Mutual Enactments Between the Client and the Psychotherapist in Psychotherapy

In a prior article, Why Your Psychotherapist Can't Be Your Friend, I began a discussion about the roles of the psychotherapist and client in therapy, which included the concept of mutual enactments in therapy.  In this article, I will delve deeper into the concept of mutual enactments with a clinical vignette that illustrates these concepts.

Mutual Enactments Between the Client and the Psychotherapist

Before I go any further, I think it would be helpful to have a definition of "enactments" in the therapy setting.

Although there are various definitions for enactments, depending upon whether psychotherapists are Classical or contemporary Relational psychotherapists, I prefer the definition given by Fonya Lord Helm in a chapter, "Enactments Leading to Insight for Patient, Therapist and Supervisor" in Enactment: Toward a New Approach to the Therapeutic Relationship edited by Steven J. Ellman and Michael Moskowitz, which is:

"An enactment is any action occurring during the psychotherapy or psychoanalysis that repeats an earlier similar experience or fantasy and communicates feeling...by nonverbal means in a way that will draw the therapist or analyst into a nonverbal communication" (p. 157).

In the past, the term "acting out" was used instead of "enactments," and this usually referred to the client's impulsive and improper behavior.  Although the emphasis was on the client's acting out behavior, it's also generally understood that psychotherapists can act out as well.

The term "acting out" is used less these days because of its pejorative connotation and also because the behavior is viewed from the psychotherapist's perspective in the type of hierarchical therapy where the therapist is seen as being "neutral" and "abstinent" as opposed to a more contemporary relational view of mutuality between therapist and client.

The contemporary view of enactments is that they are generally unconscious on the part of both the psychotherapist and the client.

In the past, enactments were seen solely as "mistakes" in therapy.  Now enactments are viewed most by therapists as an unavoidable part of therapy.

Whereas the ideal is to strive for no (or few) enactments, from a practical and therapeutic perspective, the reality is that there will be enactments, whether they are big or small and, once they occur, the therapist can discuss these enactments to further the work.

Although the focus in this article is on enactments between psychotherapists and clients, it's important to understand that enactments occur in everyday relationships, including romantic relationships, familial relationships, friendships and work relationships.

At this point, in addition to the vignette I provided in the last article, the following vignette will shed light on this dynamic between therapists and clients.

Fictional Vignette:  Mutual Enactments Between the Client and the Psychotherapist in Psychotherapy:

Liz
Liz, who was in her mid-30s, started therapy because she had longstanding problems in romantic relationships.

Although she had no problems meeting men, her problems began once the relationship became serious because she had difficulty trusting men in intimate relationships.

Her lack of trust in these relationships would manifest in her insecurity and jealousy with Liz imagining that her boyfriend at the time was cheating on her--even when she had no objective reason to think this.

When Liz began to feel jealous and insecure, she had difficulty separating her feelings from facts (see my articles:  Overcoming the Insecurity and Jealousy That's Ruining Your Relationship and Discovering That Your Feelings Aren't Facts).

Instead of observing and exploring her feelings with her boyfriend, she behaved as if her feelings were true and accused him of cheating.  She was so caught up in her emotions that she had no awareness that she was projecting her feelings onto the situation.  As far as she was concerned, when she felt her boyfriend was cheating, it must be true.

The pattern was that she would feel overwhelmed with jealousy and insecurity, accuse her boyfriend of cheating, he would be genuinely shocked and then he would try to defend himself against these accusations.

But no amount of denial or proof would dissuade Liz of her convictions that her boyfriend was unfaithful to her.

The more her boyfriend denied cheating and showed her proof, for instance, that he was with male friends at a basketball game, the more convinced Liz was that her boyfriend was lying.  And if her boyfriend refused to respond to her accusations, she also saw that as proof that he was guilty of infidelity.  So, there was no way to resolve this problem.

This is an example of an enactment in an intimate relationship.  It has many of the same qualities as enactments in therapy, which I'll discuss later.

As would be expected, this dynamic tended to erode the positive aspects of the relationship and would soon doom the relationship.  Her then-boyfriend would accuse her of being jealous and controlling, and she was convinced that he was trying to turn the tables on her when he was really the guilty one.

After each relationship was over, Liz had some insight into the fact that her accusations were irrational and she would have regrets.  But, by that time, the situation had gotten so bad that her ex-boyfriend no longer wanted to hear from her--let alone resume the relationship.

Every time Liz began to a new relationship, she vowed to herself that she wouldn't ruin it by making baseless accusations of infidelity.  But when she became jealous and insecure, the feelings were so powerful that she would lose all perspective.

These unconscious feelings overpowered her.   Once these feelings dominated her, she believed them to be true until she was out of the relationship.

When she discussed these dynamics with her therapist, she expressed sincere regret for the heartache that she caused in her boyfriends and herself and a strong desire to stop this behavior.

Mutual Enactments Between the Client and Psychotherapist

Her therapist sensed that Liz's regret as well as her sorrow for destroying her relationships. Her therapist was aware that, since this dynamic was unconscious at the time when it occurred, Liz was unable to control it.  She was also aware that Liz lacked the objectivity as well as the verbal skills to address this in her relationship when she was overwhelmed by these feelings.

Her therapist recognized Liz's behavior in her relationships as being enactments.  She also knew that there would probably be enactments in the therapy, and she would need to try to be aware of as they occurred.

Since Liz had been in therapy before, Liz knew that her family history, which was chaotic and dysfunctional, contributed to her inability to sustain romantic relationships.  But knowing this did nothing for her in terms of her enactments in her relationships (see my article: Intellectual Insight Isn't Enough to Change Problems).

From Liz's perspective, her prior experiences with therapy were disappointing.  The pattern was that the therapy would go well at the beginning, and then Liz would realize that she didn't trust the therapist.

Since she was unable to communicate her feelings of mistrust directly to her prior therapists in the past, she aborted therapy without discussing it, and she didn't respond to their outreach calls or letters (see my article: When a Client Leaves Therapy Prematurely).  These abrupt endings to her therapy were also enactments on her part.

After hearing about her previous history in therapy, Liz's therapist was aware that Liz might end this therapy abruptly too if she developed negative feelings towards her (also known as the negative transference).

Her therapist also wondered how much the prior therapists contributed to these enactments because of their own frustration and negative feelings about these dynamics.  She was aware that she would need to be vigilant about her own feelings about their therapy (known as countertransference) to minimize her own unconscious contribution to mutual enactments.

During the first few months, therapy went well.  Liz showed up on time for all her therapy appointments, she was compliant with paying her fee on time, she reflected on their sessions between sessions, and she discussed her reflections at subsequent sessions.

Her therapist enjoyed working with Liz and looked forward to their sessions.  Liz was intelligent and articulate about the issues they discussed, and she even kept a journal between sessions to write down her thoughts (see my articles: The Benefits of Journal Writing Between Therapy Sessions and Journal Writing Helps Relieve Stress and Anxiety).

But a month before her therapist was due to go on vacation for two weeks and she mentioned that she would be away, her therapist noticed an abrupt change in Liz's demeanor.  Whereas normally, Liz was relaxed in session, immediately after her therapist told her about the break, Liz looked tense and suspicious.

Her therapist mentioned her vacation in a month's time at the beginning of the session because she wanted to allow time for them to discuss any feelings that Liz might have about the break.

Her therapist could see from the abrupt change in Liz's demeanor that Liz had a negative reaction to the upcoming break, but Liz refused to talk about it when her therapist asked her about it.

From her silence and refusal to talk, her therapist was aware that she was witnessing an enactment on Liz's part, and she hoped not to get caught in a mutual enactment.

Based on Liz's history of relational problems, her therapist knew that Liz's reaction was probably unconscious on her part and Liz lacked the necessary insight and communication skills to talk about her feelings rather than enacting them in her sullen, uncommunicative behavior.  She knew it would be useless to explain this to Liz at the moment because Liz wasn't receptive to hearing an explanation.

Her therapist was aware that she was on the horns of a dilemma:  Liz was unconsciously trying to control her in the session by not talking and trying to make her feel guilty about leaving Liz (similar to how Liz tried to control her relationships with her former boyfriends).

Her therapist was also aware that, similar to Liz's dynamics with her former boyfriends, if the therapist attempted to encourage Liz to discuss her feelings, Liz would resent her and view her with increased suspicions.  But if she remained silent, Liz would feel that was too emotionally depriving and interpret that to mean that her therapist didn't care.

