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Saturday, February 9, 2013

Overcoming Your Emotional Blind Spots

Emotional blind spots are often aspects of ourselves that we're unable to see, but other people, especially people who are close to us, can see.  The problem with emotional blind spots is that they often keep us making the same mistakes over and over again or they affect our loved ones in ways we never intended.

Overcoming Your Emotional Blind Spots

The following composite scenario is an example of an emotional blind spot.  As a composite of many cases, it preserves confidentiality.

Mary
Mary never knew her father when she was growing up.  It was a family secret.  When other young children talked about their fathers, she felt sad and wished she had a father too.  

It wasn't until she attended the funeral of a family friend, when she was in her mid-20s, that she found out, inadvertently when she overheard people talking, that this "family friend" was actually her biological father.  He was always nice to her, and she was very fond of him.  

Mary was shocked and very sad to discover that she never had a father-daughter relationship with him. When she confronted her mother about it, her mother refused to discuss it, so Mary vowed that she would never do this to her future children.

When she became pregnant from a man that she had only been dating for a few months and had already broken up with because he was unreliable, she decided to have the baby and allow him to be involved in the child's life, just as most fathers would be.  But the child's father continued to be unreliable and continually disappointed their daughter by not showing up.  The child, who looked forward to seeing the father, was always disappointed and hurt.

Mary's mother and sisters tried to talk to her about how damaging this was to Mary's daughter, who was now seven.  But Mary kept insisting that it was important for her daughter to have the father in the picture.  Due to her own unresolved needs, she continued to try to keep the father involved, and he continued to disappoint the daughter.  Mary couldn't see that her emotional blind spot and her own unresolved childhood issues kept her in denial and were emotionally damaging to her daughter.

As a teenager, when Mary's daughter refused to see her father any more, Mary felt very upset.  All of her friends and family told her that her daughter's decision was an emotionally healthy decision because the father always disappointed her.  Mary had a hard time seeing it--until a close friend tactfully suggested that Mary might have an emotional blind spot about this issue and suggested that Mary see a therapist.

Somewhat hesitantly, Mary started therapy and when her therapist also pointed out her emotional blind spot, Mary began to deal with her own loss and realized that it was affecting her ability to see what was best for her daughter.  She grieved for the father she never had and, over time, she freed herself from this emotional burden that was starting to drive a wedge between her and her daughter.

Emotional blind spots are often hard for us to see on our own.  They usually involve aspects of ourselves, our lives or our loved ones that we're in denial about.  One clue that you might have an emotional blind spot, which is unconscious, is when you keep finding yourself in the same situation over and over again.

An example of a possible emotional blind spot is if you keep choosing romantic partners that have problems with alcohol or who are abusive.  If you continually find yourself in these types of situations, it's worth exploring if you have an emotional blind spot.

Getting Help in Therapy
Working through your emotional blind spots with a skilled, objective therapist usually gets you a lot further than trying to deal with emotional blind spots on your own.  Once you're free of the emotional blind spots that cause you to keep making the same mistakes, you have a chance for a much more fulfilling life.

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 abut m, 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.





Thursday, February 7, 2013

An Emotional Dilemma in a Relationship: Wanting and Dreading Love

Many people, who have experienced childhood trauma, come to therapy because they feel stuck and confused when it comes to romantic relationships.  They often feel highly ambivalent about the possibility of having an intimate connection to another person.  

An Emotional Dilemma: Wanting and Dreading Love

On the one hand, they might be very lonely and long for someone who would love them and that they could love.  On the other hand, they might also feel extremely frightened of allowing themselves to be that emotionally vulnerable.  And therein lies the dilemma.

Early Attachment Problems Can Cause Problems in Relationships Later On
Usually, people who go back and forth between wanting and dreading a deep emotional connection experienced emotional attachment problems with one or both parents or caregivers.  Based on infant research, we now know how important early attachment is to having a healthy emotional life and being able to form intimate attachments with others.

