The Psychotherapy Session: A Unique Intersubjective Experience

Over time, people who are in therapy come to appreciate the uniquely private space of the therapy room.

The Therapy Session: A Unique Intersubjective Experience

Considering how busy most people are these days, other than their therapy sessions, many people don't take the time to reflect on what's going on in their lives and to get objective feedback.

For many people, the psychological insights that they have about themselves occurs in their therapy sessions.

The Privacy of the Therapy Session
In recent times, privacy has been eroded to such an extent that there are few (if any) other places where someone can come in and say whatever is on his or her mind in an accepting, objective, nonjudgmental private place.

Making Connections Between the Present and the Past in Therapy 
It's also a unique environment where an experienced therapist is trained to help clients to make possible connections between what is going on now and the past, and to begin to understand the many different aspects of themselves.

Most people don't feel immediately comfortable divulging a lot of private information about themselves at first.  It takes time to build a relationship with a therapist and to establish a rapport.

The Therapeutic "Holding Environment"
The attuned therapist creates a comfortable, secure environment for the client where the client feels heard and cared about (see my article:  The Attuned Therapist Creates a Therapeutic Holding Environment).

During the initial therapy sessions, it's important for the client and the therapist to each assess if they are a good "match" to continue to work together.  There aren't any specific steps for the client to determine this.  Mostly, I recommend that clients trust their intuition.

The Therapy Session: A Unique Intersubjective Experience

For the therapist, it's important that she work within the scope of her knowledge and skills.  So, if a client is looking for a therapist with a particular specialty, it's important for the therapist to reveal whether or not this is one of her specialties.

When it's a good match, over time, clients develop a comfort level where they feel they can talk about anything with their therapist.

Of course, there will be times when clients will feel ashamed to talk about certain topics, but it's important to remember that most experienced therapist have heard just about everything and, most likely, won't be shocked by what clients say.

Having a compassionate, skilled therapist and the time and place to talk about whatever is on a person's mind is a very freeing experience that is rare.

Many people, who are in therapy, look forward to attending their therapy sessions because it's such a unique experience where they have their therapists undivided attention and the time is dedicated to them.

Unconscious Communication:  The Intersubjective Space Between Therapist and Client
Clients and therapists often talk about getting into a particular intersubjective space that is unique to their particular therapeutic relationship (see my article:  The Psychotherapist's Empathic Attunement).

Within this intersubjective space, there is a form of unconscious communication between client and therapist that is particular to that client-therapist dyad.

As a result, there is more being communicated than the words that are being spoken.

There is also a latent communication that therapists, who are trained to work with unconscious communication, experience on a felt sense level.

Many clients will often talk about how they also sense this unconscious communication that is part of the intersubjective space between client and therapist.

Although there is always unconscious communication between people who are together, the unconscious communication between therapist and client is more focused than it would be between two other people and it usually develops over time.

When there is a good match between a therapist and client, it's not unusual for a therapist to intuitively sense what a client is about to say or for a client to sense what a therapist is about to say.

This is because this unconscious communication is "in the air" between them.

Choosing a Therapist
Thinking of the first session as a consultation is a good way to approach that first session.

Not only are you talking about your problems in a broad way, you're also getting a sense for whether you feel comfortable with the therapist.

You might not be able to tell in the first session, but after the a few sessions, you usually get a sense as to whether it's a good match.

For more information about how to choose a therapist, 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, see my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

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

Regaining Your Sense of Self After a Traumatic Event

It's not unusual for a change to occur in the way you see yourself after a traumatic event.  Assumptions that you made about yourself, whether these assumptions were conscious or unconscious, can seem off when you experience an event that was out of your control or beyond what you were able to handle.

Let's take a look at an example of this to demonstrate what I mean.

The fictionalized vignette shows how a traumatic event can change the way you feel about yourself and how I work with this kind of issue to help to integrate the experience and to help a client regain her sense of self:

Sandra
Sandra was a woman in her early 40s when she came to therapy to deal with the loss of her husband who had died a few years before in a car accident.

Regaining Your Sense of Self After a Traumatic Event

She attended cognitive behavioral therapy (CBT) a few months after her husband's death, and from that therapy she realized, on an intellectual level, that her husband's death wasn't her fault.  But on an emotional level she was still feeling deeply guilty, and she felt as if she didn't know herself anymore.

She described to me how, before her husband died, she felt like a competent person who was the one that others usually turned to for advice of help.   But after the car accident that killed her husband, Sandra was plagued by self doubt, self blame and a sense of foreboding about her future--even though she knew intellectually that she wasn't to blame.

On an emotional level, Sandra felt that she could have prevented the accident if only she had insisted that her husband get the brakes checked immediately when he said that he heard the brakes making a strange sound.

She did, in fact, tell her husband that until he got the brakes checked, he should use her car to drive to work.  But she felt that she didn't insist enough.  Her feeling was:  If only I had really insisted, he would be alive today.

