Relationships: Becoming More Attuned to Each Other

One of the most common problems I hear about in my private practice in New York City is a lack of emotional or sexual attunement in relationships (see my article: Are You Able to Express Your Vulnerable Emotions to Your Partner?).

What is Attunement in a Relationship?

Attunement in a relationship means the ability to connect with one another on an emotional and sexual level.

Becoming More Attuned to Each Other

Some couples connect well emotionally, but they're not attuned sexually.  This often occurs in long term relationships where sex has become less satisfying for one or both partners.

A lack of attunement can occur for many reasons.  Often this problem occurs when the couple isn't working together as a team.  This causes one or both partners to feel alone and emotionally unfulfilled. 

If the lack of attunement is also occurring in the bedroom, a couple often stops having sex to avoid the problem (see my article: Have You and Your Partner Stopped Having Sex?).

How to Get Emotionally Attuned to Yourself First and Then Your Partner

Rather than engaging in blame and conflict, which can destroy a relationship, each person needs to make a commitment to approach the problem as a team (see my articles: Moving Beyond the Blame Game in Your Relationship and Improving Your Communication By Eliminating the Four Horsemen of the Apocalypse).

Becoming More Attuned to Each Other

In other words, there are no "bad guys." Instead, there is a recognition that the problems are co-created between both people, and if there is a willingness on each person's part to overcome this negative dynamic in the relationship, they can co-create the solution.

Becoming More Attuned to Each Other

Each of you can take some quiet time on your own to think and write about what you feel is missing and what you want more of in the relationship.

Start by focusing on yourself and where you feel you can improve rather than making a list of complaints about your partner.  

Are you attuned to your own emotions?  If not, take a moment to calm your mind and body so you can drop down into your own internal experience to get better attuned with yourself before you approach your partner.  

To get attuned, find a private quiet place without distractions.  

Close your eyes if you feel comfortable, focus on your breath and slow down your breathing (see my article: The Mind-Body Connection: Developing a Felt Sense of Your Emotions).

Expect to have distracting thoughts and when they come up, imagine you can put each one on a cloud and watch them float away (see my article: Basic Mindfulness Skills).

As you focus on your emotions, tune into your body to get a sense of where you can feel your emotions in your body.  Know that it's not unusual to feel conflicting emotions. Just acknowledge them and let them be.  Don't judge them or try to suppress them.

Afterwards take time to write down what came up for you and what you might want to share with your partner.

Emotional vulnerability is a pathway to intimacy, so if you can both share what came up for each of you, it could bring you closer.

On the other hand, if your emotional connection with your partner has deteriorated to the point where you don't feel comfortable being vulnerable, you can start with your less vulnerable feelings.

When you're listening to your partner, give your partner your undivided attention.  Listen without interrupting or getting distracted with other things (phones are off and put away).  

Becoming More Attuned to Each Other

After your partner has shared, instead of giving your perspective or opinion, tell your partner what you heard without criticism or judgment ("I heard you say you feel lonely in our relationship. Is that right?").  

If your partner says you didn't understand what s/he was saying, ask your partner to say it again in another way.  Repeat this process until you're really get what your partner is saying.

You don't have to agree with your partner's perspective.  You just need to let your partner know that you heard and understand based on what s/he said.

Then, it's your turn.  Follow the same steps.  Remember to slow down so you can be attuned to your own emotions as well as your partner's.

It takes time and patience to feel into and talk about your emotions, so don't rush through this exercise just to get through it.  If you do, you'll convey to your partner that you're not interested in hearing what s/he has to say or what you have to say to your partner.

You might experience some discomfort, especially if you're not accustomed to sharing your emotions on a deep level.  That's okay.  With practice, this process can get easier as you each work on these skills.

How to Get Sexually Attuned to Yourself and Your Partner

Many people feel embarrassed to talk about sex (see my articles: How to Talk to Your Partner About Sex - Part 1 and Part 2).

Becoming More Attuned to Each Other

Start by getting attuned to your own sense of sexuality in terms of what you like.  If it's been a long time since you have felt attuned to your own sexuality, start gradually.

If you have good memories of enjoying sex, you can begin by remembering times when you enjoyed sex in the past (see my article:  Reviving Your Sex Life By Remembering Your Peak Erotic Experiences).

Whether these memories involve solo sex or sex with a partner, what was it about those experiences that made sex enjoyable?  Was it your sense of connection? Was it your sense of playfulness or freedom to let go? Or something else?

