Why Chasing Happiness Doesn't Work

People often feel discouraged in their pursuit of happiness because the more they chase it, the more elusive it feels.  

Chasing Happiness Doesn't Work

Chasing happiness creates an emotional paradox which often pushes true well-being away. 

Psychological research reveals that transforming happiness into a rigid, primary goal often creates stress, disappointment and exhaustion instead of fulfillment.

The Illusion of a Final Destination to Happiness

• The Hedonic Treadmill: People often assume there is a fixed finish line--like achieving a specific career rank or purchasing a luxury item. But the truth is that once this kind of goal is achieved, the brain quickly adapts to the new baseline. This, in turn, can spark never-ending desires in the hopes of achieving happiness.

• Time Scarcity: Actively working toward a vague goal of "being happy" makes people extremely aware of time. This causes people to feel they never have enough time in the day which can cause panic and dissatisfaction.

• The Perfection Standard: Treating positive emotions, like happiness, as the default sets unrealistic and unmanageable expectations. When life inevitably brings real challenges, an "expectation gap" forms leading to severe disappointment and discouragement (see my article: Coping With Life's Inevitable Ups and Downs).

Flawed Emotional Management

• Constant Self-Monitoring: Chasing happiness forces people into a constant state of internal evaluation. Constantly asking, "Am I happy yet?" pulls people out of possible immersive, joyful experiences--also known as a flow state (see my article: What is a Flow State?).

Chasing Happiness Doesn't Work

• Suppression of Reality: People often mistakenly try to push negative emotions under the rug. But natural human experiences, like grief, sadness and frustration, are meant to be felt. Trying to suppress these feelings creates an unstable, exhausting psychological foundation.

• The Achievement Deficit: High achievers frequently replace true life enjoyment with strict struggles to achieve success. They treat hobbies or relaxation as a waste of time, which leaves them feeling empty.

Evolutionary Hurdles

• Survival Over Satisfaction: From an evolutionary standpoint, the human brain didn't evolve to be constantly happy. It evolved to survive, reproduce and scan the environment for threats.

• An Inability to Predict What Will Create Happiness: Researchers have discovered that humans have an inability to accurately predict what will make them feel fulfilled in the long run.

A Shift in Focus
To reduce a sense of discouragement, shift your focus away from direct happiness. Instead aim your focus on meaning, resilience, gratitude and deep emotional connection which can allow contentment to happen naturally.

About Me

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

I have helped many individual adults and couples over the years.

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

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

Also See My Articles:

What Are Peak Experiences?  

A "Happy Life" vs a Meaningful Life 

Becoming Your True Self 

Healing From Moral Injury

Moral injury is the profound psychological, social and spiritual distress that occurs when someone perpetrates, witnesses or fails to prevent acts that violate their deeply held moral beliefs and values.

Healing From Moral Injury

Moral injury was originally studied in military veterans returning from war. Now, it's seen as a widespread phenomenon affecting healthcare workers, first responders and everyday individuals.

The consequences of moral injury is that it has a negative impact on a person's conscience, shatters their sense of self worth and erodes their trust in institutions or leaders. 

What Are Core Causes of Moral Injury?

A moral injury is triggered by a Potentially Morally Injurious Event (PMIE) which usually break down into the following categories:

• Acts of Commission: Doing something that actively violates your moral code (e.g., a soldier either accidentally or following orders to harm civilians in a combat zone).

• Acts of Omission: Failing to act or prevent harm when your ethical compass dictates that you should (e.g., as a bystander you fail to stop an assault).

Healing From Moral Injury

• Betrayal: Witnessing individuals in authority or institutions act against what is moral and just, especially in high stakes situations (e.g., an executive ordering employees to hide serious defects in a product that can do harm to consumers).

• Bearing Witness: Observing atrocities, extreme cruelty or systemic injustices without the power to change the outcome (e.g., care workers or visiting relatives witness bed-bound residents suffering from severe bedsores, malnutrition and prolonged isolation due to corporate understaffing and regulatory failures).

What Are the Symptoms and Manifestations of Moral Injury?

