Learning to Feel Hopeful in Therapy

For many clients who start psychotherapy to deal with trauma, especially longstanding trauma stemming from significant unmet emotional needs from childhood, it can be difficult to feel hopeful that therapy will make a difference and help them to change their lives.

Learning to Feel Hopeful in Therapy:  Clients with Trauma Can Find It Difficult to Feel Hopeful

As a psychotherapist in NYC, I've found this to be especially true of clients who have been in many different types of psychotherapy before and who have experienced no resolution to their trauma.

Psychotherapy Clients with a Fear of Being Vulnerable and Only a Glimmer of Hope
Often, clients come to see me because they know that, in addition to using talk therapy, I'm also an EMDR therapist as well as a hypnotherapist and Somatic Experiencing therapist.

These clients usually come to see me because they've haven't experienced relief from their emotional trauma in traditional talk therapy.  And although there might only be a small part of them that brings them back to therapy, often they feel too emotionally vulnerable to really allow themselves to feel a sense of hope that things could change for them.

Clients with Longstanding Unresolved Trauma Can Feel Too Afraid to be Hopeful in Therapy

This is, of course, understandable when you consider that they've been disappointed too many times in their life, including disappointments in therapy.  It becomes hard for them to trust others and, often, hard for them to trust themselves.

It's also not unusual for people to come to therapy and not even know that they've been emotionally traumatized.  This is especially common if they've experienced complex trauma or they've lived their lives since childhood experiencing one crisis after another.  They might be too emotionally numb to feel a lot more than fear, anger and apprehension.

They might only know in some vague way that they feel "stuck" in their lives, but they don't make the connection between their current problems and their personal history (see my article:  When You Just Don't Feel Right and It's Hard to Put Your Feelings Into Words).

Psychoeducation in Therapy
Knowing this, I usually provide clients with psychoeducation at the start of therapy about the different types of treatment modalities that I use and any research about the efficacy of these modalities.

I also tell them about my own evolution as a psychotherapist who originally trained in psychoanalysis and psychodynamic psychotherapy and who went on to train in different types of trauma therapy, like EMDR, clinical hypnosis and Somatic Experiencing.

I can also tell new clients what I have observed in my psychotherapy private practice with regard to the different types of therapy and how it has been my experience over the years that a mind-body orientation in therapy tends to work better and faster for most people as compared to regular talk therapy.

Intellectual Insight in Therapy Usually Isn't Enough to Heal Trauma
This isn't to say that psychoanalysis, psychodynamic therapy and cognitive behavioral therapy don't work.  However, most of the time, these forms of therapy don't resolve trauma.

Clients in talk therapy often develop intellectual insight into their problems, which is important, but their trauma often remains unresolved.

Intellectual Insight in Therapy Usually Isn't Enough to Heal Emotional Trauma

Clients, who have developed only intellectual insight, often feel that there must be something really wrong with them because their insight doesn't bring about change.

Clients, who have a history of trauma, often carry within themselves the burden of guilt and shame to begin with because of their trauma.  They blame themselves for what happened to them.

So, when therapy only brings insight and not healing, they often blame themselves for that too which, in many ways, is a retraumatization.

But the problem usually isn't with them--it's a problem with the therapy that doesn't get to the core of their problems.

Overcoming Emotional Trauma:  Interpersonal Neurobiology Points the Way
Due to the relatively new field of interpersonal neurobiology and the work of professionals like Allan Schore, Ph.D. and Daniel Siegel, MD, we now know that early childhood emotional trauma and attachment problems with the primary caregiver can cause deficits in the right hemisphere of the brain, specifically the right orbitofrontal cortex and that regular talk therapy often doesn't help to heal these deficits (see:  Affect Dysregulation and Disorder of the Self by Allan Schore, Ph.D. and Healing Trauma: Attachment, Mind, Body and Brain by Dan Siegel, MD, which are both part of the Norton series on interpersonal neurobiology, as well as The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk, MD).

Healing Trauma with the Mind-Body Connection

The Neuroplasticity of the Brain
Not long ago neuroscientists believed that, over time, brain cells died and the brain just continued to lose cells without being able to regenerate cells or to make changes (hence the old saying, "You can't teach an old dog new tricks").

