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NYC Psychotherapist Blog

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Showing posts with label strengths. Show all posts
Showing posts with label strengths. Show all posts

Monday, February 26, 2024

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: 

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

I work with individual adults and couples.  

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

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

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






Focusing on Your Personal Strengths to Cope With Stressful Times

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

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




Focusing on Your Personal Strength to Cope With Stress

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

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

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

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

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

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

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

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

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

How to Focus on Your Strengths to Cope With Stressful Times

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

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

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

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

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

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

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

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

Getting Help in Therapy
Everyone needs help at some point.

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

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

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

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

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

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

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

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















Wednesday, August 18, 2021

Learning About Yourself in a Relationship

Although there are many ways to learn about yourself, including keeping a journal, talking to friends and family members, and going to therapy, being in a relationship can be very revealing (see my article:  Growing As An Individual While You're in a Relationship).


Learning About Yourself in a Relationship

Many people think they have to work out all their issues before they can be in a relationship, but there will always be issues and by waiting you could be missing out on a potentially good relationship. 

Being emotionally vulnerable is one of the keys to a successful relationship.  Although this can be difficult for some people because of their history of being hurt in their family of origin or in previous relationships, learning to be emotionally vulnerable helps you to discover who you are and enhances your relationship (see my article: Emotional Vulnerability as a Pathway to Greater Intimacy).

What You Can Learn About Yourself When You're in a Relationship
Here are some of the key things you can learn about yourself when you're in a relationship:
  • Your Communication Skills:  How well do you communicate with loved ones? Are you open to expressing your feelings or do you tend to withdraw and bottle things up?  When you're in a relationship, there are many opportunities to talk about your feelings--both positive and so-called "negative" feelings.  Even if you enter a relationship lacking good communication skills, constructive feedback from your partner can go a long way to helping you to improve this skill.
  • Your Coping Skills: Every life has its inevitable ups and downs.  Most people can handle things when life is going well, but how well you handle challenges, including problems in your relationship, reveal a lot about your coping skills.  Whether you avoid problems or deal with them as they come up reveals your particular style of handling problems. Becoming aware of your coping skills and having self compassion is the first step towards changing them (see my article: Developing a Compassionate Attitude Towards Your Maladaptive Coping Skills).
  • Your Love Language: According to Dr. Gary Chapman, who wrote The 5 Love Languages, there are five different ways of expressing and receiving love in a relationship (and some relationship experts believe there are more than five ways):  words of affirmation, quality time, receiving gifts, acts of service and physical touch.  You can learn a lot about yourself and your partner in terms of each of your love languages. When you get to know your partner, you also learn to relate to them in terms of their love language (as opposed to relating to them based on your love language).  In reality, everyone has more than one love language, but there is often one that predominates.  Here are the love languages as outlined by Dr. Chapman in his book:
    • Words of Affirmation: People with this love language value verbal acknowledgements of affection (saying "I love you" frequently, compliments and words of appreciation, encouragement).
    • Quality Time: People with this love language feel loved when their partner wants to spend time with them.  This includes active listening, eye contact and being fully present.
    • Acts of Service: People with this love language as primary like it when their partner goes out of their way to make their life easier.  In other words, actions speak louder than words.  
    • Gifts: Visual symbols of love are what is most important with people who value gifts as their primary love language.  They like to know that their partner spent the time to think about getting them meaningful gifts.  The key is the meaningfulness of the gift.
    • Physical Touch: This includes physical signs of affection, including kissing, holding hands, cuddling and having sex.  Physical intimacy is very powerful for people with physical touch as their primary love language.  They value the warmth and comfort that comes with physical touch.
  • Your Values and Priorities: What do you value most in your life? What are your goals? How important are your familial relationships, friendships and your partner?  Even if you don't usually think a lot about your values and priorities, you can learn a lot about them in a relationship in terms of how you prioritize your partner and whether your partner's values and priorities are similar to yours.  
  • Your Strengths: Ideally, your partner and you bring out the best in each other and, if not, this is an important area to work on.  You might have strengths you're unaware of--until you see yourself in a relationship and become aware of them.  You might also realize that you and your partner complement each other (or not).
  • Your Shortcomings: You might be aware that, just like everyone else, you have certain shortcomings, but when you're in a relationship, these shortcomings become glaringly clear.  Although many people feel uncomfortable acknowledging their shortcomings, when you're in a relationship, you have an opportunity to improve them.  It helps if, to start, you have self compassion because it makes it easier to change (Self Compassion: Loving Yourself Even in the Places Where You Feel Broken).
Being in a relationship, especially after the "honeymoon phase," can be challenging, but if you're in a healthy relationship, the emotional rewards, including the opportunity for self discovery, outweigh the difficulties (see my articles: How Do You Know If You're in an Unhealthy Relationship? and Developing and Maintaining a Happy Relationship).