As we went over the sequence of events, Sandra revealed that, even though her husband told her the night before that he would use her car because he didn't have time to go to the mechanic with his car, he left her a note the next morning while she was asleep that he decided to use his car because he didn't want her to be without her car for the day, and he said he would see the mechanic that night after work.  He told her not to worry--he was sure that everything would be okay.

That same morning, while Sandra, who worked from home on a business call, the police appeared at her door and told her that her husband was in a fatal car accident.  Even though she heard their words, she felt like she was in a surreal dream.

It was only after the police left that Sandra found the note that her husband left her on the kitchen table and she realized this was the last communication she would have with her husband and she felt the deepest sorrow she had ever felt in her life.

In our first session, Sandra spoke about feeling "crazy" that she could know one thing (she wasn't responsible for her husband's death) and, at the same time, she could feel the opposite (she was to blame).

Regaining Your Sense of Self After a Traumatic Event

I normalized Sandra's experience by letting her know that this is a common experience under these circumstances and she wasn't alone in thinking one thing but feeling another among people who had experienced this type of trauma.

Then I spoke to her about EMDR, Eye Movement Desensitization and Reprocess and how EMDR is used to process trauma (see my articles: What is EMDR? and How Does EMDR Work?).

During the next few sessions, Sandra and I worked on helping her to develop coping skills to work on the most traumatic event of her life, the death of her husband.

After she learned to do the Safe Place Meditation and she developed other emotional resources in our work together, we began to process the memory that she chose, which represented the worst part of her husband dying, which was the day the police came to her house and informed her that her husband was dead.

Part of the protocol in EMDR therapy is to ask the client what negative beliefs they have about themselves as a result of the traumatic memory that we're working on.

In Sandra's case, she said her negative beliefs about herself were, "I'm helpless" and "I'm a bad person."

As previously mentioned, before the traumatic event, Sandra felt like a good and confident person who could handle whatever came up in her life.  But after the accident that took her husband's life, Sandra felt just the opposite about herself.

As we processed the memory, Sandra experienced waves of sorrow that she didn't know were still there.  But she also experienced waves of deep relief between each wave.

This is what usually happens when people process loss during experiential therapy, like EMDR.  The emotional activation usually comes in waves with a build up, a peak and then a release of emotion which usually provides a sense of relief between waves.

Many people have the misconception that emotional activation will just peak in therapy and remain at that peak.  This misconception discourages some people from coming to therapy to work on their problems because they think it will be overwhelming, but for most people this isn't so.

Sandra went through feelings of guilt, self blame, and sorrow.  Then, as she continued processing the memory in our sessions with EMDR, to her surprise, she felt a sudden surge of anger towards her husband that she had never been aware of before:  "Why did he do this?" and "How could he do this to himself and to me?"

There was no question that it had been an accident, as opposed to a suicide, so this wasn't the issue.  The issue was that Sandra couldn't believe that her husband had been so irresponsible.

Even though these feelings were uncomfortable for her, this was a turning point in Sandra's therapy because, after her anger surfaced, she realized, on a deeply emotional level, that it actually wasn't her fault.  She realized that she had urged him to get the brakes checked and he was the one who chose to wait.

Regaining Your Sense of Self After a Traumatic Event

This turning point was very important to our work together because it was the first time that Sandra felt on a visceral level, as opposed to an intellectual level, that she really wasn't to blame and she said she realized, "I did everything that I could, but I couldn't stop him from choosing to drive the car with the faulty brakes."

Our work continued and Sandra was able to work through her sadness, self blame and anger. Using EMDR, she was also able to regain a sense of herself as a good and competent person. She also realized that there would be things in life that she wouldn't be able to control and she would have to accept this.

Summary
The vignette above about "Sandra" reveals that a traumatic event can dramatically change how we feel about ourselves, but experiential therapy, like EMDR, can help to restore that sense of self.

Unlike other types of therapy, like CBT, which might only provide an intellectual understanding, like it did for "Sandra," experiential therapy helps clients to have a visceral felt sense of what's real, which is what leads to people getting better in therapy.

Getting Help in Therapy
Many people live their whole lives with a diminished sense of self after traumatic events because they don't get psychological help.

If the issues that I've discussed in this article resonate with you, you owe it to yourself to get help from a licensed mental health professional who has experience working with emotional trauma and who uses experiential therapy, like EMDR, Somatic Experiencing or clinical hypnosis.

Getting help in therapy could make the difference between continuing to suffer with a diminished sense of self and feeling good about yourself.

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.

Relationships: The Problem With Trying to Change Your Partner

Are you someone who has the tendency to choose romantic partners that you try to change to try to mold them into who you want them to be (see my article: I'll Change Him/Her After We Get Married) ?

Relationships: The Problem With Trying to Change and "Improve" Your Partner?

