Are You Overreacting to Routine Disappointments?

Are You Overreacting to Routine Disappointments?

What Are Routine Disappointments?   
We all experience routine disappointments from time to time.  Rainy weather on the day you plan an outing, missing a sale for something you really like, or having to reschedule a brunch because a friend can't make it.  These are all examples of what are usually considered routine disappointments.  They're disappointing, but for most people they're not traumatic.  They're the kinds of situations that happen to everyone.  In order to preserve your own well-being and maintain your relationships, what's most important in these situations is how you respond to them.

Learning to Deal with Routine Disappointments is Part of the Developmental Process
Small children usually don't have the capacity to deal with disappointments.  It's something they have to learn over time.  Young children don't have much of a capacity to tolerate frustration.  If you've ever witnessed a small child being told by his mother that they had to leave the park to go home and the child had a temper tantrum because he didn't want to leave, you've witnessed this lack of frustration tolerance.

This is a normal part of a child's development.  If all goes well and the parents are able to weather this stage in the child's development (without either frustrating the child too much and too often, or giving in and gratifying the child's every wish), the child will learn to develop an increasing ability to handle routine disappointments as he gets older.

What Happens When Adults Haven't Learned to Tolerate Routine Disappointments?
As adults, if we don't learn to tolerate routine disappointments, we can become easily overwhelmed by stress.  We can also damage our relationships with family, friends, and colleagues.  With regard to how we respond, we need to be able to differentiate between routine disappointments and major disappointments.  Continuously responding to small disappointments as if they're major disappointments will exhaust you and can leave you feeling bitter, brittle and lonely.

Case Example
The following vignette, which is a composite of many different cases, illustrates the above:

Francine:
Francine, who was in her early 30s, wanted more than anything to be in a romantic relationship and to have close friends.  But her romantic relationships and friendships usually ended in a bad way.  Sooner or later, she would alienate people, and they would tell her that she was too demanding and disappear from her life.

By the time Francine came to therapy, she was very lonely.  The last man she dated, Tom, just ended their relationship because Francine got angry when Tom's boss sent him out of town on a business trip, and Tom asked to reschedule their date.

They were only dating for five months.  Most of the time, Tom was reliable, considerate, and easy going.  They usually enjoyed each other's company.  But, two months earlier, Francine got upset when Tom got sick and had to cancel their date.  It wasn't that she didn't believe him--she could hear that he was coughing and losing his voice.  Nevertheless, she got angry because she felt very disappointed and lonely, and she didn't want to spend the evening alone.  Afterwards, she realized that she was being inconsiderate and self centered, she apologized, and they made up.  But when it happened a second time, Tom said he felt she was overreacting, too demanding, and he had enough.

This was the ongoing pattern in Francine's life.  Usually, when she calmed down, she realized that her reactions were out of proportion to the situation but, by then, she had already alienated people.  After Tom stopped seeing her, she knew she had to change, but she didn't know how, and she was starting to feel hopeless about it.

Francine's family history was one of emotional neglect.  Her parents divorced by the time Francine was 10.  She was sent back and forth between them throughout her childhood.  They were both highly narcissistic people who had little time for her, so she spent most of her time with a succession of nannies and housekeepers.  She was given everything she could have wanted materially, but she grew up being an insecure, lonely child who had difficulty making friends.

Francine felt deeply ashamed that she was unable to keep a boyfriend or any close friends.  She had some acquaintances that she saw from time to time, but even those relationships became problematic when Francine became disappointed.

Learning Not to Overreact to Routine Disappointments

In therapy, she mourned the emotional neglect that she experienced as a child.  We worked on her self esteem and coping skills.  We also worked on how to develop and maintain friendships.  She began learning basic life skills to handle routine disappointments without overreacting. After a while, Francine also learned how to be alone without feeling lonely.  She eventually got married and had children.

It wasn't easy.  There was no "quick fix." It was a process, and it took time.

Getting Help in Therapy
Some people only realize that they are overacting to routine disappointments after they've worn themselves out emotionally and physically, and they've lost a succession of people in their lives.  

By then, it can be become a vicious cycle of disappointments, ruptures in relationships, more disappointments, loneliness and feelings of hopelessness.  

