EMDR Therapy for "Big T" and "Smaller t" Trauma

As a New York City psychotherapist who is an EMDR therapist, I see clients for EMDR treatment for both "Big T" and "Smaller t" trauma. I will clarify what I mean by "Big T" and "Smaller t" trauma below.

What is EMDR?
First, as I have written about in earlier posts, I want to reiterate that EMDR (Eye Movement Desensitization and Reprocessing) is a form of psychotherapy which has been found to be effective for healing trauma. Francine Shapiro, Ph.D., who is a psychologist, developed EMDR in the late 1980s.

EMDR Therapy For "Big T" and "Smaller t" Trauma

Since that time, EMDR has been one of the most well-researched forms of psychotherapy for posttraumatic stress disorder (PTSD) and other types of trauma. It has been recognized as a safe and effective form of treatment by the Veteran's Administration, the American Psychiatric Association, the International Society for Traumatic Stress Studies, the Israeli National Council for Mental Health and the United Kingdom Department of Health, among other mental health organizations.

EMDR uses bilateral stimulation of the right and left brain hemispheres (through eye movements, alternate taping, bilateral music, and other similar methods) to activate the brain's "information processing system" to heal trauma.

When we are overcome by experiences that produce overwhelming emotional and physical reactions, often, our minds are unable to process these experiences.

Under certain circumstances, which are unique to each person, these overwhelming experiences can produce adverse reactions, like debilitating depression, anxiety and other psychological difficulties. EMDR allows clients to reprocess these experiences, allowing us to get to the root of these emotional processes, and usually produces a long-term cure.

EMDR therapists, who have advanced training, know how to work with clients in a way so that they are not overwhelmed with the EMDR reprocessing. Each client's experience is unique.

Generally speaking, high levels of emotional reaction tend to dissipate with EMDR treatment. Also, an experienced EMDR therapist makes sure that clients are well prepared for EMDR processing before the actual processing begins by working with clients to develop internal resources (coping skills) to deal with any uncomfortable reactions that might take place during the reprocessing of emotional trauma.

What is the Difference Between "Big T" and "Smaller t" Trauma?
EMDR is usually associated with what is referred to in psychological literature as "Big T" trauma. However, it seems that it is less well known that EMDR is usually very effective for "Smaller t" trauma as well.

"Big T" Trauma
When we refer to "Big T" trauma, we are usually referring to trauma that occurs during war or natural disaster, rape, kidnapping, physical attack, and other similar types of trauma. These types of trauma are usually so overwhelming for most people that they are unable to cope.

An example, of this is the Vietnam or Iraqi veteran who has witnessed atrocities during war and who comes home, relives these atrocities through flashbacks, where it adversely affects his or her ability to function in every day life.

Another example of "Big T" trauma is when a woman who has been raped continues to have nightmares about the rape; she ruminates about what happened, reliving the event over and over again in her mind.

She might be too afraid to start new relationships or to even go outside.

Generally, "Smaller t" trauma is trauma that is more subtle than "Big T" trauma.

An example of "Smaller t" trauma can occur when we're children and we witness events that are upsetting and overwhelming to us because our child-like minds are unable to understand or process these events.

An example of a "Smaller t" trauma could be when a child witnesses loud arguments between his parents and he fears that they are going to get a divorce. As a child under these circumstances, it's normal to be concerned about his safety and well-being. After all, he worries about what will become of him and who's going to take care of him if his parents are not together.

These kinds of experiences can leave a mark on a child's psyche, leaving him vulnerable to feeling anxious, depressed, or insecure later on in life.

There are many other everyday examples of "Smaller t" trauma that people often don't recognize at the time when they're occurring. The emotional damage that has been done often does not show up until later on in life. Sometimes the events that led up to these problems later on are apparent and, other times, they're not. Either way, EMDR is usually an effective form of therapy to overcome the effects of "Smaller t" trauma.

Since most literature focuses on "Big T" trauma like PTSD, I would like to focus on "Smaller t" trauma in this post to illustrate its effects and how EMDR can help. The following vignette is a composite of many cases with all identifying information changed to protect confidentiality:

John:
When John first came to treatment, he was in his late 30s. He worked as an attorney in a large corporate law firm. Like most attorneys in his law firm, John hoped to become a partner one day in his firm.

Generally, he liked corporate law and enjoyed working with his clients. However, he felt very anxious around his boss because his boss was a bully. Whenever his boss felt that John fell below what was considered an acceptable rate of "billable hours," he berated him in the most demeaning way.

John understood the importance of "billable hours" and knew what was expected of him. He felt that, overall, he was a knowledgeable and capable attorney. However, whenever his boss berated him, John felt emotionally paralyzed.

John felt his confidence plummet and he would ruminate for days about whatever his boss told him. His colleagues experienced the same bullying from the boss and, although they were concerned about it, they were not as affected by it as John.

