Follow

Translate

NYC Psychotherapist Blog

power by WikipediaMindmap
Showing posts with label clinical hypnosis. Show all posts
Showing posts with label clinical hypnosis. Show all posts

Sunday, March 9, 2025

What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

The terms "trauma" and "PTSD" (posttraumatic stress disorder) are often used interchangeably, but there is a difference.

Understanding the Difference Between Trauma and PTSD

What is Trauma?
Trauma is an emotional response to an overwhelming event which could include shock trauma or developmental trauma .

Shock trauma is a one-time event like a robbery, an accident or the devastating effect of a hurricane, to name just a a few examples of shock trauma.

Developmental trauma is ongoing trauma experienced during childhood due to stressful and traumatic events including physical and emotional abuse, physical or emotional neglect, violence, and chronic instability.

The effects of trauma can include (but are not limited to):
  • Sadness
  • Anxiety
  • Depression
  • Avoidance of people, places and things related to the trauma
  • Anger
  • Dissociation
  • Confusion
  • Exhaustion
  • Numbing emotions and numbing yourself to your environment
  • Nightmares
Symptoms from shock trauma and developmental trauma can persist for weeks, months, years or a lifetime.  

When symptoms of trauma persist and evolve over time, these symptoms can develop into posttraumatic stress disorder (PTSD) if the symptoms of trauma go untreated.

What is Posttraumatic Stress Disorder (PTSD)?
Even though PTSD and trauma are closely related, they are not the same.

Understanding the Difference Between Trauma and PTSD

"Post" in posttraumatic stress disorder refers to the physical, emotional and psychological impact after trauma occurs.

Whereas trauma is a response to an overwhelming event, PTSD is a more serious mental health condition.

The effects. of PTSD are divided into four categories:
  • Re-experiencing symptoms: Flashbacks including emotional flashbacks, nightmares and frightening thoughts
  • Avoidance: Avoiding people, places and things related to the traumatic event(s) and avoiding related thoughts and feelings
  • Mood and Cognition: Problems remembering details of the trauma, a negative view of oneself and a lack of interest in hobbies or interactions that were pleasurable before
What is Trauma Therapy?
Trauma therapy includes a variety of therapy modalities including (but not limited to):
  • EMDR (Eye Movement Desensitization and Reprocessing) Therapy
  • AEDP (Accelerated Experiential Dynamic Psychotherapy)
Understanding Trauma Therapy
Why is It Important to Seek Help in Trauma Therapy?
Whether you're experiencing unresolved trauma or PTSD, symptoms often get worse over time so seeking help in trauma therapy sooner rather than later is recommended.

Understanding the Importance of Trauma Therapy

Both trauma and PTSD symptoms can carry over intergenerationally, which means that your unresolved trauma can have a significant impact on your children and future generations (see my articles: What is Intergenerational Trauma?).

Getting Help in Trauma Therapy
If you have been struggling with unresolved trauma, you could benefit from working with a trauma therapist (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

After you have worked through your trauma, you can free yourself from your traumatic history so you can live a more fulfilling life.

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

I have over 20 years of experience working with individual adults and couples.

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

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







Thursday, December 1, 2022

What is Complex Trauma?

Psychological trauma can be a single event, like shock trauma, which includes being the victim of a robbery, a car accident, an assault or living through a devastating hurricane where your house is destroyed, among other things. 

What is Complex Trauma?

Complex trauma involves many related traumatic events experienced by children, including abuse and profound neglect, that occur over an extended period of time and the difficulties that arise as a result of adapting to and surviving these events.

According to SAMHSA (Substance Abuse and Mental Health Services Administration), 1 in 7 children experience abuse or neglect.

