The Traumatic Impact of Verbal Abuse on Self Esteem

In a prior article I began a discussion about verbal abuse (see my article: The Connection Between "Tough Love" and Verbal Abuse).

The Traumatic Impact of Verbal Abuse on Self Esteem 

In the current article I'm focusing on how verbal abuse can affect self esteem.

How Does Verbal Abuse Affect Self Esteem?

When children experience verbal abuse, the abuse can have long lasting effects on their self esteem.

Clinical Vignettes

The following vignettes, which are composites of many cases, illustrates how verbal abuse can have long lasting effects and how trauma therapy can help:

John

As the youngest child, John grew up in a household where his father yelled and criticized him while his mother, who was intimidated by the father, stood by passively and did nothing. His older siblings would also join in the criticism by bullying John. He grew up feeling that he couldn't do anything right. His self esteem was so low that, even though he was intelligent, he was fearful of raising his hand in class to answer the teachers' questions. He only had one friend who also came from a household where he was verbally abused. 

The Traumatic Impact of Verbal Abuse on Self Esteem

By the time John got to college, he spent most of his time alone until he met Peggy in English class. She was friendly and outgoing and she asked John out on a date. They dated throughout college and both of them planned to move to New York City when they graduated. By then, John's confidence was so low that he was afraid to apply for jobs, so Peggy encouraged him to get help in therapy. 

After he began seeing a trauma therapist, John learned how his father's verbal abuse affected how he felt about himself. His therapist helped John by using EMDR Therapy (Eye Movement Desensitization and Reprocessing) to help him to overcome the traumatic effects of the childhood verbal abuse.

Nina

Nina was an only child with a single alcoholic mother. She learned to take care of herself at an unusually young age because she couldn't rely on her mother, who was often drunk and passed out. When her mother woke up with a hangover, she would be angry and hostile towards Nina. She would call her names and tell her she wished Nina had never been born. 

The Traumatic Impact of Verbal Abuse on Self Esteem

After one of her teachers suspected that Nina was being abused, she called the Administration For Children's Services Child Protective Services and Nina was eventually placed in kinship foster care with a maternal aunt who lived nearby. 

Although her aunt was much more nurturing, the impact of the mother's verbal abuse had already had a devastating effect on Nina. Even though she was no longer around her mother, Nina had internalized her mother's verbal abuse to such an extent that she was now criticizing herself silently by repeating in her mind, "I'm so stupid" or "I'm no good." 

By the time she was 18, her self esteem was so slow that she told aunt she didn't want to go to college. So, her aunt found Nina a trauma therapist who did AEDP (Accelerated Experiential Dynamic Psychotherapy) to help Nina overcome the impact of her mother's neglect and verbal abuse. After working in trauma therapy, Nina felt more confident and she applied to several colleges. 

Tom

By the time Tom was 35 years old, he had been living an lonely and isolated life for all his life. Growing up as the youngest child, he watched his parents argue constantly and his father frequently left the household for extended periods of time without saying when he would come back. Tom and his older brothers spent most of their time isolated in their own rooms. 

Eventually his older brothers moved out without a word, so Tom was left alone with his combative parents. He tried to stay out of their way, but they would often turn their anger on him by yelling at him and criticizing almost everything he did. As a result, Tom grew up with a lot of shame and low self esteem.  

The Traumatic Impact of Verbal Abuse on Self Esteem

In his mid-30s, he knew he needed to get help in therapy because he was suffering with anxiety and depression, and his self esteem was so low that he lacked the confidence to meet women. So, he sought help from a trauma therapist who did Parts Work Therapy and he began to recover from the impact of his childhood trauma.

Conclusion

The negative impact of verbal abuse experienced in childhood often endures throughout adulthood.

Even though verbal aggression tends to be minimized in our culture, verbal abuse can be just as traumatic as physical or sexual abuse.

The vignettes presented above are just some of the possible ways verbal abuse can be traumatizing. 

Often, adults don't connect their low self esteem, depression or anxiety to their childhood history.  Instead, they might blame themselves or believe they are "not good enough" or they are "unlovable" without ever making the connection to their history or realizing they can get help in trauma therapy.

Getting Help in Trauma Therapy

If you have been struggling with low self esteem as a result of unresolved trauma, you can get help in trauma therapy.

Getting Help in Trauma Therapy

A skilled trauma therapist can help you to overcome harmful effects of unresolved trauma 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 and Certified Sex Therapist.

I have over 20 years of experiencing helping individual adults and couples (see my article: What is a Trauma Therapist?).

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

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

Now That You're An Adult, Your Parents Have Changed Into the Parents You Wanted As a Child

As a psychotherapist in New York City, I hear many adult clients tell me that they have problems reconciling who their parents were in the past to who their parents are now.

In these situations, psychotherapy clients often say something like, "My mother was so abusive when I was growing up, but now she's a sweet, kind lady. I can't believe she's the same person. I'm glad she's changed, but I'm having problems reconciling that the mother from the past is the same mother in the present.  Why wasn't she kind to me when I was a child?" (see my article: Looking at Your Childhood Trauma From An Adult Perspective).

Now That You're an Adult, Your Parents Have Changed Into the Parents You Wanted As a Child

This change often presents a dilemma for clients attending psychotherapy.  They are traumatized, they are affected in their current life by the childhood abuse.  But many of these clients also feel a sense of guilt for complaining about their parents' past behavior because their parents are no longer like that.  Not only do they experience guilt, but they also feel confused about the change.

