Psychotherapy, Trauma and Meditation

Many people come to therapy to deal with unresolved trauma, whether it's a recent trauma or longstanding trauma from childhood.

Psychotherapy, Trauma and Meditation

Over the years, I've found a mind-body oriented approach to processing trauma in psychotherapy, like EMDR, clinical hypnosis or Somatic Experiencing, to be the most effective therapy for many clients who want to work through unresolved trauma.

No matter which approach I use for trauma therapy, if a client is open to it, I often like to end a session by taking the last 5 or 10 minutes to guide the client through a meditation.

Why Use Meditation at the End of a Therapy Session?
A brief meditation at the end of a session usually provides a client with the following beneficial effects:

• A reduction in stress
• A reduction in anxiety
• A sense of feeling calmer
• A sense of being emotionally grounded
• A sense of feeling whole again after processing trauma
• An awareness that, even after dealing with difficult emotions, it's possible to shift into a more relaxed state

Using Meditation in Therapy to Shift Into a Calmer State After Processing Trauma
The last item on the list above, an awareness that you can shift your emotional state from fear or anxiety (or other difficult emotions) to a relaxed state, is important because many people are afraid to come to therapy to deal with trauma because they think that processing the trauma will be too overwhelming and it will make them feel worse.

Many clients are often surprised that, even though they've just dealt with traumatic memories in a therapy session, it's possible, with a few minutes of meditation, to make this shift so, rather than feeling emotionally overwhelmed, they feel like they can "face the world again" when they leave my office.

If a client likes a particular meditation that I do, like the Safe or Relaxing Place meditation , I ask him or her to bring in a recording device so that we can record the meditation during the session which the client can then be use between therapy sessions.

They also become aware that when they're dealing with difficult emotions between sessions, they have a way that they calm and soothe themselves.

For clients who have a history of trauma, this can be very empowering, especially for clients who, prior to therapy, felt they didn't have the capacity to take care of themselves in this way.

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.

Some Tips on Negotiating Conflicting Temperaments in Your Relationship

In my last article,  Negotiating Conflicting Temperaments in Your Relationship, I began a discussion with a composite vignette about two people in a relationship, Ann and Jerry, who initially were very close in their relationship, even though they had very different temperaments.

Ann was an extrovert and Jerry was more of an introvert.

Initially, Ann and Jerry admired the qualities they saw in each other and felt was missing in themselves.  But, as time went on, they began to have arguments due to their conflicting temperaments.

Negotiating Conflicting Temperaments in Your Relationship

While Jerry, who was a writer, was working hard to meet a publisher's deadline on his book, Ann began to feel resentful, as time went on, that Jerry wasn't joining her for social activities with their friends.  She tended to be gregarious and loved being around other people and having fun.

Jerry felt that Ann was being inconsiderate because she knew that he was under a lot of stress.  And Ann missed having Jerry at social events, especially when her friends were there with their partners.

Initially, each of them kept their feelings to themselves.  But the tension built up over time, and they had an argument that developed over a petty issue.   That's when the real, underlying issue, their conflicting temperaments, came to the surface and threatened their relationship (see my prior blog post).

After their argument, they had a couple of weeks where they were distant with one another.  Jerry stayed at home most of the time, and Ann spent more time going out with her friends.

When they were at home, they barely spoke to one another. Neither of them was happy with the tension between them, but they didn't know what to do.

Then, one day, they got into another argument when Ann brought up that her parents invited them over for dinner.  There was a moment of awkward silence, and then Jerry told Ann that he was too close to his deadline and he needed to stay at home to write.

Ann became angry and told Jerry that they hadn't seen her parents since Jerry began working on his book.  She asked him, "Can't you spare one night to go with me to my parents' house?"

When Jerry lowered his head to think for a moment about how to respond, Ann interpreted this gesture to mean that he was ignoring her.  She ran out of the apartment in tears telling him that she didn't know if she wanted to be in a relationship with him any more.

Jerry was stunned and he followed her out.

Negotiating Conflicting Temperaments in Your Relationship

He said to Ann, "Look, I've been thinking about things.  Maybe we should see a couples counselor to get help.  What do you think?"

Although Jerry had been in therapy before, Ann had never seen a therapist.  She wasn't sure how she felt about it, but she knew that she and Jerry couldn't go on like this, so she agreed to go.

After listening to each of them, the couples counselor pointed out how they had very different temperaments and this seemed to be causing the conflict between them.

Neither Ann nor Jerry had thought of their problems in this way before, and it gave them each a lot to think about.

Both of them told the couples counselor that they were still in love and wanted to salvage their relationship.  But they just didn't know how.

The couples counselor helped them to learn relationship skills so that they could negotiate the differences related to their different temperaments.

Here are some of the relationship skills that they learned over time:

Negotiating Conflicting Temperaments:

     Avoid Power Struggles Over Being "Right"
There are many conflicts where both people in the relationship are "right," so basing an argument with your partner on getting your way because you think you're "right" will won't settle an argument most of the time.

Avoid Power Struggles Over Being "Right"

In Jerry's and Ann's relationship, they were both "right" with regard to how each of them felt.

