Taking Risks in Your Therapy

Many clients who are in therapy avoid expressing their reservations or negative feelings about therapy or their therapists.  Some clients, who were discouraged from expressing their feelings when they were children, continue the same pattern without even realizing it in their relationships and in their therapy as adults (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).  

Deep down, they don't feel entitled to their feelings.  Other clients are afraid that they will offend or alienate their psychotherapist by expressing negative feelings.  But in order for the therapy to be alive, meaningful and valuable for clients, they need to take risks in their therapy because, if not, these unexpressed feelings contaminate the therapy and have a negative impact on the relationship between the client and the therapist (see my articles: Why Being Honest With Your Therapist is the Best Policy and How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

Taking Risks in Your Therapy 

A Childhood History of Feeling Invisible and Undeserving
Clients who grew up in a family where they were discouraged and, possibly, even punished for expressing their feelings learn quickly to keep their feelings to themselves.  Over time, they also learn not even feel their feelings, so they are unaware of their feelings on a conscious level.

This pattern is often carried over when they become adults in their personal relationships and relationship with their psychotherapist without their even realizing it.

Therapists who recognize this pattern in clients need to provide a safe therapeutic environment (see my article: The Creation of a "Holding Environment in Psychotherapy).

Psychotherapists also need to help these clients to identify their feelings so they can express them.  Many clients, who are having the experience for the first time of expressing negative feelings might begin by having big reactions that frighten them once they begin expressing their feelings, so the therapist also needs to help these clients to manage their emotions.

Learning to express negative feelings after a lifetime of bottling them up can be challenging, so clients need to learn to respond instead of react when expressing themselves (see my article: Responding Instead of Reacting).

A Fictional Clinical Vignette: Taking Risks in Therapy
The following fictional vignette illustrates the points that I've made above and how psychotherapy can help:

Beth
Beth, who was in her early 30s, began therapy because she thought she was being taken advantage of in her two year relationship.

She told her new psychotherapist that her boyfriend, Alex, would often assume that when they went out that Beth would pay because she made more money that he did.  She said that, although she didn't mind paying sometimes, she didn't want to pay for their dinner, movies and theater tickets all the time.  She especially didn't want Alex to assume that she would always pay, which he did.  She felt that, although he made less money than she did, he made enough money to offer to pay sometimes.

Taking Risks in Your Therapy

Beth also mentioned other issues in the relationship where she felt taken advantage of.  When her psychotherapist asked Beth if she ever discussed this with Alex, Beth gave her a blank stare and then she gave all her reasons why she had not spoken to Alex about these issues, "It wouldn't make a difference anyway," "He's just like that--he won't change" and so on.

Eventually, over time, Beth came to see these "reasons" as rationalizations and excuses for her passivity.  But, at this point in her therapy, she believed her rationalizations.

It turned out that Beth had so much bottled up resentment towards Alex over the two years that they were in a relationship that she no longer wanted to be sexual with him.  But, until she came to therapy, she never made the connection between her unexpressed anger and resentment and her lack of interest in having sex with Alex.

When Beth thought about it, she said she had always been a sexual person, and she had been very sexually attracted to Alex during their first year together.

Before discussing this in therapy, she just thought that the decrease in her sexual interest was a normal part of being in a two year relationship. But now she sensed how her resentment and anger contributed to the cooling off of her feelings for Alex.

When her new psychotherapist asked Beth if she had ever been in therapy before, Beth told her that she had been in therapy with several different therapists over the last few years, but she left each of her therapists when they said or did something that she didn't like.

When her therapist asked her if she ever spoke to any of her therapists about her misgivings, Beth realized that she never did--she just left abruptly (see my article: When Clients Leave Psychotherapy Prematurely).

Beth described her parents as being emotionally distant and preoccupied with their careers.  As an only child, Beth spent much of her time alone.  She never saw her parents argue, but she also never saw them being affectionate with each other.

She remembered times when she tried to tell her mother about feeling lonely at home and at school, but her mother never wanted to hear it.