Getting Help in Therapy
If you've been struggling on your own, you're not alone.  Help is available to you.  

Taking the first step, which is contacting a licensed psychotherapist, is often the hardest one, but a skilled therapist can help you to overcome the obstacles to leading a more fulfilling life.

About Me
I am a licensed NYC psychotherapist,  hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing 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 regular business hours or email me.










Saturday, March 28, 2020

Remembering Your Strengths as a Way to Cope With a Crisis

In a prior article, Grieving Losses and Healing During a Crisis, I discussed the grief and loss that most people are feeling during this  COVID-19 crisis.  To an extent, one of the losses that some people feel is a certain erosion of a sense of self confidence (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).  Remembering your strengths during a time of crisis can help you to get through the current crisis (see my article: A Strengths-Based Perspective in Psychotherapy).


Online Therapy: Remembering Your Strengths as a Way to Cope With a Crisis

Remembering Your Strengths That Helped You During Prior Crises
Remembering your strengths is an inner way of knowing yourself and believing in your own self efficacy.  Sometimes, this sense of self comes to you with memories of your thoughts, feelings and behavior during a prior crisis.

As an example, during the last few days, I've been remembering the survivor instinct I felt during the 9/11 World Trade Center attack.  My daytime office was on Rector Street off of West Street in Downtown Manhattan, just two blocks from where the South Tower stood.

I remember that I was in early that morning and there were only a few colleagues there when we felt our building suddenly sway as the lights went off and back on. It felt like something big hit our building, and we were all confused at first about what had just happened.

I had a radio in my office and turned it onto the news as a colleague stood in my office and we both listened. We heard that a plane had hit the World Trade Center. My first thought wasn't that this was a terrorist attack.  I had no frame of reference for that.  I actually thought that the pilot of the plane must have been sick or impaired in some way and lost control of the plane.  We had no details at that point, so I was picturing a small plane--not a jumbo jet.

Then, I remember that we saw many pieces of paper that were torn and burnt floating in the air outside our windows, and it all felt very strange and surreal.  Soon after that, we heard the sirens of the fire engines and police cars.

Even though this was 19 years ago, the part of the memory that is most vivid for me is after we found out that the World Trade Center had been attacked and, after the second plane attacked the World rade Center, we were advised by our managers that the mayor said we should evacuate the building and walk north away from Downtown Manhattan.

I remember walking with two colleagues from our building and momentarily standing on the corner of Rector and West and looking at the South Tower. There was a jagged line of fire on the upper floors of the tower.  There were also many people around us who were standing there watching in disbelief.  But my immediate thought was, "We need to get out of here.  That building could fall."

I wasn't thinking the building would collapse in a pancake way, as it did.  I was actually thinking the top of building with the jagged line of fire could fall off and tumble down onto the street on top of us.
At the time, from our perspective, it looked like a real possibility.

Even though I was just as curious, if not more curious, as everyone else who was standing there looking at the South Tower, I had an overriding sense that we had to save ourselves in that moment and we should continue to walk north.

In times of crisis and during traumatic events, there can be a narrowing of the senses to deal with the immediate moment and one's own self preservation.  Many people have described this narrowing of the senses, especially a narrowing of vision, as if they had blinders on, that keeps them focused on what they need to do next.  And the usefulness of this survival strategy is obvious--it keeps you focused on what's most important: Staying alive.

It's difficult to describe what that narrowing of focus feels like if you haven't experienced it before.  The way that I experienced it was that any other extraneous thoughts and feelings fell far away, as if my colleagues and I were single-mindedly on a mission to walk north.

We eventually walked to the South Street Seaport. Fom there, after the collapse of the first tower, which shook the seaport, when it was safe to keep going, we headed to a colleague's husband's office, which was a media company.  It was there that we saw vivid images on giant screens on the wall of what had actually happened earlier that day.

Until then, we had little information.  We had heard that there might have been another plane with terrorists who were about to attack. So, we were confronted with this tragic news and had to figure out our next steps: Could we make it home safely? If there was another plane about to attack, was it safe enough to walk over the bridge or to take one the subway trains that were still running?

When I think about my own sense of self during that time, even though I was afraid and confused about what was happening, I had this inner sense that I had to stay focused and that I was going to survive.  That's the best way I could describe it.  I don't know where it came from, but it felt like a very deep and determined part of myself that emerged during this crisis. And, of course, my inner sense of knowing was right--I did survive.

Our work group was displaced for several weeks in a cramped conference room that belonged to another company.  Even though the conference room was cramped, we each worked at gathering information so that, as clinical social workers, we could provide important information to our clients, like: how to stay calm in a crisis, different ways to engage in self care or how to talk to children about the World Trade Center attack.  Soon after that, we were each conducting groups for employees all over New York City.

