How Clients Internalize Their Experience of Their Psychotherapists

One of the benefits of attending psychotherapy is that you learn so much about yourself, your relationships and the world around you (see my article: The Benefits of Psychotherapy).  Another benefits is that when you have a good relationship with your psychotherapist, you internalize your experience of your therapist.  I'm addressing this internalization process in this article and how it's beneficial to clients in therapy.

How Clients Internalize Their Experience of Their Psychotherapists

The relationship that you have with a psychotherapist is unlike any other relationship in your life.  Aside from the fact that you have a regular time and place that's just for you every week, the focus is on you and the changes you want to make in your life.

People begin psychotherapy for all different reasons.  Some people come because they have longstanding psychological trauma that's interfering with their life and they want to free themselves from the effect of the trauma (see my article:  Working Through Emotional Trauma in Psychotherapy: Learning to Separate "Then" From "Now").

Other people are interested in personal growth or performance enhancement.  Their lives are basically going well, but they believe there are areas where they can improve either in their personal life or in their career.

Regardless of what brings a client to therapy, part of psychotherapy is a learning process.  While it's not the same as being in a classroom, a skilled therapist will provide clients with psychoeducation about the therapeutic process as well as ways that clients can improve their life (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

In addition to psychoeducation, clients also internalize their experiences of their psychotherapists and, it's a good match, the client benefits from this process.

Let's take a look at a fictional vignette which illustrates how this internalization process in therapy usually works:

Fictional Vignette: How Clients Internalize What They Learn in Psychotherapy:

Jack
Jack started therapy because he was having problems setting boundaries with his mother, and it was affecting his relationship (see my article: Setting Boundaries With Family Members Who Want to Interfere With Your Relationship).

How Clients Internalize Their Experience of Their Psychotherapists

The main problem was that Jack, who was in his early 30s, had problems setting limits with his mother, who continually attempted to interfere in Jack's relationship with his girlfriend, Cathy.

Even though Jack didn't like that his mother constantly interfered in their lives, he didn't know how to talk to his mother about this, which annoyed Cathy.

Whenever Jack and Cathy came home from a visit to see his mother, Cathy would be fuming and Jack would feel ashamed that he couldn't bring himself to talk to his mother about her constant interference.

Jack and Cathy were talking about getting married, but Cathy told him that she didn't know if she could handle his mother's constant interference, which she assumed would only increase if they were married with children.  So, Jack knew he needed to address his fear of asserting himself with his mother because if he didn't, his relationship with Cathy might end.

Jack told his psychotherapist that he didn't experience any major trauma or loss as a child.  He described a fairly stable family.  He was the younger of two sons who grew up on the Upper West side of Manhattan.

The one issue that was constant throughout his life was that his mother tended to dominate everyone's life in the family.  She was also highly critical and she would give many reasons why she thought Jack and other family members were "wrong" and she was "right."

Jack's father was happy to allow the mother to control the family finances and to have the final say on all major family decisions.  His mother also became the family matriarch for her siblings after their mother died, so she was used to being in charge.

Jack's brother, Ted, resented the mother's domineering personality.  He and the mother would constantly argue.  By the time Ted left for college, he and the mother were barely speaking.  Once Ted graduated college, he moved out with his college roommates and only came to visit on holidays.  Even now, Ted's relationship with the mother was strained.

Jack quietly observed his older brother's relationship with their mother, and witnessing their battles left him feeling even more intimidated about being assertive with his mother.

As Jack and his therapist worked together, he realized that his mother's attitude that she "always knew best" undermined his self confidence and left him feeling that she was probably "right" so he couldn't assert himself.

Since the holidays were coming up, Jack told his therapist that he dreaded having to tell his mother that he and Cathy would be there for Christmas day, but they were spending Christmas Eve with Cathy's family.

On the one hand, he knew his mother would be upset.  On the other hand, he knew that Cathy would be angry if he tried to convince her to spend part of Christmas Eve at his parents' home just to appease his mother.  He told his therapist that he didn't blame Cathy.  He blamed himself.

Jack acknowledged that he thought the way that he and Cathy decided to split the time between their families was fair, but he didn't know what to say to his mother.  He feared alienating her.

Jack's therapist suggested that they use Ego States Therapy to see if there was a part of him that felt courageous enough to stand up to his mother (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are and How Your Shifting Self States Can Affect You For Better or Worse).

So, while Jack was in a relaxed state, his therapist asked him to remember a time when he stood up for himself.

At first, Jack couldn't think of anything, but then he remembered a time when he was a teenager and he stood up to a bully in high school who was bothering Jack's best friend.  At the time, Jack surprised himself by confronting the bully, telling him to back down and watching the bully defer to Jack and walk away.

Jack told his therapist that it felt good to remember how courageous and powerful he felt that day.  His therapist told him that she noticed that when he talked about standing up to the bully that his demeanor changed--his eyes were shinning with pride, he sat up straighter and his chest was out.  Even his voice was different--it was stronger with a confident tone.

When his therapist asked Jack to stay with that feeling and enhance it by seeing what else he was feeling, Jack said he was feeling much more powerful than how he felt before he recalled this memory.

Jack's psychotherapist explained to him that this courageous part was an aspect of himself and that they could continue to work to enhance that part.  She also asked Jack to keep a journal to write down every time he was aware of accessing this courageous part of himself in his daily life.

As Jack worked in therapy to enhance the courageous part of himself, he noticed a shift in how he was feeling.  Between sessions, he remembered his therapist's words about how he could continue to work between sessions to strengthen this aspect of himself, and these words encouraged him to continue to work at it.  Remembering his therapist's words was part of his internalization process of his therapist.

As the holidays got closer, Jack continued to talk to his therapist about how he could deal with his mother's insistence that he and Cathy come on Christmas Eve and Christmas day.