Ether way, her therapist would be engaging in a mutual enactment so she would have to decide quickly in the moment which course of action would be least disruptive to the therapy and might result in furthering the work.

Her therapist decided to share her dilemma with Liz, "I can see that you have feelings about the upcoming break in our therapy sessions.  I'd like us to be able to talk about that, but just now when I encouraged you to talk, you've remained silent.  I feel myself on the horns of dilemma.  Just like the dynamics in your romantic relationships, on the one hand, if I encourage you to talk, you see that as further proof that I'm doing something wrong and I don't care about you. But if I remain silent, you see that as proof that your feelings aren't important to me and I don't care about you.  Either way, you think I don't care.  Can you see my dilemma?"

Listening to her therapist express her dilemma softened Liz a bit.  She seemed to relax a little, and she nodded her head as if she understood what her therapist meant.

In the past, her therapist had spoken to Liz about what happened to her when she became jealous of her boyfriends as her being caught in a "vortex" of overwhelming emotions.

This idea of being stuck in a vortex came to Liz's mind now, and she told her therapist that she wasn't sure what she was feeling, but she felt as if her emotions were overpowering her.

Recognizing her new ability to even verbalize that she was overwhelmed and caught up by powerful emotions in the here and now represented significant progress for Liz.

Her therapist asked Liz to describe the vortex to her and she said she hoped to be able to help Liz to step out of the vortex.

Liz described feeling like she was in a whirlwind of powerful emotions that threatened to overtake her.  She said it was like being in the middle of a storm and she described those feelings.

Her therapist pointed out that Liz's ability to describe this whirlwind meant that Liz wasn't completely caught up in it--part of her was somewhat objective and could step out of the storm, even if it was momentarily, to observe herself in the storm.

Liz gave a barely perceptible nod to indicate that she agreed that she sensed a shift in her--something she had never experienced in the past.  She was able to say that, she wasn't sure why, but she felt unhappy about her therapist's announcement that they would be taking a break for two weeks when her therapist went on vacation.

Although Liz was unhappy about the upcoming break, she was pleased that she had achieved some objectivity about herself and her feelings by being able to observe herself, and she attributed this to their work together so far and her therapist telling her about the dilemma.

In the sessions that followed, Liz and her therapist continued to deal with Liz's unhappiness about the upcoming break and how abandoned she would feel (see my article: Coping With Trauma: Becoming Aware of Your Emotional Triggers and Old Abandonment Issues Can Get Triggered When Your Psychotherapist is Away).

Gradually, Liz made tentative connections between her feelings about the upcoming break and her distrust of her parents, especially her father, whom she described as a "philanderer" and "a rolling stone" who often disappeared from the household for months at a time (see my article:  Reacting to the Present Based on Your Traumatic Experience of the Past, Understanding Why You're Affected By Trauma From a Long Time Ago and Overcoming Trauma: When the Past is in the Present).

Liz also made connections between her feelings of abandonment with her boyfriends when she felt jealous and her feelings of abandonment with her father.

With the help of her therapist, she realized that in the past, on an unconscious level, she sabotaged her relationships because she feared being abandoned, and she would rather end the relationship herself than endure the pain of being left (see my articles: Fear of Abandonment: Leaving Your Relationship Because You're Afraid of Being Abandoned and Fear of Abandonment Can Occur Even in a Stable Relationship).

This realization led to Liz's recognition that, on an unconscious level, she behaved similarly with her therapists.  Her fear of being abandoned by her therapists resulted in mistrust and caused her to leave therapy abruptly.

Liz and her current therapist talked about the possibility that Liz might be tempted to leave this therapy, in much the same way that she left her prior therapies, when her therapist went on vacation.

In the past, Liz had never contemplated this possibility prior to leaving therapy.  Instead of talking about her fear of being abandoned by her therapists in the past, she enacted her fear instead by leaving.  Unconsciously, her fear caused her to leave them before they left her.

Liz told her therapist that she didn't want to leave this therapy, but she had a fear that her therapist might not come back.  She knew this fear was irrational, and she discussed this with her therapist, but the feelings were so strong, she didn't know how to keep them from overwhelming her.

Her therapist taught Liz some self soothing techniques to help her to take care of herself (see my article: Self Soothing Techniques to Use When You're Feeling Distressed).

She also encouraged Liz to continue to write in her journal between sessions to have a way to discharge some of these emotions.

In addition, prior to going on vacation for two weeks, her therapist gave Liz the name of a therapist who would be covering her cases in case Liz needed to talk during their two week break.  Then, they confirmed their next appointment in two weeks.

During the two week break, Liz struggled with her fears of abandonment.  She knew that the intensity of these feelings were triggered by her earlier experiences of being abandoned again and again by her father when he went to live with other women for months at a time.

But, even though she recognized the origin of her feelings, she still felt overwhelmed.  She thought about calling the therapist who was on-call while her therapist was away, but she didn't feel comfortable doing this.

Each day Liz's feelings about abandonment got stronger, and she wrote about her feelings in her journal.  She hoped the days would go quickly so she could talk to her therapist about these feelings when her therapist returned.

But on the day when Liz was supposed to return to therapy, she "forgot" to go to her session.  The day came and went without Liz realizing that she missed her appointment.

When Liz came in for her next therapy session, she and her therapist discussed why Liz missed her appointment, which was another enactment.

Liz recognized that she had unconsciously forgot her appointment because she was angry that her therapist was aware and she felt abandoned.

Being able to talk more comfortably about her feelings was further progress for Liz in therapy.

Mutual Enactments Between the Client and Psychotherapist

At that point, her therapist recommended that they begin work on the trauma that was being triggered in Liz's relationships and in her therapies, which was her family history, especially her history of being abandoned over and over by her father (see my articles: Healing Old Emotional Childhood Wounds That Are Affecting Current Relationships ).

Liz agreed that it was time that she dealt with the source of her problems.

Conclusion
In the clinical vignette above, both the psychotherapist and client engaged in mutual enactments in the therapy.

Even when the therapist anticipated that there would be enactments, based on Liz's history, she found herself in a dilemma in the therapy where an enactment would be inevitable, and shared her dilemma with the client.

When the therapist shared her dilemma with the client, the therapist attempted to make the unconscious conscious for Liz by putting the dilemma into words rather than just behavior.

Even though Liz wasn't able to discuss the dynamic at that point, she began to become aware of her feelings and how they affected her therapist and the therapy.  This was a major shift for Liz, who had never recognized these dynamics before.

Recognizing a mutual enactment won't necessarily prevent future mutual enactments, as illustrated in the above vignette.

The therapist was aware of the possibility that there would be probably be an enactment on Liz's part after the therapist came back from vacation.

Due of their professional training and their own psychoanalysis, most therapists are more aware of mutual enactments prior to their client's awareness.  But, being human, psychotherapist also engage in enactments from time to time, as illustrated in the vignette.

Many psychotherapists agree that it's not a matter of if they and their clients will occasionally get caught up in enactments--it's more a matter of when.

What's most important is how therapists use these enactments, after they have occurred, to shed light on the unconscious processes that are going on between the therapist and the client. The therapist can then use this new awareness to further the therapeutic work and help the client to make breakthroughs.

Getting Help in Therapy
Mutual enactments are common in relationships of all kinds.

When mutual enactments occur in personal relationships, the people in the relationship often don't have the wherewithal to make these unconscious dynamics conscious, so they continue to engage in enactments which can be damaging to the relationships.

When enactments occur in psychotherapy, they are usually related to the client's earlier personal history.

The behavior related to the enactment will continue to repeat itself until the therapist helps the client to become aware of the enactments and they work on the underlying issues instead of enacting them unconsciously.

If you realize that you continue to engage in destructive patterns in your relationships, you might be enacting unconscious behavior from the past.

Rather than continuing to behave in an unconscious way that has a negative impact on your relationships as well as your sense of self, you could benefit from working with a psychotherapist who is skilled in identifying and working through enactments, including mutual enactments (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individuals and couples (see my article: The Benefits of Integrative Psychotherapy).

I have helped many clients to learn to recognize unconscious feelings so they can discuss them and work through them in therapy rather than enacting them.

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.

Why Your Psychotherapist Can't Be Your Friend

Many clients who are new to psychotherapy don't understand why they can't have a personal relationship with their psychotherapist.  To clarify this issue, my goal in this article is to address why psychotherapists can't be friends with their clients.

See my articles: 

Psychotherapy and the Erotic Transference: Falling "In Love" With Your Therapist

Boundary Violations and Sexual Exploitation in Psychotherapy

Psychotherapy and the Positive Transference). 

Your Therapist Can't Be Your Friend

Psychotherapists have a code of ethics that they must follow.  One of the items in the code of ethics is that therapists and clients can't become friends outside of the therapy sessions.  The purpose of this stipulation is to protect the client from boundary violations and to protect the therapeutic work that the therapist and client are engaged in.

While it's understandable that clients might have a desire to become friends with their therapist, it's up to the therapist to explore this desire, try to understand how it's connected to the client's problems and history, help the client work through this issue, and maintain a professional boundary.

There are times when psychotherapists get caught up in enactments with their clients.  Enactments are usually unconscious on the part of the client and the therapist and often related to prior personal history that gets played out in the therapy.

Mutual enactments are common and exploration and resolution of these enactments can deepen and enhance the work.

The following fictional vignette is about a case where these issues come up in therapy:

Fictional Vignette: Why Your Psychotherapist Can't Be Your Friend and Understanding Mutual Enactments in Therapy

Jane
Jane moved to New York City to start a new job after she completed graduate school.  Although she loved her new job and New York, she felt very lonely on weekends because she didn't know anyone other than her coworkers and they were all married and led busy lives.

She tried various social groups and participated in local events, but she had no luck in forming friendships among the people that she met.  This reinforced a longstanding feeling that she had about herself that she wasn't lovable or good enough for people to want to care about her.

After several months of feeling increasingly lonely, Jane began therapy at a psychotherapy center where they offered sliding scale fees.

After her intake, Jane was assigned to a new woman therapist who was part of the center's training institute, and Jane began attending therapy twice a week.

Jane liked her therapist, Susan, from their first session, which was unusual for Jane.  Usually, she felt shy and awkward when she met someone new, but Susan had a way of helping Jane to be at ease.

Jane looked forward to her therapy sessions on Mondays and Wednesdays.  She liked talking to Susan and felt better afterwards.  But between sessions, Jane still felt lonely.

A few months later, a friend from graduate school, Dee, moved to New York and reconnected with Jane.

Jane and Dee were friends in graduate school and they usually enjoyed each other's company, but now whenever they got together, Jane found her mind wandering back to Susan.  She noticed that she was comparing Dee to Susan and Dee would always fall short.

As time went on and Jane continued to compare Dee unfavorably to Susan in her mind, she spoke to Susan about it in one of their therapy sessions.

Susan was already aware from the way Jane complimented her and how much Jane said she enjoyed their sessions that Jane was idealizing her.  So, she wasn't surprised when Jane told her that she was comparing Dee unfavorably to Susan.

Jane told Susan that she would really like it if they could be friends outside the therapy sessions.  She told Susan that, after all, they were close in age and she suspected that they probably had a lot in common.

Susan listened attentively and then normalized Jane's wish.  She told her that many clients feel this way about their therapists and this was part of an idealizing transference.  She also explained why it was important that they maintain their therapeutic relationship, as opposed to a personal relationship, in order not to cross boundaries and sacrifice their work together. On some level, Jane knew that she and Susan couldn't be friends, but she felt hurt and rejected when she heard Susan tell her this.  She told Susan that she didn't think their therapeutic work would be compromised in any way and, in fact, she thought the work might be enhanced if they became friends.

As Jane and Susan continued to explore these issues, Susan talked to her training supervisor about this issue.  Susan was clear that she wasn't going to violate an ethical boundary, but she felt herself defensively pulling away emotionally from Jane, and she was afraid that this would ruin their work together.

Susan and her training supervisor talked about how Susan could remain balanced in her approach with Jane--neither too friendly nor too distant--to maintain a therapeutic rapport with Jane.

During this time, Jane missed a therapy session.  She was aware that the psychotherapy center's policy was to give at least 48 hours notice (unless there was an emergency) and that she would be responsible for the fee if she gave less than 48 hours notice.  But she left a message for Susan an hour before their appointed session time saying that she wasn't feeling up to going to their session that day.

When Jane returned to her next session, Susan asked Jane about the missed session, and Jane responded that she just didn't feel like coming to therapy that day.  She offered no other explanation.

When Susan reminded her about the center's policy about broken appointments, Jane told her that she didn't feel she should be charged for the appointment because she had come to all her other appointments and this was the first appointment that she missed.

Susan sensed that something had gone awry between Jane and her and that it was probably related to their talk about why she and Jane couldn't be friends.

But when she tried to explore this with Jane, Jane said that her missed session had nothing to do with their discussion and she would rather that they "move on" and talk about more important things than continue to talk about her missed session.

Susan knew that Jane's idealizing transference wouldn't last forever and that an idealizing transference often changes to a negative transference since no therapist could live up to the idealization and remain on a pedestal indefinitely.  But she was surprised that this change happened so quickly.

Susan was also concerned that if there was a negative transference that it would interfere with the work, which she wanted to avoid.

As a new therapist and without the benefit of being able to speak with her supervisor beforehand, Susan told Jane that she would overlook the broken appointment fee this time, but if Jane had another broken appointment, she would have to pay the fee.

When Jane left another message the following week indicating that she wasn't coming to their appointment on the same day as the appointment, Susan spoke with her supervisor about it.

During their supervisory session, Susan and her supervisor talked about "enactments" between clients and therapists.  She explained to Susan that, like many therapists, Susan got caught up in an enactment with Jane when she agreed not to charge her for the missed appointment despite the fact that Jane was well aware of the center's policy and had signed an agreement about broken appointments.

Susan's supervisor told Susan that it appeared that Jane wanted to feel "special" in Susan's eyes and if she couldn't be friends with Susan, she might have unconsciously created this situation where she could feel that she was a special client to Susan where Susan would break the rules for her.

The supervisor encouraged Susan to address and explore this issue with Jane and to explain Susan's role in getting caught up in this enactment.  She also told Susan that, based on the center's policy, Susan would have to collect the fees from Jane.

Jane felt embarrassed about her role in the enactment, but she also understood that she was a new therapist, she was still learning, and that even experienced psychotherapists unconsciously get caught up in mutual enactments with therapy clients.

When Jane returned for her next session, she didn't offer a reason for the last cancellation, so Susan brought up the issue and suggested they talk about it.

Initially, Jane was defensive and told Susan that she didn't want to waste her time talking about this when she had other more important things to talk about it, "And, anyway, isn't it my session to talk about anything that I want to talk about?"

Susan explained why they needed to talk about the cancellations and the unpaid fees.  She started by acknowledging that, as a new therapist who wanted their work to go smoothly, she made a mistake allowing Jane to break the rules.

When Jane heard Susan admit to making a mistake, she softened somewhat.  She still liked Susan and she was concerned that she might have gotten Susan "in trouble" with the center (see my article: Ruptures and Repairs in Psychotherapy).

Susan explained that she wasn't in trouble with the center, but she needed to address the mutual enactment that occurred between them so they could understand the meaning of it.

Reluctantly, Jane admitted that she felt hurt and angry when Susan told her that they couldn't be friends, even though Jane was already aware of the rules.  She also admitted that she could have come in for her therapy sessions, but she was annoyed and decided to skip those sessions.

This discussion led to Jane talking about how she always wanted to feel special with her mother, but she was aware that her younger sister was her mother's favorite, which left Jane feeling that she wasn't good enough or lovable enough to be her mother's favorite.

This lead to their talking about why Jane wanted to feel special to Susan.

Although, as a new therapist, Susan initially feared that what started as a negative transference would lead to the demise of the therapy, she now saw that discussing it was key to getting Jane to open up and get to more core issues.

Jane agreed to pay for the missed sessions, and they continued to work on the core issues of her feelings of being unlovable and not good enough (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

Conclusion
The therapeutic relationship is a unique relationship unlike any other because it's focused on you.

It's common for clients to wish to have a personal relationship with their therapist--either a romantic/sexual relationship or a friendship.

It's the therapist's job to recognize these transferential issues, address them in therapy, and maintain a professional boundary.

It's not unusual for clients' transferential experience to change from an idealized transference to a negative transference, especially since no therapist remains on a pedestal indefinitely.

Addressing transference issues and mutual enactments, if handled well by the therapist, can enhance the therapy by helping the client to address the core underlying issues.

Getting Help in Therapy
If you're feeling stuck in your life, you could benefit from working with a skilled psychotherapist who can help you to overcome your problems (see my article: The Benefits of Psychotherapy).

There are also times when you and your therapist can get stuck in mutual enactments, including boundary violations, when you could benefit from a consultation with another therapist.

Rather than struggling on your own, you could work through your problems with an experienced therapist who has the skills and knowledge to help you overcome your obstacles (see my article: Choosing a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist with over 20 years of experience who works with individual adults and couples.

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

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

The Mind-Body Connection in Psychotherapy: Looking Beyond the "Happy Talk"

While I believe in positive psychology and optimism, over the years, I've seen too many psychotherapy clients who use positivity as a defense mechanism.  In other words, they only focus on the positive aspects of their life and avoid dealing with serious emotional problems  (see my article: Are You Using Your Idea of "Positive Thinking" to Deny Your Problems?).

The Mind-Body Connection: Looking Beyond the "Happy Talk" to Underlying Emotional Issues

When people only focus on the positive aspects of their life, not only do they avoid thinking about their problems, they also avoid taking action to try to change their problems.

There's often a fear of dealing with unpleasant aspects of their life, so they'll say that everything is "fine" and everything about their childhood was "great."

In the meantime, it takes so much psychic energy to maintain this defensive attitude that it often leaves people feeling mentally and physically exhausted.  And underneath it all, they feel miserable, but they just can't admit it to themselves or, initially, to their therapists.

The people who avoid their problems aren't delusional--they're in denial--and their unresolved problems manifest in other ways: insomnia, headaches, backaches, muscle spasms, excessive drinking, drug abuse, compulsive gambling, and so on.

They're often so busy "looking on the bright side" that they don't want to see other areas of their life that are falling apart.

Aside from avoidance and denial, part of the problem is our culture's infatuation with positive thinking.  For more than 50 years, we've had dozens of books on "how to be happy" and "choosing happiness" that many people develop unrealistic ideas of how their life should be.  They think they're supposed to be happy all the time and if they're not, something must be wrong with them.

Fictional Vignette:  The Mind-Body Connection: Looking Beyond the "Happy Talk"

Edna
Edna came to therapy because she was having problems sleeping.

The Mind-Body Connection: Avoiding Problems Can Cause Insomnia and Other Physical Problems

She told her therapist that she wanted to learn mindfulness meditation so she could de-stress at the end of the day, and she chose her therapist because she had an expertise in mindfulness and the mind-body connection.

One of the first things that her therapist noticed during the initial psychotherapy consultation was that Edna was stiff.  She sat rigidly at the edge of the couch with her hands tightly clasped, eyes wide open, and a rigid, tight smile on her face.  She was also clinching her jaw.

When her therapist asked her about her family history, Edna brushed this off saying that she had a "great" childhood and she didn't see any reason to dwell on her family history.

When the therapist told her that they didn't have to dwell on her family history, but it's customary to get basic information about the family, Edna reluctantly agreed to talk briefly about her family.  Then, she seemed to flounder for a few minutes, finally asking, "What do you want to know?"

Her therapist told her that she would like to know about her relationships with her parents and her siblings, how they got along, if there were any significant events when she was growing up that impacted her, and so on.

Edna thought for a moment, and then she said that she got along well with her parents while they were both alive, and she also got along with her older brother.  Her father died when she was nine "...but I got over that," and her mother and brother were still alive.

When her therapist asked her how she got over her father's death, Edna told her that she, her mother and brother "just put it behind us and we went on with our lives."

Although Edna continued to smile, her eyes were welling up with tears and she was grasping tightly to the sides of the chair.

Since this was the initial consultation, her therapist noted Edna's reaction to herself, but she didn't press her about it.

Edna went on to say that she has had a "very happy life" and it would be "perfect" if only she could overcome her problems with insomnia.  This is why she wanted to learn mindfulness meditation in therapy because she tried it on her own and she couldn't focus.

During the next few sessions, her therapist guided Edna through mindfulness meditation, but Edna continued to have problems focusing.  She also got headaches, neck pain, and backaches during the meditation and she got spasms in her right arm.

The Mind-Body Connection: Looking  Beyond the "Happy Talk" 

Edna told her therapist that she would frequently have these physical problems and her doctor told her that there was nothing medically wrong with her.  He suspected that these physical problems were psychological and possibly related to stress.  But Edna discounted this and told her doctor that her life was "wonderful" and she wasn't under any particular stress, nor did she have any psychological problems.

Her therapist asked Edna if she would be willing to try a hypnotherapy technique called the Affect Bridge where clients sense into their physical and emotional reactions to see what comes up (see my article: The Body Offers a Window Into the Unconscious Mind).

Edna told her therapist that she would be willing to try it, but she doubted that anything in particular would come up.

Using the Affect Bridge, her therapist asked Edna to sense into the tightness in her jaw and go back to  the earliest memory she could remember that was related to this physical sensation.

After a couple of minutes, Edna's jaw began to quiver and tears rolled down her face, but she seemed totally unaware of her emotional and physical reactions because she told her therapist that nothing came up for her.

When her therapist pointed out to Edna that her jaw was trembling and tears were streaming down her face, Edna seemed surprised.  She appeared to be cut off from these sensations.

Although she couldn't associate any particular memory with her physical and emotional reaction, she realized that she was feeling a little calmer--as if something in her had been released.

Her therapist recognized that the work would be slow because Edna was defending against feeling her emotions and physical reactions, and going too fast would be overwhelming for her.

When Edna returned for her next session, she said she slept better after their last session and that hypnotherapy technique, the Affect Bridge, seemed to help her--even if she didn't understand why.  So, she agreed to continue to work with the Affect Bridge.

Edna made slow and steady progress in therapy, although she continued to maintain that there wasn't anything in particular, other than her sleep problem, that was affecting her.

During that time, she was assessed in a sleep lab, and she was told that she didn't suffer with sleep apnea and there weren't any other medical problems that could explain her sleep problem.  The sleep specialist recommended that she continue to attend her psychotherapy sessions.

Over time, using the Affect Bridge, Edna began to identify an emotion that was associated with the stiffness in her jaw:  Anger.

This surprised Edna, "I can't imagine where that came from.  I don't have anything to be angry about."

Although she couldn't identify anything that she was angry about, she said that she could sense the anger in her jaw as well as in her throat and neck.

When they focused on her throat, Edna said she felt a tightness in her throat as well as tears behind her eyes.

Although this was a little frightening for Edna, she becoming more psychologically minded in therapy and she was curious as to where all of this would lead.

As usual, her therapist told Edna at the end of their session that if she remembered any dreams, she could bring them in.  Usually, Edna would say that she never remembered her dreams.

But the following session, Edna came in and she looked upset.  She told her therapist that she had a dream the previous night that disturbed her.  Her therapist asked her to tell the dream in the present tense as if she was still in the dream.

The dream was about her father on the day that he died.  He never had any health problems, but he had a sudden heart attack when Edna was 10, and in the dream she was telling him not to leave her.  As a 10 year old, she believed that if she prayed, he would be all right, but he never recovered and he was pronounced dead on arrival at the hospital.

Edna said that when she woke up from the dream, she was clinching her jaw and her jaw hurt.  She also realized when she woke up that she was crying in her sleep.

As they talked about the dream and how close it was to what actually happened 20 years ago when her father died, Edna told her therapist that she thought she had "put all of that behind me."

Even talking about the dream was disturbing to her but, by the end of the session, she was feeling calmer.  And when she came back the following session, she reported sleeping better that whole week.

Reluctantly, she acknowledged that it was obvious to her that she had never mourned her father and she was still holding onto a lot of grief.  She was also still angry about her father leaving her and that her prayers for his survival went unanswered.

Edna told her therapist that when her father died, there was no one to talk to about it.  Her mother and older brother refused to talk about it, and the other family members told her that she needed to "move on" and focus on her studies.  Now, looking back on it, she realized how ridiculous it was for her relatives to tell a 10 year old this, and she felt angry about this too.

Edna said that, in the past, she thought that if she just focused on being positive, doing affirmations, and remained goal-oriented and motivated that she would have a sense of well-being, but it was clear to her now that her body and her dream were trying to tell her something else.

Edna was now ready to accept that her insomnia and other physical symptoms were connected to trauma related to her unresolved grief.  She was now willing to listen to her therapist talk to her about the connection between the mind and the body and to work on her unresolved trauma.

Conclusion
Anything can be used as a defense against feeling uncomfortable emotions, including positive thinking, positive psychology and affirmations.

There's absolutely nothing wrong with positivity and affirmations.  The problem arises when people use positivity to avoid their problems.

This avoidance is usually due to fear of dealing with the problems and develops into denial.

When clients avoid dealing with their problems, especially unresolved trauma, these problems can manifest in physical ways (as seen in the fictional vignette above).

If clients are fortunate enough to have a medical doctor who rules out medical problems and understands the mind-body connection, the doctor will recommend psychotherapy.

There are certain mind-body therapy modalities, like the Affect Bridge in hypnotherapy, that can help clients to tap into physical sensations to understand the underlying issues.

When clients have a good therapeutic rapport with their therapist, they are usually more willing to be curious and explore the underlying issues.

When underlying traumatic issues are identified, a trauma-informed therapist can help the client to work through these issues.

Getting Help in Therapy
Fear and denial can be very powerful.

Sometimes, when people are very emotionally invested in believing that they only need positive thinking or positive affirmations--to the exclusion of dealing with underlying problems--they blame themselves when positivity isn't enough to make them feel better.

A skilled trauma-informed psychotherapist will work in a gentle way to help clients to overcome their fear and denial so they can eventually work through their underlying trauma.

If you have been feeling stuck and you think you might be avoiding dealing with emotional problems, you could benefit from seeking help from a skilled psychotherapist.

Rather than suffering on your own, you could free yourself from your traumatic history so you can lead a healthier, 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 to work through psychological trauma so they can move on with 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.

Breaking the Cycle of Emotional Blackmail

Emotional blackmail is a term that was coined by a psychotherapist, Susan Forward.  Basically, emotional blackmail is a form of manipulation where one person is trying to control and manipulate another person through guilt, threats, or by instilling fear or a sense of obligation (see my articles: Why Emotional Abuse Might Feel "Normal" to You and The Effect of Growing Up With a Parent Who Has Borderline Personality Disorder.

Breaking the Cycle of Emotional Blackmail

Emotional blackmail usually occurs between people who have an intimate relationship, like parent-child, a married couple, two siblings, close friends and so on.

When emotional blackmail works, the person who is being controlling intimidates the person who is being controlled.  The intimidation is usually of an emotional nature, but it can also be physical (threats to the person being controlled or threats of self harm by the controller).

This dynamic often becomes a cycle that begins with the controlling person trying to get something s/he wants by manipulating the person s/he is trying to control.

The person who is being controlled might recognize the manipulation, but s/he wants to avoid the feared consequences of not giving in, so s/he acquiesces to the controller, and this becomes the dynamic between them.

Breaking the cycle of emotional blackmail is often challenging, especially if this dynamic has been going on for a while.  It is especially challenging if the person who is being controlled was in this role as a child and, as an adult, chooses people who are manipulative and controlling.

Fictional Vignette:  Breaking the Cycle of Emotional Blackmail

Amy
Amy grew up as the youngest of five children raised by a single mother.  She never knew her father.

Since she was much younger than her siblings, they were already out of the house by the time she started school, leaving her to deal with her mother, who was depressed and angry.

Amy tried to please her mother in every way she could because she feared that her mother would fall apart or harm herself if Amy didn't go along with whatever her mother wanted (see my article: Ambivalence and Codependency in Mother-Daughter Relationships and The Role of the Family Scapegoat in Dysfunctional Families).

Breaking the Cycle of Emotional Blackmail

Her mother made a suicidal gesture when Amy was 10.  While in a drunken stupor, she told Amy that she took a handful of pills because she was unhappy about being alone so much of the time when Amy went out to play with her friends.

Shocked and trembling, Amy called 911 and waited with her mother while the EMTs came.  While she was waiting for the EMTs, Amy blamed herself for not giving into her mother's wish that Amy stay home with her rather than go out with friends.  She blamed herself for her mother's unhappiness and made a vow to herself that she would try to please her mother from that time on (see my article: Role Reversal in Mother-Daughter Relationships).

The EMTs brought Amy's mother to the hospital emergency room, but she was discharged the same afternoon because she hadn't taken enough pills to harm herself.

The hospital psychiatrist suspected that Amy's mother had borderline personality disorder.  He offered to make a referral to a local outpatient mental health center, but Amy's mother rejected the referral.  At that point, the psychiatrist told the mother that if she showed up again at the ER under similar circumstances, he would contact the State bureau of child welfare to investigate the situation at home.

After her mother was discharged, she seemed like a completely different person from the person who said she was suicidal only a few hours before.  She told Amy to stop looking so gloomy and offered to take her for an ice cream sundae.

After that day, whenever her mother wanted to get her way, she would remind Amy of the day she took the pills.  This was enough to frighten Amy into giving into her mother.

They lived under very precarious circumstances with Amy's mother losing one job after another.  She would usually start out being an excellent employee and getting along very well with her boss and coworkers, but within a short period of time, she would argue with people at work and she was convinced that they were all out to get her.  At that point, the usual pattern was that her work performance suffered, she took off a lot of days, and she got fired.

After Amy graduated high school, she decided not to go to college because she wanted to work to help with the household bills.  She took a job at the local bookstore.

Amy loved working at the bookstore.  She liked the store owner and her coworkers.  She also liked meeting the people who came to buy books.

She met the man who would eventually become her first boyfriend, John, at the bookstore.  He usually came in a few times a week and would hang around to talk to Amy.

Amy thought John was handsome, intelligent and charming, so when he asked her to go for a drink one day after work, she agreed.  Soon they were dating on a regular basis.

Initially, Amy was afraid that her mother would be lonely when she went out.  But her mother also met a man around that same time, and she was immersed in that relationship so Amy didn't have to worry about staying home with her mother to keep her company.

Several months later, Amy met John for dinner and he told her that he quit his job at the publishing company where he had been working for a year.  He felt he was unappreciated and underpaid.  He said that even though they tried to persuade him to stay, he decided he couldn't stand to be there another day, so he left.

Amy was shocked and asked John what he would do.  He told her that he wasn't worried.  He said he had lots of contacts in the publishing world and, with his skills, he would get another job as a copy editor in no time.

But as the weeks and months passed, John was unable to find another job, and he was running through his savings.  There were times when he asked Amy for money to pay his rent, and he didn't know when he could pay her back.

By that time, they were spending most of their time in John's apartment, and Amy became aware that John was drinking a lot.

In the past, she wondered if he had a drinking problem because she noticed some empty liquor bottles in the recycle bin, but she dismissed this idea because she never saw John drunk.

But after John was out of work for six months, he would come to the bookstore to see Amy reeking of alcohol.  Amy noticed that bookstore owner kept a watchful eye on John, and her coworkers avoided him.

One day when he came to get Amy after work, he was so drunk that he was weaving down the street. Although he refused to talk to her about his drinking in the past, Amy decided to bring it up again because she could see that his drinking was getting worse.

John brushed aside Amy's concerns as they entered into his apartment.  He was silent for a long time, and then he looked away, as if he was embarrassed, and told her that he needed to borrow more money from her.

Amy hesitated.  John already owed her over $2,000.  She was saving her money to buy Christmas presents for her mother, her siblings and John.  If she lent John more money, she would be taking it from savings.

When Amy hesitated, John slammed his hand against the kitchen table, "Goddammit!  I need the money!  You have to help me!"

Amy tried to explain her dilemma, but John interrupted her, "You say you're 'so concerned' about me.  You say you're concerned that I'm drinking too much.  Well, what do you think will happen if I get thrown out into the street because I can't pay my rent!  Do you think that would make things better!?!"

Amy didn't want John to be evicted from his apartment so, reluctantly, she gave him the money.  She rationalized to herself that her new promotion to a managerial position at the bookstore would substantially increase her salary and she would replace the money she lent John.

She also tried to persuade John to take a temporary office job that his friend offered him and that he turned down.  She told him that, until he finds a job that he really wants, if he took the temporary job, at least he would be earning some money.

John was pouring himself one drink after the next, and he was quite drunk at that point.  He raged at Amy for even suggesting that he should take a job that he considered beneath him, "How could you even suggest such a thing!?!"

Amy trembled in fear because she thought John was going to get up and hit her.  But he sank back into the couch and continued to drink and, soon after that, Amy went home.

None of Amy's friends liked John.  They thought he was narcissistic and manipulative.  They were mostly concerned that he was going to drag Amy down with him.  So, Amy didn't feel she could talk to her friends because they would just tell her to leave him.  And she couldn't talk to her mother because her mother spent most of her time at her boyfriend's place, so she was hardly around.

Everyone that Amy knew who knew John had a bad opinion of him.  She knew she needed to speak to someone who was impartial and objective, so she began therapy (see my article: Why Is It That It's Usually the Healthiest Person in a Family Who Goes to Therapy?).

Breaking the Cycle of Emotional Blackmail: Getting Help in Therapy

Soon after she started therapy, Amy became aware that John was manipulating her in much the same way that her mother manipulated her since Amy was a child.  Her therapist called it "emotional blackmail."

Over time, Amy admitted to herself and her therapist that she knew that John had serious emotional problems and she wasn't going to be able to rescue him.  She was also getting tired of his demands for money and his refusal to help himself.

At first, she tried to avoid him by making excuses as to why she couldn't see him.  But he would wait for Amy outside and try to persuade her to come back to his apartment.

One day, when he was drunk and frustrated with her excuses, he shouted at her in the street, "Why are you doing this to me!?!  Are you trying to destroy me!?!"

People on the street turned around to look at them, and Amy felt embarrassed.  Based on the work that she was doing with her therapist, Amy knew that John was trying to manipulate her by making a scene in the street.

She knew that he thought she would do anything to get him to be quiet--including go back with him to his apartment, watch him drink and then lend him more money.  But she was fed up and she had built up enough courage, confidence and self respect in therapy to quietly tell John, "You can shout all you want, but you're not going to control me any more."

John was stunned and stopped in his tracks, but Amy kept walking.  A few seconds later, she could hear him yelling at her from down the street, "Yeah, that's right!  Keep walking! What do you care what happens to me now that you think you're a big shot manager!  You were nothing when I met you.  You're nothing now."

Amy kept walking as if she was in a dream, and she could hear John still shouting down the block, but his voice was fading the further away she got (see my article: Choosing Healthier Romantic Relationships).

She continued to work in therapy to deal with the emotional aftermath of breaking up with John.  Although she never ran into him again, she feared he might wait for her outside the bookstore.

Amy and her therapist also worked on the original emotional blackmail in her life--her relationship with her mother.

Her mother was about to move in with her boyfriend and so she had little time for Amy.  But Amy knew that if her mother's relationship ever ended, she would be emotionally and financially dependent upon Amy again, which Amy didn't want.

She and her therapist worked on helping Amy to overcome the emotional trauma that she went through as a child with her mother (Overcoming the Traumatic Events of Childhood Trauma).

They also worked on Amy moving out and getting her own place.

Six months later, when her mother ended the relationship with her boyfriend and wanted to Amy all to herself again, Amy was able to set a healthy boundary with her mother and deal with her mother's angry threats.

By then, Amy already had her own place, so it was easier for her to set this boundary with her mother (see my article: Overcoming Dysfunctional Ways of Relating in Your Family and Freeing Yourself From Family Expectations That Are Harmful to You).

Working through these issues was difficult, but Amy was beginning to feel that she deserved to be treated better (see my article: Overcoming the Need to Be Everyone's Caretaker).

Conclusion
Emotional blackmail can start in early childhood, which primes the individual to unconsciously seek out people as an adult where there will be a similar dynamic.

Parents who use emotional blackmail often, consciously or unconsciously, choose the most vulnerable child in the family who will respond to manipulation.

If someone has a long history of being manipulated by emotional blackmail, this type of dynamic might seem "normal" to him or her.

Breaking the cycle of emotional blackmail can be very difficult to do without getting help in therapy.

Getting Help in Therapy
Having to choose between taking care of yourself or taking care of the person who is emotionally blackmailing you can be a daunting choice.

The person who uses emotional blackmail is usually very skilled at manipulating and causing the person s/he wants to control to feel guilty and, over time, s/he will continue to up the ante.

If you're feeling stuck in a situation where you're being emotionally blackmailed, you could benefit from seeking help from a skilled psychotherapist, who can help you to break the cycle of emotional blackmail.

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

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

How to Cope With Getting Emotionally Triggered During Family Visits

In an earlier article,  How to Cope With Difficult Family Visits, I discussed coping strategies to deal with difficult family get-togethers.  In this article, I'm focusing specifically on how to cope with getting emotionally triggered during family visits (see my articles: Overcoming Dysfunctional Ways of Relating in Your Family, Regressing to Feeling Like a Child Again During Family Visits and Learning to Develop Healthy Boundaries Within an Enmeshed Family).

How to Cope With Getting Emotionally Triggered During Family Visits

When there's a long history of dysfunction in a family, family visits can be fraught with problems, especially if you're not prepared for emotional triggers.

Have you ever wondered why you're able to overlook an unpleasant comment that an acquaintance makes, but if a family members makes the same comment, you have a different emotional reaction?

The answer is that you're not as emotionally invested with an acquaintance as you are with family members.  Also, there's probably not a long history between you and the acquaintance, whereas with your family, you've probably experienced similar problems.

Fictional Vignette:  Getting Emotionally Triggered During a Family Visit

Cindy
Cindy loved her family, but she usually found going home for family visits difficult.

Whenever she went home, Cindy experienced her family and herself falling into old dysfunctional patterns that she disliked.

How to Cope With Getting Emotionally Triggered During Family Visits

Although she knew that her mother loved her, she often made comments about Cindy's weight, which was a longstanding sensitive issue for Cindy.

This was an old pattern with her mother, and no matter how many times Cindy told her mother that her comments weren't helpful, her mother would insist that she was "trying to be helpful."

There just seemed to be no getting through to her mother, and her mother's comments would usually lead to an argument between Cindy and her mother.

Her father, who knew that Cindy wasn't in a relationship, would usually ask Cindy, "So how's your love life going?"

Then, when Cindy told him that she was seeing anyone, he would express concern and ask her why she was dating anyone, which infuriated her.

Cindy's brother earned a lot of money as a corporate attorney, and he tended to look down on Cindy's job as a Legal Aid attorney.  He also made disparaging remarks about her salary and her clients, which annoyed Cindy.  She felt that he was trying to make her feel ashamed, and they would frequently argue.

After yet another family visit where Cindy argued with her mother, father and brother, Cindy decided to get help in therapy.

She knew that these were old familial patterns, and she wasn't going to change her family, but she hoped to change her own reactions to them (see my article: You Can't Change the Past, But You Can Change How the Past Affects You).

Over time, Cindy and her therapist worked on the underling issues that got triggered for Cindy when she went to see her family.

Using a combination of EMDR Therapy and Somatic Experiencing, they were able to gradually work through these triggers so they no longer affected her.

Cindy also learned how to set limits with her family in a gentle and tactful way.

The real test of what she accomplished in therapy occurred during her next family visit when, as usual, her family made the same remarks that usually triggered Cindy.

To her surprise, Cindy discovered that while she was disappointed that they were going down the same path as usual, she didn't have an emotional reaction.  Instead, she felt that these were their issues and they didn't concern her.

Suggestions on How to Cope With Getting Triggered During Family Visits

• Prepare yourself mentally before you go so you're not caught off guard.  While you might not be able to prepare for every comment or slight, if you know that you tend to get triggered, take care of yourself beforehand by engaging in self care (see my articles:  Learning to Relax: Going on an Internal Retreat and Self Care: Feeling Entitled to Take Care of Yourself).

• Be aware that whatever your family members might say or do, they don't define you.  They might have different opinions about what you "should" or "shouldn't" being doing.  But, as an adult, you get to make your own choices.

• "Bookend" your visit with calls to supportive friends both before and after (and possibly during) your family visit so you don't feel alone.  Emotional support during a family visit can make all the difference.

• Take breaks while you're with your family.  You don't have to be with them 24/7 during your visit.  If you plan breaks where you go out for a walk, it gives both them and you a break and a way to "reset" so you can regulate yourself emotionally.

• Maintain appropriate boundaries with family members in a tactful manner so that if they attempt to cross a sensitive boundary with you, you can set limits with them.

Getting Help in Therapy
When you get emotionally triggered, this is usually a sign that you have unresolved emotional issues that need to get worked through (see my article:The Benefits of Psychotherapy and Expanding Your Window of Tolerance in Therapy to Overcome Emotional Problems).

