The Benefits of Journal Writing Between Therapy Sessions

In prior articles, I discussed how journal writing is beneficial for coping (see my articles: Journal Writing Can Relieve Stress and Anxiety and Writing to Cope with Grief).  In this article, I'm focusing on the benefits of journal writing between therapy sessions.

The Benefits of Journal Writing Between Therapy Sessions

I usually recommend journal writing between therapy sessions to my clients, especially clients where we are doing experiential mind-body oriented therapy like EMDR Therapy, clinical hypnosis or Somatic Experiencing because so much comes up for them in session and between sessions.

What Comes Up Consciously and Unconsciously Between Therapy Sessions
Just because the therapy session has ended doesn't mean that the psychological processing has ended.  Whether you realize it or not, you continue to process in your mind what came up in your therapy session consciously and unconsciously after the session ends.

What you process psychologically on a conscious level is easier to remember--thoughts, memories, reactions to your session, and so on.  Although if you're very busy, you can forget or dismiss whatever comes up.

What you process on an unconscious level usually comes up in dreams, daydreams and in other ways, including songs or "ear worms" that play in your mind.

The Benefits of Journal Writing Between Therapy Sessions

At first, you might not be aware of the relevance of what comes up between sessions to what you and your psychotherapist are working on.  You might also forget the unconscious material that comes up before your next session.

But if you write down your thoughts, dreams, daydreams, associations or whatever else comes up, you have access to this material to discuss at your next session and possibly for the next few sessions since a lot can come up between sessions.

Journal Writing to Keep the Therapeutic Dialogue Going
Aside from helping you to remember what comes up for you between sessions, journal writing can act like an internal dialogue that you have with yourself or with the various aspects of yourself that might be in conflict about a particular problem (see my article: Understanding the Many Aspects of Yourself That Make You Who You Are).

The Benefits of Journal Writing Between Therapy Sessions

It's also a good way to continue an internal dialogue with your therapist, even if you bring up the material to her during your next session.

If you've been working with your therapist for a while, you have probably internalized your sense of your therapist and you can imagine how she would respond to whatever comes up.

This is a great way to extend whatever you were working on in therapy.  It's similar to a continuation of the session and helps you to integrate and deepen your insights and emotions.

Journal Writing Between Sessions Can Lead to Emotional Breakthroughs
It can also lead to a breakthrough in your work because it can lead to your making new connections between the past and the present or to various other parts of your life.

Allow Your Writing to Flow Without Judgment
For this kind of journal writing, I find that it's best just to allow yourself to get into a flow with your writing.  Just allow what comes up to come up without judging or analyzing it before or after you write it down.

By writing in this free form way, without judgment or analysis, you're more likely to be able to turn off the internal critic in your mind so that your thoughts and emotions flow (see my article: Overcoming the Internal Critic).

This allows you to get to thoughts and emotions that you probably wouldn't get to if you were judging yourself or judging your writing.

Self Care: Take Time For Yourself
To be able to do this type of writing, you need some quiet time to yourself--even 10 or 15 minutes would be beneficial, possibly before other family members wake up or after they go to sleep to ensure that you have quiet and privacy (see my article: Reconnecting With Your Inner World Without Distractions).

Becoming Aware of Your Progress in Therapy
Another advantage of journal writing between sessions is that, over time, you get to see the progress you've made in your therapy.  It's easy to forget how you were feeling when you first came to therapy, so if you have a journal to look back on, you can see your progress as compared to when you first started.

It's also important not to be a perfectionist about your journal.  Write it for yourself and decide afterwards if you want to share it with your therapist.

Getting Help in Therapy
Everyone needs help at some point in his or her life (see my article: The Benefits of Therapy).

Supportive friends and family members are important, but sometimes you need the help of a skilled psychotherapist to help you overcome your problems (see my article: How to Choose a Psychotherapist).

Rather than suffering on your own, seek out an experienced psychotherapist who can help you to overcome your problems 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.

Psychotherapy Blog: Coping with Psychological Trauma and Asking "Why me?"

When traumatic events occur to people who are ethical, good people, it's common for them to ask, "Why me?  Why did this thing happen to me?  I've been a good person.  I didn't deserve this" (see my article: Coping with Hard Times).