Even though I had my own concerns, I remember feeling like I was on a mission and staying focused on what needed to be done.  It felt good to be useful and provide some comfort to others.  While I was doing this, for the most part, I forgot about my own concerns and focused on our clients. Of course, there was plenty of time at night when things were quiet for my own concerns to emerge.  But while I was helping others and feeling useful, I was focused on what I needed to do.

When you think back to prior times when you went through a crisis, even if you were confused and frightened or you wish you had behaved differently, you can now look back and put your thoughts, emotions and behavior in perspective: The prior crisis had a beginning, a middle and an end, and you can now look back on it and realize that you survived.

Remembering that you survived and that the experience is in the past is an important part of the memory, especially during the current crisis where time can feel distorted. For instance, many people have said that the week or so that just passed feels more like a month or more.

I suspect that this distortion in time and space is occurring because the mind is still trying to rap itself around the magnitude of the worldwide effect of COVID-19.  Also, even though experts are making projections, we don't know when it will end.  We just know that it will end one day and we will look back on our experiences one day as a memory.

People With a History of Trauma Often Forget Their Inner Strengths
Many people who have a history of trauma, especially complex trauma where the trauma occurred early and on an ongoing basis, can lose their perspective even after the trauma is over (see my article: Reacting to the Present Based on Your Traumatic Experiences From the Past).

The trauma was so profound for them that when they have a new traumatic experience, the old trauma gets triggered and it becomes difficult to distinguish feelings from the past from feelings in the present.

As a trauma therapist, when I work with a client who has developmental trauma, which is trauma that occurred over time in childhood, aside from helping clients to process the past, present and their fears about the future, I help them to distinguish "then" from "now" (see my article: Working Through Psychological Trauma: Learning to Separate "Now" From "Then").

These individuals often lose their perspective of the present and have a hard time sorting out past and current feelings.  If it becomes overwhelming for them, I help them to distinguish "now" from "then."

So for instance, I might ask them how they're different now as compared to back in their childhood when they experienced the trauma.  Or, if they're stuck, I'll help them by reminding them that, as children they were powerless to stop the trauma, but I remind them that now, as adults, they now have inner resources and capabilities that they didn't have back then, and I'll list these skills and capabilities if they're unable to do so themselves.

I'll remind them that, as compared to back then when they were children, now, as adults, they can defend themselves or choose to walk away from situations that are hurtful and harmful to them.

Of course, on some level, these are things that they know logically when they're feeling less anxious, but they might not feel it on an emotional level when anxiety overtakes them.  When they're upset, people who are traumatized sometimes forget that they're not powerless any more like they were as children.

When they're reminded that what happened to them was in the past and that they're much more powerful and capable now, they get a sense of relief and feel more empowered.  Then, I work with them to strengthen these feelings of being empowered.

For some people, especially people who come to therapy for a trauma that involved a single incident, like an incident of getting robbed or attacked, trauma therapy, like EMDR therapy, can help resolve the trauma relatively quickly (approximately, 10-12 sessions or so).  These are cases where there are no underlying developmental trauma that gets triggered.

This type of single incident trauma is often referred to as shock trauma, and it's less complex than trauma that occurred over a period of time in childhood, known as developmental trauma (see my article: The Difference Between Shock Trauma and Developmental Trauma).

However, the majority of clients who come to therapy have developmental trauma or they have shock trauma with underlying developmental trauma as part of their history, which is more complicated.

The reason why most clients who come to therapy have developmental trauma, as opposed to single incident, might be because single-events of trauma (or shock trauma) can sometimes resolve itself without a clinical intervention.

For instance, if people who are in a car accident are often initially afraid to drive to the area where the accident occurred.  However, many people are eventually able to get back in their car and drive each day passed that spot, even though they're anxious.

If they can do that, they're learning to desensitize themselves to their traumatic experience.  So, even though their initial reaction is one of fear, over time, they overcome their fear through repeated experiences of going to that spot and and having the experience of "I'm okay now."

Developmental trauma rarely if ever resolves on its own.  To resolve this type of trauma, someone needs to work through these experiences with a trauma therapist who uses specific types of trauma therapy that have been proven to be effective.

Experiential therapy, like EMDR, helps to resolve developmental trauma.  Even though the length of time is longer than it would be for shock trauma, the good news is that, generally speaking, EMDR (or any experiential therapy) is shorter and more effective than regular talk therapy (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
Remembering your strengths to cope with a current crisis can be challenging when the crisis is as unprecendented as the current COVID-19 crisis.

Healing usually occurs on a dyadic level, which means on a one-on-one level with an experienced clinician, rather than by yourself.  So, if you're feeling overwhelmed, you're not alone.  Help is available to you.

Many psychotherapists, like me, are conducting therapy sessions online to make sessions accessible to clients.

