Why Are Many Men Reluctant to Get Help in Therapy When They Need It?

As a psychotherapist in private practice in New York City, I'm seeing more men seeking help now than I did 20 years ago, but many men are still reluctant to get help in therapy when they need it.

Why Are Many Men Reluctant to Get Help in Therapy?

According to a 2020 survey, even though more men seek help now than before, there are many men who need help who don't seek it. In addition, fewer men seek help in  therapy compared to women.

Men Who Are Reluctant to Get Help in Therapy

Even though many well-known male athletes and celebrities have spoken openly about seeking help in therapy, there's still a stigma about men seeking help (see my article: Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy).

Here are some of the most common reasons why men avoid getting help in therapy:

• A belief they must conform to traditional gender roles and that "being a man" means never showing emotional vulnerability

• They don't know how to show emotional vulnerability

• They're not sure what they feel

• Even if they know what they feel, they don't know how to talk about it

• A belief that going to therapy means they're "weak" (see my article: A Common Myth: Going to Therapy Means You're "Weak")

• Going to therapy makes them feel ashamed (see my article: Overcoming Shame)

• Going to therapy makes them feel embarrassed

• A belief they should know how to handle their problems on their own without getting help

• Psychotherapy is out of reach for them due to a lack of mental health services in their area or they can't afford it (in New York there are sliding scale therapy services in psychotherapy institutes with therapists in training who are supervised by senior therapists, including Institute For Contemporary Psychotherapy which also takes some health insurance).

How Can Men Learn to Talk About Their Problems?

Over the years, I have worked with many men who seek help in therapy because their partner encouraged them and, in some cases, insisted that they get help.

Here are some of the things I do to help men who seek help:

• Normalizing the Need For Help: Since I know many men don't know how to talk about their feelings, I start by trying to help them to get comfortable talking in sessions and normalizing how awkward it can be, at first, for anyone to talk to a therapist. I also provide them with psychoeducation about therapy including letting them know that many people start therapy with a degree of anxiety and ambivalence (see my article: Starting Therapy: It's Not Unusual to Feel Anxious and Ambivalent).

Men Who Are Reluctant to Get Help in Therapy

• Creating a Safe Space in Therapy Sessions: In order for clients to feel comfortable talking in therapy, I create a safe space for them by being compassionate, nonjudgmental and going at a pace that works for them.  

• Helping Clients to Relax: For clients who are anxious, I often start the session with a breathing exercise to help them transition from wherever they came from so they can relax and be present in the room.

• Starting Wherever They Want to Start: In our culture, it's generally considered more acceptable to talk about "stress" than anxiety or depression, so a lot of men (and women too) start therapy by saying they're experiencing "stress" and they just need some tips on how to manage their stress.  I will start wherever a client feels most comfortable, so if they want to talk about ways to manage stress, I'll start there.  But what usually happens, after these clients get comfortable talking to me, is that they begin to open up and talk about what is causing them stress including problems in their relationship, problems with their children, elder care issues, issues at work, unresolved trauma and so on.

Men Who Are Reluctant to Get Help in Therapy 

• Choosing Whether or Not to Work With Goals: Some clients like to set goals early in therapy. Others feel that setting specific goals feels like too much pressure. So, I allow clients to decide how they want to work.  At the same time, I want the sessions to be meaningful to them so we might need to find a balance so the therapy doesn't just "drift" in a scattered way.

• Helping Clients to Identify Their Feelings: Many men have been raised since early childhood to suppress or ignore their feelings so that, as adults, it's difficult for them to know what they feel. Therefore, helping these clients to recognize and identify feelings is often a significant part of the work.

Men Who Are Reluctant to Get Help in Therapy

• Using Humor and Lightheartedness: Using humor, when appropriate, can help clients to relax and open up. 

• Encouraging Self Compassion: This is an essential part of the work in therapy, especially for clients who have internalized harsh messages from early childhood about what it means to "be a man" (see my article: Acceptance and Self Compassion).

• Encouraging Self Care: Many men who are reluctant to get help in therapy are also reluctant to take care of their physical health and overall well-being, so encouraging self care is often an important part of the work (see my article: Self Care Is Not Selfish).

• Encouraging Support Outside of Therapy: The problem for many men is they don't talk to anyone about how they feel even if they have people in their life who would be supportive. In addition, many men don't have partners or close friendships, so encouraging them to develop an emotional support system outside of therapy is important (see my article: Overcoming Loneliness and Social Isolation).

Suicide Rates For Men

Men's mental health struggles often go undiagnosed because they avoid getting help.

In the United States, men represent about 79% of all suicides, which is four times higher than women.

