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Wednesday, January 3, 2018

Tips For Coping With Panic Attacks

In a prior article, What's the Difference Between Fear and Anxiety?,  I discussed the difference between fear and anxiety.  In this article, I'm providing tips for coping with panic attacks.

Tips For Coping With Panic Attacks

What Are Panic Attacks?
A panic attack is usually caused by anxiety. Symptoms usually come on suddenly.  The most common symptoms can include:
  • shortness of breath
  • muscle spasms
  • choking sensation
  • nausea
  • irregular heartbeat
  • dizziness or lightheadedness
  • shaking
  • sweating
  • fatigue
  • tingling sensations in hands or feet 
  • feelings of foreboding
  • fear that you're losing your mind
  • fear that you're going to die

Not everyone gets every symptom.

If you're experiencing these symptoms, its important to see your medical doctor to rule out a medical cause.

Panic attacks can be debilitating.  Some people get occasional panic attacks, and others have chronic panic attacks.  I

Tips For Coping With Panic Attacks
If you have occasional panic attacks, relaxation, grounding and breathing exercises can be helpful.  See my articles for tips on how to cope with panic attacks:

Journal Writing to Relieve Stress and Anxiety
Learning to Stay Calm During Stressful Times
Finding Inner Peace During Uncertain Times
Self Care: Feeling Entitled to Take Care of Yourself
The Mind-Body Connection: Mindfulness Meditation
Self Reflection and Basic Mindfulness
Research Shows That Meditation Can Change Your Brain
Learning to Relax: Square Breathing
Staying Calm When You're in the Middle of Chaos
Finding Moments of Peace During Stressful Times
Self Soothing Techniques to Use When You're Feeling Distressed
Learning to Relax: Going on an Internal Retreat
Discovering the Quiet Place Within Yourself


Panic Attacks Can Get Worse If Untreated
People who have panic attacks often become afraid of when they will have the next panic attack.  For many people, this causes them to avoid certain activities, including going outside.

This avoidance causes its own problems.  For instance, panic attacks can include agoraphobia, a fear and avoidance of being out in public.  If someone develops panic attacks with agoraphobia, this is an obvious hindrance to maintaining a job and a social life.

If you have panic attacks, you could benefit from seeing a licensed mental health professional who has experience helping clients with panic attacks and other related problems with anxiety.

Getting Help in Therapy to Overcome Panic Attacks
For many people panic attacks get worse over time without treatment, so it's important to get help sooner rather than later (see my article: How to Choose a Psychotherapist).

A skilled psychotherapist can help you to overcome the debilitating effects of panic attacks, so you can live your life with a sense of well-being.

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

I work with individual adults and couples.

I have helped many clients to overcome panic attacks.

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.























Tuesday, January 2, 2018

Coping With Family Members Who Make Passive Aggressive Comments to You

In prior articles, How to Recognize Passive Aggressive Behavior and How to Change Passive Aggressive Behavior, I discussed passive aggressive behavior in relationships.  In this article, I'm discussing how to deal with family members who make passive aggressive remarks and try to pass it off with saying, "I was only telling you for your own good" or "I was only joking."

What is Passive Aggressive Behavior?
Passive aggressive behavior is a tendency to engage in indirect, thinly veiled hostile behavior.  This includes making insulting remarks, sulking, sullen behavior, stubbornness or delaying (or not doing) tasks that were agreed upon.

Coping With Family Members Who Make Passive Aggressive Comments to You

The following fictional vignette illustrates how family members make passive aggressive comments:

Fictional Vignette: Coping With Family Members Who Make Passive Aggressive Comments:

Rita
Before Rita went home for the holidays, she told her parents and her younger sister that she decided to stop drinking because she realized that she was drinking too much lately.  She knew that her family tended to drink a lot during the holidays, and she didn't want to be pressured to drink, so she let them know in advance to avoid the pressure.

When Rita arrived at her parents home, her sister, Ann, opened the door with a cocktail in hand and told Rita to help herself to whatever alcoholic drink she wanted.

