Psychotherapy: Making the Unconscious Conscious

Often, when clients begin psychotherapy, they discover that there are many aspects of themselves that they are unaware of, especially if they've never been in therapy before.  One of the main goals of psychotherapy is for the unconscious to become conscious for these clients.

Psychotherapy: Making the Unconscious Conscious 

"Making the unconscious conscious" is a common phrase in psychotherapy, but what does it mean?

A couple of examples, which are fictionalized scenarios, might help to shed some light:

John:
When John began psychotherapy for the first time, when he was in his late 30s, he was adamant that he never got angry towards anyone or anything.  His attitude was that it didn't make sense to get angry, so he never felt this.  He came to therapy because he was having panic attacks.  One of the first things that his therapist observed about John was that he was very tense.  He had deep frown marks between his eyes, and the muscles in his face and throughout his body were tight.  He had frequent gastrointestinal problems, asthma, insomnia, and joint pain, none of which his specialists were able to regulate with medication.  Even though John said he never got angry, he looked angry most of the time. And, it was apparent to his therapist (and most people who knew him) that he had been angry for many years, but he wasn't aware of it.  He was defended against it, on an unconscious level, because he felt it was "bad" to be angry.  Over time, as John developed trust in his therapist, he became more open to exploring his anger.  As he worked through his anger, most of his physical symptoms, which were psychophysiological in origin, disappeared.  It was apparent that, because his anger was so unconscious, he carried it in his body--until the unconscious (in this case, his anger) became conscious.

Mary:
Mary's parents were emotionally neglectful when she was growing up.  They provided her with a home, food clothing and basic necessities, but they were emotionallly unavailable to her.  She began therapy in her early 40s, because she was feeling depressed.  Her initial attitude in therapy, which was unconscious, was that, "My therapist should make me better."  She had no awareness that her attitude stemmed from a childhood of emotional neglect and the "inner child" part of her wanted the therapist to be a mother to her.  When this didn't occur, Mary became enraged.  She almost left therapy several times because she couldn't tolerate that her therapist couldn't make her better.  She refused to do any of the work and she all but stamped her foot to demand that her therapist do the therapy work for her.   Fortunately, even though it was difficult for her, she was able to tolerate being in therapy long enough to discover her unconscious wish to have the therapist mother her as if she were a baby.  After doing "inner child" work with her therapist, with assistance from her therapist, she learned to nurture her "inner child" and her  attitude changed to one of a mature woman.  If she had not stuck it out in therapy, the unconscious would not have become conscious for her, and she probably wouldn't have changed.

Making the unconscious conscious is one aspect of therapy, but it's an important one.  It's not always easy to face, but change is often not easy.  Until we're willing to discover and explore our unconscious attitudes, meaningful transformation remains elusive.

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

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

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

Self Soothing Techniques to Cope With Stress

As I've mentioned in prior blog posts, usually when clients begin psychotherapy with me, I like to know what emotional resources they already have before we begin trauma work.  I also like to know how resilient they are already or if they need help to develop resilience.  

Self Soothing Techniques to Cope With Stress 

If they have little in the way of internal and external resources, I usually teach them ways to take care of themselves between sessions, including meditation, certain self help EMDR therapy techniques, and using pleasant memories and images of relaxing places to help them relieve unpleasant emotional and physical activation between sessions.

I'm also continually amazed at what clients already know on an intuitive level with regard to self care. They might not even realize that what they're doing is calming themselves because they do it so  automatically with little or no awareness.

For instance, some clients know instinctively to put their hands over their hearts or their stomachs as a way to sooth themselves.  

When they're doing this, they often don't realize that they've touched themselves to soothe themselves.  

But, sitting across from them, I can see that, after they've made this gesture, their faces look calmer, their breathing is easier, there's more color in their faces, and they appear more present in the room.

When I point this out to clients and ask them to verbalize how they experience these gestures, they usually say that they're surprised that they're feeling better.  

Often, these gestures seem so basic, but they can be powerful in terms of transforming how they feel physically and emotionally.  

By verbalizing the experience, clients learn what's useful and it can become an emotional resource that they can use in the future.  Also, the act of verbalizing it helps the client to integrate the experience on both a physical and emotional level.

