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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

Friday, September 11, 2026

Developing a Deeper Understanding About Your Anxiety Using Self-Help Journal Prompts

In my last article, Self Help Journal Prompts to Cope With Anxiety, I discussed cognitive behavioral self-help tips for coping with anxiety. 

Developing a Deeper Understanding of Your Anxiety

In the current article, I'm focusing on helping you to develop a deeper psychodynamic understanding about your anxiety beyond cognitive-behavioral aspects of coping.

Developing a Deeper Understanding About Your Anxiety
Anxiety is rarely just about the current trigger or what is going on in the moment. 

Instead, anxiety is often a defense mechanism to keep even more uncomfortable feelings buried beneath the surface. This can include forbidden angergrief or shame

While the cognitive behavioral prompts from my previous article allow you to ask yourself questions like, "Is this thought realistic?", if you want to gain a deeper understanding about your anxiety, the deeper question would be "What is my anxiety trying protect me from facing?"

The Mask of Anxiety
Anxiety often acts as a "placeholder" for an emotion you unconsciously feel unsafe expressing. 

Journal prompts to uncover the underlying emotions include: 
  • If my anxiety were a mask for a heavier emotion, what emotion would be hiding underneath the anxiety?
Developing a Deeper Understanding of Your Anxiety

  • What emotions were considered unacceptable or dangerous in my family when I was growing up? Anger? Sadness? Another emotion? 
  • How do I react today when I feel that emotion?
  • Am I using anxiety to distract myself from a hard truth?
Childhood Origins and Core Templates
Our earliest relationships with parents and others form the templates for how we experience safety and danger today, so you can try these journal prompts:
  • When is the first time I remember feeling this same type of anxiety?
  • Whose voice does my inner critic or anxious voice sound like? Does it echo a parent, older sibling, another caregiver, a teacher?
  • How did my caregivers respond when I was distressed, scared or angry as a child? How might I be repeating that same response to myself as an adult?
Defense Mechanisms
On an unconscious level, our symptoms sometimes serve a hidden purpose--such as keeping us safe from failure, rejection or intimacy:
  • How does my anxiety unconsciously protect me? If my anxiety makes me want to stay home, avoid people or over-prepare, what is my anxiety shielding me from feeling?
Developing a Deeper Understanding of Your Anxiety

  • What would I have to face or acknowledge if this anxiety suddenly vanished?
  • Am I choosing the familiar discomfort of anxiety over the terrifying uncertainty of personal growth? What am I afraid would happen if I step outside this cycle? 
The Shadow of Unconscious Conflicts
The following prompts explore "Shadow Work" which includes the parts of your identity you have suppressed or rejected so you could to fit in:
  • What part of myself am I currently judging or rejecting? How might that part be related to my internal conflict?
Developing a Deeper Understanding of Your Anxiety

  • Write about a dream that left you feeling anxious (see my article: What Are Anxiety Dreams?). What do the people, symbols and locations in that dream represent to your inner self? 
Get Help in Therapy
Getting past the defense mechanisms that keep you from understanding your anxiety can be difficult to do on your own.

Get Help in Therapy

Rather than struggling on your own, seek help from an experienced psychotherapist who has an expertise in getting to underlying unconscious issues.

Getting to the root of your problems can help you to lead a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, IFS, EFT couples therapist, Somatic Experiencing and Certified Sex Therapist.

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

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

I provide a free 10-15 minute phone call before setting up an appointment.

You can reach me at (917) 742-2624 during business hours or email me.

Also See My Articles























 


Thursday, September 10, 2026

Self Help Journal Prompts to Cope With Anxiety

Journaling is a highly effective, science-backed self-help tool for coping with anxiety.

Using a journal can help reduce racing thoughts, anxious cycles, cognitive load, racing thoughts and anxious cycles (see my article: Journaling to Help Relieve Stress and Anxiety).

Coping With Anxiety

When anxiety feels overwhelming, writing in your journal helps to externalize your thoughts and feelings so you can look at them objectively.

