10 Tips to Help You Open Up With Your Psychotherapist

If you've never been in therapy before or if you haven't had a good experience with a prior therapist, you might find it difficult to open up with a new psychotherapist, so this article will provide you with some tips that can make it easier for you.

Opening Up With Your Therapist

10 Tips For Opening Up With Your Psychotherapist

• 1. Start By Choosing a Therapist Who is Right For You: The most important consideration when you're ready to go to therapy is whether you and any potential therapist you might choose are a good fit. Starting with a new therapist can be an adjustment--especially if you've never been in therapy before. It's a unique relationship where the focus is on you. Before committing to therapy with any particular therapist, you can attend a consultation with a therapist to see if you feel comfortable her. You might not be certain after one consultation, but you can usually tell after a few sessions. Even after you have chosen a therapist, it takes a while to build a rapport with a therapist because you're talking about the most emotionally vulnerable aspects of your life, so give it time. Also, make sure the therapist has the expertise you need for your problems (see my article: How to Choose a Psychotherapist).

• 2. Think About What You Want to Talk About Before Your Sessions: If you want to get the most out of your therapy sessions, take some time before the session to reflect on what you want to talk about.  Many clients find it helpful to make notes for themselves so they use their time well in session. There are also many other clients who prefer to be more spontaneous in session because that's what works best for them. But if you have problems opening up to talk about yourself, prior reflection can be helpful (see my article: Getting the Most Out of Your Therapy Sessions).

• 3. Talk About Your Fear or Anxiety About Opening Up to Your Therapist: Most therapists know that clients often have a hard time opening up, especially if they weren't encouraged to talk about their feelings when they were growing up. A skilled therapist can help you to get comfortable enough to explore your fear or anxiety about opening up so you can eventually open up.  If a therapist is a mind-body oriented therapist, she can help you to get more comfortable with breathing or grounding exercises.

• 4. Consider Your Therapy Sessions a Collaboration Between You and Your Therapist: Therapy is a team effort.  Gone are the days when therapists just listened to you talk and after a while made an interpretation that was supposed to unlock profound insights. These days therapy is much less hierarchical and there's a recognition that clients and therapists work together in therapy to make it a meaningful experience. Although your therapist can help you to speak about difficult topics, you have the responsibility for initiating what you want to talk about.  Therapists aren't advisors, so they won't provide you with answers to your problems, but they can help you through the process (see my article: Psychotherapy as a Collaborative Effort Between Client and Therapist).

Opening Up With Your Therapist

• 5. Take Some Time Before the Session to Relax, If Possible: It's understood that most people lead busy lives, but if it's possible for you to take even a few minutes before your session, do some breathing or stretching to help you relax before the session starts.

• 6. Keep Your Therapy Appointments on a Regular Basis and Come On Time: In order to keep the momentum going in your therapy, you need to come regularly. It's understood that you might have to cancel once in a while (make sure you know your therapist's cancellation policy), but weekly sessions are generally the expectation.  Coming on time allows you to have the full benefit of the therapy time because sessions start and end at the appointed time, so if you're late, you won't get a full session (see my article: How to Keep the Momentum Going in Your Therapy).

• 7, Keep the Focus on Your Sessions Without Distractions During Your Appointment: This means you don't have any other distractions (e.g., phones, pets, etc) so you can stay focused on your session. If you're having an online session, make sure you have absolute privacy. Therapy sessions where you don't have privacy are considered unethical and therapists won't conduct a session under those circumstances. 

Opening Up With Your Therapist

• 8. Recognize That Therapy is a Process: You might not feel comfortable divulging the most vulnerable parts of yourself during the initial stage of therapy and that's alright. Give it time.  If you have issues opening up about a particular topic that you would like to work on, tell your therapist about your difficulty so she can help you to get comfortable (see my article: Progress in Therapy Isn't Linear and Setbacks Are a Normal Part of Therapy on the Road to Healing).

• 9. Opening Up Usually Gets Easier Over Time: Assuming you and your therapist are a good match, opening up usually becomes easier over time as you build a rapport with your therapist and develop trust and confidence.  This is also part of the process.

• 10. Talk About the Therapy With Your Therapist: If you're not sure about the process, talk to your therapist about it. Whether you're in the initial stage of therapy or you have been attending for a while, you can talk to your therapist about how you think therapy is going.  Many therapists do a check-in with clients periodically to see how the clients are feeling about the therapy, but you can talk about the therapy at any time, especially if there's something you don't understand or an area where you and your therapist don't agree. It's also a good idea to talk about the therapeutic relationship and whether you think it's going well.  If there's anything you feel went wrong in a session, bring it up so it can be addressed as soon as possible (see my article: Ruptures and Repairs in Therapy).

Conclusion

You can usually get a sense of whether you and your therapist are a good match.  If it's not a good match, you can tell your therapist rather than ghosting her. Experienced therapist are aware that every therapist isn't for every client, so this shouldn't be a problem.

Most clients get comfortable opening up over time, but if you have a particularly difficult time and you're aware that you and your therapist are a good match, bring up your difficulty in your therapy session.

