  Instead of looking at themselves first, they point the finger at someone else to avoid taking responsibility.  An example of this is when someone drives while intoxicated after having an argument with his significant other.  Rather than taking responsibility for using poor judgment by drinking and driving, he blames his significant other for "making" him angry.

• Emotional Reasoning: Emotional reasoning is when a person assumes that his thoughts and feelings are facts.  An example of this would be a person has strong feelings about a coworker and makes the assumption based solely on his emotions that his feelings are true without having objective facts (see my article:  Discovering That Your Feelings Aren't Facts).

• The Need to Be Right:  The need to be right involves a need to prove that one's opinion, feelings or actions are correct even in the face of contrary facts.  As an example, a person who needs to be right often won't listen to what her significant other is saying because she "knows" that what she's thinking is right and her significant other is wrong.  The need to be right goes beyond having a different opinion.  This person's shaky sense of self worth is based on being right.

• All or Nothing Thinking: (see my article: Overcoming All or Nothing Thinking).

• Filtering:  Filtering involves paying attention to only certain aspects of a situation and not to others.  For instance, a person who tends to engage in filtering might only pay attention to the negative side of a situation rather than looking at the whole picture which includes positive aspects because the negative side confirms his opinion.  

In my next article, I'll discuss how psychotherapists help clients to overcome cognitive distortions: How Psychotherapy Can Help You Change Distorted Thinking.

Getting Help in Therapy

Psychotherapy can help you to overcome psychological obstacles that are getting in the way of your maximizing your potential (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist helps clients to overcome problems that keep clients feeling stuck whether it's related to a history of psychological trauma or more recent problems (see my article: How to Choose a Psychotherapist).

Rather than suffering on your own, you could work with an experienced mental health professional who can help you to overcome your problems so you can lead a more fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

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 email me.