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NYC Psychotherapist Blog

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Showing posts with label PTSD. Show all posts
Showing posts with label PTSD. Show all posts

Sunday, April 19, 2026

Debunking Common Myths About Anxiety

Anxiety is a common psychological condition; however, unfortunately, there are many misconceptions about anxiety (see my article: What is the Difference Between Fear and Anxiety?).

Debunking Common Myths About Anxiety

Anxiety is a treatable and legitimate condition--not a sign of personal weakness. 

Over 40 million adults experience some form of anxiety annually in the United States.

Debunking Common Myths About Anxiety
  • Anxiety Isn't An Overreaction or Being "Dramatic": Anxiety disorders are mental health diagnoses that are real. 
  • Anxiety Isn't a Sign of Weakness: Anyone can develop an anxiety disorder. It's not a sign of weakness and shouldn't be stigmatized. 
Debunking Common Myths About Anxiety
  • You Can't Just "Snap Out of It" or "Relax": Anxiety isn't a voluntary condition. It requires help from a mental health professional.
  • Anxiety Isn't in Your Mind: Anxiety includes physical and mental health symptoms which can include panic, racing heart, feeling dizzy, nausea and so on.
  • Medication Isn't the Only Treatment: Psychotherapy, lifestyle changes and self care are often effective without medication. Each person who experiences anxiety needs to be assessed for their particular symptoms and their particular mental health needs, which might include medication. 
Note: The purpose of this article is only to provide information. An assessment and diagnosis needs to be made by a qualified medical or mental health professional.

Getting Help in Therapy For Anxiety
Anxiety can include many different types of anxiety-related diagnoses including panic attacks, posttraumatic stress disorder (PTSD) and generalized anxiety to name a few (see my article: Getting Help in Therapy For Anxiety).

Getting Help in Therapy For Anxiety

If you have been experiencing anxiety, you owe it to yourself to get help from a licensed mental health professional.

Developing the tools and strategies to cope with anxiety and getting to the underlying issues can help you to lead a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples.

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

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

Also See My Articles:








Thursday, March 5, 2026

Emotional Numbing: The "Wall" That Once Protected You Now Imprisons You

 I've written about emotional numbing in prior articles (see my article: How Therapy Can Help You to Take Down the "Wall" You Built Around Yourself).

In the current article, I want to dive deeper into the subject of emotional numbing that started as a survival strategy and ended up imprisoning you with social isolation, an inability to feel emotions deeply, including joy, and creating stagnation in your life.

What is Emotional Numbing?
Emotional numbing is an unconscious psychological state where an individual feels detached or indifferent. They are often unable to experience, process or express emotions.


Overcoming Emotional Numbing

What Are Some of the Symptoms of Emotional Numbing?
Someone who is experiencing emotional numbing can have some or all of the following symptoms:
  • Flat Affect: A lack of emotional response, often described as "robotic" or indifferent
  • Reduced Emotional Range: An inability to feel high excitement or deep sadness
  • Detachment: Feeling emotionally and psychologically disconnected from others and, possibly, from surroundings
  • Indiscriminate Blocking: Emotional numbing blocks all emotions including sadness, joy, excitement and gratitude
  • Loss of a Sense of Self: Chronic detachment can lead to loss of identity, which can make you feel like a passive observer in your life 
  • Avoidance and Isolation: Withdrawing from people and social activities
  • Energy Depletion: Maintaining internal "walls" takes a lot of psychological energy which can lead to chronic fatigue or burnout
What Causes Emotional Numbing?
Emotional numbing can be caused by unresolved psychological trauma, PTSD (posttraumatic stress disorder), severe stress, grief, burnout or a side effect of medication (see my article: What is the Difference Between Trauma and PTSD?).

Overcoming Emotional Numbing

Emotional numbing often starts during childhood as a survival strategy or defense mechanism which is adaptive at the time because the child is in a psychologically overwhelming environment at home.

In that sense, emotional numbing helps to mitigate overwhelming stress and trauma which would be detrimental to the child.

However, when the child becomes an adult, emotional numbing is no longer adaptive because it prevents the individual from being fully present in personal relationships, friendships, social activities and at work.

As an adult, chronic emotional numbness puts a strain on relationships and daily life.

Clinical Vignette
The following clinical vignette,which is a composite of many cases, illustrates how emotional numbing which once protected a young child in a dysfunctional family from being overwhelmed but created problems later on as an adult. The vignette also illustrates how trauma therapy can help.

Nick
When Nick was growing up, he learned to cope with his parents' constant arguments by going into his room and "spacing out" with video games.

