Getting to Know the Only Person You Can Change: Yourself

As a psychotherapist in New York City, it's not unusual for me to work with clients who come in because they're upset about a loved one's behavior. It might be a husband who refuses to stop drinking, a mother who continues to be masochistic, a father who is emotionally detached, a sister who has a long history of getting involved with abusive men, and so on.

 

Getting to Know the Only Person You Can Change: Yourself

Trying to Get Loved Ones to Change:
Listening to these sad stories, I can certainly understand and feel compassion for someone who is sad and dismayed that his loved one continues to engage in dysfunctional or self destructive behavior, and that his inclination is to try to "fix" them in some way. After all, don't we all want the best for the people that we love?

Searching for "Just the Right Words" to Get Your Loved One to Change:
Often, clients come to therapy because they think they're going to learn what to do or say to change someone else's behavior. They think if they say just the right thing in just the right way, maybe they can get their loved ones to see their point of view so that they can start changing their behavior. They reason that if only they can come up with the perfect solution, their spouse, father, mother, sister, or best friend will "see the light" and everything will be okay.

Often, these clients will ask me, "Have you worked with anyone who has this problem?" (referring to their loved ones). As an experienced, psychotherapist, usually, I have experience working with people who have the same kinds of problems. At that point, when I tell them that I have, clients are relieved to know that I understand what they're talking about.

The very next question is usually, "So, what did you do or say to change that person?" When I tell a client that I don't have the power to change anyone, they often seem mystified. After all, isn't that why people come to see psychotherapists--so the therapist can make them change? Well, not really.

No One Can Make Anyone Change if He Doesn't Want to Change:
The truth is that no one can make anyone change if he or she doesn't want to change. Even when they want to change, it's not the psychotherapist's job to get them to change. When I realized that, as a psychotherapist in training, it was a humbling experience.

But, ultimately, it was a big relief: As long as I know that I did everything that I know how to do, my responsibility ends there. I might wish for a different outcome for my client, but I'm not responsible for making anyone change or saving anyone or forcing them to do anything that they didn't want to do. It's completely up to the client. I can provide compassion, some guidance and tools, help them to explore underlying issues, assist them to overcome trauma, help them through the healing process, but I can't make anyone do anything that they don't want to do.

For many clients who come in because they want to change someone else that is close to them, they often don't believe me, at first, when I tell them this. It's as if they're thinking, "Surely, she must have the answer and she's waiting for me to come up with it myself, but if I don't figure it out, she'll tell me."

"But I keep telling him that he needs to change. Why doesn't he listen to me?"
One of the saddest things that I hear in my office from clients who are trying to get someone else to change is, "But I keep telling him that if he continues to do this, he'll destroy himself. I can't understand why he doesn't listen to me." Then, often, they'll ask me to speculate as to why their loved one is not listening to reason (as if I know). They seem to think if they can only figure out why this person is not listening to them, then they can get them to listen and to change.

Just like anyone else, in the past, I've experienced these feelings too for people that I've cared about and wanted to change. So, I have a lot of compassion for clients who come in hoping that they'll learn what they can do to change or save their loved ones. I've been there, and I know what that's like. But the longer I do this work, the more I realize that some people are just not going to change, no matter how much you want them to and, sometimes, no matter how much they say they want to change.

One of the hardest things that I have to tell clients is that their loved one is probably not going to change, no matter what they say to their loved ones and no matter what they do. I wouldn't say "never" to anyone because I've also seen many people make miraculous changes in their lives. Having witnessed this, I'm always open to the possibility of someone turning their lives completely around. Every year, I get calls or emails from former clients who tell me that they're continuing to live sober lives, or they continue to be much happier than when they first came to therapy, or whatever changes they made that they might never have thought that they could make. It's so gratifying and heart warming to hear from these clients.

I Meet Extraordinary People in My Office Every Day:
So, it's not that I don't believe that people can change--because I meet extraordinary people every day, and I'm so grateful to have a job where I can witness such wonderful changes. The problem is that when clients come to therapy focused almost exclusively on changing someone else, they often neglect themselves. Not only do they neglect themselves, but they've become so immersed in trying to get the other person to change that, they're convinced, against all odds, that they can do something to get their loved ones to change.

The Role of Denial:
Years ago, I had a friend who, up until the day his wife died from alcohol-related complications, was convinced that he could get her to stop drinking. He was in such denial that, despite all evidence to the contrary (including her severe liver damage, cognitive impairment, and her non-stop drinking), he could not be deterred from his efforts to get her to be abstinent from alcohol. When she died, even though he had watched her steady decline at close range, he was the only person who was surprised by her death. He was also shattered to realize that nothing he did made any difference.

The Role of the Inner Child:
Very often, when an adult child wants to change a parent, there is an inner child part that is wishing, against all odds, that the parent will change. Clients are often surprised to hear that, even though they might be adults in their 40s, 50s and beyond, they can still have inner child parts that are still operating on a deep emotional level. They're surprised to discover that their inner child has taken control of their emotions and their reasoning, and this can have a very powerful effect on how they feel and think.

Your inner child might be buried deep, but he or she is still there and will often get emotionally triggered in certain situations. Typically, these situations involve an old desire, that is still very strong, to change someone that he or she loves. It doesn't have to be the same person that they wanted to change as a child. It could be someone else. So, for example, if a young boy had a strong desire to stop his alcoholic mother from drinking, it's not unusual for him to have the same feelings when he gets married to a woman who is an active alcoholic.

Helping the Inner Child to "Update the File:" "That was Then, This is Now":
Because our inner children are often so fragile and vulnerable emotionally, we don't want to run roughshod over them. However, we do want to help our inner children to realize that "that was then, and this is now. Of course, you had a strong wish and fantasy that your mother would stop drinking and somehow you would help her to stop. That was perfectly understandable back then, but this is now. "

Typically, a therapist, who works with clients who come to therapy primarily to help a loved one, helps these clients to "update the file." Often, this involves trauma work to work through the old trauma that is getting triggered again in the new situation. There is also grief work to be done for the old situation and the current situation.

