What is a Strengths-Based Perspective in Psychotherapy?

In recent years, many psychotherapists have become increasingly open to adopting a strengths-based perspective in psychotherapy.  This strengths-based perspective looks at not only clients' problems but also emphasizes clients' strengths and positive qualities.  

Social work has had an influence on this trend because it has a long tradition of recognizing clients' positive  aspects.  Over the years, as psychotherapists with social work background have come to dominate the psychotherapy field in New York City, psychotherapy has begun to change to reflect this positive perspective.

I believe there are many advantages to having a strengths-based perspective in psychotherapy--not least of which is that psychotherapists can help clients to develop increased self confidence as they learn to appreciate the strengths they already have.  As it is, many clients come to therapy feeling badly about themselves. Often, they can't see their many positive qualities. They dwell mostly on the negative.

A Strengths-Based Perspective in Therapy

Therapists who have a strengths-based perspective can help clients to appreciate what's right about them and not just what's wrong.

Psychotherapy's early history was one of pathologizing clients.  In recent years,  mind-body oriented psychotherapy, which includes EMDR, clinical hypnosis, and Somatic Experiencing, has emphasized helping clients to develop emotional resources as compared to only looking for pathology.  One of the best ways to help clients build emotional resources is to help them enhance the strengths they already have and might not even realize they have.  

Recognizing Strengths and Accomplishments
For instance, a client, who begins psychotherapy due to a history of trauma, might have significant accomplishments, despite longstanding trauma.  S/he might have graduated college, raised a family, and maintained gainful employment.  

Many clients don't appreciate their own resilience and ability to persevere despite adverse circumstances. They often minimize these strengths by telling themselves and others, "It wasn't such a big deal.  I just did what I had to do."  But a psychotherapist with a strengths-based perspective has the objectivity and the mindset to help a client with these strengths to appreciate and build upon these strengths.

A strengths-based perspective in psychotherapy is not a "feel good"or "Pollyanna" approach.  Therapists still need to help clients to overcome their problems and to look at how they might even be contributing to their problems.  A strengths-based perspective isn't a quick fix.  Rather, it's an even-handed, holistic approach that, I believe, in the long run, is much more beneficial to psychotherapy clients.

If you have been considering attending psychotherapy, but you've been hesitant because you fear being pathologized in therapy, I recommend that you find a psychotherapist who has a strengths-based perspective.  

Before you embark on the self exploration involved in psychotherapy, I recommend that you ask questions. Most experienced therapists expect potential clients to ask them about their psychotherapy approach in an initial consultation.  Many therapists also have websites that provide information about their particular philosophy to psychotherapy.  You have a right to be an informed consumer and to trust your instincts.

See my articles: 

A Strengths-Based Perspective in Psychotherapy: Looking at the Whole Person

Focusing on Your Personal Strengths to Cope With Stressful Times.

About Me

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

I work with individual adults and couples.  

I have helped many clients overcome obstacles so that they could lead more fulfilling lives.

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

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

Focusing on Your Personal Strengths to Cope With Stressful Times

Most people tend to focus on what they consider their weaknesses and forget to consider their personal strengths.  When they go through stressful times, focusing on where they feel deficient makes it much more stressful for them.  

In this article, I'm proposing that focusing on your personal strengths will help you more during difficult times.  For this article, I'm using the terms "personal strengths" and "internal resources" interchangeably (seems article: Discovering Your Personal Strengths and Developing Internal Resources and Coping Skills).

Focusing on Your Personal Strength to Cope With Stress

Identifying Your Personal Strengths
Everyone has personal strengths--whether they focus on them or not.

Your personal strengths are what's going to help you to cope with stress--not the areas where you feel deficient.  So, it's important to harness those inner resources to reduce your stress and resolve your problems.

Unfortunately, so many people are unable to identify their personal strengths.  They're so focused on being critical of themselves that they forget all the wonderful qualities that they possess that have gotten them through rough times in the past.

Rather than focusing on their internal resources, they worry and project their fears into the future.  So, not only are they worried about what's happening in the current situation, but they're also projecting and predicting problems in the future--problems that might never come.

If you tend to project negative outcomes, think about all the times when you did this in the past and how often your projections came true.  If you're like most people, your negative projections occurred only a fraction of the time.  That means that you spent a lot of time and effort worrying for no reason.

Should You Completely Ignore Your Weaknesses?
Does this mean that you should completely ignore about your weaknesses?  The short answer is:  No, especially if they're having an adverse effect on your life.

For instance, if your manager tells you that you're doing a great job with most of your responsibilities, but you really need to improve your presentation skills, you're not going to ignore this because it would be detrimental to your job.  You're going to find out what you can do to improve your presentation skills and then do it.

Or, if your spouse tells you that you tend to zone out with your phone when she talks and she would appreciate your being more present, are you going to ignore your wife's request?  No, you're going to make an effort to put down your phone more often so you can be fully present when you talk to each other.

So, I'm not proposing that you only focus exclusively on your strengths all the time without trying to make improvements in the areas where you could stand to improve.  What I'm saying is that many people only focus on their weaknesses, and they could use some balance in their approach.

How to Focus on Your Strengths to Cope With Stressful Times

Think About How You Got Through Difficult Times in the Past
The easiest way to focus on your strengths when you're under stress is to think about past memories  when you succeeded in getting through hard times.

Which inner resources allowed you to get through a challenging time?

Write About the Personal Strengths That Helped You in the Past
If you're struggling to identify the personal strengths that got you through, take a few minutes to write about it.  Writing helps to clarify your thoughts and concretize your ideas.  Don't spend time being critical of your writing.  This exercise is only for you--no one else needs to see it.

Write About How These Same Inner Resources Can Help You Now
Very often, the personal strengths that got you through in the past are the same strengths that can help you now.  It's a matter of remembering and using them again.

Speak to Your Loved Ones
It's often the case that loved ones can see and remember the personal strengths that helped you in the past long after you've forgotten about them.  So, if you have trusted family and friends who saw you through difficult times in the past, ask them what they observed about you.  You might be surprised to hear what they have to say.  Write it down before you forget.

What If You're Too Stressed Out to Focus on Your Personal Strengths?
There are times when people are under so much stress that their feelings and thinking are clouded by the stress, and it's difficult to get beyond worrying and expecting the worst.

When you're that worried, you need to consider how the stress will affect your health. Up to a certain point, stress can motivate you and give you the extra edge you need to get going.  But when you're flooded with stress, it can damage your health with no beneficial effects (see my article: Tips on How to Stop Worrying).

