BDSM and Kink: What is BDSM Aftercare?

In my prior articles, I explored sub-dom roles in BDSM relationships:  

BDSM and Kink: What is a Sub-Dom Relationship? 

What Are the Different Types of Sub-Dom Relationships?  

Are You Curious About Exploring a Sub-Dom Relationship?

In the current article, I'm focusing on the importance of BDSM Aftercare.

What is a Sub Drop?

BDSM activities can be physically, emotionally and mentally tiring.  So, it's important for you and your partner to engage in aftercare.

BDSM Aftercare

BDSM aftercare is the time you and your partner spend taking care of each other after you role play or engage in other kinky sex.

Some people compare BDSM activities to a vigorous athletic workout.  

A sub drop is an emotional and physical low that can begin anywhere from a few hours, days or weeks after the emotional/endorphin high following BDSM activity. It can last hours or weeks.

The term sub drop comes from the kink community.  It's usually associated with the sub (or submissive) in a sub-dom (submissive-dominant) dynamic.  But a dom can also experience a sub drop.  

Some people can engage in BDSM and never experience a sub drop.  Then, for some unknown reason, out of the blue, they can experience a sub drop after an intense BDSM play session.

What is the Connection Between a Sub Drop and Subspace?

To understand a sub drop, you need to understand the chemical reactions that occur during an BDSM scene, including intense endorphins and adrenaline. Endorphins produce euphoria and adrenaline keeps you going during an BDSM scene.

After a BDSM scene is over, the chemicals can drop quickly.  Then, the experience can feel painful and embarrassing.  

Each person can experience a sub drop differently.  

Sub drop symptoms can include (but are not limited to): 

• Depression 
• Fatigue
• Irritability 
• Anxiety
• Feeling dazed

This is why BDSM aftercare is so important.

How to Prevent or Mitigate a Sub Drop

Sometimes a sub drop can be prevented with aftercare, but not always.  

When a sub drop cannot be prevented, aftercare is important to help mitigate its effect.

What is BDSM Aftercare?

There are two different types of aftercare: physical and emotional.

BDSM Physical and Emotional Aftercare

Physical aftercare can include:

• Removing restraints or a blindfold
• Getting your partner something to eat and drink (blood sugar levels can drop during a sub drop)
• Providing warm clothing or a blanket
• Kissing and hugging your partner
• Providing affection in a quiet and peaceful environment
• Giving your partner a massage

BDSM Physical and Emotional Aftercare

Emotional aftercare can include:

• Discussing the BDSM scene to understand each other's needs
• Reminding and reassuring your partner there was nothing shameful about the scene
• Checking in with your partner a few days or more after because, as previously mentioned, a sub drop can last hours, days or weeks

Aftercare is something that both people need--whether they were in the role of the sub or the dom.  The dom's physical exertion during BDSM can produce a sub drop so, similar to the sub, they need aftercare right after the scene and possibly up to weeks after.

There is no one-size-fits-all way to provide aftercare.  It all depends on what each person needs.  That's why it's important to be open and attentive with each other and communicate your needs.  

Getting Help in Sex Therapy

Sex therapy is talk therapy about sexual issues (see my article: What is Sex Therapy?).

Getting Help in Sex Therapy

There is no physical exam, nudity or sex during a sex therapy session (see my article: What Are the Most Common Misconceptions About Sex Therapy?).

Many individual adults and couples who are having sexual problems find that attending therapy with a skilled sex therapist is helpful (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help in sex therapy so you can have a more fulfilling sex life.

About Me

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

I am a sex positive therapist who works with individual adults and couples on all aspects of their sex life.

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.

A Search For Comfort and Safety With Alcohol or Drugs

Many people who drink alcohol excessively or abuse drugs are actually seeking comfort and safety, but they might not even realize it.

A Search For Comfort and Safety With Alcohol and Drugs

A Non-Pathologizing Perspective
As a psychotherapist in New York City, I've worked with many clients who are struggling to overcome substance abuse problems.  Many of them say that the alcohol or the drug is like a friend they don't want to give up, which is understandable.

If alcohol and drugs didn't provide a certain extent of comfort or feeling of safety, people wouldn't abuse these substances.  For many people, it's might be the only comfort and sense of safety they have ever experienced.

So, asking people, who experience this comfort to give it up can feel like a very daunting process to them, especially if they haven't ever experienced comfort with another person.

A Search For Comfort and Safety With Alcohol or Drugs

From this perspective, these substances can feel like a reliable source of comfort.  Not only does it provide temporary relief, but it is usually available, especially if the substance is alcohol.  It's legal.  It can be consumed alone or with other people.  And it usually accomplishes the goal of bringing temporary relief.

Of course, the problem is that, over time, substances create other problems, including serious health problems, impaired cognitive functioning, family problems, and work-related problems, just to name a few.

Over time, it can also result in death, so that even though there is a temporary relief, there can be serious long term damage.

People often seek help when one or more of these problems develop.  By then, it can seem like a very frightening prospect to give up what works temporarily--even when people know that will ultimately do serous damage.

At that point, some people will bargain with themselves and their loved ones:  They tell themselves and their loved ones that they can control their use or that they can stop at any time.  But, often, they're the only ones who actually believe this. And if they try to stop on their own, they might discover that they can't.

It can be a long, arduous process to give up abusing substances, and many people pay the ultimate price of ruining their health beyond repair before they accept that they can't control it.