If you have never experienced pleasurable sex, do you have memories of seeing movies or reading books that got you turned on?  What was it about those scenes that appealed to you?

After each of you have engaged in your own sexual self exploration, you can share your thoughts and fantasies with your partner (see my article: Finding Your Sexual Voice).

Once again, don't be critical or judgmental. Just listen.  Their turn-ons might not be yours, but couples often find sexual activities that get them both turned on (see my article: Don't Yuk Your Partner's Yum).

When it's your turn, try to be as open as you can about what you like and allow your partner to have his or her own preferences.

Getting Help in Therapy

It's common for couples to allow emotional and sexual problems to go unaddressed for months and even years.  At that point, it's hard to try to resolve them on their own (see my article: What is Emotionally Focused Therapy (EFT) For Couples?).

If you're struggling with a lack of emotional or sexual attunement in your relationship, you could benefit from seeking help in couples/sex therapy.

Sex therapy is a form of talk therapy.  There is no physical exam, nudity or sex during sex therapy sessions (see my article:  Common Misconceptions About Sex Therapy).

Individual adults and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help from a licensed mental health professional who has an expertise with your problems so you can have a more fulfilling relationship.

About Me

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

I am a sex-positive therapist who works with individual adults and couples.

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

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

The Healing Potential of the Therapist's Empathic Attunement

In my prior article, I began discussing the therapist's emotional attunement in the therapy session.  In this blog article, I would like to continue to discuss emotional attunement by focusing on how the therapist's attunement to the client can be emotionally reparative.

The Therapist's Empathic Attunement

The following vignette, which is a composite of many cases, will help to illustrate this point:

Jane
Jane grew up in a household where she was the youngest of 10 children.  Her mother worked cleaning people's apartments, and her father worked in a factory during the day and as a taxi driver at night.  Both of them were exhausted when they came home, and they relied on Jane's older sister, Ruth, to help them with the children and the household chores.

Jane was very different from her siblings.  While they liked to go out and play in the yard, she preferred to stay in and read books.  She loved using her imagination to make up stories and do artwork.  But Ruth, who was 12 years older than Jane, had little patience for Jane.  Ruth was often irritated and resentful that so much was expected of her and she became very impatient with Jane at times, especially when she thought Jane was "wasting time" playing, reading or drawing.

All of Jane's basic needs were taken care of in terms of having a roof over her head, food to eat, and clothing to wear.  But she often felt lonely in her home.

Jane had lots of fantasies about what she wanted to do when she grew up, but she had no one to talk to about it.  Her parents' attitude was that when she graduated high school, she should be happy to find a job, any job.  It didn't matter if she liked it or not.  Liking your work seemed like too big a luxury to Jane's parents.

So, when Jane decided to go to college, her parents and older siblings were flustered and confused.  None of them had gone to college and they couldn't see why she wanted to go.  Her parents warned her that they didn't have the money to send her, so she had to rely on scholarships and part time jobs throughout college.

When Jane graduated college, she was surprised that she didn't feel good about it.  She felt like something was missing, but she didn't know what it was.  

She knew, at least on an rational level, that graduating college was a significant accomplishment. But she didn't feel it.  Her family came to her graduation, but they seemed self conscious, guarded and out of place.  Jane watched her friends' parents swell with pride about their children's graduation, and she wished her family could do the same.

Throughout her 20s, Jane continued to feel that something was missing inside of her, but she couldn't put her finger on what it was.  So, when she was 24, she began therapy.

No one in Jane's family had ever been to therapy, and she didn't dare tell her family.  She knew they wouldn't approve of it and they would think she was wasting money.  They would never understand if she told them that she felt something was missing in her.  They would probably laugh and tell her she had too much time on her hands to think about herself.

Initially, Jane felt self conscious and anxious in therapy.  On some level, she felt she didn't deserve to be there:  Maybe her family was right--maybe therapy was an indulgence that was for other people, not someone like her.  Whenever she had these thoughts, she burned with shame.  And yet...she knew there was something of value for her in therapy.

The Therapist's Empathic Attunement

Over time, Jane began to sense that her therapist cared about her and wanted to hear about what she felt.  At first, this was uncomfortable because Jane wasn't accustomed to this.  When she was growing up, she would normally keep her thoughts and feelings to herself.  Or, she would write stories about young girls like herself, never quite realizing at the time that she was writing about herself.