On an intellectual level, most clients understand that people often change and who they were in the past is no longer who they are in the present.  But on an emotional level, especially if the past trauma is getting triggered in their current circumstances, it's hard to reconcile the change (see my article: Coping With Trauma: Becoming Aware of Emotional Triggers).

These clients often experience anger, sadness and resentment for the love and nurturing they didn't get as a child.  Many of them also express surprise to discover that their parents have changed because they never thought their parents would ever change.

In many cases, the change becomes evident when these adult clients have their own children and their parents, as grandparents, interact with their grandchildren in a much more nurturing way than they ever did with these clients when the clients were children.

This sometimes creates a dilemma for these clients because, on the one hand, they feel somewhat envious that their children are getting the love and nurturance from the clients' parents that these clients wanted for themselves as children.  But, on the other hand, even though these clients' feelings are understandable, no one wants to feel envious of their own children.

A Fictional Clinical Vignette: Your Parents Today Have Changed Into the Parents You Wanted As a Child:
The following fictional clinical vignette is typical of this issue and illustrates how psychotherapy can help:

Beth
Describing a horrific childhood with both physical abuse and neglect, Beth, who was in her 40s, told her psychotherapist that, she recently gave birth to a baby girl, Cindy.  She said that, after being estranged from her parents for many years, she and her husband were considering whether or not to contact her parents about Cindy's birth.

Beth described a traumatic childhood where she and her younger sister, Sandy, often cowered in their room when one or both parents lost their tempers and hit them with a belt.  Other times, her parents would leave them alone at home over the weekend with no food as the parents went to a resort in Upstate New York.

Beth said that neither she nor Sandy ever told anyone about the abuse or neglect because they were both too afraid of the repercussions.  As a result, they endured the abusive and neglectful behavior until they were old enough to leave the household.  Beth even delayed going to college for a year so that she and Sandy could leave the household at the same time.  She feared that if she left Sandy alone with their parents, they would unleash all their anger on her after Beth was gone.

Beth's husband, John, who had heard the horrific stories of Beth's childhood, would have preferred that Beth not contact them at all.  He feared that they might want to be involved with Cindy, and he definitely felt uncomfortable with that.  But he left the decision about contacting her parents up to Beth.

Ultimately, Beth decided to send her parents a note.  She would rather that they hear about Cindy directly from her rather than hearing it from other relatives who were still in Beth's life.

Based on their experiences with their parents, Beth and Sandy both doubted that their parents would want to be involved in Cindy's life.  So, Beth, Sandy and John were shocked when her parents wrote back that they were thrilled to hear that they were grandparents and they wanted to reconnect with Beth and Sandy and see the new baby.

At first, Beth wasn't sure what to do.  Before she contacted her parents, she knew there was a possibility that they might want to meet Cindy, but she thought of it as a very remote possibility.  She was shocked that her parents would even care enough to want to reconcile and meet Cindy.

When she talked it over with John, she understood his reluctance.  He had never met her parents and, after hearing about Beth's traumatic childhood, he hoped he would never meet them.  He was angry for the hurt that they caused Beth and Sandy.

After they talked it over and Beth discussed it in several therapy sessions with her psychotherapist, Beth and John decided to have a short visit with her parents in a nearby park rather than inviting them over to their apartment.  Sandy decided that she didn't want to see her parents, so she told Beth that she wouldn't go.

With much trepidation, Beth and John waited for Beth's parents at the area they designated in the park.  While they waited for Beth's parents to show up, they both wondered if they were making a big mistake.  But it was too late to back out at that point.

During her next psychotherapy session, Beth told her psychotherapist that she was amazed at how pleasant and nurturing her parents were with Cindy and with her and John.   Not only were they thrilled that they were now grandparents, they both said how much they missed Beth.

Afterwards, Beth was so surprised that she could hardly believe that they were the same parents who were abusive and neglectful with her and Sandy.

Her amazement was so great Beth told Sandy that when she was with their parents, for a second, she wondered if the abuse and neglect had ever happened.  She wondered: How could these be the same people?  But she was relieved that Sandy, who was also shocked to hear that their parents were pleasant, confirmed Beth's sense of reality about their childhood.

John was also surprised.  After hearing about Beth's childhood, he wasn't sure what to expect when they met for the first time.  But he wasn't expecting such a warm response from them.

Aside from needing help to reconcile her parents of today with her parents from the past, Beth also started therapy because she wanted to work on her unresolved childhood trauma.  But, after reconnecting with her parents, initially, Beth had difficulty processing the earlier trauma because she felt like her parents were such different people now, and she continued to have doubts regarding her perceptions of her childhood.

She felt a guilty complaining to her therapist about her parents when they were now behaving in such a loving and nurturing way with Cindy.  Even though Sandy confirmed her sense of what happened when they were children and she knew, on an intellectual level, what happened, there were still times, on an emotional level, when Beth felt like she might be "exaggerating" or "making a big thing out of nothing."

Beth's psychotherapist provided her with psychoeducation about how adults, who were abused and neglected as children, often have doubts about their childhood history--especially if their parents had changed.  Knowing that this was a common experience for many clients, Beth felt somewhat relieved to know that other people had similar experiences.

In addition, Beth had many mixed feelings about her parents.  She told her therapist that, when she was a child, she longed to have parents who were as loving as her parents were now to her daughter.  Although she was glad that they were able to be loving towards her daughter, she also felt a lot of grief for what she didn't get emotionally from her parents when she was a child.  She told her therapist that she was felt guilty to admit that she sometimes envied Cindy because her parents could be so loving towards Cindy.