But if people, who abuse substances and their loved ones have this non-pathologizing perspective that    the substance brings a sense of comfort, it can create more self understanding and empathy for oneself as well as for others.

Learning Healthy Ways to Seek Safety and Comfort 
One of the goals of therapy or substance abuse treatment is that people who are abusing substances learn how to seek comfort and safety in other ways.

This might mean that, instead of abusing substances, they learn to self soothe by:

• learning to meditate
• learning new breathing techniques to calm themselves
• learning new grounding techniques
• developing resilience
• developing new coping skills
• learning to make better choices
• learning to choose healthier relationships
• developing a stable and manageable life step by step

Even being able to consider learning new ways involves a certain amount of trust in a psychotherapist or a substance abuse counselor, which can be challenging for someone who has never had a trustworthy relationship.

Some people will persist in abusing substances because they don't want to give up what brings temporary relief.

Building that rapport and trusting relationship can take time.  In the meantime, before people can trust enough to allow a relationship to develop, they might need to ask themselves if they are willing to try it because being willing is often half the battle.

But once people trust enough to try other ways of seeking safety and comfort, they usually discover that this is a skill the they can continue to develop and that it works.

Getting Help in Therapy
Asking for help often induces shame in people.

Most people like to think that they can control their lives and that they don't need help.  But when it becomes obvious that your life is falling apart, it takes a lot courage to ask for help.

Often, people come into therapy externally motivated because either a spouse or a boss has given them an ultimatum:  Either get help or leave.

But people who are open to the process of recovering from substance abuse often discover their own internal motivation, especially if they develop a rapport with their therapist.

Getting Help in Therapy

If you're struggling with substance abuse or you're watching someone you love abuse substances, you're not alone.

Even if you can't afford therapy or you don't have access to treatment, there are 12 Step meetings in most cities and online.

Life is short.  Getting help sooner rather than later can make all the difference in how you live the rest of your life and the quality of your relationships.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I work with individual adults and couples.

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

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

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

Emotional Survival Strategies That No Longer Work: "I don't need anyone"

Unresolved early childhood trauma usually leads to emotional survival strategies that were adaptive during childhood, but they are no longer adaptive for adults.  They also often lead to distortions in self perception.  It's not unusual for adults, who were abused or neglected as children, to become adults who deny their own emotional needs and reject emotional connections with others (see my articles: Understanding Why You're Affected By Trauma That Occurred a Long Time Ago, Growing Up Feeling Invisible and Emotionally Invalidated, Are You Feeling Trapped By Your Childhood History?, Overcoming the Traumatic Effects of Childhood Trauma, and Looking at Your Childhood Trauma From an Adult Perspective).

Emotional Survival Strategies That No Longer Work: "I don't need anyone."

These survival strategies and distortions in self perception are unconscious.  Underneath them are a lot of fear, hurt, anger and shame.

One way to avoid feeling these underlying feelings is intellectualization.  When it is used to avoid unconscious emotions, intellectualization is a defense strategy.  More about this later.

These problems can begin early in infancy when the baby's primary caregiver is either shutdown emotionally, continuously misattuned to the baby's emotional needs, emotionally neglectful or abusive.

Even if all of the baby's physical needs are being taken care of, the baby still needs emotional attunement from the primary caregiver in order to thrive and learn to develop healthy attachment.

A baby, who makes many attempts to get a caregiver to be emotionally attuned, eventually gives up and shuts down emotionally.  Not only does the baby feel resignation about getting his emotional needs met, but he also gives up and dissociates.

If this is a pervasive experience in a baby's life, it will affect brain development as well as emotional development.

This survival strategy of dissociating is adaptive at that point for the baby because it would be emotionally unbearable to continue to yearn for love and attention that won't be given by the primary caregiver.

But this survival strategy, as an adult, is maladaptive and usually results in disconnection from oneself and others.

The dilemma for this adult is that he (or she) yearns for love and connection, but he's too fearful of getting his needs met, so he either (unconsciously) connects with other adults who cannot meet his needs or he believes himself to be "independent," someone who doesn't need other people.

As mentioned before, a common pattern for people with this problem is to either avoid relationships altogether by intellectualizing ("I only need my books") to negate the yearning for love and connection.

Fictionalized Scenario
The following fictionalized scenario illustrates these dynamics:

Jane
Shortly after Jane was born, she was left with her maternal grandmother when her mother moved from Florida to New York to find work.

Jane's grandmother did the best that she could, but she was often overwhelmed by taking care of her other grandchildren, her responsibilities in the house and running the family business.  As a result, she had little time to spend with Jane aside from meeting Jane's basic physical needs.

The grandmother was raised to believe that if a baby cried, the baby should be left to cry it out rather than being picked up, otherwise, the baby would be spoiled.

How Emotional Survival Strategies Develop in Infancy

So she left Jane crying for long periods of time in the crib.  Eventually, Jane would give up out of sheer physical exhaustion as well as a primitive sense that it was hopeless to keep trying to get anyone's attention.

When Jane's grandmother noticed that Jane was quiet in her crib and was just staring into space, she thought this was good.

To be clear, the grandmother wasn't trying to harm Jane in any way.  She just didn't understand the developmental harm that was being done by not responding to the baby's crying.  And, aside from this, a quiet baby is a compliant baby and was much easier for the grandmother.

When Jane was 10, her mother sent for her to live in New York City.  Even though Jane and her mother had no contact since the mother moved to New York City, when Jane arrived, her mother expected Jane to be affectionate towards her.