Journal Prompts For Grounding Yourself in the Moment
You can use the following journal prompts when your anxiety is acute and you feel overwhelmed:

Grounding in the Moment Relief 
Use these prompts when anxiety is acute: 
  • Where do I feel the anxiety in my body right now? Write down the physical sensations (e.g., tight chest, clenched jaw) without judging them. What is one thing you can do that would help you to soften your physical sensations (e.g., square breathing)?
  • Look around the room: List 5 things you see, 4 things you can physically touch, 3 things you hear, 2 things you smell and 1 thing you can taste (this is the 5-4-3-2-1 Grounding Method).
  • Describe anxiety as a passing weather pattern: Describe the storm, but remind yourself the sky remains intact beneath the clouds.
Challenging Your Anxious Thoughts
Use these prompts to challenge irrational fears and worst case scenarios:
  • What is the worst case scenario going through my mind? After you have written down your worse case scenario, write down the best case scenario and the realistic middle-ground outcome.
  • Am I confusing my fearful thoughts for facts? Write down observable evidence for and against this worry (see my article: Thoughts Aren't Facts).
  • Look back on past challenges: When have I felt this anxious before and still managed to survive or get through it? What helped me to get through it back then?
  • Are my thoughts productive or unproductive? Am I actively problem solving or am I overthinking things?
Identifying Triggers and Patterns
Use these prompts when you feel low-level anxiety and you're not sure where its coming from:
  • Divide a page into two columns: "In My Control" and "Out of My Control" and then categorize your worries into these two buckets.
  • What story is my anxious mind trying to tell me? Who is the villain in that story and what am I trying to protect myself from? 
  • What have my energy levels, sleep habits and routines looked like over the past week? Are there physical triggers compounding my mental stress?
  • When was the last time I felt safe, calm or content? Specifically, what made me feel that way and how can I recreate that today?
Developing Self Compassion and Healing
Use these prompts when your anxiety is paired with a harsh inner critic, guilt or perfectionism:
  • If my best friend came to me feeling the same way I feel now, what would I say to them? Write down the comforting words for yourself.
  • Write a letter to your anxiety. Treat your anxiety like an overprotective, deeply misguided entity. Acknowledge its intent to keep you safe, but tell it why its panic is no longer needed right now. 
  • What would unconditional self acceptance look like today? How can I give myself permission to be a flawed, anxious, healing human being?
My Next Article
In my next article, I'll discuss how to develop a deeper understanding of your anxiety and the underlying issues that might be involved.

Get Help in Therapy
If self-help strategies aren't helping you to cope with your anxiety, you could benefit from working with a licensed mental health professional who can help you to go beyond the surface to overcome anxiety.

Rather than struggling on your own, working with a skilled psychotherapist can help you overcome anxiety so you can lead a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, IFS, EMDR, AEDP, EFT couples therapist, 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.

Before setting up an appointment, I provide a free 10-15 minute phone call.

You can contact me by calling (917) 742-2624 or by emailing me.

Also See My Articles:
















Thursday, August 13, 2026

What is the Defense Mechanism Known As "Projection" and How Does It Affect Relationships?

What is the Defense Mechanism Called "Projection"?
Projection is an unconscious psychological defense mechanism where a person attributes their own unacceptable thoughts, feelings, behavior, motives or character traits onto someone else.

What is Projection?

The projection acts as a shield for the person's ego. Instead of confronting uncomfortable truths about their own behavior, feelings and other uncomfortable truths (including feelings of guilt, shame, emotional insecurity or anger), the person who projects externalizes them so that, in their own mind, these problems belong to the other person.

This concept was originally developed in psychoanalytic and psychodynamic theories and most depth-oriented therapists today recognize projection when it's happening in the therapy session, when couples use it in couples therapy or when individual adult clients talk about it in terms of their relationships outside of therapy.

What is Projection?

Defense mechanisms are categorized in a hierarchy ranging from "primitive" (also called "early" or "immature" if the person is an adult) to "mature". The categorization is based on when the person developed the defense mechanism and how they distort reality.