During the first few months of therapy, Jane felt ambivalent about the therapy process.  On the one hand, she was grateful to have a place where she could speak uninterrupted and have the therapist's undivided attention.  It was a new experience for Jane to be heard in this way.

On the other hand, Jane felt a deep hurt because she realized what she was missing when she was growing up.  As a child, she never allowed herself to feel the pain of the emotional deprivation.  But she felt it now and it made her feel very sad.

One day, when she was feeling particularly undeserving, Jane decided to make up an excuse about not being able to afford therapy.  This wasn't true because Jane had very good out of network benefits that paid for 70% of her therapy.  

But Jane couldn't bring herself to tell her therapist that she felt she didn't deserve all this attention.  So, at the next therapy session, she went in looking outwardly cheerful and confident and told her therapist that she had to end therapy because she could no longer afford to come.

Jane was especially good, even with her close friends, at convincing people that she was happy even when she felt very sad.  She had a lot of experience pretending that she was okay when she really wasn't.  

She was sure that she would convince her therapist.  But to Jane's surprise, her therapist, who was empathically attuned to Jane, mentioned that she sensed there was something else going on, and she wondered if Jane would be willing to discuss it.

What followed in that session was an emotional breakthrough for Jane and a breakthrough for her therapy.  Jane took an emotional risk and opened up.  She cried a lot during that session for everything she didn't get as a child and for how undeserving she felt now.  She spent many sessions after that one focusing on these issues while her therapist remained empathically attuned to her.

If Jane's therapist had not been empathically attuned, she might have accepted Jane's excuse on face value.  And Jane would have continued to feel emotionally deprived and undeserving. 

More than likely, this would have had consequences for both her personal life and her career. But, being empathically attuned, Jane's therapist sensed the underlying issues going on with Jane and let Jane know.

Overall, Jane's therapist's empathic attunement was an emotionally reparative experience for Jane.  It was the first time Jane felt genuinely cared about and understood in this way.

Empathic Attunement and Therapeutic Rapport
In order for there to be empathic attunement in psychotherapy, there needs to be a good fit between therapist and client.

A good fit means there is a rapport between the client and the therapist.  Often, this develops over time.  But when it doesn't  happen, when clients don't feel a rapport with the therapist, I recommend that they discuss it with their therapist.  And if it continues to be a problem, they can find a therapist where they can feel this rapport.

A good therapeutic relationship between client and therapist is one of the best predictors of a good outcome in therapy.  And, just like anything else, some therapists are more empathically attuned than others.

Getting Help in Therapy
No therapist is going to be 100% attuned all of the time.  Therapists are human.  But, overall, as the client, you deserve to have a therapist that you feel is empathically attuned to you most of the time.  As a client, the most important thing is to trust your instincts when choosing a therapist.

And if you're with a therapist, who is usually attuned to you, but who may have lapsed into an empathic failure by not hearing you or misunderstanding you in some way, your therapist might be unaware of it.  Tell her or him.  Often these kinds of situations in therapy can be repaired and it can lead to a breakthrough in therapy and an emotionally reparative experience for the client.

About Me
I am a licensed NYC 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 to Develop Emotional Intelligence (EQ)

What is Emotional Intelligence?
Emotional intelligence is the ability to identify, attune to, and manage your emotions in healthy ways. 

When you have emotional intelligence, you're able to recognize your own emotional state as well as the emotional states of others.

Developing Emotional Intelligence

In many ways, emotional intelligence, or emotional quotient (EQ), is even more important than intelligence quotient (IQ) with regard to being attuned to yourself and others. When you're attuned to your own emotional state and the emotional states of those around you, you're more likely to build successful relationships in your personal life as well as in your career.

Emotional intelligence includes 

• Developing self awareness, 
• Managing emotions
• Picking up on social cues 
• Maintaining relationships

• Developing self awareness: When you're self aware, you recognize how your emotions affect your thoughts and behavior. You know your strengths and challenges and you feel confident.

• Managing your emotions: Part of emotional self management is being able to manage your emotions, thoughts and behaviors in a healthy way. You don't behave impulsively. You're able to take charge, when appropriate. You're able to keep your commitments. You're also able to adapt to changes in your environment, which is so important in our ever-changing world. 