Fortunately, we also now know about the neuroplasticity of the brain.  Neuroplasticity refers to the brain's ability, under the right circumstances, to reorganize itself throughout the life cycle.

The Neuroplasticity of the Brain

So, even in circumstances where there have been deficits in the right orbitofrontal cortex (right hemisphere of the brain) due to childhood trauma of early abuse or neglect, the adult brain can still change later in life to make up for these emotional deficits.

The discovery that the brain can change itself was a very hopeful discovery (see:  The Brain that Changes Itself: Stories of Personal Trauma from the Frontier of Brain Science by Norman Doidge, MD).

The Mind-Body Connection in Therapy
To heal these trauma-related deficits, a treatment modality that takes into account the mind-body connection is required, like Somatic Experiencing, EMDR or clinical hypnosis, among others (see my article:  Mind-Body Psychotherapy: The Body Offers a Window into the Unconscious Mind).

The Mind-Body Connection in Therapy

Of course, there are no guarantees that therapy is going to resolve a particular person's problems.  So, while I'm enthusiastic about the different types of therapy that I use, I'm also honest that there's no way to predict in advance if therapy is going to work.

Over the course of a therapy, I often use a combination of mind-body oriented treatment modalities because no one form of therapy works for every single client.

Also, even when a particular treatment modality is working for a while, there can be a treatment impasse and, in order to overcome an impasse, I'll switch to a different modality that is better with that particular obstacle in treatment.

Sometimes, the switch to another modality might only be temporary to overcome the impasse, and other times the client might prefer it so we continue with it (see my article:  Overcoming an Impasse in Trauma Therapy).

Emotional Trauma and Hopelessness
Getting back to clients' problems with feeling hopeful:  There are different types of challenges that clients face with regard to feeling too afraid to feel hopeful, including:

• feeling powerless
• feeling unlovable or unworthy (see my article:  Overcoming Emotional Pain: Feeling Unlovable)
• having early, and possibly later, experiences of being physically and/or emotionally abandoned
• feeling despair
• feeling helpless
• experiencing social isolation
• experiencing cognitive distortions (for an example of this see my article:  Overcoming All or Nothing Thinking)
• feeling depressed
• feeling anxious and overwhelmed
• being unable to identify and express how they feel
• unconscious decisions (see my article:  What Unconscious Decisions Have You Made That Are Impacting Your Life?

and so on.

In an upcoming article, I'll discuss how clients, who come to therapy feeling too afraid to be hopeful, can overcome this challenge.

Getting Help in Therapy
If you're feeling overwhelmed by your emotions, whether your problems are related to longstanding unresolved trauma or more recent emotional problems, you're not alone.

Getting Help in Therapy

Although you might find it difficult to ask for help in therapy, you can attend a consultation with a licensed mental health professional to see if you and the therapist are suited for each other (see my article:  How to Choose a Psychotherapist).

Rather than continuing to suffer on your own, you could benefit from working with a licensed mental health professional who is knowledgeable about mind-body oriented therapy.

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

One of my specialties is helping clients to overcome emotional trauma.

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 Guilt and Shame About Feeling Depressed: Part 3

This article is Part 3 of a series about overcoming guilt and shame about feeling depressed.  Part 1 and Part 2 of this series introduced the topic by discussing the symptoms and common misconceptions about major depression and how these misconceptions can create or exacerbate shame and guilt.

Overcoming Depression:  Overcoming Guilt and Shame About Feeling Depressed

Fear of Showing a Vulnerable Emotional Side Can Lead to Guilt and Shame in People Who Are Depressed

Many people who feel guilt and shame about being depressed feel that they're the only ones who feel this way.

Often this occurs because they feel too vulnerable emotionally to talk about their depression and they isolate themselves from others who could be helpful to them.  

Many people who are depressed are also painfully aware that, despite all we know these days about depression and brain chemistry, a stigma about depression and mental health problems in general still exists among certain people who aren't informed about depression.

Men who are depressed were often raised to feel that "big boys don't cry" and they need to be "strong" when they're men.  The implication is that to be considered "strong," they can't show their more emotional or vulnerable side, and they especially can't show that they're feeling depressed.