What Are the Symptoms of Complex Trauma For Adults?
The symptoms of complex trauma can include any of the following:
  • Feeling anxious
  • Feeling depressed
  • Experiencing flashbacks
  • Experiencing nightmares
  • Avoiding circumstances that remind you of the traumatic events (emotional avoidance)
  • Having difficulty managing emotions
  • Perceiving yourself in a distorted way
  • Feeling worthless
  • Avoiding or having difficulty with personal relationships
  • Feeling disconnected from yourself or others (a form of dissociation)
  • Having problems remembering parts of your childhood 
  • Having difficulty providing a comprehensive narrative of your childhood memories, which can include fragmented memories.
  • Experiencing sleep problems
  • Experiencing sexual problems
  • Experiencing medical problems, like Type 2 diabetes
  • Feeling body aches, including migraines, stomach and digestive problems, arthritis
  • Experiencing low energy or fatigue
  • Misusing drugs, alcohol, tobacco, food
  • Engaging in other compulsive or impulsive behavior, including compulsive gambling, sexual compulsivity, and other behaviors
Examples of Complex Trauma
Complex trauma usually begins in childhood.  These events are recurrent, overwhelming and longstanding, and they are usually perpetrated by other adults, like family members, family friends, neighbors, clergy, and so on.  These incidents often occur over a span of weeks, months or years.

Examples of complex trauma include:
  • Physical abuse
  • Emotional abuse
  • Abandonment
  • Parentification (role reversal where child takes on the parental role)
  • Medical abuse or trauma
  • Torture or being held captive
  • Living in a war zone or in an area with civil unrest
And so on.

Mind-Body Oriented Psychotherapy For Complex Trauma
The following mind-body oriented therapies are often effective to overcome complex trauma:

Getting Help in Therapy
If you are experiencing complex trauma symptoms, you could benefit from working with a trauma therapist (see my article: What is a Trauma Therapist?).

Once you have worked through your unresolved trauma, you can lead a more fulfilling life.

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

I am a trauma 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.


























Saturday, November 19, 2022

Overcoming Social Anxiety

People who have social anxiety  find it very challenging to be in social situations. I have worked with many clients in my psychotherapy private practice in New York City to help them overcome social anxiety.

Overcoming Social Anxiety

Here are some examples of situations that can be challenging for people with social anxiety:
  • meeting new people 
  • being the center of attention
  • making small talk
  • going out on a date
  • eating or drinking in public
  • attending a party
  • speaking in public
  • performing on stage
  • taking an exam
  • being teased or criticized
  • making phone calls
  • talking at a meeting
  • being called on in class
People who have social anxiety are often excessively self conscious about themselves in social situations.  They often try to avoid social situations because they fear they will embarass or humiliate themselves.  They often become excessively worried weeks or even months before an upcoming social event.  They fear they will be judged by others and that others will notice that they're nervous in social situations.

Overcoming Social Anxiety
When I work with a client who has social anxiety, I tailor each treatment to the needs of the particular client.

So, one way that I might work is that the client and I would develop a hierarchical list of the client's fears.  

So, for example, if the client has an upcoming office party, he or she might include at the top of the list (as the most feared) that he or she will have to talk to the head of the company and won't know what to say.  At the bottom of the list, might be thinking about the office party before actually going.

Using the client's list of fears, I might use EMDR or clinical hypnosis to help the client overcome these fears starting with the least feared item on the list and working our way up the list.  Each time he or she is able to overcome one of the fears in session, we would go to the next one on the list until we worked on the item that he or she most feared.

I also like to give clients tasks to perform between therapy sessions. So, the client and I would collaborate on tasks that he or she would perform between sessions.  This is a useful way to work on other areas in everyday life that the client might fear.

Tips for Coping With Social Anxiety
  • Rather than focusing on yourself and your fear of being embarrassed or humiliated in a social situation, pay attention to the others around you.
  • Listen intently to what they have to say.
  • Remember to breathe (shallow breathing can increase anxiety).
  • Develop short-term strategies to help you cope when you feel overwhelmed by social anxiety (e.g., stepping outside for a few minutes to calm yourself before going back into the social event).
Getting Help in Therapy
If you suffer with social anxiety, you know how challenging it can be for you to be in social situations.  You also know that isolating doesn't work.  

If you would like to overcome social anxiety, seek help from licensed psychotherapist who has successfully helped clients to overcome social anxiety.

There are no quick fixes for social anxiety, but working with an experienced therapist to become free of social anxiety can be one of the best gifts you give yourself.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing therapist and Sex 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.


Saturday, February 5, 2022

Moving Beyond Blaming Your Parents in Therapy

Many people think that contemporary psychotherapy is all about blaming your mother or blaming both of your parents for your unresolved problems, but this is an outdated view of therapy that is part of the many myths about modern psychotherapy (see my articles debunking common myths about contemporary psychotherapy, including the myths that Going to Therapy Means You're WeakPsychotherapy is "All Talk and No Action," and Psychotherapy Always Takes a Long Time).

