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NYC Psychotherapist Blog

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Showing posts with label substance abuse. Show all posts
Showing posts with label substance abuse. Show all posts

Tuesday, April 12, 2022

A Search For Comfort and Safety With Alcohol or Drugs

Many people who drink alcohol excessively or abuse drugs are actually seeking comfort and safety, but they might not even realize it.

A Search For Comfort and Safety With Alcohol and Drugs

A Non-Pathologizing Perspective
As a psychotherapist in New York City, I've worked with many clients who are struggling to overcome substance abuse problems.  Many of them say that the alcohol or the drug is like a friend they don't want to give up, which is understandable.

If alcohol and drugs didn't provide a certain extent of comfort or feeling of safety, people wouldn't abuse these substances.  For many people, it's might be the only comfort and sense of safety they have ever experienced.

So, asking people, who experience this comfort to give it up can feel like a very daunting process to them, especially if they haven't ever experienced comfort with another person.

A Search For Comfort and Safety With Alcohol or Drugs

From this perspective, these substances can feel like a reliable source of comfort.  Not only does it provide temporary relief, but it is usually available, especially if the substance is alcohol.  It's legal.  It can be consumed alone or with other people.  And it usually accomplishes the goal of bringing temporary relief.

Of course, the problem is that, over time, substances create other problems, including serious health problems, impaired cognitive functioning, family problems, and work-related problems, just to name a few.

Over time, it can also result in death, so that even though there is a temporary relief, there can be serious long term damage.

People often seek help when one or more of these problems develop.  By then, it can seem like a very frightening prospect to give up what works temporarily--even when people know that will ultimately do serous damage.

At that point, some people will bargain with themselves and their loved ones:  They tell themselves and their loved ones that they can control their use or that they can stop at any time.  But, often, they're the only ones who actually believe this. And if they try to stop on their own, they might discover that they can't.

It can be a long, arduous process to give up abusing substances, and many people pay the ultimate price of ruining their health beyond repair before they accept that they can't control it.

But if people, who abuse substances and their loved ones have this non-pathologizing perspective that    the substance brings a sense of comfort, it can create more self understanding and empathy for oneself as well as for others.

Learning Healthy Ways to Seek Safety and Comfort 
One of the goals of therapy or substance abuse treatment is that people who are abusing substances learn how to seek comfort and safety in other ways.

This might mean that, instead of abusing substances, they learn to self soothe by:
  • learning to meditate
  • learning new breathing techniques to calm themselves
  • learning new grounding techniques
  • developing resilience
  • developing new coping skills
  • learning to make better choices
  • learning to choose healthier relationships
  • developing a stable and manageable life step by step
Even being able to consider learning new ways involves a certain amount of trust in a psychotherapist or a substance abuse counselor, which can be challenging for someone who has never had a trustworthy relationship.

Some people will persist in abusing substances because they don't want to give up what brings temporary relief.

Building that rapport and trusting relationship can take time.  In the meantime, before people can trust enough to allow a relationship to develop, they might need to ask themselves if they are willing to try it because being willing is often half the battle.

But once people trust enough to try other ways of seeking safety and comfort, they usually discover that this is a skill the they can continue to develop and that it works.

Getting Help in Therapy
Asking for help often induces shame in people.

Most people like to think that they can control their lives and that they don't need help.  But when it becomes obvious that your life is falling apart, it takes a lot courage to ask for help.

Often, people come into therapy externally motivated because either a spouse or a boss has given them an ultimatum:  Either get help or leave.

But people who are open to the process of recovering from substance abuse often discover their own internal motivation, especially if they develop a rapport with their therapist.

Getting Help in Therapy
If you're struggling with substance abuse or you're watching someone you love abuse substances, you're not alone.

Even if you can't afford therapy or you don't have access to treatment, there are 12 Step meetings in most cities and online.

Life is short.  Getting help sooner rather than later can make all the difference in how you live the rest of your life and the quality of your relationships.

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 business hours or email me.














Saturday, January 13, 2018

Early Recovery: Overcoming Feelings of Emptiness and Loss

In previous articles about early recovery, I addressed problems with making major major adjustments to life to maintain sobriety (see my articles: Early Recovery: Focusing on the People Part of "People, Places and Things," Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations and Early Recovery: You've Stopped Drinking. Now What?.  In this article, I'm addressing another common issue that people in early recovery experience, which is overcoming the feelings of emptiness and loss after you give up your addiction.

Early Recovery: Overcoming Feelings of Emptiness and Loss 

Many people in early recovery will say that one of the hardest things they had to do in order to get sober was give up the one thing they felt they could rely on--their addiction of choice.

For anyone who is unfamiliar with addiction and early recovery, these feelings of emptiness and loss for an addiction might seem confusing.

But as a psychotherapist in private practice in New York City, who has worked with people at all stages of addiction, I know that this sense of loss and emptiness is common and understandable.

After all, if the addiction, whether it's to alcohol, drugs, compulsive gambling, compulsive sexual behavior or any other addictive behavior, didn't serve a need, the person with the addiction wouldn't persist in it.

For many people, who are contemplating giving up an addiction, one of the most daunting aspects of attaining sobriety is the thought they won't have what feels to them as a "friend" who has served a need--whatever that need might be.

The need could be a way to relax, socialize, to temporarily forget problems, to elevate a mood, to feel empowered, and so on.  And if the addiction of choice didn't "work" in some sense, even temporarily, it would have been given up long before it became an addiction.