On the Road to Acceptance: "So...I guess she's probably not going to change."A client who is starting to come to grips with the fact that their loved one is probably not going to change will often say, almost in a questioning tone,"So...I guess she's probably not going to change." This is a big step in that client's recovery. It might be a tentative step, and it might involve taking one step forward and another step backwards as denial sets in again. But it's the beginning of an opening for the adult self to nurture that inner child.

Focusing on Yourself:
Rather than continuing to neglect themselves by focusing so much on changing the other person, clients who are coming to grips with the reality of their situation, ideally, begin to focus on themselves. Maybe they've neglected their own health. Or, maybe they've neglected themselves in some other way because they've been so focused on their loved ones.

Coming to grips with the fact that, no matter how much we love them and what we're willing to do for them, sometimes, our loved ones just don't change, can be a very difficult emotional journey. We can go through many different stages as we, reluctantly, come to accept that they're not going to change: sadness, anger, disbelief, shock, and, hopefully, acceptance. We might go back and forth through these stages and there's no logical order.

Acceptance Can Be a Humbling Experience:
Accepting that you're the only one that you can change is a humbling experience. But it's often a relief for people who have worn themselves out trying to get the other person to change. By the time they stop trying, they often need to regroup and, sometimes, get to know themselves again. The focus has been so much on the other person that these people often lose a sense of themselves.

Codependence, But So Much More:
Often, what I've described in this article is called "codependence." I use this term myself, but I think it's, sometimes, misunderstood. And in the situations that I've described, where there is such a longing for the loved one to change, it doesn't even begin to capture what that experience is like for the person who is "codependent."

Getting Help in Therapy
If you're stuck in a battle with a loved one and, possibly with yourself, to try to get this loved one to change, you could benefit from psychotherapy for yourself. Your loved one either will or won't change, very often having nothing to do with what you try to do for him or her. But if in the process of your trying to get the other person to change, you lose yourself, then, really, all could be lost. So, the healthiest thing to do is to rediscover and take care of yourself.

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

I work with individual adults and couples.

I have helped many clients through their journey of acceptance in difficult situations. I've also helped them to rediscover and nurture themselves again.

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.

Are You Catastrophizing?

In my last article, I focused on Overcoming Your Fear of Making Mistakes which is a common problem for many people. Related to fear of making mistakes is the habit of catastrophizing.

Are You Catastrophizing?

Habitual Catastrophizing:

Why do I call catastrophizing a habit? Because it's usually an automatic negative way of thinking that becomes habitual over time. Many people who engage in catastrophizing don't even realize that this is what they're doing. It becomes such an automatic way of thinking that they tend to see most situations as being dire and dangerous, and they approach many new situations with fear.

What is "Catastrophizing"?
Simply, catastrophizing is when a person expects the worst in most situations. His or her fears are usually highly exaggerated without sufficient evidence for this type of fear. It's a distortion in the way a person thinks.

People who engage in catastrophizing usually fear making mistakes. Their exaggerated fear that something dire will occur if they make a mistake leads them to expect the worst in most situations. They might engage in endless "what if's" that keep them stuck in their particular situation, too afraid to go back but equally afraid to move forward.

When we think about the old story about Chicken Little running around saying, "The sky is falling! The sky is falling!" this is an example of catastrophizing.

Often, people who engage in catastrophizing can get other people very anxious as they trigger their vulnerabilities and insecurities.

The following fictionalized scenario is an example of catastrophizing, and how an individual can overcome this habitual form of negative thinking:

Joanne:
Most people who knew Joanne knew that she tended to see the worst possible scenario in just about every situation that she encountered. For Joanne, decision making was fraught with fear and anxiety about all the possible things that could go wrong. Whether she was trying to make a career decision or go on a trip, she was sure that something awful was going to happen.

Joanne's fears kept her ruminating about all the "what if's" in any given situation: What if the boss in the new job turned out to be difficult to work for? What if the plane that she was on had a malfunction and crashed? What if the house that she and her husband were considering buying turned out to have a lot of problems? What if..what if...what if...

One day, Joanne's husband, Ken, told her that she was driving him crazy with all of her exaggerated fears, "You see everything as a potential catastrophe." They had been talking about having children, but Ken told her that he didn't want to raise children in a household where they were constantly badgered about everything that could possibly go wrong. He told Joanne that, for her own sake, for his sake, and the sake of their future children, she needed to get psychological help.

At first, Joanne was offended that Ken told her to get psychological help. She felt that her fears were legitimate and not at all distorted. But when she talked to her sister and her best friend and they both agreed wholeheartedly with Ken, Joanne found his suggestion hard to ignore. Even though she didn't think that she had a problem, she thought she would, at least, go for a consultation with a psychotherapist.

No sooner did Joanne decide to find a psychotherapist than she began to worry excessively about the cost. Even though she and Ken had an upper middle class standard of living and they were in stable jobs, she worried that spending money on psychotherapy would drain their savings. Ken tried to reassure her that she had nothing to worry about, but she continued to engage in "what if's"--until, finally, Ken pointed out to Joanne that this was yet another example of her catastrophizing.

Reluctantly, Joanne began psychotherapy. She began therapy by telling the psychotherapist that she didn't think she needed to be there, and she was coming to prove it to her husband. But almost immediately, Joanne began to engage in her habitual and exaggerated negative way of thinking in her first session. When her therapist pointed this out to Joanne, she began to consider that there might be a kernel of truth to what her husband, sister and best friend were telling her.

Exploring her habitual ways of thinking was very uncomfortable for Joanne. She grew up in a family where both her mother and father had strong fears, so it seemed "normal" to her to engage in this type of thinking.

But when she was able to look at her parents' negative and distorted ways of thinking, it was much easier for her to see the problem than when she looked at her own way of thinking. She began to remember times when she was growing up that were spoiled for her because her parents approached most things like they were potential catastrophes. This made her feel very sad, and she thought back to her husband's words when he told her that he didn't want to raise children in an atmosphere of exaggerated fears and negative thinking.

As Joanne remembered those times when she looked forward to going to a party or seeing friends and her parents spoiled those times for her by not allowing her to go ("What if you get into a car accident?"), Joanne began to see how her way of thinking was just like her parents. She told her therapist, "I never wanted to be like that, and now, look at me."

With her psychotherapist's help, Joanne began to question herself whenever she began to worry excessively about ordinary things. She asked herself if there was any rational evidence that these awful things that she was projecting were likely to happen. Not if they could ever happen--but what was the likelihood of their happening? After a while, she had to admit that most of her fears were unfounded.

Over time, after she managed to get her thoughts and emotions under control, she also began to work with her therapist on the underlying issues that caused her to engage in so much catastrophizing. As she worked through these issues, she discovered that she hardly worried excessively any more. When her husband pointed out to Joanne that she was so much easier to be around now, they rekindled their relationship and it became much more passionate than it had ever been before.

Getting Help in Therapy
If you're catastrophizing, you're not alone.

There are many people who engage in this form of distorted and irrational thinking. And there are many people who have been helped in psychotherapy to overcome this problem.

Rather than agonizing about what could go wrong and causing a lot of stress for yourself and those around you, you owe it to yourself to learn to stop catastrophizing.

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

Also, see my article:  Overcoming Your Fear of Making Mistakes

Overcoming Your Fear of Making Mistakes

Fear of making mistakes is a huge problem for many people and it often follows them throughout their lives, sapping their lives of vitality, isolating them, and hindering them from experiencing new opportunities and experiences.

Overcoming Your Fear of Making Mistakes

Fear of Making Mistakes Can Start at a Young Age:
When I was in elementary school, I had a best friend and classmate who lived in my neighborhood. Let's call her Susan (not her real name). We would spend time together doing homework, either at her house or my house.

When we went to Susan's house, her mother, who was a very warm and kind woman, would hover over Susan while she was doing her homework. This became most challenging for Susan when we had to write short book reports.

Her mother would hover over Susan and practically dictate what Susan should write. As Susan was taking down her mother's words, she tried to be careful not to have any erasures on the page because her mother would ask her to start all over again on another clean page rather than turn in a page with any signs of erasures. Susan's mother meant well, but she was such a perfectionist that she made Susan feel very anxious about making mistakes.

Fear of Making Mistakes Can Start at a Young Age

When Susan was in her late teens, she continued to defer to her mother's wishes and recommendations, no matter what the subject was --her choice of college, the young men she dated, and even what she wore. Susan had such little self confidence that when she went away to college and she no longer had her mother close at hand, she agonized about even the smallest decisions. She was so afraid of making a mistake that every choice became ominous and anxiety provoking for her.

Since Susan didn't grow up in an environment where she learned to make age-appropriate decisions along the way, she panicked whenever she was faced with even a relatively minor decision. Her fear worsened, as fears usually do, over time. And it got to the point where Susan would rather skip a social event than try to decide what to wear.

When it came time to choose a major, Susan allowed her mother to persuade her to become a business major. Until then, Susan was doing very well in her foundation courses, but Susan hated the business courses, and she began to fail her classes. Her failures only reinforced her lack of self confidence and contributed to Susan becoming depressed.

After the dean suggested that Susan see a counselor at the student counseling center, she began to talk about how agonizing it was for her to make choices and her fear of making mistakes. While it's true that most of us don't like making mistakes, Susan's fear was exaggerated beyond all logic. Her fear of making mistakes was paralyzing her and making her world very small and narrow.

Fortunately, Susan was able to work on her fear in counseling. Over time, she learned to let go of her fear by asking herself. "What's the worst thing that could happen?" Usually, when she asked herself this, she realized that, most of the time, nothing monumental was at stake. But she also knew that, on an emotional level, it felt like something awful would happen if she made a mistake.

Through trial and error, Susan began to practice making relatively small decisions and working on her fear of making a mistake as it came up. She began to realize that she had internalized her mother's perfectionism and her mother's own fears about making mistakes. As she learned to let go of her fear, she was able to relax more and she began to see that she actually had good judgement when she made decisions, and her fears were groundless. Emotionally, this was very freeing for Susan, as if a huge burden had been lifted from her shoulders.

Inevitably, as we all do, Susan did make mistakes when she made decisions. But, just like anyone else, she learned from her mistakes. Over time, she also began to trust her intuition more. Rather than suffering in business courses that she hated, Susan changed her major to liberal arts, and she was much happier. Her grades also improved tremendously. She began socializing more and enjoying herself. And when her mother tried to persuade her to go against what she knew was best for her, Susan told her, tactfully, that she wanted to make her own decisions. She said, "If I make a mistake, I'll deal with it."

As you can imagine, this wasn't what Susan's mother wanted to hear but, reluctantly, she respected Susan's right to make decisions and to make mistakes.

Earlier this week, I was in a children's store. While I was searching for a gift for a young child, I watched two different parents interact with their daughters in quite different ways.

Both girls were about four years old. One of them was very neatly dressed in a matching outfit. Her father was "helping" her to pick out a new outfit. Whenever she chose something that he didn't like, he expressed his disapproval by shaking his head "no" and telling her that the color was wrong or there was some other problem in his eyes.

I watched as the young girl became frustrated with her father's criticism of whatever she liked. Eventually, she gave up and told him to choose something for her. Apparently, not understanding how discouraging he was being with his daughter, the father looked delighted to buy what he liked for his daughter rather than allowing her to pick it out. He picked out an outfit that he liked and he showed it to his daughter. She shrugged her shoulders in resignation. He took that as approval and bought the outfit for her.

The other little girl was having a very different experience with her mother. Although she was well groomed, it was obvious that this little girl picked out her own outfit to wear that day. She had on a mismatched tee shirt and shorts with clashing colors. But it didn't seem to matter to her mother. She allowed her daughter to choose what she wanted to wear that day. And, other than telling her daughter to keep her choice below a certain price range, she was pleased with whatever her daughter chose. This little girl seemed much more confident, and she was enjoying her shopping excursion with her mother.

So, we can see how fear of making mistakes can start at a young age. And parents might not even realize the effect that they are having on their children when they don't allow them to start making age-appropriate decisions along the way.

Fear of Making Mistakes is Not Limited to Any Particular Group:
Fear of making mistakes is not limited to a particular age group, gender or a particular profession. Several years ago, I was at a training workshop with about 40 other psychotherapists. Most of us are seasoned clinicians with diverse backgrounds. Our trainer could not have been more open, skilled, informative, and compassionate. Yet, even in that nurturing environment, many therapists expressed their fears of learning a new treatment modality because they feared making mistakes.

