The Unconscious Mind and Experiential Therapy: The "Symptom" Contains the Solution

Unconscious emotions and beliefs often contain meaningful emotional truths.  Experiential therapy provides an opportunity to access these unconscious emotions and beliefs, which often leads to a transformative shift and an emotional breakthrough for the client (see my articles:  How Your Unconscious Beliefs Affect Your Sense of Reality and Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

The Unconscious Mind and Experiential Therapy: The "Symptom" Contains the Solution

Accessing the Unconscious Through Experiential Therapy:  The "Symptom Contains the Solution:"
People who start psychotherapy with a desire to change an unwanted behavior are often unaware that unconscious emotions have important meanings for them in terms of the very behavior that they say they want to change (see my article:  Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious Mind).

There is a saying in clinical hypnosis, which encapsulates this idea:  "The symptom contains the solution."

Bruce Ecker, LMFT addresses "symptoms" as containing solutions within the framework of another experiential therapy that he and Laurel Hulley, Ph.D. developed, Coherence Therapy and in his two books, Depth Oriented Brief Therapy: How to Be Brief When You Were Trained to Be Deep and Vice Versa and Unlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory Reconsolidation.

The Unconscious Mind and Experiential Therapy:  The "Symptom" Contains the Solution

In his books about Coherence Therapy, which I see as a meta-explanation for many different types of experiential therapy (EMDR, Somatic Experiencing, clinical hypnosis, and other forms of experiential therapy), he describes how the client's presenting problem (referred to as the "symptom") often contains the solution to the issue.

Vignettes From Experiential Therapy Where the "Symptom" Contains the Solution
For instance, he gave an example of how a client came to therapy to overcome procrastination which kept him from completing his graduate studies.  Ecker calls the presenting problem the "anti- symptom," the problem that the client wants to change.

Knowing that the presenting problem also has an unconscious "pro-symptom" component, the therapist asked the client to imagine how things would be if he didn't procrastinate about doing the work.

There are many different ways to help clients in therapy to access the unconscious, and these techniques are only limited by the therapist's imagination and ingenuity.

Ecker uses one of those techniques in his work with this client,"symptom deprivation."

Through the use of "symptom deprivation," the therapist asked the client to imagine himself without this problem, and the client realized that procrastinating kept him from realizing an even more challenging issue for the client, which was that he was procrastinating because he really wasn't interested in his graduate studies and he was only in the graduate program to please his father.

The Unconscious Mind and Experiential Therapy:  The "Symptom" Contains the Solution

Prior to attending therapy and using his imagination to sense himself without the problem, this client had no conscious awareness of this important underlying emotional truth.

By tapping into his imagination and experiencing himself without the problem, he was able to access the unconscious reasons for his procrastination and, more importantly, recognize that his symptom of procrastination was actually keeping him for making a major life change that he didn't want.

What initially appeared as a "problem" turned out to be a solution to a worse problem, namely, completing a degree and entering into a field that the client didn't want.

Notice that in this case the therapist didn't try to use cognitive-behavioral techniques (or other similar techniques that only remain on the surface) to try to change the symptom so that the client would stop procrastinating.  The therapist also didn't try to give advice or tools to stop procrastinating, which would have been ineffective in light of the powerful underlying issues.

Instead, the therapist correctly assumed in a non-pathologizing manner that there was an unconscious emotional truth that was significant for the client and that accessing this unconscious truth in an experiential way (as opposed to just thinking or talking about it) would help the client feel and understand a very meaningful emotional truth.

Another example that Ecker gives is of a woman who comes to therapy because she's developed agoraphobia after she starts to imagine that her former therapist, who moved out of state, is still in the neighborhood and watches the client when she goes outside.

This symptom became so problematic to the client that she dreaded going outside because, even though she knew, in reality, that the therapist wasn't around, she felt like the therapist was in the area and watching her.

By the time she came to therapy, she thought she was delusional because she knew one thing (the therapist moved out of state) but she felt another (the therapist was still around watching her).

By helping the client to access the unconscious meaning of her symptom, the therapist helped the client to experience, once again through the "symptom deprivation" technique, what it would be like not to feel that the therapist was around and watching her when the client went outside.

Once again, the therapist isn't trying to persuade the client that she is just thinking about the therapist. The purpose of the "symptom deprivation" technique isn't to try to make the client stop feeling that the therapist is around.  Instead, the purpose is to access, experience and understand the unconscious meaning of imagining that the therapist was watching her.

When the client imagined that she no longer felt the therapist watching her when she went out, the client experienced the unconscious meaning of the presenting problem, which was that she missed the therapist and she was lonely.

The client also realized that she had an underlying core belief that she was unlovable, which stemmed from her early childhood.

In this case, she chose not to work on this underlying issue of feeling unlovable, which the therapist honored.   But another client might decide to work on this underlying issue, and experiential therapy can be very effective with this type of underlying problem.

Also, once she understood on a deep level that imagining her former therapist outside served a meaningful purpose for her, she relaxed about it and no longer pathologized this issue.  Instead, she felt that she had a choice, depending upon how she felt on any given day, to either imagine the therapist around or not.

Having a choice was empowering for her.

Transformative Shifts Through Experiential Therapy
Ecker stresses (and I totally agree) that these unconscious meanings often don't come to the surface for the client if s/he doesn't experience the meaning of the symptom (the symptom is also known as the presenting problem).

In other words, talking about it only in an intellectual way often doesn't get to the unconscious meaning.  It keeps the therapeutic work flat and on the surface.

In both cases, these clients would have missed important information about what was actually positive and meaningful about what each of them originally considered to be problems.

By experiencing the unconscious emotional truth, the client has an opportunity for a transformative shift, which often leads to emotional breakthroughs.

