What is a Trauma Therapist?

My previous article focused on the importance of making sure that anyone you're considering seeing for psychotherapy is a licensed therapist (see my article: Tips on How to Check If a Therapist is Licensed). The subject of this article, "What is a Trauma Therapist?," will focus on the difference between therapists who are trauma therapists vs. therapists who are generalists.

What is a Trauma Therapist?

Psychotherapists: Generalists vs Specialists

In the medical field there are generalists, like your general practitioner, and the specialists that your general practitioner refers you to when your problem is beyond the scope of the general practitioner's  skills and knowledge.

So, for instance, if the general practitioner thinks you have potential heart problems, s/he would refer you to a cardiologist who has the necessary knowledge and skills you need.  To do otherwise would be irresponsible and unethical of the general practitioner.

Similarly, in the psychotherapy field there are also generalists and specialists.  Generalists are therapists who work with a variety of common problems.  For instance, if a client is having problems adjusting to a new job or a new situation in life, a therapist who is a generalist can help a client to overcome common obstacles that are creating problems for a client.  

But if the generalist discovers that there is significant underlying trauma that is affecting the client's ability to adjust to a new situation and the client isn't making progress in therapy, the generalist will often refer the client to a trauma therapist because the problem is beyond the scope of the generalist's skills and training.

Similar to the medical field, it would be irresponsible and unethical for the generalist to continue working with this client because it would be beyond the scope of his or her skills and training.

After the generalist refers the client to a trauma specialist, the client has a choice of either continuing to work with the generalist and going to the trauma therapist for adjunctive therapy or the client can stop seeing the generalist temporarily (or permanently) to work with the trauma specialist.

What is a Trauma Therapist?

A trauma therapist, like a generalist, is a mental health practitioner who completed all the requirements for state licensure and, in addition, has the training and skills to work with trauma and posttraumatic stress disorder (PTSD).

What does this mean? It means that the trauma therapist has gone beyond the training of the generalist with specialized training in trauma therapy, like EMDR therapy (see my articles: EMDR and Emotional Breakthroughs).

Is this enough? No. Many psychotherapists train to do trauma therapy, like EMDR, but they rarely use it.  This means they haven't honed their skills.

In order to develop trauma therapy skills, a psychotherapist needs to see many clients with traumatic experiences and used trauma therapy over a period of time. 

Just like developing any other skill, it's not enough to learn a type of therapy once in a workshop and get little or no practice using it with clients.  Trauma therapy skills need to be practiced over time for a therapist to become skilled at it.  

The importance of skill level was really brought home to me a few years ago when I needed to refer a friend for trauma therapy.  Since she was my friend, I couldn't see her myself, so I needed to refer her to a specialist in trauma.

Although I know many therapists who are trauma therapists, none of them took my friend's health benefits, so I made a request on my professional listserve to try to find someone who did.  In response to my inquiry, a therapist, who was unknown to me, responded that she used EMDR therapy with clients.  She also said she took my friend's health benefits, and she would be glad to meet my friend.  So, I provided this therapist's information to my friend.

It turned out that even though this therapist said she was a trauma therapist, in fact, she was a generalized with a substance abuse background.  She admitted after several weeks of treating my friend that she attended an EMDR workshop, but she never used it.  In effect, she misrepresented herself because she wanted the referral.  Not only was this clinically irresponsible, it was also unethical, and I never made any more referrals to her.  

Fortunately, I was able to find someone else who was a qualified trauma therapist and my friend did well in that therapy.  But I never forgot that experience and, since that time, I ask more detailed questions when I'm making a referral rather than relying on a therapist describing him or herself as a trauma therapist when they're not.

So, while it's important to ask specific questions about the therapist's licensure and training, it's also important to ask how much experience a therapist has with regard to actually doing trauma therapy.  This doesn't mean that you shouldn't work with a beginner who is in training. You might choose a trauma therapist in training if that therapist works for a clinic that offers low fee therapy where the trainee is getting supervision if cost is an issue for you.

Choosing Among Trauma Therapists

Not all trauma is alike.  There are different types of trauma (see my article: What is the Difference Between Shock Trauma and Developmental Trauma?).

Within trauma therapy, some therapists have more experience with some trauma versus other types of trauma.  For instance, one trauma therapist might have more experience with the trauma of parental alienation and less with sexual abuse.  So, it's important to ask about this when considering various trauma therapists.

When you're looking for a trauma therapist, you might decide to have consultations with a few therapists to determine which therapist is right for you (see my article: How to Choose a Psychotherapist).

On the other hand, if you have a consultation with a trauma therapist and you feel she's the right therapist for you, you might choose that therapist without having other consultations because having several consultations can be time consuming and expensive.  This is a personal decision and each individual chooses what feels right.

Getting Help in Therapy

While the process of finding a trauma therapist might seem daunting, in the long run you can save a lot of time and money by making sure that you're with a specialist who has the necessary qualifications to help you.

Many trauma therapists, including me, are doing effective trauma therapy online during the pandemic crisis. Online therapy is also known as teletherapy, telemental health and telehealth (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Choosing a trauma therapist, instead of a generalist, can make all the difference between effective therapy versus ineffective therapy.  

Rather than struggling on your own with unresolved trauma, get the help you need from a trauma therapist so you can work through your trauma and lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

One of my specialties is working with trauma (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 regular business hours or email me.

Tips on How to Check If a Therapist is Licensed

More and more people are seeking help in therapy.  Unfortunately, it can be a confusing process to try to determine if someone claiming to be a therapist is actually a qualified mental health professional (see my article: How to Choose a Psychotherapist).

How to Check if a Therapist is Licensed

Tips on How to Check if a Therapist is Licensed:

It's important to check if a prospective therapist you're considering working with has a state license because working with someone who doesn't have a license means that you're working with someone who is unqualified.  