At that point, you could benefit from getting help from a licensed mental health professional, who can   help you to remember your personal strengths and help you to develop new internal resources.

Getting Help in Therapy
Everyone needs help at some point.

A skilled psychotherapist knows how to help clients to access the best part of themselves to get through tough times and also help them to cultivate new internal resources (see my article: A Strengths-Based Perspective in Psychotherapy).

If you're overwhelmed by stress, rather than struggling on your own, seek help from a licensed psychotherapist, who has helped clients to call on their personal strengths and get through stressful times.

By working with an experienced psychotherapist, you can get through a tough time and come out on the other end feeling confident in yourself and free from the worries that were so debilitating.  You'll can also feel more confident about handling new challenges.

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

I have helped many clients to focus on their personal strengths as well as develop new internal resources to cope with difficult times or unresolved trauma.

When I begin working with a new client in my psychotherapy practice in New York City, I begin by focusing on their personal strengths or internal resources, especially if the client has come in to deal with a major stressor or unresolved trauma.  I also help clients to develop new internal resources in addition to the ones they already possess.

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

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

How to Do the Body Scan Meditation to Reduce Stress

One of the tools that I teach clients in my psychotherapy private practice in New York City is doing a body scan meditation (see my article: Developing Coping Strategies in Therapy).  

Breathing and doing a body scan meditation helps to reduce tension in the body and activate the parasympathetic nervous system to help you to relax (see my article: Coping and Staying Calm During a Crisis).

How to Do a Body Scan Meditation to Reduce Stress

There are many ways to do a body scan meditation.  

The Body Scan Meditation

Here's what I teach my clients to do:

• Start By Taking a Few Deep Breaths:  
• You can close your eyes if you feel comfortable doing this or you can find a spot on the floor to look at so you can begin to narrow your focus to your body.  

• When you're breathing in, make sure that your abdominal muscles expand.  You can think of inhaling as taking in healing cleansing breaths.  

• When you breathe out, feel your abdominal muscles contract a little so you're letting out all the air, and think of letting go of all the stress from the day.

• Continue to do this until you feel yourself starting to become calmer.

• Focus on the Crown of Your Head: 
• After you have taken a few deep breaths, focus on the crown of your head as a starting point to begin scanning your body.

• Move Your Attention Down From the Crown Slowly to Your Forehead: 
• From the crown of your head, move your attention down to your forehead and sense if you feel tension in your forehead.  

• We tend to hold a lot of tension in the muscles of our forehead, especially when we're stressed or anxious.  

• If you sense the muscles in your forehead are tense, imagine that you could send your breath to your forehead to allow those muscles to relax. 

• Continue to do that until you feel those muscles relax.

• Move Your Attention to Your Eyes: 
• After the muscles in your forehead feel relaxed, move your attention to your eyes. We tend to hold a lot of tension in the muscles of the eyes without even realizing it because while we're awake, we're using our eyes all the time.  

• When you're under stress or looking at the computer, your eyes tend to be in a fixed position that can cause eyestrain and fatigue.  

• Even though your eyes are closed, you can sense if you're holding tension in your eye muscles. 

• Allow your eyes to relax and let them "drop" down in the direction of your lower eyelid.  

• Allow the muscles around your eyes to relax.  If you're having a problem getting your eye muscles to relax, imagine that you can send your breath to your eyes so they can relax.

• Move Your Attention to Your Nose and Checks: 
• After your eyes relax, sense into your nose and check muscles, and follow the same steps as you've used above, including imagining using your breath to get those muscles to relax.

• Move Your Attention to the Temples on the Sides of Your Head:
• Become aware of any tension that you're holding onto in your temples.

• Imagine sending your breath to your temples to relax them.

• Move Your Attention to Your Mouth: 
• Follow the same procedure as above. Notice any tension around the muscles in your mouth and allow those muscles to relax. Use your imagination to send your breath to get your mouth muscles to relax.

• Move Your Attention to Your Tongue: 
• The tongue holds a lot of tension.  Allow your tongue to relax at the bottom of your mouth.

• Move Your Attention to Your Jaw: 
• Allow your jaw to relax and follow the same procedures as above with imagining sending your breath to your jaw muscles to allow them to relax.

• Move Your Attention to Your Whole Face: 
• See if there's any remaining tension in general left in your facial muscles.  

• To help reduce that tension, scrunch up your face as tight as you can for about 20 seconds and then let go and feel the tension reduce.

• Continue Moving Down Your Body: 
• Your throat, chest, abdominal muscles and use the same techniques as above.

• Move Your Attention to the Back of Your Neck and Shoulders: 
• Imagine that any tension in your neck and shoulders just slides off your shoulders, down your arms and out through your fingers.

• Move Your Attention to Your Legs: 
• Imagine that any tension in your legs just slides down your legs and out through your toes.

• Move Your Attention to Your Shoulder Blades: 
• Focus on your shoulder blades and notice if there is tension there. Imagine that there's a curtain rod across your back that opens up, and as it opens up, feel your shoulder blades opening up and relaxing.

• Move Your Attention to Your Spine: 
• Notice if you're holding attention in your spine including the upper, middle and lower level.

• Imagine that your spine can float in the air and relax.

• Move Your Attention to Your Hips:
• We tend to hold a lot of tension and emotion in the hips.  Send your breath to your hips and imagine that your breath can dissolve that tension. 

• Sense into Your Body and See If There's Any Remaining Tension: 
• Even after you go through scanning the body parts mentioned above, you might still be holding onto tension somewhere in your body.  

• Just sense into your body from top to bottom slowly and pay particular attention to any areas where you still feel tension. 

• Use the same techniques used above, including imagining sending your breath to these areas to help them relax.

• Bring Yourself Back to the Here and Now: 
• After you've gone through all the areas in your body, if your eyes were closed, open them.  Whether your eyes were closed or not, orient yourself to the room where you are (look around) and feel your feet on the ground so you feel grounded.

• If you still don't feel like you're back, get up, walk around, drink a glass of water or do whatever helps you to feel yourself back in the present moment.

You Can Do the Body Scan Meditation to Sense and Reduce Stress Whenever You Need to Do It

You can use the body scan and breathing exercise whenever you want and as often as you need it to reduce your stress.

Getting Help in Therapy
If you continue to feel overwhelmed even after your do the body scan meditation and breathing exercise, you could benefit from working with a licensed psychotherapist.

An experienced therapist can help you to work through the stress and anxiety that you're unable to overcome on your own.