Women who are depressed, especially women who are in male-dominated professions (like law enforcement, medicine, engineering and so on) often get the message that if they want to excel in their profession, they have to "act like men," which means that, like men, they also shouldn't show their more vulnerable side and they shouldn't reveal that they're depressed.

Feeling Depressed and Alone: Social Isolation

People who feel depressed often isolate themselves from others, especially when they're at the point when they can't pretend any more to be happy around others because it's just too emotionally and physically exhausting.

Social isolation often makes people who are feeling depressed feel worse because they're not getting the  emotional support they could be getting from loved ones who could be helpful.

Social isolation can also make them feel that they're the only ones who have ever felt depressed which, of course, isn't true.

Getting Help in Therapy

Educating yourself about depression and becoming aware of the symptoms are the first steps in getting help.

If you've tried on your own to overcome depression and you haven't succeeded, continuing to feel ashamed and guilty will only make your situation worse.

It's important to seek out the help of a licensed mental health professional who can help you to overcome depression as soon as possible. 

A licensed mental health professional can help you to overcome depression so that you can lead a more fulfilling life.  

About Me

I am a licensed New York City 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.

Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 2

In my prior article,  Overcoming Guilt and Shame About Feeling Depressed - Part 1, I began this discussion by discussing the most common depression that people experience.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

In this article, I'm focusing on how guilt and shame about feeling depressed is often based on misconceptions about depression and how these misconceptions can get in the way of your recovering from depression.  Some of these misconceptions are popular in our Western culture.

Let's start by looking at some of the misconceptions about depression.

Misconceptions About Depression:

• If people really want to overcome depression, all they need to do is "snap out of it" to feel better.
• If people are depressed, they don't want to feel better.
• If people who are depressed just "stayed busy," they'd stop feeling depressed.
• People who are depressed aren't trying hard enough to get better.
• People who are depressed have "no reason" to be depressed.
• Other people, who have it worse, aren't depressed.
• People who are depressed have only themselves to blame for their depression.
• People who are depressed are "lazy."
• People who are depressed are "failures."
• People who say they're depressed are just trying to get attention.
• People who are depressed are self centered.
• There's no such thing as depression.  There are only people who say they're depressed and who are faking it.
• You're life is good--what do you have to be depressed about?

I'm sure you could come up with many other misconceptions about depression and people who are depressed.

The point is that these misconceptions, whether they're coming from the person who is depressed or people around him or her, serve to exacerbate the depression and often cause the person who is depressed to feel guilty and shamed.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

If you're feeling depressed, blaming yourself will only make you feel worse.

Becoming aware that these ideas are misconceptions is the first step in overcoming guilt and shame about feeling depressed.

If your loved ones are the ones who are talking to you about your depression by trying to convince you about one or more of these common misconceptions, you need to take care of yourself and stop giving credence to these ideas.

Overcoming Guilt and Shame About Feeling Depressed

If you're the one who is engaging in negative self talk about your depression, be aware that you're doing the equivalent of kicking yourself while you're down.

You need to recognize these thoughts for the distorted thoughts that they are and get professional help from a licensed mental health professional.

In my next article, Part 3, I'll continue this discussion.

Getting Help in Therapy
In the meantime, if you or someone you love is suffering with depression, it's important to take it seriously and seek help from a licensed mental health professional as soon as possible.

Getting Help in Therapy

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.

Also see:  Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 3

Overcoming Guilt and Shame About Feeling Depressed - Part 1

It's not unusual for people who are feeling depressed to feel guilty and ashamed about their depression, as if they're to blame for their depression and they remain depressed because they want to feel this way.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

For many people, who are depressed, this is one of the most frustrating aspects of depression.

Unfortunately, these feelings are often unwittingly reinforced by well-meaning friends and family members who make tactless comments to the person who is depressed, like "Why don't you just snap out of it?" or "Why are you depressed--do you want to feel this way?" or "You don't have any reason to feel depressed" and other similar comments.

We also live in a society that is sustained by the myth that everyone, no matter what's going on with him or her, "should pull themselves up by their bootstraps" and overcome their problems on their own, and if they can't, they're "weak" (see my article:  Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").

What is Depression?
At some point, anyone can feel "blue," but that's different from being depressed, so before we go any further, let's define depression.

The most common form of depression is major depression, which affects a significant percentage of the population at any given time.

