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NYC Psychotherapist Blog

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Showing posts with label anxiety. Show all posts
Showing posts with label anxiety. Show all posts

Monday, June 8, 2026

How is Therapy With a Psychotherapist Different From Using Artificial Intelligence?

In the last several years some people have been relying on Artificial Intelligence (AI) for their mental health issues instead of seeing a licensed mental health professional.  

Psychotherapy With a Live Therapist vs Using A.I.

Although AI can be useful in terms of understanding certain mental health issues, it's not a substitute for working with a psychotherapist. 

How is Therapy With a Psychotherapist Different From Using AI?
Psychotherapy and AI are fundamentally different:

The primary distinctions between AI and psychotherapy include:

The Therapeutic Relationship
  • Psychotherapy: The therapeutic relationship between a client and therapist is central to psychotherapy. Healing occurs through a felt, trusted human relationship. In addition to what is said, therapists are attuned to non-verbal cues like voice tone, micro-expressions, posture and silences. Many psychotherapists who are trained to work in a psychodynamic way also tune into the client's conscious and unconscious gestures.  When psychotherapists and clients work together, whether it is online or in person, there is a right-brain-to-right brain attunement between therapist and client which enhances the client's healing.
Psychotherapy With a Live Therapist vs Using A.I.
  • AI: AI operates on textual inputs. It cannot form a relational bond or therapeutic alliance with a client. Although it can mimic validation, it generates language statistically rather than experiencing an emotional connection with the client. 
Therapeutic Empathy:
  • Psychotherapy: Therapeutic empathy is an essential part of healing in psychotherapy. Therapists are trained to develop empathy for clients and help clients to develop empathy and self compassion  (see my article: Why Is Empathy Important in Psychotherapy?).
Psychotherapy With a Live Therapist vs Using A.I.
  • AI: An AI chatbot can adjust its responses based on sentiment analysis and learning algorithms, but lack the emotional bandwidth which is found with human psychotherapists. It can mimic empathy, but it cannot feel it. It could possibly guide, but it can't witness. 
Clinical Judgment vs Pattern Recognition
  • Psychotherapy: Psychotherapists spend years training to diagnose conditions, assess complex safety risks and change treatment based on clients' responses.
Psychotherapy With a Licensed Therapist vs Using A.I.
  • AI: AI evaluates texts based on probability and patterns from their training data. It struggles with deeply complex content and cannot make nuanced clinical choices.
Crisis Management and Safety
  • Psychotherapy: Psychotherapists are legally bound to intervene during a crisis. Therapists actively build therapeutic plans for conditions such panic attacks or psychological trauma.
Psychotherapy With a Licensed Therapist vs A.I.
  • AI: Chatbots cannot manage a crisis and often default to crisis-line referrals. If they fail to read the situation appropriately, they can provide inappropriate and stigmatizing advice.
Accountability and Ethics
  • Psychotherapy: Mental health practitioners operate under strict state boards, ethical codes and HIPAA privacy laws.
Psychotherapy With a Licensed Therapist vs Using A.I.
  • AI.: Chatbot platforms are corporate products not medical entities. Data privacy rules can vary widely which raises the risk regarding how sensitive personal information is stored and shared.
Intended Outcomes
  • Psychotherapy: Psychotherapy is designed to foster psychological breakthroughs, process deep-seated trauma and build long term, structural psychological changes.
Psychotherapy With a Licensed Therapist vs Using A.I.
  • AI: AI cannot foster psychological breakthroughs. It is best suited as an adjunct to therapy for accessing certain behavioral tools like reflection prompts, mood tracking or breathing exercises between psychotherapy sessions. 
Conclusion
The future of mental health will not be a choice between working with a human psychotherapist versus texting a chatbot.

In moments of crisis where psychotherapy is unavailable, like in a war-torn country, AI can provide information, but it has limitations.  

In terms of psychological healing, the human-to-human contact that available in psychotherapy is essential and irreplaceable for psychological healing.

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 over the years.

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:


















 

Sunday, June 7, 2026

Looking at Depression From an IFS Parts Work Therapy Perspective

As I have discussed in prior articles, IFS (Internal Family Systems) Parts Work Therapy is a form of Experiential Therapy (see links at the end of this article for more articles about IFS).

Looking at Depression From an IFS Perspective
From an IFS perspective, depression is viewed as a "part" or a collection of "parts" rather than a permanent identity or a sign of a problem in the brain.

Depression From an IFS Therapy Perspective

In IFS, the mind is naturally subdivided into parts (or subpersonalities). 