Even though Jack was feeling more confident about it, he still struggled with ambivalence.  He told his therapist that he wasn't sure if he was ready to stand up to his mother, and he wondered if maybe he and Cathy could go along with his mother's wishes just this one time.

His psychotherapist responded by telling Jack that if he didn't assert himself this time, based on what he told her about how Cathy felt, he might be endangering his relationship, aside from continuing to make himself small by always acceding to his mother's demands.

When his mother called Jack to finalize the details of the holiday plans, before he responded to his mother on the phone, he summoned that courageous part of himself that he worked in therapy to enhance.  He also remembered what his psychotherapist told him.  Not only did he remember his therapist's words, he also felt, in a way, that she was with him, as if she were standing beside him and encouraging him.

Accessing the courageous part of himself and his sense of his psychotherapist, he told his mother what he and Cathy decided about the holidays.

At first, there was silence.  Then, his mother protested that she expected them to come to the house on both Christmas Eve and Christmas day, and she wouldn't hear of anything different.  Jack responded by standing his ground.  He told his mother that he didn't want to argue with her about it, but he and Cathy had an obligation to Cathy's family too and they already made their plans.

His mother sounded surprised and unhappy, but she told him that he and Cathy should do whatever they wanted to do.

When Jack returned to his next therapy session, he told his therapist how proud he felt that he asserted himself with his mother.  He also said that Cathy was happy and gave him a big hug after the phone call with his mother.

How Clients Internalize Their Experience of Their Psychotherapists

Jack told his therapist that he intentionally summoned his the courageous part of himself because this is what he and his therapist planned when they discussed talking to his mother about the holiday.  But he was surprised that he had such a strong sense of his therapist while he was talking to his mother.

His therapist told Jack that this is common in therapy: Clients internalize their psychotherapists on an unconscious level so that, at various times, they get a sense of what their therapists would say or do in a particular situation and they're able to use that to deal with the situation.

She also explained that sometimes this phenomenon occurred without an idea of what the therapist might say or do--it was more of a feeling.  She said Jack that this seems to be what happened with Jack at the point when he was facing the challenging situation with his mother.

Jack continued to work on asserting himself with his mother.  He was tactful and respectful with her, but he also stood his ground.  Whenever he needed to, he called on the courageous part of himself and his internalized sense of his psychotherapist to help him.  Over time, his mother resigned herself to the fact that she wasn't going to be able to dominate him anymore.

Conclusion
In the vignette above, the psychotherapist helped Jack to access a courageous part of himself through Ego States therapy that he was barely remembered before he started therapy.  He was able to recall, enhance and use this part of himself to overcome his problem.  In addition, since Jack and his therapist had a good rapport, he was also able to access his internalized sense of his therapist to help him.

No matter what the issue, most clients, who have a good rapport with their therapists, experience this internalization of their therapists and they are able to use it to make changes in their life.

Getting Help in Therapy
Clients are often surprised by what they learn and how they change in therapy.

Part of the learning involves an internalized sense of their psychotherapist.  Whether it's a conscious sense of what the therapist might do or say in a particular situation or a more general sense, this helps the client to deal with difficult situations.

For many clients, this internalized sense of the therapist helps so they don't feel alone with their problems.

If you've been struggling with problems that you've been unable to overcome on your own, you owe it to yourself seek out a licensed mental health professional who can help you to overcome your problems (see my article: How to Choose a Psychotherapist).

Once you're free from the obstacles that have been in your way, you can lead a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works collaboratively with clients and uses an integrative approach in therapy to develop the treatment plan that works best for each client (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

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.

Striving to Be a Lifelong Learner

Lifelong learners are people who are inherently curious and self motivated to continue learning way beyond what's required in high school and college.  Striving to be a lifelong learner not only helps you to understand yourself, but it helps you to develop insight into other people and the world around you, whether you learn through reading, listening to music or traveling and meeting new people and discovering another culture (see my articles: Reading Literature and the Positive Effect on the Brain and Learning About Yourself While Traveling).

Striving to Be a Lifelong Learner

When I was in junior high school and high school, much of what I was required to learn was boring to me.  I learned my lessons because I had to and I got good grades, but throughout my life, whenever I've been bored with whatever I'm required to learn, I find something else that captivates me.  

That meant that my best friend in high school and I would plan our own educational day trip by going to the museum or admiring the architecture in various parts of Manhattan.  This kept us from being weighed down by the tedium of having to memorize dates in history or mathematical formulas that had no meaning for us because of the way it was taught.

In college and graduate school, things improved substantially. The classes were more interesting and I was asked to develop my mind and to think creatively rather than just give back to the instructor what s/he told us in class.  

When I was in college, I was a psychology major and loved my psychology and anthropology classes the most out of all my classes.  Learning about psychological behavior and cultural anthropology fascinated me.

My postgraduate psychoanalytic training was the best.  I enjoyed the classes on contemporary relational psychoanalysis much more than the classes on classical psychoanalysis, so when I was bored with a particular required paper on classical psychoanalysis, I would balance it for myself by reading a book by Stephen Mitchell, Ph.D., who was a contemporary relational psychoanalyst. In fact, he coined the term "relational psychoanalysis." 

I learned the most when I was a teaching fellow in my postgraduate training.  I worked at the mental health center that was connected to my psychoanalytic training department.

Initially, it was challenging because, in my opinion, graduate school hardly prepares you to do psychotherapy, so I was learning how to be a psychotherapist as I was working with clients.  But, despite the challenge, I had excellent supervisors, who provided guidance.

I was also required to be in my own three-time-a-week psychoanalysis, which was the most valuable aspect of my psychoanalytic postgraduate training.  

Even now, almost 20 years after I left the four year postgraduate training, I can say that the immersion process of taking classes, being supervised individually and in group, seeing clients at the mental health center, and being in my own psychoanalysis was one of the most valuable experiences in my life.  Not only did I learn about my clients, but I learned so much about myself.