• Picking up on social cues: Emotional intelligence enables you to pick up on social cues in your environment. You recognize your needs as well as the needs of those around you. You feel comfortable in most social situations. You also recognize the social dynamics in personal and work-related group settings.

• Developing and maintaining relationships: Emotional intelligence allows you to develop and maintain personal and work-related relationships, communicate well with others, influence people, manage conflict, and interact well in group settings. More than ever, businesses are now evaluating their employees on the basis of their emotional intelligence at work.

Ideally, emotional intelligence is a set of skills that you learn as you're growing up. However, depending upon your particular circumstances when you were growing up, you might not have learned to develop these skills. 

As a result, this could be causing significant problems in your personal and work-related relationships. 

But it's never too late to develop these skills, and many people come to therapy because they have had problems related to one or more areas where they lack emotional intelligence.

Clinical Vignette
The following scenario is a composite of many cases with all identifying information removed. This vignette illustrates how someone who has not developed emotional intelligence can learn to develop these skills in psychotherapy:

Bob:
Bob was a man in his early 30s. When he began psychotherapy, he had just received his annual performance review at his new company, and he was very disappointed to learn that his boss, Gregg, was not pleased with how Bob interacted with others at work. 

While Gregg praised Bob for his technical skills, he told Bob that he needed to improve how he interacted with his colleagues and senior management. He felt that Bob was too aloof and isolated at work, and he was not a "team player."

Gregg told Bob that this was not just his opinion--he had also received this feedback from Bob's peers and other managers at the company. He told Bob that his potential success at the company depended on Bob learning to develop emotional intelligence on the job. He recommended that Bob read Daniel Goleman's book, Emotional Intelligence. 

Gregg also told Bob to consider getting emotional help to overcome whatever emotional barriers might be getting in Bob's way from forming good interpersonal relationships at work.

Bob was also experiencing difficulty forming personal relationships. He recognized that this was a lifelong problem, but he didn't know what to do about it. 

Whenever he tried to form personal relationships, whether they were friendships or romantic relationships, they never lasted beyond a brief period of time. This left Bob feeling very lonely and lacking in self confidence. He had a couple of buddies that he went with to sports events, but he didn't have any close relationships.

Bob often felt that there was "something missing" in him that caused him to have such difficulties in his relationships, but he didn't know what it was. 

Until his boss mentioned the term "emotional intelligence," Bob was completely unaware of this concept. But as he started reading Emotional Intelligence by Daniel Goleman, he realized that he lacked these interpersonal skills, and he very much wanted to develop them.

When Bob began psychotherapy, he had very little awareness of his emotional state at any given time. He grew up in a household where his parents demonstrated very little in terms of their own emotions, and they didn't talk about emotions at all. 

Education was very important to them, and they encouraged him to do well in school. When Bob's teachers told his parents that Bob had problems forming friendships, they dismissed this as unimportant. As long as Bob got excellent grades, they were happy and they told him not to be concerned about friendships.

Bob's therapist began by helping Bob to recognize his own emotions. When he started therapy, Bob had only the vaguest notion of his emotions. 

Generally, he recognized when he felt "good" or when he felt "bad," but he couldn't distinguish whether "good" meant that he felt content or elated or if "bad" meant that he felt sad or angry.

Bob's therapist helped Bob to distinguish his emotions based on what Bob was feeling in his body. 

For instance, he learned to recognize that when his stomach was clinched, he often felt fearful. He also learned to identify other emotions based on what he was feeling physically. Gradually, he began to distinguish fear from anger or sadness. He also recognized that sometimes he felt more than one emotion at a time, which was confusing to him at first.

Bob's therapist also worked with him to begin to pick up on social cues in his work environment. Prior to this, Bob didn't pay attention at all to the emotional environment at work. 

He was emotionally disconnected from the environment and from how his colleagues were feeling at any given time. 

Over time, working with his therapist, Bob began to learn how to read "body language" with individuals and at staff meetings. This helped him to negotiate his relationships at work. It also alerted him with regard to the appropriateness of timing and others' receptivity with regard to introducing new ideas.

In addition, he learned to take an interest in his coworkers. Prior to starting therapy, it never would have occurred to Bob to ask a coworker about his or her weekend or a vacation. 

After he began working with his therapist on developing emotional intelligence, Bob began taking his first tentative steps by engaging in conversation with coworkers. 

To his amazement, his coworkers began to take more of an interest in him as well. He discovered that several of his coworkers would go out for lunch on Fridays, and they started inviting him to come along, which pleased Bob.