Coping with Psychological Trauma and Asking, "Why me?"

Not only is this a common response to psychological trauma, it's an understandable question because most people live under the unconscious assumption of a "just world" where if they are leading a good, ethical life, they expect that life will be fair and just.

This unconscious assumption begins at an early age for most people whether it's part of their religious beliefs or childhood fantasies that Santa Claus rewards children who are good and leaves no gifts for children who have misbehaved.

I'm stressing that the belief is unconscious because, on a conscious level, at some point in their lives, most people know that tragedy can strike anyone at any time.  They've seen it happen to good people that they've known.

But they have a deep and personal experience of trauma, it can feel like they've been forsaken by fate (or higher power or God, depending upon their beliefs).

Initially, many people who have experienced psychological trauma feel angry and resentful about what has happened to them.  This is completely understandable because when tragic events occur, it can upend a person's sense of how they see themselves and how they perceive the world.

Most of us go through life not expecting tragic events.  This was certainly the case for most spouses and other family members on the morning of 9/11, who expected to see their loved ones come home that night.

Initially, coming to terms with a tragic event can leave one feeling shocked and emotionally devastated.  Soon after, there can be feelings of anger and resentment as well as feelings of hopelessness and helplessness.

The following fictionalized vignette demonstrates how psychological trauma can upend a life and how psychotherapy can help.

Jane
Jane and Martin were happily married for 10  years.  Their relationship was never better and they were both at the peak of their careers when Martin got into a fatal car accident.

Jane struggled for two years on her own to try to make sense of this tragic event (see my article: Coping with Grief: It's Not Unusual to Feel Worse Before Feeling Better).

She couldn't understand why this happened to her and constantly asked herself why Martin was taken from her and "Why me?"

Coping with Psychological Trauma and Asking, "Why me?"

After feeling no relief from her sadness and anger about losing her husband, she decided to try therapy at the recommendation of her doctor.

As she told the therapist about the call she received that day, she recalled it as if it had happened yesterday.

She remembered where she had been standing when she answered the phone.  She remembered looking out the window at the trees in bloom.  She even remembered hearing a bird singing outside her window.

Worst of all, she remembered the feeling--like getting a punch to her gut--when she heard the police officer at the other end of the phone apologizing to have to tell her that her husband died instantly when another driver hit her husband's car head on that day.

She told the therapist that she felt like her vision narrowed and "everything stopped" at that moment.  Everything felt surreal, as if she were in a dream and would soon wake up and see her husband beside her.

But it wasn't a dream.  The events of that day were very real, and every day since that day she wondered, "Why?  Why did this have to happen?  Why me?"

Jane had mixed feelings about therapy.  She couldn't imagine that she would ever feel better about losing her husband.  But she didn't know what else to do, so she sat in the therapist's office that first day and told her story (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious and Ambivalent).

Afterwards, Jane braced herself for what the therapist might say to her.  So many people tried to heal her emotional wound by telling her things like, "He's in a better place now" or "Time heals all wounds."

Jane tried to be outwardly diplomatic when people said these things to her because she knew that they meant well.  But inside she was seething.  She felt they couldn't possibly understand what she was going through and she would rather they said nothing than to make these banal comments.

So, she was expecting the therapist to be like everyone else, but the therapist listened and remained attuned to Jane.  She didn't offer Jane any pat answers or try to placate her with trite sayings.

After Jane spoke, she realized that, for the first time since Martin's fatal accident, she felt she was really heard.  She felt that her words and emotions were being contained in the safety of the therapist's office (see my article: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

To her surprise, Jane felt a small sense of relief after that therapy session, so she made another appointment for the following week.  She still felt sad, lonely, resentful and angry, but she could feel a tiny sense of relief that was new.  She even slept better that night than she had in a long time.

She continued to go to her therapy sessions and talk about how lost she felt.

After a while, she found herself reminiscing about Martin and telling the therapist about how happy they had been as well as some funny things that Martin said.

Memories: Remembering That There Were More Happy Times Than Sad Times

For the first time, she was able to laugh when she remembered his sense of humor, even though she was still filled with grief. This was a new experience for her and she was surprised and curious about it.

To her amazement, she actually began to look forward to her therapy sessions.  She felt that when she spoke about her memories of Martin, he "came alive" for her internally as well as in the room with the therapist.