Rather than suffering on your own, get help from a mental health professional.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples) Somatic Experiencing and Sex Therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

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

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

EMDR is a Transformative Therapy for Trauma, But There Are a Few Exceptions

As a trauma therapist in private practice in New York City for over 20 years, I have been using EMDR therapy regularly since 2005 with excellent results.  I have found EMDR therapy to be a powerful and transformative therapy to help clients to overcome traumatic experiences.  I've also written several articles about EMDR therapy.  See my articles:

• What is EMDR Therapy?
• How EMDR Therapy Works: EMDR and the Brain
• Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs

Over the last 13 years, I have seen many clients for EMDR therapy for developmental and shock trauma.

EMDR is a Transformative Therapy For Trauma, But There Are a Few Exceptions

Clinically Assessing Clients For EMDR Therapy
As part of the initial consultation, I talk to clients about the types of trauma experiences where EMDR is effective which, fortunately, are most.  However, there are some exceptions when EMDR therapy would be contraindicated or where clients need more preparation to do EMDR, which is the focus of this article.

If a client comes to me for an initial consultation for EMDR therapy and reveals one of these contraindicated exceptions, I will discuss this with the client and will usually, if possible, provide him or her with another alternative recommendations.  If I don't do the particular alternative therapy that is needed, I usually offer to help this person to find another referral.

Although the exceptions to doing EMDR aren't many, when a client comes for a consultation and is told that EMDR therapy is contraindicated, this can be disappointing, especially since s/he may have heard about EMDR from a medical doctor, friends and the efficacy of EMDR to help resolve trauma.

But it's important for a psychotherapist who specializes in helping clients to resolve trauma to be a responsible and ethical therapist, even if the client will be disappointed and annoyed.

It's better to be honest with the client rather than go along with the client's wishes and place the client in harm's way or waste their time and money.

When is EMDR Therapy Contraindicated and When Is Additional Preparation Needed to Do EMDR?
For all EMDR therapy, after the initial consultation and a session or more to get family history, there is a preparation stage to help the client to develop the necessary internal resources and coping strategies to prepare to do EMDR.  However, there are times when EMDR is either contraindicated or additional preparation, beyond the usual, is needed.

The following is a list of the most common issues:

• Clients Who Are Psychiatrically Unstable:  Clients, who are psychiatrically unstable, need to be stabilized first before doing EMDR therapy or almost any other type of outpatient psychotherapy.  Clients who are actively suicidal, homicidal, too emotionally fragile, or who have some other serious psychiatric condition that is causing significant emotional impairment, need a period of stabilization, and after stabilization, they will need to develop the internal resources before EMDR can be considered.  Once clients are stabilized and they have the inner resources to do trauma work (of any kind), the psychotherapist can reevaluate clients to see if EMDR therapy would be the therapy of choice.

• Clients Who Are in An Unsafe or Unstable Home Environment:  Clients, who are in an unsafe or unstable home environment where they are being physically abused or they are the ones who are abusing a spouse or family member, are not ready to do trauma therapy.  They might need other types of help first, including but limited to:  supportive psychotherapy, domestic violence treatment, legal advocacy from an domestic violence agency, services from a child welfare agency, batterers' program and so on.  It would be irresponsible for a psychotherapist who does trauma therapy to ignore the fact that a client is in an unsafe home environment or is creating an unsafe environment.

• Clients Who Are Actively Abusing Alcohol, Drugs or Other Addictive or Self Destructive Behavior: Clients who are actively abusing alcohol, drugs or engaging in other addictive or self destructive behavior are often not candidates for EMDR therapy until they have had a period of sobriety.  When clients are engaging in self destructive behavior as a maladaptive way of coping, chances are good that, if they began to delve into traumatic memories, they might become more symptomatic and their addictive or self destructive behavior would become worse.  This is a situation where the EMDR psychotherapist would have to evaluate on a case-by-case basis.  There are some clients in this situation who could benefit from the EMDR protocol that is specifically designed for addictive behavior (if the psychotherapist is trained in this type of EMDR).  However, even in those circumstances, the client would have to already have the necessary inner resources and there might be a significant period of preparation work before traumatic memories can be processed with EMDR.

• Clients Who Are Unable to Engage in Dual Awareness in the Psychotherapy Session:  In order for trauma therapy to be safe and effective, clients must be able to maintain dual awareness in the therapy session.  In other words, they must be able to focus on the traumatic memory they are working on with their psychotherapist and also be aware of their here-and-now circumstances--that they are in a psychotherapist's office and not back in the traumatic situation.  So, for instance, if a client begins processing a traumatic memory with an EMDR therapist and the client plunges into the memory, she loses all consciousness of where she is, and she thinks she is actually back in that situation--rather than that she is with a psychotherapist, EMDR and other forms of trauma therapy are contraindicated.  There might be more preparatory work that needs to be done first to help the client to maintain dual awareness or, if that doesn't work, the client might not be ready for EMDR.  This might include clients who have DID (Dissociative Identity Disorder) where they become highly dissociative or switch into alters or clients who get thrown into flashbacks and have no awareness of where they are.

• Clients With Certain Eye Problems:  Clients who have certain eye problems might need clearance from their doctors in order to do EMDR.  As an alternative, the psychotherapist can use other forms of bilateral stimulation (BLS) like tappers, tapping, listening to music that alternates from one ear to the other.

• Clients With Certain Head Injuries:  Clients who have certain head injuries might need to get medical clearance from their doctors before doing EMDR.

• Clients Who Are Unable or Unwilling to Adhere to EMDR Therapy Recommendations and the Therapy Frame:  EMDR therapy is a weekly therapy.  There if often a lot that comes up in session and between sessions so if clients are unwilling or unable to come to weekly sessions, they should seek another type of therapy.  In general, consistency in therapy is necessary for any form of psychotherapy to be effective.

• Clients Who are Looking For a "Quick Fix":  Although EMDR therapy tends to be faster and more effective than regular talk therapy, it's not a "quick fix." Some clients come for an initial EMDR consultation with misconceptions about EMDR.  There are a few circumstances where EMDR therapy can be effective in 10-12 sessions.  These circumstances are rare.  They usually involve shock trauma where there were no other traumatic events prior to the shock trauma.  Even when clients come to EMDR therapy thinking that they have no other underlying trauma, in the course of doing EMDR therapy other underlying traumatic experiences might arise that are related to the current presenting problem.   In those cases, it is best to work on the underlying trauma or the client could get emotionally triggered again under similar circumstances (see my article: Beyond the Band Aid Approach to Overcoming Psychological Problems).

• Clients Who Are Engaged in Lawsuits Related to Their Trauma Should Consult With Their Lawyer First:  Clients who have a pending lawsuit are often advised by their attorneys not to do EMDR therapy before their case is settled.  There can be many reasons for this, but one of the main reasons is that if a client goes to trial after the trauma has been resolved, it might be difficult to convince a judge and/or jury that s/he was traumatized because they will not be exhibiting any traumatic symptoms.  This is more of a legal issue than a clinical issue.  However, many clients, who have lawsuits are unaware of this.  So, it's advisable to consult with your attorney first.

• Other Clients Who Need a Significant Preparatory Phase in Therapy Before Processing Traumatic Memories:  Aside from the other conditions already discussed above about clients who would need significant preparatory work, there are other conditions that might require preparatory work and reassessment.  One example of this might be clients who are unable to identify the emotions that they are experiencing.  This is important because in EMDR clients are asked to identify the emotions that they are experiencing now with regard to their traumatic memories.  If clients are so cut off from their emotions, as part of their preparation for doing EMDR, they will need help to identify their emotions (see my article: Experiential Psychotherapy Can Facilitate Emotional Development and Developing Internal Resources and Coping Strategies).  Another example might be clients who have personality disorder traits and who are emotionally unstable.  

Conclusion
EMDR is an evidence-based therapy that can help clients to overcome traumatic experiences.  This includes longstanding trauma that has not responded to other forms of psychotherapy.

There are a few circumstances where EMDR therapy is either contraindicated or where preparatory work, beyond the usual preparation, must be done first in order to determine if clients can do EMDR. This is part of the psychotherapist's clinical and ethical responsibility.

An EMDR therapist continues to assess the client during the initial consultation and throughout EMDR processing for situations that might arise in the therapy where EMDR might need to be combined with other forms of therapy to be effective (e.g., Somatic Experiencing or clinical hypnosis) as part of an integrative psychotherapy.

Although I have included the most common examples of where EMDR therapy is either contraindicated or additional preparation is needed first, there might be a few other circumstances.

Getting Help in Therapy
If you have been struggling with unresolved problems on your own, you could benefit from seeking help from a licensed mental health professional (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Working through your traumatic problems could free you from history and allow you to live a more fulfilling life.

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

I work with individual adults and couples.

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.

Understanding the Healthy Needs Underlying an Addiction

In prior articles, I've addressed issues related to addiction and recovery.  See my articles:

• People Who Abuse Alcohol Often Don't Get the Help They Need
• Sexual Addiction: Is a Compulsion For Looking at Porn Ruining Your Relationship?
• Sexually Compulsive Behavior as a Split Off Part of Yourself
• Overcoming Grief Gambling
• Learn to Stop Overspending as a Way to Deal With Uncomfortable Feelings   
• Early Recovery: You've Stopped Drinking. Now What?
• Early Recovery: Overcoming Feelings of Loss and Emptiness
• Early Recovery: Focusing on the "People" Part of People, Places and Things
• Early Recovery: What If 12 Step Meetings Are Too Overwhelming For You?
• Boredom as a Relapse Trigger
• Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations

In this article, I'm focusing on understanding the healthy needs underlying addictive behavior.

Understanding the Healthy Needs Underlying an Addiction

Why Is It Important to Understand the Healthy Needs Underlying an Addiction?

People who are involved in addictive behavior, whether it's drinking, drugging, gambling, sexual addiction, overspending or any other addiction, tend to feel shame and guilt about their behavior.  This is often exacerbated by well-intentioned loved ones who don't understand and tell them, "Why don't you just stop?" 

As a result of the guilt and shame they feel, many people who engage in addictive behavior don't get the help that they need, which often leads to an eventual downward spiral.  When they're not feeling guilty and ashamed, they might be in denial about the extent of their problem, colluding with their well-intentioned loved ones by telling themselves, "I can just stop whenever I want to."

In addition to shame and guilt often creating obstacles to getting help, these feelings frequently get in the way of any self exploration about the underlying issues related to the addictive behavior. Or, the person who is abusing substances attributes only negative reasons for the abuse, "I'm a bad person" or "I'm unworthy" or "I'm unlovable" and so on.

Understanding the healthy needs underlying the addiction enables the person engaged in addictive behavior to have more self compassion and begin to explore other ways that s/he could satisfy these needs.  Secondarily, it can also help loved ones to have more compassion for the person struggling with an addiction.

Fictional Clinical Vignette: Understanding the Healthy Needs Underlying an Addiction

The following fictional clinical vignette illustrates how understanding and separating the healthy need from the addictive behavior helps the client:

Jack

Originally, Jack started psychotherapy to deal with longstanding anxiety and feelings of low self worth (see my article: Overcoming Feelings of Inadequacy).

Jack told his psychotherapist that he couldn't remember a time, even as a child, when he didn't feel anxious.  As the oldest of four children, Jack was his mother's confidante even when he was five or six years old (see my article: Children's Roles in Dysfunctional Families).

His mother tended to be anxious mostly about the family's financial well-being.  She worried that Jack's father's gambling problem would be the financial ruin of the family, and she tended to lean on Jack for emotional support, which was developmentally beyond what he could do.  All of this was emotionally overwhelming for him.

Jack attributed much of his longstanding anxiety to worrying about his parents and siblings and feeling inadequate for being unable to be the kind of emotional support that is mother needed.

In hindsight, as an adult, Jack understood that a young child wouldn't be able to take on such an emotional burden.  But this was an intellectual understanding.  On an emotional level, he continued to feel that he should have, somehow, risen to meet his mother's needs.  So, there was a split between what he knew intellectually and what he felt emotionally, which he acknowledged.

Jack had been in therapy before and he achieved insight into his problems, but it didn't change how he felt, and it didn't change his struggle with anxiety.

That's why when he decided to attend psychotherapy again, he chose experiential psychotherapy, as opposed to regular talk therapy, with the hope of having a different experienced in therapy and a possible resolution to his struggling with anxiety.

As a start, his experiential psychotherapist worked with Jack to help him develop better coping skills and internal resources to deal with his anxiety, which was helpful.  

Then, they talked about how to help him with his unresolved childhood trauma, which resulted in Jack's posttraumatic stress disorder (PTSD).  His psychotherapist provided Jack with psychoeducation about the various therapeutic possibilities in experiential therapy, including Somatic Experiencing, EMDR therapy, and clinical hypnosis.  

This was a few months into the therapy, and it was around this time that Jack admitted to his therapist that he had been smoking marijuana for over 20 years--since he was 13 years old.

He felt so ashamed and guilty about smoking marijuana that, originally, during the initial consultation when his therapist asked Jack about addictive behavior, Jack denied it.  But now that he had more of a rapport with his therapist, he wanted to be honest with her (see my article: Why It's Important to Be Honest With Your Psychotherapist). 

He was also understandable concerned about the affect of doing trauma work on his addiction and vs. versa.  

His psychotherapist told Jack that she appreciated how difficult it was for him to admit to her that he abused marijuana and that he wasn't forthcoming about it initially.  She also told him that, in addition to understanding the harmful effects of chronic marijuana use, it was important to understand the healthy underlying needs related to Jack's addiction.

Jack told his psychotherapist that during his annual medical check up, he had recently spoken to his doctor about his marijuana use, which consisted of smoking 2-3 blunts per day several times a week, and his doctor told him that the marijuana was probably contributing to Jack's anxiety.

His doctor explained that chronic marijuana use increased the risk of anxiety and depression because it appeared to inhibit the chemical dopamine in the brain.  He also provided Jack with information about the research that substantiated these facts.  In addition, his doctor recommended that Jack stop using marijuana and tell his psychotherapist about his use.

Jack said that, until he tried to stop on his own, he always believed that he could stop smoking marijuana whenever he wanted to stop.  That's what he told himself and his wife,who wanted him to stop.  But when he attempted to stop on his own, he discovered that, although he didn't have a physical addiction to the drug, he realized that he had a psychological dependency, and he couldn't go more than a day without smoking marijuana.

Initially, Jack was focused on the negative consequences to his addiction:  He feared making himself more anxious and developing depressive symptoms; he noticed some problems with his memory,which he and his doctor attributed to long-term marijuana use; he was tired of "being in a fog"most of the time; he was concerned that his wife might get fed up with his addiction and leave him; and he was also concerned about how much money he was spending on marijuana, which he would rather spend on other things that he and his wife wanted to do--like saving for a down payment on a house.

In addition, Jack was aware that he and his therapist wouldn't be able to work on his unresolved trauma until he was sober.  His therapist explained that until he had a period of sobriety, it wouldn't be wise to start trauma therapy because when disturbing issues came up in therapy, Jack might feel an increased need to go home and smoke marijuana.

Also, even if Jack gave up smoking marijuana, his therapist explained, he might take up another form of addiction, like drinking excessively or gambling or some other form of addictive behavior (see my article: Understanding Cross Addiction: Substituting One Addiction For Another).

His psychotherapist acknowledged that these were all very important factors for Jack to consider.  In addition, she also asked Jack to consider what he got out of smoking marijuana.  Jack said he had never thought about this before. But, as they continued to explore what he got out of smoking marijuana, Jack realized that it used to help him to feel more comfortable in social situations--although, lately, it wasn't helping him as much because the chronic use made him anxious.

Jack and his psychotherapist continued to explore this healthy need underlying his drug abuse.  At first, it was difficult for Jack to separate the healthy need from the unhealthy consequences of his using the drug.  Whenever they began to explore how important it was for Jack to feel connected to his friends and what he got out of these friendships, he would revert back to shaming himself about his addiction.

It took a while before Jack could set aside his guilt and shame to separate out the healthy need from the unhealthy use.  His psychotherapist would continuously bring Jack back to separating out the healthy need--what Jack was attempting to accomplish by using marijuana.

Eventually, when he was able to put aside his guilt and shame, he began to appreciate the healthy need while, at the same time, acknowledging the unhealthy aspects of abusing the drug.

As he developed a deeper and more self compassionate understanding, he became less judgmental about his use and more open to discovering other ways to become feel more comfortable socially.  In order for Jack to get to this point, it was necessary for him to work with his therapist to reduce his shame and guilt.

Once Jack had a sustained period of abstinence and he didn't engage in any other addictive behavior, he and his psychotherapist began to work on his unresolved childhood trauma.

Conclusion
People who engage in addictive behavior are often, initially, in denial about their problem.  Once they are no longer in denial, it's not unusual for them to experience guilt and shame as they deal with the consequences of their abuse to themselves and their family members.

If they remain stuck in guilt and shame without appreciating the healthy underlying needs that contribute to the addiction, it's usually harder for them to stop the addictive behavior because they get caught in a cycle of shame and abuse.

With the help of a skilled psychotherapist, they can begin to separate out the healthy need from the abuse.  An appreciation for the healthy need helps the client to be more self compassionate with less guilt and shame.  It also usually provides an opening for healthier behavior to take care of those needs.

Getting Help in Therapy
If you're struggling with unhealthy addictive behavior, you could benefit from getting help in psychotherapy (see my article: The Benefits of Psychotherapy).

A psychotherapist who has experience with working with addiction and helping clients to understanding their healthy needs can help you to overcome addictive behavior (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, seek help from a skilled mental health professional.

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.

To find out more from 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.

Rediscovering in Psychotherapy What You Thought Didn't Exist

Psychotherapy often provides clients with an opportunity to rediscover in therapy what they thought didn't exist in their lives.  This is especially true in experiential therapy, like Somatic Experiencing, EMDR (Eye Movement Desensitization and Processing) therapy, and clinical hypnosis (see my articles: How EMDR Therapy Works: EMDR and the Brain, What is Adjunctive EMDR Therapy? and Overcoming Trauma With Somatic Experiencing).

Rediscovering in Psychotherapy What You Thought Didn't Exist

Clients who come to therapy to work on unresolved traumatic experiences are, understandably, focused on the negative experiences they had, especially if those traumatic experiences go back to childhood.

But in experiential psychotherapy, they often rediscover that there were also positive, life affirming experiences that they have forgotten because of the preponderance of traumatic experiences that overshadowed everything else.

Rediscovering these positive experiences doesn't negate the traumatic experiences that need to be resolved in therapy.  But it gives clients a broader perspective of their lives.  It can also help them to see that they have internal resources that they didn't know they had.

As a psychotherapist, I have been delighted to witness this experience many times with clients in therapy.  Often in the mist of processing a traumatic memory, a client will suddenly remember that there was someone who did something that helped him or her at that time--whether it was a teacher, mentor, a relative or a friend. Or they will remember a transformative experience that helped them while they were enduring the trauma.  When a client has forgotten these positive memories, the rediscovery of them in therapy can be an epiphany.

These rediscovered positive memories aren't necessarily dramatic experiences, but their rediscovery often leads to advances in the processing of the traumatic memories.

Fictional Clinical Vignette

The following fictional clinical vignette illustrates the healing effect of rediscovering positive memories within the context of processing traumatic memories:

Sandy

After a particularly difficult family visit, Sandy began psychotherapy to deal with longstanding unresolved trauma related to her childhood experiences in her family and the emotional triggers that were set off by the last family visit (see my article: Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Seeks Help in Therapy?).