He recognized that his coworkers were beginning to like him. While this was gratifying to Bob, he also began to feel the sadness of so many years of not having this in his life, and he realized that this was an important missing piece for him.

Socializing in his personal life was more of a challenge. Even though Bob was very lonely, he felt very awkward in social situations, and he tended to avoid them. 

He would often turn down invitations from his sports buddies to attend parties where he could have, potentially, made other friends or met a woman that he could date.

Although he was very anxious about getting out more, Bob was determined to overcome his fear. So, when an opportunity presented itself for him to attend a party, he accepted the invitation. He and his therapist had several sessions to talk about his anxiety and to work on how he could improve his interpersonal skills in these types of social situations. 

Even though he was starting to feel more comfortable socially with his colleagues, he was anxious about socializing on a personal level. He felt that, at least in his work environment, he could talk to his colleagues about work. But with new people where he did not have this in common, he felt very unsure of himself.

Bob and his therapist worked on various role plays where he practiced how to start a conversation in a social setting. They talked about all different types of scenarios and what social cues Bob should notice among those around him with regard to people's relative openness to engaging socially. 

They decided that it would be easier for Bob to start by asking the hostess to introduce him to some of the people at the party. They also decided that, to start, Bob didn't have to stay for the entire party if he was too uncomfortable, so they talked about how he could negotiate this socially with the hostess.

Fortunately for Bob, the hostess at this party was an emotionally astute woman. She recognized that Bob was anxious in social settings, and she started by introducing him to other people in his particular field of work. 

Although Bob was very nervous at first, once he began talking to these people, he felt more comfortable. One person confided in Bob that he also felt anxious at parties, and Bob felt relieved to know that he wasn't the only one who experienced social anxiety.

Working diligently with his therapist, over time Bob was able to develop emotional intelligence in his work environment and in social situations. But 

Bob also felt proud when Gregg approached him one day and told him that he was pleased to see that Bob had improved his interpersonal skills at work. 

This positive feedback motivated Bob to continue working on this issue in his therapy. 

In addition, Bob was starting to date women, and he was surprised and pleased to realize that there were women who liked him.

What Can You Do to Develop Emotional Intelligence?

If you're experiencing a lack of emotional attunement to yourself and to others, you could benefit from developing or improving your emotional intelligence skills.

Daniel Goleman is a psychologist who has done a lot of research on the topic of emotional intelligence. I recommend that you read his book, Emotional Intelligence.

While reading a book about emotional intelligence is a good start in terms of acquainting yourself with basic concepts, reading alone won't help you to develop emotional intelligence. 

Very often, it's helpful to also develop these skills in the context of your own personal therapy with a licensed psychotherapist who helps clients to overcome this problem.

Contrary to what you might think, you'll discover that you're not alone, and many people, who struggle with this issue, are able to develop these important skills to become more emotionally attuned to themselves and to others. 

You'll also discover that developing emotional intelligence will contribute to the success of your personal relationships and your career.

Getting Help in Therapy

Emotional intelligence is critical to maintaining relationships in all areas of your life.

You can learn to develop emotional intelligence by working with a licensed mental health professional.

Life is much more fulfilling when you are self aware, you can manage your emotions, pick up on social cues and maintain relationships.

About Me

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

I work with individual adults and couples.

I have helped many clients to develop emotional intelligence so that they can lead 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.

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client

In a prior article, I began a discussion about the holding environment in therapy (see my article: The Creation of the Holding Environment in Therapy).  As I mentioned in that article, the idea that the psychotherapist creates a safe therapeutic holding environment for the client was developed by British psychoanalyst, Donald Winnicott (for more on Winnicott, see my article: Books: "Tea With Winnicott" at 87 Chester Square).  In this article, I'm focusing on a particular aspect of the holding environment, which is the therapist's ability to keep the work emotionally manageable for the client.

The Holding Environment in Therapy

As an example, it's often the case that clients come to therapy because they're not feeling good about themselves.  This can be a lifelong problem or a new development for a client.  Either way, the client might focus on the aspects of himself that he is unhappy about and miss the fact that he has many strengths.

A skilled psychotherapist will usually see the client's strengths, even when the client is unaware of these strengths.  

The challenge for the psychotherapist is when to talk to the client about his strengths.

