Emotional Numbing: The "Wall" That Once Protected You Now Imprisons You

 I've written about emotional numbing in prior articles (see my article: How Therapy Can Help You to Take Down the "Wall" You Built Around Yourself).

In the current article, I want to dive deeper into the subject of emotional numbing that started as a survival strategy and ended up imprisoning you with social isolation, an inability to feel emotions deeply, including joy, and creating stagnation in your life.

What is Emotional Numbing?

Emotional numbing is an unconscious psychological state where an individual feels detached or indifferent. They are often unable to experience, process or express emotions.

Overcoming Emotional Numbing

What Are Some of the Symptoms of Emotional Numbing?

Someone who is experiencing emotional numbing can have some or all of the following symptoms:

• Flat Affect: A lack of emotional response, often described as "robotic" or indifferent

• Reduced Emotional Range: An inability to feel high excitement or deep sadness

• Detachment: Feeling emotionally and psychologically disconnected from others and, possibly, from surroundings

• Indiscriminate Blocking: Emotional numbing blocks all emotions including sadness, joy, excitement and gratitude

• Loss of a Sense of Self: Chronic detachment can lead to loss of identity, which can make you feel like a passive observer in your life 

• Avoidance and Isolation: Withdrawing from people and social activities

• Energy Depletion: Maintaining internal "walls" takes a lot of psychological energy which can lead to chronic fatigue or burnout

What Causes Emotional Numbing?

Emotional numbing can be caused by unresolved psychological trauma, PTSD (posttraumatic stress disorder), severe stress, grief, burnout or a side effect of medication (see my article: What is the Difference Between Trauma and PTSD?).

Overcoming Emotional Numbing

Emotional numbing often starts during childhood as a survival strategy or defense mechanism which is adaptive at the time because the child is in a psychologically overwhelming environment at home.

In that sense, emotional numbing helps to mitigate overwhelming stress and trauma which would be detrimental to the child.

However, when the child becomes an adult, emotional numbing is no longer adaptive because it prevents the individual from being fully present in personal relationships, friendships, social activities and at work.

As an adult, chronic emotional numbness puts a strain on relationships and daily life.

Clinical Vignette

The following clinical vignette,which is a composite of many cases, illustrates how emotional numbing which once protected a young child in a dysfunctional family from being overwhelmed but created problems later on as an adult. The vignette also illustrates how trauma therapy can help.

Nick

When Nick was growing up, he learned to cope with his parents' constant arguments by going into his room and "spacing out" with video games.

After a while, he got so good at numbing himself that he felt like he was in his own world apart from everyone and everything else.

As an adult in his first relationship, Nick had problems connecting emotionally with his girlfriend. She complained that she experienced him as emotionally detached and indifferent about her and their relationship.

At the time, Nick had no awareness about how he was numbing himself because it had become so automatic for him. At the point when he thought his girlfriend might end their relationship, Nick sought help in therapy.

Nick's therapist helped Nick to realize that the "wall" he created around himself as a child protected him from the chaos between his parents, but that same "wall" now came with a cost because he had problems connecting emotionally with his girlfriend and others.

His therapist, who was a trauma therapist, helped Nick to gradually take down his protective "wall" by working on the unresolved trauma from his childhood.

Using a combination of EMDR therapy and Parts Work therapy, over time, Nick worked through his childhood trauma so that he no longer felt the need to numb himself emotionally (see my article: Why is Experiential Therapy More Effective Than Traditional Talk Therapy to Overcome Trauma?).

The work in therapy was neither quick nor easy, but Nick was able to connect emotionally with his girlfriend as he worked through his unresolved trauma.

Conclusion

Like all defense mechanisms, emotional numbing occurs on an unconscious level and it's usually related to trauma.

Trauma therapy can help to work through the original trauma so there is no longer a need for emotional numbing.

Getting Help in Trauma Therapy

Working with a licensed mental health professional who is a trauma therapist can help you to work through unresolved trauma and emotional numbing (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

Rather than struggling on your own, seek help from a trauma therapist so you can live a more fulfilling life.

About Me

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

As a trauma therapist, I have over 25 years of experience helping 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.

Also See My Articles:

Allowing Yourself to Feel Your Feelings So You Can Heal 

What Happens When You Numb Yourself to Your Traumatic Past 

The Mind-Body Connection: Overcoming the Defense Mechanism of Denial With Experiential Therapy

In my prior article, The Mind-Body Connection: The Body Reacts When the Mind Gets Stuck in Denial, I discussed the defense mechanism of denial and how denial impacts people psychologically as well as physically due to the mind-body connection.

Overcoming the Defense Mechanism of Denial

In this article I'm focusing on how Experiential Therapy can help clients who use denial as a maladaptive coping mechanism  (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy).

Denial as an Unconscious Process

For many people using denial is an unconscious process. 

People who use denial unconsciously often have little or no awareness that they are using denial to avoid emotional pain--until there are consequences as a result of the denial and avoidance.

The consequences might be a worsening of their emotional problems and/or health.

People who have more awareness about their use of denial often realize they need help, but their fear of dealing with their problems keeps them from fully acknowledging their problem so they don't seek help.