Not only is this a waste of your time and money, it can also be harmful to you. 

Just like you would want to make sure that a medical doctor is licensed, you also want to make sure that anyone who calls him or herself a therapist has a state license.

Here are some tips to check on state licensure:

• Real Psychotherapists Have a State License
• There are many people who claim they're therapists when they're really not, including life coaches, personal coaches and other people who work outside the scope of their expertise.  
• Anyone can call themselves a therapist, but real psychotherapists have a state license.  

• Why State Licensing Matters For Real Psychotherapists
• Licensing is important because you want to make sure that the person you have chosen to help you with your problems is qualified.  
• A licensed therapist has a verified skillset to help people with various mental health issues.  
• A therapist obtains a license by satisfying various state and clinical requirements and have the necessary qualifications to treat you.
• A licensed therapist have fulfilled the necessary supervised clinical hours and have demonstrated that they have the necessary skills to obtain a license.  
• A licensed therapist has the proper training and experience to be a mental health professional.

• In New York State: Check with the Office of Professions - NYSED Website
• It's important to check that anyone who calls themselves a therapist is licensed.
• When you put yourself in someone's hands to help you with your problems, you want to know that they have the minimum requirements to work with you and that minimum requirement is state licensure.
• When you take it upon yourself to check a therapist's license, you're being a smart consumer of psychotherapy services.
• You can look up if a particular therapist you're considering by name by visiting the website of the licensing organization in the state where the therapist works.  In New York State, you can click on this link, NYSED - Office of Professions, and look up the therapist you're considering by name. 
• 
  
• Why is it Harm to Work With Someone Who Doesn't Have a License?
• Anyone who claims to be a therapist who doesn't have a license isn't a psychotherapist.
• If someone says s/he is a therapist and isn't licensed, they don't have the necessary skills, training and experience to help you.
• From a legal perspective, an unlicensed individual who attempts to practice therapy is committing fraud.
• More importantly, from a clinical perspective, anyone who isn't licensed will be harmful to your mental health and overall well-being.
• An unlicensed person who calls himself as therapist can leave you in a worse state than when you first started because s/he doesn't know what he's doing.
• An unlicensed person who fraudulently says he is a therapist is someone who hasn't demonstrated the basic skills required to be a psychotherapist.
• 
  
• Is a State License Enough to Qualify a Therapist to Treat You?
• Licensure is the minimum requirement for being a psychotherapist.  
• After a psychotherapist obtains a license, s/he must go on to do continuing education to stay current with regard to best practices in the psychotherapy field.
• For instance, if a therapist claims to have a particular expertise, like trauma therapy, s/he must have the necessary education and training beyond graduate school to develop the expertise to do trauma therapy.

Getting Help in Therapy
Beyond making sure that a therapist is licensed, finding a psychotherapist who is right for you is usually a process that begins with a consultation to see if the two of you are a good therapeutic match.

You might meet with a particular therapist a few times before you know if you're comfortable with him or her.  Ask questions about how the therapist works with the particular issue you want to work on.

There are many qualified psychotherapists in New York, but you're not going to feel comfortable with all of them, so trust your gut feeling.

During the COVID-19 pandemic, many therapist are providing online therapy, which is also called teletherapy, telemental health or telehealth (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

If you're struggling with problems and feel overwhelmed, get help from a licensed psychotherapist who is right for you.  Getting the right help from a licensed mental health professional can help you to overcome your problems so you can lead a more fulfilling life.

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

I work with individual adults and couples.

I am currently providing online therapy while I'm out of my office due to the COVID-19 pandemic.  

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.

Relationships: 10 Reasons Why Trying to Change Your Spouse Doesn't Work

So many people enter into a relationship where they see the "potential" in their partner, but they won't accept how their partner is in the present.  Although men do it too, it's usually women who try to change, "fix" or rescue their partner.  They believe they can get their partner to change to be the way they want him to be.  Many of them become so focused on fixing their partner that they neglect themselves (see my articles: Overcoming Your Need to Rescue Your Loved Ones as Part of a Codependency Pattern and You Want to Change Your Spouse, But You Can't, So What Can You Do?).

Why Trying to Change Your Spouse Doesn't Work

Many people push, prod and try to do everything in their power to get their spouse to change, and no matter how good their intentions are, it usually doesn't work.

Exploring why it doesn't work and how to change this dynamic is the subject of this article.

A Short Fictional Vignette
The following fictional vignette, which is representative of hundreds of clinical cases, illustrates why trying to change your spouse doesn't work:

Helen and Tim
Helen and Tim, who were both in their 40s, were married for 10 years.

After Tim's father died, Tim started gambling compulsively (see my article: Overcoming Grief Gambling).

Prior to his father's death, Tim and his friends would get together every few months to play Poker.  But after his father's death, Tim felt a strong urge to play Poker more often, so he found other games, including online gambling.

At first, Helen wasn't concerned, but when she saw that Tim was spending almost all his free time in Poker games and he was losing money they didn't have, she became very concerned and told Tim to stop.  Tim would respond by promising Helen that he would stop, but he continued to gamble and lose large sums of money.

By then, Helen and Tim were spending a lot of their time arguing about his gambling and no time enjoying themselves the way they used to do before.  Helen was angry most of the time with Tim, and Tim felt resentful.  He felt that Helen was nagging him and acting like his mother.

The situation deteriorated until they were barely talking to one another, and they were no longer sexual (see my article: Have You and Your Spouse Stopped Having Sex?).

A few months later, they were sitting in a couples therapist office trying to salvage their relationship. Over time, they learned that Tim hadn't grieved for his father and the gambling was not only a distraction, it was also an addictive behavior that gave Tim a dopamine high in much the same way that taking drugs gives a dopamine high.