After months of Jerry spending most of his time working on the book instead of going out with Ann, Ann missed having Jerry with her at social events.  Jerry knew Ann liked going out, so he never told Ann not to go out and see her friends.  But Ann wanted him there with her.  Ann had a right to her feelings.

Jerry, who wasn't nearly as outgoing as Ann, felt that Ann was being unreasonable:  How could she expect him to go out parties, which he didn't always enjoy, and possibly miss the deadline for his book?  He felt that Ann wasn't being understanding about what he needed to do.  So, Jerry also had a right to his feelings.

When each of them looked at it this way in couples counseling, where they were calmer than when they tried to talk about it at home, they both acknowledged that it wasn't a matter of "right or wrong."

As they talked about it, each of them acknowledging the other's feelings, they began to relax with each other more.

     Focus on Behavior as Opposed to Making Personal Attacks
The couples counselor pointed out to each of them how they both engaged in personal attacks instead of focusing on behavior.

Focus on Behavior as Opposed to Making Personal Attacks

The couples counselor also pointed out that this only exacerbated their problems, and each one of them became more entrenched in his or her argument rather than working together to try to solve their problem.

     Negotiating Differences
The couples counselor told them that every couple has problems, and couples who have different temperaments can go through challenging times.  But this doesn't mean they can't negotiate their differences.

So, each week the couples counselor gave Ann and Jerry homework assignments to do related to negotiating their differences.  Ann expected Jerry to protest about the homework because of his book deadline, but Jerry wanted to save their relationship, so he agreed enthusiastically to work on these assignments, which made Ann happy.

Over time, both Ann and Jerry developed a greater sense of empathy for each other, which helped them to make compromises.  They struggled along the way, but each of them was more willing to find common ground rather than insisting that he or she was "right."

In couples counseling, they remembered what they liked about each other and what brought them together so they were able to rekindle their relationship.

With the help of the couples counselor, they were able to make compromises between staying home and going out socially.

Negotiating Conflicting Temperaments in Your Relationship

Jerry realized that he was actually more productive when he took a break from his work to go out and have fun, and Ann realized that she could begin to appreciate staying home more and feeling close to Jerry, even when he was working.

Getting Help in Couples Counseling
Problems with negotiating conflict is a common issue in many relationships, so if you and your partner are having this problem, you're not alone.

The important thing is to get help before anger and resentment build to the point where the relationship is beyond repair.

An experienced psychotherapist who has expertise in working with couples can help you to learn the necessary relationship skills to negotiate conflict so that you can have a happier relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples.

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

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

Negotiating Conflicting Temperaments in Your Relationship

As anyone who has ever been in a new relationship knows, during the initial heady stage of falling in love in a relationship both people are usually on their best behavior.  During that stage, many people feel they have met their "soul mate."  

But conflicts can arise over time, especially when each person in the relationship has a different temperament compared to his or her partner.  If the couple doesn't know how to negotiate these differences, after a while, a relationship can end with anger and resentment.

Coping With Conflicting Temperaments in Your Relationship

What is Psychological Temperament?
Let's start first by defining what we mean by the word "temperament."

Generally speaking, psychological temperament refers to aspects of personality that are considered to be innate as opposed to being learned.  An example of contrasting temperaments would be introversion and extroversion.

Extroverts generally tend to be outgoing, gregarious, talkative and prefer being around others as opposed to being alone.  If they spend too much time alone, they often become bored.

An Example of Temperament: Extroverts

Introverts tend to be more interested in their inner emotional world.  They are often more emotionally reserved than extroverts.  They might enjoy being at social gatherings, but they can get overstimulated in certain group environments.

An Example of Temperament: Introvert

These examples of temperament are generalizations, of course, and there are many variations.

Vignette
Let's take a look at the vignette below, which is a composite of many different couples, to see how conflicting temperaments in a relationship can create problems:

Ann and Jerry:
When Ann met Jerry, she liked that he was sensitive to her feelings and that he had a calming effect on her.  She also liked that Jerry, who was a writer, was much more emotionally aware than most men that she dated in the past.  They would talk for hours about topics that Ann hardly talked about with other men, including psychology, literature, and music.  She loved Jerry's writing and admired that he was so disciplined in his work.

Ann Liked Jerry's Sensitivity and Jerry Liked Ann's Gregariousness

When they first met, Jerry liked Ann's gregariousness.  He admired how she comfortable she felt among strangers at a party, and he felt that being around her helped him to be more outgoing than he normally would be on his own.  He also liked that Ann, who was a marketing rep., tended to be a "go-getter," a trait he wished he had to promote his work.  He had never dated anyone as lively and charming as Ann.

After dating for a year, Ann and Jerry moved in together.  Jerry didn't really care about how the apartment was furnished or if they had a house warming party, so he left that for Ann to handle, who loved decorating and organizing social gatherings.  She also organized their social activities with friends.

During the first year that they lived together, they were both very happy.  Jerry enjoyed hearing about Ann's interactions in the business world, and Ann loved reading Jerry's magazine articles.  She was also thrilled that he had just received an advance to write a book, and she was very encouraging with regard to his writing.

