Overcoming Procrastination in an Uncertain World

Living in an uncertain world, most of us would love to have access to a crystal ball where we could determine with absolute certainty what was going to happen in our lives, especially when we're faced with major decisions.  I'm sure we'd like some happy surprises from time to time just to keep things interesting.  Unfortunately, much of the time we're attempting to make decisions based on whatever information we have at the time so, as adults, we need to be able to tolerate a certain amount of uncertainty.

Uncertainty and Procrastination
One of the problems with feeling the need for absolute certainty before taking action is that it leads to procrastination for many people.  Constantly weighing the pros and cons, seeking more and more information, and ruminating about the possible outcomes can keep you stuck in your tracks.  So, it's important to realize that if you've stuck obsessively weighing every possible outcome to a decision, you could procrastinate indefinitely and not take much-needed action.

Overcoming Procrastination and the Need for Absolute Certainty

The following fictionalized vignette, which is based on many cases with no identifying information revealed, illustrates how the need for absolute certainty can become problematic and what can be done to overcome this problem:

Nina
Nina was raised by a single mother, who struggled financially to take care of Nina and her three other children.  Every financial decision that Nina's mother made was carefully weighed in the context of their limited household budget and the mother's insecure job as a non-unionized factory employee.

Nina's mother worried a lot about what she would do and how the family would survive if she lost her job.  Even as a young child, Nina was very aware that she and her family lived in the shadow of constant uncertainty.

Nina knew from stories her mother told her that the boss at the factory would fire employees at the drop of a hat.  So, whenever her mother came home looking anxious, which was often, Nina held her breath and her first anxious thought was that her mother had lost her job.  When she realized that her mother was reacting to something else that happened at work and she had not lost her job, Nina would let out a sigh of relief and breathe normally again.

Nina did well in school and she managed to get a scholarship to go to college, which was fortunate because her mother didn't have the money to pay for college and Nina feared the possibility of being in debt with student loans and not being able to pay them back.

After college, Nina had two excellent job offers, but she had a hard time making a choice.  She weighed the pros and cons of both job offers. She researched each company thoroughly.
She sought advice from her college advisors and her friends.  But even with all this information, Nina felt paralyzed to make a decision.

After a few weeks, one of the companies rescinded the offer and gave the job to someone else.  So, fearing she might lose the other offer, Nina quickly accepted the other job.

By the time Nina came to therapy several years later, she had many other similar experiences where she struggled and procrastinated to the point where she felt too paralyzed to move forward.  Even though she earned a very good salary, she was living as if she was still part of a household that was always strapped for cash.  Basically, she was reliving her mother's experience without realizing it.

Our work together involved using clinical hypnosis and Somatic Experiencing to help Nina overcome her childhood trauma of an impoverished family life.

We worked on helping Nina to feel less emotionally enmeshed with her mother's experience and to feel like a separate person.

We also worked to help her "update" her emotional experience to reflect that she was no longer an anxious child worrying about whether the family would survive.  Of course, Nina already knew this on a rational level, but she didn't feel it on an emotional level.

Then, to start, we worked on getting Nina to get comfortable making relatively low-risk decisions, so she could begin to overcome her habitual pattern of procrastination.  Over time, we progressed to more complex decisions.  Rather than just talking about her problem, each week Nina worked on a particular task that we agreed upon in advance and then she came back the following week to talk about her experience.

The work wasn't easy or quick for Nina, but she was motivated to overcome her need for absolute certainty because she was tired of living her life filled with anxiety about personal decisions to the point where she felt paralyzed.  And, gradually, she made progress.  She developed a greater emotional capacity to tolerate uncertainty, a new sense of self confidence, and an ability to take action.

Clinical Hypnosis and Somatic Experiencing Can Help You to Overcome Trauma and the Need for Absolute Certainty That Causes Procrastination
My experience as a psychotherapist, who has worked with many adult clients who are affected by childhood trauma, a fear of change, and habitual procrastination, is that just talking about it in therapy isn't enough.  People often develop insight and an intellectual understanding of their problems when they just talk about it but, often, this doesn't result in change.

Both clinical hypnosis and Somatic Experiencing, as I use them, allow psychotherapy clients to have a mind-body connection experience so the therapeutic work isn't just on an intellectual level.  Clients tend to experience it on an emotional and physical as well as intellectual level.  It's a holistic experience that provides an opportunity for an emotional shift to occur so that clients can take action to make changes.

I've included links below under Resources so you can find out more about clinical hypnosis and Somatic Experiencing.

