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Showing posts with label loss. Show all posts
Showing posts with label loss. Show all posts

Saturday, May 10, 2025

How to Cope With Pregnancy Loss When You and Your Partner Have Different Feelings About the Loss

Couples often discover that they might differ in their feelings about a pregnancy loss (see my articles:  Coping With Pregnancy Loss and Allowing Room For Grief).

You might understand how you and your partner feel different about many areas in your life, including different feelings about friends, family members, in-laws, religion, politics and other areas.

Coping With Pregnancy Loss

But when you and your partner differ on your feelings about pregnancy loss, this can put a strain on the relationship, especially if each of you feels you're dealing with it in the "right way" and your partner is dealing with it in the "wrong way".

If you both have a hard time talking to each other about the way you feel, the loss can erode the relationship and, possibly, push you apart.

You might feel frustrated, angry and sad if:
  • One of you wants to talk about the loss and other doesn't.
  • Your partner experiences the loss in a different way from the way you do.
Coping With Pregnancy Loss
  • You feel alone because your partner doesn't understand how you feel or they might not want to talk about it.
  • Your partner expresses feeling alone because you don't feel the same way they do.
  • Your partner wants to "move on" to start making plans for the future including wanting to try again to get pregnant and you're not ready.
Coping With Pregnancy Loss
  • Your partner doesn't seem to think your feelings are as important as theirs.
  • You might think your feelings are more important than your partner's feelings or vice versa.
  • One or both of you feel you're either overreacting or under-reacting to the loss.
  • Your partner doesn't feel  the pregnancy loss was really a loss at all, but you feel devastated by it (or vice versa).
  • You feel your partner is getting all the attention from loved ones and you feel your feelings are being minimized or vice versa.
  • You feel so upset about the loss that you're unable to be emotionally supportive of your partner.
  • You feel the miscarriage was your fault and you have let down your partner.
  • You feel so guilty and ashamed about the miscarriage that you feel too upset to talk about it.
Clinical Vignette
The following clinical vignette is a composite of many different cases with all identifying information omitted to protect confidentiality:

Donna and Jack
Donna and Jack, who were both in their mid-30s, were married three years when Donna had a miscarriage during the ninth week of the pregnancy.

Coping With Pregnancy Loss

They had been trying to get pregnant for two years and they were both elated when Donna found out she was pregnant. 

But several weeks later, Donna felt cramping which was similar to menstrual cramps. She also had lower back pain. Suddenly she noticed that she had vaginal bleeding and she realized she was having a miscarriage.

Jack rushed Donna to the hospital in their car and their worst fears were confirmed. The emergency room doctor was empathetic and tried to reassure them that miscarriages occur about 10-20% of the time. He also told them that she should see her OB-GYN.

Donna's OB-GYN reiterated what the ER doctor told them. He offered to refer them for counseling to deal with the loss, but neither of them was ready to speak with a counselor at that point.

They avoided telling their families for a few days because Donna was sure her family would blame her for the miscarriage and Jack thought his family would feel uncomfortable talking about the miscarriage.

Coping With Pregnancy Loss

During that time, Donna tried to think about what she might have done that could have caused the miscarriage. Despite reassurances from her OB-GYN that she had done nothing to cause the miscarriage, Dona felt guilty and ashamed. She felt like she had let Jack down--despite Jack telling her that he didn't blame her and she shouldn't blame herself.

A few weeks later, they told their families about the miscarriage and both families reacted as they feared they might. Donna's mother told her that she must have done something to cause the miscarriage, which was hurtful to Donna, and Jack's family barely said a word about it. His mother came every few days to check in with them and to bring food, but neither of Jack's parents could bring themselves to talk about it.

A month later, Jack told Donna that he couldn't tolerate feeling sad about the miscarriage any more and he felt they should "move on" and try to get pregnant again. He knew Donna was still very sad, but he hoped that getting pregnant again would help Donna to feel better.

But Donna felt she couldn't even consider getting pregnant again so quickly. She feared she would have another miscarriage--even though her OB-GYN assured her that there was no reason why she shouldn't be able to have a baby.

Donna wanted to be able to talk to Jack about the loss, but Jack told her that he didn't think he could talk about it any more, "Donna, I don't know what else to say about the miscarriage. I feel sad too, but I need to feel we're moving ahead and creating a future together. Why wouldn't you want that too?"

Donna became angry and frustrated with Jack's response. She couldn't understand why he couldn't just be there for her without focusing on the future, "Besides, I can't even think about having sex at this point. I just don't feel sexual."

They decided to see a couples therapist who was also a sex therapist. Their therapist normalized that it's not unusual for two people to feel differently about a miscarriage or about any loss.  