I love attending clinical workshops and conferences to learn new treatment modalities.  This is one of the reasons why I love being a psychotherapist--as a psychotherapist, you're always learning.  

It's a wonderful time to be in the psychotherapy field because we know so much more now about the brain and the connection between the mind and the body, and this has fostered many different mind-body oriented types of therapy, like EMDR Therapy, Somatic Experiencing as well as the value of clinical hypnosis.

I also still continue to learn so much from my clients.  By listening and being attuned to their experiences, I can relate to what they're going through.  Often, I've gone through many of the same experiences, so I usually understand their problems on many different levels.

Many people have said to me, "How can you stand listening to people's problems day in and day out?" because they think that being a psychotherapist means listening to people complain (see my article: Psychotherapy is Much More Than Just Venting and Psychotherapists Listening and Learning From the Client).  

But being a psychotherapist is so much more than that.  Even when it might not be transparent to the client, psychodynamically trained psychotherapists aren't just "listening to complaints."  They're conceptualizing what's going on internally with the client and how the past and the present might be connected (see my article: Overcoming Trauma: When the Past is in the Present).

They're also listening for the transferential aspects of the therapy (see my articles: What is Transference?, Psychotherapy and the Positive Transference, What is the Negative Transference?, and Psychotherapy and the Erotic Transference: "Falling In Love" With Your Psychotherapist).

Psychotherapists and clients are also involved in an intersubjective experience that's hard to describe in words if you've never experienced it as a psychotherapist or as a client in therapy (see my article: Psychotherapy: A Unique Intersubjective Experience).

The intersubjective dynamic that's between the client and the therapist in a psychotherapy session is alive with meaning.  It's unlike anything that I've ever experienced before, and when the therapist and the client have a good rapport, there is a right brain-to right-brain connection that can be healing for both of them.  Of course, the focus is on the client, but therapists also experience the benefits of this special connection (see my article: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Encouraging Lifelong Learning

Becoming curious and psychologically mind is generally one of the broad goals of therapy.  Even when clients come to therapy for a very specific goal, like overcoming a phobia or coping with the death of a loved one, the experience of being in therapy usually broadens them along the way.

It's wonderful to see clients become curious about themselves and others in therapy.  It's like a whole new world has opened up for them.  This is something that I think most psychotherapists encourage because, in my opinion, psychotherapy should be more than just coming to resolve a particular problem.  While it can be that if that's what the client wants,  it's often much more.

Psychoanalysis and other forms of depth psychology aren't as popular as they used to be.  Most people don't want to come to therapy three times a week or focus on their dreams.  

And yet, in integrative psychotherapy, where various types of therapy are used in combination, like psychodynamic therapy and Somatic Experiencing, the client derives the benefits of depth psychology along with the benefits of more focused therapy (see my articles: Contemporary Psychoanalysis and EMDR Therapy and The Therapeutic Benefits of Integrative Psychotherapy).

And even though most clients don't want to talk about their dreams, if they're open to it, I tell them about Embodied Imagination dreamwork, a neo-Jungian form of dreamwork developed by Robert Bosnak, and almost everyone is fascinated by it because it's not the usual type of dream analysis where "this equals that" (see my article: Dreams and Embodied Imagination).

So, I encourage my clients who are open to it to be lifelong learners about themselves, the people around them, and the their larger world.  I believe it enhances personal growth and development, which keeps life fascinating.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who practices integrative therapy to collaboratively develop the best treatment plan for each client (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist)

I work 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.

5 Tips For Bouncing Back From Routine Disappointments

Everyone experiences routine disappointments at some point in life (see my article: Are You Overreacting to Routine Disappointments?).  Disappointments are unavoidable.  The question isn't whether you will be disappointed but how well you can bounce back from disappointments.  The better you get at moving on from routine disappointments, the more resilient you become (see my article: Resilience: Bouncing Back From Life's Challenges).  In this article, I'm going to provide tips for rebounding from routine disappointments.

Bouncing Back From Routine Disappointments

5 Tips to Bounce Back From Routine Disappointments

• Focus on Gratitude:  Although you might be disappointed about what you didn't get or that life is unfair, you probably have other areas in your life that are positive.  So, rather than focusing on what you don't have, focus on what you do have.  It might sound trite, but it will shift your mood, which is what you need to bounce back from a disappointment and not to wallow in it so that it colors everything in your life (see my articles: Is It Possible to Feel Gratitude Even When You're Sad?, Keeping a Gratitude Journal, and Getting Out of a Rut.

• Exercise at a Pace That's Right For You:  Movement helps to shift your mood.  Whether it's a sport, yoga or other types of exercise, movement will help you to lift your spirits (see my article: The Mind-Body Connection: Can Yoga Improve Your Mood?).

• Give Yourself Credit For Coping As Best As You Can:  Making any kind of effort after a routine disappointment deserves recognition, including self recognition.  Too often people don't give themselves credit for being able to handle disappointing situations.  As part of your self recognition, remember other times when you got through routine disappointments and how these disappointments didn't have a major impact on your life.

• Use Humor to Shift Your Attention and Lift Your Mood:  Watching funny movies, TV programs or listening or telling funny stories will release neurochemicals in your brain to shift your mood.  Don't underestimate what a change humor can make to help you to bounce back.  Having others join you can increase the benefit of using humor because humor is contagious.  Have you ever been in a crowd where people were laughing uproariously and you didn't even know what they were laughing about but their laughter made you laugh?  If so, then you know how powerful it can be to be in a group where there is humor.

• Set Goals For the Important Areas of Your Life:  Rather than focusing on your disappointment and what you don't have, take some time to reflect on what you want for your future in each area of your life (personal life, career, and so on).  Then, set broad goals for how you plan to succeed in each area.  After you write down your broad goals, narrow it down by writing what you need to do in the next year (or longer), what you need to do in the next six months, in the next month, next week, etc., so you make the steps concrete and realizable (see my article: What's Holding You Back From Achieving Your Goals?).

