What is the Difference Between Sadness and Depression?

Sadness and depression are often confused but, in fact, they are very different.

At some point in our lives, we all feel sad, but being sad is not the same as being depressed.

What is the Difference Between Sadness and Depression?

Whereas sadness tends to be a passing mood, depression is a serious mental health problem. It has physical as well as emotional implications.

APA's Definition of Depression
According to the American Psychiatric Association's DSM-IV (Diagnostic and Statistical Manual), to be diagnosed as depressed, a person must have at least five or more of the following criteria, as self reported or as observed by others, for two or more weeks where these symptoms represent a change from a person's prior functioning:

• depressed mood for most of the day, nearly every day
• decreased interest in almost all activities for most of the day, nearly every day
• significant weight gain or weight loss which is not accounted for by diet
• insomnia or hypersomnia (oversleeping) nearly every day
• psychomotor agitation or retardation
• fatigue or low energy nearly every day
• feelings of worthlessness or excessive or inappropriate guilt nearly every day
• problems concentrating or indecisiveness nearly every day
• recurrent thoughts of death or suicidal thoughts (either with or without a plan)

What is the Difference Between Sadness and Depression?

In addition to the above, people who are depressed often feel various aches and pains that cannot be explained by any particular medical condition.

Unfortunately, depression can last for weeks, months or, in some cases, for years.

Depression can be very debilitating, affecting a person's family, career, and daily activities of living.

Well-meaning but misinformed family or friends might tell a depressed person to "snap out of it," but depression is not a mood that people enter into and get over easily.

Getting Help in Therapy
If you suspect that you or someone you care about has five or more of the above symptoms, it is very important to get professional mental help as soon as possible, especially if there are suicidal thoughts.

Getting Help For Depression:  Many People Return to Their Prior Level of Functioning or Better

With treatment, many people return to at least their prior level of functioning if not better.

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, please 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.

What is the Connection Between Childhood Emotional Neglect and Adult Romantic Relationships?

Early childhood emotional neglect can lead to many problems later on in adulthood with developing and sustaining relationships.   In an earlier article,  What is Childhood Emotional Neglect?  I defined childhood emotional neglect.  In this article, I will discuss the connection between childhood emotional neglect and problems in adult relationships.

Childhood Emotional Neglect and Adult Romantic Relationships

Cycles of Problems From One Generation to the Next
Very often, parents, whose own emotional needs were unmet when they were children, have problems later on as adults being nurturing with their children.

As children, they didn't have parental role models who showed them how to form healthy, nurturing relationships.  This is especially problematic if there wasn't another nurturing adult, like a family friend, teacher or mentor, to mitigate the effects of parental emotional neglect.

Childhood Emotional Neglect and Adult Romantic Relationships

Aside from not having role models, it's usually the case that, since their emotional needs were unmet as children, they continue to have unmet emotional needs as adults, which gets in the way of their dealing with the emotional needs of their own children.

Under these circumstances, it's not unusual to see cycles of one generation after the next of children with unmet emotional needs who grow up to be adults who cannot meet the needs of their children.  This is especially evident when clinicians do intergenerational family genograms with clients where certain behavioral patterns can be traced from one generation to the next.

Potential Problems Related to Early Childhood Emotional Neglect
There are many potential problems that can develop for children who have unmet emotional needs.

The following list includes many of the most common problems:

• problems in school, including problems with focusing in class, following the teacher's directives, completing homework assignments, acting out by fighting with other students or being truant from school, and so on
• problems as a child (and later on as an adult) forming friendships and other relationships
• problems with alcoholism, drug addiction, compulsive gambling or other compulsive behaviors, like overspending or sexual addiction, as a teen or an adult
• problems with eating disorders, including overeating and obesity, anorexia and bulimia
• problems with getting and holding down a steady job
• problems with basic self care, including neglecting one's medical and dental health, getting enough sleep, eating nutritiously and so on
• problems being compassionate towards oneself and others
• problems forming healthy romantic relationships
• problems with loneliness and social isolation
• problems with self centeredness and narcissism

Potential Problems Related to Early Childhood Emotional Neglect 

The list above is by no means exhaustive, but it gives you an idea of all the potential problems that can develop for a child, who has unmet emotional needs.

