How Teletherapy Can Help You Overcome Anxiety

In a prior article, I discussed the advantages of doing teletherapy, which is also called telemental health, online therapy or telehealth.  In this article, I'm focusing specifically on how teletherapy can help you to overcome anxiety (see my articles: Common Reactions to the COVID-19 Pandemic: Fear and Anxiety and Coping and Staying Calm During the COVID-19 Crisis).

How Teletherapy Can Help You to Overcome Anxiety

Fortunately, in recent years, the stigma about attending psychotherapy has decreased significantly so that now many people feel more comfortable seeking help from a psychotherapist (see my articles: Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy and Why Is It That It's Usually the Healthiest Family Member in a Dysfunctional Family Who Seeks Help in Therapy?).

Whether you're experiencing persistent anxiety or situational anxiety related to things going on in your life, anxiety can be a debilitating condition.

Not only can anxiety keep you up at night due to insomnia and nightmares, it can also erode your sense of self and interfere with your normal self care routines.  Lack of sleep and interference with your self care routines exacerbates your anxiety and it can precipitate a downward spiral in terms of how you feel.

Different Forms of Anxiety
There are many different types of anxiety, including:

• generalized anxiety
• separation anxiety
• anxiety with depressive symptoms
• adjustment disorder with anxiety
• posttraumatic stress disorder
• obsessive compulsive disorder
• panic disorder (see my article: Tips For Coping With Panic Attacks).
• agoraphobia
• social anxiety (see my article: Overcoming Social Anxiety).

And so on.

Pandemic-related Anxiety
It's not surprising that the COVID-19 crisis has precipitated an increase in anxiety due to many factors, including (but not limited to):

• uncertainty related to the pandemic (see my article: How to Stay Calm During a Crisis)
• fear of contagion
• fear of an unknown future
• fear of going outside
• anxiety related to being isolated
• anxiety related to being lonely (see my article: Coping With Loneliness and Isolation During the Pandemic)

Mental health experts expect a record number of people will seek help for the psychological stress related to the pandemic (see my article: The Emotional and Physical Impact of Loneliness During the COVID-19 Pandemic).

Although it's important to follow the health experts' guidelines for remaining virus free, the emotional toll of being in prolonged isolation without the usual social supports systems that people normally depend on is expected to be significant.

How Teletherapy Can Help You Overcome Anxiety

Most psychotherapists are currently doing teletherapy due to the COVID-19 pandemic.

As I mentioned in a prior article, teletherapy offers many advantages when you're unable to see a therapist in person, including:

• providing a safe environment for you to talk about your distress (see my article: The Holding Environment: Maintaining a Safe Environment For the Client)
• offering guidance on how you can manage your anxiety (see my article: Reducing Stress With the Body Scan Meditation)
• helping you to develop better coping strategies (see my article: Developing Coping Strategies)
• teaching you various anxiety reduction techniques, including meditation (see my articles: Self Care During the Pandemic: Mindfulness Meditation)
• offering you guidance for self care (see my article: Stress Management: Taking Time For Self Care)
• providing you with tips on overcoming insomnia (see my article: Tips For Better Sleep)
• helping you to gain insight into possible distortions in your thinking (see my article: Changing Distorted Thinking)
• helping you to make healthy changes in your lifestyle
• offering emotional support (see my articles: The Importance of Getting Emotional Support During a Crisis)
• providing you with techniques to overcome emotional triggers (see my article: Coping With Emotional Triggers)

Getting Help in Therapy

If you're feeling overwhelmed with anxiety or other forms of emotional distress, you owe it to yourself to get help from a licensed mental health professional.

Teletherapy offers a convenient and effective way to get help.

Rather than struggling on your own, take the first step of contacting an experienced psychotherapist.  

An experienced psychotherapist can help you to overcome anxiety and develop a sense well-being so you can move on with your 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.

With over 20 years of experience as a psychotherapist, I have helped many clients to overcome anxiety-related issues.

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.

Common Nightmares During the COVID-19 Global Pandemic

Have you been having nightmares lately? If so, you're not alone. Pandemic nightmares have been common during this COVID-19 pandemic.  Regardless of age, sex, gender, sexual orientation, or nationality, many people have been having pandemic nightmares, which is the subject of this article (see my articles: How to Overcome Anxiety Dreams).

Common Nightmares During the COVID-19 Global Pandemic

These nightmares are so common that Robert Bosnak, a Jungian analyst in Santa Barbara California, has been offering a free online workshop on Friday nights at 6 PM (PST) during the pandemic called the Spooky Dreams Cafe where he uses Embodied Imagination, a method of dreamwork which he developed, to help some people on the Zoom call with these nightmares (see my article: Dream Incubation: Planting Seeds).

Many people, who lived through the crisis of the 9/11 World Trade Center attack, have reported in therapy that they're having similar nightmares during this time to the ones they had in 2001 and beyond (see my article: Tips For Getting Better Sleep).

