NYC Psychotherapist Blog

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Wednesday, September 25, 2019

Why Do Core Emotional Issues Get Triggered in Romantic Relationships?

When you're involved in a serious romantic relationship, you are at your most emotionally vulnerable.  So, it's no surprise that core emotional issues often get triggered when you're in love (see my article: Relationships: Fear of Being Emotionally Vulnerable).

Why Do Core Emotional Issues Get Triggered in Romantic Relationships?

Of course, there are usually many positive emotions that come up too when you feel loved and cared about and when you feel the same way for someone else.  But many people discover that several months into the relationship (and sometimes even before that) they begin feeling vulnerable as they realize just how important their partner is to them and how hurtful it would be if it didn't work out.

This emotional vulnerability is usually felt even more acutely when either one or both people have experienced emotional trauma from the past, including family of origin issues, prior breakups or earlier losses.  These old wounds tend to get triggered in the current relationship--even though the relationship might be going very well.  And, if it isn't going well, the current problems can trigger old emotional wounds even more.

Many people find the periods of time in a relationship when it's unclear if the relationship will go to the next level the most anxiety provoking.  These transitional times can include going from casual dating to a monogamous dating, from monogamous dating to being in a committed relationship and the period from a committed relationship to living together or getting married.

If one of both people are ambivalent about the next step, it can be unnerving as each person weighs the risk of remaining emotionally open to the other.  It helps a lot if the couple can talk about it openly.  But if they can't or if their talks are unproductive, they could benefit from couples therapy.

Clinical Vignette:  Why Do Core Emotional Issues Get Triggered in Romantic Relationships?
The following fictional clinical vignette illustrates how core issues are triggered as a romantic relationship transitions from casual dating to a more committed relationship:

Ann and Ted
After they met at a party, Ann and Ted, who were both in their mid-30s, began dating casually about once a week.  During the initial few weeks, they enjoyed each other's company, especially since they had so many common interests.

Two months into the relationship, Ann realized how much she cared for Ted, and she wondered if he was seeing other women.  She wasn't sure how to bring this up. On the one hand, she didn't want Ted to think she was being too demanding of his attention but, on the other hand, she was becoming increasingly worried that as she began to really like him, he might become interested in someone else.

When her worries became greater than her fear of appearing demanding, she broached the topic with Ted over dinner.  Initially, she felt anxious and she feared taking the emotional risk of making herself vulnerable when he might not feel the same way.  But she knew she needed to address this issue, so she told Ted she thought they needed to have a talk about their relationship (see my article: Dating: Is It Time to Have the Talk?).

Upon hearing Ann's words, Ted's expression shifted and Ann could see that he looked worried, "Is everything okay between us, Ann?"  In response, Ann took the risk and told Ted that she really liked him and she would prefer it if they could date each other exclusively rather than dating other people.

When she heard Ted laugh, Ann was confused until he said, "Oh...You looked so serious--I was worried that you were going to say that you didn't want to see me anymore. I'm not dating anyone else and I feel the same way that you do."

During the next few weeks, after they talked about how much they both cared for one another, their relationship deepened, and they spent more time together than before.  With the deepening of their relationship, they enjoyed each other's company even more and made vacation plans for the summer.

However, soon after that, Ann became worried again because she realized she had fallen in love with Ted, and she worried that if their relationship didn't work out, she would be devastated.  She thought about her last long term relationship where she and her fiancĂ© had plans to get married, but their relationship fell apart just a few months before the wedding after he got "cold feet" and ended the relationship.

Even before that engagement, Ann tended to be skeptical about relationships.  Her parents divorced when she was only six months old.  Since her father disappeared from her life after the divorce, Ann never had a relationship with him.  Her mother, who never remarried or even dated after she and Ann's father were divorced, had very negative views of men.  She would constantly warn Ann not to trust men, and she even tried to discourage Ann from dating.

Although Ann rebelled against her mother's negative views about men and began dating in high school, she never felt completely free of her mother's views.  Even though she liked boys and she wanted to be in a relationship, she feared that her mother might be right.