The symptoms of major depressive disorder, as outlined in the Diagnostic and Statistical Manual (DSM), can include five or more of the following symptoms for at least two weeks or more where at least one symptom is depressed mood or loss of interest and pleasure:

• depressed mood most of the day and nearly everyday
• a significant decrease in interests or activities that were once pleasurable
• a significant decrease in appetite and weight loss 
• insomnia or oversleeping almost every day
• agitation
• fatigue or loss of energy nearly every day
• feeling worthless or excessively guilty
• feeling helpless or hopeless
• problems with concentration or indecisiveness
• recurrent thoughts of death, suicidal ideation or suicide attempt or specific plan

To be considered major depression, the source of these symptoms cannot be otherwise accounted for by a general medical condition.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

In my next article, I'll continue discussing this topic.

Getting Help in Therapy
If you think you're depressed, especially if you're having thoughts about suicide, you're not alone and you should get help from a licensed mental health professional as soon as possible.

Many people who have suffered with depression have been able to recover from their depression in therapy with a licensed psychotherapist who has expertise in this area.

If you're unsure about how to go about finding a psychotherapist, see my article:  How to Choose a Psychotherapist.

Depression:  Getting Help in Therapy

If you're close to someone who is feeling depressed, you can help your loved one, who might feel too hopeless and helpless to seek help, by helping him or her to find a qualified therapist in your area (see my article: Are You Concerned About Your Husband's Depression?)

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 regular business hours or email me.

Also, see:  Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 2.

The Counterphobic Defense

In my prior articles, What is the Counterphobic Defense? and The Counterphobic Defense and Hypersexuality, I discussed a particular type of counterphobic response, hypersexuality, which I defined and gave a fictionalized scenario to describe how childhood sexual abuse could lead to hypersexuality.  

As I mentioned in my prior article, this fictionalized account is not about any one client--it is a composite of many different cases with all identifying information changed.

Fictionalized Scenario About Hypersexuality as a Counterphobic Response:

When we last left off in the prior article, Marie, who had been sexually abused as a child by her stepfather and who, subsequently, acted out sexually in a hypersexual manner, met a man, Tom, whom she really liked.

The Counterphobic Response:  Getting Psychological Help

But, unlike her other encounters with men, which were sexual but non-intimate and where she felt "in charge" and empowered due to her counterphobic response, Marie felt emotionally vulnerable and ambivalent about this relationship.

Her fear of being emotionally vulnerable troubled her so much that, at times, she was tempted to break off her relationship with Tom.  At the same time, she knew that this was the only healthy relationship that she had ever had and she knew she needed psychological help to overcome her fears.

Marie went to several different psychotherapists.  Each time they would get close to the core of her problems, including the early childhood loss of her father, the guilt she felt for her father leaving, the emotional abandonment by her mother, and her feelings of helplessness when her stepfather sexually abused her as a child, Marie would find a way to sabotage the treatment.

Either she would stop going to her therapy sessions or she would find faults with whichever therapist that she was seeing and then she would leave.

In her treatment with a male therapist, she attempted to seduce him, and when he set limits with her, she left treatment (see my article:  Boundary Violations and Sexual Exploitation in Therapy).

All the while, her boyfriend, Tom, tried to be patient with her ambivalence and moodiness towards him.  He knew that they loved each other, but he couldn't understand why Marie would be kind and loving to him one day and then annoyed and dismissive with him on another day.  And whenever he asked her what was wrong, she had no answer for him.  She only knew that she was terrified of being in this relationship, but she was too afraid to tell him this, so she gave him no answer.

Finally, he gave her an ultimatum:  Either she get psychological help for whatever was affecting her or it was over between them.

Faced with the possibility of the end of their relationship, Marie would have thought she would be relieved.  It would have put an end to her fears.  But, instead, she realized that she was more afraid of losing him and the relationship that they had than she was of being in the relationship, so she knew she had to get psychological help and stick with it.

When Marie came to see me for her first therapy session, it was obvious that she was very frightened.  She seemed like she was going to bolt out the door.

During the consultation, I explained how I worked and told her that I usually start with psychological resourcing (e.g., developing coping skills and mechanisms) before I deal directly with the trauma, and we would go at whatever pace she felt comfortable with because I could titrate the work so she would not become overwhelmed.  Marie seemed relieved about this.