Experiential Therapy Can Provide Access to the Client's Unconscious Emotional Truth
As I mentioned earlier, experiential therapy includes any therapy that allows the client to have an experience of the problem and the solution.

Experiencing can include emotional and, possibly, physical experiencing.

How the client experiences the unconscious is different for each client.

Some clients have an intuitive "sense."  Other clients experience the unconscious on a somatic (physical) level.  Others experience it on an emotional level.  Some clients experience a combination of intuitive, emotional and physical.

There's no one right way to experience the unconscious emotional truth.

EMDR therapy, clinical hypnosis, Somatic Experiencing and ego states therapy (parts work), among others, are all experiential mind-body oriented therapies that provide an opportunity for clients to access the unconscious beliefs and emotions that are not readily apparent in talk therapy alone.

Rather than dealing with the problem in a very limited, surface kind of way, these experiential therapies can help to transform a client's experience of him or herself as well as what, until then, was experienced as his or her reality.

The Unconscious Mind and Experiential Therapy:  The "Symptom" Contains the Solution

In the first example, where the client wanted to stop procrastinating and he considered this to be a "problem" that he needed to change, his perception of his personal reality was transformed when he experienced the underlying emotional truth that he really didn't want to continue to pursue a graduate degree in a subject that he wasn't interested in.

In the second example, the client recognized that what she considered her "problem" was actually meaningful and helping her to feel less lonely.  Her perception of her personal realty shifted and she stopped judging herself and feeling like she was delusional.  Not only did she stop feeling agoraphobic, but she was able to use and have a sense of control over whether she wanted to imagine her former therapist around or not.

The important emotional meaning in both of these cases would have been missed if the clients didn't have an opportunity to experience their unconscious reality.

In both cases, the client experienced emotional breakthroughs.

Experiential Therapies:  Clinical Hypnosis, Somatic Experiencing and EMDR
Experiential therapies usually allow clients access to a dual awareness, which is the here-in-now reality as well as the unconscious reality.

With regard to hypnosis (also known as hypnotherapy) when the client is in the hypnotic state, clients can often make an experiential shift that can lead to an emotional breakthrough (see my article:  What is Clinical Hypnosis?)

Similarly, Somatic Experiencing provides the client in therapy with a somatic awareness of unconscious thoughts and emotions which are stored in the body (see my article:  Somatic Experiencing: Overcoming the Freeze Response Related to Trauma).

I often combine clinical hypnosis, Somatic Experiencing and Ego States therapy to help clients to access the unconscious and achieve emotional breakthroughs (see my article:  Ego States Therapy)

EMDR (Eye Movement, Desensitization and Reprocessing), which is another form of experiential therapy, also helps the client to experience the unconscious beliefs that s/he has about him or herself.  One of the questions that the EMDR therapist asks is "What negative belief do you have about yourself?" related to the presenting problem.

As the client continues to process the presenting problem with EMDR, s/he comes to have access to his or her unconscious beliefs (see my articles:  What is EMDR?, How Does EMDR Work: Part 1: EMDR and the Brain, and How EMDR Works - Part 2: Overcoming Trauma).

Rather than focusing on "fixing" the presenting problem, all experiential types of therapy provide an opportunity for transformation on a deep level.

Getting Help in Therapy
In my experience as a psychotherapist, an experiential type of therapy, which provides the client with access to the mind-body connection as well as unconscious meaningful truths to the client's problems, is the most effective therapy to help clients who want to experience transformation.

The Unconscious Mind and Experiential Therapy: Getting Help in Therapy

If you've been struggling on your own to try to overcome your problems, you owe it to yourself to seek professional 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.

Empowering Clients in Therapy - Part 2: Clinical Issues

In Empowering Clients in Therapy - Part 1, I began discussing some of the basic ways that psychotherapists can empower clients in therapy.  In this article, I'll discuss clinical issues involved with empowering clients.

Empowering Clients in Therapy

Empowering Clients Clinically 
Empowering clients clinically is often one of the goals of therapy.

There are many ways to do this in therapy--too many to write about in one article.  So, I'll focus on how I do this using EMDR therapy, which stands for Eye Movement Desensitization and Reprocessing (see my articles:  What is EMDR?, How Does EMDR Work? Part 1: EMDR and the Brain and How Does EMDR Work? Part 2: Overcoming Trauma).

Many of the clinical strategies that I'm about to describe are used in other times of therapy.  The ones that I've chosen are the ones that I've often found to be most effective.

Helping Clients to Develop Internal Resources
What are internal resources? See my article:  Psychotherapy: Developing Internal Resources).

On the most basic level, internal resources are coping strategies.

Most people have developed some coping strategies just to survive, but it's useful to develop new internal resources that help clients to go beyond just surviving.  This is especially true when clients are about to begin processing traumatic emotional experiences in therapy.

Before processing traumatic experiences, I help clients to develop internal resources that they can use to calm and soothe themselves in session as well as between sessions.

A Safe or Relaxing Place:
Being able to close your eyes and to see in your mind's eye a relaxing place provides a respite from difficult material in therapy or at any time when you're feeling anxious or uncomfortable (see my article: Wellness: Safe or Relaxing Place Meditation).

Empowering Clients in Therapy:  A Safe or Relaxing Place

It helps you to breathe more easily and decide if you want to resume processing a traumatic memory or if you want to take a break in the therapy session.

Butterfly Taps:
This is a resource that I learned in training with Laurel Parnell, Ph.D., who is a world-renown expert, based in California, in EMDR therapy.  It's another resource that clients can use either in session or between sessions.

To do butterfly taps, you place your right hand on your left upper arm and your left hand on your right upper arm (so arms are crossed) and you alternate taps rhythmically at a speed that feels comfortable for you.  The tapping is soothing and helps you to calm down.

Interweaves
Using interweaves is another resource that I learned from Laurel Parnell, Ph.D.

