Compulsive Gambling and "March Madness"

The NCAA Division Basketball Tournament, also known as "March Madness," is just around the corner. 

March Madness is one of the most challenging times for compulsive gamblers. Sports gambling has become a very popular pass time, especially among college students. Online gambling is a big business. 

Compulsive Gambling and March Madness

Online gambling brought in over $5 billion from gamblers, some as young as high school age. High school and college students, who are very savvy about using these online sites, are getting caught up in gambling, and many of them are becoming compulsive gamblers.

You might think that completing a tournament bracket for $5 or $10 is harmless, but for some people, it's the beginning of compulsive gambling. Just like some people can have a couple of drinks and not become an alcoholic, some people can gamble and not become a compulsive gambler. But for many people, it's just the beginning of a downward spiral on a slippery slope.

What Are Some of the Warning Signs of Compulsive Gambling?

• Preoccupation with gambling: thinking about it frequently, talking about it a lot, checking the stats often

• Feeling a "high" or "rush" before placing a bet

• A need to bet increasing amounts of money to get that same "high" or "rush"

• Repeated attempts to stop that are unsuccessful

• A need to continue gambling when you're winning

• A need to return to gambling to chase losses

• Feeling irritable and uncomfortable when you try to stop

• Jeopardizing family relationships or your job due to gambling activities

• Borrowing money from family and friends due to gambling activities

• Using gambling activities as a maladaptive coping strategy to deal with stress or uncomfortable feelings or situations

If you have one or more of the above warning signs and symptoms, you have a compulsive gambling problem and you need help. Just like any other addictive or compulsive behavior, compulsive gambling is a progressive disorder that usually gets worse over time.

For more information about compulsive gambling, go to: http://www.gamblinghelp.org

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

I have helped many clients to overcome their addictive and compulsive behavior so they can lead fulfilling lives.

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.

Trauma Therapy: Why Establishing Safety For the Client Is So Important Before Processing Trauma - Part 1

As a psychotherapist who specializes in helping clients to overcome traumatic experiences, I see many clients in my private practice in New York City who come for trauma therapy, including EMDR therapy, Somatic Experiencing, and clinical hypnosis.  Early on in the therapy process, I provide clients with psychoeducation about why establishing safety for the client is so important before traumatic memories are  processed in trauma, which is the topic of this article (see my article: Why is Experiential Psychotherapy More Effective Than Talk Therapy Alone to Overcome Trauma? and How EMDR Therapy Works: EMDR and the Brain).

Why Establishing Safety For the Client is So Important Before Processing Trauma

How is "Establishing Safety" Defined in Terms of Trauma Therapy?
Let's start by defining what safety means with regard to trauma therapy.

It's the psychotherapist's responsibility to create a therapeutic environment that helps to establish safety in therapy (see my article about the therapeutic "holding environment" and a more detailed explanation below).  There can be many issues that get in the way of establishing a holding environment, including obstacles in the client's current life and traumatic experiences from the past (see more detailed discussion below).

Safety, which is a relative term that recognizes that there are degrees of feeling safe and the client needs to feel safe enough.  This is an important concept in any type of therapy, but it's especially important in trauma therapy because trauma therapy is experiential and without a sense of safety, the client can be retraumatized (see my article: Developing a Sense of Safety and Trust With Your Psychotherapist).

The following is a list of some of the most relevant issues with regard to establishing safety in trauma therapy with a recognition that, due to the fact this is a blog article and not a journal article or a book, this list might not include all issues:

• The Client Needs to Feel Relatively Comfortable with the Psychotherapist:  In the most basic terms, the client needs to feel a rapport with the therapist and that there is a therapeutic alliance.  The therapeutic alliance between the client and psychotherapist usually develops over time as the client senses that s/he can trust the therapist.  Many clients get a sense of whether they feel safe with a therapist during an initial consultation, even though the therapeutic alliance hasn't developed yet.  The client often intuits whether s/he will get along with the psychotherapist and that the therapist is someone that s/he can work with on whatever the presenting problem might be.  In that case, there is enough of a sense of comfort to at least set up the next appointment.  Assuming that the therapist has an expertise in the area that the client wants to work on and that she feels she can be helpful to the client, they can proceed from there.  If not, it's important for the client and the psychotherapist to recognize that not every client-therapist dyad is a good match.  Every therapist is not for every client, so it's important to recognize that, regardless of the client's motivation and the therapist's skills, sometimes a particular client-therapist dyad doesn't work (see my article: How a Psychotherapist Creates a Holding Environment in Psychotherapy, The Therapist's Empathic Attunement Can Be Emotionally Reparative to the Client, and What is the Corrective Emotional Experience in Therapy?).