Her psychotherapist used EMDR therapy to help Beth to process her traumatic childhood (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

The work was neither quick nor easy.  As part of her trauma work, Beth grieved for the love she didn't get as a child.

In the meantime, as Beth was resolving her childhood trauma, she and her husband were making decisions about how much contact they wanted Cindy to have with Beth's parents.

Conclusion
People are often amazed when parents, who were abusive to them when they were children, can now be kind and loving as grandparents.

There can be many reasons for this, including:

• Abusive parents often mellow with age.  
• Grandparents are usually under less pressure with their grandchildren than they were as parents.  Often, they can have a good time with their grandchildren without the stress they felt when they were rearing their own children.
• People change, and abusive parents might have regrets about their behavior.  
• Grandparents, who have regrets about being abusive parents, often see grandparenting as a way to make up for the abusive way they treated their own children.

Of course, every situation is different, and each person needs to make his or her own decision about whether to allow a formerly abusive parents back in his or her life.

It's also true that, even when there aren't grandchildren involved, abusive parents can change over time, and their adult children have many of the same problems reconciling the parents of the past with the current parents.

Getting Help in Therapy
Coping with a history of unresolved childhood trauma is difficult, especially when, as an adult, unresolved trauma gets triggered in the present.

Psychotherapy with a skilled trauma therapist can help you to overcome unresolved trauma, so you can free yourself from your history and live a more fulfilling life (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma therapist who works with individual adults and couples, and I have helped many clients to overcome unresolved trauma.

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.

Understanding How an Avoidant Attachment Style Affects You and Your Relationship

In my prior articles, How Your Attachment Style Affects Your Relationship and How Early Attachment Bonds Affect Adult Relationships, I discussed attachment styles in general and the affect they can have on relationships.  In this article, I'm focusing specifically on the avoidant attachment style, its origins, and how it can affect a relationship (see my article: An Emotional Dilemma: Wanting and Dreading Love).

Understanding How an Avoidant Attachment Style Affects You and Your Relationship

Relationships: From Passion and Excitement to Fear of Emotional Intimacy
While relationships often start with passion and excitement, each person's core vulnerabilities can emerge as the relationship becomes more serious, the couple becomes more attached, and the emotional intimacy increases.  If both people are emotionally secure because they grew up in loving and secure homes where their emotions needs were mostly met, when issues , they can usually be worked out more easily than one or both people have an insecure attachment style.

But people who developed an insecure attachment style, like avoidant attachment, as a coping strategy when they were children, can become increasingly uncomfortable as the relationship becomes more emotionally intimate.  With greater emotional intimacy, they become aware that they are more emotionally dependent upon their romantic partner, which can make them feel emotionally vulnerable.

People with an avoidant attachment style are often unable to put their fear into words.  Depending upon how threatened they feel by the emotional intimacy of the relationship, they will often dissociate and become estranged from their own feelings and from their partner because this is the emotional survival strategy that they developed in childhood.

They will often shut down emotionally.  Although they might appear from the outside as if nothing much is going on, internally they are in a state of turmoil and often unable to express their feelings.

They appear as if they are deliberately stonewalling their partner but, in most cases, they have really "checked out" or dissociated because they're overwhelmed, and the more the other partner insists that they talk about what's happening, the more dissociated they can become (see my article: Relationships: Are You a Stonewaller?).

How Do People Develop an Avoidant Attachment Style?
The avoidant attachment style usually begins in early childhood due to consistent neglect or abuse.  If the parents are unable to provide the baby with an emotionally safe home environment, the baby, who is unable to fight or flee, goes into "freeze" mode, which is another term for dissociation, as a last resort to cope with the abuse or neglect.

As adults, these individuals continue to be disconnected from their emotions.  Without the necessary help in early childhood about how to identify and tolerate uncomfortable emotions, these adults continue to engage in maladaptive coping strategies to avoid experiencing uncomfortable feelings.  So, a strategy that saved them as infants becomes an obstacle to their knowing themselves and connecting with others.

Fictional Clinical Vignette: Understanding the Avoidant Attachment Style
Ken
During the first three months of his relationship, Ken, who was in his mid-30s, was in a state of bliss whenever he was with Ann.  They met at a party and they were instantly attracted to one another.  Soon, they were dating a few times a week and enjoying each other's company.

By the fourth month, Ken realized how deeply he cared for Ann, and he began to feel anxious. He wasn't sure what made him feel anxious, but he knew that he was feeling different from before.  Whereas he felt loving and carefree whenever he was with Ann before, he now felt ambivalent about seeing her.

Rather than feeling carefree and in a state of bliss, he now experienced anxiety just before they got together.  He tried to think of what changed, but he couldn't think of anything.  Nothing had occurred that would account for his anxiety.

Sometimes, he wondered if he just didn't care for her anymore, but he knew this wasn't true.  If anything, he cared for her more now than during their few couple of months dating, so none of this made sense to Ken.

Ken had been in two other serious relationships before, and he experienced a similar pattern--feeling happy during the early stage of the relationship and then increasingly uncomfortable as time went on.  In each case, he assumed that his feelings had changed or they had "grown apart" and he ended the relationships.  But there was something different about how he felt this time because, even though he felt anxious, he knew he still cared for Ann.

When Ann brought up that he seemed to be more distant around her lately, she asked him if there was anything wrong.  Ken didn't know how to answer her, so he remained quiet for a while.  Then, he assured Ann that he cared for her a lot and wanted to continue to see her.  This response seemed to satisfy Ann, but Ken knew it was just a matter of time before this issue came up again.