Overcoming the Defense Mechanism of Denial

What You Can Do on Your Own

• Recognize and Acknowledge the Problem: This is the first step in overcoming denial. If you recognize you engage in a pattern of denial and avoidance, you can start to make changes. Some of the signs that you use denial as a defense mechanism include:

• Getting defensive
• Avoiding thinking about a problem
• Avoiding taking action to resolve a problem

• Slow Down: You're more likely to use denial as a way to avoid a problem when you react quickly, so taking the time to slow down can help you to self reflect on how your behavior (or lack of behavior) is affecting a problem you're avoiding.

Practice Mindfulness

• Practice Mindfulness: Along with slowing down, practicing mindfulness can help you to stay calm and grounded so you can deal with stress and your own habit of denial and avoidance.

• Develop Self Awareness: Self reflection can help you to be more self aware recognize how you might be self sabotaging.

Writing in a Journal Develop Self Awareness

• Write in a Journal: Writing about your problems in an open way can help you to observe and reflect on your thoughts, emotions and behavior (see my article:  Writing Can Help You Reflect on Your Thoughts, Emotions and Behavior).

Asking For Emotional Support

• Ask for Emotional Support: Ask trusted family and friends for emotional support. Be open to their feedback and suggestions without getting defensive (see my article: Overcoming Your Discomfort With Asking For Emotional Support).

How Experiential Psychotherapy Can Help to Overcome a Pattern of Using Denial

Experiential Therapy is different than regular talk therapy (see my article: Experiential Therapy Offers a Window Into the Unconscious Mind).

Experiential Therapy can help you:

• Develop Self Awareness: Experiential Therapy can help you to develop better self awareness about unconscious defense mechanisms you might be using, including denial, using mind-body oriented interventions (see my article: Making the Unconscious Conscious).

• Develop Greater Self Reflective Capacity: Experiential Therapy can help you to develop or improve your self reflective capacity so that you can think about their thoughts, emotions and behaviors, including unconscious motivations. Becoming aware of unconscious motivations and using self reflection can help you to think before you act so they can make better choices (see my article: The Unconscious Mind: The Symptom Contains the Solution).

Gaining Insight in Therapy

• Gain Insight: Experiential Therapy can help you to gain insight into your thoughts, emotions and behaviors.

• Provide Clinical Feedback: Experiential Therapists can provide you with clinical feedback to help them understand your patterns and how you make decisions so you can grow and change.

• Overcome Emotional Blocks: Experiential Therapists are aware that you might have difficulty making the changes you want to make because you might have emotional blocks that need to be identified. Once emotional blocks have been discovered, Experiential Therapists can help you to work through and overcome the blocks. This is often challenging and requires a commitment to let go of dynamics that are holding you back (see my article: Overcoming Emotional Blocks).

• Facilitate Transformational Experiences in Therapy: Experiential Therapists can help facilitate transformational changes.

Get Help in Therapy

Since defense mechanisms, like denial, are often unconscious, it can be difficult to overcome emotional blocks to change on your own.

Getting Help in Experiential Therapy

If you have been unable to resolve your problems on your own, you could benefit from seeking help from an Experiential Therapist who can help you to overcome maladaptive coping strategies, like denial and avoidance.

Rather than struggling on your own, seek help from a licensed mental health professional who has the expertise to help you lead to lead a more meaningful and fulfilling life.

About Me

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

I am an Experiential Therapist who works with individual adults and couples.

I have helped many clients to overcome obstacles to their growth.

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 Mind-Body Connection: The Body Reacts When the Mind Gets Stuck in Denial

I'm focusing on the mind-body connection when the mind gets stuck in denial and how denial can affect the body.

What is Denial?

Denial is a defense mechanism (see my article: Understanding Defense Mechanisms).

The Body Reacts When the Mind Gets Stuck in Denial

People use denial as a form of self protection against accepting something that would be too painful for them to admit to themselves.  

Signs of Denial

Some common signs include:

• Refusing to talk about the problem
• Finding ways to justify denial
• Blaming others or outside forces for the problem
• Persisting in behavior despite negative consequences
• Promising to address the problem in the future, but it doesn't get addressed
• Avoiding thinking about the problem

Short Term Denial vs Ongoing Denial

Short term denial can be helpful and adaptive under certain circumstances. 

However, ongoing denial, which happens the mind gets stuck in denial, is often self destructive and destructive to others.

Ongoing denial is a maladaptive use of this defense mechanism. 

Short Term Denial Can Be Helpful Under Certain Circumstances

Sometimes short term denial can be adaptive because it gives people a chance 

to get ready to face a situation they're not ready to face in the moment.

An Example of Short Term Denial Being Helpful

    Mario and Judy

When the doctor told Mario and his older sister, Judy, that their mother's cancer was terminal and that any more chemotherapy would only hasten her demise, they were shocked and they refused to believe it at first.  However, after the initial shock wore off, they talked to their mother's doctor about next steps. After their talk, they were ready to accept that their mother would be much more comfortable in hospice care where she would be made comfortable until she passed away. Three days after being in hospice, their mother passed away peacefully in and, although they grieved the loss, they knew they made the best decision for her.  In this example, Mario and Judy weren't ready, at first, to accept the news that nothing more could be done to eradicate the cancer. Their short term denial gave them a chance to process and accept the news, as hard as it was, and prepare themselves for the worst. At that point, they were able to make the decision to have the medical staff transfer their mother into hospice care so she would be made comfortable. After her death, even though they were very sad and they grieved, they knew they made the right decision in accepting the futility of further cancer treatment and hospice was the best possible option under the circumstances.