Initially, she only thought about the day of the accident.

But, as time went on in therapy, she realized that she had many more moments of joy and happiness in her life with Martin that she was now able to access and talk about because her therapist provided her with a safe space for her to do so (see my article: How a Therapist Creates a Holding Environment in Therapy).

After a few months went by, her therapist asked Jane if she would be willing to process the traumatic memory using EMDR therapy.  Her therapist explained how EMDR therapy works and how it could be helpful to Jane.

By that time, Jane had a good relationship with her therapist and she was willing to try it.  After going through the preparatory phase, Jane began EMDR therapy sessions to work on the trauma related to her loss.

EMDR therapy wasn't a quick fix, but by the time Jane and her therapist completed the EMDR therapy, Jane was feeling like a great weight had been lifted from her.  She still missed her husband and remembered the details of the day she received the phone call, but she no longer felt oppressed by the memory.

Coping with Psychological Trauma and Trying to Find Personal Meaning

Soon after that, Jane began to think that she would like "something good" to come out of her personal pain.

This was a new thought for Jane.  She wasn't sure what she wanted to do, but she knew she wanted to find inner meaning, so she and her therapist began to explore what Jane could do to create inner meaning about her experience.

Conclusion
The feeling of "Why me?" is a common experience that many people go through when they experience a deep loss or tragic event.

After the event, life feels unfair.  The world can feel precarious and unsafe.  Some people even have a sense of hopelessness and helplessness to think that something tragic could happen again without warning.

The depth of their sorrow can cause many people to feel that nothing, not even therapy, could help heal  their sorrow.  Some people come to therapy at that point with low expectations, but they don't know what else to do.

The unique experience of being with an attuned psychotherapist is hard to imagine until it is experienced (see my article: Psychotherapy: A Unique Intersubjective Experience).

Therapists who are skilled in creating a holding environment can help to contain even the deepest sorrow to help alleviate the emotional pain.

Experiential therapy, like EMDR, help a client to process psychological trauma so that the experience becomes integrated within the rest of client's life (see my article: Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
The shock, sorrow and anger brought on by a traumatic event can be overwhelming without help from a licensed mental health professional.

Therapists, who are trained and skilled in helping clients with psychological trauma, can provide the intersubjective space for healing to begin.

If you are struggling with psychological trauma that you've been unable to cope with on your own, you owe it to yourself to get professional help from a psychotherapist who is a trauma therapist.

Many people are amazed that they can not only heal from a traumatic experience but also find personal meaning and feelings of transcendence.

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

I have helped many clients to heal from psychological trauma.

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

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

Broken Promises - Surviving Infidelity

In my last two articles, I focused on expectations and promises.  In this article, I'm focusing specifically on broken promises with regard to infidelity and how it's possible for a relationship to survive this betrayal.

Broken Promises - Surviving Infidelity

Broken Promises: Infidelity
Infidelity is a broken promise that many people in relationships have to face.

Depending upon the relationship, how stable it was before the infidelity, the history of each person in the relationship, and other important factors, including prior history of infidelity, some relationships survive and others don't.

No one can tell you what's right for you when you're dealing with infidelity in your relationship--not your family, friends or your therapist.

People often think that they would never stick around in a relationship where their spouse cheated.  But once they're faced with actually dealing with infidelity, they might feel differently about it, especially if it's a long term relationship where each person feels that he or she might have invested a lot in the relationship before the infidelity came to light.

Restoring Trust: The Person Who Cheated Has an Emotional Transformation
Each person is different in terms of how s/he responds to infidelity, even when s/he has made a decision to try to work it out.

It can take a long time for the person who has been betrayed to overcome the anger, sadness and mistrust that infidelity engenders.

Although it's important for the person who cheated to feel sincere remorse, it's not enough for the person who cheated to apologize.

To help restore trust, the person who cheated must be able to explain what was going on for him or her internally that caused him or her to cheat.

There might have been external factors that contributed to the infidelity, but the most important factor in this situation is for the person who cheated to be able to discover, usually in therapy, what was going on in his or her internal world that led to the infidelity.