Feeling annoyed, Rita reminded Ann that she was not drinking.  Ann rolled her eyes at Rita, "Oh, you're not going to be any fun.  It's the holidays.  Everyone drinks on the holidays.  You can have just one drink, can't you?"

Rita ignored her sister, but her sister persisted by enlisting their mother, "Mom, can you believe Rita's not drinking?"

Their mother, who also had a drink in her hand, smiled, "Rita, don't be a bore.  Make yourself a drink."

Rita felt so angry that she was shaking and on the verge of tears, "For once, I wish you two would hear me.  I've been drinking too much lately and I want to stop"(see my articles: How to Cope With Difficult Family Visits and How to Cope With Getting Emotionally Triggered During Family Visits).

Ann laughed and waved her hand at Rita in a dismissive manner, "Don't be so dramatic.  I just want you to have a good time.  Don't take it so seriously."

Their mother joined in and said to Ann, "Rita has always been so serious.  Now, look at her long face."

When Rita angrily put her coat back on and started for the door, her mother said, "Oh come on.  You're not really leaving, are you?  I was just kidding."

But Rita was too angry to stick around, so she got back in her car and drove home with tears in her eyes the entire way.

During her next psychotherapy session, she spoke with her psychotherapist about her mother's and sister's passive aggressive comments and how much they hurt her.

Rita's therapist acknowledged that her family's remarks were passive aggressive and they talked about how Rita could deal with these kinds of remarks the next time that she visited her parents' home (see below).

How to Cope With Your Family Members' Passive Aggressive Comments
The following suggestions can be used for anyone that you encounter who makes passive aggressive remarks:
  • Stay Calm:  Although it can be difficult to stay calm when family members make thinly veiled hostile remarks, it's important to keep your cool so you can think about what you're saying and your response doesn't make matters worse.  If you can't stay calm in the moment, take a break and then speak to your family once you're composed.
  • Confront the Passive Aggressive Behavior By Setting Boundaries:   While remaining calm, confront the passive aggressive behavior and set boundaries with your family. "Confronting" doesn't mean that you're aggressive or offensive.  It means that you're asserting yourself in a healthy way.  Why assert yourself?  If you don't your family members will continue to speak to you in thinly hostile ways.  In addition, if you don't address this behavior, their remarks might erode your self esteem.  You will also harbor unspoken resentments, which can come out in your own passive aggressive or sarcastic comments.  This only makes things worse (see my article: Setting Healthy Boundaries).
  • Let Your Family Know What You Consider to Be Unacceptable:  Rather than hoping that your family will understand without being told, calmly and tactfully let your family members know what is and isn't acceptable to you.  For example, if your mother tends to make passive aggressive remarks about your weight, let her know that her remarks hurt your feelings and that you don't want to hear them.  She might respond by making another passive aggressive remark, like, "I'm only telling you for your own good."  But don't buy it.  While you're not trying to change her, you need to stick up for yourself.  Be very clear and specific about the type of topics that you don't want to discuss and stick with it--even if you have to tell your family members a few times.
  • Ask Them If There's Something They Would Like to Discuss More Directly:  There are often other issues brewing underneath passive aggressive comments.  Sometimes, it's completely unrelated to whatever they're saying to you.  They might still be angry about something that happened years ago and they're seizing on a passive aggressive remark to even the score--whether they realize it or not.  By offering to address whatever might be bothering them, you're letting your family know that you're open to hearing about things that might be bothering them that could be lurking underneath their hostile remarks.
  • Have a Direct Discussion With Your Family Members and Clear the Air:  If your family is open to admitting that there are other issues involved, have a direct discussion and clear the air.  It's better to clear up old unfinished business than to continue to be subjected to passive aggressive behavior.

Conclusion
People who make passive aggressive remarks often don't know how to communicate directly, so they use an indirect and hurtful way of communicating, namely, passive aggressive comments.

Whether they realize it or not, passive aggressive remarks can be sadistic and hurtful.  These remarks often cause rifts in families.

You will need to assert yourself in a tactful and calm way to set boundaries.  This needs to be done in person--not by email, text or over the phone.  Anything other than face-to-face communication will be less effective.