If you're motivated and willing to take the time and make the effort, a skilled therapist can help you to overcome this problem.  Rather than continuing to perpetuate this cycle, you can get help to become healthier and happier.

About Me

I am a licensed NYC 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.

Overcoming Separation Anxiety

When most people think about separation anxiety, they think of children having problems separating from their parents.   But separation anxiety can occur at any time in life.  It often has its roots in childhood, but it can continue into adulthood causing panic and shame as well as discord in relationships.

Overcoming Separation Anxiety

Elizabeth Bernstein of the Wall St. Journal online wrote an interesting article called When It Never Gets Easier to Say Goodbye about separation anxiety.  The examples that she gives remind me of many psychotherapy clients that I have treated for separation anxiety over the years.

Case Example
The following vignette illustrates how the separation anxiety affects the person who suffers from it as well as how it can affect a relationship.  As always, this is a composite of many different cases with all identifying information changed to protect confidentiality.

Rose and Mike
Rose and her husband, Mike, were together several years when he started a job where he had to travel at least once a month.  The trips were usually short and not that far from home, but they often involved his staying away at least a couple of nights.

Prior to taking this job, Mike had been out of work for several months.  Both he and Rose were concerned about how his being away from home would affect Rose because she got very anxious whenever Mike was away.  But they both felt that Mike had no choice but to take this job because he was unemployed and he had no other offers.

As soon as Rose heard from Mike that he had an upcoming trip, she would begin to worry immediately.

It could be weeks before Mike had to leave, but she would worry obsessively, asking him countless times if he really needed to go, and talk about all the things she worried about that could go wrong:  What if the plane crashed? What if a burglar broke into the house while he was away?  What if there was some other kind of emergency that she couldn't handle by herself?

Mike did his best each time to reassure Rose, but nothing he said every reassured her.  After a while, inevitably, they would get into an argument about it because Mike would lose his patience.  He felt frustrated and annoyed because nothing he said had any impact on Rose's anxiety.  She, in turn, felt hurt and misunderstood.  She also felt deeply ashamed about her worrying and out of control.

Mike and Rose tried different strategies to help her feel better:  He called her as soon as his flight landed and he would call her a few times during the day to assure her that he was all right.  But these strategies never  helped Rose stop worrying incessantly that something awful might happen to Mike and then she would be alone.

After several of these arguments, he told Rose that she needed to get help because it was affecting their marriage as well as his ability to focus on his work while he was away.   Rose decided, somewhat reluctantly, that Mike was right--she needed to get help.

After a few sessions, it was evident that Rose had separation anxiety that stemmed from a chaotic childhood with parents who were very unpredictable.  They would often leave Rose, as a child of five or six, alone at night while they went out drinking.  Understandably, she was very afraid of being alone and she would beg them each time not to leave, but they told her to "stop being a baby" and they left anyway.  When her baby brother cried at night, she didn't know what to do to soothe him, which made her even more anxious.

Then, one day, when Rose was six, she woke up to find her grandparents and aunts in the living room with her mother.  Everyone was very upset and crying, but they wouldn't tell her what was wrong.  Her father wasn't there, and when Rose asked about him, her mother told her that he was "gone," but she wouldn't give Rose any more information.  Later that day, Rose overheard her aunt talking about a car crash.  She tried to ask her aunt and her mother about it, but they refused to talk about it and sent her to her room.

Rose never saw her father again. No one ever told her, as a child, what happened to her father.  She missed him terribly, but she felt she couldn't ask her mother about it any more because she feared her mother would get angry with her and leave too, and then she'd be all alone.  It wasn't until she was in her early 20s that she heard from an uncle that her father was drunk and had a fatal car accident.

We used EMDR to help Rose to process this earlier loss, as well all the times she felt abandoned by her parents even before her father died.  While we were working on these issues with EMDR, we also worked on Rose developing better coping skills.  She learned to meditate and she also began attending yoga classes.  She also strengthened her emotional support network among her friends.

Once she worked through her earlier losses and experiences of separation anxiety, Rose was no longer anxious about Mike going on business trips.  She and Mike began getting along much better.  They stopped arguing and even planned a romantic getaway, which was something they had not done in a while.