Gradually, as Helen learned not to nag and to focus on herself, Tim agreed to go to Gamblers Anonymous (GA) and work with a sponsor.  He also entered into his own individual therapy to deal with the loss of his father.  Over time, as he dealt with his emotions, he stopped gambling.

10 Reasons Why Trying to Change Your Spouse Won't Work:

• Trying to Get a Spouse Who is Unwilling and/or Unable to Change is Futile
• Before you try to change your spouse, consider whether he actually wants to change.
• Is he capable of changing?

• Focusing on Your Spouse's Behavior Takes Your Focus Away From Your Own Behavior
• It takes two people to be in a relationship.
• If you're focusing mostly on your spouse's behavior, you might not see how your own behavior affects the situation between the two of you. 

• Focusing on Your Spouse's Behavior Takes Your Focus Away From the Dynamic Between the Two of You
• There's a particular dynamic between you and your spouse.
• When you focus on your spouse's behavior, you might miss that dynamic. 

• Trying to Get Your Spouse to Change Might Be Unrealistic
• Ask yourself how realistic you're being.
• Ask yourself if you can live with the current situation when you consider everything.

• Reframing Your Expectations Might Be More Realistic
• Reframing your expectation is not about accepting abuse or accepting a situation that you find completely unacceptable.
• If your spouse is unwilling or unable to change, is it possible to look at the situation from a different perspective that might make it acceptable to you?

• Pushing Your Spouse to Change Can Erode the Relationship
• No one likes to feel pushed or nagged.
• People rarely change when they feel pushed and, if they do, they do it with resentment which causes other problems in the relationship.

• Trying to Change Your Spouse Puts You in a Parental Role
• When you take on a parental role, you're damaging your relationship--even though you might have the best of intentions (see my article: Behaving Like a Parent to Your Spouse Can Ruin Your Relationship).
• Your spouse will probably resent you.
• You will eventually resent being in this role.

• Focusing on Changing Your Spouse Might Make You Lose Sight of What's Good in Your Relationship
• Are you only focusing on your spouse's problems and not seeing what's good in your relationship?
• Has your focus on your spouse's problems overshadowed what's positive?

• Criticizing Your Spouse Can Lead to Divorce
• Being overly critical is a relationship killer (see my article: Learn to Stop Criticizing Each Other).
• Being critical can become habitual.

• Focusing on Yourself and Making Your Own Positive Changes Can Help the Dynamic Between You and Your Spouse
• Rather than focusing exclusively on your spouse's problems, you can focus on yourself.  
• People often focus on their significant other as a way to avoid looking at themselves.
• Practice self care and try to find ways to improve things for yourself (see my article: Is Self Care Selfish?).

Conclusion
People often don't change when they feel pressured or pushed.  Not only is this not an effective strategy, it often does more harm than good.

In order to make significant lasting change, a person has to be internally motivated to change as opposed to complying with someone else's wishes. 

Even though no one should accept abusive behavior or put up with things that they know are unacceptable to them, focusing on yourself is usually more effective than focusing on what you perceive as another person's faults.

Getting Help in Therapy
It's hard to live with problems that you feel are unacceptable, especially when you love someone and also want the best for him or her.

Focusing on yourself might be challenging.  It can also be hard to break old habits of focusing on someone else instead of focusing on yourself.

Even if you're not pressuring your spouse to change, you might find it hard to decide whether to stay or to leave the relationship.

If you're struggling with one or more of these issues, rather than struggling on your own, you could benefit from working with a licensed psychotherapist who has experience helping clients with these issues.

Many therapists, including me, are providing online therapy, which is also called teletherapy and telehealth, while they are out of their office during the COVID-19 pandemic (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

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

I work with individual adults and couples.

I am providing teletherapy sessions during the COVID-19 crisis.

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.

5 Tips For Letting Go of How You Thought Things Would Be

If there's one thing that's clear during this global pandemic, it's that things don't always go as planned  and when you're faced with a crisis, you need to find ways to cope (see my articles: Coping and Staying Calm During the COVID-19 Crisis and Fear and Anxiety During a Crisis).

Letting Go of How You Thought Things Would Be

By the time you become an adult, you've had experiences, both big and small, of being surprised and disappointed when you thought things would go a certain way and they didn't.

Whether these surprises and disappointments were due to people in your life not keeping their commitments or sudden changes in plans or events, you've had to deal with things changing in a way that you didn't want or expect.

Learning to Let Go: 5 Tips on Letting Go of How You Thought Things Would Be:
When it's obvious that there's nothing you can do to change these circumstances, it becomes a matter of learning to let go of your expectations.

When it's a big disappointment, letting go can be a long process.  It doesn't happen overnight because losses, especially big losses, are challenging.  You need to allow yourself to go through the grief and sadness and whatever fear and anxiety it might bring up for you.

5 Helpful Tips For Letting Go

• Allow Yourself to Go Through the 5 Stages of Grief (see my article:  The 5 Stages of Grief).
• Denial
• Anger
• Bargaining
• Despair or Depression
• Acceptance

• This process isn't linear and you don't necessarily go from one stage directly to another. You can experience these stages in any order and go back and forth between stages.
• Certain events or memories can also bring you back to the stages of grief, such as an anniversary of the death of a close relative or a birthday.  
• Be kind and patient with yourself (see my article: Self Compassion: Loving Yourself Even in the Places Where You Feel Broken).

• Acknowledge the Loss and, When You're Ready, Practice Gratitude
• Rather than sweeping your feelings under the rug, acknowledge that your disappointment is a loss.
• When you're ready, try to remember positive things in other areas of your life where you feel grateful.  You might not be ready to see or acknowledge these things while you're dealing with a big loss.  But, eventually, it might get easier for you to look at them without denying the feelings for your loss (see my article: Keeping a Gratitude Journal).