When parents are either emotionally unreliable, neglectful, abusive, depressed, or emotionally unattuned to their young children, these children are more apt to grow up feeling emotionally insecure and vulnerable about forming relationships.  It's hard for them to trust.  They're very afraid of getting hurt or being emotionally abandoned again.  As a result, although they might feel very isolated and lonely, it's often difficult to allow themselves to open up emotionally to others.

An Emotional Dilemma: Wanting and Dreading Love


Fear of Opening Up in Therapy
Often, people who struggle between wanting and dreading an intimate connection find it difficult to come to therapy to get help for this issue.  Coming to therapy means opening up and taking a risk with a therapist, which means allowing themselves to be vulnerable.  How do they know they can trust the therapist when they couldn't trust their own parents?  It's a dilemma.


For many people who somewhat overcome their fear to come to therapy, at least enough to come to a first session, their experience is often one of being hypervigilant--waiting to see if there are any signs that the therapist will betray or hurt them in some way.

A skilled clinician, who has worked with clients on developmental attachment problems, will know not to take it personally.  She would know that she must take her time to help the client to form a therapeutic alliance over time to build a rapport and trust.

Many clients, who suffer with developmental attachment issues, find it difficult to sustain treatment, and they leave after a few sessions.  Often, they give another "reason" for leaving therapy--money or time issues, never revealing that it's their dread of opening up that's making them want to flee from treatment.

For clients who can sustain treatment with therapists who have expertise in working with attachment issues, if they can allow themselves to build a rapport and trust with the an empathetic therapist, over time, they can also learn to form trusting and loving relationships outside of treatment.

This is the kind of therapeutic work that takes time.  A client, who has a fear of getting close to others, can't be rushed into overcoming his or her fear.  Each client is different and, if there is progress in treatment, it will probably be a process where it is two steps forward and one step backward due to the high level of ambivalence and fear.  There is also usually a lot of underlying shame of feeling "not good enough" or "not lovable."

Getting Help in Therapy


Wanting and Dreading Love:  Feeling Lost?  Get Help

My experience has been that using a combination of Somatic Experiencing, psychodynamic psychotherapy, resourcing (i.e., helping the client to develop better coping skills and an increased capacity to tolerate vulnerability) along with an expertise in developmental attachment issues, is often the most effective way to help clients to overcome the dilemma of longing for love and dreading it at the same time.

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 abut 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.

Wednesday, February 6, 2013

Somatic Experiencing: Overcoming the Freeze Response Related to Trauma

Fight or flight is the response that most people associate with trauma. Most people are less familiar with the freeze response as a reaction to trauma.  But, in fact, freezing in fear is  another typical response associated with trauma.  The freeze response is also known as dissociation.

Somatic Experiencing: Overcoming the Freeze Response Related to Trauma

The following composite scenario is an example of a traumatic freeze response and how Somatic Experiencing, a mind-body oriented therapy, can help.  As always, in my composite examples, all identifying information has been changed to protect confidentiality:

Jan:
A senior manager at Jan's company had shown a sexual interest in Jan for several months.  He called her several times and sent her email to ask her out on a date.  Even though she didn't report to this manager, she feared she would get in trouble if he thought she was being rude towards him, so she always turned him down politely and tried to avoid him.  

Over time, this manager became more flirtatious in his calls and email, and this was making Jan increasingly anxious.  Every time she had to use the elevator, she was vigilant that he was not inside because she didn't want to be alone with him.  She knew about the company's sexual harassment policy and that his behavior would be considered sexual harassment, but she was too afraid that she would be blamed somehow for his behavior.

One day when she was alone in the office pantry, this manager entered the room and he said in a flirtatious tone, "Alone at last.  You've been avoiding me."  Jan was in the corner of the room and she froze in fear.  She wanted to leave the room, but she felt as if she was paralyzed and frozen in place.  Her heart was racing, she felt on the verge of tears, and she couldn't understand what was happening to her.  