What If It's a Major Disappointment?
Notice that, until now, I've been emphasizing routine disappointments.  Routine disappointments are things that everyone faces in one way or another fairly often.

In other words, routine disappointments aren't life changing.  But there are disappointments that are much more significant and that are harder to overcome.

For instance, if you found out that a close friend that you trusted betrayed you, that's a major disappointment, especially if it causes an unbridgeable breach in your friendship (see my article: Coping With a Close Friend's Betrayal).

To overcome major disappointments, all of the tips that I mentioned can be helpful, especially when you focus on what you're grateful for in life, but those tips aren't going to be enough for you to bounce back quickly because a major disappointment goes deep and hurts a lot.

Getting Help in Therapy
If you find that you're having a hard time rebounding from a disappointment, you might need help from a psychotherapist to work through the disappointment, especially a major disappointment (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

A major disappointment, like a betrayal of a spouse or a friend, can make you feel like your whole world is falling apart.  It can make you question your beliefs and your judgment.  It might even result in your questioning your plans and what you want to do in life.

Rather than suffering on your own, you could benefit from the emotional support and clinical expertise of a licensed mental health professional.   A skilled psychotherapist can help you overcome a major disappointment more effectively than you could on your own, so you can eventually move on with your life.

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

I have helped many clients to overcome major disappointments so they could go on to live fulfilling 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.

Meeting Clients Where They Are in Their Process

One of the first clinical lessons that beginning psychotherapists learn from their clinical supervisors when they work with psychotherapy clients is "meeting clients where they are."  This is a reminder that a psychotherapist might have good ideas about where the therapy needs to go, but if the therapist is getting ahead of the client, it's going to be detrimental to the client and to the therapeutic work.  The therapist needs to listen to the client to discover where the client is and be empathically attuned to the client (see my articles: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client, Psychotherapy: The Importance of Therapists Listening and Learning From the Client and Why is Empathy Important in Psychotherapy?).

Meeting Clients Where They Are

Even experienced psychotherapists can sometimes forget, in their sincere concern to help clients in therapy, that getting ahead of the client isn't useful to the client or the work in therapy.

For example, clients often come in with a particular presenting problem, but the therapist might sense that the presenting problem is really something else.

In this example, the therapist is often right, but if she gets ahead of the client and tries to steer the client in another direction before the client is ready, the client will either get confused or feel unheard and leave.

As a result, even when an experienced psychotherapist senses that there is another issue that is a bigger problem than the one the client presents, the therapist needs to proceed in a tactful and gentle way.

Rather than rushing in with astute psychological insights, the psychotherapist first needs to assess the client for what s/he might be ready for, especially at the beginning stage of psychotherapy, and then decide how to proceed.

The following fictional clinical vignette will demonstrate these issues:

Fictional Clinical Vignette: Starting Where the Client Is in Psychotherapy

Ned
When Ned began attending psychotherapy, he told his new psychotherapist that he wanted to improve how he communicated in his relationship so he and his girlfriend could get along better.

Ned described a relationship dynamic where his girlfriend, Jane, liked to talk about their relationship from time to time, especially when she thought they had problems, but Ned hated these talks.

He felt that his girlfriend usually made "a big deal out of nothing" and he told her this.  At first, when she told him that this hurt her feelings, Ned didn't understand.  But after they argued about this a few times and Jane threatened to leave him, he decided he had better improve his communication skills.

As his psychotherapist listened to Ned describe how he often dismissed other loved ones' concerns, she suspected that there were deeper issues involved, but she also knew that if she brought this up with Ned too soon, she would alienate him, so she waited for the right moment when she thought he would be more receptive.

At the point when Ned and his psychotherapist formed a good working relationship in therapy, his psychotherapist explored with Ned what he thought was going on for him in this relationship.  She recognized that Ned seemed more open to this type of exploration at that point.

Ned responded by telling his therapist that, even though he no longer dismissed Jane's concerns, he still couldn't understand why she wanted to talk about the relationship.  He thought he was being much more considerate with Jane by not dismissing her concerns.

His therapist helped Ned to put himself in Jane's shoes to try to understand what was bothering her.  He thought about it and said that Jane said she would like to get closer to him, but she felt that he pushed her away emotionally.

As he thought about it more from Jane's point of view, he acknowledged that too much closeness frightened him and maybe this was why he dismissed Jane's concerns.

Over time, as Ned and his therapist continued to explore these issues, Ned realized that he could only take so much closeness with Jane and after that, he was uncomfortable.  That's when he dismissed her concerns and, in effect, created distance between himself and Jane.

He was now realizing that whenever he did this, this made Jane anxious and the more anxious she became, the more she wanted to talk about the relationship so they could get closer.  But the more she  wanted closeness, the more distant he felt.  So, this became the cycle that they were caught in.

Meeting Client Where They Are

Earlier in the therapy, his psychotherapist suspected that Ned and Jane had two very different attachment styles.  It appeared to her that Jane had an anxious attachment style and Ned had a dismissive attachment style (see my article: How Your Attachment Style Affects Your Relationship).

As his therapist talked to Ned about this and provided him with psychoeducation about attachment styles, it was as if a light went off in his head.  Suddenly, this made sense to him and he was motivated to work on the problems in his relationship (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation).

Even though Ned was now ready to work on this problem, his therapist knew that if she had brought up this issue at the start of therapy, Ned wouldn't have been ready to hear it, and he acknowledged as much to her when they discussed it later on in therapy.

Gradually, Ed worked on the underlying issues that caused him to feel frightened of closeness with Jane.  He was also able to tell Jane that, ultimately, he wanted to be closer to her, but he needed to take it slowly.  Jane understood, and she said that she wanted Ned to tell her when he was getting frightened, so she wouldn't keep pushing him and alienating him.

