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Sunday, July 19, 2009

Overcoming Shame: Disengaged Families

In my prior post, I discussed Overcome Shame: Enmeshed Families. I'd like to discuss shame in predominantly disengaged families in this post.

Families are complex, so even though I'm describing various "types" of families and categorizing them as "enmeshed" or "disengaged" for the sake of simplicity, we know that people and families are not so easily boxed into particular categories. 

However, for the purpose of our discussion, I will use these categories to show how certain types of families where there is a predominance of a particular way of interacting, in this case "disengaged," often create shame in family members.

Disengaged Families

Overcoming Shame: Disengaged Families


Whereas, in general, enmeshed families discourage personal boundaries, disengaged families tend to be cold and distant with each other. 

Children often feel lonely and isolated. Often, family members lead very separate lives and there is little feeling of emotional connection. 

They might all be in the same house, but it is as if they are each alone. Maybe they eat meals separately. 

Conversation might be limited to impersonal topics like the weather or politics. There is little feeling of nurturance. In disengaged families parents often lack emotional attunement with their children. What does this mean? Here is an example of lack of emotional attunement:

I was on a train a few weeks ago and sitting across from me was a mother and a baby boy of about six or seven months in a stroller. The boy began asking his mother for his "binkie" (his pacifier). The mother appeared tired and depressed and she had a thousand mile stare. 
She seemed not to notice or hear her son talking to her. 

At first, he asked calmly, but as time passed and he got no response from her, he began to cry in frustration, saying, "Binkie. Binkie" over and over again. With no response forthcoming from his mother, the boy got increasingly upset and cried louder and louder as tears streamed down his face. He cried louder and louder, asked for the "binkie," banging his hand on the stroller, trying to get his mother's attention in any way that he could. 

This went on for about 10 long minutes. It was quite heart breaking to see. Finally, the boy's mother seemed to come back from wherever her far away thoughts had taken her and absentmindedly gave the boy the pacifier without even looking at him. Even after he got the pacifier, he looked very sad and ashamed because he could not get his mother's attention. Eventually, he went to sleep, looking exhausted, with his eyes still wet from his tears, sucking on his pacifier.

One could only hope that this was an isolated incident and that this was not their usual way of relating. If his mother is usually emotionally attuned to this boy and he experiences only occasional incidents like this, all other things being equal, he will probably grow up to be well adjusted because emotional attunement doesn't need to be perfect--it just needs to be "good enough" most of the time. 

As humans, we are emotionally resilient so that isolated incidents are not permanently scarring. Or, if the primary caregiver lacks attunement, but there are other relatives who are around a lot who are loving and pay attention to this boy in a loving way, this can mitigate the damage of a disengaged primary caregiver. 

However, if this is how this mother usually relates most of the time, possibly due to her own depression or because she had no one to nurture her when she was growing up, and there is no one else in the picture to make up for it, her emotional disengagement can cause this boy to feel lonely and ashamed of his own need for emotional connection and love.

Shame at an Early Age:
You might be surprised to read that babies can feel shame, but they do. They don't have the cognitive capacity or linguistic skills to express it in words, but you can see it clearly if you watch. 

There has also been a lot of infant research that has shown that babies are capable of feeling shame when their emotional needs are not met. So, shame can start at a very early age. 

When shame starts at such an early age, it often becomes a primary emotion for these people. They often grow up feeling lonely, shy and that they don't deserve to be loved. 

Their own emotional withdrawal, in turn, makes it difficult for them to connect with others, which perpetuates the loneliness and shame. 

Of course, many unforeseen things can happen in a lifetime and these people might meet others who are able to reach beyond the withdrawal and isolation to form important emotional bonds. So, all is not hopeless. But growing up in a family where there is emotional disengagement presents emotional challenges for the individuals in this family with shame being one of the primary challenges.

What to Do:
If you grew up in a family where you felt ashamed of your basic need for love and emotional connection, it may be very hard to ask for help. 

As I mentioned in the prior post, I recommend reading John Bradshaw's books (http://www.johnbradshaw.com/) about families and shame so that you can gain a better understanding of how shame might be impacting you in your life and realize that you're not alone. 

The feeling of shame can be so ingrained that you don't expect that your life can change. However, many people have been helped to overcome these feelings by psychotherapists who understand how to work with individuals who grew up feeling ashamed of their basic need for love and nurturance.

Although you might not feel it right now, you deserve to have an emotionally fulfilling life. Taking the first step might be the hardest, but it can also be the most important step in overcoming a life of shame and emotional deprivation.

About Me
I am a licensed New York psychotherapist, hypnotherapist, EMDR therapist and coach. 

I have helped many individual adults and couples to overcome feelings of shame and emotional deprivation.

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:  Overcoming Shame














Saturday, July 18, 2009

Overcoming Shame in an Enmeshed Family

In my last post, I wrote about Overcoming Shame. In this post, I will introduce a particular aspect of the origin of shame and how it affects individuals in enmeshed families.

What is an "Enmeshed" Family?
Salvador Minuchen introduced the concept of enmeshed families in his family systems theory in the mid-1970s.

Overcoming Shame in an Enmeshed Family

An enmeshed family allows individual members little to no autonomy or personal boundaries. The roles among family members can be very rigid. One person might be "the scapegoat," another person might be "the hero" and so on.

These roles are not explicitly assigned. It's usually an unconscious process and much more subtle than that. The point is that individuals in this type of family often grow up not knowing how they really feel or what they want to do in their lives because they are encouraged to feel whatever the rest of the family feels (usually initiated by one or both of the parents) and strongly discouraged from developing their own feelings and preferences.

What are the Consequences of Growing Up in an Enmeshed Family?
There is often a strong sense of shame in enmeshed families. The family might designate a particular family member to contain these feelings of shame by making that member "the scapegoat" of the family.

When families scapegoat a particular family member, rather than looking at the dysfunctional family dynamic, they point to this family member and say that he or she is the cause of the family's problems.

Often, the scapegoated person is the one who strives to be an individual, which is threatening to the rest of the family. He or she is often the healthiest one in the family, but other family members don't see it this way. In their eyes, if only this family member would shape up and think and behave the way that the rest of the family does, everything would be all right. 

Needless to say, this person carries the family shame and often grows up to feel ashamed of him or herself and defective in some way. The other rigid roles that are assigned in this type of family also cause the individual members to feel ashamed as well.

Enmeshment leads to shame and shame often leads to depression, anxiety, alcoholism, drug abuse, eating disorders, compulsive gambling, sexual addiction, and other addictive behaviors as well as family violence.

How to Overcome the Effects of Enmeshment as an Adult
Often, enmeshed families do not seek mental health treatment unless they're forced to do it after serious problems have developed.

So, for instance, if one of the children begins to have problems in school and the local Bureau of Child Welfare investigates and finds abuse or neglect, the family is often encouraged (and sometimes mandated) to attend family therapy.

However, many times the family problems are overlooked because no one outside the family knows what's going on. So, the individual children grow up with a strong sense of shame and problems in their own intimate adult relationships, assuming that they are able to have intimate relationships.

For adults who grew up in enmeshed families, the idea of getting help for themselves might feel like they're being "disloyal to the family." They've grown up with such a strong sense that they must go along with the family dynamic that it's hard for them to think for themselves--let alone think or do something different from the rest of the family. 

If they are able to begin individual psychotherapy, they often feel highly ambivalent about the treatment and they might drop out before completing the work.

If you grew up in an enmeshed family, I recommend that you read John Bradshaw's books and find a psychotherapist who has worked with individuals who suffer with shame as a result of growing up in an enmeshed family. 

It might feel uncomfortable at first to seek help for yourself, but it can be enormously helpful to free you from the bonds of shame and allow you to flourish in your life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist and EMDR therapist.

I work with individual adults and couples.

I have helped many individuals to overcome shame to be able to go on to lead satisfying lives.

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

To set up a consultation, please feel free to call me at (917) 742-2624 or email me.