John recognized this and he knew he needed to get help or his boss's tirades continued to be detrimental to him. He realized that his reaction to his boss's comments were out of proportion to the current situation.

The First Phase of EMDR Treatment: During the first phase of EMDR treatment with John, I obtained a detailed history from John about his background. From his family history, I learned that John's father was very much like his boss. He was hypercritical of John and often berated him, leaving him feeling like he could never please his father. If John came home with a report card with all A's and one B, John's father focused on the "B" and berated him for not getting an "A" in that subject, leaving John to feel badly about himself.

Developing Coping Skills: During that initial phase of treatment, I also helped him to develop basic coping skills. Since he didn't do anything to manage his stress, John began working out and going to yoga class. I also taught John to meditate.

In addition, we developed internal resources that he could use during EMDR processing. For instance, John learned to think about and visualize certain "protective" figures from his life (his grandfather, a kind uncle, his nurturing older sister, as well as a lifelong friend and confidant). Through EMDR processing, we worked to help John to internalize these protective figures in such a way that he could "call on them" (essentially, remember, visualize and sense them) when he felt emotional distress either in the psychotherapy session or outside. Just using these internal resources whenever he had to deal with his difficult boss helped John tremendously.

EMDR Processing: During the next phase of treatment, John chose a particular incident that occurred at work with his boss and we began to process that incident using EMDR eye movements. 

Before the processing, John rated this incident as a "9" out of a possible 10 in terms of how emotionally disturbing it was to him (with 0 being no disturbance and10 being the highest level of disturbance). So, overall, it started out as being very disturbing to him. 

However, as we continued to do EMDR processing, the incident became less and less disturbing. It gradually went down to a 5 for John. He felt relieved, compared to how he felt originally, but it was still disturbing. Further processing of that incident did not decrease John's level of disturbance.

When Processing of Trauma Gets Blocked: When the level of processing gets "blocked" (meaning that it stays at a certain level of disturbance and it won't go down to 0 or 1), it generally means there is underlying trauma that is feeding into the current situation and is making it more emotionally charged than it might normally be. Having already obtained John's family background, I was aware that John's relationship as a boy with his father was probably feeding into his current problems and activating his emotional response.

The Difference Between EMDR and Regular Talk Therapy for Trauma: If we were doing regular talk therapy, we might have discussed John's relationship with his father and how if affected him now.

It probably would have been enlightening to John but, usually, this would only remain as an intellectual insight. In other words, it's interesting and informative to know, but it doesn't produce any change. And therein lies the problem with regular talk therapy and trauma.

In addition to my EMDR training, I'm also trained as a psychoanalyst, so I understand and value psychodynamic treatment for most problems. However, when it comes to trauma, regular talk therapy is often limited in terms of resolving and healing trauma.

Processing the Earlier Trauma that Triggers the Current Trauma: So, knowing that there were probably earlier memories that were feeding into and triggering John's emotional reaction to his current situation, we did what is known in EMDR as a "float back."

During a "float back," the client thinks back to an earlier time when he might have experienced these same feelings. An experienced EMDR therapist might have a sense of what those memories might be, but he or she doesn't make any suggestions about them. The EMDR therapist allows the client to come up with whatever he or she remembers or senses.

In John's case, his earliest memory of feeling the same way as he did in his current situation was when his father berated him during Little League practice. According to John, he struck out each time that he was up at the plate during a big game with a rival team.

Afterwards, he was feeling bad enough, but when his father yelled at him in front of his team mates and the other parents, John was mortified. John rated his level of disturbance as being a "10" for this memory. Gradually, as we continued to process the memory with EMDR, his level of disturbance went down to a "0." When it went down to 0, he, of course, remembered the memory with all of the details, but he no longer felt disturbed by it.

Resolution of the Trauma: After we processed this earlier memory, which was emblematic of his experiences with his father, we went back to the current situation with his boss. As is usually the case, having reprocessed the earlier "Smaller t" trauma produced a "0" in terms of John's level of emotional experience in the current situation.

John was really surprised and greatly relieved. He was able to go back to work, deal with his boss, and when his boss saw that he could no longer intimidate John the way he used to, he stopped ranting at him and chose to bully another more vulnerable attorney instead.

EMDR Follow Up: When John checked in with me several months later, he told me that the results of our work continued to hold. He also said that his self esteem was now higher than it ever had been and his boss told him that he was on track to become a partner, which made John feel very happy.

The above vignette is one brief example that demonstrates how EMDR can work. Everyone's experience of EMDR is unique.

EMDR is an effective treatment for dealing with trauma, and it is usually faster than regular talk therapy.

Getting Help in EMDR Therapy
If you have unresolved trauma, you could benefit from working with an experienced EMDR therapist who is a licensed psychotherapist.

About Me
I am a New York City licensed psychotherapist and EMDR therapist.