Taking Action
Taking action is an important component in my work with clients.  While talking about the problem is important, it's vital that the client take action to make changes, otherwise, more than likely, the problem isn't going to change, especially when the problem is about procrastination, fear and dealing with uncertainty.

Overcoming Procrastination:  Getting Help in Therapy

Getting Help in Therapy
If you're having problems overcoming habitual procrastination, you owe it to yourself to get help from a skilled, licensed mental heath professional who works with clients on this issue.

Imagine what your life might be like in five or 10 or 20 years if you continue to have this problem.   Then, try to imagine what your life could be like if you were free from this problem and you could be more confident and spontaneous in the world.

Which life would you prefer?

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.

APA: Research Reveals Psychotherapy Is Effective But Underutilized

According to the American Psychological Association (APA), research reveals that psychotherapy is an effective treatment for that helps to reduce not only mental health problems but also improves long term health.  

Yet, despite this research, according to the APA, mental health treatment has decreased over the last 10 years or so as more people attempt to rely on psychotropic medication for their emotional problems (see link below for the APA article).

Research Reveals Psychotherapy is Effective But Underutilized

The article cites the findings of 50 peer-reviewed studies that demonstrate psychotherapy's effectiveness across age and racial groups.

According to the APA article, research has shown that a combination of psychotherapy and medication is effective in treating anxiety and medication.

In my experience as a psychotherapist, I've found that many clients who might think, initially, that they might need to be on medication are often helped with psychotherapy alone combined with exercise or yoga.  Of course, each client is different and what works for one client might not work for another.  But this is also true for psychotropic medication.

The APA article also indicates that research has shown that the positive effects of psychotherapy often last longer than psychotropic medication.

Also, psychotherapy is often effective for teaching clients life skills that the clients benefit from long after they have completed psychotherapy.

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.

Research Shows Psychotherapy is Effective But Underutilized

Are Your "Cold Feet" Just Common Pre-Wedding Jitters or a Cause For Concern?

It's not unusual for people who are about to get married to feel a little anxious about taking such a life-changing step in their lives.  We often refer to this as "having cold feet" or "pre-wedding jitters," and most people recognize this as a common experience.  But how do you know if what you're experiencing is just "pre-wedding jitters" or if what you're sensing are "red flags" about the marriage?

Are Your "Cold Feet" Just Common Pre-Wedding Jitters of a Cause For Concern

Many couples find it helpful to go to pre-marital counseling to talk about their hopes and expectations about their upcoming marriage.

Pre-marital counseling provides an opportunity to discuss important issues like, for example, your views about: 

• what it means to be married
• how you feel about sex
• whether you want to have children or not
• if your religious or spiritual beliefs are in synch with each other
• how you want to conduct your financial affairs

Pre-marital counseling is also usually the place where people raise any concerns they might have about the other person or about how well suited they are as a couple to get married.  

Are You Experiencing Common Pre-Wedding Jitters or Sensing Red Flags?
Attending pre-marital counseling can help you to determine if what you're experiencing is just common pre-wedding jitters (so-called "cold feet") or if your anxiety is a signal that something might be wrong in your relationship that could cause problems in a marriage.

Don't ignore or override your concerns.  It's better to express your concerns before you get married than to go through with the wedding and have regrets later.


If you're just experiencing the kind of "cold feet" that people often feel before getting married, you can set your mind at ease before the wedding.

But if there are real concerns, you also have an opportunity to try to work these issues out, if they can be worked out, before you get married.

If you're trying to determine if your anxiety is normal pre-wedding jitters or if you're sensing "red flags" about getting married, it's best to seek a counselor who is a licensed mental health professional who can be objective and who has experience working with couples.

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.


photo credit: sergcot via photopin cc

Are Toxic Secrets Ruining Your Relationship?

The ability to maintain privacy and healthy boundaries is a part of normal development.  As part of normal development, you don't divulge very personal details about yourself indiscriminately to people you're not close to in your life.  But when you keep secrets, especially toxic secrets, from your spouse, you can ruin your relationship.

Are Toxic Secrets Ruining Your Relationship?

What Is a Toxic Secret?

The following list are examples of toxic secrets:

• You're having an extramarital affair
• You're drinking excessively or using drugs when the rest of the household is asleep
• You're overextended on credit cards and you haven't told your spouse
• You have a bank account that you've never told your spouse about
• You're being audited by the IRS and you haven't told your spouse
• You have a child from another relationship that you've never told you're spouse about
• You've lost your job, but you haven't revealed it to your spouse yet

I'm sure you can think of many more examples of toxic secrets, but this gives you an idea of what I'm referring to in this blog article.