Why is Projection Considered a "Primitive Defense"?
When adults use projection as a defense mechanism, it is considered to be on the primitive end of the defense mechanism spectrum for several important reasons:
  • 1. Early Development Origin: As previously mentioned, defenses are categorized on a spectrum. The early developmental defenses, like projection, are the mind's earliest boundary-making tools. Projection usually develops in early childhood before a child has the emotional and cognitive capacities to process complex internal conflicts. Projection is also considered a primitive defense because it develops when a child is still learning to differentiate "me" from "not me" (i.e., their internal world vs their external world).
  • 2. A Gross Distortion of Reality: Adults with higher level, more mature defense mechanisms (rationalization, intellectualization and so on) accept reality, but they might reframe it. This is in contrast to how primitive defenses actually alter the way a person perceives reality. Projection forces a severe distortion: The individual completely misperceives an internal truth as an external threat. This fundamentally alters their view of another person's intentions or character.
  • 3. All-or-Nothing Thinking: Primitive defenses, like projection, operate on binary all-or-nothing thinking. With projection, the person's ego cannot tolerate what they perceive as a "bad" trait within the inner world, so they project the trait or behavior externally. This lack of nuance is the hallmark of primitive psychological functioning (see my article: Overcoming All-or-Nothing Thinking).
Common Examples of Projection
  • Relationship Insecurity: Without realizing it, someone who is feeling like they would like to end their relationship because they cannot tolerate the relationship problems often uses projection. This is especially true when the problems they bring to the relationship feel intolerable. So, instead of owning and taking responsibility for their own thoughts and feelings, they accuse their partner of wanting to end the relationship. Another example: If someone is cheating, they accuse their partner of cheating or wanting to cheat.
What is Projection?
  • Workplace Hostility: An employee who dislikes another coworker might tell others, "That person hates me". They convert what they are feeling, which is, "I don't like that person" into "They don't like me."
  • Bullying and Insecurity: A person who criticizes others for being "weak" or "stupid" is often projecting their own deep-seated insecurities onto others.
Why Do Adults Use Projection as a Defense Mechanism?
Projection is unconscious, as I mentioned before, so it's not usually done maliciously. It often happens for specific psychological reasons:
  • Reducing Anxiety and Stress: It's very difficult for a person who uses projection to face their own worst traits. Unconsciously shifting these uncomfortable thoughts, feelings  and traits onto a "scapegoat" relieves the immediate internal pressure because the traits have been externalized.
  • Protecting Self Esteem: Projection allows an individual to maintain a positive self image by denying their own worst traits and habits.
  • Avoiding Accountability: By focusing on the perceived faults of others, the person avoids taking responsibility for their own problems.
  • Personality Disorders and Early Trauma: Projection is heavily associated with narcissistic personality disorder, paranoid personality disorder and avoidant personality disorder. It is also associated with early unresolved trauma. Note: Just because someone uses projection as a defense mechanism doesn't necessarily mean they have a personality disorder, but there is a high association between projection and personality disorders. However, if someone uses projection, they usually have early unresolved childhood trauma, which is called developmental trauma. Projection develops during early childhood and for many people it continues into adulthood if they don't get help in therapy.
How Does Projection Affect Relationships?
Projection acts like a psychological shield when the person projecting shifts internal insecurities onto a partner. This damages trust and communication in the relationship.

Projection damages relationships because it:
  • Creates False Accusations: Example: A person accuses their partner of trying to control them instead of dealing with their own controlling behavior towards their partner.
  • Erodes Mutual Trust: Baseless accusations makes the other person feel targeted and unsafe. Over time, the accused partner stops sharing thoughts and feelings to avoid conflict. 
What is Projection?
  • Blocks Real Conflict Resolution: Arguments center on the imagined behavior instead of the actual root issueThe person who is projecting refuses to acknowledge their problem so conflicts aren't resolved and the couple keeps arguing about the same issues over and over again without resolution.
  • Causes Emotional Exhaustion: The accused partner keeps defending themselves against baseless and unfair accusations. This cycle drains energy, leads to deeper resentment and perpetuates the same ongong cycle. This usually happens if the person who is projecting doesn't get help in psychotherapy with a qualified therapist.
  • Triggers Reality Distortion: The projecting partner truly believes their distorted thinking, feeling and perception of reality, which is distorted. This dynamic can cause the accused partner to question their own sense of reality if they allow the projecting partner to overcome their sense of reality.
Breaking the Cycle of Using Projection as a Defense Mechanism
Since projection is unconscious and develops at a very early age, it can't be resolved without professional help in therapy.