I work with individual adults and couples.

I have helped many clients resolve both "Big T" and "Smaller t" trauma.

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.

Workplace Issues: Strategies for Dealing With Malicious Gossip

I came across an interesting article in the New York Times by John Tierney called Can You Believe How Mean Office Gossip Can Be?  It was based on a journal article in the Journal of Contemporary Ethnography. 

Workplace Issues:  Strategies for Dealing With Office Politics and Malicious Gossip

Considering the fact the many of us spend at least eight or more hours in an office and gossip is part of most organizations, this is an important issue to explore.

Years prior to my becoming a psychotherapist, I was a human resource manager. In my prior career. I saw, first hand, the negative effects of gossip, which included undermining and, in some cases, ruining people's career.

Workplace Issues: Strategies for Dealing With Office Politics and Malicious Gossip

People engage in office gossip for all sorts of reasons. Some people, who work in organizations where there are reorganizations or layoffs looming, gossip to deal with the stress of the situation, the lack of information, and to try to give and get information. The problem is that the information is often wrong.

Other people gossip to vent about the boss or top management when they feel disempowered in their work environment. The obvious danger with this is that you could lose your job if the boss finds out that you're talking about him/her. The other problem is that this kind of gossip can undermine your entire office, which could have repercussions in how others, including future prospective employers, see you. They could easily say, "If the boss is a incompetent, everyone under him is probably incompetent too.

Workplace Issues: Strategies for Dealing with Office Politics and Malicious Gossip

Even if you don't lose your job because you're gossiping about the boss, frequent malicious gossip can produce a toxic office environment where the group's dissatisfaction grows, festers, and feeds on itself, reducing morale and making it a very unpleasant place to work.

Some people gossip because they're bored or dissatisfied with their jobs. Others hope to form certain alliances among a particular group of employees while alienating other employees.

Gossiping might seem like a harmless diversion and it might bring about a certain temporary cohesiveness within the group where the gossiping is taking place. But there is usually a certain amount of suspicion within the group, "If he's gossiping about her, he's probably gossiping about me too." And, of course, this is often the case.

One situation that was not explored in the article is when employees purposely start a cycle of gossip as a way to intentionally sabotage an employee. If you happen to be that employee, it can be extremely difficult to combat this form of sabotage because you might not be able to find out who started it and you might not be able to control it due to the covert nature of the gossip.

When you're in a work setting where there's a lot of office gossip, it's hard to avoid. John Tierney's article suggests certain strategies if you happen to be part of a gossipy group and you feel uncomfortable.

One suggestion is to say something positive about the person being maligned. This makes it difficult for others to continue to talk negatively about that person. Another strategy is to change the subject, a subtle suggestion that you're not interested in engaging in this gossip. A third recommendation is that you suggest, in a tactful manner, that you and others get back to work.

Workplace Issues:  Strategies for Dealing with Office Politics and Malicious Gossip

In my opinion, one of the most effective strategies for discouraging office gossip is for top management to encourage employees to come forward with their dissatisfaction.

Now we all know that many managers talk a good game about having an "open door policy," but not all of them mean it. Employees quickly pick up on the disingenuousness of this, and it creates more bad feelings. But if employees see that top management is genuinely concerned and problems are addressed and resolved, this can go a long way towards decreasing office gossip.

But what can you do if the boss is the one who is gossiping to you about his/her colleagues, superiors or your coworkers? This situation is not addressed in the article. This is obviously a very ticklish situation where you may be damned if you do and damned if you don't join in the conversation with your boss.

Tact and diplomacy are essential, and you might suddenly "remember" that important call that you need to make to a client or the report that's due today, making it necessary to excuse yourself. If possible, you might also consider looking for another job before it's your turn to be the object of your boss's disaffection.

Whether we like it or not, gossip is a fact of life in most offices. Men and women both engage in it.

Learning to deal with office gossip requires tact and maturity as you balance your need not to participate with the reality that, for as long as you're in this work environment, you still need to work with the worst offenders of office gossip.

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

I have helped many clients deal with workplace and career issues.

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.

Boredom as a Relapse Trigger

As a psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist in New York City, one of my specialities is working with people who have problems with addictions and codependency. Over the years, I've found that one of the most challenging aspects of overcoming addictive and codependent behavior is overcoming boredom as a relapse trigger.

Overcoming Addiction: Boredom as a Relapse Trigger

What is Boredom?
For most people, feeling bored means that they're doing the same things over and over again and not feeling fulfilled. Life feels dull and monotonous. They feel like they're in a rut and can't get out. Life and relationships might not feel as meaningful when someone is bored.

Why Does Boredom Often Lead to Relapse?
For someone who is accustomed to feeling "high" from drinking, drugging, overspending, overeating, bingeing and purging food, gambling, engaging in sexual addiction, cutting, or getting overly involved in someone else's life drama, trying to live a clean, sober and healthy life might feel unexciting and dull.