As he became increasingly concerned about what was going on for him, he contacted a psychotherapist to try to understand himself. When his psychotherapist asked Ken to talk about his family history, Ken talked about being an only child in a household where his mother was emotionally distant and his father was emotionally and physically abusive.  He had few specific memories of his childhood, but he knew that he was happy to go away to college, and he never moved back in with his parents again.

Ken discussed how emotionally distant he was becoming when he was around Ann.  He also spoke about being concerned that if he didn't get help, he might be jeopardizing his relationship.

After his psychotherapist assessed Ken over the next several sessions, she provided him with psychoeducation about attachment styles.  She told him that due to his traumatic childhood, he developed an avoidant attachment style which surfaced when relationships became more emotionally intimate and threatening to him.

His psychotherapist explained that their work in therapy would be neither quick nor easy, but if he stuck with therapy, he had a chance of overcoming his fearful, avoidant attachment style.

She began by helping Ken to identify his emotions.  Initially, this was very hard for Ken when he thought about his relationship with Ann.  He knew that he was happy at first when they were first getting to know each other.  He also knew that he felt anxious around her lately, but he didn't know why.

His psychotherapist taught Ken how to sense his emotions in his body.  She told him that the body offers a window into the unconscious mind and that if he could sense into his body, over time, he might be able to identify more specifically what he was experiencing (see my article: The Body Offers a Window Into Unconscious Mind).

At first, Ken had difficulty sensing into his body.  It took a while for him to be able to sense tension in his neck and chest.  Then, gradually, he was able to identify other emotions, like fear, when he thought about getting together with Ann.

Over time, Ken also noticed in therapy that as he focused on an emotion in his body, like fear, that it eventually dissipated.  So, after a while, he realized that emotions often come and go and that he was not identified by his emotions.

Ken's psychotherapist paid particular attention to what Ken was able to tolerate with regard to uncomfortable emotions.  She knew that his window of tolerance for emotions that made him uncomfortable was narrow, so she was careful not to have Ken dwell on uncomfortable emotions longer than he could tolerate.

Over time, Ken's window of tolerance expanded so he could tolerate uncomfortable emotions for longer periods of time.  Using Somatic Experiencing, this allowed them to explore what thoughts, memories of physical sensations came up for him as he experienced these emotions.

Over time, Ken had expanded his window of tolerance significantly.  Then, his therapist recommended that they work on the root of his problem, which was the childhood abuse and neglect, using EMDR therapy (see my articles:  How EMDR Therapy Works: EMDR and the Brain).

In the meantime, Ann, who knew that Ken was in therapy working on his problems, was patient.  She mentioned to him that she noticed some progress.  Specifically, she sensed that his ability to remain emotionally connected to her had improved somewhat.  She noticed that he wasn't as emotionally distant with her as he had been before.  This was encouraging to both of Ken and Ann.

Understanding How an Avoidant Attachment Style Affects You and Your Relationship

Over the next year, Ken continued to work with his psychotherapist using EMDR therapy to resolve his traumatic past.  EMDR therapy helped Ken to make emotional connections between his current fear and the fear that he experienced when he was a child.

He also began to develop an ability to separate his fear from childhood from what was getting emotionally triggered in his relationship (see my article:  Overcoming Emotional Trauma: Separating "Then" From "Now").

He understood on an emotional level that, whether he was in a close relationship with Ann or with someone else, this fear would get triggered (see my article:  Coping With Trauma: Becoming Aware of Emotional Triggers).

Eventually, Ken worked through his early trauma, he became more connected to his internal world and more connected to Ann.

Conclusion
Attachment styles are developed early in childhood.  If a child grows up in a secure, loving home environment, all other things being equal, s/he will usually develop a secure attachment style.  If a child grows up in an abusive and/or neglectful home environment, s/he will probably develop an insecure attachment style.

The avoidant attachment style is one form of insecure attachment.  It becomes more obvious in a relationship as the relationship becomes more emotionally intimate.

At that point, what usually happens is that, on an unconscious level, the person with an avoidant attachment style uses the same emotional survival strategy that s/he used as an infant--s/he dissociates, which creates an internal emotional estrangement as well as creating distance from a romantic partner.

Although this is a maladaptive coping strategy as an adult, it keeps him or her from becoming overwhelmed.  However, it also creates the kinds of problems which I described in the vignette above.

Since the root of the problem is in childhood, this is where the therapeutic work needs to be.  However, the psychotherapist must make sure first that the client can tolerate feeling his or her uncomfortable emotions.  If the client can't tolerate uncomfortable emotions, which is usually the case, the therapist needs to help the client to expand his window of tolerance first so that, gradually, s/he can tolerate difficult emotions.

Once the client can tolerate difficult emotions, then the therapist can help the client to overcome the original traumatic experiences which are at the root of the problem using a form of trauma therapy, like EMDR (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
It can be very confusing to realize that your feelings have changed from bliss to anxiety during the course of a romantic relationship which has become more emotionally intimate.

A skilled psychotherapist, who uses experiential therapies, like Somatic Experiencing and EMDR therapy, can help you to expand your window of tolerance and, eventually, help you to work through the root of your traumatic experiences (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than suffering alone, you owe it to yourself to get help in trauma therapy.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

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 regular business hours or email me.