Moving Beyond Blaming Your Parents in Therapy

While it's true that historically traditional psychoanalysis from a generation ago focused blame on parents, especially mothers, most contemporary psychotherapists have moved beyond that.

Most contemporary psychotherapists know that while it's important to understand how problems might have developed early on, they also know that if that's all therapy has to offer, clients will remain stuck in an angry, frustrated place and change will be difficult at best.

Developmentally, our perspective about our parents usually changes over time (see my article: How Your Perspective About Your Parents Changes Over Time).

While many young children see their parents as being wise and powerful, as these children get older they begin to see their parents in a more realistic way.  They recognize that their parents have their own problems, which might be intergenerational (see my article: Psychotherapy and Intergenerational Trauma).  

This isn't to say that some parents weren't emotionally and physically abusive to their children which created trauma. But, after recognizing the origin of their problems, which might also include genetics, temperament, and other important relationships, clients need to be assisted in therapy to move beyond blaming their parents so they can make progress in therapy.

How to Move Beyond Blaming Your Parents For Your Problems
Everyone's situation is different, and I don't know your particular situation or your personal history.  

While you might have good reason for being angry with your parents for things they did (or didn't do), at the same time, this can't be the where your development in therapy stops if you want to overcome your problems because, as previously mentioned, you'll get stuck blaming your parents and not taking steps to overcome your problems.

After you process your anger in therapy towards your parents (or someone else), you need to move beyond that stage to actually process your problems because your parents can't do it for you.

Processing the trauma is how you will heal. Depending upon your individual problems and what therapy might work best for. you, therapy could include the following forms of experiential therapy:
  • Parts Work: This form of therapy, which has many different names, including Ego States work, Internal Family Systems (IFS), as well other names. It was developed by many different therapists over time, including Dr. Richard Schwartz.  It involves recognizing that we're all made up of a multiplicity of selves, which includes a child part as well as an adult part, and many other parts. So, to give just one example of how this type of therapy can be used, if you grew up in a home where you were emotionally neglected, a Parts Work therapist can help you to develop a more nurturing adult part so that you can nurture the child part of you that holds the trauma. With this type of therapy, there's a recognition that you mihjt not have gotten what you needed emotionally when you were a child, but you can always give it to yourself if you learn how to do it (see my article: Understanding the Many Aspects of Yourself).
    • attachment theory
    • affective neuroscience
    • trauma research
    • developmental research 
    • mind-body/somatic therapy
    • emotion theory
    • phenomonology 
    • transformational studies
  • Somatic Experiencing (also known as SE): SE, which was developed by Dr. Peter Levine, takes into account that trauma is stored in the body.  This often leads to emotional numbing also known as dissociation. SE can help clients to release the trauma and help them to feel more integrated emotionally and physically.
  • Clinical Hypnosis (also known as hypnotherapy): Clinical hypnosis helps clients to achieve a relaxed state where they can have access to deeper, unconscious material and that can help clients to become more open to change.
It's not unusual for experiential therapists to use the different modalities mentioned above during different stages of therapy, depending upon what the client needs.  

For instance, in my prior article, where I discussed that clients aren't defined by their psychological trauma, I gave an example in the clinical scenario where the therapist started with Parts Work and then used EMDR therapy.

Conclusion
Unlike outmoded forms of psychotherapy from a century ago, contemporary psychotherapy recognizes that if clients don't move beyond the stage of blaming their parents, they will remain stuck with their problems.  

Experiential therapy, including EMDR, Parts Work AEDP, Somatic Experiencing and clinical hypnosis provide clients with an opportunity to work through unresolved problems so they can move on with their life (see my article: What is a Trauma Therapist?).

Rather than remaining stuck in a blame trap, contact an experiential psychotherapist who can help you to overcome the obstacles that are blocking your growth.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Parts Work and Somatic Experiencing therapist.

As an experiential therapist, helping clients to overcome trauma is my specialty.

I work with individual adults and couples.

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

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


















Wednesday, December 1, 2021

Breaking an Unhealthy Habit With Pattern Interruption

Breaking an unhealthy habit can be challenging, especially a longstanding habit.  As I discussed in an earlier article about smoking cessation, one way to break a bad habit is using a pattern interrupt, which is the topic of this article.