Most of the time, interweaves are used in EMDR when clients feel stuck in the processing of traumatic material.

Interweaves help to:

• integrate memory networks
• differentiate memory networks
• create a coherent narrative
• create a broader perspective

To determine which interweave would be best to use, the therapist asks the client what s/he needs at that moment.   The client is usually the best judge of what s/he needs.

Sometimes, when clients are stuck, they're not sure what they need at that moment, so the therapist, being attuned to the client, can different suggestions to see if any of them resonate with the client.

There are many different types of interweaves, including imagining:

• nurturing figures
• protector figures
• inner wisdom figures
• other types of figures that the client feels would be helpful

The reason why resource interweaves are developed before the actual processing of the trauma memory is that the therapist wants the client to have these interweaves in mind if the processing becomes difficult.

Empowering Clients in Therapy:  Resource Interweaves:  A Protector Figure

In case the client gets stuck, s/he can use the resource interweave to get the therapeutic work back on track.

So, for instance, if a client is processing a memory using EMDR therapy about childhood physical abuse and she feels stuck because she is in touch with her "child self" and she feels frightened by the person who abused her, she can call on a protector figure in her mind to imagine that person protecting her in the situation.

This protector figure can be someone real (someone from the past or the present) or imagined (from a movie, TV program, book, and so on).  The protector figure could also be the client's "adult self" who helps his or her "child self" in the client's mind's eye.

The "Ideal Mother" Interweave
Another example of an imaginal interweave is imagining an ideal mother who is loving, attuned, soothing and protective as well as powerful (or whatever qualities a client would need in an ideal mother).

An ideal mother is usually the type of mother that the client wishes s/he had.  If the client feels stuck in processing a traumatic memory, s/he can imagine an ideal mother with all the attributes that s/he wished she had.

Like all of these resources, they can be used even if the client isn't in EMDR therapy.

Empowering Clients in Therapy:  Imaginal Interweave:  Ideal Mother 

If you haven't experienced using imaginal interweaves, they might sound silly, fantastic or unrealistic.  But most clients feel soothed by the ideal mother and it "makes sense" to the emotional part of the brain.   In effect, it creates a new symbolic memory in the emotional part of the brain (see my article:  Healing Trauma With New Symbolic Memories).

It doesn't effect narrative/biographical memory which, of course, knows who the actual mother was when the client was a child.

Sometimes, clients feel guilty imagining an ideal mother because they feel that they're being disloyal to their actual mother.  In that case, a client can imagine that the ideal mother is a co-mother, as Laurel Parnell suggests.

There are times when clients feel enmeshed with their parents and the idea of imagining an ideal mother feels like they're abandoning their actual mother, so they can imagine giving their actual mothers an ideal mother as well.

This can also be used for earlier generations so that the client can imagine that the grandmother had an ideal mother so that the grandmother could have been nurturing to the mother and mother could have been nurturing to the client.

Most clients respond very well to imaginal resources, but there are some clients who say, "But I know that I didn't have an ideal mother," to which I respond, "Try suspending disbelief and see how it feels." Almost always, if the client can suspend disbelief, s/he feels relieved by the imaginal resource and the work gets back on track.

What Does the Client Need?
Everyone is different.  The particular client's needs determine the type of clinical intervention used to empower him or her.

Sometimes, clients come up with their own resources.

They might use art work, prose, poetry, dance or some other creative endeavor to empower themselves.

Empowering Clients in Therapy:  Keeping a Journal Between Sessions

Many clients find journal writing to be empowering and an important bridge between sessions, and this is something that I recommend.

The possibilities are endless.

Empowering Clients in Therapy
People often come to therapy because they're feeling disempowered in one way or another in their lives--either due to their history, their current situations or some combination of both.

When the client is assisted in therapy to be more empowered, the client usually feels better able to tackle problems, overcome traumatic memories and have a sense of a hopeful future.

Discovering that they had the power within themselves all along is one of the best discoveries that a client can make in therapy.

Getting Help in Therapy
If you've been on the fence about starting therapy, you're not alone.

If your own efforts to overcome your problems haven't worked out for you, you could benefit from working with a licensed mental health professional whose priority is helping to empower clients.

When you find a skilled and empathic therapist who is a good match for you, you might be surprised to discover the progress that you can make 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.

Empowering Clients in Therapy - Part 1

Many people, who are depressed, anxious or traumatized, avoid coming to therapy because they feel ashamed of their problems, they fear they'll be overwhelmed by opening up emotionally in therapy or they feel a sense of helplessness related to a history of trauma (see my article: Overcoming Feelings of Helplessness Related to Childhood Trauma).

Empowering Clients in Therapy

As compared to the number of people who need mental health treatment, only a small percentage actually come to a therapist's office.

This is all the more reason why it's so important for psychotherapists to find way to empower the clients who, although apprehensive, come to therapy.

Empowering Clients in Therapy
There are many ways to empower clients in therapy, including:

Helping Clients to Feel Safe
As I've mentioned before, for many people coming to therapy is an act of courage.  It's not easy coming for a consultation with a stranger, not knowing what to expect.

The therapist sets the tone, especially at the start of therapy, and it's important that s/he create a safe, comfortable, respectful environment (see my article:  The Creation of a Holding Environment in Therapy).

An emotionally attuned therapist can make all the difference to clients who feel apprehensive.  Empathy and respect are the hallmarks of good therapy and help clients to feel comfortable (see my article:  The Therapist's Empathic Attunement Can Be Emotionally Reparative to Clients in Therapy).

Providing clients with information
Many clients who have never been in therapy before don't know what to expect.  They might not understand about the treatment frame regarding regular appointment times, lengths of sessions, fee arrangements, therapist's education and skills, and so on.

Empowering Clients in Therapy

Even if clients have been in therapy before, each new experience will be different.