When an individual's ethical boundaries are crossed or when they are placed in a situation where they violate their own moral beliefs and values, it alters their worldview.

Common symptoms include:

• Sustained Guilt and Shame: Feeling a persistent sense of remorse or believing "I am a bad person."

• Social Isolation: Withdrawing from loved ones, peers or community activities due to feeling unworthy or that they will "contaminate" others.

Healing From Moral Injury

• Loss of Trust: An inability to trust authority figures, organizational leadership or systems.

• An Existential or Spiritual Crisis: Questioning long-held religious or spiritual beliefs, faith n a higher power or the fundamental goodness of society.

• Anger and Disillusionment: Directing profound bitterness toward a system or the people that forced an impossible choice.

What is the Difference Between Moral Injury and Posttraumatic Stress Disorder (PTSD)?

While moral injury and PTSD often co-occur, they are distinct psychological concepts:

Whereas moral injury is primarily a guilt, shame and values-based condition, PTSD is a mental health condition after experiencing of witnessing a deeply traumatic, terrifying or ife-threanting event or ongoing events. 

Primary Triggers

• Moral Injury: Ethical transgressions or a betrayal of core values

• PTSD: A life threatening, psychological event (or series of events) that overwhelms an individual emotionally and psychologically

Core Emotions

• Moral Injury: Guilt, shame and deep remorse

• PTSD: Fear, horror, helplessness or panic

Biological Impact

• Moral Injury: Identity disintegration (i.e., a shattering of a person's core sense of self, moral identity and personal narrative)

• PTSD: hypervigilance, visual replay (e.g., visual replay, present-moment distortion, flashbacks, body memories and so on) and a heightened startle response

Clinical Status

• Moral Injury: Recognized as a moral problem and clinical focus, but not a separate diagnosis

• PTSD: A formal psychiatric diagnosis

What Are Current Examples of Moral Injury in Everyday Life?

There are many current examples including but not limited to:

• Healthcare Resource Triage: A doctor or nurse is forced to triage care by rationing ventilators or critical ICU bed during a pandemic which, effectively, determines which patients will live and which will die.

• Family and Caregiver Burnout: A family member caring for a relative with severe dementia becomes completely exhausted and places the relative in an understaffed nursing home. This results in a deep sense of abandonment.

• Navigating Marital Separation and Divorce: A parent files for divorce to escape an unhappy marriage, but they experience profound guilt over the emotional distress and disruption caused to their children.

How to Heal From Moral Injury

Since moral injury is a wound of the conscience rather than a fear-based disorder (like PTSD), conventional trauma treatment focused only on anxiety reduction might not be enough.  Recovery requires specialized multi-dimensional support including:

• Meaning Making: Processing the event to contextualize actions within a chaotic or impossible situation.

• Self Forgiveness: Moving away from persistent self punishment and developing self compassion.

Healing From Moral Injury

• Communal Recognition: Speaking the truth to a supportive group of peers who understand the unique pressures of the situation.

• Moral Repair: Engaging in altruistic actions, volunteerism or advocacy work to reaffirm personal values.

• Psychotherapy: Therapy helps to heal moral injury by providing a structured, nonjudgmental place to process guilt and shame, deconstruct impossible standards or responsibility and rebuild a functional moral identity.

About Me

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

I have helped many individual adults and couples over the years.

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

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

 

Cinema Therapy: How Can Watching Movies Improve Your Mental Health?

Watching movies with complex characters can be beneficial to your mental health. The practice known as cinema therapy (also known as movie therapy) is a growing therapeutic technique which uses the narrative arc and depth of films to foster psychological growth.

Cinematherapy Can Improve Your Mental Health

When you engage in multi-layered, three-dimensional characters, rather than flat, predictable archetypes, it stimulates specific cognitive and emotional processes that can directly support well being.

Watching complex characters can benefit your mental health through several key mechanisms:

Safe Emotional Distance and Projection

Discussing or processing your own personal pain can sometimes make you feel vulnerable  under certain circumstances. In cinema therapy complex characters in a movie provide an emotional buffer that includes:

• Safe Exploration: You can project your own fears, unvoiced struggles or internal conflicts onto a character.