Working with a skilled psychotherapist, you can work through these unresolved issues so that you're not constantly getting triggered by the same situations (see my article: How to Choose a Psychotherapist).

If you find yourself continually getting triggered with your family, you owe it to yourself to get help from a licensed mental health professional.

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

I have helped many clients to work through unresolved trauma so they are no longer triggered in familiar situations.  

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.

Creating a Sense of Home Starts Within Yourself

Your home is more than just a place.  Whether "home" means your parents' house or a home that you have created on your own, the emotional meaning of "home" has a lot to do with your earliest experiences of living in a secure, stable environment--or not (see my article: A Happy Family Doesn't Have to Be a "Perfect" Family).  Creating a home starts from within yourself.

Creating a Home Starts Within Yourself

If you were lucky enough to live in a stable, happy home with both parents and your siblings, your home was more than a financial asset.  It was the place where you knew you would be loved and cared for and where you could always return.

As the poet, Robert Frost once said, "Home is the place where, when you have to go there, they have to take you in."

If you were fortunate, home was a place where you would have pets, bring friends, and celebrate birthdays and holidays.

It didn't have to be perfect--it just had to be "good enough" for you and your family to thrive and have a sense of well-being.

Developing a Home For Yourself
How do you create a home for yourself?

Creating a Home Starts Within Yourself 

Creating a home for yourself is about feeling comfortable with yourself and having people that you love and who love you in your life.

Your home starts within yourself--it's a feeling that you carry around inside you.

If you were fortunate enough to grow up in a relatively happy home, you already have a sense of what this means.

If you weren't fortunate enough to grow up in a happy home or if you experienced a lot of upheaval in your early life, you might have more of a challenge creating a home for yourself.

The following fictionalized vignette illustrates the challenges of creating a home for yourself when your early childhood was chaotic, and how therapy can help you to develop a feeling of "home" inside yourself first:

Fictionalized Vignette:  Creating a Home Starts Within Yourself

Ken
By the time Ken was 11, he and his family had lived in five different apartments.

On average, he and his family moved every two years or so because his family couldn't afford to pay the rent or because the landlord forced them out in order to get another family who could afford to pay more.

Ken was the youngest of four children being raised by a single mother.  He never knew his father.

He often felt confused and unhappy about moving away from his friends and his school.  No one ever explained to him why they had to move and why there was such chaos each time.

When he was seven, his mother told him that they would have to give up their dog because the apartments that she saw wouldn't allow dogs.  This was a terrible loss for Ken.

When he was nine, his family lost most of their possessions because the landlord put their things out on the street and they were stolen.

The family had to move in with Ken's maternal grandmother in an apartment that was already overcrowded with other relatives.  They lived this way for another year until his mother could save up enough money for the first month's rent for their next apartment.

Although Ken was bright, he began to have academic problems by the time he was 10.  His teacher, who knew that Ken was intelligent and capable to doing the work, spoke with his mother to encourage her to try to motivate Ken to be more diligent about studying and doing his homework.  But his mother already had her hands full with working two jobs, so she had little time to spend with Ken.

With Ken's mother's permission, his teacher introduced Ken to the school counselor, who became a mentor to Ken.  The counselor saw that, in addition to being smart, Ken was artistic and she encouraged him to pursue his artistic talent.  This made a tremendous difference for Ken (see my article: How One Person Can Make a Difference in a Traumatized Child's Life).

His elementary school counselor remained a mentor to Ken even after he went to high school, and she encouraged him to apply to college.

At that point, Ken didn't have a sense of a future for himself, and he was beginning to hang around with other teens who were involved in a gang.

Creating a Home Starts Within Yourself 

When his mentor found out about this, she spent more time with him to help him to find other groups and outlets for himself.

Soon after that, Ken came home and was shocked to find his mother and maternal grandmother crying.  He always thought of them as "strong women" and he couldn't ever remember a time when he ever saw either of them cry.

His mother sat Ken down and told him that his oldest brother, Tom, was shot in the spine, and he was rushed to the hospital.  His mother and grandmother were about to leave for the hospital, but they were waiting for Ken.

The family found out from the police that Tom was part of a gang and he was shot by a member of a rival gang.  This was all that the police knew from their sources.  Since witnesses refused to identify the shooter, there were no suspects so far.

After Tom was operated on, he learned that he would probably be in a wheelchair for the rest of his life.  Physical rehabilitation might help him somewhat, but the doctors were not hopeful.

This tragedy had a profound impact on Ken.  When he spoke with his mentor about it, he told her that  he didn't want to end up like Tom, so he would do whatever it took to get into college to try to make a better life for himself.

Ken applied himself in high school like he had never done before.  He took an SAT test prep course and passed the SAT with a high score.  With high hopes for getting into a college, Ken, his mother and maternal grandmother visited various colleges and explored scholarships.

Five years later, Ken graduated college and he was hired as a marketing representative by a company that recruited him while he was still in college.

When he started working, he helped his mother financially, but he really wanted his own place.

Looking for an apartment, he discovered how expensive rents were, especially in Manhattan, so he chose an apartment in the Bronx that was barely affordable for him.

After he moved out, he began dating a woman, June, that he met through a friend.  When he invited her over to his apartment, she was surprised that, even though he lived there for a year, he had done nothing with the apartment other than getting some basic necessities, like a bed and a TV.

When June asked Ken why he had no pictures on the wall and why he barely had any furniture, he told her that he didn't know how long he would stay, so he didn't want to invest any money in the apartment to try to make it into a home for himself.

Then, he told her about all the apartments that he and his family had over the years and the loss of their dog and so many of their possessions.  He didn't think it was worth trying to make it into a home for himself.

After June heard about his family history, she understood that Ken didn't really have a concept of what a home is and, aside from the upheaval that he experienced as a child, he didn't really know where to begin.  She also realized that, based on his history, he also had no sense that he deserved anything better.

When June got her own apartment, she couldn't afford to spend a lot on furnishings, but she made modest purchases to make the place a haven for herself.  Unlike Ken, she grew up in a home where she and her family lived most of their lives, so she knew how important it was to come home to a place where she would feel comfortable and secure--even on her modest salary.

When Ken visited her apartment for the first time, he was impressed with how creative she was in making her place cozy and comfortable for very little money.

June offered to help Ken to make small, inexpensive changes to his apartment so he would feel that he had a comfortable place to come home to, but he rejected her help.  When she asked him why, he said he wasn't sure why.

When Ken spoke with his mentor, she told Ken that he had lived through many traumatic experiences in his childhood, and she suggested that he seek help in therapy.

Initially, Ken balked at the idea of therapy.  It was one thing for him to speak with his mentor, who was his former school counselor, but he felt it was a ver different thing for him to speak with a psychotherapist, "I'm not a weak person" (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak").

But, over time, the more he thought about it, the more Ken realized that he really wasn't happy in his apartment, which was supposed to be his "home."  He wasn't even sure what a "home" was supposed to be.  That's when he decided to seek help in therapy.

During the initial therapy sessions, Ken felt anxious and ambivalent about talking to a stranger (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious and Ambivalent).  But, as he continued to go, he developed a rapport with his therapist and he felt she understood what he was talking to her about.

Working through the traumatic issues that caused Ken to feel rootless as a child was hard work, but he usually felt better afterwards.

Ken and his therapist talked about what a "home" meant to him.  At first, he couldn't think of anything, except that it was a place where you live, eat, and watch TV.

When his therapist asked Ken to imagine what he would have liked as his ideal home, at first, Ken thought about having a big expensive house with a pool and a housekeeper.

But as they continued to talk, Ken realized that what he really wanted was something that he never had--a place where he could feel comfortable and secure.

Over time, Ken realized that creating a home for himself wasn't about having an expensive house or fancy furniture.  It was more about what he could create from the inside out.  In other words, the feeling of "home" was something that he needed to create inside himself first and then he could create it externally.

Since Ken was artistic and he liked to draw, his therapist recommended that Ken draw what his apartment would look like if it were a more of a haven.

Creating a Home Starts Within Yourself

During that time, Ken also worked with his therapist to overcome the childhood trauma that created emotional obstacles for him, including that he grew up without a father (see my article: Understanding Why You're Affected By Trauma From a Long Time Ago).

Gradually, as Ken thought about what "home" meant to him and he made drawings of how he could create a haven for himself in his modest apartment, he began to make small changes that made both him feel more comfortable in his home, and a place he could share with his girlfriend, June.