Common Themes in Pandemic Nightmares
There are certain themes that are common in these COVID-related nightmares, including (but not limited to):

• Anxiety-related events or circumstances in the dream
• Places, which were once known and familiar, suddenly looking and feeling unfamiliar in the nightmare
• A need to escape or run
• Feeling trapped, helpless and/or lost
• A regression to an earlier age (e.g., an adult dreaming that they're a child again)
• Losing someone or something
• Phones and other gadgets malfunctioning
• Other sudden and inexplicable changes 

Typical Nightmares During the COVID-19 Global Pandemic
The following dreams are typical of the type of dreams people have been having during this COVID-19 crisis (as told to me by friends and used with permission):

Dream 1:
I'm in a classroom, which is taking place in my apartment. The instructor, whom I like, is taking things out of my dresser drawer to show the class. These items include a silk scarf I haven't seen in many years.  At one point, he breaks apart the wooden dresser drawer, and I'm fascinated by this (it seems like a deconstruction of some sort). Then, I notice that there's a similar dresser in the room that remains in tact.  I leave the room to go to the rest room, and when I come back, my laptop is gone. Somehow, I know that the instructor gave it away to one of my classmates, and I'm annoyed that he did this without my permission. I look around for it, but I can't find it. I see a male friend, who is sitting in a far off corner of the room. Then, suddenly, the scene changes: I'm walking around in an area of my neighborhood, not far from my home, where I've been many times before. I know that this place is familiar to me, but it looks and feels eerily unfamiliar.  I know I need to get back to class, but I don't know which way to go because I'm lost.  Then, I see a cab and get in it.  There's a couple, who are on their way home from the airport, who are already in the cab.  I don't know where to tell the cab driver to go because I'm lost, but I'm relieved to be in the cab.  The cab stops because the couple have arrived outside their home. I get out too because I realize it's useless to be in the cab if I don't know where I'm going.  The couple tell me that I have to pay thousands of dollars to them for the short distance that I went with them, and I get angry and tell them that I won't pay.  I know that my male friend is back in the class, he has his car and he would come get me if I call him, but I don't know where I am, so I can't tell him. The scene changes: I'm sitting at an outdoor bar with this same friend and our classmates.  We're all dressed up. I suddenly realize that I forgot that he's much taller than me.  I tell my friend about what just happened (that I was lost) and he's surprised and laughs. I'm feeling much better.  The outdoor bar is up on a bridge that overlooks people's homes down below. These people have shallow outdoor pools in front of their homes.  I tell my friend that we could do that too (we could each have outdoor pools).  Then, as I'm gazing out at the water from the bridge, I tell my friend, "Let's pretend that we're on the Arno Bridge in Florence" and he agrees.

Dream 2:
I'm a child of 7 or 8 years old. My mother tells me that we have to escape from where we're living to move back to the US.  Only a few close relatives know because it's a secret.  My mother doesn't want her husband, my stepfather, to know that we're running away because he's abusive and we're escaping from him.  I grab whatever I can quickly because we have to get to the airport fast, and I kiss my relatives goodbye.  I don't have time to say goodbye to a male friend, who has been good to me (I'm older in this part of the dream).  So, I try to text him to tell him that I had to leave due to an emergency, but my phone won't work. I know he's going to be hurt that I left suddenly without an explanation, and I feel terrible about this. Then, my mother, brother and I run to the airport to get on a rescue flight that's been arranged for us by the US government to bring us back to the states. Somehow, I get separated from my mother and brother (I'm a young child again in this part of the dream). I don't know which way to go. I'm scared and I call out to my mother, but I don't see her anywhere. Nothing looks or feels familiar, even though I know I've been to this area many times before. I see other people who are also running and I ask them the way to the airport because I'm lost.  They point the way and I run all the way to the airport. Once I get there, I realize I don't have a plane ticket. I call out to my mother again saying that I don't have a plane ticket.  Even though she's still nowhere to be found, a reassuring male voice tells me over the airport public address system that I don't need a plane ticket because this is a special government rescue flight for my family to escape. When I get to security, I realize that I'm not wearing a face mask so I'm not going to be allowed on the flight. I see everyone else around me wearing a face mask, and I look around to see if there's somewhere I can buy as mask (I'm older again in this part of the dream). Then, I realize that I do have a mask, but I've been wearing it on my chin, so I pull it over to cover my nose and mouth.  When I arrive at the gate, I still don't see my mother or brother, but I feel a little calmer because I know I'm going to make the flight and I'll escape from this place.  Somehow, I see the long document that my mother had to fill out to get approval from the government for this rescue flight. I feel badly that I didn't know before about the abuse that my mother endured at the hands of my stepfather.  While I'm waiting for the flight at the gate, I try to text my male friend again. I desperately want to reach him so he won't feel abandoned by me, but my phone still doesn't work. I feel sad that he's going to feel sad and abandoned.

A Word About These Nightmares
I'm going to deconstruct these nightmares and discuss how to work with nightmares in my next article but, for now, suffice it to say that both of these dreams have many typical features of anxiety dreams and, specifically, many elements typical of current pandemic nightmares (outlined above at the beginning of this article).

Getting Help in Therapy
Nightmares during times of crisis are often a way for the unconscious mind to work through difficult emotions and reconsolidate traumatic memories.

In addition, these nightmares sometimes reveal underlying unresolved trauma (see my article: Before and After Psychological Trauma).

If you've been having nightmares during this global pandemic, you're not alone.

An experienced psychotherapist, who helps clients during times of crisis and who works with dreams, can help you to understand and heal from nightmares.

Rather than suffering on your own, take the first step by calling a licensed psychotherapist for help.  Being able to work through your fears and nightmares can provide you with relief and allow you to feel more empowered.

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 unresolved trauma.

During the global pandemic, like most psychotherapists, I'm providing online therapy, which is also known as teletherapy and telehealth (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

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 Emotional and Physical Impact of Loneliness During the COVID-19 Crisis

Everyone experiences some degree of loneliness at some point in their lives. Even prior to the COVID-19 pandemic, loneliness was already an epidemic throughout the world, especially among the elderly.  However, the need to physically isolate from others to stop the spread of the virus has made the problem of loneliness much worse for many people (see my article: Coping With Loneliness During the COVID-19 Crisis and The 5 Stages of Grief During the COVID-19 Crisis).