Cinematherapy Can Improve Your Mental Health

• Objective Detachment: This allows you to process intense themes, including grief, trauma or confusion, with enough distance to evaluate them objectively without flooding your nervous system.

Catharsis and Emotional Regulation
Bottled up feelings can lead to anxiety and pent up stress.  Complex stories act as an emotional pressure valve:

• Controlled Release: Watching a character face existential dilemmas or deep emotional pain provides a structured container that invites you to laugh, cry or feel anger in a safe way.

• Neurochemical Reset: This cathartic release can trigger a drop in cortisol and an increase in dopamine which can lower physical and emotional tension.

Cognitive Flexibility and Shattering Binary Thinking

Flat characters teach us to view the world in black-and-white terms (good vs evil). Complex, morally ambiguous characters force your brain to stretch:

• Brain Activation: Neuroimaging studies show that watching complex characters activates the parts of the brain that handle perspective-taking and the management of cognitive conflict.

• Nuanced Realism: Seeing a character who is deeply flawed yet capable of profound kindness helps you to reject harsh, binary judgments about yourself and others, which builds tolerance for life's natural ambiguities.

Building Inner Resources and Resilience
When characters navigate complicated psychological terrain, they model coping mechanisms and self discovery:

• Inner Resources: Watching a character struggle to find their authentic self amidst social pressure or personal crisis can awaken forgotten internal resources and coping skills as well as help to build resilience.

Cinematherapy Can Improve Your Mental Health

• Active Reflection: It inspires post-viewing reflection, which is the mental integration that happens after watching the movie. It can help you to apply the character's breakthroughs and gained wisdom to your own life.

Universal Experiences and Reduced Isolation

A core part of many mental health problems is that you feel alone with your experience and that no one else has ever experienced what is happening to you, so watching movies with complex characters helps you to realize you're not alone:

• Validating the "Hidden Self": Complex cinematic portrayals capture the messy realities of the human condition. An example of this is putting on a happy public persona while struggling on the inside (see my article: Looking Happy on the Outside But Feeling Broken on the Inside).

Cinematherapy Can Improve Your Mental Health

• The Power of Shared Humanity: Seeing those hidden, complicated parts of yourself reflected on the screen helps you to realize that many problems are universal. This can help you to realize that your struggles are a normal part of being a human being.

How Does a Psychotherapist Use Cinema Therapy in Therapy Sessions?

A psychotherapist uses cinema therapy (or movie therapy) as an emotional bridge to help clients to discuss personal issues. 

The therapist uses a structured framework where clients watch the movie, discuss the movie and process their own real-life experiences which are similar to what the characters dealt with in the film.

How Therapists Use Cinematherapy With Clients

Talking about fictional characters can feel less threatening than if clients talk directly about their problems. 

The therapist will often ask questions like, "Why do you think the main character made that choice?" or "What would you have done in this character's place if you had the same dilemma?"

The therapist can also explore with clients what it was like to watch the movie and to realize they aren't the only ones who have these types of problems. 

They also ask questions like "Would you have handled this problem in the same way or in a different way?"

After clients have processed their thoughts and feelings about the movie with the therapist, the therapist can also ask what it was like to discuss the movie with her. This is called metaprocessing.

This can help clients to open up to discuss their own problems and reflect on their therapeutic relationship with the therapist.

What Kind of Movies Can Help to Improve Your Mental Health

There are so many movies that can be beneficial.

Here is one example that can be beneficial for individuals and couples to watch:

The Before Trilogy: The Before Trilogy is a highly acclaimed series of three romantic dramas by Richard Linklater and starring Ethan Hawke and Julie Delpy. The three films in the trilogy are:

• Before Sunrise (1995)
• Before Sunset (2004)
• Before Midnight (2013)

The trilogy follows the evolving relationship between an American man named Jesse and a French woman named Celine. This series, which was filmed in real time over several years, is famous for its naturalistic conversation-driven format.