Breaking an Unhealthy Habit With Pattern Interruption


Healthy habits and routines are a valuable part of life because they get reinforced automatically after a while.  For instance, relaxing, reading a book or listening to calming music might be part of the pattern that reinforces healthy sleep hygiene.  

In the same way that healthy habits get reinforced through certain patterns, unhealthy habits get reinforced in the same way.  So, although there is no one way to break bad habits that works for everyone, one method that works for many people is to interrupt the pattern.

Steps to Breaking an Unhealthy Habit
The following method is one that I use when I work with clients who want to stop smoking. Although I use it with clinical hypnosis, it can be used without hypnosis for almost any unhealthy habit that you want to change:
  • Set Up a Chart For Yourself: Get clear on what you want to change.  Focus on one unhealthy habit rather than trying to change two or more at the same time.  At the top of a chart write down what you want to change (e.g., smoking habit, nail biting, stress eating, etc). It doesn't have to be a fancy chart. It can be something simple, which has the following columns:
    • Date and Time
    • Trigger and Emotion
    • Reward
    • Small Change You Can Make
  • Get Curious: Rather than being critical, get curious about your habit. If you find yourself getting judgmental, ask yourself if you would be as judgmental towards your best friend who was making an effort to change (see my article: Overcoming the Internal Critic).

  • Fill Out the Chart With the Date, Trigger (or Cue) and Emotion: For instance, if you want to stop biting your nails, write down the date and time you bit your nails, the trigger that came just before you bit your nails (e.g., you had a confrontation with a coworker, you argued with your spouse, etc), and the emotion(s) you experienced with that trigger (anxiety, anger, sadness, etc).
  • Identify the Reward: This can be challenging because rewards don't always look like rewards, so you might be unaware of them. But there is almost always a payoff for engaging in the bad habit. For instance, if you bite your nails whenever you get anxious, you might momentarily dissociate (zone out) from whatever is making you anxious, so biting your nails provides temporary relief.  Also, if you bite your nails very low, you might experience an endorphin release.  
  • Identify a Small Change You Can Make: Rather than trying to stop engaging in the bad habit altogether, identify one small change you can make.  This can help you by not setting you up for failure by trying to make too big a change at once or eliminating the habit altogether. For smokers, a small change might be changing a brand or, if you smoke just before breakfast, change that habit so that you smoke after breakfast.  
  • Identify Your Successes: Recognize that breaking an unhealthy habit can take time and effort, so don't focus on trying to do it "perfectly."  For example, if you're trying to stop biting your nails and you're able to do it for two days (when you've never been able to stop it before), identify this as a success and renew your efforts (see my article:  Achieving Your Goals: Learn to Celebrate Small Wins Along the Way).

Getting Help in Therapy
There are often unconscious reasons why people develop unhealthy habits, and these underlying reasons are difficult to identify on your own.

A skilled psychotherapist can help you to identify the unconscious reasons that make it difficult to change and provide you with tools to succeed.

By seek help from a licensed mental health professional, you can make positive changes so you can lead a more fulfilling life.

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

I work with individual adults and couples.

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

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












Friday, October 16, 2020

What is the Felt Sense in Experiential Therapy?

There is a concept known as the "felt sense" that is central to all modalities of experiential therapy, including EMDR therapy (Eye Movement Desensitization and Reprocessing), Somatic ExperiencingAEDP (Accelerated Experiential Dynamic Psychotherapy) clinical hypnosis (also known as hypnotherapy) and EFT (Emotionally Focused Therapy for couples).  

What is the Felt Sense in Experiential Therapy?

What is the Felt Sense?
Eugene Gendlin developed the concept of the felt sense in the 1960s and he included it as a central part of his experiential therapy known as Focusing.  Since the 1960s, the felt sense has become an essential part of all cutting edge experiential therapies.  

Experiential therapists help clients to develop a felt sense by teaching them to tune into their embodied experiences of emotions and memories.  

By tuning into these embodied experiences, clients increase their awareness of the connection between their physical and emotional experiences, which is the integration of the mind-body connection (see my article: Experiential Therapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

How Do You Detect the Felt Sense?
Developing an awareness of the felt sense takes practice.  It starts with turning your attention inward to notice what you're aware of in your body.  