Approximately 36,000 men commit suicide every year in the U.S. due to undiagnosed mental health and/or substance misuse problems.

Many of these deaths could have been prevented with professional help.

Note: If you or someone you know needs immediate help for suicidal thoughts, call 988, which is the suicide prevention lifeline or go to your nearest emergency room.

Getting Help in Therapy

The first step, which is making an appointment, is often the hardest.  

Getting Help in Therapy

If you have been struggling on your own, you could benefit from getting help from a skilled mental health professional.

Most clients who are initially reluctant to start therapy usually discover that therapy helps them to overcome their problems so they can lead a meaningful life.

About Me

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

I have over 20 years of experience helping individual adults and couples for a variety of issues, including 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.

Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy

May is Mental Health Awareness month.  As part of Mental Health Awareness month, The National Alliance of Mental Illness (NAMI) has chosen the theme of reducing the stigma of mental illness, "Cure Stigma" as its theme this year to acknowledge that a stigma still exists for people with mental illness as well as a stigma for getting help in therapy. In addition, NAMI also to provides information, encourages people to get help, and provides advocacy for people with mental health problems.

Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy

Treating Physical Symptoms Instead of the Underlying Emotional Problems at the Root of the Problem
Research has shown that one in every five Americans has a mental health problem, but many of these same people suffer in silence and never get help.

As a result their symptoms often get worse or develop into physical symptoms.  For instance, a person with untreated anxiety might develop headaches, backaches, digestive problems, insomnia or other physical problems.

Whereas this person might feel ashamed to get help for his anxiety, he feels much more comfortable seeing his primary care doctor about his physical symptoms because there's no stigma about the physical symptoms.

What Are the Consequences of Treating Physical Symptoms Instead of Treating the Underlying Emotional Problems at the Root of the Problem?
With regard to the example above, it's this person's doctor might treat only the anxiety-related physical symptoms without ever treating the underlying anxiety.

The doctor might provide this person with anti-anxiety medication for insomnia, which might help the insomnia, but then the underlying anxiety can manifest in another symptom--like irritable bowel syndrome (IBS).

At that point, the primary care doctor might refer the patient to a GI doctor, who might send this same patient for a CT scan to rule out any serious internal problems.   Finding none, the GI doctor will probably prescribe a different type of medication for the IBS to control the symptoms.

This can go on for quite some time as the anxiety-related symptoms manifest in all different physical symptoms because none of the doctors are dealing with the underlying emotional problem, which is anxiety, that is at the root of the physical problems.

But if someone with similar problems happens to have a primary care doctor who is trained to know that psychological problems are often at the root of medical problems, after the doctor has ruled out more serious physical problems, the doctor will advise the patient to get help in therapy.

Why is There Still a Stigma For Getting Help in Therapy?
Although it's now somewhat more acceptable for people to get help in therapy, many people, who need help, are afraid to seek the assistance that they need for a variety of reasons related to the stigma of going to therapy:

• They judge themselves harshly for needing help and feel ashamed.
• They believe they should just "get over" their problems.
• They believe they would be "self indulgent" or "too self centered" if they went to therapy.
• They believe only rich people attend therapy.
• They think that only "crazy" people seek help in therapy.
• They believe, far from being real, their problems are only in their imagination.
• They feel they don't deserve help.
• They believe that they must be "weak" if they need help (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").
• They believe they will have to remain in therapy for a long time to overcome their problems (see my article: Common Myths About Psychotherapy: Therapy Takes a Long Time).
• They're worried about what their family and friends might say if they found out that went for help in therapy.
• They believe the therapist will judge them.
• They don't know about Federal confidentiality laws, so they believe that their therapist might tell their employer or other people about the problems they discuss in therapy.
• They believe that going to see a therapist means they're paying the therapist to be their "friend," which makes them feel ashamed because they believe a therapist couldn't actually care about them.

What Can You Do to Reduce Your Fear of Getting Help in Therapy?

• Know that you're not alone.  There are skilled mental health professionals who can help you.
• Know that a skilled therapist has experience helping other clients with similar problems to yours and she won't judge you for your problems.
• Know that a licensed psychotherapist can't divulge your information under Federal law without your written consent unless you're an active harm to yourself or others (you have a thought, intent and plan to hurt yourself or someone else and you refuse to make an agreement with your therapist not to take action) or you're engaging in child abuse (psychotherapists are mandated reporters and must report child abuse to the state).
• Know that seeking help in therapy doesn't mean you're "weak."
• Know that seeking help in therapy doesn't mean you're "crazy."
• Know that everyone needs help at some point in their lives and everyone is deserving of help.
• Talk to trusted family and friends who would be supportive of your getting help.
• Know that you can see a psychotherapist for an initial consultation to see if you feel comfortable with her and to obtain psychoeducation about how therapy works (see my article: Why It's Important for Psychotherapists to Provide Psychoeducation About How Therapy Works).
• Know that you decide what your therapy goals are, you're in charge of your therapy and you can go for as long as you want to go.
• Most psychotherapists are empathetic towards their clients' suffering.  You're not paying them to be your "friend."  You're paying them for their expertise and time to help you to help yourself.