Leaving Therapy Prematurely: Overcoming the Urge for a "Flight Into Health"

In a prior article, When Clients Leave Therapy Prematurely,  I wrote about clients leaving therapy before they've completed the work.  In this article, I'm focusing on a particular dynamic called a "flight into health" where a client avoids any further exploration of his or her problems out of fear with a temporary cessation of symptoms that brought the client into therapy in the first place.

Psychotherapy: Overcoming the Urge for a "Flight to Health"

Often, this "flight into health" is unconscious.  It is based on a fear of further in-depth work on the presenting problem.  At the time, the client is convinced that s/he is feeling better and no longer needs to come to therapy.

S/he is usually unaware that what's really happening is that s/he has convinced him or herself that everything is fine now.  But, usually, s/he is suppressing the symptoms, and the suppression of these symptoms can only be maintained for so long before they come to the surface again.

There are some clients who go through this time after time with different therapists and they are unaware of what they're doing, so they can be in and out of therapy many times.

In many cases, these clients haven't developed the necessary internal resources and coping skills to do the work (see my article:  Developing Internal Resources and Coping Skills).

Let's take a look at a fictional vignette, based on many different cases, to understand how this plays out:

Lynn:
Lynn had been in therapy several times as an adult.  Each time she started therapy, she came for the same reason:  to deal with a history of physical abuse by her mother when she was a child.

Psychotherapy: Overcoming the Urge For a "Flight Into Health"

Her pattern was that she would remain in therapy for several sessions, and when she and her therapist began to speak about how angry and sad she felt about the physical abuse, she would suddenly "feel better" and decide that she no longer needed to be in therapy.

Against her therapist's advice, she would leave, feeling somewhat relieved to have talked about the abuse.  But within a few months, she would begin feeling depressed and anxious about her childhood abuse and decide to try a different therapist.

From her perspective, the prior therapies "didn't work" because she began feeling anxious and depressed again.  She didn't realize that she had fooled herself each time into thinking her problem was resolved when, in fact, it wasn't.

Instead, on an unconscious level, she suppressed her anxiety and depression, and covered it over with a lot of activity to mask her feelings.  She would plan many trips, outings, and social events to keep herself distracted and exhausted.

But after a while, this defensive behavior no longer worked for her and she felt disappointed that her old feelings were back.

When she talked about her prior attempts to get help in therapy with her latest therapist, she expressed her sadness and disappointment that prior therapists were unable to help her.

When the therapist discerned what was happening, she explained the concept of "flight into health" to Lynn as a way to help Lynn to understand her history in therapy.  Somewhat skeptical, Lynn listened, but she didn't feel it applied to her.

She wanted to begin immediately by delving into her traumatic history.

But suspecting that Lynn might be having problems with containing difficult emotions, her therapist told her that it was important to start with building the internal resources to do the work.

Her therapist explained that, without the internal resources and the necessary coping skills, Lynn could become easily overwhelmed and want to leave therapy by convincing herself that she was "feeling better" when, in fact, not much had changed.

Her therapist spent several sessions teaching Lynn how to calm herself with a breathing exercise, the Safe Place exercise, and certain mindfulness exercises.

She also helped Lynn with various containment exercises, including a visualization exercise where Lynn imagined that, before she left each session, she could place her uncomfortable feelings and reactions into an imaginary box with a lid on it that was kept in the therapist's office ready and waiting for the next time that Lynn came to therapy.

Initially, Lynn felt impatient with this preparation phase of therapy.  But when they began working on a memory about the early childhood physical abuse, using EMDR (Eye Movement Desensitization and Reprocessing) and Lynn began to feel overwhelmed, her therapist reminded her to use her internal resources, including the breathing, internal resources and visualizations.

By using her internal resources, Lynn was able to calm herself and contain difficult emotions.  She also made good use of the imaginary box with the lid that allowed her to imagine that she was leaving this traumatic memory and the difficult emotions associate with it with her therapist.  In other words, she didn't have to take it with her.

By the Lynn completed therapy, she felt the difference between her usual "flight into health," which was a defense against completing the work and actually overcoming the trauma.  In hindsight, she realized that whenever she thought she was "feeling better" before, it was only temporary.

Psychotherapy: Overcoming the Urge For a "Flight Into Health"

Lynn and her therapist went back to the traumatic early childhood memories again and Lynn no longer felt upset by them.  She felt compassion for herself as a child, but she no longer felt anxious or depressed.

Her therapist followed up with Lynn several months later, and Lynn told her that their work was holding.

Conclusion
While it's understandable that no one wants to dwell on traumatic memories, the reason why people come to therapy is that these memories are getting in the way of their leading the life that they want.

Emotional trauma doesn't resolve itself on its own (see my article:  ).

Without working through the trauma in therapy, it continues to have a strong impact on your current life.

A "flight into health" is an unconscious defense mechanism that clients use when their fear becomes  too much for them.  They convince themselves that they're "better" when, in fact, "feeling better" is a self generated feeling and only temporary.  Sooner or later, the problem makes itself felt again.

Preparation to do trauma work is essential to help the client to deal with the difficult emotions that can come up.  When clients have developed the necessary internal resources and tools beforehand, the trauma work is usually tolerable.

Rather than going from one therapy to the next, clients can complete the work and go on to lead more fulfilling lives without the affect of the earlier trauma.

Getting Help in Therapy
If you recognize yourself in this article, you owe it to yourself and your loved ones to get help with a therapist who can assist you with the necessary initial preparation.   The time spent doing on preparation before trauma work is well spent in the long run (see my article: The Benefits of Therapy).