For someone who is unfamiliar with addiction, it would be hard to imagine just how scary and how courageous it is when someone who has an addiction gives it up.  Many people, who are not educated about addiction, think that the person with the addiction "should just stop."

But aside from the fact that there might be a physical danger to "just stopping" for many addictions where a detox is necessary, the person contemplating giving up the addiction is also taking a leap of faith that they will be able to survive physically and emotionally with the addiction.

This is why there's a high rate of relapse for people struggling to stay sober, especially if they try to do it without sober support and, eventually, working through the underlying emotional problems that led to the addiction in the first place.

What Will Take the Place of the Addiction for the Person in Early Recovery to Fill the Emotional Void?
Without the addiction, the person in early recovery will usually become aware of an emotional void and the sense of loss.

Early Recovery: Overcoming the Feelings of Emptiness and Loss

Since isolation and loneliness is often a part of addiction, many people in early recovery find support in 12 Step meetings like Alcoholics Anonymous or Gamblers Anonymous.

They discover that there are people in these self help meetings in all different stages of recovery--from early recovery to many years in recovery.

They also discover that they have much in common with the people in these self help rooms, including a continuing struggle to avoid relapse and to maintain the values and principles they learned in those rooms.

I usually recommend that people in early recovery give 12 Step meetings a chance by going to several beginners meetings to see if they find a particular meeting where they feel comfortable and where they can also find a sponsor to help them work the 12 Steps.

There is no one-size-fits-all approach to recovery, so I also understand that for some people in early recovery the 12 Step model doesn't resonate with them or they find the meetings too overwhelming after they've tried several meetings (see my article: The Early Stage of Recovery: What to Do If 12 Step Meetings Are Too Overwhelming For You?).

So, many people in early recovery prefer to go to structured treatment in either an inpatient or  outpatient substance abuse program, if they have health benefits that recovers this treatment, where they can also get group support from people with similar problems.

Other people seek out psychotherapists who have experience working with people in recovery, including early recovery.

For psychotherapy option to work well in early recovery, the psychotherapist needs not only to be familiar with addictions, she must also know how to assess the timing and what the client can tolerate in terms of working on the underlying issues.

It's essential that clients in early recovery have sufficient sober time, the coping skills and necessary internal resources to deal with the underlying emotional issues in therapy, so it's psychotherapists need to help clients to develop these internal resources before delving deeper (see my article: Developing Internal Resources and Coping Strategies).

All of these modalities--12 Step meetings, structured substance abuse programs, and psychotherapy--all have the potential to help clients to remain sober.

In addition, in many cases what's also needed is something deeper that will fill the void that's left from no longer engaging in the addiction.

Some people find meaning by discovering or rediscovering a sense of spirituality.

Spirituality doesn't necessarily mean religion, although it could (see my article: A Search For a Meaningful Life and Spirituality: Are You Contemplating Your Faith of Origin in a New Light?).

Spirituality can take on many different forms aside from formal religion.  For instance, many people feel a sense of spirituality when they volunteer to help others, including volunteering at 12 Step meetings or in schools or a local community program.  Others discover a sense of spirituality in nature and find a connection to nature a transcendent experience.

The important aspect of spirituality in whatever form it takes is that it is meaningful, fulfilling and transcendent.

I believe this applies to everyone--not just people in early recovery.  Whether you call it "spirituality" or something else, without a sense of meaning, purpose and transcendence, you're just living from day to day and it can feel empty.

Many people who don't struggling with addiction but who focus only on material things will often feel a sense of emptiness in midlife when money and possessions no longer serve elevate their moods.

Usually, midlife brings an awareness that money and material things, although necessary to a certain extent to meet basic needs and give some comfort, are never enough to fill up a sense of emptiness.

This is why many people in midlife, especially those who have more years behind them than ahead of them, recognize that they need to make changes (see my articles: Midlife Transitions: Part 1: Reassessing Your LifeMidlife Transitions - Part 2: Living the Life You Want to LiveIs That All There Is? When "Having It All" Leaves You Feeling Empty  and Redefining Happiness and Success For Yourself).

Conclusion
The early recovery stage presents certain challenges, including dealing with the sense of emptiness and loss that often occurs after giving up the addiction.

Early Recovery: Overcoming Feelings of Emptiness and Loss

Aside from the physical aspects of getting sober and maintain sobriety, people in early recovery need to find healthy and meaningful ways to fill the void.

Sober support from 12 Step meetings, substance abuse programs and psychotherapy offer various options for staying sober and, in the case of psychotherapy, working through the underlying emotional problems that led to the addiction in the first place.

Beyond these options, people in early recovery need to find a sense of meaning and purpose in their lives.  I refer to it as "spirituality," but it doesn't have to involve a formal religion or even a belief in a higher power.

Without a sense of meaning and transcendence, people in early recovery often struggle with the sense of loss and emptiness that usually follows after they become sober.

Getting Help in Therapy
Many people choose to attend psychotherapy to address underlying emotional issues at the core of their addiction (see my article: The Benefits of Psychotherapy).

As previously mentioned, it's important to find a psychotherapist who has an expertise in addiction and who can work with you in a way that feels emotionally manageable for you (see my article: How to Choose a Psychotherapist).

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

I work with individual adults and couples.

I have helped many clients in all stages of recovery to maintain their sobriety and work through the underlying emotional problems that were at the root of their addiction.

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

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






Monday, January 8, 2018

Understanding the Different Types of Boredom

Everyone feels bored at some point.  This article is primarily about people who feel bored most of the time and remain immersed in their boredom. Boredom can lead to either destructive or creative behavior.  It all depends on what you do with it. Unfortunately, many people react to boredom in a self destructively way (see my article: Coping With Addiction: Boredom as a Relapse Trigger ).  The word "boredom" is very broad.  When people say they're bored, they often mean different things, which is why it's important to understand that there are different types of boredom.

Understanding the Different Types of Boredom

Understanding the Different Types of Boredom
  • Apathetic Boredom:  People who feel the type of boredom characterized primarily by apathy have a lack of positive or negative feelings that is usually associated with feelings of helplessness and, in some cases, depression.  This type of boredom can lead to self destructive behavior, like drinking excessive or using drugs, as a way to elevate their mood.
  • Unpleasant Restless Boredom:  Unpleasant restlessness is usually associated with a negative kind of boredom where a person thinks about other things s/he might want in his or her life, like a new job, different activities, and so on.  If the restlessness leads to a search for new activities, it can be turned into something positive and productive.  But if the person just continues to ruminate about his or her boredom, then, at best, nothing will change and, at worse, it can lead to self destructive behavior.
  • Reactive Boredom:  A person who is experiencing reactive boredom often wants to escape from or avoid his or her responsibilities.  There might be a significant level of restlessness and aggression involved as the person dwells on alternative scenarios.  Whether this leads to taking constructive action can make all the difference.
  • Indifferent Boredom:  A person who experiences indifferent boredom usually appears calm and they are often withdrawn.  Many people who habitually abuse marijuana can fit into this category.
  • Calibrating Boredom:  People who experience this type of boredom want to do something different, but they're not sure what to do.  They might have wandering thoughts about what they might want to do, but they usually don't take action.
In future articles, I'll discuss how boredom is often a secondary emotion that hides other emotions like anger and sadness.  I'll also discuss how boredom can lead to creativity.

Conclusion
Boredom is a broad term that can lead to either destructive or creative behavior.

There are at least five different types of boredom.

Once you become aware of what type of boredom you're experiencing, you can choose to take action to overcome your boredom.

Getting Help in Therapy
As I mentioned before, boredom can lead to self destructive behavior as people look for ways to elevate their mood, possibly through alcohol, drugs, compulsive gambling or other destructive mood altering behavior.

When people are immersed in boredom and they don't know how to overcome it, it can be helpful to seek assistance from a licensed mental health professional who has experience helping clients to delve deeper into their feelings to understand the root problems and how to overcome them.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples (see my article:  ).

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.










Friday, December 15, 2017

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

Many people who are recovering from addiction don't understand the concept cross addiction, which is substituting one addiction for another (see my other articles about substance abuse:  Recovery: Maintaining a Balanced Life,  "Liquid Courage:" Overcoming the Temptation to Abuse Alcohol to Cope With Social SituationsThe Myth About Having to "Hit Bottom" to Change, and Coping With Addiction: Boredom as a Relapse Trigger).

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

The reason it's so important to understand cross addiction is that people who have a history of addiction often switch from one addiction to another, especially when they're under stress.

So, for instance, if someone who has been sober from alcohol for a few years suddenly finds himself under a lot of stress at work, instead of picking up a drink, he might start to abuse prescription drugs or gamble compulsively or engage in some other form of addiction.

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

It's easy to fool yourself into thinking that you can dabble with another addiction because it's not your primary addiction.

But when you're under a lot of stress and you haven't developed adequate skills, if you have a history of addiction, you're more likely to either relapse with your primary addiction or engage in cross addiction.

Let's take a look at a fictional vignette to see how this plays out:

Fictional Vignette: Recovery: Understanding Cross Addiction: Substituting One Addiction For Another:

Connie:
Connie was sober from alcohol for two years.  During that time, she struggled to maintain her sobriety, but with the help of her psychotherapist and her sponsor, she celebrated her second year as a sober person.

Soon after she celebrated her second anniversary of sobriety, she left Alcoholics Anonymous and told her psychotherapist that she wanted a break from therapy.

A few months later, her mother fell, broke her hip and had to go to an inpatient physical rehabilitation center.  When her mother got home, she needed Connie's help because she wasn't able to take care other daily needs.

Although Connie and her mother had a conflictual relationship, Connie agreed to move in with her mother temporarily to help her.  She knew that other siblings, who also had conflicts with their mother, wouldn't be willing to do it and her mother really needed help.

The stress of taking care of her mother and working a full time job took a toll on Connie after a few weeks (see my article: Are You Experiencing Chronic Stress and Unaware of It?).

There were times when she wanted to tell her mother to fend for herself, but she knew her mother couldn't be alone, so she tolerated her mother's emotional abuse.

Connie was often tempted to have a drink, but she knew that if she had one, she wouldn't be able to stop, so she refrained from drinking.  But she started using food to soothe her stress, and she gained 20 pounds within a few months.

Recovery: Understanding Cross Addiction - Substituting One Addiction For Another

When she went to the doctor for her annual checkup, her doctor couldn't believe that Connie had put on so much weight since the last time he saw her.

Knowing that Connie had a history of alcohol abuse, her doctor asked her if she was overeating.  When Connie told him that she was "stress eating" at her mother's home, he talked to her about cross addiction and recommended that she get back into therapy.

Connie had never heard of cross addiction.  Before she saw her doctor, she thought that as long as she didn't touch alcohol, she was doing well.  But when her doctor explained cross addiction to her, it made sense to Connie, and she knew she needed to take care of herself (see my article: Self Care For Caregivers).

The next day, Connie called a family meeting with her siblings and explained to them that they needed to pitch in.  She could no longer take on the sole responsibility of being her mother's caregiver.

At first, her siblings balked, but Connie insisted that either they help her out or she would hire a home attendant for their mother.

None of Connie's siblings wanted a home attendant in their mother's home, so they agreed to work out a schedule so they could take turns taking care of their mother.  Since there were seven of them, they each took a day, and sharing the responsibility made it less stressful.

Once her siblings were involved, Connie went back to her former psychotherapist to deal with her stress eating and unresolved issues about her mother (see my article: Returning to Therapy).

She also resumed attending Alcoholics Anonymous meetings, and she contacted her old sponsor on a daily basis.

With emotional support and reduced stress, Connie was able to get back on track so she could eat in a healthy way again and lose the weight she gained.

She also had a new appreciation for how stress could put her at risk for cross addiction.

Conclusion
The term "cross addiction" refers to substituting one addiction for another.

The fictional vignette above highlights how important it is to recognize your particular vulnerability to cross addiction and also the importance of self care, self help meetings, and getting help in therapy.

Getting Help in Therapy
Setbacks are part of recovery and part of psychotherapy (see my article: Setbacks Are a Normal Part of Psychotherapy on the Road to Healing).

If you've had a setback in your recovery, it's important to get help before the problem progresses (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist, who is knowledgeable about addictions, can help you to get back on track again (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, contact a licensed mental health professional who has an expertise in addictions so you can remain healthy.

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

I work with individual adults and couples.

I have helped many clients to establish and maintain their recovery.

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, December 14, 2015

The Myth About Having to "Hit Bottom" to Change

The myth that people who have addiction problems have to "hit bottom" before they decide to change is both extremely dangerous and completely wrong.  This is an outdated concept that is still around in some recovery circles, and it has been detrimental to many people.

Recovery: The Myth About Having to "Hit Bottom" to Change

Even though many people in recovery now realize that "hitting bottom" is detrimental, there are still some people in recovery who still believe it.

If you're struggling with addiction, whether it's drinking, drugging, compulsive gambling, sexual addiction or some other form of addiction, or you love someone who has an addiction problem, it's important that you understand why the "hitting bottom" myth is dangerous.

Let's take a look at a fictionalized scenario and see how believing in the "hitting bottom" concept can be dangerous and what to do if you or a loved one is stuck in this type of distorted thinking.

Ed
Ed began gambling in college.  Initially, his gambling involved sports, like gambling on the Super Bowl.  Over time, it grew to include other forms of gambling.

While in high school, Ed was able to hide his gambling from his parents.  But by the time he was a senior in college, he gambled away his tuition money, so he was forced to reveal his gambling problem to his parents.

Ed promised his parent that he would never gamble again, so they lent him the tuition with the agreement that he would pay them back when he graduated college and began working.

When he graduated college, Ed got a high-paying job in finance and he began to pay his parents back.  Little did his parents know that Ed never stopped gambling, and his secret gambling problem had progressed to include going to the casinos, playing high stakes poker with friends, and online gambling.

Recovery: The Myth About Having to "Hit Bottom" to Change

After a few months, despite his high salary, Ed was making excuses to his parents as to why he was unable to make his monthly payments to them.  He was also asking to borrow more money from them.

By then, Ed's parents realized that he had not been honest with them and he was still gambling, so they confronted him about it.  At first, he denied it.  Then, he admitted that it was true.  But he felt that he could "control it" if he wanted to and rejected their suggestion to get help in therapy or to attend Gamblers Anonymous.

Recovery:  The Myth About Having to "Hit Bottom" to Change

Not sure what to do, Ed's parents spoke to a close friend, Tom, who once had a gambling problem, but who overcame it by attending Gamblers Anonymous (G.A.).  Tom had been in recovery for many years, and he rejected their idea to have a family intervention to confront Ed about his gambling problem.

Instead, Tom told Ed's parents that Ed would only be willing to change after he had "hit bottom." He told them that it would be useless for them to try to persuade Ed before that, and they should let Ed find his own way to his "bottom."

Ed's parents weren't sure what to do.  They were worried that Ed's gambling would continue to get progressively worse if they didn't urge Ed to get help.  But they decided that Tom had a lot of experience in G.A. and he must know what he was talking about.  So, with much difficulty, they stood by while Ed continued to gamble, hoping that he would "hit bottom" soon before he had ruined his life.

A year later, Ed's parents were shocked and dismayed to discover that Ed was arrested for attempted fraud as part of an internal investigation in his company.  He was taken out of the company in a pair of handcuffs.

Recovery: The Myth About Having to "Hit Bottom" to Change

Fortunately, since it was his first offense, the judge mandated Ed to get into treatment, a combination of psychotherapy and Gamblers Anonymous in lieu of going to jail.

His parents attended some of his therapy sessions in order for them to understand what happened and for Ed to repair his relationship with his parents, who were hurt and angry.

During one of those sessions, Ed told his parents that, before he was arrested, he was sure that he could stop gambling at any time if he really wanted to do it.  But, after a while, he was deeply in debt to loan sharks and he was so desperate that he did what he never would have thought he would do--he tried to embezzle money from his company.

Ed took full responsibility for his actions.  But his parents realized that following Tom's advice to allow Ed to "hit bottom," rather than doing a family intervention earlier on, was ill advised.

The therapist, who had an addictions background, also advised them that "hitting bottom" was a dangerous myth.

Conclusion
The motivation to change can come in many different ways.

Sometimes, people get a wake up call that they're heading down a slippery slope and they need to make changes in order to avoid a disastrous end.

Other times, people make a few false starts before they make a commitment to change.

The idea of "hitting bottom" would certainly be seen as ridiculous with just about any other type of problem.  Imagine telling someone who had a progressive medical problem that s/he had to wait until the problem got much worse before s/he got help.

The idea of "hitting bottom" is just as ridiculous and dangerous when it comes to addiction.

Getting Help
If you have a loved one who is caught in the grip of an addiction, rather than waiting for the problem to get worse, express your concern.  If that doesn't work, try doing a family intervention in a loving and tactful way to let your loved one know that the family cares and is concerned.

If you're the one who is struggling with addiction, get help sooner rather than later, before there are serious consequences to you and your loved ones.

Living a healthy and fulfilling life is its own reward.

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 business hours or email me

































Monday, January 26, 2015

Allowing Room for Grief

Experiencing grief, especially when it involves the loss of someone close to you, can be very painful.

For many people, the emotional pain of grief can be so painful that they try to push away or push down their feelings to avoid feeling the sadness and loss.

Allowing Room for Grief:  Some People Try to Push Away Their Feelings

While it's understandable that people who are going through grief might be tempted to deny or push away their feelings, it's important to make room for grief so, eventually, these painful feelings can be worked through.

Pushing Away Grief

People often try to avoid or distract themselves from feeling grief by:
  • denying to themselves and others that they feel sad
  • zoning out in front of the TV
  • binge watching videos
  • playing video games for hours
  • surfing the Internet for long periods of time
  • drinking excessively
  • abusing drugs
  • engaging in compulsive gambling (see my article:  Overcoming Grief Gambling)
  • engaging in compulsive sexual activities
  • overeating
  • overworking
  • engaging in sexual affairs
and so on.

What Are the Possible Negative Consequences of Not Making Room for Grief?
When you try to avoid feeling grief, not only are you shutting yourself off to painful emotions--you're also shutting down to positive feelings.

Allowing Room for Grief

Whether you're numbing yourself by denying your feelings or distracting yourself in any one of a myriad ways, you're also numbing yourself to all of your other feelings.  

After a while, emotional numbing can make you feel out of touch with yourself as well as your loved ones.  You can start to feel that you're just "going through the motions" in life rather than living your life in a meaningful way.

Making Room for Grief
"The healing comes from letting there be room for all of this to happen:  room for grief, for relief, for  misery, for joy."
 Pema Chodron

No one wants to feel sad and upset all of the time, but it's important to make time, when you're ready, to feel your feelings, whether you do this on your own, with a trusted friend or in therapy.

Allowing Room for Grief:  Take Time and Space to Connect With Your Feelings

Here are some suggestions for how you can do this during quiet times when you have privacy (you can consider as to whether they would work for you or not):
  • looking at pictures of your loved one
  • taking time and space to connect with your feelings
  • remembering good times together
  • writing down your feelings in a journal
  • engaging in creative arts related to your loved one (drawing, making collages, etc)
  • revisiting places that were important to the two of you
  • listening to music that brings back happy memories
  • meditating on your feelings about your loved one
  • attending or creating a spiritual ritual that is meaningful to you
  • hearing positive stories about your loved one from family members or friends
and so on.

Grieving is an Individual Experience
No two people grieve in the same way.  It's a very individual experience.

In our society, we tend to rush people to "move on" before they're ready.  Not only is this unhelpful, it can also make the person who is grieving feel ashamed, as if he or she is abnormal in some way.

Although people close to you might have good intentions, don't let anyone tell you that you should be "over it" already.

Allowing Room for Grief

There's a difference between avoiding grief and taking the time that you need to deal with your grief.  So, even though I've provided some suggestions above about what many people find helpful, if you're not ready to look at pictures, listen to music that was meaningful to the two of you or engage in any of the activities mentioned above, trust your intuition about this.

At the same time, it's important to be honest with yourself.

So, for instance, if years have passed since your loved one has died and you're still holding onto his or her clothes or keeping a room as a "shrine" to your loved one, as painful as it might be, you need to ask yourself if you're refusing to let go of your grief.

Letting go of grief doesn't mean that you don't care about your loved one.  It means that you're accepting the loss and, hopefully, finding other meaningful ways to integrate this experience into your life.

Allowing Room for Grief:  Finding Meaningful Ways to Integrate the Experience

Many people discover that when they've gone through the hardest part of their grief and they're willing to be open to what comes next, they realize that they still feel a deep and loving connection to their loved one that allows them feel close to him or her.

Getting Help in Therapy
Many people find that their grief is too overwhelming to deal with on their own or they feel stuck in the grieving process.

If you're struggling with your feelings of grief on your own, you could benefit from working with a licensed mental health professional who has expertise in helping clients with bereavement issues.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples.

Helping clients to deal with grief is one of my specialties.

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

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

Also see my article:
Grief in Waiting



















Monday, April 14, 2014

The Early Stage of Recovery: What to Do If 12 Step Meetings Are Too Overwhelming For You

Generally speaking, as a psychotherapist, I recommend 12 Step meetings, especially during the early stage of recovery.  But I also know that for many people, especially people who have a history of emotional trauma, going to 12 Step meetings can be too overwhelming during the initial stage of recovery.

Early Stage of Recovery: What to Do If 12 Step Meetings Are Too Overwhelming For You

12 Steps Meetings Have Saved Many Lives
The 12 Steps, which are principals for living life, provide a structured step-by-step philosophy that many people describe as having been life saving for them.

Many of these people struggled in isolation and shame with their addiction before they began attending 12 Step meetings. But when they began going to meetings, they discovered that they were not alone.  This provides many people with a sense of comfort and safety.

12 Step Meetings Have Saved Many Lives

In most 12 Step meetings, many people in early recovery can find mutual support among other people who are also struggling with addiction.  There is also an opportunity to find a sponsor who can help with working through the 12 Steps.

For Many People With Emotional Trauma, 12 Step Meetings Are Too Overwhelming
But there are many other people, who have a history of emotional trauma, who find the meetings to be too overwhelming, especially when they hear stories in the meetings that triggers their trauma.

When people feel triggered during the early stage of recovery by hearing stories that are overwhelming, they can feel like drinking or drugging (or gambling, overeating and so on, depending upon their addiction).

Many people, who get emotionally overwhelmed override their own sense that they are making themselves too emotionally vulnerable to relapse because they feel that there's something wrong with them if they can't tolerate being at the meetings.

After all, they think to themselves, many people have told them that going to 12 Step meetings is good for them.  So they continue to force themselves to go and continue to get triggered and retraumatized because they're not ready to hear other people's traumatic stories in the meeting.

Of course, there are also a multitude of success stories in the meetings about how people have achieved years of sobriety and many stories about hope and transcendence.

But, for many people with a history of emotional trauma, it only takes one difficult story to overwhelm them and then they relapse.  They're just not ready, at that point, to attend 12 Step meetings.

Getting Triggered is a Common Experience For People Who Have Been Traumatized
There is no reason to feel ashamed about this.

Getting Triggered is a Common Experience For People Who Have Been Traumatized

Getting emotionally triggered is a common experience for people who experienced trauma.

Just like a veteran who returns from war can get triggered when he or she hears the backfiring of a car which sounds similar to an war time explosive, anyone who has trauma can get triggered when they're in particular situations.

Getting Help in Therapy
If you are in the early stage of recovery and you're finding it too difficult to attend 12 Step meetings, you can get help by working with a licensed mental health professional who has expertise in working with clients in early recovery who have a history of emotional trauma.

An experienced therapist can help you to develop the necessary coping skills to deal with early recovery issues as well as relapse prevention.

Many people who are in the early stage of recovery want to rush into dealing with their trauma before they're ready.  They feel that they've wasted too much time and they want to make up for lost time by rushing into things.

But usually this isn't a good idea during the early stage.  You need to learn coping skills and develop internal and external resources before you begin to deal with trauma.



Getting Help in Therapy
Once you have developed coping skills and the therapist assesses that you're ready, then you can begin to work on the underlying emotional trauma.

Being safe, both physically and emotionally, is the first priority.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples.

I have worked with many clients who are in recovery.

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.




Saturday, November 2, 2013

You and Your Spouse Disagree About Your Adult Child's Substance Abuse Problem - Part 2

In my prior blog article, You and Your Spouse Disagree About Your Child's Substance Abuse Problem - Part 1, I gave a composite vignette of a family struggling with an adult child who moved back home and who has a substance abuse problem.

As often happens, the parents in this family disagree about how to handle their son's problem.  The mother wants their son to get help, but the father thinks the son is just going through a phase.  The problem drives a wedge between them. And their son, who moved back home, uses their conflict to his advantage by going to his father whenever he feels the mother is being too hard on him.

This vignette is a common problem in families and can create increasing conflict and havoc in the household.

You and Your Spouse Disagree About Your Adult Child's Substance Abuse Problem

Of course, every situation is different, so one blog article can't address every issue.

Above all, if your family is having a similar problem and you and your spouse just can't come to an agreement about how to handle it, you should seek out a licensed mental health professional who has expertise in dealing with substance abuse problems.

Here's what I would recommend to Dan and Marie Smith (from the vignette in the prior blog post):

You Can't Ignore Your Child's Problem Drinking Anymore:
The best strategy would have been to discuss what to do before Matt moved back home.  It would have given both of you a chance to get your feelings out in the open with each other and, hopefully, come to a compromise, if possible.  Then, you both could have presented your conditions for allowing Matt to move back home together with one voice.

But since Matt was allowed to move back home without any conditions or guidelines, at this point, now that it has become obvious that he has a drinking problem, you can't ignore it anymore or pretend that it's just a phase.

Based on the fact that 1) Matt lost his job (at least in part due to his excessive absenteeism, which could be telltale sign of excessive drinking) and that 2) you found lots of empty beer bottles hidden in his closet, you can't ignore the problem anymore.

As His Parents, You Need to Provide a United Front to Matt When You Talk to Him About His Drinking
Until now, Matt has been allowed to manipulate the situation at home because the two of you can't agree on what to do and you're arguing about it.

Naturally, Matt has been turning to his father, Dan, who is siding with him.  To this, I would say, "Dan, you're in denial about your son's problems and, even though I know you love Matt and want the best for him, what you're actually doing is enabling him to drink by minimizing the problem and giving him money which he's using to buy alcohol."

To Marie, I would say, "You picked up pretty quickly that there was something else going on that Matt wasn't telling you.  It's understandable, given your childhood history with a father who was an active alcoholic at the time, that you would be upset to discover that Matt is drinking excessively.  But it's important to remember, in order to preserve your well-being, that although it feels similar to what you experienced as a child, you're an adult now and you have a greater capacity to cope and a lot more options than when you were a child.  At some point, after this crisis, it would be helpful for you to work through that earlier trauma in therapy because might be getting triggered in this situation."

But, for now, it's important that you listen to each other and come up with a compromise that you can both live with and then present it to Matt as a united front.

It's important not to be judgmental or harsh when you talk to Matt.  He has a problem and he needs help.  Be empathetic but also clear and firm about your expectations.

It's also important for you to be supportive of one another throughout this process.

Setting Boundaries and Rules For Your Household
Your son is an adult who is living in your household and you have the right to set rules if he wants to continue to live there.  He doesn't have to like your rules, but he needs to follow them.  Decide beforehand what the consequences will be if he doesn't follow your rules.

Doing an Intervention and Alcoholics Anonymous
If talking to Matt isn't enough, the family could benefit from doing an intervention.  In this particular case, there are a couple of routes you could go.

One possibility is that you could hire a professional to do an intervention with the family, although this tends to be costly and, in most cases, your insurance won't pay for it.

Another possibility, in this particular case, involves Marie's father, who is in recovery and has been sober for many years.  He could talk to Matt about his experience of being a person who actively abused alcohol in the past, how he got sober, and what he's doing to maintain his sobriety.

Marie's Father, Who is in Recovery and Sober For Many Years, Could Speak With Matt

He could also take Matt to an Alcoholics Anonymous meeting (click on link for a list of meetings in your area).

Going to Al-Anon
Alcoholism is a family disease because it affects the whole family--not just the person who is drinking.  Al-Anon is a wonderful resource for families (click on link for meeting list).  These 12 Step meetings are free and, although no one will give you advice on what you can do for your particular problem, you'll hear many people, who were once in your shoes, speak about what has worked for them. Al-Anon will help you take care of yourself.

Going to Couples Counseling With a Licensed Mental Health Professional Who Has Expertise Helping Families With Substance Abuse Problems
If you're stuck because either you can't come up with a compromise that you can each live with or you come up against another obstacle along the way that you're unable to surmount as a couple, you could benefit from seeing a licensed mental health professional who has expertise helping families with substance abuse problems.

When you're dealing with a child who has substance abuse problems, especially if s/he is living at home, you can feel like your whole world has been turned upside down.

Sometimes, the most challenging and painful outcome is that your adult child refuses to get help.  Since your child is an adult, you can can't force him to do what you want, and nagging or pleading will often make matters worse.

See my article:  When Someone You Love Rejects Your Help.

If the problem persists, it can jeopardize your relationship.  Before that happens, do what many families before you have done--get help from a licensed therapist to work through this problem.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.  I am also a certified Substance Abuse Professional.

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

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









Wednesday, October 30, 2013

You and Your Spouse Disagree About Your Adult Child's Substance Abuse Problem - Part 1

One of the most difficult problems that parents can face is having an adult child who has a substance abuse problem.  It's challenging enough trying to figure out what to do, but when each parent has strong opposing feelings about it, this can divide the couple as well as the family. Then, add to this that your adult child doesn't have to abide by either of your wishes because he or she is over 18, and you can have a serious problem on your hands.

Disagreements About Your Adult Child's Substance Misuse


The following vignette, which is a composite of many different cases with all identifying information changed, illustrates this problem:

The Smith Family:
Dan and Marie were shocked to find out that their 22 year old son, Matt, lost his job.  He told them  it was all "office politics" and he felt confident he would find another job.  But, in the meantime, he couldn't afford to keep his apartment, so he needed to move back home.  

Marie told Dan that she thought they should set down some rules with Matt before he moved back in. She wasn't sure why, but she suspected that there was more to the story about Matt getting fired than just "office politics."  But Dan brushed off her suspicions, and told her they should "leave the boy alone," let him move back home, and give him a chance to get back on his feet again.

Marie had serious reservations about this, but she decided to go along with Dan to see how things went after Matt moved back in.  So, when they saw Matt, they told him that they were there to be supportive in any way that he needed.  Matt responded by telling them that, besides "office politics," his boss overacted to Matt taking off a few days from work.

Once again, Marie's antenna went up, but Dan told her to stay calm and give Matt some space so, reluctantly, Marie bided her time.

During the first few days after Matt moved back home, he spent all day and almost all night watching TV in his old room.  He only came out to get food to bring it back to his room or to go to the store.

This didn't sit well with Marie, who was home all day. So, after three days of this, she told Dan that she thought they should talk to Matt.  But, once again, Dan brushed off her concerns and told her that she was worrying needlessly. He was sure that after a week or so, Matt would settle down and start looking for work.

After the third week of Matt keeping odd hours and not making an effort to look for work, Marie was fuming.  She felt that Dan tended to spoil their only child.

She knew that Dan was now giving Matt money, and she felt this added to the problem because there was less of an incentive for Matt to look for work.  When she confronted Dan about it, he told her she was overreacting.  He didn't see anything wrong with giving Matt money.  He was sure that Matt would start looking for work soon.

Marie told Dan that, even though she wasn't sure why she felt this way, she still had a bad feeling about  Matt losing his job.  She felt sure that Matt didn't tell them the whole story.  Dan told Marie that she was worrying needlessly.

Marie's suspicions were confirmed when she took the opportunity to go into Matt's room, when Matt was out, and found a large pile of empty beer bottles hidden in closet.  When Matt got back and he found his mother looking in his closet, he became furious.  He yelled at her for violating his privacy.  Then, he stomped out of the house, slamming the door behind him.

Marie sat down and cried.  She grew up in a household with an alcoholic father, and she remembered how miserable she felt, before her father got sober, when her father came home drunk and her parents argued.

When Dan got home from work, Marie told him what happened and showed him the pile of beer bottles in Matt's closet.  Even though Dan was shocked by the pile of empty beer bottles , he sided with their son and told Marie that she shouldn't have looked in Matt's closet.

Marie was furious and told Dan that she didn't want Matt in the house if he didn't get help for his drinking problem.  She didn't want to live with an active alcoholic again.  Dan responded by telling her that he wouldn't throw his son out of the house no matter what happened.  He felt that Matt would find his way and this was probably a temporary reaction to the job loss.

By the time Matt came home, Marie and Dan were having a loud argument.  He told his parents that he didn't really have a drinking problem.  He said he was just having a few beers to "relax" before he started looking for another job.  But nothing changed, and Matt learned to go to his father whenever he felt his mother was being too hard on him.

This drove a wedge between Marie and Dan, who were barely speaking after the first month of Matt being home.

Getting Help in Therapy
The composite vignette above is a common experience for many families who could benefit from getting help.

In my next blog article, I'll offer some tips on what families in this type of situation can do to get help.

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 web site:  Josephine Ferraro, LCSW - NYC Psychotherapist.

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

Friday, May 3, 2013

Adults Who Were Traumatized As Children Are Often Afraid to Experience Their Feelings - Part 2

In my prior blog article,  Adults Who Are Traumatized As Children Are Often Afraid to Feel All Their Feelings  - Part 1, I began a discussion about how difficult it can be for traumatized adults to allow themselves to feel all their feelings.  Today, I would like to continue this discussion and focus on some of the consequences for adults when they continue to suppress uncomfortable feelings.

Traumatized and Afraid of Emotions


Suppressing Uncomfortable Feelings Can Have Many Negative Consequences
As I mentioned in my prior article, traumatized children often have no choice but to suppress their feelings.  It's often an adaptive thing to do because allowing themselves to feel uncomfortable feelings related to the trauma would be too overwhelming for them in most cases.

But when these same people become adults, if they continue to suppress uncomfortable feelings, it isn't useful any more.  As adults, suppressing uncomfortable feelings can cause all kinds of other emotional, physical and interpersonal problems.


Suppressing Uncomfortable Feelings Can Lead to the Following Emotional, Medical, Marital, Family, Career and Interpersonal Problems:

Depression and Anxiety 
When you suppress uncomfortable feelings, it can lead to depressive and anxiety-related disorders.  Why does this happen?  Well, when you suppress your feelings, these feelings don't just go away.  They often intensify.  The more you try to push them down, the more intense they become.  It becomes a vicious cycle that for many people can lead to serious episodes of depression and anxiety.

Medical Problems
Medical problems like migraines, high blood pressure, diabetes, heart problems, IBS (irritable bowel syndrome), insomnia, muscle aches, joint stiffness, and a compromised immune system are among the many physical problems that can result from suppressing feelings. 


Marital and Family Problems
Think of the employee at work who feels he must do everything possible to suppress his anger at his boss while he is at work.  Then, he comes home and he often loses his temper with his wife and children.  It's often not intentional--he just can't contain his feelings any more.  There can be misunderstandings between him and his wife or between him and his children because he's so distracted by his pent up feelings.

Career Problems
There can be so many ways that suppressed feelings can cause problems in a career.  It can cause poor communication with your boss or colleagues.  You also might not be picking up on social cues because all of your energy and focus is going into keeping your feelings down.  This can have disastrous consequences for your career.

Substance Abuse, Sex Addiction, Gambling and Other Impulsive and Addictive Behavior
Many people, who try to suppress feelings, turn to alcohol, drugs, gambling, sex and other forms of addictive behavior in an effort not to feel their feelings.  Aside from the physical problems that addictive behavior can create, addiction ruins lives for those who are addicted as well as their loved ones.  Without help, it usually leads to a downward spiral 

Problems with Feeling Inauthentic to Yourself and to Others
Suppressing feelings can also make you feel disconnected from the core of who you are as a person.  It can make you feel inauthentic to yourself as well as to others, especially if you're trying to "put on a happy face" to hide your true feelings.  This often doesn't work because others can sense that there's something amiss.

Developing the Capacity to Feel and Accept Your Feelings: Clinical Hypnosis and Somatic Experiencing
When you've spent a lifetime suppressing feelings that you're uncomfortable with, you need to learn how to develop the capacity to feel and accept your feelings.  I will address this in more detail in future blog posts but, for now, I'll close by saying that, I've found the combination of clinical hypnosis and Somatic Experiencing to be one of the most gentle and effective ways to develop this capacity.  

Clinical hypnosis and Somatic Experiencing allow the therapist and client to work with manageable segments of the problem in a way that's usually tolerable for the client.  In my experience, these two treatment modalities, which emphasize the body-mind connection, help the clients to deal with traumatic experiences and work through these issues so that clients learn to feel and accept all their feelings.

Getting Help in Therapy
If you have unresolved trauma, you owe it to yourself to get help from a licensed mental health professional who has expertise in trauma work.

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

I have helped many clients to work through their trauma so they can 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.