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:

• What is EMDR Therapy? 

• EMDR and the Brain: How Does EMDR Therapy Work?

• Overcoming Trauma With EMDR Therapy

• EMDR Therapy - When Traditional Psychotherapy Isn't Enough

• EMDR Therapy Helps to Achieve Emotional Breakthroughs

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.

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

• Arousal/Reactivity: Getting easily triggered, having difficulty falling or staying asleep, problems calming down, getting easily frightened and experiencing intense anger

• 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

• Somatic Experiencing (also known as Somatic Therapy)
  

• Clinical Hypnosis (also known as Hypnotherapy)

• Parts Work Therapy (also known as Internal Family Systems or IFS and Ego States 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.

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

• Somatic Experiencing
  

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Parts Work including IFS (Internal Family Systems) and Ego States Therapy

• Clinical Hypnosis (also known as Hypnotherapy)
  

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.

Healing Attachment Trauma in Trauma Therapy

Attachment trauma, which involves attachment wounds, can occur at any time of life. 

Healing Attachment Trauma in Trauma Therapy 

Attachment trauma often occurs when there are significant disruptions in close relationships.

Examples of Attachment Wounds Which Are Part of Attachment Trauma

Attachment wounds include but are not limited to:

• Early loss or abandonment in childhood

• Death of a parent in childhood

• Lack of affection during childhood

• Being separated during infancy or any time in childhood from parents or primary caregivers

• Physical or emotional abuse, childhood emotional neglect or sexual abuse

• A caregiver who is the source of overwhelming emotional distress for a child

• Infidelity in a relationship including extramarital affairs and financial infidelity

• A caregiver who has a substance abuse problem

• A caregiver with mental health issues or who is emotionally unstable

• A caregiver with an anxious, avoidant or disorganized attachment style

• A caregiver with poor emotional, physical or sexual boundaries

• A caregiver who treats a child like a friend (see my article: Why Your Child Can't Be Your Friend)

• A caregiver who is controlling to the point where a child has difficulty individuating (being their own person)

• Divorce in the family during childhood

• Intergenerational trauma

• Betrayal in a romantic relationship, family relationship or friendship

• Lack of support from a partner, spouse or significant other during a significant event or transition

What Are Signs and Symptoms of Attachment Trauma?

The signs and symptoms of attachment trauma include but are not limited to:

• A pattern of difficulties in relationships with friends, family members, significant others and work relationships

A Pattern of Difficulties in Relationships

• A tendency to experience humiliation, shame and/or guilt

• Hyper-reactivity to stress (see my article: Responding Instead of Reacting)

• Hyperarousal

• A tendency to be anxious, avoidant or disorganized in romantic relationships including healthy relationships (see my article: How Your Attachment Style Affects Your Relationship)

• Enmeshed relationships with family members, friends or significant others

• Poor interpersonal boundaries 

Mental Health and Substance Abuse Issues Related to Attachment Trauma

Mental health and substance abuse issues related to attachment trauma include but are not limited to:

• Depression

• Anxiety
  

• Trauma and Posttraumatic Stress Disorder (PTSD)

• Complex trauma

• Alcohol misuse

Attachment Trauma and Alcohol Misuse

• Drug misuse or addiction

• Compulsive gambling

• Overspending

• Overeating

• Out of control sexual behavior (OCSB)
  

Healing Attachment Trauma in Trauma Therapy

There are many different types of trauma therapy, which all come under the umbrella of experiential therapy including:

• Eye Movement Desensitization and Reprocessing (EMDR)

• Accelerated Experiential Dynamic Psychotherapy (AEDP)

• Parts Work Therapy including Ego States Therapy and Internal Family Systems Therapy

• Somatic Experiencing Therapy
  

How Will You Know When You're on the Path to Healing an Attachment Trauma?

There is no quick fix for healing attachment trauma, but Experiential Therapy, like EMDR, AEDP, Somatic Experiencing and Parts Work tend to be more effective than regular talk therapy for healing trauma (see my article: Why Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma).