Rather than suffering on your own, if you feel overwhelmed, get help from a licensed psychotherapist who can help you to get through this difficult time.

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

For couples work, I use Emotionally Focused Therapy, a well-researched and effective form of couples therapy.

I'm currently providing confidential online therapy sessions.

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.









































Thursday, October 11, 2018

How Experiential Therapy Can Help You to Discover Your Personal Strengths

In my prior article, Discovering Your Personal Strengths in Therapy: You're Much More Than Your Traumatic History, I began a discussion about seeing beyond your traumatic history to discover your personal strengths (see my article: You're Not Defined By Your Diagnosis and Discovering Your Personal Strengths in Psychotherapy).

How Experiential Therapy Can Help You to Discover Your Personal Strengths

As a trauma therapist in New York City, many clients come to see me to overcome their history of trauma. As I'm helping them to overcome their trauma, I'm also assisting them to discover their personal strengths (see my article: A Strengths-Based Perspective in Psychotherapy).

As I mentioned in my prior article, it's important to be able to appreciate the personal strengths that got you through difficult times as well as that you can use these same strengths to cope with whatever challenges you're dealing with now.

Fictionalized Clinical Vignette: How Experiential Therapy Can Help You to Discover and Use Your Personal Strengths:
The following fictionalized clinical vignette, which is representative of many cases in therapy, illustrates how an experiential therapist can help a client to explore and use his personal strengths:

Ed
Before Ed began experiential therapy, he had been in conventional talk therapy for several years trying to overcome the effects of the childhood trauma he experienced as a young child.

Ed explained to his new therapist that he was grateful for the work he did with his prior therapist in talk therapy, but he felt no relief from the traumatic effects of childhood emotional neglect and abuse.  This is why, at the suggestion of a friend, he was willing to try experiential therapy.

From the very first session in experiential therapy, Ed noticed the difference in the way his new psychotherapist interacted with him.  Whereas his former therapist, who practiced conventional talk therapy, said very little in his sessions, his new therapist, who was interactive and dynamic.  She also talked about working in a collaborative way so that the therapy would be meaningful and effective for Ed.

In addition, she explained the different types of experiential therapy that she did with individuals, which included EMDR therapy (Eye Movement Desensitization and Reprocessing) therapy, AEDP (Accelerated Experiential Dynamic Psychotherapy), Somatic Experiencing, and clinical hypnosis.  She also explained that her original training was in depth psychotherapy so she had an ability to work deep and do brief therapy at the same time.

Ed could tell from his new therapist's facial expressions, gestures and demeanor that she already seemed to care about him, even though they were just having their initial consultation.  This surprised him because he never experienced this before in therapy.

His therapist emphasized that, in addition to helping him to resolve the effects of his traumatic history, she thought it was equally important to help Ed to explore and experience his personal strengths on an emotional level.

When Ed thought about it, he realized that he never really thought about his personal strengths.  He knew, on an intellectual level, that he had somehow survived the effects of his parents' abuse and neglect, but he never explored how he was able to do this in his prior therapy.

As he thought about it more, he told his new therapist that friends and other relatives who knew him often commented to him that, considering his family history, he accomplished a lot in terms of his success at college and in his career.

But Ed only experienced their praise as mere words.  He knew they were sincere, but he didn't know how to relate to what they were telling him.  He didn't think he had done anything out of the ordinary with regard to surviving his childhood history and being successful.

After his therapist heard his traumatic history, she said she was amazed that he had accomplished so much, and she asked him how he did it.

Ed seemed confused at first, and he said that he didn't know what he did to succeed at college and in his career, "I just did it.  I didn't think it was such a big deal."

Even though, at that point in therapy, Ed couldn't identify his personal strengths, he began to get curious.

In order to help Ed to appreciate that he had personal strengths that helped him, his therapist recommended that he think of his early history and his subsequent successes as if they were about someone else.

After thinking about it for a few minutes, Ed said that he had a close friend, who had a similar family history and similar accomplishments.  Ed told his therapist that when he thought about his friend, he admired his friend for being able to overcome his early challenges so that he could succeed in his career.  But when he thought about his own history and accomplishments, he wasn't able to appreciate them as much as he appreciated his friend's, which made him curious as to why he couldn't appreciate his efforts.

Over time, Ed talked about how both of his parents, who were physically abusive, also told him repeatedly from a young age that he would never amount to anything.  Although on some level, he believed them, he said, he was also determined to be independent of them.

As a result, even though he had low self esteem, he persevered in his studies as if his life depended on it.  And, in many ways, he felt that his life did, in fact, depend on being able to get a good job so he could move out of his parents home.

Since he did well in high school, despite the ongoing abuse and neglect, he was able to get a scholarship to an out of state college where he excelled.  From the time he moved out to go to college, he never moved back home.  He only went for brief visits.

