NYC Psychotherapist Blog

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Wednesday, February 28, 2024

Is It True That "Real Men" Are Always Ready to Get It Up?

In my previous article, Overcoming Problems With Anxiety-Related Erectile Dysfunction, I focused specifically on how stress and anxiety can make it difficult for men to get and stay hard and how sex therapy can help with this problem.

Is It True That "Real Men" Are Always Ready to Get It Up?
In the current article, I'm addressing the idea that "real men" are always ready and willing to get it up any time, any place and with anyone.  

Is this true?  In a word, no.

Problems With Getting an Maintaining an Erection Are Common

It's not true because, at some time or another, most men have problems with getting or maintaining an erection.  

It's a common problem that occurs occasionally for many reasons, which will be discussed below, and when it occurs occasionally, in most instances, once medical problems have been ruled out, it's not a cause for concern.

The idea that "real men" are always ready to get it up is a form of toxic masculinity which perpetuates psychologically destructive misinformation for men and their partners. And one of the primary reasons it's so destructive is that the logical conclusion to this myth is that a man who isn't always ready to get it up is "less than a man" or deficient in some way. 

This myth often creates feelings of shame and inadequacy for men and feelings of being sexually undesirable for their partners--regardless of sexual orientation and gender.

This myth can also perpetuate a cycle of anxiety, shame, doubt and fear that can lead to ongoing problems with erectile dysfunction (ED) when ED was never the problem to begin with.

Why Can't a Man Get Hard If He Wants to Have Sex and He Finds His Partner Sexually Desirable?
Men aren't machines so it's not a matter of pressing a button to automatically get their penis hard.

Men can find their partners very sexually desirable and still not be able to get or maintain an erection for a variety of reasons, including (but not limited to):
  • Stress
  • Tiredness
  • Too much alcohol
  • Side effects of certain medications
  • Anxiety
  • Depression
  • Other emotional issues
  • Relationship problems
  • Health concerns like diabetes, high blood pressure, heart problems, poor circulation, prostate problems, age-related problems and so on
  • Financial problems
  • Other related issues
When a man's partner assumes that his problems with getting and maintaining an erection reflect poorly on the partner, this perception compounds the problem even further by creating stress and bad feelings in the relationship.

At that point, a man can feel even more pressure to get and stay hard because he feels his masculinity is in question and also because he doesn't want to disappoint his partner.  

But stress and pressure make it harder to get and maintain an erection, so this can become a negative cycle.

Are There Times When a "Real Man" Just Doesn't Want to Have Sex?
In a word, yes.

Why should wanting to have sex be any different from wanting to do anything else?

If we were discussing a preference for anything else--going to the movies, eating dinner at a particular restaurant, watching TV and so on, it would be obvious that there are times when people don't want to engage in an activity and other times when they don't.  

It's the same for having sex and, once again, it's not a reflection on the man or his partner.  

But, once again, if a man feels pressure because he doesn't want to have sex, he might feel he has to "man up" to have sex when he doesn't want it because he fears being judged as "less than a man" and he also doesn't want to disappoint his partner.  

To complicate matters, many men (and women) don't feel comfortable talking about sex with  their partner because they don't know how and/or they feel ashamed (see my article:  How to Talk to Your Partner About Sex - Part 1 and Part 2).

In addition, even though it's often assumed that "real men" are always ready for sex, many men experience responsive desire as opposed to spontaneous desire so, even if they're willing to have sex, they need time to get sexually aroused (see my article: Both Responsive and Spontaneous Sexual Desire Are Normal).

What If Problems With Getting Hard Are Due to Relational Problems?
There are times when men (and women) don't want to have sex because there are problems in the relationship.  This is a common problem.

It's a good idea for a man to see a urologist or sexual health doctor to first rule out any other health reasons that are affecting his ability to have an erection.  Once those problems are ruled out, the problem can be related to other problems, including relational problem with a partner.

With regard to relational problems, it makes sense that feelings of anger, sadness, hurt or emotional numbness aren't conducive to wanting sex.  

Under these circumstances, couples often need to get help both relationally and sexually from a couples therapist who is also a sex therapist to overcome problems that are creating emotional and sexual obstacles in the relationship.

Getting Help in Couples and Sex Therapy
Couples seek help in couples and sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Getting Help in Couples and Sex Therapy

Sex therapy, in particular, is for individual adults and couples (see my article: What is Sex Therapy?

There is no nudity, sex or physical exams in sex therapy (see my article: What Are Common Misconceptions About Sex Therapy? ).

If you're having problems, rather than struggling on your own, seek help from a licensed mental health professional who has an expertise in both couples and sex therapy.