For instance, when you close your eyes and focus on your body, you might notice you feel a tightness in your throat, and your therapist would ask you to stay with that sensation in your throat if it felt tolerable to you.  As you continue tuning into your throat, you might sense not only that the muscles in your throat feel tight but you also feel an emotion connected to that physical sensation--sadness.  

As you continue focusing on that bodily sensation and emotion in your throat, you might also become aware that this is a very familiar experience to you--you have felt it many times before when you tried not to cry.  

Then, as you continue focusing, a memory might come of your father telling you, "Don't cry. Big boys don't cry" and how you choked back your emotion in shame when you heard your father say this (see my article: Overcoming Shame in Experiential Therapy).

As you continuing focusing on your physical and emotional experiences in your throat and you tell your therapist what you're experiencing, you might feel a loosening of the muscles in your throat as you release the emotions that have been pent up for a long time.

This example is just one of many that clients in experiential therapy have experienced.  Other examples could include noticing a heaviness in your chest that's related to pent up sadness or a tightness in your jaw that's related to unreleased anger and so on.

A skilled experiential therapist can help you to modulate your experiences in session so that they remain manageable for you and you're not overwhelmed (see my article: Expanding Your Window of Tolerance).

How is Working With the Felt Sense in Experiential Therapy Different From Talk Therapy?
Talk therapy usually focuses on helping clients to develop intellectual insight into their problems.  While this is important, it often doesn't change clients' problems (see my article: Why is Experiential Therapy is More Effective Than Regular Talk Therapy?).

As shown in the example above, the felt sense in experiential therapy isn't just about intellectual insight.  It's an embodied experience that integrates both the mind and the body, and as such, it brings greater awareness on both levels and offers a window into the unconscious mind.

Getting Help in Experiential Therapy
As I mentioned at the beginning of this article, experiential therapy includes many different mind-body oriented psychotherapy modalities.

Clients who work with experiential therapists usually discover that using the mind-body connection to work on their problems is a more integrative approach that brings about transformative experiences in less time than regular talk therapy.

If you have been struggling on your own, you're not alone.  An experiential psychotherapist can help you to overcome the obstacles that are getting in the way of making positive changes in your life.  

Rather than continuing to struggle on your own, seek help from an experiential therapist so you can live a more fulfilling life.

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

I work with individual adults and couples.

One of my specialties is helping clients to overcome traumatic experiences (see my article: What is a Trauma Therapist?).

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

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



 











Saturday, October 6, 2018

With Experiential Therapy, There Are No Blank-Slate Therapists - Part 2

In my prior article, I began a discussion about how experiential psychotherapy is different from conventional psychotherapy.  I discussed that some therapists in conventional therapy still work with their clients from a stance of neutrality with little to no self disclosure.  This is in contrast to experiential therapy where the psychotherapist is a dynamic, empathic, emotionally accessible, and a collaborative presence in the therapy session with the client (see my article: Why Experiential Psychotherapy is More Effective Than Conventional Talk Therapy).

With Experiential Therapy, There Are No Blank-Slate Therapists

Fictional Clinical Vignette: With Experiential Therapy, There Are No Blank-Slate Therapists
The following fictional clinical vignette, which is representative of the issues being discussed in this article, illustrates the difference between experiential psychotherapy and conventional psychotherapy where the therapist takes a neutral stance with the client:

Alan
Attending therapy twice a week, Alan endured long silences in his therapy sessions with his conventional talk therapy psychotherapist.

Alan dreaded these silences because it reminded him of the times when he was a young child and he and his parents sat in stony silence at the dinner table.  During those days, when he attempted to talk at the dinner table about things that went on at school, his father would reprimand him, "Be quiet and eat your food" (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).

Afterwards, his mother would oversee his nightly ritual of washing up and putting on his pajamas before he went to bed.  He often wished that his mother would read him a bedtime story, which is what his friend, Tom's mom would do when Tom went to bed.  But having asked his mother for a  bedtime story in the past, Alan knew that his mother would reject his request and just tell him to go to sleep.

As he lay on the couch in his therapist's office for his second session of the week, he stared at the ceiling as he became increasingly uncomfortable.  From behind him, Alan could hear his therapist shift slightly in his chair, but that was the only sound that Alan heard.  He knew from his prior sessions that his therapist could go nearly an entire session without saying anything if Alan didn't know what to say.  Alan dreaded those long silences and he hoped this wouldn't be one of those sessions.