But by the second year, tension developed between Jerry and Ann.  Jerry was spending a lot of time at home working on his deadline for the book, which left little time for social activities.  Ann continued to be supportive of Jerry's writing, but she missed going out to parties and seeing her friends more.

Ann was beginning to feel stifled by her relationship with Jerry.  Even though she would see her friends when Jerry was too busy with his writing, she wanted him to come along.  Her other friends' husbands came out with her friends, and she felt awkward being the only one who went to social gatherings on her own.

At first, she tried not to complain to Jerry because she knew that it was important for him to meet his publisher's deadline.  But, even though she didn't tell him directly that she was feeling annoyed that she was going out without him, her resentment came out in other ways.  She found herself snapping at Jerry for petty things, like when he forgot to call the superintendent to fix a leaky faucet.

Jerry, who was immersed in his work, felt guilty that he wasn't accompanying Ann to the social gatherings that she normally enjoyed going to with him.  But he felt he had no choice.  He had to meet the publisher's deadline, and he wouldn't enjoy spending time at a party knowing that he was at risk of not meeting the deadline.  He also didn't like or understand why Ann was snapping at him for petty issues.  He felt she was being inconsiderate when she knew how much pressure he was under.

Then, one day, when Ann came home to discover that Jerry forgot, once again, to call the superintendent to fix the leaky faucet, she felt upset and exploded at Jerry:  He was at home all day.  Couldn't he take a minute to call the superintendent?  How many times did she have to remind him to do this?  She was busy at work all day. She didn't have the time to do it.  And so on.

Coping With Conflicting Temperaments: Ann Felt Upset

Jerry, who was already anxious because he was falling behind where he wanted to be in terms of meeting the publisher's deadline, became exasperated:  Did Ann think that she was the only one working because she went to an office?  Wasn't his work important too?   She knows that he has been under a lot of pressure.  Why is she making it worse by stressing him out about a leaky faucet?  How could she be so inconsiderate.  And so on.

Their argument escalated to the point where Ann told Jerry that she felt bored in their relationship.  She wanted to go out more and be around people.  She wanted to go to parties, skiing and snow boarding with friends.  She didn't want to just sit around the apartment and watch him write.  She felt like she was suffocating.

Jerry responded by telling her that he didn't mind going to parties sometimes, but he would feel irritated after a while by the loud music and people trying to shout over the music to be heard.  He couldn't understand why Ann found this enjoyable.  And while many of her friends were "nice," he thought some of them were "vapid," like teenagers who never grew up.

Coping With Conflicting Temperaments in Your Relationship

Ann took offense to Jerry calling her friends "vapid" and asked him if he thought she was "vapid" too because she wasn't as intelligent as he is.  As Jerry was gathering his thoughts to respond, Ann interpreted this as meaning that he did think she was "vapid," and he didn't want to say it out loud, so she shot back, "Well, I think you're boring and we might have made a mistake moving in together."

After that, Jerry retreated into the den to cool off and reflect on what just happened.  Ann, who felt abandoned when Jerry walked away, texted a friend to meet her at a local bar to talk.

During the next few weeks, their relationship was strained.  They each felt hurt and angry, and neither of them knew what to do.

Conflicting Temperaments in a Relationship
As you probably realize, in the vignette above, generally speaking, Jerry is an introvert and Ann is an extrovert.

Each of them was drawn to the other, in part, for the qualities that they felt was missing within him and herself.  But, after the initial stage of their relationship, conflicts arose when each of them, based on their different temperaments, felt that their needs weren't being met by the other.  The very personality traits that they each liked in each other at the beginning of the relationship now annoyed each of them.

In a situation like this, the relationship can quickly unravel when neither person knows how to negotiate these issues or if they don't get help from a licensed mental health professional who works with couples and who knows how to help couples develop the relationship skills required to negotiate conflicts based on conflicting temperaments.

In my next article, I'll focus on how couples who have conflicting temperaments can negotiate their relationship so that these type of conflicts don't destroy the relationship.

Next Article: Tips on Negotiating Conflicting Temperaments in Your Relationship

Getting Help in Couples Therapy
If you and your partner are having problems in your relationship because of conflicting temperaments, you owe it to yourself to get help from a couples therapist who has expertise in this area.  It could make the difference between salvaging your relationship or breaking up.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Sex Therapist who works with individuals and couples.

I have helped many couples to have more fulfilling relationships.

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 That People Won't Like the "Real You"

Many people have an intense fear of allowing people to get to know who they really are (see my article:  Learning to Feel Comfortable With Yourself).

Overcoming the Fear That People Won't Like the"Real You"

In my psychotherapy private practice in New York City, over the years, many clients, both men and women, have come to therapy because they feel they're "defective" in one way or another.

Although their fears that others won't like them if their "real" self became evident is projection of how they feel about themselves, before they recognize this, this fear feels very real.  And, unfortunately, they live their lives as if it is true.

Many of these therapy clients feel that they're hiding this part of themselves from others and it makes them feel unhappy and inauthentic.

Although there are many reasons why people have this fear, it's often rooted in unconscious issues from their early childhood.

It's very painful to feel that you're hiding some aspect of yourself that's "defective" and that others would shun you if they knew about it.