Also, see my article:  Overcoming Shame: Disengaged Families














Thursday, July 16, 2009

Overcoming Shame in Therapy

Shame can be a crippling emotion with serious consequences for the individual who is experiencing it as well as his or her loved ones.


Overcoming Shame

What is shame?
Shame is an emotion where an individual feels defective or damaged in some fundamental way. Certain other emotions, like embarrassment and guilt, are often confused with shame.

Embarrassment is usually about a particular incident and it involves other people. It is mostly a temporary, passing feeling, whereas shame is a deep feeling about oneself that one is basically flawed at the core.

Guilt is a feeling that is related to shame, but it's not the same. When an individual feels guilty, he or she feels remorse about something that he or she did or said.

How Does Shame Develop?
People often develop shame after they experience a traumatic event, especially if they blame themselves for what happened. Also, when people grow up in dysfunctional families, either highly enmeshed (where there are poor boundaries) or disengaged, shame is often a strong emotion. I'll discuss this in more detail in later posts.

What are the Consequences of Shame?
The effects of shame are serious. Shame often causes people to want to isolate, withdraw and, in some cases, want to die.

Shame can keep people from forming and developing relationships. Shame can keep people from excelling in life.

Teens who experience shame are more likely to drop out of high school.

Teens Who Experience Shame Are More Likely to Drop Out of High School

As adults, they might drift from job to job feeling trapped but unable to overcome that feeling.

People who experience shame are more likely to develop substance abuse problems.

Shame is often at the core of domestic violence where shame is covered over by rage and directed outward at family members.

Shame can also lead to eating disorders, compulsive gambling, sexual addiction, and other forms of addictive behavior as people who experience shame use these compulsive behaviors as maladaptive ways of coping.

In extreme cases, shame can lead to suicide. Shame is also often linked with traumatic stress.

How Can You Overcome Shame?
People who experience shame often don't talk about it. They might feel so defective and isolated that they are unable to get the emotional support that they need.

Often, people who experience shame feel that they are the only ones who feel this way. They feel that other people could not understand what they feel.

People who feel ashamed often don't know what they feel or how to express it. They often feel locked in with their emotional pain and it's hard for them to find a way out.

Getting Help in Therapy
If you or someone that you love is experiencing the debilitating effects of shame, it's important to get professional mental health.
Getting Help in Therapy

Psychotherapy can be very helpful to people who experiencing shame to overcome this potentially crippling emotion.

In future posts, I'll be discussing the origins and effects of shame in more detail.

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

I have helped many clients overcome the effects of lifelong shame so that they can grow and flourish in their 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 articles:  
Overcoming Shame: Enmeshed Families

Overcoming Shame: Disengaged Families









Wednesday, July 15, 2009

Toxic Family Secrets

Did you grow up in a home where there were toxic family secrets?

Toxic Family Secrets

Here are a few examples of typical secrets in a dysfunctional family:

Susan's family's toxic secret
It's morning and dad is passed out in bed again from his prior night of binge drinking. Susan, who is nine, overhears her mother calling dad's boss to say that dad is sick and won't be going to work. Even though the mom knows that Susan has seen dad drunk many times, she tells Susan that dad has "the flu" and tells her not to talk to anyone about what she saw the night before. In doing this, she gives Susan a mixed message about what they both know to be true. Susan grows up resenting her mother and father and feeling that she can't trust men and she never wants to get married.

George's family's toxic family secret
George is 15 years old. His father just died. At his father's funeral, to his shock and amazement, he overhears people whispering that the man that he knew and loved was not really his biological father. When he confronts his mother about this a few weeks later, she turns away from him, refusing to talk about it, and only says, "Your real father was no good." George feels overwhelmed, angry and betrayed. He has so many questions, but no one to talk to about it. He doesn't want to upset his mother, so he never brings it up again, but he grows up feeling lost and confused and he has difficulty trusting in his intimate relationships.