 An Example of How Ongoing Denial Can Affect the Body

    Nina

Mario and Judy's younger sister, Nina, had a very different experience. After their mother died, Mario and Judy grieved their mother's death and eventually they made peace with her passing. But Nina wasn't able to accept her mother's terminal cancer diagnosis. She was in complete denial. She argued with the oncologist and the nurses on the cancer ward.  She also opposed putting the mother in hospice and argued with her siblings. She kept insisting that more chemotherapy would help, but Judy was on the mother's health proxy and she had power of attorney, so Nina couldn't stop her siblings' decisions. 

After her mother died, Nina contacted several malpractice attorneys. She channeled all her denial and anger about the mother's death into bringing a malpractice suit against the medical staff that treated her mother. But, after reviewing the medical records, every lawyer she contacted told her that she didn't have a case.  No one in the family was able to help Nina to accept that everything that could have been done was done. 

After several months, Nina's denial took a toll on her health. She developed insomnia, frequent headaches and high blood pressure. Her primary care physical advised her that she needed to accept and mourn the loss of her mother. But she wouldn't accept her mother's death and her health continued to deteriorate until she was hospitalized.  

It wasn't until the hospital sent a clinical social worker who was on staff to speak with Nina about the impact her denial was having on her health that she began to take her first tentative steps to overcome her denial. Part of her hospital discharge plan was to see a psychotherapist to deal with her denial and release the grief that was bottled up inside her.

How the Body Reacts When the Mind Gets Stuck in Denial

In Dr. Bessel van der Kolk's excellent book, The Body Keeps the Score, he discusses the connection between the mind and the body.

The Body Reacts When the Mind Gets Stuck in Denial

Ongoing denial occurs when a person refuses to accept something that is too painful for them.  Even though their mind might reject whatever they cannot accept, their body can react.

When someone gets stuck in denial, they use a lot of mental energy to maintain this defense mechanism. This causes stress and muscle tension. 

Over time, stress hormones can take their toll on the body. 

The person who is in denial might not make the connection between their denial and the consequences to their body.

  Other Examples of Denial

• Someone denies they have an alcohol or drug problem because they're still able to function on a day-to-day basis.

In Denial About Substance Abuse Problems

• Someone hurts their partner's feelings, but instead of accepting this, they blame their partner for their hurtful behavior.

Blaming a Partner For One's Own Behavior

• Someone who is having an emotional problem refuses to accept it or get help, so it gets worse over time both emotionally and physically.

Getting Help in Therapy

Before denial takes its toll on your mind and body, seek help from a licensed mental health professional.

Getting Help in Therapy

A skilled psychotherapist can help you to identify your particular pattern of denial and other defense mechanisms you might be using to avoid dealing with your problems.

Rather than allowing your problems to get worse, seek professional help so you can lead a healthier and more fulfilling life.

See My Other Related Articles

The Mind-Body Connection: Responding Instead of Reacting to Stress

The Mind-Body Connection: What is Somatic Awareness?

Clinical Hypnosis and the Mind-Body Connection

The Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind

About Me

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

How Experiential Psychotherapy Can Facilitate Emotional Development in Adult Clients

In prior articles, I've discussed experiential psychotherapy and how it helps clients in therapy to overcome emotional problems, including:

• Experiential Psychotherapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind

• What's the Difference Between Top-Down and Bottom-Up Approaches to Psychotherapy?

• Using Somatic Psychotherapy When the Client Has No Words to Describe the Problem

• Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone

How Experiential Psychotherapy Can Facilitate Emotional Development

In this article, I'm focusing on how experiential psychotherapy can facilitate emotional development in adult clients who who grew up in childhood homes where there was no one to share and help process emotional experiences.

Tracking Clients' Emotional Expression During the Psychotherapy Sessions 
A psychotherapist who practices experiential psychotherapy usually tracks clients' emotional expression as they talk about the issues that brought them to therapy.  She does this by watching and listening to clients and how they expresses themselves as they talk about traumatic experiences.

Some of the problem areas that an experiential psychotherapist will track will include the clients' use of defense mechanisms:

• Clients, who use the defense mechanism of isolation of affect as their primary defense mechanism, will often talk about traumatic experiences with little to no emotion.  They might relate a horrendous family history in the same matter-of-fact tone that they would give a news report from another part of the world. When the therapist is tracking the clients' emotional expression, she will detect this disconnect between emotions and a traumatic experience, and this will inform her as to where the work needs to focus.

• Clients, who use minimization as their defense mechanism, might have more of a range of emotional expression when they talk about traumatic experiences but, at some point, they might cut off their emotions and minimize the impact of the trauma ("My father use to beat me, but that's how it was back then in a lot of families.  Every parent did it, so I guess I shouldn't complain").  By noting that the client began by relating the trauma experience with emotion and then defensively cutting off the emotion by minimizing the negative impact of the trauma, the psychotherapist notes how the client wards off feelings, and she can work with the client on this.

• Intellectualization is another defense mechanism that clients often use when they are defending against feeling the emotional pain related to traumatic experiences.  Rather than allow themselves to feel the pain, they cut off their emotions by relating their trauma in a logical way with little to no affect.  The experiential psychotherapist will notice this defense mechanism and work towards helping the client to connection emotionally to the trauma so the trauma can get worked through.