How Can a Toxic Secret Ruin Your Relationship?
People who maintain toxic secrets from their spouse are often in denial about the effect on their relationship of maintaining these secrets.  They often think they can keep secrets indefinitely and it won't have any affect, especially if their spouse never finds out.

But even if your spouse never finds out about your secret, it can still have a detrimental effect on your relationship.

For one thing, it creates a lot of tension and makes the secret keeper guarded and defensive with the spouse.

If you're leery about your spouse finding out about a secret, you're going to be very cautious to do everything you can to maintain that secret.  This means you're must be careful about everything you say and do so that you don't reveal the secret, which can create a lot of anxiety and guilt for you.

You might also misunderstand simple things that your spouse says and even an innocent question like, "Where are you?" might cause you a great deal of distress if you think your spouse is questioning your whereabouts because he or she is trying to find out your secret.  This could make you irritable and jumpy which, in itself, can cause problems in your relationship.

Keeping toxic secrets can also cause health problems.  The guilt and stress involved with keeping a toxic secret can take a physical toll of the secret keeper.  Over time, this can cause stress-related illnesses.

On the other hand, if your spouse finds out about your toxic secret and s/he doesn't find out about it from you, at the very least, it will probably cause a great deal of emotional pain, anger and mistrust.

Many couples don't survive the kind of blow to their relationship involved with a spouse discovering a toxic secret.  Often, the spouse who feels betrayed doesn't regain the trust needed to remain in the relationship.

Getting Help in Therapy
Of course, no one can tell you what to do with regard to keeping secrets from your spouse.  

But if you think that keeping secrets from your spouse is eroding the emotional intimacy in your relationship or if your spouse has discovered your secret and this has become a major obstacle to the stability of your relationship, you owe it to yourself to get help.

Don't wait until it's too late.  The negative impact of toxic secrets has a way of getting worse over time.

A skilled mental health professional who has experience working with this type of issue can help you and your spouse to work through this problem if both of you want to salvage your 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.

Overcoming the Fear of Falling In Love and Getting Hurt Again

I see many clients who have had their hearts broken in prior relationships and who fear falling in love and getting hurt again.

Overcoming the Fear of Falling in Love and Getting Hurt Again

An article that I read in the New York Times Modern Love section called:  "Fear of Surrendering Again: Ready In Case the Other Shoe Drops" by Julia Anne Miller is a good example of how people often fear getting hurt again in a new relationship (see link below).

Even when people really yearn to love and be loved again, an overwhelming fear of being retraumatized in a new relationship can keep them from getting involved with someone new.

The following fictionalized vignette, which is a composite of many cases with no identifying information revealed, is an example of how someone can yearn to be in a relationship again but needs help to overcome the fear of getting hurt again:

Lee
When Lee first came to see me, she had been dating Bob, a man she met at a friend, Beth's wedding, for several months.  It had been several years since she had been in a serious relationship. She was in her early 40s, and after getting hurt in her marriage and a subsequent long term relationship, she was sure she was through with dating and relationships.

And then she met Bob.

Lee smiled to herself as she thought about Beth, even on her wedding day, orchestrating this meeting by placing Lee next to Bob at the singles' table.  Beth was forever trying to set up introductions for Lee to eligible men and Lee was forever rejecting Beth's efforts.  Now, at last, knowing that Lee was coming on her own to the wedding, Beth had a chance to use her match making skills.

Normally, Lee would be annoyed by Beth's efforts to match her up with a man, but not this time.

Lee wasn't sure what there was about Bob that made her want to reconsider remaining single.  Sure, he was good looking, intelligent, kind, funny and successful.  But there was something else.

When she looked in his eyes, she felt that she just might be able to trust him.  But what if she was wrong?

After her last breakup, which was particularly painful, she preferred to bury herself in her work during the week and see friends or stay home alone on the weekends.  She had resigned herself to remaining single for the rest of her life.  She considered getting a cat, but that was the extent of willingness to make another commitment to a living being.

After 10 years of marriage, her husband (now ex), who everyone agreed seemed like the most caring and trustworthy man alive, ended up leaving her for a woman he met at work.  Her last boyfriend, who also seemed sweet and kind, decided, after six years, he wanted to be free to date other women.  Lee felt she would never get over the pain of that breakup.

Having experienced such excruciating emotional pain in our prior relationships, how could she know if she could trust Bob?

Then, there was her father, who was in and out of the household, constantly cheating on Lee's mother and then coming back to ask for forgiveness whenever things didn't work out with his last girlfriend.  Although Lee understood that her mother was financially dependent upon the father, she still felt anger and resentment towards her mother for taking him back again and again.  She spent most of her childhood and adolescence hating her father, and she only reconciled with him after he was diagnosed with advanced cancer, just before he died--the ultimate abandonment.

