The Mind-Body Connection: Mindfulness Meditation

Mindfulness Meditation:
When you're overwhelmed by stress, you might experience anxiety-related problems, such as difficulties concentrating, memory problems, or problems with insomnia, to name just a few possibilities. On a physical level, if you're under too much stress, you can become physically exhausted and your immune system can become compromised, causing you to get sick.

Mind-Body Connection: Mindfulness Meditation

This is why it's so important to learn ways to take care of yourself on a regular basis to keep your mind and body calm.

Why Mindfulness Meditation?
Mindfulness meditation is one way that many people find helpful, not only to stay calm, but also to become more aware and develop insight about their inner emotional world.

When you practice mindfulness meditation, you allow whatever thoughts and feelings that arise to come up and you just notice them. You don't try to control them. You don't make judgments about them. You're simply observing what's happening in your inner world. Everything and anything that comes up is welcomed in mindfulness meditation.

The intention of mindfulness meditation is to be aware and awake to what's going on inside you. You're developing the ability to become a impartial observer of your own internal experience.

Mindfulness can be used in just about any area of your life. You can eat in a mindful way. You can walk in a state of mindfulness. You can engage in your relationships in mindful ways.

People who practice mindfulness meditation over a period of time often become insightful about themselves and others.

How to Begin Mindfulness Meditation:
As a psychotherapist, I usually recommend that clients begin with a guided mindfulness meditation CD (see resources below).

As a beginner, you can start by just paying attention to your breath, feeling what it's like to inhale a refreshing breath and what it's like to exhale, letting go of stress. It helps to close your eyes to keep your eyes and mind from wondering.

You an also look down at a point close to you if you don't feel comfortable closing your eyes. I also usually recommend that people sit up when they do meditation because it's easy to fall asleep if you're lying down, and this is not the purpose of doing meditation. Usually, a chair where your spine is straight and comfortable is best.

Mind-Body Connection: Mindfulness Meditation

Everyone is different as to when they like to do meditation. Some people find it most helpful to do in the morning before they start their day. It sets the tone for their day. Other people prefer to do it at night before they go t sleep. And others prefer to do it some time in the middle of the day. To be consistent, it's helpful to have a regular routine for meditation.

Some people who begin mindfulness meditation, find it helpful to concentrate on how their abdomen expands and contracts when they breath. You can begin by practicing for 5 minutes a day and work your way up, over time, to 20 minutes or more.

You don't have to be spiritual to practice mindfulness meditation. Mindfulness meditation can be done in a secular way (see resources below). And if you are spiritual, you will probably find that it will enhance just about any spiritual practice.

As a beginner to mindfulness meditation, you can expect that your mind will probably wonder. This is normal. The important thing, rather than getting frustrated with yourself, is to bring your attention back to your breath each time, even if you must do this countless times. It gets easier over time if you persevere.

Resources for Mindfulness Meditation:
Any of the books and CDs by Jon Kabat-Zinn, PhD., are especially helpful.

Websites:
Mind and Life Institute: http://www.mindandlife.org/

Mindfulness CDs: http://www.mindfulnesstapes.com/
CD for Beginners: Mindfulness for Beginners - by Jon Kabat-Zinn

Books:
Wherever You Go, There You Are - by Jon Kabat-Zinn

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness - by Jon Kabat Zinn

The Mindful Way Through Depression (includes CD) - by Jon Kabat-Zinn

Mindfulness meditation is one way to de-stress and become more aware of your inner emotional world. In future blog posts, I'll discuss other ways.

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

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

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

Starting Psychotherapy: Developing a Sense of Psychological Mindedness

What is Psychological Mindedness?
Often, for people who are starting psychotherapy for the first time, there is a misconception that the client comes to see the psychotherapist, explains the problem, and the therapist gives the client "the answer" about what to do. This is what's meant by the client who seeks the "quick fix."