Conclusion
Starting where the client is in therapy is important for the client and the success of the therapy.

A psychotherapist needs to use her clinical skills to assess where the client is, especially at the start of therapy, so she doesn't jump ahead of the client.  She also needs to use her clinical skills to assess when the client is ready to go deeper.  The timing will be different for each client.

It's important for the client and the psychotherapist to have a good therapeutic relationship first before going any deeper in therapy.  A good therapeutic relationship means that the client trusts the therapist and would most likely be willing to look at underlying issues.

If you're in therapy and you feel your therapist is jumping ahead of you or something else in the therapy is bothering you, it's important for you to communicate this to the therapist (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

Getting Help in Therapy
Asking for help can be challenging.  

If you're considering getting help in therapy, the first step is making an appointment for a consultation (see my article:  Tips on Overcoming Your Fear of Asking For Help).

When you choose a psychotherapist, it's important that you feel heard by the therapist (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

I usually advise clients to trust their instincts when they're trying to decide if a particular therapist is right for them.

Psychotherapy can free you from your problematic history so that you can maximize your potential, and a skilled psychotherapist can help you to overcome your problems at a pace that feels right for you.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who uses Integrative Psychotherapy to tailor the therapy to each client's needs (see my article: The Benefits of Integrative Psychotherapy).

I work with individuals adults and couples.

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

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

Overcoming a Need to Rescue Your Loved Ones as Part of a Codependent Pattern

Many people attempt to rescue the people in their lives, especially family members and romantic partners (see my articles:  How to Stop Being the Rescuer in Your Family, Overcoming Codependency: Taking Care of Yourself First, and Overcoming the Need to Be Everyone's Rescuer).

Overcoming the Need to Rescue and Fix Your Loved Ones as Part of a Codependent Pattern

I believe most people who try to rescue others have a genuine concern for their loved ones and want the best for them.  Their intention comes from a good place within them.

At the same time, there are problems involved with rescuing.  One problem is that there are usually underlying emotional issues involved for the rescuers which causes them to feel compelled to fix others. They avoid dealing with their problems by focusing on others instead of themselves.

Another problem is that this dynamic often causes problems in relationships because the person, who is the "rescuee," often doesn't want to be rescued or fixed.  This is bound to cause friction.

Even if they do want to be rescued, the problem is that this dynamic keeps both people from facing their problems and growing and developing as mature, responsible adults.

Usually people who try to rescue others have developed this pattern first with their families and then it carries over into other relationships.

Let's take a look at a fictional vignette which illustrates this dynamic:

Fictional Vignette: Trying to Rescue and Fix Your Loved Ones:

Nina
As the oldest in her family, Nina's parents and siblings relied on her to resolve family problems from the time she was a young child.

From the time Nina was seven or eight years old, Nina's mother, who was a single parent, often confided to Nina about her problems.  She treated Nina as if she were a close friend rather than a child (see my article: Why Your Child Can't Be Your Best Friend).

Even after they were grown, Nina's siblings relied on Nina to bail them out when they got into trouble or needed money.

Helping her mother and siblings often meant that Nina would put herself in a financial bind, but she found it impossible to say no to them.

When she started dating Ed, Nina recognized that he drank too much, but she liked him a lot and she thought, "I can change him" (see my articles: Relationships: "I'll Change Him After We Get Married.")

Little did she know that Ed didn't want to stop drinking, and he resented her suggestions that she could help him.  After a few months, Ed's resentment led to his breaking up with Nina, which upset her.

A few months later, she became friendly with Tom, who worked in the same restaurant where Nina worked.  At first, they were friends.  But, as time went on, their friendship turned into a romance.

Shortly after Nina began dating Tom, she discovered that he had serious financial problems even though he did well as the bartender at the restaurant.

When Nina offered to lend him money and make a budget for him, Tom felt ashamed and told her that he didn't need her help.  But Nina persisted, which resulted in Tom ending their relationship.

Soon after they broke up, Tom left the restaurant and took a job somewhere else because it was too uncomfortable for both of them to work in the same place after they broke up.  This saddened Nina because she felt she lost a lover and a friend.

Right after Tom ended their relationship, Nina began getting headaches and backaches, which she never had before.  Her doctor ruled out any medical problems and suggested that it might be related to emotional problems.  He suggested that she seek out help from a psychotherapist.

As Nina described her family history and her romantic relationships, she and her psychotherapist discussed her need to try to fix others--even when these people didn't want it.

Nina said that she felt she could see others' problems much clearer than them could, and she wanted to help.  She took pride in being the "go to" person to be relied upon, "I'm the one everyone comes to for help in my family."

When her psychotherapist asked Nina who she went to when she had a problem, Nina acknowledged that she usually didn't go to anyone--not even her close friends--because it made her feel too uncomfortable.

Over time, as Nina and her therapist continued to discuss these issues in their psychotherapy sessions,  Nina realized how much she was neglecting herself by trying so hard to help others.

Since she gave her adult siblings so much money, she had little for herself.  She had not even bought herself a new coat in several years because her youngest brother had a gambling problem and she was constantly giving him money to bail him out.  She thought it would be "cruel" to allow him to face the consequences of his actions.

She also paid her mother's bills, even though her mother had a good job and could afford to pay her own bills, "Ever since I began working, I've just always paid my mother's bills."

When her therapist asked Nina to think about her situation as if it were someone else's story, Nina thought about her it for the first time, "It's just what I've always done, and I've never thought about it before."

But as she considered the personal sacrifices that she was making, she realized that she couldn't continue to do this.  She knew it would be hard for her to stop and for her family, "How will my family get along without my help?  They're not used to taking care of themselves."

What really convinced Nina that she needed to change was when she realized that she was focusing so much on other people so that she wouldn't focus on herself.

Nina's psychotherapist provided Nina with information about codependency so Nina could understand this is a dynamic and the ways to overcome it (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation).

Nina's psychotherapist also told her about how Al-Anon  meetings can help to overcome codependency.  Nina tried a few meetings, but she felt too overwhelmed by what others shared, so she decided not to continue and read the literature instead (see my article: The Early Stage of Recovery: What to Do If 12 Step Meetings Are Too Overwhelming For You?).

As difficult as it was for Nina, she and her therapist came up with a plan to deal with her codependency:  Over the next several months, she would gradually stop contributing as much financially to her family so they had time to work on becoming more independent and she had time to learn how to stop rescuing them.  Nina realized that, although she thought she was helping them, she was really fostering an unhealthy dependency and they would never learn to take care of themselves.

She was aware that her mother and siblings would protest because this would be a big change for them, and they wouldn't like it.

At the same time, Nina and her therapist began to explore the underlying reasons why Nina felt compelled to take care of others.  She discovered that she felt a need to have control over her siblings and her boyfriends because things were so chaotic when she was growing up.  Taking care of others and feeling in control helped her to have a sense of stability.

She began to understand that her intention for wanting stability in her family was a good one, but the codependent dynamic was hurting her and her family and her former boyfriends.

As part of Nina's plan, she told her family about the plan.  Initially, Nina's mother and siblings were angry with her and they refused to talk to her. They felt like she was being cruel, even though the plan would take place over several months.

But things gradually turned around.  During that time, Nina's mother became more conscious of how she spent money and took over her own bills.  After a several months, she told Nina that she felt a sense of pride that she could manage on her own because she never thought she would be capable of doing it.

Her brother, who gambled, got help from a psychotherapist who specialized in working with people with compulsive gambling problems.  He also began attending Gamblers Anonymous and got a sponsor.  He had a few "slips" along the way, but he took responsibility for them and felt better about himself.

Nina's other siblings got more serious about finding work and, after a few months, they were each employed and taking more responsibility for themselves.

Even though Nina developed insight into her codependent patterns, she had to remain aware of her problem at first or she knew she could easily fall back into her old ways.

Nina and her therapist worked on the underlying issues related to her childhood trauma, including how overwhelmed she felt as a child by the chaos in the household, using EMDR therapy (see my article: What is EMDR Therapy?).

As Nina dealt with her own underlying issues, her headaches and backaches went away.  As her doctor suggested, what appeared to be solely medical problems were related to her emotional problems.

Overcoming the Need to Rescue Your Loved Ones as Part of a Codependent Pattern

Working through her early trauma helped Nina to make healthier choices in her relationships (see my article: Choosing Healthier Romantic Relationships).

Conclusion
Trying to rescue and fix others is damaging to the rescuer as well as the people the rescuer wants to help.

A pattern of rescuing behavior usually involves codependency, which keeps the rescuers from focusing on their own problems because they're so busy trying to rescue others.

This pattern is often a blind spot for people who are codependent, but it can be worked through in therapy (see my article: Overcoming Your Blind Spots).

Changing patterns isn't easy or quick, but when people begin to see how beneficial these changes are for themselves and others, they realize that it's worthwhile.

Getting Help in Therapy
If this article resonates with you, you could benefit from getting help from a licensed mental health professional who specializes in helping people overcome codependency (see my article: The Benefits of Psychotherapy).

Dealing with the underlying issues at the root of the problem and freeing yourself from a traumatic history allows you and your loved ones to grow and flourish.

Rather than suffering on your own, you could get the help you need from a skilled psychotherapist (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

I have helped many clients to overcome their codependent patterns as they work through the traumatic roots of their problems.

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. 

Integrative Psychotherapy: Discovering the Root of Self Abandonment

In prior articles, I've discussed fear of abandonment where it involves a fear of being abandoned by other people.

See my articles: 

How Psychotherapy Can Help You to Overcome Your Fear of Abandonment 

The Connection Between Abandonment Issues and Codependency

Fear of Abandonment: Leaving Your Relationship Because You're Afraid of Being Abandoned).  

There is also another common issue around abandonment that involves always being the "giver" to the point where it's hurtful to oneself, which is a self abandonment, the focus of this article.

Integrative Psychotherapy: Discovering the Root of Self Abandonment 

Self Abandonment: Always Being the Giver to the Person Who is Always the Taker
Many people, who focus on others more than they focus on themselves, tend to be givers to people where there is little to no reciprocity in their relationship.  As a result, the people who are givers are always giving and the people who are receiving are always taking.  This is a typical codependent relationship  (see my article: Overcoming Codependency).

While others, who are outside of this situation, might see the imbalance in this type of relationship, the person who is the giver rarely, if ever, notices the problem.  They're so focused on giving that they emotionally abandon themselves on behalf of others, especially others who are all too willing to take advantage of them.

The following fictional vignette illustrates this dynamic:

Tania
Tania began therapy after a tumultuous breakup with her last boyfriend.

She and Ray were dating on and off for four years.  During that time, Tania lost several friends, who didn't like Ray and who were constantly telling Tania to leave him.  They were tired of hearing Tania complain about the on again off-again relationship with Ray.

The breakup occurred after Ray lost his job again, and Tania couldn't afford to give him any more money.

Prior to that, Tania had given Ray thousands of dollars over the years every time he was terminated from a job, and he never paid her back.  But she was unable to help him this time because it would have meant she couldn't pay her own bills.

She explained to her psychotherapist that Ray interpreted this as Tania not caring about him, and he ended their relationship and refused to talk to Tania, which upset her.

Tania told her therapist that she would have given Ray the money if she could have afforded it, but she just couldn't do it.  She felt hurt and sad that Ray thought she didn't care.

As Tania and her therapist talked about Tania's history of relationships, it became evident that Tania had a similar pattern in all of her past relationships.  She would give and give until until she couldn't give anymore, then her boyfriend at the time would leave her (see my article: Unhealthy Relationships: Bad Luck or Poor Choices?).