His therapist helped Ed to see that two of his personal strengths were his determination and perseverence despite the challenges at home.  She helped him to appreciate these personal strengths as well as his other strengths, on a visceral emotional level by having him identify the emotions that he felt when he was able to feel good about these strengths and where he felt these emotions in his body.

Initially, this was difficult for Ed because he was so accustomed to minimizing his strengths and accomplishments as being "no big deal."

But one of the things that made it easier for him to eventually appreciate his personal strengths was how his therapist reflected back to him, on a emotional level, how delighted she was that he had these strengths to help him to excel.  He was able to see in her eyes and in her face the genuine caring and delight--something he never experienced with his own parents.

Over time, Ed had what is called a "corrective emotional experience" with his experiential therapist (see my article:  What is the Corrective Emotional Experience in Therapy?).  In contrast to his early experience with his parents, who were angry, abusive and neglectful, Ed experienced his therapist as being genuinely caring, warm and empathetic.  Compared to his prior therapist, his new therapist was emotionally accessible and enthusiastic about his well-being.

In addition, rather than just having an intellectual understanding of his problems and his personal strengths, Ed was able to develop an ability to actually feel these experiences on a core emotional level. He learned that, in order to make positive changes, being able to experience his innermost, primary emotions was essential for transformation.

These experiences in therapy were new and exciting for Ed, and he looked forward to his therapy sessions with his experiential therapist as he continued to make progress in therapy.

Conclusion
Many clients, who have a history of trauma, are almost exclusively focused on the effects of their trauma and their emotional problems.

While, ultimately, the goal of therapy is to help clients to overcome their trauma, along the way, as part of experiential therapy, it's important for clients to also recognize their personal strengths that allowed them to survive and, in many cases, to thrive despite the obstacles.

Not only does it help clients to appreciate how their strengths helped them in the past, it also helps them to recognize that they have these internal resources to call on in the present.

An experiential therapist is focused on helping to undo the aloneness that clients experienced during their traumatic history by being emotionally accessible to clients as they work through their trauma. She also helps clients to access their personal strengths.

In addition, she strives to help clients to have a new corrective emotional experience in therapy that is healing to clients.  All of this helps clients to overcome trauma and make positive changes in their lives.

Getting Help in Experiential Therapy
If you have been unable to resolve your problems on your own or you feel frustrated by intellectual insight that doesn't lead to a healing experience, you owe it to yourself to get help in from a licensed psychotherapist who practices experiential therapy (see my article: How to Choose a Psychotherapist).

Experiential therapy, like AEDP, is an evidence-based therapy that is effective and can lead to a transformation in your life.

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

I work with individual adults and couples.

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

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

































Tuesday, October 9, 2018

Discovering Your Personal Strengths in Therapy: You're Much More Than Your Traumatic History

In a prior article, You're Not Defined By Your Diagnosis, I discussed how clients, who have been in prior therapy, often think of themselves as defined by their diagnosis ("I'm depressed" or "I'm anxious") rather than seeing the totality of who they are, including their strengths.

Similarly, when clients come to therapy to deal with a traumatic history, their self concept is often defined by their trauma--rather than also seeing their resilience and personal strengths (see my article: A Strengths Based Perspective in Psychotherapy).  This is especially true of clients who have been in conventional talk therapy.

Discovering Your Personal Strengths in Therapy: You're Much More Than Your Traumatic History

As I mentioned in the prior article, it's not a matter of being in denial about the client's negative experiences.  It's more about seeing their problems as well as seeing beyond those problems to include everything that's positive about them.

As a psychotherapist in New York City, who specializes in working with trauma, I take a holistic view of clients and want to help them build on their strengths as well as helping them to overcome unresolved trauma.

Clients, who have been in prior therapy, are often accustomed to being pathologized to the point where all they see about themselves are the "negative" parts that they want to overcome.

While I understand a client's need to focus on the trauma and trauma therapy is one of my specialties, I also want the client to appreciate the parts of that helped him or her to get through the traumatic experiences and excel in other areas of life.

As part of AEDP therapy (Accelerated Experiential Dynamic Psychotherapy), which is an experiential therapy, I help clients to take the time to really internalize their experiences of their strengths at the same time that I help them to overcome their traumatic experiences (see my article: Why Experiential Therapy is More Effective Than Talk Therapy).

Part of AEDP therapy is helping clients to have a deep sense of their personal strengths, which can feel unusual, at first, for clients who are so focused on their problems.

This might mean slowing things down experientially when a client talks about an obstacle s/he overcame or a courageous stance that s/he took. Interestingly, slowing things down experientially actually helps to speed the work up in the long run.