Clearing his throat to speak, Alan said in a low voice, "I'm not sure what else to talk about.  We have discussed so many times before how I feel like I'm an unlovable person and how lonely that is for me.  I don't know what else to say about it" (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

From behind him, Alan heard his therapist writing, but his therapist didn't respond to Alan's remark.  Alan thought about how he had been coming to therapy with Dr. Walsh for three years, and he felt he wasn't making any progress.  In the past, when he mentioned this to Dr. Walsh, he told Alan that it would take many years of therapy for Alan to see progress (see my article: Common Myths About Psychotherapy: Therapy Takes a Long Time).

Alan, who was about to turn 35, didn't feel like he could endure his emotional pain without relief for several more years.  Whenever he told his therapist this in the past and asked his therapist what he thought was getting in the way of his progress, his therapist turned the question back on Alan and asked Alan what he thought.  But Alan didn't know what he thought, and this was frustrating to him.

After enduring another session where they were mostly silent, Alan left feeling worse than before the session.  As he walked to meet his friend, Ed, for coffee, Alan thought about how he knew nothing about Dr. Walsh even though he had been attending twice-a-week sessions with him for three years.

At one point in an earlier session, he asked Dr. Walsh if he had ever experienced feeling as insecure in his life as Alan was feeling, but Alan didn't get an answer.  Dr. Walsh, once again, turned the question back on Alan and wanted to explore the question rather than answer it.  This left Alan feeling like he had done something wrong by asking the question, and he felt ashamed.

On the rare occasions when Alan looked back to see Dr. Walsh, he saw a very serious, authoritarian look at Dr. Walsh's face similar to the look that his father used to give him.  During those times, Alan wondered if Dr. Walsh even liked him or thought about him when they weren't in session.

In the coffee shop, Alan shared his frustration with Ed about his therapy sessions, "I just feel like I'm getting nowhere in my therapy, and I worry sometimes that my therapist might not even like me.  He's kind of distant and impersonal in the sessions so it's hard to tell."

Ed looked surprised.  He said his therapist was completely different--she was emotionally engaged, supportive and dynamic in their therapy sessions.  He told Alan that she was active in helping him to get to the underlying emotions (also called primary emotions) that were at the core of his problems, and this helped him to start making changes.

In addition, Ed explained, she occasionally shared stories that let Ed know that she understood his problems.  There were also times, he said, when they laughed in session, and Ed felt how this helped to release tension and open him up to the therapeutic process (see my article: Humor Can Be Effective in Therapy).

Alan was shocked to hear that Ed's experience in psychotherapy was so different from his own, and he asked Ed, "What type of therapy are you doing?"

Ed responded, "My therapist is an experiential therapist who does all kinds of therapy, including AEDP, EMDR, Somatic Experiencing and clinical hypnosis.  Maybe you should have a consultation with an experiential therapist." Alan thought about it for a minute and then asked Ed to get a referral from his therapist to another experiential therapist.

By the following week, Alan was sitting in an experiential therapist's office having a consultation.  He noticed the big difference in how he felt with this therapist immediately.  Not only was she warm and emotionally accessible, she sat facing him (rather than behind him) and he could see that she was emotionally attuned to what he said (see my article: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Rather than coming across as a blank screen, Ed realized, this therapist allowed Ed to see that she was intensely engaged in their session.  She also shared with Ed how she experienced him in the session which felt heartfelt and genuine.

In addition, she explained how experiential therapy was different from conventional talk therapy (see my article: What's the Difference Between "Top Down" and "Bottom Up" Approaches to Therapy?).

During his next session with Dr. Walsh, Alan revealed that he had gone for a consultation with another psychotherapist who did experiential therapy.  Hoping that Dr. Walsh would respond, Alan waited in vain.  After several minutes had passed, Alan told Dr. Walsh that he felt the other therapist was more attuned to him, but Dr. Walsh said nothing, which brought back more memories of his silent childhood dinners with his parents.

Alan knew from his prior therapy that there was a termination phase before ending therapy, so he told Dr. Walsh that he would like to have a few more sessions to end therapy and then he wanted to move on to work with an experiential therapist.