After a while, he got so good at numbing himself that he felt like he was in his own world apart from everyone and everything else.

As an adult in his first relationship, Nick had problems connecting emotionally with his girlfriend. She complained that she experienced him as emotionally detached and indifferent about her and their relationship.

At the time, Nick had no awareness about how he was numbing himself because it had become so automatic for him. At the point when he thought his girlfriend might end their relationship, Nick sought help in therapy.

Nick's therapist helped Nick to realize that the "wall" he created around himself as a child protected him from the chaos between his parents, but that same "wall" now came with a cost because he had problems connecting emotionally with his girlfriend and others.

His therapist, who was a trauma therapist, helped Nick to gradually take down his protective "wall" by working on the unresolved trauma from his childhood.

Using a combination of EMDR therapy and Parts Work therapy, over time, Nick worked through his childhood trauma so that he no longer felt the need to numb himself emotionally (see my article: Why is Experiential Therapy More Effective Than Traditional Talk Therapy to Overcome Trauma?).

The work in therapy was neither quick nor easy, but Nick was able to connect emotionally with his girlfriend as he worked through his unresolved trauma.

Conclusion
Like all defense mechanisms, emotional numbing occurs on an unconscious level and it's usually related to trauma.

Trauma therapy can help to work through the original trauma so there is no longer a need for emotional numbing.

Getting Help in Trauma Therapy
Working with a licensed mental health professional who is a trauma therapist can help you to work through unresolved trauma and emotional numbing (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

Rather than struggling on your own, seek help from a trauma therapist so you can live a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

As a trauma therapist, I have over 25 years of experience helping 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.

Also See My Articles:

















Monday, February 23, 2026

The Silent Treatment and Gaslighting As Emotional and Psychological Abuse

The combination of the silent treatment and gaslighting is a powerful form of emotional and psychological abuse (see my article: What is Psychological Manipulation?).

Let's look at each one separately and then we'll look at them together.

What is the Silent Treatment?
It's important to distinguish the silent treatment from someone who communicates they need a break from an argument.  

The Silent Treatment

When someone communicates they need a break, they usually do it because they are feeling overwhelmed or they feel a conflict is getting out of control and both people need a break. The understanding is that this is a temporary break and both sides will come together again in a calmer state to continue talking.

The silent treatment a deliberate and prolonged withdrawal of communication. It's usually used to control and inflict punishment.  

What is Gaslighting?
Gaslighting involves manipulating someone into questioning their own thoughts, perceptions and memories (see my article: What Are the 7 Stages of Gaslighting in a Relationship?).

Gaslighting

Gaslighting is a control tactic to get someone to doubt their reality so they often become dependent upon the abuser.

    Common tactics or phrases include:
  • Denial of Facts: "That never happened" or "I never said that" even when they are confronted with proof
  • Trivializing Feelings: "You're overreacting" or "You're too sensitive"
  • Diverting/Blocking: "You're just imagining things" or accusing someone of being "crazy"
  • Twisting Information: Manipulating events to make the other person feel guilty or at fault
    Signs of Gaslighting:
  • Second-Guessing Yourself: You constantly second guess your memories or decisions.
  • Confusion, Anxiety, Disorientation: You feel confused, anxious or disoriented.
  • Self Doubt: You feel like you can't do anything right.
How Does the Combination of the Silent Treatment and Gaslighting Function as Abuse?
  • Gaslighted By Silence: When someone uses the silent treatment, they are withholding emotion and connection. If they deny they were cold or indicate that they were "just taking space", despite engaging in a cruel and prolonged shutdown, they are using silence as a form of gaslighting.
Gaslighting By Silence
  • Creating "Crazy-Making" Doubt: They might ignore the other person after a disagreement and then act as if nothing happened or accuse the other person of overreacting when they try to address their prolonged coldness. This can cause the other person to question their perceptions.
  • The Cycle of Punishment and Reward: They use silence to punish the other person as a way to manipulate them into "working" for the resumption of the conversation (e.g., apologizing for something they didn't do).
  • Narcissistic Tendencies: People who use the silent treatment and gaslighting tend to have narcissistic tendencies. They often engage in this behavior to avoid taking responsibility.
What is the Psychological Impact of the Silent Treatment and Gaslighting?
  • Internalized Blame and Feelings of Inadequacy: The person who is experiencing the silent treatment and gaslighting can feel shame, guilt and a decrease in their sense of self worth.
Self Blame and Doubt
  • "Walking on Eggshells": They can develop high anxiety and hypervigilance while monitoring the other person's mood to avoid another episode of the silent treatment.
  • Trauma Bonding: The unpredictable cycle of severe disconnection followed by sudden reconnection can create trauma bonds making them increasingly dependent on the other person (see my article: What isTrauma Bonding in a Relationship?.).
  • Physical and Neurological Pain: Research indicates that being deliberately ignored activates the same area in the brain, the anterior cingulate cortex, that processes physical pain.
  • Long Term Effects: Prolonged exposure to a combination of the silent treatment and gaslighting can lead to symptoms similar to posttraumatic stress disorder (PTSD) including chronic stress, anxiety, depression and confusion.
What Can You Do If You're Experiencing the Silent Treatment and Gaslighting?
  • Be Aware This is Abuse: By recognizing this behavior as abuse that is meant to control you can help you to reduce self blame.
Setting Boundaries
  • Document Incidents: Keep a record of these incidents to counteract the effects to gaslighting.
Getting Help in Therapy
  • Seek Support: Reach out to trusted friends, family members and a licensed mental health professional to break the cycle of isolation.
About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), AEDP, Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have over 25 years of experience helping 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.