Overcoming your problems can allow you to have a more meaningful relationship and a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, trauma therapist (EMDR, AEDP, Somatic Experiencing), Emotionally Focused Couples therapist and a sex 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.

Tuesday, February 27, 2024

Overcoming Problems With Anxiety-Related Erectile Dysfunction (ED)

Anxiety-related erectile dysfunction is a common problem for men regardless of sexual orientation, age or race (see my article: What is Sexual Anxiety?).

What is the Link Between Anxiety and Erectile Dysfunction?
Most men experience occasional problems with maintaining an erection and most of the time these occasional problems aren't a cause for concern.

Anxiety-Related Problems With ED

Occasional problems can be related to not getting enough sleep, drinking too much or other factors.

Occasional problems are different from ongoing problems with erectile dysfunction.  

Assuming medical problems have been ruled out by a urologist or a sexual health doctor, erectile dysfunction (ED) is often caused by stress and anxiety, especially when men worry about their ability to please their partner (see my article: The 5 Most Common Male Sexual Insecurities).

Anxiety and stress-related ED can include one or more of the following problems:
  • Problems with Body Image: For many men body image problems involve worrying that their penis is too small.  There can be a lot of variation in penis size, however, the average size of a flaccid penis is 3.5 inches and 5.1 inches for an erect penis.  Men who compare the size of their penis to male actors in pornography can develop a distorted view of what an average penis looks like, especially if they don't realize that male actors in porn are chosen for their unusually large penises.  
Anxiety-Related Problems With ED
  • Relationship Conflict: Stress and anxiety related to relationship conflict can be a contributing factor to ED and an inability to experience sexual pleasure. Relationship conflict can include frequent arguments, a history of emotional and/or sexual infidelity, financial infidelity, child-rearing disagreements, problems with one's own family or with in-laws, and so on.
  • Unresolved Sexual Trauma: When there is unresolved sexual trauma, partnered sex can trigger trauma-related guilt and shame which often has nothing to do with the current sexual partner.  Trauma-related triggers occur in an instant without a person's conscious awareness.  Since trauma-related triggers often occur outside a person's awareness, a man might not understand why he feels so emotionally overwhelmed in the moment because he doesn't realize he is triggered and that the trigger has nothing to do with his current partner.  Anything can act as a trigger including a scent, a word, a gesture, a movement, a particular sexual position and hundreds of other things that were related to the original trauma (see my article: How Unresolved Trauma Can Affect Your Relationship and Overcoming a History of Sexual Abuse).
  • Lack of Sexual Experience: When a man worries he won't be able to "perform" sexually or that he won't be able to satisfy his partner, this can lead to "spectatoring" where a man becomes so self conscious that he becomes a so-called "spectator." Rather that enjoying sex with his partner, he is  "spectatoring" which takes him out of the sexual experience and can create a problem ED (see my article: What is Performative Sex?).
  • Stress and Worry Unrelated to Sex: A little stress in the form of sexual anticipation can enhance sexual pleasure, but too much stress can lead to ED.  
  • Other Mental Health Problems: Generalized anxiety, depression and other mental health problems that are not directly related to sex can also contribute to ED.
How Does Sex Therapy Help Men to Overcome Erectile Dysfunction?
Sex therapy is a form of talk therapy for individual adults and couples (see my article: What is Sex Therapy?)

Sex therapy is an effective treatment for sexual anxiety and other sexual problems.

During a sex therapy session, there is no sex, nudity or physical exams (see my article: What Are Common Misconceptions About Sex Therapy?).

Individuals and couples seek help in sex therapy for many reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Regardless of the sexual problem, sex therapy usually begins with an assessment, including taking a family history, relationship history and sexual history to determine how the current problem might be related to the client's history.  This usually takes several sessions.

Sex therapy is an effective form of treatment for ED and other sexual problems (see my article: How Sex Therapy Can Help With Sexual Anxiety).

The underlying issues of erectile dysfunction are different for each person, so there is no one-size-fits all approach to overcoming ED.  

If a man is able to maintain an erection when he masturbates and if he experiences normal erections during sleep and upon waking up (also known as "morning wood"), ED is usually related to an underlying issue that he might have no awareness about before beginning sex therapy.

A sex therapist is a trained mental health professional who has special training in sexual-related problems, including erectile dysfunction.

Sex therapists give sex therapy clients assignments to do at home either alone or with a partner.  This can include (but is not limited to):
  • Reading assignments 
  • Other assignments between sex therapy sessions
If the ED occurs within the context of a relationship, it's considered a relationship problem and sex therapy is more effective if both partners are attending sex therapy sessions together.