Getting Help in Therapy
If you suffer with separation anxiety, you owe it to yourself and your loved ones to get help from a licensed mental health professional who has experience working with separation anxiety.  Getting help can make all the difference between living a life of constant anxiety and a fulfilling life that you and your loved ones can enjoy.

About Me
I am a licensed NYC 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.

Overcoming Resistance to Change

I read a blog article by Rosabeth Moss Kanter in the Harvard Business Review Blog Network called Ten Reasons People Resist Change.  The article addressed business leaders about why many employees resist change in the workplace.  As I was reading the article, I realized that there are parallels to the kinds of resistance many psychotherapy clients experience--even though they come to therapy, at least initially, because they want to change.

Overcoming Resistance to Change

Skilled Therapists Know that Clients Often Resist Change
Skilled therapists recognize that psychotherapy clients often have mixed feelings about change.  Most of the time, clients come to therapy because there's a problem they want to change.  They know that, on some level, their lives aren't working out.  They might know that they can't keep going in the same direction.  So, they come to therapy because they want to make changes in their lives.  Or do they?

It's not unusual for psychotherapy clients to become afraid of the very change that they say they want. 

Change can represent the unknown, uncharted territory.  It raises a lot of questions and uncertainty:

• How will this change affect the rest of their lives?  They've been accustomed to living their lives a certain way, possibly for many years, and now they're faced with making changes.  
• What if it doesn't work out?  
• What if they "fail" with these new changes?  
• What if it's too much of a hassle?  
• What if things come up in therapy that are completely unexpected?  How would they handle the unexpected?
• What will they have to give up for this change? 

These are all questions that Rosabeth Moss Kanter writes about in her blog article about employees, and they're equally true for psychotherapy clients.

The following vignette, which is a composite of many cases with all identifying information changed to protect confidentiality, is an example of how a psychotherapy client dealt with his fears about changing the issue he came to therapy to change:

Rick:
After Rick's family confronted him in an intervention, organized by his wife, to talk to him about his drinking, Rick had to admit that his life at home and at work had become unmanageable.  He knew he couldn't go on drinking the way he had been, and he stood to lose his wife, his children, and his job if he didn't change.  So, he contacted a therapist who specializes in substance abuse.

Before his first session, Rick nearly walked out of the waiting area.  His stomach felt queasy, his hands were sweaty, and his thoughts were racing:  "Maybe my problem isn't so bad.  Why do I need to come to therapy?  Maybe I can do this on my own? Maybe I can try to cut back?"

As the therapy session started and he heard himself give his alcohol history, he had a new realization about how long he had been drinking and how alcohol had affected his life, starting from his teenage years:  he almost got thrown out of college for being drunk on campus; he lost his first job because he took off too many days when he was hung over; his first girlfriend left him because she couldn't deal with his drinking; and now his wife and family were confronting him.

Of course, he knew all of these things before, but saying them out loud, at one time, had a big impact on him.  Suddenly, he realized that he had been rationalizing away his drinking for most of his adult life.  Now, in his mid-30s, he was looking back and he didn't like what he was seeing.

Overcoming Resistance to Change

Rick left that first session feeling more motivated than ever to stop drinking.  When he got home, he thanked his wife for having the intervention that was the catalyst for his seeking help.  But, later that week, one of Rick's drinking buddies called him and asked Rick to meet him and a few other friends at the bar they usually frequented.

Rick hadn't told any of his drinking buddies that he started therapy to stop drinking.  He felt too embarrassed to tell them.  He didn't want to lose face with them.  He tried to make up an excuse for not going, but his friend was very persistent.  Rick went back and forth in his mind about what to do.  On the one hand, he knew that if he went to the bar, he would begin drinking and he wouldn't be able to stop.  He knew that if he did that, he would be a disappointment to himself and his family.  On the other hand, he really liked his drinking buddies and he would miss them if he stopped hanging out at the local bar with them.

After a few minutes, he thought to himself, "What the hell, I'll go and I won't drink."  An hour later, Rick was at the bar having his usual drink and telling himself that he'd only have one.  After the second drink, he told himself that he would set the limit at three which, after all, was a lot less than he usually drank.  But by the third drink, Rick was "off to the races" and he couldn't stop.  His buddies drove him home, and he staggered into the living room where his wife was waiting for him.