Thursday, September 25, 2025

What is the Purpose of the Preparation and Stabilization Phase in EMDR Therapy?

In the past I've written other articles about EMDR therapy including:
In the current article I want to focus on Phase 2 of EMDR Therapy: The Preparation and Stabilization Phase.

Before focusing on Phase 2, let's review the eight stages of EMDR therapy.

The Preparation and Stabilization Phase of EMDR Therapy

What Are the 8 Phases of EMDR Therapy?
The eight phases of EMDR Therapy:

Phase 1: History Taking and Treatment Planning: 
  • Taking a thorough family history
  • Taking a history of the problem
  • Establishing a rapport with the client
  • Selecting target memories to process with EMDR
Phase 2: Preparation and Stabilization:
  • Teaching the client about EMDR processing
  • Helping the client to develop the necessary coping and relaxation skills to process the trauma with EMDR
  • Ensuring the client is ready to process the trauma with EMDR
Phase 3: Assessment:
  • Identifying the client's negative belief
  • Identifying the images related to the traumatic memory to be processed
  • Helping the client to identify their level of disturbance about the memory (Subjective Unit of Disturbance or SUD)
  • Rating the level of disturbance (SUD)
Phase 4: Desensitization:
  • Using bilateral stimulation (tapping, eye movements or tones) while the client focuses on the traumatic memory
  • Reducing the client's disturbance (SUD) to a manageable level
Phase 5: Installation:
  • Helping the client to identify and integrate a positive belief that contradicts the client's negative belief
  • Strengthening the client's positive belief with bilateral stimulation
Phase 6: Body Scan:
  • Helping the client to recognize any residual body sensations associated with the trauma
  • Addressing any residual discomfort client has with regard to the trauma
Phase 7: Closure:
  • Helping the client to develop a calm and grounded state
  • Providing strategies so that the client can manage any future triggers
Phase 8: Reevaluation:
  • Assessing the client's progress and revisiting the traumatic memory
  • Deciding whether any further processing of the traumatic memory is needed
What is the Purpose of the Preparation and Stabilization Phase of EMDR Therapy?
Phase 2, known as the Preparation and Stabilization phase of EMDR, is essential because it:
  • Builds Resources: The EMDR therapist helps the client to identify and strengthen internal resources  and external resources as well adaptive memory networks to support the client in processing the trauma.
  • Helps to Build Coping Skills: The client learns various coping skills such as a breathing exercise, a container exercise, imagery, and grounding techniques to manage any intense emotions so the client can remain stable.
  • Establishes a Relaxing Place Imagery: The client creates a mental image of a relaxing or safe place that they can return to if the processing feels overwhelming or between EMDR sessions.
  • Increases Trust and Safety: This phase helps the client to develop trust and a sense of safety as well as enhance the therapeutic alliance between the client and therapist.
  • Provides Psychoeducation: The therapist educates the client about trauma, the processing of trauma and what to expect in EMDR therapy. 
  • Assesses the Client's Readiness to Start EMDR Processing: The therapist assesses the client's readiness to do EMDR therapy, determining if the client is sufficiently stabilized to proceed with the processing of trauma or if the client needs additional resources or more attention to stabilization. 
Why is the Preparation and Stabilization Phase Important in EMDR Therapy?
Without the necessary preparation and stabilization phase of EMDR, a client can become overwhelmed or retraumatized. 

They might be unable to stay in the present moment during the processing of the trauma or between sessions.

The Preparation and Stabilization Phase of EMDR Therapy

Preparation and stabilization ensures the client has the necessary internal stability and resources to safely process trauma using EMDR therapy.