• Ask Yourself If Your Expectations Are Realistic
• While it's true that you might not always know what's realistic and what's not, there might be times when you have expectations of someone who disappointed you multiple times in the past, and you keep hoping and expecting this person will fulfill your expectations each time.
• Recognize the difference between hope and expectations. You might hope you won't be disappointed again by someone who disappointed you repeatedly in the past, but you're not accepting the reality of your situation. You're setting yourself up.
• Having expectations of someone who is either unwilling or unable to meet them is a guarantee for disappointment and hurt.

• Remember Other Times When Things Changed For the Better
• When you first experience a disappointment, you don't always see the silver lining.  Sometimes, it takes time to look back on a situation and see that even though you didn't get what you wanted, eventually things turned out better.
• For example, maybe you lost a job in the past, but then you decided to pivot and go for the career that you really wanted instead of settling for the job you had.

• Set Boundaries With People Who Constantly Disappoint You
• Rather than trying to control or manipulate someone into doing what you want, learn to accept that you won't get what you want from this person and set boundaries with them.
• Setting boundaries will mean different things in different situations (see my article: Setting Boundaries).
• For instance, if you're seeing someone who can't make a commitment to be in a relationship, don't settle for less than you want (see my article: Are You Dating Someone Who Has Problem Making a Commitment?).

Getting Help in Therapy

There are times when, despite your best efforts, you have problems letting go of your expectations.  This might be because the current situation is related to experiences from your past (see my article: Reacting to the Present Based on Your Traumatic Experiences From the Past).

If you're having problems letting go, you could benefit from working with a licensed therapist who has experience helping clients overcome this problem.

Many therapists, including me, are providing online therapy, also known as teletherapy, telemental health and telehealth, while they're out of the office due to the COVID-19 crisis (see my article:  The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Contacting a therapist for help is often the first step to freeing yourself from obstacles that are keeping you stuck.

About Me

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

I work with individual adults and couples.

I am currently providing online therapy during the COVID-19 pandemic.

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.

Should You Hook Up With Your Ex?

In my prior article, 7 Reasons Why You Might Be Struggling to Get Over a Breakup, I focused on the primary reasons why many people have a hard time getting over a breakup. In this article, I'll be discussing a topic that I covered briefly in that article about breakups, which is whether you and your ex should get back together to have sex. The focus in this article isn't a moralistic one.  It's about your emotional well-being and what works for you.

Should You Hook Up With Your Ex?

I get it--even though you might not have been compatible in other areas, you and your ex might've had amazing sex which you're finding hard to give up.

Maybe it was even the best sex of your life.  Maybe it was exciting, hot and fun and you both felt great afterwards.  So, it's understandable why you're missing the sex and wanting to hook up, especially if you're either not seeing anyone else or your experiences with dating have been disappointing.

Why Hooking Up With Your Ex Might Be Okay
Here are some reasons why it might be okay:

• You and Your Ex Are Both in Agreement About Having Casual Sex and Nothing More
• You've both on the same page that, while the relationship didn't work out, you can still have no strings attached (NSA) sex with the understanding that you're not in a relationship and you're not going to get back together.
• You respect one another's well-being and only want the best for each other.

• You Don't Have Unrealistic Expectations
• You have no expectations that your ex will only see you and not date other people and vice versa.
• Both of you are beyond the point of feeling jealous if either of you is casually dating and having sex with other people.

• You're Not Trying to Use Sex to Get Back Together
• Neither you nor your ex is using sex to try to get back together again (see my article: The Heartbreak of the On Again, Off Again Relationship).

• You're Free of Any Illusions and Can Enjoy the Pleasure of Having Sex With Your Ex
• Having no expectations or illusions about what's possible, you're both free to enjoy the pleasure of being sexual, especially since you both know what the other person likes and you're sexually compatible with each other.
• You can give yourself over to sexual pleasure without guilt, resentment or regret afterwards.

Why Hooking Up With Your Ex Could Be a Bad Idea
Here are some reasons why it might not work out for you:

• You're Still in Love
• If you're still emotionally attached to your ex and you have sex with him (or her), you're going to have a much harder time getting over the breakup if you're sexually involved.  
• Not only might you both continue to carry a torch for each other, you both might have a hard time being open to meeting new people.

• You're Secretly Hoping to Get Back Together Again
• You need to be honest with yourself and your ex. 
• Saying that you don't want to get back together (when you really do) and using sex to lure your ex back is a form of manipulation.
• The falsehood will probably become apparent soon.
• If you get involved again, as a couple, you might end up in the same place as you were before the breakup, which will be even more painful.

• You Feel Lonely and Want Your Ex's Companionship
• It's common to feel lonely after a breakup.  This is normal.  It's also something that most people overcome after a period of healing.
• Although loneliness can feel overwhelming, hopping back in bed with your ex isn't the solution, especially if you're not both on the same page about what it means that you're being sexual again.
• You might feel better temporarily but, once again, this is just a short term solution to a much larger problem, which is that you're unwilling to go through this stage of the breakup (see my article: Coping With the Stages of a Breakup
• In seeking a short term solution, you're losing sight of the longer term problem and that you could both get hurt again when things go back to how they were before the breakup.

• You're Using Your Ex to Get Someone Else Jealous
• Maybe you've started seeing someone new and this person isn't paying as much attention to you as you would like, so you reconnect with your ex to try to make the new person jealous.
• Not only is this manipulative, it also has the potential for everyone in the situation to get hurt, including you.
• Both your ex and the new person might see the manipulation for what it is and both of them could end up not wanting to have anything to do with you.

