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NYC Psychotherapist Blog

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Showing posts with label shame. Show all posts
Showing posts with label shame. Show all posts

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:











Thursday, January 8, 2026

Why Do People Suppress Their Emotions?

Many people have a difficult time experiencing certain emotions in a healthy way so they suppress their emotions, which has health and mental health consequences.

Emotional Suppression

Which Emotions Are Commonly Suppressed?
The following emotions are the ones that are commonly suppressed among people who feel they need to hide these emotions:
  • Anger: Anger is often perceived as being aggressive or out of control (even for people who are experiencing anger in a controlled way). Frustration and rage, which are part of anger, are often suppressed (see my article: Fear of Anger is Often Coupled With Guilt and Shame).
  • Sadness or Grief: Crying or showing sadness or grief is often discouraged in our society, especially for men. This often leads to emotional suppression.
Why Do People Suppress Emotions?

Emotional Suppression
  • Social Conditioning: As mentioned above, many people are taught to be "tough" or polite which leads to hiding emotions which are perceived as negative.
  • Fear of Judgment: People who suppress certain emotions often fear that they will be judged or criticized for expressing certain emotions, so they suppress these emotions rather than expressing them.
  • Maladaptive Coping Mechanism: People who suppress certain emotions hide these emotions as a maladaptive coping strategy to avoid discomfort or situations they feel would be overwhelming for them (see my article: Avoidance as a Maladaptive Coping Strategy).
What Are the Consequences of Emotional Suppression?
The most common consequences of emotional suppression include:
Emotional Suppression
  • Emotions Resurface More Intensely: People who suppress their emotions often discover that these emotions resurface in a more intense way. They are also more at risk, compared to people who can express their emotions in a healthy way, for alcoholism, drug abuse and other impulsive or compulsive way
Get Help in Therapy
If you tend to suppress emotions that make you feel uncomfortable, you could benefit from getting help from a licensed mental health professional.

Get Help in Therapy

Learning to express your emotions in a healthy way can help you to be more self aware, reduce anxiety and stress, improve health and mental health and develop healthier relationships (see my article: Learning How to Express Your Emotions in a Healthy Way).

Rather than struggling on your own, seek help from a licensed psychotherapist so you can live a more fulfilling life.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Parts Work (IFS and Ego States), Somatic Experiencing and a 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 Article:













 

Sunday, December 7, 2025

What is the Connection Between Secrets and Shame?

Secrets and shame are connected in many ways:
  • Shame often drives keeping secrets.
  • Keeping secrets creates more shame.
The Connection Between Secrets and Shame
  • Shame and secret keeping often create an ongoing cycle of:
    • Isolation
    • Rumination
    • Anxiety
    • Guilt
    • Negative self judgment
    • Feelings of worthlessness
    • Depression
How is Keeping Secrets Different From Maintaining Privacy?
While secrecy is often about concealing information due to shame or fear, maintaining privacy is about setting boundaries and choosing what information to share. 

Privacy usually doesn't involve shame or fear (see my article: Privacy vs Secrecy in a Relationship).

The Connection Between Secrets and Shame

A person who maintains privacy limits access to their life in terms of what they want to share, to whom and how much they want to share or not share.

The motivation for maintaining privacy is autonomy and personal space. An example of this is if a young child asks a parent how much money they earn and the parent knows the child can't handle this information in a responsible way, the parent might keep this information private until the child is mature enough to be responsible with it.

A person who maintains secrets is actively hiding something they feel ashamed about. Their motivation is to conceal something, avoid judgment or other negative consequences. An example of this is a husband who keeps a secret from his wife about gambling away his paycheck.

How Do Secrets Affect Relationships?
As previously mentioned, keeping secrets creates shame and shame can create secrets (see my article: Why Do People in Relationships Keep Secrets?).
  • Fear of Being Judged as Having Flaws: People who keep secrets from loved ones often experience fear and shame that their loved ones will see them as flawed if they knew certain things about them. This might include their mental health status, financial struggles, addiction or similar issues.
The Connection Between Secrets and Shame
  • Inauthentic and Emotionally Distant Relationships: Keeping secrets involves presenting an inauthentic self to loved ones. People who hide certain aspects of their life have to pick and choose what to tell their loved ones and keep track of what they have already told them. These secrets create emotional distance. Over time, as an individual continues to keep secrets, even if the other partner doesn't know what the secrets are, the emotional distance widens to the point where it can damage the relationship beyond repair.
  • Betrayal and Mistrust: If the secret is discovered, the partner who discovers the secret feels betrayed and mistrusts for their partner. In many cases, depending upon the secret and the couple involved, a secret can ruin a relationship (see my article: Common Relationship Problems After Infidelity).
Clinical Vignette
The following clinical case is a composite of many cases with all personal information changed to protect confidentiality:

Jim
A big part of Jim's job was frequent travel around the country. He often had secret affairs while he was away and he never told his wife, Linda, about them because he considered them harmless. At the time, his attitude was: What she doesn't know won't hurt her.

Jim also liked the way he felt when he was able to attract women and have sex with them (see my article: The Connection Between Infidelity and the Need to Feel Desirable).

During a one week business trip to California, Jim met Tina at a hotel bar and they spent a few nights together. He told Tina he was married and he had no intention of leaving his wife. He said they could have fun together while he was in California, but their time together would never amount to more than that.

The Connection Between Secrecy and Shame

A month later Jim heard from Tina that she was pregnant with his child and she planned to have the baby. He told Tina that he wanted nothing to do with her or the child. He tried to convince her to have an abortion, but she insisted she would have the child. She also told him that, unless he gave her a large sum of money, she would contact his wife and tell her about the child.

Shocked and upset, Jim didn't know what to do. In the past, he had many affairs and there were never any consequences. After getting the call from Tina, he felt angry with himself for not using a condom and believing her that she was on a birth control pill. 

Jim didn't want to hurt Linda. He also feared that Linda would leave him if she found out about the affair and the pregnancy.  He felt deeply ashamed and, after thinking about it, he decided to ignore Tina's calls and keep the secret from Linda.

Although Linda didn't know his secret, she sensed something was off between her and Jim. She asked him numerous times if there was something wrong because she sensed he was emotionally distant from her. 

Jim denied there was anything wrong. Inwardly, his felt increasingly ashamed. He felt so awful that he thought he didn't deserve Linda. He developed anxiety, insomnia and ruminating thoughts about the end of his marriage.

A few months later, when Jim came home, he found Linda sitting on the couch looking very upset. His worst fears were confirmed when Linda told him she received a call from Tina about the affair and the pregnancy.  She told Jim she wanted to know the truth.

After much hesitation, Jim admitted that he had an affair and he heard from Tina that she was pregnant. He said that without a paternity test to confirm the baby was his, he wasn't sure if he was the father, but he feared that the baby might be his.

At Linda's request, Jim moved into a hotel. Linda said she needed time to think about whether she wanted to remain in the marriage. Although he had opportunities to have sexual affairs while he was at the hotel, he felt so depressed that he rejected women who approached him.

A month later, Linda said she wanted to attend couples therapy to see if their relationship could be salvaged. 

During couples therapy Jim admitted to having numerous affairs which he now regretted. He expressed sincere remorse. He also admitted he had been selfish and he now realized he put their relationship at risk. In response, Linda expressed her anger, hurt, disappointment and sense of betrayal.

Soon after that, Jim entered into his own individual therapy to understand the underlying reasons for why he cheated, to make changes and to try to save his marriage. 

Subsequently, a paternity test revealed that Jim wasn't the father of the baby. Linda decided to stay in couples therapy with Jim to see if they could repair their relationship and if she could regain trust in him.  She told him that she wasn't promising him anything but, after investing 20 years in their marriage, she wanted to give it a try (see my article: Rebuilding Trust After an Affair).

Conclusion
Secrets and shame are connected in an ongoing destructive cycle.

Keeping secrets is different from maintaining privacy for the reasons mentioned above.

Getting Help in Therapy
If you have been struggling with secrets, you could benefit from seeking help from a licensed mental health professional.

Getting Help in Therapy

Being able to talk about a long-held secret can provide you with a sense of relief. 

Although a psychotherapist can't tell you what to do, she can help you to sort out how the secret has been affecting you and your loved ones so that you can make decisions about what to do and how to change.

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





































Friday, November 28, 2025

What is Transference in Relationships?

I discussed the topic of transference in prior articles as it relates to psychotherapy (see the list of articles at the end of this article).

In the current article, I'm focusing on transference in relationships.

Aside from the transference that clients experience in therapy, transference can also occur in everyday relationships, especially romantic relationships.


Transference in Relationships

In general, transference occurs on an unconscious level when you redirect feelings, attitudes and behavior from the past onto a person in your current life. These can be both positive and negative feelings.

Transference can cause you to react to someone in your current life as if they were someone from your past.  Transference tends to happen more in intimate relationships.

This often leads to misunderstandings in your relationship and emotional responses that don't belong to the present relationship.  This usually occurs because you have unresolved issues from the past that get played out in your relationship.

One of the keys to having healthier relationships is to recognize and understand when you're transferring these feelings and attitudes from the past into your present circumstances (see my article: Learning to Separate Then From Now).

What Does Transference Look Like in Relationships?
  • Redirecting Feelings: You redirect feelings from the past onto your current partner. 
  • Unconscious Behavior: When you redirect feelings from the past onto your partner, this happens on an unconscious level. For instance, let's say you grew up with a critical father when you were a child and, now that you're an adult, your partner tries to be supportive by making a suggestion about how you can do something in a better way. If you're experiencing transference for your partner, you could hear their suggestion as being critical when it's not. If so, you could experience unexplained anxiety, anger or resentment towards your partner--similar to what you felt towards your critical father. You might get confused about your feelings in the current circumstances because the trigger is outside of your awareness (see my article: Coping With Triggers).
Transference in Relationships
  • Replaying Old Patterns: You can replay old patterns from the past in your current relationship and, over time, this leads to unhealthy dynamics between you and your partner.
  • Intense Reactions: As mentioned above, reacting to your partner as if they were someone from your past can lead to disproportionate reactions in your current relationship (see my article: Reacting to the Present Based on Your Past).
How Can You Manage Transference in Your Current Relationship?
  • Develop Awareness: Notice when your reactions seem out of proportion to the situation. Ask yourself:
    • Why am I having such a strong reaction to my partner when they're trying to be supportive?
    • Have I felt this way before?
    • When have I felt this way before?
    • What was happening in that past situation?
    • How do these feelings from the past remain unresolved for me?
  • Be Aware of the Differences Between the Past and the Present: Be aware of how your partner is different from the person in your past. This is often easier said than done when you're trying to do it on your own (see my article: Making the Unconscious Conscious).
  • Separate the Past From the Present: Make an effort to separate your past self from your present self. For instance, recognize that you're no longer a child struggling with this issue when you experienced it in the past. Also, separate your partner as an individual from the person you reacted to in the past. 
Transference in Relationships
  • Communicate: Once you realize you reacted to your partner as if they were someone from the past, communicate this openly to your partner. This can help your partner to understand why you had such a strong reaction towards them. It can also help you to express your feelings under the current situation (as opposed to the past). You can also get clarification from your partner as to what they were actually trying to communicate to you as opposed to what you thought they were saying.
Clinical Vignette
The following clinical vignette is a composite of many different cases with all identifying information changed to protect confidentiality:

Jim
Jim and his wife, Tina, usually got along well. But whenever Jim heard Tina telling him how he could be more organized, no matter how kind and supportive she tried to say it, Jim experienced her comments as critical and he reacted angrily.

Transference in Relationships

Immediately after he reacted, he realized his reaction was out of proportion to what Tina was saying to him and he felt confused, guilty and ashamed. Then, he would apologize to Tina and tell her, "I'm sorry. I don't know what came over me. I realize now you're trying to be supportive, but when you said it, I got angry."

Tina usually accepted Jim's apology, but after this occurred several times, she suggested he get help in therapy because she was fed up with his reactions. 

She told him, "I'm afraid to make any kind of suggestion to you, but now that you're calm again, I think you should get help in therapy because you keep having these big reactions and I'm getting fed up."

Jim realized that, even though he felt regret and remorse for overreacting, if he continued to react this way towards Tina, she might leave him. So, he obtained a referral from his primary care physician for psychotherapy.

Jim's doctor referred him to a trauma specialist.

After getting a thorough family history, the trauma therapist helped Jim to realize his reaction belonged to unresolved issues with his father. She told him he was reacting to Tina as if she was his critical father.