Conclusion
There are many reasons why people avoid going to therapy even though they would benefit from it.

Although it's considered much more acceptable to go to therapy now than it was in the past, there is still a stigma among some people about going to therapy.

Psychoeducation about psychotherapy is important, and you can consult with one or more psychotherapists to get this information and see which therapist is right for you.

Rather than suffering on your own and risking that your problems will get worse, you would benefit from getting help from a licensed mental health professional so you can resolve your problems and lead a more fulfilling life.

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

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

I use Emotionally Focused Therapy (EFT), recognized as the leading couples therapy, when I work with 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.

Overcoming the Need to Be Everyone's Caregiver

The need to be everyone's caretaker often starts in childhood in a family where a young child feels she must be the one to protect and take care of the rest of the family (see my article: The Trauma of the Family "Hero" in a Dysfunctional Family and How to Stop Being the Rescuer in Your Family of Origin).

The Need to Be Everyone's Caretaker Often Starts at a Young Age

While being the caretaker might help a child to feel that her family life is less out of control, there are many problems with trying to be everyone's caretaker over the course of a lifetime (see my article: Overcoming Codependency: Taking Care of Yourself First,  Dynamics of Adult Children of Dysfunctional Families and Reacting to the Present Based on the Past).

Let's take a look at a fictionalized vignette which illustrates these dynamics:

Amy
Amy was the oldest of four children who grew up in a chaotic family.

Her parents were both active alcoholics who were constantly losing their jobs due to alcohol-related reasons.  They were often out of the house, sometimes for days, and none of the children knew where they were.  When they were home, they were frequently drunk and fighting with each other.

The Need to Be Everyone's Caretaker Often Starts at a Young Age

At an early age, Amy stepped into the parental role with her siblings, cooking, cleaning and assuming overall responsibility for their care.

She also intervened on her siblings' behalf when their father got angry with them and wanted to hit them.  She would step in front of her siblings and tell the father to hit her instead.

Despite the problems at home, Amy did well in school.  Eventually, she got a scholarship to go to the college that she had always wanted to go to, but she turned it down because she was afraid to leave her siblings alone with her parents.  Instead, she went to a local college to maintain her parental role and protect her siblings.

Amy didn't move out of the house until her younger siblings were independent and on their own.

Even then, she had some doubts about moving out because she feared that her parents' alcoholism had gotten so bad that they wouldn't be able to function on their own.  But she also longed to have her own place and have a life of her own, so she moved out.

She would usually go to her parents' house on the weekends to check in on them, something that none of her other siblings did because they had so much resentment towards them.

Although she did as much as she could for them over the weekends, her parents were usually so drunk that they barely noticed that she was there.

It wasn't until her father's doctor warned him that her father stopped drinking.  Shortly after that, he left Amy's mother for another woman.  Shocked by her husband's abandonment, Amy's mother moved in with her mother and also stopped drinking.

Amy was doing well in her job and she received several promotions.

A few years later, a new CEO took over and began to make changes which worried Amy and her colleagues.

They were very concerned about some of the directives that they were given by senior management under the new CEO.  At best, some of these directives were questionable and, at worst, some were clearly unethical.

Since Amy was accustomed to being in the caretaking role, she assumed that role at work with her colleagues.  She was the one that her colleagues came to when they were upset about these changes.  She always made time to listen to them, often giving up her lunch hour or staying late at work.

The Need to Be Everyone's Caretaker Often Begins in Childhood and Continues Into Adulthood

Although Amy wasn't in a position to challenge the CEO, she spoke to her director on behalf of colleagues and herself to let him know about their concerns.

After he listened attentively, he told Amy that this situation was out of his hands and he felt there was nothing that he or anyone else could do.  He also confided in her that he was looking for another job and advised her to do the same.

Over time, Amy became anxious and developed insomnia.  She knew that, for her own well-being, she couldn't stay at this company.  But she also felt responsible for the well-being of her colleagues and she didn't want to desert them.

Eventually, she began therapy for help with this dilemma:  She felt that her choices were to either take care of herself and abandon her colleagues or remain there to be supportive and her health would continue to deteriorate.

