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Thursday, February 6, 2025

Why Do People Go to Therapy?

When I was 18 years old, I sought help in therapy to deal with certain issues I was struggling with at the time. 

I'll never forget our family doctor's response when I told him that I started therapy: "Why are you going to therapy? Do you think you're a movie star?" 
Why Do People Go to Therapy?


I knew he was trying to make light of a subject that made him feel uncomfortable but, even back then, as a teenager, I realized his response was unenlightened and behind the times. 

I would like to think people are better informed now, but I still hear from clients in my psychotherapy private practice that their friends and family respond negatively when they hear about therapy: 

"Why are you going to therapy?" 
"Therapy is for crazy people. You're not crazy"
"You must be weak if you going to therapy" and so on 
    
        See my articles below about common misconceptions about therapy.

So, after hearing these remarks many times, I thought it would be worthwhile to write about the reasons why people go to therapy. I'm hoping this article can help to normalize the therapy process.

Why Do People Attend Psychotherapy?
People attend therapy for a variety of reasons including but not limited to:
  • Personal Growth: Many people seek help in therapy to develop self awareness and self reflective capacity. Self reflective capacity is the ability to examine, analyze and evaluate your thoughts, feelings and behavior.  This includes the capacity to reflect on your inner emotional and psychological world to understand the ways you feel, think and behave. This allows you to make changes in the way you see yourself and how you interact with others (see my article: The Growth Mindset vs the Fixed Mindset).
Going to Therapy For Personal Growth
  • Unresolved Trauma: Unresolved trauma often has a negative impact on day-to-day interactions with loved ones or colleagues. Getting help in trauma therapy can help to overcome trauma. Note: Trauma can be a one-time event or it can occur over time such as unresolved childhood abuse or neglect.
                      See my articles:
Going to Therapy to Overcome Trauma
  • Relationship Issues: People who seek individual therapy or couples therapy to work on relationship issues often find they benefit from therapy and they have more fulfilling relationships. Also, some couples want to work on having an amicable separation or divorce or help on how to co-parent in a healthy way ,

Going to Therapy For Relationship Problems

  • Low Self Esteem: Problems with low self esteem can have a negative impact on all areas of life. People who attend therapy can develop a healthy sense of self (see my article: What is Low Self Esteem?).
  • Sexual Problems: Individual clients and people in relationships benefit from seeking help in sex therapy to overcome sexual problems.
                See my articles: 
    • Grief: Even though grief is a common experience for everyone at some point, grief can be overwhelming especially if people don't know how to grieve or they experience complicated grief.
    Going to Therapy For Grief Work
    Going to Therapy For Work-Life Balance

    Going to Therapy to Manage Emotions

    Common Misconceptions About Therapy
    Generally, people are better informed about psychotherapy than in the past, but there is still a stigma among people who don't understand therapy.

    I have included links below for the most common misconceptions about therapy:




    Getting Help in Therapy
    People seek help in therapy for many different reasons.

    Getting Help in Therapy

    Whether you're considering therapy for your personal growth or you have problems you have been unable to cope with on your own, you could benefit from working with a skilled psychotherapist.

    Rather than struggling on your own, seek help from a licensed mental health professional so you can live a more fulfilling life.

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

    With over 20 years of experience, I have helped many individual adults and couples (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.























    Wednesday, February 5, 2025

    How to Cope With News Anxiety

    Do you feel overwhelmed by the news? (see my article: Living With Uncertainty).

    Coping With News Anxiety

    If you do, you're not alone. 

    I'm hearing about news anxiety from almost everyone I know who is anxious about what they're hearing on the news (see my article:  Self Care During Turbulent Times).