The Emotional and Physical Impact of Loneliness During the COVID-19 Crisis

In this article, I'm focusing on the emotional and physical impact of loneliness on people who are isolated.  In my next article, I'll address the issue of loneliness during this pandemic if you live alone.

What is Loneliness?
First, let's define what we mean by loneliness.

Loneliness is a subjective negative emotion that occurs when our social needs aren't met. It's the discrepancy between our desire for connection and our actual experiences of connection.

Our need for social connection is hardwired in us from infancy. We are born with the need for attachment.  As infants, we need more than being fed, clothed and sheltered. We need to feel an emotional attachment to our primary caregiver in order to survive and thrive.

The need for emotional attachment doesn't end in infancy.  It continues throughout the lifespan. Although some people like spending a lot of time alone because it gives them a feeling of solitude, most people need to feel connected with others in a meaningful way (see my article:  How the Early Attachment Bond Affects Adult Relationships and Loneliness vs Solitude).

To form meaningful connections with others, our social needs must be met in terms of both quantity and quality.  So, while superficial relationships can distract us momentarily from our loneliness, they don't fulfill the deeper need to feel connected meaningfully in safe and secure surroundings.

What is the Emotional and Physical Impact of Loneliness?
Experiencing loneliness heightens our feelings of vulnerability and often takes a toll on our mind and body.

     The Connection Between Loneliness and Depression
Loneliness can put us at risk for depression.  The reason for this is that we often turn our attention inward in a critical way when we're isolated and lonely.  We become self critical and engage in negative self talk (see my articles: Are You Sabotaging Yourself With Negative Self Talk? and 5 Tips For Overcoming Chronic Negative Thoughts).

Negative self talk and the feelings connected to it can create a downward spiral that reinforces itself.  So, the more lonely and disconnected we feel, the more likely we are to criticize ourselves, and the more we criticize ourselves, the more likely we are to experience a downward spiral.  This makes it harder for us to connect with others because we feel unworthy (see my article: Overcoming the Internal Critic and Overcoming the Emotional Pain of Feeling Unlovable).

To stop this downward spiral, first, it's important to become aware of this cycle of negativity.  Second, we need to step back from our negative thoughts to be objective and question these thoughts to recognize that thoughts and feelings aren't facts (see my article: Your Thoughts and Feelings Aren't Facts).

If you're unable to stop the downward spiral into depression, you could benefit from seeking help from a licensed mental health professional (see the section below: Getting Help in Therapy).

Depression can lead to suicidal thoughts. So, if you're feeling suicidal, call 911 immediately to get help.

     The Connection Between Loneliness and Physical Problems
Aside from the emotional impact, loneliness can put you at risk for physical problems.

Loneliness and isolation creates stress and can also create increased inflammation in the body.  This is a genetic reaction that goes back centuries, and it occurs because the body still perceives loneliness and isolation as a threat to survival--like a physical attack or an infection.

Inflammation is the body's way of defending itself against the danger of an attack, and the body reacts the same way whether it's a real danger or only a perceived danger.  So, although inflammation is a way for the body to protect itself, too much inflammation can create serious medical problems. 

Chronic inflammation puts the body at risk for heart problems, stroke, cancer, autoimmune disorders and other medical problems.

Physical Distancing and Social Connection
Physical distancing is necessary to prevent the spread of COVID-19, but you can still maintain social connections with loved ones (see my article: Reframing Social Connections).

Connecting with loved ones online isn't the same as connecting with them in person, but it's the next best thing (see my article: Undoing Aloneness: Staying Socially Connected While Being Physically Distant and Developing a Felt Sense of Connection While Physically Distant).

Getting Help in Therapy
If you're feeling overwhelmed, you could benefit from seeing a licensed mental health professional.

Many therapists are providing online therapy during this pandemic (see my article: The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Rather than struggling on your own, you could benefit from working with a licensed psychotherapist to combat the emotional and physical impact of loneliness and social isolation.

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.

During the COVID-19 pandemic, I am providing online therapy.

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.

5 Tips For Challenging and Restructuring Distorted Negative Thoughts

In a prior article, I discussed how your distorted thoughts can have an negative impact on your overall mood and perspective (see my articles: How Psychotherapy Can Help You to Change Distorted Thinking).  In this article, I'm providing tips on how to challenge and restructure your negative thoughts which are distorted, so you don't get stuck in a pattern of negative thinking that affects your mood.

Challenging and Restructuring Distorted Negative Thoughts

How Negative Thoughts Affect Your Perspective
During a crisis, like the current pandemic, it's easy to get caught in a cycle of negative thoughts that gives you a pessimistic outlook and affects your mood.

While it's important to be realistic about the real challenges, if you don't find ways to overcome a habitual negative thoughts, they often have a way of crowding out anything that's positive.  So, it's important to notice if your thoughts and mood have become overly negative to the point where you're no longer seeing positive things that are happening in your life.

5 Tips For Challenging and Restructuring Your Negative Thoughts

• Write Down and Monitor the Accuracy of Your Negative Thoughts: When you have a negative thought, write it down.  Sometimes writing, rereading what you've written or even saying it out loud can help you to see that your thought is distorted.  

• Test Your Thoughts: Many negative thoughts remain untested, which gives them more power over you.  Try testing your thoughts to see how accurate they are.  For instance, if you tell yourself that you have no time--not even 5 minutes--to meditate, take a look at how you spend your time. If you're spending a lot of time online, can you take 5 minutes from that activity to close your eyes to meditate and relax?

• Evaluate the Likelihood of Your Negative Thoughts Coming True: Ask yourself how likely is it that your negative thoughts will come true.  Is there evidence for it?  What is this evidence?  How solid is this evidence? If there's no evidence, where are these thoughts coming from and what might they related to in your past?