For many people who feel this way, they think they have to put on a facade for others, which is not only emotionally, mentally and physically draining, it also makes them feel inauthentic, which exacerbates the problem.

Let's take a look at an example of this phenomenon, which, as always, is a composite of many cases with all identifying information changed to protect confidentiality:

Nina
When Nina, who was in her mid-30s, began therapy, she felt like she was almost to the point of exhaustion in her interactions with the people in her life.

Overcoming the Fear That People Won't Like "Real You"

In order to always seem like she was positive and engaging, she tended to "people please" most of the time.  In order to do this, she tended to acquiesce to most of the demands that friends and coworkers placed on her so that they would think she was "nice."

Overcoming Fear That People Won't Like the "Real You"

Often, these demands would be at the expense of Nina's time, energy and finances that she needed for herself.  But, no matter.  She wanted to others to see her as being kind and generous all of the time.  So, it was very rare for Nina to say "no" to the people in her life, unless she was sick and, physically, she just couldn't do.

Even when people weren't making demands (and most of them weren't), Nina would go out of way to be extra helpful and extra kind.

As we talked about this dynamic, it became apparent that, although she was, in fact, a kind and generous person, she was also defensively fending off any possibility that these people would see her as anything but kind and generous by going above and beyond in her interactions with others.

The emotional risk for her if she didn't engage in this dynamic was that if they didn't see her as being always kind and generous, they would, instead, discover that she was really a 'fraud," which is how she felt about herself.  And, more than anything, she wanted to avoid this.

As we continued to explore her dynamic with the people in her life, Nina realized that she couldn't go on doing this because she would wear herself out.  And all this focus on others and not enough on herself was making her feel emotionally depleted and deprived.

Nina came to realize that there was a lot more going on for her emotionally under the surface than she ever realized before she came to therapy.  And, given her fear of being "defective," exploring this dynamic in therapy was a big challenge for Nina.

As with any client in therapy, we had to proceed at a pace that she could tolerate.  If not, Nina would be emotionally overwhelmed and might drop out of therapy rather than work through this issue.

Her ambivalence about exploring the underlying issues in therapy was strong.  For instance, sometimes,  especially in the beginning stage of therapy, she would "forget" to come to therapy and when I contacted her, she would be surprised that she missed our session.

It was less of a challenge of her to pay for the broken appointment, which she already knew was my policy, than to appear for the session and deal with the underlying issues.

But, over time, Nina and I worked together to develop the kind of therapeutic rapport that is necessary to work on these kinds of issues.

When she felt she could trust me and trust our work together, we began to make connections between her family history of growing up with highly critical and punitive parents and how this history affected her sense of self.

Of course, just knowing this isn't enough to change the kind of "people pleasing" dynamic that Nina was engaged in.

We had to work through the original childhood trauma, which took time.  And then, Nine had to stop trying to ingratiate herself with the people in her life in order to fend off what she saw as the possibility that they would see she was "defective."

In our work together, I helped Nina to separate her life as a child from her life as an adult.

See my articles: 
Working Through Emotional Trauma: Learning to Separate "Then" From "Now" 

Overcoming Trauma: When the Past is in the Present.

Only when she was able to develop an awareness of the dynamic she was engaging in by "people pleasing," work through her emotional trauma and learn to interact in a healthier way with others, was she able to have healthier relationships.

Of course, there were some people who were accustomed to Nina being willing to bend over backwards for them, and they didn't like this change in her, at first.  This was especially hard for Nina.  There were times when she reverted to her old behavior to fend off these people's disapproval.

Over time, she was able to catch herself before she reverted to her old "people pleasing" behavior.

But a surprising number of her friends and coworkers told her that they sensed a change in her. They felt she was more present and authentic with them, which they really liked.

Some of them even told her that they much preferred this way than when she was that she was overly solicitous and self sacrificing, as she was before, because it made them feel uncomfortable.  This made Nina feel happy, and it helped to reinforce her new dynamic with the people in her life.

Overcoming Fear That People Won't Like the"Real" You

Over time, she also learned to choose people who wouldn't expect her to be so self sacrificing, and she eventually let go of the existing people who couldn't accept the positive change in her.

Getting Help in Therapy
The example that I gave in the scenario above is one of many possible dynamics that people engage in when they feel that people wouldn't like them if they knew the so-called "real" person who is "defective."

Getting Help in Therapy

Aside from "people pleasing," there are many other dynamics that people who have this fear engage in to compensate for their feelings of low self worth.

If you recognize yourself in the composite vignette above, rather than continuing to suffer on your own, you could benefit from getting help from a licensed mental health professional who helps clients to overcome this problem.

Once you're free from feelings of low self worth, you have an opportunity to live a more fulfilling life.

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

I have helped many clients to overcome the feelings of low self worth that caused them to fear that people wouldn't like them if they knew them better.

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.

How Early Attachment Problems Can Affect Your Relationship With Your Therapist

In an earlier series of articles about early attachment bonds between infants and their primary caregivers, including How the Early Attachment Bond Affects Adult Relationships, I discussed how problems with early attachment can affect adult romantic relationships.  In this article, I'll focus on how early childhood attachment problems can affect adults in their relationship with their psychotherapist.

How Early Attachment Problems Can Affect Adults' Relationships With Their Therapist

The attachment style that people develop early in life with their primary caregiver usually continues on in adult relationships.

When the emotional bond between the baby and the primary caregiver goes well, it's a secure attachment and if there's no major trauma in childhood, as an adult, this person will probably be able to form healthy, secure attachments in adult relationships.

But if the attachment bond that the baby develops with the primary caregiver is an insecure attachment, which is traumatic for the baby, problems often develop later on in adult relationships (see my article: How the Early Attachment Bond Affects Relationships: Insecure Attachments for an explanation of insecure attachment).

How Attachment Problems Can Affect Adults in Therapy
When someone has an attachment problem that developed in early childhood, the insecure attachment doesn't just carry over only into romantic relationships.  Depending upon the severity of the insecure attachment, it can also carry over into other adult relationships, including work relationships, friendships, and the therapeutic relationship with a therapist.

Generally speaking, people are complex, and people with insecure attachment styles don't fall into neat categories of avoidant, ambivalent, disorganized or reactive attachment.

But to illustrate the point that therapy clients often develop therapeutic relationships with their therapist based on their attachment style, I'll simplify the example I'm about to give in the vignette below to deal specifically with the avoidant attachment style.  The same principles would apply for the other forms of insecure attachment, but they would probably show up in a different way.

As always, this vignette is a composite of many cases with all identifying information changed to protect confidentiality:

Ella
Ella, who was in her late 20s, came to therapy because she had a history of problems in her romantic relationships.

Ella's Avoidant Attachment Style Caused Problems in Her Romantic Relationships 

Although she was focused primarily on her problems in romantic relationships, Ella also had problems with her relationships at work.  However, since she made a lot of money for the company, her superiors overlooked her interpersonal problems.

Ella said she wanted to meet someone that she could settle down with, get married and have children, but her relationships never lasted more than a year.  She was also keenly aware that she would be entering into her 30s soon, and she was concerned about her "biological clock."

Her problem was that whenever a romantic relationship became serious, she became fearful that her partner would leave her.

In each relationship, Ella's fear became a self fulfilling prophecy because, even though she loved the man she was in a relationship with, her fear would become so overwhelming that she would become avoidant and start to distance herself from him.

She did this by finding all kinds of reasons for canceling plans, making excuses, including that she didn't feel well or that she had too much work to do.

Sooner or later, the man she was seeing at the time would get fed up and leave the relationship, and Ella would feel sad and frustrated.

After this happened in three relationships, Ella also began to feel angry with herself because she couldn't understand why she was sabotaging each relationship.  It also left her feeling very lonely.

Each time this happened, Ella would promise herself that she wouldn't give in to her fears in the next relationship. But each time her fear overwhelmed her in the next relationship, and she found ways to distance herself again.

Knowing that clients' attachment styles can affect their therapeutic relationship with their therapists, I usually address this issue early on in therapy to educate clients so they won't be surprised to see that they're engaging in the same dynamic in therapy.

When a client with this problem knows in advance that it can affect how they engage (or disengage) in therapy, it can help clients to anticipate this before it happens.  It gives the therapist and client an opportunity to talk about it before client acts on it.

Although talking about it beforehand can help to mitigate an insecure attachment style, simply having this information doesn't necessarily stop it.

Attachment dynamics are usually unconscious, so that when a client engages in an insecure attachment style in therapy, s/he isn't necessarily aware of it at the point when it's happening.

It can take a while for a client to develop enough awareness in therapy to anticipate the behavior and, even more time to change it.

Ella was psychologically minded, so she was surprised and curious about how this avoidant dynamic might play out in therapy.

In the initial stage of therapy, as I was learning about Ella's family history and how it contributed to her insecure attachment style, Ella seemed fine.  She had been in therapy several times before, and she had talked about her family history many times before.  She was almost somewhat detached and unemotional as she gave her history.

When Ella told me about the many false starts she had in her prior therapies, I pointed out to Ella that, just like she found ways to be avoidant in her romantic relationships, she also became avoidant in her therapeutic relationships with prior therapists.

Ella's Avoidance in Prior Treatment Was Unconscious

Ella had never thought of this before but, as we discussed it, she realized that she usually left therapy just when she and the therapist were at the point where they were delving deeply into her problems.  Whenever she left therapy, she thought she was doing it because "it wasn't helping."

But, as we discussed this, Ella was able to see, in hindsight, that she didn't really give any of her prior treatments a chance because she would leave before she made progress.

We spent time talking about the internal cues that Ella might have missed before she aborted therapy in the past, and we also talked about whether she could pick up on these cues this time if she felt like aborting therapy again.

For many clients, this is hard work, especially for clients who really believe that, each time they leave therapy, it isn't because they're avoiding dealing with their problems.  They want to believe that they have a legitimate reason each time because "therapy isn't working."

This isn't to say that clients don't leave therapy for legitimate reasons or that their therapist really isn't helping them.  But for clients who have an avoidant attachment style, they often have a pattern of leaving therapy prematurely (see my article:  When Clients Leave Psychotherapy Prematurely).