But, instead of an affectionate child, Jane's mother encountered a child who showed little emotional reaction to her.  Jane was obedient and passive, but it was obvious that she felt no emotional connection to her mother.

Jane understood that the woman she was meeting after so many years was her mother--she understood it as a fact.  But it had no emotional resonance for her.  She complied with her mother's rules and directives, but Jane remained emotionally disconnected from her (see my article: Adults Who Were Traumatized as Children Are Often Afraid to Feel Their Emotions).

Jane's mother thought of Jane's emotional distance as Jane being willfully disrespectful of her.  She had no understanding, as many parents wouldn't, that Jane's aloofness was an unconscious survival strategy that she developed at an early age to cope with the lack of love and connection from infancy.

Meanwhile when she was at school, Jane's teachers noticed that she tended to isolate herself from other children.  While other children were playing during recess, Jane sat in the corner by herself reading a book.

When Jane's teacher told her mother that she was concerned that Jane wasn't interacting with the other children, Jane's mother dismissed the teacher's concerns, "My daughter is here to learn.  She's not here to make friends.  It's better for her to read than to play."

Throughout high school, Jane's mother discouraged her from dating, "There will be plenty of time for that after you graduate from college."   Jane didn't mind because she felt no need to date boys or to make friends, "I have my books.  I don't need anyone."

During her first year of college, Jane kept to herself. At first, her classmates tried to befriend her, but when they saw that Jane wasn't receptive, they thought that Jane thought of herself as being "too good" for them.  Their friendliness turned to scorn, and they laughed and ridiculed Jane.

Although Jane pretended not to notice, she saw and heard their criticism.  Sometimes it would bother her, but most of the time, she pushed down her discomfort and told herself that she didn't care what they thought, "I don't need anyone."  Then, she would study harder in an effort to avoid feeling her loneliness, anger and hurt.

Jane graduated college with a 4.0 GPA, which she was very proud of and so was her mother.  But she didn't get any interviews from the college recruiters at campus.

Jane applied for many jobs after she graduated college, but she received no responses.  She wasn't  aware that many companies looked not only for good grades--they also wanted to see that students were involved in college activities, and Jane avoided any activities while she was in college.

Eventually, Jane found a job as a part time bookkeeper, which didn't require a college degree.  She worked in a small office by herself.

After a year, Jane found a full time bookkeeping job.  This allowed her to move out of her mother's home to become a roommate in an apartment with three other young women.

Jane didn't really want to have roommates, but she couldn't afford to have her own apartment.  Even though Jane had no interest in making friends with her roommates, one of them, Cathy, went out of her way to be friendly with Jane.

To her surprise, Jane realized that she didn't mind being around Cathy because Cathy did all the talking when they were together and all Jane had to do was be polite and pretend to be interested in what Cathy was saying.

After Cathy asked Jane many times, Jane agreed to go with Cathy to a silent meditation retreat.  Jane thought, "How bad could it be?  All I have to do is be silent."

But when Jane began the silent meditation at the meditation center, she was surprised to discover that she felt upset and emotionally overwhelmed, and she didn't know why.  She asked the center director if she could read books instead, but she was told that she had to focus on meditation.

After a couple of days of silent meditation with no other distractions, Jane felt so emotionally overwhelmed with sadness that it was unbearable.  She felt ashamed to leave early, but she couldn't bear being so overwhelmed.

When she got home, Jane tried to distract herself from her sadness by immersing herself in her books and going online but, no matter what she did, she still felt engulfed by sadness and she didn't know why she was feeling this way and why she couldn't distract herself.

After experiencing overwhelming sadness for a couple of weeks, Jane knew she needed help, but she wasn't sure where to turn, so she sought help from her medical doctor.

Although she felt very ashamed of her feelings, especially since she couldn't think of any reason for her sadness, her fear that she was "going crazy" got her to talk to her doctor.

Jane's doctor explained to her that there was nothing physically wrong with her and that she needed to address these psychological issues in psychotherapy.  Then, he referred her to a psychotherapist.

Getting Help in Therapy For Emotional Survival Strategies That No Longer Work 

Over time, Jane learned in therapy that, as an infant, she developed an emotional survival strategy of disconnecting from her environment as a way to deal with the environment that she grew up in.  Her therapist explained to her that this is called dissociation and it's what babies do when they are being raised by a caregiver who neglects or abuses them.

Jane learned from her therapist that this early emotional survival strategy was adaptive at the time because to continue to yearn for love and attention when none was forthcoming would have been even more emotionally painful when she was an infant.

Her therapist explained that Jane continued to use this emotional survival strategy as an adult.  Jane used books and other intellectual pursuits to distract herself and dissociate from her environment, but it was no longer adaptive in Jane's life--in fact, it was getting in the way of developing healthy friendships and relationships.

When Jane went to the silent meditation retreat, her psychotherapist explained, and she wasn't allowed to distract herself with books, her sadness about years of emotional neglect and disconnection came bubbling up to the surface, and this was what Jane was experiencing now.

The feelings were so strong that Jane could no longer push them down so, rather than trying to suppress them, Jane needed to engage in trauma therapy in order to heal.

She could no longer remain in denial about not needing anyone, which was a defense against feeling her longstanding sadness.  Jane saw this defense mechanism for what it was--an emotional survival strategy and distortion in self perception that was now maladaptive.