Timing is everything.  If the therapist brings up the client's strengths too early in therapy, the client, who has a particularly negative view of himself, will often minimize or dismiss the idea that he has these strengths (see my article: Overcoming the Internal Critic).

Some clients, who are focused on what they perceive as emotional deficits in themselves, might even think the therapist is being disingenuous when she tries to talk to them about their strengths (see my article: A Strengths-Based Perspective in Psychotherapy).  

In many cases, on an unconscious level, these clients are too afraid to consider the possibility that they have strengths.  Rather being overwhelmed by their fear, they protect themselves emotionally by remaining stuck in their denial.

It's important that the psychotherapist not interpret the client's reluctance as "resistance."  This comes across as judgmental.  It would only make the client feel uncomfortable and it's not helpful to the work.

If the therapist doesn't know how to handle the client's fear,  this could lead to the client leaving therapy prematurely to avoid dealing with uncomfortable feelings (see my article:  When Clients Leave Therapy Prematurely).

So, the skilled psychotherapist, who is aware that it would be premature to talk to the client about his strengths, must keep these observations to herself until the time is right.  This requires the therapist to be emotionally attuned to the client (see my article: The Psychotherapist's Empathic Attunement).

Even with self critical clients who are willing to explore the possibility that they have strengths, they might perceive their strengths on an intellectual level but not on a deeper emotional level.

For these clients, the therapist might broach the topic of the client's strengths, let the client know that she (the therapist) sees these qualities and will hold a space for them until the client can accept this on an emotional level.

This is a way for the therapist to create a safe holding environment for the client because the client knows that the therapist holds onto these observations until the client is ready.

Let's take a look at a fictional vignette that illustrates these points:

John

John had been in and out of therapy for many years.

He usually attended a few sessions with a therapist, and then he aborted therapy because he felt the therapist didn't understand him.

John struggled with depression, including low self esteem, since he was a child.  He grew up in a household where both parents were mostly preoccupied and paid little attention to John, who was an only child.

John's father often criticized him and told John that he would never amount to anything.  His father's critical comments were so frequent that John internalized them and, over time, believed them.  John's mother was depressed and withdrawn, and she was emotionally unavailable to him.

When he was in school, his teachers often told John that he had a lot of potential, but he was not trying.  From John's depressed perspective, he didn't see a reason to try since he believed his father that he wouldn't ever amount to anything.

As an adult, John drifted from one job to another.  Since he never expected to do well, he put little effort into his work, which resulted in disappointment for him.

John also had very low expectations about relationships.  He had a few close friends, but his romantic relationships didn't last beyond a few months.

He would go through long periods when he didn't even try to meet anyone, but then his loneliness caused him to try again with the same low expectations.  It was an ongoing cycle.

By the time John came to therapy again, he felt he was at a low point.  He was already in his mid-30s and he felt he had nothing to look forward to in his life.

The Holding Environment in Therapy

He told his current therapist at the start of therapy that he left his prior therapists because they were unable to see him as he was.  He felt that each of them saw him as they wanted him to be, which frustrated him.

He appreciated that his former therapists were "nice people" and they tried to speak to him about his personal strengths, but he didn't believe what they were saying.  He wasn't sure if they were mistaken or if they were intentionally trying to boost his confidence in a false way.  

Either way, whether the therapist was well-meaning but wrong or whether the therapist was only trying to boost his confidence and didn't really believe he had strengths, John found these discussions intolerable and he would abort therapy.

John's current therapist could see how self critical he was.  She also saw that he had many strengths.  But she also heard John loud and clear that he was unable to even consider that he had strengths, and she knew, based on what he was telling her, that if she tried to broach this with him, he would leave therapy, as he did in the past.  So she waited until he was ready.

Until then, his therapist remained attuned to John's experience and reflected back to him what he told her.  In doing this, she showed John that she understood how he felt about himself, and for the first time in his life, John felt that he was finally seeing a therapist who understood him.

In the meantime, his therapist held onto her perception of the many strengths she saw in John over time.  She waited until she saw a possible opening to explore this with him.

Gradually, as John felt more comfortable with his therapist, he opened up more with her, and she continued to let him know that she understood how he felt by mirroring back to him.

One day, John came to therapy in an agitated state.  He told his therapist that his new supervisor complimented John on a project.

John's first reaction was to get angry because he thought his supervisor was lying to him or he was trying to manipulate John in some way.