Since you might not have experienced emotionally supportive relationships when you were a child, you will probably need time to develop a therapeutic rapport with your trauma therapist, so it's good to be aware of this as you start trauma therapy (see my article: Can You Learn to Trust Your Therapist If You Weren't Able to Trust Your Family?).

Signs that might be part of your path to healing an attachment trauma include but are not limited to:

• You're beginning to respond instead of react to stress

• You're starting to feel safer in your body

• You're getting better at setting boundaries

• You're becoming more aware of when you feel ashamed, guilty or humiliated when there's no objective reason to feel that way

• You're beginning to feel less anxious

• You're becoming aware that your depression is beginning to lift

• You're starting to make healthier choices in relationships

• You're feeling less anxious, avoidant or disorganized in a healthy relationship

• You're cutting back or you have stopped drinking excessively

• You're cutting back or you have stopped misusing drugs

• You're feeling less inclined to gamble compulsively

• You're less inclined to overspend

• You're less inclined to overeat during times of stress 

• You no longer feel comfortable in enmeshed relationships

• You're prioritizing self care

Getting Help in Trauma Therapy

If you're struggling with attachment trauma, you're not alone.

Healing Attachment Trauma in Trauma Therapy

A skilled trauma therapist can help you to overcome unresolved trauma.

Rather than struggling on your own, seek help from a licensed mental health professional who is a trauma therapist.

Trauma therapy can help you to free yourself from your traumatic past so you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist (see my article: What is a Trauma Therapist?).

I work with individual adults and couples.

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

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

How to Use "Anchors" to Cope With Trauma-Related Triggers - Part 2

In Part 1 of this topic, I defined anchors and how they are used to cope with psychological triggers based on a history of trauma. 

If you haven't read Part 1, I suggest you read that article first to understand the current article.

How to Use Anchors to Cope With Triggers

In the current article, I'm providing examples of how anchors can be used for trauma-related triggers as well as other situations where you might feel anxious, emotionally overwhelmed or stressed.

Anchors can be used between therapy sessions to help you cope with disturbing thoughts, feelings or memories that might come up for you. 

Note: If you're in therapy, always speak to your therapist first before you try using anchors or any other type of resource or coping skill.

Examples of How to Use Anchors to Cope

As mentioned in my prior article, anchors can be used any time you're experiencing distress. Your experience doesn't need to be trauma related.

Here are two examples of how to use external and internal anchors (the cases presented below are composites of many cases with different names and all identifying information removed to protect confidentiality):

    Panic Attacks

Panic attacks bring intense fear and physical reactions, including symptoms of depersonalization (a condition where the person feels disconnected from their body, emotions and environment) where there is no real danger or apparent cause. Panic attacks are frightening. Some people feel they are losing control or even dying when they have a panic attack (see my article: Tips For Coping With Panic Attacks).

    Using An External Anchor

    John

John can usually sense when he's about to have a panic attack because he starts to feel disconnected from his body. 

His panic attacks have been much less frequent since he started working with an Experiential Therapist.  However, he still gets them from time to time, so his therapist recommended that he carry a small stone in his pocket which is meaningful to him because he found the stone when he was a child looking for an unusual stone with his grandfather. 

When he feels the onset of a panic attack, John holds the stone in his hand and it brings back happy memories of feeling safe and secure with his grandfather, and it helps to ground and calm him. 

Journaling Between Therapy Sessions

Once he is calm again, he writes about his experience in his journal to put words to his experience and to be able to discuss what happened at his next session with his psychotherapist (see my article: The Benefits of Journaling Between Therapy Sessions).

    Using an Internal Anchor

    Alice

Since she started EMDR Therapy, Alice rarely has panic attacks anymore. 

Prior to EMDR therapy, she would have a panic attack whenever she visited her parents. She would feel like she was a helpless and hopeless child again (see my article: Feeling Like a Helpless Child Again During Family Visits).

However, even though she is coping better with triggers involved with being around her parents, there are still times she feels like she regresses when her parents criticize her.