• Other clients are not sure how they feel about their traumatic experiences.  They might have a very narrow range of affect because there was no one available when they were growing up to help them process difficult emotions.  As an emotional survival strategy, when they were children, these clients learned to feel as little as possible, especially emotions that made them feel uncomfortable, to keep from being overwhelmed and maintain an attachment to their parents.  As adults, they might not be able to identify their so-called "negative emotions," so the psychotherapist will know that this will be part of the work.

There are many other examples where a psychotherapist, who practices experiential psychotherapy, will detect clients' problems with emotions and use the therapy to help facilitate emotional development, but the examples above give you an idea of the type of problems that can come up that indicate a need for help with emotional development.

With tact and empathy, an experiential psychotherapist can begin to talk to clients who are having problems with experiencing and expressing their emotions and address their defense mechanisms.

This would include psychoeducation about how these defense mechanisms were necessary earlier in life to survive emotionally, but they are now getting in the way.

Facilitating Emotional Development in Experiential Psychotherapy
This is important because if clients continue to use defense mechanisms to ward off their emotions, their emotions remain constricted and buried under their defenses, so that the psychotherapist and the clients cannot get to the core emotions involved in the problem in order to resolve the trauma.

Depending upon the particular client and the type of defense mechanisms that they use, some of the ways that the experiential psychotherapist will facilitate emotional development would be by:

• Establishing a strong therapeutic alliance in therapy so the client realizes that, unlike when s/he was a child and felt alone with uncomfortable emotions, s/he now has a caring psychotherapist who will be a "witness" to the client's history and provide emotional support.

• Empathically attuning to the client and paying attention to the client's conscious and unconscious communication in the therapy sessions.

• Helping the client to be aware of how s/he uses defense mechanisms to avoid feeling certain emotions ("I'm wondering if you're aware of how you tend to look away and drift off when you talk about the emotional neglect that you experienced as a child?)"

• Asking the client, when s/he is ready, to try to not use the defense mechanism that s/he usually uses to see what that's like.  If the client says that it would be unbearable to experience these emotions, the psychotherapist will not push the client beyond where s/he can go, but would take smaller steps to facilitate emotional development.

• Helping the client to expand his or her window of tolerance if the client has only a limited threshold for experiencing difficult emotions.  

• Assisting the client to identify emotions by helping him or her to locate emotions in the body ("I notice that your hands are clenched and your jaw looks tight when you talk about how your mother humiliated you in front of your friends when you were a child.  When you focus on your clenched hands and tight jaw, what emotions are you feeling?").  This helps the client to connect emotions within the body, which will assist the client to identify and express emotions.

Engaging in Metaprocessing of Experiential Therapy in the Session
For clients who were abused or neglected as children, emotional development in psychotherapy is ultimately healing and allow for the working through of unresolved trauma.

But along the way, it can be challenging, so the experiential psychotherapist will do metaprocessing with clients at the end of the therapy session to discuss how clients experienced the work.

This helps the client to understand his or her reactions to the work in therapy, and it also allows them integrate the changes that they are  making.  Some examples might include:

• "You did a lot of good work today in session.  What was it like for you to begin to experience emotions that you have been avoiding for most of your life?"

• "You were able to feel the grief of your loss today for the first time.  What was that like for you?

• "You were able to talk about things that you haven't been able to discuss before.  What was that experience like for you today?"

Encouraging the Client to Retain Therapeutic Gains Between Sessions
Defense mechanisms that have been used for a lifetime to ward off uncomfortable feelings don't just disappear after a few sessions.  They have been clients' default mode and will often reappear between sessions and sometimes even in the same session, which is why it's so important for experiential psychotherapists to metaprocess with clients at the end of the session.

Many clients, who have unresolved trauma, often walk out of the therapy session and forget the therapeutic gains they made during the session.  It's as if they leave these gains and their memories of the session in the therapy room.

It can be frustrating for clients when they return for their next session and they realize that they have little to no memory of what they experienced in the prior session.  They might feel like they're starting at "Square One" again at each session.

To try to help clients to retain the therapeutic gains they achieved, experiential psychotherapists often encourage clients to keep a journal between psychotherapy sessions (see my article: The Benefits of Journal Writing Between Psychotherapy Sessions).

By writing about their thoughts, emotions, fantasies, memories, physical reactions and whatever else comes up related to the therapy session, clients are more likely to retain and integrate the therapeutic gains achieved in the prior therapy session so they're ready to continue the work in their next session.

Helping Clients to Reflect On and Consolidate Therapeutic Gains
Many clients who come to therapy to resolve trauma are in significant emotional pain and they are, understandably, in a hurry to work through traumatic experiences.  As a result, they might have unrealistic ideas about how long it will take in therapy to resolve problems they have had for a lifetime.

An experiential psychotherapist helps clients to realize that therapy isn't something that is "done" to them.  It is a collaboration between the therapist and the client, and each client is different in terms of how long it will take to resolve traumatic experiences.

The experiential psychotherapist is constantly assessing and reassessing the client in terms of what s/he needs from the therapist and how far s/he can go without being overwhelmed by the work.

This is an important clinical judgment call the therapist has to make in order to keep the work moving as long as it is emotionally tolerable for the client.  It would be detrimental to the work and retraumatizing for the client if the therapist attempted to push the client too quickly.