    How News Anxiety Can Affect You
    News anxiety can affect your mental health in many ways including:
    • Feeling frustrated, powerless and helpless
    • Having sleep problem (see my article: Tips to Improve Your Sleep)
    • Feeling depressed
    • Feeling anxious
    • Anxiety-related health problems
    • Over or under-eating
    • Other anxiety-related symptoms
    How to Cope With News Anxiety
    Make Self Care a Priority
      • Taking a relaxing bath
      • Reading or listening to a book you like
      • Enjoying your favorite movie, podcast or TV program
      • Engaging in hobbies you enjoy
    Staying Physically Active
    • Choose a Reliable Source of Information: Use good judgment when you're selecting your news source. Choose a news source which is known to be reliable. Don't rely solely on social media because there's a lot of misinformation on social media.
    • Limit the Time You Watch or Listen to the News: It's important to be well informed, but that doesn't mean listening or watching the news for hours. In many cases, the same news is being rebroadcast over and over again. That means that you're watching or listening to the same disturbing information multiple times and possibly seeing the same disturbing images. 
    • Avoid Doomscrolling: Don't spend a lot of time scrolling negative posts on social media. 
    Put Your Phone Away at Night to Get Better Sleep
    • Turn Your Phone Off and Put It Away at Night: Have a wind down routine before going to sleep. Scrolling on your phone, texting or reading or listening to the news at night when you need to relax can make you anxious and keep you up. Turn off your phone and put it away so you can get the rest you need.
    • Try to Find Positive News Story: While it's true that there's lots of bad news, there are also positive stories. Try to find positive and inspiring stories so you don't feel like everything is doomed.
    • Maintain Positive Social Connections: It's easy to feel alone and overwhelmed by the news, so it's important to stay connected with friends and loved ones. If you can't see them in person, give them a call or meet online.  
    Maintain Positive Social Connections
    • Get Involved to Feel Empowered and Make a Difference: There are many positive advocacy and social justice organizations where you can donate your time and money. Find the ones you like and find out what they're doing to overcome problems. When you get involved, you're can make a difference. When you feel you're making a difference, you're less likely to feel helpless and hopeless. You will also be around other like-minded people so you won't feel alone.
    Get Involved to Feel Empowered
    • Be Aware That the News Might Be Triggering Unresolved Trauma: If you have unresolved trauma, listening to disturbing news can not only increase your anxiety--it can also trigger unresolved trauma. This can increase feelings of anxiety, hopelessness and helplessness. If this is happening to you, you could benefit from working with a trauma therapist to resolve your trauma so it no longer gets triggered (see my article: How Does Trauma Therapy Work?).
    Getting Help in Therapy
    News anxiety can have a negative impact on your mental health including triggering unresolved trauma. 

    Get Help in Therapy

    If unresolved trauma is getting triggered, you could benefit from working with a trauma therapist.

    Rather than struggling on your own, seek help from a licensed mental health professional who has the training and expertise to help you to overcome unresolved trauma so you can lead a more fulfilling life free of your trauma.


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

    I work with individual adults and couples.

    As a trauma therapist with over 20 years of expertise, I have helped many clients to overcome 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.








     

    Monday, February 3, 2025

    The Connection Between "Tough Love" and Verbal Abuse

    The concept of tough love has been around for decades and it has often been used to justify verbal abuse and bullying.

    Rationalizing Verbal Abuse With Tough Love
    The practice of tough love is used in many families, sports teams and gymnastic competitions.

    In recent years, tough love has been exposed, especially in gymnastics, foir what it really is--a form of verbal abuse and bullying.

    The Connection Between "Tough Love" and Verbal Abuse

    For many years, tough love has been justified as a way to disparage any form of mental anguish including grief, sadness and other forms of mental and physical distress.

    In my psychotherapy private practice in New York City, many clients have recounted how they were ridiculed and shamed by parents who justified the verbal abuse of tough love by telling their young children that they were doing this for the children's own good.

    Clinical Vignette:
    The following clinical vignette, which is a composite of many different cases to protect confidentiality, illustrates the trauma of tough love and how trauma therapy can help:

    Jim
    When Jim described his upbringing, he said his father used tough love with him.

    Jim said he was never good at sports. He preferred to draw, play piano, and go out into nature, but his father, who was also Jim's baseball coach, told him that those activities were for "sissies". He told Jim he needed to "toughen up".

    Jim was nine years old when he played on the baseball team his father coached his team.

    Whenever Jim made mistakes during baseball practice, his father would lose his temper and yell at him, "What the hell are you doing, you sissy! You missed the ball by a mile!"

    Jim said he would feel so ashamed and humiliated by his father's bullying that he try to hide his tears, but his father's response was, "Stop crying, you crybaby!"

    Usually his father would refuse to speak to him on the drive back home, which made Jim feel even worse.  

    Then, when they got home, his father would disappear in the garage to avoid Jim and Jim would sit with his mother in the kitchen.

    His mother tended to be the more compassionate parent, but she seemed to be intimidated by her husband's temper, so she would try to soothe Jim by telling him, "You know your father loves you. When he yells at you, that's just his way of using tough love to help you."

    Even though he knew his parents loved him, Jim was confused when his mother told him this. He couldn't understand why his father's attempts to help him made him feel so bad.

    He was also aware that his father was raised by parents who constantly berated him and so he was repeating this pattern with Jim because he grew up believing that tough love was the best way to raise children.

    As an adult, Jim tended to choose romantic partners who were verbally abusive. These relationships were very painful for him and further eroded his self esteem.