As I discussed in my prior article, What is the Connection Between IFS Parts Work Therapy and Neural Networks?, the word "parts" is a metaphor for these naturally occurring subdivisions that everyone has. This makes the language of IFS understandable and accessible to clients.

In IFS, depression is typically viewed as either a proactive part, a reactive part or a wounded part depending upon the function of the part:
  • Depression as a Proactive Part ("The Shield"): Depression can act as a protective proactive part where the objective is for the part to act as a preemptive "shutdown" mechanism.  The goal is to keep you safe from taking risks that could lead to failure, rejection or overwhelming disappointment. In IFS language, this part is called a "Manager" due to its proactive role.
Depression From an IFS Therapy Perspective
  • Depression as a Reactive Part ("The Circuit Breaker): When emotional pain from the outside world is sudden or overwhelming, this reactive part can step in as a way to numb you emotionally. The goal is to instantly extinguish anxietyshame or grief. This part is called a "Firefighter" due to its sudden reactive function.
  • Depression as a Wounded Part ("The Wound"): This is often a young wounded part of you that is stuck in unresolved trauma. This part isn't trying to protect you. Instead, it carries the burden of the early emotional wounds ("I'm unlovable" or "I'm no good" or "I'm powerless"). This part is called an "Exile". The Exile is frozen in the past at whatever age the trauma occurred. The feelings it carries are raw and unprocessed. When someone is triggered, it is the Exile that experiences the trigger. However, the Exile, as the name implies, usually remains below the surface (unless triggered) and what is usually more apparent is either a the proactive Manager or reactive Firefighter.
How is IFS Therapy Different From Traditional Therapy For Depression?
Traditional therapy usually treats depression as a single entity. This can leave clients feeling consumed by it. 

Depression From an IFS Therapy Perspective

IFS therapy teaches clients how to "unblend" from the part of them that is depressed so instead of a client saying "I'm depressed", an IFS client would say, "A part of me is depressed."

This shift allows an IFS client to access their Core Self with the guidance from the IFS therapist so they can approach their depression from a curious and compassionate stance rather than be consumed by it.  

How Does the IFS Therapist Verify the Role of the Depressed Part?
An IFS therapist tracks the depressed part by facilitating communication between the client's Core Self and the depressed part. This is a skill the therapist helps the client to develop.

The depressed part might respond that they are protecting the client from failing, which would indicate a proactive protector part (a Manager).  Alternatively, they might say they are tryng to numb the client, which would indicate a reactive part (a Firefighter).  The other possibility is that the part is a young wounded part that is feeling alone and stuck in unresolved early trauma (an Exile).

How is Depression Healed in IFS?
An IFS therapist will lead the client through a process of helping them to lift the depression which would include recognizing depression as a part, helping the client to access their Core Self and from the Core Self's perspective the client observes the depressed part, befriends the part, and encourages the part to release their psychological burden.

Depression From an IFS Therapy Perspective

This allows the parts to take on a new and healthier role .

Although this might sound simple, it's often not so simple for a variety of possible reasons. Most of the time the proactive and reactive pars will step aside when asked, so that the client and therapist can work with the wounded part that holds the trauma. 

But there are times when these parts haven't developed trust yet with the client and the therapist, so it can take longer for them to agree to step aside.  

In the long run, IFS, which is a gentle, evidence-based trauma therapy, tends to be more effective at helping clients with depression. This is due to IFS's non-pathologizing stance and its step-by-step process of working with depression and unresolved trauma.

Get Help in IFS Therapy
If you have been struggling on your own or you haven't had success in traditional talk therapy, you could benefit from working with a licensed mental health professional who is an IFS therapist.

Get Help in IFS Therapy

When you free yourself from the burden of depression and trauma, you can lead a more fulfilling life.

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

I have helped many individual adults and couples over the years.

To find out more about it, 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, June 1, 2026

IFS Parts Work Therapy is a Gentle Evidence-Based Trauma Therapy

Some types of trauma therapy rely on exposure to traumatic events as their way of working with trauma, which can retraumatizing to certain clients.

IFS Therapy is a Gentle Evidenced-Based Trauma Therapy

IFS Parts Work Therapy, which is a gentle, effective, evidence-based* therapy, doesn't use exposure like many types of exposure therapies.

    *In 2015, SAMHSA (US Substance Abuse and Mental Health Administration) designated IFS as an evidence-based therapy.