Mary grows up feeling ashamed of toxic family secret
Mary is 10 years old. Every night her mother's boyfriend comes into her room and touches her in ways that make her feel uncomfortable. When Mary finally summons up enough courage to tell her mother, her mother gets angry with her and accuses Mary of making up lies. She tells Mary that if she ever mentions this to anyone else, she'll send her away. But later that night, Mary hears her mother and the boyfriend arguing about his going into Mary's room. The next day Mary's mother and the boyfriend act as if nothing has changed and go on with their daily routine. The nightly visits stop, and the subject is never brought up again, leaving Mary deeply confused: Did her mother believe her or not? She grows up feeling ashamed-- she must have done something wrong to cause the mother's boyfriend to behave in this way and for her mother to get angry with her. She also learns not to trust her own feelings. Whenever her romantic relationships start to become serious, she shuts down emotionally and her boyfriends leave her.

John's family's toxic secret about father's gambling
John is 13. He knows that his father earns a good living and should be able to support the family. And yet, there is constant tension and anxiety in the house because his parents are continually struggling to pay the bills. They're unable to give him money for class trips or his football uniform. One day he sees his father going over a horse racing form which he quickly puts away when John walks into the room. Later on, John asks his mother if dad has a gambling problem, and she changes the subject, telling him to go clean his room. John feels hurt and confused. He grows up with anxiety about money and wonders if he'll be able to take care of himself when he grows up.

The Consequences of Toxic Family Secrets:
From these few examples, you begin to see how damaging family secrets can be. Maybe you've identified with one or two of them or they might have brought to mind secrets that your family kept and might still be keeping.

These kinds of family secrets are emotionally toxic. The consequences far exceed what the parents ever could have imagined: hurt, mistrust, shame, guilt, self doubt, anger, resentment, and sometimes an inability to enter into or maintain intimate relationships. Sometimes, people who grew up with toxic family secrets don't realize how they've been affected by them. They might perpetuate these dynamics when they get married with their own children because this way of relating is familiar to them. Toxic family secrets have been known to be a contributing factor to alcohol and drug abuse, sexual addiction, compulsive gambling, eating disorders, anxiety disorders, depression, codependence, and other problems.

What to Do?
Ask yourself if you grew up with toxic family secrets and, if so, ask yourself how it is affecting you and your current relationships. 

If you sense that family secrets are adversely affecting you now--maybe they're getting in the way of your having or maintaining relationships or you feel you can't trust your own feelings because you don't always know what they are (from years of doubting what you know versus what you were told by your family), it's time to see a mental health professional so that you can learn to overcome the consequences of family secrets and have a fulfilling life.

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

I work with individual adults and couples.

I have helped many clients to overcome the effects of toxic family secrets.

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 or email me.

Also, see my article:  Overcoming Shame



Tuesday, July 14, 2009

Overcoming Perfectionism

Are you a perfectionist?
Do you feel that your efforts are meaningless unless you give 110% every single time because "good enough" is not good enough for you?

Are your projects late because you keep going over them again and again to try to achieve "perfection"?

Do you feel like you've failed when others think that what you've done is "very good" and not "excellent" or "the best"?

If you find yourself struggling with some or all of these issues, chances are you're a perfectionist and, if so, you may be very hard on yourself as well as those around you.

What are the Consequences of Being a Perfectionist?
Perfectionists often look outside of themselves for approval. Their self esteem, which is usually low, is dependent upon others telling them that they've done an excellent job.

Overcoming Perfectionism


Often, although they get momentary pleasure from hearing others say that they've done an "excellent" job, perfectionists tell themselves, "Well, of course it's great. That's what's expected of me."

Perfectionism causes a lot of anxiety because being perfect all of the time is impossible. Sooner or later, a perfectionist's achievements will fall short of "perfect" and then they feel deeply disappointed and guilty.

It's quite a burden to be a perfectionist. Perfectionists are often their own worst taskmasters, working themselves day and night to try to always be "perfect." And, contrary to what you might think, success often eludes them because they keep reworking projects or ideas well past their deadlines in their attempts to make them "perfect. "

Perfectionists often have difficulty in relationships because they expect others to be perfect too. Their "all of nothing" thinking ("it's either perfect or it's not good at all") gets them into trouble. Their partners feel exasperated, their children feel anxious, and their bosses feel frustrated with their relentless perfectionism.

