Leading a Double Life as the Other Woman or Other Man in an Affair

In prior posts, I've discussed affairs from the point of view of the people in the primary relationship, where one of the people in the relationship was having an affair, and how psychotherapy and couples/marriage counseling could help in these situations. In this post, I'd like to focus on the person who is the "other woman" or "other man" in the affair, some of the possible emotional effects of leading a double life in an affair, and how individual psychotherapy can help in these situations.

Leading a Double Life as the Other Woman or Other Man

Most People Begin Psychotherapy When the Affair and Leading a Double Life Becomes Too Painful:
As a psychotherapist in NYC, over the years, I've worked with many individuals who were leading double lives, having affairs with people who were in primary relationships with someone else.

Being the "Other Man" in an Affair

Usually, clients who are the "other woman" or the "other man" begin psychotherapy with me when they've come to a point where they're either trying to decide whether or not to end the affair or being in the love triangle and leading a double life has become too painful for them to endure, but they feel "stuck."

The Emotional Effects of Being the "Other Woman" or "Other Man" and Leading a Double Life in an Affair:
Being involved in a love triangle, from the perspective of the "other woman" or the "other man," can be very lonely. Often, the person who is in this situation feels too ashamed to talk to friends or family members about it because he or she fears their judgment or condemnation. So, very often, the affair is kept a secret and this person endures the emotional pain, including self condemnation, by him or herself. This is a difficult and lonely place to be.

Whereas the beginning of the affair might have started out as being mostly sexual and fun, if romantic feelings develop and you begin to feel attached to someone who is in a primary relationship with someone else, the feelings often turn to ones of hurt, longing, fear, anger, resentment and shame.

Expectations Change:
At the beginning of the affair, from the point of view of the "other woman" or "other man," there might not have been any expectations, but once a more serious attachment forms, this often changes. The longing and loneliness for the other person, especially on certain days, like weekends, holidays and birthdays, when the person in the primary relationship is not around, can be intense. It can feel overwhelming to deal with this by yourself.

The following vignette is a composite of various clients who were involved in affairs with someone who was in a primary relationship with someone else. All identifying information has been changed to protect confidentiality:

Mary
When Mary came to see me for individual psychotherapy, she had been involved in an affair with her graduate school professor, Dan, for almost two years. She was leading a double life, and she was feeling very lonely, sad, ashamed, angry with herself, angry with him, and resentful.

She knew he was married when she first got involved with him but, at the time, she felt swept away by his good looks, charismatic personality, intelligence, and all the attention that he was giving her. He made her feel "special." She had no prior history of getting involved in affairs, and she felt confused about the situation, confused about herself, and confused about Dan.

The affair began while she was helping Dan with a research project and they were spending many hours alone together after class. At first, Mary was satisfied just to spend time with him working on the research project, often going back to her place for hours of passionate sex, and allowing him to go back to his wife and children in the evenings. During that stage of the affair, she felt special, beautiful and sexy, and she was flattered by his attention.

But, as time went by, they both developed strong romantic feelings for each other, and then things changed. Mary began to resent that he left her for his wife after they made love. She wanted him to stay, but he didn't want his wife to suspect that he was having an affair, and he definitely didn't want to leave his wife and children.

At that point, what was once a fun affair for Mary turned lonely and sad. She began to resent being "the other woman" in his life and she wanted him to leave his wife to be with her. But time after time when Mary demanded more of his time and attention, although he said he loved her very much, he told Mary that he had no intention of leaving his wife.

Mary couldn't understand why, if he loved her (and she felt sure that he did), he wouldn't leave his wife to be with her. Before she began psychotherapy, she had a big "blind spot" about the fact that this man also really loved his wife and the life that he had with her, even though he was cheating on her.

Prior to therapy, Mary ruminated about this constantly and couldn't come up with any answers for herself, and Dan seemed just as confused. At that point, she was leading this secret double life, and she had no one to talk to about it because she felt too ashamed about it. So she continued to live a double life, kept the secret of the affair and her feelings about it to herself, which made it even more emotionally painful.

At the point when Mary began psychotherapy, she was considering giving Dan an ultimatum: "Either leave your wife and be with me or let's end this affair." But she had a lot of mixed feelings about this, and she couldn't make up her mind about it.

On the one hand, she felt she couldn't endure the feelings of sadness, loneliness, anger, fear and shame any more. It was beginning to feel too overwhelming for her, and it was taking up a lot of her time and emotional energy. Leading this double life, she was starting to isolate from friends and family because of the affair and her feelings about being involved in a love triangle. And it was also hard for her to concentrate on her studies.

Worst of all, Mary was feeling very bad about herself. She was plagued by self doubt, anger and humiliation. And, whereas initially, she felt special, attractive and sexy when she was with Dan, now she felt that she wasn't "good enough" because he wouldn't leave his wife.

This also triggered many old emotional wounds of not feeling "good enough" with her parents when she was a child. Her constant thought was, "If I were good enough, Dan would leave his wife for me, but I'm not. There must be something wrong with me. "

On the other hand, Mary felt that life without Dan at all would be unbearable. She thought, "Maybe I should just try harder to enjoy the time we have together and make him see that he really loves me more." But, at this stage, their times together were not so enjoyable. Mary and Dan were spending a lot of time arguing and crying together. He told her that he didn't want to hurt, he didn't want to hurt his wife, and he didn't want to lose either one of them--he wanted them both. He also didn't know what to do.

Initially, our work focused on helping Mary to develop better coping skills and to increase her support network. Her sleep and appetite were poor and she often felt angry, sad and irritable. As therapy progressed, she began to spend more time engaging in self care, taking yoga classes, learning to meditate, and going to the gym. Her sleep and appetite improved. Also, she began talking to her friends about what was going on.

Although, at first, she feared that her friends might judge her harshly, when we talked about it in our psychotherapy sessions together and she thought about it more realistically, she realized that her friends cared about her a lot and wouldn't judge her. And this turned out to be true.