Despite a History of Emotional Neglect, Some People Are Inherently Resilient
Of course, there are exceptions.  I've met people, both in my personal life and in my professional life as a psychotherapist, who grew up in families where their emotional needs were unmet and, inexplicably, they grew up to be nurturing adults (see my article:  Resilience: Tips on How You Can Learn to Cope With Life's Ups and Downs).

Despite a History of Emotional Neglect, Some People Are Inherently Resilient

In many cases, especially where there weren't other adults outside their families who made up for the emotional neglect, it's hard to see how, against the odds, they were able to grow up with an ability to be loving and nurturing.  One possible explanation is that these people are inherently resilient.  Resilience is a basic part of their makeup, and it helps them to overcome many of the obstacles that most people, under the same circumstances, encounter.  But, as I've mentioned, these people tend to be the exception.

Emotional Blind Spots: Some Parents Are Unable or Unwilling to See How They Continue the Cycle of Emotional Neglect
Then again, unfortunately, as many of my psychotherapy clients tell me, there are many parents who have emotional blind spots (see my article: Overcoming Your Emotional Blind Spots).

Emotional Blind Spots:  Some Parents Are Unable or Unwilling to See How They Continue the Cycle of Emotional Neglect

From their perspective, they weren't nurtured as children but they think they were nurturing parents to their own children.  They're often unable or unwilling to see that, as adults with deep unmet needs, they've continued the cycle with their children.

In future blog articles, I'll delve deeper into the different aspects of this topic.

Getting Help in Therapy
If some of these issues are familiar to you, rather than continuing to be unhappy, you can work through these problems with a licensed psychotherapist so that you can lead a more fulfilling life.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and children.  

I have helped many clients to overcome the effects of childhood emotional neglect and abuse so they could lead happier, more meaningful 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.

What is Childhood Emotional Neglect?

The concept of "emotional neglect" is often mentioned in psychotherapy journals, newspapers, popular magazines, movies, TV programs and social media.  But there is often confusion about what this term means.

What is Childhood Emotional Neglect?

When it comes to children's emotional needs, I think it's important to define "emotional neglect" in terms of unmet childhood needs.

Defining this concept is important to many adults, including psychotherapy clients and potential psychotherapy clients, who are confused and unsure as to whether they were affected by emotional neglect when they were children.

Defining emotional neglect is important for parents and parents-to-be, who might feel anxious about parenting their children and trying to create a balance between limit setting and overindulgence.

Teachers, day care workers, child protective workers, child therapists, health care workers, clergy and other people who come in contact with children often suspect that certain children might be suffering due to emotional neglect at home, so understanding this concept is important to them as well.

"Good Enough" Parenting vs Perfection
First of all, no childhood is perfect.  No parent can be perfectly attuned to his or her child 100% of the time.  It's not humanly possible.  There will be times in any childhood when a child's needs go unmet for a variety of reasons.

What is Childhood Emotional Neglect: "Good Enough" Parenting vs Perfection

When we refer to emotional neglect, we're referring to a pattern of behavior where a child's emotional needs were unmet more often than they were met.

The British psychoanalyst and pediatrician Donald Winnicott referred to this as parenting that was "good enough," where the parent created an emotionally nurturing home environment that he referred to as "a holding environment" most of the time (see my article: The Creation of a Holding Environment in Psychotherapy).

Of course, every child will be different in terms of his or her emotional needs, as most parents who have more than one child can tell you.

Resilience in the Context of a Nurturing Family Environment
The reason why most of us can sustain instances of parental lapses in emotional attunement is that most of us have a certain amount of resilience.  We can withstand certain lapses in emotional attunement as long as the parenting is "good enough" most of the time.

Resilience in the Context of a Nurturing Family Environment                              

So, if, for example, a parent, who is normally nurturing and attuned to his or her child's needs is distracted and doesn't notice on a particular occasion that a child is sad or angry and doesn't ask the child about it, this usually doesn't result in irreparable harm.