The psychotherapist talked to Jane about EMDR therapy. She also took a thorough family history and helped Jane to prepare to do EMDR (see my articles: Overcoming Trauma With EMDR Therapy: When the Past is in the Present and EMDR Therapy: When Talk Therapy Isn't Enough).

The work was neither quick nor easy (see my article: Psychotherapy: Beyond the Bandaid Approach).

But by the time Jane and her therapist began processing her early trauma, Jane trusted her therapist and, eventually, she was able to free herself from her history to lead a fuller life.

Conclusion
When infants are neglected or abused, they're able to develop survival strategies, on an unconscious level, that are adaptive at the time to ward off the devastating emotions that are the result of neglect and abuse.

Although it was adaptive at the time, these emotional survival strategies are no longer adaptive as an older child, teen or an adult.  These strategies keep people cut off from their feelings and in denial about their emotional pain.  It also keeps them cut off from other people.

Although they might believe that they really don't need anyone, this emotional survival strategy and distortion in self perception takes a lot of energy to maintain.

People often distract themselves from difficult underlying emotions with intellectual pursuits, drinking excessively, abusing drugs, gambling compulsively or engaging in other addictive and compulsive behavior.

When someone can no longer distract himself, these underlying emotions often come to the surface in a powerful way so that these emotions can no longer be denied.

Getting Help in Therapy
Various forms of trauma therapy, like EMDR therapy, clinical hypnosis or Somatic Experiencing are effective in helping people to overcome emotional trauma.

Rather than suffering on your own, you owe it to yourself get the help you need from a skilled psychotherapist who specializes in helping clients to overcome trauma.

By freeing yourself from a traumatic history, you can lead a more fulfilling life.

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

I specialize in helping clients to overcome emotional 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.

A "Flight Into Health" as an Escape From Therapy

In a prior article, Overcoming the Urge for "a Flight Into Health," I discussed a particular dynamic that comes up with many clients as they talk about childhood abuse.  In this current article, I'm focusing on childhood neglect, which is often more difficult to detect than abuse, and how it can affect relationship choices as an adult.

See my articles: 

What is Childhood Emotional Neglect?

What is the Connection Between Childhood Emotional Neglect and Problems Later on in Adult Relationships? 

As an Adult, Overcoming the Effects of Childhood Trauma).

"A Flight Into Health" as an Escape From Therapy

In psychotherapy, the term "a flight into health" implies that the client leaves therapy abruptly out of fear, telling herself that she no longer needs therapy.  This often happens when something comes up in therapy that the person is frightened by and not ready to deal with at that point.

This doesn't mean that the client is lying or trying to fool the therapist.  Usually, the client really believes that s/he is ready to leave therapy but, based on whatever came up just before the client decides to leave, the therapist usually knows that this is a defensive gesture on the client's part that comes from fear.

An astute psychotherapist will try to reengage the client to discuss what came up and what might have frightened the client.

If the therapist and client have a good rapport, the client might be willing to come back for another session to explore whatever might have come up to cause him or her to leave.

If the therapist and client haven't established a rapport, the client might not be open to exploring this further because s/he really believes everything is okay or, even if s/he knows things aren't okay, s/he might feel too emotionally vulnerable to explore it further.

A Fictionalized Scenario
Let's take a look at a fictionalized scenario, based on many cases, which deals with a "flight into health" involving a history of childhood emotional neglect:

Mary
Mary started therapy because she wanted to make healthier relationship choices (see my articles: Choosing Unhealthy Relationships: Bad Luck or Poor Choices?, Falling In love With "Mr. Wrong" Over and Over Again and Choosing Healthier Romantic Relationships.

She attended a few sessions with a psychotherapist who was recommended to her, and told the therapist about her tendency to get involved with men who were in and out of life.

The relationships usually started out well.  With each relationship, Mary thought there was a possibility for a long term relationship.  But whenever she and the current man in her life would became more serious, the man disappeared.

Mary was very confused and hurt about these dynamics and wanted to stop choosing men who turned out to be so unreliable.

By the second session, the therapist asked Mary to share her family history, and Mary said she thought she had "a very good childhood."  But when she talked about her parents, she was very vague, and the therapist had to ask questions in order to understand the family dynamic.

A "Flight Into Health" as an Escape From Therapy 

As a result of the therapist's questions, Mary alluded to her father being around sometimes and not around other times.  But as soon as she said this, Mary looked uncomfortable and guarded.

She folded her arms in front of her chest, and said, "He was a very good father, even if he wasn't around all the time.  He had a rough childhood himself and I don't hold it against him that he would sometimes have to disappear for months at a time."

Having said this, Mary appeared upset.  She told the therapist that, until now, she never thought about how similar the dynamics were between her and her boyfriends and her and her father.

Since Mary was the one who made this connection, the therapist asked Mary what it was like to realize this.  But Mary was at a loss for words.

Mary remained quiet for a while, and then she said that she needed to leave the session early.  The therapist tried to help Mary to calm down, but Mary told the therapist that she was "alright"--she just needed to leave.  She said she would come in for her session next week.

But a few days before her next session, Mary left a message on the therapist's voicemail, at a time when she knew the therapist wasn't there, saying she was "feeling better" and no longer needed to come in.

Her therapist knew that Mary was bothered by what came up in the prior session, and she tried to reach Mary a few times, but Mary didn't return her phone calls.

Several months later, after being hurt and disappointed again by another man, Mary resumed therapy with the same therapist.