• Practice Mindfulness Meditation: Your mindfulness meditation can be as simple as closing your eyes and paying attention to your breathing.  As you focus on each inhalation and exhalation, notice the quality of your breath and how focusing on your breath calms your mind and body (see my article: The Mind-Body Connection: Calm the Body and Calm the Mind).  Mindfulness meditation also provides an opportunity to see your negative perspective with a sense of calm so you can evaluate if you're catastrophizing.

• Practice Self Compassion: Notice if you're being overly critical of yourself or if you're in the habit of berating yourself for your mistakes.  It's often true that people who have compassion for the mistakes of others have little to none for themselves because they believe they don't deserve it.  So, practicing self compassion can be challenging.  Start by challenging yourself whenever you berate yourself ("I'm such an idiot for making that mistake").  Ask yourself if you would be as hard on someone else as you are on yourself.  Accept that you're human and, like everyone else, you're going to make mistakes.  Practice have compassion for yourself (see my article: Self Compassion: Loving Yourself Even in the Places Where You Feel Broken).

Getting Help in Therapy
Sometimes habitual negative thinking is linked to a history of trauma. 

When negative thinking is linked to trauma, trying to challenge your negative thoughts on your own often doesn't change them.

A crisis or a stressful event in the present can trigger unresolved trauma that requires the help of a trauma therapist (see my articles: Becoming Aware of Triggers Related to Unresolved Trauma and What is a Trauma Therapist?).

Many therapists are providing online therapy (also known as teletherapy and telehealth) during the COVID-19 crisis (see my article:  The Advantages of Online Therapy When You Can't See Your Therapist in Person).

Rather than getting stuck in a cycle of negativity, you could get help from a licensed psychotherapist who can help you to get through a difficult time and work through any underlying trauma.

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.

I'm currently providing online therapy while I'm out of the office due to the global pandemic.

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 5 Stages of Grief During the COVID-19 Crisis

Most of us have been feeling many different emotions, including varying degrees of grief for our losses during this COVID-19 pandemic.  I've been writing articles about psychological reactions and coping strategies to get through this stressful time, including the concept of the 5 Stages of Grief (see my articles: Grieving Losses During the Crisis and Healing and Coping and Staying Calm During the COVID-19 Crisis).

The 5 Stages of Grief During the COVID-19 Crisis

I began discussing the 5 Stages of Grief as it relates to the COVID-19 pandemic in an earlier article, and I would like to expand on that discussion here.

The 5 Stages of Grief:

• Denial
• Anger 
• Bargaining
• Despair or Depression
• Acceptance

The 5 Stages of Grief: It's Not a Linear Process
As I've mentioned before, although these stages might appear to be a linear process, they're not.  These stages are fluid.  Most of the time, people move back and forth between stages at various times and people might experience a combination of feelings on any given day.

The 5 Stages of Grief: The Grief Process and COVID-19
Let's take a look at each stage and how it might relate to the grief process that many people are going through now (see my article: Common Defense Mechanisms).

• Denial
• Denial is a defense mechanism.  
• It can be a useful temporary strategy when people feel overwhelmed.  But in the long run, it can keep people stuck and prevent them from successfully moving through the grief process.
• Common reactions during the denial stage:
• "People are overreacting to this problem."
• "It's not any different from the regular flu."
• "I'm a healthy person, so I can't get it."

• Anger
• Anger is often a secondary emotion when people feel too vulnerable to allow themselves to feel emotions like sadness or fear (see my article: Anger as a Secondary Emotion).
• People in this stage often blame others for the problem rather than focusing on their own needs and reactions.
• People can become defiant in terms of following the health experts' advice.
• Common reactions during the anger stage:
• "I don't care what the experts are saying. I'm bored and I'm going to hang out with my friends."
• "No one is going to control me or tell me to do social distancing. I'm my own person."
• "It's __________'s (fill in the blank) fault. If they had been more careful, we wouldn't be in this predicament."
• "Someone's making a buck, and it's not me. I'm not going to quarantine."

• Bargaining
• The bargaining stage often begins when people can no longer be in denial because there's evidence that the pandemic is actually happening and not overblown.
• During this stage, people are starting to come to terms with the reality of the situation, but they're not fully ready to accept it yet.
• Common reactions during the bargaining stage:
• "Okay, the pandemic is real, but I can socialize with others and I don't need to keep distant or wear a mask as long as I wash my hands."
• "The crisis is real, but it'll be over soon. We'll all be back to work in a few weeks."
• "Sure there are people who are sick, but as long as I only hang out with people who are healthy, I'll be okay. I won't get the virus."

• Despair or Depression
• When reality sets because people realize that their other defensive strategies aren't working, despair and depression can set in.  
• People begin to feel hopeless and helpless about the pandemic. They lose a sense of agency and feel powerless.  
• They often feel that they and the situation are beyond help.
• Common reactions during the despair or depression stage:
• "There's nothing that I or anyone else can do. This situation will never improve, so why should I even try to make things better for myself or anyone else?"
• "I'm going to lose everything, and I'll die alone and penniless."
• "If I get sick, no one will be able to help me."

• Acceptance
• If and when people get to the acceptance stage, they're ready to surrender to the current situation and cope with it as best as they can (see my articles: Empowering Yourself During the Pandemic).
• Common reactions during the acceptance stage:
• "Everything is changing, but maybe some things will change for the better."
• "Things are bad, but I can also look for the silver lining."
• "I can't control the pandemic, but I can take care of myself and control my own reactions to it."
• "I can try to find ways that I can help others in a safe and responsible way."