This phase also helps to reduce the risk of negative experiences and to a better overall outcome for the client.

Clinical Vignette
The following clinical vignette, which is a composite of many different cases to protect confidentiality, illustrates the importance of the EMDR Preparation and Stabilization Phase:

Tom
As a US veteran who experienced significant trauma during the Iraq war, Tom suffered with Posttraumatic Stress Disorder, which is also known as PTSD (see my article: What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

After he heard about EMDR therapy, he had consultations with a few EMDR therapists in his area.

When the therapists spoke to Tom about the need for preparation and stabilization before processing his traumatic memories, he felt discouraged about the time this would take. Understandably, he wanted to get rid of his PTSD symptoms and he wanted it now

One of his friends, John, an unlicensed mental health intern, told Tom that he had read books about EMDR therapy.  Even though he had no formal training in EMDR, John felt he could help Tom to overcome his trauma, so he offered to do EMDR for Tom.

Aside from John not being a licensed mental health professional and having no training in doing EMDR, Tom jumped right into Phase 4 of EMDR (Desensitization) by skipping Phases 1-3.

Within minutes of processing the trauma, Tom went into a dissociated state and believed he was back in the battlefield. He had no awareness of the present moment with John. He began shaking, crying and cowering on the floor. It was obvious to John that Tom was being retraumatized.

Panicked and not knowing what else to do, John called 911 and the Emergency Medical Technicians were there with 10 minutes. They helped to stabilize and calm Tom so that he became aware of his current surroundings.  They also suggested he contact his primary care physician.

In addition, the EMTs told John that, as an unlicensed intern, it was unethical and dangerous for him to undertake doing any type of therapy.

A few weeks later, Tom's primary care doctor referred him to a licensed mental health professional who had advanced training in EMDR therapy.

Although the therapy took longer than Tom would have liked, by the time his therapist prepared him for EMDR processing, he felt safe enough with her and prepared to do EMDR.

The work was not quick or easy, but by the time Tom completed EMDR therapy, he was relieved of his trauma symptoms and he felt ready to move on with his life.

Conclusion
EMDR is a safe and effective therapy to process and overcome trauma when done responsibly by a licensed mental health professional who has advanced EMDR training.

This article seeks to explain the importance of the Preparation and Stabilization Phase of EMDR (also known as Phase 2).

The Preparation and Stabilization Phase of EMDR Therapy

All the phases in EMDR therapy are important, however, as illustrated in the clinical vignette above, it's important not to skip any of the phases, including Phase 2, because of the risk of  experiencing negative mental health consequences, including retraumatization.

Some clients who seek help in EMDR therapy are initially disappointed that they cannot immediately start processing their trauma on Day1 in therapy.

They might seek help from unlicensed and untrained people because they think it will be quicker, but many of these individuals become retraumatized and in a worse state than they were originally.

Only seek help in EMDR therapy with a licensed mental health professional who has advanced training in EMDR.

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

I work with individual adults and couples.

One of my specialties, as a trauma therapist, is helping clients to process and overcome trauma (see my article: What is a Trauma Therapist?).

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

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























Sunday, March 9, 2025

What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

The terms "trauma" and "PTSD" (posttraumatic stress disorder) are often used interchangeably, but there is a difference.

Understanding the Difference Between Trauma and PTSD

What is Trauma?
Trauma is an emotional response to an overwhelming event which could include shock trauma or developmental trauma .

Shock trauma is a one-time event like a robbery, an accident or the devastating effect of a hurricane, to name just a a few examples of shock trauma.

Developmental trauma is ongoing trauma experienced during childhood due to stressful and traumatic events including physical and emotional abuse, physical or emotional neglect, violence, and chronic instability.

The effects of trauma can include (but are not limited to):
  • Sadness
  • Anxiety
  • Depression
  • Avoidance of people, places and things related to the trauma
  • Anger
  • Dissociation
  • Confusion
  • Exhaustion
  • Numbing emotions and numbing yourself to your environment
  • Nightmares
Symptoms from shock trauma and developmental trauma can persist for weeks, months, years or a lifetime.  

When symptoms of trauma persist and evolve over time, these symptoms can develop into posttraumatic stress disorder (PTSD) if the symptoms of trauma go untreated.

What is Posttraumatic Stress Disorder (PTSD)?
Even though PTSD and trauma are closely related, they are not the same.

Understanding the Difference Between Trauma and PTSD

"Post" in posttraumatic stress disorder refers to the physical, emotional and psychological impact after trauma occurs.

Whereas trauma is a response to an overwhelming event, PTSD is a more serious mental health condition.