After therapists get to know clients, clients need help to understand their problems.  If they've never spoken to anyone about their problems, they might feel that they're the only ones who feel this way or who have had these experiences.

As much as possible, it's important for therapists to normalize clients' experiences so they know that they're not the only ones who have ever gone through these problems before and that other people have been able to work through these issues in therapy.

This empowers clients so they don't feel ashamed and guilty about their problems.  It might also help them to feel hopeful that they can also work through their problems.

Talking to Clients About Their Expectations and Goals
Clients who are new to therapy (or new with a particular therapist) might not know what to expect in treatment or they might come with misconceptions.  For instance, they might think that the therapist will provide them with "answers" to their problems rather than being someone who facilitates their development and growth in treatment.

Even if they've been in therapy before, they might have had bad experiences and they are, once again, summoning their courage to give it another try.

Empowering Clients in Therapy

Discussing their expectations and what they would like to accomplish in therapy encourages them to be active participants in their own treatment.  This is something which might be new and unfamiliar at first but, ultimately, it can empower them.

Some clients might need help formulating goals and strategizing how to accomplish their goals.  They might need help to understand that, for some people, setting goals are a work in progress, and that's okay.

Other clients might not even feel that they are entitled to want anything or to set goals because of their early history of being subjugated in their families.  Just the idea that they have choices might be a new experience.

Offering Clients Choices in Therapy
There is no one-size-fits all treatment, especially when it comes to mental health issues.

It's important for therapists to be skilled in different treatment modalities so that clients have choices.

This can be empowering for clients in therapy, especially since many clients didn't have choices when they were growing up.

Listening to the Client
Many people have never had the experience of really being listened to by another person before they came to therapy.

It's important that therapists be willing to listen to what is being said and also to what is not being said, which could be just as important.

It's also important for a therapist to learn from clients (see my article:  Psychotherapy: Listening and Learning From the Client).

For instance, the client might have a different perspective about a situation because s/he is from a different culture.  No therapist can know about every culture, so listening and learning from the client can help the therapist to see things from the client's point of view.

Repairing Ruptures Quickly When They Occur
Even the best therapist will make mistakes at times.  No one is perfect.  It's important for therapists to repair ruptures in treatment as soon as possible.

Empowering Clients in Therapy:  Ruptures and Repairs in Therapy

This can be empowering to clients, especially clients who grew up in households where they were hurt, emotionally or physically, by parents who never made amends.

Often, after a rupture is repaired between a client and a therapist, the therapeutic relationship is strengthened and it is better than before the rupture (see my article: Psychotherapy: Ruptures and Repairs in Therapy).

Aside from these basic ways of empowering clients in therapy, there are also clinical ways to empower clients, which I'll discuss in my next article:  Empowering Clients in Therapy - Part 2: Clinical Issues

Getting Help in Therapy
Asking for help is never easy.

Considering therapy might be a new idea that you've never considered before or you might be returning to therapy after having been away for a while.

There are many different types of therapies and many psychotherapists with different orientations to therapy and different levels of skill and experience, so I recommend that, if you're considering therapy, ask for a consultation first to find out about the therapist, to see if you're comfortable with him or her, to give an overview of the issues that you would like to work on, and to ask questions.

You might need to see a few therapists before you find someone that you're comfortable with, and most therapists will understand this.

For more information, see my article:  How to Choose a Psychotherapist.

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.

Emotional Trauma Often Creates Negative Expectations About the Future

People who suffer with a history of emotional trauma often have negative expectations for the future because of their trauma.  This is a common experience that many psychotherapists see in their clients, especially among adults with early childhood trauma.

 Emotional Trauma Often Creates Negative Expectations About the Future

Negative Expectations About the Future Are Often Unconscious
These negative expectations are often unconscious so people, who experience them, often don't question them because these thoughts are outside of their conscious awareness.

However a skilled therapist, who is attuned to clients, can recognize these negative expectations, especially when these clients talk about their future in an overly pessimistic way.

If a traumatized client is in therapy where only cognitive behavioral therapy (CBT) is used, the therapist usually will point out the distortions in the way that the client is thinking and the problematic behavior that s/he is engaging in.

This is a useful first step because it makes clients' unconscious feelings conscious and they can learn to become aware of these feelings in order to change them.

By becoming aware of their pessimism, they can begin to challenge their thoughts and feelings by asking themselves if these thoughts and feelings are objectively true.  This assumes that clients can take a step back for self reflection.

If they're able to challenge their thoughts and feelings, they might be able to entertain an alternate scenario where the possibility of the future could be more realistic.

If they're not at the point where they can actually imagine a positive future for themselves, they might, at least, be able to see that there is the potential for a future that is better than their past or present experiences.

Counteractive Therapy vs Experiential Therapy
As I mentioned in a prior article, Experiential Therapy, Like EMDR, Helps to Achieve Transformational Breakthroughs, CBT works as a counteractive therapy that provides clients in therapy with an alternate scenario to their usual way of thinking and feeling.

But, for many traumatized clients, this form of counteractive therapy isn't enough.  They can see the distortions in their thinking, but they're unable to feel it in an authentic way or to change it.

Emotional Trauma Often Creates Negative Expectations About the Future

This can be very frustrating and, for some clients, it makes them feel ashamed.  They feel like they're "not doing therapy right."  For some clients, the contradiction between how they feel and what they can  see can make them feel that there's something seriously wrong with them.

These clients often leave therapy because they continue to have negative expectations for their future.  At that point, they leave therapy with the idea that "I tried therapy--it doesn't work for me."

But the problem isn't with the client.  The problem is with the type of therapy, CBT.

Experiential Therapy and Brain Research
When it works, CBT affects the logical part of the brain, but it often has no impact on the emotional part of the brain, which is the part of the brain that needs to be changed when emotional trauma is involved.