During the next three sessions, things remained basically the same in Alan's sessions with Dr. Walsh. He encouraged Alan to talk about what he felt he had gained from their therapy together, and Alan told him that he felt he had gained some insight into his problems.  But what Alan didn't tell him was that, even though he had gained intellectual insight, he felt nothing had changed or shifted in his life. He felt his problems remained the same (see my article: Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

At the end of the last session with Dr. Walsh, Alan wasn't sure what to do, so he offered to shake Dr. Walsh's hand as he was about to leave.  He noticed how reluctant Dr. Walsh was to extend his hand, which hurt Alan's feelings.  But Dr. Walsh did, reluctantly, extend his hand, shook Alan's hand and told him that he could return to therapy with him in the future.  His words sounded pro forma to Alan, as if Dr. Walsh had said these words many times before.  Then, it was over, and Alan walked out feeling empty.

During the initial stage of experiential therapy, Alan was surprised that his new therapist was so dynamic.  She was so engaged in their conversation that, for the first time in his experience with psychotherapy, Alan didn't feel alone with his problems, which was such a relief to him.  He felt like his new therapist actually cared about him and his well-being.

Not only that.  When he was ready, she helped him to access the underlying emotions involved with his feeling like an unlovable person.  They talked about his relationship with his parents, but the difference, compared to his prior therapy, was that she explained the importance of the mind-body connection and she helped him to connect to his emotions in his body about those experiences (see my article: Experiential Psychotherapy: Learning to Sense Emotions in the Body).

After a while, Alan began to understand that "talking about" his problems only provided him with intellectual insight.  But since experiential therapy used the mind-body connection, in addition to insight, he also had a deep sense of something shifting for him at a core level.  Even more important, he felt a sense of hope that he could change.

Over time, he realized that for him to make the kind of changes that he wanted, he had to make those changes based on his primary emotions, which his new therapist was helping him to access.

Gradually, Alan began to sense a shift in how he felt based on his shifting emotions and the positive regard he felt from his therapist (see my article: What is the Corrective Emotional Experience in Therapy?).

Conclusion
As illustrated in the clinical vignette above, rather than taking a neutral, impersonal stance, the experiential therapist is attuned to the client and emotionally engaged.

Along with her clinical training and expertise, the experiential therapist uses her own emotional experience to attune to the client and help the client to access the primary emotions that lead to change.

The experiential psychotherapist is aware of the brain's neuroplasticity, the brain's ability to change based on learning and experience.

There are many problems with the neutral stance in conventional psychotherapy, including the triggering of earlier emotional experiences of emotional neglect.  This, of course, isn't the intention of the neutral stance, but if often occurs.

In addition, experiential therapy, which uses the mind-body connection, tends to be faster than conventional talk therapy (see my article: Experiential Psychotherapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind).

Getting Help in Experiential Therapy
If you have been struggling with unresolved problems, you could benefit from working with an experiential therapist.

Experiential therapy tends to be more effective and work faster than conventional therapy.

Rather than struggling on your own, you could begin to get a sense of emotional relief as you work towards freeing yourself from problems that keep you stuck.

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

I work in an dynamic, interactive and collaborate way using cutting edge modalities, including EMDR therapy (Eye Movement Desensitization and Reprocessing), clinical hypnosis, AEDP (Accelerated Experiential Dynamic Psychotherapy), Somatic Experiencing, contemporary psychodynamic psychotherapy, and Emotionally Focused Therapy for Couples (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

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

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





















Wednesday, October 3, 2018

With Experiential Psychotherapy, There Are No Blank-Slate Therapists

When I was training to be a psychotherapist in postgraduate training, we were taught that the ideal stance for a therapist was neutrality.  From the neutral perspective, the therapist should not convey what is going on internally, make any unnecessary gestures and, in general, remain as a blank slate (see my article: What's the Difference Between "Top Down" and "Bottom Up" Psychotherapy?).

Experiential Psychotherapy: There Are No Blank-Slate Therapists

Because of my background and temperament, this was especially hard for me.  I was raised in a family that was warm, gregarious and effusive.  There were no blank slates.

I also found that it was better for my patients for me to be an accessible human being in the therapy session, and the less my supervisors knew about my human response to clients, the better.