Many clients, who want to work through trauma, come to therapy after avoiding it for many years.  So, after they acknowledge that they need help, they want to make up for lost time and they're unaware of the negative clinical implications of moving too quickly and being emotionally overwhelmed in therapy.

So, an experiential psychotherapist will help the client to reflect on the work that has been done so far.  She will remind the client of where the client started in therapy (i.e., unable to tolerate uncomfortable emotions) and how far s/he has come (i.e., able to tolerate increasingly difficult emotions).

Why is this important?

For one thing, many traumatized clients have difficulty giving themselves credit for positive achievements, especially if they grew up in households were "perfection" was considered the norm.  So, it's important for the psychotherapist to remind the client of his or her progress so s/he can have a sense of pride about it.

Another issue is, as mentioned before, that clients, who have an unrealistic idea of the time frame for overcoming their traumatic experiences, often need a reminder of how far they have come from where they started.

If they're only focused on, "I'm not where I want to be yet," they will be likely to run roughshod over themselves--in much the same way as they were treated by their parents when they were children.

An experiential psychotherapist will provide clients with psychoeducation that progress in therapy isn't linear, respond to their concerns ("My friend completed EMDR therapy in only 10 sessions.  Why am I still processing my trauma with EMDR?) and remind them not to compare themselves to others because everyone is different.

Conclusion
Clients who have a traumatic history often have problems experiencing their emotions.

For some clients, this means that they are unable to feel what they are experiencing because of defense mechanisms they developed in childhood as part of a much-needed emotional survival strategy at the time.

Other clients will have only a narrow range of emotions that they allow themselves to experience (e.g., they can experience anger and frustration, but allowing themselves to feel sadness makes them feel too vulnerable).

The experiential psychotherapist tends to work differently than most talk therapists by helping the client to not just talk about their problems but to work through their issues in a more in-depth experiential way.

Experiential psychotherapy, like EMDR therapy, Somatic Experiencing and clinical hypnosis, is more effective than regular talk therapy.

Getting Help in Therapy
Most people who have a history of emotional trauma are unaware of how their history is impacting their current life.  As a result, they never seek the help they need in therapy (see my article: The Benefits of Psychotherapy).

If you have been struggling with unresolved problems, you owe it to yourself to get help from a skilled experiential psychotherapist (see my article: How to Choose a Psychotherapist).

Once you free yourself from a traumatic history, you can live a more fulfilling life.

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

I work with individual adults and couples, and I have helped many clients to overcome their traumatic experiences.

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

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

How Contemporary Psychotherapy Has. Changed - Part 2

In Part 1 of this topic, I gave a history of the early psychoanalytic views of psychotherapists' reactions to clients (also known as countertransference) and gave an overview of more contemporary views on this subject.

How Contemporary Psychotherapy Has Changed

There are many ways for psychotherapists to share their reactions with the client--too numerous to write about in one blog article.

In this article, which is Part 2, I provide an example of contemporary psychotherapy with a fictional clinical vignette which illustrates one way that the psychotherapist's willingness to share her views with the client can accelerate the work in therapy and help to heal the client.

Fictional Clinical Vignette: Psychotherapists' Reactions to Clients

Nina
After struggling on her own for years with low self esteem, Nina began psychotherapy again to deal with this issue which was getting in the way of her personal life and her career.

She had been in therapy a few times before in the past and, although she developed intellectual insight into her problems, nothing changed for her.  Overall, her experiences in her prior therapy were not good because her psychotherapists tended to remain silent, and this made Nina feel uncomfortable.  But she decided to give psychotherapy another chance with a psychotherapist who was recommended to her.

As Nina was providing her psychotherapist with a family history, she discussed feeling unlovable in her family, especially after her younger brother was born (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

She explained to her therapist that she found out as an adult that after her birth, her mother was depressed and unable to care for Nina, so Nina's maternal grandmother and various aunts took turns caring for her.

She also found out that after her younger brother was born a year later, her parents were ecstatic to have a boy.  They had always wanted a boy to carry the family name.  And, whereas Nina continued to be shuttled off to various relatives for care, her brother was treated as precious and special throughout his life.

Apparently, by the time Nina's brother was born, the mother was no longer depressed, but she never bonded with Nina.  Her focus tended to be on the brother.  Her father also doted on the brother.  So, from a young age, Nina felt there must be something wrong with her since her parents practically ignored her, and she grew up feeling unworthy of love.

Although she loved her brother, Nina felt angry and resentful towards him.  Intellectually, she knew it wasn't his fault if her parents favored him over her but, on an emotional level, even at a young age, she had fantasies that he would die from a mysterious cause and then her parents would love her more.  These fantasies, which continued into adulthood, caused Nina to feel guilt and shame.

Although she dated in college, at the age of 33, Nina had never been in a long term romantic relationship. Whenever a man expressed interest in her beyond casual dating, Nina would begin finding faults with him in her mind and, eventually, she would end their dating relationship.

At the same time, Nina said, she was very lonely, and when she wasn't dating anyone, she longed to be in a serious relationship.  She would tell herself that she wouldn't be so critical of the next man she dated, but it was an ongoing cycle (An Emotional Dilemma: Wanting and Dreading Love).