We're fortunate now to have the brain research to prove this, as cited in Unlocking the Emotional Brain: Eliminating Symptoms at Their Roots Using Memory Reconsolidation by Bruce Ecker, Robin Ticic, Laurel Hulley and Robert A. Neimeyer, and in other recent books and articles about brain research as it applies to emotional trauma.

Experiential Therapy and Brain Research

In their book, the authors discuss research that demonstrates that experiential therapies, like EMDR and other similar types of therapy, help these clients to have a transformational experience, as I mentioned in my prior article about experiential therapy.

Rather than just being a counteractive therapy that only provides an alternative on a logical level, experiential therapy affects the limbic system so that the client not only recognizes the distortion on a cognitive level--they also feel it.

With experiential therapies, like EMDR, Somatic Experiencing and clinical hypnosis, clients remember the narrative of their traumatic memories, but they experience the memories differently on an emotional level from how they did before they came to therapy.

Experiential Therapies Can Provide Transformative Experiences

Often, clients, who participate in experiential therapy, will make comments like:

• "When I think about the memories, I remember everything that happened, but I no longer feel traumatized."
• "I never thought I would be able to think about these memories without feeling upset about them."
• "I used to feel so upset by these memories, but now when I think about them, my feelings about them are neutral."

Experiential therapies also help clients to overcome feelings of foreboding (based on their trauma past) about the future.

Getting Help in Therapy

If you have a history of trauma that causes you to feel pessimistic about your future, you could benefit from getting help in therapy with a licensed psychotherapist who provides experiential therapy.

Getting Help in Therapy

Rather than feeling trapped by your emotional history, you could be free to live a fulfilling life.

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.

Developing Realistic Expectations About Your Family of Origin

In my prior articles, I discuss "emotional neglect" and how unmet childhood needs often cause problems for adults.  In this article, I'll be focusing on how adults, who had unmet childhood emotional needs, often have unrealistic expectations about their family of origin, and how therapy can help them to develop more realistic expectations and heal emotionally.

See my articles: 

What is Childhood Emotional Neglect?

What is the Connection Between Childhood Emotional Neglect and Problems in Adult Relationships, 

Developing Realistic Expectations About Your Family of Origin

The Effect of Unmet Child Emotional Needs
As I mentioned in my earlier articles, without help in therapy, unmet emotional needs from childhood usually carry over into adulthood.

If they haven't worked this issue out in therapy, most people are unaware of the effect of these unmet needs.   They're also usually unaware of how they might still hold out hope that their parents or siblings might change and, finally, give them the love and nurturing they didn't give them when they were children.

From a psychotherapist's point of view, this makes psychological sense:  Just because someone is an adult doesn't mean that s/he doesn't still carry that strong wish to finally get what was their birth right as a child.

As most people would agree, every child deserves to be loved and nurtured.

Of course, there's no such thing as a "perfect family" and every parent makes mistakes.  Fortunately, parents don't have to be "perfect."

Due to most children's inherent resilience, parents just need to be "good enough" to provide their children with the a relatively stable, loving home.

But, as we know, for a variety of reasons, this doesn't always happen in every family, especially in families that are chaotic or dysfunctional.  Among the many reasons for this is that, often, the parents of these children weren't nurtured themselves, so they don't know how to nurture their own children.

Whatever the underlying cause might be, unless there are mitigating factors, children who have significant unmet emotional needs usually grow with these same needs.

Developing Realistic Expectations About Your Family of Origin

This doesn't mean that someone who grew up under these circumstances is doomed for the rest of his or her life to be emotionally unfulfilled.  On the contrary, people often find nurturing friendships and romantic relationships if they're discerning and choose healthy relationships.  These relationships help to mitigate what they didn't get when they were children.

Also, there are times when parents and siblings, who were once unloving, can and do change so that familial relationships can be repaired.

But this isn't always the case:  Many people who lived in an unloving family environment continue to perpetuate this in their relationships by choosing unhealthy friendships and relationships, and parents and siblings often don't change, especially if they haven't worked out their personal issues in therapy.

    See my articles:  

Falling In Love With "Mr. Wrong" Over and Over Again

The Connection Between Obsessive Love as an Adult and Unmet Childhood Emotional Needs

Letting Go of Unhealthy Relationships

Choosing Healthier Romantic Relationships).

What Happens When Family Members Don't Change to Become Who You Want Them to Be?
When dysfunctional family relationships don't change, the person who grew up feeling unloved can still yearn to gain the love s/he never got from the family.  In many cases, people in these circumstances still hope, against all odds, that they can change a parent or sibling(s).

Developing Realistic Expectations About Your Family of Origin

Does this mean that they should stop trying to repair their family relationships?  No, not necessarily.  After all, people do repair family relationships later in life all the time.

Developing Realistic Expectations About Your Family of Origin

The problem arises when someone doesn't accept the reality of the current situation and continues to have unrealistic expectations of his or her family, even after repeated attempts to change the family dynamic.

Unrealistic Expectations Are Often Unconscious
The person in this situation often doesn't even realize that s/he has unrealistic expectations because this yearning can be unconscious.

So, how do these unconscious, unrealistic expectations come to light?

In many cases, these expectations come to light when someone airs his or her grievances about family members.

S/he might say something like, "Can you believe that my dad let me down again?" or "After all that I've done for my sister, she still won't do even this small favor for me?" or "Why is my mom still nasty to me on the phone?"

A close empathic friend might commiserate with this person about the unfairness of the situation.  Anyone would agree that it's disappointing to be hurt or let down by a family member, especially if there's a lifelong history of this.

But an attuned psychotherapist will hear something more.