Conclusion
Creating a home for yourself comes from your internal experience of what a home means to you.

For people who grew up in a home where they felt secure and loved, even if it was a modest home, being able to create an emotionally meaningful home for themselves is usually second nature.  They don't have to think about it a lot.

But if you grew up with chaos and upheaval, you might not know what it means to create a home for yourself.

Getting Help in Therapy
A skilled psychotherapist can help you to overcome the psychological obstacles that are getting in the way of your taking care of yourself (see my article: The Benefits of Psychotherapy).

An experienced therapist can help you to learn how to create a home for yourself that feels like a haven.

The process of creating a home for yourself begins internally with you discovering what you need, the obstacles in your way of creating what you need, and the willingness to see the process through in therapy (see my article: Overcoming Obstacles to Making Changes in Your Life).

If you're stuck in your life, you could benefit from working with a licensed mental health professional who can help you to overcome emotional obstacles so you can lead a more fulfilling life.

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

I have helped many clients to overcome emotional obstacles so they could lead a more rewarding life.

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.

Grief: Who Are You After Your Parents Die?

I'm continuing a theme about grief for the loss of both parents that I began recently (see my articles: Grief: The Emotional Impact of Losing Both Parents, You Continue to Have a Relationship With Your Parents Even After They Die, and The Emotional Pain of Clearing Out Your Parents' Home After They Die).  In this article, I'm focusing on changes in how you see yourself after your parents have died.

Grief: Who Are You After Your Parents Die?

As I mentioned in prior articles, nothing can prepare you for the loss of both of your parents.  For most people the experience of feeling like an "orphan" can be devastating--no matter what kind of relationship you had with your parents.

Relationships, including relationships with your parents, are a complicated mix, rather than being "good" or "bad."  So, when the last parent dies, adult children's feelings can also be mixed: Sorrow for the loss and a sense of relief that they're no longer suffering and there is no longer a need to worry about parents.

Who Are You After Your Parents Die?
Your primary identification as a child is as your parents' child.  This identification continues through adulthood, although usually in combination with other identifications: husband, wife, mother, father, friend, teacher, and so on.

So, at the point when you have lost both of your parents, you can feel that part of you has gone with them:  You're no longer anyone's son or daughter--at least, not in the here-and-now.

Most people don't anticipate the loss of this identification, and after their second parent dies, they struggle with loss and question who they are now that their parents are no longer around.

Much also depends upon the separation-individuation process that children go through.  This is a process that starts in childhood and progresses through adolescence when children identify more with peers than with their parents and strive to be their own person.

But some people struggle with the separation-individuation process for a variety of reasons, as I will demonstrate in the fictionalized vignette below.

Depending upon the individual and the quality of the relationship with the parents, this can be a time of doubt and soul searching.  For other people, it can be liberating.  For others, it's a combination of doubt, soul searching and liberation.

Fictional Vignette:  Who Are You After Your Parents Die?

Ida
Ida was an only child.

Throughout her life, she had an ever-present awareness of the sacrifices that her parents made to come to the United States from their native country where they were harassed and oppressed because of their religion.

As a child, Ida wanted to be a writer, but her parents were vehemently opposed to this.  They wanted her to be a teacher or an accountant, preferably as part of a union so her job would be protected.

They told her many times of their own struggles when they came to the US as immigrants--how they were looked down upon for their clothes, their traditional food, and their foreign ways.

They both went to college in the US, studied hard and chose "practical" careers.  Her father became an engineer and her mother became a teacher.

Not wanting to disappoint her parents, Ida became an elementary school teacher, like her mother.  She loved the children and the feeling that she was making an impact on their lives.  But she still longed to write.

Being a teacher gave Ida little time to write.  She often came home feeling exhausted from a full day at school.  Here and there, she wrote short stories that she told no one about, especially her parents, who would have ridiculed her for wasting her time.

When she was in her mid-20s, she got married to another teacher she met at a union meeting.  They had two children, and soon after that Ida had even less time to write, other than a few occasional snippets.

Although she was happy with her husband and family and she liked working with the children, she still longed to write.  She felt she had many stories in her head.

When both of her children were in college, Ida had more time to write the short stories that were in her head.  So, she would spend a couple of hours a week secretly writing.

Grief: Who Are You After Your Parents Die?

She still carried her parents' voices in her head that writing was a waste of time and she should spend her time on more "practical" matters.

Over the years, Ida had written several short stories that she would have liked to have published, but her parents' ideas about the impracticality of writing were so ingrained in her mind that she remained in conflict about it.

When Ida was close to retirement, her father died unexpectedly.  It was such a shock to her mother that she became emotionally incapacitated, and Ida and her husband took her in.

After her mother moved in with her, Ida was even more surreptitious about her writing.  Sometimes, she would get up early in the morning before her husband and mother got up and spend a half hour writing.

One day, her husband walked into the kitchen unexpectedly while Ida was typing on her laptop.  Ida became so startled that she closed her laptop abruptly.

When her husband asked her what she was doing, she responded with hesitation that she was writing a short story.

Rather than being disapproving, as Ida expected, her husband was thrilled and asked her why she was so secretive about it.

When Ida explained how disapproving her parents were about her desire to write, she was delighted that her husband encouraged her.  He even offered to take over more of the household responsibilities so she could have more time to write.

But even with the extra time and her mother spending more time in her own room, Ida continued to feel conflicted about writing.

Although she knew that she was an adult and her parents could no longer tell her what to do, she still felt a sense of disloyalty to her parents when she wrote because she felt she owed them so much.

When she spoke to her husband about this, he suggested that she speak with a psychotherapist who could help her to sort out her longstanding issues related to her parents and writing.

Soon after Ida began therapy, her mother died.  Although Ida knew that her mother's death had nothing to do with her attending therapy or her writing, she still felt guilty, as if she had betrayed her mother by talking about her in therapy.

Gradually, Ida began to work through her grief and these related complex issues in therapy.

Over time, her therapist helped Ida to grieve the loss of her parents.

Her therapist also helped Ida to understand that she had not achieved sufficient separation-individuation from her parents as an adult due to her sense of obligation and guilt about their sacrifices.  As a result, Ida was overly identified with their ideas about who she should be instead of trying to be the person that she wanted to be.

Developing her own sense of self was neither quick nor easy.  After Ida retired, her therapist encouraged her to join a writing group so she could be around other writers who might be struggling with similar issues and who would be supportive.

Grief: Who Are You After Your Parents Die?

The combination of attending her weekly therapy sessions and attending the weekly writers group helped Ida to come into her own (see my article: Listening to Your Inner Voice to Discover Your "Calling" in Life).

Although she struggled at times with her own internalizations of her parents' prohibitions, she was writing every day.

Her husband and other people who knew saw the difference in her.  They told her that she looked much younger and happier than she had been in a long time.

As time went on, Ida felt more confident as a writer and she submitted her stories for publication.  She also had a greater sense of well-being because she was being her true self and doing what she loved (see my article: Becoming Your True Self).

Conclusion

Losing both parents can be a devastating experience regardless of your age or your relationship with them.

After the loss of the second parent, adult children often question their identity, especially if they had problems individuating before their parents died.

The time after a second parent dies can be a time of confusion, soul searching and a search for a new identity.

For many people, it's a time to discover their own voice and their true selves.

Getting Help in Therapy

The mourning process can be a confusing, lonely time even if you have many people around you.

Losing both parents can create a sense of being an "orphan" with all the feelings that go with that.

Part of that mourning process is often coming to terms with your identity now that your parents are gone.

Many people feel freer to pursue endeavors that their parents might not have approved of when they were alive.  

Other people have so internalized their parents' prohibitions that, even after their parents are dead, they continue to feel too guilty to go against their parents' wishes.  

To go against their parents' wishes makes them feel that they are moving further and further away from parents that they are missing.

Seeing a skilled psychotherapist can help you to work through the grief of losing your parents.

An experienced therapist can also help you to work through guilty feelings about finding your own voice and being your own person (see my article: The Benefits of Psychotherapy).

If these issues resonate with you, rather than struggling on your own, you could benefit from working with a licensed mental health professional who can help you to overcome your struggles so you can have a greater sense of well-being (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.

I have helped many clients to work through grief and their own individuation process so they could lead more fulfilling lives.

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.

See my other articles about grief.