Once Rick saw the hurt look on her face, he felt deeply ashamed.  He wanted to apologize, but he was too drunk to even get the words out.  The next day, he was too hung over to go to work, so he called in sick.  He felt despondent.  Later in the day, he renewed his commitment to himself and to his wife that he would stop drinking.

Overcoming Resistance to Change

During the next several weeks in therapy, Rick talked about how his life was changing now that he wasn't drinking any more.  Life was hard, and Rick wasn't sure that this was what he wanted.  Now that he was sober, he had to face the mounting bills he was avoiding, problems his son was having at school, a reorganization at work, and his wife's distrust that he would stay sober.  And, he had to do all of this without alcohol.  He realized now that alcohol had become a sort of "friend" that helped him to relax and zone out.  He wasn't sure if he liked being sober.  He thought it might be too hard to live a sober life, and he wasn't sure he wanted to do it.

During the next several months, Rick struggled to remain sober with the help of his therapist, A.A, and an A.A. sponsor.  It seemed to him that every week brought a new challenge.  He hated having to give up his drinking buddies.  But he realized that they weren't going to stop drinking and if he had any hope of not ruining his life with alcohol, he couldn't hang around with them.  So, he began forming new friendships with people he met at A.A.

Step by step, Rick began to put his life back together.  There were times when he was tempted to leave therapy because part of him wanted his old life back.  Working towards change was a constant emotional battle, going back and forth in his mind about whether or how much he wanted to change.  There were times when he went into denial and told himself that he could drink and he didn't need to be in therapy.  At those times, he battled with himself and found the strength to continue making positive changes.

Change isn't Easy
Many psychotherapy clients struggle with the changes they say they want.  Change isn't easy, especially in the beginning.  Some people have many false starts before they commit themselves to changing.

Some Resistance to Change is Normal in Therapy
Resisting change, to a certain extent, is part of changing.  It's rare that someone comes to therapy and doesn't have some mixed feelings about change.  A skilled therapist can help psychotherapy clients to sort out this resistance.  A therapist won't tell you what to do, but s/he can help you to figure it out for yourself.

Do You Want to Stay on the Fence Forever?
For some people, change feels so daunting, even change that they want, that they stay on the fence about coming to therapy for years.  Then, at some point, they might look back on their lives and regret the time they wasted.

Getting Help in Therapy
You don't have to be 100% convinced about the changes you're considering before you come to therapy.  If you think about where you are and where you want to be all at once, it can seem overwhelming.

You can look at it as a process where you take one step at a time, knowing that you can stop at any time.  It can begin with having a consultation with a therapist, knowing that you can decide at each step how far you want to go.  If you've been on the fence about making changes for a long time, don't you owe it to yourself to at least take that first step?

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 make positive changes so they could 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.

The Power of Rituals

Rituals touch our lives in so many ways. From the simple everyday rituals of our morning routines to special occasions like celebrating our birthdays, anniversaries, graduations, weddings, holidays, and other rites of passage--all of these are rituals that we can experience at various times in our lives.

The Power of Rituals

What are Rituals?
Aside from the everyday mundane rituals, what do we mean by "rituals"? Whether they are religious, civic, family, societal, or personal rituals are usually activities performed for their symbolic value and they are often meaningful to that particular group or community. For instance, most cultures have some type of ritual initiation. In Christianity, the sacrament of Communion is a form of initiation. In Judaism, there is the Bar or Bat Mitzvah. The ancient Greeks had the Eleusinian Mysteries. These ritual initiations are part of the rites of passage for these groups. They mark important transitions from one stage of life, as well as a particular stage of consciousness, to another.

Joseph Campbell
The American mythologist, Joseph Campbell, discussed the importance of rituals and initiations when he discussed the "hero's journey." He believed the "hero's journey" was a common pattern found in many societies where the "hero" goes from the every day "Known World" on a quest through the "Unknown World," which contains ordeals and struggles to overcome, in order to return to the society of the "Known World" as a mature, valued, and contributing member of the community.

Joseph Campbell's The Power of Myth

Healthy rituals can provide people with a sense of structure, comfort, stability, and a sense of continuity. Children need and want healthy rituals that they can depend on. An example of this would be the nighttime ritual of a parent reading a bedtime story to a child every night. 

Children usually love hearing the same stories over and over again because they like knowing what to expect and this is also how they learn to integrate information. So, the ritual is not only that the parent spends this special time with the child, it is also about the repetition of the story.

Also, see my article: The Power of Creating Rituals

About Me

I am a licensed psychotherapist, hypnotherapist, Somatic Experiencing therapist and EMDR therapist in NYC. I work with individuals 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 Fear of Anger

Fear of Anger:
Does the thought of dealing with anger, whether it's your own or other people's anger, make you feel uncomfortable?  You're not alone.  There are lots of people who have a hard time either acknowledging their own anger or dealing with other people's anger.  I'm not talking about violent or explosive anger.  I'm talking about everyday, run of the mill expressions of anger.

Overcoming Fear of Anger

Most of the time, feeling angry isn't pleasant and because it's not pleasant, many people will go to great lengths to avoid feeling angry.  Rather than allow themselves to feel angry, they'll suppress and deny their feelings to themselves as well as others.  It might be very apparent to everyone around them that they're angry.  Their faces might be flushed, jaws clenched, and they might be trembling with the fight or flight adrenaline running through their bodies, but they'll still smile through clenched teeth and deny they're angry, "Who me?  Angry?  I'm not angry."

Why Are So Many People Afraid of Anger?
There can be many reasons why people are afraid of anger.  Usually, it starts when they're children.  Sometimes, children grow up in families where expressions of anger were extreme--either on one end of the spectrum or the other.  So, on the one hand, they might have had a mother or father who had an explosive temper, and the lesson they learned from this was that anger is dangerous and should be suppressed and avoided at all costs.

On the other hand, they might have had a parent on the other end of the spectrum who was too afraid to express anger and came across as either timid or too accommodating.  So, the unspoken message was that anger is bad and should be avoided.

In some cases, a child might have two parents who are unable to express their anger in healthy ways--with one parent exploding and the other cowering in fear.  Or, there might have been two explosive parents or two repressed and timid parents.  The point is that in all of these cases, the child doesn't see healthy expressions of anger being modeled, so s/he doesn't learn that anger can be expressed in a healthy way.

In other cases, people were taught as children, especially girls, that they have to be nice to everyone, no matter what happens.  The implication is that if they're not nice all of the time, they're bad and other people won't like them.  So, being liked becomes primary and anything they think would cause people to think they're not nice has to be suppressed.

Suppressed Anger and Health Problems
When people deny and suppress their anger, it can result in health problems like headaches, upset stomach, teeth grinding at night, muscle aches, insomnia, fatigue, irritable bowel syndrome, and other medical problems.  It takes a lot of energy to constantly deny and suppress anger.  Eventually, the body can break down under the strain.

Emotional Numbing
In order to suppress their anger, many people numb themselves emotionally.  So, not only are they numb to their anger, but they're numb to other emotions as well, like happiness.  This can happen over time without a person even realizing.  After a while, everything feels flat and dreary.   It might cause them to feel depressed.

Warding Off Anticipated Anger
For some people who are afraid of anger, they'll often go to great lengths to ward off any type of anticipated anger.  They'll often engage in "people pleasing" behavior in an effort to avoid dealing with any anticipated anger from others.  When this becomes the primary goal, they'll often lose touch emotionally with what they want for themselves because they're so focused on other people.

Healthy Anger vs Violent Temper Tantrums
Learning to express your anger in a healthy way doesn't mean that you allow yourself to have violent temper tantrums with others.  There are many people who will say, "My therapist told me that I have to express my anger" and use that as an excuse for unhealthy expressions of anger.  No responsible therapist would tell a client to have violent temper tantrums.  When someone uses this as an excuse for ongoing rageful behavior, it's a distortion of what they're being told in therapy.  When we get angry, we're still responsible for our behavior.  