What Can You Learn From Watching the Before Trilogy? (No spoilers)

The Before Trilogy teaches that long term relationships require active continuous choices rather than relying only on romantic fate:

• Love changes over time
• Communication predicts survival of the relationship
• Love requires constant effort
• Time can alter your perspective

When I assign this trilogy to watch over a period of a few weeks, I use the films to help the client reflect on their personal struggles and how the characters in the movie dealt with similar struggles.

If I assign it to a couple, I ask them to watch the movies and discuss it afterward in terms of the characters and the dilemmas the characters faced in an effort to stimulate deeper communication between them and a deeper understanding of their relationship.

Conclusion

Cinema therapy is an expressive therapeutic modality where a mental health professional assigns a certain movies to help clients process emotions, gain new perspectives and heal. Therapists can also use TV programs or other types of videos.

Cinema therapy works by using carefully selected movies as a "third person" tool to mirror real-life struggles, encourage empathy and prompt breakthroughs.

It can be beneficial for individual adult clients or couples.

About Me

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

I have helped many individual adults and couples over the years.

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

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

How to Set Boundaries With Friends If They're Texting You Too Much

There are some people who enjoy texting back and forth with their friends all day long and it's mutually satisfying for all the texters involved.

Setting Boundaries With Friends About Texting

But if you're not one of those people who enjoys constant texting and you have a friend who likes to send you lots of texts, rather than letting resentment and emotional distance grow, you can tactfully set a limit with your friend (see my article: Do You Feel Entitled to Set Boundaries With the People in Your Life?).

In a world where people can reach others in a flash by texting, a lot of people find it gratifying to express their thoughts and feelings in texts and enjoy the dopamine hit when their friends text back.

People who have problems understanding boundaries can text all day long without considering whether the person they're texting has the time and emotional bandwidth to deal with a barrage of texts (see my article: Do You Feel Overwhelmed By Your Friend's Problems?).

If you haven't set a limit, you can give your friend the benefit of the doubt that they might not know you don't like a lot of texts and that you don't have the time or emotional bandwidth for it. Therefore, it's up to you to communicate this to them so you take care of your time and mental health.

Why Do Excessive Texts Create Stress and Anxiety?

Here are some of the most common reasons:

• Pressure to Respond (Expectation of Availability): You might feel pressure to respond immediately. This often leads to stress and anxiety when you can't or you don't want to respond immediately.

• Digital Burnout and Overstimulation: Constant notifications can break concentration. The ongoing distraction can lead to mental fatigue.

• Lack of Personal Space: Excessive non-urgent texts throughout the day can feel like an intrusion on your privacy and downtime.

• Anxiety Trigger: A high volume of text messages can induce anxiety and a feeling of being overwhelmed.

• Disruption to Workflow and Personal Tasks: Constant interruptions can make it difficult to focus on work or personal tasks.

How to Set Boundaries With a Friend Who Texts Too Much

Here are some suggestions that might be helpful:

• Shift the Focus from Their Behavior to Your Own Needs and Boundaries: First, recognize that you have the right to your feelings as well as the right to set boundaries. If you can't set boundaries with others, you're going to feel frustrated and you'll probably have ongoing interpersonal problems due to the lack of boundaries. Assuming you want to maintain this friendship, you can say, "Having to check texts many times per day makes me feel anxious. I'm trying to check these notifications less."

• Express Appreciation For Their Friendship: Assuming you want to maintain this friendship, express your appreciation for your friend and the things you like about them so that you're not just focusing on something that bothers you about their behavior. 

Setting Boundaries With Friends About Texting

• Shift Time Spent With Your Friend From Texts to In-Person Visits: Suggest to your friend that you would like to know what's going on in their life, but you would prefer to do it in person. Then, suggest a time when you're free to meet in person. 

• Let Them Know When You're Available: Let your friend know when you're reachable and manage their expectations about when you're free to respond to texts. You can say something like, "I don't have time to check texts throughout the day, so I only check them after work" or "I've been so busy lately that I haven't had time to check personal texts." Then, as previously mentioned, you can suggest meeting when you're both free.

