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NYC Psychotherapist Blog

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Showing posts with label psychotherapist. Show all posts
Showing posts with label psychotherapist. Show all posts

Friday, February 6, 2026

Healing From Childhood Trauma: What is the Difference Between Abuse and Emotional Neglect?

I've written about childhood trauma in prior articles, including articles about childhood abuse and neglect.

Childhood Abuse vs Neglect

A common question that clients ask when they are in trauma therapy involves understanding the difference between abuse and neglect, which is the subject of this article (see my article: How Trauma Therapy Can Help You to Overcome Unresolved Trauma).

What is the Difference Between Abuse and Neglect?
The main difference between childhood abuse and neglect is action versus inaction of the caregiver as well as the intent of their behavior. 
  • Abuse: Abuse is often an active, intentional, effort to harm, threaten or injure a child. It is an act of commission. Examples include (but are not limited to) physical harm, emotional abuse and sexual abuse. Abuse usually involves intentional, reckless and premeditated behavior.
  • Emotional Neglect: Emotional neglect is often passive. It is an act of omission. The caregiver does not provide the necessary basic care (food, shelter, medical care) and emotional nurturance which includes the emotional support, validation, empathy and secure emotional connection for healthy childhood development.
Clinical Vignettes
The following clinical vignettes illustrate the difference between childhood abuse and neglect.  All identifying information has been removed to protect confidentiality.

An Example of Abuse: Sara
When Sara was a young child, her father would often come home drunk and beat Sara and her siblings. He would also hit their mother who felt powerless to stop him from hitting her and the children. By the next day, when the father was sober, he didn't remember hitting his wife and children. But after Sara's maternal uncle moved into the home, he put a stop to the abuse by restraining the father and calling the police. After several incidents where the police were called, the father was court mandated to get into alcohol treatment and the family received mental health services from a local community mental health service.

An Example of Neglect: Tom
When Tom was a young boy, he was emotionally neglected by both of his parents. His mother focused on her design business so that she rarely went to any school activities that Tom participated in. She would frequently place Tom in front of the television while she entertained clients in the house. His father was usually away on business trips and, when he was at home, he spent most of his time in his den watching sports while Tom was alone in his room. When a young family moved next door, the mother would invite Tom to come over to play with her children. She was also kind and compassionate with Tom because she realized he was a lonely boy.

The Trauma of Childhood Abuse and Neglect
Both abuse and emotional neglect are traumatic.

There are times when emotional neglect can be more damaging than abuse because:
  • Emotional Neglect is Often Invisible: Emotional neglect can be hard to identify because it's often invisible. Neglect is characterized by what didn't happen (lack of love, attention or validation) as opposed to certain forms of abuse that can be detected based on marks or scars on a child's body that are noticeable.
Childhood Abuse vs Neglect
  • Children Internalize Neglect: Whereas children who are abused might blame the abuser, children  who are emotionally neglected often blame themselves. These children believe they are flawed in some way and, as a result, they were unlovable (see my article: Overcoming the Emotional Pain of Feeling Unlovable).
  • Brain Development: Many children who are severely and chronically neglected can experience cognitive and language deficits.
What Are the Long Term Effects of Childhood Abuse and Neglect?
Both abuse and neglect can have a long lasting potential psychological effects including:
  • Relationship Problems: Problems with trust, fear of intimacy or self abandonment in relationships (see my article: What is Self Abandonment?)
  • Problems with Emotions: Difficulty identifying, managing and expressing emotions 
Conclusion
Although both abuse and neglect can have long lasting effects, studies have shown that neglect is often particularly damaging especially when the neglect is unseen, ignored or overlooked.

Although I have discussed abuse and neglect separately to distinguish one from the other, there can also be a combination of abuse and neglect.

Many adults believe their experience wasn't bad enough to get help.  However, the trauma of abuse and neglect usually require the therapeutic interventions of trauma therapy.

Getting Help in Trauma Therapy
Trauma therapy includes a group of therapies that were specifically developed to help clients to overcome the traumatic effects of their history (see my article: Why is Experiential Therapy More Effective at Resolving Trauma Than Talk Therapy?).

Getting Help in Trauma Therapy

Trauma therapy includes:
  • EMDR Therapy (Eye Movement Desensitization and Reprocessing)
  • AEDP (Accelerated Experiential Dynamic Psychotherapy)
Rather than struggling on your own, seek help from a licensed mental health professional who is trained as a trauma therapist.

Working through unresolved trauma can help you to free yourself from your history so you can live a more fulfilling life.

