Are Your Relatives' Financial Problems Affecting Your Relationship?

As a psychotherapist in New York City who works with individuals and couples, I have been hearing more and more from individuals and couples about the adverse impact that the recession has had on their relationships. Even for couples who have been fortunate enough not to have lost their jobs, they are often dealing with relatives who are in dire financial straits. It's often difficult to turn down requests for financial help from your mother, father, brother, sister, son or daughter.

When Your Relatives' Financial Problems Affect Your Relationship?

You might want to help, but what if the situation is adversely affecting your relationship, either because you and your spouse don't agree about lending the money or because you've been lending your relative money and it's becoming too much of a hardship for you--and there seems to be no relief or end in sight?

How do you and your spouse decide what to do?

How do you keep this type of situation from ruining your relationship?

There are no easy one-size fits all answers to these questions that many couples are now facing. Maybe your brother lost his job and he can no longer pay his mortgage, or your mother can no longer afford to pay her rent, or your sister has asked you and your spouse for money because the court is about to issue a judgment against her and freeze her bank accounts due to unpaid credit card debt. There are so many other variations on these types of situations.

Not only do these situations often place an emotional strain on a couple's relationship, but it also puts a strain on the relationship between the relative who is lending the money and the one who is borrowing it. The person who is lending the money might feel anxiety as to whether he or she will ever see this money back again. And the relative who is receiving the money often feels ashamed for having to ask. Then, there is the question of whether the person who is lending the money has the right to tell the borrower how to spend the money.

The following is a vignette, which is a composite of several actual cases from the past with all identifying information changed to protect confidentiality, that will serve to illustrate some of the complications involved in these types of situations:

Jane and Alex:
When Jane and Alex, who were married for over 20 years, began marriage counseling, they were barely speaking to each other. They started marriage counseling because Alex's son, Bob, from Alex's first marriage, borrowed a sizable amount of money from them more than a year ago, and Bob was not making any attempt to pay them back, even though he started a new job.

When Your Relative's Financial Problems Affect Your Marriage

Initially, after Alex lost his job, he and his wife could no longer make ends meet on her part-time salary. The bills began to pile up and they were taking out cash advances on their credit cards. When that proved to be too costly, Bob approached Alex and asked for $20,000 to pay off his bills and meet basic expenses. Alex told Bob that he would need to talk this over with Jane. Jane thought the amount was too high and suggested that Alex lend Bob only $10,000. Initially, Alex agreed to this, but when he talked to Bob, Bob pleaded with him, telling him that he needed the full $20,000 because he feared that he would lose his house if he continued to miss mortgage payments.

Alex felt caught in the middle between Bob and Jane. He wanted to help his son and his daughter-in-law, but he didn't want to upset his wife. Alex and Jane talked about this and went back and forth about it for a while.

When they came to speak to me, they both agreed on the story until that point. After that, they each had a different recollection of what happened. According to Alex, he and Jane came to a decision that they would lend the money to Bob and tell him that he could pay them back when Bob and his wife were in a better financial situation. According to Jane, she and Alex agreed to lend the money to Bob, but they wanted Bob to sign an agreement that he would start to pay back the money once he began working. Each of them insisted on his or her version of the story.

They both agreed that the problem between them developed after Bob started working again. Instead of starting to pay Alex and Jane back, Bob chose to invest what was left of the money. Not only did Bob not make an effort to pay back the money to Alex and Jane, he never mentioned it again.

At that point, Alex felt hurt and Jane was enraged. Even though part of the $20,000 was her money too, she felt awkward talking to Bob about it and insisted that Alex talk to Bob. She was also angry because she thought that she and Alex had agreed on specific terms for Bob repaying the money. She felt that Alex was being too passive with Bob and that Bob was taking advantage of their generosity. She and Alex began arguing about this situation and it was causing a rift in their marriage.

After several marriage counseling sessions, Alex agreed that it would be best if he was the one who approached Bob. Although he felt very uncomfortable bringing up the loan with Bob, Alex didn't want this situation to continue to come between him and Jane any more than it already had.

The following week when Alex and Jane came for their next session, Alex reported that when he approached Bob about the money, Bob told him that he thought the money was a gift--he never realized that Alex wanted him to pay him back. Alex said that he was stunned. Jane was extremely angry about this. Alex admitted that, when he lent the money to Bob, he was very unclear about it and, although it seemed surprising to him that Bob would assume that it was a gift, he could see where his lack of clarity might have caused Bob to think this.

Based on our working on this issue in the marriage counseling sessions, Alex was careful not to make it seem that Jane was the only one who wanted the money back. It would have been easy for Alex to try to make Jane seem like the "heavy" to try to preserve his relationship with Bob. Although Bob wasn't happy about it, he agreed to various terms of repayment and began to repay back the loan. For a while, this placed a strain on the father-son relationship between Alex and Bob, but they eventually worked it out.

In the meantime, once Bob began paying back the money, the tension between Jane and Alex began to ease. They learned to improve their communication with each other and agreed that if ever they found themselves in this type of situation again with either of their relatives, they would approach it with much more clarity and mutual understanding.

Jane and Alex Worked Out Their Issues in Couples Counseling

Often, what begins as a gesture of kindness and good will to help a family member can turn into a tension-filled situation for everyone involved.

Here are some tips if you and your spouse decide to lend money to a friend or relative:

• Make sure that you both agree on the situation beforehand.
• Never go behind your spouse's back to lend money to a relative because this can cause serious problems in a relationship.
• Make sure that you and your spouse understand what the money is for before you make the loan.
• Make sure the relative who is the borrower is clear that this is a loan and not a gift.
• Be clear about what your expectations are with regard to repayment and, even though it might sound cold, it's often best to put terms in writing, if only for the sake of clarity.

Getting Help in Therapy
If you and your spouse are having difficulties about money that you've lent to a friend or relative, you might benefit from sorting out this issue in marriage counseling.

When choosing a couples counselor, make sure you see a licensed mental health professional.

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

I have helped many couples to work out emotional issues.

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

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

When Job Loss Means Loss of Identity

Aside from the financial loss, job loss can also mean the loss of an important identity for the person who has lost his or her job: One day, you're the head of accounting in a prestigious firm, and the next day you're an unemployed person sitting at home wondering what happened, who you are, and what you will do next.

When Job Loss Means Loss of Identity

As I've mentioned in other posts, prior to being a psychotherapist, many years ago, I was involved in other fields, including banking and finance. Being in the banking and financial field as a human resource manager, I had many occasions to see people laid off from their jobs due to mergers, cutbacks, and "downsizing" (a euphemism that I have never learned to like).

Even though I had seen many employees lose their jobs (through no fault of their own), nothing prepared me for when it actually happened to me.

A few months prior, I had received an excellent performance evaluation and there was no reason to think at the time that I would be laid off. But I can still remember how my mouth went dry and my brain was slowly trying to catch up to my boss's words when she told me that she was truly sorry to be letting me go.

She had tears in her eyes, assuring me that it was nothing that I had done (or not done), she offered to give me an excellent letter of recommendation, and help me in any way that she could.

But, based on company protocol, which I knew well, I had to pack my personal belongings and leave by the end of the day. That protocol, which is generally observed for security reasons (the idea being that an employee might get angry and engage in sabotage) is one of the most dehumanizing experiences you can go through.

I think some part of me went on automatic and I gathered my things in boxes. There was no time to say goodbye to colleagues (and I don't even know what I would've said to most of them at the time). But, before I left, I called one colleague that I had a close collegial relationship with to tell her that I had just been "let go." She knew and admired my work, and she was shocked. Months later, she told me that she was so surprised when I called her that she didn't know what to do or say, so she just put her head down on her desk.

Afterwards, as I was taking the train home, I was so distracted that I got on the wrong train and only realized it when I had traveled a distance from my home.

I felt like I was in a fog. I was fortunate to have a good emotional support system, and that night, I made up my mind to do what I had been thinking about doing for a long time--completing my undergraduate degree, going to graduate school, and changing careers. So, I was able to channel my emotions into advancing my new plan with determination.

But it wasn't easy at all. Even though I had this new determination, I still went through most of the feelings that people go through when they lose their job: shock, denial, sadness, and anger.

I also come from a family with a very strong work ethic, which has generally been beneficial to me. My grandparents lived through the dark days of the Great Depression and their attitude was: "If you have a job, no matter what kind of job you do, do it with pride to the best of your ability, and be happy that you have a job."

My father, grandfather, uncles, and cousins were all hard workers. Although my cousins and I knew that our grandparents suffered during the Depression, we never dared to ask them about it directly. We heard oblique references to it at times and how hard it was, but that was it.

And, as children, we knew that there were two things that you did not ask my grandfather about because it was too upsetting for him: 1) Did he miss his family in Italy, a family that he was very close to, and that he never saw again after he came to the US by himself when he was 17 years old, and 2) What happened after he lost his job during the Depression?

Of course, by the time my cousins and I arrived on the scene, they were okay: My grandfather had a job as a janitor for the post office that he was very proud of. He talked about the post office a lot when the whole family got together every Sunday for dinner.

Having gone through the Depression, we sensed that it was like a badge of honor for him that he had this secure Federal civil service job. And, through a lot of hard work, before my cousins and I were born, my grandparents also eventually achieved the American Dream of buying their own home: Be it ever so humble in a part of Brooklyn where goats still roamed the streets at the time when they bought their two-family house.

Since both of these topics were so taboo and shrouded in a dark mystery, as children, we grew up feeling that losing your job would be one of the worst calamities that could ever happen to you. Even though I was living in a very different time than when my grandfather lost his job and I was not a child when it happened to me, I still had a sense (as distorted as it might have been) that this terrible thing happened to me, and I was somehow at fault. This is a common initial reaction for many people who are laid off as they try to sort through in their minds what happened to them.

At this point, I'm fortunate to be able to say that losing that job was one of the best things that ever happened to me. I went on to complete my undergraduate and graduate degrees, and obtained postgraduate training. I can honestly say that I've never had any regrets about it. But that's jumping ahead in the story quite a bit and, at the time, I didn't have a crystal ball that would predict a good outcome, so I was worried.

Aside from losing a daily routine that gives so much structure to people's lives and losing the day-to-day affiliations with coworkers, when people lose their jobs, they often lose their sense of identity. No matter how much you might like to say, "I'm not my job" or "I'm not my title," it's the rare person who doesn't go through this kind of loss of identity.

In my case, I went from being a full time assistant manager to being a full-time student. I'm a naturally curious person and love learning.

But, aside from losing a regular income and knowing that there was no cushion of a second income, it was a hard adjustment to being a returning college student as a middle-aged person among people in their late teens and early 20s.

So, to cope with this adjustment and the accompanying doubts and fears, I had to learn to keep very focused on my goal, which was years away for me at that point. I took whatever part-time work that I could find (we were going through another recession at the time, so work was not plentiful), took out student loans, and reigned in my spending immediately.

Tips For Coping With a Job Loss

Even though this occurred to me many years ago, I still remember how it felt for me, and I have a lot of empathy for people who are going through it now. Of course, everyone's situation is different, but in general, to sustain yourself emotionally, I would recommend:

• Stay connected with your emotional support system: Allow your spouse or partner, close friends, and other family members to be supportive of you. As tempting as it might be to not pick up the phone when a friend calls, this is not the time to isolate.

• Stay in contact with former colleagues and supervisors. They are often a valuable resource for references, tips about job openings, and what's going on in the field.

• Join business networks like LinkedIn (http://www.linkedin.com/) to pursue career opportunities.

• Find meaning and value in the other aspects of your life: You're still the same person that you were before you lost your job--father, mother, son, husband, wife, Little League coach or whatever other roles you might have.

• Don't blame yourself if you were laid off due to cutbacks. Chances are the decision to lay you off, which is, of course, very personal to you and your family, was made based on financial decisions. And if you were terminated for cause (for something that you did or did not do), learn from whatever mistakes that you might have made.

• After you go through the initial shock, denial, grief, and anger, work towards accepting what has happened and mobilize yourself to take action. Avail yourself of whatever resources there might be in your local library or State Department of Labor. Take advantage of whatever funds there might be through Unemployment insurance for additional educational training.

• Recognize that you're going through a crisis and take good care of yourself. This is not the time to skimp on medical and dental visits, especially if you are eligible under the new current Federal COBRA law, to extend your health benefits at a reduced rate, if you qualify. Engage in stress management techniques that work for you (like meditation or going for regular walks).

• Remember other times when you went through other crises and you came out of it okay--maybe even better than okay. Maybe you'll be able to make changes in your life, as I did, that you might not have made if you didn't lose your job. Also, remember, that we're often more resilient than we realize.

Stay Connected With Your Emotional Support System

About Me

I am a psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist in New York City who works with individuals and couples to help them lead more fulfilling lives.

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

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

Developing Self Awareness and Making Personal Changes

At certain points in our lives, we might become aware that we're either not satisfied with our lives and that we want to make changes. At those points, we might not even be able to identify what's wrong or what changes we want to make, but we may have a vague sense that we're either not happy or we feel out of synch with our environment. 

Developing Self Awareness and Making Personal Changes

This may be the start of a rudimentary sense of self awareness or it might be longstanding feelings that "something isn't right." Even if we're not aware of what is going on with us, other people who are close to us might see it better than we can. One of the benefits of psychotherapy is that it can help us to develop self awareness so that we can start to identify what's not working in our lives and we can begin the process of change.

What Do We Mean By "Awareness" and "Self Awareness"?
A few weeks ago, as I was walking home from yoga class, I walked along a block of beautiful, turn- of-the-century limestone buildings. Now, the reality is that I've walked by these same limestone residential buildings countless times before. On this particular day, instead of rushing by as I usually do, I had a little extra time so I was strolling more leisurely. It was also a lovely, sunny day and I was very relaxed from yoga class and feeling more connected to my environment.

So, as I passed these buildings, I suddenly noticed something that I've never noticed before: Each of these two-story residential buildings has a large beautiful image of a young, serene-looking woman just above the entrance way. I was so surprised to notice this, after all these years, that I stopped to admire the artistry and the detail of these images. The images were very pleasing to the eye and, combined with the serenity I felt from my yoga class, I felt a sense of attunement with my environment and more connected to my own internal response to such beauty.

Developing Self Awareness and Making Personal Changes

Then I thought to myself: How odd that I've passed these buildings so many times before and I've never noticed these images which have been around since the late 1800s. This experience made me think about issues of awareness and self awareness in general. Since that day, I now notice these beautiful images all the time, and I have the same sense of appreciation and well-being whenever I see them.

Developing self awareness is an ongoing process. Self awareness is not a state where we feel that we have "arrived." My example above is a simple illustration. But awareness and self awareness, like many things, are on a spectrum. At the other end of the spectrum, where there is more of a lack of awareness and self awareness, there can be delusion.

What Do We Mean By Ordinary "Delusions" and "Self Delusion"?
For most people, when they hear the word "delusion," they usually think about a form of psychotic delusion: the person who thinks they're Jesus Christ or the person who thinks that the FBI has installed cameras in their house to watch them. But ordinary, every day delusion is not psychotic. It's much more subtle than that. For each person, it starts in a different way but, often, self delusion becomes a habitual form of denial. Over time, self delusion can become a serious emotional problem as we go through life not realizing that we've placed blinders on ourselves--about ourselves, the people in our lives and, possibly, the world around us.

The following vignette, which is a composite of several people with all identifying information changed to protect confidentiality, may help to illustrate the detrimental impact of ordinary delusion and self delusion:

Helen:

When Helen came for a psychotherapy consultation, she came at the urging of her best friend who was worried about her. Helen did not seem concerned about her friend's worry and brushed it off as well-meaning but misguided. She wasn't sure what her friend was concerned about--maybe her friend noticed that she was under more stress than usual at work. Helen also lacked any real curiosity about her friend's concerns. Helen had never been in therapy before, she was curious about psychotherapy on an intellectual level, and she decided to give it a try.

From Helen's perspective, she felt she was under a lot of stress at work--all she really needed was a vacation so she could relax and she was sure that she'd be fine after that. She described a wonderful, "perfect" childhood. She also talked about her husband and her marriage in glowing terms. Other than some recent stress at work, she felt her life was "perfect" and, it seemed, her attendance at the consultation with me was perfunctory. She felt that, at worse, she would be wasting her time and money and, at best, she might learn some stress management techniques to deal with recent work stressors.

Although she expressed her overall happiness and contentment with her life, Helen seemed somewhat disconnected from her feelings, and she had a somewhat rigid and stiff demeanor. Of course, it's not unusual for people to feel anxious during an initial psychotherapy consultation with a therapist that they don't know. So, we agreed to meet for several psychotherapy sessions to continue the dialogue and see what might develop. I was open to Helen's assertion that she was basically fine and, at the same time, I was also curious to see how the therapy would unfold.

Over the next few weeks, Helen continued to come to her sessions saying that her personal life was "perfect." We talked about stress management techniques, which she began to use. And she continued to tell me that she didn't think she needed to be in therapy. However, increasingly, I noticed that Helen's words, her tone, her emotions, and her body language didn't match. While she was saying that her personal life was "perfect" and that she was really very happy, she came across as being unhappy and anxious. When I gently pointed this out to her, she brushed it off, once again, attributing it to her need for a vacation.

When Helen came to her sessions, it was obvious that she was very meticulous about how she dressed. Her outfits were always appeared expensive, of good quality, and always completely coordinated. It was obvious that she spent time and effort wanting to look put together and, from outward appearances, she did look very well put together.

About a month later, which was a week before what was supposed to be our last session, she and her husband went on vacation. Prior to going on vacation, Helen was anticipating coming back feeling relaxed and refreshed. During our last session prior to her vacation, Helen told me that she was using the stress management techniques that we had discussed. She said she felt sure that she was just fine and after the next session, she would not continue in therapy.

The following week, when Helen arrived for her post-vacation therapy session on what was supposed to be her last session with me, I hardly recognized her. Not only was she not meticulously dressed or relaxed and refreshed--she looked almost disheveled. It was also obvious that she had been crying. It took a while before she could gather herself to begin to talk, but when she did, the words pored out of her.

Apparently, during their vacation together, Helen's husband told her that he wanted a divorce. He revealed that he had been having an affair for several years and he realized that he wanted to be with the other woman. He told her that he would leave her well provided for and she would have nothing to worry about financially, but he wanted to move out as soon as they returned from vacation. He was very apologetic, but he had made up his mind, and he saw no reason to delay what he saw as the inevitable.

Helen talked about feeling like she had been beaten up by her husband's words. His words and the reality of their situation crashed through her sense of reality like a ton of bricks. As soon as they returned, he moved out to be with his girlfriend, and Helen felt more alone than she had ever felt in her life. She was unable to eat, she couldn't sleep, she cried most of the day, and she was unable to return to work. She talked about pacing around her large apartment, where she and her husband had lived together for 10 years, and feeling estranged from everything around her.

Developing Self Awareness and Making Personal Changes: Trying to Piece Together What's Happening

To make matters worse, when Helen confided in her best friend (the one who recommended that Helen come to therapy), she found out that her friend had seen Helen's husband with the other woman and suspected that he was having an affair. It seems that Helen's husband had been to local restaurants and he was openly affectionate with this other woman and not at all discreet about the affair. So, on top of her feelings of betrayal about the infidelity, she also felt betrayed by her best friend for not telling her about the affair. Helen also realized that many of her other friends and neighbors probably knew about the affair long before Helen knew what was going on. Her sense of humiliation was profound.

Over time, as Helen continued to come to her therapy sessions and piece together what had happened, she began to see that there had been telltale signs of the infidelity all along that she refused to see. She also realized, when she thought about it, that her friend had tried to tell Helen about it several times, but Helen was so emotionally invested in believing that her life was happy, well ordered, and "perfect" that she refused to hear her friend. She kept her emotional blinders on. The Helen that came to these therapy sessions was angry, sad, hurt, and resentful, a far cry from the person who had been coming to therapy prior to this but, at the same time, she was much more emotionally authentic.

After her initial shock about her husband's affair, Helen realized that she had been deluding herself in many areas of her life, including her childhood and her history with her family. It took this emotional crisis in her marriage to open her to the many lies that she had been telling herself, aided and abetted by her parents, who wanted to preserve an image of the "perfect" family. Helen realized, for the first time in her life, that her father was an alcoholic and her mother was depressed and withdrawn when Helen was growing up. When she finally allowed herself to see the truth about her childhood, she wondered how she had not seen these things before.

As Helen continued to come for her therapy sessions, she realized that, as a child, she had entered into this fantasy world where everything was "perfect" as a way to protect herself from an emotional reality that would have been too overwhelming at the time. Rather than blame herself from these fantasies, she learned to develop compassion for herself. In her childhood fantasy world, she and her family were happy and loving, and no one had any problems. This fantasy was reinforced by her family who presented a happy front to the world around them. And, without realizing it, Helen continued to engage in this fantasy of perfection as an adult in her marriage. So, what started out as an emotional defense to ward off overwhelming feelings as a child became a habitual form of delusion that she continued to live by.

Although it was painful to come to terms with her self delusion, Helen talked about feeling emotionally authentic for the first time in her life. Her words, emotions and overall demeanor were more congruent. Gradually, as she learned in therapy to use her new, fledgling sense of self awareness to change her way of being, she realized the countless times during the day when she was tempted to lie to herself and to close friends about how she felt or about her life.

Rather than deluding herself when she felt uncomfortable about some aspect of herself or in her environment, she learned to stay emotionally attuned and true to her reality. Gradually, she learned to feel more comfortable in her own skin, even when she felt sad, and that she preferred to feel her feelings rather than mask them with self deception. After a while, Helen also realized that her delusions kept her from hearing her best friend's warnings. As a result, Helen took responsibility for the breach in her relationship with her best friend and reconciled that relationship.

Developing Self Awareness, Making Personal Changes and Feeling More Authentic

Helen realized that, even after she left therapy, there would be many times when she might be tempted to revert back to deluding herself because this emotional pattern was so strong and ingrained in her. She knew she would have to continue to work on her own with the skills that she developed in psychotherapy to continue to be authentic with herself and with those who were close to her. 

Even though it was challenging, she preferred to have a genuine sense of emotional authenticity, regardless of whether she felt happy or sad, than to remain in denial and in fantasies about life being "perfect."

Self Delusion is Common:
Self delusion often starts as a way to protect ourselves from unconscious feelings that we fear will be too hurtful and overwhelming. There are many ways to develop a better sense of self awareness and emotional authenticity. Meditation and yoga practices are often helpful tools to develop increased self awareness.

Getting Help in Therapy
Psychotherapy with a licensed therapist can also help you to see where you might be holding onto delusions about yourself or your relationships. 

Psychotherapy can also help you to work towards changing your life to be more emotionally authentic.

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

To find our 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.

Exploring the Secondary Gains of Codependency

In prior posts to this psychotherapy blog, I've defined and explored codependency from the vantage point of relationships where there is substance abuse in the family as well as in other codependent relationships (see the link to one of those earlier articles at the end of this article). In this article, I would like to explore the secondary gains of codependency in relationships.

Exploring the Secondary Gains of Codependency

 What do we mean by "secondary gains" in codependent relationships?
When we talk about the secondary gains in codependent relationships, we're usually referring to the hidden benefits that are derived from engaging in codependent behavior. The reason I described them as "hidden" is because these behaviors are often unconscious and are often not seen for what they are by the people involved in codependent relationships.

However, at times, some people are aware of it, just below the surface of their awareness. And, even though they might be complaining about another person's dependence on them or how dependent they are on someone else, both people involved are usually getting something out of maintaining the codependency--even when they don't realize it. These so-called secondary gains might not be psychologically healthy, but often both people involved want to maintain the status quo on some level.

A composite vignette, which represents a combination of many psychotherapy clients with all identifying information changed to protect confidentiality, might help to illustrate the secondary gains involved with maintaining codependency:

Edward:
When Edward started psychotherapy, he talked about feeling exhausted by all of the demands that he felt people in his life placed on him--his adult son, other relatives, coworkers, his boss at work, and even his ex-wife. He talked about wishing that he could get away from everyone and everything so that he could just rest. He felt physically and emotionally depleted.

We started Edward's psychotherapy sessions by exploring his relationship with his adult son, Tom, an unemployed 25 year old man who lived at home with Edward. According to Edward, Tom was an honor student in college. 

Everyone thought that Tom showed a lot of promise and they expected that Tom would be successful in whatever career that he decided to pursue. However, after Tom graduated from college, he never pursued any work. Instead, he moved back in with Edward and he spent most days playing video games and watching TV. Tom's girlfriend got tired of waiting for him to make a life for himself, so she broke up with him. Since that time, Tom dated a few women, but he was not focused on relationships.

Edward expressed his sadness, worry and disappointment to me that Tom was just "loafing around the house" instead of "trying to do something with his life." However, as we continued to explore the dynamics in Edward's relationship with his son, Tom, another picture began to emerge next to Edward's account of his concern and disappointment. As this other picture emerged, it became apparent that Edward relied on Tom for his emotional needs and vice versa.

After his divorce, which occurred while Tom was in college, Edward stopped seeing friends, he didn't date, his social life just stopped. His life consisted of going to work and coming home and doing more work. He held a position as a senior vice president of a large company, and he worked long days. Most of his social contact was with clients that he entertained during the week. He also spent weekends immersed in his work. By most people's standards, Edward was a workaholic.

As we continued to discuss Edward's relationship with his son, Tom, we explored how, over time, Edward began to depend on Tom emotionally to fulfill his social needs: After the divorce, Edward began to visit Tom at college a couple of weekends out of the month. He considered Tom to be his "buddy" and expected Tom to forgo other social events at his college when Edward came to visit him.

When Tom was in his senior year, Edward told him that there would be "plenty of time" to look for a job and, anyway, Edward earned a lot of money, so he could support Tom until he found the "right job." Throughout college, Edward paid for Tom's tuition, an expensive apartment off campus, and he gave him generous amounts of money every month so Tom never had to work or be concerned about money.

Over time, as we traced back the development of Edward's relationship with his son, this other hidden picture began to emerge along side of Edward's concern for Tom's idleness. It wasn't that Edward was not concerned about his son. Rather, both pictures were true: Edward loved his son very much, he wanted him to be a success and, without realizing it, he also wanted to have a mutually dependent relationship with his son.

Initially, Edward had some difficulty with seeing both sides of this picture. If we had a split screen movie available to us and we could project on it the two sides of Edward's feelings and his actions, this is what we would see: On one side, Edward was the encouraging father telling Tom that it was important for him to do his best and go out to make a life for himself. On the other side, the side that Edward was not aware of, Edward was the father who tended to make life too easy for Tom so that Tom never had to venture out on his own. If we looked closer at that side of the split screen, we would also see that Tom was deriving secondary gains to keeping Tom dependent upon him because, underneath it all, Edward felt lonely and he was emotionally dependent on his son.

As we explored both sides of this so-called split screen image of Edward's relationship with his son, Edward was only able to see one side--the side where he encouraged Tom to go out into the world and make his own way. He would often say in those early psychotherapy sessions with me, "But I tell Tom to go out and get a job all the time. I want him to have his own life." 

While it was certainly true that Edward did tell Tom these things and even made efforts through his many business contacts to get Tom a job, Edward also behaved in ways to keep Tom dependent on him: He continued to be very generous with money, he never had any expectations of Tom doing anything around the house, and so on. So, it was a picture filled with ambiguity as Edward gave mixed messages to Tom.

Denial is a common reaction in codependent relationships. None of us like to think of ourselves as holding back another person for our own emotional needs, especially people that we love. So, Edward's denial was no different than many other people in similar situations. However, gradually, over time, as Edward learned to become more psychologically-minded and developed more emotional insight into his relationship with his son, he began to see how he had created a codependent relationship with Tom.

It took a while before Edward could tolerate the feelings that this engendered in him so that he could let go of his denial and look at both sides of the picture. However, once his denial began subsiding, he also started to see how he also created codependent relationships with the other people. He began to realize that he couldn't fulfill his emotional needs by controlling his son with money and attention. He also realized that, often, his behavior was not consistent with his words.

There was no quick fix for Edward in his psychotherapy sessions. Over time, he began to change his behavior so that, even when he felt the urge to keep Tom dependent upon him, he learned not to give into it. He worked hard in psychotherapy to find fulfillment in his own life outside of his relationship with his son and in his work. Gradually, he began to socialize more, develop new interests, develop new friendships, and he even began dating. He started delegating more of his work to his subordinates and not taking work home.

Even though he was going out more, he had new found energy. He was no longer exhausted and emotionally depleted. Also, as his message and his behavior became more consistent with Tom, Tom learned, gradually, to become more independent. He started working at a job where there was potential for moving up in the company. He also began forming healthy relationships with other men and women his age, so he was not as emotionally and financially dependent on Edward any more.

Over time, Edward also learned to change the codependent dynamics in his other relationships. By the way, not everyone in Edward's life was happy about this change because they had come to rely on this dynamic as well. However, Edward learned to focus more on himself and not on trying to please and control others. Over time, these other people had to accept it if they wanted to remain in Edward's life.

Most of the time, progress in psychotherapy is not linear--like a straight arrow that keeps going upward. Usually, when people start making progress, their progress is more like a spiral--a few steps forward and one or two steps backwards. 