When you're used to dealing with your problems by looking for stimulation in unhealthy habits, you might feel a void in your life as you let go of these habits, people you used to engage in these habits with, and former places where you used to go.

At that point, if you haven't developed other healthy habits to take the place of addictive behavior, you are at risk for relapse as you begin to think about stimulative and thrill seeking behavior. It's very tempting to revert back to old habits as you bargain with yourself: "I'll just do this one more time, and then I'll stop" or "I can have one drink. I can control it" or other self deceptive thoughts.

How to Overcome Boredom to Avoid Relapse:
First: Realize that you're not alone. Many people who are struggling with addictions and codependence have faced the same challenge as you have and they have successfully overcome having boredom lead to relapse.

Second: It's important to get out, talk to people who have overcome these problems, and get support. Self help groups like A.A., N.A., Debtors Anon, Al-Anon, Sexual Compulsives Anon, Gamblers Anon, Overeaters Anon and other self help groups are often an excellent source of support (see resource list below at the end of this post).

When you listen to other people talk about how they struggled and overcame boredom as a relapse trigger, you'll often hear aspects of their stories that will resonate with you and help you develop your own ideas about overcoming boredom. Get a sponsor to help you work the Steps and navigate through your difficulties with relapse.

Third: Think about activities and hobbies that you used to enjoy that you might have given up after you began engaging in the addiction of your choice. Maybe you used to like to listen to music before. Or, maybe you liked a particular sport, hobby, or other healthy recreational activity. Often, when people get immersed in addictive behavior, they let go of and forget about activities that they used to enjoy. You can recapture the enjoyment that you used to get from these activities.

Overcoming Boredom to Avoid Relapse

Fourth: Be willing to try new and healthy activities to get out of the rut that you're in. If you're out of shape, consult with your doctor and find out if you're up to exercising at the gym, or taking a yoga or dance class. For most people, walking, at a pace that is healthy and right for you, is often a safe form of exercise. Join a book club where you can clear out the cobwebs from your mind, meet new people, and find other ways to stimulate your mind through new ideas.

Fifth: Get involved by volunteering. There are so many organizations that desperately need help: from soup kitchens for the hungry and homeless to reading and mentoring programs in schools. When you help someone else or make a positive contribution to a worthwhile organization, you feel good about yourself and it helps to build your self-esteem. Even if you have a tendency towards codependence, you can learn to help others in a healthy way.

If you find that you're still struggling with boredom as a relapse trigger, you could benefit from working with a licensed mental health professional who has an expertise in helping people overcome addictive and codependent behavior.

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

I work with individual adults and couples.

I have helped many clients overcome addictive and codependent behavior.

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

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

Using the Affect Bridge to Heal Old Emotional Wounds

Old emotional wounds often get triggered in intimate relationships. Most of these unresolved feelings are core issues that originated in childhood and usually involve one or both of your parents or caregivers. These old wounds might involve feelings of abandonment, betrayal, feeling unloved, feeling abused or neglected, feeling like you're "not good enough" and other similar feelings.

Bridging Back to Heal Old Emotional Wounds

These feelings can come up unexpectedly, whether your partner behaves like one of your parents or not. So, for instance, to others, who might be more objective than you, your partner's behavior might seem like a minor slight or a minor empathic failure.

But if you have an early history of emotional neglect or abuse and you get triggered by a current dynamic between you and your partner, you would probably experience this slight or empathic failure as being much more intense.

This is because you're not only experiencing the current situation--you're also feeling the old emotional wound that is getting triggered, so you're experiencing both together. This adds an emotional charge to the current situation, and when you feel hurt, it's often hard to distinguish the old emotional wound from the current situation.

Unresolved wounds have a way of remaining just beneath the emotional surface where you might not be aware of them most of the time. But under certain circumstances, when you feel hurt by your partner, these old wounds come alive, as if they just happened yesterday, even though they might have occurred many years ago.

When you see a competent hypnotherapist, who is a licensed mental health professional, clinical hypnosis is often very effective in helping to heal these emotional wounds. In order to heal, it's important to be able to deal with the original emotional wound that is being triggered. There is a technique called the Affect Bridge and when it is performed by a competent hypnotherapist, it often helps to heal those old wounds.

Clinical Hypnosis and the Affect Bridge
As a hypnotherapist, when I use the Affect Bridge technique, I prepare clients beforehand by making sure that they have the internal resources that they need to feel safe, calm and emotionally protected. Internal resources is another term for coping skills.

Clinical Hypnosis and the Affect Bridge

The following vignette is a composite based on many clinical cases and demonstrates the use of the Affect Bridge in clinical hypnosis treatment:

Alan:
Alan and his wife were married for five years. They had a good and stable relationship most of the time. However, whenever Alan felt that his wife, Evelyn, was distracted, not listening to him, or not understanding him, he became very angry and upset. An hour or two later, Alan usually realized that he over reacted and he would feel very guilty and remorseful.