• The Client is Not Involved in an Ongoing Crisis or Creating New Crises in His or Her Life:  It's not unusual for clients who have a history of unresolved trauma to be involved in an ongoing crisis or creating new crises in his or her life--often without even realizing.  This topic warrants its own article and it will be discussed further in my next article.  At this point, suffice it to say the processing aspect of prior trauma cannot be done when the client is still in crisis and needs help with crisis management .  The need for crisis management must take priority over processing trauma that is based in the past.  Likewise, if the client is creating new crises in his or her life, s/he needs to recognize this dynamic so s/he can change it before any processing of historical trauma can be done.  Once the client is no longer involved with a current crisis and s/he is no longer creating new crises or emotional drama, the psychotherapist can assist the client to prepare for the processing of trauma (see my articles: Do You Have a Pattern of Creating Chaos in Your Life?, How to Stop Creating Chaos in Your Life and How a Crisis Can Bring About Positive Change in Your Life).

• The Client is Not Involved in Excessive Drinking, Drug Abuse, Gambling or Other Compulsive Mood-Altering Behavior:  If a client is engaged in mood altering behavior, whether it involves alcohol, drugs, compulsive gambling, compulsive overspending, sexual addiction or compulsive viewing of pornography, including Internet pornography an eating disorder or other compulsive behavior, s/he isn't ready for processing traumatic memories from the past because s/he hasn't developed the necessary coping skills for trauma therapy.  The psychotherapist would need to assist the client to be stable enough without mood-altering behavior in order to delve into traumatic memories.  If not, the client's mood altering behavior will continue or increase because s/he won't be able to cope with delving into the trauma.  So, the mood-altering behavior must be addressed first, and there would need to be a period of "sobriety" before trauma processing can begin.  Without a period of six months or so of "sobriety," the client is likely to relapse into compulsive behavior.  So, as a first step, this might mean that, if the psychotherapist has a background in helping clients to overcome mood-altering behavior, the therapist will assess the client's true motivation.  Specifically, many clients say they want to stop engaging in mood-altering behavior, but they're not ready.  Since there is always some ambivalence, the therapist can help the client to recognize the ambivalence and, if the client is motivated enough, try to help the client to stop the compulsive behavior or refer the client to a higher level of care, like a detox, rehab or residential treatment.

• The Trauma Therapist Helps the Client to Prepare For Trauma Processing in Therapy: Unlike regular talk therapy, trauma therapy is experiential, as mentioned above.  Whereas in talk therapy, the client and therapist talk about the trauma, in experiential therapy, they revisit traumatic memories and the experience is more immediate.  In order for the client not to be retraumatized by revisiting traumatic experiences from the past, the therapist needs to help the client to prepare for trauma processing.  The preparation phase, which is also called the resourcing phase, is crucial to trauma therapy and no responsible trauma therapist will proceed without first going through this phase of treatment.  To proceed without the preparation phase would be clinically irresponsible and unethical--no matter how much the client wants to jump right into processing the trauma.  Depending upon the individual client's coping skills, the preparation phase can be as little as a few sessions or, where the client has little in the way of coping skills, the preparation phase can be several months or more.  As a result, the therapist needs to assess the client's coping skills first.  At the very least, the therapist needs to assess if the client is able to maintain dual awareness when discussing the trauma.  In other words, when discussing the trauma, the client remains aware that s/he is in the here-and-now as well as remembering a memory from the past at the same time.  If the client gets so immersed in the memory that s/he forgets where s/he is in the here-and-now, the therapist cannot proceed with trauma processing before helping the client to develop the ability to maintain dual awareness--however long that takes.  An example of a client who cannot maintain dual awareness would be a client who loses all sense of the present moment.  S/he dissociates to such a degree that s/he completely forgets that s/he is in the therapist's office and actually relives the trauma as if it were happening now and not in the past.  This is an example of a retraumatizing experience, as opposed to a healing experience.  Assuming that the client is able to maintain dual awareness, the preparation, at a minimum, would include the client learning ways to de-escalate and cope with uncomfortable emotions during the session and between sessions (see my article: Developing Coping Strategies in Therapy Before Processing Trauma, Empowering Clients in Therapy, Trauma Therapy: Using the Container Exercise Between Therapy Sessions, Trauma Therapy: Using Grounding Techniques Between Therapy Sessions, Safe or Relaxing Place Meditation

• The Client Keeps Appointments and Comes to Regular Weekly Sessions: Due to the intensity of processing traumatic memories in therapy and the psychotherapist's need to continually assess the client's emotional state during trauma processing, clients must be able to come to weekly sessions.  This is an issue that often comes up during initial consultations when the client raises the issue of coming every other week or monthly or randomly.  Between therapy sessions, traumatic memories continue to be processed on an unconscious level, so the trauma processing continues even when the client is not in session. This often means that new material in the form of new memories or current emotionally triggering experiences can come up between sessions where the client needs the therapist's help.  Even the space of one week can be a long time for certain clients who have problems containing emotions that come up between sessions--even though they have gone through the preparation phase of therapy.  Progress in therapy, especially trauma therapy, isn't linear.  Sometimes, the client feels worse before s/he feels better, so weekly sessions are important for the client to maintain emotional stability.  If money is an issue, the client can inquire as to whether the therapist has a sliding scale or, if not, if the therapist can make a referral to a psychotherapy center where sliding scale therapy is available.