An Empathically Attuned Psychotherapist Hears the Underlying Unconscious Wish
A psychotherapist also will hear something more, which is the underlying issue that the client, who has lived all of his or her life being disappointed by family members, seems to still expect different behavior from family members who have been consistently disappointing (see my article:  The Psychotherapist's Empathic Attunement to Unconscious Communication in the Therapy Session).

Many therapists, who do ego states therapy, will also realize that there is an aspect of this client's personality, usually the child self with unmet emotional needs, who is still hurt and continues to have unrealistic expectations.

Ego States Therapy and the Inner Child (or Child Aspect of the Adult)
This type of therapy is called ego states therapy because it recognizes that we all have many different aspects of self, and certain situations elicit different aspects.

So, even though someone is an adult, s/he can still experience a situation, in part, as his or her child self (see my article:  Untreated Emotional Trauma is a Serious Issue: Overcoming an Impasse in Trauma Therapy for an explanation of ego states therapy).

Ego States Therapy and the Inner Child

As I've mentioned in other articles, ego states therapy (as called "parts work") has nothing to do with multiply personalities or dissociative identity disorder.

These different aspects of self are a part of everyone, but most people don't recognize this because these aspects often remain just under the surface.

Therapists who are trained in ego state therapy are attuned to the various states that come to the surface in therapy sessions.

So that if I hear a client, who came from a chaotic and unloving environment as a child tell me, as an adult, that "it's unfair" that a parent or sibling is continuing to behave in the same dysfunctional way he or she always has, I listen to see if there is a child state under the surface that needs psychological help.

Listening to a client in this way helps therapists to be more attuned and empathic to what's going on with the client.  Equally important, it alerts the ego state therapist that the client needs psychoeducation about ego states and the child state needs to be treated.

Due to the popularity and accessibility of John Bradshaw's books (Healing the Shame That Binds You and Healing the Child Within), many people know about their "inner child."  His books have provided much-needed psychoeducation for people who grew up in unloving dysfunctional homes.

So, whether we call this aspect of self the "inner child" or the child aspect of self, we're talking about the same phenomenon.

Over the years, I've had many clients who have told me that these books have helped them to understand their shame, emotional longing and family dynamics.  Knowing that this is a phenomenon that is experienced by many people helps to normalize how they feel and helps to decrease their shame.

Mind-Body Oriented Psychotherapy and the Unconscious Mind
As I've mentioned in other articles, often regular talk therapy isn't enough to heal certain emotional problems.  Clients might gain an intellectual understanding about the issue, but talk therapy might not be enough to actually change the problem on an emotional level (see my article:  When Talk Therapy Isn't Enough).

In my article, Mind-Body Psychotherapy: The Body is a Window Into the Unconscious Mind, I explain how certain experiential mind-body oriented types of therapy, like EMDR, Somatic Experiencing and clinical hypnosis help to resolve psychological problems when talk therapy might not be adequate.

Ego states therapy, which explores and heals the various states, including the child state, can be used in combination with any of the experiential types of therapy.

Mind-Body Psychotherapy:  The Body is a Window Into the Unconscious Mind

Although there are no quick fixes, experiential mind-body oriented therapy can often help with psychological healing much faster than regular talk therapy.

As I usually like to point out, I am psychoanalytically trained and I have seen the value of both psychodynamic and cognitive behavioral therapy (CBT).  But I also know that every therapy has certain limitations.

The limitation with CBT talk therapy is that CBT often stays on the surface without a transformative  effect for the client.  And psychoanalysis or psychodynamic psychotherapy can be transformative, but it can also take a long time (see my article:  Experiential Therapy Helps to Achieve Emotional Breakthroughs).

There are many ways that experiential mind-body oriented psychotherapy, like EMDR, Somatic Experiencing and clinical hypnosis and ego states therapy can help when an adult has a child aspect that, understandably, wants a parent or sibling to be different (see my articles:  What is EMDR?, How Does EMDR Work - Part 1, How Does EMDR Work - Part 2,  Overcoming Emotional Trauma With Somatic Experiencing,  Somatic Experiencing: Overcoming the Freeze Response and Clinical Hypnosis and Hypnoprojectives to Overcome Emotional Problems).

Getting Help in Therapy
It can be very hurtful and frustrating to hold to hope against all odds that a family member will change to be the attuned, loving person that you want him or her to be.

Letting go of these types of unrealistic expectations can be very difficult without doing work in therapy to heal the child self in you that still yearns to be loved and nurtured.

Getting Help in Therapy

In my experience as a psychotherapist, a mind-body oriented therapy is usually the best type of therapy to help with this healing process.

Rather than continuing to suffer with unrealistic expectations from family members who show no signs of changing, the best course of action is to focus on yourself and heal the emotional wounds that are keeping you stuck.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, ego states 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.

Reconciling Your Relationship With a Sibling Now That You're Both Adults

In a prior article, Overcoming Unresolved Guilt Towards a Sibling, I discussed how guilt that interferes with a sibling relationship can be resolved.  In this article, I'm focusing on a related topic, reconciling a longstanding conflictual relationship between adult siblings that began in childhood.

Reconciling Your Relationship With a Sibling Now That You're Both Adults

Sibling dynamics are usually developed early in childhood with the possibility of many different influences, including overall family dynamics, age, gender, emotional trauma and other factors.

Many siblings, who grew up with conflictual sibling relationships often feel that they want to overcome the pattern of conflict and reconcile these sibling relationships when they become adults, but this can be challenging, especially if these patterns are longstanding.

The following composite scenario, with all identifying information changed to protect confidentiality, is an example of these issues between siblings and how they were able to overcome them:

Bob and Joe
Bob and his younger brother, Joe, spent most of their time as young children with their mother, who was diagnosed by her psychiatrist with major depression and borderline personality disorder.

Their mother spent much of her time in bed, too depressed to rouse to get up to cook or take care of her sons.  Their father, who was a salesman, spent most of his time away on business.  As a result, Bob took on the responsibility of taking care of himself and his younger brother.