• Your Ex Didn't Treat You Well When You Were in a Relationship
• Chances are good that if you ex didn't treat you well when you were in a relationship, s/he won't treat you well if you're hooking up.
• If you couldn't trust your ex when you were together, even if your expectations have changed, you probably won't be able to trust your ex with whatever ground rules the two of you have set up for having casual sex or in other areas (see my article: Are You Giving Away Your Personal Power to Someone Who Doesn't Treat You Well?).

Conclusion
This isn't a moralistic perspective.  It's about your emotional well-being.

There are times when hooking up with your ex might work for both of you without either of you getting hurt.  But this all depends on if you both are on the same page about having casual sex together without trying to get back to a dynamic that didn't work before.

Only you can decide what's best for you, but making that decision can be challenging because emotions can get in the way. You might need help from a licensed mental health professional who would be impartial and without judgment but who also has the expertise to help you make the best decision for yourself.

Getting Help in Therapy
Trying to decide what's best for you can be confusing, especially when your emotions are in conflict with what you know is best for you.

Many therapists in New York City, including me, are providing online therapy, which is also called teletherapy, telemental health and telehealth (see my article: The Advantages of Online Therapy When You Can't Meet Your Therapist in Person).

If you're feeling stuck, you could benefit from getting help from a licensed psychotherapist who has experience with helping clients with relationship and sexual issues.

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

7 Reasons Why You Might Be Struggling to Get Over a Breakup

Breaking up is hard.  Whether it was a mutual decision to end the relationship or you were the one who ended it, breaking up is a challenge, especially in a long term relationship (see my articles: Overcoming the Heartbreak of a Breakup and Coping With the Stages of a Breakup).

Breakups Are Challenging 

There's no timetable for when people get over a breakup. Healing is an individual process.  It's understandable that you would want the emotional pain of the breakup to end as soon as possible, but emotions don't always respond to what you want or think.

In addition, most people have unrealistic expectations about healing from a breakup.  Part of this problem might be that they're harsh with themselves (see my article: Self Compassion: Loving Yourself Even in the Places Where You Feel Broken).

Another problem is that other people, including friends and family, who have good intentions, also have unrealistic expectations and they might try to push you to "move on" before you've worked through the grief and loss.

7 Challenges After a Breakup
Aside from the heartache which takes time to heal, there can be other issues that make it difficult to get over a breakup:

• Co-Parenting Children Together: 
• If you and your ex have children together, this is a big challenge because you'll need to interact with one another until the children are of age and can go off on their own. 
• There are countless things that need to be worked out when you have children, including: child custody, childcare, child support, housing arrangements, and other co-parenting issues.
• Being able to put aside your differences to focus on your children is paramount, but anger and resentment don't always go away after the breakup, so it takes work to reman primarily focused on the needs of your children (see my articles: Talking to Your Child About Your Divorce and Co-parenting After the Divorce).

• Giving Up the Emotional Ties With Your Ex's Family: 
• Often, the problem isn't just that you're missing your ex--you can also feel strong emotional ties to your ex's family.  
• This makes the loss much bigger.  
• Maintaining emotional ties with your ex's family can be difficult and can keep you feeling stuck in terms of healing from the breakup. Boundaries would need to be negotiated, if it's even possible to do that.

• Maintaining Mutual Friendships: 
• If you and your ex have mutual friends, it can be difficult for you, your ex and your friends to negotiate the boundaries around these friendships.  
• Friends might feel their loyalty is being tested or they might feel that they have to side with either you or your ex.  
• You or your ex might have unrealistic expectations of your mutual friends in terms of sharing information about what's going on with you or your ex after the breakup.
• Your friends might inadvertently tell you things about your ex that are hurtful or they might slip and divulge things you don't want your ex to know.

• Communicating With Your Ex After the Breakup: 
• Assuming for the moment that you and your ex don't have children or other compelling reasons to be in touch, if you're still communicating with your ex, healing from the breakup is going to be that much more difficult.  
• One or both of you might still be holding onto hope that things can be worked out between you.  But if nothing has changed, you're probably going to be facing the same problems that led to the breakup (see my articles: You're Considering Getting Back Together Again, But What Has Changed?).

• Tolerating Loneliness and Redefining the Relationship as "Friends With Benefits:" 
• After a breakup, many people feel lonely (see my article: Overcoming Loneliness).
• Many people would rather go back to a relationship that isn't working out than tolerating loneliness. 
• Some people find being out of a relationship and alone intolerable, so they try to redefine the relationship as being "friends with benefits" and continue to get together with their ex to hook up.  
• In the long run, "friends with benefits" rarely works out for people who are or were in love without confusion and resentment, especially if one person is already dating other people.  The boundary issues get muddied fast.

• Dating Again: 
• After a breakup, some people refuse to start dating again--even after they have healed from the breakup. 
• While there's a reality that dating, especially dating online, can be challenging and discouraging, many people refuse to see other people, even after they've healed.  In those instances, there can be other underlying issues, including unrealistic hopes of rekindling the former relationship or fear of getting hurt again (see my article: Overcoming Your Fear of Getting Hurt Again).

• Ruminating About Your Ex and Looking at Your Ex's Social Media: 
• It's common to think about your ex after a breakup. You can't just turn off your feelings like a faucet.
• It can take a while to heal and there's no one-size-fits-all time or way to do it 
• If you're spending a lot of time looking at pictures of you and your ex together or doing frequent checks to your ex's social media accounts, you're prolonging your emotional pain and not allowing yourself to heal (see my article: You Can't Stop Looking at Your Ex's Social Media Accounts).

Conclusion
Even under the best of circumstances, breakups are difficult.  Aside from the challenges that I've outlined above, there can be other problems, like unresolved earlier trauma.

For instance, a breakup often triggers old unresolved issues which make it even harder to deal with the breakup.  Many people who felt emotionally abandoned as children have an especially difficult time during a breakup because of this triggering (see my articles: Fear of Abandonment and How Past Psychological Trauma Leaves on in the Present).