Getting Help in Therapy

If you're having problems coping during this crisis, no matter what you're feeling, you could benefit from working with a licensed psychotherapist who can help you to get through the grieving process.

Many therapists, including me, are providing online therapy, which is also known as teletherapy and telehealth, while they're out of their offices during the pandemic (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

Rather than feeling stuck and overwhelmed, take action to get help so that you can strengthen your coping skills and feel more empowered.

About Me

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

I work with individual adults and couples.

I am currently providing therapy online.

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.

Reflecting on What's Important in Your Life During a Crisis

During the current COVID-19 pandemic, when most people have been staying home in isolation, many people have been thinking about their lives and reflecting on what's most important to them (see my articles: A Search For Inner Meaning,  What is Happiness and Where Do You Find It? and Redefining Happiness and Success For Yourself).

Reflecting on What's Important in Your Life During a Crisis

The unprecedented nature of the coronavirus pandemic has people reconsidering their lives and their priorities, including:

• Family: 
• People who are fortunate to have good (or good enough) relationships in their family are considering some of these relationships in a new light (see my article: A Happy Family Doesn't Mean a "Perfect" Family).
• Before COVID-19, when people were busy commuting to work and working long hours, family often took a backseat to work.  
• With the potential for getting a life-threatening illness, like the coronavirus, many people are thinking of family relationships as being the #1 priority.  
• There are even some family members who have been out of contact for a long time who are reconnecting and making amends.

• Spirituality and Values: 
• Coping with a crisis often makes people re-evaluate their religion or their spiritual beliefs (see my article: Are You Contemplating Your Faith of Origin in a New Light?).
• Spirituality isn't necessarily a formal religion.  It can be a set of spiritual beliefs and values that are important to the individual.
• Some people, who might not have considered themselves to be spiritual before, are making religion or spirituality more of a priority to help them get through this difficult time (see my article: A Happy Life vs a Meaningful Life).

• Intimate Relationships:
• The current crisis has affected couples who were on the brink of breaking up before the pandemic. 
• For some couples, the crisis affirmed their decision that they want to be happier in their lives and they have decided that they can't be happy with their current partner.
• Other couples are finding it difficult to spend so much time together due to the need to stay home (see my article: Tips on Getting Along as a Couple During the COVID-19 Crisis).
• For other couples, who were having problems, put aside their differences now to focus on getting through the crisis, especially if they have children.
• Many couples have experienced a renewed sense of commitment to their relationship in light of the current emergency.  
• For other couples, the lack of commitment of one partner has caused the other partner, who wants a commitment, to reconsider the relationship (see my article: Are You Dating Someone Who Has a Problem Making a Commitment to Being in a Relationship?).
• Some individuals, who aren't in a relationship, feel lonely during this time of isolation and have made a firmer commitment to meeting someone new.
• Other individuals have reaffirmed their commitment to themselves to remain single because this is their preference.

• Friendships:
• The recognition of the importance of emotional support through friends has been especially important during this crisis (see my article: The Importance of Getting Emotional Support During a Crisis).
• Similar to family relationships, former friends, who were estranged, are reconnecting in some cases.
• An awareness of the importance of kindness has also been an important part for many people of re-evaluating their lives (see my article: The Impact of Kindness During Difficult Times).

• Health:
• Fortunately, for most people, the virus has been mild.  
• For people who are older or who have underlying conditions that make them more vulnerable to developing a more serious reaction to the virus, health considerations have been uppermost in their mind (see my article: How Serious Medical Problems Can Affect How You Feel About Yourself).
• The rate of contagion of the virus is forcing most people to consider their health habits and ways to improve on them.

• Work-Life Balance
• Everyone isn't fortunate enough to re-evaluate their work-life balance.  Some people have no choice but to work three or four jobs just to survive.
• For people who are fortunate to consider their work-life balance, some people are considering how much longer they want to work and whether they would rather spend their time doing other things, like spending more time with family, traveling, spending time on a hobby or living a simpler, quieter life (see my article: Balancing Your Career and Your Personal Life).
• Other people are considering whether they want to remain in their current career or whether they want to transition to something else eventually.  There is a recognition that life is short and putting off what they really want might not be wise (see my article: Navigating Life's Transitions).
• Some people are realizing that they prefer to live life at a slower pace, which might mean making changes in their work, retiring or eventually or moving to a place where the pace is slower (see my article: Midlife Transitions and Preparing Emotionally For Making Major Changes in Your Life).

• Money
• People who have been laid off, furloughed or had their work hours reduced are concerned about money.
• Other people are struggling emotionally because they have been terminated from their jobs, which means a loss of income and a loss of identity (see my article: When Job Loss Means Loss of Identity).
• Many people are re-evaluating their priorities, what they spend money on and how much to save and how much to spend.
• Many people are considering the amount of debt that they carry and they're hoping to be able to develop a plan to get out of debt.
• Many couples have been arguing about money during this time (see my article: Are You and Your Spouse Arguing About Money?).

What Have You Been Reflecting on During This Crisis?
The areas that I've included above is by no means exhaustive.

What have you been thinking about? Is the current crisis causing you to re-evaluate your life?

Getting Help in Therapy
Major crises are often difficult to get through.  But they can also be an opportunity for change (see my article: How a Crisis Can Bring About Positive Changes in Your Life).

If you're thinking about how you would like to change your life, you could benefit from working with an experienced psychotherapist who can help you to consider what's most important to you and help you develop strategies for changing your life.

Many psychotherapists, including me, are doing online therapy, which is also known as teletherapy or telehealth (see my article: The Advantages of Online Therapy When Your Therapist Isn't Available in Person).