At first, Evelyn was understanding. She accepted his apology and forgave him. But, after a while, as this continued to happen, she got annoyed. Each time that it happened, Evelyn tried to remind Alan about how he over reacted in the past to similar situations between them and how this was another one of those times. But, when Alan was in this state, he was unreachable and he could not hear what Evelyn was saying.

When they came in as a couple, Alan admitted that he would over react for relatively minor incidents with his wife. He explained how, at the time, it felt like she was ignoring him or not hearing him, and this felt intolerable to him in that moment. He said he felt like he was "going crazy" because, when he was upset with his wife, he couldn't hold onto the fact that this was another situation where he was over reacting to her--no matter how many times it happened.

As I explored Alan's history, he talked about having an alcoholic mother who had a long history of drinking heavily and then passing out on the couch, leaving Alan and his younger brother to fend for themselves. His father had left the family when Alan was three, so there were no other adults in the household.

During the preparatory phase of our work together, I asked Alan to choose protective figures that he could visualize. I told him that they could either be real people that he knew or, if there was no one, he could visualize a fictional character from a book, movie, or TV program. Alan chose to visualize his first grade teacher and his Little League coach as his protectors for the clinical hypnosis work we were about to do. I suggested to Alan that he picture these protective figures as being with him as we began our hypnosis work together, which he was able to do.

Using the Affect Bridge technique, I asked Alan to focus on the feeling that he had when he felt that his wife was not paying attention to him or not hearing or understanding him. He said he felt it like a tense, heavy feeling in his stomach. Then, I asked him to go back in his mind and remember the first time that he felt this way. Alan remembered many incidents with his mother when she didn't hear him because she was in a drunken stupor.

His earliest memory of these feelings was when he was four years old. As usual, his mother was passed out on the couch as a result of a day of heavy drinking. Alan was trying to cook a meal for himself and his younger brother when his pajama sleeve caught on fire. He became very frightened and called out to his mother to help him, but she didn't hear him. Although he was very frightened, he was able to turn off the gas by himself, but not before he sustained a second degree burn on his arm. The neighbor who lived downstairs heard his cries and came running upstairs to help him. His mother never roused herself from her sleep.

Revisiting this memory during clinical hypnosis sessions and picturing his protective figures with him and helping him at that time had a healing effect on Alan. Although Alan knew what had actually happened when he was four and he got burned, after a while, being able to re-experience this memory with his protective figures allowed him to heal this old wound.

He felt safe, protected and nurtured by the protective figures that he visualized. As a result, after doing this hypnotherapy work for a while, he was no longer triggered when his wife either didn't hear him or misunderstood what he said. It was not just a matter that Alan realized this in a logical way, he actually felt healed and the old trauma was resolved.

Getting Help With Clinical Hypnosis
Clinical hypnosis is a safe and effective form of treatment when performed by a competent hypnotherapist with advanced training.

If you think you're becoming triggered by unresolved trauma, and regular talk therapy hasn't helped to resolve these issues, you might benefit from seeing a hypnotherapist for clinical hypnosis.

To find out more about clinical hypnosis, you can visit the web site of the professional organization, the American Society of Clinical Hypnosis also known as ASCH.

I am a licensed psychotherapist and hypnotherapist in NYC. I have helped many clients work through trauma.

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: Romantic Reconnections

Many people are reconnecting through social media with former high school and college sweethearts after 10, 15, 20 years or more of having no contact.

As a psychotherapist in New York City, I've been seeing more and more people who are reconnecting through these sites and falling in love all over again. The excitement of these reconnections is often very compelling. Often, these are long lost love connections from a happier time when both people were much younger and when there was much promise in their lives.

Relationships: Romantic Reconnections

It's exciting to find out what the other person has been doing all these years later and to tell your story. It can also be a heady experience to find out that this person has been thinking about you all this time, wondering what you're doing, and thinking about your former relationship. It can also be uplifting to remember your youthful self at that time and cause you to remember a more passionate and optimistic part of yourself that you might not have been in touch with for a long time. There's a certain romantic nostalgia about these romantic reconnections.

Of the many stories that I've heard, many times, these reconnections seem to work out well. However, there are times when, after the initial reconnection, problems begin to emerge and these couples come into couples counseling to try to work out these problems.

Based on what I've seen, one of the main problems seem to be around expectations: When you remember how you and your old love were years ago, often, there are expectations that the two of you will be that same way again, and when this doesn't happen, it's disappointing.

Trying to recapture the love that you and your former partner had all those years ago in just the same way as you had it back then, when you were both young and the world seemed like it was going to be your oyster, can be tricky.

It can be fraught with disappointment if, as you're getting swept up in this romantic reconnection, you forget that time and circumstances have probably changed a lot of things for you and for your old love. Aside from the more superficial changes, like weight gain and wrinkles, along the way, each of you has had many experiences that have probably changed you and your outlook on life to a certain extent.

If you don't take these changes about yourself and your former love into account, you're probably setting yourself up for a fall. Also, you might be faced with whatever unresolved issues thee may have been from the past.

The following vignette, which is a composite of various cases, is an example of a romantic reconnection that started with a lot of excitement and then began to go wrong:

Sally and George:
Sally and George were in a relationship during their last two years of college. At the time, they were very in love and talked about getting married. All of their friends considered them to be "the perfect couple." However, towards the end of their last semester in college, they had a big argument about George joining his father's manufacturing business rather than pursuing his dream to be a teacher, which is all that he talked about while in college--making a difference for young students and helping to shape young minds.

Sally couldn't believe that George would give up his dream and give in to his father's pressure. She was furious. Unlike many teens and young people in their early 20s, George had never gone against his parent's wishes and he didn't know how to tell his father "no."

Sally also didn't want to move to Chicago where George's parents lived. All along, she and George had talked about either living in New York, where she was from, or Boston, a city that they both liked. By the end of the school year, both of them were heart broken about this argument, but neither of them saw a compromise, so they broke up.

Sally moved back to New York. She found a teaching job and an apartment with friends. And George moved back in with his parents and joined his father's firm as an assistant manager.

Neither Sally nor George had any contact again--until 20 years later when George found Sally's name on Facebook. Initially, when they reconnected by email and then by phone, they were both very excited. Both of them were now divorced and available.

Neither of them had children. Sally had been teaching for many years, and George inherited his father's business, sold it for a large profit, and eventually returned to his initial chosen profession, teaching. They both flew back and forth on weekends and holidays to see each other and they were caught up in a whirlwind romance.

After the first six months, George moved to NYC and they moved in together. He obtained a teaching job and things seemed to be going fine.

 However, as the initial excitement began to wear off, they each felt that "something was missing." Neither of them could put their finger on what it was, but they each began to feel vaguely disappointed. They began bickering about little things, and this was even more disappointing.

One day, in the middle of an argument, George said to Sally, "What happened to you? You're not the girl that I knew in college." This was a turning point in their relationship. George regretted saying these words as soon as they left his mouth, and Sally was very hurt. They both still loved each other, but they recognized that their relationship was spiraling down and they didn't know what to do. They decided that, to try to save their relationship, they needed to go to couples counseling.

After several sessions of couples counseling, they realized that they reentered their relationship hoping to find the same people that they were when they were in college but, in reality, both of them had changed somewhat.

They were no longer the idealistic young people that they were and time, their divorces, and other life experiences had changed them. Also, when they broke up in college and all the years since, they were left with the romantic fantasy of what it could have been like if they had stayed together all those years ago.

Now, 20 years later, they were actually living the reality of that experience. And while their experiences together now were generally good, the reality of their life together couldn't live up to the romantic fantasies that had built up in their minds over the years.

Through couples counseling, gradually, Sally and George learned to work out their differences and to let go of unrealistic expectations. They also had to work through the initial disappointment that lead to their break up in college. Sally realized that she had been immature about it all those years ago, and George realized that he wasn't assertive enough to be his own person back then. Within a few months, they became more realistic about their expectations of themselves and each other and their love for each other matured, deepened and reflected who they are now, as individuals as well as a couple.

It's wonderful that we now have ways of reconnecting with old friends and loved ones through the Web. It has provided us with opportunities that we didn't have before for reconnecting with people who were once important in our lives. When these reconnections are romantic, they present special opportunities and some challenges.

Getting Help in Therapy
If you and your partner have reconnected romantically after many years and you're facing certain challenges in your relationship, you could benefit from couples counseling with a licensed mental health professional.

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

I have helped many couples who have reconnected romantically to have more fulfilling relationships.

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

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

Clinical Hypnosis and the Mind-Body Connection

During the last 15-20 years mental health and medical experts have become increasingly aware of the strong connection between our emotions and our physical health and well-being. 

Clinical Hypnosis and the Mind-Body Connection

As medical experts become more knowledgeable about the mind-body connection, clients with certain physical problems that were once treated by doctors solely as medical disorders are now being referred to licensed mental health professionals with an expertise in clinical hypnosis (also known as hypnotherapy) due to a more sophisticated understanding of how our emotions affect us physically and the effectiveness of clinical hypnosis.

The following vignettes, which are composites of actual cases, with all identifying information changed to protect confidentiality, illustrate the connection between medical problems, the mind-body connection, and the effectiveness of clinical hypnosis:

Migraines and other Headaches:
When Lisa began having severe, debilitating headaches, she went to her medical doctor for help. She explained to her doctor how her headaches got so bad at times that she was unable to get out of bed. This resulted in significant time off from work as well as her husband having to take over most of the household responsibilities. These headaches were also starting to make her feel depressed and anxious. She tried most of the over-the-counter medications, to no avail.

When her medical doctor could not find any physical reason for her headaches, he referred her to a neurologist who conducted a battery of tests and tried various prescription medications to alleviate Lisa's headaches. But her neurologist ruled out any physical reason for her headaches and, not only did the medications not work, but they produced many annoying side effects.

As a result, the neurologist consulted with the medical doctor and they both agreed that whatever was causing Lisa's headaches had its origins in some emotional issue. They both concluded that Lisa could benefit from seeing a hypnotherapist to get rid of her headaches. Since Lisa knew nothing about hypnotherapy, at first, she was stunned and somewhat leery of their recommendation.

Clinical Hypnosis and the Mind-Body Connection

But her primary care doctor explained that many physical symptoms are derived from emotional issues, and he took the time to explain the mind-body connection of many different medical issues. He also explained the difference between stage hypnosis and clinical hypnosis (also known as hypnotherapy). He told her that when hypnotherapy is performed by a licensed mental health professional who is a trained hypnotherapist, it is an effective and well-respected form of treatment. He explained how Lisa would be in a relaxed state during hypnosis and in control at all times, maintain a dual awareness of the here-and-now as well as whatever she and the hypnotherapist were working on.

Lisa trusted her primary care physician, and she accepted his referral to a local hypnotherapist. She was a little anxious at first, but the hypnotherapist helped to set her mind at ease by patiently answering all of her questions during the initial consultation. Lisa was amazed that, within three sessions, her headaches were gone. Even more amazing to her, the hypnotherapist taught her how to do self hypnosis so that she could proactively manage her stress levels and prevent further occurrences of her debilitating headaches. Her hypnotherapist followed up with her in a month and then again in three months, but there was no recurrence of Lisa's headaches. At this point, it has been over three years since Lisa has had a headache. She continues to use self hypnosis to manage her stress. She no longer feels depressed or anxious, and she is grateful to be fully engaged in her life again.

Back Pain:
Robert woke up every morning with severe back pain in his lower back. When his primary care physician, his chiropractor, and a physical therapist could not find any medical reason for his back pain and medication only provided temporary relief, they all agreed that the origin of Robert's back pain probably had an emotional connection. They also all agreed that Robert could benefit from seeing a hypnotherapist.

Robert didn't know anything about clinical hypnosis and, even with their detailed explanations and the literature that they provided to him, Robert didn't feel comfortable seeing a hypnotherapist. He began taking painkillers, which helped for a while. But he soon found that he had to take higher and higher doses to get temporary relief from his back pain.

Clinical Hypnosis and the Mind-Body Connection

His primary care doctor warned him that the painkillers were addictive and Robert needed to be careful not to become addicted to the drugs. So, Robert stopped taking the medication and he decided to tough it out for a while. But after a week, he could barely get out of bed, he could no longer have sex with his wife, and he was falling behind in his work because he could hardly sit still at his computer, due to his excruciating back pain.

Reluctantly, he asked his doctor for a referral to a hypnotherapist. Robert approached his initial consultation with the hypnotherapist with a lot of skepticism, but he was desperate for a solution to his back pain so he listened attentively and tried to keep an open mind as the hypnotherapist explained the mind-body connection. The hypnotherapist answered all of his questions and concerns. Robert was especially fearful that he would lose control during the hypnotic state, and being in control at all times was very important to him.

To help ease Robert's mind, with Robert's permission, the hypnotherapist helped Robert to get into a relaxing, hypnotic state. Robert was amazed--this was the most relaxed that he had ever felt in his life. He was aware of the ticking clock in the office, the sounds coming from the street outside the office, and he felt that, if he wanted to, he could get up and leave at any time. It was just as the hypnotherapist had said--he was able to maintain a dual awareness of everything around him at the same time that he was enjoying this relaxed state. He was even more amazed when he returned to his usual state that he was only in this hypnotic state for five minutes. His experience of the hypnotic state was that it felt timeless.

Having had this relaxing, positive experience of clinical hypnosis, Robert was now ready to have the hypnotherapist use hypnosis to treat him for his back pain. Within five session, Robert was pain free. The hypnotherapist also taught Robert how to control his stress levels on his own through self hypnosis. A follow up session after one month revealed that Robert had no new occurrence of back pain. And after two years, Robert continued to report to his primary care physician that he continued to have no back pain.

These vignettes are just two examples of many that demonstrate the mind-body connection and the effectiveness of clinical hypnosis for pain management. Clinical hypnosis is also an effective tool for smoking cessation (usually within 3-5 sessions).