Her friends were surprised, but they were compassionate and empathetic towards Mary. They told Mary that they wished she had come to them before.  They also helped Mary to remember "who she was" before Mary felt sad and ashamed about the affair. Mary's friends saw what I also saw: An intelligent, vibrant, outgoing, attractive woman who had a lot going for her.

Talking about the affair in our psychotherapy sessions, letting her friends know about the affair and getting so much emotional support took some of the pressure off of Mary. She still felt all of her difficult feelings, but she wasn't alone with these feelings any more, and she didn't feel she was leading such a double life any more.

After several psychotherapy sessions, Mary decided that the pain of being the "other woman" was more than she could stand and worse than being without Dan.

She began to understand that it's possible for someone (like Dan) to love two people at the same time, and this was probably what Dan was feeling. Increasingly, she also allowed herself to feel what it might be like to be Dan's wife under these circumstances. She wondered, even if he left his wife and married her, if he would be unfaithful to her as well. Whereas before she would push down any feelings of compassion for Dan's wife, she now felt more than just guilty--she felt remorse. She felt that the situation was unfair to everyone involved, including Dan's wife and his children.

Mary was also at a point where she was feeling better able to cope with the loss of the relationship with Dan. She knew it would be very painful, but she also knew that she had the support of our psychotherapy sessions as well as the love and support of her best friend. So, when they saw each other again, instead of slipping into their usual routine of going back to her apartment to make love, she told Dan that, as much as she loved him and she knew that he loved her, she thought it was best for them to end their affair. They both cried about ending their relationship, but Dan agreed that it would be for the best.

Even though she felt resolved to end their relationship, Mary was surprised that, when she did it, there was still a part of her that hoped Dan would tell her that he loved her too much to leave her. But he didn't. He said he also felt that it was too hard for him to go on hurting Mary and too hard to continue to cheat on his wife and risk hurting her. So, since the research project was over and Mary was about to graduate, they decided to end all contact.

The following weeks and months were difficult. Mary was tempted to call Dan many times and tell him that she missed him and wanted to see him, but she didn't. She continued to come to her psychotherapy sessions with me, talk to her best friend and, even though many times she didn't feel like, she began seeing old friends again and making new ones. The thought of never seeing Dan again was very hard for her so, through our work together, she learned to take it "one day at a time." Thinking about not seeing Dan for a day was a lot easier than thinking about never seeing him again. It was a process.

But, as it turned out, Mary did see Dan again--but not in the way that she would have ever liked to see him: She was leaving the university one day when she saw Dan waving to a woman who was in a car with two small children. Dan didn't see Mary, but Mary watched from the sidelines, feeling sad and bitter, as Dan kissed and hugged his wife and greeted his children. Dan looked so happy. Before seeing Dan on that day, Mary knew that he loved his wife and children, but seeing it made Mary realize it on a much deeper level: This was Dan's life, and Mary would never be a part of it. It hit home in a way that it never had before.

Mary went home and cried but, afterwards, she felt that something had lifted. The last vestiges of any hope that she might have had that, somehow or some way, maybe she and Dan would get back together again in the future were gone. She was sad, but she also felt free. Mary and I continued to work on the emotional aftermath of the affair. Rather than condemning herself, she began to understand, on a deep emotional level, the dynamics involved and the feelings that had been triggered in this affair from her family history.

Several months later, Mary began dating another man, and she fell in love. She realized then that having someone who was available and who cared about her exclusively was so much more satisfying than leading a double life in an affair. A couple of years later, they got married. They shared a life together with friends and both of their families, and Mary was happy.

Not all affairs for the "other woman" or "other man" end this well. Some people are involved in love triangles, leading double lives, for years, and they find it too difficult to extricate themselves from these relationships. After years have gone by and they regret the time that they have lost and possible missed opportunities to be happy with other romantic partners who are actually available, they have many regrets and often wish they had chosen more emotionally fulfilling lives for themselves.

Getting Help in Therapy
If you find yourself involved in a love triangle where you are the "other woman" or "other man," leading a double life, you could benefit from seeking the help and support of psychotherapy with a licensed mental health professional.

Get Help in Therapy

Most psychotherapists won't give you advice about what to do--that's not their job. But a licensed mental health professional can help you to figure out what you want to do if you are in this type of untenable situation. You might feel that you can never leave your current situation and, at the same time, it feels too hard to stay. But many other people, who were faced with your situation, have been able to resolve their problems in psychotherapy with a qualified therapist.

About Me

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

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

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

Relationships: Is Your Partner Stuck in a Codependent Relationship with An Ex?

Codependency and Problems with Letting Go of the Ex Are Not Unusual:

Is Your Partner Stuck in a Codependent Relationship with His Ex?

As a psychotherapist in New York City who sees individuals and couples with relationship problems, this is a problem that I hear about often: The client is in a relationship with a person who is wonderful in every other way, except that they still maintain regular contact with a former romantic partner, who is dependent upon them, and this creates problems in the current relationship (see my article: Are You In a Codependent Relationship With Your Ex?).

The dependence is often an emotional dependence or it can be a dependence related to basic every day things. But the point is that the ex still relies heavily on the partner, who is reluctant to set boundaries with their ex.

This can be a thorny issue to contend with and often leads to hurt feelings and, in some cases, the breakup of the current relationship.

When there are Children Involved:
Of course, there are times when this problem is unavoidable--specifically, when there are children involved. 

If you begin a relationship with someone who has children from a former relationship, you know (although you might not like it) that your partner must talk to his ex about matters relating to the children.

This is what a responsible parent does, and it requires a good dose of understanding, compassion and patience on your part to deal with this situation. 

It helps a lot if you feel secure in your relationship and you know that you can trust your partner to maintain appropriate boundaries with their ex, basing their contact solely on the children's welfare without blurring the lines.

This is a dynamic that I help individuals and couples with in individual psychotherapy and couples counseling. These are issues that people deal with in blended families, but that's not the focus of this particular posting.