Your therapist can help you to identify and work on overcoming whatever emotional obstacles might be getting in your way.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT therapist (for couples), Somatic Experiencing and sex 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.

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

Trauma Therapy: The Therapeutic Benefits of Somatic Experiencing Therapy

As a trauma therapist, I have been using Somatic Experiencing (SE) to help clients overcome traumatic experiences for the last 12 years in my private practice in New York City (see my articles: Somatic Experiencing: A Mind-Body Oriented Therapy and Overcoming Emotional Trauma With Somatic Experiencing Therapy).

The Therapeutic Benefits of Somatic Experiencing Therapy

The Somatic Experiencing Framework: SIBAM

Whereas most types of talk therapy use a top down approach, which focuses only on developing insight, SE and other types of Experiential Therapy, use a bottom up approach that incorporates the mind-body connection to work through trauma (see my article: What is the Difference Between Top-Down and Bottom-Up Approaches to Trauma Therapy?).

The basic SE framework consists of the following:

• Sensation: This includes learning to experience sensations in your body in an emotionally safe way. In other words, if you're not accustomed to feeling bodily sensations as a result of your traumatic experiences, an SE therapist will help you to feel these sensations in a way that feels manageable to you. You will learn how to track internal sensations in your body as you work on issues in SE, including:

• Kinesthetic: Muscle tension patterns
• Proprioceptive: Awareness of your position in space
• Vestibular: Movement, gravity and sense of balance
• Visceral: Sensations from the gut, lungs, heart

• Imagery: The use of imagery is an important part of SE healing. This includes using your five senses:
• Sight
• Sound
• Taste
• Smell
• Hearing

• Behavior: The behavioral aspects of SE include:
• Voluntary gestures
• Facial expressions
• Posture
• Autonomic signals, including
• heart rate
• breathing

• Affect: Affect is how you show categorical emotions, including anger, sadness, happiness, fear and disgust. It also includes sensation-based feelings of attraction and avoidance, which is referred to as the felt sense (see my article: What is the Felt Sense in Experiential Therapy?).

• Meaning: Meaning refers to the words you use to describe your experiences in therapy related to all of the above (sensation, imagery, behavior and affect).  It includes whatever trauma-based negative beliefs about yourself and the world around you that you might have formed as a result of traumatic experiences. It also includes how open you are to positive emotions.

What Are the Benefits of Somatic Experiencing?

Unresolved traumatic experiences, which are held in the body, often cause problems with managing emotions.

The Therapeutic Benefits of Somatic Experiencing Therapy

Traumatic responses include fight, flight, freeze and fawn (fawn refers to people pleasing).  

Somatic Experiencing can help you:

Develop Bodily Awareness: Unlike regular talk therapy, which focuses on developing intellectual insight, Somatic Experiencing and other Experiential Therapy, helps you to develop a mind-body awareness including an awareness of the unconscious mind (see my article: Experiential Therapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind and Why Intellectual Insight Isn't Enough to Overcome Trauma).

The benefits of bodily awareness include:

• Learning Grounding and Containment Techniques: You learn how to calm your body and mind using various grounding and containment techniques (see my article: Trauma Therapy: Using Grounding Techniques and Trauma Therapy and Containment Exercises).

• Developing Resources and Using Visualization: You learn to develop internal resources so that you feel safe emotionally and physically (see my article: Developing Internal Resources and Coping Skills).

• Learning to Do a Body Scan: You learn how to sense into your body and assess where you're holding onto tension or pain and what you're feeling emotionally in your body (see my article: Doing the Body Scan Meditation).

Transform Emotional Dysregulation into Emotional Regulation

When you become aware of your emotions and how they are stored in your body, including emotional triggers related to trauma, you can learn how to use your bodily awareness, including grounding and containment techniques, internal resources, visualization and body scans, to bring your mind and body into a calm state.

Use SE Techniques on Your Own: The resources you learn in SE can be used at home, including the grounding and containment exercises, internal resources, visualization and the body scan, so that you can calm yourself between sessions and learn to deal with emotional triggers before trauma is processed to completion.

Release Trauma: Over time, as you become aware of the physical and emotional sensations in your body, you can learn to release trauma and reset your nervous system with the help of your SE therapist so you no longer feel affected by trauma from the past.

Conclusion

Somatic Experiencing (SE) is a mind-body oriented Experiential Trauma Therapy.  

SE is a gentle form of trauma therapy because SE therapists work in a titrated way to help clients to process trauma in a manageable way (see my article: Trauma Therapy: Why Establishing Safety For the Client is Important Before Processing Trauma).

SE also uses a technique called Pendulation which helps clients to manage and cope with distressing emotions. Pendulation is another resource you can use on your own (see my article: Coping With Emotional Distress by Using the SE Techniques of Pendulation).

Many people experience posttraumatic growth after they work through psychological trauma (see my article: Posttraumatic Growth: A Greater Sense of Hope and Meaning After Working Through Trauma).

When to Get Help in Trauma Therapy

If you have been unable to overcome psychological trauma on your own or in other types of therapy, you could benefit from working with a Somatic Experiencing therapist.