When her fiancĂ© left her, Ann couldn't help feeling that this was a sign that her mother might be right that she shouldn't trust men.  It took Ann a couple of years to overcome the pain of that loss. She was very hesitant to get involved again, but she didn't want to resign herself of a life of being alone.  So, when she met Ted, she decided to give dating another chance.

But as her feelings for Ted grew, her fear also continued to grow.  Aside from this, she wanted to have children, and she feared that if she waited too long, she might have problems getting pregnant.

There were days when she almost wanted to end the relationship rather than face the possibility that at some point in the future he might leave her.  On a rational level, she knew that there were no signs of this but, on an emotional level, her fear became overwhelming.

They were now dating exclusively for six months, and Ann knew that Ted wouldn't initiate a conversation about where they were in their relationship.  He seemed to be content with the way things were going between them.  So, she knew she would have to do it, but she was even more fearful than she had been the first time they talked.

One night when they were out to dinner, Ted noticed that Ann was much quieter than usual, and she was just pushing the food around her plate, so he asked her, "Is something wrong, Ann?"

Ann's initial inclination was to try to smile and say that there was nothing wrong, but she couldn't do it.  She was barely holding back tears.  She knew that Ted was aware of how devastated she felt when her engagement ended suddenly because they talked about their history of relationships soon after they started dating.  But she wasn't sure if he knew about the lasting effect it had on her and how it was affecting their relationship.

With much effort, Ann told Ted about her fears of getting hurt in their relationship and how it was becoming increasingly difficult for her to cope with those fears.  While she was telling him about this, she could barely look at him because she felt so ashamed.  She was sure that he would think she was being ridiculous and that her fears would push him away.

But, to her surprise, Ted listened and he was very understanding.  Although he had never experienced the kinds of losses that Ann experienced, he was deeply moved by her fears and sadness.  He gave her the time and space she needed to express her feelings without being judgmental.  Then, he assured her that his feelings for her had deepened over time and he had no intention of leaving her.

Ann was momentarily relieved to hear this, but her fears continued to mount.  She was afraid that her fears would bring about the end of the relationship, so she suggested that they go to couples therapy.

At the recommendation of a friend, who attended Emotionally Focused Therapy (EFT) for couples, Ann and Ted began couples therapy.  With the help of their EFT couples therapist, they developed a better understanding of their attachment styles and how these attachment styles affected their relationship (see my article: What is Emotionally Focused Therapy (EFT) For Couples?).

After the EFT couples therapist recommended that Ann attend her own individual therapy to deal with the loss of her father, which was getting triggered in her current relationship, Ann started individual therapy.  In her individual therapy, Ann was able to separate out her family of origin experiences and losses (including the negative views about men that her mother attempted to impart on Ann) and her current experiences with Ted.

Both Ted and Ann discovered in EFT that they had different communication and attachment styles, and they learned how to communicate better (see my article: How Your Attachment Style Affects Your Relationship).

Most importantly, they learned how to be emotionally vulnerable with each other in order to ask for what they needed from one another and to enhance their relationship (see my article: EFT Couple Therapy: Learning to Ask For What You Need From Your Partner).

At the same time, Ann got more comfortable with trusting that, even though she knew there were no guarantees, things would work out between them, especially once she was no longer triggered.

Core issues, including emotional insecurities, old emotional wounds, and negative beliefs about oneself, often get triggered in romantic relationships because people are most vulnerable when they open themselves to loving another person.

When there is a history of loss and emotional trauma, it's not unusual for these issues to enter into the relationship and cause one or both people to become fearful of getting hurt.

Emotionally Focused Therapy for couples, which has been well researched, is an effective couples therapy to work out these and other relationship issues.

When one or both people have previous trauma that is affecting the current relationship, it's often beneficial to also seek help in individual therapy.

Getting Help in Therapy
Fear due to previous losses and trauma often have a significant negative impact on romantic relationships.

Being able to separate out the trauma from the past from the current relationship is difficult to do when someone is being triggered.  It takes the expertise of a trained trauma therapist or EFT couple therapist to begin to help people to uncouple these issues.