Remember that you have a right to stick up for yourself.  You're not trying to change them.  You're setting boundaries, letting them know what's acceptable and what's not, asking them to respect your feelings and your wishes, and you're setting boundaries.

Getting Help in Therapy
Confronting passive aggressive behavior and setting boundaries with family members can be difficult, especially if there is a long history of problems.

Rather than suffering on your own, seek help from a licensed mental health professional who can help to address these issues (see my article: How to Choose a Psychotherapist).

Once you have been assertive and set boundaries with your family, you'll feel better about yourself and you will have grown in a way that you didn't think possible before.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who provides integrative psychotherapy in a dynamic and collaborate way (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

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.









Sunday, December 31, 2017

Marriage: Are You Expecting Too Much From Your Spouse?

People are relying much more on their spouses these days to fulfill all their needs, which puts a strain  on the relationship and can lead to the demise of the marriage.  If you're having problems in your marriage due to possible unrealistic expectations, you might want to ask yourself if you're expecting too much from your spouse, which is the subject of this article (see my article: Relationships: Your Spouse Can't Meet All Your NeedsWhen Love Doesn't Conquer All and Developing and Maintaining a Happy Relationship).

Marriage: Are You Expecting Too Much From Your Spouse?

Spouses With Unrealistic Expectations: Your Spouse Can't Meet All Your Needs
Over the years, I've seen many couples in my psychotherapy practice in New York City who love each other and want to make their marriages work, but one or both of them have unrealistic expectations.

When these expectations aren't met, the spouse with the expectations often feels angry and resentful.  The spouse who is being blamed for not living up to expectations can feel pressured by the demands and resentful that s/he is being held responsible for the problems in the marriage.

Traditional marriage vows include cherishing your spouse, remaining in sickness and health and for richer or poorer.  Those used to be the expectations people had when they entered into a marriage.  But now many couples expect, in addition to those expectations, that their spouses will make them feel emotionally fulfilled, attractive, successful, competent, and help them to grow psychologically.

This would be a tall order for several people to fulfill, but to expect one person to fulfill all these needs is too much pressure and can lead to an erosion of the marriage.

I think most people, who have unrealistic expectations, don't realize how much pressure they place on their spouses because they haven't stopped to think about it.  They might be focused on one aspect of their expectations at any given time and not think about all the other demands that they've made.

Complicating all of this is that so many people see less of close friendships and family members after they get married and rely solely on their spouses for all their needs.

Whereas before these other relationships probably fulfilled them to a certain degree emotionally, intellectually and perhaps creatively, now they expect their spouses to fill all these roles.

Let's take a look at a fictionalized vignette which illustrates the typical dynamics in a marriage where too much is being demanded of the spouse:

Fictional Vignette: Are You Expecting Too Much From Your Spouse?

Nina and Dan
Two years into their marriage, Nina and Dan began couples counseling because they were constantly arguing (see my article: Starting Couples Counseling).

When they first started dating five years before, they enjoyed each other's company and hardly ever argued.  They had a passionate relationship and enjoyed similar interests.  But after two years of marriage, they were each questioning whether they made a mistake by getting married.

Nina complained that Dan used to make her feel attractive, intelligent and fun to be around.  But after two years of marriage, she felt that he hardly ever complimented her and no longer made her feel special.

She also complained that they were no longer having as much sex as they used to have before they got married, and there were times when the sex felt boring rather than how passionate it used to feel while they were dating.

Nina also resented that Dan took less interest in her personal growth, whereas before he spent time encouraging her and making suggestions on how she could grow as a person.  All of this made Nina feel lonely, sad and angry.

Dan fumed that he was currently working 80 hours or more a week at his law firm, and he was often exhausted, "The last thing I want to hear when I come home exhausted is that I'm not living up to Nina's expectations.  I love her, but I can't take all her demands.  She used to see more of her friends and her sisters, who were emotionally supportive of her, but she hardly sees them now.  She expects me to be everything to her.  But I can't be everything.  She doesn't understand that."