Working through psychological trauma allows you to live free of your traumatic history so you can live 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: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to overcome psychological trauma (see my article: What is a Trauma Therapist?).

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

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

Somatic Experiencing: A Mind-Body Oriented Therapy

Somatic Experiencing is a mind-body oriented psychotherapy that was developed by psychologist, Peter Levine, Ph.D. 

One of the basic premises of Somatic Experiencing is that people have a natural ability to heal emotionally if they are provided with the tools. Somatic Experiencing recognizes that there is a mind-body connection, and traumatic memories are not just stored in the mind--they're also stored in our bodies as well.

Mind-Body Oriented Psychotherapy: Somatic Experiencing

Experiences of Being Retraumatized in Regular Talk Therapy:
When traumatic memories are triggered, they're often overwhelming for people. Regular talk therapy is often inadequate for dealing with trauma.

Years ago, therapists used to think that all clients needed to do was to "vent" about their traumas and they would experience an emotional release that would be curative. However, now that we know more about the mind-body connection, trauma experts know that not only is it not helpful to just have someone venting about their trauma--it can actually be a retraumatizing experience.

Why is this? When a someone recounts their traumatic experience, if he has not developed coping mechanisms (called "resources" in Somatic Experiencing) to deal with the trauma, he's just reexperiencing the same emotions and physical body sensations that he experienced at the time of the trauma. 

This assumes that the client is not completely cut off from his feelings, which is another type of traumatic reaction called dissociation. 

In effect, he is reliving the trauma and going around and around in the same trauma "vortex," so to speak. There is usually no healing going on in this situation.

Titrating Trauma Experiences in Somatic Experiencing:
Somatic Experiencing (SE) techniques allow the SE therapist to help the client titrate the traumatic experience into manageable pieces. 

The Somatic Experiencing therapist doesn't go directly for the most traumatic aspect of the experience immediately. As previously mentioned, the SE therapist makes sure that the client has adequate internal and external resources to call on before doing the trauma work.

Mind-Body Oriented Psychotherapy: Somatic Experiencing

Once the SE therapist and client begin processing the trauma, the experience is dealt with in manageable parts, often starting with what might have been happening that was positive just before the trauma. 

So for instance, to give a simple example, if someone was in a car accident, she might have been enjoying her favorite song on the radio just before impact.

Why is this significant?

The SE therapist helps the client to recognize where she is holding onto emotions in the body. Often, these traumatic emotions are "frozen," so to speak, in the body, without the client even realizing it.

So, to help clients to deal with the difficult emotions that are stored in the body, it helps to access internal resources.

So, in the above example, this client has also stored in her body the pleasant experience of listening to her favorite song. In effect, this is a positive resource that the client can use. Connecting to these pleasant feelings is one part, of many, that would help to fortify the client to deal with the trauma.

As part of processing traumatic experiences, in addition to helping clients to use both internal and external sources, the Somatic Experiencing therapist also helps clients to develop a greater emotional capacity to deal with the trauma before the worst part of the trauma is processed. In SE, this is called, metaphorically, developing a larger "container" for the experience.

What does this mean?

Well, if we think of pouring a lot of water into a small container, we know what will happen--the container will be flooded and the water will spill all over the place.

Similarly, Somatic Experiencing therapists recognize that people have "emotional containers" of various sizes.

Some people have larger "emotional containers" than others and they can absorb more emotional content. 

However, people who have been traumatized, by definition, have been "flooded" by emotional experiences that are too overwhelming for them and their "emotional containers" were not large enough. This is not a negative comment about the client. It is a recognition that we all have our limits.

It's the Somatic Experiencing therapist's job to help clients develop a larger "emotional container" in order for the client not to be flooded while processing the trauma in therapy. 

In doing so, Somatic Experiencing therapists help clients to become more resilient and better able to process the trauma without becoming retraumatized.

In Somatic Experiencing, after a client has been prepared by developing resources and a larger "emotional container," the therapist helps the client to titrate the experience through a process called "pendulation."

Somatic Experiencing and the Process of Pendulation
An example of this might be that the client has already learned to visualize a "relaxing place" in his mind's eye prior to processing the trauma.

Not only has the client learned to visualize this place, but he has also learned how to shift his emotional and physical state from one of high emotional activation, which would be too uncomfortable, to a relative state of calm.

Usually, after clients have experienced some degree of calm, they're willing to go back to processing the trauma, knowing that if they experience a degree of emotional activation that is too high again, they can go back to accessing the relaxing place.

The Somatic Experiencing pendulation process allows clients to be in control. Somatic Experiencing assumes that clients know innately what's best under these circumstances. The Somatic Experiencing therapist is there to teach and facilitate the process.

Does this mean that Somatic Experiencing is effortless and there is no discomfort? No, it doesn't. But it does mean that, as opposed to regular talk therapy, the Somatic Experiencing therapist works to ensure that the client is not overwhelmed and not retraumatized.

One blog post is not sufficient to cover Somatic Experiencing. To learn more about Somatic Experiencing, I suggest that you read Peter Levine's books, each of which are written in an accessible way for the general public. His first book is called Waking the Tiger, and his latest book is called In An Unspoken Voice.