Working with an experienced psychotherapist who understands the unconscious nature of projection (not all therapists are trained to understand projection) can help an accusing individual to pause and look at their own dynamic--before they accuse their partner.

A skilled psychotherapist can help to uncover and address deeply hidden insecurities that are at the root of using projection. She can also help an individual to develop other higher functioning ways of interacting with others, including intimate partners. 

The work isn't quick or easy because projection is a deeply ingrained defense mechanism that is used from early childhood into adulthood. A person who uses projection must be motivated to change and stick with the therapy.

The challenge is that people who use projection often go from one therapist to another because they use projection to defend against the therapist and the therapy. This means they blame the therapist--in the same way as they use projection with others.

Consequently, a licensed mental health must know how to work in a way that feels relatively safe for the client and, at the same time, gently helps the client to make unconscious projection conscious. 

That is the first step. After developing awareness of how the client uses projection, they need to be willing to take steps to change, which is also challenging because of their internal fragility.

For a client who is psychologically fragile, which includes people who use projection, the therapist needs do a thorough assessment, including assessing the client's window of tolerance and help the client to develop the necessary internal resources and coping skills to deal with making these changes.

Unfortunately, most people who use projection never seek help in therapy and they remain stuck in their negative cycle.

Get Help in Therapy
If you use projection as your defense mechanism, you risk placing your relationships with others, especially your intimate relationship, in jeopardy.

What is Projection?

Although it might not be easy to accept that you're using a primitive defense mechanism from early childhood, using projection and damaging your relationships is much worse.

You can learn about yourself and transform in therapy with a therapist who has an expertise in helping clients with primitive defense mechanisms. This can help you to live a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing, IFS Parts Work, EFT Couples Therapist 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.

I provide a free 10-15 minute phone call before I set up an appointment.

You can reach me at (917) 742-2624 during business hours or you can email me.

Also See My Articles:




















Friday, August 7, 2026

Journal Prompts to Cope With Perfectionism

As I discussed in a prior article, Journaling to Relieve Stress and Anxietyjournaling is a powerful tool when you want to make changes in your life.

When you're struggling with trying to be "perfect", journaling can help you to soften your perfectionistic tendencies, including calming down your inner critic (see my article: The Cycle of Perfectionism, Procrastination and Paralysis).

Writing in a Journal to Cope With Perfectionism

Journaling can also help you to understand the root of your problem and also develop self compassion for the critical part of yourself (see my article: Making Friends With Your Inner Critic).

The act of journaling gives you a safe space to explore your feelings.

The other benefits to journaling about perfectionism include:
  • Explore the Roots of Your Problem and the Triggers - Understanding the origin of your problem can also help you understand how perfectionism became a survival strategy and coping mechanism.
    • Your Early Influences: Did your parents, teachers, mentors or other people in your life exhibit perfectionist behavior?
Writing in a Journal to Cope With Perfectionism
    • Your Earliest Memories: What is your first memory of feeling the urge to be "perfect"?
    • Your Current Triggers: What specific situations trigger your inner critic and perfectionist behavior (e.g., family, relationships, work, fitness etc)?
    • Your Cultural Pressure: How do your cultural and social circles influence how you feel about past achievements and future aspirations?
    • Your Past and Current Survival Strategies: How did perfectionism act as a survival strategy in the past and in current situations? How is it hurting you now?
  • Have Dialogues With Your Inner Critic - Perfectionism often shows up in extreme ways of thinking, feeling and behaving. You can challenge rigid rules and reframe distorted thoughts and unhelpful feelings and behaviors:
    • Define "Good Enough": What internal or external benchmarks do you use to decide if a task or project is "good enough" and complete? (Perfection vs. Good Enough).
    • Expose the Hidden Rules: What unconscious rules do you live by that keep your anxiety and perfectionism high?
    • Consider the Worst Case Scenario: If you were to fail at your current goal, project or task, what is the worst thing that could happen?
    • Choose Alternative Self Talk: What is a harsh thought about yourself that you had recently? What is a kinder, more realistic alternative that you can tell yourself instead?
    • Redefine Failure: What is your current emotional relationship with failure? How can you see it as useful information for you instead of failure?
  • Release Control and Embrace Failure - Letting to of perfectionism allows you to focus and feel free about the process:
    • Loosen Your Grip: Where in your life are you trying to control the outcome the most?
Writing in a Journal to Cope With Perfectionism
    • Try an Experiment: What is one small thing you can intentionally do imperfectly this week just to see the outcome?
    • Lower the Bar: Which of your deadlines or unrealistic self-imposed standards can you safely lower today?
    • Learn to Enjoy the Mess: What would you enjoy right now if you weren't concerned about making it "perfect"?
    • Reclaim Your Time: What would help the perfectionist part of yourself to relax and soften to give you some free time back?
  • Celebrating Progress and Self Compassion - Shift your focus to the personal growth you have developed and not on what you have left to do:
    • Focus on Past Desires: What do you currently do or possess that you wanted in the past? Ten years ago? Five years ago? One year ago?
    • Focus on Boundary Wins: What demands are you now declining that you used to  accept out of guilt or shame?
    • Recognize Unseen Achievements: Write down three wins from this week that have nothing to do with external productivity--no matter how small they are.
    • Recognize Your Unconditional Self Worth: Aside from your accomplishments or hoped-for accomplishments and regardless of productivity, what qualities do you possess that make you an inherently valuable person?
Writing in a Journal to Cope With Perfectionism