Rather than spending the rest of your life carry the burden of your emotional trauma and having it get in the way of leading a happy life, you can learn to contain and tolerate the emotions that arise so that you can resolve the trauma (see my article: How to Choose a Therapist).

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.

Confusing Starting to "Feel Better" With Emotional Healing

People often to come to therapy after their own efforts to heal emotionally haven't worked for them and they realize that they need help from a licensed mental health professional.  

It's understandable that a big part of the reason why they come to therapy is because they want to feel better, and it's often the case that when they begin to talk about their problems, they start to feel better.  

But the problem arises when clients stop attending therapy as soon as they start feeling better as opposed to when they have emotionally healed by working through the problem (see my article:  When Clients Leave Psychotherapy Prematurely).

Leaving Therapy:  Confusing Starting to "Feel Better" With Emotional Healing

Since starting to feel better often begins during the initial stage of therapy, a client who leaves therapy before s/he has worked through the problem is leaving prematurely and will usually experience a "relapse" of the emotional problem because starting to feel better isn't the same as resolving the problem.  It's just a temporary alleviation of symptoms until the symptoms come back to the surface again.

Let's take a look at an example of this in the following vignette which is a composite of many different cases to protect confidentiality:

Jack
Before coming to therapy, Jack tried to deal with his panic attacks around his difficult boss by working out at the gym, attending yoga classes, and talking to friends about it.  But none of these efforts helped him (see my articles:  Workplace: Coping with a Difficult Boss and How Your Workplace Can Feel Like a Dysfunctional Family).

Leaving Therapy:  Confusing Starting to "Feel Better" With Emotional Healing

When he went to see his medical doctor, his doctor gave him a prescription for anti-anxiety medication for short term use and recommended that Jack see a psychotherapist to work out whatever underlying issues might be affecting him.

Jack discovered that the medication helped to relieve his panicky symptoms for short periods of time. But he realized that, after a while, he needed a higher dose to alleviate symptoms, and he didn't like becoming dependent upon medication.  So, although he preferred not to go to therapy, he followed his doctor's advice and contacted me for help.

After we talked about his family history, both Jack and I began to see parallels between his situation at work and his abusive father.  Both men were overbearing and verbally abusive.  Jack's father was also physically abusive with Jack when Jack was a child.

Just knowing this was a tremendous relief for Jack.  Until then, he felt that he was "going crazy" whenever he had a panic attack around his boss.

As Jack started to understand that he was reacting to his boss as if he were a child and his boss was his abusive father, he began to be able to separate his current experiences from his childhood experiences (see my articles:  Reacting to the Present Based on Your Traumatic Past).

At that point, Jack decided that he didn't need to continue in therapy anymore because he "understood" why he was having his panic attacks.  So, during a period of time when his boss was away on an extended business trip, Jack decided that he was "feeling better" and he would end therapy.

Leaving Therapy:  Confusing Starting to "Feel Better" With Emotional Healing

I tried to explain to Jack that the alleviation of his symptoms was probably temporary since he had not worked through the underlying emotional problems (his childhood history of being abused) involved in his current problem.  Understanding logically was the first step, but it usually doesn't resolve these types of problems.  There was also the fact that his boss was away so Jack wasn't getting triggered at that point by the boss's abusive behavior.

But Jack had made up his mind about leaving therapy.  So, I told him that my door remained open and he could return in the future.

Within a couple of weeks, after his boss returned, I received a call from Jack, who said that he was having panic attacks again. In one instance, he thought he was having a heart attack and he went to the ER.  After the ER doctors ruled out a heart attack, they told Jack that he was having a panic attack with heart palpitations, shakiness and sweating and he should seek help from a licensed mental health professional.

Leaving Therapy:  Confusing Starting to "Feel Better" With Emotional Healing

Jack said that this was, by far, the worst panic attack that he had ever had and it frightened him to the point where he was now constantly worried that he would have another panic attack.

We resumed our work that week.

I began by helping Jack to develop internal resources, which are basically coping skills (see my article:  Developing Internal Resources in Therapy).

After helping Jack to develop the internal resources to do the therapeutic work, we started doing EMDR therapy (Eye Movement Desensitization and Reprocessing), a mind-body oriented type of therapy to work on the current situation as well as the underlying issues that were getting triggered by his unresolved childhood trauma (see my articles:  What is EMDR?, How EMDR Works: Part 1: EMDR and the Brain, How EMDR Works - Part 2: Overcoming Trauma and EMDR: When the Past is in the Present).

As we worked together, Jack learned to manage his panic-related symptoms.  More importantly, over time, the EMDR therapy helped Jack to work through the unresolved childhood abuse he experienced with his father that was getting triggered with his boss (see my article:  Mind-Body Psychotherapy: The Body Offers a Window into the Conscious Mind).

He no longer had panic attacks because the underlying traumatic issues triggering the attacks got worked through so they were no longer there to be triggered (see my article:  Experiential Therapy. Like EMDR, Helps to Achieve Emotional Breakthroughs).

Leaving Therapy:  Confusing Starting to "Feel Better" With Emotional Healing

Not only did Jack "feel better," but his boss's abusive behavior no longer frightened him.  In fact, for the first time, Jack saw that his boss was really an insecure man who bullied employees to bolster his own low self esteem.

Rather than freezing in panic, Jack's attitude about the work situation was that, although it was unpleasant, he no longer felt threatened by it.

A few months later, Jack found a better job where he felt happier, respected and well compensated.

Summary
Just like "Jack," many clients think that their work in therapy is over once they understand their problem and they start to "feel better."  Unfortunately, this usually doesn't last, especially when emotional trauma is involved.