But if there are too many instances where a parent doesn't notice and doesn't attend to a child's emotional needs, this can be emotionally damaging to the child and often has long lasting traumatic effects into adulthood if the adult doesn't get professional help.

Childhood Emotional Neglect is Often Invisible and Goes Unnoticed
Unlike physical abuse where there are often physical bruises or other signs that are obvious, childhood emotional neglect is often invisible and goes unnoticed.

Since childhood emotional neglect usually involves a parent who is not responding to the emotional needs of a child, it is less obvious to see.

If, for example, people see a child who looks well fed, properly groomed and well dressed, they often assume that the child is being taken care of emotionally as well.  This is because many people judge situations by outer appearances.

Also, some children, especially children who tend to be overachievers, are very good at pushing down their own emotional needs under these circumstances and excelling academically.  If they are quiet children who aren't having behavior problems in school, teachers and other adults who come in contact with them often won't notice that anything is amiss with these children.

Many children, who come from families where their emotional needs aren't being met, learn how to hide their sadness by covering up their feelings.  They might appear to be outgoing or cheerful, but underneath, they're often unhappy and lonely.

Worse still, they're often hiding a lot of shame about their sadness and unmet emotional needs.  The shame that they carry often has serious repercussions for them as adults (see my article:  Unresolved Childhood Issues Can Create Problems in Adult Relationships).

In future articles, I'll continue to discuss childhood emotional neglect.

Getting Help
Many people come to therapy because of underlying issues related to their unmet needs in childhood that continue to affect them as adults.  

It's never too late to get help to overcome the effects of childhood emotional neglect.  

Working with a licensed mental psychotherapist, you can work through these issues in therapy so you can overcome them and lead a more fulfilling life.

About Me

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

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

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

Are Fantasies About Someone Else Distracting You From Your Relationship?

It's not unusual for people who are in relationships, especially long term relationships, to fantasize about other people.  But if you find that your fantasizes about someone else have been distracting you from your relationship with your spouse, it's time for you and your spouse to ask yourselves what's going on in your relationship (see my articles: Fantasizing About Someone Else During Sex and The 7 Core Sexual Fantasies).

Are Fantasies About Someone Else Distracting You From Your Relationship?

The old saying that "the grass always seems greener on the other side" is especially apropos when it comes to fantasizing about another woman or another man.  

In your fantasies about someone else, they're always just the way you want them to be:  always loving, sexy, infinitely patient, kind and understanding.  In your fantasy, the another person (like a coworker) might seem perfect for you.  

Fantasizing About a Coworker?  The Grass Always Looks Greener

Meanwhile, the reality might be completely different, and no one can live up to an idealized romantic fantasy.

The Reality Might Be Completely Different From Your Fantasy

While these fantasies might provide a temporary relief from whatever boredom or frustration you might feel in your relationship, if you find yourself spending more and more time engaged in the fantasies about someone else and not paying attention to your relationship, your relationship will eventually suffer.

Some Tips on What to Do If Fantasies About Someone Else Are Distracting You From Your Relationship:

Be Aware

Developing an awareness about how much time you're spending fantasizing about someone else is the first step.  

It's possible that, when you first began fantasizing about someone outside of your relationship, these fantasies were only occasional and weren't taking away from your relationship with your spouse.

But if you find yourself spending more and more time with your thoughts focused on someone else, you need to admit this to yourself and recognize it as a sign that there's a problem.

Don't Get Carried Away With Your Fantasies

If you don't know the other person well (or, maybe, not at all), don't allow yourself to get carried away with your fantasies about "how wonderful" it would be between you.  

Although it might be exciting at first, eventually you'd be dealing with the reality of day-to-day living where the two of you would have to deal with who will clean the bathroom and who will take out the garbage.  That's life.

Ask Yourself What You Feel is Missing in Your Relationship

Are you feeling bored or frustrated because you and your spouse are in a temporary rut or are the problems longstanding?

Be honest with yourself:  No relationship is exciting all the time.  So if the problems are temporary rather than longstanding, be patient and think about how you and your spouse can get through this period of time.

But if you sense that you're distracted from your relationship due to a steady decline emotional or sexual intimacy (or both) that's missing in your relationship, obviously, that's a more serious problem.

Take a Look at Yourself First

Often, people in relationships are all too willing to blame their spouse or partner before they look at themselves.  So, before you blame your spouse, look at yourself first.

Fantasizing About Someone Else?  Take a Look at Yourself First Before You Blame Your Spouse

Be willing to ask yourself if what's missing from your relationship is you.

If, after thinking about the state of your relationship, you realize you haven't been as attentive as you used to be, ask yourself why and what you can do to change.

Communicate With Your Spouse or Partner

Although you can't make assumptions before you talk to your spouse, you might not be the only one who is feeling bored or distracted.

Be tactful.

Don't tell your spouse that you're consumed with thoughts about someone else.  This would be hurtful to hear and it won't improve things between you.

Ask your spouse how s/he is feeling and if there are ways the two of you can enhance your relationship.

Remember What Brought the Two of You Together in the Early Stage of Your Relationship

It's easy to forget, especially in long-term relationships, what brought the two of you together in the early stages in your relationship.  

When I'm seeing a couple in my psychotherapy private practice in NYC, I can tell a lot about how the couple talks about the early days of their relationship.  If talking about the early days brings a smile to each of their faces and they gaze at each other warmly, there's usually hope that the relationship can be salvaged.  But if they gloss over the early romantic period or, worse, if neither of them can remember it, that's usually a bigger a problem.

Stuck in a Routine? Make Changes

Are you and your spouse stuck in too much of a routine?

While some routines are hard to change, there is probably room for change in certain areas of your life.

For instance, you and your spouse can probably make some changes in your love life or your social life.

So, if your lovemaking has become boring and predictable, talk to your spouse about how to spice it up.  Maybe you have a particular fantasy (maybe it's even one of the fantasies you've thought about with the other person) that you'd like to try with your spouse.  Talk to your spouse about it.

Sometimes, even making small changes can make a big difference.  Changes to your love life don't need to involve acrobatics or swinging from the chandelier.  It can be as simple as adding a little more sensuality to your lovemaking, like giving (or receiving) a massage.

Not Sure If You Want to Remain in the Relationship?

If you're really not sure if you want to remain in the relationship, this is a more serious problem.

Whether you're on the fence about the relationship or you know you want to end your relationship, you and your spouse could benefit from talking to a couples counselor.

While it's probably fairly obvious how you could benefit from seeing a couples counselor when you're not sure if you want to stay or go, it might not be as obvious why you would see a couples counselor if you're sure the relationship is over.  

When people ask me about this, I usually tell them that, even if the relationship is over, this person once meant a lot to you and there are better ways to end a relationship than ending it with bitterness and anger.

A couples counselor can help you to be your "better selves" rather than ending the relationship with animosity. 

Getting Help in Therapy

If you're having problems in your relationship, you could benefit from seeing a licensed mental health professional who works with couples.

Problems are usually easier to deal with earlier rather than later, so if you and your spouse or partner are having problems, don't wait.  Get help.

About Me

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

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

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

When Trust Breaks Down in Relationships - Lies of Omission

In prior blog posts about couples counseling, I've explored the topic of trust with regard to infidelity in relationships. This is one important aspect of mistrust in relationships. In this blog post, I would like to explore another aspect of trust and mistrust that I see as a NYC therapist who works with individuals and couples, specifically the topic of "lies of omission."

When Trust Breaks Down in Relationships: Lies of Omission

When we talk about trust, generally, we recognize that, in most cases, there are degrees of trust rather than either total trust or total mistrust, and this can change over time in a relationship.

We also recognize that when trust is an issue in a relationship, like most other issues, the individuals' family histories are often a contributing factor as to how the issue plays out and how it affects the current relationship.

A composite vignette should help to illustrate these points. As always, composite vignettes are representative of numerous cases and do not violate confidentiality:

Sandy and Tom:
When Sandy and Tom came to see me for marriage counseling, they were married for three years. Both of them were accomplished professionals in their 30s.  It was the first marriage for both of them.