Setting Boundaries With Friends About Texting

• Let them Know You're "Unplugging" to Manage Your Stress: Let your friend know that, as part of a new lifestyle change, you're taking time to "unplug" from your phone and computer. You can tell them that, as part of your digital detox, you're cutting back on the time you spend reading email and texts. You can also tell them that if they don't hear from you for a few days, this is the reason.  

• Evaluate the Friendship: If your friend doesn't understand that you don't have the time and emotional bandwidth for a lot of texts in a day, you can evaluate whether the aspects you like about this friend outweigh this problem. If you have communicated your boundaries and they don't respect them, there might be other areas where you'll find they will cross your boundaries. At some point, you'll need to decide whether you want this friend in your life.

About Me

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

I have over 25 years of experiencing helping individual adults and couples.

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

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

Cultivating Hope During Uncertain Times

During uncertain times it's more important than ever to cultivate hope (see my article: Combining Hope With Meaningful Action).

Cultivating Hope During Uncertain Times

According to Viktor Frankl, holocaust survivor and author of Man's Search For Meaning, hope is a choice and a powerful force during the worst of times. 

He posited that everything can be taken away from an individual, but hope cannot be taken away (see my article: A Search For a Meaningful Life).

Cultivating Hope During Uncertain Times

Hope isn't contingent on external circumstances (see my article: Living With Uncertainty).  

Instead, hope is your own internal resolve and perspective. Hope requires a desire for a particular outcome and, even though that outcome isn't guaranteed, the act of hoping can strengthen your sense of resilience.

What Can You Do to Cultivate Hope During Uncertain Times?

To cultivate hope:

• Find Purpose and Meaning in Your Life: Engage in activities that give you a sense of purpose, meaning and joy (see my article: Finding Meaning and Purpose in Your Life After Trauma).

• Remember Your Successes From the Past: Remember the times in the past when you overcame challenges and allow those memories to motivate you.

Cultivating Hope During Uncertain Times

• Journal: Write down your thoughts, emotions, progress and insights along the way (see my article: Journaling Can Help Relieve Stress and Anxiety).

• Prioritize Connection and Community: Connecting with others who also want to cultivate hope can provide you with a sense of belonging and a community. Getting together with others can help build strong relationships and a collective sense of hope (see my article: The Need For Community and a Sense of Belonging).

• Seek Out Inspiration: Inspiration can come from others who have overcome whatever challenges you're facing. This could be people you know or you might find it in a story or biography about someone who overcame adversity.

• Challenge Your Negative Thoughts: Become aware of how your negative thoughts might be causing you to slip into a state of hopelessness and helplessness.  Don't allow your negative thoughts to spiral. Look for evidence, no matter how small, of a more hopeful outcome to problems (see my article: 5 Tips For Challenging Negative Thoughts).

• Reframe "What If" Thoughts: Instead of focusing on "What if I fail?" or "What if it all goes wrong?", reframe your thoughts to focus on what might be the silver lining in your situation (see my article: Developing a Different Perspective Through Reframing).

Cultivating Hope During Uncertain Times

• Take Small Steps: If the problem you're facing is big, take small and steady steps towards your goal so you can build momentum toward the bigger goal. 

• Celebrate Small Wins Towards Your Goal: Learn to celebrate small wins on your way to accomplishing your goal (see my article: How to Celebrate Your Progress).

• Practice Self Care: When you're going through uncertain times, you need to prioritize self care in ways that are meaningful to you. Eat well, get enough sleep and exercise at a level that's right for you to boost your mood (see my article: Taking the Time For Self Care).                        

Get Help in Therapy

If you are going through a particularly difficult time and self help strategies aren't enough, seek help from a licensed mental health professional.

Get Help in Therapy

A skilled psychotherapist can help you to overcome the obstacles that might be getting in your way so you can lead a more fulfilling life.

About Me

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

I have over 25 years of experience helping individual adults and couples.

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

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

 

The Challenges of the "Sandwich Generation": Raising Children and Taking Care of Elderly Parents

The "sandwich generation" refers to adults who are raising their own children while taking care of elderly parents at the same time.  It's called the "sandwich generation" because these individuals are caught between their responsibilities for their children and their aging parents.