Her mother especially didn't want to hear any complaints from Beth about anything going on at home or about Beth feeling angry towards her parents.  So, eventually, Beth learned to keep her feelings to herself, and she approached her romantic relationships in the same way.

Beth's therapist helped Beth to feel comfortable in therapy and encouraged Beth to tell her if she had any misgivings about the therapy or her therapist.  She told Beth that she wanted her to be able to talk about any problems in therapy rather than Beth just disappearing from therapy as she did in her prior therapies.

As Beth continued to attend her therapy sessions, she got more comfortable with her therapist.  At one point, when Beth felt misunderstood by her therapist, Beth broached this topic with trepidation.  Beth felt that her therapist didn't understand what she was trying to say, so she got up her courage to tell her therapist.

But when she began to talk about it, she felt such uncontrollable rage welling up inside her that she couldn't get the words out.  She felt unable to breathe, her heart was pounding, and it was as if the words were stuck in her throat.

Her therapist helped Beth to calm down enough so she could breathe and feel grounded.  Then, even though she still had difficulty, Beth was able to speak clearly and articulate her feelings.

Taking Risks in Your Therapy

With the help of her psychotherapist, she also made connections between her family history of feeling  invisible and undeserving and how this affected her adult relationships.

Over time, Beth gradually became more comfortable taking risks in her therapy. She was able to speak up when she felt misunderstood or something occurred that she didn't like.  Unlike her childhood experiences with her parents, Beth saw that her therapist was open to talking about any problems in therapy and there were no negative repercussions.

Similarly, when Beth felt there was a rupture with her therapist, after she talked about it with her therapist, she also saw that these ruptures could be repaired (see my article: Ruptures and Repairs in Psychotherapy).

This helped Beth to feel more confident in other areas in her life, including her relationship with Alex.  As a result, she was able to talk to him about the areas in their relationship where she had misgivings, which helped to clear the air and also helped them to make positive changes in their relationship.

Conclusion
When clients have problems expressing negative feelings about aspects of their therapy or about their psychotherapist, there is usually a long history of this problem that goes back to childhood.

For these clients, in the short term, it's easier to leave therapy abruptly than take the risk of expressing their feelings and dealing with their fear of rejection or some form of retaliation by the therapist.  This usually results in a string of aborted therapies over time which, in the long run, is usually damaging to the client.

By the same token, these same clients often tolerate inappropriate behavior in their relationships, similar to Beth in the fictional vignette above.  Their anger and resentment have the same effect--they either leave the relationship or the relationship slowly dies because the relationship becomes buried in these unexpressed negative feelings.

If clients, who are reticent about expressing negative feelings, can learn to express these types of feeling in therapy, they can use this skill in their relationships.

At first, it might feel uncomfortable but, over time, clients can become more comfortable expressing themselves, which leads a greater sense of authenticity as well as more authentic relationships.

Getting Help in Therapy
The unspoken and, possibly unconscious, fear that it's dangerous to express negative feelings is very hard to overcome on your own because it's usually so ingrained.

A skilled psychotherapist can help you to recognize and express uncomfortable feelings in an effective way.  She can help you to develop the necessary tools so that you don't feel overwhelmed by your own feelings (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

She can also help you express yourself in an effective way--without your minimizing your feelings or overreacting in ways that would be overwhelming to you or to others and make your communication ineffective.

Rather than struggling on your own, you could benefit from getting help in psychotherapy so that you will eventually feel more comfortable and confident in yourself.

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

I work with individual adults and couples.

I have helped many clients to take risk in therapy so that they can lead more fulfilling and authentic 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.

Growing Up Feeling Invisible and Emotionally Invalidated

Healthy emotional development is based on parental attunement and secure attachment. 

See my articles: 

How the Early Attachment Bond Affects Adult Relationships

What is Childhood Emotional Neglect?

When children grow up in a family where a chronic lack of attunement and their feelings are invalidated, they often grow up feeling invisible as children as well as feeling invisible later on as adults.

