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Monday, March 14, 2016

Clients Struggling With Shame Can Leave Therapy Abruptly

In an earlier article, Healing Shame in Therapy, I addressed how feelings of shame often bring clients into therapy.  Shame is often at the core of many psychological problems, even when clients in therapy don't realize it.  The unconscious roots of shame usually go deep and can make clients feel uncomfortable in therapy.

Clients Struggling With Shame Can Leave Therapy Abruptly


In this article, I'm focusing on a particular dynamic that occurs when clients feel their shame is so unbearable that they leave therapy abruptly.

Being able to communicate about feeling uncomfortable in therapy is an important skill.  Unfortunately, it's a skill that people starting therapy don't have because they weren't encouraged to express their feelings in their families, so they never developed that skill.

Also, for many clients, feeling ashamed can feel so intolerable that they would rather leave therapy than deal with their uncomfortable feelings.  Unfortunately, it's a skill that many people starting therapy don't have because they weren't encouraged to express their feelings in their families when they were growing up, so they never developed that skill.

For many clients in therapy feeling ashamed can feel so intolerable that they would rather leave therapy abruptly  than deal with their uncomfortable feelings.

Their discomfort might be intense but, at the same time, they might not be able to identify their feelings or they might think their feelings are different emotions, so they might not identify these feelings as shame.  Rather than accepting their feelings, they might think that their therapist is causing them to feel this way rather than seeing that the feelings of shame are coming from within them rather than outside.

The following is a fictionalized example of how this can play out in therapy:

Bill
Bill came to therapy because he was feeling depressed, anxious and angry about a breakup that occurred several months before.  Even though he was the one who ended the relationship, he felt victimized, once again, by a woman who mistreated him.

Clients Struggling With Shame Can Leave Therapy Abruptly


As he talked about the relationship, he gave many examples of how the woman he was dating, Ina, was inconsiderate and hurtful from the start.  There were many "red flags" that were evident from the beginning, but Bill wanted so much to be in a relationship that he overlooked them--until he couldn't overlook them anymore.

The final straw was when he found out from his best friend, Joe, that Ina called Joe and asked him out on a date.  Bill felt deeply humiliated and told Ina that he didn't want to see her anymore.

As we talked about his history of prior relationships, the pattern was similar:  Bill chose women who mistreated him, but rather than ending these relationships when he first experienced the mistreatment, he held on until he was so hurt that he couldn't stand it anymore.

After each breakup, Bill's sense of self worth was so low that he felt that no woman was ever going to live him.  At that point, he felt hopeless about ever finding anyone that he could be happy with in a long term relationship.  He said he felt like he was unlovable (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

After discussing his family history, which included a fair amount of emotional abuse from both parents, Bill recognized that he was unconsciously repeating this pattern with the women that he was dating--he was choosing women that would be emotionally abusive (see my article: Unhealthy Relationships: Bad Luck or Poor Choices?).

When he came in for his next session, he seemed very uncomfortable.  His therapist asked him how he experienced their last session.  Looking very ill at ease, he said he wasn't happy about the last session.  Then, with increasing agitation, he said that he was offended that the therapist told him that he felt unlovable.

His therapist tried to tell him that she wasn't the one who said this--he was the one who identified feeling unlovable.  But, with increasing agitation, he interrupted her, denied that he ever said this.  At that point, the therapist attempted to help Bill to calm down, but he walked out of the therapy room abruptly.

His therapist contacted him afterwards and asked him to come to another session so that they could talk about what happened.  At first, he rejected this idea, but by the next day, he was calm enough to come in to talk.

As they talked about the last session, Bill remembered that he was the one, not his therapist, who said he felt unlovable.  As his discomfort increased around these feelings, his therapist slowed down the session so that Bill was able to stay calm, even though he was uncomfortable.

Over the course of the next few weeks, Bill realized how deeply ashamed he felt about himself and that his feelings of shame were longstanding, going back to his childhood.  From the time that he was a child, he believed that if his parents didn't care about him, there must be something very wrong with him.  He must be defective in some way.

His therapist pointed out that this is a common response that many children have when they are emotionally and/or physically abused by their parents.  Rather than thinking that their parents are abusive, they believe that there's something wrong with them because it would be too painful to believe that their parents had problems taking care of them.

Feeling unlovable feels shameful for children and this feeling often continues into adulthood, even when adult children recognize that their parents were the ones who had problems.

This is what was happening to Bill, but the emotional pain involved with feeling this shame felt unbearable to him, so his therapist slowed down the work and helped Bill to develop the emotional resources and coping skills to tolerate doing the work.  She also helped Bill to learn to express his feelings about the shame.

As Bill progressed, there were still times when he wanted to leave therapy, but he began to trust his therapist more and their sessions felt like a safe place where he could deal with his emotions.

The work wasn't easy or fast, but Bill felt, for the first time in his life, that he deserved to with a woman who loved him and treated him well.

Overcoming Shame in Therapy

As he began to date again, he no longer felt so desperate to be loved that he would tolerate being mistreated.  And, when he saw the early warning signs that he used to ignore in the past, he wouldn't continue seeing that person.

Gradually, Bill realized that shame is a common response for many people who were abused or neglected as children.  He wasn't alone.

Over time, his confidence grew.  He realized that he was a genuinely lovable person and there were people in his life who also found him to be a lovable person.  They were there all along but, in the past, Bill was focused on the people who were mistreating him.

Eventually, he entered into a healthy romantic relationship where he was able to both give and receive love.

Conclusion
Shame is a powerful emotion.  Shame is at the core of many psychological problems.

For many people, without help in therapy to develop the wherewithal to deal with shame, shame often feels too uncomfortable to tolerate.

Many of people unconsciously project their feelings about themselves onto their therapists and, in a state of anger, they leave therapy abruptly.

For clients who are able to allow themselves to recover emotionally enough to come back and talk to their therapist, there is a good chance that this dynamic will change over time.

Learning to recognize feelings of shame and low self worth can be challenging.  Clients need the time and space to develop an emotional tolerance to recognize that they feel ashamed of themselves and it is their own feelings about themselves.  Then, there is a possibility for healing from the shame.

Getting Help in Therapy
Shame is often poses a barrier to people either starting therapy of staying in therapy.

It's not unusual for people to leave therapy because they feel ashamed of themselves and their problems.

If you feel burdened by shame, you could benefit from seeing a licensed mental health professional who helps clients with this issue (see my article: Overcoming Shame in Therapy).

Once this burden is lifted, you can develop self confidence and live a more fulfilling life.

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

I have helped many clients overcome their feelings of shame.

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.












Monday, March 7, 2016

Coping with the Sudden Realization That You Don't Really Know Your Spouse

In an earlier article, Movies: "45 Years:" An Old Secret Haunts a Loving Long Term Marriage, I discussed how events from the distant past upend a long-term marriage causing the wife to feel suddenly that she really didn't know her husband or understand their marriage.  Until then, they had been, seemingly, going along happily.

Betrayal

As I mentioned in my prior article one of the things that makes this movie so powerful is that this is the sort of thing that happens in many relationships.  If it's happening to you, you can feel that you're the only couple going through it because, similar to the couple in "45 Years," couples often don't talk about these issues aside of their relationship or their couples therapy.

If you're experiencing a betrayal in your relationship, aside from the shock, you can feel very alone in your experience.

The betrayal can make you ask yourself: Who is this person that I'm married to?  You can also question your marriage.

This can be extremely disturbing and leave you reeling, especially in a long-term relationship where, prior to the betrayal, you  thought you understood your spouse well and you felt confident in your marriage.

In prior articles, I've written about infidelity (see my articles: Your Relationship: Your Spouse Cheated on You--Should You Stay or Should You Go?  and Coping with Infidelity in Your Relationship).

But infidelity is not the only form of betrayal that couples often go through.

The following vignette, which is a fictionalized example of many different cases with all identifying information changed, I discuss another form of betrayal in a long-term relationship:

Donna and Jim:
Donna and Jim came to couples counseling because they were struggling to overcome Donna's sudden realization that Jim had gambled away their life savings (see my article: Compulsive Gambling: Beware of March Madness).

They were married for 15 years, until Jim's secret gambling problem emerged, Donna felt content and secure in their relationship.

Jim worked as a stockbroker and Donna worked as an executive assistant.

Until recent events unfolded, Donna was unaware of any serious problems in their relationship.

Jim took care of their finances, so Donna was unaware that there was any problem--until she came across a bank statement that Jim had accidentally left out and she saw that their savings was a fraction of what she had always known it to be.

Alarmed, Donna approached Jim with the statement to show him what she thought was a bank error.  But when he hung his head down and averted her gaze, she felt queasy and knew something was terribly wrong.

Over the next hour, Jim broke down in tears and confessed to Donna that he had been secretly gambling in the last several years and he had depleted their savings.  He apologized to her over and over again, but Donna was in a state of shock trying to come to terms with what she was hearing.

Donna described how she suddenly felt like the floor under her feet had dropped away and she was falling into an abyss.  She was so upset that she could barely understand what Jim was telling her.  She felt like she was in a bad dream and any moment she was going to wake up and feel relieved.

But, as the hours passed, she realized that this was no dream and her shocked turned to rage.  She told Jim to stay at his parents' home for the time being so she could wrap her mind around what was happening.

During the days that Jim was away, Donna felt lonelier that she had ever felt.  She couldn't bear to tell her family or close friends what had just happened.  At that point, she couldn't even bear to tell her daughters.

All the while, Donna felt like she was going through the motions in her life. It was as if everything looked the same, but nothing felt the same.  She felt like her every day life had been replaced by replicas of people and things that she ordinarily knew.  Nothing seemed real.

All of this time, she could never have imagined that Jim had a gambling problem or that he was gambling away their savings.  The thoughts that kept going around in her mind were:

Who is this man that I thought I knew for all of these years?
Does he really love me?
How could he do this?
What is our marriage about if he could be so dishonest and ruin us in this way?
How can I ever trust him again?

Initially, Donna considered divorce and told Jim that she didn't think they could ever overcome this betrayal.  But Jim begged Donna for forgiveness and pleaded with her to reconsider and not give up on their marriage.

After several weeks of trying to talk it out between them to no avail, Jim sought out couples counseling as a last resort, and Donna agreed reluctantly to give it a try.

After a couple of sessions, Donna agreed to stick it out in couples counseling to see if they could work out their problems.  She was still deeply hurt and upset but, after the initial shock wore off, she realized that she still loved Jim and she didn't want to give up their marriage.  She also realized that he had a serious problem and he needed help.  She was still very angry, but less so than she had initially been.

Betrayal

Clearly, finding out about Jim's gambling problem was traumatic for Donna, especially since she grew up in a household where her father was a gambler with devastating consequences for her family.  She had always vowed to herself that she would never marry a gambler and to find out about Jim's secret reopened old emotional wounds related to her father's gambling.

Jim agreed to attend his own individual therapy with a therapist who specialized in addiction.  He also began to attend Gambler's Anonymous regularly and obtained a sponsor.

On a practical level, Jim had to borrow money from his family, which meant that he had to reveal his gambling problem to them.  Donna took over the finances because, at that point, she didn't trust Jim with their money.

Betrayal

On an emotional level, they had a steep road to climb to repair their relationship.  Jim acknowledged that he had been deceitful and seemed genuinely remorseful.  Over time, Donna realized, in hindsight, that there had been signs of Jim's secrecy that she chose to ignore.  Eventually, she attended Gam-Anon, which are self help meetings for spouses or family members of gamblers.

Over the next two years, with much difficulty, Donna and Jim reconciled their relationship.

Jim discovered in his own individual therapy that, on an unconscious level, he wanted to be found out.  Although it appeared that he had accidentally left the statement out, he realized that he felt so guilty and worried about his secret that he wanted Donna to know, but he didn't know how to tell her.

Jim also discovered what triggered his craving to gamble, and he learned to develop better coping skills.  He also changed careers because his job as a stockbroker was not conducive to overcoming his gambling problem.

After they completed couples counseling, Donna entered into her own individual therapy to deal with the aftermath of Jim's betrayal as well as her own unresolved issues regarding her father.

As time went on and Jim abstained from gambling, the family became closer again.

Having gone through this traumatic event in their lives, Donna and Jim seemed to grow as a couple and as individuals.

Conclusion:
There can be many forms of betrayal in a relationship.

The fictionalized scenario presented in this article illustrates many of the stages that a couple can go through when a betrayal comes to light.

In the scenario presented above, the couple got help in couples counseling and decided to remain together.  Of course, this is not always the case.  But after the initial shock of a betrayal, many couples decide to try to reconcile their relationship in couples counseling.

Often, couples who come to couples counseling learn new things about themselves as individuals and as a couple.  They often learn that they are more resilient than they thought they were.

A couples counselor won't tell you whether or not to stay together (see my article: Your Relationship: Should You Stay or Should You Go?).  However, she will facilitate the process so that each person in the relationship can decide if he or she wants to try to salvage the relationship.

If a couple decides that they can't salvage their relationship, they can benefit from going to couples counseling to try to end the relationship as amicable as possible, especially if there are children involved.

Getting Help in Therapy
When you feel betrayed in your relationship, you can feel confused and bewildered about what to do.  It's often not the best time to make any lasting decisions.

You might not feel comfortable talking to family or friends because you might know that could make any decision that you're trying to make that much more difficult.  Family and friends usually want the best for you and they might try to sway your decision one way or the other before you're ready to make a decision.

Many people seek help in individual therapy first to be able to sort out their feelings about the betrayal and how they feel about the relationship.  Over time, like Donna in the fictionalized scenario in this article, people often discover that the betrayal opens up old wounds from their childhood.

Other people enter into couples counseling and then one or both people might attend their own individual counseling.

If you're struggling with a betrayal in your relationship, you're not alone.

Rather than trying to deal with it on your own, you could benefit from seeking help in therapy to help you to work through the issues involved (see my articles: The Benefits of Therapy and How to Choose a Psychotherapist).

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

I have helped many clients struggling with a betrayal in their relationship to overcome the emotional trauma and make important decisions about their lives.

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

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


















































Wednesday, March 2, 2016

Movies: "45 Years": An Old Secret Haunts a Loving Long-Term Marriage

In the movie, 45 Years, an old secret, which is suddenly thrust upon them, haunts an older married couple, who were, seemingly, happily married for many years (for 45 years, hence, the name of the movie).  They face the emotional challenge, both alone and together, that could ruin their relationship.

An Old Secret Haunts a Loving Long-Term Marriage*

Until this old secret surfaces, the couple, Kate and Geoff Mercer (portrayed beautifully by Charlotte Rampling and Tom Courtnay) seem to have an ordinary, serene life in their retirement in the beautiful English countryside.

Suddenly, their world is upended by a letter that Geoff receives about a deceased girlfriend, Katya, who died during a mountaineering accident when Katya and Geoff were very young, and whose body was just found intact in a glacier after all of these years.

Geoff's short-lived romantic relationship with Katya preceded his relationship with Kate, and he told Kate about it many years before.

But as he starts to ruminate about Katya and he sinks into a depressed state about this old loss, Kate begins to realize that he never revealed to her how important that past relationship was to him.  They never talked much about it, and the news about finding Katya's body is now threatening their marriage.

It haunts both Geoff and Kate in different ways.

For Geoff, the power of memory has overtaken him.  He can't sleep.  He starts smoking again.  He is preoccupied and lost in thought about his short, youthful romance with Katya.  He wants to immerse himself in pictures and mementos of her.  When he speaks about his old romance to Kate, he calls Katya "my Katya."

Initially, Kate comforts herself by telling herself that Geoff's youthful romance with Katya was very brief and a long time ago, especially compared to the many years that he and Kate have been married.  After all, Kate and Geoff have had a whole lifetime together, and it's been a good life.

She reasons to herself:  A brief romance from many years ago with a woman who is long dead can't compete with their 45 year marriage.

And, yet, it does in ways that gradually unfold in this movie.

Kate makes her own secret discoveries into Geoff's past romantic attachment to Katya.

As Kate becomes more aware of the effect of this old romance, she wonders how she can compete with the memory of an attractive, young lover who is deceased, but who is still very much alive in Geoff's memory.

Over the course of only one week, with the backdrop of Kate planning a big party for their 45th wedding anniversary, it gradually dawns on Kate that all of her assumptions about her husband and their marriage might be wrong:
  • How does Geoff really feel about Kate and their marriage?
  • How well does she understand Geoff's romantic history with Katya? 
  • Has Geoff been secretly harboring unspoken feelings for Katya all along throughout their long marriage? 
  • How can she be jealous of a ghost from the past?
  • Would Geoff still have married her if Katya was still alive?
  • Now that these secrets have come to light, what does all of this mean for their marriage?
  • What is the truth about about their marriage?
Far from being melodramatic, 45 Years, is a the story of a very ordinary couple and the devastating effects of time and memory, which can change everything.  This is what makes it so haunting:  It could happen to anyone.

Without giving too much away, the expression on Kate's face, which is so dissonant from the all the revelry around her at the anniversary party, says it all.

Time seems to stand still for Kate and her expression tells us everything there is to know about how she feels and her dawning emotional awareness.

But there are no easy answers for this couple--just as there are no easy answers for any couple faced with this emotional dilemma.

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 it, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

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



*The couple in this picture are not from the movie.  The picture is from Shutterstock.















Monday, February 29, 2016

An Emotional Problem You Thought You Resolved Gets Triggered Again

It's not unusual for people to revisit emotional problems in therapy that they thought they had already worked through at an earlier time in their life.  Different life stages and events can trigger these problems in new and different ways.  Rather than feeling disappointed or discouraged, it can be an opportunity to work through an issue in a deeper, more meaningful way.

The following fictionalized scenario is an example of this type of phenomenon:

Alice
Alice came to therapy to work on fears of being abandoned in her current relationship (see my article: Overcoming Fear of Abandonment).

An Emotional Problem You Thought You Resolved Gets Triggered Again Later in Life

She knew logically that there was no objective reason to believe that her boyfriend of three years would leave her, but she still felt overwhelmed by this fear.  But, on an emotional level, she was constantly worried that her boyfriend would leave her no matter how many times he reassured her.

When this happens, it's often the case that there are underlying emotions, usually related to memories, that are getting triggered.

By doing an "affect bridge," which is a technique used in clinical hypnosis, we were able to trace back her fear to an earlier loss that she thought she had already worked through in a previous therapy--the loss of her father when she was 10 (see my article about the affect bridge technique:  What is the "Affect Bridge" in Clinical Hypnosis?).

Alice knew that she missed her father and she often wished that he was still alive, especially now that she and her boyfriend were talking about getting married.  But she said that, without doing the affect bridge, she never would have made the connection between her current fear and her earlier loss.

In a sense, Alice was relieved to know that her current feelings "made sense" in terms of the earlier loss, especially since there were no signs that her boyfriend would ever abandon her.

But, in another sense, she felt disappointed and frustrated that she had to revisit a problem that she thought she had worked through earlier.

As we explored her feelings, it became evident that she had worked through her grief in her last therapy for that time in her life.  But the intensity of her feelings for her boyfriend and their talk about getting married brought her to a deeper level, which she had been unaware of before.

Symbolically, for the sake of simplicity, we can think of the unconscious mind as if it had different layers.  Very often, when we work through an emotional problem, like a big loss, we work through it as best as we can at that time given our emotional development, life experience, and whatever is going on at that time.

Later on, at a different stage in life or with a different life event, like the possibility of getting married, this problem can resurface at a deeper layer, so to speak, of the unconscious mind that we were unaware of before.

In Alice's case, although she grieved for her loss earlier, she was not aware of feeling abandoned at that time.  Those feelings remained unconscious until the affect bridge made her unconscious feelings conscious (see my article: Psychotherapy: Making the Unconscious Conscious).

We started by separating her feelings related to her earlier loss from her current situation (see my article:          Working Through Emotional Trauma: Separating "Then" From "Now" in Therapy).  This helped to ease some of her fears so that she didn't feel the need to keep asking her boyfriend for constant reassurance.

Then, using EMDR therapy, we processed Alice's feelings about feeling abandoned by her father when he died (see my articles:  What is EMDR?How EMDR Works: EMDR and the Brain, and How EMDR Works: Overcoming Emotional Trauma).

Initially, she talked about knowing, logically, that her father loved her and he didn't want to leave her.

As we continued to process her feelings of being abandoned, Alice realized on a deeper emotional level that her feelings "made sense" on an emotional level, especially since she was only 10 when her father died.

The sudden and unexpected nature of her father's death contributed to her feeling abandoned.  She also realized that these feelings of abandonment were on a deeper level of her unconscious mind and they were inaccessible to her during her last therapy.   These feelings didn't surface until this time in her life when she felt emotionally vulnerable with her boyfriend as they talked about making a life commitment to each other.

EMDR therapy enabled Alice to work through her feelings of abandonment so that she was no longer getting triggered in her relationship.

An Emotional Problem You Thought You Resolved Gets Triggered Again Later in Life

Alice still missed her father, especially on her wedding day, but she was no longer vulnerable to fears of abandonment.

Conclusion
As human beings, we are complex emotional creatures.

At different stages of life, old emotional wounds can resurface in new and unexpected ways, even emotional wounds that we thought we had worked through at an earlier time in life.

Often, if we're unaware of what is going on unconsciously, we don't know what is at the root of the problem.

Using experiential types of therapy, like clinical hypnosis, Somatic Experiencing, and EMDR therapy, usually helps to get to deeper, unconscious levels in a shorter period of time than regular talk therapy and also helps to work through the problem at a deeper level (see my article: Experiential therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
If you've been unable to work through your problems on your own, you could benefit from seeing a licensed mental health professional who has expertise in your problem.

I usually recommend that people work with psychotherapists who are trained to work experientially to get to these deeper levels.

Recognize that it's not at all unusual for old emotional wounds to resurface at different stages of your life.  Working through an old emotional wound at a deeper level can help you to feel more emotionally integrated and fulfilled.

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.































Monday, February 22, 2016

Being the Different One in Your Family

In a prior article,  The Role of the Family Scapegoat in Dysfunctional Families, I discussed how the family scapegoat is usually made to feel like s/he is "different" from the rest of the family and the cause of the family's problems, even when s/he isn't really the source of their problems.  In this article, I'm focusing on what it's like to feel "different" in a family.


Being the Different One in Your Family


Examples of Being the "Different One" in a Family:
  • A first generation child, whose parents are originally from a different country, not only feels different, but often feels conflicted because s/he can feel caught between the family's traditions from their country of origin and the culture of the new country.
  • A child, who is gay, in a family that has traditional views of what it means to be a man or a woman, can feel different from other family members and, depending upon the family.
  • A child, who has liberal views and who grows up in a family who conservative traditional views can feel different.
  • A child, who is artistic and who grows up in a family that devalues artistic skills and wants their child to pursue a more mainstream career, can feel devalued and question his or her own views.
  • A child, who grows up in a family where the parents and the siblings all abuse alcohol and drugs and who all dropped out of high school, might feel misunderstood because s/he values education and wants to avoid abusing substances.

These are just a few of many possible examples of how a child can feel and be perceived as different from other family members.  There are many other examples.

Of course, there are families who are open minded and who can accept a child who is different.  This can help the child to feel accepted and loved as well as accepting of his or her own values.

The problem arises when being "different" in the family is perceived as being "less than" the rest of the family.  The parents might feel that the child's differences are a threat to the family and, in that sense, the differences feel dangerous to them.

The following scenario is a fictionalized example of how growing up being the "different one" in a family can be difficult and how this problem can be overcome in therapy.

Mark
Mark grew up in a traditional religious family.  He was the youngest of five children.

When he was a young child, he never questioned his religion.  But when he was in his mid-teens and he socialized with friends and their families from different backgrounds, he became increasingly aware that there were other ways of seeing the world and he began to question whether he believed the basic principles of the family's religion.

When he told his parents and older brothers that he wasn't sure if he believed in these basic principles, they were stunned.  His father became angry and told Mark that the family's religion is what got them through many difficult times going back to Mark's great grandfather's time and probably before. He felt that Mark's questioning was heresy.  He warned Mark that no good would come of it.

Mark couldn't understand why his father was so upset.  But, after he experienced his father's anger, Mark kept his questions to himself.  He continued to observe the family's religious traditions but, inwardly, he continued to wonder how meaningful, if at all, these traditions were to him.

As Mark entered college, he was encouraged by his parents to take business courses so that he could become an accountant or a business manager.

During his first two years of college, Mark's college required him to take certain core courses where he was exposed to many different subjects and new ideas.

By the time he was a college Sophomore, he was very drawn to art history.  But when he told his parents that he wanted to be an art history major instead of a business major, they were even more upset than when he told them that he was questioning their religion.

His parents talked to him about how financially difficult it had been for both the mother's and the father's families and for them before Mark was born.  They stressed the importance of choosing a major that would be "practical."  They didn't want Mark to struggle financially the way they did or the way their parents did.  They urged him to major in business because, as a business major, he could find a job, whereas as an art history major, he might end up jobless.

Mark considered what his parents told him.  He was aware that his older brothers followed their parents'  suggestions and each of them was doing well financially.  They had secure jobs, and they seemed happy with their choices.

But Mark was becoming increasingly aware that he wouldn't be happy as a business major.  He understood his parents' concerns and their practical advice, so he felt torn.

He was also more and more aware of how different he was from his parents and brothers.  He loved them very much, but he knew he needed to find his own way, which was probably going to be different from the rest of his family.

He also felt that his parents were still traumatized by their experiences of going through difficult financial times.  Even though they overcame their earlier financial difficulties, he knew that, on an emotional level, they never got over their fear and sense of vulnerability.  It was as if they were living in the past.  He knew they couldn't see that he had opportunities now that they never had.

Feeling more and more conflicted and confused between what he wanted and his loyalty to his family, he decided to start therapy.  This was difficult for him because, on a certain level, he felt he was being disloyal to his family by going to therapy (see my article:  When Family Loyalty Gets in the Way of Your Psychotherapy Sessions).  

He didn't tell his family about his therapy because he was sure they wouldn't understand.  He knew that they would think that he shouldn't talk about the family to a stranger, even if the stranger was a licensed mental health professional.

During his therapy, Mark's therapist, who was trained as a hypnotherapist, helped him to have greater access to his unconscious feelings and wishes by using clinical hypnosis.  While he was in a relaxed hypnotic state, his therapist asked him to imagine his future self as he wanted himself to be when he completed college (see my article: Experiencing Your Future Self: The Self You Want to Become).

As Mark became more comfortable with hypnosis, he was able to gradually put aside his conflicts and focus on what he wanted for himself.  As he did this, he felt how deeply he wanted to pursue a career in art history.

Over time, with increasing confidence, Mark became more open to exploring this possibility by seeking out people who were already in the field, including his professor.  With more information from people in the field, Mark realized that he wanted to pursue an art history career, possibly working in an art gallery.

After he graduated with a major in art history, despite his family's disapproval, Mark went on to get a graduate degree in art history.  His degree also included business courses related specifically to the art world so he felt he would be better prepared for the field.

As part of his educational courses, Mark interned at one of the more prestigious art galleries in New York City, and by the time he had his Master's degree, the gallery owner hired him full time.

Although his fear was that he would alienate his family, he came to realize that his family still loved him, even if they didn't understand why he wanted to pursue a career that was so different from what they wanted for him.

Over time, as Mark continued to advance in his career, his parents' and older brothers' disapproval softened and they came to accept that Mark was happy in his field and that's really all that mattered.  Mark also let go of his conflictual feelings about being different and embraced his choice.

Getting Help in Therapy
Being the "different one" in your family can be an emotionally painful and lonely experience if your family members don't understand or accept what you want.

Trying to appease others by sacrificing your core sense of self will only make you unhappy. Although it can be difficult to be an individual who is different from other family members, being true to yourself is the best way to lead a fulfilling life.

If you're struggling with feeling different, rather than struggling on your own, you could benefit from working with a licensed mental health professional who can help you to deal with these emotional struggles, learn to be an individual, and feel more confident (see my article: How to Choose a Psychotherapist).

About Me:
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex 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.
































Monday, February 8, 2016

Overcoming Anticipatory Anxiety

In a prior article, How to Stop Worrying, I addressed a concern that many chronic worriers have.  In this article, I'm addressing a specific type of worrying, which is called anticipatory anxiety.


Overcoming Anticipatory Anxiety

Many people struggle with anticipatory anxiety, which is worrying about something in advance of it occurring.

The thing that you're worried about is something that may or may not occur at some point in the future.

Anticipatory anxiety isn't an anxiety disorder.  It's part of different types of anxiety disorders, including generalized anxiety, panic attacks, posttraumatic stress disorder (PTSD) and other forms of anxiety.

What Are the Symptoms of Anticipatory Anxiety?
Symptoms can include:
  • excessive worrying
  • insomnia
  • muscle aches
  • nausea
  • headaches
  • hyperventilation
  • feelings of dread
  • overeating
  • gastrointestinal problems
  • panic attacks
When, Why and How Does Anticipatory Anxiety Occur?
Anticipatory anxiety can occur at any time and for many people it's a chronic condition.

Anticipatory anxiety can include worrying in advance of anything being wrong about money, job loss, problems in a relationship or any other event or situation that hasn't occurred yet.

The fact that it hasn't occurred yet is key--it is the anticipation that something bad will happen.  It's not necessarily based on anything objective that is going on now.

Anticipatory anxiety can occur based on your past, including early childhood experiences.

For instance, if you grew up in a home that was chaotic where your parents were constantly worried about real and imagined problems, you can grow up feeling that the world isn't a safe place and, generally, anything that can go wrong will go wrong in your life as an adult.  This can develop into generalized anxiety disorder.

Many people who suffer with anticipatory anxiety are unaware that they have become accustomed to this habitual way of worrying.  Their habit of worrying has become automatic.

If you had significant trauma that has resulted in your developing posttraumatic stress disorder (PTSD), you might respond to many events or situations in your life as if they will result in catastrophe (see my article:  Are You Catastrophizing?)

There is no differentiation between traumatic events and normal non-traumatic life events.

How to Overcome Anticipatory Anxiety?
Here are some tips that might be helpful to you:
  • Rather than allowing your thoughts to run away with you, make a conscious effort to step back from worrying and question whether the things you're worrying about are likely to happen.
  • Ask yourself if you're okay now (as opposed to your worries about the future).
  • Think about all the other times when you worried about something and things turned out well.
  • Distract yourself from your worries by focusing on something else.
  • Talk to a friend or loved one to get a better perspective.
Getting Help in Therapy
The tips outlined above work for some people.

Many other people, who try to deal with their anticipatory anxiety on their own find that they need the help of a professional mental health professional, especially if their problems are longstanding and ingrained.

A licensed psychotherapist can help you to get to the root of the problem that causes you to have anticipatory anxiety.

Rather than suffering on your own, with the help of a licensed therapist, you can overcome this problem so you can lead a more fulfilling life.

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





















Monday, February 1, 2016

Redefining Happiness and Success For Yourself

Developing your own definition of happiness and success for yourself is part of an important personal growth and development process.

Redefining Happiness and Success For Yourself

Throughout the different stages of your life, you could find yourself redefining what happiness and success means to  you as you grow and change.

It's not unusual for people to change what they want, especially as they approach midlife and reevaluate their lives (see my articles:  Midlife Transitions: Reassessing Your Life and Midlife Transitions: Living the Life You Want).

Sometimes, what seemed important at an earlier stage in your life becomes less important later on in life.

Maturity, life experience, losses, aging, surviving a serious illness and other important experiences can contribute to your need to reevaluate your life and what makes you happy.

The following brief fictionalized scenarios are examples of how people change their minds about what's important to them:

Larry:
Larry came from a long line of doctors in his family.  His great grandfather, grandfather, father and older brother were all doctors.  So, from an early age, his family urged him to follow in his family's footsteps to become a doctor.

Redefining Happiness Success For Yourself

Although Larry was interested in painting, his father urged him to forget about his artwork and concentrate on science and math.

Fifteen years after Larry graduated from medical school, he was a successful cardiologist at a prestigious hospital, but he was deeply unhappy.  Although he cared about his patients, he was disenchanted with all the changes in the health field and he longed to get back to painting.

Burnt out and at his wit's end, he began therapy to explore what he wanted to do with the rest of his life.  Gradually, over time, Larry realized that he allowed his family to dictate what it meant to be successful and happy because he didn't want to disappoint them.  And, although he was good at taking care of his patients, he wasn't nurturing himself.  So, he decided to cut back on his hours to give himself time to paint.

Once he began painting, he felt more emotionally integrated and approached his work as a cardiologist with a new sense of purpose and devotion.  He also began to think about spending more time painting when he retired.

Mary
Mary spent most of her adult life in banking.  She started as a teller and worked her way up to a position as a managing director.  Although the work was financially rewarding, Mary felt that something was missing in her life.  She was two years away from retirement and she found herself daydreaming about running a bed and breakfast in the country.

Initially, she pushed these thoughts out of her head because they seemed so far fetched to her.  But, over time, as this daydream continued to occupy her thoughts, she realized that she needed to pay attention to them.

Redefining Happiness and Success For Yourself
When she approached her husband about it, he was surprised at first because Mary had never mentioned this to him before.  But the idea of moving out of the city, living in the country and running a small bed and breakfast began to appeal to him.  Their children were already grown and on their own.  With their retirement savings, they could afford to do it.

The main challenge for Mary was that, since she was in her early 20s, she had defined herself, to a large extent, based on her career in banking.  She was also very successful in her field and she derived satisfaction from being recognized as successful.  Retiring from banking and running a bed and breakfast would be a big change.

As she discussed her daydreams with her therapist, she began to feel more comfortable with the idea of making plans for this major change.

Martin
Martin spent his 20s working as a flight attendant.  Although he loved the travel benefits, he found the work uninspiring.

After a close friend died suddenly from a brain aneurysm, Martin began to reevaluate his life.  He realized that life is short and he wanted to do something that had meaning for him.   But he didn't know what he wanted to do.

Feeling lost and confused, he began therapy to explore these questions.  As he opened up to his internal experience in therapy, he realized that he wanted to help others.  Exploring many options by talking to people in various medical and social service settings, he decided to become a social worker.

Redefining Success For Yourself

Although giving up the travel benefits was hard, as Martin began his first internship in the social services field, he knew that he had made the right choice.  Working with children and seeing the difference that he made in their lives was the most fulfilling experience of his life.

Conclusion
These fictionalized scenarios are just a few examples of how people grapple with a need for change and a process of redefining what is meaningful to them.

These types of changes are often preceded with ambivalence and anxiety.  In many circumstances, it can feel like you're stepping into the unknown, which is why people going through this process often find it helpful to work with an experienced mental health professional who can help them to understand and work through the underlying issues, including deep underlying fears, that might be holding them back.

Getting Help in Therapy
Asking for help isn't always easy.  Anticipating change can also be anxiety provoking.

If you're struggling with your own definition of what it means for you to be successful and happy or you identify with one of the fictionalized scenarios above, you could benefit from seeking help from a licensed mental health professional.

Working with a licensed psychotherapist, you can explore your own anxiety and ambivalence about what it means to be successful and happy, and overcome the underlying issues that might be getting in your way.

Seeing a licensed psychotherapist to help you to discover what makes you happy can help you to lead a more fulfilling life.

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

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

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