• The Client is in Control During Trauma Processing:  Even the best psychological assessment cannot always predict when a client might need a break during trauma processing.  This is why it's important for the client to tell the therapist when s/he might need to take a break during the processing of a traumatic memory.  In many cases, a trauma therapist will be able recognize when a client is feeling overwhelmed and help the client to de-escalate before going back into processing the trauma or to debriefing.  But some clients have gotten so good at pretending that they are okay because they feel ashamed of needing help that they override their own internal signals that they need a break from the processing.  They need to learn in therapy how to honor internal signals that they need to de-escalate and feel comfortable enough to tell the therapist.  This doesn't mean that the client will necessarily need to stop when s/he is somewhat uncomfortable if s/he is within his or her window of tolerance.  It also doesn't mean that an inexperienced therapist, who has her own discomfort with seeing clients feeling tolerably uncomfortable, should stop the processing.  If the therapist senses that the client is overriding internal signals to stop, she can ask the client if it's okay to continue processing.  Similarly, clients, who are accustomed to people pleasing, need to learn to overcome their fantasy that they are pleasing the therapist by continuing to process a traumatic memory even though they feel overwhelmed.  Based on the issues that are being presented in this section, it's obvious that the client being in control of trauma processing can be complicated (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

• The Client Uses Coping Skills Between Trauma Therapy Sessions:  It's one thing to learn coping skills and it's another to actually use them between trauma therapy sessions.  Since, as mentioned above, clients continue to process traumatic memories on an unconscious level between sessions, it's not unusual for the client to have thoughts or dreams about traumatic memories between sessions.  Or, the client can get triggered by something in his or her current life between therapy sessions.  This is why the preparation phase of trauma therapy is so crucial.  If, for example, a highly traumatized client doesn't follow the therapist's recommendation to practice de-escalation techniques between sessions in order to stay calm, s/he might discover that s/he is unable to contain his or her experiences between sessions.  For clients who practice coping techniques between sessions, they are usually more likely to either avoid having experiences which are intolerable or mitigate such experiences (see my article: The Benefit of Journal Writing Between Therapy Sessions).

As I mentioned above, establishing safety in trauma therapy (or in any therapy) is a big topic, and a blog article cannot address every possible issue (see my article: Trauma Therapy: Why Establishing Safety For the Client is So Important Before Processing Trauma - Part 2).

How to Start Trauma Therapy

An exploration as to whether you want to begin trauma therapy (or any therapy) and work with a particular therapist begins with an initial consultation in person.  

As mentioned earlier, it's important to your emotional well-being to get a sense as to whether or not you feel comfortable with a particular therapist.  

When clients come to see me for an initial consultation, I tell them that the consultation is for them to provide me with an overview of the problem, ask questions about the process, my skills and experience, to see whether they feel comfortable enough to come back for another session and for me to assess if they appear to be ready to start therapy and if I have the particular expertise that they need.

Obviously, this is a very tall order for one session, and their comfort level and my assessment will continue, and it will be ongoing if they come back for therapy sessions.  As mentioned before, just like any relationship, it takes time for most clients and their therapists to develop a therapeutic alliance--assuming the therapist-client dyad works well enough for the client to want to return beyond the initial consultation.

It's also important to realize that although psychotherapists might approach the initial consultation in different ways, most therapists recognize that being in therapy involves participating in therapy while clients learn how to be clients in therapy at the same time.  In other words, you don't have to know all the answers before you start.  You learn as you go along with the therapist's help.

Choosing a psychotherapist that you feel comfortable with is important, and you might want to see more than one therapist before you make a decision (see my article: How to Choose a Psychotherapist).

Getting Help in Therapy

Unresolved trauma usually impacts issues in your current life, no matter how long ago the trauma occurred.  Whether the impact is in your personal life, where core issues are most likely to come up, or in your work life or both, unresolved trauma often creates current problems (see my article: Reacting to Your Current Life Based on Your Traumatic Past).

Rather than struggling on your own, you owe it to yourself to get help from an experienced trauma therapist.

If you're already in therapy and your therapist isn't trained in trauma therapy, like EMDR therapy, Somatic Experiencing or clinical hypnosis, you can explore the possibility of adjunctive trauma therapy with a therapist who is trained in trauma therapy.  

Adjunctive therapy means that you continue to see your existing psychotherapist and see a trauma therapist for adjunctive therapy.  It's important to discuss this with your primary therapist first before you begin adjunctive therapy with a trauma therapist.  Also, in most cases, the primary therapist and the adjunctive therapist will ask for your written consent to be able to confer with each other (see my article: What is Adjunctive EMDR Therapy?).

Taking the first step, which is contacting a trauma therapist by phone or email, is often the hardest step.  

Once you have worked through your unresolved trauma, you have an opportunity to let go of your traumatic history so you can lead a more fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who provides integrative psychotherapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy)

As a trauma therapist, I work with individual adults and couples, and I have helped many clients to overcome their traumatic experiences.

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.

Making Changes: Overcoming the "Inner Voice of Negative Prediction"

When you're trying to make positive changes in your life, whether it's to improve your diet, lose weight, become a successful nonsmoker, return to school to complete your education or whatever changes you might want to make, very often, one of the main obstacles is "the inner voice of negative prediction."

Making Changes: Overcoming the "Inner Voice of Negative Prediction"

What is the "Inner Voice of Negative Prediction"
"The inner voice of negative prediction" is that internal voice that tells you that you can't do it and says things like, "If you try to improve your diet, you're going to fail just the way you have every other time so you might as well not even try" or if you want to become a successful nonsmoker, it might say, "If you give up cigarettes, you're going to become extremely anxious, overeat and get fat, so don't do it."

I believe that the term "inner voice of negative prediction" was originally coined by Al Pesso in his psychomotor psychotherapy theory (http://www.pbsp.com ).

Often, this internal negative voice has been a part of your inner world for a long time and it becomes an obstacle in whatever positive changes you try to make. But instead of berating that inner voice, it's often better to find out what that inner voice wants. Maybe that negative or insecure part needs reassurance in much the same way that an insecure child might need reassurance.

Getting Help:  How Clinical Hypnosis Can Help
When clients come to me to try to make changes in their lives and their "inner voice of negative prediction" starts getting in the way of making those changes, I often find it helpful to address the needs of that part in hypnosis.

Hypnosis is a powerful tool for making positive changes. Through hypnosis, my clients get to sense that part of themselves that is holding them back and to soothe that part.

Overcome the "Inner Voice of Negative Prediction"

Very often, when my clients see themselves in their minds' eye in a hypnotic state taking care of that insecure part, the part calms down, just as an insecure child would, and stops making "negative predictions."

When that inner part calms down, then it's usually possible to make whatever changes you want to make in your life.

If you want to make changes in your life, you could benefit from hypnosis.

About Me:
I am a licensed NYC psychotherapist, hypnotherapist and EMDR therapist. I have helped many clients to make positive changes in their lives.

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 a Meaningful Life

Book:  Victor Frankl's Man's Search for Meaning
I'm rereading the book, Man's Search for Meaning, by Viktor E. Frankl. Frankl was a psychoanalyst and holocaust survivor. He developed the existential form of psychotherapy called logotherapy. The book recounts his experiences and the experiences of other inmates in Nazi concentration camps.

Man's Search for Meaning by Victor Frankl

A Quest for Meaning

The basic premise of the book and of logotherapy is that life is primarily a quest for meaning, and the primary task for one's life is to seek out what is meaningful. Frankl saw three potential areas where a person could find meaning in his or her life: work (doing something significant, whether it is paid work or voluntary work), love (caring for someone else), and courage during difficult times. 

He posits that suffering in itself is meaningless. What gives it meaning is how we respond to it. According to Frankl, in many cases, we cannot always control what happens to us. But we can control how we deal with it.

In his experiences as a concentration camp inmate, he witnessed that the inmates most likely to survive were those who had the inner resources and found meaning in their lives, despite the cruel and inhumane circumstances. 

He recounts many examples of people who willed themselves to live, against formidable odds, by keeping an internal focus on seeing loved ones again or thoughts of resuming work that was meaningful to them.

Frankl thought of his wife, not knowing if she was alive or dead, picturing her face and imagining what she would say to him. 

Even though he was stripped of all possessions and nearly starved to death, he held onto his conviction that all material possessions and comfort was taken from him, but he maintained the freedom of his mind, his thoughts, and the inherent value of life itself.

One of the most prevalent problems of our times is that people find life meaningless. Generally, as a society, we have more leisure time than our ancestors ever dreamed possible. Yet, so many people don't know what to do with their time, which isn't meaningful to them. They're bored and fill their time with meaningless activities or engage in addictions.

One of the biggest triggers for alcohol and drug abuse is boredom and a feeling that life is meaningless. The alcohol or drugs (or compulsive gambling, overspending, or sexual addiction) gives a temporary reprieve from boredom and a sense of meaninglessness. 

In many cases, it temporarily obliterates the feelings of hollowness. But once the feelings of being drunk or high wear off, at best, the person with substance abuse problems is back where he or she started. At worst, the substances themselves add to their misery in terms of increasing their depressed mood, causing misery for their loved ones, and financial ruin.

It's no wonder that so many people with substance abuse problems find hope and inspiration in 12 Step meetings like A.A. or N.A. For many of them, possibly for the first time, they see the possibility of leading meaningful lives and a purpose greater than themselves, whether they call this purpose "God," "higher power," or a deep commitment to their lives and the lives of their loved ones. This can be a revelatory experience.

Everyday we're faced with obstacles, sometimes small, sometimes life threatening. How we respond to those circumstances and the meaning we find, whether it's spiritual or not, can make the difference in how we transcend our difficulties.

Transcending Our Difficulties with a Sense of Meaning and Purpose

Transcending our difficulties with a sense of meaning and purpose doesn't necessarily mean we're going to be "happy." 