Fortunately, a colleague came into the room and the senior manager left.  The colleague approached Jan and said, "Are you all right?  You look white as a ghost."  Jan, finally able to move, excused herself, went into her office, closed the door, and burst into tears.

Jan began therapy shortly after that incident.  She revealed a history of sexual molestation by an uncle starting when she was five years old.  According to Jan, when she told her mother, her mother blamed Jan and told her that she must have done something to provoke the uncle into molesting her.  Jan's response was to blame herself, as children often do.  And, even though her parents severed their ties with the uncle, they blamed her for the problems.

Therapy began with emotional resourcing whereby Jan began to develop enough self confidence that she was able to report the senior manager to the company's Equal Employment Officer.  His email alone incriminated him.  During the EEO investigation, other women also revealed that he was also sexually harassing them, and he was terminated.

There were many parallels between the original sexual abuse when Jan was a child and the sexual harassment she experienced as an adult at work.  So, an important part of Jan's therapy, which was the mind-body therapy known as Somatic Experiencing, was for Jan to learn to distinguish "then" from "now."  

In other words, whereas her initial freeze reaction to the senior manager triggered the original trauma from her childhood, leaving her feeling like a child, she learned to separate (or "uncouple" in Somatic Experiencing terms) her childhood experience from her adult experience.  This alone was an empowering experience.  She not only knew on a cognitive level that she had more power now than she did as a child, but she felt it on an emotional level.  

Somatic Experiencing is a Mind-Body Oriented Trauma Therapy  
Using Somatic Experiencing, over time, Jan was also able to work through the original trauma of being sexually molested.

Overcoming the Freeze Response Related to Trauma With Somatic Experiencing Therapy

In the scenario above, there is a clear connection between Jan's response to the sexual harassment at the office and the sexual molestation that occurred when she was a child.  In other cases, the connection isn't always so clear.  But, unlike regular talk therapy, Somatic Experiencing doesn't require this kind of clear connection for it to be effective.

Getting Help in Therapy
If you have a history of trauma that is affecting you now, you owe it to yourself to get help to overcome the trauma so you can lead a fulfilling life, trauma free.  My professional experience as a therapist who uses Somatic Experiencing with clients who have tried, unsuccessfully, to work through trauma with regular talk therapy is that Somatic Experiencing tends to be more effective for most people.

I've included a link below for the professional Somatic Experiencing website, which provides more information about Somatic Experiencing and a directory of Somatic Experiencing therapists.

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.


Monday, February 4, 2013

Relationships: Overcoming Power Struggles

Couples often come to couples counseling because they're stuck in what I call "push-pull power struggles" that keep them constantly frustrated and at odds with one another.

What Are Power Struggles?
Push-pull power struggles can emerge in just about any aspect of a relationship.  One common example of a push-pull power struggle often occurs during arguments.  So, for example, one person might need to take time away from the other person to cool off  while his partner might feel the need to resolve the situation right then and there.

Relationships: Overcoming Power Struggles

If both people feel strongly about what they feel they need, they are at an impasse.  Rather than trying to find a compromise, each person often insists on having what s/he needs.  This just escalates the argument as one person feels crowded in while the other person feel abandoned.

Push-Pull Power Struggles and Problems With Intimacy
Intimacy, both emotional and sexual intimacy, is often another area where there can be push-pull power struggles.

Power Struggles and Problems With Intimacy

Some people need to have their "space" every so often, while others feel the need to be close most of the time.  Once again, if each person insists on having his or her way, this exacerbates the problem.  The person who needs "space" occasionally will feel hemmed in, while the person who likes to spend more time together can feel hurt and abandoned.

Childhood Histories Can Complicate Relationship Dynamics
Complicating these situations are the individual personal histories of each person in the relationship.  It's not unusual for people in relationships to experience earlier childhood trauma triggered in their adult relationships.  In the examples above, the person who might have grown up feeling smothered by a parent might feel smothered by a partner who doesn't allow him his "space."  Or, a person who needs to spend more time with a partner who needs "space" might feel old feelings of being abandoned as a child.

When old feelings are triggered, it intensifies emotions, and it's hard to distinguish how much of the current emotional reaction is due to the current situation and how much might be part of old unresolved emotional wounds.

Getting Help in Therapy
Couples counseling is a place where push-pull power struggles can be negotiated and resolved.  If you and your spouse find yourself constantly getting caught up in these kinds of power struggles, you owe it to yourself to get help so you can work through these issues and enjoy a more fulfilling relationship.

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.





















Saturday, February 2, 2013

How Traumatic Childhood Memories of Being Powerless Can Get Triggered in Adults

People are often surprised to discover that traumatic childhood feelings of being powerless can get triggered even when they're adults.  

Trauma: How Childhood Feelings of Being Powerless Can Get Triggered in Adults

Certain situations can trigger those old feelings from childhood.  Whether it's a work situation with a domineering boss or a relationship with a spouse who is a bully or other similar situations, these feelings of helplessness, fear, rage, and sadness can arise unexpectedly.

The following scenarios, which are composites of many different cases to protect confidentiality, are examples of how these traumatic emotions can get triggered in an adult:

Pete:
Pete's boss, who was the company bully, tended to be domineering and demeaning with everyone who reported to him.  Most people knew from experience that his "bark was worse than his bite" and they didn't take his reprimands seriously, especially since he behaved this way with all of his subordinates and nothing ever came of it.  Rationally, Pete was also well aware of this.

Trauma:  How Childhood Feelings of Being Powerless Can Get Triggered in Adults

But whenever the boss called him in, Pete would tremble in fear and he found himself close to tears.  He couldn't understand why he had such a severe reaction--until he began therapy and he learned that these situations with his boss were triggering traumatic childhood memories of being abused by his father.

Mary:
Mary married Alan because he was older and she felt he would take care of her.  But after the first few months of marriage, she began to see a different side of Alan that she had never seen before.  Whenever Alan got frustrated, he would lose his temper and raise his voice with her.  Not only was Mary surprised to see Alan react this way, but she was also surprised at her own reaction to his anger--she would freeze in her tracks.  She felt immobilized and unable to speak.  Part of her wanted to hide or make herself invisible.  It was only after she began therapy to understand her reaction that she realized that earlier traumatic feelings were being triggered of when her alcoholic father went into a rage and, as a child, she hid in the closet.

Trauma:  How Childhood Feelings of Being Powerless Can Get Triggered in Adults

These are just two of many examples of how childhood feelings of being powerless can get triggered in adults--often without warning.  When this happens and people don't understand what's happening to them, it can feel scary and confusing.

What most people often don't realize is that, even though they're adults now, these traumatic emotions are stored in the body and are there to be triggered in current situations.  The feelings can feel just as real now as they did in childhood.

Somatic Experiencing
Somatic Experiencing is a gentle form of mind-body psychotherapy that helps adults to develop emotional resources and work through the original trauma so that it is no longer there to be triggered.

During Somatic Experiencing people also discover the types of unconscious psychological defenses that they've developed to ward off these traumatic feelings.  As shown in the composite scenarios above, these psychological defenses aren't always adequate to defend against these feelings, which is why people are often triggered.

Getting Help in Therapy
If you think you're currently getting emotionally triggered as an adult by unresolved childhood trauma, you owe it to yourself to get help so you can live a fulfilling life free of trauma.

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

I work with individual adults and couples, and I've helped many adults to overcome trauma so they can lead 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.

Sunday, January 27, 2013

How Psychotherapists Listen to Their Clients

Psychotherapists in training often feel they should immediately know and give advice to clients who present in therapy, especially with clients who are upset during the first session.  In situations where new clients come in very upset, sometimes even demanding, "Tell me what to do!,"it's better to help clients to get emotionally grounded, and not fall into the trap of giving advice with potentially disastrous results.  