In addition to discussing Ella's avoidant behavior in therapy, as part of our preparation for our work, we also worked on helping her to develop coping strategies to deal with her anxiety and fears.

We also talked her commitment to therapy and the treatment frame, including my cancellation policy, which is 48 hours unless there's an emergency.

Although this preparation helped Ella to deal with her urges to leave therapy during the early stage of treatment, as we delved deeper into Ella's early childhood history with an unstable mother, Ella began to cancel appointments more frequently.

For many people, a cancellation policy where they had to pay the full fee for broken appointments can be a deterrent to their canceling appointments when they want to cancel because they're uncomfortable with the material that we were discussing in the prior session.

But Ella earned a very good salary and it wasn't a hardship for her to pay for broken appointments.  So, the cancellation policy didn't keep her from missing sessions.  She also became adept at canceling the appointments 48 hours in advance so, technically, she complied with the cancellation policy but, in effect, she was sabotaging her treatment because of her fears of dealing with emotional material that came up.

At the point when she cancelled the appointments, she had no insight as to what was happening with her because her fears were unconscious at the time.  It was only after she returned to her therapy sessions and we discussed what happened that she was able to see, after the fact, that she was being avoidant.

Fortunately, even though there was a part of Ella that was ambivalent about dealing with her problems in therapy, there was a bigger part that was motivated.  So, we worked with the motivated aspect of her in therapy to strengthen it so she wouldn't allow the fearful part of herself to sabotage her sessions.

We also had to develop some new ground rules that we would mutually agree to about cancelled appointments.  So, we agreed that she could only have so many cancellations per six months, and she was able to abide by that.

Since regular talk therapy often isn't as effective for insecure attachment problems, we used a combination of Somatic Experiencing and clinical hypnosis, which are both mind-body oriented therapies that are considered a "bottom up" approach as compared to regular talk therapy, which is more of a "top down" approach.

Ella's therapy was long-term treatment because, even though she was making progress over time, she would sometimes revert to avoidant behavior.  So, our work together required patience on both of our parts.  But as we continued to work together, Ella began to trust me more over time and this allowed her to open up more.

And, as is usually the case, the interesting thing was that as she was developed the skills to form a stronger, stable therapeutic alliance with me, she used these same skills to form a more stable relationship with the new man that she was dating as well as her colleagues at work.

Over Time, Ella Worked Through Her Avoidance in Therapy and in Relationships

Over time, Ella worked through her avoidant behavior, and when she felt the urge to withdraw out of fear, she was able to see the signs before she acted on it, which was a major breakthrough for Ella.

The Challenge of Working on Insecure Attachment in Therapy
Working on any one of the insecure attachment styles in therapy can be challenging for the client and the therapist.

In the vignette that I presented above, even though Ella was fearful, she also had strengths and she had access to a part of herself that was motivated to overcome her avoidant behavior.  She was able to use the therapy well and, over time, she was able to work through her early childhood trauma and overcome her fears.

Many people who have an avoidant attachment style never come to therapy at all.  Their fear of developing a therapeutic relationship with a therapist is so great that, unfortunately, it keeps them out of therapy and, as a result, they never work out their problems in relationships.

For other people who start therapy and who might not be as motivated or as psychologically mind,  they often have a hard time sustaining it.  They might go from one therapist to the next in an effort to get help, but they don't remain in therapy long enough to work through their problems.  Sometimes, in hindsight, some of these clients see that their fear overwhelmed them.

But other people with this problem, no matter how many different therapists they see, they tend to externalize their problems and believe that they left because of the therapist as opposed to what usually happens:  They leave because of their insecure attachment style and the fear and dread that are associated with this problem.

When you consider that overcoming an insecure attachment style is not short term work, this presents another challenge for these clients.

Getting Help
The good news is that many clients who come to therapy to overcome the consequences of problems with early attachment are able to work through these problems.

Just like in any other therapy, it's important for the therapist and client to be a good match.

It's also important that the therapist, who should be a licensed mental health professional, is knowledgeable about insecure attachment issues.

Also, in many cases, as I mentioned earlier, straight talk therapy, which is usually a "top down" approach, isn't as effective as a more "bottom up" approach in therapy, like Somatic Experiencing, EMDR or clinical hypnosis.

If the composite vignette above resonates with you, you could benefit from working with a licensed therapist who has expertise in working with clients who have attachment problems.

It's common for most people to feel some discomfort about starting therapy.  But it's preferable to deal with the fear than to look back late in life and have regrets that life has passed you as you continue to suffer with attachment problems.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples.

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

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

Staying Positive and Focused on Your Goals

Staying positive and focused on your goals, especially long-term goals, can be challenging.

Many people who made New Year's resolutions in January have already given up on keeping their resolutions (see my article: Making and Keeping New Year's Resolutions).

There are many reasons why people, who start out motivated at the beginning of the year, lose their motivation after just a few months or even a few weeks.

Here are some of the primary reasons why people give up on their goals:

Having Unrealistic Goals
Many people have unrealistic ideas about what they can achieve.

New Year's resolutions tend to be about things like losing weight, exercising more or eating healthier.

These are all worthy goals, but the problem arises when people set unrealistic goals, like wanting to lose 50 lbs in a month.  This is an unrealistic and unattainable goal for most people and it sets them up for failure.

In addition to being realistic and attainable, you're more likely to succeed at accomplishing your goals if they're specific, measurable, relevant and time bound.

Engaging in All or Nothing Thinking
When goals are unrealistic and unattainable, people usually become discouraged and give up rather than recognizing that the goal was unrealistic and modifying it.

It becomes an all-or-nothing proposition for them (see my article:  Overcoming All or Nothing Thinking).

Having False Expectations that Accomplishing Your Goals Will Create a "New You"
The idea of people "reinventing" themselves is a part of the American culture.

We read in self help books and hear ads all the time that say that you can create a "new you" if you only lose weight, have whiter teeth or ____________________ (fill in the blank).

This cultural stereotype appeals to people who want a "quick fix" as opposed to people who recognize that change is a process that usually occurs over time.

Avoid False Expectations That Accomplishing Your Goals Will Create a "New You"

When people focus exclusively on external change without focusing on internal change, even when they succeed at their external goal, it's harder to persevere in that goal if they haven't done the psychological work that's necessary to maintain the process.

For instance, I've known people who had lap band surgery to lose weight.

After the surgery, they lost a lot of weight.  But if they didn't work on the psychological issues that triggered overeating, they often either reverted to overeating and got sick or they developed another addictive behavior, like gambling.

Allowing People in Your Life to Discourage You
When you have an important goal, it's important to share your intention with people who are going to be supportive of you (see my article: Beware of Emotional Saboteurs).

Emotional support to accomplish a goal can make the difference between accomplishing your goal or giving up.

Don't Allow Emotional Saboteurs to Discourage You From Accomplishing Your Goals

In an ideal world, everyone in your life would be supportive and encouraging.  But, as most of us know, this just isn't the case.

When you share your intention to accomplish a goal with people who tend to be discouraging, you're exposing yourself to their negative thinking and, possibly, allowing their negativity to derail you.

People who tend to be negative and discouraging aren't always doing it to sabotage you.  Sometimes, without even realizing it, they project their own discouragement about themselves onto you.

If you know you have a healthy, realistic and worthy goal, you have to become more self protective and talk about your goal with other motivated people who are doing positive things in their lives and want the same for you.

Allowing Self Sabotage and Negative Thoughts to Keep You From Accomplishing Your Goals
Even more detrimental than other people's negativity are your own negative thoughts that can creep in so easily, before you realize it, to discourage you from accomplishing your goals (see my article:  Are You Sabotaging Yourself With Negative Self Talk?)

Negative thoughts (also known as negative self talk) can be so insidious and so automatic that, before you know it, you've talked yourself out of pursuing your goals.

Staying Positive and Focused on Your Goals
Remember that change is a process.

Staying Positive and Focused on Your Goals: Change is a Process

Keeping a journal where you write down your progress along the way to accomplishing your goals can help you to stay positive and focused on your goals (see my article:  Are You Able to Celebrate Your Progress or Are You Only Focused on How Much More You Have to Go?).

Along the way, keeping a gratitude journal can also help you to appreciate all that you have to be grateful for throughout the process of working on your goals.

Getting Help in Therapy
It can be challenging to stay positive and focused on your goals even under the best of circumstances, but if you have a history of emotional trauma or there are other psychological issues that are creating obstacles for you, it's even harder.

If you realize that psychological issues are preventing you from fulfilling your dreams, you owe it to yourself to get help.

Working with a licensed mental health professional who has expertise in helping people to overcome psychological issues that create obstacles to realizing your goals can make the difference for you of being successful or falling short of your goals.

Getting help can lead to a more meaningful, fulfilled life.

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

I have worked with many clients to help them to overcome emotional obstacles in their 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.

Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations

As a psychotherapist in NYC, I've been seeing more clients these days, as compared to the past, who are experiencing crippling fears in social situations, and many of them are relying on alcohol to give them "liquid courage," which provides a false sense of confidence in these situations (see my article: Overcoming Social Anxiety).

Fear and Shame in Social Situations

Fear and Shame in Social Situations
There have been tons of article written about why people are having such difficulty overcoming their feelings of vulnerability and shame when it comes to socializing and dating (see my articles: Overcoming Loneliness and Social Isolation and Overcoming Shame).

                   Fear and Shame in Social Situations

These articles give many reasons why this phenomenon is especially prevalent these days, including the fact that people are communicating more online than in person, and many people haven't learned the basic skills necessary to interact socially in person without experiencing dread.

Fear and Shame in Social Situations

Fear of Socializing Without "Liquid Courage"
So, I'm not going to focus so much on the reasons for this problem, which have have already been discussed in many other articles.  Instead, I'm going to focus on a social phenomenon that I've seen with people of all ages, which is that they feel they can't socialize without "liquid courage" to get them through.

Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations

As I usually do in my articles, I'll give a scenario to highlight the problems and some of the ways these problems can be overcome in therapy.

Although the example that I give is about a man, this issue affects both men and women regardless of age, race or sexual orientation.

As always, this scenario is a composite of many cases with all identifying information changed to protect confidentiality:

Mike
Mike, who was in his early 30s, never attended any social event without having at least one drink before he went.