If you are suffering with a physical problem and your doctor cannot find a medical cause for your problem or if you have decided that you want to stop smoking, you could benefit from clinical hypnosis.

Getting Help - How To Choose A Hypnotherapist:
If you're considering clinical hypnosis, it's important to make sure that you see a licensed mental health professional who is a trained hypnotherapist and not a "hypnotist." There are important distinctions between a hypnotherapist and a hypnotist.

A hypnotist might have learned various hypnotic techniques, but he or she is not a therapist, not licensed, and will not have any mental health training. A hypnotherapist is a licensed mental health professional who understands the mind-body connection and who has been trained under the guidelines of a professional organization like the American Society of Clinical Hypnosis (ASCH). For more details, you can visit the ASCH web site: http://www.asch.net/.

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

To find our 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.

Developing a Different Perspective Through Reframing

Often, the way that we respond to a situation has a lot to do with our particular perspective and attitude about it. One way to help yourself to look at certain situations or problems is to "reframe" them for yourself. By reframing, I mean looking at the same situation from a different angle to come up with other creative points of view.

Developing a Different Perspective Through Reframing

Here are a few vignettes that are examples of reframing:

Peg:
Whenever Peg met Susan for lunch, she would feel so annoyed because Susan was habitually 15 minutes late. Peg would sit and fume, thinking about how busy she was and all the things that she needed to do, and here she was sitting and waiting for Susan.

One the one hand, she felt like she was wasting her time waiting for Susan when she could be taking care of some of these other things. On the other hand, she also liked Susan very much and she didn't want to give up their lunches together because of Susan's problem with lateness.

One day, as she hesitated to pick up the phone to invite Susan to a lunch that she was sure Susan would be late for by 15 minutes, she decided that she needed to find another way to deal with this problem. She knew that she didn't have the power to change Susan, nor did she want to.

So, she thought about what change she could make, without giving up their friendship, where she could feel that her needs were being met. That's when an idea popped into her head: Instead of sitting and fuming about all the things that she needed to do, she could bring some of those things along with her and take care of them while she waited for Susan.

Developing a Different Perspective Through Reframing

It seemed so simple that Peg couldn't believe she had not thought of this before. So, the next time that she met Susan, Peg brought her checkbook and some of her bills with her as well as her Blackberry to respond to email. When Susan arrived 15 minutes late, as usual, Peg felt that she had taken care of what she needed to do for herself and she could now relax and enjoy Susan's company instead of being distracted with her own annoyance and impatience. What Peg did was take a situation that was normally annoying to her and reframed it for herself into a time when she could do some things for herself.

Linda:
Linda was a receptionist in a small firm. She had worked there for many years. One of her duties was to keep the daily appointment calendar listing clients who were coming to visit managers. She had never become accustomed to using the computer to keep track of these appointments, relying on a basic appointment book instead.

Linda was extremely meticulous about this appointment book. Her supervisor thought she was meticulous to a fault. In fact, Linda was a perfectionist. She hated it whenever anyone crossed out names in the book or when there was any kind of messiness.

She would sometimes scold the managers if they crossed out anything in the book, but she refused to write in pencil. She had very set ideas about what was appropriate and what was not. Her supervisor spoke to her a few times about trying to be more flexible in her approach and warned her that if she continued to berate the managers, she would be written up.

Linda decided that she needed to change her attitude about this, but she wasn't sure how to do this. Then, one day, one of the managers approached her desk and told her that one of the clients cancelled his appointment. Linda noticed that her supervisor was standing nearby watching her reaction as this manager crossed out the client's name in the appointment book. Linda held her tongue.

After the manager walked away, Linda's supervisor approached her and suggested to her that this could be a chance for Linda to reframe this situation for herself: It could be an opportunity to practice letting go of her perfectionism. Linda thought about it for a few minutes and the more she thought about it, the more she liked her supervisor's suggestion: Instead of getting angry and frustrated, she could use this situation to practice. After a while, Linda was able to reframe for herself what was once an annoyance as a challenge to change her attitude and, over time and with practice, her attitude did change.

Reframing: An Opportunity For a Positive, Creative Response
The vignettes above are simple examples of reframing. I'm sure you can think of many others where you can challenge yourself to reframe what is usually an annoyance into an opportunity to have a more positive, creative response:

• Getting stuck in traffic
• Dealing with a rude sales clerk
• Waiting for a train that is late
• Being placed on "hold" for a long time
• Missing a flight

With practice, reframing becomes easier to do. When we reframe our experiences, we use our creativity to look at the same situation in a different way. Reframing helps us to deal with stressful situations in a more effective way. Often, we can find a lesson that can be learned from a particular problem. The facts of the situation remain the same, but we reframe the issue for ourselves so that we develop a new perspective about it.

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

I work with individual adults and couples.

I have helped many clients learn to develop new perspectives to old problems through reframing.

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

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