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

As a trauma therapist, I have over 25 years of experience helping 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.




















Tuesday, February 3, 2026

How Avoidance of 1ntimacy Turns Into Emotional Distance in Relationships

One of the most common reasons why couples seek help in couples therapy is due to lack of emotional and sexual intimacy (see my article: Have You and Your Partner Stopped Having Sex?).

Sexual Avoidance Turns Into Emotional Distance

Why Do Couples Avoid Emotional and Sexual Intimacy?
Emotional and sexual avoidance is a complex issue with many possible causes including relational and psychological issues.

Sexual avoidance creates relationship distance by transforming lack of sexual avoidance into emotional detachment. 

Sexual Avoidance Turns Into Emotional Distance

Sexual avoidance is rarely just about sex. It often involves relational, emotional, psychological and behavioral factors. For some couples, it can include physical and medical factors.

Sexual avoidance and emotional distance often stem from one or both partners feeling the need to protect themselves from against vulnerability and pressure. 


Sexual Avoidance Turns Into Emotional Distance

This can set up a cycle where an avoidant partner pulls away and the other partner feels rejected, anxious and lonely.

Here are some of the most common reasons for sexual avoidance and emotional distance:

Relational Issues:
Emotional and Psychological Issues:

Unresolved trauma for one or both partners including:
  • A history of sexual assault
  • Anxiety including
Physical or Medical Conditions
  • Chronic pain
  • Cardiovascular problems
  • Diabetes
  • Hormonal imbalances including low testosterone
Behavioral Patterns
  • An obsessive avoidance of sexual intimacy
  • A tendency to detach emotionally or feel unsafe with closeness
Getting Help in Sex Therapy
Sex therapy is a form of talk therapy where individuals or couples seek help (see my article:    What is Sex Therapy?).

Getting Help in Sex Therapy

Sex therapy does not include any nudity or sex during therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?).

Individuals and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Reasons Why Individuals and Couples Seek Help in Sex Therapy?).

Not all couples therapists have training as sex therapists so it's important to ask whether or not a couples therapist is a certified sex therapist.

Rather than struggling on your own, seek help from a licensed mental health professional who ia a certified sex therapist.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have over 25 years of experience working 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.

Also See My Articles:











Monday, February 2, 2026

How to Support a Friend Who is Depressed

Supporting a depressed friend can be challenging, especially if you don't understand what it means to be depressed, so it can be helpful to familiarize yourself with the symptoms of depression (see my article: What is the Difference Between Sadness and Depression?).

Supporting a Friend Who is Depressed

What is Major Depression?
Major depression is a common serious mood disorder.

Depression isn't just "feeling bad". It's a persistent condition that is often episodic and which usually lasts at least two weeks.

Depression isn't a sign of "weakness." It's a mental health condition that is treatable for most people.

Approximately 8-9% of adults in the U.S. experience at least one episode of major depression in their lifetime.

Approximately 15-20% of children ages 12-17 experience depression in the U.S. (see my article: Adolescent Depression).

There are gender differences with women being twice as likely to experience depression than men in the U.S.

Symptoms can include:
  • Intense sadness
  • Irritability
  • Loss of interest in activities that were once enjoyable
  • Feeling worthless
  • Problems concentrating
  • Poor appetite
  • Weight loss
  • Possible suicidal thoughts
  • Possible intent and plan to commit suicide
What Causes Major Depression?
Major depression is often a combination of genetic and environmental factors including (but not limited to):
  • A genetic predisposition for depression
  • Low self esteem
  • Pessimism
  • Medical conditions
  • Substance misuse/abuse
  • Financial problems
  • Medications
How Can You Help a Friend Who is Depressed?
Supporting a friend who is depressed can be challenging.

Supporting a Friend Who is Depressed

Here are some tips for helping a depressed friend:
  • Listen without judgment
  • Keep in touch to check in with them
  • Offer help including
    • Helping with chores
    • Running errands
    • Offering childcare to give them a break
    • Helping with other tasks
  • Encourage your friend to get professional help which might include helping them to find a psychotherapist or psychiatrist in their area.
  • Be patient and understand that recovery from depression can take a while.
What Should You Not Do?
  • Don't say things like "Snap out of it' or "Cheer up" or "You have so much to be grateful for."
  • Don't minimize or dismiss their pain by saying, "Things could be worse."
  • Don't blame them for their depression.
  • Don't try to be their psychotherapist. Be their friend.
Take Care of Yourself
Supporting a loved one who is depressed can be physically and emotionally draining 

Self Care

Make sure you have your own friends and support system.