Getting Help in Therapy
Working through the grief and challenges of a breakup can be difficult to do on your own, especially if you've been feeling stuck for a while.

If you feel stuck and overwhelmed, you could benefit from working with a licensed NYC psychotherapist after a breakup to help you work through unresolved issues so you can heal.

Most therapists are doing online therapy (also known as teletherapy, telemental health and telehealth) during the COVID19 crisis (see my article: The Advantages of Teletherapy When You Can't See Your Therapist in Person).

Asking for help can feel scary at times, but remaining stuck is even harder (see my article: Overcoming Your Fear of Asking For Help).

Taking the first step of contacting a licensed mental health professional could make all the difference between prolonging your grief and getting closure that leads to a more fulfilling life.

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

I work with individual adults and couples.

I am providing online therapy sessions during the COVID19 pandemic.

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.

The 5 Stages of Grief During the COVID-19 Crisis

Most of us have been feeling many different emotions, including varying degrees of grief for our losses during this COVID-19 pandemic.  I've been writing articles about psychological reactions and coping strategies to get through this stressful time, including the concept of the 5 Stages of Grief (see my articles: Grieving Losses During the Crisis and Healing and Coping and Staying Calm During the COVID-19 Crisis).

The 5 Stages of Grief During the COVID-19 Crisis

I began discussing the 5 Stages of Grief as it relates to the COVID-19 pandemic in an earlier article, and I would like to expand on that discussion here.

The 5 Stages of Grief:

• Denial
• Anger 
• Bargaining
• Despair or Depression
• Acceptance

The 5 Stages of Grief: It's Not a Linear Process
As I've mentioned before, although these stages might appear to be a linear process, they're not.  These stages are fluid.  Most of the time, people move back and forth between stages at various times and people might experience a combination of feelings on any given day.

The 5 Stages of Grief: The Grief Process and COVID-19
Let's take a look at each stage and how it might relate to the grief process that many people are going through now (see my article: Common Defense Mechanisms).

• Denial
• Denial is a defense mechanism.  
• It can be a useful temporary strategy when people feel overwhelmed.  But in the long run, it can keep people stuck and prevent them from successfully moving through the grief process.
• Common reactions during the denial stage:
• "People are overreacting to this problem."
• "It's not any different from the regular flu."
• "I'm a healthy person, so I can't get it."

• Anger
• Anger is often a secondary emotion when people feel too vulnerable to allow themselves to feel emotions like sadness or fear (see my article: Anger as a Secondary Emotion).
• People in this stage often blame others for the problem rather than focusing on their own needs and reactions.
• People can become defiant in terms of following the health experts' advice.
• Common reactions during the anger stage:
• "I don't care what the experts are saying. I'm bored and I'm going to hang out with my friends."
• "No one is going to control me or tell me to do social distancing. I'm my own person."
• "It's __________'s (fill in the blank) fault. If they had been more careful, we wouldn't be in this predicament."
• "Someone's making a buck, and it's not me. I'm not going to quarantine."

• Bargaining
• The bargaining stage often begins when people can no longer be in denial because there's evidence that the pandemic is actually happening and not overblown.
• During this stage, people are starting to come to terms with the reality of the situation, but they're not fully ready to accept it yet.
• Common reactions during the bargaining stage:
• "Okay, the pandemic is real, but I can socialize with others and I don't need to keep distant or wear a mask as long as I wash my hands."
• "The crisis is real, but it'll be over soon. We'll all be back to work in a few weeks."
• "Sure there are people who are sick, but as long as I only hang out with people who are healthy, I'll be okay. I won't get the virus."

• Despair or Depression
• When reality sets because people realize that their other defensive strategies aren't working, despair and depression can set in.  
• People begin to feel hopeless and helpless about the pandemic. They lose a sense of agency and feel powerless.  
• They often feel that they and the situation are beyond help.
• Common reactions during the despair or depression stage:
• "There's nothing that I or anyone else can do. This situation will never improve, so why should I even try to make things better for myself or anyone else?"
• "I'm going to lose everything, and I'll die alone and penniless."
• "If I get sick, no one will be able to help me."

• Acceptance
• If and when people get to the acceptance stage, they're ready to surrender to the current situation and cope with it as best as they can (see my articles: Empowering Yourself During the Pandemic).
• Common reactions during the acceptance stage:
• "Everything is changing, but maybe some things will change for the better."
• "Things are bad, but I can also look for the silver lining."
• "I can't control the pandemic, but I can take care of myself and control my own reactions to it."
• "I can try to find ways that I can help others in a safe and responsible way."

Getting Help in Therapy

If you're having problems coping during this crisis, no matter what you're feeling, you could benefit from working with a licensed psychotherapist who can help you to get through the grieving process.

Many therapists, including me, are providing online therapy, which is also known as teletherapy and telehealth, while they're out of their offices during the pandemic (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

Rather than feeling stuck and overwhelmed, take action to get help so that you can strengthen your coping skills and feel more empowered.

About Me

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

I work with individual adults and couples.

I am currently providing therapy online.

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.

Developing a Felt Sense of Connection From a Distance

In my two prior articles, The Mind-Body Connection: Developing a Felt Sense of Your Internal Experiences and Developing Your Inner Sense of Being Calm, Grounded and Centered, I discussed the felt sense of connecting to internal experiences of emotions and physical sensations. Aside from experiencing a felt sense of internal experiences, during this pandemic most of us are grappling with how to develop a felt sense of connection with others even though we're not physically present with them.

Developing a Felt Sense of Connection From a Distance

Connecting With a Felt Sense From a Distance
When I was in Somatic Experiencing training about 10 years ago, I remember our instructor starting our morning sessions by having us close our eyes and breathe so we could settle in (see my article: Somatic Psychotherapy).