Not only would this demonstrate that s/he is taking responsibility, but it also shows, hopefully, that there is a possibility for an emotional transformation--a profound emotional shift.  And this profound emotional shift, which is a genuine emotional breakthrough, can bring about the change that the betrayed spouse needs to see in order to trust again.

There's no way to predict in advance how long, if ever, it will take the spouse who has been betrayed to heal from the betrayal, even if the spouse who cheated has a genuine emotional breakthrough.  So, it's important for the spouse who cheated to be very patient.

Let's take a look at a fictional vignette, which is based on many different cases, to see how this can happen in therapy.

Peg and Ed
Peg found out about Ed's infidelity when she signed onto the computer at home and discovered emails of a sexual nature on Ed's email account.

Peg wasn't snooping. Ed left the computer on, and the sexual subject line in an email caught Peg's eye.  As she clicked on the email, Peg discovered that Ed had been having a long distance affair with another woman.

One email led to another email, and as the extramarital affair was exposed, Peg realized that Ed had been cheating on him with woman in California during his business trips.

Peg was shocked.  She could hardly believe that her husband, whom she had always thought of as being kind and faithful, could have done this.  But the proof was in front of her eyes, the emails back and forth between the other woman and her husband.

When Ed got home from work, Peg confronted him with the emails.  At first, he denied it.  He told Peg that he didn't know who this woman was and someone must have hacked into his email.

Broken Promise - Surviving Infidelity

Then, Ed got quiet.  He hung his head down in shame looking away from Peg, and he admitted that he had been having an affair for several months with a woman that he met at a bar in California.  He hastened to say that he didn't have serious feelings for this woman and he was very sorry.  He never meant to hurt Peg.

Peg asked Ed to move out for a few weeks to give her time to think about what she wanted to do.  At that point, she wasn't sure if she wanted to remain in the marriage or she wanted to end it (see my article:

After a month, Ed asked Peg if she would consider going to see a couples therapist to talk about what happened.  Reluctantly, Peg agreed.  Ed wanted to save their marriage, but Peg wasn't sure what she wanted to do.  At that point, she mostly felt emotionally numb.

Broken Promises - Surviving Infidelity

The couples counselor that they consulted with recommended that they each see separate therapists for individual therapy so that they could each work on how the infidelity affected them.

Ed remained with the couples therapist who had a specialty in working with infidelity, and she referred Peg to another therapist.

In the meantime, they continued to live apart and maintained minimal contact by phone.  Although Ed wanted to come home, this was all that Peg could tolerate at that point.

In Peg's therapy, she was able to talk freely about her shock, anger and sadness about the infidelity.  Deep down, she knew that she still loved Ed, but she didn't know if she could forgive him.

Initially, Ed blamed the infidelity on the fact that he and Peg were only having sex about once a month and it felt routine.

When he met the a young, attractive woman, Tania, at the bar, they had both had one too many drinks.  She came onto him and, before he knew it, they were back in her room having the most passionate sex that he had ever had.  It made him feel young, sexy and attractive in a way that he had never felt.

Broken Promises - Surviving Infidelity

After the first time, Ed knew that he had made a mistake and vowed to himself that he wouldn't see Tania again.  But she kept calling and emailing him sexy pictures of herself telling him that there would be "no strings attached," she just really loved having sex with him.

Even though he knew he should have avoided Tania, he was drawn to her each time that he went to California for a business trip, which was happening with increased regularity because of a new business  deal.

After a while, it got easier for him to lie to Peg about being in late night meetings in California so he could spend all of his free time with Tania.  Even though he loved Peg and he wasn't in love with Tania, he felt obsessed with his sexual relationship with Tania.  He describe it as feeling like he was "addicted" to her.

Sex with Tania was constantly on his mind, and all he could think about was the next time that he would see her.  Between his trips to California, he even flew Tania in a few times so that they could spend weekends together in a hotel in New York.  During those times, he lied to Peg and told her that he was away on business.

Whenever he was with Tania, he felt happy and alive.  She was constantly telling him how sexy and attractive he was--things that Peg never told him.  He loved her wild, free spirit and how she pushed him to be more open and daring sexually.

At first, although Ed said he took responsibility for his behavior, he also blamed Peg for always being tired or disinterested in sex.  He said he had "sexual needs" that weren't being fulfilled in his marriage and, even though he never sought out an affair, he felt he couldn't resist this attractive, sexy woman who threw herself at him.