We spent much of our early work together helping Lee to rebuild her sense of resilience.  She understood that there were no guarantees in relationships.  Her biggest fear was that if her relationship with Bob didn't work out, she would spiral down into a deep depression and she wouldn't be able to function.

Lee had witnessed her mother become incapacitated by depression after Lee's father left the household for the third time.  Lee bore the brunt of taking care of her three younger siblings.  She vowed to herself that she would never allow a man to make her feel so depressed.  Even in her darkest moments after her marriage, as devastated as she felt, she was still able to go to work, take care of her apartment and function in life.

But after her last relationship, she wasn't sure she could bounce back again from another disappointment if Bob hurt her.

On the one hand, when she became especially fearful, she was tempted at times to call it off with Bob.  On the other hand, most of the time, she knew she wanted to be with him and see where their relationship would go.

We also worked on helping Lee heal from her prior childhood trauma as well as the losses she experienced in her marriage and last relationship.  This was hard work for Lee, but it enabled her to experience her relationship with Bob as separate from those other disappointments, so she could experience it as new and not as being part of a string of disappointments.

Lee also learned to trust her judgment again.  Over time, she was able to open up more with Bob and allow their relationship to grow without feeling the oppressive fear she felt before.

Getting Help in Therapy
There are so many people who close themselves off to the possibility of falling in love again because they fear they'll get hurt.  Even though they might be lonely, their fear overwhelms any possibility of finding happiness with someone new.

If you're someone who would like to have someone special in your life, but you're overwhelmed by fear based on your experiences from the past, you owe it to yourself to get help.

A skilled mental health professional can help you heal from your losses and develop a greater sense of resilience and self confidence.

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.

Modern Love: Fear of Surrendering Again: Ready In Case the Other Shoe Drops

Psychotherapists Need to Stop Labeling and Stigmatizing the So-Called "Help Rejecting" Client and Be More Creative Instead

One of the most unhelpful labels that a therapist can pin on a client is the so-called "help rejecting client" or, worse still, "the help rejecting complainer."

Stop Labeling and Stigmatizing the So-Called "Help Rejecting" Client

No matter how a therapist tries to qualify these labels by saying that he or she understands that the client isn't intentionally rejecting the therapist's recommendations or that the client is responding this way out of fear, there's no way around it, these labels are pejorative and damaging to the therapeutic work.  And I can't help feeling that using these labels is a way of blaming the client, making him "wrong" and making the therapist "right."

Generally speaking, clients who are referred to as "help rejecting" are often seen as finding reasons why interventions the therapist attempts in treatment won't work or responding to the therapist's treatment recommendations with, "Yes, but..."

No doubt, when this happens, it's frustrating for the therapist and the client.

Reconceptualizing the So-Called "Help Rejecting Client"
I think it's time that mental health professionals reconceptualize these outmoded labels and begin to "think outside the box."

Better yet, I think we should "retire" the terms "help rejecting client" and "help rejecting complainer" in much the same way we retire certain baseball uniform numbers.  Let's agree to stop using these labels.

I'm not saying that therapists are actually calling clients "help rejecting" to their faces.  It's more of a term used in psychotherapy literature, although I've also seen it written about in certain therapy blogs for the lay public.

Many people might disagree with me, but I think that even if a therapist never utters the words "He's a help rejecting client,"just thinking about the client in this way has the potential to sabotage the therapy.  After all, if the client is "help rejecting" and the therapist's job is to help, what's left to do?

The Client's Fear and Ambivalence
There are clients who are ambivalent about treatment and about making changes.

If you've lived your entire life relating in a certain way and engaging in certain behavior, even if behaving in these ways has caused a lot of emotional pain, it's scary to venture into unknown territory to change.

If a client is afraid to make a change, it's up to the therapist to help the client to feel safe.  The old maxim of "starting where the client is" comes to mind.

This could mean that the therapist might need to get out of his or her "comfort zone" to try something different.  It could mean working in a different way from how he or she would.  This is why it's important to have many different ways of working because therapy can't be a one-size-fits-all endeavor.

It could also mean seeking a consultation with a more seasoned therapist.

In some cases, the therapy might take longer than the therapist and client anticipated.  At times, it might be frustrating for both the therapist and the client.  But the therapist can't go any faster than the client is willing to go.

Engaging the Motivated Part of the Client That Wants Help
Most people understand that, as human beings, we're complex.  Even when we say we want to change, there's often a part of us that doesn't want to change at all.