I also explained that, given her significant childhood trauma, this would not be short-term therapy, so she would need to know that it required a commitment to do the work involved with trauma therapy.

Once she was in therapy and Tom realized that she was committed to getting psychological help this time, he agreed to remain in the relationship as long as she remained in treatment.

Marie and I worked on resourcing to help her develop coping mechanisms that she never developed before.  There were many times that Marie wanted to leave therapy, but she remained.

After a few months of her developing internal resources to do the trauma work, she and I agreed that she was ready to deal her counterphobic response and the underlying trauma.

We used EMDR (Eye Movement Desensitization and Reprocessing) therapy to deal with her early childhood losses and sexual abuse as well as her feelings of sadness, anger and helplessness.

Despite her trauma, Marie had a lot of strengths  She also came to her weekly sessions regularly.  The coping tools that she developed during the initial stage of therapy helped her to deal with her fear and ambivalence about her relationship with Tom.

The Counterphobic Response:  Getting Psychological Help

As she continued to work through the trauma and used her coping skills to deal with her fears, she was able to allow Tom to get closer to her.  She was no longer tempted to act out sexually with other men when she felt afraid.  Instead, she was able to communicate her fears to Tom, and they were able to talk it out.

Marie became increasingly aware that there was no "quick fix" for her problems, but she remained motivated in treatment, even though it was difficult at times.

When Marie divulged her history to Tom, including her hypersexuality, he was understanding and willing to be supportive in any way that she needed.

As she became psychologically healthier, Marie began to understand what it felt like to feel genuinely empowered as opposed to the pseudo empowerment she felt, which was related to her former counterphobic response.

The Counterphobic Response:  Getting Psychological Help

By the time Marie completed her treatment, she was more emotionally open and vulnerable with Tom than she had ever been with anyone.  They made plans to move in together and talked about getting married.

Getting Help in Therapy
Overcoming the counterphobic response, whether it involves hypersexuality or other counterphobic responses, is challenging but it is possible.

If you think you're affected by a counterphobic defense in your life, you could benefit from getting help from a licensed mental health professional.

Getting psychological help could make the difference between you living a life where you are constantly trying to quell your fears through compulsive or dangerous behavior and living a fulfilling and meaningful life with a genuine sense of empowerment.

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.

The Counterphobic Defense and Hypersexuality

In my prior article, What is the Counterphobic Response?,  I began discussing the counterphobic defense mechanism by defining it and giving some general examples of it.  In this article, I'm focusing specifically on the link between the counterphobic response and hypersexuality.

The Counterphobic Response and Hypersexuality

As I mentioned in my prior article, there are many different ways that the counterphobic defense mechanism manifests.

It's easier to understand the counterphobic response and denial involved in situations where people, who are fearful, deny their fears by becoming daredevils about the very situations that they fear.

The counterphobic response is more difficult to see in situations where a man or a woman is hypersexual.

What is Hypersexuality?  
Hypersexuality, also known as sexual addiction, is defined as a dysfunctional preoccupation with sexual fantasy or in combination with obsessive pursuits of casual/non-intimate sex.  It can involve pornography, compulsive masturbation, romantic intensity or objectification of a sexual partner.  Usually, it occurs for at least six months or more.

Hypersexuality affects both men and women.

Like most addictive behavior, this adult obsessive pattern of thoughts and behaviors will continue despite the person affected by hypersexuality:

• making attempts to stop this problematic sexual behavior
• making promises to him/herself and significant others to change sexual behavior
• experiencing significant negative life consequences

Let's take a look at common situation in a fictionalized scenario where early childhood trauma leads to hypersexuality as an adult:

Marie
When Marie was five, her parents split up and Marie and her older siblings didn't see their father again for many years.  Neither their father nor their mother talked to them about the separation.  They learned about it when they came home from school one day and their father, who was normally there, was gone.

Marie felt responsible for her father leaving the family

When Marie asked her mother where her father was, her mother, Ann, slapped her and told her not to be disrespectful by asking her this question.  Then, her mother told her to go to her room and do her homework.

As most children at her age would react, Marie assumed that she did something "bad" and her father went away.  She believed that she was the cause of the problems in her family and she prayed every night that she would become a better person so that her father would return.