Other simple movements that can be soothing emotionally and physically include:  moving your neck (looking from side to side to help alleviate muscle tension in the neck and a feeling of emotional constriction); pressing your feet on the floor to feel more grounded; feeling the back of the chair against your back and how supportive this feels; and feeling how the weight of your body is supported by the chair you're sitting in.

Dance therapists know that movement can be very healing.  In order to use movement as a self soothing technique, you don't have to be a dancer or go to a dance therapist.  Very simple movements can shift how you feel.  

For instance, if you're feeling emotionally and physically constricted in your chest, you might try slowly and gently moving your arms out to your side and then raising your arms up along the sides of your ears (keeping your shoulders down).  

If you've ever done the Sun Salutation in yoga, you'll recognize this simple movement.  Most people find that moving your arms in this way helps to open up their chest, giving some relief on both a physical and emotional level.

Likewise, loosening up the joints, where a lot of tension is often stored, can help to release the tension.  Both yoga instructors and Reiki practitioners know we often hold a lot of emotion in our joints and simple, very gentle movements can be so beneficial.

The simple act of exhaling can also release stress and agitation.  Most of us will let out large sighs, sometimes without even realizing it, when we're experiencing stress or agitation.  The exhalation is a form of emotional and physical discharge.

In a prior blog post, I discussed Square Breathing as another form of self soothing that people can use when they're anxious or having a panic attack (see my article: Learning to Relax With Square Breathing).

We all need supportive people in our lives for our well-being, especially during distressing times.  

But knowing that there are self soothing techniques that we can use when other people might not be around is, in itself, empowering because we know that we can take care of ourselves. 

And self care is an important part of maintaining our well-being.

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

Setbacks Are a Normal Part of Therapy on the Road to Healing

It often comes as a surprise to psychotherapy clients that setbacks are a normal part of any effort to change, including efforts to change in psychotherapy treatment.  Progress is almost never linear.  Along the way, there may be some detours and setbacks.  The challenge for most clients in psychotherapy is to stick with therapy when there are setbacks rather than giving up.

Setbacks Are a Normal Part of Therapy on the Road to Healing

For many people, the inclination is to leave or to feel that therapy isn't working.  But if you know ahead of time that there will be certain setbacks along the path, you're more inclined to see these setbacks as temporary obstacles rather than getting frustrated and giving up.

People who have been involved in recovery programs for a while are more inclined to take setbacks in stride.  For instance, most people who are involved in 12 Step programs know that "relapse is part of recovery."  This doesn't mean that relapse is encouraged.  Rather, it recognizes, as human beings, we need to have compassion for ourselves and recognize that we'll make mistakes along the way.

The issue isn't about making mistakes or about temporary setbacks.  The real issue is about what you do when you have a setback:  Do you give up?  Do you become so frustrated with yourself that you feel you've failed?  Do you demand perfection of yourself (and possibly others)?  

A better approach for success in the long run is to learn from your mistakes or setbacks and get back on the path to progress.  Often, we learn more from making mistakes, in the long run, than if we just have a completely smooth path.  

If you look back on your own life, you can probably identify times when you learned a lot from making a mistake.  At the time, it might have felt very uncomfortable.  But with the advantage of hindsight, you can probably see that you learned from your mistake or setback and, possibly, you changed for the better in ways that you might never have changed if you hadn't experienced the setback.

When you have strong feelings about setbacks in psychotherapy, rather than leaving treatment, it's much more beneficial to discuss your feelings with your therapist.  You might not only be frustrated with yourself, but you also might feel angry with your therapist.  This is also a normal part of psychotherapy and most skilled, experienced psychotherapists know that this is part of treatment for many clients.  

For many clients who leave treatment when they've had a setback, this is part of a larger pattern in their lives where they give up and abandon their efforts when they make mistakes or when there are problems.  If this is your pattern, you have an opportunity to change this pattern in therapy in a way that's usually not available to you outside of therapy.  

Often, if you can stick it out and learn to tolerate your discomfort about a temporary setback, you can change a lifelong pattern so that you become more self confident.

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 or email me.

Are You Too Afraid to Talk to Your Spouse About What's Bothering You?