    During his time in therapy, Jim was able to make the connection between his unhealthy romantic choices and his early childhood experiences with his father (see my article: Choosing Healthier Romantic Relationships).

    Once he saw the connection, he wanted to overcome his history of trauma because he realized his history was getting unconsciously repeated in his adult relationships with women.

    Using a combination of EMDR Therapy and Parts Work Therapy (Internal Family Systems as well as Ego States Therapy), we worked on his history of trauma.

    The work was neither quick nor easy, but Jim made steady progress so that, by the time he completed therapy, he no longer felt affected by his traumatic childhood and he chose healthier relationships.

    Conclusion
    Tough love by any other name is verbal abuse, shame inducing, a form of bullying and traumatic.

    Verbal abuse can have lifelong consequences for adults including the choices relationship choices they make.

    If you're experiencing the negative impact of tough love, you could benefit from seeking help from a trauma therapist.

    Rather than struggling alone, seek help so you can lead a more fulfilling life free of your history of trauma.

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

    I work with individual adults and couples.

    As a trauma therapist for over 20 years, I have helped many clients to overcome 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.












    Saturday, February 1, 2025

    What is Self Reflective Awareness and Why Is It Important For You?

    The capacity for self reflective awareness is an essential life skill to develop for yourself and for your relationships with others (see my article: What is Self Awareness?).


    Developing Self Reflective Awareness

    What Are the Signs of Low Self Reflective Awareness?
    The following are some of the most common signs of low self reflective awareness:
    • A Problem With Emotional Vulnerability: Emotional vulnerability is essential for your overall mental health, self compassion and empathy for others, open communication with your loved ones and the ability express your emotions, including emotions that might be difficult to express. If you see emotional vulnerability as being "weak", you're going to have a hard time connecting with your internal world and with others (see my article: Emotional Vulnerability as a Pathway to Intimacy in Relationships).
    Emotional Vulnerability as a Pathway to Intimacy
    • An Inability to Admit to Mistakes: If you have problems reflecting on your thoughts, feelings and behavior, you have problems with self awareness which can lead to an inability to admit to mistakes. Instead, you blame others for mistakes you have made. This often occurs due to fear and insecurity (see my article: Having the Courage to Admit You Made a Mistake).
    An Inability to Admit to Mistakes
    • A Tendency to Criticize Others: Along with an inability to admit mistakes, if you have low self reflective awareness, you might have a tendency to criticize others instead of looking at how you might have contributed to the problem.  Being hypercritical might make you feel better in the moment, but it usually comes at the expense of the people you're criticizing. This often leads to impaired relationships where resentment builds up and problems become more difficult to resolve. Equally important: It also comes at the expense of self awareness because you're too busy externalizing your problems (see my article: Improve Communication in Your Relationship By Eliminating the Four Horsemen of the Apocalypse).
    • A Problem Making Decisions: If you lack self reflective awareness, you might be indecisive because you're unable to reflect on what would be best for you and your loved ones. You might avoid making decisions because you feel insecure and you fear being judged or criticized. Instead of assessing your options, you might just accept whatever you're feeling at the moment ("I don't feel like going to work today, so I won't go"). Aside from a lack of self awareness, there's no critical thinking about the consequences of your behavior.
    Problems Making Decisions
    • A Problem Understanding Your Feelings: Without self awareness, you probably have a problems understanding your feelings. You also might not be comfortable with your feelings, especially if you got the message when you were growing up that feelings are dangerous. You might not be able to distinguish between feelings of sadness, anger, anxiety, shame, fear, happiness or disgust. Instead, your feelings might be value . You might only be able to say things like, "I feel bad" which is too vague to help you understand what's happening to you or to be able to communicate how you feel to others. In addition, if you lack self awareness, you might assume that just because you feel bad that means things are bad. In other words, a person with self reflective capacity, can step back from their feelings to assess what's going on. They can identify their feelings and think about why they're feeling that way instead of assuming that a "bad feeling" means things are bad (see my article: Your Thoughts and Feelings Aren't Facts).
    • Ruminating About the Past: Without self awareness, you can easily fall into a pattern of constantly dwelling on the past--your mistakes, other people's mistakes, what might have been and so on (this is different from when someone is stuck in unresolved trauma where their mind keeps going round and round about what happened as part of a trauma response). When you ruminate about the past (when it wasn't traumatic) and you don't have self awareness, you don't have the ability to observe and challenge yourself. Being aware of your rumination helps you to stop and reach a level of acceptance about the past so you can move on.
    Dwelling on the Past and Worry About the Future
    • Worrying Unproductively About the Future: If you lack self awareness, you might have a tendency to be a chronic worrier about the future. You might also be unaware of the anxiety and stress you're causing yourself by worrying about something that hasn't happened yet. Without the ability to step back and observe how you think, feel and behave, you just reinforce your habit of worrying without getting curious about why you're doing it. 
    Why is Self Awareness Important?
    Everyone could benefit from improving their self awareness.  But if you're having problems similar to what I have described in this article, you have a problem.