It's up to the therapist to understand the part of the client that fears change and to engage the part of the client that came in wanting help.

At the start of therapy, the more dominant aspect of the client might be rejecting what the therapist has to offer.  But, usually, underneath the fear and ambivalence there's an aspect of the client that wants to change but doesn't know how.

After all, if a client spends the time and money to come to therapy every week, there must be some aspect of him or herself that wants to change or s/he wouldn't be there.

Therapists Need to Be Creative
Gone are the days when the therapist can take a "neutral stance" with the client.  Good riddance to the days when the therapist sat back and just said, "Uh huh," retraumatizing the client as he poured out his problems!

Therapists need to learn to be creative in their work to help the work come alive.  They need to be a presence in the therapy room rather than being neutral.

Clinical Hypnosis and Somatic Experiencing
There are many creative ways to overcome therapeutic impasses with clients who are ambivalent and/or fearful about change.

I often find clinical hypnosis and Somatic Experiencing to very useful in helping clients to soothe the part of themselves that fears change and connect with the aspect of themselves that wants to change.

Talking about these aspects of self without helping clients to connect to where they're feeling these emotions in the body is very limited.  Talking about it often becomes an intellectual exercise that doesn't lead to actual change.

Helping the client to have a "felt sense" of these conflicting aspects of him or herself makes the therapy come alive in a way that regular talk therapy often doesn't.

Helping Clients to Use Their Imagination
Helping the client to use his or her imagination in an embodied way can open the door for the client to have a "felt sense" of internal and external resources to invoke.

Over time, clients can learn to use these resources to have a corrective emotional experience that wasn't available to them before.  At that point, the client has access to more of him or herself to do the work to make changes.

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 the Insecurities That Are Ruining Your Relationship

I've seen many clients in my psychotherapy office in New York City, both individuals and couples, where personal insecurities were having a negative effect on their relationship.  Often, this takes the form of one or both people needing constant reassurance that they are loved by their partner.

When Needing Constant Reassurance in Your Relationship Becomes a Negative Habit
Needing constant reassurance about your relationship can become a negative habit.  This dynamic can ruin a relationship fast.  It can be exhausting, especially when the person doing the reassuring realizes that no amount of reassurance will alleviate his or her partner's insecurities.

Overcoming the Insecurities That Are Ruining Your Relationship

The following fictionalized vignette is an example of where one person's insecurities in a relationship can have a negative impact:

Jane and Bob:
After Jane and Bob were dating for three months, they realized that they had fallen in love and decided to become exclusive with each other.

As soon as Jane realized that she was in love with Bob, she started feeling insecure:  Did he really love her or was he just telling her this?  Would he meet another woman at work, where there were so many attractive women, and leave her?

When they were together, Jane was vigilant as to whether Bob was looking at other women.  If she thought she saw him looking at another woman, she would panic and ask him for assurances that he loved her.  At first, Bob was flattered and reassured Jane.

But when it kept happening nearly every time that they went out, he began to feel irritated and he told her she had nothing to worry about, and it was annoying for him to feel pressured to constantly reassure her.  This only made Jane feel worse.

Jane's insecurities got worse over time.  If Bob didn't call her back immediately, she wondered if he was with someone else.  When she mentioned this to Bob, he got angry.  He asked her if he had given her any reason to think this.

When Jane calmed down, she knew, in reality, that Bob wouldn't cheat on her.  But once doubt crept into her mind, she had a hard time containing her worries and keeping it to herself. She felt compelled to ask him about it.

After a while, Bob got frustrated and told Jane that she should go to therapy to deal with this.  Jane knew that Bob was right--she was having a problem and if she didn't overcome these insecurities, their relationship wouldn't last.  So, she sought the help of a licensed mental health professional.

During her therapy, Jane realized that a lot of her insecurities stemmed from feelings of abandonment from childhood.  Jane's mother was in and out of her life from the time Jane was born.  So, Jane needed to work through this early loss and her fears of abandonment so she wouldn't displace her fears on Bob.

Jane also developed better coping skills in therapy.  As she was working on her earlier trauma, she learned how to contain her fears and insecurities so she no longer blurted them out to Bob.  Soon, they were getting along much better and talking about moving in together.

Getting Help in Therapy
Assuming that your romantic partner doesn't give you any objective reasons to feel insecure about your relationship, your insecurities might be linked to unresolved childhood issues.  It's hard to see this on your own because your fears and insecurities often feel so real in the current situation, even though they're really part of an earlier trauma.

You could benefit from getting help from a licensed mental health professional who can assist you to work through your fears and insecurities.

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.