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

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

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

With Experiential Psychotherapy, There Are No Blank-Slate Therapists

When I was training to be a psychotherapist in postgraduate training, we were taught that the ideal stance for a therapist was neutrality.  From the neutral perspective, the therapist should not convey what is going on internally, make any unnecessary gestures and, in general, remain as a blank slate (see my article: What's the Difference Between "Top Down" and "Bottom Up" Psychotherapy?).

Experiential Psychotherapy: There Are No Blank-Slate Therapists

Because of my background and temperament, this was especially hard for me.  I was raised in a family that was warm, gregarious and effusive.  There were no blank slates.

I also found that it was better for my patients for me to be an accessible human being in the therapy session, and the less my supervisors knew about my human response to clients, the better.

Of course, I was always careful not to cross any ethical boundaries or provide more information about myself than was necessary or warranted.  The focus was still very much on the client.

Since that time, we now know how emotionally depriving it is for psychotherapists to try to be a blank slate.  I say "try" because no one is ever a blank slate.  We are all always reading and picking up on what's going on with each other all the time.  So, the notion of a "blank slate" is a fallacy.

I'm not sure where the idea of being so impersonal came from.  It certainly wasn't part of Freud's practice.  He regularly walked clients around his garden at his home and had them over to his house.  From everything that I have read, he was rather engaging.

It seems like it was more of an overreaction by American psychiatrists, who were the psychoanalysts of their day, during the early days of psychoanalysis when there were few rules and some analysts were acting out with their clients.

The one thing that Freud didn't like was to be looked at directly by the client when he was with them in his therapy room--even though they looked directly at him when they were in his garden or in his home.   So, he came up with the idea that the therapist should sit behind the client out of the client's sight so he could listen with "evenly hovering attention," ostensibly, without the distraction of looking at the client.

Over time, most therapists discovered that there is a lot that is missed when a therapist isn't looking at the client directly or when the client isn't looking at the therapist.  The therapist isn't picking up on body language, facial cues, gestures and, in general, the intersubjective experience of being with a client.  This is certainly a lot to miss.

There have been certain times when I have had a client who preferred for me to sit behind him so the client couldn't see me and I could only see only the back of his head.  While I honor this request, I also explore the meaning of it with the client.  For some clients, it's easier for them to talk if they don't watch the therapist's face or gestures.  I get that, and I want my clients to be comfortable, so I will arrange to sit behind that particular client.

But the vast majority of clients want the therapist to be human, collaborative, interactive and dynamic rather than a therapist who is trying to be a blank slate.  This suits me fine since it feels most natural to me to work in that way.

There Are No Blank-Slate Therapists With Experiential Psychotherapy
Experiential therapy, including EMDR Therapy (Eye Movement Desensitization and Reprocessing), AEDP (Advanced Experiential Dynamic Psychotherapy), Somatic Experiencing, clinical hypnosis, Emotionally Focused Therapy for couples and other types of experiential therapies emphasize the importance of the therapist being relatively open and emotionally accessible.

How did this change from the blank slate therapist?  Through research and clinical experience, researchers and clinicians discovered that change occurs when psychotherapists and clients are emotionally engaged with each other in therapy.

Some of the research is extrapolated from Ed Tronick's still face experiments between mothers and babies.  Other research from AEDP and Emotionally Focused Therapy also reveals that the therapist and client need to be emotionally engaged for change to take place.

Having a cognitive understanding of their problems is an important part of therapy but, in terms of change, it's limited (see my article: Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

In order to make changes, clients need to be able to get to their underlying emotions (also called primary emotions), and this is difficult to do with a therapist who is sitting there like a mannequin.

In the next article, I'll provide a clinical vignette to illustrate how experiential therapy is different from older forms of conventional psychotherapy and psychoanalysis (see my article: With Experiential Therapy, There Are No Blank-Slate Therapists - Part 2).

Of course, much has also changed in psychoanalysis, especially Relational Psychoanalysis and other contemporary forms of psychoanalysis so there is more of a collaborative approach and more self disclosure on the part of the therapist.  However, unfortunately, there are still some therapists who try to be blank slates.

Getting Help in Psychotherapy
As previously mentioned, these days most clients want a collaborative, interactive and dynamic psychotherapist.

Experiential therapists provide this experience to clients in a supportive and empathic environment.

Experiential therapists also help clients to connect with the mind-body experience.  This is different from conventional talk therapy, which provides more limited insight-oriented experiences.

We now know, based on research and clinical experience, that getting to the core of emotions is what brings about transformation (see my article: Experiential Psychotherapy Helps to Achieve Emotional Breakthroughs).

If you have been struggling with unresolved problems and conventional talk therapy hasn't helped you to resolve these issues, you owe it to yourself to contact an experiential psychotherapist.

Experiential therapy can help to free you from unresolved problems so you can live a more satisfying life.

About Me
I am a licensed NYC experiential psychotherapist who uses clinical hypnosis, EMDR therapy, AEDP therapy, Somatic Experiencing and Emotionally Focused couple therapy (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.