She focused on getting them each to listen and validate each other's feelings.  She helped them to communicate with each other about how they were each feeling instead of focusing on the "right" or "wrong" way to feel.

When she encouraged them to create a ritual together to remember the loss, Donna suggested that they light candles for a week while they sat together in front of the candles to memorialize the loss. This worked out well for Jack because he felt he didn't have the words to talk about the loss outside the couples therapy session.

When they returned to their couples therapy session a week later, Donna said she was feeling somewhat calmer. She was still sad, but she didn't feel angry and frustrated with Jack. She said they sat together holding hands in front of the candles and she felt emotionally supported by Jack.

Jack said he felt less pressure to come up with what he wanted to say about the miscarriage. He also indicated that he felt a lot more empathy for Donna when they sat together in this way.

This was a turning point in their loss and, gradually, Donna was able to begin thinking about the possibility of trying to get pregnant again. She still wasn't in the mood to have sex, but Jack was patient.

Their couples therapist was also a sex therapist so they worked on reviving their physical intimacy together until they both felt ready to reconnect sexually. 

Initially, they focused on reconnecting emotionally and enjoying the sexual intimacy before they tried to get pregnant again.

How to Deal With Pregnancy Loss Together When You Each Have Different Feelings
  • Accept You Both Have Different Feelings: It's normal for two people to feel and react differently to a loss. Also, two people can have different times when they grieve. Some people grieve immediately and others grieve in a few months (see my article: The Many Layers of Grief).
  • Listen and Talk to Each Other: Even if you don't feel the same way your partner feels, allow your partner to tell you how they feel. If they can't talk about it, maybe they can write down their feelings. Be emotionally supportive of each other (see my article: Writing About Grief).
  • Find Ways to Memorialize Your Loss: You and your partner can find ways to memorialize your loss together in whatever way is meaningful to you including lighting candles together or finding other meaningful rituals you can do together (see my article: The Power of Personal Rituals).
Get Help in Therapy
If you and your partner are unable to talk to each other about the loss, seek help in therapy. 

A skilled therapist, who has experience helping couples deal with pregnancy loss, can help you both to grieve in whatever way is meaningful to each of you.

Get Help in Therapy For Pregnancy Loss

Rather than struggling on your own and allowing the loss to erode your relationship, seek help from a licensed mental health professional so you can heal together.

Also see my other articles about grief:


About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

With over 20 years of experience, I have helped many individual adults and couples to work through their grief.

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.







Friday, May 9, 2025

Coping with Pregnancy Loss

It is a little known fact that approximately 10-20% of all pregnancies end in a miscarriage.

The actual number might be even higher because most miscarriages occur early in the pregnancy and many women don't even realize they had a miscarriage. 

Coping With Pregnancy Loss

Some of these women don't even realize they were pregnant before they had a miscarriage.

Coping With Pregnancy Loss
The sense of loss for women and their partners can be profound and isolating because, unlike other losses, there are no funerals or rituals to process this loss with their loved ones. 

In addition, family and friends are often not emotionally supportive. 

Coping With Pregnancy Loss

Some loved ones can be emotionally invalidating by brushing off the loss and telling the woman and her partner, "Oh, you can just try again" as if there was no loss at all involved with the miscarriage.

Aside from feeling the sadness of the loss, many women also feel ashamed and guilty because they believe they did something to cause the loss--even when it's objectively clear that they didn't.

Many loved ones believe a miscarriage is no loss at all because they believe there wasn't enough time for the woman to develop an emotional attachment. But this negates the fact that the woman and her partner had a dream of having a child and now that dream is lost.

Difficulty Grieving Pregnancy Loss
Many women and their partners never grieve for pregnancy loss, but the trauma of the miscarriage lives within them and between them.

Coping With Pregnancy Loss

The lack of rituals to grieve the loss with loved ones often leads the woman and her partner to suppress their emotions about the loss so they can "move on" and try to get pregnant again.