The main issue that brought them into marriage counseling was that Sandy felt she could not trust Tom at times. They both agreed there were no issues of infidelity.

The main problem seemed to be that, over time, Sandy detected a recurring pattern where Tom deliberately withheld certain information from her about an insignificant aspect of whatever topic he was discussing.

Her concern was more about the recurring pattern of deliberately not telling her certain things and not about the particular piece of information that he left out. She was completely confused and hurt about Tom's lies of omission.

Tom acknowledged that he often felt a compelling urge to withhold information from Sandy. He agreed with Sandy that, when each example was looked at by itself, it didn't seem significant. However, when looked at as a pattern of his communication with Sandy, it raised a "red flag." He seemed to be just as baffled by his behavior as Sandy was, and he wanted to change this pattern.

Lies of Omission: Tom acknowledged that he felt a compelling urge to withhold information from Sally

To illustrate her point, Sandy gave numerous examples. Each of them seemed to be of no particular importance, except when looked at together as a pattern.

A typical example was when Tom told Sandy about a business dinner and discussed each person in detail--except one. He never mentioned that person at all. There was nothing particularly significant about this one person's attendance at the meeting, and Sandy had no reason to be concerned about this person.

What was significant was that Tom felt the need, as he often did, to withhold a particular piece of information from Sandy.

He acknowledged that he had deliberately withheld this information, and if he had not withheld this particular piece of information, he would have withheld some other insignificant piece of information.

Usually, later on, whatever Tom had omitted would come to light in some other way, and Sandy would be confused about why Tom had not told her.

Exploration of Tom's background revealed that both of his parents were loving and nurturing towards him, but they were also highly intrusive. As a child, Tom was not allowed to close the door to his room because his parents wanted to be able to see what he was doing at any given time.

As a result, Tom felt he had no privacy until he moved out to go to college. Tom had never thought much about this before but, as we continued to explore his family background, he traced back his pattern of engaging in lies of omission to the time he was about 10 or 11 years old.

Over time, as we continued to discuss this in marriage counseling, Tom realized that he resented his parents' intrusiveness and he compensated for it, without realizing it, by finding ways to withhold certain information from them.

Unconsciously, he found a way to preserve certain things for himself that he did not want to share with them. None of the things that he kept from them were significant--it was more the idea that he could have something for himself that his parents could not intrude upon.

Realizing this was a major breakthrough for Tom and it served as a starting point to change his pattern of communication with Sandy. And, once Sandy understood more fully how his parents' intrusiveness affected him, she felt a lot more compassion for Tom, and she became more patient.

When looked at from the perspective of a young boy who felt relentlessly impinged upon by his parents, you could begin to understand how Tom would develop an unconscious pattern of withholding information.

As a child, he didn't have the ability to stop his parents from being intrusive or to communicate his discomfort to them or to cope with it in other ways. As a result, he did the only thing he knew how to do to preserve a sense of privacy for himself.

So, what started out as a way to cope with intrusive parents developed into a maladaptive form of communication with his wife. And since his wife was not an intrusive person, in reality, Tom had no reason to continue this pattern, but it had become habitual.

Although it took a while for Tom to feel "safe" enough to be more open with Sandy, eventually, he did learn to stop engaging in lies of omission, and this significantly improved the relationship.

Tom Was Able to Change His Pattern of Lying After He Worked Through Childhood Issues

An Excuse to Lie?
Reading this vignette, some people might think that Tom used his family background as a convenient excuse to be withholding with Sandy.

However, as a psychotherapist in the room with a client who is describing the pain and feelings of powerlessness of never having privacy as a child and feeling constantly intruded upon by well-meaning but intrusive parents, I have a clear sense that this type of family background can have a profound effect on a child.

It's not a matter of condoning this behavior, but of understanding the origins of it. And the unconscious patterns that we develop as children often don't disappear automatically when we become adults. Often, we carry these patterns into our adult relationships where they have adverse effects.

Without understanding the significance of how certain patterns develop and just looking at these circumstances on the surface, many people might say, "Why doesn't he just get over it?"

However, often, once the roots of the problem are traced back, we can see the complexity of the problem more clearly.