This is usually more of an unconscious process than a conscious one which often leads to disappointment and frustration for both people involved.

In healthy relationships people develop and grow together.  There is a mutuality.  There is reciprocity. Each person contributes to the growth and development of the other in different ways.

The dynamic that I'm referring to in this article is where there's a pattern of choosing one romantic partner after the next as a "project" to be worked on, changed and "improved."

Often people who tend to engage in this dynamic focus on their fantasy of what they want their partner to be rather than who he or she is at the moment.  It's as if they get caught up in the fantasy and lose sight of the actual person in front of them (see my article:  Relationships: Are You In Love With Him or Your Fantasy of Him?)

Assuming that their partner goes along with this dynamic (for his or her own unconscious reasons), this becomes a codependent relationship where each person in this relationship usually ends up being frustrated, disappointed and resentful.

To explore this dynamic further, let's take a look at a fictionalized vignette:

Jane and Ed
When Jane met Ed, she was attracted to his gregariousness and easygoing nature.  Unlike the men that she usually met, he was kind and unpretentious.

Although she liked him and she was attracted to him, she felt that he needed to lose weight and, since she was so health conscious and physically fit, she knew that, with her help, he could lose the weight.

Relationships: The Problem With Trying to Change and "Improve" Your Partner

As they began to date, she wanted to be tactful about how she broached the topic of his weight.  So when he mentioned that he admired her for being so health conscious and fit, she saw an opening to talk to him about changes that he could make to be healthier.

Ed was open to hearing her suggestions and expressed a desire to lose weight and get fit, which thrilled Jane.  By the following week, he accompanied her to the gym and she invited him to her aerobic classes.

Within a few weeks, Ed was starting to lose weight and feel healthier.  He was grateful to Jane for her help, and Jane felt a great deal of satisfaction in helping Ed to make these changes.

A few weeks later, while she and Ed were at a party where her friends were talking about a book on the best seller list that , Jane realized that, compared to her, Ed wasn't as well read.  She felt embarrassed that Ed had nothing to contribute to the conversation about that book or any other books.

Not wanting to offend him, Jane talked to a close friend about this and asked her if she thought it would be offensive for her to give Ed a list of recommended books to read.

Her friend warned Jane against doing what Jane had done so many times before--working so hard to change the man that she was seeing and feeling frustrated and angry when it ended badly.

Jane understood what her friend was telling her, but she felt that this time it would be different.  She really cared for Ed and she felt that he could benefit from her guidance.  She didn't detect any of the resentment that she experienced from prior boyfriends.

Relationships: The Problem With Trying to Change and "Improve" Your Partner

But when she gave Ed a reading list, she was surprised at his reaction.  He took the list and looked at it with an absent stare.  Then, he handed it back to Jane and told her that he appreciated her intention, but he felt that she was saying he wasn't smart enough for her and this hurt his feelings.

Jane felt anger welling up in her and she took a moment to compose herself outwardly.  But inwardly her thoughts were racing:  How could he be so ungrateful?

They tried to talk about it, but their discussion devolved into an argument, so they agreed to take a couple of days apart to cool down and then talk again.

When Ed called her a few days later, he told her that, even though, he appreciated how much she helped him to be more fit and healthy, he felt hurt and annoyed that she was now trying to get him to change his reading habits--as if she was saying that he wasn't good enough.  He asked her if she could accept him as he is without trying to change him.

At that point, Jane realized how much she hurt and offended him and she felt badly about this.  But she also realized that she didn't want to accept him without trying to change him and this was a problem for each of them as well as for their relationship.

She thought about what her friend told her and she realized that, once again, she was on the brink of ruining another relationship by trying to change and "improve" Ed.

Although she felt confused and conflicted, Jane apologized to Ed for hurting his feelings and she told him that she needed more time to think about why she was doing this.  So, they both agreed to take a break from each other for a few weeks until they could both sort out their feelings.

At the suggestion of her best friend, Jane got into therapy to try to understand why she was always trying to change and "improve" the men that she went out with and why she kept doing it even though things ended badly each time.

Exploring her family history revealed that Jane's mother did the same thing with Jane's father, pushing him into one self improvement endeavor after another.  And even though Jane's father, who was passive, went along with it, her mother would still express to Jane, from the time Jane was a young child, how dissatisfied she felt with her marriage.

Jane became aware that, without even realizing it, she came to believe that all men needed improving and it was the woman's role to change them.

When these unconscious beliefs came conscious for Jane, she was surprised and dismayed.

Awareness is the first step in making a change and, with this new awareness Jane realized why she tried to "make over" her boyfriends.  She also realized that she wanted to stop.

Using EMDR, over time, we processed her childhood experiences that were triggering her current behavior (see my article:  Overcoming Childhood Trauma That Affects Your Relationship).  She was able to process her anger and disappointment towards both parents as well as the distorted beliefs that arose from her childhood experiences.