She explained to her psychotherapist that she had a contentious relationship with her parents from an early age.  She said parents often belittled her and physically abused her when she was a child, which resulted in her low self esteem and anxiety.

Rediscovering in Psychotherapy What You Thought Didn't Exist

Since moving to New York City, Sandy limited her contact with her parents because their interactions were still contentious.  But, generally, she went home a couple of times a year during the holidays to try to maintain some type of connection with them, even though these visits often left her feeling disappointed and hurt.

During the holidays in 2016, she went to visit her parents for Christmas, and she found this visit to be the most challenging of all.

She and her parents never agreed on politics, and she tended to stay away from political conversations because she knew they would lead to arguments.  But, on the first day of her visit, her parents were so elated that their candidate won the presidential election that they could barely talk about anything else to Sandy, who voted for the candidate who lost (see my article: How to Cope With Difficult Family Get-Togethers).

Sandy was already reeling from the results of the presidential election, and she wasn't prepared to deal with the usual tension in her relationship with her parents as well as hearing them gloat about the election.  Tactfully, she suggested that they change the subject because it was upsetting to her.  But, as usual, her parents paid no attention to her feelings and her mother told her that she was being "too sensitive" and a "spoiled sport."

Sandy told her therapist that hearing those two phrases triggered childhood memories when both of her parents tended to disregard her feelings by telling her that she was "too sensitive" and a "spoiled sport" (see my article: How to Cope With Getting Emotionally Triggered During Family Visits).

Even though she was an adult, she said she felt like she was a helpless child again in her family home where she could neither fight back nor flee. As a child, she would stay in her room and fantasize about the day that she would be old enough to move out.  When she graduated high school, she was relieved to go away to college, and she never moved back into the family home.  

During the family visit that occurred shortly after the presidential election, Sandy told her parents that  if they didn't stop talking about the election, she would leave.  In response, they were dismissive and continued to disregard her feelings, so she packed her things and took a cab to the airport where she spent the Christmas holiday waiting to get a flight back to New York City.

She told her psychotherapist that it was a miserable Christmas for her.  But she felt she had to take care of herself by doing what she was unable to do when she was a child--leave her parents' home.  She explained that since that visit, she was flooded by childhood memories of her mother hitting her with a belt and her father taunting her for being "a crybaby."

That's when she decided that, in addition to coping with her current problems with her parents, she needed to work through her traumatic childhood memories so these memories wouldn't continue to get triggered.

Over the next several sessions, after Sandy and her psychotherapist talked about her family history and did the preparation work for trauma therapy, they began trauma therapy using a combination of Somatic Experiencing and EMDR therapy to work on past trauma as well as current difficulties with her family (see my article: Integrating EMDR Therapy and Somatic Experiencing).

During the trauma therapy, Sandy told her psychotherapist that her childhood was one long, bleak, lonely experience with no one to help her.  Not only was she an only child, but she had little contact with other relatives, who lived out of state.  Since her parents didn't allow her to invite friends over or to go to friend's homes, Sandy often felt lonely and unlovable as a child (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

Then, one day in therapy, after they did several sets of EMDR, Sandy suddenly remembered a high school teacher, Ms. Scott, who took Sandy under her wing.  She spent time with Sandy after class and encouraged her to open her mind to possibilities beyond their town, including applying to out of state colleges (see my article: How One Person Can Make a Difference in a Traumatized Child's Life).

Sandy was moved in her therapy session by remembering the impact of her former high school teacher, "How could I have forgotten how much Ms. Scott helped me?"

She said that if it had not been for the encouragement of Ms. Scott, she probably would have never applied to colleges--much less colleges out of state--because her parents didn't believe it was necessary for her to go to college.  They told her that what was most important was for her to get a job, any job, so she could contribute to the household.

Ms. Scott helped Sandy to see that a whole new world was waiting for her.   And, when Sandy's parents refused to help her with the college application process, Ms. Scott helped her with that process as well as the financial aid process when Sandy was accepted into a college in New York City.

Sandy's psychotherapist noticed how Sandy's face lit up and how alive she seemed after she remembered Ms. Scott, so they used these experiences as internal resources to help Sandy through the processing of the trauma.

Sandy said that she had forgotten how kind and generous Ms. Scott was to her.  Looking back now on those memories, she realized that there was someone who made her feel she was worthwhile and lovable at that time.  Recapturing those feelings facilitated the processing of the past trauma as well as the current difficulties with her family.

Soon after that, Sandy contacted Ms. Scott, who had since retired but who continued to live in the same town.  Ms. Scott, who now asked Sandy to call her Betty, was delighted to hear from Sandy and they planned to get together for lunch during Betty's next visit to New York City.

Conclusion

A long history of trauma can overshadow positive experiences in a person's memory.  But experiential psychotherapy can create the therapeutic environment that leads to the rediscovery of positive, life affirming experiences even in a traumatic childhood.  The rediscovery of these memories can facilitate the processing of traumatic memories.

Getting Help in Therapy

Unresolved traumatic memories often get triggered by current experiences, which is why it's so important to work through the unresolved trauma (see my article: The Benefits of Psychotherapy).

Experiential therapy, like EMDR, Somatic Experiencing and clinical hypnosis, is usually more effective than regular talk therapy to process trauma (see my article: Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone).

Along the way, it's not unusual for clients in trauma therapy to rediscover people and experiences that they forgot about who were helpful to them in the past.  Combined with trauma therapy, those past positive memories can provide the client with the much needed internal resources to work through the trauma.  

Rather than continuing to get triggered, you owe it to yourself to get the help you need from a skilled trauma therapist (see my article: How to Choose a Psychotherapist).

Once you have worked through unresolved trauma, you can live a more fulfilling life.

About Me

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

I work with individual adults and couples, and I have helped many clients to overcome unresolved 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.

Relationships: Is Your Partner's Behavior Kindness or Controlling Behavior?

I've written about relationship issues in prior articles (see my articles: How Your Attachment Style Affects Your Relationship and Fear of Being Emotionally Vulnerable).  In this article, I'm focusing on the difference between kindness vs. controlling behavior (see my article: Changing Maladaptive Behavior That No Longer Works For You: Controlling Behavior).

Relationships: Kindness or Controlling Behavior?

Over the years, I've met many individual adults and couples where the issue of kindness vs. controlling behavior has come up.  Usually, one or both partners in a relationship weren't sure if what they were experiencing from their partner was kindness, controlling behavior or some combination of the two.