So, rather than looking at it in terms of someone making convenient excuses for his problem, it becomes a starting point for understanding the problem and it often contains the key for the resolution.

Getting Help in Therapy
If you and your partner struggle with similar issues in your relationship, you could benefit from attending couples therapy with a licensed mental health professional to overcome these problems.

About Me
I am a NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing who works with with individual adults and couples. I have helped many individuals and couples to lead more fulfilling lives.

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

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

Starting Therapy With a Sense of Curiosity and Openness

"Try to love the questions themselves as if they were locked rooms or books written in a very foreign language." Rainer Maria Rilke

In a prior article, I discussed How to Choose a Therapist and gave some tips on choosing a psychotherapist who is best for you.

A Sense of Openness and Curiosity in Therapy
In this article, I'm focusing on a healthy way to approach therapy.

People who are considering therapy, who have never been in therapy before, often ask me how they should approach this personal exploration, and I usually respond by suggesting that they start therapy with a sense of curiosity and openness.

Many people have concerns about whether they're ready for therapy, what it will be like and if the therapist will judge them.

Starting Therapy With a Sense of Curiosity and Openness

I've been on both sides of the couch, so to speak.  I know how difficult it can be, especially for someone who has never been in therapy before, to begin therapy.  

A number of years ago, after graduate school, as part of my training to become a psychotherapist, I was required to be in my own three-time per week therapy for four years.

I remember very clearly what it was like to attend psychotherapy consultations with various therapists, who were connected to my training program, and what it was like to choose a therapist for my four year postgraduate training.  It was a daunting task.  

Initially, I had many of the same concerns that most people have: 

• Where do I start?
• How much should I divulge about myself during the initial therapy consultation?
• What will the process be like?
• Will the therapist be judgmental and see me as being unfit to be a therapist?

Since the therapists who were on the list were also part of the training institute, it was a bit of a "fish bowl" experience, and I discovered that many other people in the psychotherapy training program felt the same way.

Starting Therapy With a Sense of Curiosity and Openness

But, over time, I (and most of my peers) overcame these feelings and we learned to become open and curious about the therapeutic process.   I was also fortunate to find a therapist who was empathetic and a good fit for me, which is very important.

Therapy as a Process of Self Exploration
Many people come to therapy because they want to overcome specific issues.  

Others just have a sense that they're not feeling right and they don't understand why.  They sense they need to change in some way, but they're not sure how or why.

Starting Therapy With a Sense of Curiosity and Openness

Whatever leads you to consider psychotherapy, a sense of openness and curiosity helps you to expand your sense of self awareness and develop emotional insight.  It can also help you to make important changes in your life.

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

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

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



Also see my articles:
Psychotherapy From a Strengths-Based Perspective: Seeing the Whole Person
Overcoming Your Fear of Starting Therapy to Overcome Emotional Trauma
Psychotherapy: Listening and Learning From the Client
Mind-Body Psychotherapy: The Body as a Window Into the Unconscious Mind

Letting Go of an Unhealthy Friendship

There's no such thing as "a perfect friendship."  Most friendships have their ups and downs, and most people make allowances for friends who might be difficult at a certain point because they're going through a difficult time.  

But if you have a friend who is generally difficult and who causes you a lot of stress most of the time, you might want to re-evaluate your friendship in light of the emotional or physical toll it might be having on you.

Letting Go of ab Unhealthy Friendship

The following vignette is a composite of many different cases with all identifying information changed:

Sally and Nina:

Sally and Nina were friends in college.  Even though she really liked Nina and she thought Nina was a fun and interesting, Sally found Nina difficult at times when they were in college because she felt that Nina tended to be selfish.

There were times when they made plans that Nina would break if a young man that she liked asked her out.  There were also times when Nina would forget to pay Sally back when she borrowed money from Sally.  

At the time, Sally didn't know how to talk to Nina about these incidents, so she didn't say anything about it.  But, afterwards, she felt badly about herself for not speaking up.  She also realized that she felt highly ambivalent about the friendship and she wondered why she remained friends with Nina.