Healthy Expressions of Anger
Even though many people think of anger as being bad, healthy anger often mobilizes us to take care of ourselves.  For instance, if someone feels angry and unappreciated at work, he might recognize his anger as a cue to either assert himself to ask for a raise or look for another job.

If someone feels angry and taken for granted in a relationship, she could recognize her anger as a cue to try to make changes in the relationship.  Or, if she's angry and deeply dissatisfied, after many efforts to make change, she might leave.

Getting Help to Overcome Your Fear of Anger:
Going through life being afraid of your own or other people's anger can have emotional as well as physical consequences.  Rather than spending your life being fearful of anger, you owe it to yourself to get help from a licensed mental health professional so that you can lead a more fulfilling life.

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

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.

For a related topic, you can read my article:
How Do We Balance Our Own Needs With Being Responsive to Our Loved Ones?

When Someone You Love Has Alzheimer's - Part 2

Yesterday my blog article When Someone You Love Has Alzheimer's - Part 1 discussed some basic information about Alzheimer's disease and the Alzheimer's Association as a resource for support and valuable information.  Today I would like to discuss how to navigate family dynamics when family members disagree about elder care issues involving a loved one.

Making Decisions for a Loved One with Alzheimer's:

Making decisions for a loved one who has Alzheimer's can be one of the most difficult things that you and your family will ever have to do.

First of all, to accept that a mother or father (or other relative) who was once an independent and capable person is no longer capable of making decisions for her or himself can be heart wrenching.  But even after you've accepted this, you and other family members might not agree about how to proceed.  This can quickly lead to family conflict and degenerate into warring factions in the family, adding to an already very difficult situation.

The Alzheimer's Association:  Alzheimer's Organization
As I mentioned yesterday, the Alzheimer's Association, can be a wonderful resource for general information, but they can't make personal decisions for you about your loved one.  That's up to you and your family.

Getting a Diagnosis:
As I mentioned yesterday, Alzheimer's can look like other medical conditions.  It's a "rule out" diagnosis and a good place to start is with your family doctor.  Often, your family doctor will refer your loved one to a neurologist.

Important Elder Care Decisions to Make:
Once you have a diagnosis of Alzheimer's and you've obtained basic information from the Alzheimer's Association, it's often helpful to get an objective professional evaluation about your loved one's specific needs:

• Can s/he take care of daily activities of living (e.g., getting dressed, preparing meals, paying bills, etc). 
• Is it safe for your loved one to live alone?
• Is it safe for your loved one to continue to drive?

These are just some of the many questions that need to be addressed.

So, what do you and your family members do after your loved one is diagnosed with Alzheimer's?

Call a Family Meeting:
Rather than going it alone, I recommend calling a family meeting and discussing the important elder care issues that are involved when a family member has Alzheimer's.  Usually, an important decision is whether or not to involve the family member who has Alzheimer's.  A lot will depend on whether he or she is still capable of understanding what's going on.  If not, it might be more confusing than helpful to him or her.

Prepare for the Family Meeting:
Before the meeting, gather your thoughts and write down the main issues that need to be discussed.  You don't need to cover everything in one family meeting and, in fact, it can be overwhelming.  Unless the situation is urgent and you need to make immediate decisions, it might be better to plan a couple of meetings, if possible, so you don't wear yourself and others out by trying to do it all at once.

Stay Calm and Be Patient with Other Family Members:
Although this can be a very emotional time, especially if family members don't agree or if they're in denial about the Alzheimer's diagnosis, try to stay calm so you can listen to your family's concerns.  You might have overcome denial about your loved one's diagnosis, but it might take other family members a little longer to come around.  Try to be patient.

Get an Objective Professional Evaluation:
Once your loved one has been diagnosed with Alzheimer's by a medical doctor, you need to know what are his or her particular needs.  So, it's often very helpful to start with an objective professional evaluation about the particular needs of your loved one who has Alzheimer's.  Having an evaluation often helps families in the decision making process.

Consult with a Geriatric Social Worker:
Geriatric social workers evaluate the needs of a person with Alzheimer's disease.  They are trained to evaluate and make recommendations for the elderly.  You and your family can start by getting information through various geriatric social work websites, including:  http://caremanager.org.