    Self Awareness is Part of Emotional Intelligence

    Self awareness is an essential part of emotional intelligence which helps you to know yourself and build and maintain healthy relationships with others.

    When you're self aware, you have the capacity to identify and learn from your mistakes which allows you to grow, learn new skills and develop resilience.

    Next Article
    In my next article, I'll discuss how to develop self reflective awareness.

    Getting Help in Therapy
    One of the most common reasons why people seek help in therapy is because they realize they're not self aware. They don't know how they feel and they're having problems in their relationships.

    Getting Help in Therapy

    It's also not unusual for someone to seek help in therapy because a partner is complaining. 

    Even though the client might not be internally motivated at first, they often develop the curiosity and motivation to change. 

    If you're struggling to understand yourself and others, you could benefit from working with a licensed mental health professional who can help you to become more self aware.

    Rather than struggling on your own, seek help from a licensed psychotherapist so you can lead a more meaningful life.

    About Me
    I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and 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.






    Monday, January 27, 2025

    Reconnecting With Deceased Loved Ones in Your Dreams

    Having dreams about deceased loved ones is a common experience for many people (see my article: Common Reactions to the Loss of a Loved One).  

    Reconnected With Deceased Loved Ones in Dreams

    Some people believe loved ones come to them in dreams to reconnect or to impart an important message.  

    Others believe these dreams come from a place deep inside them as a way to remember and mourn their loss.

    Whatever you believe, these dreams can be an important part of your healing process as way to come to terms with your loss. 

    A Child's Recurring Dreams About a Deceased Father
    When I was a child, I had recurring dreams about my father, who died suddenly (see my article: Grief in Waiting After the Death of a Parent).

    Reconnecting With Deceased Loves Ones in Dreams

    Each dream was slightly different, but there were certain recurring themes. 

    One recurring theme was that I would be shocked to see my father appear suddenly in front of me.  I would be happy to see him, but I would also feel confused and I would say to him, "But I thought you were dead..."

    In some of the dreams he would tell me he had just gone away and now he was back, and in other dreams he would acknowledge that he was dead. 

    Whichever response I received would confuse me: How could he be dead and still be standing in front of me?

    Then, at some point, I would tell my father I wanted to let my mother know he was back. But when I turned around, he was gone and I felt the painful loss again.

    Many clients tell me how real these dreams feel to them and I know this from my own experience. 

    Each person comes to their own understanding of the meaning of their dreams. 

    Looking back now, I believe these dreams were a way for my unconscious mind to work through the loss when my conscious mind couldn't make sense of it (see my article: Making the Unconscious Conscious).

    In other words, my unconscious mind helped with the healing process. 

    Many years later, when I was ready, a skilled psychotherapist helped me with a deeper level of working through the grief (see my article: The Many Layers of Grief).

    Dreams About a Deceased Psychotherapist
    Over the years I've had dreams about a psychotherapist who was important in my healing process as a young adult.

    In some of those dreams, I talked to the therapist about current issues in my life.  

    In those dreams it was as if he were still very much alive and I was having a therapy session to talk over a problem. 

    I usually wake up feeling a little wistful but also refreshed.

    After I wake up, I allow myself to enjoy the experience of the dream without analyzing the meaning--at least not at first.

    For me, allowing myself to linger in the experience of this reconnection with someone who was so important to me during my youth is more meaningful (initially) than an analyzing the dream.  There's always time for that later, if I want it.

    Conclusion
    There are many ways to grieve and work through the loss of a loved one including healing through dreams (see my articles: Writing About Your Mother After Her Death).

    Although not all dreams about deceased loved ones are healing, the ones that are can help with the grief and mourning process.

    It doesn't matter whether you believe your loved one actually came to you or you believe the dream was your unconscious mind's way of helping you to deal with the loss.  Either belief can help in the healing process.

    Recalling, writing down and talking about these dreams with trusted friends and family can help you to cope with loss.

    Although dreams can be healing, sometimes grief is too difficult to work through on your own and therapy can help.

    Getting Help in Therapy
    Time alone doesn't heal all wounds (see my article: Time Doesn't Heal All Wounds).

    Grief work in therapy can help you to move through the mourning process at a pace that feels right for you.

    Getting Help in Therapy

    Rather than struggling on your own, seek help from a skilled psychotherapist who does grief work with clients.