Neither her mother nor the other adult relatives would talk to her or her siblings about why her father "disappeared."  It became the "family secret."

Marie felt so ashamed of what she thought her role was in this that she felt too guilty to talk to anyone else about it, so she kept her fear and sadness to herself.

A year later, Marie's mother, Ann, began seeing a man she met at a party, John.  A few weeks later, John moved into the household and Marie and her older siblings were told that he was their "new father."

John tended to be irritable and bossy.  He expected the children to adhere to his demands without any back talk.  When Marie's teenage brother protested that he didn't want to do a chore that John demanded that he do, John knocked him to the ground and told him to never disobey him again.  When Ann came home and Marie brother told her what happened, Ann sided with John.

After that, Marie and her siblings were more afraid of John than ever.  They tiptoed around him and hoped not to experience his rage.

Marie became to anxious that she began wetting her bed at night, which angered John and brought on the first of many spankings from him.

When Marie turned six, John came into her bedroom late after Ann and the other family members were asleep and he began fondling her breasts.  Marie was shaking with fright, but she pretended to be asleep because she didn't know what to do.

John knew that she wasn't asleep and began taunting her, telling her that she was a "bad girl" and she "liked it."

When he told her to open her eyes, she was too afraid not to do as he said, so she did and, as she did, she saw his leering smile and penetrating gaze.

She began to feel very confused about what was happening.  On the one hand, she felt terrified and helpless.   She knew that what he was doing was "bad."  But, on the other hand, no one else in the household paid any attention to her, and she liked the attention.

John told Marie that if she told anyone about it, no one would believe her.  And, if they did, he would her mother and siblings and he would beat her.

Having already felt responsible for her father leaving the household, Marie didn't want to cause any more problems, so she kept quiet about it.  Whenever she heard his footsteps as he approached her room, she close her eyes and pray.  Then, when he began touching her, she went into a traumatic dissociated state to the point she felt she could look down on herself from the ceiling and see what was going on.

Afterwards, she always felt "dirty" and would go into the bathroom and scrub her body hard with a towel until it was red.

These nightly visits continued for several months until Marie couldn't stand it anymore.  So one day, when she was alone with her mother and no one else was around, she told her mother about John touching her.  She just wanted to make it stop.

Ann reacted by getting angry with Marie and telling her that it must be Marie's fault if John is behaving this way.  She told Marie to lock her door at night and to stay away from John.  She refused to confront John and told Marie that she was being selfish.  After all, wasn't John helping to support the family?

Marie felt devastated that her mother wouldn't help her.   But she also believed that, if her mother said it was her fault, it must be true.  Even worse, she felt frightened, powerless and lonely.

When John realized that Marie locked her door, he got angry and jimmied the lock to get in.  Feeling helpless and frightened, Marie submitted to John and escaped into a dissociated state whenever he touched her.

The sexual abuse continued into Marie's adolescence.  By that time, Marie felt angry about feeling helpless and developed a counterphobic response to John's sexual advances.  She was tired of feeling like he was the predator and she was the victim.

So by the time she was 17, without realizing it, on an unconscious level, she decided that she would be in charge in the situation--no longer behaving like a powerless victim.

One night when John came into her room, Marie told him that she wanted to have sex with him.  Shocked at first, John had sexual intercourse with Marie.  Marie was sure that her mother, who was next door, heard them having sex, but she chose to ignore it.

After that, John seemed to lose interest.  He preferred when Marie was childlike and frightened.  He seemed confused and a little frightened by Marie's boldness, so he stopped coming to her room.

But because Marie was experiencing the counterphobic defense mechanism, she didn't want John to feel he was in charge any more about if they would be sexual, so she would be seductive around him when no one else was around, taunting him for being "less than a man" for ignoring her.

Each time after she seduced him and they had sex, he always blamed her for being "a tramp," but she didn't care--she felt she was the powerful one in the situation.

When Marie was 18, she became pregnant.  By that time, she was having sex with John as well as several other older men that she met in the neighborhood, so she didn't know the identity of the father of the baby.

She had an abortion without telling anyone and, by the time she was 22, she was had two other abortions.  Her hypersexuality included seducing many men that she didn't know.  Each time that she seduced a different man, she felt empowered.