Rather than struggling on your own, you could work with a licensed therapist who has experience helping people to make changes in their 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 Psychotherapy).

I work with individual adults and couples.

I am providing online therapy during the COVID-19 crisis.

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.

Developing Your Inner Sense of Being Grounded, Centered and Calm

During stressful times, it helps if you can feel an internal sense of being grounded, centered and calm (see my article: Grounding Techniques).  Feeling centered and grounded might not change your external circumstances, but it will help you to handle your circumstances with a sense of calm as well as a sense agency rather than a feeling powerless (see my article: Empowering Yourself During COVID-19: There Are Things You Can Control).

Developing Your Inner Sense of Being Grounded, Centered and Calm

Being able to detect a feeling of being centered, grounded and calm requires you to slow down and sense into your body, which I'll discuss later on in this article.

How Do You Know if You're Not Feeling Centered and Grounded?
First, let's talk about the opposite experience--when you're not feeling calm, centered and grounded, which can include:

• Experiencing anxiety and worry most of the time
• Creating or participating in emotional drama
• Feeling spaced out 
• Getting easily distracted
• Spending a lot of time worrying about how you look and what others think of you
• Having frequent sleep problems, including problems with falling or staying asleep (see my article: Tips on Getting Better Sleep)
• Experiencing chronic pain
• Having inflammation in your body
• Experiencing poor circulation in your body
• Feeling tired most of time

How to Develop a Sense of Being Grounded, Centered and Calm
As I mentioned earlier, you need to start by slowing down and noticing what's going on in your body.

Practice this at least once a day (more if you're feeling stressed at various times during the day or night):

• Find a quiet place for yourself in your home where you'll be undisturbed for at least 5-10 minutes (see my article: Reconnecting With Your Inner World Without Distractions).
• Depending upon your situation at home, this might mean getting up earlier than the rest of your family or taking a few minutes when it's quiet at another time of day, including bedtime.
• If there's no particular time when you usually have alone time, ask your family to allow you a few minutes to yourself (see my article: Is Self Care Selfish?). 
• Since both positive and negative emotions are often contagious, if you get calm and centered, it will help the rest of the family, including children,
• Sit up in a chair where you have back support and your feet touch the floor.

• Close your eyes (if you don't feel comfortable closing your eyes, find a spot on the floor to focus your attention so you're not distracted and your eyes aren't wandering around).

• Take a couple of regular breaths.
• After you have taken a couple of regular breaths, do a simple breathing exercise where you inhale and exhale through your nose (as opposed to your mouth).  Do this at your own pace:
• Breathe in to the count of 4
• Hold your breath for a count of 4
• Breathe out for 8
• Repeat as many times as required until you feel yourself getting calm

• Do the Body Scan meditation 
• When you do the Body Scan meditation, you're slowly sensing into your body to see where you're holding onto any tension.
• Wherever you sense tension in your body, imagine you could send your breath to that part of your body to help it relax.
• Thoughts will probably come up to distract you.  This is a common experience.  Imagine that you could take each thought and put it on a puffy white cloud so that it can float away, and then return to sensing into your body.

• Practice Breathing and the Body Scan meditation daily 
• If you're not accustomed to doing these exercises, you'll probably discover that they become easier with practice.
• It all starts with slowing down your mind and your body.

If you practice these exercises daily, but you're still having problems with sensing what's going on with your body, don't worry--this is a common experience that you can overcome.  I discuss this in my next article: The Mind-Body Connection: Developing a Felt Sense of Your Internal Experiences.

Conclusion

When you're going through a stressful time, as most of us are now during the COVID-19 crisis, it's easy to get overwhelmed physically and emotionally.

One way to get a handle on your stress is to start by slowing down and doing the exercises mentioned above to get more centered.

Getting Help in Therapy

You're not alone.   Many people are experiencing more stress than usual at this time, and they're having problems coping (see my article: Common Reactions During a Crisis: Fear and Anxiety).

During times of high stress, unresolved problems from the past can get triggered and they can feel overwhelming.  

Most therapists, including me, are offering online therapy (also called teletherapy or telehealth) while they're out of the office due to COVID-19 (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

Rather than struggling on your own, seek help from a licensed psychotherapist.  

About Me

I am a licensed New York City 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 during business hours or email me.

Using Your Imagination: How Imaginal Interweaves Help to Overcome Trauma - Part 1

I realize that during times of crisis, like the current pandemic or the 9/11 World Trade Center attack, there are certain songs that repeat in my mind (see my article: Remembering Your Strengths as a Way to Cope in a Crisis).

Trauma and the Imagination

One of those songs is "Imagine" by former Beatle, John Lennon, which was released in 1971 during the Vietnam war as part of the peace movement (see lyrics).

Almost 50 years later, "Imagine" continues to be an inspiring symbol of the pursuit of peace and a symbol of hope.

Whenever I have a song that repeats in my mind, I get curious about why I'm thinking about this particular song and what my unconscious mind is trying to tell me (see my article: Undoing Aloneness: The Client's and Therapist's Parallel Experience During a Crisis).

So, as I thought and I realized that during times of uncertainty imagination plays such a powerful role in both a positive and negative way, and "Imagine" is call for us to use our imagination to create a better world in terms of how we think and behave (see my article: Using Imagery as a Powerful Tool).

Uncertainty and Negative Imagination

The current discussions about "the new normal" are reminiscent of 9/11 and the loss of innocence, among other things, that we experienced after our country was attacked.

There's something jarring about the words "the new normal" at this point in time when people are still grappling with their fear, anxiety, grief for the losses, and social deprivation (see my article: Grieving Losses and Healing During a Crisis).