Broken Promises - Surviving Infidelity

His therapist called Ed on the excuses and asked him if he ever spoke to Peg about feeling dissatisfied with their sex life.  Reluctantly, Ed admitted that he had not.

Then, his therapist told him that he was making excuses for his behavior by blaming Peg, and she told him that if there was any hope of salvaging his marriage, he would have to look deep within himself to discover what caused him to cheat on his wife.  That would be his only hope for trying to get Peg to trust him again and to believe that it wouldn't happen again.

They also talked about the fact that Ed left the computer open with his emails exposed for Peg to find.  On an unconscious level, did he want Peg to find out?  He and his therapist explored this.

Over time, Ed's therapist helped him to look beyond the surface and delve into the underlying issues.

Not surprisingly, these issues had nothing to do with Peg or his marriage to Peg.  They involved long-standing feelings of inferiority and unattractiveness that went back to a young age when his family would tease him for being overweight, calling him "an ugly duckling."

Even though Ed had lost the weight when he was in college, he still harbored this deep sense of inferiority.  Peg was his first and only girlfriend when they met in college.  He had never had sex with another woman--until he met Tania.

Although he loved Peg, he felt like he "missed out" on dating other young women at college.  So, when he met Tania, he felt like a young man again.  Even though he felt ashamed to say it, he realized that knowing that she found him attractive and that she wanted to have sex with him, made him feel good about himself.

This helped him to realize that he wasn't "addicted" to Tania, he was really drawn to how his affair with her made him feel about himself.  It also helped him to realize that he had been carrying around this sense of inferiority without realizing it for a long time.

Realizing this was an emotional breakthrough for Ed.  He understood that he was still responsible for his behavior, but now everything made sense to him.

Broken Promises - Surviving Infidelity

He and his therapist were able to work directly on his longstanding feelings of inferiority to enhance his sense of self worth.  He mourned for all the years that he harbored his low sense of self and gained new confidence in himself.  He knew now that he would never need to resort to having an affair again to feel good about himself.

Ed blocked Tania's emails and text messages, and he erased her number.  He had no desire to be with her ever again.

Eventually, Peg joined Ed so that he could talk to her about the emotional breakthrough that he had in therapy and to assure her that it would never happen again.

Peg was happy for Ed and, for the first time, she felt there was a real possibility for reconciliation because she believed that Ed had undergone a transformation in therapy.

Over the next several months, they worked at reconciling and repairing their relationship.

Conclusion
Discovering the internal experiences that led to the infidelity doesn't excuse the infidelity.  It's not a justification.  But it helps both spouses to understand what drove it so that the person who cheated can work on these factors in therapy to ensure that it doesn't happen again.

In order to trust again, the spouse who was betrayed needs to know that the spouse who cheated has undergone an emotional transformation that leads to a major shift emotionally as well as in terms of behavior.

Broken Promises - Surviving Infidelity

Surviving infidelity isn't easy or quick--if it happens at all.

It requires a commitment from both people.

Often the underlying issues are unconscious and longstanding.

There is often a need to do grief work to grieve for earlier losses as well as the loss of innocence and trust in the current relationship.

Both people need to be patient and there is no way to predict how long it could take to restore trust.

Getting Help in Therapy
Many couples, who experience infidelity in their relationship, avoid coming to therapy because they feel ashamed, angry and hopeless about salvaging their relationship.

Many relationships fall apart after infidelity is discovered, and there's no way to predict which relationships will survive and which ones will end.

Doing nothing and trying to "put it behind you" or "start over" almost never works because nothing has changed.  Neither person has gained insight into what and why things happened.

Some couples need individual therapy before they can come together for couples therapy in order for each person to understand how s/he feels and the underlying emotions experienced by each person.

Getting help in therapy can help to save your relationship if you're serious about making a commitment to change.

Don't wait until it's too late.  Get help.

About Me

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

I have helped many individuals and couples with infidelity.

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

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

Experiential Therapy, Like EMDR, Helps Achieve Emotional Breakthroughs

In an earlier article, Self Blame and the Internal Critic, I began a discussion about how people often experience self blame.  In this article, I will discuss self blame, the need to feel in control and how experiential therapy, like EMDR, helps to achieve emotional breakthroughs.

Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs

Self blame can come in many forms, including a general feeling of "I'm wrong" or "I can't do anything right."

Self blame can also relate to a specific misfortune or trauma in one's life, including loss.

For people who are stuck and mired in self blame related to a traumatic incident, the feelings of self blame often give them the sense that they could have controlled some aspect of the traumatic event when it occurred and that this would have brought about a different outcome.

In most cases, this is an illusion and keeps people stuck emotionally at the point where the trauma incident occurred.

The following scenario is a composite of many different cases to protect confidentiality:

Rena
Rena came to therapy because she blamed herself for the death of her husband, who died on 9/11 at the World Trade Center.

Several years had passed since the tragic event and every day Rena thought about how she could have prevented her husband from dying that day if only she had insisted that he stay home from work because he wasn't feeling well.

She replayed the last moments in her mind over and over again--when she saw her husband as he was standing in their bedroom trying to decide whether to go to work or stay home.

He was sneezing and coughing, and she thought about telling him to stay home but, for some reason which she could never figure out, she didn't say it.  Instead, she told him to come home early if he felt worse and, with that, he kissed her, walked out the door, and she never saw him again.

Rena had attended cognitive behavioral therapy (CBT) a few months after her husband died and, because of that therapy, she realized that she wasn't really to blame.  But her realization was very much on an intellectual level and it didn't help to dispel the grief and guilt that she felt.

Deep down on an emotional level, she still felt that if only she had insisted that her husband stay home, he would be alive today.  Even though she knew logically that this made no sense, on an emotional level, she carried this heavy burden.

The weight of her grief and guilt was such that all she could do was go to work, come home and sleep.  She no longer saw her friends or engaged in activities that she used to enjoy.

Since Rena's prior therapy only helped her in a limited way, she wanted to try a different type of therapy.

So, when her friend told her that she was able to resolve a personal trauma with Eye Movement Desensitization and Reprocessing therapy (EMDR), Rena read up on EMDR and decided that she wanted to try this experiential form of mind-body oriented therapy (see my article:  What is EMDR?).

Rena wanted to work on the memory that she replayed in her mind over and over since 9/11.

After getting Rena's personal history and helping Rena to develop coping skills to work on the trauma, which took several sessions, we began to process the trauma.

When I asked Rena to think about an image that represented the worst part of that memory, she told me that in her mind's eye, she saw her husband standing in their bedroom as he was weighing whether or not to go to work and she was standing nearby, concerned, but silent.

Just saying these words caused Rena a great deal of pain and she sobbed.  After a few moments, she stopped crying and she was able to identify where in her body she felt the grief and guilt--in her chest and throat.

Identifying feelings in the body is an important difference between experiential therapies (like EMDR) and CBT, which tends to stay on the cognitive level.

Then, in keeping with the EMDR process, I asked her what words would best describe how she feels about herself now with regard to that memory, and she said, "I should have made him stay home so he would be alive now."

In terms of how disturbing this memory was for her on a scale of 0-10 (where 0 equals no disturbance and 10 equals the most painful disturbance imaginable), Rena said it felt like a 10.

Then, I asked Rena what words best describe how she would like to feel about herself in relation to that memory, and she said she wanted to feel, "I did the best that I could."

At that point in EMDR therapy, Rena didn't feel this way about herself at all.

Before we started processing this traumatic memory, I reminded Rena that if at any time she felt she was too upset to continue, she could signal me and we could stop for a few minutes or stop altogether for the rest of the session.  It was important for her to know that she was in charge.

Although Rena experienced waves of sorrow during the EMDR processing, she did not want to stop because she felt that something was shifting inside of her, but she wasn't sure what it was yet.

This sense of internal shifting is a common experience for clients who are in EMDR therapy.

We continued to work on this memory for several more weeks.

At the end of each session, we talked about the session, and Rena continued to say that she felt something, which was unidentifiable to her, that was shifting internally.  At that point, it was still hard for her to imagine that she could ever let go of her guilt and sadness for not stopping her husband from going to work on 9/11.

Then, a few weeks later, Rena had an emotional breakthrough.

Until then, as I mentioned earlier, her understanding that her husband's death was not her fault was only a logical construct in her mind--she didn't feel it emotionally, and she continued to carry this contradiction within herself.

But on that day, as she sensed into her body to feel what emotions came up for her about the memory, she realized that she wasn't feeling self blame.  She was sad that her husband died, but she didn't feel responsible for his death.

At first, she could hardly believe that there had been this internal shift within her.

Instead of feeling self blame, she felt a deep sense of knowing that she couldn't have altered the chain of events.  She felt deeply that she wasn't to blame.  She knew deep down that no matter what she would have said, based on how her husband reacted in similar situations prior to that day, he still would have gone to work.  So, she couldn't have controlled the situation--and now she knew this on a an emotional level.

Afterwards, when we talked about this, Rena said that her sense of knowing that she wasn't to blame was different this time from how she had felt before.  She said that this time she felt it in her gut and in her heart.

She knew on a deep level that the idea that she could have changed the course of events was an illusion that she had been hanging onto.

As we continued to work together, what surfaced was that Rena's illusion that she could have changed the course of events at that pivotal point (when he was standing in the bedroom trying to decide what to do) served to keep her feeling emotionally attached to her husband--to that last time that she saw him.

This is why, prior to her emotional breakthrough, thinking about that moment over and over again was so powerful for her.

This emotional breakthrough for Rena helped her to release her grief, which had been pent up in her for several years.  It also allowed her to deal with other emotions that had been covered over by her feelings of self blame.

Over time, we continued to work on other emotional issues that arose about her husband's death, including her feelings of abandonment.  Even though she knew logically that her husband didn't choose to leave her, she experienced this common reaction that people often have when loved ones die.

Along the way, Rena learned other ways to have an internal experience of closeness for her husband without having to remain stuck in the traumatic memory.

Being able to feel the release of grief helped her to start putting her life back together again.  Gradually, she began to see friends again and she took up hobbies that she had neglected since her husband's death.

CBT as a Counteractive Therapy vs EMDR as Experiential Therapy
Each client is different and there's usually no way to know in advance what will be emotionally transformative for a particular client.

I do use CBT for some clients under some circumstances, but my experience as a psychotherapist who specializes in working with trauma, has been that, although CBT can be useful to a certain extent, it often offers limited help, particularly in situations described in the scenario about "Rena."

Of course, it's important for clients to understand on a cognitive level that they're not to blame for traumatic incidents that they could not have controlled.  But, as in the case with Rena, this kind of cognitive understanding is limited and clients will often say, "I know logically that I wasn't to blame, but I still feel on an emotional level that it was my fault."

It's important that clients understand that feeling this contradiction isn't at all unusual when it comes to trauma.

The problem with CBT in these instances is that it is a top-down approach that acts only as a counteractive force to the negative feelings that clients feel about themselves, which often keeps the internal conflict of what they know vs. what they feel in place for clients.

It provides the client with an alternative to how they're thinking, which is good, but it often doesn't change the feelings where they reside, which is deep in the limbic part of the brain.

EMDR Therapy Helps Achieve Breakthroughs

Experiential therapies, which use a bottom-up approach that involves the mind-body connection, like EMDR, Somatic Experiencing, clinical hypnosis and other types of experiential therapies, go to that deeper level and help to make the emotional shift that leads to emotional breakthroughs.

Skilled EMDR therapists also know how to work in a way where clients feel emotionally safe, which is important for clients who have experienced trauma.

I'll discuss this topic further in a future article.

Getting Help in Therapy
Many people live their whole lives blaming themselves for traumatic events that they could not have changed.  They live with the illusion that they could have controlled events, and this serves to keep them stuck in the memory.

For people who are stuck in this way, on an emotional level, it's as if there is no difference between "then," when the event occurred vs "now," their current life (see my article:  Overcoming Trauma With EMDR: When the Past is in the Present).

If this resonates with you, you owe it to yourself to get help from a licensed mental health professional who has expertise in one of the experiential types of therapy, like EMDR, Somatic Experiencing and clinical hypnosis, among others.

Once you're no longer living as if you're still in that traumatic memory, you will be free to live a fulfilling life.