Quick Tips For Journalers Who Are Perfectionists
People who have perfectionist tendencies often struggle with journaling because they get stuck in certain areas. This is usually because they:
  • Want to pick the "perfect" book or online site to use to journal.
  • Believe their journal should be "flawless" with no scratch outs or scribbles.
  • Believe that whatever they write should be very insightful all the time.
If this sounds like you, you can try these quick tips to see if they're helpful for you:
  • The "Ruin It" Strategy: If you're writing in a journal book, you can start your journal with a big intentional scribble to break the distortion in your thinking that your journal must be "perfect".
  • Time Your Writing Sessions: Set a timer for 5 or 10 minutes and stop writing when the timer goes off--even if you are in mid-sentence. This can help you to overcome the habit that what you're doing must be completely finished.
  • No Editing Allowed: Use a pen. Don't cross out mistakes. Don't tear out pages from your journal. Allow the journal to be messy.
Get Help in Therapy
These journal prompts and tips can help you to cope with perfectionism.

However, if you want to overcome perfectionism, you might need to do deeper work with a licensed mental health professional who can help you to overcome the problems that are holding you back.

Get Help in Therapy 

Rather than struggling on your own, IFS Therapy is particularly effective at helping clients to overcome perfectionism and other problems (see my article: IFS Therapy is a Gentle, Evidence Based Therapy).

I will write more about how proactive and reactive parts develop from an IFS therapy perspective.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, IFS Parts Work, EFT Couples Therapist, Somatic Experiencing and Certified Sex Therapist.

I have helped many individual adults and couples.

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

I provide a free 10-15 minute phone call before setting up an appointment.

You can call me at (917) 742-2624 during business hours or you can email me.

Also See My Articles:





















 

Friday, July 31, 2026

What is the Approach-Avoidance Conflict in Psychotherapy and How Can IFS Therapy Help?

In my prior article, Why Are So Many of Us Fearful of Change While Others Embrace It?, I mentioned the approach-avoidance conflict as it relates to making changes.

The Approach-Avoidance Conflict

In the current article, I'm focusing on the approach-avoidance conflict as it relates to many clients in therapy.

What is the Approach-Avoidance Conflict in Therapy?
As I mentioned in the prior article, although many people want to make positive changes in their life, they often experience ambivalence about the change--even when it's something they really want.

As a New York psychotherapist in private practice, I see this all the time.

Since it's a common experience, if you learn to expect it, you can learn to accept and deal with that part of yourself that might want to avoid positive change.

So, let's explore this dynamic further.

In psychotherapy, the approach-avoidance conflict is a psychological state of tension that occurs when a client is simultaneously drawn towards and repelled by the exact same goal, action or dynamic.

The approach-avoidance conflict was originally introduced by Kurt Lewin, a psychologist, who described this dynamic as a "tug of war". 