By slowing down the work at that point, I'm helping the client to have more than just an intellectual understanding of their strengths.  Instead, in addition to their intellectual understanding, I'm helping the client to have an embodied experience of his or her strengths.  In doing so, I'm helping the client to have a more integrated mind-body experience.

You might ask, "Why is this important?"

Well, it's an important part of helping a client to have a transformative experience in which s/he recognizes that the trauma history is only one part of who s/he is and there is so much more than the trauma.

It also helps the client to see that they have internal resources and coping skills that s/he can call upon when faced with adversity.  This is a crucial part of the way I work with clients who have been traumatized.

Anyone who has survived a traumatic history has personal strengths that got him or her through.

Being able to recognize and value those strengths is a part of AEDP work in therapy and in all experiential modalities that I use, including EMDR therapy, Somatic Experiencing and clinical hypnosis.

In my next article, I'll provide a clinical vignette that illustrates how I work with clients' strengths while helping them to overcome trauma.

Getting Help in Therapy
Being pathologized in therapy by psychotherapists who only focus on diagnosis or "the problem" makes overcoming trauma more difficult and can diminish your sense of self.

If you have been struggling with unresolved problems, you owe it to yourself to seek help from a skilled licensed psychotherapist who has a strengths-based perspective.

Freeing yourself from your traumatic history and, at the same time, recognizing that you have strengths can help you to lead a more fulfilling life.

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

I work with individual adults and couples.

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

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






Monday, October 16, 2017

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client

In a prior article, I began a discussion about the holding environment in therapy (see my article: The Creation of the Holding Environment in Therapy).  As I mentioned in that article, the idea that the psychotherapist creates a safe therapeutic holding environment for the client was developed by British psychoanalyst, Donald Winnicott (for more on Winnicott, see my article: Books: "Tea With Winnicott" at 87 Chester Square).  In this article, I'm focusing on a particular aspect of the holding environment, which is the therapist's ability to keep the work emotionally manageable for the client.

The Holding Environment in Therapy

As an example, it's often the case that clients come to therapy because they're not feeling good about themselves.  This can be a lifelong problem or a new development for a client.  Either way, the client might focus on the aspects of himself that he is unhappy about and miss the fact that he has many strengths.

A skilled psychotherapist will usually see the client's strengths, even when the client is unaware of these strengths.  

The challenge for the psychotherapist is when to talk to the client about his strengths.

Timing is everything.  If the therapist brings up the client's strengths too early in therapy, the client, who has a particularly negative view of himself, will often minimize or dismiss the idea that he has these strengths (see my article: Overcoming the Internal Critic).

Some clients, who are focused on what they perceive as emotional deficits in themselves, might even think the therapist is being disingenuous when she tries to talk to them about their strengths (see my article: A Strengths-Based Perspective in Psychotherapy).  

In many cases, on an unconscious level, these clients are too afraid to consider the possibility that they have strengths.  Rather being overwhelmed by their fear, they protect themselves emotionally by remaining stuck in their denial.

It's important that the psychotherapist not interpret the client's reluctance as "resistance."  This comes across as judgmental.  It would only make the client feel uncomfortable and it's not helpful to the work.

If the therapist doesn't know how to handle the client's fear,  this could lead to the client leaving therapy prematurely to avoid dealing with uncomfortable feelings (see my article:  When Clients Leave Therapy Prematurely).

So, the skilled psychotherapist, who is aware that it would be premature to talk to the client about his strengths, must keep these observations to herself until the time is right.  This requires the therapist to be emotionally attuned to the client (see my article: The Psychotherapist's Empathic Attunement).

Even with self critical clients who are willing to explore the possibility that they have strengths, they might perceive their strengths on an intellectual level but not on a deeper emotional level.

For these clients, the therapist might broach the topic of the client's strengths, let the client know that she (the therapist) sees these qualities and will hold a space for them until the client can accept this on an emotional level.

This is a way for the therapist to create a safe holding environment for the client because the client knows that the therapist holds onto these observations until the client is ready.

Let's take a look at a fictional vignette that illustrates these points:

John
John had been in and out of therapy for many years.

He usually attended a few sessions with a therapist, and then he aborted therapy because he felt the therapist didn't understand him.

John struggled with depression, including low self esteem, since he was a child.  He grew up in a household where both parents were mostly preoccupied and paid little attention to John, who was an only child.

John's father often criticized him and told John that he would never amount to anything.  His father's critical comments were so frequent that John internalized them and, over time, believed them.  John's mother was depressed and withdrawn, and she was emotionally unavailable to him.

When he was in school, his teachers often told John that he had a lot of potential, but he was not trying.  From John's depressed perspective, he didn't see a reason to try since he believed his father that he wouldn't ever amount to anything.

As an adult, John drifted from one job to another.  Since he never expected to do well, he put little effort into his work, which resulted in disappointment for him.