Initially, she was defensive, saying that she didn't want to talk about her family, "After all, my parents both did the best that they could."

When her therapist asked Mary why she left the last time, Mary didn't respond to the question.  She said she only wanted to focus on her current life and what she could do to find a man who would treat her well.

As soon as she said that, she began to sob and told her therapist, "I don't even know why I'm crying."

Her therapist realized that Mary wasn't ready to make any further connections between her father and the unconscious choices she was making about the men in her life.

She knew she had to develop more of a rapport with Mary.

The therapist also knew that  they would need to go slowly, and she would need to help Mary with the anxiety about these issues--otherwise, Mary would become too anxious again and she might take another "flight into health." And next time, she might not come back.

Her therapist suggested that they begin by working on coping skills and helping Mary to develop internal resources.

Based on their work together, Mary began to meditate for 10 minutes in the morning and at night.  She also started a beginners yoga class.  In addition, her therapist helped Mary to visualize a relaxing place so that whenever she felt anxious, she could imagine herself going there.

As the holidays approached, Mary talked about trying to decide if she wanted to go home to see her family or not.  She still maintained that she had "a very good childhood," but she also expressed her strong ambivalence about going home.

When her therapist asked Mary about this, Mary started getting agitated, so her therapist suggested that Mary visualize the relaxing place, do the breathing exercises she taught her, and then they could resume talking about her family--if Mary wanted to do it.  Her therapist made it clear that it was up to Mary if they talked about the upcoming holiday and her family or not.

After Mary relaxed a little, she said she didn't want to make it sound like there were problems in her family home.  She said, "Far from it..."  But she was unable to articulate why she had mixed feelings about going home to her parents.

By the next session, Mary brought in a dream:  She was five years old and she was waiting for her father by the window that faced the street.

In the dream, every time she saw a man walking towards the house, she got excited because she thought it was her father.  But each time the man got closer, she could see that it wasn't her father and she was disappointed each time. The dream ended with Mary waiting and waiting and her father never showed up.

After she told the dream, Mary burst into tears.  She remembered being that little girl by the window many times, hoping to see her father, but he didn't come.

Her therapist was listening and sensing what was going on for Mary and if she would be able to explore this further.  Rather than push her to go somewhere where she wasn't ready to go, she would take her cues from Mary (see my article: The Therapist's Empathic Attunement and The Creation of the Holding Environment in Therapy).

Mary seemed to be in her own world, as if she was back in the dream, "I don't understand why my father came and went like that.  I know he loved us, but he would just suddenly leave without saying a word and we never knew when he was coming back."

Her therapist remained attuned to Mary and stayed close to Mary's experience, reflecting back to her how difficult that must have been for such a young girl.  Mary nodded her head.

By the end of the session, Mary told her therapist that she felt supported by her and she was grateful for that.  She had never felt so supported in her life before.

During the next few sessions, Mary continued to talk about the dream and how it reflected her childhood experience with her father.  She went back and forth between feeling sad and defending her father vs. telling her therapist what a good man he was.

When Mary felt comfortable, they did "parts work" where Mary imagined her younger self sitting next to her and she spoke to her younger self to soothe and reassure her.

Then, her therapist asked her to switch roles and be her younger self and ask Mary for what she needed.  Mary said she felt soothed by these exercises.

When she came in the next time, she talked about a recent dream where she was sitting on the couch next to her five year old self, holding and rocking her.  She said she felt the sadness from her younger self, but her younger self also felt comforted, and Mary was happy that she could do this for her.

Several months later, Mary came in and told her therapist that she thought she felt a little more comfortable now exploring the connection between her relationship with her father and her relationships with the various men that she dated.

Her therapist said they could do this, but she wanted Mary to tell her if she began to feel like she wanted to leave therapy.  She asked Mary to talk about it, if she could, rather than acting on it.

Mary said she would try to do this, and she said she might feel like leaving, but she really wanted to stay and talk about it, especially now that she felt a stronger bond with the therapist.

A "Flight Into Health" as an Escape From Therapy

Gradually, over time, Mary was less defensive and she was able to express her sadness and anger about her father's erratic behavior when she was a child.

She also began to understand how she was unconsciously repeating these experiences in her current life by choosing men who would behave in a similar way as her father.  Unconsciously, she was repeating this behavior in the hope that there would be a different outcome.  This is called repetition compulsion in psychotherapy.

This was a big step for Mary, and it was the beginning of her healing process.

She admitted that talking about this felt a little anxiety provoking, but her anxiety was no where near what it had been.  She also felt good that she could say this, and it didn't feel nearly as frightening as it did when she first made the connection on her own when she began therapy.

Conclusion
A "flight into health" is a reaction that many people in therapy have when something comes up in therapy that causes them to feel anxious and they're not ready to deal with it.

This is usually an unconscious response.  At that point, the client is often convinced that whatever symptoms or problems brought them into therapy are now gone--they're "better" now.

If clients in this situation remain long enough for the therapist to help them to develop the skills to cope with their fear, they can eventually go back, when the client is ready, to explore together what was too frightening before.

When clients leave therapy, as in the fictionalized vignette above about "Mary," they often return at some point because they become aware that their problems aren't really gone.  It just seemed that way because they convinced themselves of it out of fear.

At that point, the client and therapist can strengthen the therapeutic alliance between them by allowing the client to set the pace.

Most skilled psychotherapists know that it's counterproductive to push clients beyond where they can go emotionally, especially if they're not feeling safe.