But as he thought about it, John said that he knew his supervisor wasn't a manipulative person, so he doubted that this was the reason for his compliment.  He said that maybe his supervisor was just trying to make him feel good--like some of John's prior therapists.  

Whatever the supervisor's intentions, John found it difficult to sit there and listen to his supervisor's compliments.  He said nothing to his supervisor but, for some reason, John realized, it brought up a lot of shame and sadness for him.

During the next several sessions, John continued to talk about this because his supervisor came to him again and told him that he really liked his work.  This continued to baffle John.

Over time, John became more open to exploring this issue and his own sadness and shame.  He was able to connect his negative feelings about himself to his critical father.

During that time, his therapist continued to maintain an open and empathetic stance with John, allowing John to draw his own conclusions (see my article: Why is Empathy Important in Therapy).

She knew that if she intervened prematurely, John would shut down emotionally and he might leave therapy.  She had to wait until he was ready.

Then, one day John came in and told his therapist that his supervisor took him to lunch.  John was surprised that he enjoyed talking to his supervisor over lunch.  He was also surprised to realize that his supervisor liked him and that his praise really was genuine.

As John opened up more emotionally in therapy, he allowed himself to feel his sadness about being a disappointment to his father.  He wished he could have had a father who was more like his supervisor--a kind and generous man.

As he continued to discuss this in therapy, John became aware that his father was a disappointed, bitter man, and his father didn't feel good about himself.

As he looked at his childhood from an adult perspective, he realized that his father was projecting his own negative feelings about himself onto John (see my article: Looking at Your Childhood Trauma From an Adult Perspective).

This led to John questioning whether his father's perceptions about him were accurate, "Maybe I'm not such a loser after all.  What do you think?"

At that point, his therapist realized that John created a small opening for them to be able to discuss the possibility that he wasn't "a loser" and he might have positive qualities.  She also knew that this was a tentative opening that could shut down if she rushed in because John might get overwhelmed, so she had to be cautious.

His therapist said she observed positive qualities in him, and she explored with him whether he would be open to discussing this.  John responded by shifting in his seat and telling her that it felt uncomfortable but, at the same time, there was a part of him that wanted to talk about it.

Gradually, John was able to explore his feelings.  He trusted his therapist enough to know that she wasn't going to lie, hurt him or try to manipulate him.

His therapist relied on John to tell her whether their discussions about his strengths felt too uncomfortable, and he told his therapist when he felt uncomfortable.  In this way, his therapist was able to maintain an emotionally safe environment for John in their sessions.

The Holding Environment in Therapy

Over time, John developed the emotional tolerance to discuss seeing himself in a positive light.  This was new and scary for him at first, but he was starting to feel better about himself.

By being attuned to John, his therapist was able to provide him with feedback about his positive qualities in "manageable doses" for him.  She respected his feedback when he told her that he was beginning to feel overwhelmed, and she would not push him beyond where he could go emotionally.

Working with John in this way, over time, his therapist was able to help John to mourn what he didn't get as a child and to develop more self confidence (see my article: Psychotherapy and Compassionate Self Acceptance).

Conclusion

There are many ways for a psychotherapist to create a therapeutic holding environment for a client.

One way, as I have discussed in this article, is to keep the therapeutic work manageable for the client.

To create a holding environment, the therapist must be emotionally attuned to the client and intuitively sense when the client is ready to explore uncomfortable issues.  She must also ask the client for feedback.

When the client provides a tentative opening, a skilled therapist doesn't rush in.  She helps to facilitate an exploration that is manageable for the client.

In this way, by being attuned and titrating the work, the therapist helps the client to make progress in therapy.  In other words, going slowly in these particular cases, is more effective than trying to get under the client's defenses and overwhelming the client.

From the outside, it might appear that the work is going too slowly, but with regard to the client's internal world the client is developing the internal resources for more in-depth work.  

Not every client has these particular problems, and in many cases the therapist senses that she can make observations early in therapy without jeopardizing the work.  But for clients who aren't ready, premature explorations often lead to premature endings in therapy because the client aborts therapy.

Getting Help in Therapy

Many people, who could be helped in therapy, never come to therapy and struggle on their own without success.

Finding the "right fit" with a particular therapist might be a matter of trial and error as you interview various therapists (see my article: How to Choose a Psychotherapist).  