When she was 25, she met a man her own age, Tom, that she liked.  She realized that her feelings for him were different and she felt frightened and emotionally vulnerable, which she didn't like.  When she tried to seduce him, she was surprised that he told her that he really liked her and he thought they should wait rather than crossing that boundary too soon.

Even though she liked him a lot, Marie felt confused by how he treated her and how she felt.  To alleviate her fears, she continued to sneak around with other men without Tom knowing.  These other experiences continued to make her feel empowered, but she also felt guilty about seeing these men behind Tom's back.

The Counterphobic Response and Hypersexuality

When Marie and Tom became sexual, Marie felt very uncomfortable and she couldn't understand why. She prided herself in being sexy and attractive, and she knew that Tom really liked her.  But, unlike how she felt with other men, she felt increasingly frightened by the feelings that she was developing for Tom.

Marie was tempted to break it off, but she knew she would also miss Tom and he was different from other men that she was with.  At the same time, her emotional vulnerability in this relationship made her feel like a helpless child.

Marie knew that she couldn't deal with her ambivalence on her own, so she sought psychological help.

Getting Help
The counterphobic response, as an unconscious defense mechanism, can manifest in many different situations where a person is in denial about their fear and trauma and wants to feel empowered.

This sense of "power" isn't really empowerment.  It's a way to deny the underlying fear by moving towards a feared situation or person as a defense against the fear.

If you feel that you're caught up in a counterphobic response and you want to get help, you could benefit from seeing a licensed mental health professional who can provide you with the psychological help that you need to overcome this problem.

Confronting underlying fears isn't easy but, in the long run, once you've overcome the counterphobic response, you have an opportunity to live a more meaningful and authentic life.

About Me
I am a licensed New York City 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.

What is the Counterphobic Defense?

The counterphobic defense is an unconscious defense mechanism that some people use to fend off anxiety.  It's the opposite of the avoidant defense mechanism (see my article:  Changing Coping Strategies That No Longer Work For You: Avoidance about the avoidant defense mechanism).

What is the Counterphobic Defense?

When people use a counterphobic defense, instead of moving away from something that they fear, they move towards it.  They seek out what they fear.

The following list gives some examples of the counterphobic defense:

• a woman, who was traumatized as a child due to domestic violence between her parents, has an unconscious pattern of seeking out romantic relationships as an adult where she will be abused
• a person who dreads heights seeks out dangerous situations that involve heights as a way to deny that he has this fear
• a veteran, who was traumatized in combat, seeks out dangerous missions as a soldier during war and dangerous situations as a civilian to deny his fears
• a person, who has fears of being sexually intimate, engages in hypersexual activity to deny his or her fear of closeness and sexuality
• a person who compulsively engages in daredevil activities, as a form of denial about these activities, with the hope of feeling a sense of power and control 
• a teenage boy, who has anxiety about his social environment, engages in acting out behavior at school as a form of denial about his fear

What is the Counterphobic Defense?

There are many other examples of the counterphobic defense, but the list above gives you a sense of how people who use the counterphobic defense actively and often compulsively seek out the very types of people and situations that they fear the most.

This is not to say that everyone who does mountain climbing, rides a motorcycle or engages skydiving or other similar activities is using a counterphobic defense.

The key to understanding this defense mechanism is to understand that there is an underlying fear that the person is defending against.

The counterphobic defense mechanism, which might seem counterintuitive at first, isn't as common as the avoidant defense mechanism.  And, yet, many of us know of people who actively seek out dangerous or anxiety-provoking situations or relationships as a way to deny that they have these fears.

What is the Counterphobic Defense?

As I mentioned earlier, as a defense mechanism, it's usually, for the most part, unconscious, so the person who uses this defense mechanism often doesn't realize that they are in denial about what they're doing and why.

In the next article, I'll give more detailed examples of the counterphobic defense and how facing up to the underlying psychological causes can help people, who use this defense, to overcome their fears.

Getting Help in Therapy
If you are behaving in ways that are self destructive, you could be unconsciously using a counterphobic defense as a way to deny underlying traumatic issues that are at the root of your problems.

Rather than continuing to place yourself in dangerous situations, you could benefit from seeking help from a licensed mental health professional.

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.

See my article:  The Counterphobic Response and Hypersexuality.