In future articles, I'll explore, among other topics, how the penis is often a barometer of physical, emotional and sexual health.

Getting Help in Sex Therapy
In addition to whatever underlying issues there might be, men often feel too ashamed to seek help in sex therapy.  This is often due to distorted stereotypes of what it means to "be a man" or to "be strong."

Getting Help in Sex Therapy

Sexual shame is often reduced or eliminated when men learn how common erectile dysfunction is for men regardless of age, sexual orientation, race and other identifying factors.

If you're experiencing ED, rather than struggling on your own or ignoring the problem, seek help from a licensed mental health professional who is a trained sex therapist.

Getting Help in Sex Therapy

Overcoming anxiety-related ED can lead to more satisfying sex and a more meaningful life.

About Me
I am a licensed psychotherapist, sex therapist, couples therapist, hypnotherapist and trauma therapist (EMDR, AEDP, Somatic Experiencing and other forms of trauma therapy) with more than 20 years of experience.

I work with individual adults and couples and I have helped many clients to overcome sexual problems.

My office is conveniently located in Greenwich Village, Manhattan where I provide in-person and virtual sessions.

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

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

Monday, February 26, 2024

5 Reasons Why Hope is Essential to Your Well-Being

Life can be so challenging at times that you might find yourself balancing feelings of hope and dread (see my article: Focusing on Your Personal Strengths to Get Through Stressful Times).

Hope is Essential to Your Well-Being

While it's important not to be overtaken by dread, it's also important not to live on false hope, which will be discussed later on in this article.

This article will also discuss the role of unresolved trauma and how it can get in the way of having a sense of hope for the future.

5 Reasons Why Hope is Important to Your Sense of Well Being
There are many reasons why hope is important to your sense of well-being, including that it can provide: 
  • 1. An Openness to New Possibilities: When you feel hopeful, you're more likely to be open to new and better possibilities for the future.  Even if there's just a glimmer of hope, it can be enough for you to envision a better future for yourself (see my article: Being Open to New Possibilities).
  • 2. A Sense of Motivation: Hope can motivate you to take action because when you feel hopeful enough--even if you also feel some dread--you're more likely to take positive steps towards the goals or challenges you're facing (see my article: Developing Internal Motivation).

Hope is Essential to Your Well-Being

  • 3. A Willingness to Persevere: Goals often require perseverance and perseverance is easier to sustain if you feel hopeful that your goals are achievable. This is especially true for long term goals where you might not always see progress immediately. Hope can sustain you through rough times when you might be tempted to give up (see my article: Achieving Your Goals With Perseverance).
  • 4. A Willingness to Overcome Setbacks: With many long term goals, there are often setbacks because progress isn't linear. This is true of many long terms projects. It's also true for psychotherapy.  When you feel hopeful, you're more likely to take temporary setbacks in stride rather than letting setbacks deter you from your goals (see my article: Setbacks Are a Normal Part of Therapy on the Road to Healing).
  • 5. An Improvement to Health and Well-Being: A sense of hope can improve your physical and mental well-being. When hope reduces stress, it can improve your immune system. Hope can also reduce anxiety and sadness.  In addition, it can increase your confidence.  Feeling hopeful and wanting to remain in a state of hopefulness can encourage you to surround yourself with like-minded people.
Avoiding False Hope and Unrealistic Expectations
Being hopeful doesn't mean that you latch onto false hope or unrealistic expectations.

It also doesn't mean "never giving up on your dreams" if your dreams aren't achievable or they're based on toxic positivity.

For example, if you have a dream of being an Olympic swimmer, but you never learn to swim, your dream is rooted in false hope and unrealistic expectations.  Or, if you want to become a concert pianist, but you hardly ever practice the piano, you're not going to fulfill your dream.

The examples given above are easy to see, but it's not always clear when you're indulging in false hope. 

For example, if you're in a relationship that has long-standing problems, you might not have a sense of whether your relationship can be salvaged or if it's beyond repair.  

In that case, a couples therapist, who is a relationship expert, can help you both to assess how you feel about the relationship and whether you each feel it's still viable.

Seeking Help in Therapy
If you have unresolved trauma, you might find it challenging to feel hopeful even under the best of circumstances because your prior traumatic experiences can cloud your perspective (see my article: Overcoming Trauma: Separating Then From Now).

Seek Help in Therapy

If you feel you're constantly "waiting for the other shoe to drop" even when there's nothing in your current circumstances to warrant your concern, you could benefit from seeking help from a trauma therapist.

A skilled trauma therapist can help you to free yourself from your traumatic history so you can live a more hopeful and meaningful life.

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

As a trauma therapist, I have helped many individual adults and couples to overcome their traumatic history (see my article: What is a Trauma Therapist?).