By slowing down and getting quiet, we transitioned from wherever we had been prior to coming into the training room to where we were in the here and now in the training room (see my article: Being in the Present Moment).

I was always so grateful for that transitional time because it allowed me to let go of the stress of getting around in New York City, especially on the subway, to being fully present in the moment in the training.

After the Somatic Experiencing training group settled, our instructor asked us to feel our connections with other healers in the area.  By healers, she was referring to healers of all kinds and all traditions, both traditional and nontraditional--whether they were doctors, nurses, other psychotherapists, physical therapists, bodyworkers and other nontraditional healers.

Part of the meditation was to feel the connection with these healers in our immediate area and slowly extend our sense of connection to all of New York City, then the tri-state area, the East Coast and gradually expanding to encompass the whole country, other countries and the universe.

This meditation of connecting with healers from everywhere was so comforting and it was wonderful to know that, at any given time, other people in the healthcare and healing world might also be connecting and resonating in this way.

During the first week that New York City residents were told to stay home and I began Zoom teletherapy sessions, I thought of this meditation and used it with my clients.  I was so happy that, just as I found it comforting to connect with other healers in this way, my clients also felt comforted.

Discovering New Ways to Develop a Felt Sense of Connection From a Distance
During this pandemic, there's a difference between knowing that we're all going through this experience together and actually feeling the resonance of these connections.

Over time, as we continue to be challenged by the COVID-19 crisis and we are physically distant from one another, we'll find new ways to make that heart-to-heart connection with people we care about because we need to feel those connections.

Being able to feel these social connections are vital to our sense of emotional and physical well-being, and our imagination and creativity will enable us to find new ways to connect with each other.

Getting Help in Therapy
If you're feel overwhelmed, you're not alone.  Help is available to you.

Many psychotherapists have transitioned to online therapy, which is also called teletherapy or telemental health), during this time (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

Developing a Felt Sense of Connection From a Distance

Making the phone call or sending the email to get help from a licensed therapist is the first step in your healing process.  If you need help, take the first step in your healing process.

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

I work with individual adults and couples.

I am currently providing online therapy while I'm out of my office.

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.

Reflecting on What's Important in Your Life During a Crisis

During the current COVID-19 pandemic, when most people have been staying home in isolation, many people have been thinking about their lives and reflecting on what's most important to them (see my articles: A Search For Inner Meaning,  What is Happiness and Where Do You Find It? and Redefining Happiness and Success For Yourself).

Reflecting on What's Important in Your Life During a Crisis

The unprecedented nature of the coronavirus pandemic has people reconsidering their lives and their priorities, including:

• Family: 
• People who are fortunate to have good (or good enough) relationships in their family are considering some of these relationships in a new light (see my article: A Happy Family Doesn't Mean a "Perfect" Family).
• Before COVID-19, when people were busy commuting to work and working long hours, family often took a backseat to work.  
• With the potential for getting a life-threatening illness, like the coronavirus, many people are thinking of family relationships as being the #1 priority.  
• There are even some family members who have been out of contact for a long time who are reconnecting and making amends.

• Spirituality and Values: 
• Coping with a crisis often makes people re-evaluate their religion or their spiritual beliefs (see my article: Are You Contemplating Your Faith of Origin in a New Light?).
• Spirituality isn't necessarily a formal religion.  It can be a set of spiritual beliefs and values that are important to the individual.
• Some people, who might not have considered themselves to be spiritual before, are making religion or spirituality more of a priority to help them get through this difficult time (see my article: A Happy Life vs a Meaningful Life).

• Intimate Relationships:
• The current crisis has affected couples who were on the brink of breaking up before the pandemic. 
• For some couples, the crisis affirmed their decision that they want to be happier in their lives and they have decided that they can't be happy with their current partner.
• Other couples are finding it difficult to spend so much time together due to the need to stay home (see my article: Tips on Getting Along as a Couple During the COVID-19 Crisis).
• For other couples, who were having problems, put aside their differences now to focus on getting through the crisis, especially if they have children.
• Many couples have experienced a renewed sense of commitment to their relationship in light of the current emergency.  
• For other couples, the lack of commitment of one partner has caused the other partner, who wants a commitment, to reconsider the relationship (see my article: Are You Dating Someone Who Has a Problem Making a Commitment to Being in a Relationship?).
• Some individuals, who aren't in a relationship, feel lonely during this time of isolation and have made a firmer commitment to meeting someone new.
• Other individuals have reaffirmed their commitment to themselves to remain single because this is their preference.

• Friendships:
• The recognition of the importance of emotional support through friends has been especially important during this crisis (see my article: The Importance of Getting Emotional Support During a Crisis).
• Similar to family relationships, former friends, who were estranged, are reconnecting in some cases.
• An awareness of the importance of kindness has also been an important part for many people of re-evaluating their lives (see my article: The Impact of Kindness During Difficult Times).

• Health:
• Fortunately, for most people, the virus has been mild.  
• For people who are older or who have underlying conditions that make them more vulnerable to developing a more serious reaction to the virus, health considerations have been uppermost in their mind (see my article: How Serious Medical Problems Can Affect How You Feel About Yourself).
• The rate of contagion of the virus is forcing most people to consider their health habits and ways to improve on them.

• Work-Life Balance
• Everyone isn't fortunate enough to re-evaluate their work-life balance.  Some people have no choice but to work three or four jobs just to survive.
• For people who are fortunate to consider their work-life balance, some people are considering how much longer they want to work and whether they would rather spend their time doing other things, like spending more time with family, traveling, spending time on a hobby or living a simpler, quieter life (see my article: Balancing Your Career and Your Personal Life).
• Other people are considering whether they want to remain in their current career or whether they want to transition to something else eventually.  There is a recognition that life is short and putting off what they really want might not be wise (see my article: Navigating Life's Transitions).
• Some people are realizing that they prefer to live life at a slower pace, which might mean making changes in their work, retiring or eventually or moving to a place where the pace is slower (see my article: Midlife Transitions and Preparing Emotionally For Making Major Changes in Your Life).