The effects. of PTSD are divided into four categories:
  • Re-experiencing symptoms: Flashbacks including emotional flashbacks, nightmares and frightening thoughts
  • Avoidance: Avoiding people, places and things related to the traumatic event(s) and avoiding related thoughts and feelings
  • Mood and Cognition: Problems remembering details of the trauma, a negative view of oneself and a lack of interest in hobbies or interactions that were pleasurable before
What is Trauma Therapy?
Trauma therapy includes a variety of therapy modalities including (but not limited to):
  • EMDR (Eye Movement Desensitization and Reprocessing) Therapy
  • AEDP (Accelerated Experiential Dynamic Psychotherapy)
Understanding Trauma Therapy
Why is It Important to Seek Help in Trauma Therapy?
Whether you're experiencing unresolved trauma or PTSD, symptoms often get worse over time so seeking help in trauma therapy sooner rather than later is recommended.

Understanding the Importance of Trauma Therapy

Both trauma and PTSD symptoms can carry over intergenerationally, which means that your unresolved trauma can have a significant impact on your children and future generations (see my articles: What is Intergenerational Trauma?).

Getting Help in Trauma Therapy
If you have been struggling with unresolved trauma, you could benefit from working with a trauma therapist (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

After you have worked through your trauma, you can free yourself from your traumatic history so you can live a more fulfilling life.

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

I have over 20 years of experience working 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.







Sunday, December 1, 2024

What is the Connection Between Anxiety and Depression?

Although anxiety and depression often look different, they're more closely connected than most people think (see my article: What is the Difference Between Fear and Anxiety?)

The Connection Between Anxiety and Depression

While anxiety is usually considered a high energy state, depression is usually perceived as a low energy state. 

Even though they appear to be different, it's not unusual for a person with depression to also experience anxiety, including panic attacks, and vice versa.

How Are Anxiety and Depression Connected?
Anxiety is more than just common worry and nervousness. 

Anxiety can cause debilitating fear beyond what most people might experience.  

People who experience debilitating anxiety usually know that many of their anxious thoughts aren't rational, but they might not be able to stop these thoughts. 

Over time, this constant sense of dread can lead to depression.

What is the Cycle Between Anxiety and Depression?
When people feel highly anxious and they're unable to overcome or control their anxious thoughts, they often feel they have failed, which can lead to depression (see my article: Looking Happy on the Outside But Feeling Broken on the Inside).

The typical cycle between anxiety and depression can include one or more of the following:
  • The chance of becoming depressed is much higher if you're already grappling with anxiety. About 50% of people who suffer with major depression also suffer from debilitating anxiety.
  • Anxiety and depression can trigger each other.
The Connection Between Anxiety and Depression

  • People who have unresolved trauma including PTSD (posttraumatic stress disorder) are prone to depression.
  • Many people have a genetic predisposition for anxiety and depression so that, without therapy, these conditions are passed on from one generation to the next. This includes intergenerational trauma.
What Are the Signs of a Combination of Anxiety and Depression?
Symptoms of anxiety and depression include (but are not limited to):
  • Persistent irrational fears and worries
  • Feeling helpless or powerless
  • Feeling hopeless
  • Difficulty falling and staying asleep
  • Feeling tired and irritable
The Connection Between Anxiety and Depression
  • Changes in eating habits including overeating or eating too little
  • Memory problems
  • Difficulty making decisions
  • Problems concentrating
  • Loss of interest in former activities or hobbies
  • Problems relaxing
  • Problems with being in the moment
  • Suffering with panic attacks
Getting Help in Therapy to Overcome Anxiety and Depression
There are many different types of therapy to overcome anxiety and depression.

If your anxiety and depression are rooted in unresolved trauma, Experiential Therapy is safer and more effective than regular talk therapy (see my article: Why is Experiential Therapy More Effective Than Talk Therapy to Overcome Trauma).

Getting Help in Therapy For Anxiety and Depression

Experiential Therapy includes therapy modalities that work due to the mind-body connection (see my article: Experiential Therapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Experiential therapy includes the following types of therapy:
  • EMDR (Eye Movement Desensitization and Reprocessing) Therapy
  • AEDP (Accelerated Experiential Dynamic Psychotherapy)
  • Parts Work including IFS (Internal Family Systems) and Ego States Therapy
Instead of struggling on your own, seek help from a licensed mental health professional who can help you overcome anxiety and depression so you can lead a more fulfilling life.

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

I work with individual adults and couples.

I have helped many clients to overcome anxiety and depression, including problems related to unresolved trauma (see my article: What is a Trauma Therapist?).

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

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