After a while, when she realized what was happening, our trainer would start the day by saying, "Please, please make mistakes. Make lots of mistakes. I really mean it," which elicited knowing smiles and laughter. She told us that the only way that we could learn this new treatment modality was to risk making mistakes as we practiced on each other.

Fortunately, the trainer's encouragement to "please make mistakes" was very freeing, and allowed clinicians to practice a treatment modality that was completely different from anything that they had done before. They began to feel more confident in terms of practicing with each oher, "playing" with the modality, and seeing how it fit in with what they already knew.

Fear of Making Mistakes Can Limit Your Life, Causing You to Stagnate:

When you allow your fears about making mistakes to prevent you from trying new things, you might not realize how limiting this can be in your life. If you're always "playing if safe," hardly ever trying anything new or taking risks, you impose a very circumscribed life for yourself. Everything becomes dull and predictable. And rather than grow and learn from mistakes, you stagnate.

Overcoming Your Fear of Making Mistakes

If you think that you're overwhelmed by your fear of making mistakes, you can start by asking yourself whose voice is getting replayed in your head. Is it one of your parents? A former schoolteacher? Or some other authority from your childhood? Those "old tapes" from your childhood can be very powerful. Without your even realizing it, you could be giving in to your fears in order to avoid making mistakes.

Some of our greatest inventors, like Thomas Edison, were willing to try and try again, making many mistakes along the way, until they achieved their goals. If these inventors were too afraid of making mistakes, we wouldn't have the wonderful inventions that they eventually created.

Getting Help in Therapy:
If you think that your fear of making mistakes is holding you back in life, you could benefit from working with a licensed psychotherapist to overcome this fear. 

Once you've overcome your fear of making mistakes, you'll probably discover that new opportunities will open up for you in your personal life and in your career.

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 their fear of making mistakes so they could broaden their horizons and lead happier lives.

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

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

Changing Maladaptive Coping Strategies that No Longer Work for You: Controlling Behavior

In prior blog posts, I addressed avoidant and passive coping strategies as maladaptive strategies that usually do not work by the time we become adults. I mentioned that these maladaptive coping strategies usually develop from a combination of individual temperament and early home environment. In this blog post, I will focus on controlling behavior as a maladaptive coping strategy.

What Are the Signs of Controlling Behavior?
Just like any other type of behavior, controlling behavior is very individual and it will manifest in a variety of ways. Similarly, controlling behavior is on a continuum from moderate to severe.

Controlling Behavior

People who are moderately controlling will try to control some aspects of their lives and the lives of those around them, but they realize that they can't control everything. Often they will respond to others' discomfort with their controlling behavior by backing off--at least for a while.

People who are severely controlling have a need to control or micromanage nearly everything. In most severe cases, when others around them express their discomfort, people who are severely controlling become angry. In some cases, they might become violent.

In both cases, controlling behavior often stems from underlying anxiety, fear, or insecurity.

The following fictionalized vignette, which is not about any one particular person, is an example of moderately controlling behavior:

Ruth:
Ruth grew up in a household that was almost always on the verge of chaos. She was the oldest of six children. Her mother, who stayed at home, tended to be very anxious and overwhelmed most of the time. Her father spent long hours at the office, leaving the mother to take care of the children and the household.

By the time she was 10, Ruth was helping her mother to prepare meals, do the wash, and take care of chores around the house. Since her mother tended to be in a state of high anxiety most of the time, this caused Ruth to feel anxious and insecure too.

By the time Ruth was married with children, she tried to make a lot of decisions for her husband and her teenage children, which caused friction in the household. Often, when she and her husband went out to dinner, she would order his meal for him, even before he had a chance to look at the menu. Whenever her husband pointed out to her that he would like to order his own meals, Ruth would realize that she overstepped her bounds and she would apologize. Similarly, when she continued to choose clothes for her 19 and 20 year old daughters, who still lived at home, and they told her that they wanted to make their own choices, she backed off. But even though Ruth backed off, in both instances, not being in control of these situations made Ruth feel anxious. It wasn't until she began psychotherapy to deal with these issues that she realized that she had underlying family of origin issues and her own temperament that caused her to develop this maladaptive coping style.

The following fictionalized scenario is an example of the other end of the spectrum of controlling behavior, severe controlling behavior:

Henry:
When Henry was 18, he moved out of his family's household to get away from his abusive father. For most of his life, he grew up witnessing his father hit his mother. He also witnessed his mother's passive response. He thought his father was a tyrant--always wanting to control every aspect of their lives.

Henry vowed to himself that he would never be like his father. He quit high school, got his GED, began working, and got his own apartment.

In his early 20s, Henry began dating a young woman, Linda, that he really liked. After a few months, they decided to date each other exclusively. At first, their relationship was going well. But after a while, as Henry got closer to Linda, he began asking her to let him know where she was going and with whom. At first, Linda was flattered because she thought this meant that Henry really cared about her. Whenever they went to a restaurant, Henry ordered for Linda. Initially, Linda felt he was being chivalrous, and she liked this.

After a while, Linda got tired of having to answer questions all of the time about where she was going and with whom, and she wanted to order her own food when they went out. Whenever Linda tried to talk to Henry about all of this, he refused to talk about it.

One day, when Linda brought this up again, Henry felt like he was going to explode. As Linda continued to insist that they talk about Henry's controlling behavior, Henry lost his temper and he slapped her. Linda was stunned and hurt. Henry was shocked by his own behavior. After that, despite his repeated attempts to apologize to her, Henry could not get through to Linda . She wanted nothing to do with him.

Shortly after that incident, Henry began psychotherapy to understand how and why, despite his vow to himself that he would never become like his father, he had become severely controlling and violent in his relationship--just like his father.

These two vignettes illustrate that, depending upon the person and the circumstances, controlling behavior is on a continuum. I provided examples of moderate and severe controlling behavior with the understanding that there is a wide variety of behavior between those two extremes.

Getting Help in Therapy
If you engage in controlling behavior and it is affecting how you feel about yourself as well as how others feel about you, you're not alone. 

Many individuals and couples come to therapy to work on and resolve these issues. Often, you can work through the underlying issues in psychotherapy and learn new ways of coping so that you're no longer engaging in maladaptive coping strategies.

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

I work with individuals and couples, and I have helped many clients to overcome maladaptive coping strategies that no longer work for them.

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

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

Also, see my articles:
Changing Coping Strategies that No Longer Work For You: Controlling Behavior

Coping Strategies that No Longer Work For You: Avoidance

Changing Maladaptive Coping Strategies that No Longer Work for You: Passive Behavior

In my last blog post, I addressed the maladaptive coping strategy of avoidance, and how it develops due to a combination of early childhood experiences and a person's particular temperament (see my article: Changing Maladaptive Coping Strategies That No Longer Work For You: Avoidance).

Another maladaptive coping strategy is passivity, also referred to as lack of assertiveness or surrendering to the will of others.

As mentioned in my prior blog post, coping strategies that develop in early childhood often help a child to survive in a situation where he or she doesn't know what else to do and/or doesn't have the ability to do anything else. 

These coping strategies, which are usually unconscious, develop outside of the our awareness so we don't realize that we're continuing to use the same strategies that we used as children.

Even though these coping strategies might have worked when we were children, these strategies are no longer adaptive.

What is a Passive Coping Strategy?
A passive coping strategy is usually associated with a person being overly compliant and subjugating his or her needs to others. 

Coping Strategies That No Longer Work: Passivity

Often, this occurs because the overly compliant person fears being abandoned or punished or that they will incur the anger of others if they don't comply. 

There might also be a wish, often unconscious, that by complying, this person will gain the love or admiration of the other person. For an overly compliant child, this person is usually a parent or some authority figure. 

So, the passive coping strategy is an effort to ward off negative repercussions that the person fears as well as, at times, a wish to feel loved.

The following fictionalized scenario, which is not related to any particular person, is an example of a passive coping strategy and how this strategy can be overcome:

Ronald:
By the time Ronald started psychotherapy, his wife was threatening to leave him because she was fed up with Ronald's passivity. 

Ronald, who was in his 40s, was unable to assert himself with his domineering father, which was affecting Ronald's relationship with his wife. 

Ronald was also underpaid and overworked at his job as an engineer because he couldn't assert himself to ask his boss for a raise and a change in his workload. The demands of his job were also affecting his relationship with his wife.

Ronald grew up in a household where he was taught that his emotional needs weren't important. Neither his mother nor his father ever told Ronald this explicitly, but he was given this message implicitly nearly all of the time.

Ronald's father ruled the household with an iron fist. The father controlled almost every aspect of that household from how money was spent to what they ate to the clothes that they wore. 

The father had an explosive temper, and if he didn't get his way, he would yell, break furniture, and threaten to hit the mother, Ronald, and Ronald's siblings. 

The father never actually hit anyone, but he was a big man and his threats were enough to keep everyone in line. 

Ronald grew up not only acceding to his father's every wish, but he also learned to anticipate what his father wanted before his father even expressed it so that he could comply with his father's wishes and ward off any negative repercussions.

After Ronald got married, he and his wife bought a two-family house so that his parents could live downstairs and he and his wife could live upstairs. 

Even though Ronald was now an adult, he continued to comply with his father's dictatorial style. His father continued to control everything from the heating system in the house to what plants were planted in the garden. Without consulting with Ronald or Ronald's wife, he took it upon himself to hire a crew to paint the house a color that Ronald's wife hated.

That was the last straw for Ronald's wife. She had been telling Ronald for years that she was fed up with his passivity and she wanted Ronald to stand up to his father. Now, she told him that, unless he took a stand with his father, she was leaving. 

At that point, Ronald felt caught between wanting to comply with his father's wishes and also wanting to comply with his wife's demands, and he didn't know what to do. At his wife's urging, he sought therapy.

During his psychotherapy sessions, Ronald's therapist helped him to understand the particular coping strategy that he developed as a young boy. Ronald was able to see that, when he was a child, he did the best that he could do by complying with a domineering father. 

He was also able to see that he was still reacting to his father (as well as to his boss) as if he was still a young boy without choices and that his passivity was now detrimental to his marriage and his life in general.

Ronald's therapist worked with him by helping him to recognize where he was capitulating to his father's demands. Then, Ronald chose certain situations where he could begin asserting himself with his father. His therapist helped him by doing role plays where the therapist was the father and Ronald was his adult self.

Over time, Ronald recognized that he was continuing to operate from his old fears that his father would either hit, abandon or ridicule him. 

He also recognized that these old fears didn't apply any more. Not only wasn't he a small boy looking up to his big father but, at this point in his life, he was a strong man who was bigger than his father, and his father was no longer a physical threat to him. 

He also became aware that his deepest wish was that by complying with his father's demands, he would gain his father's love and praise. Since his father tended to be more critical than praising or affectionate, Ronald's deepest wish remained unfulfilled.

After practicing in a role play with his therapist, Ronald went home to talk to his father about his hiring a crew to paint the house. 

Before Ronald could get a word out of his mouth, his father began telling Ronald about the renovations he envisioned for the house. 

Ronald had planned what he wanted to say but, hearing his father's words, his stomach turned queasy and he began to perspire. Feeling defeated, he lapsed back into a state of passivity and abandoned his efforts to confront his father.

Ronald almost cancelled his next psychotherapy session because he feared that his therapist would be angry with him for not being assertive with his father. But instead of cancelling, he went and told his therapist that not only did he feel that he was not complying with his wife's wishes, but now that he was in therapy, he also felt that he was not complying with his therapist.

As he and his therapist talked about what was happening between them and how Ronald was applying the same passive strategies in their therapeutic relationship as he did in the rest of his life, that session was one of the best sessions that he had. 

He had a here-and-now experience of how he felt victimized even in his own therapy, and how this was the type of interpersonal template that he applied to most of his relationships. 

He also realized that, rather than owning the part of himself that wanted to assert himself with his father, he was projecting it onto his therapist--as if she was the one that was coercing him to be assertive rather than it coming from inside of him.

In addition, Ronald also began to become aware of a very important aspect of psychotherapy--that psychotherapy is a process, and progress in psychotherapy is usually not linear, but more like a spiral where clients make some progress and then they revert back to their old ways before they move forward again. 

This can happen many times in psychotherapy and it's all part of the process. 

In Ronald's case, his progress was his continuing to come to therapy, talking to his therapist about his hopes and fears, and being willing to put into practice what he learned in therapy. 

His false start with his father is a common experience for most people and it's all part of the process.

Ronald and his therapist did other role plays where his therapist played the part of his father in a way that was similar to how his father had come across when Ronald tried talk to him about having the house painted. 

Ronald practiced how he could assert himself under these circumstances. With a few false starts, Ronald found his voice and he felt even more determined to assert himself with his father.

On the day that Ronald decided to talk to his father again about the house, Ronald's father interrupted him, and he began telling Ronald that his arthritis was bothering him. 

As if for the first time in a long time, Ronald looked at his father and saw a certain fragility in his father he had not seen before. 

His father was no longer the towering, fierce figure that he had been when Ronald was a child. He was now a man in his 70s who was starting to have the kind of health problems that many senior citizens have. This made Ronald feel sad and guilty about what he was about to do.

Ronald's first inclination was to back down. He felt that internal child part in him that wanted to please his father, hoping that his father would express some affection or praise. 

He began to think about how one day his father wouldn't be around any more, and this made him feel sad as well as guilty. But Ronald and his therapist had prepared for this, and he gathered his inner resolve and began to talk to his father.

Much to Ronald's surprise, his father listened to him that particular day. Ronald talked for a long time. He hadn't anticipated that he would say as much as he did, but after he told his father about how he felt about having the house painted, he poured his heart out about how he felt unloved by his father. 

His father began turning away at that point because he was a man who was uncomfortable with any talk about love or affection. But Ronald asked his father to hear him out, so his father stayed, looking uncomfortable.

When Ronald finished, there was silence for a couple of minutes, which seemed like an eternity to Ronald. 

Then, his father apologized to him about the house, and he told Ronald that he had always told other people how proud he felt of Ronald, but he never told Ronald directly because he was afraid that Ronald would develop a "swelled head." He apologized for that too.

This was the beginning of Ronald's process of learning to be more assertive in his relationship with his father. It continued to be a work in progress for a long time because his father would often revert back to his domineering ways and Ronald would feel the old pull to revert back to his old passive behavior. But Ronald was definitely making progress. He also began working in therapy on asserting himself with his boss so he could ask for a raise and some changes in his workload.

When Ronald's wife saw Ronald making progress, she decided not to leave the marriage and their relationship improved over time.

This scenario demonstrates how maladaptive coping strategies develop and continue into adulthood, and the underlying issues that continue to influence an adult's behavior. 

It also demonstrates that people with maladaptive coping skills can learn to change and grow in psychotherapy if they're willing to work on these issues.

Getting Help in Therapy
If you feel that you need to change coping strategies that are no longer working for you, you're not alone. 

This is a common problem for many people. 

Rather than struggling with this on your own, you can work with a psychotherapist who has expertise in this area and learn to develop healthy coping strategies.

About Me

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

I have helped many clients to improve their coping strategies so they can live more fulfilling lives.

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

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

Also, see my articles:
Changing Coping Strategies that No Longer Work: Controlling Behavior

Changing Maladaptive Coping Strategies That No Longer Work For You: Avoidance

Do you ever wonder how people develop maladaptive coping strategies?

Changing Coping Strategies That No Longer Work for You:  Avoidance

Well, to begin with, we all learn different coping strategies that start out being a combination of our own particular temperament and as well as the coping strategies that we learned growing up in our home environment as children. Two children who live in the same household under the same conditions can develop very different coping strategies.

Often, there are coping strategies that might have worked for us as children to preserve our safety and emotional well-being that no longer work for us as adults. Avoidance is a particular maladaptive coping strategy.

Avoidant Coping Strategies

What are Avoidant Coping Strategies?
The following is a list of the most common avoidant coping strategies:

Social Withdrawal:
The person who uses social withdrawal or social isolation as a coping strategy disconnects from the people around him.

Social Withdrawal as Avoidance

He might disconnect by staying home alone and watching an excessive amount of TV or spend many hours on the Internet without having in-person social contact with others.

He might appear to be very "independent," but this is often a pseudo independence whose main purpose is to avoid dealing with others. People who engage in social isolation often prefer jobs where they work alone and only engage in minimal social contact.

Psychological Withdrawal:
The person who uses psychological withdrawal as a coping strategy copes by "numbing" herself emotionally.

The main goal is to keep herself from feeling overwhelmed. She might also spend a lot of time in her own fantasy world as a way to avoid dealing with the people and problems around her.

Another form of psychological withdrawal is dissociation, which can range from moderate to severe. An example of moderate dissociation is something that we all do from time to time--daydreaming. Daydreaming. in and of itself, is not necessarily avoidant.

Psychological Withdrawal as Avoidance

Many creative ideas come to us from daydreaming. However, if a person spends a lot of time daydreaming, rather than dealing with the world around her, this is considered a form of avoidant coping.

An example of severe dissociation is when a person has Dissociative Identity Disorder (DID), formerly known as Multiple Personality Disorder. When someone has DID, most often, she has experienced severe trauma and her personality fragments as a way to compartmentalize the overwhelming experience.

Compulsive and Addictive Behavior:

Compulsive and Addictive Behavior as Avoidance

Compulsive and addictive behavior include many different types of behavior: abusing drugs, abusing alcohol, overeating, bingeing and purging food, compulsive exercise, compulsive overspending, compulsive gambling, workaholism sexually compulsive behavior, compulsive risk taking, and other tendencies that seek excitement and distraction to avoid dealing with whatever is too emotionally overwhelming.

The following fictionalized scenario, which is not based on any one person, illustrates how these avoidant coping strategies develop over time:

Jeff:
Jeff and his older brother, Tom, grew up in a household with an alcoholic father and a passive, emotionally overwhelmed mother. Their father, Dan, would come home from work everyday, eat his dinner alone in the den without interacting with the rest of the family, and then spend the rest of the night drinking beer and, eventually, falling asleep on the couch.

Sometimes, he would become angry and belligerent and pick an argument with his wife, Betty. Most of the time, she ignored him by retreating into the bedroom and closing the door. Sometimes, she would yell back at Dan and they would have an explosive argument. Even though he would wake up most mornings with a bad hangover, Dan almost never missed work as a train operator for the MTA subway system.

Even though Jeff and Tom were only a year apart and growing up in the same household, they each experienced their father's drunkenness in very different ways.

Jeff tended to be a very quiet child who would retreat into his room and watch TV quietly, losing himself in whatever program he was watching. If he was watching a program about an ideal family, he would fantasize that he was part of that family.

Tom would often leave the house, slamming the door behind him. By the time he was a teen, he had his own car and he would sometimes drive off in anger to get away from the home. He would meet his friends and they would go drag racing on the boulevard. He was brought home by the police a few times for speeding at 90-100 mph.

One day, Dan was sent home from work after he tested positive for alcohol on a random alcohol test at work. His supervisor told him that he would be brought up on disciplinary charges and he would either have to get into an alcohol treatment program or face losing his job.

They considered him to be too high a risk to allow him to drive the train. Before his disciplinary hearing, he would have to serve a 30-day suspension without pay.

Until then, even though he was an active alcoholic, Dan had been a good provider. Now, his job was in jeopardy, and this placed another burden on the family and created more tension in the household.

Neither his mother or his father talked to Jeff about this, but he overheard them talking quietly in the living room. He heard them say that they wouldn't tell Jeff and Tom about Dan's problems at work, so Jeff had to pretend that he didn't know and try to act "normal" around them.

When Tom got home, Jeff spoke to him quietly about what happened. Tom was furious. He told Jeff that he hated their father and he wished the father would die.

Fearing that his parents would hear Tom, Jeff tried to get Tom to be quiet, but Tom was so enraged that he ran out of the house, and sped away in his car. Jeff knew that Tom liked to speed and he worried that his brother would get into trouble. His parents were so preoccupied that they hardly noticed that Tom left in a rage.

Jeff spent the rest of the night in his room spacing out in front of the TV for hours. He had fallen asleep in front of the TV when he heard the doorbell ring late at night.

From inside his room, he heard a commotion at the front door. When he got up to see what was going on, he was not surprised to see a police officer at the door informing his parents that Jeff had gotten into an accident while speeding and he was in the local hospital. Fortunately, he survived the crash and he only had a broken leg and no one else was hurt, but the car was totalled. This was the beginning of Tom's long arrest record for reckless driving.

When Jeff got older, he moved out on his own. He had a few people that he socialized with occasionally, but he tended to keep to himself.

He was employed as a technical researcher, so he spent most of his working time alone as well. Although he tended to avoid socializing, he was often very lonely.

Part of him wanted to have close friends and a special woman in his life but, at that point, a bigger part of him was too afraid of getting hurt and disappointed.

Because he had spent most of his childhood isolating, he also lacked the social skills to go out to meet other people. And when he had opportunities to meet others in college or at work, he was too afraid to open up to these experiences.

By the time he was in his late 20s, he felt depressed and miserable. His father had long since retired on disability due to alcohol-related medical problems, and his mother was depressed and emotionally withdrawn. His brother had moved out of state and he was estranged from the family. No one knew where he was. So, Jeff felt like he had no family and no friends.

Jeff couldn't imagine spending the rest of his life in this state, so he knew he had to do something, but he felt too afraid to seek professional help.

For the next year, he went back and forth in his mind about whether he should see a psychotherapist. He realized that he was spending far too much time by himself watching TV and feeling lonely, but he couldn't get passed his fear of opening up to a stranger.

Finally, when he began having thoughts of killing himself, he called the Suicide Prevention Hot line and they gave him a referral to a therapist.

Because the pain of remaining isolated became greater than his fear of opening up in psychotherapy, Jeff decided to make an appointment to see the psychotherapist.

During the first session, he found it very hard to remain present in the session. He alternated between wanting to zone out and fall asleep.

Over time, Jeff learned how his avoidant coping strategies helped him when he was a child to avoid dealing with the situation at home, which would have been emotionally overwhelming for any child, but especially for a child who was as sensitive as Jeff.

Changing Coping Strategies That No Longer Work For You:  Avoidance

He also learned how this avoidant coping strategy was no longer working for him and that he needed to learn new coping strategies so he could live a full life and not spend the rest of his life hiding. He also needed to learn new social skills so he could meet other people and have a life outside of his work.

It wasn't easy, and there were many times when Jeff wanted to quit therapy because he felt too afraid to come out of his emotional shell. But when he thought of the alternatives, Jeff stuck with it.

Gradually, he learned to trust his therapist. Step by step, he developed better internal and external coping strategies.

Instead of losing himself in front of his TV, he incorporated new coping strategies: He began attending a yoga class and learned how to meditate in that class. He joined a local running club and met other young men and women who liked to jog and bike.

Jeff also began to date, and soon he met a woman that he really liked and they began dating exclusively.

As often happens in intimate relationships, some of Jeff's core emotional issues came up in this relationship, and he was often tempted to withdraw emotionally. However, he dealt with these issues with his psychotherapist as they came up, and he learned to cope with emotions that were difficult for him.

Even though this was a lot of hard work for Jeff, he felt like he was alive for the first time in his life. He realized that by withdrawing from difficult emotional experiences all of his life, he was also withdrawing from positive experiences as well.

Getting Help in Therapy to Change Coping Strategies That No Longer Work

He came to realize that, to survive as a child, he had blunted his emotions so that he felt almost nothing. So, taking the risk of feeling some pain came to outweigh feeling nothing.

In the above scenario, we can see several examples of avoidant behavior in Jeff's family, including alcoholism, social and psychological withdrawal, emotional numbing, and reckless risk taking behavior.

We can also see that engaging in avoidant behavior as children often allows us to survive overwhelming emotions. It comes at a cost in terms of the child's emotional development, but often the child has no choice if he or she wants to survive emotionally.

In addition, we see that the avoidant coping strategies that serve children in terms of emotional survival don't work for adults who must interact and make their way in the world.