Coping with uncertainty often leads to negative imagination where people can only imagine the worst case scenario. And, when we understand that the brain is hardwired to anticipate danger in order to stay alive, it's easy to see why negative imagination can be so important as well as overwhelming.

So, let's not underestimate the value of being vigilant and negative imagination in anticipating danger.  If early cavemen and cavewomen weren't vigilant about danger, they might just as easily walk into the cave with the bear, instead of their home cave, with disastrous results.

So, anticipating danger is important and so is accepting your negative emotions.  But when negative imagination goes into overdrive, people often lose their perspective and the ability to anticipate anything that is good and positive.

Balancing Overwhelming Negativity By Using Positive Imagination to Cope: Imaginal Interweaves

Your creative imagination is powerful--regardless of whether you dwell on positive or negative scenarios (see my article: Empowering Yourself During the COVID-19 Crisis).

Let me be clear that I'm not advocating being positive all the time and ignoring what's negative.  That would be impractical, at best, and dangerous at worst.  Be prepared, cautious and follow the health experts recommendations are necessary for staying healthy (see my article: All Emotions Are Welcome Here).

Rather than being impractical or Pollyannish, I'm encouraging you to use positive imagination as a coping strategy to counteract many of the negative scenarios that might be going through your mind.

In Dr. Laurel Parnell's Attachment Focused model of EMDR therapy, which is a trauma therapy, she uses "imaginal interweaves" as a way of helping clients to develop the necessary internal resources to cope with working on the trauma (see my article: Empowering Clients in Therapy).

Using imaginal interweaves is a way of "interweaving" positive, powerful, nurturing, and wise figures into the therapeutic work.

An imaginal interweave can be imagining people you know in real life or characters from a movie, book, TV program (or iconic figures that you might know about but don't know personally) to imagine drawing upon the qualities that they have.

In Laurel Parnell's model, imaginal interweaves are people who have one or all of the following qualities:

• Powerful
• Nurturing
• Wise

• Examples of Imaginal Interweaves:
• Powerful: Your favorite superhero, a person you know and admire who overcame adversity, a character from a movie like Atticus Finch from "To Kill a Mockingbird" or whoever feel powerful to you ("powerful" is whatever it means to you).
• Nurturing: A close friend, a loved one, a mentor, a coach, a favorite aunt, or a character from a TV program
• Wise: Your favorite teacher or mentor, a wise uncle, a friend, a spiritual leader, Dumbledore from Harry Potter

As I discussed in an earlier article about imaginal interweaves, most of the time, interweaves are used in trauma therapy when clients get stuck while processing a traumatic memory.

But imaginal interweaves can also be used whenever you feel you need to empower yourself, including the current pandemic crisis.

• Imaginal interweaves help to: 
• integrate memory networks
• differentiate memory networks
• provide a creative and coherent narrative
• create a broader perspective
• provide a counterbalance to negative imagination

In My Next Article:

Using positive imagination to cope is a big topic, and one blog article isn't enough to cover it sufficiently, so I'll continue this discussion in my next article (see Part 2 of this topic).

Getting Help in Therapy

If you're feeling emotionally overwhelmed, you're not alone.  

Fear, anxiety and grief are all common reactions to the current crisis.

Many therapists, including me, are using online therapy (also known as teletherapy, telemental health and telehealth) to help clients during the current crisis when clients cannot be seen in person (see my article: The Advantages of Online Therapy).

Rather than struggling on your own, getting help from a licensed psychotherapist can make all the difference between feeling overwhelmed and having a sense of well-being (see my article: The Importance of Getting Emotional Support During a Crisis).

About Me

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

I work with individual adults and couples.

I am currently providing online therapy while I'm out of the office.

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.

Welcoming All Emotions

These simple words, "All emotions are welcome here" touched me deeply.  

These words, which were  spoken by an online facilitator in a support group for therapists, were said with such genuine kindness, acceptance and caring that it provided the metaphorical container and holding environment that we all need as we go through the physical, emotional and spiritual challenges during this pandemic (see my articles: Common Reactions to COVID-19: Fear and Anxiety,  The Powerful Impact of Kindness and Reframing Social Connection With Intentionality).

All Emotions Are Welcome Here

So often well-meaning people, who are struggling with accepting their own emotional vulnerability, have difficulty hearing someone else's pain.

In their desire to be uplifting, they unintentionally override the other person's sadness, grief and anger by telling them prematurely to "Be positive" or "Be strong," which makes the other person feel that their emotions are unacceptable in some way or that they're "weak" (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak".

While it's true that, as we deal with the challenges of this global pandemic, some of us are more fortunate than others, most people are struggling with a myriad of emotions as time goes by.  It's important to feel that all emotions, no matter how difficult, are accepted and acceptable (see my article: Resilience: Accepting Your Negative Emotions).

You might think that telling someone that you accept where they are emotionally might not be enough to soothe them, but keeping an open heart and mind and remaining in empathic resonance with another person is truly a gift that he or she might not receive from anyone else.

If you're feeling too emotionally vulnerable to delve into someone else's feelings, that's okay.  You can respond by simply saying, "I'm here for you" or "I care about you."

If words don't come at all, you can convey your love and caring by looking at them through your online connection and putting your hand on your heart.

At this time when so many people are trying to make sense of their emotions, when words don't come to you, whatever non-verbal loving gesture you can make will be received like a healing balm by your loved ones when you convey it with a loving intention.

Getting Help in Therapy
The concept of "starting where the client is" is the hallmark of good therapy.  Meeting and accepting the client wherever they are emotionally is the beginning of healing for them.