It's better to take a step back and help the client to develop the necessary internal resources so that if and when the client becomes ready, s/he can feel more confident to deal with whatever comes up, knowing that the therapist is there for them.

Getting Help in Therapy
It's often comforting for clients to know that if they've taken "a flight into health" that they're not the only ones who have ever experienced this.

If you recognize this dynamic in yourself, you can be assured that an experienced psychotherapist understands this dynamic.

Whether you return to your former therapist or decide to see someone else, you're not alone.  You can think of the"flight into health" as a temporary obstacle that a skilled therapist can help you to overcome.

Being afraid and ambivalent about exploring uncomfortable personal problems is normal.

It's also alright to tell a therapist that you're uncomfortable, and the two of you can work together to help you get to the point where you feel more comfortable.

The first step is making the phone call to get help.

Freedom from a traumatic history allows you to live a more fulfilling life.

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

One of my specialties is helping clients to overcome emotional trauma.

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

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

How Therapy Can Help You to Gradually Take Down the "Wall" You've Built Around Yourself

The idea of a protective "wall" is often used as a metaphor for a common defense mechanism that many people use to protect themselves from getting hurt.

How Therapy Can Help You to Gradually Take Down the Wall

This wall, which often develops in early childhood, helps protect the child from being too vulnerable and emotionally overwhelmed (see my article:  Are You Living Your Life Trapped By Your Childhood Trauma?)

So, in that sense, the wall serves a good purpose, especially since children have fewer emotional defenses.   But erecting this wall comes at a significant emotional cost in other ways:  Not only does it keep out potential hurt and emotional pain, but it can also keeps out potential love and nurturing.

When this child grows up to be an adult, the wall also creates loneliness and isolation.  After many years of  living behind an emotional wall, it's usually difficult to overcome this on one's own.  There is usually a strong sense of ambivalence:  Wanting to take down the wall for emotional support and, at the same time, wanting the protection of this wall.

So, therapy with a licensed mental health professional, who understands the unconscious dynamics involved and who can titrate the work to make it emotionally manageable, can help someone struggling with this issue to develop the emotional resources, courage and the understanding necessary to slowly take down this emotionally defensive wall.

Why slowly?  Most people would find it too scary if their defenses were removed too quickly.  So, it's a relatively slow process depending upon the client's level of comfort and feeling of safety in the therapy.

To a greater or lesser degree, we all have emotional walls, depending upon the people around us and the circumstances.  None of us walk around without any emotional defenses.  The wall is either thicker or thinner and more or less permeable depending upon how much we trust others.  Ideally, it allows for a flow love, understanding and intimacy for those who are closest to us, if we allow closeness.

So, it's not an all or nothing matter of either having the wall or not--it's more a matter of allowing a certain amount of emotional vulnerability to be able to relate to others and develop close relationships.

Continuing with the metaphor of the wall, people who have built thick walls around themselves often don't differentiate between people they can potentially trust and people they can't.  A history of significant psychological trauma creates the kind of defensive structure that keeps most, if not all, people out.

But, as I mentioned before, this is a lonely and isolating existence, which often leaves people feeling trapped between wanting closeness and fearing it (see my article: An Emotional Dilemma: Wanting and Dreading Love and Overcoming Loneliness and Social Isolation).

The following fictional vignette demonstrates how therapy can be helpful to feel safe enough to slowly begin taking down this defensive wall.

Edna
From an early age, Edna learned that she had to be hypervigilant around her parents, who were both active alcoholics.

How Therapy Can Help You to Gradually Take Down the Wall

On the rare occasions when they weren't drinking, they were kind and generous with Edna.  During those times, her mother was affectionate and would read Edna's favorite stories to her at bedtime.  Her father would take her to the park and teach her how to roller skate and ride a bike.

But when they were drunk, which was most of the time, they would yell at Edna and tell her to get away from them.

Edna never knew when her parents might be sober or drunk, so she learned at an early age to pick up cues from each of her parents in order to protect herself from their anger.

Because it was too emotionally painful to want affection from her parents when they were drunk and angry, she learned to shut down emotionally.  It wasn't a decision that she made conscious.  Rather it was an unconscious decision that she made to protect herself emotionally.

As an only child, she endured this on her own, and she would bury herself in her books or play by herself with her toys in her room while they were raging at each other while drunk.  She learned to stay out of their way most of the time.

It was hard for her to enjoy those times her parents were affectionate (during those rare times when they were sober) because she never knew when, like Dr. Jekyll and Mr. Hyde, they would turn into angry drunks again.  She knew that the good times wouldn't last because they were rare and they were often followed by the bad times when they were hurtful towards her.

Since she knew that she couldn't count on her parents emotionally, she developed a pseudo independence where she only relied on herself.  As a young child, she sometimes imagined a fairy godmother hovering around her to magically protect her.

After she left home to go to college, she only developed a few friends on campus.  She had a difficult time allowing people to get close to her, so the few people who showed themselves to be loyal and trustworthy were the ones that she allowed to get relatively close to her.  But even these friends told her that sometimes they felt that she shut them out.

Relationships with young men were even more difficult for her.  She dated a few men in college, but as soon as it seemed that things could get serious, she ended the relationship.  This left her feeling sad and lonely, but she didn't know how to overcome her fear of getting hurt.

When she graduated college and moved to NYC to start a career, she felt even more isolated and lonely.  She spent a lot of time by herself when she wasn't at work, and the weekends seemed very long to her.