Her therapist taught her to use an internal anchor based on the Somatic Experiencing concept of pendulation, which is also called oscillation in Sensorimotor Psychotherapy (see my article: Coping with Emotional Distress By Using the Somatic Experiencing Technique of Pendulation).

Pendulation is similar to Babette Rothschild's concept of Dual Awareness which she writes about in her book, The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment.

Similar to a swinging pendulum or watching a pendulum on a grandfather clock, pendulation involves shifting your awareness back and forth between a sense of safety in one part of your body to the emotional activation in another part of your body.

In Alice's case, she learned in therapy how to use her felt sense in her body to identify a place of safety. Most of the time, her place of safety is in her heart area.  She also learned to identify areas in her body of anxious activation which usually involves her stomach.

Pendulation For Coping

When she is on the verge of having a panic attack or she is actually having a panic attack, Alice senses into her place of safety, her heart, and she senses the feeling of safety. Her heart area is her internal anchor. 

Then she senses briefly into the area where she feels anxious, her stomach, and she shifts her awareness back to her chest, her place of safety. She continues to pendulate her awareness back and forth between her place of safety and her place of anxious activation until she is able to calm herself. 

Then she talks about what triggered her in her next therapy session so she and her therapist can work on this issue.

Other Examples of When to Use Anchors:

As previously mentioned, you can also use anchors for temporary relief when you feel 

• Anxious
• Stressed
• Emotionally overwhelmed or flooded 
• Other types of emotional distress

Internal Anchors vs External Anchors

The external anchors tend to be easier for most people to use because they are meaningful concrete objects that you can carry with you: a stone, a shell, a picture of a relaxing place, and so on.

The internal anchors take practice to learn. If you're adapt at sensing emotions in your body, you can learn to detect where you feel safe in your body and where you feel activated.  If not, you will need to practice sensing emotions and activation in your body with a therapist who works in an embodied/experiential way.

Sensing emotions and activation in your body is one of the skills Experiential Therapists help clients to develop. It's a very useful skill because you can use it on your own between sessions or whenever you need it. 

If you're trying this on your own, you might want to start with an external anchor, especially if you haven't yet developed the felt sense skill.

Getting Help in Therapy

If you have been struggling on your own, you could benefit from seeking help from an Experiential Therapist.

Experiential Therapy is an umbrella term for mind-body oriented therapy modalities like:

• EMDR (Eye Movement Desensitization and Reprocessing) therapy
• AEDP (Accelerated Experiential Dynamic Psychotherapy)
• Somatic Experiencing
• Hypnotherapy
• Emotionally Focused Therapy, among others

Getting Help in Experiential Therapy

A skilled Experiential Therapist can help you overcome obstacles that keep you from living a  meaningful and more fulfilling life.

About Me

I am a licensed New York City experiential psychotherapist, hypnotherapist, EMDR, AEDP, Emotionally Focused Therapist for couples, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples (see my article: What is a Trauma Therapist?).

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

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

 

Getting Help in Therapy For Anxiety

It's not unusual to experience stress during the normal course of our lives. Normal stress occurs in every day life and can actually help us to be more effective and productive at times. However, compared to mild stress, an anxiety disorder such as generalized anxiety, panic disorder, obsessive compulsive disorder, phobias or post-traumatic stress disorder can cause us to feel significant and debilitating distress. Without help, these anxiety disorders can interfere with our relationships and our every day activities (see my articles: Self Help Tips For Coping With Anxiety and What is the Difference Between Fear and Anxiety?).

Getting Help in Therapy for Anxiety

Common Forms of Anxiety

The following list includes some of the most common forms of anxiety:

• Generalized anxiety disorder: Generalized anxiety disorder occurs when a person worries excessively and has a feeling of foreboding and dread that bad things are going to happen. He or she might be worrying excessively about issues like money, health, or his or her relationship. These worries are often not related to a particular circumstance in the present, and they are recurring and persistent. These worries are also intense enough to interfere with a person's relationships and daily activities. He or she might have problems concentrating or sleeping. Generalized anxiety might affect appetite. These persistent worries might interfere with a person's ability to communicate or relate to others because he or she is so consumed with anxiety.

• Panic disorder: People with panic disorder often feel a sudden feeling of dread. Their heart might start racing. They might also start sweating profusely. The actual panic might only last a few minutes, but the person with panic disorder often worries about when the next panic will occur. Often, people with panic disorder start to avoid the situations, places or people that they associate with their panic. Without treatment, the people, places and situations that they avoid can increase until, in severe cases, they are too afraid to go outside (see my article: Tips For Coping With Panic Disorder).

• Phobias: Phobias are irrational fears of various things: fear of heights, fear of animals, fear of being in enclosed places, fear of flying, and so on. Similar to people with panic disorder, people who suffer with phobias often try to avoid the situations and things that they fear. This is not always possible, so when they are forced to deal with their phobia, their phobic reaction often turns into panic (see my article: What Are Phobias?).

• Obsessive-compulsive disorder (OCD): People who suffer with OCD engage in certain obsessive thoughts or compulsive activities. These obsessive thoughts and compulsive activities are unwanted, but the person with OCD feels compelled to do them when they feel anxious. For many people, these thoughts or activities become ritualized, so that they might have to do things in a certain order or a certain way or a certain number of times. OCD can also involve an excessive fear of germs or contamination, excessive checking (e.g., checking that the door is locked several times in a row or checking many times in a row that the gas is turned off, etc). OCD can also involve excessive hand washing.

• Post-traumatic stress disorder (PTSD): People who experience overwhelming trauma, possibly due to a natural disaster, a crime, a combat situation, an accident or other emotionally overwhelming events, can develop PTSD. We often associate PTSD with soldiers in war. Originally, PTSD during combat was called "shell shock." However, we now know that PTSD can develop outside of combat situations. People who develop PTSD might not experience any symptoms for months or even years after the event. Anything that reminds them of the traumatic event might cause them to feel like they're reliving the original traumatic event. They might feel panic or intense fear whenever they are confronted with reminders. For instance, if someone gets into a severe car accident, after he recovers from the accident, he might be too afraid to drive again. Or, even if he is able to get behind the wheel again, he might experience feelings of terror and dread if he has to drive to the same place where the accident occurred. Without help, PTSD can be a severe and debilitating disorder that can seriously affect a person's life as he or she relives the incident emotionally and tries to avoid anything that brings up these feelings again (see my article: Postttraumatic Growth).

Getting Help for Anxiety Disorders:
Anxiety disorders are not the same as normal stress and every day anxiety. Left untreated, anxiety disorders often have serious adverse effects on people's lives. It's not unusual for a fear that begins about a particular situation or event to generalize to other areas, causing tremendous disruption to a person's life.

For instance, if a person has an untreated fear of being in an elevator because it is an enclosed space, this fear often generalizes to fear of being on a train or plane or in a small room. Since we now know more about the mind-body connection, we also know that untreated anxiety disorders can often lead to medical problems. We also know that some people with anxiety disorders turn to drinking excessively, abusing drugs, gambling, sexual addiction, and other addictions as a maladaptive way of coping.

How I Treat Anxiety Disorders:
As a licensed psychotherapist in New York City, I use a variety of psychotherapeutic treatment modalities to treat anxiety disorders, including psychodynamic psychotherapy, EMDR (Eye Movement Desensitization and Reprocessing), clinical hypnosis (also known as hypnotherapy), Somatic Experiencing, Ego States work (also known as Parts Work) and AEDP.

Each therapy is tailored to the needs of the individual client.

After the initial evaluation, I work collaboratively with the client to come up with the treatment plan that is best for him/her/them.

If you think you might be suffering with an anxiety, it's important to know that you're not alone and you can get help from a licensed mental health professional.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who has helped many clients to overcome anxiety disorders (see my article: What is a Trauma Therapist?).

I work with individual adults and couples.

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

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