Getting Help in Therapy
We also see that there is a lot of emotional pain for adults who recognize that they're stuck in maladaptive coping strategies, but there is also hope for those who seek the help of a licensed mental health professional.

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

I have helped many adults to overcome coping strategies that no longer work for them and learn to develop new coping skills.

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

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

Also see my articles:  Coping Strategies that No Longer Work: Passive Behavior

Coping Strategies that No Long Work for You: Controlling Behavior

Stress Management: Creating Quiet Time for Yourself

Many people have such busy personal and work-related schedules that they consider finding quiet time for themselves to be a luxury. Most people are far too accessible by cell phone, Blackberry or other modern technology that, even when they make an attempt to create quiet time for themselves, they're often intruded upon when they're trying to relax

Stress Management: Creating Quiet Time For Yourself

Far from being a luxury, creating quiet time for yourself is a necessity for your physical health and overall well-being. And, as such, creating quiet time is an important part of stress management. The medical benefits have been known to include lower blood pressure and heart rate. Even just taking a few minutes each day to close your eyes to relax can be helpful to your peace of mind.

In the US, we tend to be people who are always on the go. Pressuring ourselves and responding to outside pressure in our lives, we feel we have to work faster, harder and longer. Even when we play, so many of us feel that we must "play hard."

For many people, the idea of taking quiet time during the day seems like a waste of time that could be better used to do one more chore, to make one more phone call, or to do one more task.

When I talk to people about creating quiet time in their lives, they often respond that they don't have time. They tell me about all of the things that they must do and all of the things that they don't get to that they feel guilty about.

How I Create Quiet Time For Myself:
I understand how busy life can be. My workdays tend to be long and my schedule is often hectic. If I chose to, I could fill my every waking hour with work, phone calls and other tasks. In order for me to have quiet time in my day, I have to make a conscious effort to build it into my schedule, just like any other appointment or task.

Usually, during the week, I find at least 10-15 minutes around lunch time to either meditate or do some restorative yoga poses as part of my stress management routine. I turn off the phone, put my Blackberry away, and take off my watch in order to feel that this time is really mine. Those 10-15 minutes of relaxation make such a positive difference in how I feel the rest of the day.

Over the weekend, I usually attend two yoga classes that include several minutes of quiet relaxation at the end of the class. During the class, the yoga instructors give very detailed instructions about each pose so that I must focus my attention on what they're saying, what I'm doing, and how the pose feels in my body. I don't have time or space to focus on anything else, so that the hour and a half that I spend in class allows me to get away completely from my daily concerns. It feels like a moving meditation. Afterwards, not only do I feel relaxed, I also feel refreshed and leave the class with a sense of contentment.

For me, simple pleasures are best for creating quiet time. One of my favorite simple pleasures is going to the local community bookstore, which has been there for over 25 years (even though one of the major bookstore chains has been within walking distance for the last 10 years). The staff in this bookstore is knowledgeable, friendly, and involved with what's going on in the community. They encourage customers to come in and relax.

If I go early enough, this bookstore is usually quiet. I can choose a book from the shelf, sit on the couch and allow myself to enter into the author's world. My cell phone and Blackberry are usually off during this time.

There are two cats in this bookstore, and if I'm lucky, one of them comes to cuddle and sleep in my lap. Aside from enjoying the cats' company, as creatures who know how to relax, they remind me how to stretch and find a few peaceful moments to myself. On sunny days, the garden in the back is the perfect place to sit, read, sip tea, admire the plants and trees, listen to the birds, play with the cats, or get lost in a book.

From early on, my mother instilled in me a love of books. We would make trips to the local library at least twice a week to take out new books. Then, we would go to the park that was across the street from my school and my mother would read to me. The books that really stick in my mind are the Madeline series by Ludwig Bemelmans. Even today, when I'm in the local bookstore, which has a section for children, and I hear a parent reading  to her child, I get vicarious pleasure from eavesdropping and hearing the familiar stories.

I might stay in this bookstore 10 minutes or I might stay a couple of hours. How ever long it is, I usually feel like I've gotten away because it's a special time and a special place that's just for me that I allow myself to have.

So, those are some of the things that I do to create quiet time for myself. But what about you?

Suggestions for Creating Quiet Time For Yourself:

Get Up a Little Earlier Than You Usually Do to Have Some Quiet Time:
There is something so precious about having 10-30 minutes to yourself before the rest of the family gets up or you're expected to respond to other people's needs. Even if all you do is have a soothing cup of tea before your day begins, it's a good time to reconnect with yourself.

Rather than using that time to make to-do lists or take care of other chores, just sit, be quiet and breathe. I'm convinced that most of us are so busy talking and doing things that we don't take time to relax and be quiet. And many of us go through the day not realizing that we're often holding our breath much of the time due to excessive tension. So, remembering to be conscious to breathe fully is an important part of relaxation.

Take Time to Be Quiet at Lunch:
Even just a few minutes at lunch time to close your door to relax can be beneficial and, in the long run, make you more productive. Going out for a walk to a nearby park, river or peaceful place in nature can also be very relaxing. Can't find a nearby nature spot? How about watching dogs play at the local dog run?


Create a Peaceful Environment for Yourself:
I have two offices and both of them have pictures of nature. In one of them, I have a picture that's called "Proust's Garden." I have no idea if this is actually what Marcel Proust's garden looked like, but the name of the picture and the picture itself, full of plants and trees with dappled sun and shadows, has such a positive association to relaxation and beautiful prose that whenever I look at it, I feel peaceful. It's a very inviting picture that draws you in.  Clients often comment about that picture and how soothing it is. 

 In that same office, I have seashells on my bookshelf. Aside from the actual beauty of the shells, they're a reminder of the ocean and peaceful days spent by the water. In my other office, the picture that's behind me is of a garden and a gazebo. Clients often comment about that picture too and how restful it is when their eyes land on it.

Even if you have one picture or one object that you like that your eye can land on from time to time, your association to that object can bring about a state of well-being when you can't get away.

If you think about it, I'm sure that you would discover other ways that are meaningful to you to create quiet time for yourself. And when you do, you'll experience the benefits of having that special time that you deserve.

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

I work with individual adults and couples.

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

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