After they graduated from college, Nina moved back to California and Sally moved to NYC.  They kept in touch for a while, but then they gradually lost touch with one another.

Then, several years later, Nina emailed Sally to let her know that she was moving to NYC for a new job, and she wanted to reconnect with Sally.

When Sally got Nina's email, she cringed.  She considered what she wanted to do and she decided that she would meet Nina for a drink and see whether Nina had changed in the intervening years.

A couple of hours before Sally and Nina were supposed to get together, Nina texted Sally to let her know that she had to cancel because she wanted to get together with a friend of a friend who could be helpful to her.  Nina explained that she thought this person could be someone who could help her to advance in her career and, since this person was available, she wanted to meet with her as soon as possible.  Nina made her apologies, she hoped they could get together another time, and told Sally that she hoped Sally would understand.

Sally didn't have a lot of spare time, and she set aside the time to see Nina.  When she got Nina's email, Sally realized that Nina had not changed, and she decided that she didn't want to reconnect with her.  

Put Things in Perspective and Get Clear on What's Bothering You About Your Friendship

Try to get clear on what's bothering you about this friendship.

Think about particular instances when you felt uncomfortable, hurt or annoyed and weigh this against what your overall feeling about the friendship.

This isn't a matter of keeping a strict account of what you've done for your friend and what your friend has done for you.  It's more a matter of putting things in perspective.

Consider Whether You and Your Friend Can Work Out the Friendship

There are times when sitting down and having a talk about what's bothering you can be helpful in resolving whatever the problem might be between you and your friend.

You might find that, even though it was obvious to you, your friend might not have realized that anything was bothering you.  If it seems like you and your friend can work things out, you can give the friendship another chance.

Is the problem related to something temporary that is going on in your friend's life or is it a more ingrained problem that is part of his or her personality, which is usually more difficult, although not impossible, to change.  

For instance, in the vignette above, Nina had a tendency to be self centered and unable to consider how her friend might feel.  Some people lack emotional intelligence or never developed good interpersonal skills to be able to maintain friendships.

Consider Whether This is Someone You Would Choose as a Friend Now
People change.  You might have changed.

There are times when you might have a long term friendship that no longer feels right for you, and you're aware that if you had met this person now, you wouldn't be inclined to form a friendship with him or her.

Consider  Whether  You Can Work Things Out and If This is Someone You Would Choose as a Friend Now

If you feel that the friendship is causing you a lot of emotional pain and you wouldn't be friends with this person if you were to meet him or her now, think about what this means for you:

• Why are you continuing to be friends?
• Are you avoiding ending the friendship because it would be uncomfortable?
• Do you feel it would be mean of you to end the friendship?
• Are you stuck because you don't know how to end the friendship?

Think About Whether You Can Have a Different Kind of Friendship With This Person?
There are different kinds of friendships.  There are close friends that you trust and you confide in, and there are some friendships that are not as close, but you might have a common interest that brings you together.

If you have a friendship that was once close, but it's a matter of not wanting to be as close to this person (and there are no major issues between you), consider whether you want to keep this person in your life as a casual friend rather than letting go of the friendship altogether.

Letting Go of Toxic Friendships
There are times when it's clear that a friendship is just too toxic for you and it would be unhealthy for you to keep this person in your life.

This can be difficult and sad. Sometimes, it's more difficult than going through a breakup in a romantic relationship.

There can be so many different toxic friendships and unhealthy situations, so it's hard to generalize in one blog article.

Depending upon the situation, try to be as tactful as possible in explaining that you wish this person well, but the friendship isn't working for you.

Try not to get into an argument, which won't be beneficial you or the other person.

It might not feel comfortable at the time to assert yourself and take care of yourself in this way, but remaining in a toxic friendship that is detrimental to your overall emotional well-being just to avoid the discomfort of ending the friendship isn't the answer.

Once you've let go of an unhealthy friendship, you might be sad, but you'll probably realize, in the long run, how much less stressful your life is and that you have more emotional and physical energy for other healthier relationships.

Also see my articles:  

Coping With a Close Friend's Betrayal
Do You Feel Overwhelmed by a Friend's Problems?

About Me

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

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

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