Psychotherapists' Reactions to Clients 

The psychotherapist listened to Nina's history with compassion.  She recognized that Nina was caught in a dilemma of wanting love at the same time that she dreaded it.  She wondered if Nina would be able to form a therapeutic alliance with her to do the work or if the therapeutic relationship would be too threatening to Nina.

She also recognized that Nina used the defense mechanism of avoidance in her relationships with men. She could see that this was a necessary emotional survival strategy that Nina developed unconsciously when she was child to ward off the overwhelming feelings of hurt and still maintain a tenuous attachment to her parents (see my article: Understanding Internal and External Defense Mechanisms).

With regard to her career, Nina explained, she lacked confidence in her ideas in a field that was very competitive.  As a result, junior staff, who had much less experience but who were more willing to take risks in presenting their ideas, were getting promoted ahead of Nina, which was discouraging for her.

In the next psychotherapy session, the psychotherapist noticed when Nina spoke, she tended to defensively avert her gaze, and she decided to ask Nina if she recognized this about herself.  At first, Nina hesitated, and then she responded that other people also told her this.  When her therapist asked her if she had any insight into what caused her to do this, at first, Nina said she didn't know (see my article: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Her psychotherapist decided to explore this further with Nina, and asked Nina if she feared what she might see in her therapist's eyes.  In response, Nina looked directly at the therapist and then looked away again.

Her therapist asked Nina what she saw when she looked into her eyes, and Nina responded that she saw a lot of compassion and empathy, which she liked, but she was not accustomed to it.

Her psychotherapist decided to share her reaction with Nina regarding the neglect that Nina experienced when she was a child by telling Nina that she was moved by what she said in the first session.  By sharing her genuine reaction about Nina, her therapist hoped this would be the beginning of a positive relationship, although she was aware that Nina might feel a little uncomfortable.

The therapist's disclosure to Nina was in stark contrast to the more traditional stance in psychotherapy  that she had experienced with her prior therapists.  In the traditional stance, the psychotherapist wouldn't disclose any personal reactions about the client because it would be considered "overly gratifying."  But, in this case, the psychotherapist, who worked in a contemporary way, used her clinical judgment with the hopes of forming a positive relationship with Nina.

When Nina heard her psychotherapist's words, she looked up and smiled, "Thank you.  No one has ever said that to me. I can see that you really are moved, and that feels good."

As they continued to work together in therapy, the psychotherapist saw that Nina sometimes minimized the neglect that she experienced in ways which Nina, unknowingly diminished her own self worth.  Minimization was another defense mechanism that Nina used.

One day Nina talked about something that occurred when she was five years old.  She said she overheard her mother tell a maternal aunt that she felt Nina was a "burden." Her psychotherapist could see that there was a moment when Nina felt sad.  But then Nina swept her feelings under the rug by minimizing the incident, "My mother was probably having a bad day, so I shouldn't feel bad about that.  Anyway, it happened a long time ago."

Rather than allowing Nina to discount her own feelings about overhearing such a hurtful remark from her mother, her psychotherapist said in an empathetic tone, "That would be a nightmare for a five year old to hear her mother say" (with emphasis on the word "nightmare").

Nina seemed surprised by her psychotherapist's reaction.  As she allowed her therapist's words to sink in, she began to cry, "Yeah, it was.  I went back to my room and cried myself to sleep.  You're the only person that I've ever told this to."

Her psychotherapist explored with Nina what it was like for her to hear her therapist express her reaction to what happened as "a nightmare."  In response, Nina said that it felt good to have someone who understands what it was like because, back when she was five, she had no one.  She said she felt it gave her "permission" to feel her emotions rather than trying to ward them off.

Then, her psychotherapist explained that, even though this incident and many more like this happened a long time ago, these experiences had a significant impact on Nina emotionally and they were at the root of her problems (see my article: Understanding Why You're Affected By Trauma That Happened a Long Time Ago).

During the course of her therapy, there were many more instances where Nina's therapist used her reactions to Nina to help her to overcome defensive strategies that worked when she was a child but were now creating problems for her.

Over time, Nina was able to catch herself as she was about to use a defense mechanism to ward off uncomfortable feelings.  This allowed the work in therapy to deepen.

When Nina was ready, her psychotherapist suggested that they use EMDR therapy to help Nina to overcome her unresolved childhood trauma and also work on current problems (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

The work in therapy was neither quick nor easy.  But over time, Nina became increasingly comfortable with her psychotherapist's more contemporary way of working, as compared to the more tradition way of her prior therapists.

She found her psychotherapist's expressions of compassion and empathy to be healing, and this allowed Nina to open up more in therapy.

After a while, Nina was able to feel on a deep level that she had been a lovable child, and it wasn't her fault if her parents were so unloving towards her.  This understanding was not just an intellectual understanding--she felt it deeply.

Gradually, Nina became more self confident.  She no longer feared developing a loving, committed relationship with a man.  So, when she met someone that she really liked and who cared for her too, she didn't push him away like she did in the past.  She allowed the relationship to grow and flourish, and she was able to accept her own feelings and that he cared about her without feeling threatened by the emotions.

She also became more confident in presenting her ideas at work, which her director noticed.  Eventually, she received the promotion that she had wanted for such a long time.

Conclusion
In traditional psychotherapy, psychotherapists don't divulge their reactions to their clients.  They attempt to maintain a neutral stance.