How the Former Relationship Affects the Current Relationship:
The particular dynamic that I'm addressing has more to do with someone who leaves his relationship (where there are no children), enters into a new romantic relationship but, for whatever reason, he finds it extremely difficult to sever his ties with his former girlfriend or wife.

If you're in a new relationship with someone (whether it's with a boyfriend or a girlfriend) who can't or won't let go of his former partner and it's affecting your relationship, I don't need to tell you that you're in a challenging situation.

I'm not even talking about situations where there is actual infidelity going on with the former partner. I'm focusing on the situation where your partner still makes and receives calls to his ex, still gets together with her (without you), and where this interferes with your relationship.

I know that there are situations where maintaining contact with ex partners doesn't interfere with the current relationships. I've had clients who divorce, both people remarry and maintain friendships with their ex-husbands and ex-wives.

Not only is it not a problem, but the couples enjoy going out together, they vacation together, and they value the friendship. The boundaries are clear, and it isn't a problem for anyone.

I'm mostly referring to situations where, for all intents and purposes, the prior romantic relationship has ended, but the two people who were involved decide to try to maintain a friendship. So, for example, in this type of situation, you begin a new relationship and you find that your boyfriend is still very focused on his ex.

 Maybe they've ended the romantic and sexual aspects of their relationship, but (even though they might not admit it) they're still very emotionally dependent upon each other: He still feels that he must have her advice before he makes any major decisions, she still calls him frequently to help her with her problems, and so on. And if it happens frequently enough and it starts to impact your relationship, there you are, feeling left out and, possibly, feeling like you're having an affair with your own boyfriend.

Feelings Don't Always End When the Former Relationship Ends:
Just because two people have broken up doesn't mean that there might not still be strong emotional feelings between them. It's usually better to know about this before you enter a new relationship with someone. Then, you have the option of deciding whether you can handle a relationship with someone who still has strong emotional ties with his or her ex.

As I mentioned earlier, for some people, it's not a problem because there is a recognition that the girlfriend or wife in the new relationship is primary and, usually, when this type of situation works out well, the new girlfriend is included in any plans and it's clear that the former romantic relationship has developed into a real friendship and it's not a threat to the new relationship.

 Anyway, the point is that the end of a relationship doesn't necessarily mean the end of feelings. And if your boyfriend (or girlfriend) is unwilling and/or unable to be clear about whether you or the ex is primary, that's when problems develop.

The following vignette, which is a composite of many clients' stories over the years with all identifying information changed, is an example of the type of problem that I'm addressing:

Susan and John
When Susan met John, he had broken off his relationship with Jane about six months before. Susan and John began dating and they hit it off right away. They both felt a strong romantic connection that was different from anything either of them had experienced before. Their relationship seemed ideal--with the exception of one thing: He still maintained frequent contact with Jane.

When Your Boyfriend is Stuck in a Codependent Relationship with His Ex

John was very upfront from the start that he and Jane wanted to remain friends. They had been together for five years, and they still cared about each other, even though they weren't romantic or sexual any more. At first, since everything else seemed to be going so well, Susan told herself that it was admirable that John and Jane were able to maintain a friendship. But, over time, she began to resent John's frequent contact with Jane, especially as it began to interfere with her relationship with John. It seemed that things were not quite what they appeared to be at first. Susan never felt that John was cheating on her, per se. But she sensed that now that Jane knew that John was seeing someone new, Jane called John more frequently and seemed to depend on him more.

Whether it involved household repairs, late night talks about how lonely she felt or about her personal problems or wanting to get together with John (without Susan), more and more, Susan began to feel that Jane was taking up a lot more time than Susan felt comfortable with, and she was resenting it. Susan sensed that Jane still wanted to maintain an emotional hold on John, even though he was in a new relationship, and she sensed something manipulative in the way that Jane played on John's feelings of guilt for having ended the relationship with Jane. She also sensed that, for whatever reason, John was caught up in this dynamic.

When Susan talked to John about this, he responded by trying to reassure Susan that nothing romantic was going on between him and Jane and Susan had nothing to worry about. He seemed unable to see how much time Jane was taking up and how this affected his new relationship with Susan.

For a while, Susan tried to be understanding. She loved John, she trusted him, but she also had a bad feeling about the dynamic between John and Jane. Then, one night, John was staying over with Susan and they were starting to be intimate. It was close to 11 PM when John received a call on his cell phone from Jane. Susan asked John not to take the call, but he gave her a pained look and said that if Jane was calling at this time, it must be important. He asked Susan to be understanding, and he took the call. From her side of the bed, Susan could hear Jane sobbing on the other end. Susan felt the now-familiar anger and resentment welling up in her. John could see that Susan was getting annoyed, but he gave her a helpless shrug, as if to say, "I can't abandon Jane. She needs me" and took the call in the other room.

A half hour later, when John came back into the bedroom, Susan pretended to be sleeping. She felt too hurt and angry to talk to John, and she didn't want to have a late night argument with him. So, they each slept on either side of the bed and feelings were tense the next morning before they each left for work.

This was the situation when Susan and John began coming for couples counseling. Susan felt that she was in a terrible dilemma--she loved John and she knew that he loved her, but she couldn't tolerate how his friendship with Jane was affecting their relationship. For his own reasons, having to do with his history with a dependent mother and his complicated relationship with Jane, John was unwilling to give up his friendship with Jane.

 He loved Susan, he didn't want to hurt her, and he didn't want to ruin the relationship, but he felt tangled in a strong emotional web with Jane, and he said he couldn't let go of his friendship with her or even set limits with her constant emotional demands. He had an intellectual understanding that he was in a dysfunctional and codependent relationship with Jane, but he didn't know what to do.

It was a very sad and painful situation for both Susan and John. John began his own individual psychotherapy to deal with his family history which was a big part of the problem. Over time, he began to see that each time that Jane called in crisis, he felt emotionally triggered in the same way that he felt with his mother who had been overly dependent on him when he was a child. In many ways, John was "primed" for the codependent situation with Jane due to his family history, and this was primarily why he had such a hard time letting go of Jane or even setting limits with her.

As John began to work through those earlier issues, he developed greater awareness and insight into the current situation and realized, on a deep emotional level, that he was caught up in a codependent situation with Jane and it was ruining his relationship with Susan.

Although it was difficult for him, he began setting limits with Jane, letting her know that his relationship with Susan was primary--no more late night crisis calls, no more getting together without Susan, and so on. Jane did not respond well to this type of limit setting and, eventually, she decided to sever her ties with John. Over time, John dealt with the loss of this friendship in his own individual psychotherapy, how it related to his family history and, over time, his relationship with Susan began to thrive again.

It Takes a Commitment from Both People in the Relationship:
This vignette illustrates that couples can work out problems when one or both of them can't let go for a former partner.

 It takes a big commitment from both people, a willingness to work on this issue in couples counseling, an understanding of the underlying psychological dynamics that are often involved in this type of situation beyond the current people involved, a recognition and acknowledgement that the friendship with the ex is having an impact on the current relationship and, ultimately, a commitment to the current relationship as being primary and a recognition that, if the friendship with the ex cannot be modified so that it's not adversely impacting the current relationship, that relationship needs to end.

Unfortunately, not all relationships that have this problem end well. Sometimes, there's just too much unfinished business with the former partner or spouse. Other times, the partner who is maintaining an enmeshed or codependent relationship with the ex refuses to see it for what it is and thinks the current partner is being unreasonable. Sometimes, it just gets too complicated. But it's more likely to work out if you don't wait too long to try to get help.

Getting Help in Therapy: 
If you find yourself in the type of situation that I've described in this posting, whether you're the person with the partner who is stuck in a codependent relationship with your ex or you're in a relationship with someone who can't let go, recognize that you're not alone.

Getting Help in Therapy

This is a phenomenon that often occurs in relationships, and you and your partner could benefit from attending couples counseling. If your partner or spouse is unwilling to attend couples counseling, you could benefit from seeking help in individual psychotherapy.

Also see my article: Are You Stuck in a Codependent Relationship with an Ex?

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Sex Therapist who works with many individuals and couples who have successfully worked through relationship problems.

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.

Healing Old Emotional Childhood Wounds that are Affecting Your Relationships

As a psychotherapist in New York City, I see many clients in both individual psychotherapy and couples counseling who are struggling with old, unresolved childhood wounds that are affecting their current relationships. 

Healing Old Emotional Childhood Wounds Affecting Your Relationships

Most people know, at least on an intellectual level, that their unresolved family of origin issues have the potential to impact their current relationships. But when you've actually experienced how powerful these old emotional wounds are when they get triggered in current relationships, you have a deeper emotional understanding of their adverse impact in your intimate relationship.

Often, these old emotional wounds remain buried for a long time and don't get triggered until you're in an intimate relationship. The closer you are to your spouse or partner, the more likely it is that issues like fear of emotional abandonment, fear of not being lovable, and other similar feelings will arise in your relationship. 

The reason for that is that you're most vulnerable emotionally when you're in an intimate relationship. When you're experiencing these issues in your relationship, it's often difficult to know if you're feeling these emotions due to problems in the current relationship, past family of origin issues, or they represent some combination of the two.

One clue that these feelings are connected to unresolved emotional issues from the past is that your emotional reactions in your current relationship are out of proportion to the situation. Obviously, to recognize this, you must have some degree of insight and objectivity or, at least, be willing to talk it over with a trust family member or friend who can offer an insightful perspective.

The following scenario, which is a composite of different clients with all identifying information changed, illustrates how unresolved childhood emotional issues can get triggered and cause problems in a current relationship:

Tom:
Tom was a man in his mid-30s. He and Jennifer had been in a relationship for two years. They were talking about getting married. But, at the point when Tom came to see me for individual psychotherapy, they were arguing and Jennifer expressed serious concerns about whether they should stay together.

As Tom explained it, they were very happy together until Jennifer took a job where she had to travel to the West Coast every couple of months. Whenever Tom heard that Jennifer had a business trip coming up, he would become highly anxious, irritable and argumentative with Jennifer.

Usually, Jennifer's business trips lasted no more than a week. But during the time when Jennifer was away, Tom became despondent and he had a terrible feeling of foreboding that he would never see Jennifer again. Neither Jennifer nor Tom understood why Tom was experiencing such strong emotional reactions. At first, she tried to be empathetic and console him. However, after a while, Jennifer felt frustrated and questioned whether she could be happy with Tom as a lifelong partner.

As Tom and I discussed his childhood history, I discovered that his father would often disappear for months at a time without warning, leaving the Tom, his mother, and his younger brother in a state of emotional and financial chaos. It became clear that whenever Jennifer left for a business trip, Tom's old, unresolved trauma was getting triggered and he was feeling the same fear and sadness that he experienced when he was a child. Realizing this on an intellectual level helped Tom to realize that he wasn't "crazy," but that knowledge alone did not prevent his fears.

Over time, Tom and I worked on his unresolved issues using EMDR (Eye Movement Desensitization and Reprocessing) and clinical hypnosis. Using these two powerful psychotherapeutic treatment modalities helped Tom to work through his trauma so that he was no longer triggered.

The real test came when Jennifer went on her next business trip. Tom was amazed that, despite fearing that he might have one of his usual traumatic reactions, he felt all right about Jennifer leaving. 

 It was the first time, since she started traveling, that he wasn't in a panic, he didn't feel despondent, and he didn't feel abandoned by her. He felt completely free of his former traumatic symptoms. Jennifer was also greatly relieved. Within six months, they got married. When I followed up with Tom six months later, he reported that he continued to feel symptom free and they were happy together.

Often, when dealing with unresolved childhood trauma, regular talk therapy is not enough to overcome these problems. Talk therapy might provide intellectual insight into the trauma and what triggers the traumatic symptoms. But, often, it is not enough to heal old emotional wounds. 

 Within the last 10-15 years, research has shown that, when it comes to healing trauma, mind-body oriented psychotherapy is usually more effective than regular talk therapy. Both EMDR and clinical hypnosis are considered forms of mind-body psychotherapy.

Many clients who are already in regular talk therapy will often come to an EMDR therapist or hypnotherapist for adjunctive therapy, where their current psychotherapist is the primary therapist and the EMDR therapist or hypnotherapist provides treatment in collaboration with the primary psychotherapist.

Getting Help in Therapy
When choosing a psychotherapist, EMDR therapist or a hypnotherapist, always choose a licensed mental health professional. 

 Also, there is a big difference with regard to training and professional background between a "hypnotist" and a hypnotherapist. 

 As the name implies, a hypnotherapist is a licensed therapist and a hypnotist is usually someone who has learned hypnosis techniques but who does not have the therapeutic background and expertise to deal with emotional issues.

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

I have helped many clients in individual therapy as well as in couples therapy to overcome unresolved emotional trauma that is adversely affecting their current relationships.

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

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

Psychotherapy and Compassionate Self Acceptance

As a psychotherapist in New York City, I have found that one of the major challenges for people who begin psychotherapy is overcoming their own critical and judgmental beliefs and assumptions about themselves. When I work with clients who have developed a harsh sense of self, I often begin by talking to them about how psychotherapy can help them to become more mindful, attuned and compassionate towards themselves.

Psychotherapy and Compassionate Self Acceptance

Low Self Esteem, Lack of Self Compassion and Self Acceptance, and the Development of the "False Self":
Many clients who begin psychotherapy to overcome low self esteem want to find a way to feel better about themselves. As their psychotherapy unfolds, often, what comes to light is that they have rejected parts of themselves that they have come to hate. Hate is a strong word, but it is usually apt for the type of self loathing that these clients have come to feel for parts of themselves over time.

This lack of self acceptance and self loathing is not always obvious to see at first. Sometimes, it manifests itself in a critical and judgmental attitude towards others. Other times, it shows itself through a need to be "perfect" themselves and to have others be "perfect." Very often, this self loathing and lack of compassion for oneself can be seen when people develop a "false self" when they are interacting with others.

Donald Winnicott and the "False Self"
Donald Winnicott, a British Object Relations psychoanalyst and pediatrician, was one of the first psychotherapists who developed a theory about the "false self."

In his developmental model of the "false self," Winnicott posits that, early on, when parenting is "good enough" a baby learns to relate to his or her primary caregiver in an authentic and loving way.

"Good enough" is the operative term here, since parenting can never be perfect and parents cannot always be perfectly attuned to their children.

However, according to Winnicott, when the primary caregiver (usually the mother) is sufficiently and lovingly attuned to the baby, the baby is usually able to thrive emotionally and, over time, learns to relate well to others as well as to him or herself. However, when the primary caregiver is unable to connect emotionally with the baby, either because he or she is depressed or for some other reason, the infant feels rejected and develops a "false self" to try to elicit the caregiver's love and attention.

People who have developed a "false self" often describe themselves as feeling "empty" or "hollow" and have difficulty relating to themselves as people who are worthy of love and compassion. They also often have difficulty relating to others because their own critical judgments and self loathing gets projected onto others: What they unconsciously cannot accept in themselves becomes intolerable when they sense these qualities in others.

So, over time, in psychotherapy, it becomes apparent that low esteem, depression, anxiety and other emotional problems are often connected to a lack of compassionate self acceptance for oneself and the development of a "false self." It may seem somewhat contradictory, but until you can accept the parts of yourself that you don't like, they're difficult to change.

The following is a vignette which represents a composite of several psychotherapy cases where a client has a "false self":

Carol:
Carol began psychotherapy because she felt that her life was "meaningless." She was in her mid-30s and she had never had a romantic relationship that lasted for more than a year. She described herself as feeling that she "existed" but she was "not really living." She could only express this feeling in the vaguest of terms, but the feeling was strong in her. Her emotional world felt flat--no passion, no real highs or lows.

Psychotherapy and Compassionate Self Acceptance

She worked as an attorney for a nonprofit social service agency, and her employer valued her work because she worked very hard advocating for the clients and often won her cases. However, even though she knew that she was highly esteemed in her organization, she could not feel good about herself at work or in any other part of her life.

In describing her childhood history, she emphasized that she felt she had good parents and she denied any abuse or big traumatic events. As such, she had a hard time understanding why she felt the way she did, "If my parents beat me, I could understand why I feel this way about myself, but they didn't, so there must be something very wrong with me."

It soon became apparent in psychotherapy that underneath that flat sense of meaninglessness, Carol had a strong sense of self loathing. Most of the time, she was able to push down those feelings of self hatred by working long hours and keeping herself distracted. However, as she talked about herself in a judgmental and critical way, it became evident that she lacked a sense of acceptance and compassion for herself.

She ran roughshod over herself with a sense of perfectionism and judgement that was truly soul crushing. No matter how much external praise she received from others, she never felt that anything she did was good enough. She spent a lot of time ruminating about what she perceived as her personal flaws or how she "could have done it better." She was her own worst taskmaster with standards that were unattainable.

In discussing her family history in more depth, it turned out that her parents, who were highly-regarded Ivy League college professors, were rather critical and emotionally distant with Carol. They provided her with everything that she needed on a material level, but they gave Carol the overarching message again and again that what they truly valued in her was her accomplishments in school. There was little sense that they valued her just as she was as a person.

Carol learned as a child that if she got very good grades and tried to be as "perfect" as she could, her parents would praise her efforts. But if she fell short in any way, as all of us do at some point or another because we're human, they found this intolerable.

Carol was also very aware that her mother, who stayed home with Carol until she was five years old and started school, had a lot of resentment about this. Her mother would have preferred to be teaching her classes and continuing her research than staying home with a helpless, dependent baby.

Carol had heard her mother lament many times about how the time she spent away from her field was detrimental to her career and that she was never able to regain the stature that she had prior to staying home with Carol.

Carol's father concurred with her mother about this. One can only surmise that Carol's mother's anger about her role as a mother probably did not allow her to be as emotionally attuned to Carol as an infant. And throughout Carol's childhood, neither parent demonstrated much emotional attunement for Carol as a child who deserved love for herself, without having to perform to their impossibly high standards.

Prior to starting psychotherapy, Carol had never questioned her parents' attitude towards her. The feeling that she was somehow to blame for her mother's lost professional opportunities and that she needed to perform to gain her parent's love and attention was so deeply ingrained at such a young age that it had become a strong part of Carol.

And even though her parents had somewhat mellowed as they aged and they no longer had such a punitive attitude towards Carol, it didn't matter because Carol had internalized their critical and judgmental attitude on such a deep and unconscious level that she was now doing it to herself.

Over time, Carol was able to see how she had developed a "false self" to please her parents. And even though this "false self" might have developed due to her parents lack of emotional attunement, she realized that it was now her responsibility, as an adult, to overcome the emotional obstacles that kept her from accepting herself just as she is.

It was a real challenge for her, but Carol began to question her harsh, punitive attitude towards herself. She mourned for the inner child part of herself who didn't get the unconditional love that she deserved.

She also began to learn to love that part of herself that she had learned to hate--the part that needed to be loved for herself and not for her "accomplishments." As she did this, she began to feel more authentic.

She no longer felt that she was performing a role or just going through the motions in her life. Life became richer and more meaningful as she became more emotionally attuned to herself. She also learned to forgive her parents and she developed better relationships with them as she recognized that they were no longer the punitive, emotionally withholding parents that she grew up with.

As they aged, they went through their own emotional transformation and she learned to relate to them as they are now and not how they were when she was a child.

As Carol became more compassionate and accepting towards herself, she felt better about herself.

Psychotherapy and Compassionate Self Acceptance

Accepting that she was human, she could make mistakes, she no longer needed to be "perfect," her self worth did not have to be based on her accomplishments, and that she deserved love, enabled her to open up others in an authentic way that she had never experienced before.

Eventually, she was able to open up to a relationship with a man who loved for her for herself, and they developed a healthy, loving and stable marriage.

Getting Help in Therapy
If you are struggling with your own critical and judgmental beliefs and assumptions about yourself, you could benefit from participating in psychotherapy with a licensed mental health professional. Although it can be a challenge, you can learn to develop a more self accepting and compassionate sense of self so you can improve your relationship with yourself and others.

I am a licensed NYC psychotherapist, hypnotherapist and Somatic Experiencing therapist. I have helped many clients to develop a more self accepting and compassionate sense of self.

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.

Relationships: Oxytocin, Trust and Empathy

After I wrote my post yesterday about psychotherapy, gratitude and balance, which was in keeping with the Thanksgiving holiday, I read a fascinating article by Nancy Angier in the Science Times section of the NY Times that piqued my interest. The article is called 
The Biology Behind the Milk of Human Kindness.

Relationships: Oxytocin, Trust and Empathy

Research Links Oxytocin to Increased Levels of Trust and Empathy
Ms. Angier discusses new research linking the hormone, oxytocin, to increased levels of trust and empathy. (Oxycotin is a naturally-occurring neurotransmitter in mammals--not to be confused with the drug, Oxycodan).

Relationships: Oxytocin, Trust, Empathy

Prior to this research, researchers have long known that oxytocin has aided in child birth (many doctors inject women in labor with oxytocin to induce labor), breast feeding, and that it usually increases naturally during sexual arousal and orgasm.

Oxytocin Facilitates Bonding and Has Implications For Relationships
Researchers have also known that increased levels of oxytocin facilitates bonding between mothers and babies in humans and other mammals. It is also generally accepted that when there is sexual chemistry between two people, there are high levels of oxytocin and when there is a lack of sexual chemistry, there are lower levels of oxycotin.

Oxytocin Facilitates Bonding and Has Implications For Relationships

However, this new research, which links increased levels of oxytocin with a greater capacity for trust and empathy has important implications for our relationships.

If you haven't read Ms. Angier's article in Science Times, I recommend that you take a look at it to understand the connection between oxytocin and our ability to feel trust and empathy in our relationships (see link that I have provided at the top of this post).

About Me

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

One of my specialities is helping individuals and couples to enhance their personal and work-related 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.

Balance, Gratitude and the Evolution of Contemporary Psychotherapy

A common myth about psychotherapy, especially among people who have never been in in-depth psychotherapy before, is that clients primarily "complain" to their psychotherapists about their families and their lives or come in to "fix" a particular problem. 

Balance, Gratitude and the Evolution of Contemporary Psychotherapy

This is a very narrow view of psychotherapy and does not take into account the full richness and experience of the in-depth psychotherapy process as a place where clients, in addition to resolving particular problems, often find balance and gratitude in their lives, their relationships and for themselves as well.

During this Thanksgiving season, when we tend to be more aware of the people and things in our lives that we are grateful for, I'd like to focus in this post on how in-depth psychotherapy often leads to a greater sense of balance and gratitude.

Often, when people first begin psychotherapy, they either come for a particular problem or they have a sense that "something is wrong" in their lives, but they don't know what it is. In our culture, our tendency is to approach problems in a logical, linear way: identify the problem, analyze the various options, chose an option, fix the problem, and the process is finished.

There's nothing wrong with this approach and, in many instances, it works very well. It also often works well for some specific problems in psychotherapy and hypnosis, like smoking cessation or overcoming a particular fear or phobia. However, in-depth psychotherapy can be so much more than this for people who are interested in finding a greater sense of balance and contentment in their lives.

How Contemporary Psychotherapy Has Evolved Over the Years:
As psychotherapy has evolved over the years, there has been more of an emphasis on cultivating and building a more balanced sense of self. As opposed to more classical ways of working in psychotherapy where the emphasis was primarily on uncovering and working through problems, contemporary psychotherapists also help clients to build a stronger sense of self.