An intellectual understanding is a good start, but it's not the same as actually working through the problem, as "Jack" discovered.

The working through process necessitates working on a deeper level than just having a cognitive understanding.

EMDR and other mind-body oriented types of therapy, like Somatic Experiencing and clinical hypnosis tend to be more effective and efficient than regular talk therapy when the problem involves emotional trauma (EMDR: When Talk Therapy Isn't Enough).

Of course, everyone is different and these types of therapy aren't a quick fix but, as an experienced therapist, I have found that EMDR and other mind-body oriented types of therapy tend to work faster to resolve trauma.

Getting Help in Therapy
If you have tried unsuccessfully to work out your problems on your own, you owe it to yourself to get professional help from a licensed mental health professional (see my article:  How to Choose a Psychotherapist).

Rather than continuing to suffer on your own, you could work through your problems so that you can lead 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.

In addition to providing mind-body oriented psychotherapy, I also use talk therapy with clients who would benefit from it.

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.

Relationships: Why Emotional Abuse Might Feel "Normal" to You

People who were emotional abused as a children are more likely to experience emotional abused in an adult relationship as "normal" (see my article:  Overcoming the Effects of Childhood Trauma).

Relationships: Why Emotional Abuse Might Feel "Normal" to You

As compared with people who were emotionally abused as children, people who weren't emotionally are less likely to tolerate abuse in an adult relationship.  Generally speaking, they tend to end emotionally abusive relationships faster than people who experienced abuse as children.

People who have a history of emotional abuse as children will often come to therapy with an intellectual understanding that the abuse they're experiencing in their relationship is a problem, but often they don't feel it emotionally.  

It's not unusual for there to be a disconnect between what they know intellectually and what they feel emotionally because abusive behavior was the norm when they were children.

Rather than "alarm bells" going off in their head when they're being abused in a relationship, they're either too emotionally numb to recognize the abuse or it's just so familiar to them that it seems "normal."

Often, they don't come to therapy until a close friend or relative tells them that they're in an unhealthy relationship (see my article:  Do Your Friends See Things About Your Lover That You Don't Want to See?).

When they begin therapy, they might feel confused about the disconnect between what they know intellectually and what they feel emotionally.

Initially, they might minimize the abuse by telling themselves and their therapist that "It's not that bad."

Once they begin to realize the toll that the emotional abuse has taken on them, they're more likely to see and feel the depth of the emotional damage that the abuse has caused and then become motivated to overcome this problem in treatment (see my article: Overcoming Childhood Trauma So You Can Have Healthier Adult Relationships).

At that point, not only are they recognizing the damage of current abuse, but they also recognize the damage of the childhood abuse and how their history of abuse affects them as adults.

When these clients begin to process the trauma, it's important that their therapist recognizes how daunting this can be, especially for people who have been in denial for years about the childhood abuse.

The Need For Therapist's Empathic Attunement

The therapist needs to be not only empathetic and emotionally attuned to the client, she also needs to prepare the client to do the trauma work in a way that feels emotionally safe (see my article:  The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

If a client doesn't feel emotionally safe, s/he is more likely to abort treatment before the treatment is completed.

The therapist needs to do a thorough assessment of each client to determine how much preparatory work needs to be done before the trauma processing begins.

In a prior article,  I talked about this type of preparatory work, which is usually called resourcing in trauma therapy (see my article:  How EMDR Works).

Even after the trauma work has begun in therapy, the therapist needs to continuously monitor how the client is doing and encourage the client to talk to the therapist about how s/he is responding to the treatment.

Let's talk a look at an example of the dynamic that I've been discussing in this article.  As always, the example is a composite vignette of many different cases to protect confidentiality.

Nina

Nina came to therapy at the urging of her best friend after her friend witnessed, once again, how emotionally abusive Ed was towards her.

Relationships: Why Emotional Abuse Might Feel "Normal" to You

During her first session, Nina talked about how Ed would call her names (like "stupid") when they were around other people and also when they were at home.  This had been going on during the entire time of their four year relationship, and she recognized that other people seemed much more upset about it than she was.

When I asked her how she felt, she seemed unsure.  This lead her realization that most of the time she's out of touch with her emotions, and she has felt this way since she was a child.

When she was a child, she tried to avoid her father, who was highly critical of everyone in the family, including Nina's mother, who was passive.  She remembered closing the door in her room and turning on her radio so she wouldn't hear them argue.

Other times, she would spend hours by herself in her room daydreaming about having different parents who were kind and loving.

There were times when she couldn't avoid her father.  Dinner time was especially fraught because he would berate her for minor issues and call her names.  She would try to eat as quickly as possible to get away from him.

As we continued to explore her earlier experiences of emotional abuse with her father, Nina realized that she was numbing herself with her boyfriend, Ed, in the same way that she did with her father.

We worked on the earlier emotional abuse with EMDR and, as we did, Nina began to gradually feel her feelings.

Over time, she worked through the trauma of that earlier abuse, and she mourned for the family she wished that she had.

As she was working through her family trauma and she was more aware of her feelings, she realized that she deserved to be with someone who would treat her well and she became less tolerant of Ed's emotional abuse.

Relationships: Why Emotional Abuse Might Feel "Normal"

Eventually, Nina left Ed and she met another man.   They cared about each other deeply and he treated her well.

Conclusion
When an adult has a history of childhood emotional abuse, s/he is more likely to repeat this pattern in adult relationships by unconsciously choosing partners who are emotionally abusive.