Couples who come for counseling often reveal that they were too afraid to talk to their spouses about things that were bothering them about the relationship.  It's not until they come for couples counseling that one or both of them reveal their fear of communicating what they perceive as upsetting discussions. Often, this takes the other spouse, who has not heard about it before, by surprise.

Are You Too Afraid to Talk to Your Spouse About What's Bothering You?

Imagine the following scenario, which is a fictionalized account where one spouse was too afraid to talk to her husband about what was bothering her about their marriage:

Mary and Scott:

Mary and Scott, who were in their early 30s, were married for two years when they came to couples counseling.  Within the first year of marriage, Scott felt that Mary was distancing herself emotionally from him and he couldn't understand why.  Whenever he asked her about it, she would tell him that there was nothing wrong, but Scott had a strong sense that Mary was bothered about something and she just wasn't telling him.  

By the second year or marriage, Mary and Scott were hardly having sex.   Mary almost never initiated sex any more, and when Scott tried to initiate sex, most of the time, Mary said she was too tired or she had various aches and pains.  

Scott continued to feel that Mary was avoiding talking about something.  He was feeling increasingly frustrated by Mary's emotional and physical distancing from him, so he told her he thought they should attend couples counseling.  He hoped that, whatever was bothering Mary, maybe a skilled couples counselor could help them to communicate better.

Mary, who was from a traditional family where family members didn't talk about their feelings, wasn't comfortable with going to see a stranger to talk about their relationship.  She continued to insist that she was fine, but she relented when Scott told her how unhappy he was in their marriage and he hoped to be  able to salvage it in couples counseling.

Scott was very open in couples counseling.  But Mary found the initial sessions to be anxiety provoking.  It took several sessions for Mary to reveal that she felt jealous of Scott's new business partner, Linda, a vivacious, intelligent woman.  

Mary trusted Scott and she knew he wasn't cheating on her, but she felt inadequate whenever she compared herself to Linda.  She imagined whole scenarios in her mind where Scott would find Linda more attractive and interesting than her.  She was afraid Scott would fall in love with Linda.  Mary revealed, the more she thought about it, the less attractive she felt.  And the less attractive she felt, the more she wanted to avoid having sex because she felt inadequate. She told Scott that she was too afraid to tell him about her fears because she felt ashamed about it.

Scott was completely dumbfounded when Mary revealed what was bothering her.  He had no interest in Linda, other than as a business partner, and he didn't even find Linda to be attractive.  But he was more concerned that Mary allowed these thoughts to build up in her imagination and she never revealed this to him before.  

Mary, who had little relationship experience before she met Scott, learned to overcome her own feelings of inadequacy over time in therapy.

Overcoming Your Fear to Talk to Your Spouse About What's Bothering You

She also gradually learned how to communicate with Scott about things that made her feel uncomfortable.  Soon after that, they rekindled their relationship and they began having sex again, where Mary sometimes initiated.

There can be many reasons why someone is too afraid to talk to a spouse or romatic partner about what's bothering him or her.  Men are just as likely to have this problem as women.  Sometimes, as in the scenario above, it's because they come from a family where people don't talk about their uncomfortable feelings.  Sometimes, it's because they're not aware of what's bothering them or they minimize it. 

These kind of communication problems can erode a relationship over time, causing emotional and sexual distance.  

Getting Help in Couples Counseling

If you or your partner are having problems communicating about what's bothering either of you in  your relationship, you owe it to yourself and your partner to get professional help.  Many couples who come for couples counseling to deal with this issue have overcome this problem and have gone on to have satisfying relationships.

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.

Obsessive Jealousy: Are You Arguing with Your Spouse About His Sexual History Prior to Your Relationship With Him?

Are you and your spouse arguing about your sexual histories with other people that you knew before you met each other?  Unfortunately, arguments about spouses' sexual histories aren't unusual.  It often begins with one or both people in the relationship asking questions about the other's sexual history and, before you know it, one or both people get jealous or insecure and arguments ensue.

Arguing With Your Spouse About His Sexual History

While it's important to know whether your partner, soon-to-be spouse or spouse practiced safe sex before he or she met you, it's often a mistake to get into the details of who, want, where, and how often.

Talking about these kinds of details can degenerate into bitter arguments.  Once you've both determined that there have been no sexually transmitted diseases through testing, it's better to let the past be the past--no matter how tempting it might be to seek more information.