What Are the Possible Consequences of Not Grieving a Pregnancy Loss?
Failing to process the loss can result in physical, emotional and relationship difficulties:

Physical symptoms might include:
  • Fatigue
  • Sleep disturbance
  • Change in appetite (either under-eating or over-eating)
  • Physical discomfort
Emotional symptoms might include:
  • Depression
  • Anxiety
  • PTSD (post-traumatic stress disorder)
  • Guilt
  • Shame
  • Complicated grief where the grief becomes prolonged and intense
  • Isolation due to avoiding the judgment of others
Relationship difficulties might include:
  • Difficulty communicating about their feelings about the miscarriage including fear of talking about the loss
  • Problems being sexual with each other after the loss
  • A higher risk of a breakup as compared to couples who experience a live birth
How to Cope With Pregnancy Loss
  • Be Emotionally Supportive of Each Other: Even though you and your partner might not feel the same way about the pregnancy loss, be supportive of each other.
  • Get Emotional Support From Loved Ones Who Understand: You want to confide in people who will be supportive and who will not make you feel emotionally invalidated. Anyone who would be likely to dismiss your feelings by saying, "Just move on and try to get pregnant again" isn't the right person to confide in.
  • Grieve the Loss of the Pregnancy and Your Dream of Having a Baby At That Point in Your Life: Grieve in any way that is meaningful to you. Each of you might have different ways of grieving. Respect that. There is no one "right way" to grieve a pregnancy loss.
  • Get Help in Therapy: Get help in couples therapy with a supportive therapist who helps clients with grief, especially grief related to a miscarriage. If your partner refuses to go, at first, start going yourself and your partner might join you in time.
Seeking Help in Therapy For Pregnancy Loss
You and your partner might not be ready to seek help in therapy immediately after the pregnancy loss, but don't struggle too long with your loss by yourselves.

Seeking Help in Therapy For Pregnancy Loss

A compassionate psychotherapist who has experience helping clients with loss can help you to grieve your loss so you don't develop the physical, emotional and relational problems mentioned above.

Rather than struggling on your own, seek help from a licensed mental health professional has the expertise to help you to work through your loss.

Also See My Article:

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I have helped many individual adults and couples to overcome grief.

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.












Monday, January 27, 2025

Reconnecting With Deceased Loved Ones in Your Dreams

Having dreams about deceased loved ones is a common experience for many people (see my article: Common Reactions to the Loss of a Loved One).  

Reconnected With Deceased Loved Ones in Dreams

Some people believe loved ones come to them in dreams to reconnect or to impart an important message.  

Others believe these dreams come from a place deep inside them as a way to remember and mourn their loss.

Whatever you believe, these dreams can be an important part of your healing process as way to come to terms with your loss. 

A Child's Recurring Dreams About a Deceased Father
When I was a child, I had recurring dreams about my father, who died suddenly (see my article: Grief in Waiting After the Death of a Parent).

Reconnecting With Deceased Loves Ones in Dreams

Each dream was slightly different, but there were certain recurring themes. 

One recurring theme was that I would be shocked to see my father appear suddenly in front of me.  I would be happy to see him, but I would also feel confused and I would say to him, "But I thought you were dead..."

In some of the dreams he would tell me he had just gone away and now he was back, and in other dreams he would acknowledge that he was dead. 

Whichever response I received would confuse me: How could he be dead and still be standing in front of me?

Then, at some point, I would tell my father I wanted to let my mother know he was back. But when I turned around, he was gone and I felt the painful loss again.

Many clients tell me how real these dreams feel to them and I know this from my own experience. 

Each person comes to their own understanding of the meaning of their dreams. 

Looking back now, I believe these dreams were a way for my unconscious mind to work through the loss when my conscious mind couldn't make sense of it (see my article: Making the Unconscious Conscious).

In other words, my unconscious mind helped with the healing process. 

Many years later, when I was ready, a skilled psychotherapist helped me with a deeper level of working through the grief (see my article: The Many Layers of Grief).

Dreams About a Deceased Psychotherapist
Over the years I've had dreams about a psychotherapist who was important in my healing process as a young adult.

In some of those dreams, I talked to the therapist about current issues in my life.  

In those dreams it was as if he were still very much alive and I was having a therapy session to talk over a problem. 

I usually wake up feeling a little wistful but also refreshed.

After I wake up, I allow myself to enjoy the experience of the dream without analyzing the meaning--at least not at first.

For me, allowing myself to linger in the experience of this reconnection with someone who was so important to me during my youth is more meaningful (initially) than an analyzing the dream.  There's always time for that later, if I want it.

Conclusion
There are many ways to grieve and work through the loss of a loved one including healing through dreams (see my articles: Writing About Your Mother After Her Death).

Although not all dreams about deceased loved ones are healing, the ones that are can help with the grief and mourning process.

It doesn't matter whether you believe your loved one actually came to you or you believe the dream was your unconscious mind's way of helping you to deal with the loss.  Either belief can help in the healing process.

Recalling, writing down and talking about these dreams with trusted friends and family can help you to cope with loss.

Although dreams can be healing, sometimes grief is too difficult to work through on your own and therapy can help.

Getting Help in Therapy
Time alone doesn't heal all wounds (see my article: Time Doesn't Heal All Wounds).