Psychotherapist Listening to Client

The Therapist's Experience of Getting Comfortable with "Not Knowing"
Fortunately, for most therapists, getting comfortable with "not knowing" during the initial stage of treatment gets easier with time and experience.  Rather than assuming that they're supposed to know immediately what's best for clients, skilled therapists know that they need to listen and learn about the client from the client rather than adhering to any particular theoretical orientation.

Even though the client might not get "the answer" from the therapist, this doesn't  mean that the client doesn't experience emotional relief during the initial stage of therapy. A skilled therapist knows how to create a therapeutic "holding environment," which often, in itself, brings emotional relief.

When the Therapist is Tempted to "Rescue" the Client 
When therapists feel pulled to "rescue" the client, who is not a danger to himself or others, this urge to "rescue" is potentially important information about what might be going on unconsciously in the consultation room with the therapist and client as individuals as well as dynamically between them.

This can happen to even to the most seasoned therapist.  Experienced therapists usually recognize it more readily than psychotherapists in training.  If a therapist finds it happening a lot with particular clients, it's best to obtain clinical supervision, talk to experienced colleagues or address the issue in her own therapy or all of the above if it's a big problem.

It's also important to recognize that not every therapist is for every client (see the link below for my article on "How to Choose a Psychotherapist").

Listening, Learning and Becoming Attuned to the Client
It takes more than one or two sessions for a therapist to get to know and become attuned to a client.  No matter how experienced, a therapist can't assume that she knows what's best for the client without first listening to and learning from the client, except, of course, in cases when a client is in a dangerous situation or a harm to himself or others.  (Then, it's important to know how to handle a psychiatric emergency and determine if the client is in the right level of care.)

Clients Are Looking For Answers
Clients are, understandable, looking for answers to their problems.  Why else would they come to therapy?  If they've never been in therapy before, they might equate the therapy session to a medical exam with their doctor.

During medical exams, unless further tests or consultations with specialists are needed, a doctor often gives a diagnosis and prescribes a course of treatment in one session.  In a day or so, the client might be feeling better.  But the human psyche is much more complicated than taking a pill, and it's rare that a therapist can help a client to resolve a psychological problem in one or two sessions.

What new clients might not understand, and what therapists need to help clients to understand, is that the therapist isn't there to give advice or tell the client what to do.  And even if the therapist was willing to give advice to a new client, who's to say this advice would be right for the client without the client participating in the process?

What Does the Therapist Do, If She Doesn't Give the Client "Answers"?
As mentioned before, the new client often comes looking for answers to her problems.  It might be disappointing to hear that the therapist can't provide immediate answers.

No matter what type of therapy the contemporary therapist practices, basically, the skilled clinician is trained to help the client, in collaboration with the client, to develop greater insight into her problems and work through the problems--rather than telling the client what to do.  Over time, the client, who has never been in therapy before, learns to become more open and curious about her process.  She also learns to become more resilient.  And, the healing process continues unconsciously for the client between sessions.

Mistakes, Ruptures and Repair in Therapy
Of course, therapists are human and make mistakes just like anyone else.  As I've written before, when a psychotherapist makes a mistake with a client, the most important first step is for the therapist to acknowledge the mistake to the client, and make an effort to repair the rupture with the client as soon as possible (see link below for my article, "Psychotherapy:  Ruptures and Repairs in Treatment").  Hopefully, the mistake isn't egregious, the therapeutic relationship remains intact, and the work continues.

Thank goodness, the days when therapists and doctors were assumed to be almost infallible are gone.  These days, many clients are better educated about the psychotherapy process, and they're more likely to approach it as informed consumers.  They know that during a psychotherapy consultation, they're interviewing the therapist and asking questions just as much as the therapist is interviewing the client.