Many therapists, including me, are providing online therapy (also known as teletherapy or telehealth) during the COVID-19 crisis (see my article: Advantages of Online Therapy When You Can't See Your Therapist in Person).

If you're feeling overwhelmed, you're not alone.  Getting the emotional support that you need is crucial now.

Taking the first step of making that phone call to get help is often the most difficult, and it's also the start of healing.

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

I work with individual adults and couples.

I am providing online therapy while I am out of the office.

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.

Reframing Social Connection with Intentionality to Create Meaningful Connections Online

We are social beings, and the need and impulse to connect with others is real, especially during a crisis (see my articles: Coping Wih Loneliness and Social Isolation and Undoing Aloneness: Staying Socially Connected Even Though We Are Physically Distant).

We have a need to feel held, embraced and safe in the company of people we trust.  This need to be with others helps us to co-regulate each other's well-being.  This need to be in close physical proximity to others is also in direct conflict to the more pressing need right now to physically distance ourselves from each other to avoid getting getting the COVID-19 virus.

Reframing Social Isolation with Intentionality as You Connect With Loved Ones Online

How to Overcome the Negative Impact of Social Isolation During the COVID-19 Crisis

There's no question that physical distancing from others is necessary during this pandemic.  If you're not essential workers, you must stay home and only go out only when necessary using the precautions recommended by the Center For Disease Control and Prevention (CDC).

Remaining at home and physically distant isn't just difficult because you're feeling bored, more importantly, it goes against human beings' basic instincts to connect with others. 

As people become more physically isolated, the mind and the body go into defensive mode. After a period of being physically/socially isolated, people often become more anxious, fearful and worried (see my article:  Common Reactions to the COVID-19 Crisis: Fear and Anxiety).

Given that physical distancing creates a paradox between the needs of your nervous system and your need to survive this pandemic, how do you take care of your need for social connection?

Reframing Social Connection Online with Intentionality

Although you can't be physically connected with friends and other loved ones, you can remain connected online with intentionality.

What Does It Mean to Communicate with Intentionality?
When you're with someone in person, both of you are picking up or attuning to conscious and unconscious signals that you're both sending with regard to what's going on between you.

Aside from the words and the body language, you're picking up on other implicit cues you sense in person about what's being communicated. Sometimes the words and what's being communicated on an unconscious level don't match.

For instance, someone might tell you that they're not angry with you.  But their body language, facial expressions, tension in their body, and the emotional resonance that you sense might be communicating something very different.  Whether you realize it or not, the words are less important than the other cues you're picking up from the other person.

Another example would be that when someone says, "I love you," aside from the words, you pick up on other cues to understand the meaning behind the words. Does the person's facial expression, body language, and other subtle forms of nonverbal communication, including the resonance you feel between you and them, match their words?  If not, you're not going to believe the words.

How to Communicate Online With Intentionality
Sometimes you might not perceive the nonverbal cues online. So, you need to be more intentional and explicit online than when you're with someone in person.  The good news is that there are ways to do this:

• Human beings are an adaptable species, so we often find alternatives to the ways we normally do things.

• Appreciate and normalize for yourself your impulse to connect meaningfully with others--even as you're inhibiting yourself from doing it in person to remain healthy.

• Monitor your body's need for these social connections. Be conscious of your emotional needs. Reach out to others when you feel the need and be kind to your loved ones who are reaching out to you (see my article: The Powerful Impact of Kindness During Stressful Times).

• Reaching out to loved ones online is powerful.  If online communication isn't available, the phone is the next best thing. Emailing and texting are better than nothing, but not as powerful as seeing and hearing one another.  The problem with texting and emailing is that these modes of communication don't provide facial expressions and voice intonation, which are critical for feeling socially connected.

• The value of seeing someone's face and hearing their voice is powerful to the nervous system and fulfills a basic need for connection.

• It's not about the words.  It's not about chatting or just getting caught up, although this has its place too.  You're not just exchanging content or news.

• Communicating with intentionality is more about conveying with your facial expressions, your voice and your behavior that you care.

• By communicating how much you care with intentionality, you and your loved ones are coregulating each other's nervous systems and well-being so that you feel emotionally and physically better.

• You can each feel a sense of well-being in your body and mind as you help each other to coregulate your well-being. You're feeling connectedness.  This can't be emphasized enough.  Coregulating by seeing each other, hearing each other's voices and communicating with intentionality is a way of grounding each other. You're being attuned with each other.  You're entering into each other's consciousness to say, "You're not alone. I'm here with you and I care about you."

Conclusion

Requiring people to physically isolate from one another is counter to what we are hardwired to do as social beings who need social connections for physical and emotional well-being.

As social beings, we coregulate our physical and emotional well-being through meaningful connections with others.  Yet, the current pandemic requires that we remain at home physically isolated from others.

Although we cannot connect in person, we can do the next best thing, which allows us to reframe social isolation: Communicate with intentionality by using the power of our facial expressions, our words, behavior and voice intonality to communicate that we care.  

Getting Help in Therapy

Many mental health experts are concerned about the long term effects of isolation and loneliness.  

If you're feeling overwhelmed, help is available to you through online therapy, which is also known as teletherapy, telemental health or telehealth (see my article: The Advantages of Online Therapy When You Can't Meet With Your Therapist in Person).

Therapists via Online Therapy, Also Known as Teletherapy, Telemental Health and Telehealth

Working with a licensed psychotherapist who can help you through this difficult time can help you maintain a sense of well-being.  

If you're feeling powerless during this time, you can overcome your sense of powerlessness by taking action: Contact a mental health professional who can help you overcome your fear and anxiety.

About Me

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

I work with individual adults and couples.

I am working with clients online so we can remain connected.

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.