Fictionalized Vignette:  Relationships - Kindness or Controlling Behavior
The following fictionalized vignette is an example of this problem and how psychotherapy can help:

Sara and John
Sara and John, who were together for a year, came to couples therapy because they were having disagreements about what Sara saw as John's controlling behavior and what John saw as his being kind to Sara.

Six months into their relationship, Sara took a job where she had to travel internationally a few times a month.

When Sara began traveling, John asked her to provide him with all the information regarding her flights, arrival time, and hotel.  He also asked her to call call or text him when her plane landed.

At first, Sara wasn't completely comfortable with John's request, but she didn't want John to worry, so she provided him with the information beforehand and would usually call him or send a text message to him when her plane landed.

But there were a few times when she was with colleagues and they were in a hurry to get to a meeting with a customer, so she didn't have time to text John immediately.

She felt she always tried to be considerate of him, so she didn't delay more than 10-15 minutes.  But, when she couldn't reach him immediately, by the time she turned on her phone, she already had a few panicky text messages from John wondering if she was okay.

During those times, John would also call her at the same time that she was texting him, and she didn't have privacy to talk because she was with her colleagues.

After this happened a few times, Sara tried to explain to John that she would always try to text or call as soon as she could, but when he panicked and she had to try to calm him down, he was adding to the stress she was already experiencing on the trip.

John told Sara that he felt hurt that she was experiencing him as adding to her stress when, from his perspective, he was being kind and caring.  He said he didn't want to be controlling.  He cared about her and he just wanted to make sure that she was safe.

Since they were getting nowhere on their own with these arguments, they decided to go to couples therapy.

During their couples therapy sessions, Sara told John and their therapist that she appreciated that John cared about her, but she couldn't understand why he needed to be contacted immediately.  She explained that she was often with senior managers on these business trips, and she didn't always have privacy to try to calm John down when he panicked.

She also expressed feeling confused and annoyed that John felt the need to be contacted immediately when nothing bad had ever happened on her business trips.  She couldn't understand his behavior, and she felt it was a boundary issue between them.

As John listened to Sara during their couples therapy sessions, over time he was able to acknowledge that he worried excessively when Sara traveled, and he wasn't sure why.

Sara told their therapist that, other than these business trips, John didn't try to keep tabs on her at any other time.  He never questioned when she went out with friends or went to business meetings locally.

John said that he tried to stay calm, but 10 minutes or so before he knew Sara's plane was about to land, he would become highly anxious.

By arrival time, he was on the verge of a panic attack imaging all the things that could have gone wrong.  So, he felt he needed to hear from Sara immediately when the plane landed to help him to calm down.

Relationships: Kindness or Controlling Behavior?

When he looked back on those times when he was calm, he acknowledged that, even though he still felt that he was being kind, his behavior was excessive, but he didn't know how to calm himself once he began to panic (see my article: Tips For Coping With Panic Attacks).

During one of their couples therapy sessions, John revealed to Sara for the first time that he had a history of panic disorder, and even as a child, he worried excessively whenever his father traveled on business.  He feared that something catastrophic would occur and he would never see his father again.

Since his father was self employed, he was usually on his own, and it wasn't a problem for to call John from his hotel to let him know he landed safely.  All the while, until John got his father's call, he imagined the worst.  But once he received the call, he calmed down.

John said that his parents never took him to see a psychotherapist when he was a child because they thought he was "outgrow" his anxiety.  But he never did and it was a problem in his prior relationships before he met Sara.

John said he felt deeply ashamed of his panic attacks and, as an adult, his shame got in the way of his getting help in therapy.  Even when he was talking about this with Sara and their therapist, his face was red and he didn't make eye contact (see my article: Healing Shame in Psychotherapy).

Since John eventually acknowledged that he had a problem, the couples therapist recommended that John see an individual psychotherapist to work on his anxiety and panic attacks while he and Sara worked in couples therapy to try to resolve these issues in their relationship.

The couples therapist also taught John a few techniques to calm himself when he felt a panic attack coming on (see my articles: Developing Coping Strategies and Internal Resources).

But she said that there were probably deeper issues involved that he would need to work on with an individual psychotherapist.

After John had a few individual sessions to give his family history, his individual psychotherapist recommended that they use a clinical hypnosis technique called the "Affect Bridge" to try to get to the root of his problem.

When they used the Affect Bridge, John remembered overhearing his grandfather talk about a plane accident where the grandfather lost his best friend.

When the grandfather was telling the story to John's parents, none of them knew that John was nearby listening to the conversation, so they talked about the accident in a detailed way that they would not have if they knew that four-year old John was listening to them.

Afterwards, John and his individual psychotherapist talked about what came up during the Affect Bridge.  He said he had completely forgotten about that memory and he was amazed that it was at the root of his panic attacks when Sara traveled.

His individual therapist explained that John was getting emotionally triggered whenever Sara traveled abroad and his fears stemmed from that earlier memory.

She explained that, even though John didn't witness the plane accident that his grandfather talked about, the story was told in such vivid detail that it was almost as if John had witnessed it and he became traumatized by it (see my article: Overcoming Trauma: When the Past is in the Present).

His individual psychotherapist recommended that they use EMDR Therapy to help John to overcome the trauma that was getting triggered whenever Sara traveled.

Gradually, as John processed the memory of hearing his grandfather's tragic story, he began to be able to separate out that memory from the times when Sara traveled (see my article: Working Through Emotional Trauma: Separating "Then" From "Now").

In the meantime, Sara felt much more compassionate towards John after she realized he was getting triggered.  She told John in their couples therapy that she now understood why he would become so upset.

Until John could work through the original trauma that was getting triggered, Sara continued to call or text John so he wouldn't worry.  But when she couldn't contact him immediately, John used the techniques he learned in his therapy to stay calm.

Relationships: Kindness or Controlling Behavior?

Over time, when John worked through the original trauma with EMDR therapy, he no longer kept tabs on when Sara's plane landed and he no longer panicked.

After a while, when he was no longer symptomatic, John told Sara that it was no longer necessary for her to contact him--he could wait to hear from her whenever it was convenient for her.

Conclusion
Sometimes, it's difficult to distinguish between kindness and controlling behavior.

There are times when what is meant to be kind also has elements of controlling behavior.  Sometimes, there are more than just elements--it's mostly controlling behavior and the person who is engaging in it has little to no insight into it.

The vignette above is one example of this kindness vs. controlling behavior.