Key Framework of Gentleness in IFS Parts Work Therapy
IFS, which stands for Internal Family Systems Therapy, is a parts work therapy that prioritizes pacing that works for the client, internal consent and a non-pathologizing framework:
  • No Forced Reliving of the Trauma: IFS focuses on how trauma lives in the body and mind in the here-and-now.  This means that clients can use current emotions, thoughts and body sensations or images.  
  • Permission Based Pacing: IFS is designed in such a way that therapists don't bypass defense mechanisms. Healing only progresses as "protector parts" (i.e., defense mechanisms) give permission and soften naturally.
IFS Therapy is a Gentle Evidence-Based Trauma Therapy
  • Reframing Symptoms as Protectors: IFS is non-pathologizing, as mentioned above, so that symptoms aren't viewed as "destructive" or "bad". In IFS therapy there are no bad parts. Symptoms are viewed as protectors who are doing their best to protect the client. This reframing helps to reduce shame.
  • Preventing Emotional Flooding: IFS relies on a gentle process called "unblending" When a client experiences emotional pain, fear or shame, the therapist asks the part to step back so that the client can witness the pain without feeling overwhelmed by it.
  • Building Self Trust: Healing happens through your own inner wisdom rather than through an external source.
  • Self-Lead Healing: The source of healing doesn't come from the authority of the therapist. Instead, it comes from the client's own Core Self which is an undamaged core that is characterized by calmness, compassion, curiosity and clarity. So, you set the pace.
  • Gentle Unburdening: Parts of the client which hold the trauma are allowed to safely release their historical pain, shame and fear in an environment of internal containment and at their own pace.
Get Help in IFS Parts Work Therapy
If you have been struggling on your own with unresolved trauma, you could benefit from working with a licensed mental health professional who is a IFS therapist.

Get Help in IFS Parts Work Therapy

Unburdening yourself of trauma can help you to lead a meaningful life free of your traumatic history.

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 in over more than 25 years.

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 Other Articles About IFS:















Sunday, May 31, 2026

Relationships: How is Curiosity a Gateway to Empathy?

Curiosity is a gateway to empathy by shifting your mindset from judgment to exploration. 

Curiosity as a Gateway to Empathy

Curiosity is the capacity to feel and understand another person's internal experience. However, you cannot share a feeling that you have not first tried to understand. Curiosity bridges this gap by creating the cognitive framework for deeper emotional connection. 

Curiosity breaks down the barriers to true empathy through several important mechanisms:

Curiosity Replaces Judgment With Inquiry
  • Assumptions Are Blocked: When you enter an interaction with a curious mindset, your brain stops trying to instantly categorize, label and judge the other person's behavior.
  • Understanding "Why" Becomes Prioritized: Instead of dismissing a behavior you don't like with a statement like, "He's being hostile towards me", curiosity poses the question, "What is causing him to react in this way?"
  • Cognitive Loops Are Interrupted: This simple shift de-escalates emotional defensiveness which makes space to objectively observe the other person's reality.
Curiosity Unlocks Deep Listening:
  • Focus is Externalized: Curiosity allows you to set aside your internal dialog, your biases and your premeditated responses.
Curiosity as a Gateway to Empathy
  • Meaning is Prioritized Over Winning: When you focus on trying to understand the meaning of the interaction, you stop focusing on your counter-argument or a need to offer unsolicited advice.
  • Open-Ended Exploration is Invited: By asking non-judgmental questions, you actively invite the other person to share their nuanced, authentic experience.
Curiosity Expands Your Imagination
  • Perspective-Taking is Activated: Curiosity and empathy encourages you to put yourself in the other person's place.
Curiosity as a Gateway to Empathy
  • New Perspectives Can Be Explored: Curiosity provides the spark to wonder about other perspectives and other realities that are different from your own.
  • Biases Are Dismantled: Curiosity can help you to bridge the gap so you can empathize with others.
Clinical Vignette
The following vignette, which is a composite of many cases, illustrates how curiosity can lead to empathy:

Ann and Frank
Ann and Frank were married for 10 years.  During that time, whenever Ann became fearful or anxious, Frank became impatient and harsh with her, "Why are you afraid to go on this job interview? You have the skills and experience to get this job. Stop worrying so much."

Curiosity as a Gateway to Empathy

Whenever Frank spoke to her in this way, Ann felt her feelings were dismissed by Frank and  then she felt ashamed of herself. Logically, she knew had the right skills and experience, but she didn't feel this way emotionally.

When they attended their next couples therapy session, Ann brought up how dismissed and ashamed she felt whenever Frank scolded her for being fearful and anxious. 

When their therapist explored what was happening for Frank emotionally when Ann got anxious or fearful, at first, he said he wasn't aware of feeling anything about it. So, their therapist asked Frank to slow down and sense into his body while remembering the conversation he had with Ann.