Raising Children and Taking Care of Elderly Parents

What Are the Challenges Faced By the "Sandwich Generation"?

Here are the most common challenges for individuals trying to balance their roles as caregivers for their children and their elder parents:

• Stress and Emotional Toll: Juggling these two major caregiving roles can lead to high levels of stress, exhaustion and feeling overwhelmed.

• Role Reversal: The role reversal of taking care of parents can be emotionally challenging, especially as parents' health declines.

• Time Constraints: These individuals spend a good deal of time balancing their responsibilities for their children and their parents which can leave little time personal time (see my article: Self Care For Caregivers).

• Financial Strain: The cost of taking care of children and elderly parents can create a significant financial burden.

How to Cope With the Challenges

• Get Organized: Keep track of appointments, medications and finances to address stress and confusion.

Raising Children and Taking Care of Elderly Parents

• Don't Forget Self Care: Try to find time for self care. Make sure you get enough rest, eat healthy meals and get exercise at a level that is appropriate for you.  Also, try to find time to do activities you enjoy (see my article: Learning to Balance Taking Care of Your Own Needs and the Needs of Your Loved Ones).

• Communicate Openly With Family Members: If you (or you and your partner) are bearing the brunt of taking care of elderly parents, have an honest conversation with family members about your feelings and needs.

• Seek and Accept Help: After you have had an honest and open talk with family members, delegate certain tasks to them when possible. If that's not possible, ask them if they can help financially so you can hire a home attendant (see the clinical vignette below).

• Set Boundaries: Learn to say "no" to additional responsibilities and try to avoid taking on too much (see my article: Setting Boundaries Without Guilt).

• Look For Small Joys: Try to find moments of joy and connection with your loved ones--even in the midst in all you have to do. 

Clinical Vignette

The following clinical vignette, which is a composite of many cases, illustrates how to deal with some of the challenges of being part of the "sandwich generation":

Dina

As the oldest of three daughters, Dina took in her elderly parents when they could no longer live on their own.  At the same time, she and her husband, Tom, were raising their two teenage sons.

When Dina was growing up, she was expected to take on responsibilities, as compared as the oldest child and her two younger sisters took on none.  Her parents expected her to do many of the household chores while her sisters were allowed to go out with their friends.

When she graduated high school, Dina attended an out of state college to get away from her family responsibilities and, after she graduated, she got an apartment with her former college roommates.

Years later, after Dina got married and she had children, she continued to help her parents, but after they could no longer live on their own, she felt obligated to take them in. 

Raising Children and Taking Care of Elderly Parents

Before her parents came to live with Dina and Tom, Tom urged Dina to talk to her sisters about helping out more. Tom had always been generous in helping Dina's parents, but he could foresee the toll it was going to take on each of them. Dina was so accustomed to taking on responsibilities as the oldest child that she didn't question whether her sisters should help and she didn't want to talk to them about it.

Their teenage sons helped out when they could, but they were busy with school, their friends, applying to college and sports, and Dina didn't want to rely on them or deprive them of what they needed and wanted to do.

Within a few months, Dina and Tom felt overwhelmed taking care of her parents. Dina wasn't sleeping well and she had very little appetite. She also stopped her usual self care routines--meditation and yoga practices because she didn't have time. She also stopped seeing her close friends. 

Tom also curtailed his outings with friends because he was trying to do as much as he could to help Dina. He was also concerned about his elderly parents who were independent at that point, but he didn't know when they would also need help.

One day when Tom came home from the grocery store, he found Dina in their bedroom sobbing. She looked stressed and worn out. When she saw him, she tried to dry her tears and act like she was alright, but Tom knew Dina had reached her limit.

Tom sat next to Dina and put his arm around her, "We need to talk to your sisters. I know what you're going to say--that as the oldest you've always been the one to take on all the responsibilities, but we can't keep going on like this."

At first, Dina insisted she could continue to take care of her parents, but she knew Tom was right, so they talked about how to approach her sisters.  

A week later, Dina's sisters, Paula and Meg, came over for lunch on a Saturday. At that hour, their parents were upstairs napping. 

Dina felt anxious and guilty. She felt she was abducating her responsibilities. She also anticipated that Paula and Meg wouldn't respond well to her asking them to help.

When Dina told her sisters that she was completely overwhelmed with taking care of their parents, she had to endure her sisters' silence and discomfort. Both sisters looked off in the distance and appeared annoyed.

Tom supported Dina in the conversation and told them that they needed to help.  Paula and Meg responded with many excuses about why they didn't have the time and couldn't help. Soon after that, they both left in a hurry.

Dina felt angry, resentful and sad after they left. She and Tom talked about what they could do next and they decided to have another meeting with Paula and Meg, but this time they would include a third party, a geriatric care manager, there to mediate their discussion.

Initially, Paula and Meg continued to make excuses for not helping at all. While they spoke, the geriatric care manager listened carefully and empathized with them.  Then, she tried to find a compromise where they could offer financial help so Dina and Tom could hire a home attendant for help.

Dina's sisters were so relieved that they didn't have to take their parents in that they readily agreed to offer financial help so Dina and Tom could have more time for themselves.  After that, Dina and Tom felt a lot less stressed because they had help and more time to themselves.

A few months later, Dina's parents decided they would prefer to live in an assisted living facility, so Dina and Tom went with them to see several facilities until they found one they liked and could afford.

After this experience, Dina realized she was so conditioned since childhood to take on most of the responsibilities and she had not learned to take care of herself.  

Once her parents were situated in the assisted living facility, she began therapy to work on this.  Her therapist helped Dina to feel entitled to take care of herself. Dina also worked through the sadness, anger and resentment she had been unaware of for most of her life.  

Conclusion

Being in the dual role of taking raising children and taking care of elderly parents is stressful and emotionally draining for most people.

Without even realizing it, you might be repeating lifelong patterns of doing too much and not taking care of yourself, as discussed in the vignette above.

In certain situations, there might be ways to help alleviate the stress if other family members are willing to help.  If not, you might be able to use the services of a geriatric care manager or someone who is outside the situation who can mediate family discussions to see if there is a compromise.

If you're able, you could benefit from working with a licensed mental health professional who can help you to cope with the stress and emotional toll. She can also help you to overcome old behavioral patterns that keep you stuck.

About Me

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

I work with individual adults and couples.

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

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

What is Hypervigilance and How is it Related to Unresolved Psychological Trauma?

Hypervigilance is a heightened state of awareness that allows humans to sense threats in their environment.

Hypervigilance and Psychological Trauma

People who are in a perpetual state of hypervigilance feel like they are constantly under a threat.  The part of the human brain that manages emotions, the amygdala, is in overdrive.

What Causes Hypervigilance?

This article focuses on psychological trauma. However, there are other potential mental and physical causes of hypervigilance including:

• Anxiety
  

• Panic Attacks
  

• Depression
  

• Dementia

• Adrenal Disorders

• Fibromyalgia 

Hypervigilance and Unresolved Childhood Trauma

Children who grow up in a dysfunctional family where parents might be unpredictable, violent, abusing substances, physically abusive or neglectful learn to be hypervigilant as an unconscious survival strategy. They learn to sense their parents' shifting moods so they can be ready at all times to protect their safety.

Hypervigilance and Unresolved Childhood Trauma

Without help in therapy, these traumatized children usually grow up to be traumatized adults and they continue to be hypervigilant in their surroundings.

Examples of Hypervigilance in Adults

• Hypervigilance to Their Surroundings: People who grew up in an abusive family or who experienced abusive relationships as an adult might have a strong startle response reflex where they are startled by the slightest sound or movement.

• Hypervigilance to Other People's Thoughts, Feelings and Behavior: People who experience hypervigilance might be very observant of other people's thoughts, feelings, behavior and body language for any signs of change or potential danger.

• Hypervigilance of Their Own Body: People who experience serious medical problems or who have someone close to them who have experienced serious medical problems are often hypervigilant of their own body. A minor experience of pain might be perceived as a catastrophic disease.