In my clinical opinion, there is no such thing as a neutral stance--no matter how much a psychotherapist attempts to hide what s/he feels.  Even if a psychotherapist attempts to maintain a neutral stance, clients can be very perceptive and sense what a psychotherapist is feeling.

Attempting a neutral stance is not only outmoded, in opinion, it's actually hurtful for the client, especially a client who was raised in an abusive or neglectful environment as a child.  In many ways, attempts at therapist neutrality are often retraumatizing for the client.

But, even though the field has progressed, many psychotherapists are still being trained to be neutral with their clients, as I was when I was trained more than 20 years ago.

This doesn't mean that a psychotherapist should share whatever comes to her mind without regard for how it will affect the client.  That could be equally hurtful.  Instead, a psychotherapist needs to make clinical judgment calls with each client and in each session with each client as to what would be helpful for the therapist to share and what would not.

For many clients, as in the fictional vignette above, having a psychotherapist who can, in effect, go back in time with them to explore the client's history in a compassionate and empathetic way, is a healing experience that they might never have experienced before.  It helps the client to open up and accelerates the work in therapy.

Getting Help in Therapy
Many people, who experienced early trauma, never come to therapy because they're fearful of being retraumatized (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist with good clinical judgment and who is trained in trauma therapy can provide the client with a healing experience that allows them to work through early traumatic experiences (see my article: How to Choose a Psychotherapist).

If you have unresolved trauma that is having a negative impact on your life, you owe it to yourself to get help from an experienced trauma therapist.

Working through your trauma can free you from your history and allow you to live a more fulfilling life.

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

I am a trauma therapist, who works with individual adults and couples.

I have helped many clients to overcome past and current trauma so they can move on to live happier lives.

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.

Letting Go of Hope That is Based on Denial

Being hopeful and optimistic can improve your mood, your outlook on your personal life and the world around you.  But when hope is based on denial, this can only lead to disappointment and disillusionment.

Letting Go of Hope That is Based on Denial

For instance, it can be challenging to allow yourself to know when you're in an unhealthy relationship that isn't going to change.  This is especially difficult when you really love someone and you want things to work out between you.

You naturally want to give the person you're with and the relationship every chance to improve.  But after a certain point, you probably know deep down that things aren't going to change and you're just avoiding the inevitable (see my article: Wishful Thinking Often Leads to Poor Relationship Choices).

The first step to overcoming this problem, especially if this is a pattern for you, is to become aware that you're avoiding seeing the situation objectively.  If you're having difficulty doing this on your own, a trusted friend or family member might be helpful (see my article: Letting Go of Unrealistic Fantasies of a Happy Future in an Unhappy Relationship).

If you continue to avoid dealing with the situation even with the help of loved ones, you could benefit from seeking help in psychotherapy where an objective mental health professional can help you to see what you can't or won't see.

Once you have admitted to yourself that you're in denial about an unhealthy relationship that isn't going to change, your psychotherapist can help you to understand how your current situation might be based on earlier experiences so you can understand why holding on has become so compelling to you.

Having this understanding doesn't resolve your problems, but it helps you to have more self compassion rather than beating yourself up or feeling ashamed.

Then, when you're ready, your psychotherapist can help you to take the necessary steps to get out of a situation where you have been stuck and help you deal with the emotional aftermath (see my article: Overcoming the Heartbreak of a Breakup).

A Fictional Clinical Vignette: Letting Go of Hope That is Based on Denial
The following fictional clinical vignette illustrates how a skilled psychotherapist can help you to overcome your denial about an unhealthy relationship:

Amy
Prior to starting psychotherapy, Amy frequently spoke to her close friends over the course of her two year relationship to get advice.  Her friends gave her the same consistent message:  Her boyfriend was mistreating her and, by staying in her relationship, she wasn't taking care of herself.

Amy had spoken to her friends so many times that she knew they were getting tired of hearing from her about the same problems, especially since she would come to them when she was upset about her relationship with Jim, listen to their advice and then disregard what they had to say.  It had become a self destructive cycle, and Amy knew that she needed help.

She told her psychotherapist that she was happy in her relationship with Jim during the first few months, but shortly after that, he became verbally abusive with her when he was drunk.  She said that Jim said mean and hurtful things to her that he didn't remember when he was sober.

When she confronted him about his hurtful comments to her when he was sober, he would apologize and promise her that it wouldn't happen again.  But these incidents were becoming more frequent as he got drunk more often, and he refused to get help.

There was an incident where Jim got drunk and verbally abusive with Amy during a visit to see Amy's family.  Afterwards, Amy's parents told her that she was welcome to come see them, but they didn't want Jim in their home again.

Amy's friends also told her that they didn't like being around Jim when he was verbally abusive with her, and they told her that they would be willing to get together with her, but they didn't want to be around Jim.

Over time, Amy felt more and more caught between Jim and her loved ones.  He was also offended that her family and friends didn't want him around.

Although, on some level, Amy understood her loved ones' reactions to Jim, she also resented her them because she felt they were putting her in a difficult situation. This was another area where Amy was in denial and she was unable to see that they weren't the ones who were putting her in a difficult situation--she was making a choice to be with Jim, despite his verbal abuse, and she didn't see how her choice affected her relationships.

If she spent time with friends or family and she didn't include Jim, he would get angry with her.
From his perspective, she was siding with other people over him. If she tried to convince her loved ones to include Jim, she ended up getting into arguments with them because they were adamant that they didn't want him around.