After a few moments, Frank remembered, "When I was child, whenever I tried to talk to my father about how scared I was of trying out for the Little League team, my father yelled at me and told me I had to face my fears and stop being a baby. He gave me a disgusted look like he was ashamed of me for being scared. That's how it was whenever I told him I was scared--until I stopped telling him."

As he said this, Frank's eyes welled up with tears, "I felt so ashamed, so I pushed down my fears and toughed it out."

At that point, Frank realized he was dismissing and shaming Ann in the same way his father dismissed and shamed him, "All I ever wanted was for my father to encourage me and give me emotional support. I realize now that's what Ann wanted, but whenever she feels anxious and afraid, it brings up those old feelings for me that I pushed down when I was a kid. It's so hard for me to tolerate because it triggers my own insecurities." Then, he apologized to Ann.

Their therapist spoke to them about using curiosity as a way to avoid judgment, criticism, dismissiveness and shaming.

Ann and Frank practiced these new skills in their couples therapy sessions as well as between therapy sessions. When he was able to get curious, he felt empathetic towards Ann and he discovered that Ann's fear and anxiety were also tied to her own childhood experiences of emotional neglect.

Frank became much more emotionally supportive and, in the process, he was able to talk in session about his own insecurities that he was never able to express as a child. Feeling understood for the first time by his wife and his therapist helped Frank to heal these old wounds.

Ann was also able to talk about how she was affected by emotional neglect in her family and she realized that, as adults, she and Frank could be emotionally supportive of each other as one way to heal their emotional wounds.

Being able to support one another also helped Ann and Frank to deepen their emotional connection (see my article: How to Develop Emotional Depth in Your Relationship).

Conclusion
Curiosity is a gateway to empathy.

Understanding the underlying issues that get in the way of being curious can help you to understand the emotional barriers you might be experiencing to feeling empathetic (e.g., unresolved traumatic childhood experiences).

Get Help in Therapy
If you have difficulty letting go of defensiveness that gets in the way of getting curious, you could benefit from working with a licensed mental health professional.

Get Help in Therapy

Working through these issues in therapy can help you to live a more meaningful life.

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

I have helped many individual adults and couples over the years.

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:











































Wednesday, May 27, 2026

Understanding Your Core Self and Your Parts in IFS Parts Work Therapy

I have written about IFS (Internal Family Systems) Parts Work Therapy in prior articles (see links for these articles at the end of this article).

What is IFS Parts Work Therapy?
IFS is an evidence-based therapy approach to psychotherapy that views the human mind as made up of a complex system of parts that are led by an undamaged Core Self.


IFS Core Self, Managers, Firefighters and Exiles

Developed by Dr. Richard Schwartz in the 1980s, IFS operates on the fundamental principle that there are "no bad parts". In other words, every part of yourself developed with a protective intention of helping you to survive.

What is the Structure of the Mind in IFS?
In IFS your mind consists of of a Core Self (also known as a True Self) and three distinct aspects:

The Core Self
The authentic, compassionate part of your being, the Core Self cannot be damaged by trauma. The qualities of the Core Self consist of the 8 Cs: 
Exiles
Exiles are the wounded, vulnerable parts of your mind. They usually originate from childhood trauma which often carry painful emotions like shameanxiety and loneliness. Exiles are often out of conscious awareness until they get triggered so that they might not cause you overwhelming pain. They are "managed" by Manager and Firefighter parts (see below). 