How Therapy Can Help You to Gradually Take Down the Wall

Edna knew herself well enough to know that she was struggling with a terrible dilemma.  She knew she had built a wall around herself and that she allowed only a few people to get through a little bit.  She also knew that if she continued like this, she would be alone, which she didn't want.  So, on the recommendation of her primary doctor, who diagnosed her as being mildly depressed, she started therapy.

After hearing Edna's family history, her therapist, who was a trauma therapist, started by providing Edna with psychoeducation as to why she was so ambivalent about allowing people to get close to her. Edna was relieved to hear that she wasn't the only one who was suffering in this way.

How Therapy Can Help You to Gradually Take Down the Wall

Over time, her therapist also helped Edna to develop inner resources to do the necessary trauma work to help her overcome her defensiveness (see my article: Developing Internal Resources and Coping Skills).

These resources included:

• learning to calm herself when she felt anxious, fearful or overwhelmed
• developing a felt sense to know when she felt happy and safe
• being able to mentally call on people, some of whom she knew and others that she imagined, that she could imagine helping her when she felt upset
• learning breathing exercises to calm herself
• helping her to sense and identify emotions in her body (the mind-body connection)

After Edna developed these resources and learned how to use them, her therapist began using experiential therapy to help Edna work through the earlier psychological trauma so that she would feel freer to develop close relationships.

Edna was committed to her work in therapy and she came to her sessions regularly.

How Therapy Can Help You to Gradually Take Down the Wall

Gradually, she began to feel that her fears were lifting and she felt the possibility of developing closer relationships with people.

As she started dating again, she talked to her therapist about the men that she met.  With the help of her therapist, she became more discerning--rather than fearing everyone, she got to know people over time slowly and developed insight into how much she could trust people.

This wasn't easy work and sometimes she had setbacks (see my article:  Setback are a Normal Part of Psychotherapy on the Road to Healing).

But, over time, she developed a secure relationship with her therapist, which made her feel hopeful that she could develop secure relationships with others.

Along the way, she did "inner child" work with her therapist to help the most vulnerable part of herself to feel nurtured and understood.

As she developed a closer internal relationship with her inner child, she realized that it was this young part of her that was often overprotective to the point where it discouraged her from getting too close to others.

If this inner child could speak, it was as if she was sounding an alarm for the adult Edna, "Danger! Danger! Don't get close to that person.  You're' going to get hurt!"

The inner child work helped that part of Edna to feel safer.  The adult part of Edna reassured her inner child that she would protect her so that she no longer needed to feel fearful of everyone.

How Therapy Can Help You to Gradually Take Down the Wall

Little by little, Edna opened up more. She began to allow more people in as she felt it was safe.  Rather than her wall being thick and impenetrable, so to speak, it was now more permeable as she learned whom she could trust and allow to get closer to her.

Eventually, as she became more discerning, she began to see that she could have different relationships with different people:  She was developing a relationship with a boyfriend; she had more close friends and confidantes; and she also had a few acquaintances, who weren't close, but whom she liked doing certain activities with and who were fun.

Conclusion
The description of someone having a wall around them is a metaphor to describe an emotional defense mechanism that helps to protect him or her from feeling too emotionally vulnerable.  Other metaphors include having a protective "shell" or "armor."

While the wall serves an important protective purpose, especially in early childhood, it also keeps a person feeling lonely and isolated.

The dilemma becomes that, on the one hand, it feels too scary to allow others to get close but, on the other hand, keeping people away leads to loneliness and isolation.

Psychotherapists who are trauma therapists and trained to help clients to overcome these struggles, usually working gradually to overcome this dilemma.

Developing a secure and trusting relationship over time is part of this process, and trauma therapists know how to facilitate this process.  It will be different for each client.

Developing internal resources is another important part of the process before actually working directly on the unresolved trauma.

Once the client has worked through the trauma and learns to be discerning about relationships, s/he is usually free to interact without fear that s/he will be too vulnerable.

Getting Help in Therapy From a Trauma Therapist
Often, part of the dilemma is that, since it's hard to trust others, it's also hard to open up to a psychotherapist, even a therapist who is trained in trauma therapy.

I usually recommend that clients go to a few sessions with a therapist and find out how s/he works before delving into the trauma work (see my article: How to Choose a Psychotherapist).

Loneliness and isolation are painful to endure on your own.  If you're struggling with fears about getting close to others, you can overcome your fears and lead a more fulfilling life by getting help in therapy from a trauma therapist.  It could open up a whole new life for you without so much fear and pain.

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

One of my specialties is helping clients to overcome psychological 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.

Being the Different One in Your Family

In a prior article,  The Role of the Family Scapegoat in Dysfunctional Families, I discussed how the family scapegoat is usually made to feel like s/he is "different" from the rest of the family and the cause of the family's problems, even when s/he isn't really the source of their problems.  In this article, I'm focusing on what it's like to feel "different" in a family.

Being the Different One in Your Family

Examples of Being the "Different One" in a Family:

• A first generation child, whose parents are originally from a different country, not only feels different, but often feels conflicted because s/he can feel caught between the family's traditions from their country of origin and the culture of the new country.

• A child, who is gay, in a family that has traditional views of what it means to be a man or a woman, can feel different from other family members and, depending upon the family.

• A child, who has liberal views and who grows up in a family who conservative traditional views can feel different.

• A child, who is artistic and who grows up in a family that devalues artistic skills and wants their child to pursue a more mainstream career, can feel devalued and question his or her own views.