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.

What is a Strengths-Based Perspective in Psychotherapy?

In recent years, many psychotherapists have become increasingly open to adopting a strengths-based perspective in psychotherapy.  This strengths-based perspective looks at not only clients' problems but also emphasizes clients' strengths and positive qualities.  

Social work has had an influence on this trend because it has a long tradition of recognizing clients' positive  aspects.  Over the years, as psychotherapists with social work background have come to dominate the psychotherapy field in New York City, psychotherapy has begun to change to reflect this positive perspective.

I believe there are many advantages to having a strengths-based perspective in psychotherapy--not least of which is that psychotherapists can help clients to develop increased self confidence as they learn to appreciate the strengths they already have.  As it is, many clients come to therapy feeling badly about themselves. Often, they can't see their many positive qualities. They dwell mostly on the negative.

A Strengths-Based Perspective in Therapy

Therapists who have a strengths-based perspective can help clients to appreciate what's right about them and not just what's wrong.

Psychotherapy's early history was one of pathologizing clients.  In recent years,  mind-body oriented psychotherapy, which includes EMDR, clinical hypnosis, and Somatic Experiencing, has emphasized helping clients to develop emotional resources as compared to only looking for pathology.  One of the best ways to help clients build emotional resources is to help them enhance the strengths they already have and might not even realize they have.  

Recognizing Strengths and Accomplishments
For instance, a client, who begins psychotherapy due to a history of trauma, might have significant accomplishments, despite longstanding trauma.  S/he might have graduated college, raised a family, and maintained gainful employment.  

Many clients don't appreciate their own resilience and ability to persevere despite adverse circumstances. They often minimize these strengths by telling themselves and others, "It wasn't such a big deal.  I just did what I had to do."  But a psychotherapist with a strengths-based perspective has the objectivity and the mindset to help a client with these strengths to appreciate and build upon these strengths.

A strengths-based perspective in psychotherapy is not a "feel good"or "Pollyanna" approach.  Therapists still need to help clients to overcome their problems and to look at how they might even be contributing to their problems.  A strengths-based perspective isn't a quick fix.  Rather, it's an even-handed, holistic approach that, I believe, in the long run, is much more beneficial to psychotherapy clients.

If you have been considering attending psychotherapy, but you've been hesitant because you fear being pathologized in therapy, I recommend that you find a psychotherapist who has a strengths-based perspective.  

Before you embark on the self exploration involved in psychotherapy, I recommend that you ask questions. Most experienced therapists expect potential clients to ask them about their psychotherapy approach in an initial consultation.  Many therapists also have websites that provide information about their particular philosophy to psychotherapy.  You have a right to be an informed consumer and to trust your instincts.

See my articles: 

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

I work with individual adults and couples.  

I have helped many clients overcome obstacles so that they could lead more fulfilling lives.

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

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

Focusing on Your Personal Strengths to Cope With Stressful Times

Most people tend to focus on what they consider their weaknesses and forget to consider their personal strengths.  When they go through stressful times, focusing on where they feel deficient makes it much more stressful for them.  

In this article, I'm proposing that focusing on your personal strengths will help you more during difficult times.  For this article, I'm using the terms "personal strengths" and "internal resources" interchangeably (seems article: Discovering Your Personal Strengths and Developing Internal Resources and Coping Skills).

Focusing on Your Personal Strength to Cope With Stress

Identifying Your Personal Strengths
Everyone has personal strengths--whether they focus on them or not.

Your personal strengths are what's going to help you to cope with stress--not the areas where you feel deficient.  So, it's important to harness those inner resources to reduce your stress and resolve your problems.

Unfortunately, so many people are unable to identify their personal strengths.  They're so focused on being critical of themselves that they forget all the wonderful qualities that they possess that have gotten them through rough times in the past.

Rather than focusing on their internal resources, they worry and project their fears into the future.  So, not only are they worried about what's happening in the current situation, but they're also projecting and predicting problems in the future--problems that might never come.

If you tend to project negative outcomes, think about all the times when you did this in the past and how often your projections came true.  If you're like most people, your negative projections occurred only a fraction of the time.  That means that you spent a lot of time and effort worrying for no reason.

Should You Completely Ignore Your Weaknesses?
Does this mean that you should completely ignore about your weaknesses?  The short answer is:  No, especially if they're having an adverse effect on your life.

For instance, if your manager tells you that you're doing a great job with most of your responsibilities, but you really need to improve your presentation skills, you're not going to ignore this because it would be detrimental to your job.  You're going to find out what you can do to improve your presentation skills and then do it.