Relationships: Learn to Stop Trying to Change and "Improve" Your Partner

Once the triggering experiences were gradually processed using EMDR, Jane no longer had the urge to try to change Ed, and her relationship improved over time as she accepted him as he was and she stopped trying to change him.

Conclusion
People who get into one relationship after the next where they're trying to change their romantic partners tend to have underlying issues that trigger this behavior.

Often, these underlying issues are unconscious and once they are made conscious, this awareness is the first step in changing this dynamic.

But awareness isn't enough.  The underlying issues need to be processed and experiential therapy, like EMDR, is usually the best type of therapy for processing.

Usually, after the underlying issues that are triggering the behavior are processed, the current behavior tends to change.

In the fictionalized vignette in this article I gave a particular family dynamic that triggered these issues for "Jane," but there can be many other underlying issues.

Getting Help in Therapy
If you have a tendency to try to change and "improve" your romantic partners, you could benefit from seeing a licensed mental health professional who uses experiential therapy so you can work through the underlying issues that are triggering this behavior.

Overcoming the urge to change your romantic partner is beneficial for you, your partner and your relationship.

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.

Relationships: Why Emotional Abuse Might Feel "Normal" to You

People who were emotional abused as a children are more likely to experience emotional abused in an adult relationship as "normal" (see my article:  Overcoming the Effects of Childhood Trauma).

Relationships: Why Emotional Abuse Might Feel "Normal" to You

As compared with people who were emotionally abused as children, people who weren't emotionally are less likely to tolerate abuse in an adult relationship.  Generally speaking, they tend to end emotionally abusive relationships faster than people who experienced abuse as children.

People who have a history of emotional abuse as children will often come to therapy with an intellectual understanding that the abuse they're experiencing in their relationship is a problem, but often they don't feel it emotionally.  

It's not unusual for there to be a disconnect between what they know intellectually and what they feel emotionally because abusive behavior was the norm when they were children.

Rather than "alarm bells" going off in their head when they're being abused in a relationship, they're either too emotionally numb to recognize the abuse or it's just so familiar to them that it seems "normal."

Often, they don't come to therapy until a close friend or relative tells them that they're in an unhealthy relationship (see my article:  Do Your Friends See Things About Your Lover That You Don't Want to See?).

When they begin therapy, they might feel confused about the disconnect between what they know intellectually and what they feel emotionally.

Initially, they might minimize the abuse by telling themselves and their therapist that "It's not that bad."

Once they begin to realize the toll that the emotional abuse has taken on them, they're more likely to see and feel the depth of the emotional damage that the abuse has caused and then become motivated to overcome this problem in treatment (see my article: Overcoming Childhood Trauma So You Can Have Healthier Adult Relationships).

At that point, not only are they recognizing the damage of current abuse, but they also recognize the damage of the childhood abuse and how their history of abuse affects them as adults.

When these clients begin to process the trauma, it's important that their therapist recognizes how daunting this can be, especially for people who have been in denial for years about the childhood abuse.

The Need For Therapist's Empathic Attunement

The therapist needs to be not only empathetic and emotionally attuned to the client, she also needs to prepare the client to do the trauma work in a way that feels emotionally safe (see my article:  The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

If a client doesn't feel emotionally safe, s/he is more likely to abort treatment before the treatment is completed.

The therapist needs to do a thorough assessment of each client to determine how much preparatory work needs to be done before the trauma processing begins.

In a prior article,  I talked about this type of preparatory work, which is usually called resourcing in trauma therapy (see my article:  How EMDR Works).

Even after the trauma work has begun in therapy, the therapist needs to continuously monitor how the client is doing and encourage the client to talk to the therapist about how s/he is responding to the treatment.

Let's talk a look at an example of the dynamic that I've been discussing in this article.  As always, the example is a composite vignette of many different cases to protect confidentiality.

Nina

Nina came to therapy at the urging of her best friend after her friend witnessed, once again, how emotionally abusive Ed was towards her.

Relationships: Why Emotional Abuse Might Feel "Normal" to You

During her first session, Nina talked about how Ed would call her names (like "stupid") when they were around other people and also when they were at home.  This had been going on during the entire time of their four year relationship, and she recognized that other people seemed much more upset about it than she was.

When I asked her how she felt, she seemed unsure.  This lead her realization that most of the time she's out of touch with her emotions, and she has felt this way since she was a child.

When she was a child, she tried to avoid her father, who was highly critical of everyone in the family, including Nina's mother, who was passive.  She remembered closing the door in her room and turning on her radio so she wouldn't hear them argue.

Other times, she would spend hours by herself in her room daydreaming about having different parents who were kind and loving.

There were times when she couldn't avoid her father.  Dinner time was especially fraught because he would berate her for minor issues and call her names.  She would try to eat as quickly as possible to get away from him.

As we continued to explore her earlier experiences of emotional abuse with her father, Nina realized that she was numbing herself with her boyfriend, Ed, in the same way that she did with her father.