I usually tell prospective clients to follow their own instincts when choosing a therapist and not to remain with a therapist if their gut feeling is telling them that it's not working out.  However, if you have a long history of aborting therapy prematurely, it might be worth considering that you're avoiding dealing with certain issues in therapy.

Rather than struggling on your own, you could benefit from seeing an experienced therapist who can help you to work through the problems that are keeping you stuck.

By working through problems that are keeping you stuck, you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and Sex Therapist who works with individual adults and couples.

I work in an empathetic, attuned and respectful manner with clients to help them to overcome their problems and maximize their potential.

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.

What is Childhood Emotional Neglect?

The concept of "emotional neglect" is often mentioned in psychotherapy journals, newspapers, popular magazines, movies, TV programs and social media.  But there is often confusion about what this term means.

What is Childhood Emotional Neglect?

When it comes to children's emotional needs, I think it's important to define "emotional neglect" in terms of unmet childhood needs.

Defining this concept is important to many adults, including psychotherapy clients and potential psychotherapy clients, who are confused and unsure as to whether they were affected by emotional neglect when they were children.

Defining emotional neglect is important for parents and parents-to-be, who might feel anxious about parenting their children and trying to create a balance between limit setting and overindulgence.

Teachers, day care workers, child protective workers, child therapists, health care workers, clergy and other people who come in contact with children often suspect that certain children might be suffering due to emotional neglect at home, so understanding this concept is important to them as well.

"Good Enough" Parenting vs Perfection
First of all, no childhood is perfect.  No parent can be perfectly attuned to his or her child 100% of the time.  It's not humanly possible.  There will be times in any childhood when a child's needs go unmet for a variety of reasons.

What is Childhood Emotional Neglect: "Good Enough" Parenting vs Perfection

When we refer to emotional neglect, we're referring to a pattern of behavior where a child's emotional needs were unmet more often than they were met.

The British psychoanalyst and pediatrician Donald Winnicott referred to this as parenting that was "good enough," where the parent created an emotionally nurturing home environment that he referred to as "a holding environment" most of the time (see my article: The Creation of a Holding Environment in Psychotherapy).

Of course, every child will be different in terms of his or her emotional needs, as most parents who have more than one child can tell you.

Resilience in the Context of a Nurturing Family Environment
The reason why most of us can sustain instances of parental lapses in emotional attunement is that most of us have a certain amount of resilience.  We can withstand certain lapses in emotional attunement as long as the parenting is "good enough" most of the time.

Resilience in the Context of a Nurturing Family Environment                              

So, if, for example, a parent, who is normally nurturing and attuned to his or her child's needs is distracted and doesn't notice on a particular occasion that a child is sad or angry and doesn't ask the child about it, this usually doesn't result in irreparable harm.

But if there are too many instances where a parent doesn't notice and doesn't attend to a child's emotional needs, this can be emotionally damaging to the child and often has long lasting traumatic effects into adulthood if the adult doesn't get professional help.

Childhood Emotional Neglect is Often Invisible and Goes Unnoticed
Unlike physical abuse where there are often physical bruises or other signs that are obvious, childhood emotional neglect is often invisible and goes unnoticed.

Since childhood emotional neglect usually involves a parent who is not responding to the emotional needs of a child, it is less obvious to see.

If, for example, people see a child who looks well fed, properly groomed and well dressed, they often assume that the child is being taken care of emotionally as well.  This is because many people judge situations by outer appearances.

Also, some children, especially children who tend to be overachievers, are very good at pushing down their own emotional needs under these circumstances and excelling academically.  If they are quiet children who aren't having behavior problems in school, teachers and other adults who come in contact with them often won't notice that anything is amiss with these children.

Many children, who come from families where their emotional needs aren't being met, learn how to hide their sadness by covering up their feelings.  They might appear to be outgoing or cheerful, but underneath, they're often unhappy and lonely.

Worse still, they're often hiding a lot of shame about their sadness and unmet emotional needs.  The shame that they carry often has serious repercussions for them as adults (see my article:  Unresolved Childhood Issues Can Create Problems in Adult Relationships).

In future articles, I'll continue to discuss childhood emotional neglect.

Getting Help
Many people come to therapy because of underlying issues related to their unmet needs in childhood that continue to affect them as adults.  

It's never too late to get help to overcome the effects of childhood emotional neglect.  

Working with a licensed mental psychotherapist, you can work through these issues in therapy so you can overcome them and lead a more fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

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.