Often this pattern goes unrecognized because the process is unconscious and also because children who were emotionally abused learn to protect themselves emotionally by numbing themselves.

Emotional numbing often continues into adulthood, which creates blind spots for people who are in abusive relationships.

Even if someone knows that a partner is being abusive, s/he usually has more of an intellectual understanding than an emotional understanding due to the emotional numbing.

Many people who are in emotionally abusive relationships never come to therapy.  Either they're not consciously aware of the abuse.  Or, if they're aware of it, they're too afraid of confronting this problem because they think they will be overwhelmed if they attempt to deal with it.

The therapist's empathic attunement helps the client to prepare to do the work and can make all the difference in being able to work through these problems.

Many people, who have sought help in therapy, have been able to work through these types of issues and, having worked through them, have found life to be a lot more fulfilling.

Getting Help in Therapy
You deserve to be with someone who treats you well.

If you're in an emotionally abusive relationship, seek help from a licensed mental health professional who has expertise in this area.

Rather than continuing to numb yourself emotionally to both painful feelings as well as good feelings, you could be leading a fuller and happier life.

About Me
I am a licensed New York City 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.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

This is the third article in a series of articles that looks at the effect of growing up with a parent who had borderline personality disorder.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

In my first article I gave an overview of borderline personality disorder, and in my second article I provided a fictionalized scenario of a young woman, Karen, from the time she was an infant until college, who grew up with mother who suffered with borderline personality.

In this article, I'll discuss how this fictionalized character, Karen, was affected by her mother's problems and how she was able to get psychological help in therapy to overcome these problems.

Karen
As I mentioned in the prior article, Karen grew up in a chaotic home environment with a mother who exhibited many of the symptoms of borderline personality disorder.

Karen often felt anxious because of her mother's anger, depression and unpredictable moods.  She wished that she could help her mother, especially after many of her mother's frequent breakups with men and a suicide attempt.  But Karen was too young, and she often felt helpless.

Fortunately, she had a schoolteacher who took Karen under her wing.  This teacher liked Karen, and she motivated and inspired her to look forward to a future that included college.  This was a new perspective for Karen.

Karen had a lot of inherent strengths and, with the help of this teacher, who helped to mitigate the chaos that was going on in Karen's home, Karen worked hard in school and she eventually got a scholarship to attend an out of state college.

Karen was happy to be away from home.

Initially, Karen's time at college went well.  But in her third year, after a relationship with a young man that she had been dating got serious, she became anxious and ambivalent about the relationship.

The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder

Karen knew that her relationship with Dan was a loving relationship.  Even though they were both young, deep down she knew that they could be happy together--if only she didn't feel like running away when she felt emotionally vulnerable and scared.

She knew she needed to get psychological help before she ruined things between her and Dan so, although she felt hesitant, she went to the student counseling center.

After hearing about Karen's family background, the school counselor, who was an empathetic therapist,  knew that Karen needed more than the short term therapy that the counseling center provided.  So, she provided Karen with psychoeducation about trauma and why it was important to get psychological help (see my article:  Untreated Emotional Trauma is a Serious Issue).  Then, she referred her to a trauma therapist who had an office nearby.

Karen's only experience with therapy was in family therapy when she was a child, after her mother made a suicide attempt.  She remembered liking the family therapist, so she had a favorable memory of family therapy.  But she had never been in individual therapy.

Karen explained to her therapist that she couldn't understand why she was feeling so afraid of being in a relationship with Dan.  After all, Dan treated her well and she knew they loved each other.  She explained that whenever she felt so frightened that she wanted to run away from him, she felt like she was going crazy.

Her individual therapist helped Karen to understand that her current reaction to Dan was being triggered by her early childhood experiences.  She told Karen that she would help her to separate "now" from "then"(see my article:  Working Through Emotional Trauma: Learn to Separate "Then" From "Now" in Therapy).

Her therapist began by helping Karen to develop internal resources to deal with her fears and to cope with working through her early trauma.  These resources included mindfulness meditation, breathing exercises and safe place meditation.

Once Karen developed and used these resources to cope with her fears, her therapist spoke to her about EMDR (Eye Movement Desensitization and Reprocessing) therapy, which is a trauma therapy that has helped many clients who are suffering with trauma.

Karen processed her traumatic memories and fears in EMDR therapy over time.  Gradually, using the EMDR float back technique, they were able to get back to Karen's earliest traumatic memories.

At the end of each EMDR therapy session, her therapist used the last part of the session to help Karen to debrief and to do a meditation to help her to feel calm and safe.

During this time, Karen continued to see Dan and she was feeling much less anxious about the relationship.  Knowing that Karen was getting help, Dan was also patient and understanding.

EMDR isn't a "magic bullet," especially when a person has had the kind of underlying trauma that Karen experienced.  But, over time, Karen was able to work through her trauma and her fears.  She was also able to have a stable and happy relationship with Dan.

Getting Help in Therapy
Growing up with a parent who had borderline personality disorder can be traumatizing and have a negative effect on your adult relationships, especially romantic relationships where core issues tend to surface.

EMDR is one form of therapy that is used by EMDR therapists to help clients to overcome trauma.  Other forms of trauma therapy include Somatic Experiencing and clinical hypnosis, also known as hypnotherapy.

Getting Help in Therapy

If you have underlying trauma that is getting in the way of your having a more fulfilling life, you could benefit from getting help from a licensed mental health professional who is an experienced trauma therapist.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who has helped many individual adults and couples.

One of my specialties is helping clients to overcome emotional trauma.

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.