Boredom as a Secondary Emotion: Discovering the Underlying Emotions in Therapy

In my prior article, Understanding the Different Types of Boredom,  I discussed the different types of boredom and how being aware of the type of boredom you're experiencing can lead to your taking action to address your needs.  In this article, I'm focusing on boredom as a secondary emotion that masks deeper unconscious feelings.

Boredom as a Secondary Emotion: Discovering the Underlying Emotions in Therapy

Boredom as a Secondary Emotion
Regardless of the type of boredom someone might be experiencing, when a client comes to my private practice in New York City and tells me that he's bored, I know that boredom often masks other underlying emotions like anger, sadness or fear.

In other words, boredom can be used unconsciously to defend against feeling these other emotions that are more difficult for most people.

The Mind-Body Connection in Psychotherapy
Often, talking about boredom in therapy goes nowhere.  But using the concept of the mind-body connection in psychotherapy often leads to discovering unconscious feelings (see my article:  The Body Offers a Window Into the Unconscious Mind).

Clinical Hypnosis, Somatic Experiencing and EMDR Therapy are three types of mind-body oriented treatment modalities that can help to discover the unconscious roots to emotional problems.

A Fictional Vignette to Discover the Unconscious Roots of Boredom
Let's take a look at a fictional vignette which illustrates how the mind-body connection works:

Sam
Sam started therapy because he felt bored and stuck in a rut at work, and he didn't know what to do about it (see my articles: Getting Out of a Rut - Part 1 and Getting Out of a Rut - Part 2).

Sam had been in therapy before, but he wanted to try something different, so he chose a psychotherapist who focused on the mind-body connection because he thought it would help him to go deeper than he had in his prior talk therapy.

As he described his boredom with his job, his psychotherapist explained that there are different kinds of boredom and it seemed that the particular type of boredom that he was experiencing was reactive boredom where he wanted to escape from his responsibilities, but he didn't know what to do.

In subsequent therapy sessions, his therapist spoke to Sam about boredom being a secondary emotion that often masks other unconscious feelings.

She also spoke to him about using a technique in clinical hypnosis called the affect bridge  to help him to get to the underlying emotions.  She explained that he would be in a relaxed state where she would help him to focus on the boredom, where he felt it in his body, and they would see what else came up in terms of underlying emotions and possible memories.

By the time Sam and his therapist spoke about the affect bridge as part of hypnosis, he already felt comfortable with her and the way she worked, so he agreed to try it.

His therapist started by helping Sam to get grounded and to relax.  Then, she asked him to notice where he sensed the boredom in body.  Sam thought for a few moments, and then he responded by saying he felt the boredom in his upper stomach.  He experienced it as agitation.

His therapist encouraged Sam to continue to feel into the boredom, including the agitation, in his upper stomach.  After a couple of minutes, Sam said that he was aware of a rising sense of anger.

A few minutes later, he remembered a conversation he had with his parents when he was in his early teens.  At the time, he was angry with them because they would often go out and leave him in charge of his three younger siblings.

He said that his anger made no difference to his parents, who continued to force him to babysit for his younger siblings even after Sam complained that he was missing out on social activities with his friends because he was often busy taking care of his siblings.

Suddenly, Sam realized that he had similar feelings towards his boss and his subordinates at work.  He never wanted to supervise employees, but his promotion, which included new responsibilities that he really liked, also included supervising three employees who were difficult.

Sam told his therapist that he often felt that he could be spending more time doing the parts of his job that he really liked if he didn't have to spend so much time "babysitting" for these subordinates, who were often late or didn't come to work.

Instead of spending more time on the projects that he enjoyed, he had to spend time having individual conferences with his subordinates and even more time writing them up.

Over time, Sam realized that, before he did the affect bridge work with his therapist, he was unaware of feeling angry and how his anger about his work connected to his earlier family experiences.

Although both situations felt similar to him, Sam realized that there was an important difference--whereas when he was a teenager he had no choice but to watch his siblings whenever his parents told him to, as an adult, he could speak to his boss about how unhappy he was with the supervisory aspects of his job.

Sam knew that he probably wouldn't have been able to get to the deeper feelings underneath his boredom as quickly if he and his therapist had not used a mind-body oriented approach.

Boredom as a Secondary Emotion: Discovering the Underlying Emotions in Therapy

A few weeks later, Sam met with his boss and asked him if they could restructure his job so he no longer had to supervise employees.  His boss listened attentively.  Then he told Sam that he was thinking of restructuring Sam's job because the company needed him to do more of the creative work.  He said he would reassign Sam's subordinates to two other supervisors.

In his therapy sessions Sam and his psychotherapist worked on the older issue related to his anger towards his parents using EMDR therapy, a therapy developed specifically for resolving traumatic experiences.

Conclusion
Boredom often masks unconscious feelings, such as anger, sadness and fear.

It's often difficult to get to the unconscious feelings that lie beneath boredom with talk therapy.  But using a mind-body oriented therapy, like clinical hypnosis, EMDR or Somatic Experiencing helps to get to the unconscious material so that it can be worked through.

Getting Help in Therapy
If you tend to experience boredom, you could benefit from thinking of boredom as being a secondary emotion that hides unconscious feelings (see my article: The Benefits of Psychotherapy).

An experienced psychotherapist, who uses a mind-body oriented approach in therapy, can help you to discover the unconscious feelings that are being masked by the boredom so you can get to the root of the problem and work through it in therapy (see my article: How to Choose a Psychotherapist).

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

I have helped many clients to discover the unconscious feelings that are at the root of 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.

Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations

In prior articles about developmental trauma, I discussed that it's not unusual for adults, who have  developmental trauma from childhood, to have problems putting words to their feelings and sensations (see my article:  Developmental Trauma: Living in the Present As If It Were the Past and Developmental Trauma: "This is Who I Am" vs "This is What I Do").  In this article, I'm focusing more on this clinical issue.

Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations 

For infants to develop neurologically and emotionally, their primary caregiver (usually the mother) must be emotionally attuned to the infant.  Beyond providing basic physical care, the mother must enter into an intersubjective dynamic with the infant where she interacts in an emotionally nurturing way.

Over time, this emotional attunement facilitates the infant's brain development, especially the right side of the brain which is the dominant side of the brain up until the third year of life.

Since the right side of the brain is already activated for infants, they learn quickly using the right side until the age of about 3 when dominance shifts from the right side to the left side of the brain.

The right side of the brain is involved in the processing of social-emotional information, the facilitation of attachment functions, and regulating bodily and emotional states.

If the primary caregiver's provides "good enough" emotional responses to the baby's movements, gestures and sounds, the baby will develop a secure attachment bond to the primary caregiver and, as an adult, will have the capacity to form healthy relationships with other adults.

But if the primary caregiver does not provide these emotional responses to the baby or provides them in an inconsistent or disorganized manner, the baby develops an insecure attachment to the caregiver, which has negative implications later on for adult relationships.

In addition, if the infant is neglected in this way or abused by the caregiver, there are also negative implications for emotional regulation as well as the ability to identify feelings and sensations.

Needless to say, these deficits in the ability to identify feelings and sensations have serious consequences for the adult's inner world as well as the ability to form healthy relationships.

Clients, who start psychotherapy because they're having problems understanding themselves and forming relationships and who often blame themselves for their problems, usually don't make the connection between early neglect or abuse and their current problems, which is why it's so important for psychotherapist's to provide this psychoeducation to them (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

Providing these clients with psychoeducation isn't a matter of blaming the mother or the primary caregiver, who often had an early history of abuse or neglect.  It's a first step in helping the clients to understand the origin of their problems.

Also, if they have children, having this psychoeducation helps them to understand the importance of forming a secure attachment bond with their own children so the problems don't continue into the next generation (see my article:  Psychotherapy and Intergenerational Trauma).

Unfortunately, many adults who have problems identifying their feelings and sensations never make it to therapy.  For some people, it's a matter of shame.  They think that, somehow, their problems are their own fault, and their parents might have communicated this to them when they were children.

Other people with developmental trauma don't come to therapy because they're confused about their problems and they think they have to be able to articulate their problems or they can't be helped.  They don't know that most psychotherapists will start at whatever point they find themselves when they begin therapy, and therapists will help clients to  understand these problems as they work towards resolution.

Then again, there are other practical issues involving health insurance and other financial concerns that keep so many people out of therapy in general.

Let's take a look at a fictional vignette, which illustrates the issues that are so common to this problem.

Fictional Vignette: Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations

Amy
Amy started psychotherapy when she was in her early 30s because she had problems sustaining romantic relationships (see my article: The Psychotherapy Session: A Unique Intersubjective Experience and The Psychotherapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Overcoming Developmental Trauma: Developing the Capacity to Put Words to Feelings and Sensations

Attractive and intelligent, Amy had no problems meeting and dating men that she was interested in.  Typically, her problems began a few months into the relationship when the relationship became more emotionally intimate.

At that point, Amy became unsure of herself.  She usually knew when she was sexually attracted to a man and she enjoyed the sex during the first few weeks of the relationship.  But as the relationship intensified, she felt confused about what she felt for her boyfriend and she no longer enjoyed sex.

This left Amy and whoever she was dating at the time confused and frustrated.  And when these issues didn't clear up, the relationship would fall apart.

After a recent breakup where Amy found herself in this predicament again, she decided that she needed help in therapy.

At first, she was unsure how to describe her family background.  However, over time, it emerged that she was the only child of a single teenage mother, who sent Amy to live with an elderly great aunt shortly after Amy was born.

As an adult, Amy learned from relatives that this great aunt, who suffered with a multitude of medical problems, was barely able to care for Amy.

After the first year, the great aunt sent Amy to live with Amy's mother's sister, a woman who struggled with major depression her whole life and who resented taking care of Amy.

Throughout her childhood Amy was shifted from one relative to the next in different states around the country until she was 10 and her mother was in a better position financially to take care of her.

Since Amy's mother made no effort to maintain a relationship with Amy, Amy described how awkward it was for both of them.

Although her mother provided her with food and shelter, her mother didn't know how to develop a mother-child relationship with Amy because she never had that experience with her own mother.  She treated Amy was if Amy was a small adult with no understanding of what Amy needed from her.

If Amy was upset, her mother, who didn't know how to soothe Amy, would tell her, "If you're upset, it's your own fault."

When Amy was 18, she got a scholarship to an out of state college and jumped at the chance to get away from her mother.  After college, she got a job and moved in with women she knew from college, and she hardly saw her mother after that.

Amy's last relationship ended in much the same way that her other relationships ended.  She and Tom met through friends.  There was a strong attraction between them from the start.  But after a few months, Amy felt confused about whether she still liked Tom or not.

Tom was confused and couldn't understand the change in Amy, and Amy couldn't explain what happened. Soon after that, Tom ended the relationship and Amy felt she was to blame, once again, for a relationship not working out.

Amy's therapist provided Amy with psychoeducation during the initial stage of psychotherapy.  She also explained to Amy that core emotional issues tend to come up as a romantic relationship becomes more emotionally intimate, which would explain why Amy began having problems when her relationships became more intimate.

In addition, Amy's therapist explained how psychotherapy could help Amy.

With regard to Amy's developmental trauma, her therapist explained that, as a result of Amy's childhood history where her caregivers were unable to form an emotional attachment with Amy, Amy experienced emotional neglect (see my article: What is Childhood Emotional Neglect? and How Your Attachment Style Affects Your Relationship).

Her therapist also explained that when she went to live with her mother, Amy experienced emotional abuse because her mother blamed Amy whenever Amy had problems and, due to her own lack of maternal nurturing, her mother didn't know how to nurture Amy.

As a result of these issues, Amy never developed the skills she needed to form intimate adult attachments.  Amy's developmental trauma also had negative implications for Amy being able to identify her feelings and sensations.

Since Amy's psychotherapist used mind-body oriented psychotherapy, like Somatic Experiencing, she was able to help Amy to begin to identify her feelings using her body (see my article: Somatic Experiencing: Tuning Into the Mind-Body Connection).

For instance, Amy learned to recognize that when she felt fearful, which was often, her stomach would clinch.  She also learned that when she felt angry, she felt a tightness in her throat.

Using this mind-body oriented "bottom up" approach, rather than a "top down" approach which is used in cognitive behavioral therapy (CBT), Amy's therapist helped Amy to recognize her feelings and to be able to put words to those feelings.

This work in therapy was neither quick nor easy since Amy was working to overcome early developmental trauma and to develop skills that she never developed early on.

As time went on and Amy got better at connecting to her body to identify feelings and sensations, she and her therapist were able to process her early developmental trauma using EMDR therapy (see my articles: What is EMDR Therapy? and How EMDR Therapy Works: EMDR and the Brain).

Over time, as Amy became more adept at connecting with her emotions, she also developed better relationship skills.  When she entered into a new relationship, she was able to remain connected to herself emotionally and physically as well as being attuned to her boyfriend.

Rather than shutting down emotionally and physically, as she did in the past, Amy was able to remain open in herself and her boyfriend as the relationship became more serious.  Eventually, she and her boyfriend moved in together and they began talking about getting married.

Conclusion
When an infant's needs aren't met because the primary caregiver is unable or unwilling to meet those needs or because there has been multiple and inconsistent caregiving over time, the infant's brain development, in particular the right brain, suffers.

These developmental deficits have negative implications for adult relationships and often result in the individual being unable to identify feelings and sensations.

There is now a greater understanding of developmental trauma due to infant research and the development of trauma-informed therapy.  Within the last 20 years or so, there has also been many advances in psychotherapy to help clients to overcome developmental trauma.

Getting Help in Therapy
A skilled trauma-informed psychotherapist can help clients to overcome developmental trauma.

Trauma treatment modalities, such as Somatic Experiencing and EMDR therapy, help clients to overcome developmental trauma.

Somatic Experiencing and other Somatic psychotherapies help clients to begin to identify their feelings and sensations.

EMDR therapy helps to process traumatic experiences.

If the problems described in this article resonate with you, you owe it to yourself to get help from a trauma-informed psychotherapist (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than continuing to suffer internally and in your interpersonal relationships, you could work with a trauma-informed psychotherapist to overcome your problems.

By resolving your trauma, you free yourself from a history that has been an obstacle to your happiness.

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

I have helped many clients to overcome developmental trauma so they could go on to lead happier 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.

Using Somatic Psychotherapy When Clients Doesn't Know How to Express Emotions

In prior articles, I've discussed the mind-body connection and psychotherapy.

See my articles:  

Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious Mind

Clinical Hypnosis and the Mind-Body Connection

Overcoming Childhood Trauma That Affects You as an Adult

Experiential Therapy, Like EMDR, Helps to Achieve Clinical Breakthroughs).  

In this article, I'm focusing on how Somatic Psychotherapy can be used when the client has no words to describe a psychological problem.

Using Somatic Psychotherapy When the Client Has No Words

There are times when, due to the nature of the problem or for a variety of reasons, the client might not have words to describe the problem.

So, when might this happen?  

One possibility is that the traumatic event might have occurred when the client was very young so there aren't clear memories or it might have even occurred preverbially (a birth trauma would be an example of preverbal trauma).