We worked on the earlier emotional abuse with EMDR and, as we did, Nina began to gradually feel her feelings.

Over time, she worked through the trauma of that earlier abuse, and she mourned for the family she wished that she had.

As she was working through her family trauma and she was more aware of her feelings, she realized that she deserved to be with someone who would treat her well and she became less tolerant of Ed's emotional abuse.

Relationships: Why Emotional Abuse Might Feel "Normal"

Eventually, Nina left Ed and she met another man.   They cared about each other deeply and he treated her well.

Conclusion
When an adult has a history of childhood emotional abuse, s/he is more likely to repeat this pattern in adult relationships by unconsciously choosing partners who are emotionally abusive.

Often this pattern goes unrecognized because the process is unconscious and also because children who were emotionally abused learn to protect themselves emotionally by numbing themselves.

Emotional numbing often continues into adulthood, which creates blind spots for people who are in abusive relationships.

Even if someone knows that a partner is being abusive, s/he usually has more of an intellectual understanding than an emotional understanding due to the emotional numbing.

Many people who are in emotionally abusive relationships never come to therapy.  Either they're not consciously aware of the abuse.  Or, if they're aware of it, they're too afraid of confronting this problem because they think they will be overwhelmed if they attempt to deal with it.

The therapist's empathic attunement helps the client to prepare to do the work and can make all the difference in being able to work through these problems.

Many people, who have sought help in therapy, have been able to work through these types of issues and, having worked through them, have found life to be a lot more fulfilling.

Getting Help in Therapy
You deserve to be with someone who treats you well.

If you're in an emotionally abusive relationship, seek help from a licensed mental health professional who has expertise in this area.

Rather than continuing to numb yourself emotionally to both painful feelings as well as good feelings, you could be leading a fuller and happier 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.

Overcoming the Confusion Between Compassion and Responsibility in Therapy

In Part 1 and Part 2 on the topic of confusing compassion and responsibility, I began discussing the problem that many adults, who traumatized as children, have with this issue.

Confusing Compassion With Responsibility:  This  Pattern Often Begins in Childhood

As I mentioned in the prior articles, traumatized children often take on the responsibilities of the parents in a dysfunctional family where one or both parents are impaired due to mental illness, substance abuse or some other problem.

Developmentally, the responsibilities that these children take on is way beyond what any child should ever have to do.  But they do it because they have become "parentified children" who function beyond their years in order to rescue their parent(s) and/or other siblings.

As parentified children, they develop distorted beliefs, which include confusing compassion and responsibility, and they usually continue to perpetuate this problem in their adult relationships, often with disastrous consequences.

Unfortunately, as I mentioned in my prior article, most of the time, adults who had these experiences as children never get help in therapy.  As a result, they often go from one destructive relationship to the next without even realizing that they're repeating patterns from their childhood.

Even when they come to therapy, they often have a hard time letting go of their distorted beliefs--even when they're able to see it logically.  This is usually because these beliefs have a tremendous hold on them emotionally.

To illustrate the dynamic that I've been discussing, I've presented a scenario below that is a composite of many different cases to protect confidentiality:

Ed

Ed came to therapy because he just ended another unhappy relationship, and he was beginning to despair that he might never be in a healthy relationship.

As we went over his family history, Ed described a highly dysfunctional family where his father drank excessively and hit Ed and his younger siblings, and his mother gambled most of the family's money.

Ed grew up feeling that it was his responsibility to take care of his siblings.  

When Ed's father got drunk, he would often hit Ed and his younger siblings.  As the oldest, Ed would try to shield his siblings from their father's blows, which only angered the father even more and made him more abusive.

Ed grew up feeling that if his father was physically abusive towards him, it must be because he deserved it.  

He believed that if he could be the "best son" that a parent would want to have, his father would stop drinking and his mother would stop gambling, so he tried as hard as he could do be "perfect."  

Confusing Compassion and Responsibility

But since this was a distorted belief, there's no such thing as a "perfect" person, and his behavior had no bearing on his parents' problems, his efforts never worked the way he hoped they would. 

When the father was out drinking and the mother went to the casino, Ed took care of his siblings, cooking for them, washing their clothes, helping them with their homework, and so on.

This often meant that, rather than go out and play with his friends, Ed would stay home with his brothers and sisters and take care of their needs.

During the times when his mother gambled away the family money, Ed would take on jobs before school, like delivering newspapers, to try to make up for the short fall so the family would have food.

Even though life was very difficult for Ed, there were times when his father would vow to stop drinking and the mother would say she would stop gambling, and life seemed like it was going to be normal for a short time.

During those times, Ed felt a great deal of love and compassion for each of his parents, and he knew that they were struggling emotionally.

Unfortunately, those times never lasted very long.  After a while, the father would begin drinking again and the mother would return to gambling, and the household would be chaotic again.

This cycle was repeated over and over again.