Clinical Vignette
The following fictionalized vignette, which is a composite of many different cases with all identifying information changed, illustrates how easily arguments can begin while talking about each other's sexual history with other people:

Dan and Betty:
After Dan and Betty were married for several months, Betty asked Dan about his sexual activities with other people.  She already knew about the two prior relationships before he met her.  They also each had tests for sexually transmitted infections (STIs) early on when they began dating to ensure that neither of them had STIs.

Dan was hesitant to talk to Betty about his sexual history, but she told him that she felt that they should be able to talk about anything and she urged him to tell her.  

After Dan revealed that he had slept around quite a bit in college and in his early to mid-20s, Betty became upset. And the more upset she became, the more she asked him, and his answers only made her more upset.

Even though Betty didn't know any of the women that Dan slept with and he wasn't in touch with any of them, she imagined that he enjoyed being with these women sexually more than he enjoyed being with her.  No matter how much he assured her that he loved her and he enjoyed their sex life together, Betty couldn't stop thinking about all the women that Dan slept with.

Over time, Betty's obsessive jealousy about Dan's former sexual partners began to get in the way of their lovemaking.  Whenever Dan touched her, Betty wondered if he touched the other women in the same way.  

When it got to the point where they couldn't enjoy each other sexually any more, both Dan and Betty agreed that they needed to see a couples counselor.

In couples counseling, Dan and Betty learned that they had to let the past be the past.   Betty realized that she needed to let go of her obsessive thoughts about Dan's prior sex life or she would ruin their relationship.  

She also realized that the problem was that she was feeling insecure about herself.  Since she trusted Dan and she wasn't concerned that he would cheat on her, she realized that she needed to work on her own self esteem rather than argue with Dan about his past.

Once they stopped arguing about the past, they were able to rekindle their relationship.

Many couples feel that they must "tell all" about their prior sexual experiences, but unless you know for sure that you can handle this, it's best not to delve too deeply into your prior histories.

Getting Help in Therapy
If you and your spouse are arguing abut your prior sexual histories, you could benefit from seeing a licensed mental health professional who sees couples for couples counseling to help you salvage your relationship.

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

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.

Listening to Your Inner Voice to Discover Your "Calling" in Life

People often come to therapy because they feel like they're just drifting through their lives, but they sense somewhere deep down that there's something more that they want, but they just haven't found it yet.  Some people describe this as finding their purpose in life.  To me, it means the same thing, but I like to think of it as finding your "calling" in life because I feel there's an inner voice in everyone that knows what this "calling" is, if we would just learn to listen.

Listening to Your Inner Voice to Discover Your "Calling" in Life

What is a "Calling"?
Often, when people hear the words "finding your calling in life," they think of a religious "calling."  And while you might feel drawn to a religious calling, it can also be so many other things, and it doesn't necessarily have to be your job.  Your job might be working in an office, but your passion might be volunteering on the weekends to work with children.  Or, you might feel a passion to write poetry or play music.

Your Inner Voice Knows Intuitively What's Right For You
To hear and really listen to your inner voice, that voice that knows intuitively what's right for you, you need to get quiet and open yourself to your inner voice.  Many people discover their inner voice through meditation.  I've found meditation to be especially helpful to hearing my inner voice.  I've found my dreams to be even more helpful because the unconscious speaks to us in our sleep.  Over the years, since I began keeping a dream journal, I've noticed recurring dreams with certain themes that have given me new insights.  I've also discovered fascinating synchronicities between my dream life and my ordinary waking life.  Many people have told me that they've had similar experiences.

What Happens When We Don't Listen to Our Inner Voice
Sometimes, our inner voice is clear as to our "calling" in life, but we don't listen.  When I was a teenager, I developed an interest in psychoanalytic literature, especially books by Karen Horney, who was an influential neo-Freudian analyst who dared to challenge Freud.  I devoured her books, and early on, I wanted very much to become a psychoanalyst.  But, then, in my 20s, as I've mentioned in prior blog posts, I thought I should do something more "practical."  I left the Liberal Arts program and went to a business college.  Even though I disliked and felt very hemmed in by the courses, I pushed myself to continue there for a while because I thought this was the "practical" thing to do.