• Make sure that the geriatric social worker you choose is a licensed social worker who is certified in geriatric care.  
• Ask questions when you call about the geriatric social worker's credentials, the fee, and what services s/he provides.  
• Before you go for the consultation, prepare questions in advance so you're organized for the meeting and use the time most effectively.
• The geriatric social worker can't make decisions for you.  He or she can only make recommendations after the evaluation, and then it's up to you and your family to make important elder care decisions.  
• A geriatric social worker can also help you to navigate through the confusing, bureaucratic morass of the health care system, whether your loved one is able to stay at home and get a home health aide or whether s/he needs to be placed in a nursing home.  S/he might also be able to recommend an elder care attorney so you can get a durable power of attorney or handle other legal issues involved.

Take Care of Yourself Throughout this Process:
People who go through this process often don't realize how stressful and frustrating it can be, even when there isn't family conflict about how to proceed.  It's easy to neglect yourself during this time.  So, it's important to take extra good care of yourself by eating well, getting enough sleep, and having emotional support.

You're Not Alone:
When you're faced with these difficult decisions and, possibly, your own conflicting emotions, you can feel very alone.  But, as the population ages, there are thousands of people going through what you're going through now.  You're not alone.  If you're able to attend a support group through the Alzheimer's Association, you could benefit from one of these mutual support groups.

Get One-on-One Emotional Support in Therapy:
Many people find it helpful to get objective emotional support in their own therapy while they're going through this challenging time.  It can be helpful to be in your own therapy to sort out your feelings about what to do.  It's one thing to have an objective recommendation and to know logically what to do, but it's another thing to handle it emotionally.

This is obviously a huge topic, which can't be completely covered in one or two blog posts, but if you're currently going through a difficult time with someone who has Alzheimer's, I hope these blog posts have been helpful. 

About Me

I'm a licensed NYC 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.

Photo Credit:  Photo Pin

When Someone You Love Has Alzheimer's Disease

One of the most difficult things to deal with in life is to watch someone you love deteriorate over time because of Alzheimer's disease.  Currently, there is no cure for Alzheimer's.  There are medications that can slow the progression of the disease, but they cannot stop it from ravaging the brain.  Since there is no cure, you can feel extremely helpless watching someone you love get worse and not being able to do anything about it.

Alzheimer's is a "rule out" disease, which means that other medical problems must be eliminated first in order for a medical doctor to diagnosis someone with Alzheimer's.  Over time, Alzheimer's causes memory loss, usually starting with short term memory and eventually progressing to long term memory.

In the early stages, it can be hard to detect because it can look like many other medical problems, which is why other disorders and diseases must be ruled out first.  As Alzheimer's progresses, it will eventually affect a person's ability to perform basic tasks, like taking care of themselves.  It will also, in the advanced stage, affect their ability to speak and walk.  People with advanced Alzheimer's often have poor judgment.  It affects mood, so the person often becomes irritable or loses his or her temper.

If you have a loved one that has Alzheimer's, you need emotional support.  Taking care of someone with Alzheimer's can wear you down.  It's painful to watch someone who was a very vibrant and capable person before Alzheimer's, deteriorate.  Your loved one might not even seem to be the same person that you've always known.  He or she might not recognize you and lash out at you.  At those times, you might feel very alone and need help yourself.

The Alzheimer's Association is a wonderful resource.  They provide support to caregivers on so many levels:  emotional as well as educational.  Participating in one of their support groups with other people who have loved ones with Alzheimer's can be very helpful.  Being around others who are going through what you're going through can be a tremendous relief, so you don't feel so alone.

The Alzheimer's Association also provides free meetings to help you with financial and legal questions. Elder care attorneys present legal information that affect people who have spouses, parents or other relatives with Alzheimer's.  In addition, the Alzheimer's Association has a virtual library online so you can educate yourself.

Also, see When Someone You Love Has Alzheimer's Disease - Part 2:  http://psychotherapist-nyc.blogspot.com/2012/09/when-someone-you-love-has-alzheimers_20.html. 

If you have a loved one with Alzheimer's, don't go it alone.  Contact the Alzheimer's Association near you and get support.

To contact the Alzheimer's Association, you can go to their website:  http://Alz.org.

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.

Photo Credit: Photo Pin