Nina acknowledged that she used to spend more time with her sisters and friendships, but she thought once she got married, Dan would fulfill her needs.  She said she knew he came home exhausted and she didn't want to pile on a bunch of complaints, but she felt increasingly unhappy and she didn't know what to do.

As Nina and Dan began to work on their problems in therapy, Nina came to see just how much she was expecting from Dan and that she needed to reconnect with friends and family to get some of her needs met.  For his part, Dan acknowledged that he could cut back on his work hours to spend more time with Nina.

Over time, they were able to discuss in couples therapy what each of them could reasonably expect from the other.  Nina spent more time with her friends who met many of her needs.  She also spent more time with her sisters, who were emotionally supportive and fun to be around.  She realized how much she missed these relationships once she reconnected with them.

Dan was able to cut back on the hours he worked so he could come home and spend more time with Nina.  Once she stopped criticizing him, he also felt more open to her emotionally and sexually.

Nina also realized in couples therapy that, after a while, sex isn't as passionate as it was during the early stage of the relationship, but it could be more emotionally fulfilling. Together Dan and Nina planned special evenings together to revive their emotional and sexual intimacy.

As they got closer, Nina told their couples therapist that prior to coming to couples counseling, she didn't realize that she was piling all these demands on Dan.  But after talking about it in their therapy, she realized that it would have been too much for any one person.  She was also happier to be reconnected with friends and family and to discover that some her needs could be met in these relationships.

Marriage: Are You Expecting Too Much From Your Spouse?

Dan said he was now pleased to come home to Nina.  After she reconnected with family and friends, he felt a weight was lifted from him and he no longer felt like "a bad husband."  He was glad that Nina no longer saw him as failing in their marriage.

Conclusion
Generally, people have greater expectations these days that they will have all of their needs met in their marriage.  This is especially true if one or both people in the marriage have given up other important emotional connections with family and friends who met some of those needs.

It's important for each person to be open and to discuss what they want from their spouse and what they each can reasonably do (see my articles: Are You Too Afraid to Talk to Your Spouse About What's Bothering You?  and How to Communicate More Effectively in Your Relationship).

Becoming aware of what you're demanding of your spouse is the first step in resolving this problem.  Each of you needs to be able to listen to and respect what the other person has to say, even when it's difficult to hear.

Once you've become aware of your spouse's feelings, you both have an opportunity to renegotiate your expectations.  This might mean that you don't get everything that you want or need, but you might have a happier marriage.  Also, consider the importance of maintaining connections with supportive family and friends.

Getting Help in Therapy
If you've gotten to a point in your marriage where you can no longer communicate with each other without your discussion devolving into an argument, you could benefit from seeing a couples therapist (see my articles  Relationships: When Expressing Your Feelings Turns Into Verbal Abuse and The Benefits of Therapy).

Choose a licensed mental health professional that you both feel comfortable with and who has experiencing helping couples with your issues (see my article: How to Choose a Psychotherapist).

Getting help to discuss what you would like and how you can renegotiate your relationship could save your marriage and help you both to feel more fulfilled.

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

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 regular business hours or email me.








Saturday, December 30, 2017

EMDR Therapy For Performance Enhancement

Many clients start psychotherapy because they want to enhance their performance in their career or in their personal life.  Although EMDR therapy is generally known for resolving psychological trauma, since it was developed by Francine Shapiro, Ph.D. in the 1980s EMDR has been used in many other areas, including anxiety reduction, overcoming phobias, and performance enhancement (see my articles: What is EMDR Therapy? and What is Adjunctive EMDR?).

EMDR Therapy For Performance Enhancement

Executives, actors, writers, singers, athletes, artists and people in many other situations seek help from EMDR therapists to overcome their performance anxiety and their related negative beliefs that are getting in the way of their success.

The following fictional vignette illustrates how EMDR therapy is used for performance enhancement:

Fictional Vignette: EMDR Therapy For Performance Enhancement:

Tom
When Tom's director told him that he was promoting him to an executive level position with a significant increase in salary, Tom was thrilled.  He worked hard for this promotion, and he was happy that he was being recognized by his director.