Although, at this point in his life, he very much wanted to be in a relationship, he felt almost paralyzed with fear when he thought about talking to an attractive woman at a party.

Before, he went, he imagined all the things that could go wrong and how embarrassed he would be:  What if there were uncomfortable pauses in the conversation because he couldn't think of anything to say?  What if he looked "stupid" because he didn't understand what she was talking about?  What if she thought he was a bore?  What if he spilled his drink all over himself?  And he ruminated on and on, which escalated his fear.

At times, he felt so emotionally vulnerable when he thought about an upcoming party that he would agonize for days beforehand.

Sometimes, his fear and shame were so great that he would cancel at the last minute rather than deal with facing a situation where he felt sure he would make a fool of himself.

But the immediate relief that Mike felt from avoiding the social situation was often short lived.  Within hours, he regretted not going because his avoidance kept him feeling stuck and lonely for female companionship.

He had plenty of male friends that he hung out with, but socializing with women that he had never met before felt like an insurmountable challenge for him.

Although he felt confident in his career (where he worked mostly with men) and hanging out in a sports bar with his buddies, he lost all confidence in himself when he was in a situation where there were women he didn't know.

On those occasions when he did go to parties, he fortified himself with "liquid courage" (one or two drinks) before he left the house.  Then, he had a few more drinks when he arrived at the party and he was able to loosen up enough to chat with women he didn't know.

Overcoming the Temptation to Use "Liquid Courage"  to Cope With Social Situations

With a few drinks in him, Mike felt less inhibited and he was able to forget about being self conscious.  He was often funny after a few drinks, and women would tell him that he had a great sense of humor.  He also felt more confident about asking women to go out.

The problem was that, by the next day, without alcohol, he still felt the same crippling fear as before, and he was sure that when he called the woman that he met, he would be so socially inept that she wouldn't want to go out with him.

Fear and Shame in Social Situations Without Alcohol

After struggling this way for a couple of years, Mike realized that he had a real problem and he came to therapy.

In therapy, Mike and I worked on the underlying issues, including a childhood with overly critical parents, that were at the core of his problems.  Even though he was an adult, he continued to struggle with these old messages that made him feel worthless in social situations with women he didn't know.

Aside from working through these underlying emotional issues, Mike also needed to practice getting more comfortable approaching these social situations without fortifying himself with alcohol.

On a rational level, Mike knew that he couldn't keep relying on alcohol to get him through because it was only a temporary fix.  And, since his father had problems with alcoholism, Mike also knew that a possible genetic predisposition to alcoholism could create a bigger problem for him if he continued to rely on alcohol.

But, on an emotional level, Mike felt that alcohol had become his reliable "friend" in helping him to get through these situations.  Even though Mike wasn't an alcoholic, he knew that his maladaptive ways of coping with social situations wasn't going to be easy to change.

We worked on Mike's childhood history of emotional abuse using EMDR therapy.  We also used the cognitive behavioral technique of desensitization for his fears related to socializing.

Using a desensitization technique, we set up a hierarchy of Mike's fears and worked on them, step by step, one by one (from low to high) so that he could overcome his fears.

In addition, we used clinical hypnosis (also known as hypnotherapy) to help boost Mike's confidence.

In the meantime, Mike cut back on his drinking.  He practiced going to social events without having a drink beforehand.  He also cut back on the alcohol that he drank while at social events.

Needless to say, it wasn't easy for him.  Initially, he was so afraid that he just hung out with mostly friends that he knew and steered clear of talking to women that he really would have liked to meet.

But as we continued to work together, over time, Mike became more comfortable taking small steps to allow himself to be more emotionally vulnerable in these situations.

As you would expect, some days were better than others.  But what was most important was that Mike was willing to work on these issues in therapy and, even more important, he was willing to put himself out there in ways that were, initially, uncomfortable.

Overcoming the Temptation to Use "Liquid Courage" to Cope With Social Situations

It wasn't easy but, gradually, he overcame the near paralyzing fear and shame that had kept him feeling too vulnerable, and he was able to do it without relying on alcohol as a social lubricant.

At the same time, Mike developed more confidence in himself socially, and he eventually met a woman  he really liked and, a couple of years later, they got married.

Getting Help in Therapy
If you're often tempted to use "liquid courage" as a maladaptive way to cope with social situations, you're not alone.

Chances are that you also know a lot of people, possibly even your close friends, who are doing the same thing.  But, whether they admit it to themselves or not, most people who are struggling with this problem realize deep down that relying on alcohol isn't the solution.

Rather than trying to go it alone, you owe it to yourself to get help from a licensed mental health professional who has the expertise to help you overcome this problem.

Although there's no quick fix for this issue, by getting help you can give yourself an opportunity to approach social situations with more pose and confidence.

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

In addition to being a licensed therapist, I am also a certified Substance Abuse Professional.

I also work adjunctively with clients who want to remain with their primary therapists who might not have expertise in this area.

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.

Resources:
If you think you have an alcohol or drug problem, see my article:
Early Recovery: You've Stopped Drinking. Now What?

You can also find an Alcoholics Anonymous meeting in your area by clicking on this link:
Alcoholics Anonymous.