What Can You Do If You're a Perfectionist?
The first step is to admit that you have a problem.

Think about your life and the consequences of your perfectionism. If you're not happy and the people around you are unhappy because of your need for perfection, it's time to change the way you think, feel and behave.

It's important to realize that people who are close to you and who love you don't value you because of what you do or how you do it. They care about you because you're you--someone who is an imperfect being, just like everyone else. They will probably appreciate your letting go of your perfectionistic standards so that you and they can relax.

Learn to discriminate and prioritize in the different areas of your life. Remember, if you try to do your absolute best on everything that you do, you'll probably not do well on most things because there just isn't enough time and energy.

Once you have prioritized, practice aiming for 80% or 90% instead of 100% in areas that are less important. If you're not sure what 80% or 90% looks like because you always strive for 100%, ask a trusted friend, family member or colleague to help you gain some perspective. You'll be surprised at how many more things you'll accomplish because you won't be procrastinating and reworking things to be "perfect."

Learn to manage your anxiety. Ask yourself, "What's the worst thing that could happen?" and "Objectively, how likely is it that the worst thing will happen?" "What's a realistic outcome?"

Remember that many things that were seen as "a mistake" at first turned out to be great successes: The 3M inventor of "Post Its" was originally trying to make an adhesive. Imagine if he and his company had not seen the value of what he had made. We wouldn't have "Post Its" today and 3M would not have made lots of money.

The famous Irish writer, James Joyce, said,"Mistakes are the portals of discovery."

Getting Help in Therapy
If you find that you are unable to break away from your perfectionistic tendencies, you would probably benefit from seeing a mental health professional.

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

I work with individual adults and couples.

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

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

Thursday, July 9, 2009

Setting Healthy Boundaries in Your Relationship

Being able to set healthy boundaries is an important part of being in a relationship.

What Are Healthy Boundaries?
Setting healthy boundaries means that you're able to set limits with your partner about how close or distant you are with each other in terms of the physical, emotional, financial and, possibly, spiritual aspects of your lives together. An example of this would be that you both understand that it is unacceptable for you or partner to hit or cheat on each other (see my prior post about infidelity). Another example is that you won't tolerate cursing or belittling comments.

Setting Healthy Boundaries in Your Relationship

Another example might be that when you come home from work, you might need 15 minutes to yourself to calm down from the day before you hear about everyday, non-emergency problems with your children. It could also mean that you want to keep whatever money you had before you entered into the relationship separate from any combined income that you and your partner set up when you entered into a committed relationship (see my prior posts regarding talking about money with your partner). Or, that you want your partner to respect your privacy with regard to your personal journal. There are so many other examples. The emphasis is on healthy boundaries (neither too rigid nor too loose) and that these are aspects of your relationship that are important to discuss early on and to maintain.

Why do some people have a hard time maintaining healthy boundaries?
There can be so many reasons. Often, the issue for the person who has problems setting healthy boundaries is that he or she has low self esteem (see my prior posts on low self esteem). When you have low self esteem, you might not feel that you deserve to set boundaries with your partner (or with anyone else).

You might fear that if you set boundaries with your partner, he or she might leave the relationship. But it's important, for your own self respect as well as the respect that you deserve from your partner, that you be able to say what you do and don't want. This assumes, of course, that you know what you want. For some people whose personal boundaries were violated at an early age, it's hard for them to know what they want at any given time. Sometimes, they set boundaries that keep them too distant from their partners and other times they allow their partners to encroach upon them too much because they were never allowed to set boundaries when they were younger so they don't know how to set healthy boundaries.