Seek help for yourself if you feel overwhelmed by your friend's depression.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Parts Work (IFS and Ego States Therapy), EFT (for couples), Somatic Experiencing and Certified 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.

Also see my articles: 













Wednesday, January 28, 2026

What Does It Mean to Be "On a Break" From Your Relationship?

Anyone who watched the "Friends" episode, "The One Where Ross and Rachel Take a Break" remembers the problems that resulted from Rachel telling Ross during a heated argument that they should take a break.

Taking a Break From Your Relationship

During their argument, after Rachel suggests they take a break, Ross walks out feeling devastated. Then, he goes out to a club, gets drunk and he gets sexually involved with Chole, the "copy girl."

Soon afterwards, Rachel finds out that Ross slept with Chloe, which leads to another argument about what it means to be "on a break" and whether it meant that Ross and Rachel were broken up or they were temporarily not seeing each other but also not seeing anyone else.

This misunderstanding leads to a breakup because Rachel is hurt, angry and mistrustful of Ross.

What Does It Mean to Be "On a Break" From Your Relationship?
To avoid potential misunderstandings, it's important to be clear on what it means when you say you want a break in the relationship.

Here are some factors to consider:
  • Define the Terms: Be clear with each other as to whether you're each taking a "pause" from the relationship in order to fix problems or if the break is actually the beginning stage of a permanent breakup.
  • Establish Ground RulesBe specific: Does it mean a one week break or a one month break or some other time period? Also, be clear as to whether you can each date other people or if other people are off limits.  Does it mean you're going to go no-contact? If not, what type of contact will you have (text? phone calls? etc) and how often. Whatever you both decide, respect the boundaries you have both agree to.  If you don't define the terms together, you're going to have misunderstandings similar to Ross and Rachel on "Friends".
Taking a Break From Your Relationship
  • Focus on Self Care and Reflection: Use your time apart to think about your needs, your partner's needs, the relationship issues and whether or not you want to be in this relationship.
  • Avoid Manipulation: Do not use the break to gain leverage or make your partner jealous.
  • Manage Your Expectations: Be prepared for an outcome that could go either way including the possibility that the break can lead to a permanent separation.
  • Don't Use a Temporary Break to Avoid Saying You Want a Permanent End to the Relationship: Many people who don't feel comfortable saying they want to end the relationship tell their partner that they want a temporary break knowing beforehand that they don't plan to reunite with their partner. They're too uncomfortable to talk about their real feelings, so they use the excuse of a temporary break as a way to exit the relationship. Then, they ghost their partners and don't respond when their partners contact them which leaves their partners feeling hurt, angry and betrayed. If you know. you want to end the relationship, say so. It will be a lot less painful for both of you in the long run if you're upfront and honest with yourself and your partner.
Get Help in Couples Therapy
If you're not sure how to handle being on a break or you're not sure if you even want a break, seek help in couples therapy.

Get Help in Couples Therapy

A skilled couples therapist can help you to define what you each want from your relationship and, if you choose to stay together, provide you with the tools and strategies to get there. 

If you decide not to stay together, a couples therapist can help you to break up in a way that is caring and respectful.

So, rather than struggling on your own, seek help from a licensed mental health professional who is a couples therapist.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have over 25 years of experience working 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.




Tuesday, January 27, 2026

How to Build Your Self Esteem

What is Self Esteem?
Before we discuss how to build your self esteem, let's start by defining self esteem.

Building Your Self Esteem
Self esteem includes 
  • A sense of self worth and value
  • Self respect
  • An overall sense of yourself
What Affects Your Self Esteem?
Your self esteem is shaped by many aspects including
  • Early childhood experiences 
  • Personal relationships and prior experiences
  • Thoughts
  • Relationships
  • Motivation
  • Acceptance of imperfections, mistakes and challenges
What Are the Key Aspects of Self Esteem?
  • Self evaluation including your subjective thoughts and beliefs ("I am lovable" or "I am capable") and other feelings about yourself
Building Self Esteem
  • A foundation of well-being that supports your mental health and relationships
What is the Difference Between Healthy Self Esteem vs Low Self Esteem?
Healthy Self Esteem: 
  • You accept your strengths.
  • You recognize areas where you need to improve and accept this with self compassion and without judgment.
  • You are resilient to constructive criticism.
Low Self Esteem: 
  • You experience self doubt.
  • You might have a fear of failure. 
  • Other possible behavioral dynamics
How is Self Esteem Different From Self Confidence?
Self esteem and confidence are related; however, self esteem is your general sense of self worth and self confidence is usually related to certain skills.

For instance, your overall self esteem might be good, but you might feel less confident in your public speaking ability and more confident in your ability to solve problems.

How to Build Your Self Esteem
Building your self esteem includes:

A Healthy Mindset
  • Practicing Self Compassion: Treat yourself with the same compassion and kindness you would treat a loved one. 
Building Self Esteem
  • Identify Your Strengths: Write down your strengths and focus on them.
Actions and Habits
  • Set Achievable Goals: Start small and celebrate your victories as you build momentum to bigger goals (see my article: Celebrate Your Success).
  • Engage in Enjoyable Activities: Engage in hobbies and activities you enjoy and you're good at.
Building Self Esteem
  • Prioritize Self Care: Get enough sleep, eat nutritious meals, exercise at a pace that's right for you (see my article: Taking Time For Self Care).
  • Help Others: Volunteering and engaging in acts of kindness can give you a sense of purpose and meaning.
Relationships
  • Choose Supportive People: Choose people who value you and treat you well.
Building Self Esteem
  • Limit Negativity: Reduce your exposure to negative influences, including social media.
  • Communicate With Trusted Loved Ones: Share your struggles with trusted loved ones to build connection and realize that others often struggle with the same problems.
Deeper Self Esteem
  • Take Action: Take steps to build your self esteem rather than waiting for it to happen.
Get Help in Therapy
If you have tried to build your self esteem and you feel stuck, rather than struggling alone, consider working with a licensed mental health professional who has an expertise in helping clients to overcome obstacles that are getting in your way.

Get Help in Therapy

Building your self esteem can help you to live a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

With over 25 years of experience, I have helped many 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.
















Monday, January 26, 2026

What is the Difference Between Assertive and Aggressive Behavior?

Many people don't understand the difference between being assertive and being aggression, so I think it's worthwhile to define each of these terms and differentiate them from one another.

Assertiveness vs Aggressive Behavior


What is Assertiveness?
Assertiveness is the ability to express your needs, feelings and boundaries with confidence, clarity and respect.  While being assertive, you're not diminishing or violating the rights of others.

What is Aggression?
Aggression attempts to control, manipulate or intimidate others to get your own way. This often violates boundaries and damages relationships.

What is the Difference Between Assertiveness and Aggression?
Based on the descriptions above, the difference between assertiveness and aggression lies in whether you respect yourself and others, which would be assertiveness, or prioritizing yourself at the expense of others, which would be aggressive.

Let's take a closer look at the differences between assertiveness and aggression:

Intent: 
  • Assertiveness seeks understanding, resolution and mutual respect. 
  • Aggression is often fueled by a desire to control, win or punish.
Respect For Others:
  • Assertive behavior seeks to consider the needs of others while expressing your own needs. 
  • Aggressive behavior often disregards the needs and feelings of others.
Emotional State:
  • Assertiveness is usually calm, rational and firm. 
  • Aggression is usually emotionally charged and accompanied by anger or contempt.
Focus:
  • Assertiveness focuses on the problem using "I" statements.
  • Aggression focuses on attacking and blaming the other person using "you" statements.
Why Is It Important to Know the Difference Between Assertive and Aggressive Behavior?
  • Long Term Impact: Assertiveness seeks to build trust, self esteem and healthier, more productive relationships.
  • Consequences: Aggression causes resentment, fear and disconnection.
  • Cultural Context: Women, people of color and others are often labeled as "aggressive" for behavior that is viewed as "assertive" in others. This makes it important to recognize and challenge these biases.
Examples:

Joe:
After a contentious staff meeting where Joe attempted to intimidate and dominate his colleagues, his director confronted Joe about his aggressive behavior, but Joe told his director that he didn't care if his colleagues didn't like him because the only thing he cared about was "winning" the company prize for highest sales. He told his director he thought his colleagues were "losers" and they should be fired. 

Aggressive Behavior

In response, his director attempted to work with Joe to help him to understand the impact his behavior was having on his work relationships. He explained how Joe could be assertive, rather than aggressive, by speaking in a calm tone and showing his colleagues respect. When Joe's behavior continued to be aggressive, his director terminated him.

Julie:
As the only Black woman on her executive team, Julie talked to the other executives on the team about the negative impact some the company's policies had on women. She could sense their discomfort while she was speaking and she asserted she felt there was a need to address these issues to make certain changes which would benefit employees and the company. 