    Working through grief can help you to heal from the pain and live a more fulfilling life.

    Also See My Other Articles About Grief:





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

    With over 20 years of experience, I have helped many individuals and couples to heal.

    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, January 22, 2025

    Arousal Non-Concordance and a History of Sexual Abuse

    In an earlier article, I wrote about arousal non-concordance to explain what it is and to normalize it as a common experience for many people (see my article: What is Arousal Non-Concordance?).

    Arousal Non-Concordance and a History of Sexual Abuse

    What is Arousal Non-Concordance?
    Arousal non-concordance occurs when there is a disconnect between how someone feels physically and how they feel emotionally and psychologically.

    Arousal non-concordance can occur when someone feels physically aroused, but they don't want to have sex. 

    It can also occur when someone wants to have sex, but they don't feel physically aroused.

    What is the Difference Between Sexual Desire and Sexual Arousal?
    Arousal non-concordance highlights the difference between feeling sexual desire and sexual arousal.  

    Sexual desire is a psychological state. It's a state of mind which is often described as being "in the mood" to have sex.  Desire is often influenced by thoughts, emotions and the particular context a person is in.

    Sexual arousal is a physical response which can include changes in erection and lubrication. 

    Sexual arousal is often triggered by visual or physical cues or memories.

    Sexual desire and sexual arousal often go together--but not always. This is evident with arousal non-concordance.

    Examples of Arousal Non-Concordance
    The following short vignettes are just a few examples of arousal non-concordance:
    • Liz and JaneLiz feels sexually turned on when Jane kisses her. But when Jane touches Liz's genitals, she discovers Liz feels dry. As a result, Jane assumes Liz doesn't want to have sex so she stops kissing her. She assumes that if Liz was turned on, she would be lubricated. So, Liz tells Jane that, even though she's not wet, she really wants Jane, so they continue to kiss and make love.
    • Mary and Bill: Bill touched Mary's genitals and she knew this meant he wanted to have sex. But she had a headache and she wasn't in the mood. She told Bill that she loves him, but she would rather wait until the morning to have sex after her headache goes away. Bill was confused and said to Mary, "You're so wet. I don't understand how you're not in the mood." Mary explained to him that her body was sexually aroused, but she wasn't  desiring sex at that moment. By the morning, Mary's headache was gone away and she and Bill enjoyed sex.
    • John and Ed: John and Ed were in bed when John told Ed that he wanted to have sex. But during foreplay Ed noticed that John wasn't getting an erection so he stopped kissing and touching him because he assumed that John didn't desire him. At that point, John explained that, even though he really desired Ed a lot, he sometimes had problems having an erection when he was anxious. He said he just needed to relax. So after they cuddled for a while, John felt calmer and he was able to have an erection.
    Arousal Non-Concordance and Memories of Sexual Abuse
    Arousal non-concordance can occur under many circumstances, including while having memories of sexual abuse (see my article: Overcoming the Trauma of Sexual Abuse).

    Arousal Non-Concordance and Memories of Sexual Abuse

    The concept of arousal non-concordance is important to understand when there is a history of sexual abuse.

    Many children and adults, who were sexually abused, might have felt physically aroused when they were being abused--even though they had no desire to be sexual with their abuser

    This happens because the body can become sexually aroused even though the person has no desire to have sex (see my article: Coping With Trauma: Managing Sexual Abuse Triggers).

    It's common for people who were sexually abused to get confused about why they get physically aroused with these memories because they don't know about arousal non-concordance. They feel like there's something wrong with them or they were to blame for the sexual abuse. But, in fact, there's nothing wrong with them at all and they're not to blame.

    Everyone is different. Some people who were abused feel ashamed and guilty about getting aroused by the memories.

    Other people accept their arousal as a common experience and they're not bothered by it.  

    Other people incorporate their earlier experience in a roleplay with a partner to feel empoweredIn other words, when the original experience occurred, they had no control over what was happening to them. But in a roleplay with a partner they use their imagination to feel in control and they experience a different outcome

    In that sense, the roleplay becomes healing for them.

    Getting Help in Therapy
    Most licensed mental health professionals have no sex therapy training and don't understand arousal non-concordance.

    Getting Help in Therapy

    If you want to work through issues around arousal non-concordance, including a history of trauma, you need to work with a psychotherapist who has training in both sex therapy and trauma therapy.

    Rather than struggling on your own, seek help from a psychotherapist who has the expertise you need so you can live a more fulfilling life.

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

    With over 20 years of experience, I have helped individual adults and couples to resolve sexual and/or trauma-related issues (see my article: What Are Common Issues Discussed in Sex Therapy?).

    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.