• Money
• People who have been laid off, furloughed or had their work hours reduced are concerned about money.
• Other people are struggling emotionally because they have been terminated from their jobs, which means a loss of income and a loss of identity (see my article: When Job Loss Means Loss of Identity).
• Many people are re-evaluating their priorities, what they spend money on and how much to save and how much to spend.
• Many people are considering the amount of debt that they carry and they're hoping to be able to develop a plan to get out of debt.
• Many couples have been arguing about money during this time (see my article: Are You and Your Spouse Arguing About Money?).

What Have You Been Reflecting on During This Crisis?
The areas that I've included above is by no means exhaustive.

What have you been thinking about? Is the current crisis causing you to re-evaluate your life?

Getting Help in Therapy
Major crises are often difficult to get through.  But they can also be an opportunity for change (see my article: How a Crisis Can Bring About Positive Changes in Your Life).

If you're thinking about how you would like to change your life, you could benefit from working with an experienced psychotherapist who can help you to consider what's most important to you and help you develop strategies for changing your life.

Many psychotherapists, including me, are doing online therapy, which is also known as teletherapy or telehealth (see my article: The Advantages of Online Therapy When Your Therapist Isn't Available in Person).

Rather than struggling on your own, you could work with a licensed therapist who has experience helping people to make changes in their life.

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

I work with individual adults and couples.

I am providing online therapy during the COVID-19 crisis.

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.

Developing Your Inner Sense of Being Grounded, Centered and Calm

During stressful times, it helps if you can feel an internal sense of being grounded, centered and calm (see my article: Grounding Techniques).  Feeling centered and grounded might not change your external circumstances, but it will help you to handle your circumstances with a sense of calm as well as a sense agency rather than a feeling powerless (see my article: Empowering Yourself During COVID-19: There Are Things You Can Control).

Developing Your Inner Sense of Being Grounded, Centered and Calm

Being able to detect a feeling of being centered, grounded and calm requires you to slow down and sense into your body, which I'll discuss later on in this article.

How Do You Know if You're Not Feeling Centered and Grounded?
First, let's talk about the opposite experience--when you're not feeling calm, centered and grounded, which can include:

• Experiencing anxiety and worry most of the time
• Creating or participating in emotional drama
• Feeling spaced out 
• Getting easily distracted
• Spending a lot of time worrying about how you look and what others think of you
• Having frequent sleep problems, including problems with falling or staying asleep (see my article: Tips on Getting Better Sleep)
• Experiencing chronic pain
• Having inflammation in your body
• Experiencing poor circulation in your body
• Feeling tired most of time

How to Develop a Sense of Being Grounded, Centered and Calm
As I mentioned earlier, you need to start by slowing down and noticing what's going on in your body.

Practice this at least once a day (more if you're feeling stressed at various times during the day or night):

• Find a quiet place for yourself in your home where you'll be undisturbed for at least 5-10 minutes (see my article: Reconnecting With Your Inner World Without Distractions).
• Depending upon your situation at home, this might mean getting up earlier than the rest of your family or taking a few minutes when it's quiet at another time of day, including bedtime.
• If there's no particular time when you usually have alone time, ask your family to allow you a few minutes to yourself (see my article: Is Self Care Selfish?). 
• Since both positive and negative emotions are often contagious, if you get calm and centered, it will help the rest of the family, including children,
• Sit up in a chair where you have back support and your feet touch the floor.

• Close your eyes (if you don't feel comfortable closing your eyes, find a spot on the floor to focus your attention so you're not distracted and your eyes aren't wandering around).

• Take a couple of regular breaths.
• After you have taken a couple of regular breaths, do a simple breathing exercise where you inhale and exhale through your nose (as opposed to your mouth).  Do this at your own pace:
• Breathe in to the count of 4
• Hold your breath for a count of 4
• Breathe out for 8
• Repeat as many times as required until you feel yourself getting calm

• Do the Body Scan meditation 
• When you do the Body Scan meditation, you're slowly sensing into your body to see where you're holding onto any tension.
• Wherever you sense tension in your body, imagine you could send your breath to that part of your body to help it relax.
• Thoughts will probably come up to distract you.  This is a common experience.  Imagine that you could take each thought and put it on a puffy white cloud so that it can float away, and then return to sensing into your body.

• Practice Breathing and the Body Scan meditation daily 
• If you're not accustomed to doing these exercises, you'll probably discover that they become easier with practice.
• It all starts with slowing down your mind and your body.

If you practice these exercises daily, but you're still having problems with sensing what's going on with your body, don't worry--this is a common experience that you can overcome.  I discuss this in my next article: The Mind-Body Connection: Developing a Felt Sense of Your Internal Experiences.

Conclusion

When you're going through a stressful time, as most of us are now during the COVID-19 crisis, it's easy to get overwhelmed physically and emotionally.

One way to get a handle on your stress is to start by slowing down and doing the exercises mentioned above to get more centered.

Getting Help in Therapy

You're not alone.   Many people are experiencing more stress than usual at this time, and they're having problems coping (see my article: Common Reactions During a Crisis: Fear and Anxiety).

During times of high stress, unresolved problems from the past can get triggered and they can feel overwhelming.  

Most therapists, including me, are offering online therapy (also called teletherapy or telehealth) while they're out of the office due to COVID-19 (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

Rather than struggling on your own, seek help from a licensed psychotherapist.  

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT 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 email me.