Grief work in therapy can help you to move through the mourning process at a pace that feels right for you.

Getting Help in Therapy

Rather than struggling on your own, seek help from a skilled psychotherapist who does grief work with clients.

Working through grief can help you to heal from the pain and live a more fulfilling life.

Also See My Other Articles About Grief:





About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

With over 20 years of experience, I have helped many individuals and couples to heal.

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.




Monday, December 2, 2024

The Many Layers of Grief

There is no right or wrong way to grieve. Everyone grieves in their own way and in their own time (see my article:  Common Reactions to the Loss of a Loved One).

The Many Layers of Grief

The 5 Stages of Grief
The idea that there are stages of grief was developed by Swiss-American psychiatrist Dr. Elizabeth Kubler-Ross in the late 1960s. 

According to Kubler-Ross, these stages are:
  • Denial
  • Anger
  • Bargaining
  • Depression 
  • Acceptance
Although these stages are usually thought to be linear, they often occur in no particular order and they're often reoccurring. 

For instance, if someone experiences anger first, they might experience denial, depression and bargaining and a certain level of acceptance

But over time this same person will probably re-experience these stages in no particular order on certain anniversaries (e.g, birthdays, anniversaries of their loved one's death and holidays).

In addition, acceptance has many layers to it. There is the initial acceptance that the death has occurred, but over time acceptance can deepen as the meaning of this loss also deepens.

The Many Layers of Grief
In addition to the 5 Stages of Grief, people often experience grief in waves and in layers.

Anyone who has ever grieved for the loss of a loved one is aware that grief comes in waves. Weeks, months and years after the loss you might experience a wave of grief come over you for no apparent reason that you're aware of at the time.

The Many Layers of Grief

The concept that there can be layers of grief over time isn't commonly recognized.  The layers, which often go with the stages, are usually experienced from surface to depth.  

In other words, even if you go through all five stages several times and in a different order or in a combination of stages each time, you might go through these stages in more profound ways each time from surface to depth.

Although this is understandable when the loss is close, people are often surprised to go through many layers of grief even when they were estranged from the person who died or the death was of a relative they never knew (see my article: (see my article: Mourning the Death of a Father You Have Never Known).

Clinical Vignette
The following clinical vignette illustrates how grief can come in layers over time for an estranged family member:

Sara
When Sara received the phone call from the police that her estranged older sister, June, was found dead from an overdose of heroin hundreds of miles away, she was shocked at first. She and her sister had estranged for over 20 years (see my article: Family Estrangements: Understanding the Barriers to Reconciliation).

Growing up Sara wasn't close to June. By the time Sara was five years old, her older sister had already quit high school to move in with a boyfriend that no one in the family liked, so Sara never saw her sister again.

As friends and family members heard about the June's death, they reached out to Sara to express their condolences (see my article: Expressing Condolences in a Caring and Tactful Way).

In response to their concern, Sara told them that she didn't have a sense of loss because she and June weren't close. She said she was just glad that June wasn't suffering anymore.

After Sara and her husband arranged for June's burial, they resumed their daily activities as if nothing had happened. But over time June's feelings changed. She noticed that her level of acceptance of June's death evolved over time.

As time passed and she went through what was left of June's personal belongings, Sara felt waves of sadness to be missing the sister she had never really known. 

Going through one of June's picture albums, Sara was surprised to discover that June kept pictures of her when she was a baby. It was at that point that Sara realized, even though June was someone she never really knew, she was important to June in ways she had never known.

The Many Layers of Grief

After discovering the pictures of herself, Sara made an effort to find out more about her sister. 

With much effort, she was able to find people in the area where June lived who knew her. She discovered that, before her life took a precipitous decline, June liked to draw portraits, including portraits of Sara when she was a baby.

She also discovered that up until June began abusing heroin, she loved to cook and she often invited friends and neighbors to her home for a meal, including people who were much less fortunate than her.

No one who knew June in the past was sure why her life took such a turn for the worse because she isolated herself in her final years. 

But some former friends believed her life got worse after she began a relationship with a man who introduced her to heroin. They surmised that after he left June, she kept to herself and her heroin use got worse until the day she overdosed.

As she discovered more about her sister, Sara was surprised to feel a depth of grief for June she would have never anticipated. 

Soon after that, she began therapy to deal with her loss.

People who are estranged from family members for a long time and people who have never known certain relatives are often surprised by the many layers of grief they feel.

Grieving in Your Own Way
We're hardwired for attachment in order to survive as babies. We're not hardwired for grief.

Grief is a topic that makes many people feel uncomfortable. In fact, many people try to avoid feeling emotions related to grief. 