It takes time to change ingrained ways of thinking and behaving. The roots of codependency often go deep in a person's history and those issues must be overcome as well. It was no different for Edward and other clients. But, on the whole, when he left psychotherapy, Edward had learned a lot, on an intellectual as well as on an emotional level, about codependency and watching for the pitfalls of the secondary gains associated with codependency.

Getting Help in Therapy
The secondary gains of codependency and other behaviors are often difficult to see when you're in the middle of a codependent relationship. 

It requires an ability to look at the whole picture and not just one side. Overcoming denial can be a challenge, but it also often leads to emotional breakthroughs.

If you think you might be engaging in codependent behavior, you could benefit from seeing a licensed psychotherapist who has expertise in codependent relationships.

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

I work with individual adults and couples.

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

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

Overcoming Adult Separation Anxiety Disorder

Up until about 15 years ago, separation anxiety disorder was mostly discussed in psychotherapy literature as it related to children, not as a problem that adults have. And, yet separation anxiety disorder is a phenomenon that has been experienced by adults for hundreds (if not thousands) of years. 

Now that it is more widely recognized and treated by psychotherapists, there is a greater recognition that adult separation anxiety disorder is a problem that exists in about 6-7% of the adult population, which is significant.

Overcoming Adult Separation Anxiety Disorder

Traditionally, separation anxiety has been viewed as a normal development in some infants starting at about the age of seven or eight months when babies begin to become aware that their caregivers are separate from them. 

As most children develop over time, they realize that even though their caregivers might leave the room, they still exist and will come back. For most children, this resolves separation anxiety, unless they have anxious caregivers, there are problems with bonding with their caregivers, or there is some other disorder or problem that causes them to feel anxious when their caregivers leave them.

Episodic Separation Anxiety vs. Separation Anxiety Disorder:
It's not unusual to have some degree of separation anxiety as an adult at certain points in your life (e.g., after the death of someone close to you or when experiencing other losses). This would be considered episodic separation anxiety. However, adult separation anxiety disorder is a recurrent and persistent problem that is not linked to anything objective that is going on in a person's life at the time.

Typical symptoms of adult separation anxiety disorder are:

• Recurrent excessive worry about separating from a place or a person that you are close to (like a spouse)
• Persistent and recurring fear about losing people close to you or that something bad will happen to them (when there is no objective reason for feeling this way)
• Recurrent reluctance to go to school or work or go elsewhere due to fear of separating from someone close
• Persistent and excessive fear of being alone
• Persistent and excessive fear or reluctance of going to sleep without having someone who is close to you in the house or nearby
• Repeated complaints about headaches and other physical symptoms when you are separated from the person or people that you are close to
• Recurrent nightmares about separation
• This anxiety causes significant impairment in one or more major areas of your life (e.g., your relationships, work life or in other significant areas).
• These symptoms last a month or more, and they are not attributable to any other physical or emotional causes.

The following fictionalized scenario is an example of adult separation anxiety disorder:
Maureen was a married woman in her mid-30s when she started psychotherapy to deal with separation anxiety disorder. She had gone to her primary care doctor, at the insistence of her husband, because she would become extremely anxious and worried whenever her husband wanted to do anything on his own or when he was not around her for even a short period of time.

Overcoming Adult Separation Anxiety Disorder

It didn't matter if they had spent the entire day together and he wanted to go out for a short walk on his own to clear his mind. Maureen would become extremely anxious and worried at just the thought of her husband being away from her. She would become upset, tearful and angry if he told her that he preferred to go out on his own for his walk and not with her. She was convinced that something awful would happen to him (e.g., he would get hit by a car or someone would kill him or kidnap him) and she would never see him again.

At work, she would call him several times a day to "check in" and if she couldn't reach him, she would panic: What if something happened to him and no one knew how to contact her? When she finally reached him, she was a nervous wreck and this would anger him. He felt that she was too "clingy," "needy" and "insecure," and he told her that if she didn't get help, he didn't know how much longer he could deal with this.

Maureen's primary care doctor recognized the symptoms of adult separation anxiety disorder. He told her that he was not qualified to treat her, and he advised Maureen to see a licensed psychotherapist. Maureen's therapist took a detailed psychosocial history and provided Maureen with psychoeducational material about adult separation anxiety disorder.

They also began using clinical hypnosis to help Maureen to calm herself and to internalize a felt sense of a loving, caring figure in her life (in this case, it was her grandmother) that she could call on in her mind when she felt extremely anxious. After a while, she was able to mentally call on this loving person in her mind with ease and feel a secure attachment to her.

Overcoming Adult Separation Anxiety Disorder

Maureen worked hard in therapy and attended her sessions regularly. She learned that there would be no quick fix for her problem. However, over time, with the help of her therapist, Maureen's separation anxiety dissipated and her relationship with her husband improved.

Why Clinical Hypnosis?
There are many ways to treat adult separation anxiety. Clinical hypnosis is a safe and effective form of therapy. It allows you to relax enough to get to the unconscious causes of the problem. You maintain a dual awareness of the here-and-now as well as whatever comes up in the clinical hypnosis session. It also allows you to discover if you are being triggered by other prior events in your life.

Clinical hypnosis is usually faster than regular talk therapy--although, for adult separation anxiety disorder, it's important to understand that this is not a 3-5 session treatment. Separation anxiety disorder is a complex problem and requires a lengthier treatment, even with clinical hypnosis, than some of the other problems that lend themselves to short-term hypnosis treatment, like smoking cessation.

When seeking clinical hypnosis treatment, always make sure that the person you plan to see is a licensed mental health practitioner and not a lay "hypnotist." As I've mentioned in prior blog posts about clinical hypnosis (also known as hypnotherapy), there is a big difference with regard to the education, clinical expertise and skills between a hypnotherapist and a lay "hypnotist."

If You Suffer with Adult Separation Anxiety, Seek Help from a Licensed Psychotherapist:
If you suffer from adult separation anxiety, the people around you might not understand what is happening to you. They might tell you that you're being dramatic or immature. They might also tell you that you "just need to get over it." But for you, the symptoms are very real and painful. Rather than suffering alone, you could benefit from seeing a licensed psychotherapist who has experience working with clients who suffer with adult separation anxiety disorder.

There are many ways in psychotherapy to work with clients who have separation anxiety, including a combination of cognitive behavioral treatment, psychodynamic psychotherapy, EMDR and clinical hypnosis. You want to find a therapist who tailors treatment to the individual client's needs.

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

I have helped many clients overcome adult separation anxiety.

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.

Your Anxiety or Depression Could Be Having a Negative Effect on Your Relationships

As a psychotherapist in New York City, I often see clients who begin psychotherapy after spouses or partners have spoken to them about how their anxiety or depression are affecting their relationships at home. Often, people don't recognize that they might be experiencing depression or anxiety until someone close to them or someone at work tells them about the impact that it's having with people around them.

Anxiety and Depression Could Be Having a Negative Effect on Your  Relationships

The following vignette is a composite of a psychotherapy client who began psychotherapy after his wife spoke to him about his anxiety and depression and how it was affecting his relationshp with her and their children. All identifying information has been changed to protect confidentiality:

Jack:
Jack was a man in his late 50s. He and his wife were married for over 20 years and they had two teenage children.

When Jack first came to see me in my psychotherapy private practice, he talked about how his wife had a difficult talk with him a few weeks before, telling him how his depressed and anxious mood affected their relationship as well as his relationship with their children.

After their talk, Jack realized that he was having many of the typical symptoms of depression and anxiety that he had heard about on TV commercials about antidepressants and that he had read about: insomnia, irritability, a feeling of foreboding that something bad was going to happen to him, decreased appetite, feeling like he wanted to isolate himself, and feeling sad and anxious most of the time. He had been feeling this way for months, but he hated to go to the doctor and he thought it would eventually pass.

Anxiety and Depression Could Be Having a Negative Effect on Your Relationships: Jack and His Wife Had a Talk

After his wife spoke to him and told him that she was finding it difficult to be around him and his children were trying to avoid him when he came home from work, in hindsight, he recognized that his depressed and anxious mood was getting worse.

He realized that, in many ways, he had been in denial about his anxiety and depression. He also realized that his mood was affecting his relationships with his colleagues and subordinates at work. Since he did not want to alienate his family or his colleagues any further, he went to his primary care doctor.

Jack was almost hoping that his doctor would find a medical reason for his depressed and anxious mood. He also hoped that, even if his doctor couldn't attribute his mood to anything medically wrong with him, at least, maybe the doctor could give him a pill to help him feel better.

But, to Jack's surprise, his doctor ruled out any medical cause for his mood and counseled Jack that medication alone is not as effective for anxiety and depression as psychotherapy with medication or even psychotherapy alone. He provided Jack with psychoeducational material about depression and anxiety, advised him to try psychotherapy first before he tried medication, and gave him my telephone number to set up an appointment for psychotherapy.

Jack procrastinated calling my office for a couple of weeks, going back and forth in his mind whether he felt that he really "needed" psychotherapy. He called his doctor again and his doctor urged him not to wait--to call my office and begin psychotherapy. Jack had been going to his doctor for a long time, and he trusted doctor so, even though he had some misgivings about psychotherapy, he decided to follow his advice.

When Jack came for his initial psychotherapy consultation, I asked him if he had ever felt this way before. Jack thought about it and realized that he had felt depressed and anxious off and on since he was a child. He had never thought about it before, but my question made him realize that he had at least five or six prior episodes of depression and anxiety in the past.

Over time, we worked on helping Jack to overcome his depressed and anxious mood. Once he began to manage his current stress and work on the underlying issues that precipitated his depression and anxiety, Jack's relationships with his wife, children and colleagues improved. He felt better than he had in a long time.

The Impact of Anxiety and Depression on Your Relationships:  Jack's Relationship With His Wife Improved After He Began Therapy

This upward spiral, in turn, became an incentive to continue in psychotherapy and he became more internally motivated to make other improvements in his life.

Denial Can Be a Powerful Factor in People Avoiding Dealing with Depression and Anxiety:
Denial can be a powerful factor in people with depressed and anxious mood from seeking help. People often will deny to themselves that they are feeling what they are feeling.

Even if they admit to themselves that they don't feel like themselves, they also might tell themselves that their depressed and anxious feelings will go away or they attribute their mood to outside factors (e.g., the weather, their boss, their age, etc).

But it's usually harder to ignore that there's something wrong and that you need to do something about it when people close to you tell you that your mood is not just affecting you--it's having a negative affect on them as well.

Depression and Anxiety Often Go Together:
Depression and anxiety often go hand in hand. Sometimes, people start by feeling anxious and their anxiety triggers depression, and sometimes it's the other way around. Often, depression and anxiety don't go away by themselves without professional help.

Getting Help in Therapy

If you've been experiencing depression or anxiety for more than a few weeks, don't suffer alone. 

You owe it to yourself and your family to seek professional help with a licensed mental health professional.

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 to overcome depression and anxiety.

To find 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.

Overcoming Low Self Esteem

As a New York City psychotherapist, I often see clients who come to psychotherapy because they want to overcome low self esteem. In my prior psychotherapy blog posts I've addressed issues of self esteem from different vantage points. In this post, I would like to discuss the link between self esteem, a sense of self mastery (also called self efficacy) and learning the life skill of self discipline.

Overcoming Low Self Esteem

The Importance of Learning Self Discipline, Self Mastery and Developing Healthy Personal Habits as Children:
Having a sense of self discipline, developing healthy personal habits, and a sense of self mastery are important to personal development and our sense of self esteem. These traits begin to develop, without our realizing it, when we're children.

When children learn to develop healthy habits like learning to put away their toys after they play, doing simple age-appropriate chores around the house, keeping their word about the commitments that they make, and so on, they're learning important life skills that are essential to their development beyond the particular chore or event that is involved. They're also learning to be responsible and deal with certain aspects of life that they might not want to do but that are essential to every day life as well as their personal growth and development.

Learning Healthy Habits as Children

When children don't learn to master certain chores or develop healthy personal habits like the importance of getting up on time, doing homework and turning it in when it's due, keeping their word about a commitment that they've made (and so on), they often have a much harder time as adults dealing with more mature issues in their work and personal lives than children who have gradually learned these life skills over time when they were growing up. Not learning these skills can also have a profound effect on a person's self esteem as well as how others view them as adults.

As a psychotherapist, I hear from many adult clients who talk about how frustrated they feel that their teenagers and young adult children have not developed healthy personal habits and self discipline and how this has affected the children's self esteem. These clients are often concerned that their children's lack of self discipline will not bode well for their chances out in the world with regard to personal relationships, school, and career.

 They fear that their children are just drifting without purpose and that they might have a hard time setting goals, holding onto a job or maintaining healthy relationships later in life. They talk about children who only want to do chores when they want to do them (or not at all), who spend most of the weekend loafing around or playing video games, who have no healthy routines, and they worry: "How is my child going to make his way in the world?"

When I hear clients who express these concerns about their teenagers or young adult children, I can understand why they're concerned. As any responsible adult knows, there are many things that we might not want to do, but we know that we must as essential parts of our lives. For instance, even if you think you have the most interesting job in the world, there are often parts of work that you don't like or you might find boring or unfulfilling.

 Imagine telling your boss that you just "didn't feel like" doing those aspects of your job, or you procrastinated doing them so that your boss had to come to you several times to ask about them, or if you pretended not to hear your boss because you were listening to your music (some of you who have teens might relate to this). After a while, you might not have that job for long. Aside from how your boss and colleagues might feel about you, you probably would not feel good about yourself and it would start to erode your self esteem.

Learning to develop healthy habits and self discipline should start gradually when you're young. Even young children can begin by learning to do simple tasks. Is it possible that they might grumble, pout or cry when you ask them to do simple things like learning to put away their toys when they're done playing? They might. They might question you as to "why" they need to do this or tell you that they don't want to do it.

They might test the boundaries with you in many ways. As a parent, you might even tell yourself that you would do it better and quicker and use that as an excuse to yourself to avoid having a confrontation with your child. But the importance of your child learning to do these simple chores is not only about the chores themselves--it's about their learning self discipline, responsibility and a sense of self mastery. They are probably too young to realize this but, as an adult, you know it.

Learning to do simple tasks, as a child, as well as learning to keep your word is also about learning to deal with your emotions when you feel annoyed and frustrated about something that you don't want to do--or just life, in general. Whether it's about learning to make your bed, practicing the piano or doing other things that you might not want to do at the moment because you're thinking about doing more interesting things, the skills that you learn by doing these tasks anyway (even when you don't want to do them) become part of your emotional development as well because you learn how to tolerate frustration.

We've all witnessed or experienced two year old children when they are having temper tantrums. The parent who is able to withstand the child's temper tantrum with love and patience, while the parent stands his or her ground, is helping that child to develop emotionally. For instance, when a child doesn't want to leave the park when it's time to go home or doesn't want to get in the carriage and a parent sets limits with the child (in a loving way), that child, without realizing it, is gradually developing a tolerance for acceptable amounts of frustration.

In these situations, the child has tested the boundaries with his mother, the mother demonstrates that she knows best, the child has a temper tantrum for a while (maybe a long while) but, in the end, the child learns that he must do something that he doesn't want to do.

 More importantly, he learns that he has survived in this ordeal, and that his mother has survived as well (although she might feel inwardly exasperated), and he learns that his mother still loves him and he still loves her. Can the two year old articulate these lessons? No. But, over time, we see the evidence of this in his personal development as he grows and continues to learn these important lessons in life skills. We can see it as the child learns to take on bigger, more complex age-appropriate responsibilities as they grow. We also see it in their sense of confidence.

Similarly, when a child learns life skills like keeping her word and following through with commitments , she will be better equipped as an adult to maintain her adult commitments. But when a child doesn't learn to develop these skills when they're younger, it's harder for them to keep their commitments when they're adults.

 If they haven't learned to develop a sense of the importance of keeping commitments and they only do certain things when they want to do them, they will probably struggle as adults. Lacking guidance from their parents as a child, they won't have internalized it as an adult. They will lack the internal emotional resources to deal with commitments and their only own internal "guide" might be whether they feel like it or not, which won't be acceptable in many circumstances in the outside world.

Lacking these internal resources as an adult will also affect how they feel about themselves. It's hard to feel confident, resourceful, and effective as an adult if your only guide to dealing with your responsibilities and commitments is whether you feel like it or not. You're definitely on shaky ground if this is your compass for functioning in the world. After a while, as friends, romantic partners and work supervisors refuse to put up with this, it reinforces an internal sense of incompetence and failure.

Conversely, when children learn to stick with their commitments and see the results of their efforts and diligence, it increases their self esteem and sense of self mastery.

 For instance, the child who learns to stick with practicing the piano on a regular basis (even though he would prefer to play video games at the moment) begins to make the link between practice, being diligent and responsible and a sense of self mastery. He sees that, over time, his time and effort has led to being able to play a certain piece of music with increasing skill. It becomes gratifying to him.

He also learns to translate this into other areas of his life: Studying and doing his homework, which might be boring in the short term, produces better academic results. Better academic results often leads to a more successful career. These life skills become an important part of his personal growth and development as well as his sense of self confidence.

It's certainly possible to learn to develop these life skills as an adult. I often work with clients in my psychotherapy practice helping them to learn these skills and this leads to a greater sense of self esteem. However, it's harder to learn when you're an adult and, often, by the time an adult comes to psychotherapy to deal with self esteem issues related to the lack of these related life skills, they have often struggled for a while in their relationships and career.

Getting Help in Therapy
If you're struggling with a sense of low esteem and you see that continuing on the same path has hindered your personal growth, you might benefit from working with a licensed psychotherapist.

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

I work with individual adults and couples.

I have helped many clients to overcome low self esteem to lead more fulfilling lives.

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

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