Patrick Casement's Book:  Learning From the Patient
When I was in my first year of psychoanalytic training in 1996, I read Patrick Casement's book, Learning From the Patient.  It wasn't part of the curriculum in the first year.  At the time, the reading list for first year psychoanalytic students was mostly works by Freud.

While I enjoy reading Freud (especially his papers that read almost like poetry) and admire his genius, as a first year psychoanalytic student in training, I didn't always find his papers helpful when I was in the psychotherapy consultation room with a new client.

Somehow, during my first year in training, I came across Patrick Casement's book and, along with the guidance of seasoned clinical supervisors, I found it enormously helpful.

Some of the concepts that Casement writes about are now incorporated in current training programs in the first year, rather than waiting for the second or third year.  I'm sure it's a relief for first year psychotherapists in training, as it was for me, to realize that it's okay, and even not helpful, to think they should know the answers immediately, and it's more important to listen and learn.

Since my early days of training, I've learned other therapeutic ways of working, aside from talk therapy, including EMDR, hypnosis and Somatic Experience.  Whichever method I use, I value listening to and learning from the client.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work in a contemporary, dynamic way in collaboration with the client.

I work with individual adults and couples.

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

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

A New Relationship: Understanding the Loyalty Dilemma for Someone Whose Spouse Died

In today's Sunday New York Times Modern Love section, there's an article by Eve Pell about her relationship with her husband (see link below).  One of the things that she mentions is that when they were dating, her then-boyfriend was hesitant about making a commitment to their relationship because he still felt loyal to his deceased wife, who had died several years before.

Understanding the Emotional Dilemma For Someone Whose Spouse Died
Reading this article brought to mind how common this experience is.  Rather than getting competitive with a deceased spouse, Ms. Pell, who sounds like a wise woman, understood her boyfriend's emotional dilemma and let him know.

Understanding the Loyalty Dilemma for Someone Whose Spouse Died

Instead of feeling like his love for his deceased spouse meant more to him than his love for her, she spoke to him about it with a lot of empathy.  She acknowledged that she understood, respected his feelings for his former spouse, and reframed the issue as there being enough room in his heart for both of them.  According to Ms. Pell, her boyfriend appreciated this and, eventually, they got married.

Working Through the Loss of a Deceased Spouse
There are times when people haven't worked through the loss of a deceased spouse and it keeps them stuck.  Each situation is different.  But reading Ms. Pell's article reminded me of how conflicted a person can feel with a new love, especially when the former relationship ended because of a death.

People, who are widowed, who are still in love with their deceased spouse, often feel that it's an act of disloyalty to begin a relationship with someone new.  Their spouse might be gone, but their feelings are still very much alive.  They might feel confused and not know how to reconcile the fact that they can fall in love with someone new while still loving their former spouse.  If the new love gets jealous and makes emotional demands too soon, it can create an even bigger conflict and ruin an otherwise good new relationship.

Reframing the Love and Loyalty Dilemma
Like Ms. Pell, it's often better to take an empathetic step back, try to understand your romantic partner's emotional dilemma and talk to him about it.  When the dilemma is reframed as there being room for both the deceased spouse and the new partner, it can reduce a lot of tension and offer options that your partner might not have seen before.  Your partner doesn't need to completely bury his feelings for his deceased spouse, which wouldn't be possible anyway.  It's really not an either/or question.  He can still honor the feelings he feels for her and make room for you.

Some people, who have lost a spouse, never get over it, and they're unable to make a commitment to a new relationship.  For other people, this issue works itself out with understanding on both sides.  Sometimes, the person who is widowed needs help in individual therapy to work it out.  Other times, it helps for both people to come into couples counseling to negotiate this problem.

Either way, I found Ms. Pell's approach to this common dilemma to be a mature and refreshing approach.  Thank you, Ms. Pell, for a heart warming article.

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

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

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


The Race Grows Sweeter Near Its Final Lap--Modern Love, NY Times by Eve Pell (1/27/13)