Bob and Joe as Children

On those occasions when the mother felt well enough to get out of bed, she favored her younger son, Joe, lavishing him with praise for his looks, his personality, his school work and just about everything about him.

In contrast, she criticized almost everything about Bob, and she told him that no one would ever love him when he grew up.

Not only did she criticize and denigrate Bob, but she instigated Joe against Bob.  At a young age, Joe learned that if he wanted to keep his mother's love, he had to side with her against his brother and so, being too young to understand his mother's emotional problems, he sided with her against Bob.

As a result, this set the dynamic between these two brothers from an early age.  It was deeply hurtful to Bob, who was also too young to understand that his mother's borderline traits were the underlying cause of the problem (see my article:  The Effect of Growing Up With a Parent Who Had Borderline Personality Disorder).

Bob tried to please is mother by trying to help her, making things for her in art class, and trying to be as good as he could be.  He did very well in school.  He won academic and sports awards, always with the hope that he could gain his mother's love.

But his mother didn't changed how she treated her two sons--Joe was the "good one" and Bob was "the bad one," and Joe remained close to his mother by disparaging Bob.

Bob grew up feeling that he was flawed and unlovable in some basic way that he couldn't understand.  Even though he had friends, he was lonely.

On the rare occasions when the father was at home, he distanced himself from Bob, Joe and their mother.  She was disparaging of him too.  Eventually, he left the family to be with a new girlfriend who lived out of state, and he had little contact with Bob and Joe.

Bob went away to college, and he moved to New York City for his first job.  Joe went to a community college near home and continued to live with their mother.  He became a sort of emotional surrogate husband to their mother even in his late teens.

As time went on, Bob saw less and less of his mother and Joe because these visits were very hard emotionally.  He was successful in his career, but he was deeply affected by his mother telling him for many years that he was unlovable and would end up alone.  And, each time that he saw his mother and brother for an occasional family visit, he felt the sting of his mother's disdain which, for him, confirmed that he was unlovable.

Reconciling Your Relationship With a Siblings Now That You're Both Adults

Joe never moved away.  He remained with his mother, taking a local job so he could continue to be live with her rather than moving away for better job opportunities.  None of Joe's attempts to have a  romantic relationship worked out because his mother would come between him and his girlfriend and Joe felt compelled to side with his mother.  Since none of the women wanted to put up with this, these relationships ended quickly.

Bob's sense that he was a deeply flawed individual affected his ability to get into a relationship with a woman.  He was afraid that after a woman got to know him, she would discover how unworthy he was and she would leave him (see my article:  Overcoming the Fear That People Won't Like You If They Discover the "Real You").

But when he was in his mid-20s, he met a woman, Sandy, that he really liked.  Sandy took the initiative to ask Bob out for a date.  As they continued to see each other, even though he liked her, Bob became increasingly afraid of allowing himself to be emotionally vulnerable with her (see my article:  Relationships: Fear of Being Emotionally Vulnerable).

Since Bob felt Sandy was very special and she seemed to like him a lot too, he decided to come to therapy to deal with his fear and confusion.  As we explored his family history, the origins of Bob's fear and feelings of being unlovable became clear.

Although Bob was able to understand intellectually why he felt unlovable, on an emotional level, it didn't change how he felt about himself, so we began to use EMDR (Eye Movement Desensitization and Reprocessing) to help him overcome his traumatic family history and his feelings of being unlovable (see my articles:  What is EMDR? and EMDR: When Talk Therapy Isn't Enough).

Gradually, over time, as Bob processed the emotional trauma of having a unloving, critical mother who played his brother against him, he began to feel better about himself for the first time in his life.  He was able to open up to Sandy in a way that he never believed possible.

He also began to feel that he wanted to try to reconcile his relationship with Joe, if Joe was willing.  Even though he wanted this reconciliation, Bob knew that he couldn't force the issue and that he might have to accept Joe's refusal, especially since Joe remained very close to their mother.

Bob and Joe hadn't been in touch with each other for more than a year when Bob called Joe.  Bob could hear his mother in the background telling Joe to get off the phone after she found out that Bob was calling.  After that, Joe's voice sounded shaky and he ended the conversation abruptly.

We had prepared for this possibility in therapy and although Bob was deeply disappointed, he took Joe's rebuff in stride.  A few months later, feeling that he was doing well and his relationship with Sandy was going smoothly, he left therapy knowing that he could return at any time.

About a year later, Bob contacted me because his mother was diagnosed with advanced cancer and she was already in hospice.  Bob was preparing himself emotionally to see her, possibly for the last time and to see Joe.  So, Bob returned to therapy (see my article:  Returning to Therapy).

We met for a couple of therapy sessions that week before he went home to see his mother and Joe.  His mother, who was heavily sedated, spent time with Bob alone while Joe waited outside.  To Bob's amazement, with tears in her eyes, his mother apologized to him for how cruel she had been over the years.  She asked Bob for his forgiveness and, to Bob's relief, they were able to reconcile just a couple of days before she died.

Although he was relieved to have made amends with his mother, Bob also felt sad for all the time that he and his mother allowed to pass before they reconciled.

After the death of their mother, Joe was so bereft that he asked Bob if he could come stay with him.  Bob realized that, without their mother, Joe felt desperately sad and confused. Joe also expressed shame for the way he treated Bob and said he would understand if Bob refused to have anything to do with him.

Bob hoped this could be the beginning of a reconciliation between them and he took Joe in without hesitation.  It was awkward at first for both of them.  So many years of being at odds with each other couldn't be erased immediately.

After a few weeks, Joe agreed to come to a few sessions of therapy with Bob to try to reconcile their relationship.  He was able to see, for the first time, how their mother influenced the dynamic between them and he felt deeply sorry.  They each expressed sadness, anger, and resentment.  They also felt hopeful, for the first time, that they could have a better relationship now.