Despite her friends trying to tell Tania that Ray and the other boyfriends were taking advantage of her, Tania didn't see it when she first started therapy.  She felt that her friends didn't understand the men that she dated and why she sacrificed so much for each of them (see my article: Could It Be That Your Friends See Things About Your Lover That You Don't See?).

When she was describing her family history to her psychotherapist, she said she was raised in a religious household where the emphasis was on putting others first.  She felt that she was practicing the beliefs that she was raised with, but her parents and siblings didn't agree.  They felt she was carrying it too far because she wasn't taking care of herself.

Tania's psychotherapist practiced Integrative Psychotherapy, which included an integration of psychodynamic therapy and other forms of therapy, including EMDR therapy, Somatic Experiencing, clinical hypnosis, and Ego States work, also known as Parts work (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

Her therapist recommended that she and Tania explore the part of her that tended to give so much to others--to the point of hurting herself--and to expect little to nothing in return.

In doing Ego States therapy, Tania was able to sense the part of her that felt she had to give to others even when it had a negative impact on her.  While she was in a relaxed state, Tania went back to a memory with Ray where she gave him her last $2,000 so that she had little money for herself.  She had so little that she had to cut back on seeing her friends until she got paid later in the month.

When she was back in that memory, Tania remembered feeling she must help Ray, even though it came as a big sacrifice to her.

As she got back into that self state, she remembered having a moment of doubt before she gave she gave Ray the money but, at the time, she quickly brushed that feeling aside because it made her feel guilty.  Rather than brushing that feeling aside during the therapy session, her therapist asked her to stay with it and see what else came up.

As Tania held together both feelings--the feeling that she must give the money to Ray and the feeling of doubt that she had--Tania felt the inner conflict, which was mildly uncomfortable for her.  But she was able to tolerate the inner conflict while she was with her therapist, so she stayed with it and gave that doubting part of voice, "If that part could speak, it would say, 'Don't give him the money.  He always loses his job and you bail him out even when bailing him out hurts you'" (see my article: Shifting Self States).

Immediately after allowing this doubting part to express itself, Tania told her therapist that she felt guilty for feeling this way, "This is what my family and friends were saying."

It was clear to Tania and her psychotherapist that this doubting part was small in terms of the influence that it had on her and especially in comparison to the part of her that felt compelled to give.

But after she expressed the doubts that made her feel so guilty, she was surprised that she also felt more relaxed.  She realized that this conflict between these two parts of herself were going on inside for a long time, but she never allowed herself to feel the doubting part for long.

Over time, as Tania and her psychotherapist continued to do Ego States work, Tania discovered other parts of her that were angry and sad.

The sad part of her contained feelings that she wasn't allowing herself to feel before she started therapy--sadness for herself that she gave so much and got so little in return.  The angry part, which she also suppressed until now, was angry with Ray and her prior boyfriends for not appreciating her more.

She also discovered another part of her that was very young and felt unlovable (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

The part that felt unlovable was at the root of her need to always give to her boyfriends.  That part felt that since she was unlovable, she had to keep giving so that these men would love her.  But she realized that it never worked out that way.

Not only did her boyfriends not appreciate her, but when she had no more to give, they left her.  So, she experienced self abandonment as well as abandonment by them.

Tania worked hard in therapy to distinguish these conflicted inner states and to separate the parts of herself from her religion.  She even spoke with her minister about her pattern of giving so much to her boyfriends and getting little to nothing in return.  He told her that Ray and the others took advantage of her and she needed to take care of herself first.

Over time, Tania was able to see that, before these men ever left her, she abandoned herself because she felt so unlovable and unworthy, so she and her therapist used a technique in clinical hypnosis called the Affect Bridge to trace back when she started to feel this way.

Once they discovered the earliest memory of Tania feeling unlovable, which was part of her childhood, they were able to use EMDR therapy to work through the trauma related to unresolved childhood issues.

Conclusion
With regard to abandonment issues, most of the focus in psychotherapy tends to be on how clients feel abandoned by others.

But many clients also abandon themselves when they become overly giving with people who take advantage of them.  Each client has his or her own underlying reasons as to why they continue to engage in this dynamic.

Integrative psychotherapy, which includes a combination of different types of therapy depending upon the needs of the client, is often effective in getting to the root of these problems so they can be worked on and resolved.

In the fictional vignette above, the therapy began with psychodynamic therapy (essentially talk therapy) and then the psychotherapist used Ego States therapy to help the client to understand the various parts of herself involved in this self defeating dynamic.

In this vignette, initially, the client was much more aware of the part of herself that felt compelled to keep giving to boyfriends, even when they were unappreciative.

As Tania and her therapist were able to distinguish other parts of herself that she had suppressed in the past, she discovered a sad part and an angry part that were in conflict with the giving part.

The Affect Bridge, a technique in clinical hypnosis, allowed the client to trace back the earliest memory related to the over-giving part which felt unworthy and unlovable.  As a result, they discovered the root of the problem.

Using EMDR therapy, they were able to process this earlier developmental trauma so that it no longer affected Tania.

Although this work is summarized briefly of necessity since this is a blog article, the therapeutic work involved is neither quick nor easy since it usually involves many layers of history.  But it tends to be faster and more effective than just talk therapy alone.

Getting Help With Integrative Psychotherapy
Integrative psychotherapy gives the psychotherapist and the client much more flexibility to use different types of therapy to get to the root of the problem and resolve it.

Using psychodynamic or talk therapy alone could take years to get to the root of this type of problem, which is a common problem for many people.

If the dynamics in this article resonate for you, you could benefit from getting help from a licensed mental health professional who practices Integrative Psychotherapy.

Rather than continuing to engage in self defeating patterns, you could work through these issues in Integrative Psychotherapy and free yourself from your traumatic history (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 uses Integrative Psychotherapy in a collaborate way with each client to develop the most effective psychotherapy plan.