Each time that his parents attempted to have some normalcy in their lives, Ed hoped that it would last.  But each time he was disappointed.

When it came time to go to college, Ed chose a local college so he could continue to live at home and help his younger siblings.

He was so accustomed to juggling home and school that he didn't realize that he was exhausting himself.  Eventually, he got sick and was bed ridden.

During that time, his maternal aunt came to visit from out of state.  Shortly after she arrived, she realized how bad things were and she gave Ed's parents an ultimatum--either get help or she would contact Children's Services to report their neglect.

After that, things began to improve at home, which was a relief for Ed, but the emotional damage was already done.

As Ed entered into one romantic relationship after another, he continued to perpetuate the same dynamic that he grew up with as a child.  

The women that he chose initially seemed emotionally healthy but, over time, it would come to light that they either had a drinking problem, a drug problem or a gambling problem.  

Confusing Compassion and Responsibility

Ed felt compassion for each of his girlfriends, and he would feel, as the boyfriend in a committed relationship, that he had to do everything that he could to try to help each of these women.  But each time it was the same--he would exhaust himself physically, emotionally and sometimes financially, but he couldn't save any of them.

His friends would tell him that he was so focused on his girlfriend at the time that he wasn't taking care of himself.  On on intellectual level, Ed understood this, but on an emotionally level, Ed felt compelled to continue to try to take responsibility for each of these women.

After several disastrous relationships, Ed came to therapy and we were able to trace back his pattern to early childhood.  

We began working on the earlier experiences that were impacting his adult life using EMDR, Eye Movement Desensitization and Processing therapy, which is a therapy that was developed for trauma (see my article:  What is EMDR?)

Even though Ed knew that his beliefs about compassion and responsibility were distorted, these beliefs remained very strong for him on an emotional level.

As is often in the case when this happens in therapy, there was a part of a young part of him, a child self, that wouldn't allow Ed to overcome his early experiences.

So, having seen this many times in similar situations, I asked Ed to ask his younger self what he felt he needed.  

Tuning Into Ed's Younger Self

As Ed tuned into this younger part of himself, he sensed the younger self letting him know that he felt he couldn't allow Ed to let go of the trauma without feeling that his parents were taken care of.

As an adult, Ed knew that his parents had overcome their problems when he was 20.  But his younger self, who acted as the container for those earlier memories, was stuck at an earlier time when the father was still abusing alcohol and the mother was still gambling.

At first, Ed was confused because he couldn't understand why this younger part of himself was stuck in the past and had not gotten caught up with the present reality.  

So, I explained to Ed that we are all made up of many different aspects, including the adult self, the teenage self, the child self and many other selves (see my article:  Psychotherapy and "Parts" Work).

This is a normal experience.  This has nothing to do with multiple personalities or dissociative identity disorder.  

It so happened that in Ed's case, as often occurs for adults who were abused and traumatized as children, that this younger self was the repository for these earlier memories and remained stuck emotionally.

So, in order for the therapy to progress, we had to take care of this younger self's needs first.

Over time, through gentle exploration, we discovered that this younger self would be willing to allow Ed, as an adult, let go of his distorted beliefs if he felt that Ed's parents had ideal parents that would have taken care of each of them so they wouldn't have grown up to be so unhappy that they used alcohol and gambling to deal with their unhappiness.

Of course, there's no way to actually change the past, but one effective strategy is for the client to use his or her imagination to overcome this treatment impasse.

So, guided by what Ed's younger self communicated that he needed, Ed began to imagine the kind of idealized parents that his father and mother would have needed.  

I helped guide Ed so that he could use his imagination to make each of these idealized parents as vivid as possible with all of the qualities that his younger self felt was necessary.

Then, we took each of those images and Ed imagined his mother as a baby being held and loved by her idealized parents.  He imagined his mother growing up as a young child, a teenager and as an adult with these idealized parents who were loving and nurturing so that Ed's mother grew up to be a loving mother towards Ed and his siblings.

Ed did the same thing for his father--imagining him with loving, nurturing parents, so that his father also grew up to be a loving father towards Ed and his siblings.

By using his imagination, facilitated by an EMDR technique of using tappers to strengthen this experience, Ed created a new symbolic memory (see my article:  Mind-Body Psychotherapy: Healing Trauma With New Symbolic Memories).

The interesting thing about using your imagination in this way is that, even though the logical part of your brain knows that things didn't really happen this way, the emotional part of your mind experiences it as if it  happened, so that it becomes a healing experience.

There are some clients who difficulty with this because they remain so aware that reality was so different from what they imagined that they have a hard time allowing themselves to suspend disbelief.

For those clients, I usually gently ask them try suspending disbelief for the sake of the exercise so we can see what happens.  Most of the time, they're able to experience the healing that comes with this.

Ed was open to using his imagination and, afterwards, he discovered that his younger self felt taken care of to the point where he was able to allow Ed's adult self to process his traumatic experiences.

Over time, Ed mourned for the childhood that he wished that he had.  This was an important step for him.  

Many people avoid coming to therapy because they fear that they'll be overwhelmed by their grief.  But if they have a good rapport with their therapist and the therapist can provide a "holding environment," most people discover that letting go of their grief isn't nearly as upsetting as they had anticipated (see my article: Creating a Holding Environment in Psychotherapy).

Gradually, Ed learned to distinguish compassion from taking responsibility.  He discovered that he could feel compassion for someone, but he didn't have to take on their problems.

As he continued to make progress in therapy, Ed also no longer felt the need to rescue women that were in trouble.  He learned that it wasn't his responsibility to "save" them. 

A Healthy Relationship

Over time, he was also attracted to healthier women, so he was able to enter into a relationship that was healthy and satisfying for the first time in his life.

Getting Help in Therapy

The scenario that I presented in this article is, unfortunately, common for adults who were abused and traumatized as children.

Getting Help in Therapy

If this scenario seems familiar to you because you had similar experiences, you owe it to yourself to get help from a licensed mental health professional who has experience working with trauma.

You can overcome emotional trauma that's keeping you stuck and unhappy.  

Making the decision to get help is the first step.

About Me

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

Helping clients to overcome trauma is one of my specialities.

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. 

Psychotherapy Blog: Understanding the Difference Between Compassion and Responsibility - Part 2

In my previous article, Understanding the Difference Between Compassion and Responsibility - Part 1, I began a discussion about people who are emotionally traumatized who confuse compassion with taking responsibility.  In the current article, I'm continuing this discussion with a composite scenario as an example of this dynamic.

Understanding the Difference Between Compassion and Responsibility

The following scenario is a composite of many different cases to protect confidentiality:

"Rose:"
When Rose was a child, she grew up in a household where her mother was abusing prescription drugs and her father was usually away on business.

As the oldest child, she was more aware than her younger siblings of their mother's drug problem.

By the time she was seven, she was already cooking dinner for her siblings, cleaning and washing clothes while their mother was passed out on the sofa.

Understanding the Difference Between Compassion and Responsibility

When her mother was awake, she often confided in Rose, telling her how depressed she felt.  Since Rose was only a child, she felt overwhelmed by these talks.  But she also felt a great deal of love and compassion for her mother.

So, not only was Rose taking on adult responsibilities for herself and her siblings, she also tried to comfort her mother and tried to help her to cheer up.

More than anything, Rose wanted her mother to be happy, and she thought that if she listened to her mother and was "a very good girl," it might make her mother feel better.  But, of course, it never did.

It wasn't until Rose was in her early 30s and ending her latest unhappy relationship where she was unable to rescue her boyfriend that she realized that she needed help.

As Rose talked about her history of romantic relationships, she described one relationship after another where she felt love and compassion for each boyfriend and she wished, more than anything, to save him from himself.

The men that she chose to be in relationships with were men with either gambling or abusing alcohol or drugs.

In each relationship, similar to her relationship with her mother, she felt it was up to her to rescue these men, but none of these relationships ever worked.

Understanding the Difference Between Compassion and Responsibility

Each time, Rose came away feeling that she "wasn't enough" and if she had been good enough, she would have helped these men to change.

We used a mind-body oriented therapy, EMDR (Eye Movement Desensitization and Reprocessing), to find the earliest memory of when Rose felt this way (see my article: What is EMDR?).

Rose remembered being seven years old and seeing her mother slumped on the couch, passed out on prescription drugs, as Rose was cooking dinner for her siblings.

She remembered feeling so compassionate for her mother, wishing that she knew what to do to make her happy so she wouldn't be so unhappy.

As an adult, Rose recognized that her feelings for the men that she tried to rescue were similar.

As we continued to process this earliest memory about her mother, I asked Rose if a seven year old child can rescue a mother.

Of course, Rose knew logically that this didn't make sense.

But, due to the way EMDR helps clients to integrate memories with new information, Rose was able to do something she had never been able to do before--she was able to feel this on an emotional level.

Then, something else happened that never happened before:  She began to feel love and compassion towards the child that she was growing up.

She realized, for the first time, how lonely and unhappy she was back then, and she imagined herself holding and soothing her younger self.

We also did an EMDR interweave where she imagined that, as a child, she had an ideal mother who would have cared for her.  She described what the ideal mother would have looked like, her scent, how soft her skins was, how loving she would have been towards Rose, and imagined this mother holding and soothing her.

The integrative process of EMDR made this imagined ideal mother come alive for Rose so that she could even close her eyes when she wasn't in a therapy session and imagine her soothing her.

Over time, Rose was able to mourn for her unmet emotional needs.

She also began to distinguish feeling compassion for someone vs taking responsibility for his well being.