When Joe went home, he also began his own individual therapy to deal with the effect of his enmeshed relationship with his mother now that she was gone.  He struggled but, over time, he began to put his life together and he maintained contact with Bob in the context of their new relationship.

Reconciling Sibling Relationships as Adults
The composite scenario above isn't unusual.  Children are often influenced by their need to remain close to a parent who might engage in splitting between siblings.

This is usually an unconscious process for the sibling who sides with a parent against another sibling.  The child's need to have his or her emotional needs met by the parent can overshadow everything else.  And this doesn't automatically change when a person becomes an adult, especially when the sibling remains overly attached to the parent, as in the case with Joe.

Even though the siblings in this scenario weren't able to reconcile until after the mother died, many siblings do work out their relationships as adults before the parent who is engaging in splitting dies.

Reconciling Your Relationship With a Sibling Now That You're Both Adults

This type of reconciliation requires that each sibling has matured enough to be his or her own person; s/he sees the splitting dynamic for the destructive pattern that it is; and s/he is willing to risk the anger of the parent in order to have a better relationship with the sibling as well as to be his or her own person.

Getting Help in Therapy
The scenario that I presented above is one example, among many, of how siblings can grow up to be estranged from each other and how they can reconcile.  There are many variations on this theme.

As adults, many siblings have been helped by seeking the assistance of a licensed mental health professional to help them navigate the emotional difficulties involved with a reconciliation where there has been longstanding animosity or estrangement.

If you and a sibling want to explore the possibility of an emotional reconciliation, you could be helped by a psychotherapist who has experience with this issue.

About Me
I am a licensed NYC psychotherapy, 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.

Allowing Room for Grief

Experiencing grief, especially when it involves the loss of someone close to you, can be very painful.

For many people, the emotional pain of grief can be so painful that they try to push away or push down their feelings to avoid feeling the sadness and loss.

Allowing Room for Grief:  Some People Try to Push Away Their Feelings

While it's understandable that people who are going through grief might be tempted to deny or push away their feelings, it's important to make room for grief so, eventually, these painful feelings can be worked through.

Pushing Away Grief

People often try to avoid or distract themselves from feeling grief by:

• denying to themselves and others that they feel sad
• zoning out in front of the TV
• binge watching videos
• playing video games for hours
• surfing the Internet for long periods of time
• drinking excessively
• abusing drugs
• engaging in compulsive gambling (see my article:  Overcoming Grief Gambling)
• engaging in compulsive sexual activities
• overeating
• overworking
• engaging in sexual affairs

and so on.

What Are the Possible Negative Consequences of Not Making Room for Grief?

When you try to avoid feeling grief, not only are you shutting yourself off to painful emotions--you're also shutting down to positive feelings.

Allowing Room for Grief

Whether you're numbing yourself by denying your feelings or distracting yourself in any one of a myriad ways, you're also numbing yourself to all of your other feelings.  

After a while, emotional numbing can make you feel out of touch with yourself as well as your loved ones.  You can start to feel that you're just "going through the motions" in life rather than living your life in a meaningful way.

Making Room for Grief

"The healing comes from letting there be room for all of this to happen:  room for grief, for relief, for  misery, for joy."
 Pema Chodron

No one wants to feel sad and upset all of the time, but it's important to make time, when you're ready, to feel your feelings, whether you do this on your own, with a trusted friend or in therapy.

Allowing Room for Grief:  Take Time and Space to Connect With Your Feelings

Here are some suggestions for how you can do this during quiet times when you have privacy (you can consider as to whether they would work for you or not):

• looking at pictures of your loved one
• taking time and space to connect with your feelings
• remembering good times together
• writing down your feelings in a journal
• engaging in creative arts related to your loved one (drawing, making collages, etc)
• revisiting places that were important to the two of you
• listening to music that brings back happy memories
• meditating on your feelings about your loved one
• attending or creating a spiritual ritual that is meaningful to you
• hearing positive stories about your loved one from family members or friends

and so on.

Grieving is an Individual Experience

No two people grieve in the same way.  It's a very individual experience.

In our society, we tend to rush people to "move on" before they're ready.  Not only is this unhelpful, it can also make the person who is grieving feel ashamed, as if he or she is abnormal in some way.

Although people close to you might have good intentions, don't let anyone tell you that you should be "over it" already.

Allowing Room for Grief

There's a difference between avoiding grief and taking the time that you need to deal with your grief.  So, even though I've provided some suggestions above about what many people find helpful, if you're not ready to look at pictures, listen to music that was meaningful to the two of you or engage in any of the activities mentioned above, trust your intuition about this.

At the same time, it's important to be honest with yourself.

So, for instance, if years have passed since your loved one has died and you're still holding onto his or her clothes or keeping a room as a "shrine" to your loved one, as painful as it might be, you need to ask yourself if you're refusing to let go of your grief.

Letting go of grief doesn't mean that you don't care about your loved one.  It means that you're accepting the loss and, hopefully, finding other meaningful ways to integrate this experience into your life.

Allowing Room for Grief:  Finding Meaningful Ways to Integrate the Experience

Many people discover that when they've gone through the hardest part of their grief and they're willing to be open to what comes next, they realize that they still feel a deep and loving connection to their loved one that allows them feel close to him or her.

Getting Help in Therapy

Many people find that their grief is too overwhelming to deal with on their own or they feel stuck in the grieving process.

If you're struggling with your feelings of grief on your own, you could benefit from working with a licensed mental health professional who has expertise in helping clients with bereavement issues.

About Me

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

Helping clients to deal with grief is one of my specialties.

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

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

Also see my article:
Grief in Waiting

Inconsolable Grief After a Mother's Death