Then, his director told Tom that part of the new responsibilities would be to give presentations to the board of directors, and Tom felt a sinking feeling in the pit of his stomach.

While Tom really wanted the promotion, he dreaded giving presentations--especially to the board of directors.  He suffered with a lifelong dread of public speaking.  Even when he was in high school and he was asked to address his teachers and fellow students, he stammered and trembled on stage.

Giving his presentation in high school was one of the most humiliating experiences of his life. After that experience, he avoided public speaking.  Even in college, he managed to get through without having to do a presentation.  But now he knew that there was too much at stake for his career and he wanted to overcome his fear of public speaking.

A close friend, Jim, told Tom that his son, who was a college basketball player, was seeing an EMDR therapist for performance enhancement.  His son tended to "choke" in a big game, which made him feel ashamed and discouraged.

Jim told Tom that the EMDR therapist helped his son to overcome his performance anxiety and build his self confidence, which helped to enhance his performance.  He recommended that Tom find an EMDR therapist to deal with his anxiety about public speaking.

Tom had never heard of EMDR therapy before, but he looked it up online and saw all the positive research about EMDR's effectiveness, so he contacted an EMDR therapist to begin therapy.

During the first several sessions, Tom's EMDR therapist obtained information about Tom's family history and helped him to develop internal resources.

Then, they were ready to begin processing Tom's fear of public speaking.  His therapist asked Tom to recall his memory of speaking in the auditorium in high school.  After Tom accessed the memory, she asked him several questions, including what his negative belief is about himself as it is related to that memory.

Tom thought about it and said, "I feel powerless when I have to speak in front of an audience."  He told his therapist that he wanted to feel confident and in control when he does public speaking.

Then, Tom and his EMDR therapist began the desensitization phase of EMDR.  While they were doing EMDR, they discovered that there were several other earlier memories that were related to the memory they were working on so, over time, they processed these underlying memories as well.

When Tom no longer felt anxious about his memories, they worked on the current situation and a future situation until Tom no longer felt anxious about speaking in front of the board of directors.

When his therapist checked with Tom to find out if he felt confident and in control about public speaking, Tom said he was very surprised that he actually did feel confident and in control.

The proof came a few months later when, in his new executive position, Tom had to go before the board of directors to do his first presentation to them.

Before the presentation, Tom was surprised to notice that he wasn't at all nervous.  He felt confident that he was the top expert in his company for the topic he would be presenting, so there was no one else who knew more about it than he did.

EMDR Therapy For Performance Enhancement

During his presentation, Tom felt confident and in control.  He also saw his director standing in the back of the room smiling and nodding at him, which made him feel even more confident.

Afterwards, the chief executive officer thanked Tom for an informative presentation and told him that he hoped it would be the first of many.

Conclusion
EMDR therapy was originally developed to help clients to overcome psychological trauma.  However, since it was first developed, EMDR therapy has been found to be highly effective for other types of problems, including performance enhancement.

The fictional vignette presented above represents one way that clients react to EMDR therapy for performance enhancement.  Of course, everyone is different and will have their own idiosyncratic responses.

Getting Help in Therapy
If you're struggling with a problem related to performance anxiety--whether it relates to career issues, taking steps to improve your health or whatever anxiety might be getting in your way of success--you could benefit from EMDR therapy.

The complexity of the anxiety-related problem will be different for each person.  Some people can overcome their performance anxiety in a relatively short time.  Other people have more complicated problems that have roots that go beyond the current situation and would need more time doing EMDR.

Rather than struggling on your own, you could benefit from working with a licensed mental health professional who is an EMDR therapist.

Overcoming your performance anxiety can open up a new world for you.

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

I work with individual adults and couples.

I have helped clients to free themselves from their performance anxiety so they could go on to achieve success in their fields.

I also work as an adjunct psychotherapist for clients who want EMDR, clinical hypnosis or Somatic Experience and who want to remain with their primary therapist 

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.















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.



























Friday, December 29, 2017

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 TransferenceWhat 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.
  • 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.