John also had very low expectations about relationships.  He had a few close friends, but his romantic relationships didn't last beyond a few months.

He would go through long periods when he didn't even try to meet anyone, but then his loneliness caused him to try again with the same low expectations.  It was an ongoing cycle.

By the time John came to therapy again, he felt he was at a low point.  He was already in his mid-30s and he felt he had nothing to look forward to in his life.

The Holding Environment in Therapy

He told his current therapist at the start of therapy that he left his prior therapists because they were unable to see him as he was.  He felt that each of them saw him as they wanted him to be, which frustrated him.

He appreciated that his former therapists were "nice people" and they tried to speak to him about his personal strengths, but he didn't believe what they were saying.  He wasn't sure if they were mistaken or if they were intentionally trying to boost his confidence in a false way.  

Either way, whether the therapist was well-meaning but wrong or whether the therapist was only trying to boost his confidence and didn't really believe he had strengths, John found these discussions intolerable and he would abort therapy.

John's current therapist could see how self critical he was.  She also saw that he had many strengths.  But she also heard John loud and clear that he was unable to even consider that he had strengths, and she knew, based on what he was telling her, that if she tried to broach this with him, he would leave therapy, as he did in the past.  So she waited until he was ready.

Until then, his therapist remained attuned to John's experience and reflected back to him what he told her.  In doing this, she showed John that she understood how he felt about himself, and for the first time in his life, John felt that he was finally seeing a therapist who understood him.

In the meantime, his therapist held onto her perception of the many strengths she saw in John over time.  She waited until she saw a possible opening to explore this with him.

Gradually, as John felt more comfortable with his therapist, he opened up more with her, and she continued to let him know that she understood how he felt by mirroring back to him.

One day, John came to therapy in an agitated state.  He told his therapist that his new supervisor complimented John on a project.

John's first reaction was to get angry because he thought his supervisor was lying to him or he was trying to manipulate John in some way.

But as he thought about it, John said that he knew his supervisor wasn't a manipulative person, so he doubted that this was the reason for his compliment.  He said that maybe his supervisor was just trying to make him feel good--like some of John's prior therapists.  

Whatever the supervisor's intentions, John found it difficult to sit there and listen to his supervisor's compliments.  He said nothing to his supervisor but, for some reason, John realized, it brought up a lot of shame and sadness for him.

During the next several sessions, John continued to talk about this because his supervisor came to him again and told him that he really liked his work.  This continued to baffle John.

Over time, John became more open to exploring this issue and his own sadness and shame.  He was able to connect his negative feelings about himself to his critical father.

During that time, his therapist continued to maintain an open and empathetic stance with John, allowing John to draw his own conclusions (see my article: Why is Empathy Important in Therapy).

She knew that if she intervened prematurely, John would shut down emotionally and he might leave therapy.  She had to wait until he was ready.

Then, one day John came in and told his therapist that his supervisor took him to lunch.  John was surprised that he enjoyed talking to his supervisor over lunch.  He was also surprised to realize that his supervisor liked him and that his praise really was genuine.

As John opened up more emotionally in therapy, he allowed himself to feel his sadness about being a disappointment to his father.  He wished he could have had a father who was more like his supervisor--a kind and generous man.

As he continued to discuss this in therapy, John became aware that his father was a disappointed, bitter man, and his father didn't feel good about himself.

As he looked at his childhood from an adult perspective, he realized that his father was projecting his own negative feelings about himself onto John (see my article: Looking at Your Childhood Trauma From an Adult Perspective).

This led to John questioning whether his father's perceptions about him were accurate, "Maybe I'm not such a loser after all.  What do you think?"

At that point, his therapist realized that John created a small opening for them to be able to discuss the possibility that he wasn't "a loser" and he might have positive qualities.  She also knew that this was a tentative opening that could shut down if she rushed in because John might get overwhelmed, so she had to be cautious.

His therapist said she observed positive qualities in him, and she explored with him whether he would be open to discussing this.  John responded by shifting in his seat and telling her that it felt uncomfortable but, at the same time, there was a part of him that wanted to talk about it.

Gradually, John was able to explore his feelings.  He trusted his therapist enough to know that she wasn't going to lie, hurt him or try to manipulate him.

His therapist relied on John to tell her whether their discussions about his strengths felt too uncomfortable, and he told his therapist when he felt uncomfortable.  In this way, his therapist was able to maintain an emotionally safe environment for John in their sessions.

The Holding Environment in Therapy

Over time, John developed the emotional tolerance to discuss seeing himself in a positive light.  This was new and scary for him at first, but he was starting to feel better about himself.

By being attuned to John, his therapist was able to provide him with feedback about his positive qualities in "manageable doses" for him.  She respected his feedback when he told her that he was beginning to feel overwhelmed, and she would not push him beyond where he could go emotionally.