I work 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.

Integrative Psychotherapy: Psychotherapy and Somatic Mindfulness to Overcome Developmental Trauma - Part 2

In a prior article, Integrative Psychotherapy: Psychotherapy and Somatic Mindfulness to Overcome Developmental Trauma - Part 1, I began a discussion about how I use somatic mindfulness with developmental trauma.  In this article, I'll provide a clinical picture of using the somatic mindfulness, which is an aspect of Somatic Experiencing, as part of an integrative approach in psychotherapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

Integrative Psychotherapy: Psychotherapy and Somatic Mindfulness to Overcome Developmental Trauma

The following fictional vignette is an example of how somatic mindfulness can be used in integrative psychotherapy to help a client overcome unresolved early childhood trauma.

Fictional Vignette: Integrative Psychotherapy: Psychotherapy and Somatic Awareness to Overcome Developmental Trauma

Meg
Meg had been in therapy before and talked about her childhood trauma.  But even though her prior psychotherapists were empathetic and supportive, Meg continued to feel negatively affected by her unresolved trauma.  She continued to feel fearful of being in a serious, committed romantic relationship because she had problems with trust.

When she spoke with a friend, who was seeing a psychotherapist who used a mind-body integrated psychotherapy approach, Meg decided to look for her own therapist who used an integrative psychotherapy approach.

Meg explained to her new psychotherapist that she witnessed domestic violence between her parents when she was growing up.  Although her father never hit Meg, she grew up with a fear of trusting men.

As a result, whenever a relationship became serious, on an unconscious level, she would find a way to sabotage the relationship.  The subsequent break was a relief to her at first.  But soon after that she regretted it.

Her previous therapy helped Meg to gain insight into how she destroyed her relationships and the connection with her childhood trauma, but it didn't help her to stop doing ruining her relationships.

Now that she was in her early 30s, Meg wanted to get married and have children, but she feared that if she kept sabotaging her relationships, she would be alone.

Her new psychotherapist provided Meg with psychoeducation about how intellectual insight isn't enough to overcome trauma.

She also explained to Meg how she used integrative psychotherapy to help clients overcome trauma (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

Next, her therapist helped Meg to develop internal resources so that when they would eventually begin to process her traumatic experiences, Meg would be able to self soothe rather than get emotionally overwhelmed (see my article: Developing Coping Strategies in Therapy Before Processing Trauma).

In addition, her psychotherapist introduced Meg to Somatic Experiencing (SE) and the concept of somatic mindfulness, which is part of SE.

Since Meg had difficulty identifying her emotions related to her unresolved childhood trauma, her therapist slowed things down and helped Meg to begin to notice what she was feeling in her body when she talked about her early memories.

Initially, Meg had problems feeling much of anything in her body.  But, as she and her therapist continued to use Somatic Experiencing, Meg became aware of how much tension she held in her throat and jaw when she talked about these early traumatic memories.

As they focused on the tension in Meg's jaw and throat, Meg remembered how she wanted to yell at her father when she heard him hitting her mother, but she was too afraid to do it at the time.

As she continued to focus on the tension in her jaw and throat and she talked about her fear and anger related to those early memories, she felt an emotional and physical release and a relaxation in her throat and jaw.

Meg also talked about how, as a child, she wanted to run to get a neighbor to help her mother when her father was hitting  the mother, but she felt "frozen" in her room, so she couldn't move (see my article: Somatic Experiencing: Overcoming the Freeze Response Related to Trauma).

As she talked to her therapist about this, Meg became aware that she felt a numbness in her lower legs from her knees down.  This was something that Meg had never felt before.

Using a technique in Somatic Experiencing, her therapist helped Meg to imagine that she could take one molecule of energy at a time from the upper part of each leg that felt connected to her and move it to the lower parts of her leg that felt numb.  Gradually, Meg could feel the energy flowing back in her legs.  She also felt empowered.

Gradually, over time, Meg felt more connected to her body and was able to more easily connect feelings to various parts of her body in her therapy sessions.  As more parts of her body came back "online" again, she felt more empowered and energized.

There was still one particularly difficult memory that she was grappling with, so her therapist used EMDR therapy to help her to overcome the trauma related to this memory (see my article: What is EMDR Therapy?).

Gradually, as Meg worked through her earlier trauma in therapy, she was no longer afraid to be in a relationship. She was able to separate out the trauma that occurred to her in the past from her adult life now (see my article:  Working Through Emotional Trauma in Psychotherapy: Separating "Then" From "Now").

Conclusion
Integrative psychotherapy allows psychotherapists to combine the best aspects of different types of therapy to tailor the treatment plan to the needs of each client.

Combining psychotherapy and somatic mindfulness, which is a part of Somatic Experiencing, is an important aspect of integrative psychotherapy.  It allows clients, who have unresolved trauma, to begin the process of overcoming dissociation, especially dissociation which has caused a disconnection between the mind and the body.

This gentle approach to resolving trauma allows clients to work at their own pace in a safe way.

As clients re-establish a connection between the mind and the body, they are able to overcome traumatic events from the past.

Getting Help in Therapy
If you have been suffering with unresolved trauma, the past is still affecting you in the present.

An intellectual understanding of your trauma is usually not enough for you to overcome the negative impact of traumatic experiences, especially trauma that occurred in childhood.

Rather than suffering alone or continuing to feel frustrated by talk therapy, you could benefit from working with a licensed psychotherapist who uses Integrative Psychotherapy so you can free yourself from your traumatic past (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 practices Integrative Psychotherapy.

I work with individual adults and couples, and I have helped many clients to overcome their traumatic experiences.

I also work adjunctively with clients who want to maintain their relationship with their primary psychotherapist who doesn't practice Integrative Psychotherapy.

Using Integrative Psychotherapy, I work collaboratively with each client to develop the treatment plan that is best for his or her particular problems.

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.