Over time, her therapist helped her to discover the underlying reasons why it felt so compelling to Amy to take care of her colleagues.

Amy was able to make the connection between her childhood history of being the caretaker in her family and her current situation with feeling she had to remain in a bad work environment to take care of her colleagues (see my article: Psychotherapy to Overcome Your Past Childhood Trauma).

Gradually, she began to see that in her family, she felt compelled to be the caretaker so that life at home didn't feel so out of control, and in her work situation, she also felt the need to be the caretaker in another dysfunctional situation (see my article: How Your Workplace Can Feel Like a Dysfunctional Family).

Several months later, Amy was contacted by a search firm that found her profile online and wanted to refer her to another job.  It sounded like a great opportunity to Amy, and they were sure that Amy would be the perfect fit for this job.

Although, on one level Amy was happy to get this call, on another level, it made her feel even more conflicted about what to do.

When Amy's therapist explored this with her and asked her under what circumstances she would feel comfortable with taking another job, the first thing that came to Amy's mind was that she would only feel good about leaving after her colleagues were comfortably situated in other jobs.

Hearing herself say that, Amy realized that this was exactly how she felt about her siblings--she couldn't allow herself to leave the home until each of her siblings was out of the house and independent.

All along, Amy's anxiety and insomnia was worsening, and she was increasingly concerned about her health.

Over time, her therapist helped Amy to distinguish between her younger siblings, who really couldn't take care of themselves vs. her colleagues, who were competent and resourceful adults.

Amy realized on a deep emotional level, not just on an intellectual level, that her colleagues would survive without her help.

She also looked at, for the first time in her life, the price that she paid for being the caretaker in her family--the social events that she missed, the school clubs that she didn't participate in, the dates she didn't go on, the sacrifice of not going to the college she wanted to go to, and many other missed opportunities.

She also understood that her emotional needs weren't taken care of in her family when she was a child, and now she wasn't taking care of her needs (see my article: Psychotherapy Can Help You to Understand Your Emotional Needs).

Making the distinction between the past and the present and acknowledging that she no longer wanted to be so self sacrificing enabled Amy to accept a great job offer (see my article: Working Through Emotional Trauma in Psychotherapy: Learning to Separate "Then" From "Now").

Overcoming the Need to Be Everyone's Caretaker

Getting to the point where she could do this wasn't easy or quick (see my article: Beyond the "Band Aid" Approach in Psychotherapy).

There were a complex array of early problems to be worked through.  But Amy stuck with her work in therapy and she stopped trying to be everyone's caretaker.

She also began attending Al-Anon as another resource to help her learn to focus on herself first (see my article: Al-Anon: Beyond Reciting Slogans).

Conclusion
Becoming a caretaker at a young age often results in trying to be everyone's caretaker as an adult.

It's understandable that a young child in Amy's situation would want to do whatever she could to try to help her siblings as well as help herself to feel less out of control.

But one of the problems with this is that it comes with big sacrifices to the child who assumes this role with regard to many missed opportunities that can never be regained.

Another problem is that it often sets a pattern for how this child will function later on as an adult with all the dilemmas involved with taking care of oneself vs. taking care of others.

In addition, it increases the likelihood that, as an adult, the person who tries to be a caretaker to everyone will choose relationships with people who have many problems, including substance abuse, gambling and other serious problems, and try to "fix" their significant others.

The person who takes on the caretaker role often feels that he or she can resolve whatever problems another person has regardless of the problems.

This is a kind of inflated sense of self that the child fools him or herself into believing at a young age in order to believe that s/he can do whatever it takes to solve the family's problems.

And while this might have saved the child from feeling despair at the time, it creates a false sense of self and continues to perpetuate these caretaker dynamics (see my article: Understanding the False Self).

Getting Help in Therapy
Trying to be everyone's caretaker is a problem that many people struggling with as adults.

Many people come to therapy when they find themselves in what they perceive to be a no-win situation of taking care of themselves vs taking care of others.

Aside from the emotional anguish involved, trying to be everyone's caretaker often results in physical problems, including anxiety-related problems: insomnia, headaches, stomach problems, high blood pressure and so on.

The dilemma is often too great to resolve on their own, so they seek the help of a psychotherapist.

People who have this problem often discover that once they no longer feel compelled to be a caretaker for others, they have increased vitality and happiness in their own life.

If you recognize yourself as being someone who tries to be everyone's caretaker with all the problems  involved in these dynamics, you owe it to yourself to help from a licensed mental health professional (see my article: How to Choose a Psychotherapist and How Psychotherapy Can Help You to Develop a New Perspective About Yourself and Others).

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

I have helped many individuals to overcome problems with taking care of everyone else and not taking care of themselves.