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

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

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

Why It's Best to Be Honest With Your Psychotherapist

One reason why therapy doesn't work out sometimes is that some clients don't feel comfortable being completely honest with their therapists about important issues in their lives that are causing problems for them.

Why It's Best to Be Honest With Your Psychotherapist

When Shame Keeps Clients From Being Completely Honest With Their Therapists

Often, it's not a matter of psychotherapy clients deliberately attempting to deceive their therapists.  Usually, it's more a matter of clients feeling ashamed of their problems and wanting to appear in a more favorable light.

Shame can be overwhelming.  And, when clients intentionally omit important information about what's going on with them because they feel too embarrassed to reveal their problems to their therapist, they usually end up sabotaging their own treatment because the therapist is missing important information, which doesn't allow her to help the client.

Building a Rapport With Your Therapist

When clients begin therapy, it usually takes a while for the client and therapist to develop a rapport in treatment.  This is normal part of treatment.  So, it's understandable that clients might not reveal things they're ashamed of when they start therapy before they know if they can trust their therapist.  

Withholding Information From Your Therapist Can Result in an "As If" Therapy

When months and years go by and clients don't divulge important information about themselves, the therapy often becomes an "as if" therapy.  The therapist is operating on certain assumptions about the client and offering help related to what she knows, but the secrets that the client is keeping from the therapist have gone underground.   

This might become obvious to the therapist after a while.  She might have an intuitive sense that something is amiss in treatment.  Most experienced and skilled therapists would understand that a client feels too ashamed to discuss certain aspects of himself that he might be too embarrassed to reveal.  

Getting Honest With Your Therapist Can Lead to an Emotional Breakthrough

Once the therapist becomes aware that the client was withholding information, if the therapist approaches this issue with tact and compassion, it can be a real breakthrough for the client and the therapeutic work.  The client usually feels relieved that he no longer has the burden of keeping secrets from his therapist.  

More importantly, he realizes that his therapist still cares about him and wants to work with him.  This is often an emotionally reparative experience, especially if the client came from a family where love was conditional, based on his being a certain way in the family.

Attention-Seeking Behavior: Fictitious Disorder

Another reason why clients aren't honest with therapists is that they might be engaging in attention-seeking behavior.  Attention-seeking behavior could involve either lying to the therapist or exaggerating problems.

For instance, a client might make up a very traumatic family history that is completely false with the intent of getting attention and sympathy.  This type of behavior is called Fictitious Disorder (see my blog article:  Attention-Seeking Behavior in Therapy: Understanding Fictitious Disorder).

A Mismatch Between Therapist and Client Can Result in a Client Withholding Information

Another factor might be that the client and therapist are not a good therapeutic match.

Unfortunately, many clients don't realize how important it is to be with a therapist with whom they have a good rapport.  Of course, as previously mentioned, this is developed over time.  But if months pass and a psychotherapy client still feels he doesn't "click" with his therapist, rather than remaining silent about it or aborting treatment, it would be better for him to speak to the therapist about it.

Ultimately, if this issue cannot be worked out, it would be better for the client to find another therapist. Most experienced therapists understand that every therapist is not for every client, and it's important for the client to feel comfortable.

Some Discomfort With Revealing Uncomfortable Aspects of Yourself is Understandable
Being open in therapy isn't always easy.  It takes courage to go to therapy and open up about things that you don't feel comfortable about.  But, in the end, if you're not honest with your therapist, you're only hurting yourself.

Often, concerns about what the therapist might think if you reveal what you're ashamed of is actually a projection about how you feel about it yourself.

Adjunctive Treatment Might Be Necessary
Recognize that most experienced therapists have heard just about everything you could think of and more.

If your problem is outside of the scope of what your therapist is knowledgeable about, she will tell you and might refer you for adjunctive treatment.

So, for instance, if you reveal that you're having a substance abuse problem and your therapist has no experience with substance abuse, she might refer you to a 12 Step program or a structured outpatient chemical dependency program.

Recognize That You're Not Alone
Many, if not most, people in therapy have gone through times when they feel uncomfortable discussing certain aspects of their lives with their therapists.

But I believe that if you were to ask people who overcame their discomfort and were honest with their therapists, they would tell you that getting over the initial discomfort was worth it in terms of the treatment and how they felt about themselves.

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

I work with individual adults and couples.

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

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