Growing Up Feeling Invisible and Emotionally Invalidated

By "invisible" I mean feeling left out, unlovable, excluded, unimportant, ignored, and passed over.

Many of these same children, who grew up feeling invisible and emotionally invalidated in their families continue to feel that way as adults.  They grow up with negative core beliefs about themselves, including:  "I'm not important," "I'm unlovable,""I'm powerless" and so on (see my article:  Overcoming the Emotional Pain of Feeling Unlovable).

Without realizing it, many people with these core beliefs perpetuate the problem by withdrawing emotionally if they are in a social situation.  

People around them will often think they are picking up social cues that they're not approachable, so they hesitate to connect with them.

Growing Up Feeling Invisible and Emotionally Invalidated

This often becomes a cycle where people with negative core beliefs eventually avoid social situations because they don't realize that people around them are reading into their facial expressions and overall demeanor that they want to be left alone.

To make matters even more complicated, people with negative core beliefs about themselves are often ambivalent about whether they want to be approached or not.

There is usually a part of them that craves social connection and another part that is fearful of it based on their experiences of feeling rejected from an early age.

See my articles:  

Untreated Emotional Trauma Can Have Serious Emotional Consequences

An Emotional Dilemma: Wanting and Dreading Love

This can leave these individuals feeling lonely, on the one hand, but afraid of making social connections on the other hand (see my article:  Overcoming Loneliness and Social Isolation).

When the loneliness is greater than the fear, people with negative core beliefs about themselves often seek help in therapy.  

It's a brave step for these individuals, who expect to be rejected and abandoned, to seek help in therapy.  If their own parents couldn't provide them with the emotional attunement and validation that they needed, it's hard to believe that a psychotherapist, who starts out as a stranger, would do it.

For many people in this situation, it's a last ditch effort to turn around a lonely, unhappy life, and if they've never been in therapy before, they're taking a leap of faith that they can make themselves emotionally vulnerable in therapy (see my article: Fear of Being Emotionally Vulnerable).

Let's take a look at a fictionalized scenario to illustrate some of these issues and to see how these problems can be overcome in therapy:

Pam

Pam came to therapy when she was in her early 30s.

She thought about seeking help in therapy since she was in her early 20s, but her fear of being disappointed and emotionally abandoned by a therapist kept her from seeking help.  

What precipitated her coming to therapy was that her last close friend, who wasn't married, had gotten engaged and she was preoccupied with her fiancé and her wedding plans to the extent that she spent less time with Pam.  This made Pam feel very lonely, and she realized that if she didn't overcome her fear of being rejected and abandoned that she would ensure that she would be alone for the rest of her life.  

The fear of being alone for the rest of her adult life was greater than her fear of being disappointed and emotionally abandoned in therapy, so she obtained a referral from her doctor and set an appointment.

Pam was intelligent and she had a lot of insight into her negative beliefs about herself and how these beliefs developed from a young age.

Even though she could see where her problems began and how they were affecting her as an adult, she had little faith that anything, including therapy, could make a difference for her.  But she didn't know what else to do so, at the recommendation of her doctor and her close friends, she kept the appointment.

She was very apprehensive while she sat in the therapist's reception area waiting for the initial consultation. She was tempted to get up and leave, but before she knew it, the therapist came in to the reception area to get her (see my article:  Starting Therapy: It's Not Unusual to Feel Anxious and Ambivalent).

The therapist started the session by asking Pam what brought her to this consultation and what she hoped to get out of therapy.  Pam knew the therapist was going to ask her this, but when she attempted to speak, she felt overcome with sadness and shame and choked back tears in order to speak.

Seeing that Pam was having a hard time, the therapist told Pam to take her time. She helped Pam to feel more comfortable by normalizing her experience and telling her that many people feel uncomfortable during the initial consultation, so Pam's reaction wasn't unusual.

Pam took a deep breath and spoke about how afraid she was that she would be alone in life.  She had three close friends, all of whom were either married or engaged and this precipitated an emotional crisis for Pam.  