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 the Difference Between Sadness and Depression?

Sadness and depression are often confused but, in fact, they are very different.

At some point in our lives, we all feel sad, but being sad is not the same as being depressed.

What is the Difference Between Sadness and Depression?

Whereas sadness tends to be a passing mood, depression is a serious mental health problem. It has physical as well as emotional implications.

APA's Definition of Depression
According to the American Psychiatric Association's DSM-IV (Diagnostic and Statistical Manual), to be diagnosed as depressed, a person must have at least five or more of the following criteria, as self reported or as observed by others, for two or more weeks where these symptoms represent a change from a person's prior functioning:

• depressed mood for most of the day, nearly every day
• decreased interest in almost all activities for most of the day, nearly every day
• significant weight gain or weight loss which is not accounted for by diet
• insomnia or hypersomnia (oversleeping) nearly every day
• psychomotor agitation or retardation
• fatigue or low energy nearly every day
• feelings of worthlessness or excessive or inappropriate guilt nearly every day
• problems concentrating or indecisiveness nearly every day
• recurrent thoughts of death or suicidal thoughts (either with or without a plan)

What is the Difference Between Sadness and Depression?

In addition to the above, people who are depressed often feel various aches and pains that cannot be explained by any particular medical condition.

Unfortunately, depression can last for weeks, months or, in some cases, for years.

Depression can be very debilitating, affecting a person's family, career, and daily activities of living.

Well-meaning but misinformed family or friends might tell a depressed person to "snap out of it," but depression is not a mood that people enter into and get over easily.

Getting Help in Therapy
If you suspect that you or someone you care about has five or more of the above symptoms, it is very important to get professional mental help as soon as possible, especially if there are suicidal thoughts.

Getting Help For Depression:  Many People Return to Their Prior Level of Functioning or Better

With treatment, many people return to at least their prior level of functioning if not better.

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, please 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.

Letting Go of an Unhealthy Friendship

There's no such thing as "a perfect friendship."  Most friendships have their ups and downs, and most people make allowances for friends who might be difficult at a certain point because they're going through a difficult time.  

But if you have a friend who is generally difficult and who causes you a lot of stress most of the time, you might want to re-evaluate your friendship in light of the emotional or physical toll it might be having on you.

Letting Go of ab Unhealthy Friendship

The following vignette is a composite of many different cases with all identifying information changed:

Sally and Nina:

Sally and Nina were friends in college.  Even though she really liked Nina and she thought Nina was a fun and interesting, Sally found Nina difficult at times when they were in college because she felt that Nina tended to be selfish.

There were times when they made plans that Nina would break if a young man that she liked asked her out.  There were also times when Nina would forget to pay Sally back when she borrowed money from Sally.  

At the time, Sally didn't know how to talk to Nina about these incidents, so she didn't say anything about it.  But, afterwards, she felt badly about herself for not speaking up.  She also realized that she felt highly ambivalent about the friendship and she wondered why she remained friends with Nina.

After they graduated from college, Nina moved back to California and Sally moved to NYC.  They kept in touch for a while, but then they gradually lost touch with one another.

Then, several years later, Nina emailed Sally to let her know that she was moving to NYC for a new job, and she wanted to reconnect with Sally.

When Sally got Nina's email, she cringed.  She considered what she wanted to do and she decided that she would meet Nina for a drink and see whether Nina had changed in the intervening years.

A couple of hours before Sally and Nina were supposed to get together, Nina texted Sally to let her know that she had to cancel because she wanted to get together with a friend of a friend who could be helpful to her.  Nina explained that she thought this person could be someone who could help her to advance in her career and, since this person was available, she wanted to meet with her as soon as possible.  Nina made her apologies, she hoped they could get together another time, and told Sally that she hoped Sally would understand.

Sally didn't have a lot of spare time, and she set aside the time to see Nina.  When she got Nina's email, Sally realized that Nina had not changed, and she decided that she didn't want to reconnect with her.  

Put Things in Perspective and Get Clear on What's Bothering You About Your Friendship

Try to get clear on what's bothering you about this friendship.

Think about particular instances when you felt uncomfortable, hurt or annoyed and weigh this against what your overall feeling about the friendship.

This isn't a matter of keeping a strict account of what you've done for your friend and what your friend has done for you.  It's more a matter of putting things in perspective.

Consider Whether You and Your Friend Can Work Out the Friendship

There are times when sitting down and having a talk about what's bothering you can be helpful in resolving whatever the problem might be between you and your friend.

You might find that, even though it was obvious to you, your friend might not have realized that anything was bothering you.  If it seems like you and your friend can work things out, you can give the friendship another chance.

Is the problem related to something temporary that is going on in your friend's life or is it a more ingrained problem that is part of his or her personality, which is usually more difficult, although not impossible, to change.  

For instance, in the vignette above, Nina had a tendency to be self centered and unable to consider how her friend might feel.  Some people lack emotional intelligence or never developed good interpersonal skills to be able to maintain friendships.

Consider Whether This is Someone You Would Choose as a Friend Now
People change.  You might have changed.

There are times when you might have a long term friendship that no longer feels right for you, and you're aware that if you had met this person now, you wouldn't be inclined to form a friendship with him or her.

Consider  Whether  You Can Work Things Out and If This is Someone You Would Choose as a Friend Now

If you feel that the friendship is causing you a lot of emotional pain and you wouldn't be friends with this person if you were to meet him or her now, think about what this means for you:

• Why are you continuing to be friends?
• Are you avoiding ending the friendship because it would be uncomfortable?
• Do you feel it would be mean of you to end the friendship?
• Are you stuck because you don't know how to end the friendship?

Think About Whether You Can Have a Different Kind of Friendship With This Person?
There are different kinds of friendships.  There are close friends that you trust and you confide in, and there are some friendships that are not as close, but you might have a common interest that brings you together.

If you have a friendship that was once close, but it's a matter of not wanting to be as close to this person (and there are no major issues between you), consider whether you want to keep this person in your life as a casual friend rather than letting go of the friendship altogether.

Letting Go of Toxic Friendships
There are times when it's clear that a friendship is just too toxic for you and it would be unhealthy for you to keep this person in your life.

This can be difficult and sad. Sometimes, it's more difficult than going through a breakup in a romantic relationship.

There can be so many different toxic friendships and unhealthy situations, so it's hard to generalize in one blog article.

Depending upon the situation, try to be as tactful as possible in explaining that you wish this person well, but the friendship isn't working for you.

Try not to get into an argument, which won't be beneficial you or the other person.

It might not feel comfortable at the time to assert yourself and take care of yourself in this way, but remaining in a toxic friendship that is detrimental to your overall emotional well-being just to avoid the discomfort of ending the friendship isn't the answer.

Once you've let go of an unhealthy friendship, you might be sad, but you'll probably realize, in the long run, how much less stressful your life is and that you have more emotional and physical energy for other healthier relationships.

Also see my articles:  

Coping With a Close Friend's Betrayal
Do You Feel Overwhelmed by a Friend's Problems?

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works 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.

Tips for Overcoming Shyness

Are you uncomfortable about attending social events because of your shyness?  Is the thought of attending an after work activity with your coworkers enough to make you want to hide with the covers over your head?

If you're tend an introvert rather than an extrovert, you don't need to change your whole personality in order to overcome your shyness.

Tips For Overcoming Shyness

The following tips can help you to overcome shyness so that you learn to actually enjoy yourself during social events:

Prepare Before the Social Event
If you fear that you'll have nothing to say or that people won't find you interesting, think about some topics that you might talk about.

If you happen to know that you and other people at the party enjoy yoga, consider this as a topic that you might bring up to get the conversation going.

Allow the Hostess to Introduce You to Like-Minded People
Hostesses (or hosts) who are adept at giving parties know how to introduce certain people that they think might hit it off.

If you have a hostess with good people skills who is aware that certain guests share particular interests, she might introduce you to others by saying something like, "Joe, this is Alice.  I thought you'd like to meet each other because you both share an interest in jazz."

Although this isn't something you can always rely on, when it happens, it can help you to overcome some of the awkwardness you might feel in a social situation.

Learn to Focus on Others, Instead of Yourself, at Social Events
Shy people often feel so self conscious at social events that they're afraid that they'll have nothing interesting to say and no one will want to talk to them.

Being shy and fearing social events can keep shy people locked in a state of self absorption, which only makes matters worse.

Tips for Overcoming Shyness:  Focus on Others at Social Events

Rather than focusing on yourself and all the deficiencies you fear others will find in you, try to forget about yourself and focus on the other people at the party or social event.

Get curious and develop an interest in the other people who are there.

Asking appropriate questions of the strangers that you meet at a party (i.e., how they know the host) can be an ice breaker and give you and others a topic to talk about that could lead to other topics.

Showing an interest in others also allows you to forget about your own feelings of being self conscious.

Be Aware of Your Body Language and the Social Signals That You're Sending Out
Without even realizing, many people who are shy come across as if they're unfriendly, rather than shy, because they're sending out the wrong signal to others at social events.

If you're sitting hunched over in the corner and avoiding eye contact with others, chances are that people will think you're unapproachable rather than thinking that you're shy.

Learn to maintain an open posture and smile.  Not only will this make you appear more approachable, but it might be helpful to others who might also be shy.

Think About How You Can Put Others at Ease
If you can stop focusing on your own shyness, as I mentioned, you might realize that there are other people, besides you, who are also struggling with shyness.

If you can find ways to help put others to feel more at ease, not only will this be helpful to others, but it can also be helpful to you.

One possible way to help yourself and others to be more at ease is to volunteer to help out in some way at the social event.

So, for instance, if you've been invited to a party, you can ask the hostess if you can help to show people around the garden or help with the drinks.

Being involved with a task related to the party can help you to feel like you're more a part of the event.  And, you'll also be adding to other people's comfort and ease.

Learn to Calm Yourself:  Remember to Breathe
When people feel shy or anxious, they often breathe in shallow ways, which only adds to their discomfort.

As simple as it sounds, taking a deep breath can help to calm your body and your mind.

One particular breathing exercise that is particularly helpful is called Square Breathing.
See my article:  Learning to Relax: Square Breathing.

Another exercise you can try before you go to a social event is called Safe Place Meditation.

Getting Help in Therapy
If these simple tips aren't helpful to you and your shyness is really getting in the way of your personal life and your career, you could benefit from working with a licensed mental health professional who has expertise with this issue.  It's possible that your problem isn't just shyness but, possibly, something more deep seated.

People who are able to overcome shyness are relieved to be able to socialize and meet others without feeling hampered by feeling self conscious and socially awkward.  By getting help, you can also learn to overcome your shyness so you can feel more confident in social situations.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works 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.

Psychotherapy and Compassionate Self Acceptance

As a psychotherapist in New York City, I have found that one of the major challenges for people who begin psychotherapy is overcoming their own critical and judgmental beliefs and assumptions about themselves. When I work with clients who have developed a harsh sense of self, I often begin by talking to them about how psychotherapy can help them to become more mindful, attuned and compassionate towards themselves.

Psychotherapy and Compassionate Self Acceptance

Low Self Esteem, Lack of Self Compassion and Self Acceptance, and the Development of the "False Self":
Many clients who begin psychotherapy to overcome low self esteem want to find a way to feel better about themselves. As their psychotherapy unfolds, often, what comes to light is that they have rejected parts of themselves that they have come to hate. Hate is a strong word, but it is usually apt for the type of self loathing that these clients have come to feel for parts of themselves over time.

This lack of self acceptance and self loathing is not always obvious to see at first. Sometimes, it manifests itself in a critical and judgmental attitude towards others. Other times, it shows itself through a need to be "perfect" themselves and to have others be "perfect." Very often, this self loathing and lack of compassion for oneself can be seen when people develop a "false self" when they are interacting with others.

Donald Winnicott and the "False Self"
Donald Winnicott, a British Object Relations psychoanalyst and pediatrician, was one of the first psychotherapists who developed a theory about the "false self."

In his developmental model of the "false self," Winnicott posits that, early on, when parenting is "good enough" a baby learns to relate to his or her primary caregiver in an authentic and loving way.

"Good enough" is the operative term here, since parenting can never be perfect and parents cannot always be perfectly attuned to their children.

However, according to Winnicott, when the primary caregiver (usually the mother) is sufficiently and lovingly attuned to the baby, the baby is usually able to thrive emotionally and, over time, learns to relate well to others as well as to him or herself. However, when the primary caregiver is unable to connect emotionally with the baby, either because he or she is depressed or for some other reason, the infant feels rejected and develops a "false self" to try to elicit the caregiver's love and attention.

People who have developed a "false self" often describe themselves as feeling "empty" or "hollow" and have difficulty relating to themselves as people who are worthy of love and compassion. They also often have difficulty relating to others because their own critical judgments and self loathing gets projected onto others: What they unconsciously cannot accept in themselves becomes intolerable when they sense these qualities in others.

So, over time, in psychotherapy, it becomes apparent that low esteem, depression, anxiety and other emotional problems are often connected to a lack of compassionate self acceptance for oneself and the development of a "false self." It may seem somewhat contradictory, but until you can accept the parts of yourself that you don't like, they're difficult to change.

The following is a vignette which represents a composite of several psychotherapy cases where a client has a "false self":

Carol:
Carol began psychotherapy because she felt that her life was "meaningless." She was in her mid-30s and she had never had a romantic relationship that lasted for more than a year. She described herself as feeling that she "existed" but she was "not really living." She could only express this feeling in the vaguest of terms, but the feeling was strong in her. Her emotional world felt flat--no passion, no real highs or lows.

Psychotherapy and Compassionate Self Acceptance

She worked as an attorney for a nonprofit social service agency, and her employer valued her work because she worked very hard advocating for the clients and often won her cases. However, even though she knew that she was highly esteemed in her organization, she could not feel good about herself at work or in any other part of her life.

In describing her childhood history, she emphasized that she felt she had good parents and she denied any abuse or big traumatic events. As such, she had a hard time understanding why she felt the way she did, "If my parents beat me, I could understand why I feel this way about myself, but they didn't, so there must be something very wrong with me."

It soon became apparent in psychotherapy that underneath that flat sense of meaninglessness, Carol had a strong sense of self loathing. Most of the time, she was able to push down those feelings of self hatred by working long hours and keeping herself distracted. However, as she talked about herself in a judgmental and critical way, it became evident that she lacked a sense of acceptance and compassion for herself.

She ran roughshod over herself with a sense of perfectionism and judgement that was truly soul crushing. No matter how much external praise she received from others, she never felt that anything she did was good enough. She spent a lot of time ruminating about what she perceived as her personal flaws or how she "could have done it better." She was her own worst taskmaster with standards that were unattainable.

In discussing her family history in more depth, it turned out that her parents, who were highly-regarded Ivy League college professors, were rather critical and emotionally distant with Carol. They provided her with everything that she needed on a material level, but they gave Carol the overarching message again and again that what they truly valued in her was her accomplishments in school. There was little sense that they valued her just as she was as a person.

Carol learned as a child that if she got very good grades and tried to be as "perfect" as she could, her parents would praise her efforts. But if she fell short in any way, as all of us do at some point or another because we're human, they found this intolerable.

Carol was also very aware that her mother, who stayed home with Carol until she was five years old and started school, had a lot of resentment about this. Her mother would have preferred to be teaching her classes and continuing her research than staying home with a helpless, dependent baby.

Carol had heard her mother lament many times about how the time she spent away from her field was detrimental to her career and that she was never able to regain the stature that she had prior to staying home with Carol.

Carol's father concurred with her mother about this. One can only surmise that Carol's mother's anger about her role as a mother probably did not allow her to be as emotionally attuned to Carol as an infant. And throughout Carol's childhood, neither parent demonstrated much emotional attunement for Carol as a child who deserved love for herself, without having to perform to their impossibly high standards.

Prior to starting psychotherapy, Carol had never questioned her parents' attitude towards her. The feeling that she was somehow to blame for her mother's lost professional opportunities and that she needed to perform to gain her parent's love and attention was so deeply ingrained at such a young age that it had become a strong part of Carol.

And even though her parents had somewhat mellowed as they aged and they no longer had such a punitive attitude towards Carol, it didn't matter because Carol had internalized their critical and judgmental attitude on such a deep and unconscious level that she was now doing it to herself.

Over time, Carol was able to see how she had developed a "false self" to please her parents. And even though this "false self" might have developed due to her parents lack of emotional attunement, she realized that it was now her responsibility, as an adult, to overcome the emotional obstacles that kept her from accepting herself just as she is.

It was a real challenge for her, but Carol began to question her harsh, punitive attitude towards herself. She mourned for the inner child part of herself who didn't get the unconditional love that she deserved.

She also began to learn to love that part of herself that she had learned to hate--the part that needed to be loved for herself and not for her "accomplishments." As she did this, she began to feel more authentic.

She no longer felt that she was performing a role or just going through the motions in her life. Life became richer and more meaningful as she became more emotionally attuned to herself. She also learned to forgive her parents and she developed better relationships with them as she recognized that they were no longer the punitive, emotionally withholding parents that she grew up with.

As they aged, they went through their own emotional transformation and she learned to relate to them as they are now and not how they were when she was a child.

As Carol became more compassionate and accepting towards herself, she felt better about herself.

Psychotherapy and Compassionate Self Acceptance

Accepting that she was human, she could make mistakes, she no longer needed to be "perfect," her self worth did not have to be based on her accomplishments, and that she deserved love, enabled her to open up others in an authentic way that she had never experienced before.

Eventually, she was able to open up to a relationship with a man who loved for her for herself, and they developed a healthy, loving and stable marriage.

Getting Help in Therapy
If you are struggling with your own critical and judgmental beliefs and assumptions about yourself, you could benefit from participating in psychotherapy with a licensed mental health professional. Although it can be a challenge, you can learn to develop a more self accepting and compassionate sense of self so you can improve your relationship with yourself and others.

I am a licensed NYC psychotherapist, hypnotherapist and Somatic Experiencing therapist. I have helped many clients to develop a more self accepting and compassionate sense of self.

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

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