• A child, who grows up in a family where the parents and the siblings all abuse alcohol and drugs and who all dropped out of high school, might feel misunderstood because s/he values education and wants to avoid abusing substances.

These are just a few of many possible examples of how a child can feel and be perceived as different from other family members.  There are many other examples.

Of course, there are families who are open minded and who can accept a child who is different.  This can help the child to feel accepted and loved as well as accepting of his or her own values.

The problem arises when being "different" in the family is perceived as being "less than" the rest of the family.  The parents might feel that the child's differences are a threat to the family and, in that sense, the differences feel dangerous to them.

The following scenario is a fictionalized example of how growing up being the "different one" in a family can be difficult and how this problem can be overcome in therapy.

Mark
Mark grew up in a traditional religious family.  He was the youngest of five children.

When he was a young child, he never questioned his religion.  But when he was in his mid-teens and he socialized with friends and their families from different backgrounds, he became increasingly aware that there were other ways of seeing the world and he began to question whether he believed the basic principles of the family's religion.

When he told his parents and older brothers that he wasn't sure if he believed in these basic principles, they were stunned.  His father became angry and told Mark that the family's religion is what got them through many difficult times going back to Mark's great grandfather's time and probably before. He felt that Mark's questioning was heresy.  He warned Mark that no good would come of it.

Mark couldn't understand why his father was so upset.  But, after he experienced his father's anger, Mark kept his questions to himself.  He continued to observe the family's religious traditions but, inwardly, he continued to wonder how meaningful, if at all, these traditions were to him.

As Mark entered college, he was encouraged by his parents to take business courses so that he could become an accountant or a business manager.

During his first two years of college, Mark's college required him to take certain core courses where he was exposed to many different subjects and new ideas.

By the time he was a college Sophomore, he was very drawn to art history.  But when he told his parents that he wanted to be an art history major instead of a business major, they were even more upset than when he told them that he was questioning their religion.

His parents talked to him about how financially difficult it had been for both the mother's and the father's families and for them before Mark was born.  They stressed the importance of choosing a major that would be "practical."  They didn't want Mark to struggle financially the way they did or the way their parents did.  They urged him to major in business because, as a business major, he could find a job, whereas as an art history major, he might end up jobless.

Mark considered what his parents told him.  He was aware that his older brothers followed their parents'  suggestions and each of them was doing well financially.  They had secure jobs, and they seemed happy with their choices.

But Mark was becoming increasingly aware that he wouldn't be happy as a business major.  He understood his parents' concerns and their practical advice, so he felt torn.

He was also more and more aware of how different he was from his parents and brothers.  He loved them very much, but he knew he needed to find his own way, which was probably going to be different from the rest of his family.

He also felt that his parents were still traumatized by their experiences of going through difficult financial times.  Even though they overcame their earlier financial difficulties, he knew that, on an emotional level, they never got over their fear and sense of vulnerability.  It was as if they were living in the past.  He knew they couldn't see that he had opportunities now that they never had.

Feeling more and more conflicted and confused between what he wanted and his loyalty to his family, he decided to start therapy.  This was difficult for him because, on a certain level, he felt he was being disloyal to his family by going to therapy (see my article:  When Family Loyalty Gets in the Way of Your Psychotherapy Sessions).  

He didn't tell his family about his therapy because he was sure they wouldn't understand.  He knew that they would think that he shouldn't talk about the family to a stranger, even if the stranger was a licensed mental health professional.

During his therapy, Mark's therapist, who was trained as a hypnotherapist, helped him to have greater access to his unconscious feelings and wishes by using clinical hypnosis.  While he was in a relaxed hypnotic state, his therapist asked him to imagine his future self as he wanted himself to be when he completed college (see my article: Experiencing Your Future Self: The Self You Want to Become).

As Mark became more comfortable with hypnosis, he was able to gradually put aside his conflicts and focus on what he wanted for himself.  As he did this, he felt how deeply he wanted to pursue a career in art history.

Over time, with increasing confidence, Mark became more open to exploring this possibility by seeking out people who were already in the field, including his professor.  With more information from people in the field, Mark realized that he wanted to pursue an art history career, possibly working in an art gallery.

After he graduated with a major in art history, despite his family's disapproval, Mark went on to get a graduate degree in art history.  His degree also included business courses related specifically to the art world so he felt he would be better prepared for the field.

As part of his educational courses, Mark interned at one of the more prestigious art galleries in New York City, and by the time he had his Master's degree, the gallery owner hired him full time.

Although his fear was that he would alienate his family, he came to realize that his family still loved him, even if they didn't understand why he wanted to pursue a career that was so different from what they wanted for him.

Over time, as Mark continued to advance in his career, his parents' and older brothers' disapproval softened and they came to accept that Mark was happy in his field and that's really all that mattered.  Mark also let go of his conflictual feelings about being different and embraced his choice.

Getting Help in Therapy
Being the "different one" in your family can be an emotionally painful and lonely experience if your family members don't understand or accept what you want.

Trying to appease others by sacrificing your core sense of self will only make you unhappy. Although it can be difficult to be an individual who is different from other family members, being true to yourself is the best way to lead a fulfilling life.

If you're struggling with feeling different, rather than struggling on your own, you could benefit from working with a licensed mental health professional who can help you to deal with these emotional struggles, learn to be an individual, and feel more confident (see my article: How to Choose a Psychotherapist).

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