Understanding that you and your partner might have different attachment styles and how these attachment styles affect your relationship is an important component of EFT couples therapy.

If you're having problems in your relationship, rather than allowing your relationship to deteriorate, you owe it to yourself and your partner to get help so you can have a more fulfilling, loving relationship.

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

I am trained in Emotionally Focused Therapy for couples and I have found it to be an effective modality for helping couples to overcome their problems.

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.

Tuesday, September 17, 2019

Acceptance and Self Compassion

In a prior article, I discussed the concept of self compassion (see my article: Psychotherapy and Compassionate Self Acceptance).  In this article, I would like to expand on this topic and explore why self compassion is so important.

Acceptance and Self Compassion

As I mentioned in the prior article, many psychotherapy clients come to therapy being harsh and punitive with themselves.  This harsh sense of self usually develops at an early age due to traumatic childhood experiences and, without therapy, continues into adulthood.

If this harsh sense of self goes unaddressed by the psychotherapist, it will become an obstacle in the therapeutic work.  This is due to the fact that a harsh sense of self often comes with a negative belief  of "I don't deserve to feel better."

If this negative belief of not deserving to feel better goes undetected and unresolved in therapy, it will undermine the client's and therapist's work together.

Even though, initially, clients might be unaware of feeling undeserving of compassion, if a therapist explores this possibility with clients, most clients, who have this unconscious negative belief, are able to identify it.

Identifying a negative belief about oneself is only the first step, but it's an important step.

Certain forms of experiential therapy, like EMDR (Eye Movement Desensitization and Reprocessing) therapy, ask the client for the negative belief with regard to the presenting problem.  Discussing the negative belief about oneself is an essential part of the therapy (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs and Why Experiential Therapy is More Effective Than Regular Talk Therapy to Overcome Trauma).

However, if the negative belief about oneself remains unconscious, the therapist needs to use therapeutic techniques to get to this unconscious level because just asking some clients won't be enough.  This is because talking about the negative belief is addressing to the client's prefrontal cortex, which is the logical part of the brain.  But trauma "lives" deeper in the brain in the limbic system of the emotional part of the brain, so the therapist needs a method of getting to this unconscious level if the client is unable to access it through a discussion.

In those instances, the therapist needs to use a form of experiential therapy to get to a deeper level.  The Affect Bridge is one technique to get to this deeper unconscious level (for an explanation of the Affect Bridge and how it works, see my article: Bridging Back to Heal Old Emotional Wounds).

The next step is working directly with this negative belief and its associated emotions.  In doing so, the therapist provides the client with the psychoeducation that the negative belief/emotions are just one part of him or herself--not the whole self (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are and Parts Work in Therapy).

It's usually a relief to clients to realize that this problem is only one aspect of themselves and that they continue to have access to the healthier parts of the self to do the therapeutic work.

Once the negative belief/emotions have been worked through in therapy, the client usually has a greater capacity for self compassion, which contributes to the healing experience and the working through of the trauma.

A lack of self compassion is usually indicative of early unresolved childhood trauma.

The child internalizes the negative beliefs/emotions that his or her caregiver imparts--whether this is done consciously or unconsciously.

Unless the child receives therapy to overcome the trauma, these negative beliefs/emotions will follow him or her into adulthood and have a significant negative impact on self perception as well as interpersonal relationships throughout life.

When negative beliefs/emotions present themselves as an obstacle in adult trauma therapy, the trauma therapist must have the necessary therapeutic tools and techniques to identify and work through them.

Whereas experiential therapy, like EMDR therapy, gets to the deeper part of the brain, the limbic system where the trauma "lives," talk therapy usually does not get to this level.  Even though talk therapy can provide intellectual insight into unresolved trauma, it often doesn't result in healing or change on an emotional level.

When the client is able to develop self compassion, this becomes part of the healing and working through of the trauma.

Getting Help in Therapy
Unresolved psychological trauma is very difficult, if not impossible, to resolve on your own.

To overcome traumatic experiences and develop self compassion, you need the help of an experienced trauma therapist.

Once you have worked through the trauma, you can free yourself of your traumatic history and lead a more fulfilling life

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

I work with individual adults and couples.

One of my specialties is helping clients to overcome trauma.

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

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

Thursday, September 12, 2019

Are You Thinking About Canceling Your Therapy Session Because You're Having a Good Day?

In a prior article, I discussed scenarios where clients left therapy prematurely before they completed their work in therapy (see my article: When Clients Leave Therapy Prematurely).  In this article, I'm focusing on clients who think about canceling their therapy session when they're having a good day.

Are You Thinking About Canceling Your Therapy Session Because You're Having a Good Day? 

You might wonder why it would be a problem to cancel your therapy session when you're feeling good, and this is a legitimate question, especially for people who are new to therapy.

The following factors will help you to develop a deeper, more comprehensive perspective about therapy, which goes beyond being in crisis, and why canceling when you're feeling good might not be a good idea:
  • Many people only seek help in therapy when they're in an emotional crisis.  Once the crisis is over, they leave therapy.  But even though you might not be in an emotional crisis anymore, if you have only focused on the latest crisis, you've only touched the surface of the problem.  Beyond developing insight into the problem, you need time and help to integrate and consolidate what you've learned about yourself and the situation.  You also need assistance to maintain new healthy coping strategies that you just learned in therapy.  If not, you're likely to find yourself in a similar (if not exact) emotional crisis again soon.  The people, places and particular circumstances might be a little different with the new crisis, but the underlying issues, which haven't been resolved, are probably the same (see my article: Remaining in Therapy Beyond the Immediate Crisis).
  • When you consider canceling a session, you might be avoiding issues in therapy that are emerging and that are frightening to you.  Rather than avoiding these issues, speak to your therapist about it.  A discussion with your therapist could help you to understand what's frightening you.  It will also help your therapist to understand that you might not be ready to tackle these issues head on but, instead, you might need some preparation and the development of additional coping skills to be able to, eventually, work through the issues that are frightening you.  If your therapist is a trauma therapist, she can help you to break down the work into manageable pieces so that you're not delving too deep into the worst aspects of the problem before you're ready.
  • Having a "good day" is often a welcomed relief, especially if you've had many emotionally challenging days before that.  However, one "good day" doesn't mean that your problems are all worked out, and "feeling good" isn't a good measurement by itself of your progress in therapy.  Change often comes by taking two steps forward and one step back, so a "good day" or two is often followed by a setback.
If you think you have worked through the problem that brought you into therapy, discuss this with your therapist rather than just leaving without telling her (see my article: Why Ghosting Your Therapist is Harmful to You).

Of course, the decision to stay or go is up to you, but your therapist can shed light on the process and help you to terminate therapy in a way that's healthy and helpful to you.

Getting Help in Therapy
Many people have outdated views of the therapy process (see my articles:  Common Myths About Psychotherapy: Going to Therapy Means You're Weak and Common Myths About Psychotherapy: Therapy Takes a Long Time).

Although there are certain people who enjoy coming to therapy, learning about themselves and having a time and place that's dedicated just to them to talk about what's going on in their lives, some people come to deal with a specific issue.  They might want to remove obstacles that are getting in the way of making changes, develop insight into certain emotional patterns or deal with an unresolved trauma that is affecting them now.

Psychotherapy has evolved over the last decade, and there are now experiential therapy modalities, like EMDR therapy, AEDP (Accelerated Experiential Dynamic Psychotherapy), Somatic Experiencing, clinical hypnosis and other experiential therapies that tend to be more effective than regular talk therapy.

If you're unfamiliar with these newer experiential therapies, feel free to browse the articles in my blog that discuss how and why these types of therapy are more effective (see my articles: Why Experiential Therapy is More Effective Than Regular Talk Therapy and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Rather than waiting until a problem develops into an emotional crisis, you owe it to yourself to seek help from a licensed mental health professional.

Once you have worked through your problems, you will have freed yourself from your history, and you will be free to live a more fulfilling life.

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

I work with individual adults and couples (see my article: How to Choose a Psychotherapist).

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.