Of course, I was always careful not to cross any ethical boundaries or provide more information about myself than was necessary or warranted.  The focus was still very much on the client.

Since that time, we now know how emotionally depriving it is for psychotherapists to try to be a blank slate.  I say "try" because no one is ever a blank slate.  We are all always reading and picking up on what's going on with each other all the time.  So, the notion of a "blank slate" is a fallacy.

I'm not sure where the idea of being so impersonal came from.  It certainly wasn't part of Freud's practice.  He regularly walked clients around his garden at his home and had them over to his house.  From everything that I have read, he was rather engaging.

It seems like it was more of an overreaction by American psychiatrists, who were the psychoanalysts of their day, during the early days of psychoanalysis when there were few rules and some analysts were acting out with their clients.

The one thing that Freud didn't like was to be looked at directly by the client when he was with them in his therapy room--even though they looked directly at him when they were in his garden or in his home.   So, he came up with the idea that the therapist should sit behind the client out of the client's sight so he could listen with "evenly hovering attention," ostensibly, without the distraction of looking at the client.

Over time, most therapists discovered that there is a lot that is missed when a therapist isn't looking at the client directly or when the client isn't looking at the therapist.  The therapist isn't picking up on body language, facial cues, gestures and, in general, the intersubjective experience of being with a client.  This is certainly a lot to miss.

There have been certain times when I have had a client who preferred for me to sit behind him so the client couldn't see me and I could only see only the back of his head.  While I honor this request, I also explore the meaning of it with the client.  For some clients, it's easier for them to talk if they don't watch the therapist's face or gestures.  I get that, and I want my clients to be comfortable, so I will arrange to sit behind that particular client.

But the vast majority of clients want the therapist to be human, collaborative, interactive and dynamic rather than a therapist who is trying to be a blank slate.  This suits me fine since it feels most natural to me to work in that way.

There Are No Blank-Slate Therapists With Experiential Psychotherapy
Experiential therapy, including EMDR Therapy (Eye Movement Desensitization and Reprocessing), AEDP (Advanced Experiential Dynamic Psychotherapy), Somatic Experiencing, clinical hypnosis, Emotionally Focused Therapy for couples and other types of experiential therapies emphasize the importance of the therapist being relatively open and emotionally accessible.

How did this change from the blank slate therapist?  Through research and clinical experience, researchers and clinicians discovered that change occurs when psychotherapists and clients are emotionally engaged with each other in therapy.

Some of the research is extrapolated from Ed Tronick's still face experiments between mothers and babies.  Other research from AEDP and Emotionally Focused Therapy also reveals that the therapist and client need to be emotionally engaged for change to take place.

Having a cognitive understanding of their problems is an important part of therapy but, in terms of change, it's limited (see my article: Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

In order to make changes, clients need to be able to get to their underlying emotions (also called primary emotions), and this is difficult to do with a therapist who is sitting there like a mannequin.

In the next article, I'll provide a clinical vignette to illustrate how experiential therapy is different from older forms of conventional psychotherapy and psychoanalysis (see my article: With Experiential Therapy, There Are No Blank-Slate Therapists - Part 2).

Of course, much has also changed in psychoanalysis, especially Relational Psychoanalysis and other contemporary forms of psychoanalysis so there is more of a collaborative approach and more self disclosure on the part of the therapist.  However, unfortunately, there are still some therapists who try to be blank slates.

Getting Help in Psychotherapy
As previously mentioned, these days most clients want a collaborative, interactive and dynamic psychotherapist.

Experiential therapists provide this experience to clients in a supportive and empathic environment.

Experiential therapists also help clients to connect with the mind-body experience.  This is different from conventional talk therapy, which provides more limited insight-oriented experiences.

We now know, based on research and clinical experience, that getting to the core of emotions is what brings about transformation (see my article: Experiential Psychotherapy Helps to Achieve Emotional Breakthroughs).

If you have been struggling with unresolved problems and conventional talk therapy hasn't helped you to resolve these issues, you owe it to yourself to contact an experiential psychotherapist.

Experiential therapy can help to free you from unresolved problems so you can live a more satisfying life.

About Me
I am a licensed NYC experiential psychotherapist who uses clinical hypnosis, EMDR therapy, AEDP therapy, Somatic Experiencing and Emotionally Focused couple therapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

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

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