This dynamic is key to understanding why at a certain stage of therapy many clients experience anxiety and stagnation about the changes they want to make.  

What is the Typical Pattern For the Approach-Avoidance Conflict in Therapy?
This conflict often operates on a predictable pattern based on how close clients are to their goal:
  • The Approach to a Goal: When clients are far away from a goal, they can see the positive benefits of their goal ("the approach"). This motivates them to move forward.
  • The Avoidance of a Goal: As clients move emotionally or physically closer to the goal, many of them begin to perceive negative consequences or fears ("the avoidance") which grows sharply the closer they get to their goal.
  • The Point of Stagnation: Eventually, the force of the avoidance equals the force of the approach. At that point, these clients can get stuck as they experience anxiety, indecision or behavioral paralysis.
What Are the Clinical Scenarios Where the Approach-Avoidance Conflict Shows Up in Therapy?

Here are some typical examples:

Intimacy and Relationships:
The Approach-Avoidance Conflict in Therapy
  • The Avoidance (Fear): Fear of vulnerability, rejection or losing independence.
  • Resulting Behavior: Sabotaging relationships just as they become serious.
Trauma Processing:
  • The Approach (Pull or Desire): Wanting to heal, gain closure and reduce traumatic symptoms.
The Approach-Avoidance Conflict in Trauma Therapy
Career Change:
  • The Approach (Pull or Desire): Desiring a fulfilling, high-paying and prestigious position.
  • The Avoidance (Fear): Fear of failure, longer work hours or more responsibilities.
  • Resulting BehaviorProcrastination in submitting a job application or applying for a promotion.
Behavioral Change
  • The Approach (Pull or Desire): Wanting a healthier body and stable life.
The Approach-Avoidance Conflict and Behavioral Change
  • The Avoidance (Fear): Fear of facing reality the necessary changes involved.
  • Resulting Behavior: Reverting back to unhealthy behavior, missing sessions or dropping out of therapy prematurely.
How Does IFS Therapy Deal With the Approach-Avoidance Conflict?
IFS (Internal Family Systems) Therapy is uniquely suited for this dynamic (see my article: IFS Therapy is a Gentle Evidence-Based Therapy).

IFS Therapy and the Approach-Avoidance Conflict

The IFS therapist deals with the approach-avoidance conflict by recognizing that clients who experience this dynamic have a clash between two or more parts of themselves.

Instead of trying to push through the conflict, the IFS therapist helps clients to overcome this dilemma by identifying clients' internal parts and identifying the positive intentions of each of the conflicting parts. She also helps clients to negotiate between these conflicting parts.

What is the IFS Therapy Framework For the Approach-Avoidance Conflict?
In IFS, the "approach" and "avoidance" aspects of clients are seen as separate parts of the client who have good intentions. There is a recognition that these conflicting parts have served the client in the past by protecting old emotional wounds:
  • The Approach Part: This is usually an internal proactive protective part. This part wants to move forward, achieve goals or seek connection because doing so will bring safety, fulfillment or a sense of increased self worth.
IFS Therapy and the Approach-Avoidance Conflict
  • The Avoidance Part: This is usually a reactive protective part. It stops progress because it senses danger. It fears that moving forward will trigger an old emotional wound, shame or trauma from the past.
What is the IFS Therapy Step-By-Step Process For Resolving Internal Conflict?
The IFS therapist will guide the client through the following process to overcome the client's behavioral conflict:

Differentiating the Internal Parts: Instead of saying, "I want to change, but I can't", the therapist helps the client to reframe it: "A part of me wants very much to move forward, and another part of me is terrified to do it." In addition, the therapist helps the client to discover and embody Core Self, which is the compassionate and curious part of the client. This enables the client to look at both of these internal parts without taking sides.
  • Honoring The Avoidant Part (The Protector): Traditional psychotherapy often wants to override the client's avoidance. IFS does the opposite: It focuses on the avoidant part first. The IFS therapist asks the client to get curious about the avoidant part by asking: "How is this part protecting you?" and "How did it protect you in the past?". Also, "What is this part afraid will happen if you take this step?" By validating that the avoidant part has a positive intention (e.g., protecting the client from rejection, failure or an old emotional wound), the protecting part usually loosens its grip. This usually doesn't happen immediately because the avoidant part must first learn to trust the Core Self of the client as well as the intention of the therapist.
IFS Therapy and the Approach-Avoidance Conflict
  • Facilitating Internal Negotiation: Once each of the conflicting parts feels heard and seen by the client's Core Self and the therapist, the therapist helps the client to invite these parts to talk to each other. The Core Self might ask the avoidant part, "If I promise to go very slowly and protect you, would you be willing to allow the approach part to take a small step?" Since this protective/avoidant part is no longer being resisted or ignored, it usually agrees to soften or step aside temporarily.
  • Working With the Wounded Part: Ultimately, the avoidant part is hypervigilant because it's protecting the wounded part of the client. Once this protector feels safe enough to step aside, the IFS therapist guides the Core Self to witness, work through the original trauma and heal. When the underlying emotional pain and trauma have been resolved, the avoidant/protector part usually drops the avoidant behavior because the underlying danger no longer exists.
Clinical Vignette
The following clinical vignette illustrates how the approach-avoidance conflict is overcome in IFS therapy:

John
When John met Donna, he felt a strong attraction to her and he asked her to go out on a date.

As they got to know each other, they both enjoyed each other's company and the new relationship energy that comes with being in a new relationship.

A few months later, as the relationship became more serious, Donna wanted a commitment from John but, even though he knew he loved Donna, he felt himself pulling away from her and he didn't understand what was happening to him.

At that point, Donna's friends told her she should end the relationship because they thought John was a "commitment-phobe".  But Donna felt John was struggling with some kind of internal conflict and she wanted to give him a chance to overcome the conflict, so she suggested that he get help in therapy.

IFS Therapy and the Approach-Avoidance Conflict

Since John also wanted to understand why he felt so conflicted about making a commitment with Donna, he started therapy with an IFS therapist.

John had never heard of IFS therapy, but he was curious as to how it might help him to overcome his internal conflict.

Over time, as they explored John's family history, they discovered that John had an unresolved trauma related to his mother's anxiety and depression. When he was a child, John felt he was unlovable because his mother was emotionally distant and his father was often away on business.

With the help of his therapist, John realized that this old emotional wound was making him feel emotionally vulnerable with Donna in a way where a part of him wanted to escape the relationship, but another part of him wanted to remain, which reflected his ambivalence.

The work in therapy was neither quick nor easy, but John was motivated to work through his internal conflict about making a commitment to Donna. With the help of his therapist, he was able to see the good intention of the avoidant part of him and how it protected him in the past when he was a child.

His therapist guided John into feeling curious and compassionate towards this avoidant/protector part so that, eventually, it softened enough so he and his therapist could work on his traumatized wounded child part.

Over time, John was gradually able to let go of his fear because he had an embodied sense that, unlike when he was a child, he was now safe and more capable of being in a committed relationship with Donna.

Once he was freed from his traumatic history, John made a commitment to Donna and they moved in together with the eventual goal of getting married.

Conclusion
Although many people want to make positive changes in their life, they often experience an ambivalence about the change as the change becomes more of a reality--even when it's something they really want.

In psychotherapy, the approach-avoidance conflict is a common psychological state of tension that occurs when a client is simultaneously drawn towards and repelled by the exact same goal, action or dynamic.

This is a common experience in therapy. 

In traditional psychotherapy, therapists often try to push through the ambivalence, which can make a client feel even more ambivalent, so this usually doesn't work.

An IFS therapist recognizes that we all have many different internal parts and some of these parts are polarized so they are in opposition to each other. They also recognize that this is often outside a client's awareness, so they reach for the ambivalence so it can be worked on.

IFS therapy is ideally suited for dealing with the approach-avoidance conflict.

Get Help in IFS Therapy
If you are stuck in an approach-avoidance dilemma, rather than struggling on your own, you could benefit from working with an IFS therapist.

Get Help in IFS Therapy

Being able to work through the conflict provides you with an opportunity to live a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, IFS Parts Work Therapist, EFT Couples Therapist, 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.

I provide a free 10-15 minute telephone call before setting up an appointment.

You can contact me at (917) 742-2624 during business hours or you can email me.

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