In Western culture, especially in the US, "the pursuit of happiness" is is a much sought after goal--so much so that when people aren't feeling happy, many of them think there's something wrong with them. But happiness can be fleeting and transitory. We can't always feel happy. But we can try to find meaning, as Frankl did, in even the most dire circumstances.

One of the exercises that Frankl gives his clients is to imagine themselves at the end of their lives talking about what was most meaningful in their lives. Even clients who were very depressed found meaningful aspects of their lives. It also gave them an opportunity to think about how short life is and what changes they might want to make so their life would be more meaningful.

At times, we might need help to overcome the emotional obstacles that keep us from finding meaning and purpose in our lives. 

A licensed psychotherapist, who has experience helping clients to transcend trauma and emotional difficulties can help clients to find or reconnect with purpose in their lives. Viktor Frankl was an exceptional psychoanalyst and human being. He seemed to have very strong internal resources that helped him survive and succeed. Viktor Frankl points the way to what's possible and to what we can aspire.

About Me

I am a licensed NYC psychotherapist. I work with individuals and couples to help them overcome emotional obstacles so they can lead meaningful lives.

I provide EMDR, clinical hypnosis, Somatic Experiencing as well as psychodynamic psychotherapy.

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.

photo credit: Pickersgill Reef via photopin cc

Overcoming Workaholism

What is Workaholism?
Workaholism is a powerful obsession. It occurs when a people don't have a healthy balance between work and the other areas of their lives: their relationships, family, friends, leisure time, and social activities. 

Overcoming Workaholism

People who work excessively derive their sense of self and feel good about themselves primarily through work activities. They use work to derive a sense of approval, respect and success. They might spend 60-70 hours or more per week working. They have a hard time slowing down and relaxing. 

They often feel irritable and uncomfortable when they're not working. For some workaholics, even if they're not actually working, they're thinking about work most of the time. It's their main preoccupation. Often, relationships with their partners, children, and family suffer.

We Encourage Workaholism in Our Society
In our society, we often, unwittingly, encourage workaholism to the detriment of the individuals involved. Workaholics are often rewarded with praise, status, and money. Rather than encouraging people to have a healthy balance between work and personal life, many work settings take a narrow view only in terms of how their employees add to the bottom line.

But, over time, workaholism takes its toll on the individual's health and his or her relationships. Often, over time, when workaholics can't relax, workaholism will also take a toll on their work life because an extreme workaholic will eventually suffer from "burn out."

Martin (a composite of several cases with all identifying information changed):
When Martin came to see me for his first session, I found him pacing up and down in my reception area, on his cell phone and looking at his Blackberry at the same time. He sat at the edge of my couch and he had difficulty settling down. I encouraged Martin to take a few deep breaths before we began talking because he seemed so agitated. After a few minutes, he was able to calm down somewhat, but he kept glancing nervously at his Blackberry. I could tell that he was annoyed when I asked him to turn off his phone and put away the Blackberry.

Martin was referred to me by his coach, who had been trying to help him achieve more balance in his life. According to Martin's coach, Martin, who had been a successful salesman, was suffering from burn out. His burn out was evident in his insomnia, exhaustion, poor diet, problems at home with his wife, who felt neglected by him and, ultimately, in his sales performance.

Martin's personal life and ability to take care of himself (e.g., learn to relax, get to bed at a reasonable hour, eat nutritious meals, and so on) had been declining for some time. It wasn't until his boss spoke to Martin about his declining work performance that Martin sought out an executive coach. He found it intolerable that his work performance was slipping.

At first, he thought that he could just whip himself back into shape and his sales numbers would soar again, as they usually did. But Martin was running on empty, and if he couldn't whip himself back to where he had been before, he didn't know what to do. He thought that if he hired an executive coach, he could get back to his peak performance. But his coach recognized early on that Martin had more serious emotional problems that were beyond coaching. So, he referred Marin to me.

Initially, Martin had difficulty seeing that his life was completely out of balance. He had worked compulsively for so long that it seemed normal to him to work 80-100 hours a week. Even when he was not physically working, he was thinking obsessively about work. His wife was completely fed up with Martin's workaholism, and when she threatened to divorce him, Martin began to finally admit that he had a problem that could not be solved by beating himself up constantly.

Admitting that he had a serious problem was the first step in Martin's recovery from workaholism. But learning to actually let go of his obsessive need to work was a big challenge for him. As a result, work in therapy went slowly at first. But, gradually, over time, he began to understand that his obsessive need to work was just like any other addictive behavior.

Since he didn't know how to relax, at first, he had to learn to schedule in leisure time into his week. With some difficulty, he learned to meditate in our therapy sessions and he started meditating once a day in the mornings. He and his wife also scheduled a date night once a week. During their date night, Martin learned to turn off his phone and focus on his wife. Gradually, he learned to incorporate other leisure activities in his life.

As Martin learned to relax and take better care of himself, his work performance also improved substantially, even though he was spending a lot less time working. Because he was taking care of himself, he approached his work with much more vitality and creativity. His boss noticed and commended him for his improved performance. But Martin had to learn not to allow that praise to trigger him into starting to work obsessively again.

As we explored Martin's family background, it became evident that praise and admiration were strong triggers that drove Martin's workaholism. His father, who was usually emotionally distant, was a workaholic himself. He only praised Martin and showed any affection for him when Martin achieved perfect grades (all A's). His father could not tolerate anything less than perfection. So, as a child, Martin pushed himself harder and harder to gain his father's praise, which meant everything to him. Martin's relentless need to achieve as a child was the beginning of his workaholism.

Part of Martin's work in therapy was to grieve that he didn't have a father who could express affection to him for Martin just being himself. Martin grew up feeling that he was "not enough" and had to excel at whatever he did, especially schoolwork, in order for his father to love him. He only felt as good as his current grades. He was very competitive with his fellow students and felt that he always had to be the best.

The type of work that Martin chose was also conducive to his workaholic style. He was paid by commission and his salary structure fueled his obsession to earn more and more money. But no matter how much he earned, he only felt gratified for a while before he felt the need to earn more. Prior to coming to therapy, Martin was caught in a vicious cycle of greed. As an adult, instead of measuring himself by his grades, he now measured himself by the amount of money that he earned. In many ways, this was worse than performing for grades because his earning potential was nearly limitless if he brought in the business. The sales numbers for all the sales people were also always available for Martin and his colleagues to see, so that also fueled Martin's obsession to work compulsively.

Martin's therapy was not short term. After he was engaged in therapy and learned to be curious about his problems, he was able to delve deeper into the roots of his compulsively. It wasn't easy for him, but Martin came to his sessions regularly. Over time, he learned to have more balance in his life and he found his life much more fulfilling.

Workaholism Also Shows Up at Home
Workaholism is not just about what people do in their careers. It can also show up at home: The man or woman who cleans obsessively at home is also a workaholic. It's the same obsessive need that drives the person at work.

If you're a workaholic, learning to slow down is often a challenge. Learning not to treat yourself like you're a human being and not a production machine can also be challenging. But the benefits to your overall well being and your relationships cannot be overestimated.

Getting Help in Therapy

People who are workaholics often cannot learn to stop working obsessively on their own.

If you think you're a workaholic, ask for support from your loved ones and get help from a licensed psychotherapist.

About Me
I am a licensed NYC psychotherapist, hypnotherapist and EMDR therapist. I have helped many clients overcome obsessive and addictive behaviors.

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.

Boredom as a Relapse Trigger

As a psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist in New York City, one of my specialities is working with people who have problems with addictions and codependency. Over the years, I've found that one of the most challenging aspects of overcoming addictive and codependent behavior is overcoming boredom as a relapse trigger.

Overcoming Addiction: Boredom as a Relapse Trigger

What is Boredom?
For most people, feeling bored means that they're doing the same things over and over again and not feeling fulfilled. Life feels dull and monotonous. They feel like they're in a rut and can't get out. Life and relationships might not feel as meaningful when someone is bored.

Why Does Boredom Often Lead to Relapse?
For someone who is accustomed to feeling "high" from drinking, drugging, overspending, overeating, bingeing and purging food, gambling, engaging in sexual addiction, cutting, or getting overly involved in someone else's life drama, trying to live a clean, sober and healthy life might feel unexciting and dull.

When you're used to dealing with your problems by looking for stimulation in unhealthy habits, you might feel a void in your life as you let go of these habits, people you used to engage in these habits with, and former places where you used to go.

At that point, if you haven't developed other healthy habits to take the place of addictive behavior, you are at risk for relapse as you begin to think about stimulative and thrill seeking behavior. It's very tempting to revert back to old habits as you bargain with yourself: "I'll just do this one more time, and then I'll stop" or "I can have one drink. I can control it" or other self deceptive thoughts.

How to Overcome Boredom to Avoid Relapse:
First: Realize that you're not alone. Many people who are struggling with addictions and codependence have faced the same challenge as you have and they have successfully overcome having boredom lead to relapse.

Second: It's important to get out, talk to people who have overcome these problems, and get support. Self help groups like A.A., N.A., Debtors Anon, Al-Anon, Sexual Compulsives Anon, Gamblers Anon, Overeaters Anon and other self help groups are often an excellent source of support (see resource list below at the end of this post).

When you listen to other people talk about how they struggled and overcame boredom as a relapse trigger, you'll often hear aspects of their stories that will resonate with you and help you develop your own ideas about overcoming boredom. Get a sponsor to help you work the Steps and navigate through your difficulties with relapse.

Third: Think about activities and hobbies that you used to enjoy that you might have given up after you began engaging in the addiction of your choice. Maybe you used to like to listen to music before. Or, maybe you liked a particular sport, hobby, or other healthy recreational activity. Often, when people get immersed in addictive behavior, they let go of and forget about activities that they used to enjoy. You can recapture the enjoyment that you used to get from these activities.

Overcoming Boredom to Avoid Relapse

Fourth: Be willing to try new and healthy activities to get out of the rut that you're in. If you're out of shape, consult with your doctor and find out if you're up to exercising at the gym, or taking a yoga or dance class. For most people, walking, at a pace that is healthy and right for you, is often a safe form of exercise. Join a book club where you can clear out the cobwebs from your mind, meet new people, and find other ways to stimulate your mind through new ideas.

Fifth: Get involved by volunteering. There are so many organizations that desperately need help: from soup kitchens for the hungry and homeless to reading and mentoring programs in schools. When you help someone else or make a positive contribution to a worthwhile organization, you feel good about yourself and it helps to build your self-esteem. Even if you have a tendency towards codependence, you can learn to help others in a healthy way.

If you find that you're still struggling with boredom as a relapse trigger, you could benefit from working with a licensed mental health professional who has an expertise in helping people overcome addictive and codependent behavior.

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

I work with individual adults and couples.

I have helped many clients overcome addictive and codependent behavior.

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

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

Letting Go of Resentment

Resentments are feelings that we hold onto and replay in our minds, reliving the events, remembering what was said and done to us, experiencing it on a mental, emotional, and physical level. 

When we hold onto resentments, we keep ourselves stuck in the situation that hurt us and emotionally bound to the people who hurt us. 

Letting Go of Resentment

It often prevents us from moving on in our lives. We remain mired in the past, ruminating about whoever hurt us, and possibly thinking of ways to avenge ourselves on them. But when we stay stuck in this way, we're really hurting ourselves.

Here is a fictionalized account, made up of many different stories that I have heard over the years:

Ellen:
Whenever Ellen thinks about how her ex-husband betrayed her by having an affair, she feels the anger rise up in her again. Her face becomes flush, and she feels her blood pressure rise. She remembers every detail of how she picked up the extension phone that day to call a friend and overheard that conversation between her husband and another woman that changed her life forever. She relives the feelings of shock and disbelief and the thoughts that this can't be real--she must be having a bad dream. She relives the confrontation that she had with her husband and how he denied everything at first and then admitted that he had been unhappy in their marriage for a long time and he was so much happier with this other woman.

All the details come flooding back to her of the messy divorce and how lonely it has been since the breakup of her marriage. Waves of sadness overtake her and she alternates between feeling emotionally paralyzed and thinking about how she would like to get back at her ex. To pacify her feelings, Ellen often binges on junk food and she has gained 50 lbs. Her doctor has warned her that she needs to lose weight because the weight gain has resulted in hypertension and she is also pre-diabetic. But Ellen is unable to let go of her sadness and resentment.

Because of her resentment, she blames her ex, she blames all men, she blames herself for marrying her ex, and she blames God. As a result, she is unable to open herself to new relationships. She thinks about her ex and how he hurt her and all the events related to that hurt every day. Her friends and family are tired of hearing about it. They tell her to "move on," but she doesn't know how. Whenever she relives the hurt and anger, it's as if it just happened yesterday. She can hardly believe that this all happened 20 years ago because the pain is still fresh.

Reliving Old Resentments:
It's not unusual for people to come to therapy with old resentments that they have been harboring for many years. The trauma of these events keeps them reliving the old feelings as if the mind is saying, "Maybe if I go over it again, I'll figure it out this time and it won't hurt any more." But replaying old hurts just makes you re-experience the pain and trauma. It doesn't alleviate the pain. Overeating, drinking excessively, abusing drugs, overspending, compulsive sex, compulsive gambling, and other compulsive behavior might make you feel better temporarily, but it's not the solution to dealing with your resentments. These behaviors only make your situation worse in the long run.

How to Let Go of Resentment:
There's no magical solution to letting go of resentments. It's a process. To start, it's important that you make a decision that you want to let go of the hurt and anger. Letting go or forgiving doesn't mean that you forget that it ever happened to you. It doesn't mean that it's okay that it happened, or that you go back to an unhealthy relationship or situation. It means that you want to unburden yourself of these feelings for your own health and well-being. You're doing this for yourself--not for anyone else. When you make the decision that you want to let go of resentments because they're affecting your health, keeping you stuck emotionally, keeping you from being present and really alive in the moment or being able to think about the future, you've taken a very big step.

Depending upon the particular situation and the people involved, this process might be your own internal process or it might mean that you tell whoever hurt you that you forgive him or her. It's not always possible or safe to communicate with the other person: He or she might have died, or going back to that person would be unwise for you or that person, either because it's not safe or it would be too disruptive for one or both of your lives or for many other reasons. The most important thing is that it starts with you and your decision that you no longer want these painful feelings taking up so much time, space, and energy in your mind and in your life.

After you decide to let go, it often happens over time. Depending upon what the resentment is, there are often degrees of letting go. Usually, it doesn't happen all at once. If you feel really stuck, it might help to think about what your life could be like if you were no longer burdened by carrying around these resentments: What might you be doing if you were free of these resentments? How might your life be different? What might you have in your life that you don't have now? What would you be doing with the time and energy that you're spending on these resentments now?

Getting Help in Therapy
Letting go of resentments can be one of the most challenging efforts you make in your life, but it can also be one of the most rewarding. Be compassionate with yourself. You don't need to have all of the answers immediately.

If you find that this is too difficult to do on your own and talking to friends and family has not gotten you to the place where you want to be, you would be wise to consider working with a licensed psychotherapist who can help you to let go of these old feelings that are keeping you stuck and unhappy.

About Me
I am a NYC licensed psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  

I work with individual adults and couples.  I have helped many clients to let go of old resentments so they can lead more fulfilling lives.

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

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

Overcoming Shame in Therapy

Shame can be a crippling emotion with serious consequences for the individual who is experiencing it as well as his or her loved ones.

Overcoming Shame

What is shame?

Shame is an emotion where an individual feels defective or damaged in some fundamental way. Certain other emotions, like embarrassment and guilt, are often confused with shame.

Embarrassment is usually about a particular incident and it involves other people. It is mostly a temporary, passing feeling, whereas shame is a deep feeling about oneself that one is basically flawed at the core.

Guilt is a feeling that is related to shame, but it's not the same. When an individual feels guilty, he or she feels remorse about something that he or she did or said.

How Does Shame Develop?
People often develop shame after they experience a traumatic event, especially if they blame themselves for what happened. Also, when people grow up in dysfunctional families, either highly enmeshed (where there are poor boundaries) or disengaged, shame is often a strong emotion. I'll discuss this in more detail in later posts.

What are the Consequences of Shame?
The effects of shame are serious. Shame often causes people to want to isolate, withdraw and, in some cases, want to die.

Shame can keep people from forming and developing relationships. Shame can keep people from excelling in life.

Teens who experience shame are more likely to drop out of high school.

Teens Who Experience Shame Are More Likely to Drop Out of High School

As adults, they might drift from job to job feeling trapped but unable to overcome that feeling.

People who experience shame are more likely to develop substance abuse problems.

Shame is often at the core of domestic violence where shame is covered over by rage and directed outward at family members.

Shame can also lead to eating disorders, compulsive gambling, sexual addiction, and other forms of addictive behavior as people who experience shame use these compulsive behaviors as maladaptive ways of coping.

In extreme cases, shame can lead to suicide. Shame is also often linked with traumatic stress.

How Can You Overcome Shame?
People who experience shame often don't talk about it. They might feel so defective and isolated that they are unable to get the emotional support that they need.

Often, people who experience shame feel that they are the only ones who feel this way. They feel that other people could not understand what they feel.

People who feel ashamed often don't know what they feel or how to express it. They often feel locked in with their emotional pain and it's hard for them to find a way out.

Getting Help in Therapy
If you or someone that you love is experiencing the debilitating effects of shame, it's important to get professional mental health.

Getting Help in Therapy

Psychotherapy can be very helpful to people who experiencing shame to overcome this potentially crippling emotion.

In future posts, I'll be discussing the origins and effects of shame in more detail.

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

I have helped many clients overcome the effects of lifelong shame so that they can grow and flourish in their lives.

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:  
Overcoming Shame: Enmeshed Families

Overcoming Shame: Disengaged Families

What is EMDR Therapy?

EMDR (Eye Movement Desensitization and Reprocessing) therapy is a form of psychotherapy that was developed by psychologist, Francine Shapiro, in the 1980s (see my article: Experiential Therapy, Like EMDR, Can Achieve Emotional Breakthroughs).

What is EMDR Therapy?

What is EMDR Therapy?

EMDR was originally developed to treat posttraumatic stress disorder (PTSD). Since that time, EMDR has been used successfully for many other issues, including stress, insomnia, performance anxiety, performance enhancement, abuse, substance abuse, sexual addiction and many other issues (see my article: How EMDR Therapy Works: EMDR and the Brain).

Why is EMDR Therapy More Effective Than Regular Talk Therapy?

EMDR Tends to Work Faster Than Talk Therapy for Trauma: 

Generally speaking, EMDR tends to work faster for trauma than most talk therapies. Among other things, much depends on the skill of the therapist as well as the rapport between therapist and client. Also, most clients will require a period of time where the EMDR therapist helps clients to develop internal resources and coping skills before the actual EMDR processing begins (see my article: EMDR Therapy: When Talk Therapy Isn't Enough).

EMDR Uses a 3-Pronged Approach: Past, Present, Future: 

EMDR uses a three-pronged protocol: working with the client's past, present and future. EMDR processes old memories, creating new links with adaptive functioning.

Current problems are targeted and desensitized and past and future events are integrated to assist clients in healthy functioning. 

There has been quite a bit of research on the success of EMDR and the treatment of trauma and PTSD. However, no one is completely sure as to how or why EMDR works. It is believed that part of its success is due to the fact that EMDR uses Rapid Eye Movement (REM) as its basis.

EMDR helps process negative memories and emotions. It helps the brain to successfully process these experiences.

Getting Help in EMDR Therapy

If you have been unable to work through your history of trauma, you could benefit from working with an EMDR therapist.

Once you are free from the effects of your traumatic history, you can live 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.

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 EMDR Works: Overcoming Emotional Trauma

What is Adjunctive EMDR Therapy?