Working with John in this way, over time, his therapist was able to help John to mourn what he didn't get as a child and to develop more self confidence (see my article: Psychotherapy and Compassionate Self Acceptance).

Conclusion
There are many ways for a psychotherapist to create a therapeutic holding environment for a client.

One way, as I have discussed in this article, is to keep the therapeutic work manageable for the client.

To create a holding environment, the therapist must be emotionally attuned to the client and intuitively sense when the client is ready to explore uncomfortable issues.  She must also ask the client for feedback.

When the client provides a tentative opening, a skilled therapist doesn't rush in.  She helps to facilitate an exploration that is manageable for the client.

In this way, by being attuned and titrating the work, the therapist helps the client to make progress in therapy.  In other words, going slowly in these particular cases, is more effective than trying to get under the client's defenses and overwhelming the client.

From the outside, it might appear that the work is going too slowly, but with regard to the client's internal world the client is developing the internal resources for more in-depth work.  

Not every client has these particular problems, and in many cases the therapist senses that she can make observations early in therapy without jeopardizing the work.  But for clients who aren't ready, premature explorations often lead to premature endings in therapy because the client aborts therapy.

Getting Help in Therapy
Many people, who could be helped in therapy, never come to therapy and struggle on their own without success.

Finding the "right fit" with a particular therapist might be a matter of trial and error as you interview various therapists (see my article: How to Choose a Psychotherapist).  

I usually tell prospective clients to follow their own instincts when choosing a therapist and not to remain with a therapist if their gut feeling is telling them that it's not working out.  However, if you have a long history of aborting therapy prematurely, it might be worth considering that you're avoiding dealing with certain issues in therapy.

Rather than struggling on your own, you could benefit from seeing an experienced therapist who can help you to work through the problems that are keeping you stuck.

By working through problems that are keeping you stuck, you can lead a more fulfilling life.

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

I work in an empathetic, attuned and respectful manner with clients to help them to overcome their problems and maximize their potential.

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, March 20, 2017

Discovering Your Personal Strengths in Psychotherapy

People have many misperceptions about psychotherapy (see my articles: Common Myths About Psychotherapy: Therapy Takes a Long Time and Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").  Another common misperception is that psychotherapy tends to be negative, but an integrated contemporary approach to psychotherapy also focuses on clients' strengths (see my article: A Strengths-Based Perspective in Psychotherapy).

Discovering Your Personal Strengths in Psychotherapy

Many clients who come to therapy, especially clients who are anxious or depressed, are unaware of their personal strengths either because it hasn't been their focus or because they're so immersed in their current problems that they forget that they have strengths.

When new clients begin therapy with me, especially when they want to work on unresolved psychological trauma, after I find out the presenting problem and get their personal history, we focus on reinforcing their internal resources and healthy coping mechanisms.

Discovering Your Personal Strengths in Psychotherapy

Often, it's a matter of perspective.  Even when clients come in thinking that they have little in the way of personal strengths, as we explore these issues, many of them are surprised and happy to discover these strengths.

Even clients with severe trauma, who feel they're lacking in internal resources, have strengths just based on the fact that they survived their ordeals.  But they often overlook this.

How I Work With Clients in Psychotherapy
I've been helping clients overcome psychological trauma since 1996, and over the years I've discovered that taking the time to reinforce internal resources as well as external resources is well worth the time spent (see my article: Coping Strategies in Mind-Body Oriented Psychotherapy).

It's not unusual for clients, who have a history of trauma, to want to delve immediately into the trauma.  The feeling is often something like,  "The sooner we get to the bottom of this, the sooner I'll be rid of these bad feelings."

But delving directly into the trauma without taking time to reinforce internal resources is a mistake.

Discovering Your Personal Strengths in Psychotherapy

Clients, who have significant trauma, need to have their internal resources reinforced and available to help them deal with working through the trauma.  Aside from having the therapist as a resource, these internal resources act as their "safety net," something to fall back on if they get triggered in session as well as between sessions.

Working on internal resources also helps clients to get a more complete picture of themselves.  They realize that they have many aspects of themselves as multidimensional human beings (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

In the early days of psychotherapy, there was more of an emphasis on looking at clients' problems rather than looking at their strengths.

In fact, we need to do both.  We can't ignore either the strengths or the problems.  There needs to be an integrated approach.

Getting Help in Therapy
If you've been procrastinating about going to therapy because you're concerned that it will be a negative experience that is too daunting for you, you could benefit from working with a psychotherapist who uses a strength-based approach to psychotherapy.

By working with a psychotherapist who uses an integrated approach, you're bound to discover parts of yourself that you've been overlooking.

Rather than struggling on your own, consider setting up a consultation with a psychotherapist who is an integrationist and who will incorporate the positive aspects of who you are (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC 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 during regular business hours or email me.