Common examples of exile parts include: 
  • The Abandoned Child Part: This part carries a deep terrifying fear of being rejected, left behind or unloved.
  • The Shamed Child Part: This part carries the core belief of being inherently defective, unlovable, ugly or not good enough.
Shamed Child Exile Part
  • The Invisible Child: This part feels completely unseen, unheard, uncared for and unimportant to caregivers and peers.
  • The Terrorized Part: This part stores the raw terror, helplessness and physical panic of a past traumatic event.
  • The Neglected Part: This part experiences chronic emptiness and a painful longing for affection and care.
  • The Judged Part: This part contains the harsh criticism, feeling constantly scrutinized and inadequate.
What Are Common Triggers That Activate Exiles?
  • A partner not responding to a text immediately
  • Receiving constructive feedback during a work review
  • Feeling excluded from a social event or group chat 
  • Experiencing a minor medical scare or physical injury
Managers
Proactive protectors that run your daily life, they help to keep you organized, controlled, safe by trying to ensure that Exile parts don't come to the surface and flood you with overwhelming pain. Examples of manager parts include: 
  • The Inner Critic: Monitors and evaluates your behavior with harsh self-talk. It shames you internally as a maladaptive way to motivate. It aims to correct flaws before anyone else detects them and judges you (see my article: Making Friends With Your Inner Critic).
Inner Critic
  • The Perfectionist: Sets impossibly high standards and demands flawlessness. This part believes that if your performance, appearance or work is completely "perfect", you will remain safe from failure, rejection or embarrassment (see my article: What is Perfectionism?).
The Perfectionist
  • The People Pleaser/Caretaker: Prioritizes the emotions, comforts and needs of others over your own self-care. It seeks constant validation and smooths over external conflict to keep others happy, ensuring they never abandon you or reject you (Trauma and the People-Pleaser Part).
The People Pleaser/Caretaker
  • The Planner/Controller: Attempts to micro-manager every aspect of your life, schedule and relationships. It obsesses over predictability and prepares for worst case scenarios to eliminate the danger of unforeseen emotional triggers. 
  • The Achiever/Taskmaster: Drives relentless productivity and focuses heavily on success. It links your basic human worth to tangible output and accomplishments to shield you from feelings of inadequacy.
The Achiever/Taskmaster
  • The Intellectualizer/Thinker: Relies strictly on logic, data and rational analysis. It acts as a cognitive shield, analyzing problems from a detached distance to explain away feelings and keep you from experiencing raw emotion.
  • The Avoider/Passive Pessimist: Keeps a safe distance from emotionally risky situations, intimacy or new challenges. It protects the system by shutting down, opting for withdrawal or passivity so that closeness cannot trigger suppressed wounds.
Firefighters:
Firefighter are reactive protective parts that step in aggressively when an Exile's pain breaks through the Manager's defenses. They attempt to rapidly extinguish or numb emotional distress by any means necessary. 

Unlike Manager parts which proactively plan to manage pain, Firefighter parts act impulsively and they are focused on immediate, short term relief without considering the long term consequences. These include:

The Numb-Out and Escape Strategies: These parts seek to detach from reality or dull the intensity of an activated emotion:
  • The Binge Watcher/Compulsive Scroller: This part can spend hours scrolling social media, playing video games or binge watch TV to completely tune out reality.
Binge Watcher/Compulsive Scroller on Social Media
  • The Dissociator: Pulls your mind away from your body causing you to "zone out" during intense situations or to feel detached from your physical presence.
  • The Sleeper: Uses extreme fatigue or unprompted naps as a tactical emergency exit to avoid experiencing distress.
  • The Daydreamer: Escapes chronic pain by retreating entirely into elaborate fantasies or internal worlds. 
The Substance Abuse and Comfort Soothers
These parts look to external, chemical or physical substances to smother painful feelings immediately:
  • The Drinker/User: Relies heavily on alcohol, marijuana or other substances to artificially quiet an internal emotional storm.
  • The Comfort Eater: Urges overeating to blanket feelings of loneliness, sadness or stress.
The Impulse and Adrenaline Chasers
These parts attempt to replace unbearable underlying emotions, like shame or helplessness, with highly stimulating, high octane physical sensations:
  • The Rager: Deflects vulnerable feelings by launching into sudden, explosive angry outbursts, slamming doors or starting verbal fights.
The Risk Taker
  • The Risk Taker: Drives dangerously or engages in reckless behavior such as extreme speeding, gambling or unsafe sexual encounters, using adrenaline to overpower emotional pain.
  • The Self Harmer: Expresses internal pain or seeks release from emotional numbness through physical self injury or suicidal ideation.
How Do Managers and Firefighters Differ From Each Other?
To understand your internal world, it helps to understand the difference between Manager parts, Firefighter parts and Exiles:

Managers
  • Core Strategy: Control and prevention
  • Behavioral Goal: Keep life orderly; minimize social and emotional risk
  • Timing: Proactive (before pain occurs)
Firefighters
  • Core Strategy: Distraction and numbing
  • Behavioral Goal: Extinguish overwhelming emotional fires at all costs (e.g, drinking, drugging, gambling, dissociation, etc).
  • Timing: Reactive (after an exile is triggered)
Exiles
  • Core Strategy: Vulnerability and burden
  • Behavioral Goal: Contain deep emotional wounds, childhood trauma, shame and loneliness
  • Timing: Suppressed (hidden beneath protector parts)
Getting Help in IFS Parts Work Therapy
IFS is an effective, evidence-based, gentle trauma therapy. 

Although it is gentle, it is also powerful in terms of healing trauma.

Get Help in IFS Parts Work Therapy

IFS prioritizes pacing, internal consent and a non-pathologizing framework that doesn't force a client to relive their traumatic events. 

If you have been unable to work through problems on your own, consider working with a skilled IFS therapist so you can lead a more fulfilling life.

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

I have helped many individual adults and couples over the years.

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: