Mother-Daughter Relationships: Early Bonding

In my prior blog post, I discussed Life Stages in Mother-Daughter Relationships from infancy to middle age for daughters and later years for mothers:  Life Stages in Mother-Daughter Relationships. In today's blog post, I'll focus on the early stage of bonding between mothers and daughters.

Mother-Daughter Relationships: Early Bonding

Why is Early Bonding Important?
First, let me say that bonding between infants and parents is extremely important for the infant to grow up to be a healthy, well-related adult.

Even though I'm focusing on mothers and daughters in this blog post, it's important to understand that both parents need to bond with their babies, whether the babies are girls or boys. So, even though the focus is on mothers and daughters, it's understood that fathers need to bond with their children as well.

Bonding between mothers and infants is an intense attachment. When bonding is going well, not only is it gratifying to both mother and infant, but the infant begins to learn in her first intense relationship how to relate.

Mother-Daughter Relationships: Early Bonding

If the mother is responsive to the baby, all other things being equal, the baby will usually grow up with a sense of security and positive self esteem. How the mother responds to the baby affects the baby's social and cognitive development.

Bonding is a process that takes place over time. It doesn't have to be perfect--it just needs to be good enough.

Often, bonding takes place, without the mother even necessarily being aware of it, through the normal caregiving responses that she performs for the baby if the mother is also emotionally attuned and related to the baby.

An example of this is when a mother is changing a baby's diaper and she's talking lovingly to the baby at the same time. The baby often responds by smiling and cooing, which is gratifying to the mother, who responds even more lovingly to the baby. Under ordinary circumstances, this is a natural part of the mother-infant bonding process.

Babies respond to touching (skin-to-skin contact), which they find soothing. They also respond to their mother's voice and the mother's scent. Eye-to-eye contact, where the mother mirrors the baby's expressions and the baby attempts, even at an early age, to mimic the mother's expressions, is a very important aspect of bonding.

Breast feeding is another bonding experience between the mother and infant, as the infant learns to associate the mother with comfort, warmth, love and sustenance. All of these examples are powerful ways for mothers and infants to bond.

Secure and Insecure Attachment:
Most of the time, bonding is a pleasurable experience for mother and infant, and it tends to go well. But there are times when there are problems with bonding for a variety of reasons: mothers might be suffering with fatigue, depressive disorder, postpartum depression, medical issues or other problems that get in the way of their bonding with their infants.

 If there are problems during birth, babies might need to placed in intensive care. Under those circumstances, some mothers are put off by all of the equipment, and if they don't take the time and effort to bond, there can be serious consequences for the baby as well as their primary and other relationships later on.

In addition, aside from problems that the mother might have, the baby's temprement might affect the bonding process.

Attachment Theory:
In this blog post, there won't be time or space to go into all of the complexities of attachment theory. However, some basic concepts can be helpful in our discussion.

When we refer to attachment, we're referring to the quality of the bond between the infant and the caregiver.

Attachment theory was originally developed by John Bowlby (1907-1990), British psychiatrist, psychologist and psychoanalyst. His work was enhanced by his American student and eventual colleague, Mary Ainsworth (1913-1999) who observed mother-infant interactions in her infant research. Through her research, she identified four different types of attachment: secure, avoidant, ambivalent/resistant, and disorganized.

Before going describing the different types of attachment, I want to stress that just because an infant demonstrates a particular type of attachment, which might not be secure attachment, does not mean that this can never change. Scientists have discovered the remarkable plasticity of the brain in terms of people being able to make significant behavioral changes, even in old age.

Based on Ms. Ainsworth's research, secure attachment is optimal. When there is secure attachment, caregivers respond consistently and lovingly to the infants' needs most of the time. Studies have shown that about 65% of infants develop secure attachment.

Avoidant attachment in babies often occurs where the primary caregivers show little or no response to the babies' distress. These caregivers often discourage crying and want their babies to be emotionally "independent" beyond the babies' capacity. Due to these caregivers' lack of responsiveness, these babies often avoid emotional attachments and connections.

When babies show ambivalent/resistant attachment, the primary caregivers are often inconsistent, vacillating between being emotionally responsive and being neglectful or abusive. These babies are often insecure because they cannot rely on their primary caregivers.

Disorganized attachment usually occurs when primary caregivers are too intrusive or abusive with the infant. These infants are traumatized.

Consequences of Secure and Insecure Attachments:
Once again, I want to stress that an insecure attachment does not necessarily become that adult's inevitable destiny. So, what I'm about to say are generalizations about what has been found in research.

When bonding goes fairly well, as it does with 65% of infants, all other things being equal, these infants tend to grow up as secure adults. Of course, there are many other factors to take into account besides attachment, but for the sake of simplicity and brevity, let's just look at attachment and assume that everything else has gone reasonably well for these infants who grow up to be adults.

Generally, these adults, who experience secure attachment with their primary caregivers, tend to be able to trust in their adult relationships. They usually have healthy self esteem; they're empathetic towards others; they feel deserving of love, and they're able to form healthy adult relationships.

Infants who grow up with insecure attachment often have difficulty trusting. Self esteem is often impaired. They might also have a hard time understanding and being empathetic towards others. In addition, they often have difficulties forming healthy adult relationships.

We can already anticipate what the challenges might be in the mother-daughter relationships as well as other adults relationships for daughters who have developed insecure attachments as infants.

Getting Help in Therapy
These problems can be overcome and repaired in psychotherapy. Many people who didn't have secure attachment as infants overcome this problem and are able to form healthy adults relationships. I will explore this as well as the implications for mother-daughter relationships in future blog posts.

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

I have helped many clients to overcome problems in mother-daughter relationships.

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.

Life Stages in Mother-Daughter Relationships

In a prior blog post, I wrote about Ambivalence and Codependence in Mother-Daughter Relationships. That blog post presented the complex nature of mother-daughter relationships when there are problems with enmeshment. At this point, I would like to return to the topic of mother-daughter relationships to step back and look at these relationships over the course of the various life stages that mothers and daughters go through.

Life Stages in Mother-Daughter Relationships

Mother-Daughter Relationships - Early Bonding:
There is no doubt that, in general, fathers are more involved with their children than they were a generation ago, which is encouraging. But the primary parental relationship for most girls and women remains the mother-daughter relationship.

During the 1940s and earlier, people believed that babies were born as blank screens, but we now know that from early infancy we're biologically "hard wired" for attachment. That means that infants seek warmth and comfort from Day One: the warmth and scent of her mother's skin, the comfort of her mother's breast, and the sound of her mother's voice. When bonding goes well between mother and infant, the baby feels a secure attachment to her mother. This secure attachment between mother and child makes it more likely, all other things being equal, that the child will develop healthy relationships later on in life.

Under optimal conditions during infancy, the baby and mother are also bonded through the mother's loving gaze. The baby sees herself in the mother's eyes and feels the mother's love. The mother, in turn, sees how comforted the baby feels being mirrored in the mother's eyes and this is comforting to the mother as well. This interaction provides a positive feedback loop between mother and child and reinforces this bond.

Mother and Daughter Relationships - From Early Years (18 months to age 5):
At around the age of 18-24 months, babies begin to learn to separate from their mothers for short periods of time. Margaret Mahler referred to the "separation/individuation" phase when, under optimal circumstances, babies learn that their mothers continue to exist even when they are out of sight. This is also the time when babies begin to assert some of their autonomy by saying, "No!" If the mother is patient and recognizes this as a normal stage of development, babies gradually outgrow this sometimes difficult stage.

From about the age of four or five, most daughters idealize their mothers. They often find their mothers to be attractive and glamorous. At this stage, many girls want to mimic their mothers by putting on the their mothers' makeup or playing dress-up with "mommy's clothes." They often think of their mothers as beautiful and all-knowing.

Some daughters have a hard time separating from their mothers when it's time to start school (this occurs with sons as well sometimes). It's their first time away from the security they feel with their mother to be in a new and strange environment with a stranger (the teacher) who is now in charge. Most of the time, young girls are able to make this adjustment, and the mother remains their primary attachment figure.

Mother-Daughter Relationships - During the Daughter's Adolescence:
While mothers are idealized when children are four or five years old, teenagers often see their mothers as being old fashioned or "out of it." This is another stage where children are learning to separate themselves emotionally from their mothers.

This stage can be bewildering to mothers who often say, "What happened to my relationship with my daughter?" This is a time when teens bond with their peer group, and a friend's advice or opinion is often valued more than a mother's.

Tension and conflict during this period of time can be managed if both mothers and daughters accept and respect each other rather than viewing each other as the enemy. Since they're the adults, mothers have a greater onus for being understanding and fostering good relationships with their daughters. However, daughters must also learn to be open and respectful towards their mothers. Mothers need to learn to allow their daughters an age-appropriate degree of autonomy, but mothers must also provide guidance and support while setting boundaries for their daughters. Daughters will often test these boundaries, but this is also a normal part of adolescence.

Mother-Daughter Relationships - Daughters in Their 20s and 30s:
During their 20s, daughters are no longer teenagers, but some of them, depending upon their level of maturity, might not feel like adults yet. Prior to the 1990s, many daughters were able to go out on their own and live independently after college because apartments were more affordable. Now, with fewer rent stabilized and moderate income housing, many daughters continue to live at home for longer periods of time, depending upon their parents for longer as compared to prior generations.

During their 20s, many daughters often realize that their mothers are fallible and they don't always have all of the answers. During this period, many of them are being challenged by career choices and choosing a mate. Often, they're learning how to distinguish themselves from their mothers while attempting to maintain a bond with them.

During their 30s, many daughters are starting to come into their own with regard to career and their own family. Under ideal circumstances, they are less emotionally and financially dependent on their mothers. They often realize that their ideas differ from their mothers with regard to certain values. At this point, if they are in committed relationships with a significant others, under optimal circumstances, daughters are learning to put their partners first. This can create tension in the mother-daughter relationship, unless mothers understand that this is a normal part of development.

Mother-Daughter Relationships - 40s and Beyond:
Although there are many sons who help to take care of their elderly mothers, traditionally, for better or worse, it has been the daughter's responsibility to take care of elderly parents. For many women, who are "sandwiched" between their own families and their parents, this can be very challenging. During this time, daughters and mothers start to come to terms with the fact that mothers are aging and have more years behind them than ahead. How well they deal with this is often dependent upon how well their relationship has developed until this point.

Life Stages in Mother-Daughter Relationships

This is also often a time when mothers and daughters let go of old resentments in light of the fact that mothers are elderly at this point and time might be short for reconciliation. Under most circumstances, daughters often develop a different perspective of what's important, especially if they now have their own children and they understand better what their mothers went through with them.

In future blog posts, I will continue to explore mother-daughter relationships.

About Me
I am a New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist. 

 I work with individuals and couples.

As a psychotherapist, I have helped many mothers and daughters, individually and together, to improve their relationships.

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

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

What is Intergenerational Trauma?

The topic of my prior blog post was Psychotherapy: Healing Your Emotional Wounds.  In that blog post, I mentioned that when people have unresolved, unhealed trauma, they often pass on their fears and anxiety, unconsciously, to their children and that it's not unusual, under these circumstances to see intergenerational trauma.

Intergenerational Trauma

What is Intergenerational Trauma?
As the name implies, intergenerational trauma involves emotional wounds that are passed on from one generation to the next, usually, in an unconscious manner. 

Most of the time, this passing on of trauma from one generation to the next occurs because there is little or no understanding about how trauma affects the self and others and the trauma has not been worked through by the person who originally experienced the trauma.

The following vignette, which is a composite of many cases with no identifiable information, illustrates how transgenerational trauma gets passed on:

Sonia:
Sonia, who was a woman in her mid-30s, came to therapy because she was extremely anxious and her anxiety was affecting her family.

When we went over her personal history, there were no overt signs of abuse or neglect. She grew up in a loving family in New York City. 

Based on Sonia's account, her parents were supportive and attentive to Sonia and her siblings. Sonia couldn't see any reason why she felt as anxious as she did: She had difficulty sleeping, she worried about almost everything, and she had a terrible sense of foreboding almost all of the time that something bad was going to happen.

Her husband encouraged Sonia to start psychotherapy because he felt that Sonia's anxiety was affecting their five year old daughter. Their daughter was already showing signs of being an anxious child, even though it was obvious that both Sonia and her husband were loving parents.

"My husband says that I make our daughter nervous," Sonia told me, "but I don't see how I do that and I don't understand why I'm so nervous myself most of the time."

Based on her account, Sonia seemed like she was a very attentive mother who was emotionally attuned to her daughter. But, it was obvious that she was passing on her own anxiety to her daughter somehow.

When we went over Sonia's parents family history, I could see that both of them had experienced early trauma when they were growing up in their native country. 

Sonia's father lost his parents in a car accident when he was five, and he was raised by an aunt who was both physically and emotionally abusive towards him and his brothers. By the time he was 18, he left the aunt's household to be on his own. He lead a precarious existence until he came to New York City and met and married Sonia's mother. At that point, his life settled down and he had a more stable life, but he tended to be anxious and he worried a lot.

Sonia's mother, who grew up in the same country, lived through several dangerous hurricanes, one of which destroyed the family home. As a young girl, not only did she see the family home destroyed, she also witnessed the drowning of her beloved uncle when the family was attempting to cross a river during the severe flooding related to one of the hurricanes. From that time on, Sonia's mother had nightmares and panic attacks. She never obtained professional help for her anxiety and she managed her panic attacks by taking anti-anxiety medication. But her nightmares never stopped.

As Sonia and I continued to work together, I discovered that Sonia's parents tended to be overprotective of her and her siblings when they were growing up. Without being aware of it, they passed on their worries to Sonia their children. Sonia grew up feeling that the world was not a safe place and anything that could go wrong at any time.

Until we began talking about it, Sonia never realized that her unnamed fears originated with her parents and she was now conveying her fears to her daughter. 

I provided Sonia with psychoeducation about the nature of intergenerational trauma. Gradually, we worked through Sonia's anxiety using a combination of EMDR and clinical hypnosis until she worked through her fears.

It was only after Sonia had worked through her anxiety and she realized what it felt like to be calm that she realized how anxious she had been all of this time. 

During that time, Sonia also took her daughter to see a psychotherapist who worked with children so that her daughter wouldn't grow up with the same anxiety that Sonia experienced.

Often, Without Realizing It, People Who Experience Trauma Pass on Their Anxiety and Fears to Their Children 
It's not unusual for people who experience trauma to inadvertently pass on their anxiety and fears to their children. There have been many documented cases of this with Holocaust survivors, even in cases where the survivors never discuss what happened. Without realizing it, they convey their fears on an unconscious level to their children so the children often feel that the world is not a safe place.

Getting Help in Therapy
If you think that your trauma is affecting your loved ones or that you are the one who is affected by intergenerational trauma, you're not alone and you owe it to yourself to get help from a licensed psychotherapist who has expertise in dealing with trauma and transgenerational trauma.

About Me

I am licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

I work with individual adults and couples.

I have helped many clients to overcome trauma and transgenerational trauma.

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

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

Also, see my article:  Psychotherapy: Healing Your Emotional Wounds

Healing Your Emotional Wounds in Therapy

Emotional wounds are a source of shame for many people. Often, rather than getting help, their initial inclination is to either suppress or deny these emotional wounds in an effort to rid themselves of the emotional pain. But when we deny or suppress emotional wounds, the result is that they intensify.

 

Healing Your Emotional Wounds in Therapy

When we're physically hurt, we usually don't think about getting rid of the body part that is injured. So, for instance, we wouldn't think of cutting off an arm that was bruised or burnt. We know that, in most cases, there needs to be special care and attention for the arm to heal.

But when it comes to emotional wounds, many people are much more impatient and rejecting of help than they would be for a physical wound. They either don't know or they don't want to know that, often, these emotional wounds have been around for a long time and, no matter how much they might want to banish them, they'll still be there unless they get special attention and care, much the same as a physical wound.

We know that if we have a physical wound and we don't take care of it, it will get worse. Lack of care can create severe or life threatening consequences. In much the same way, emotional wounds can also become worse and, in some cases, become life threatening if a person is very depressed or anxious.

We have choices as to how we relate to our emotional wounds. We can deny, suppress or ignore them, all of which tends to make them worse. Or, we can look upon them with compassion and see them for what they usually are--early childhood aspects of ourselves that either suffered from abuse or neglect and that need professional psychological help.

When we neglect these emotionally wounded aspects of ourselves, we are, unconsciously, perpetuating the original trauma. Not only can we perpetuate it in ourselves, but we can also have a profound traumatic effect on our loved ones. It's not unusual to see transgenerational trauma that is passed down from one generation to the next, unintentionally, because the original trauma remains unhealed.

Making the Unconscious Conscious:
As I mentioned, when we retraumatize ourselves or we pass on the effects of our trauma onto others, this is an unconscious process. So, if it's unconscious, how can we become more aware of it so that we can make the unconscious conscious?

Often, if you observe your thoughts and attitudes towards yourself, you can begin to see where you're being overly critical, judgmental and harsh with yourself. For many people who practice mindfulness meditation, they become aware of their punitive thoughts and attitudes towards themselves and also become aware that they need to develop more self compassion. They begin to see how they're being overly critical of themselves and engaging in negative self talk.

Even if you don't practice mindfulness meditation and you take the time to observe your internal dialogue, you can see if you're being too hard on yourself and you ask yourself where this harshness originates from. Very often, it originates from early trauma that created emotional wounds.

Many people become aware of their own harshness towards themselves when their friends or loved ones observe it and comment on it. These same people, who are being so harsh on themselves, would almost never be as harsh on someone else in similar circumstances. They often reserve their most punishing attitudes towards themselves because this is what they have internalized, in most cases, when they were growing up.

For most people, they learn to make the unconscious conscious in psychotherapy where the psychotherapist has a psychodynamic orientation as part of the treatment modalities he or she uses with clients, and can help clients to heal from their trauma.

Self Compassion for Your Emotional Wounds:

If you think of the emotional wound as an aspect of your inner child, you'll probably have more compassion for that part of yourself. This could be the start of your being more open and willing to seek help to heal.

Getting Help in Therapy 

Taking the first step is often the hardest. When you're mired in hurt and shame, you might feel that you're the only one who is experiencing this. 

But you're not alone. Once you've become aware that your emotional wounds are having a detrimental effect on your life, the next step is accepting this and taking action to find a professional mental health practitioner who specializes in trauma because the healing work that needs to be done cannot be done by you alone.

Rather than spending the rest of your life adversely affected by your trauma, you could benefit from working through these issues with a licensed psychotherapist who has expertise in this area.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

I work with individuals and couples.

I use a variety of treatment modalities, including mind-body oriented psychotherapy, psychodynamic psychotherapy, and cognitive behavioral treatment, depending upon the needs of the client.

I have helped many people overcome their emotional wounds so that 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.

Also see my article:  Psychotherapy and Transgenerational Trauma

The Mind-Body Connection: Can Yoga Improve Your Mood?

According to the Journal of Alternative and Contemporary Medicine, recent studies have demonstrated that yoga has been shown to increase GABA (gamma-aminobuturic acid), a chemical in the brain that helps to regulate nerve activity.  GABA is usually reduced in people with mood disorders, and doctors often prescribe medication to increase GABA to improve mood and decrease anxiety.

Mind-Body Connection:  Can Yoga Improve Your Mood?

According to the journal article, the study, which was conducted by Dr. Christopher Streeter and his colleagues of Boston University School of Medicine, measured GABA levels in people who practiced yoga and found an increase in GABA levels after a yoga session.

Dr. Streeter and his colleagues found these results encouraging and suggest that longer term research studies are needed to continue to explore the benefits of yoga with regard to mood and anxiety.

The study seems to corroborate what many yoga practitioners have been reporting anecdotally for years--that they have a sense of peace and well-being after their yoga sessions.

A word of caution: Although the research findings about how yoga can improve your mood are encouraging, it's always best to consult with your doctor and psychotherapist before you stop or decrease your medication.

About Me

I am a New York City psychotherapist, hypnotherapist, EMDR therapist, and Somatic Experiencing therapist. 

I work with individual adults and couples.

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

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

Flirting with Disaster: Sex on the Job

The workplace can be an intimate setting where you and your colleagues are working closely together for long hours on projects of mutual interest. It's not unusual for sexual attractions to develop on the job, especially under these circumstances. But acting on those sexual attractions, even if you're both single, is like flirting with disaster.

Flirting with Disaster: Sex on the Job

What might start out as a romantic encounter or a fun and sex encounter can end up costing you your job and, possibly, your reputation in your industry.

The following vignette is a composite account, with all identifying information changed, of what could happen if you get sexually involved at work:

Ray:
Ray was a successful account manager in his mid-30s at a public relations firm. He had a reputation for being smart and creative. He was becoming increasingly visible at his company due to his success with his accounts, and his boss told him on more than one occasion that senior management had their eye on him for future promotions.

Ray was also single and attractive, and many women in the office were interested in him. In the past, he dated a couple of women at work when he first started on the job. But, when he became an account manager, he decided that office romances were too risky because when the relationship ended, there tended to be hard feelings on one or both sides and he had to continue to have contact with these women, which made it very uncomfortable.

When Sally, the new administrative assistant, began working at the firm, Ray felt an instant sexual attraction for her. She was attractive, sexy smart, and single. Ray also sensed that Sally was attracted to him. He thought about what it might be like to go out with her, but he had no intention of asking her out since they worked together.

A few months later, Ray was working on a project with a short deadline and he was working long hours to try to meet the deadline. His boss assigned Sally to assist Ray as the deadline approached so Ray and Sally found themselves working in close quarters, alone, late at night.

When they were alone, they tended to flirt with each other a little but the pressure to complete the project kept them focused on their task. There was a lot at stake.

On the final night of the project, Ray thought they were really working well as a team. Without Sally's help, Ray knew that he wouldn't have completed the project on time. He also knew that Sally was underemployed as an administrative assistant, and she hoped that she might make a good junior account assistant.

When they had put the final touches on the presentation, they both breathed a sigh of relief. It was late at night and they were both tired. Ray was about to call a limousine service to take Sally home when he looked up at her, saw her staring at him with obvious interest and, without thinking, he kissed her.

As Ray described it to me when he came to see me in my psychotherapy private practice in NYC, maybe it was the excitement of completing the project and the sexual tension that was building up between them but, before he knew it, they were having sex on the floor.

When it was over, according to Ray, he felt embarrassed and guilty for initiating the sexual encounter between them. He knew that they couldn't get involved again, and he told Sally this. She told him that she was disappointed and hoped he would change his mind.

After that, Ray found it very awkward to see Sally at work. He tried to pretend that nothing happened between them, but it was hard. He sensed that Sally was hurt and annoyed with him because he only interacted with her when he absolutely had to and he kept it professional.
A few months later, Sally was assigned to help Ray again with another project deadline. Ray tried to get another administrative assistant to help him, but no one else was available. So, once again, Ray and Sally were alone in the office. Ray tried to focus on the project document, but he was very sexually aroused by Sally and he knew that she felt the same way. Since they had already had been sexually involved, it was that much more tempting.

Ray decided to work in another office and to give Sally work to do in her area. He thought if he didn't have to look at her, he wouldn't be so distracted by the sexual attraction between them. But by the end of the night, the forbidden nature of the situation made it even more tantalizing, and Ray went back to Sally's place, against his better judgment, and they spent the night together.

Afterwards, Ray told Sally again that, even though they had fun together, he wasn't interested in dating her because it would be too complicated. Once again, Sally was annoyed and hurt. She told Ray that they could date without anyone knowing about it, but Ray wasn't interested.

Soon after that, Sally applied for a position as an account manager. Ray's boss asked Ray what he thought about Sally for the job. Ray told his boss that he thought Sally would make a good junior account manager, but he didn't think that she was ready for the more senior position. He told me that he based this solely on her skills and experience, and it had nothing to do with his sexual encounters with her.

But that's not how Sally saw it. When she heard that Ray didn't think she was qualified for the job, she assumed that he was saying this because he was uncomfortable with her due to their sexual encounters. And she went straight to the EEO (Equal Employment Opportunity Office) officer and filed a sexual harassment complaint against Ray.

There was an investigation, which was very humiliating for Ray. He admitted that he had sex with Sally on two occasions, but he denied that this had anything to do with his opinion that she was not ready for the job. Soon after that, Ray's boss reprimanded Ray for getting sexually involved with a someone at work. He told Ray that, as a manager, he should have known better. He was mandated to attend an EEO training on sexual harassment. He was also told, informally, that, even though he was not being terminated, his future with the company was dim and encouraged to resign as soon as possible.

Due to the recession, it took Ray more than a year to find a comparable job and, in the meantime, he had exhausted his savings.

By the time Ray came to see me, he was doing well on his new job, but he was emotionally traumatized by what he allowed to happen at his former job, which is why he came to therapy.

Ray was lucky that Sally didn't go outside the firm to sue for damages, and he realized this. He had a lot to consider in therapy when he thought about his impulsive behavior on his former job.

Getting sexually involved at work can turn out to be a personal and career disaster. This is not to say that many people don't meet at work and eventually get married without a problem, but for many other people, it creates tremendous problems. Even if your company doesn't have a policy where employees are not allowed to date each other, you would be wise to carefully consider getting sexually involved with someone at work.

About Me

I am a licensed New York. City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

I work with individual adults and couples.

I have helped many clients with personal and career issues.

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

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

Mind-Body Connection: The Source of Our Emotions

Book: Molecules of Emotion by Candace B. Pert, Ph.D.

Molecules of Emotion by Candace B. Pert, Ph.D. (http://www.candacepert.com) is a fascinating read about how our emotions are stored throughout our body.

 

The Mind-Body Connection: The Source of Emotions

Through her research work as a scientist and Section Chief of the NIH (National Institute of Health) in the 1980s, Candace Pert discovered that emotions are not just in the brain, as we might normally think, but that emotions are stored throughout the body, mostly in neuropeptides at every level of the body and mind. 

She uses the phrase "bodymind" to emphasize that the body and mind are one.

Using precise scientific research methods, Dr. Pert and her colleague, Michael Ruff, Ph.D. give scientific credence to what many Eastern gurus have known for centuries--that the mind, as such, is not just in the brain, but all over the body, which is why it's possible for us to have "body memories."

This also explains why mind-body oriented psychotherapy, like Somatic Experiencing, EMDR and clinical hypnosis can be so effective.

At the time, Dr. Pert's work was ridiculed by many in the scientific community because it was considered the "new paradigm" and many in the conventional scientific world found it threatening.

Aside from providing fascinating and accessible information about the "bodymind" and emotions, Dr. Pert gives us a rare glimpse into the hallowed halls of the research establishment and how research gets approved (or disapproved) based on internal politics and maintaining the status quo.

If you're interested in the mind-body (or "bodymind") connection, I recommend that you read Molecules of Emotion by Candace Pert, Ph.D.

About Me

I am a licensed psychotherapist, hypnotherapist, Somatic Experiencing therapist and EMDR therapist in New York City. 

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.

Awareness and Acceptance: Being Willing to See Things You've Been in Denial About

Awareness and Acceptance: Being Willing to See Things As They Are:
One of the primary sources of emotional pain is that we sometimes keep ourselves unaware and refuse to see and accept things as they are because we want them to be different. This is a common phenomenon that most of us struggle with at various times in our lives.

Awareness and Acceptance

This refusal to see and accept things as they are comes up all the time in psychotherapy sessions:

"My boyfriend keeps cheating on me, but I'll change him."

"My wife has been drinking too much for years, but she promises that she'll stop on her own."

"My teenage son was arrested again for selling drugs, but I think this is just a phase he's going through."

"My husband hit me again, but I know he feels badly about it and he won't do it again."

"My boss says I'm always late, but I wouldn't be if he would just get off my back."

"I just got my second DWI, but I don't have a drinking problem."

Denial Can Be Powerful:
It's understandable that, sometimes, we don't want to see things as they are because we want things to be different or we're hoping that things will change. This can distort our perception and judgment.

But as long as we cling to how we'd like things to be instead of how they are, we're living in denial, and the likelihood that things will change decreases as long as we're in this state of denial.

What Does Acceptance Mean?
People often have problems with the word "acceptance." They think that if they "accept things as they are" that this means that they don't care or they've given up or they won't take action to change the situation. But this isn't what this means at all.

Accepting things as they are is a starting point where you acknowledge the status of the current situation. You are aware and recognize how things are at that moment. Once you've brought some awareness and acceptance to a situation, then you can decide how or if you want to change it or if it can be changed by you or needs to be changed by someone else or if it can be changed at all.

Being Aware and Attuned:
You must be aware and attuned to yourself and the people and situations in your life first to be able to accept them or, if possible, make changes. If your basic emotional defense is to tune out, you might find yourself continually being surprised by what seems like your own and/or other people's "sudden" behavior--when, in fact, it's not "sudden" at all. It just seems that way to you because you're in denial and tuned out.

By keeping yourself blissfully unaware, which is often an unconscious process, you set yourself up for disappointments and rude awakenings when the situation you've been ignoring or in denial about worsens.

Cultivating Awareness and Acceptance, Then Taking Action:
As I've mentioned in prior blog posts, a regular practice of mindfulness meditation, also called Insight Meditation, helps to develop self awareness as well as awareness of the people and things around you.

Psychotherapy is also a form of self exploration as well as a way to develop insight and take action in the areas that you want to change.

When someone comes to see me for psychotherapy in my private practice in NYC, I work with him or her dynamically to not only help them to be more aware and honest about the situation, but also to take action where they can.

It's not enough just to talk about the problem, which is where many psychotherapy treatments get bogged down. If it's possible to take action, I help clients to feel more empowered to make changes. If it's not within their power to make changes, I also help clients to see the situation for what it is rather than what they want it to be.

If you find that your predominant way of coping is to go into denial or get stuck in wishful thinking, you could benefit from seeing a licensed mental health professional to help you overcome this problem.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist.

I have helped individuals and couples to overcome areas where they're stuck in their lives 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.

Relationships: Creating a Safe Haven for Each Other

Creating a safe haven within your relationship is one of the most important aspects of a happy relationship, and it includes:

Being Able to Trust Each Other:
Trust is at the root of any successful relationship. Part of any happy relationship includes you andnyour partner being able to trust and be emotionally supportive of one another.

Relationships: Creating a Safe Haven For Each Other

Having a safe haven in a relationship means that you can confide in each other about issues that are private and meaningful to you without being afraid that the information will be used against you in an argument or that your partner will disclose it to others.

Putting Your Relationship First:
Putting your relationship first is also essential to creating a safe haven for each other. This doesn't mean that you and your partner don't have relationships with family and friends because loving friends and family are important too.

But there is a recognition that your relationship with your partner comes first. That means that under ordinary circumstances, you are sufficiently independent from your family so that if there is any question of loyalty, your relationship comes first.

Putting Your Relationship First

Many relationships fall apart because one or both partners are still too enmeshed with their parents or other family members. As a result, they're unable to set boundaries with their family and this interferes with the relationship.

The same can be said about friendships. In a healthy relationship, both partners have close friends that are important to them. But these friendships don't interfere with your relationship.

Spending Time Together - Quality and Quantity:
Spending quality time is essential for creating a safe haven in your relationship. You can't have quality time without having a sufficient quantity of time.

Spending Time Together

If you two of you are shortchanging the relationship because you're too scattered by other responsibilities and this goes on for a while, your relationship will suffer. This can be challenging, especially for a couple where both people have careers or child care responsibilities, but it's important that the two of you be able to negotiate this.

Resolving Conflicts and Letting Go of Resentments:
Having a safe haven in a relationship means that when conflicts arise, you can resolve them as quickly and equitably as possible. Let go of petty arguments and misunderstandings.

Focus on the importance of the relationship rather than "being right" about issues that are inconsequential. When resentments build up in a relationship, trust often goes out the window.

Needless to say, there is no place for revenge in a healthy relationship or acting out sexually with other people.

Resolving Conflicts and Letting Go of Resentments

Many relationships get into trouble because couples forget how to provide a safe haven for each other. Relationships with a long history go through many challenges and it' s easy to forget what's important. Hurt, anger and resentment can cloud your judgment making it hard for you to find your way back to what was once a loving and supportive relationship.

At that point, you and your partner might need the professional help of a marriage or couples counselor to help you get back on track.

Getting Help in Therapy: Don't Wait Until It's Too Late:
One of the main reasons why marriage and couples counseling is unsuccessful in certain cases is that couples wait until it's too late to seek help. By the time they come to counseling, the relationship is over in all by name.

It's not unusual for me to hear people say, "We've already hired divorce attorneys, but we thought we would give it one last ditch effort." Often one or both people are really not motivated to stay together. One of the partners might really know that he or she wants the relationship to end, but comes to couples counseling to appear as if he or she is being fair, especially if the other person doesn't really want the divorce.

This is not to say that relationships at this stage can never be salvaged, but the odds of repairing a relationship are greater if the couples comes for counseling as soon as they realize that they're unable to resolve their problems on their own.

If you and your partner are having problems in your relationship that you've been unable to resolve on your own, don't wait until it's too late. You could benefit from seeking the help of a marriage or couples counselor who is a licensed mental health professional.

About Me
I am a licensed psychotherapist in NYC who works with individuals and couples.

My services include: psychodynamic psychotherapy, cognitive behavioral treatment, clinical hypnosis, EMDR, and Somatic Experiencing.

I've helped many individuals and couples, both heterosexual and gay, to improve their relationships.

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.

Mind-Body Connection: Responding Instead of Reacting to Stress

Stress is a normal part of life. As long as we're alive, we'll have a certain amount of stress in our lives. An optimal amount of stress is often helpful to motivate us to accomplish our goals. But what happens when stress exceeds the optimal level and we feel overwhelmed?

Mind-Body Connection: Responding Instead of Reacting to Stress

Many people who become overwhelmed by stress have maladaptive ways of coping. Rather than responding to stress by taking a moment to catch their breath, they react in negative ways that cause them to feel worse. Usually, their maladaptive reactions aren't intentional. It's more a matter that they've never learned healthy ways to manage their stress.

The following vignette, which represents a composite of many cases to preserve confidentiality, illustrates how you can learn to respond rather than react to stress:

Tammy:
By the time Tammy came to see me in my private practice in NYC, she described her life as being "a complete mess." She appeared tense and exhausted. Her marriage was on a downward spiral. And boss was threatening to fire her if she didn't get help.

Mind-Body Connection: Responding Instead of Reacting to Stress

Tammy said that, up until two years ago, her life had been "fine." Her 20 year marriage to Tom had its "ups and downs," but they were generally happy.

But when Tammy's company began laying off employees due to the recession, she was faced with having to take on a lot more responsibilities and spending more time at work. This meant that she spent a lot less time at home with her husband, and she hardly saw her friends. At first, her husband was understanding, but as time went on, her husband began to complain that he hardly ever saw her.

Tammy tried bringing work home, spending early evenings with her husband and then focusing on her work late at night after he went to bed, but then she was exhausted and irritable the next day. After a few days of this, she could hardly get out of bed, and she began snapping at home and at work.

Tammy didn't know what to do, so she tried just working harder, but she kept feeling that she was falling further and further behind in her work. Her boss was complaining at work, and her husband was complaining at home. She felt completely unappreciated by everyone and as if she was caught in this vortex that she couldn't get out of no matter what she did.

She knew that her relationship with her husband was deteriorating, and she worried about this. But she said she felt like a hamster on a wheel--like she was running, but staying in the same place.

When she tried to talk to her boss about it, she completely lost it and began shouting at him. She said she was just as startled by her reaction as he was. Since he knew that this was uncharacteristic of her, he told her that he would overlook her outburst for now, but she had better get help. He also told her that he was going to redistribute some of her work to other employees because it was obvious that she was overwhelmed by stress.

Initially, Tammy was relieved that her workload would be lightened, but then she began to worry about this. She described herself as a "perfectionist" and she felt that she "should" be able to manage all of her work assignments as well as maintain her relationship with her husband. So, even after Tammy had more time to relax, she still felt like she was on a never ending treadmill because her mind kept churning, berating herself for not being able to handle everything. She just couldn't give herself a break.

Before Tammy came to see me, she had never considered what she could do to manage her stress. The concept of stress management was completely foreign to her. Initially, when we began to talk about it, she seemed skeptical. This didn't fit in with her idea that she should be able to handle everything and she shouldn't have to do anything to manage her stress. She felt that if she had to engage in stress management, she was "weak."

But after Tom spoke to Tammy, telling her that he was considering a separation, Tammy began to seriously consider that she needed to make some changes. She didn't want to lose her marriage so, with some hesitation, Tammy became more open to learning how to respond to stress rather than becoming reactive. She also had to learn to manage her harsh and rigid expectations of herself, which meant doing some family of origin work where these unrealistic expectations were first developed.

Tammy began by learning to observe her breath. She was surprised to observe that there were times when she was hardly breathing or she was breathing in a very shallow way. Learning healthy breathing techniques helped to calm her down significantly.

After she learned to breath properly, Tammy and I worked on helping her to observe herself in stressful situations. Over time, she realized that she often reacted to stressful situations without thinking, which often made these situations worse for her and for those around her. She learned some simple techniques for stopping herself from reacting and shifting out of her reactive mode into a more responsive mode. She learned that by stopping, sometimes for only a few seconds, she was able to modulate her emotions, calm herself, and respond on a more even keel.

As Tammy learned to be more responsive and less reactive, she began to feel better about herself and more in control. She was also getting compliments from her husband, her boss and her colleagues, who noticed the positive changes in her.

Mind-Body Connection: Responding Instead of Reacting to Stress

During this upward spiral, Tammy became more willing to explore other ways to manage her stress through meditation and yoga. And for the first time in five years, she and Tom planned a vacation together to rekindle their relationship.

Getting Help in Therapy
Without realizing it, the negative effects of reacting rather than responding to stress can creep up on you until you find yourself in an unmanageable situation.

Rather than waiting until stress feels overwhelming, it helps to work with a professional who can help you to change the way that you're handling stress. Very often, once you learn to respond to stress rather than becoming reactive, your overall sense of well being improves and so do your relationships.

About Me
I am a licensed psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR therapist in New York City.

I have helped many clients learn to respond rather than react to stress so they could lead more fulfilling lives.

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

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

Psychotherapy and Beginner's Mind

"In the beginner's mind, there are many possibilities, in the expert's mind there are few."
Shunryu Suzuki

Psychotherapy and Beginner's Mind

What is "Beginner's Mind"?
Beginner's Mind, also called Shoshin in Japanese in Zen Buddhism, is maintaining an attitude of openness and curiosity, even when you're considered to be at an advanced level of whatever you're doing, whether it's spiritual, emotional, interpersonal, or just living your daily life.

I'm not a Buddhist, but I like the concept of Beginner's Mind because it reminds us not to prejudge ideas, people or places. In this way, we remain open to the experience. If you think you already know, then your mind is closed off to new possibilities, even when you're an "expert" in the field. We can think of many ideas and inventions that wouldn't have been created if their creators had gone along with accepted wisdom at the time of what people thought they "knew" about what was possible and what wasn't.

I believe that Beginner's Mind is a state that we can continually remind ourselves about and bring ourselves back to in our daily living. It's not a place where you "arrive" and then can forget about it. It's normal to revert back to old habits and ways of thinking beause they're so ingrained in us.

Self Compassion and Beginner's Mind:
Rather than berate ourselves for falling back into the same old habits, as we are apt to do, it's far better to acknowledge our humanity and bring ourselves back to the practice of Beginner's Mind, as we do when we meditate and we find our minds wandering.

Psychotherapy and Beginner's Mind

During meditation, when we find our minds wandering, we bring our attention back to our breath or whatever we were focusing on before we got distracted. With practice, it's possible to get better at maintaining our attention.

In the same way, practicing Beginner's Mind can improve our abllity to cultivate this state of mind over time.

We're not looking for perfection, only an increased awareness.

With Beginner's Mind, We Don't Throw Away Our Experiences and Skills:
We're also not looking to throw away what we already know when we talk about Beginner's Mind. So, for instance, if we're crossing the street or driving a car, we don't want to approach these activities as a complete beginner. If we were in plane, we wouldn't want the pilot to forget about experience and abandon all of his or her skills. The same would be true if we're having surgery. We would want the surgeon to be experienced and know what he or she is doing. We want to use the skills that we have and pay attention.

It's more about creating a balance between using what we know and also being open and curious to new things.

Beginner's Mind and Children:
It's wonderful to observe children, especially infants from about six months to a year old, as they explore their world. Everything is new and exciting to them. A simple spoon can be an object of complete wonder and fascination as something to look at, put in the mouth, bang on a table or hurl in the air.

I remember being a very curious child who wondered about a lot of things and asked a lot of questions. Somewhere around the first or second grade, I learned in school that it was better, in the teacher's eyes, to have "the right answer" rather than to question or wonder about things. 

It seemed that whenever the teacher had a question, a sea of hands would go up and if someone gave "the wrong answer," the teacher went on to the next student until she heard the "right answer" and then she rewarded the student with a smile and praise. There was no rewarding smile or praise for "the wrong answer" or encouragement for working your way through the process so that you could learn and grow, possibly by starting out being wrong and learning from there. The emphasis was on knowing and being "right."

Hopefully, this has changed in schools and teachers are more interested in developing curious minds and not people with "the right answer," which tends to stunt curiosity and creativity.

Being a Beginner as an Graduate Intern:
When I was an intern in graduate school, as I've mentioned in earlier blog posts, my internship was working primarily with men who were homeless in a homeless drop-in center. The atmosphere at this drop-in center could best be described as organized chaos with hundreds of clients with many complex challenges.

After a three week training by the internship clinical supervisor, we began our work with these clients. At the time, I was transitioning from the human resources field and I was working full time at a commercial bank, where I worked with investment bankers, going to my classses on Saturdays, and doing my internship in the evenings from 5:30 PM-8:30 PM every evening during the week. It was a very busy schedule.

I remember thinking then, more than I had ever experienced before, that I didn't like being a beginner. Nothing in my work history, education or personal therapy had prepared me for the experience of working with clients who needed so much with regard to housing, their physical health, their emotional health, and the need to connect interpersonally.

I felt completely unskilled and found myself often thinking that these clients really needed someone who was far more experienced and skilled than I was as a complete beginner. I felt like they were being cheated.

I wish that I had known about Beginner's Mind at that time. Of course, the clinical supervisor was there for part of the time and we had weekly supervision. But most of the time, when I was in the moment with these clients, I didn't know what I was doing, especially at the beginning of the internship.

I think most of the interns felt this way during that internship, and we often talked to each other and our supervisor about it. Our supervisor had a completely different view. He thought that the clients really benefitted from having beginners assist them because most of us didn't have very many preconceived ideas about the work or about the clients. He thought that we could approach the clients with open minds, and he encouraged us to maintain a sense of openness and curiosity. Again and again, he emphasized being curious and open, the same concept as Beginner's Mind, although he never called it that.

Learning about the concrete services that the clients needed came a lot easier than beginning to understand the emotional fallout of being homeless, and most of the clients had long trauma histories.

Spending my days working on Park Avenue with investment bankers and my evenings with the poverty-stricken clients made both worlds seem unreal after a while because each world seemed so extreme. It also struck me as unreal that I could walk just a few blocks from Park Avenue to this homeless drop-in center and I was in a completely different world, but this is so true of many areas in New York City and other large cities.

Psychotherapy and Beginner's Mind

Over time, I realized that my supervisor was right. I began to see many experienced social service workers who were jaded and somewhat inured at the center. Many of them were burnt out and just trying to survive themselves on low wages.

But most of the interns felt they had to be on their toes all of the time. We knew that we were beginners. We also knew that, often, we didn't even know what we didn't know. But most of us were ready to roll up our sleeves and do what needed to be done, trying to remain curious and keeping an open mind.

Not only did we learn a lot from our supervisor, but we learned even more from our clients. I was amazed at how generous most of the clients were, considering their circumstances, to share whatever information they had from being in and out of different social service systems over the years or learning about the law while incarcerated.

Most of the clients were truly grateful that we spent time and effort with them. And, even though there was violence at times at the center among the clients, while I was there, I never witnessed any violence towards any of the interns. The clients seemed to have adopted us as their "students," even though most of us were older than them, they were protective, and most had a genuine affection for us. It was an experience that I'll never forget.

Being a Beginner as a Psychotherapist:
After I completed graduate school, I went on for postgraduate training at a psychoanalytic instiitute. It was one of the most intense, rigorous, and fascinating educational experiences of my life. It was considered an "immersion" experience because we attended classes, supervision, our own 3x per week personal psychoanalysis while seeing clients for psychotherapy at the same time.

Once again, I was a beginner, especially the first year, with all of the feelings of anxiety, humility, and confusion that went with that experience. During the first year, most of us felt like we were in a fish bowl, being observed by our instructors, supervisors, as well as our clients.

Many of the clients who came to the institute were feeling depressed, anxious, panic stricken, challenged by difficult relationships, and traumatized by their childhoods, among other problems.

During the first few months, I was more frightened than I would've admitted to my supervisors or teachers, about what might come up in a psychotherapy session--maybe something that I wouldn't know how to handle. Of course, as new therapists, we were not alone and there was an entire institute of seasoned professionals to call on--eventually. But in the moment when each of us were sitting with clients in an office, we were alone and on our own.

I still didn't know about Beginner's Mind or meditation at that time. I felt that I was expected to know, even though I often didn't know. And each week, each of us were on the "hot seat" at least once or twice in our individual supervisions or group supervisions to present a client's case, verbatim (what the client said, what we said to the client).

I don't want to make it sound like we were being grilled as new therapists because we weren't. Most of supervisors and instructors were kind and compassionate people who had gone through the same training that we were going through. I think, as new therapists, who wanted to help our clients and who wanted to seem competent to our instructors and supervisors, we put most of the pressure on ourselves. This also served to keep us on our toes to be diligent about finding out about situations that we didn't know about or to understand unfamiliar concepts.

I remember thinking to myself, once again, that these clients deserved to be seeing someone else--a therapist with a lot more experience and knowledge than I had. Even though there was no secret that this was a postgraduate training center, I wondered how many clients really knew that they were seeing psychotherapists in training. I suspect that many of them thought that if you were seated in the psychotherapy room and you were seeing them, you must know what you're doing, which only added to the pressure the trainees felt.

By the second year, we were over the period of "baptism by fire" of the first year. Many of us were continuing with the same clients and we were feeling a little more confident, still new, but not so worried about the proverbial fish bowl.

Part of what came next in training was that we had to become more proficient at diagnosis. While the psychodynamic processs was the emphasis of training and, fortunately, diagnosis was not the major focus of psychoanalytic training, it was still significant.

While I think it's important to be able to diagnosis to a certain extent, especially if clients have major depression, bipolar disorder, ADHD, or other problems that have a strong biological component and where medication might be needed, focusing exclusively on diagnosis is very limiting to the work.

When you're first learning about diagnoses, it's an occupational hazard that not only do you feel you often see the diagnoses in your clients, but you begin to see it in your friends, family, loved ones (much to their chagrin), and in yourself.

I can laugh now when I think that it was not unusual in that early stage of training for new therapists who became friends to say to each other, "Do you think I suffer with narcissistic personality disorder?" or "I think I have some borderline personality disorder traits."

I've heard that medical interns go through similar experiences. I think this happens when you're so immersed in learning about the diagnoses that you think you see them everywhere.

The problem with too much of a focus on diagnosis is that you can reduce the client to a particular set of behaviors and dynamics. It becomes too easy to rely on the American Psychiatric DSM (Diagnostic and Statistical Manual) and forget that you have a client in front of you who is multi-dimensional and multi-faceted in many ways. People are too complex to reduce them to a few lines in a manual. And when we reduce people to a diagnosis, it's easy to lose compassion for them.

The other problem is that when a therapist reduces a client to a diagnosis, it's often the opposite of keeping an open mind because the therapist can think that she or he knows, using only the diagnosis, what's going on with the client. It's the opposite of Beginner's Mind. It's far better to remain open and curious about what's going on, holding onto any particular diagnosis in a tentative way, if it's relevant, keeping in mind that this might not be correct, it could change, each person is unique and that not all people with a particular diagnosis are the same.

Beginner's Mind as a Psychotherapist:
I don't want to sound like I'm presenting myself as someone who has reached the pinnacle of using Beginner's Mind. Far from it. I still need to remind myself to be open and curious, but I think I remember more often now beforehand rather than remembering after the fact. Now that I have more experience, I'm also more willing to be wrong, as compared to when I was new to the field years ago.

Part of the job of any experienced psychotherapist is to approach each client and each new session with Beginner's Mind, even if they don't call it that. Skilled therapists who are willing to use their skills and their intuition are usually better therapists than therapists who think they always know what's going on with clients.

Therapists are only human and it's easy to make the mistake by assuming that you absolutely know. It's a far better approach for therapists to consider ideas that they might have as possibilities, not to get wedded to them, so that, if they're wrong, these possibilities can be thrown out and the therapist can learn from the client what's really going on.

If they're right and their skills and intuition have lead them in the right direction for the benefit of the client, that's great. But assuming, as a therapist, that you're always right is a big mistake (as it would be for anyone). It's better to start with Beginner's Mind. And if a therapist forgets, as I sometimes do and must remind myself, it's better to acknowledge it and bring yourself back to an open mnd. This is a humbling, but necessary process.

Being a Smart Consumer of Mental Health Services:
It's a delicate balance and an ongoing challenge. Clients, of course, want therapists that are licensed, experienced and skilled. Licensure, skills and experience count, just as they do for a doctor, a pilot, or a teacher. Before there was licensure, anyone could call him or herself a psychotherapist in NY, but now that there's licensure, it's no longer legal to call yourself a psychotherapist if you don't have a license.

Getting Help in Therapy
As a smart consumer of mental health services, you want to know that your therapist is qualified to treat you. I've seen many clients hurt when they went to unlicensed, inexperienced and unskilled people for psychological problems. Unfortunately, there are some people who advertise themselves as coaches or New Age counselors, offering "quick fixes," who are working outside the scope of their skills and knowledge, and this is often hurtful to clients.

 If you want to find out more about Beginner's Mind and how you can develop more of an openness and curiosity about life, I suggest you read a book called Zen Mind, Beginner's Mind by Shunryu Suzuki. As I mentioned previously, I'm not a Buddhist, and I've found the concept of Beginner's Mind to be valuable. Even if you're not a Buddhist and you have no interest in Buddhism, you could benefit from reading this book to learn more about Beginner's Mind.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, Somatic Experiencing therapist, and EMDR 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.