Jim told his therapist that his father had a hair trigger temper and whenever Jim made a mistake as a child, instead of trying to be supportive and helpful, his father would lose his temper and criticize Jim.

Jim recalled that, over the course of his childhood, his father yelled at him many times for small mistakes. His father also humiliated him in front of his friends and other family members which left Jim feeling ashamed, angry and upset.

Since Jim's father died, it was no longer possible for Jim to work out these issues with him. But Jim also knew that even if his father was still alive, his father wouldn't have been open to talking about it.

Over time, Jim's therapist helped him to work through his unresolved feelings from the past using EMDR and Parts Work Therapy

The work was neither quick nor easy, but Jim stuck with it because he wanted to save his marriage and he didn't want to continue to reacting in the present based on unresolved issues from the past.

As Jim learned to be aware of the present versus the past and to communicate better with Tina, their relationship improved.

By the time he completed trauma therapy, Jim felt relieved to no longer being carrying a burden from the past.

Conclusion
Transference occurs on an unconscious level when you redirect feelings, attitudes and behavior from the past to someone in your present life.

Transference can occur in any relationship including with your partner, a friend, a family member or your therapist.

Getting Help in Therapy

When you learn to distinguish your unconscious feelings in the present from your unresolved feelings from the past, you can develop a more conscious awareness of what's happening to you.

Although you might realize after you react that you're really reacting to some unresolved issue from the past, your awareness might not be enough to keep you from continually reacting this way.

A licensed mental professional, who is trained to help clients to work through unresolved trauma is called a trauma therapist (see my article: What is a Trauma Therapist?).

A trauma therapist can help you to work through unresolved problems from the past so you're no longer getting triggered and overreacting with your partner.

Once you have worked through your unresolved problems, you can have a healthier relationship and live a more meaningful 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

As a trauma therapist, I have helped many individual adults and couples to work through unresolved traumatic issues.

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.

My Other Articles About Transference:






































Tuesday, November 25, 2025

What is Survivor Guilt in Family Dynamics?

Survivor guilt in family dynamics usually involves surviving one of the following when other family members have not:
  • A traumatic incident
  • A difficult or traumatic upbringing
  • Achieving a better quality of life than other family members
Survivor Guilt 

Incidents such as the above often lead the "survivor" to feel a sense of remorse, guilt, worthlessness, undeserving as well as responsible for the fate of other family members who weren't as fortunate.

Survivor guilt is often irrational because these individuals usually weren't at fault for the other family members either not surviving or not doing as well as they did.

Key Aspects of Survival Guilt
  • Traumatic Loss: A family member dies or suffers serious consequences and the person who experiences survival guilt did not. This might include:
    • A car accident
    • A natural disaster
    • A medical problem
  • Generational Trauma: Prior generations suffered under traumatic circumstances and the person who is from a younger generation, who didn't suffer, feels guilty for surviving or not having it "easier" than the previous generation (see my article: What is Intergenerational Trauma?):
    • Family violence
    • War
    • Poverty and/or oppression
    • Systemic violence
    • Other atrocities, including the Holocaust and other forms of genocide
  • Parental Guilt: A parent can experience survivor guilt that they passed on a gene to their child and the child has medical problems as a result. They can feel guilty even though they had no control over passing on this gene.
  • Everyday Situations: If one family member achieves success while other family members are not as fortunate, the one who achieves success can feel guilty that they are fortunate while the others are not.  
How Does Survivor Guilt Manifest in Families?
Survival guilt can have a big impact on family relationships including:
  • Social Withdrawal: The individual who has been more fortunate might isolate themselves from family activities as a way to avoid dealing with their guilt.
  • Overprotectiveness: In order to avoid another loss, the individual who has been more fortunate might become overly protective of the other family members.
Survivor Guilt, Shame and Self Blame
  • Shame and Self Blame: These individuals might dwell on how they could have done things differently to help family members--even if, objectively, there was nothing else they could have done (see my article: Self Blame and the Internal Critic).
  • Difficulty Feeling Joy: They might believe they don't deserve to experience joy, happiness or success because they feel guilty that they are more fortunate than other family members.
  • Atoning Behavior: In order to atone for their good fortune when other family members have suffered, these individuals might be overly giving so they can atone for their good fortune. This is another maladaptive coping strategy.
Clinical Vignettes
The following clinical vignettes are  composites of many different cases with all identifying information changed to protect confidentiality:

Alan
When Alan was 15, he and his 13 year old brother, Tom, went surfing at the beach during the off season, even though there were red flags posted warning swimmers to stay out of the water due to rough waves from a fast approaching hurricane. Since it was the off season, there were no lifeguards at the beach, but Alan and Tom had fun surfing under similar circumstances before, so they disregarded the warnings.  After a while, Alan took a break to rest on the shore and Tom stayed in the water.  After Alan dried himself off, he turned to call Tom to tell him to come out of the water, but Tom was nowhere to be seen. He jumped back into the water to try to find Tom to no avail and he became frantic. When a police car approached, they called a rescue team who found Tom's lifeless body an hour later. Alan was devastated with sadness and guilt. No one in the family blamed him for Tom's death, but as Tom's older brother, Alan felt responsible. His shame and self blame was so great that he became overly protective of his other younger siblings. Later on in life, he felt guilty that he had career success because Tom never had this opportunity. Alan often engaged in self sabotage and self destructive behavior including excessive drinking. One day his doctor warned him about the connection between excessive drinking and his high blood pressure. Then, he providing Alan with a referral for trauma therapy (see my article: How Can Trauma Therapy Help You to Overcome Unresolved Trauma?).

Linda
Even though her grandmother never discussed her experiences during the holocaust, Linda knew her grandmother spent time as a young child in a concentration camp in Poland. By the time Linda was born, her grandmother was doing well financially, but she lived like she was poor. Specifically, the grandmother hoarded food because she feared anything could happen where she might not have enough to eat. In addition, when she ate, the grandmother always ate sparingly and saved scraps of food for another day. As a result both Linda and her mother surmised that, as a child, the grandmother probably had very little to eat in the Treblinka concentration camp and now, as an adult, she was always afraid food would become scarce again. The impact on Linda was that she couldn't enjoy food in her grandmother's presence--even foods she normally enjoyed.  Her mother had a similar problem. As time went on, Linda realized she had a problem and she sought help in trauma therapy to prevent her problem from getting worse.

Sara
When she was a child, Sara heard many stories from her father about his family's severe poverty when he waa a child. Her father told her there were many days he and his siblings had nothing to eat. Even though they were hungry, they would tell their parents they weren't because they didn't want their parents to feel bad. Although Sara's parents were doing well financially by the time she was born, she always felt guilty whenever they bought her a gift or new clothes. She felt she didn't deserve to have more than her father had when he was a child. Later on in life when Sara had a successful career, she felt that no matter how much she tried to do for her parents, especially her father, she couldn't do enough. She felt guilty about her financial success and, as a way to assuage her guilt, she bought her parents many gifts--even though they told her they didn't need them.  One day her mother took Sara aside during a family gathering and told Sara she understood why she was buying them so many gifts but, she said, no matter how many gifts she bought them, she couldn't undo her father's childhood poverty. She told Sara that both she and the father wanted her to enjoy her life and they could see how guilt was eating away at her. She suggested Sara get help from a licensed mental health professional who did trauma therapy.

How Can Trauma Therapy Help With Survivor Guilt?
Trauma therapy is an umbrella term that include following types of therapy:
  • EMDR (Eye Movement Desensitization and Reprocessing)
Survivor Guilt and Trauma Therapy
  • AEDP (Accelerated Experiential Dynamic Therapy)
These therapies were developed specifically to help clients to overcome trauma by:
  • Processing the Trauma: To work through the trauma in a safe and structured way
  • Developing Self Compassion: Helping clients to give themselves compassion to heal
Survivor Guilt and Self Compassion
  • Challenging Negative Beliefs: To identity and challenge negative beliefs
  • Developing Genuinely Positive Beliefs: Beliefs that are sincere and realistic about  themselves and others
  • Grieving Losses: Grieving what has been lost is essential to healing from trauma (see my article: The Many Layers of Grief).
  • Finding a New Purpose: Honoring their losses and channeling their guilt into meaningful behavior like volunteering
Getting Help in Trauma Therapy
If you are struggling with unresolved problems, you're not alone. Help is available.

Getting Help in Trauma Therapy

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

Overcoming unresolved trauma can help you to live a more meaningful life.

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

As a trauma therapist, I have helped many individual adults 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.