Or, if your spouse tells you that you tend to zone out with your phone when she talks and she would appreciate your being more present, are you going to ignore your wife's request?  No, you're going to make an effort to put down your phone more often so you can be fully present when you talk to each other.

So, I'm not proposing that you only focus exclusively on your strengths all the time without trying to make improvements in the areas where you could stand to improve.  What I'm saying is that many people only focus on their weaknesses, and they could use some balance in their approach.

How to Focus on Your Strengths to Cope With Stressful Times

Think About How You Got Through Difficult Times in the Past
The easiest way to focus on your strengths when you're under stress is to think about past memories  when you succeeded in getting through hard times.

Which inner resources allowed you to get through a challenging time?

Write About the Personal Strengths That Helped You in the Past
If you're struggling to identify the personal strengths that got you through, take a few minutes to write about it.  Writing helps to clarify your thoughts and concretize your ideas.  Don't spend time being critical of your writing.  This exercise is only for you--no one else needs to see it.

Write About How These Same Inner Resources Can Help You Now
Very often, the personal strengths that got you through in the past are the same strengths that can help you now.  It's a matter of remembering and using them again.

Speak to Your Loved Ones
It's often the case that loved ones can see and remember the personal strengths that helped you in the past long after you've forgotten about them.  So, if you have trusted family and friends who saw you through difficult times in the past, ask them what they observed about you.  You might be surprised to hear what they have to say.  Write it down before you forget.

What If You're Too Stressed Out to Focus on Your Personal Strengths?
There are times when people are under so much stress that their feelings and thinking are clouded by the stress, and it's difficult to get beyond worrying and expecting the worst.

When you're that worried, you need to consider how the stress will affect your health. Up to a certain point, stress can motivate you and give you the extra edge you need to get going.  But when you're flooded with stress, it can damage your health with no beneficial effects (see my article: Tips on How to Stop Worrying).

At that point, you could benefit from getting help from a licensed mental health professional, who can   help you to remember your personal strengths and help you to develop new internal resources.

Getting Help in Therapy
Everyone needs help at some point.

A skilled psychotherapist knows how to help clients to access the best part of themselves to get through tough times and also help them to cultivate new internal resources (see my article: A Strengths-Based Perspective in Psychotherapy).

If you're overwhelmed by stress, rather than struggling on your own, seek help from a licensed psychotherapist, who has helped clients to call on their personal strengths and get through stressful times.

By working with an experienced psychotherapist, you can get through a tough time and come out on the other end feeling confident in yourself and free from the worries that were so debilitating.  You'll can also feel more confident about handling new challenges.

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

I have helped many clients to focus on their personal strengths as well as develop new internal resources to cope with difficult times or unresolved trauma.

When I begin working with a new client in my psychotherapy practice in New York City, I begin by focusing on their personal strengths or internal resources, especially if the client has come in to deal with a major stressor or unresolved trauma.  I also help clients to develop new internal resources in addition to the ones they already possess.

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.

Wednesday, February 14, 2024

4 Ways Unresolved Trauma Can Have a Negative Impact on You and Your Relationship

There are many ways unresolved trauma can create problems for you and your relationship, especially unresolved childhood trauma (see my article: How Unresolved Trauma Can Affect Your Ability to Be in a Relationship).

Unresolved Trauma Can Affect You and Your Relationship

4 Ways Unresolved Trauma Can Have a Negative Impact on You and Your Relationship
In this article, I'm focusing specifically on the following four problems:
  • Developing Rigid Negative Beliefs About Yourself and Relationships
  • Choosing an Unhealthy Partner
  • Getting Triggered During Conflicts with Your Partner
  • Staying in an Unhealthy Relationship Too Long
1. Developing Rigid Negative Beliefs About Yourself and Relationships
Your early childhood experiences have an important impact on your beliefs about yourself and about relationships in general.

If you grew up in a dysfunctional family where life was chaotic and you felt unlovable and emotionally invalidated, you might have formed rigid and negative beliefs about yourself and relationships, including:
  • "I don't deserve a loving partner."
  • "No one will find me lovable."
  • "All men are cheaters."
  • "Women can't be trusted."
  • "Men only want sex."
And so on.

You might also have a strong fear of rejection and abandonment based on your early experiences. In addition, you might even anticipate rejection and abandonment where these problems doesn't exist.

These rigid negative beliefs make it difficult to trust anyone so even though you might want to have a partner, you might also dread getting into a relationship (see my article: An Emotional Dilemma: Wanting and Dreading Love).

2. Choosing an Unhealthy Partner
If you don't know what a healthy relationship looks like because you grew up in a dysfunctional family, you might not know how to choose someone who is right for you.

Consciously, you might tell yourself you want a relationship that's different from what you experienced growing up, but unconsciously you might gravitate towards partners who feel familiar to you. If what's familiar is dysfunction, that might be what you're drawn to when you're meeting a potential partner.

On an unconscious level, you might also be drawn to people who aren't interested in you because these types of situations activate a familiar longing in you from your childhood (see my article: Letting Go of an Unhealthy Relationship: Unrequited Love).

3. Getting Triggered During Conflicts in Your Relationship
If you have unresolved trauma, you can get easily triggered during an argument with your partner.  

Unresolved Trauma Can Get Triggered During Arguments

In the moment, you might not realize that you're stuck in a trauma response because you don't realize your unresolved trauma is getting triggered or, even if you're aware of it, you could find it hard to distinguish between your current emotions from past experiences (see my article: Overcoming Trauma: Learning to Separate Past Traumatic Experiences From Now).

Even if you're in a healthy relationship, your old emotional wounds can get triggered from unresolved trauma. This can create a trauma response including:
  • Fawn
    • Engaging in people-pleasing behavior with your partner to ward off your unpleasant feelings to the detriment of your emotional needs (see my article: Trauma and the Fawn Response).
4. Staying in an Unhealthy Relationship Too Long
People who have unresolved trauma often develop an unhealthy tolerance for emotional abuse because it's familiar to them from their childhood and they don't realize they're in an unhealthy relationship (see my article: Should You Stay or Should You Leave Your Relationship?).

Even if you realize you're in an unhealthy relationship, you might feel this is all that you deserve and it's the best you can do because you feel so unworthy.  This is related to negative beliefs about yourself mentioned above.

You might also leave an unhealthy relationship, but you enter into a succession of unhealthy relationships after that because you haven't done the necessary psychological work to overcome your history of trauma that creates relationship problems for you.

Getting Help in Trauma Therapy
Trauma therapy is different from regular talk therapy.

Getting Help in Trauma Therapy

Regular talk therapy where you talk about your trauma, but you don't actually process the trauma with specific trauma therapy interventions, isn't as effective as Experiential Therapies like EMDR Therapy (Eye Movement Desensitization and Reprocessing), Somatic Experiencing or AEDP (Accelerated Experiential Dynamic Psychotherapy).

Instead of struggling on your own, you could benefit from working with a trauma therapist to overcome trauma that keeps you stuck. 

A skilled trauma therapist can help you to overcome trauma so you can lead a more fulfilling life (see my article: What is a Trauma Therapist?).

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

As a trauma therapist, I have helped many individual adults and couples 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.

Valentine's Day: 5 Tips For a Long and Happy Relationship

It's Valentine's Day. If you're in a relationship, it's a reminder to show your appreciation for your spouse or partner. 

5 Tips For a Long and Happy Relationship
When you're in a long term relationship, it's easy to take each other for granted and forget to show love and appreciation, so here are some tips:

1. Remember what brought you together when you first fell in love: 
In long-term relationships and marriages, it's easy to fall into the negative habit of nitpicking and fault finding.  While you can't always expect that you'll feel the same passion and head-over-heels in love feelings you felt when you first met, it helps to remember the positive things that brought you together and reinforce those things in your relationship.  For instance, if an interest in music brought you together, when was the last time the two of you went to a concert with your favorite artist?  Make plans to do the things you both enjoy doing to bring back some fun and passion into your relationship.

2. Make Your Relationship the Priority: 
It's important to maintain friendships and family relationships but, over all, making your relationship with your spouse the priority will go a long way to setting the stage for a healthy, happy marriage.  Don't take your spouse for granted.  If friends and relatives are making constant demands of your time and this consistently takes away from your time with your spouse, you would be wise to rethink your priorities.  Don't take the path of least resistance just because your spouse is always "understanding."  Even if you have the most understanding spouse, when you consistently put others first, over time, you're eroding the quality of your relationship with your spouse.

3. Create Special Times with Your Spouse: 
Every so often, it helps to create a special time with your spouse.  Whether this means, you stay at home, unplug the phones and your gadgets, and have a romantic champagne brunch together or you have a romantic evening where you play with new sex toys, make an effort to create special times together. Nothing kills a marriage more than boredom, day after day, week after week, doing the same old things. Special times together help to rekindle your love for each other.

4. Choose Your Battles: 
Nitpicking and nagging is a real turn off in any relationship.  Sometimes,  you have to ask yourself whether it's worth getting into an argument over something that, if you thought about it for a few minutes, is really a petty issue.  Sometimes, it's necessary to have a larger perspective of the relationship and over look the "small stuff."

5. Show Respect For Each Other at all Times, Even When You're Arguing: 
Contempt is one of the biggest relationship killers.  If you're the type to say disrespectful and contemptuous things to your spouse when you're arguing, you need to learn a different way of communicating because you're endangering your relationship.  Once the contemptuous words leave your mouth, it's hard to take them back.  Respectful communication between spouses is key to any long-term happy marriage.

Getting Help in Therapy
If you and you partner have unresolved problems, you could benefit from couples therapy (see my article: How Emotionally Focused Therapy For Couples Can Improve Your Relationship).

Rather than allowing things to continue to slide downhill, take steps to have a more fulfilling relationship.

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

I work with individual adults and couples.

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

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

Sunday, February 11, 2024

How to Stop Arguments in Your Relationship

In recent articles I've been focusing on how Emotionally Focused Therapy For Couples (also known as EFT) can help people in relationships to identify and break their negative cycles:

In the current article, I'm discussing an EFT strategy called TEMPO developed by George Faller, LMFT, EFT therapist and senior trainer, that can help you to stop arguments.

How to Stop Arguments in Your Relationship

George Faller and Laurie Watson discussed TEMPO in Episode 273 of their podcast, Foreplay Radio.

TEMPO can be especially helpful for couples who have the same argument over and over again without resolution.  This means they are stuck in a negative cycle, and they probably have no idea this is happening because they're unaware of their cycle. 

As I've mentioned in the previous articles, over time, the negative cycle erodes the relationship because couples don't know how to deal with it.

So, TEMPO is a way you and your partner can stop arguing about the same thing so you can break the negative cycle.

What is TEMPO?
First, let's define what TEMPO means.

George Faller, LMFT developed the acronym TEMPO based on the work of Magda B. Arnold, a Canadian psychologist who was the first contemporary theorist to develop the appraisal theory of emotions.

TEMPO stands for:

T: Trigger
E: Emotion
M: Meaning
P: Protection
O: Organization
  • Trigger: An emotional trigger includes the thoughts, memories, words or behavior that spark an intense negative reaction in you. Emotional triggers are immediate and come on suddenly without warning (see my article: Coping With Emotional Triggers).
  • Emotion: In the context of having an argument, emotions are what you experience that are related to the trigger.  You experience emotions in the body first before you can identify them mentally, so it's important to develop somatic awareness in order to be able to identify emotions (see my article: The Mind-Body Connection: Developing Somatic Awareness).
  • Meaning: Meaning refers to the story you tell yourself about what happened. It's what you tell yourself about what happened between you and your partner (see my article: How a Negative Narrative Develops).
  • Protection: Protection refers to what you say or do to protect yourself when you're faced with unpleasant emotions related to the situation you're in with your partner. This is usually an automatic reaction: fight, flight, freeze or fawn.  Protection can also be thought of as defense mechanisms.
  • Organization: Organization is a way to pause and slow down to:
    • Identify the Trigger
    • Identify the Emotion and where you feel it in your body
    • Identify the Meaning you're making of the situation--what you're telling yourself about it.
    • Identify the Protection strategy you use. 
Clinical Vignette
Let's take a look at a clinical vignette, which is a composite of many different cases, to clarify how the TEMPO strategy:

Ina and Pete
Ina and Pete, both in their early 40s, have been married for five years, and they continue to have a recurring argument about lateness.

When they meet for dinner at a restaurant, Ina tends to get there at least 10-15 minutes early and Pete tends to come 5-10 minutes late so that Ina usually has to wait for Pete.  Pete usually doesn't acknowledge his lateness or apologize for it, which sets off Ina.

When Ina is set off, she confronts Pete because, in EFT terms, she's an Emotional Pursuer and she wants to get to the bottom of why he continues to comes late and he doesn't take responsibility for it.

In EFT terms, Pete is an Emotional Withdrawer, so when Ina confronts him, he wants to avoid arguing.  As a result, he dismisses and deflects Ina's concerns, which triggers her even more.  So, Ina confronts him even more, which makes Pete withdraw more.  

This is pursuer-withdrawer dynamic is their negative cycle: The more Ina pursues, the more Pete withdraws. Eventually, they get tired of the argument and after an hour or so, they talk about something else. 

Even though it appears on the surface that they have resolved their argument, they really haven't because there has been no resolution to their negative cycle, so they will continue to have this argument the next time Pete is late again.

Let's look at how to use TEMPO as it applies to each of them and then how to look at their dynamic together.

Trigger: When Pete comes late and he doesn't acknowledge his lateness or take responsibility.

Emotion: Ina feels angry, frustrated and hurt that Pete continues to arrive late--even though she has told him many times how much this bothers her.  She feels especially upset when Pete doesn't say anything to acknowledge and apologize for his lateness. In terms of where she feels the emotions in her body, she feels the anger and hurt in face, shoulders and her stomach.

Meaning: When she is triggered, in that moment Ina feels, "He must not love me if he continues to come late and he doesn't apologize to me--even though he knows it bothers me so much."

Protection: In EFT terms, as mentioned before, Ina is an Emotional Pursuer. She wants to get to the bottom of this problem immediately. She has a sense of urgency about it because she wants him to care about her and she also wants save their relationship.

Organization: If Ina knew the EFT TEMPO strategy, she would pause to identify the trigger, emotions and meaning she made out of this situation before she reacted.

Pete's TEMPO
Trigger: Pete gets triggered when Ina confronts him about his lateness. He rushed to the event, despite dealing with pressing issues at work that needed to be handled before he left. 

Emotion: He feels unappreciated and unloved when Ina gets angry with him for his lateness. He's told her so many times that he can't help being late when he gets delayed at his office or when he gets stuck in traffic. He also feels angry and frustrated that she's not more understanding. He feels his emotions in his chest and the back of his neck.

Meaning: In the moment when he's triggered, he feels she must not love him if she greets him in such a confrontational way. 

Protection: In EFT terms, as mentioned already, Pete is an Emotional Withdrawer. He feels so overwhelmed when Ina confronts him that he can't think straight. He needs time to step back and gather his thoughts. But when he hesitates, he's confronted even harder by Ina, which makes him want to withdraw even more.

Organization: If Pete knew the EFT TEMPO strategy, he would pause to identify the trigger, emotions and meaning he was attributing to this situation before he reacted.

Putting It All Together: Organizing the Negative Cycle For the Couple:
Once you understand your side of the negative cycle in terms of your own trigger, emotion, meaning and protection strategy, you and your partner can discuss how to break the negative cycle.

In the vignette with Ina and Pete, it might go something like this:

Pete: "I know how much it upsets you when I'm late and I'm sorry. Instead of ignoring your emotions, I wish I had acknowledged it right away instead of getting defensive about it. From now on, I'll call you when I have a situation at work that will cause me to be late. I love you very much. Our relationship means everything to me, and I don't want to do anything to jeopardize it."

Breaking the Negative Cycle in a Relationship

Ina: "I know you do the best you can to try to come on time and sometimes you get delayed by emergencies at work or traffic. I know that what I feel in the moment--that you don't love me--is the story I'm telling myself when I get triggered and not how you really feel.  Instead of coming at you as soon as I see you, I'll take a moment to pause and calm myself instead of lashing out at you."

Pete: "I know you love and appreciate me too. In the moment when you get angry with me as soon as you see me, I feel like you don't care about me. That's the story I tell myself in that moment because I feel like I'm disappointing you and failing you."

Ina: "Let's make an agreement to pause when we're both upset so we don't react and we don't argue."

Pete: "I think that's a great idea. Let's do that."

Notice that both Ina and Pete had to approach each other with emotional vulnerability, which is often the opposite of what they were feeling at the moment when they were arguing (see my article: Are You Able to Express Your Vulnerable Feelings to Your Partner?).

This is why it's so important to slow down and pause so you're not reactive and you can each get vulnerable with each other because, ultimately, vulnerability is the way out of the negative cycle.

Is TEMPO an Automatic Fix For Recurring Arguments?
In a word, no--at least not immediately.

A negative cycle can be very challenging to change, especially if it's been a longstanding one. Emotions occur in a fraction of a second without a person's conscious awareness. 

It takes a lot of practice using TEMPO to try to change an ingrained negative cycle, but it can be done.

To complicate matters, emotional triggers are often related to earlier unresolved traumatic experiences from childhood (see my article: How Unresolved Childhod Trauma Affects Relationships).

For instance, if Ina grew up in a household where her father was unreliable and he was often late or he disappeared for days, she would be dealing with the current situation with Pete as well as, unconsciously, experiencing the old unresolved trauma related to her father.

If Pete grew up in a household where his parents criticized him a lot, he would be dealing with the current situation with Ina as well as, unconsciously, experiencing the old unresolved trauma related to his critical parents.

Getting Help in EFT Couples Therapy
TEMPO is a tool you and your partner can use, but if you continue to get stuck in a negative cycle, you could benefit from EFT Couples Therapy.

A skilled EFT couples therapist can help you to identify and break your negative cycle.

Instead of struggling on your own, seek help in EFT Couples Therapy to have a more fulfilling relationship.

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

I have helped many individual adults and couples to overcome their problems, including unresolved trauma (see my article: What is a Trauma Therapist?).

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.