This is done, in part, through the development of clients' internal resources. These internal resources can take many different forms. Sometimes, they're coping abilities that clients have had all along but have been overlooked and under utilized. Often, they're internal resources, or parts of ourselves, that are discovered and developed during the psychotherapy process.

When people are depressed or anxious, it's common to focus on what's wrong or missing in their lives. This is understandable. Often, under these circumstances, their view starts out being narrow until they begin to feel some relief from their anxiety-related or depressive symptoms in a supportive psychotherapy treatment environment.

In contemporary in-depth psychotherapy, clients can begin the process of building a stronger sense of equanimity: a greater capacity to soothe themselves, love and value themselves more, appreciate subtle and richer aspects of themselves, and develop a stronger sense of identity.

With a greater sense of balance for themselves often comes an increased capacity to value and have a greater sense of gratitude and compassion in their relationships, their work, and other important areas in their lives. So, what might have started as a narrow view at the start of psychotherapy begins to open up and broaden to include a more holistic and nuanced view of themselves and others: Not just what's wrong--but what's right too.

Keeping a Gratitude Journal:
I often recommend to clients that they keep a gratitude journal as a way to start developing a greater awareness and appreciation for the positive things that occur in their lives on a daily basis. 

The gratitude journal can be a simple list of two, three or more things that you feel grateful for each day. Over time, cultivating a sense of gratitude, even for the small things in life, can help to create a greater sense of balance, appreciation, and compassion in how we see our world as well as how we see ourselves.

About Me
I am a psychotherapist and hypnotherapist in New York City. 

I have helped many clients to develop a greater sense of self and an increased sense of balance and gratitude in their lives.

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.

Getting the Most Out of Your Psychotherapy Sessions

As a psychotherapist in New York City, I often see clients who are coming to psychotherapy for the first time or clients who have been in therapy before where they didn't have a positive outcome.

Getting the Most Out of Your Therapy Sessions

Participating in psychotherapy involves a commitment of time, effort, and money. If you've never participated in psychotherapy or if your prior therapy experience was not a positive one, you might not know what to expect from your therapist or what your therapist expects of you. So, I usually like to talk to new clients about this so they can understand the treatment frame and they can get the most out of their sessions with me.

Choosing a psychotherapist:

A Good Therapeutic Relationship:
If you're trying to find a psychotherapist in a large city like NYC, you usually have many therapists available to you, especially if you have the ability to go outside of your managed care network.

Generally, the most important factor in choosing a psychotherapist is whether or not you feel a rapport with him or her. This might not be evident immediately. It takes time to build a professional rapport with your therapist. Having a good therapeutic working relationship is usually the best predictor of whether or not your therapy will be successful.

It's important to feel that your therapist has empathy and cares about you within the bounds of the professional treatment relationship.

Not every therapist is for every client. Someone else might really like a particular therapist and establish a good rapport with that therapist, whereas you might feel that you're not connecting with that same therapist. It doesn't mean that there's anything wrong with you or necessarily wrong with the therapist. It means that we're all unique and what works for one person might not work for someone else. Usually, after a few sessions, you can tell intuitively if you're connecting with a particular therapist.

Establishing a good therapeutic relationship doesn't mean that you're always going to "feel good" in your psychotherapy sessions. After all, the change process can be challenging and you might be discussing topics that bring up uncomfortable emotions. So, it's important to distinguish between those feelings and the overall rapport you feel with your therapist.

Different Types of Psychotherapy:
Aside from feeling a rapport with your therapist, there are also many different types of psychotherapy.

As a psychotherapist, I work in many different ways, depending upon the needs of the client: psychodynamic psychotherapy, cognitive behavioral treatment (CBT), EMDR (eye movement, desensitization and reprocessing), clinical hypnosis (also known as hypnotherapy), and Somatic Experiencing are among the different treatment modalities that I use.

You might find that you like and respond best to certain forms of psychotherapy and not others. Obviously, you're not responsible and cannot be expected to know about these different forms of psychotherapy before you start therapy, but you can ask any prospective therapist about them, and he or she should be able to explain in plain English any treatment modality that he or she uses.

Choosing A Licensed Psychotherapist:
It's important that whoever you choose is a licensed mental health professional.

There are people who call themselves counselors or therapists who have no professional training, expertise or psychotherapy background. They might be very nice people but, in most states, including New York State, if they're not licensed, they're not psychotherapists.

Knowing that your therapist is licensed lets you know that he or she mets the basic professional requirements in his or her profession.

It doesn't guarantee that he or she will be a good therapist or the right therapist for you, but it demonstrates that the minimum requirements stipulated by your State have been met. It also means that the therapist is governed by a State professional licensing bureau and is ethically bound and accountable to that bureau.

If you're not sure, you can ask your therapist. You can also check with the State professional licensing board. In New York State, you can go to the Office of the Professionals - NYS Education Department: http://www.op.nysed.gov/ and go to the section for verifications.

Choosing a Psychotherapist Who Stays Up-to-Date With Current Practices:
Aside from meeting the minimum requirements for licensing, you should ask any prospective psychotherapist that you're considering about his or her background and training. Generally, you want someone who has stayed up-to-date with current practices.

Choosing a Psychotherapist

Often, clients who would be concerned about these issues when choosing a doctor, don't think about it when they're considering a psychotherapist.

So, for instance, if you needed surgery, you would want to make sure that your surgeon continued to get training beyond his or her medical school training and stayed current with state of the art medical and surgical practices, especially for your particular medical problem. You wouldn't dream of seeing a surgeon who said, "I've never done this type of surgery before, but I'm happy to try it out on you" or "It's been a long time since I've performed this surgery. I might be rusty, but I think I can muddle through."

It's no different with psychotherapy. If a prospective therapist has not continued to train beyond graduate school, in my professional opinion, this isn't a good sign.

Ethical Considerations in Psychotherapy:
Ethical considerations in psychotherapy is a vast topic. There have been many books and articles written about it. I cannot possibly do justice to this topic in one posting. 

I think the vast majority of psychotherapists are ethical and caring people who want to help their clients. However, unfortunately, there are instances where there are boundary violations which are detrimental to the client. I will touch on some important factors:

"Dual Relationships" in Psychotherapy Are Unethical:
The psychotherapeutic relationship is unlike most relationships. It's different from a friendship or a familial relationship, even though you're talking about very personal things about yourself. Your therapist is not going to be your friend, not even after you stop therapy with him or her.

Psychotherapists' code of ethics considers it a boundary violation for therapists and clients to be in "dual relationships." That means that your relationship with your therapist will be strictly professional and limited to your therapy

Even though your therapist might have a warm and friendly manner, as a mental health professional, he or she is responsibile for maintaining clear and consistent boundaries.

Getting romantically or sexually involved with clients or taking advantage of clients in other ways is strictly forbidden. If a therapist seduces you into a romantic or sexual relationship, he (or she) can lose his license. You have the right to report the therapist to his or her professional board of ethics sessions (see my article:  Boundary Violations and Sexual Exploitation in Psychotherapy).

The therapy should be focused on you. An ethical therapist will not be discussing his or her own personal problems or focusing on him or herself.

This is another way that the psychotherapeutic relationship is different from most other relationships. Depending upon the psychotherapist, most therapists do not disclose a lot of personal information, especially if the therapist works in a psychodynamic way. The primary reason for this is, once again, to keep the focus on you.

That doesn't mean that the therapist might not selectively disclose certain things about him or herself if it's in the service of furthering the treatment.

Therapists' self disclosure is also another vast topic. Generally, even the most conservative psychoanalysts today no longer believe that they are "blank screens" for clients to project their thoughts and fantasies on. However, it's important to understand that if a therapist is not disclosing personal things about himself or herself, it's usually in the service of providing the best possible treatment for you.

Ethical Issues Regarding Managed Care Fees:
If your therapist is an in network provider on your managed care insurance panel, he or she should not be asking you to pay additional money, beyond your copayment, to bring your fee in line with his or her non-managed care fee structure.

When your therapist is on a managed care panel, he or she signed a contract with the managed care company to accept their fee. The contract also stipulates how to handle missed or broken appointments. If your therapist asks for additional money beyond what is allowed in the insurance contract, this is insurance fraud and is reportable to your insurance company and your therapist's professional board of ethics.

Also, most managed care companies don't allow your psychotherapist to charge the insurance for your missed or broken appointments. This is a contractual issue between your therapist and your managed care company.

That means that, in most cases, you are often responsible for the entire fee (not just the copayment) when you have a broken appointment with your therapist. This is a topic that should be discussed at the first sssion so that you're clear about your responsibility with regard to missed appointments. If you're not clear, you can call your insurance company and ask.

Some therapists bill the managed care company for broken appointments, even though it's against their contract with the insurance company. Possibly, they feel that they're being nice to clients by not charging them or they're trying to preserve the therapeutic relationship. However well intentioned this might be, you should know that, unless an insurance contract allows for this (and I don't know of any that do) this is insurance fraud and your therapist can lose his or her license for this.

Doing Your Part in Psychotherapy:
Usually, the therapeutic hour is somewhere between 45-60 minutes per week for individual therapy, depending upon your therapist and the type of therapy. An hour out of a week is not very much time. So, if you want to get the most out of your therapy, it's important that you know what is expected of you in therapy.

Doing Your Part in Therapy

Showing up for your appointments:
This might seem obvious, and most clients don't start therapy with the intention of not showing up for their appointments. However, it's not unusual to feel ambivalent about going to therapy. Clients will often start therapy saying that they want change, but the process of change is sometimes diffiicult, and when a client and therapist begin to discuss topics that are uncomfortable, some clients begin missing appointments.

They might not even realize that they're missing appointments because of their discomfort. Emotional discomfort and ambivalence can show up in many different guises: "forgotten" appointments, missing therapy because you feel "tired," and other reasons that might mask an unconscious wish to avoid change. Clients might also begin arriving late for their appointments as an unconscious way to avoid dealing with the process of change.

Thinking About What You Discussed in Therapy Between Sessions:
As I've mentioned, the therapeutic hour is brief compared to the rest of the time in your week. If you want to get the most out of therapy, it's important to think about what you and your therapist have discussed. That means taking time during the week to think or journal about the issues and feelings that come during and after your session.

It's also important to apply whatever you've learned in your every day life. Your therapy will be of little value to you if you have insights in your therapy session, but you forget them once you've left the therapist's office. Also, pay attention to whatever emotions come up between sessions and let your therapist know, even if you might feel uncomfortable. Chances are, if you're seeing an experienced, licensed mental health professional, he or she has already dealt with these issues before.

Doing Homework:
As a psychotherapist, I usually don't give a lot of homework to most clients between sessions. However, at times, I might recommend reading an article or a book, practicing something that has been learned in the session (like meditation or self hypnosis) or I might ask a client to journal or reflect on a particular issue or emotion. I might recommend attending a 12 Step meeting, getting a sponsor, etc.

I might also come to an agreement with a client to take a particular step or action to further the process.

For instance, if a client has problems with procrastination, it's important to talk about it and try to understand it but, ultimately, the client needs to take certain steps in order to overcome this problem. So, we might come to an agreement about what the next step might be to further the process along. Among other things, doing homework between sessions helps to bridge one session with another. A week might not seem like a long time, but in psychotherapy, it can be very long--enough time to forget or put out of your mind what you and your therapist have discussed. So, finding ways to bridge that time can be very valuable.

One posting about how to get the most out of your psychotherapy sessions is not enough to cover all the relevant topics. However, if you're thinking about starting therapy or if you're already in therapy, I hope this posting will be a good start for you and get you thinking about it.

About Me.

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

I have helped many clients to lead more fulfilling lives.

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.