The Many Layers of Grief

Those who aren't grieving often express surprise when people who have experienced a loss are continuing to grieve. 

Many make unkind remarks like, "You're still sad about your loss? How can this be when it's been over a year?" or "You just need to get out there and meet someone new."

As I mentioned at the beginning of this article, there's no one right or wrong way to grieve so if you're grieving, you'll go through it in your own time and in your own way, but it's important to make room for all your feelings.  

Certain rituals in various cultures are meant to help those who are grieving to acknowledge their feelings and come together with other people for emotional support (see my article: The Power of Creating Rituals).

The Many Layers of Grief

But after everyone has gone home and returned to their lives, you'll probably realize your life has changed in unanticipated ways after your loss.  

You might return to work and other routines but, just like any other profound experience, grief can change you.

Aside from experiencing the loss, you might also discover that, over time, grief can give you a new appreciation for love and life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples and I have helped many clients to work through grief in their own way.

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.































Monday, June 3, 2024

Healing Attachment Trauma in Trauma Therapy

Attachment trauma, which involves attachment wounds, can occur at any time of life. 

Healing Attachment Trauma in Trauma Therapy 

Attachment trauma often occurs when there are significant disruptions in close relationships.

Examples of Attachment Wounds Which Are Part of Attachment Trauma
Attachment wounds include but are not limited to:
  • Early loss or abandonment in childhood
  • Lack of affection during childhood
  • Being separated during infancy or any time in childhood from parents or primary caregivers
  • A caregiver who is the source of overwhelming emotional distress for a child
  • A caregiver who has a substance abuse problem
  • A caregiver with mental health issues or who is emotionally unstable
  • A caregiver with poor emotional, physical or sexual boundaries
  • A caregiver who is controlling to the point where a child has difficulty individuating (being their own person)
  • Divorce in the family during childhood
  • Lack of support from a partner, spouse or significant other during a significant event or transition
What Are Signs and Symptoms of Attachment Trauma?
The signs and symptoms of attachment trauma include but are not limited to:
  • A pattern of difficulties in relationships with friends, family members, significant others and work relationships
A Pattern of Difficulties in Relationships

  • A tendency to experience humiliation, shame and/or guilt
  • Hyperarousal
  • Enmeshed relationships with family members, friends or significant others
  • Poor interpersonal boundaries 
Mental Health and Substance Abuse Issues Related to Attachment Trauma
Mental health and substance abuse issues related to attachment trauma include but are not limited to:
  • Trauma and Posttraumatic Stress Disorder (PTSD)
  • Alcohol misuse
Attachment Trauma and Alcohol Misuse
  • Drug misuse or addiction
  • Compulsive gambling
  • Overeating
Healing Attachment Trauma in Trauma Therapy
There are many different types of trauma therapy, which all come under the umbrella of experiential therapy including:
How Will You Know When You're on the Path to Healing an Attachment Trauma?
There is no quick fix for healing attachment trauma, but Experiential Therapy, like EMDR, AEDP, Somatic Experiencing and Parts Work tend to be more effective than regular talk therapy for healing trauma (see my article: Why Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma).

Since you might not have experienced emotionally supportive relationships when you were a child, you will probably need time to develop a therapeutic rapport with your trauma therapist, so it's good to be aware of this as you start trauma therapy (see my article: Can You Learn to Trust Your Therapist If You Weren't Able to Trust Your Family?).

Signs that might be part of your path to healing an attachment trauma include but are not limited to:
  • You're beginning to respond instead of react to stress
  • You're starting to feel safer in your body
  • You're getting better at setting boundaries
  • You're becoming more aware of when you feel ashamed, guilty or humiliated when there's no objective reason to feel that way
  • You're beginning to feel less anxious
  • You're becoming aware that your depression is beginning to lift
  • You're starting to make healthier choices in relationships
  • You're feeling less anxious, avoidant or disorganized in a healthy relationship
  • You're cutting back or you have stopped drinking excessively
  • You're cutting back or you have stopped misusing drugs
  • You're feeling less inclined to gamble compulsively
  • You're less inclined to overspend
  • You're less inclined to overeat during times of stress 
  • You no longer feel comfortable in enmeshed relationships

Getting Help in Trauma Therapy
If you're struggling with attachment trauma, you're not alone.

Healing Attachment Trauma in Trauma Therapy

A skilled trauma therapist can help you to overcome unresolved trauma.

Rather than struggling on your own, seek help from a licensed mental health professional who is a trauma therapist.

Trauma therapy can help you to free yourself from your traumatic past so you can lead a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist (see my article: What is a Trauma Therapist?).

I work with individual adults and couples.

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

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