There are many other examples:

• The parents who tend to show up at their adult child and spouse's home without calling ahead to see if it's convenient for them because they want to see them--even though this feels intrusive to their adult child or the spouse.  If couple tries to set a boundary with the parents, the parents feel offended because, from their perspective, they're just trying to be "nice." Then, the adult child and the spouse feel guilty for hurting the parents (see my article: Setting Boundaries With Family Members Who Want to Interfere in Your Relationship and Learn to Stop Interfering in Your Adult Child's Relationship).

• The friend, who tends to want to help by giving unsolicited advice, and then gets angry when the friend with the problem tries to set a boundary with her (see my article: Friendships: Losing a Friend After Giving Advice).

• The overprotective boss who gets involved in her employees' personal problems and tries to resolve these problems.  When an employee, who feels the boss is being intrusive, tells the boss tactfully that she doesn't want to talk to her about it, the boss becomes offended.  From her perspective, she only wants to help.

And so on.

Getting Help in Therapy
Although you have a right to set boundaries with the other people, setting boundaries can be difficult, and these situations aren't always easy to work through on your own, especially if the person who thinks s/he is being kind takes offense to boundary setting.

If you find yourself in this type of situation and you've been unable to resolve it on your own, a skilled psychotherapist can help you to discern what's going on and how to deal with it (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than struggling on your own, you could get help from a licensed mental health professional, who has experience assisting clients to overcome these problems.

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.

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.

Is It Possible to Feel Gratitude Even When You're Sad?

I've written prior articles about gratitude for this psychotherapy blog (see: Psychotherapy, Balance and Gratitude,  Keeping a Gratitude Journal, The Importance of Expressing Gratitude To Your Spouse and Being in the Present Moment).  I'm focusing on a particular topic relating to gratitude in this article, which is a question that often comes up in therapy:  Is is possible to feel gratitude even when you're sad?

Is It Possible To Feel Gratitude Even When You're Sad?

It might sound pollyanaish or naive to talk about feeling grateful when you feel sad.  But cultivating an attitude of gratefulness on a regular basis helps you, especially during the times when you're not at your best.

Why is this?  Well, when you develop the ability to find things in your life that you can be grateful for, you're developing a particular skill that will help you during good times and bad.

In many ways, it's easier to focus on the things that aren't going well in your life and, at any given time, you might have numerous challenges.

But if you have developed a habit of looking for the positive things, the things that are going well in your life, no matter how small, it helps to alleviate some of the emotional pain that you might be going through.

Is It Possible to Feel Gratitude Even When You're Sad?

Developing a habit of noticing things to be grateful for doesn't mean that you're trying to deny that you have problems or that you're upset or depressed (see my article: What is the Difference Between Sadness and Depression?)

It's a way of getting a bigger perspective about your life and the people in your life that includes the challenges as well as the positive aspects.

So, how to you do this?

How to Begin to Develop the Ability to Notice Positive Aspects of Your Life:

If you've never tried to develop the ability to find the positive things in your life to be grateful for, you can start in small ways by jotting down things that were positive each day.  

Make a List:

This list can be as simple as the smallest things:  

• Someone smiled at you and lifted your spirits for a moment.
• You heard your favorite song.
• You remembered a happy memory.
• You heard from a friend.
• You noticed a job online that you could apply for to get out of your current job.
• Someone complimented you.
• You found a parking space easily.
• The sales assistant in the store was helpful to you.

Keeping a Gratitude List

And so on.

Getting into the habit of noticing the positive aspects of your life each day helps you to begin to be attuned to these experiences on a regular basis.

It can also help you to realize that, even though you might be sad, life is complex and good feelings can still coexist with sad feelings.

Once you've begun to notice that there are usually at least one or two things that make you feel good and that you can appreciate, you can learn to deepen these feelings by using the mind-body connection.

Using the Mind-Body Connection to Deepen Your Sense of Gratitude

It's not unusual, especially if you're feeling sad, to notice positive aspects of your day and experience them in only an intellectual way.

Experiencing something in an intellectual way is very different from feeling it on an emotional and physical level.

One way to go from experiencing these positive aspects from purely an intellectual perspective to deepening the feeling to an emotional and physical level is to use the mind-body connection.

One method that I use with my therapy clients when they're starting therapy is called "internal resource building."

When we're engaged in internal resource building (also known as developing coping skills), I ask clients to bring in 10 positive memories from their life, no matter how long ago it was and no matter how fleeting the memory might be.  If they can't come up with 10, I'll use whatever they bring in and that's just fine.

I ask the client to close her eyes, get back into the memory and notice what emotions and sensations she feels in her body.  Then, we use some form of what is called "bilateral stimulation" (from EMDR Therapy) to reinforce that feeling.

The bilateral stimulation can be done with "tappers" (one tapper in each hand) that provide alternate or bilateral buzzing in each hand.  This is done for only a few seconds to focus on the positive aspect of the memory and to try to prevent negative aspects from coming up so the memory remains positive.

Since you won't have tappers, you can use another EMDR therapy technique, which is alternate tapping.  Alternate tapping, which is a form of bilateral stimulation can be done by using your hands to gently tap, and it can be done in several ways:  

• Alternate tapping of your leg--right leg, then left leg, back and forth (see Laurel Parnell's Book, Tapping In).
• The "Butterfly Tap" where you cross your arms in front of your chest and do alternate taps of your upper arms
• Bilateral music that goes from one ear to the other (see Bilateral Music).

The idea is that you're focusing on the positive emotion that you're feeling in your body, and this helps to strengthen the positive feelings.  

By strengthening the positive feelings, your experience of gratitude usually goes from an intellectual experience to a felt sense of gratitude.

It also provides you with a reprieve from your sadness.

So, to answer the question that I posed at the beginning of this article:  Yes, it is possible to feel both sadness and gratitude, but it can be challenging to feel gratitude when you're overcome with depression or unresolved trauma.  At that point, you might need the help of an experienced psychotherapist.

Getting Help in Therapy

There's a difference from feeling sad and feeling depressed.

When you're depressed, it's harder to access positive feelings and gratitude and you could benefit from seeking help from a licensed psychotherapist who has an expertise is helping clients to over come depression.

Depression is episodic and you can have multiple episodes throughout your life.  Getting help from a mental health professional can help you to overcome these depressive episodes so that they are shorter than they would be without help.

Getting help in therapy also helps you to develop the necessary coping skills to help you lead a more fulfilling life (see my article:  How to Choose a Psychotherapist).

If you've tried to cultivate an ability to feeling grateful, but emotional problems or a history of trauma are hindering you, rather than suffering alone, find a skilled therapist to help you through these challenges.

About Me

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

I have over 20 years of experience as a therapist and I helped many clients to overcome their problems.

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.