Hypervigilance and Catastrophizinglo

• Hypervigilance and Catastrophizing: People who are hypervigilant tend to create negative narratives in their mind which can spin out of control. Small things, like a friend not responding to a text immediately, can develop into a catastrophic story where the friend has died. Even when things are going well, people who are hypervigilant might find it difficult to enjoy happy times because they are always waiting for the other shoe to drop (see my article: Are You Catastrophizing?).

• Hypervigilance and Insecurities: Since hypervigilance is mostly about preventing or avoiding potential threats, people who are hypervigilant might attempt to ward off threats by people pleasing or fawning. They might struggle with regulating their emotions or trusting others. They might have problems letting their guard down so they can relax or they might be fearful they will say or do the "wrong thing" (see my article: Trauma and the Fawn Response

• Hypervigilance and Avoidant Behavior: People who struggle with hypervigilance can be avoidant in ways that are detrimental to themselves and others. They might avoid people, places and things they fear. This can cause problems in their personal life as well as their career. For instance, if they experience minor turbulence on a plane trip, they might avoid ever getting on a plane again--even if it means they won't see close friends or family members or they might lose a job that involves travel. Another example is if someone is in a minor car accident where no one was hurt, they might avoid driving again--even if it means they can't visit people close to them or go to work.  A third example: If someone goes through a bad breakup, they might avoid dating or getting into another relationship. In other words, many other people, who don't experience hypervigilance, might be hesitant after having a bad relationship experience, but they learn to cope and they don't avoid.  In contrast, the person who is hypervigilant takes it to an extreme because it's their way of protecting themselves. However, in the process, they don't learn to cope or overcome their fears. They remain stuck (see my article: What is Avoidant Behavior?).

What is the Potential Physical and Psychological Impact of Hypervigilance?

People who experience hypervigilance might experience some or all of the following characteristics:

• Chronic Stress: A constant flood of cortisol and adrenaline is exhausting and can cause medical, emotional and psychological problems.

Hypervigilance and Relationship Problems

• Relationship Problems: While people who experience hypervigilance might be more aware of potential red flags in a relationship, they might also have problems getting close or trusting even in a healthy situation. They might be overly sensitive or emotionally overreactive to a partner's comments. Some people might avoid getting involved in relationships at all because o they fear getting hurt (see my article: How Trauma Can Affect Your Ability to Be Emotionally Vulnerable in a Romantic Relationship).

Hypervigilance, Loneliness and Isolaton

• Loneliness and Isolation: A fear of making friends or seeking romantic relationships due to fear of getting hurt, can lead to isolation and loneliness (see my article: Loneliness and Social Isolation).

How to Cope With Hypervigilance

Here are some interventions that might be helpful to you:

• Grounding Exercises: You can learn to calm yourself with breathing exercises, mindfulness meditation and journaling.

Coping with Hypervigilance By Meditating

• Limiting or Eliminating Coffee, Alcohol or Other Substances: If you notice you feel worse after drinking coffee or alcohol, consider either limiting your intake or eliminating these substances.

• Seeking Help in Trauma Therapy: If you work with a trauma therapist, you can learn to: 

• Identify your triggers

• Learn to overcome your triggers

• Be able to differentiate your feelings from objective reality (see my article: Discovering Your Thoughts and Feelings Aren't Facts)

• Work through the psychological trauma underlying your hypervigilance so you are free from your traumatic history

Getting Help in Trauma Therapy

Trauma therapy includes various types of therapy that were developed specifically to help people to overcome trauma. 

These include:

• EMDR Therapy (Eye Movement Desensitization and Reprocessing Therapy)

• Somatic Experiencing
  

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Hypnotherapy
  

• Parts Work Therapy (including Internal Family Systems Therapy and Ego States Therapy)

When you work with a skilled trauma therapist, you can overcome hypervigilance and unresolved psychological trauma.

Getting Help in Trauma Therapy

Rather than struggling nn your own, seek help from a licensed mental health professional who is a trauma therapist so you can lead a more fulfilling life.

About Me

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

I work with individual adults and couples (see my article: What is a Trauma Therapist?).

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

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

Also See My Articles:

8 Tips For Coping With Triggers

What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)

What is Trauma-Related Dissociation?