Even though she was happy for her friends, she couldn't help comparing herself to them and feeling like she was coming up short because she had never been in a serious relationship before.  Worse still, her friends weren't as available to her as when they were all single.  All of this combined to make Pam feel anxious that she would be alone and lonely for the rest of her life.

Even though she was lonely and wanted very much to be in a relationship, she was also afraid of getting hurt and disappointed.  This made it difficult for her to put herself in social situations or to sign on to social dating sites to meet men.

She told the therapist that she was seeking help because she knew she couldn't overcome her ambivalence on her own and, even though it was difficult to believe that therapy could help, there was a part of her that wanted to give it a chance.

Pam sensed that the therapist was listening to her attentively and compassionately, which helped her to express her feelings, even though it was still difficult.

Towards the end of the session, the therapist explained how she worked in a contemporary way and that it was important to her that her clients feel emotionally safe before they began processing their innermost feelings.

She explained that, for some people, it takes time to build a strong therapeutic alliance with the therapist and that this was crucial to doing the work.

She also explained how the mind-body connection was important to the way that she worked (see my article:  (see my article: Mind-Body Oriented Psychotherapy: The Body Offers a Window Into the Unconscious Mind).

After the first session, Pam realized that she felt a little better.  She felt relieved to finally put her feelings into words and speak with someone who was compassionate and seemed to understand her.

See my articles:  

The Creation of the Holding Environment in Therapy

The Therapist's Empathic Attunement Can Be Emotionally Reparative For Clients

During the next session, Pam spoke about her family history, including growing up with parents who were preoccupied with their own lives and who often dismissed Pam's early childhood emotional needs as being "childish." 

There was no recognition that what Pam wanted and needed was what any child needed--to feel their loving attention and emotional attunement.  Instead, they invalidated her feelings to the point where Pam grew up questioning whether her feelings were valid or even real. She often felt invisible to her parents and to others and that her feelings weren't important.

As an only child, Pam spent much of her time at home alone while her parents were focused on work projects.  To cope with her loneliness, she often lost herself in imaginary games and stories where she had many brothers and sisters to play with and a fairy godmother who anticipated all of her needs.

This was a creative attempt for a small child, but it was no substitute for having nurturing parents.

Being shy and feeling badly about herself made it difficult for her to make friends.  Fortunately, there were outgoing students in her classes who saw Pam's kindness and intelligence and who went out of their way to befriend her.

When she was in college, she dated a few men, but these relationships never lasted more than a few months.  Most of the young men that she dated had similar traits to her parents, self involved and lacking in empathy, so these relationships were unsatisfying to Pam.

Three young women in college befriended Pam, and Pam remained friends with them after they graduated.  Over time, Pam realized how much these friends cared about her and how much she cared about them.  She valued these friendships and they were like the sisters that she never had.

But, over time, as each woman got into a serious relationship, they had less time for Pam.  She still saw them and spoke to them by phone, but it wasn't the same.  As mentioned earlier, after the last remaining single friend got engaged, Pam feared that she would be alone.

Pam's therapist validated her feelings, which was a relief to Pam.  But there was also a part of her that felt she was being "childish" and making too big a deal out of these things.

When she told the therapist that this is how part of her felt, her therapist recognized that this part of Pam was speaking to Pam in Pam's mother's voice, the voice that Pam had internalized from childhood (see my articles: Understanding the Different Aspects of Yourself That Make You Who You Are and Overcoming the Internal Critic).

The therapist spoke to Pam about how traumatic it was for a young child to have to fend for herself emotionally and the impact that this had on Pam's adult life.

She spoke to Pam about doing EMDR therapy to process the trauma and helping Pam to develop the necessary coping skills before processing began (see my articles:  How EMDR Therapy Works: EMDR and the Brain.

Pam was feeling increasingly more comfortable with her therapist and she felt ready to work on coping skills, which is called resourcing in EMDR (see my article:  Coping Strategies in Mind-Body Oriented Psychotherapy).

But there was still a part of her that was ambivalent and fearful about trusting the therapist and allowing herself to be emotionally vulnerable.