This is a more complicated problem and usually needs the help of a mental health professional. Another reason might be cultural differences between you and your partner. Maybe one of you is from a culture where personal boundaries in a relationship are not as important. If this is the case, it will take time and effort to negotiate with your partner what the personal boundaries will be in your relationship. For other people, the challenge might be that they are "people pleasers" and they have a hard time saying "no" to just about any request. This is also related to low self esteem. Another possibility is that one or both people in the relationship might be codependent with each other (more on this in future posts). And, there can be so many other reasons why someone would find it difficult to set healthy personal boundaries.

What Do You Do If Your Partner Doesn't Respect Your Boundaries?
Well, this depends on what we're talking about. It's never acceptable for your partner to hit you, take your money without permission, try to control what you wear, verbally abuse you, keep you from having friends or seeing your family or to threaten you. These are all forms of abuse. If any of these things are going on in your relationship, you and your partner need immediate help. You can call your local chapter of Safe Horizons or speak to a mental health professional.

You might also need to protect yourself by going to stay with a trusted friend or family member if your partner is physically abusive. You deserve to be safe. But assuming that we're talking about other less serious boundary infractions (like not allowing you a few minutes to relax when you come home before talking about daily problems, for instance), you might need to remind your partner. Negotiating and making changes in a relationship can be challenging and a gentle reminder from time to time might be necessary if your partner forgets or if you forget what you have agreed to regarding personal boundaries.

As we can see, this is a big topic and can be challenging for you and your partner. It might also be challenging for you in your other relationships with your family, your partner's family, your friendships and your work relationships.

Feeling entitled to set healthy boundaries and setting them with others is important to your self respect and to how much others will respect you.

Since this is such a big topic, I'll be writing more about this in future posts.

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

I am a sex positive therapist who works with adult individuals and couples.

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

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


Wednesday, July 8, 2009

Relationships: Is Your Spouse Depressed?

Just like diabetes or high blood pressure, depression is a serious problem and requires professional help. When a person is depressed, it's not just a matter of dealing with "the blues." A person who is depressed cannot "just snap out of it."


Is Your Spouse Depressed?


What is Depression?
Depression causes biochemical changes in the body and the brain so that it affects the depressed person both physically, emotionally, and psychologically. It can affect a depressed person's appetite, sleep pattern, and energy level.

Depression can cause physical aches and pains. It can also cause a person to lose interest in things that he or she used to enjoy doing. Depressed people often lose interest in sex and might seem apathetic toward your relationship.

They might become forgetful or have problems concentrating. Sometimes, a depressed person isolates from others. A sad mood and crying are common.

The person might become irritable, anxious, and easily annoyed. Depending on the level of depression, accomplishing every day daily activities of living--like getting out of bed, bathing, getting dressed, going to work, helping with the housework, and relating to others-- might be very difficult for the depressed person.

Depression is often progressive so that, without professional, help, it can start out being a minor depression and progress to major depression. Major depression can also lead to suicide.

How Common is Depression?
At any given time, millions of people in the US suffer with either minor or major depression. Often, depression goes undiagnosed because the depressed person and their loved ones don't know the signs and symptoms of depression. The spouse of a depressed person might label the depressed person as "l
"lazy" or "uncaring." This makes the depressed spouse feel worse and can worsen the depression.

Getting Help
If you recognize the signs or symptoms of depression in your spouse:

Gently and tactfully express your concern and offer to make an appointment with a licensed mental health professional.

Assure your spouse that depression is a common problem that affects millions of people and it's not his or her fault.
If your spouse is too depressed to take the initiative, make the appointment yourself and go with your spouse to the evaluation.

Before you go to the appointment, make notes of your observations of your spouse's depression so that you can discuss these observations with the psychotherapist. For many people, depression is overcome with psychotherapy or with a combination of psychotherapy and medication.

However, you should be aware that even after a particular episode of depression is over, another episode can and often does develop. So, you and your spouse should be alert to the signs and symptoms so you can recognize a relapse.

While you're helping your depressed spouse, it's important that you also take care of yourself. Coping with a depressed spouse can be very stressful and lonely. Being around someone who is depressed can also make you feel depressed or anxious. So, it's important that you continue to engage in activities that you enjoy and stay connected to your support system.

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

I have helped many therapy clients to overcome depression.

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

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