Starting Psychotherapy: Developing a Sense of Psychological Mindedness

Aside from certain specific problems. like coming for clinical hypnosis for smoking cessation, generally, there are no "quick fixes" in psychotherapy. There are certain types of psychotherapy that tend to be faster and more effective than regular talk therapy, like EMDR and clinical hypnosis, for certain problems.

But, generally, psychotherapists don't tell their clients what to do. Unlike counseling, where counselors often give advice, in most cases, psychotherapy involves a self exploration of your internal emotional world. And in order to engage in this self exploration of your internal emotional world, you need to begin with a sense of curiosity that allows you to develop psychological mindedness.

When you develop a sense of psychological mindedness, you're more open and curious about your emotional world. Rather than passively waiting for the therapist to tell you what to do, you become actively involved in your own internal process. I emphasize the word "process" because this is not a one-time event. It's a process that usually unfolds over time.

Developing psychological mindedness involves more than just coming to vent about your problems or "report" on what happened in the last week. When you develop a sense of psychological mindedness, you develop an awareness of your thoughts, feelings and behavior.

If you're working with a psychotherapist who emphasizes the mind-body connection, as I do, you also become more aware of where you feel your feelings in your body. Learning to recognize where you feel your feelings in your body can be very powerful. It helps you to develop emotional insight and not just intellectual insight.

The difference between emotional insight and intellectual insight is that when you have emotional insight, you feel it in your "gut." You have a deeper sense of knowing than you would when you only have intellectual insight and it's just ideas in your head.

When you're psychologically minded, your emotional world as well as your external world around you, opens up for you in a new way. You begin to become more aware and make psychological connections in your life that you wouldn't have made if you remained passively waiting for a therapist (or anyone else) to tell you what to do. Generally, you begin to see more readily what you're doing that's not working for you. You also often see what triggers your behavior, whether it's unresolved issues from the past or something that is going on in the here-and-now.

Being psychologically minded and making psychological connections about your internal world and how you interact with others allows you to start making changes, if you're ready and willing to make those changes.

You might wonder why I would say "if you're ready and willing." After all, if you're coming to see a psychotherapist, doesn't that imply that you're having problems and you want to change? Well, not necessarily.

Often, people begin psychotherapy because the discomfort of having certain emotional problems has become overwhelming. They know that they're emotionally overwhelmed and they don't want to feel that way. They want the emotional pain to stop or the problems to end. But actually going through the psychological process of developing curiosity and awareness so they can make changes in their life is not always what they bargained for.

Once again, the desire for the "quick fix" can be strong, and it might be hard to understand why coming to psychotherapy is different than going for a one-time visit to your medical doctor where your doctor diagnoses the problem, tells you what it is, and gives you a pill or an injection to solve it.

Psychological problems are more complex than most regular medical problems. There are often multiple layers of meaning to your thoughts, feelings and behaviors. So, when your therapist listens to the problems that you bring into your session, he or she is not just listening for a list of symptoms and connecting it to a particular illness that can be readily resolved with a prescription.

Developing Psychological Mindedness as a First Step in Psychotherapy:
So, becoming curious and open to your thoughts and feelings as well as your behavior, and learning to make psychological connections between them is the beginning of developing psychological mindedness. It's a much richer and more rewarding process than if someone just tells you what to do (even if there were someone who actually knew what was best for you). It's the beginning of your psychological process in psychotherapy.

Developing a Sense of Psychological Mindedness in Therapy

Why do I say developing psychological mindedness is just the beginning? The answer is that, in order to make changes, in most cases, you need to take action. Most of the time, it's not enough to just be psychologically minded, understand the problems and stop there. Depending upon the problem, you often need to actually do something to make a change.

Getting Stuck After Developing Psychological Understanding and Before Taking Action:
Many clients in psychotherapy get stuck at the point where they need to take action. Developing a psychological understanding of the problem, while being essential, is not the be-all and end-all of the process. Getting stuck before taking action is common obstacle, but it doesn't need to be a permanent state. It can be a stage in the process that needs to be overcome and clients often do overcome these obstacles if they're willing to stick with the process.

Once again, psychological mindedness can help clients to understand why they get stuck before they take action to change their problems. It can be that they're really not ready yet to make the changes they need to make. It can also be a fear of what it might be like to change and have things be different. There can be so many other factors involved.

A skilled psychotherapist can often help clients to translate emotional insight and psychological understanding into action, but the therapist can't do it for them. When a client gets stuck, patience on the part of the client and the therapist is usually helpful. There might be other underlying issues, possibly trauma, that might not be immediately apparent at first to the client or even to the therapist.

If you're seeing a thearpist who is trained in different forms of psychotherapy, it might be necessary to switch from one form of psychotherapy, like regular talk therapy, to EMDR or clinical hypnosis to overcome the particular obstacles or trauma that have arisen which prevent the client from making the change. But that's a different blog post (see my earlier posts that describe EMDR and clinical hypnosis and how they're different from regular talk therapy).

Learning to be a Psychotherapy Client:
Most clients who begin psychotherapy learn how to be psychotherapy clients as they go along with the help of their therapist. Learning to be a psychotherapy client is a learning process in itself because participating in psychotherapy is different from most anything else that you've ever done before. You might have seen movies or TV programs of people in psychotherapy and, even if it's an accurate portrayal of psychotherapy (and it's often not), when it's your personal psychotherapy, you experience it on a very different level.

When you begin psychotherapy, developing a sense of psychological mindedness can be a challenge. But it's often an experience that allows you to know yourself in a deeper and more fulfilling way. Developing a psychological understanding of yourself involves more than just brief treatment. It involves dedication and patience that develops over time.

As I mentioned earlier, there are certain problems (like smoking cessation) that can be overcome in 3-5 sessions. But for most complex problems, even problems are amenable to EMDR and clinical hypnosis, developing psychological understanding is a process that takes time.

About Me

I am a licensed psychotherapist, hypnotherapist and EMDR therapist in NYC.

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.

Returning to Therapy

It's not unusual for people to return to psychotherapy, over the course of a lifetime, for a second or third treatment (or more) to deal with the same issues, often on a deeper level or in a different way. Many times, the first therapy might have been to develop coping skills to deal with a particular issue and subsequent treatments are for developing greater emotional insight into the problem.

Returning to Therapy

The following scenarios, which are composite accounts of actual cases (with all identifying information changed to protect confidentiality) are examples of clients returning to psychotherapy to deal with the same issues or emotional patterns in a different way:

Scenario 1:
When John attended psychotherapy sessions in his late 20s, his girlfriend of five years had just left him. After the breakup, John was highly anxious and depressed. He was also very isolated and lonely because his relationship with Jane had been everything to him. At that point, John had never participated in psychotherapy before. He had always thought that a person had to be "crazy" or "weak" to seek out the help of a psychotherapist. However, he did some research on his own and read that most people who attend psychotherapy were "normal" people who wanted to work on their problems with a mental health professional who could help them in ways that friends and family members could not.

Returning to Therapy

During the first psychotherapy session, John talked about the relationship, and about his anxiety and depression following the breakup. The psychotherapist explained how she worked and answered general questions about psychotherapy and her professional background, training and experience. John attended weekly sessions for about three months and, gradually, he began to feel better. He no longer felt anxious or depressed, and he was beginning to date again. At the point when he decided to leave therapy, he and his therapist were just beginning to deal with his codependent patterns in relationships. However, after his anxiety and depressive symptoms subsided, John no longer felt motivated to attend therapy.

His psychotherapist talked to John about remaining in psychotherapy so he could gain emotional insight into his patterns and he would not continue to repeat them in his next relationship, but John decided that he was "feeling good," he no longer felt anxious or depressed, and all of this talk about codependency was bringing him down, so he left therapy. He felt that as long as he knew that he behaved in ways that were codependent, he would "just stop" behaving in that way and it shouldn't be a problem. He told his therapist, "I know what to do now" and he left treatment.

After he left therapy, John began dating someone new, and they entered into a relationship almost immediately. A year later, his girlfriend broke up with him, telling him that she found him "too needy." John was upset, but he used the coping strategies that he learned in psychotherapy to deal with his depression and anxiety. Soon afterwards, he entered into another relationship with a woman who was an active alcoholic. 

He thought he could help Mary to overcome her alcoholism and, deep down, he felt that she would never leave him because he thought she needed him. Mary was unemployed and broke at the time. She moved in with John within a few weeks and John supported her. After several months, Mary began attending A.A., at the urging of her psychotherapist. She obtained a sponsor and began forming sober friendships in the program. Three months later, Mary found a good job and she decided that she wanted to be single again, so she broke up with John.

This time John was devastated. He never saw it coming. He tried to use the coping strategies that he learned in psychotherapy, but his self confidence plummeted after this last breakup. He bought self help books to try to understand what he was doing wrong and to bolster his confidence, but the self help books didn't help him. 

Reluctantly, he called his former therapist and returned to therapy. John began therapy again with the sole motivation that he wanted to "feel good" again. However, over time, he began to understand that while "feeling good" was important, psychotherapy was about more than just "feeling good" and he needed to look at some of the underlying issues involved with his codependency.

Over time, John developed an understanding that "knowing what to do" in an intellectual sense was not the same as having a deeper, emotional understanding and getting to the root of his problems so that he could change his patterns. So, when he began to feel better again and he was tempted to leave therapy, rather than giving in to this temptation, he stayed to do the deeper work to overcome his codependency.

When he entered into the next relationship with Susan, he was tempted to leave again because he felt that, for sure, this new woman was "the one." He felt happy for the first time in a long time. From his perspective, he thought, "Why should I stay in therapy? I feel very happy now." 

However, soon after they got together, John recognized the early signs of codependency in his relationship. He realized that he was falling into the same old patterns again, and he was able to work on these issues with his therapist. He learned to avoid the same codependent pitfalls from the past, and he gained a deeper emotional understanding of the origins of his problems.

With the help of his psychotherapist, his own diligence in going to his therapy sessions on a regular weekly basis, and applying what he learned, John's relationship began to flourish into a mature, stable, healthy relationship. He and Susan also began forming friendships outside the relationship so they were no longer solely dependent on their relationship for all of their emotional needs.

He worked through his family of origins issues that were at the root of his codependency problems; he no longer had the need for Susan to depend on him; and, he felt that he had grown as a person. 

At that point, he and his therapist talked about John terminating therapy. They spent about a month going through the termination process to help John consolidate the gains that he made in therapy, and then John and his psychotherapist mutually agreed that it was time for him to end treatment. His therapist told him that he could come back in the future. A couple of years later, John and Susan got married and they continued to have a stable and happy relationship.

Scenario 2:
Kathy, who was in her early 20s, began attending psychotherapy sessions to deal with the death of her grandmother. Kathy was close to her grandmother and she took the loss very hard. Several months before Kathy began psychotherapy, her grandmother was home recuperating from a heart attack and Kathy would come to see her everyday after work to check in on her. 

Over time, her grandmother got stronger and she was soon able to take care of herself and get back to her regular activities. At that point, assured that her grandmother no longer needed her help, Kathy decided to go on a week long vacation with her friends to the Bahamas.

Returning to Therapy

Kathy and her friends were having a wonderful time in the Bahamas when she got back to their hotel and found a message to call her mother immediately. When she called her mother, she found out that her grandmother had a massive heart attack that day, and she had died. Kathy was devastated. She blamed herself for going away and thought, "Maybe if I had been there, she might not have died."

After a couple of months of therapy, Kathy grieved the loss of her grandmother. She also came to understand, in an intellectual way, that there would have been nothing she could have done to save her grandmother from her massive heart attack and death. After all, she wasn't a doctor. Everything her psychotherapist told her made logical sense to her. Soon after that, she cancelled her appointments and she left treatment against her therapist's clinical advice.

Several years later, Kathy got married to Paul. They were both very happy in their marriage. One day, during the third year of her marriage, Paul began having chest pains. Kathy broke out into a cold sweat and felt panicky. She was afraid that Paul was having a massive heart attack, just like her grandmother. 

She could barely think straight, but she managed to call 911. After an extensive battery of tests, the doctor told Kathy and Paul that Paul's heart was very healthy and overall he was in good physical shape, but he had acid reflux and the symptoms were often similar to the symptoms of a heart attack. Paul was greatly relieved. Kathy was somewhat relieved, but she worried and feared that the doctors might be wrong.

After that, Kathy was afraid to go to work or to leave Paul, who worked from home, for any length of time. At first, Paul was understanding. He was taking his acid reflux medication and he told her that he was feeling fine. 

But nothing he said soothed Kathy's nerves. She called him at home numerous times from her job and would often come home early to check on him. She also refused to have sex with him because she was afraid that he would have a heart attack, even though the doctors had assured them that his symptoms had nothing to do with his heart. Finally, Paul told Kathy that he thought she needed to get help.

On the one hand, on an intellectual level, Kathy realized that her worrying and her behavior was excessive. But her feelings made her worried thoughts feel very real to her, and this was confusing. 

On the other hand, she didn't want to ruin her marriage with Paul, so she returned to see her former psychotherapist. She felt somewhat ashamed to return to therapy because she thought her problems "should have been fixed" after the first therapy. She was afraid that her therapist would think that she was "stupid." But she learned from her psychotherapist that returning to therapy to deal with the same issue, on a deeper level, was very common, and she felt relieved.

Kathy also discovered that her current worries were being "triggered" by the death of her grandmother. Even though she had grieved this loss during her first treatment, she had not dealt, on a deeper emotional level with the trauma of how helpless and guilty she felt while she was away and her grandmother died. 

She also realized that, during her first treatment, she went as far as she could at the time on an intellectual and logical level. But these other traumatic feelings had not surfaced in the first treatment.

When she realized this in her second psychotherapy treatment, Kathy was glad to know that she wasn't "going crazy" and that there was an explanation for her excessive worrying. It made sense to her. 

At that point, knowing this, she was about to leave therapy again, but her psychotherapist recommended that she stay to work on the trauma on an emotional level. Over time, Kathy learned the difference between intellectual insight and emotional insight. 

She realized that it was not enough to have intellectual insight. Her psychotherapist used a combination of clinical hypnosis and EMDR treatment to help Kathy process the original trauma. By the time Kathy and her psychotherapist mutually agreed that she had processed the original trauma, Kathy was no longer worrying about Paul's health. They began to have sex again, and they became closer than ever.

Over the course of a lifetime, old problems can resurface in new ways. Sometimes, there are residual issues that remain hidden and don't surface in the original psychotherapy treatment. Also, over time, as we mature and grow, we have a greater capacity for emotional insight (as opposed to only intellectual insight) and so we can approach old problems with a deeper understanding to resolve them.

Returning to psychotherapy, whether you return to your original psychotherapist or you choose to see someone new who might have a different way of working, is not anything to feel ashamed about.

Returning to therapy doesn't mean that you failed in your original psychotherapy treatment or that you were inadequate in any way. Sometimes, it might mean that you left therapy prematurely. Usually, when this happens, people think that "feeling better" means that the problem has been resolved. But what it might really mean is that some of the worst symptoms have subsided, but that none of the underlying issues that caused the problem have changed. It might also mean that your psychotherapist or counselor was not skilled in the particular issue that you were dealing with at the time.

Also, often, as you mature and your life changes, it means that you now have the emotional capacity and you are ready to deal with a particular problem on a deeper level to resolve it.

About Me

I am a licensed psychotherapist, hypnotherapist and EMDR therapist in New York City.

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

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

Also, see article:  When Clients Leave Psychotherapy Prematurely