With regard to preverbal issues, before a child can speak, she cannot symbolize her problems for herself or others because she doesn't have language, so there are no words.  

However, as I've discussed in a prior article, the body holds onto unconscious memories, and it's possible to use mind-body oriented psychotherapy (also known as Somatic Psychotherapy) to work on the problem.  More about this below.

Most forms of psychotherapy rely exclusively on words to resolve psychological problems. That's the nature of talk therapy.  The client comes to see the psychotherapist, describes the problem as best as she can and they work on the problem by exploring the current situation, getting history, and helping the client to make psychological connections and work through the problem.

But when the problem is outside of the client's conscious awareness, she might only have a vague awareness, if at all, of what the problem is.

At that point, psychotherapists who are trained to use mind-body oriented therapy, like EMDR therapy, clinical hypnosis or Somatic Experiencing, can help the client to explore the problem by using the mind-body connection.

The following fictionalized vignette illustrates how the mind-body connection can help when the client is unable to express the problem in words:

Nina
Prior to starting therapy again, Nina had been to several therapists in the past.

Although she liked her prior therapists, she didn't feel she got much out of therapy because she didn't know how to describe her problem.  She only knew that she felt extreme anxiety whenever she went home to visit her grandmother.  Other than going to her grandmother's home, she usually didn't feel anxious.

Talking about her anxiety with her prior therapists didn't help her.  They were only able to get so far, but she continued to have this extreme anxiety whenever she went on these visits.  Even talking about going on one of these visits was somewhat anxiety producing.

Nina chose her current therapist because she read articles that certain types of mind-body oriented therapy are helpful with clients where regular talk therapy hasn't been helpful.

Using Somatic Psychotherapy When the Client Has No Words to Describe the Problem

Nina's current therapist worked with Nina to help her to explore the sensations and emotions that she felt in her body using a technique called the Affect Bridge in clinical hypnosis (also known as hypnotherapy).

Nina was able to tell her therapist that, aside from the anxiety she felt, she also felt a tightening in her stomach when she thought about those visits.

Over time, as Nina and her therapist continued to explore these emotions and sensations, Nina realized that her anxiety about going to her grandmother's house was longstanding--ever since she was a young child.

Further exploration in her therapy sessions revealed that Nina felt most anxious about her grandmother's basement.

Then, gradually, over the course of months, as Nina became more attuned to what she was experiencing, she remembered that she saw a man molesting her cousin, Betty, one day in the basement.  At the time, Nina became so frightened that she ran upstairs and she was too afraid to tell anyone what she saw.

Since memories tend to be unreliable, even memories that are associated with the mind-body connection, Nina called Betty and she began speaking to her about her anxiety when she visited their grandmother's home.

She didn't know how to ask Betty about whether she was sexually molested or not, but she didn't have to because Betty told her that she also felt very uncomfortable going there and then she told Nina what happened:  A handyman who came to do repairs was in the basement when Betty went down there.

He seemed nice at first, but after talking to her for a few minutes, he grabbed her and touched her breasts.  As soon as she was able to pull away, Betty ran upstairs, but she never told anyone what happened--until she had this conversation with Nina.

Then, Nina told her that she recently remembered in therapy that she was on the basement steps when she saw this man molesting Betty, but she was also too afraid to tell anyone, so she ran.

Nina and Betty talked for a long time and Betty was able to confirm the details that Nina remembered in her therapy.  They were also able to be emotionally supportive of each other.

When Nina had her next therapy session, she told her therapist that Betty confirmed the memory.

Her therapist told her that, even though Nina wasn't the one who was molested, that it was emotionally traumatizing to see her cousin being molested.

From that point on, now that they knew they had a valid memory, her therapist used EMDR therapy to help Nina to work through the trauma.

Conclusion
There can be times when, for a variety of reasons, psychotherapy clients are unable to express their problem in words.  In some cases, there are no words and in other cases the issues might be unclear.

Using a mind-body oriented therapy can get to unconscious issues that regular talk therapy often cannot.  The reason for this is that the body offers a window into the unconscious mind.

Mind-Body Connection: Using Somatic Psychotherapy When the Client Has No Words to Describe the Problem

It can take a while before a client becomes accustomed to accessing emotions and sensations through the body, but many clients become adept at this over time.

Clients who are already in talk therapy and who want to remain with their current therapist can have adjunctive therapy sessions with a therapist who uses mind-body oriented psychotherapy (see my article: What is Adjunctive Therapy?).

In that case, the talk therapist is the primary therapist and the mind-body oriented therapist is the secondary therapist.

For clients considering adjunctive therapy, it's best to start by talking to your primary therapist about it.

Getting Help in Therapy
If you're finding that regular talk therapy hasn't been helpful to you, you might consider a form of somatic psychotherapy (How to Choose a Psychotherapist).

We know so much more now about the connection between the mind and the body than we ever knew before, and psychotherapists who use various forms of somatic psychotherapy usually know how to help clients to access unconscious issues.

Rather than suffering on your own, you could benefit from getting help from a psychotherapist who uses somatic psychotherapy.

The first step is to set up a consultation.

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

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

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