It took me a while to realize that I wasn't following my "calling" in life and I needed to get back to what I needed to do.  I mention this because, having gone through this experience myself, I have a lot of compassion for other people who struggle with finding their purpose or "calling" in life.  Also, having gone through my own experience, I know that it's also possible to transform your life by listening to your inner voice.

Eventually, I became a Masters level social worker and did my postgraduate psychoanalytic training.  A few years later, I discovered that, although I love psychoanalysis, I needed other tools to help psychotherapy clients because psychodynamic psychotherapy didn't help to heal all psychotherapy clients.

By listening to my inner voice, I trained in EMDR, clinical hypnosis and Somatic Experiencing as well as Embodied Imagination dream work, and discovered new ways of working with clients that brought about deeper healing experiences for them.

Listening to Your Inner Voice and Self Exploration Can Lead to a More Fulfilling Life
If you feel like you're drifting through life without having discovered your purpose or "calling" yet, you owe it to yourself to begin a self exploration that can lead to a more fulfilling life.  As I've mentioned, I believe this starts by listening to your inner voice.

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.

Unhealthy Relationships: Bad Luck or Poor Choices?

I remember having a conversation with a friend, several years ago, who told me, "I have the worst luck when it comes to relationships with men."  

After a few tumultuous relationships, she started therapy to deal with the emotional aftermath of the last unhealthy relationship.  During the course of her self exploration, she discovered that luck had very little to do with her chaotic relationships with men.  Instead, she discovered that, on an unconscious level, she was choosing men who were emotionally abusive and very irresponsible.

There is Big Difference Between Having Bad Luck and Making Poor Choices
There is a world of difference between seeing yourself as the passive victim of bad luck and realizing that you're responsible for choosing the unhealthy relationship that you're in.  And, it was quite an eye opener for my friend.  

Unhealthy Relationships: Bad Luck or Poor Choices?

Once she accepted that this was her reality, she knew she needed to work in therapy to discover the underlying issues so she could stop making these unhealthy choices.  And it didn't take long to realize that she was replicating her parents' relationship in her own relationships--even though she swore from an early age that she never wanted to have a relationship like the one  her parents had.  This speaks to the power of the unconscious and how we often don't realize what forces are driving our choices.

Feeling Like You Deserve a Healthy Relationship
What was more challenging for my friend was to realize that, deep down, she didn't feel like she deserved to have a healthy relationship.  She understood on an intellectual level that she was "a good person" and, therefore, she deserved a healthy relationship.  But, on a deeper emotional level, she didn't feel it.  It took time and effort in psychotherapy for her to overcome these feelings so that, eventually, she did make healthier choices.

Whenever I hear a psychotherapy client (or anyone else) say they've always had "bad luck" in relationships, I think of my friend's story as well as so many other stories I've heard in my experience as a therapist.  No one likes to think that they're in their current unhealthy relationship due to a choice that they've made.  Of course, there is an element of luck in terms of the people you meet but, more often than not, when someone remains in a dysfunctional relationship, they're making an unconscious choice.

While some people are open to exploring that they're making a choice, other people totally resist it, no matter how compassionate and empathetic a therapist might be.  They feel blamed and criticized.  More importantly, they feel ashamed, and when there is a lot of underlying shame, a therapist must have the client's trust and she must proceed with as much tact as possible.  But the therapist can't avoid dealing with this situation altogether--otherwise, how would the client make progress?

If clients are able to overcome their shame enough to look at their choices, the next dilemma they face is what to do about it.  After all, once this unconscious choice is made conscious, if they remain in an emotionally unhealthy relationship, by virtue of being aware of it now, they're making a conscious choice.  There might be some back pedaling along the way.  But, if a client develops a healthier sense of self, he or she usually wants to be treated better and the current relationship is no longer satisfying.

Do You Have a Pattern of Being in Emotionally Unhealthy Relationships?
If you have a pattern of being in emotionally unhealthy relationships, you owe it to yourself to consider if it is really bad luck that you keep getting into these relationships or are you choosing, on a level that you might not be aware of, these unhealthy relationships.

This can be one of the hardest questions that you will ever ask yourself, but it can also be the start of turning your life around.

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.