She realized, on a cognitive and emotional level, that she no longer had to rescue people.  Even more than that, having worked through the early memories that were triggering her in her current relationships, she no longer felt the desire to do that.

Rose was, at last, free to nurture herself and have healthy, reciprocal relationships.

Getting Help in Therapy
The dynamic that I've described in the above composite scenario is an all too common one.

If this scenario resonates with you, you're not alone and you don't need to continue to repeat this dynamic in your life.

Getting Help in Therapy

You can get help from a licensed psychotherapist who knows how to help you to learn to distinguish feeling compassion and taking responsibility for others, and free yourself from this dynamic.

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.

Understanding the Difference Between Compassion and Responsibility - Part 1

Understanding the difference between compassion and responsibility is often confusing for adults who were abused and traumatized as children.

Understanding the Difference Between Compassion and Responsibility

Compassion vs Responsibility
Since one of my specialties is helping clients to overcome emotional trauma, I see many adult clients who were traumatized and abused as children.

Many of these clients, as children, felt responsible for parents who were impaired either due to substance abuse, mental illness or for some other reason.  This is a common experience for children who became parentified children, which means that at a young age they took on the parental role with their parents and siblings.

This is a tremendous burden for a child to take on, but I often hear from adult clients that if they had not taken on that role, the household wouldn't have functioned:  There would have been no food, no clean clothes, the younger siblings wouldn't have been helped to get dressed to go to school, and so on.

The child who takes on this role isn't only robbed of a childhood, she also grows up feeling confused about the difference between feeling compassion and taking on responsibility.

Confusing Compassion and Responsibility: An Abusive Mother

So, for instance, there might have been a mother who drank excessively and who, while drunk, was physically abusive with the children.

But this same mother, when sober, might feel tremendous remorse for being physically abusive when she was drunk.  She might have apologized profusely, while sober, and promised her children that she would never do it again--only to repeat this cycle over and over again.

Confusing Compassion and Responsibility: A Cycle of Abuse and Remorse

In this situation, a child, who takes on the parent's responsibility often feels a tremendous sense of compassion for the mother when she is sober and remorseful.

This same child might feel that she cannot leave her younger siblings alone with the mother because she knows that if she leaves, her siblings will suffer at the hands of the mother.  So, she has to stay and take care of the family.

Staying to protect her siblings might mean missed opportunities to play with friends, attend after school programs, sports activities and the usual children's activities.

Later on, it might also mean that she will be too afraid to leave to go to college because she fears the household will fall apart without her there to pick up the pieces when her mother gets drunk.

It's also common for young children, who are abused emotionally and physically, to feel that they're responsible for their abuse.

These children will often say, "It's my fault that she got drunk" or "If I were a better daughter, she wouldn't have beat me."

Distorted Beliefs About Compassion and Responsibility Often Continue Into Adulthood
Even as adults, they often continue to have these distorted beliefs on an emotional level, and this can have tremendous repercussions for them.

Even when they understand logically that that their beliefs are distorted, on an emotional level, they continue to feel this way.

It usually affects how they feel about themselves, especially in terms of their self esteem or their ability to feel that they deserve good things in their lives.

Distorted Beliefs About Compassion and Responsibility Often Continue Into Adulthood

It can affect the types of relationships that they choose as adults, possibly choosing partners that they feel they have to rescue or take responsibility for in some way.

For instance, if, as adults, they're in a relationship with someone who is abusing alcohol and they feel compassion for their partner, they might feel that they must take on the responsibility for rescuing the partner--even if the partner is abusive.

In these cases, this is an unconscious repetition of what they experienced as children because they've grown up to feel that compassion equals responsibility.   So, they will often try to rescue their partner even when it comes at a great emotional, physical and/or financial risk to themselves.

In these situations, people might feel unhappy and trapped, but they don't see a way out because they feel they can't leave their partner.

Even when they do manage to leave an abusive relationship, they often get into another relationship where there is a similar dynamic and start the cycle all over again.

Once again, this is usually on an unconscious level, so they don't realize that they keep repeating this pattern each time.

It's not unusual to see this pattern continue from one generation to the next.

This dynamic also has repercussions for adults in psychotherapy who want to overcome childhood trauma, and I will address this issue in my next article (see my article:  Understanding the Difference Between Compassion and Responsibility - Part 2).

Getting Help in Therapy
Most people who were abused as children never come to therapy.  They continue to blame themselves for what happened to them as children as well as the abuse that they endure as adults.

They also continue to perpetuate the self destructive pattern of confusing compassion with responsibility.

If the dynamic that I've described in this article resonates with you, you're not alone.

Getting Help in Therapy to Lead a More Fulfilling Life

Although taking the first step is usually the most challenging, it can also be the most empowering.

Getting help in therapy from a licensed trauma therapist can help you to overcome the early emotional trauma that's keeping you stuck in your life.

Getting help in therapy can free you from your emotional history so you can lead a happier, more fulfilling life.

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

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

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