When she spoke to her therapist about this, her therapist helped Pam to understand that even though this part might seem "negative" to Pam, this part was actually attempting to be protective.

They mutually decided that it was important to work with this part first to address the fears and help this part to feel comfortable.  

Pam's therapist explained that the preparation work would be gradual to help Pam to develop the skills she needed to work on the trauma.  Her therapist wanted Pam to have these necessary skills so that she would have the wherewithal to deal with whatever came up when they processed the trauma of growing up with parents who were unable to give Pam what she needed emotionally.

Pam didn't mind that the preparation work was gradual because, along the way, she was seeing progress in her ability to talk about feelings that she had buried as a child.

By the time Pam was ready to do EMDR, she focused on an early memory of feeling alone and lonely as a young child (see my articles: Looking at Your Childhood Trauma History From an Adult Perspective).

As Pam processed this memory with EMDR, initially, she couldn't believe that she could ever feel better about it.  Pam and her therapist focused on same memory for a few months because there were so many related experiences.  

As she continued to do EMDR therapy, Pam noticed that she felt less upset about the memory and, in general, she was feeling better about herself.

Working Through Emotional Trauma With EMDR Therapy

The work was not easy or quick because the feeling of being invisible and unlovable as a child was so pervasive throughout her childhood.  But, gradually, the trauma was processed and worked through (see my articles:Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Gradually, Pam felt more confident in herself and she began socializing more.  Unlike how she felt for most of her life, she now felt that she not only wanted to be in a relationship but she deserved to be with someone who loved her and treated her well.

Eventually, Pam met someone whom she loved and who loved her very much.

Conclusion

Healthy emotional development is predicated on developing a secure attachment with emotionally attuned parents.

When a child grows up with parents who are dismissive of their feelings and when there are no other mitigating factors (e.g., a loving grandparent, aunt or uncle), the child's emotional needs often become unbearable for her to contain.  

This often results in a child burying their feelings because it becomes too hurtful to continue to have unmet emotional needs.

Children who have unmet emotional needs usually grow up to be adults who feel unworthy of love.  This makes it difficult for them to form relationships with others.

Under these circumstances, adults often feel lonely and want social connections, but they are also very afraid of being rejected.  This ambivalence gets played out in an internal tug of war within the adult of wanting and yet dreading love.

As in the fictionalized scenario about Pam, these individuals are often afraid to come to therapy because they fear making themselves emotionally vulnerable in therapy.  This is understandable because if your own parents couldn't be attuned to your needs, why would you think that a stranger (the therapist) would be?

Often, when the fear of being alone for the rest of their lives is greater than the fear of trusting a therapist, these individuals come to therapy, albeit with much trepidation.

A skilled therapist can help these clients to develop the necessary therapeutic alliance so they can begin preparing to process the early trauma.

The preparation stage in any trauma therapy is crucial.  To jump into processing the trauma before the client has developed the necessary skills to do the work can be retraumatizing.

Talk therapy is often of limited help when it comes to processing these types of early trauma.  Clients will become knowledgeable about the source of their trauma, but often nothing changes.

Experiential therapy, like EMDR therapy, is more effective in helping clients to overcome psychological trauma, whether it is a one-time trauma or pervasive developmental trauma.

Getting Help in Therapy

People with pervasive childhood trauma take a leap of faith when they come to therapy.

Often, they don't know what to expect or if they will feel better or worse by coming to therapy.

It's a good idea to consider the first session to be a consultation to talk about your problem in a broad way and to ask the therapist questions.

You might feel that you want to rush into processing your traumatic experiences, but a skilled therapist will first help you to develop the necessary skills to do the work so that the work isn't retraumatizing.

Rather than suffering on your own, seek help from an experienced trauma therapist who can help you to work through your unresolved problems so you can live a happier, more fulfilling life (see my articles:  The Benefits of Therapy and How to Choose a Psychotherapist).

About Me

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

One of my specialties is helping adult clients to overcome traumatic experiences that are having a negative impact on their 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.