By the time Amy came to therapy, she said she didn't know what to do.  On the one hand, she loved Jim and she didn't want to leave him.  But being with him meant limiting her time with friends and family because they didn't want him around and he didn't like that he wasn't included.  On the other hand, she could see that his drinking and his behavior were getting worse, and he adamantly refused to get help.

Amy's psychotherapist could see that, as things stood, Amy was in denial about the severity of her problems related to Jim and she was staying in this relationship at a significant cost to her personal well-being and her social support network.  But her therapist also knew that Amy hoped that the problem would somehow get better on it's own, so Amy wasn't ready to let go of the relationship.

Her psychotherapist also sensed that the root to Amy's problems was deeper than the current situation, which is why Amy was having such a problem acknowledging what everyone else could see and why she remained in denial.

Amy talked in therapy about wanting to "be there" for Jim and hoping that she would one day be able to convince him to get help.  She felt that if she left him, she would be abandoning him when he was at a low point and she couldn't do this (see my article: Overcoming Codependency: Taking Care of Yourself First).

As Amy and her therapist continued to explore her current situation, her therapist asked Amy if she had ever felt this way before.  In response, Amy thought about her therapist's question, and she said that when she was younger, her paternal grandfather lived with the family and he had a serious drinking problem.

When he was sober, he was a kind, gentle man.  But when he was drunk, he was mean and nasty.  Unfortunately, his drinking progressed and he refused to get help.  Her parents, who were fed up, asked the grandfather to leave the household, which upset Amy.  She was afraid that if her grandfather was on his own, his problems would get worse.

So, even though she was only 17 at the time, Amy took the problem on her shoulders and decided that it was up to her to help her grandfather.  In hindsight, Amy realized that her grandfather only gave lip service to getting into alcohol treatment.  But at the time, she took him at his word and she was relieved.

A few weeks after her grandfather agreed to get help but failed to do so, he had an alcohol-related stroke, and he never recovered.  Amy explained to her psychotherapist that this was a devastating experience for her, and she blamed herself for not convincing her grandfather to get help earlier.

Until Amy discussed this with her psychotherapist, she never made the connection between how she reacted to her grandfather's problems and how she related to Jim's problems.  After she saw the connection, she was stunned, and it was the subject of the next several psychotherapy sessions.

At her current age of 32, Amy was able to look back on her experiences with her grandfather when she was 17, and she saw that she had been naive and in denial all along about her grandfather's problems and his willingness to get help. She also saw that she couldn't possibly be responsible for her grandfather at 17 or at any age.  This was the beginning of Amy developing insight into her current problems.

After that, two new incidents with Jim were pivotal in Amy's decision-making process.  The first incident occurred when Jim was arrested for drunk driving and his license was revoked.  At first, Amy couldn't understand why his license was revoked and not temporarily suspended, but then he revealed what he had never told her before--he had several arrests in the past for drunk driving that he was too ashamed to tell her about.

The second incident occurred shortly after Jim's arrest when he tried to reach Amy at work while he was drunk.  When he was unable to reach Amy directly, he became verbally abusive with the receptionist, who put the director on the phone.  In his drunken state, Jim cursed the director and threatened him.

Later that day, when the director called Amy into his office, he told her what happened and she was humiliated.  He told her that he was concerned for her and asked her if she wanted him to give her information about the company's employee assistance program so she could get help for herself. She told him that she was already in therapy and would speak with her psychotherapist about what happened.

Amy spoke about these two incidents with her therapist.  She realized that she couldn't remain with Jim anymore.  She would need to ask him to leave her apartment.  But this was very difficult for her because it was so similar to the situation with her grandfather when her parents wanted him to leave their home.

Amy talked to her psychotherapist about her dilemma.  Her psychotherapist recommended that they use EMDR therapy to work through the current situation and the original trauma related to her grandfather (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

As they began using EMDR, Amy began letting go of any false hope that she had been holding onto, and she eventually told Jim to leave.

Once Amy was out of the relationship, she was able to see clearly how deep her denial had been.  Along with dealing with the aftermath of the breakup and the loss of her grandfather in therapy, she also dealt with the shame she felt for remaining in a verbally abusive relationship with someone who was unwilling and/or unable to change.

Therapy was neither quick nor easy, but Amy felt herself gradually becoming more confident that she made the right decision by ending her relationship with Jim, and she deserved to be treated better in her next relationship.

Getting Help in Therapy
Letting go of hope that's based on denial is challenging.  The current problem often has roots in earlier problems.

Loved ones might see clearly what you're not allowing yourself to see, even though you might know on some level that you're in an unhealthy situation.

What often happens is that loved ones get tired of hearing you complain and might ask you to stop talking to them about your problems.  This can damage your relationships with friends and family, and you might feel ashamed.

Rather than suffering on your own, you owe to yourself to get help from a licensed mental health professional (see my article: The Benefits of Psychotherapy).

Although a psychotherapist won't tell you what to do, a skilled therapist can help you to deal with your denial, make connections to earlier experiences and assist you to take the necessary steps for your own well-being (see my article: How to Choose a Psychotherapist).

Once you're free from an unhealthy situation, you can work on restoring your self esteem in therapy and reconnecting with family and friends.

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

I work with individual adults and couples, and I have helped many clients to work through difficult problems so they can live more fulfilling lives.

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.