Assertive Behavior

After the meeting, she overheard one of the male executives remark quietly to another male executive, "I can't stand aggressive women." She reflected on her behavior in the meeting and she concluded that she was assertive and not aggressive. Soon after that, she consulted with the human resource director who agreed that the policies should be reviewed and changed. She also told Julie she would do a company-wide training to educate employees about the difference between assertiveness and aggressiveness especially as it applied to women and people of color.

Mark:
When his friends confronted Mark about his aggressive behavior with women at a club they often attended, Mark shrugged it off by saying, "Women want men to dominate them. No matter what they say in public, privately they want a strong man." In response, his best friend, John, pointed out that women usually rebuffed Mark at the club because they were put off by his controlling behavior. 

Aggressive vs Assertive Behavior

He also explained that some of the women in their friend group also complained that they sometimes felt bullied by Mark and that he usually focused on what he wanted even if the rest of the group wanted something else. Mark respected John so he thought about the negative consequences his aggressive behavior had in his personal relationships and he decided to try to change. John suggested that Mark get help in therapy to understand what caused him to try to control and manipulate others. Over time, he realized that his father, who was aggressive within the family, only expressed praise for him when Mark was also aggressive in his relationships. At that point, Mark realized he had a lot of work to do in therapy and he felt it was worth it.

Conclusion
Although many people confuse assertive and aggressive behavior, there are important differences.

Understanding the differences can help you to have a healthier relationship with yourself and others.

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

I have over 25 years experience working 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,

Also See My Article:











Wednesday, January 21, 2026

Relationships: Jealousy Isn't Love

Jealousy is a common emotion experienced in varying degrees in most romantic relationships (see my article: Overcoming Jealousy That's Ruining Your Relationship).

What is Jealousy?
Feeling jealous is often a signal of perceived danger to the relationship. 

Jealousy usually involves a fear of losing a partner to a rival. 

Jealousy Isn't Love

A little bit of jealousy can be a signal that you and your partner need to talk about insecurity and unmet needs. 

Communication between you and your partner about what makes each of you jealous or uncomfortable can help you to make positive changes in your relationship.

Why Do People Confuse Jealousy and Love?
People confuse jealousy and love because jealousy tends to: 
  • Signal a deep emotional investment
  • A fear of losing someone who is important 
  • A perceived threat to a valued bond
Jealousy is often romanticized as proof of devotion, but this is incorrect because jealousy isn't love.

What Can Trigger a Jealous Reaction?
Almost anything can trigger a jealous reaction. It depends on the person.

Examples might include:
  • Spending time with friends
  • Talking to an attractive person at a party
  • Going to lunch with a coworker
  • Talking about a former romantic partner which is called retroactive jealousy
How is Jealousy Different From Envy?
People often confuse jealousy and envy.

Whereas jealousy is losing someone or something to a third party, envy is wanting something that someone else has.

When Does Jealousy Become Unhealthy?
A fleeting pang of jealousy which leads to you and your partner talking about the relationship in a calm and thoughtful way can be a good thing and can bring you closer.  

This is different from excessive jealousy.

Jealousy Isn't Love

Excessive jealousy can lead to:
  • Obsessive thoughts and an inability to let go of fears, which leads to constant worry
  • Controlling behavior like dictating who a partner can see or where a partner can go, dictating what a partner can wear, forbidding certain activities and so on
  • Constant unwarranted suspicion with unfounded accusations and excessive questioning
  • Possessive or accusatory reactions
  • Invading privacy such as checking a partner's phone and demanding constant updates, which can erode a relationship
  • Isolation such as trying to isolate a partner from friends and family
Overcoming Excessive Jealousy
  • Self Reflection: If you're the partner who is excessively jealous, reflect on your behavior and identify your insecurities. Recognize that you have a problem and work on building your self esteem and confidence.               

Jealousy Isn't Love
  • Personal Safety: If you're the partner who is experiencing excessive jealousy from your partner, consider your personal safety first. If your partner is threatening you, you need to confide in at least one trusted loved one and remove yourself from harm.
  • Communication: Assuming you can both remain calm, speak openly with your partner about your feelings without blame.
Get Help in Therapy
  • Seek Help: Seek help in individual therapy or couples therapy to work out issues around jealousy.
About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work (IFS and Ego States Therapy), Somatic Experiencing and Certified Sex Therapist.

I have worked with individual adults and couples for over 25 years.

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.

Also See My Articles: