How to Recommend Psychotherapy to a Friend

Recommending psychotherapy to a friend can be a sensitive issue.  While it's true that seeing a psychotherapist no longer has the same stigma that it used to have, especially in New York City, there are still many myths and misconceptions about therapy. There are still people who think that that going to therapy means you're "weak" or "crazy"  (see my articles: Common Myths About Psychotherapy: Going to Therapy Means You're "Weak", Common Myths About Psychotherapy: Therapy Takes a Long Time and Common Myths About Psychotherapy: Therapy is "All Talk and No Action."

How to Recommend Psychotherapy to a Friend

So, if you have a friend that you think could benefit from psychotherapy and you know your friend might be offended by the suggestion that s/he go to therapy, you need to proceed with sensitivity and tact and find the right time and way to approach your friend.

Suggestions For Emergency Situations
Take Action in an Emergency:
The suggestions that I'm offering below are for non-emergency situations.  If your friend is threatening to hurt him or herself or someone else, don't minimize your friend's threats.  You need to get your friend immediate help by either calling 911 or bringing your friend to a hospital emergency room.

Suggestions For Non-Emergency Situations

• Start By Listening and Finding Out What Your Friend Needs:  If your friend confides in you that s/he has been anxious or depressed and s/he's not suicidal or homicidal, you need to start by listening.  In some cases, your friend might just want emotional support.  S/he might just need you to listen.  You can let your friend know that you're available to listen and provide emotional support.  In other cases, your friend might need more than just emotional support.  S/he might need help from a licensed mental health professional.

• Normalize Your Friend's Problem (if possible): Sometimes people feel that there's something wrong with them because they have a particular problem.  It's often a relief to them to hear that you and many other people have struggled with the same type of problem.  It can help your friend to feel less ashamed.  So, to the extent that you can, try to normalize your friend's problem by telling him or her if you can relate to the problem.  If you've never experienced this type of problem, be as empathetic as possible to show your friend that you care.

• Ask Questions About What Your Friend Has Already Done to Resolve the Problem:  If your friend is open to therapy then there's no problem.  You're not going to risk alienating him or her with a recommendation that s/he attend psychotherapy.  The trickier situation is when a friend has misconceptions about psychotherapy and would be insulted if you suggested it.  In a situation where you think your friend would be offended by a suggestion to go to therapy, you could start by asking your friend what s/he has already tried to resolve the problem.  Very often, people with longstanding problems have tried many different things before they consider psychotherapy.  Someone who has tried many different ways to resolve a problem might be more open to considering psychotherapy.

• Talk About Your Experiences in Therapy:  After you listen to your friend describe his or her efforts to resolve the problem, you could talk about your experiences and how it helped you, if you feel comfortable doing this.  Knowing that a close friend was or is in therapy helps people to feel more comfortable with the idea of going to therapy themselves.

• Talk About the Benefits of Going to Therapy:  After you describe how therapy helped you, you could also talk about the benefits of going to therapy and address the misconceptions that your friend has (see my article: The Benefits of Psychotherapy).

• Help Your Friend With Suggestions About How to Get Started in Therapy:  If your friend is open to the idea of giving therapy a try, but s/he doesn't know where to start, you could tell him or her that a primary care doctor or health insurance can provide a referral.  Your friend can also find out from other friends if they would recommend a particular psychotherapist.  You can stress to your friend that s/he just needs to take it one step at a time.  The first step would be going to a consultation with a psychotherapist, which does not obligate your friend to continue.  The consultation would be an appointment with a therapist to talk about the problem in a broad way, ask questions, and to see if s/he feels comfortable with the therapist.  Your friend can also have consultations with a few psychotherapists before choosing one (see my article: How to Choose a Psychotherapist).

• Be a Good Friend:  If your friend isn't open to considering psychotherapy at this point in time,  don't push it.  If you push it, your friend might be less likely to get help.  You can just let him or her know that you're available to continue the conversation at another time.  Your friend might need time to absorb the information that you've provided, so let him or her know that you're open to continue the dialogue.  Your role as a friend isn't to convince your friend to go to therapy.  Your role is to be a good friend who listens, provides emotional support and psychoeducation about psychotherapy to the best of your ability.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples (see my article: 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 regular business hours or email me.

Strategies For Making Major Changes in Your Life

Change is hard, especially when it's a major change.  This is why so many people make the same New Year's resolutions every year and why many give up a few weeks into the New Year.  When you want to make a major change, it helps to have strategies to help you through the change process (see my articles: Preparing Yourself Emotionally For Major Changes, Understanding the Difference Between "I Can't" and "I Won't" and Overcoming Obstacles to Making Changes in Your Life).

Strategies For Making Major Changes 

Strategies For Making Major Changes: Ask Yourself the Following Questions:

How Does This Change Fit in With My Core Values?

Ask yourself why this change is important to you and how it fits in with your core values.  This might seem obvious, but many people decide to make a major change without asking themselves this important question.

So, for instance, instead of deciding that you want to lose weight, ask yourself why you want to lose weight and how this fits in with your core values.  Rather than focusing on how many pounds you want to lose, ask yourself why this is important to you.  Is this part of a larger goal to improve your health?  How does this change fit in with the rest of your life?

When the change you want to make is part of your core values, the value of making that change is more apparent, and you will feel more motivated than if you have a narrower focus (see my article: Living Authentically Aligned With Your Values). 

Am I Willing to Deal With the Challenges in the Process of Making a Major Change?

Major changes usually involve long term goals that you make a commitment to achieve and maintain.  So,  you need to ask yourself if you're willing to be in it for the long haul.  That means not getting discouraged and quitting when things start to get tough.

Being able to tolerate a certain amount of discomfort is usually part of making a major change.  So, for instance, if your goal is to save money to buy an apartment because this is an important goal for you, you will probably have to rein in your spending.

That might mean being more disciplined about how you spend money, which will involve some self sacrifice.   Without being clear that saving money to buy a home for yourself is part of a larger goal of feeling secure, you're going to find it more challenging to give up things you want for immediate gratification in order to achieve your long term goal.

How Will I Handle Setbacks?

Setbacks are a part of life for everyone.  Even highly motivated people experience setbacks when they're in the process of making major changes.  If you know this in advance and you plan for it, you're less likely to give up when the going gets tough.

In the long run, it's not whether or not you have a setback but how you handle that setback.  Do you give up or do you bounce back and recommit to your goals?  So, for instance, if your goal is to live a healthier life and that includes losing weight, do you feel everything is lost when you deviate from your eating plan?

The best strategy is to have a plan for how you're going to handle the setbacks that will inevitably occur.  One way to do this, rather than giving up, is to acknowledge the setback, learn from it and then start again  (see my article: Resilience: Remembering Your Past Comebacks to Overcome a Current Setback).

Getting Help in Therapy

Many people, who start with great strategies, give up because of unconscious negative beliefs they have about themselves that convince them that they won't succeed no matter what they do.  These unconscious beliefs often get triggered during setbacks (see my article: Overcoming the Internal Critic).

If you continue to struggle to make major changes in your life even when you have great strategies, you could benefit from working with a licensed mental health professional who can help you to discover and overcome the unconscious negative beliefs  that are getting in your way (see my articles:  The Benefits of Psychotherapy and How to Choose a Psychotherapist.

Rather than giving up on the things you really want in your life, you owe it to yourself to work with a skilled psychotherapist who can help you to overcome the obstacles that are keeping you from having the life that you want and deserve. 

About Me

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

I have helped many clients to overcome the obstacles that were keeping them stuck.

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.

Integrating EMDR and Somatic Psychotherapy

In prior articles, I've discussed how I use an integrative approach to psychotherapy to tailor therapy to the needs of each client. In this article, I'm focusing specifically on the integration of EMDR and somatic psychotherapy as a powerful combination to overcome psychological trauma.

See my articles: 

What is EMDR Therapy? 

What is Adjunctive EMDR Therapy? 

Using Somatic Psychotherapy

Integrative Psychotherapy

Integrating EMDR and Somatic Psychotherapy

How EMDR Therapy Developed
EMDR therapy was originally developed by Francine Shapiro, Ph.D. in the mid-1980s for PTSD (postraumatic stress disorder).  It is one of the most researched therapies that has been shown to be effective to help clients to overcome trauma.

Since that time, EMDR has been shown to be effective for other problems, including performance enhancement, substance abuse, development trauma and other problems (see my article: EMDR Therapy and Performance Enhancement).

Enhancements to EMDR Therapy
EMDR therapy has also changed since its inception to include various enhancements to make it more effective for a wide variety of clients in therapy.  

One of those enhancements is the recognition that EMDR combines well with most other therapies, including psychodynamic psychotherapy, psychoanalysis, cognitive behavioral therapy and mind-body oriented therapies, like somatic psychotherapy (see my article: Contemporary Psychoanalysis and EMDR Therapy: A Powerful Combination to Overcome Trauma).

Combining EMDR Therapy and Somatic Psychotherapy
Combining EMDR therapy and somatic therapy works especially well for clients who are cut off from their emotional and physical experience of their body.  These clients often intellectualize about their problems.  They might be able to talk about their problems with significant insight, but that's where their experience ends.

Unfortunately, this usually means that their problems don't change.  So, they can remain in regular talk therapy for years and they experience no resolution to their problems (see my article: EMDR Therapy When Talk Therapy Isn't Enough).

By combining EMDR with somatic psychotherapy, the psychotherapist helps clients to connect to their experience on an emotional and physical level so that the client is no longer intellectualizing with about their problems (see my article: Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs.

The use of somatic psychotherapy also helps to titrate the therapeutic work in a way that makes it manageable for the client, and since every client is different in terms of his or her window of tolerance, this makes the combination of EMDR and somatic therapy ideal for tailoring the therapy to the individual client's needs (see my article: Expanding Your Window of Tolerence in Therapy to Overcome Emotional Problems).

For instance, if a client is processing a traumatic memory from childhood with EMDR therapy and she begins to feel afraid, a psychotherapist who uses somatic psychotherapy can help the client to calm down and ground by asking her to become aware of how her feet feel against the floor and how the floor and all the other floors below support the weight of her body. 

The therapist can also bring the client's attention to other parts of her body where she feels calm and safe.  Then, when the client is ready, they can return to processing the trauma with EMDR.

When the client knows in advance that the work will be titrated in a way that she controls based on what feels manageable for her, she is more likely to be open to processing traumatic experiences that she might have been reticent to do before.

Using somatic psychotherapy with EMDR also helps to integrate changes made in therapy because the therapeutic work is experienced more fully based on the mind-body connection rather than just depending on an intellectual integration.

Getting Help in Therapy
EMDR and somatic psychotherapy are a powerful combination for processing traumatic experiences as well as for performance enhancement.

If you have unresolved traumatic experiences that are holding you back and preventing you from maximizing your potential, you could benefit from working with a licensed mental health professional (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, you owe it to yourself to get help from a skilled psychotherapist who can help you overcome your problems.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who uses integrative psychotherapy in.a dynamic and collaborative way to tailor each treatment to the needs of the particular client.

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. 

What is Empathic Failure in Psychotherapy?

Most licensed psychotherapists are individuals who are credentialed and skilled in their areas of expertise. I believe the vast majority of psychotherapists are ethical and empathetic individuals who have their clients' best interests at heart and help their clients to overcome their psychological problems. But there can be big differences in terms of skills and experience from one psychotherapist to the next, and I believe that clients should be informed consumers, which is why I'm focusing on this issue.  

Psychotherapists are also human and, like everyone else, they make mistakes in therapy.  In this article, I'm focusing on a particular mistake called "empathic failure" where this is not an occasional problem but a recurrent problem with some psychotherapists (see my article: Why is Empathy Important in Psychotherapy?).

What is Empathic Failure in Psychotherapy?

What is Empathy?
Empathy involves a psychological process where you're able to put yourself in other people's shoes and get a sense of what they're feeling.  For instance, if your friend is upset because her dog died, even if you never had a dog in your life, you can put yourself in your friend's shoes and understand why she's upset about the loss.  You can tap into your friend's feelings and sense what she's feeling and resonate with her sadness about the loss.

What is Empathic Failure in Everyday Relationships?
Empathic failures occur all the time between friends, spouses, family members, students and teachers and so on.  Except when dealing with highly insensitive people, I believe that most instances of empathic failure occur inadvertently.

For instance, a husband might forget that his wife told him that she would like a particular perfume for her birthday. Instead, he buys her a vacuum cleaner and he feels proud of himself because it's energy efficient.

He expects that his wife will be thrilled.  But his wife's reaction is the complete opposite of what he expected--she is upset and angry because she feels he didn't hear her when she told him what she wanted.  She also feels that he sees her only as a "housewife" who cleans the apartment rather than a sensual woman.

While this might be very disappointing for his wife and it's an empathic failure, this isn't a reason to get a divorce if he is usually empathetic and they have a good relationship most of the time.  They can work out this problem and the husband can be more aware next time.

What is Empathic Failure in Psychotherapy?
When clients begin psychotherapy, they usually have a certain degree of trust that the psychotherapist is a credentialed mental health professional who will be attuned to their needs in therapy and help them to overcome the emotional problems.

Aside from all the other clinical skills that psychotherapists learn, one of the most important is how to be empathetic towards clients in therapy.  This is a skill that is honed in graduate school and, if the psychotherapist goes to postgraduate training, this skill usually developed even more.

I believe that most psychotherapists are empathetic individuals and those who go to graduate school who lack this skill are weeded out by supervisors and instructors.  That's not to say that there aren't some people who somehow make it through the screening process at times.

Even the best psychotherapists make mistakes in therapy at times, including empathic failures.  But there's a difference between a therapist who makes occasional mistakes related to empathic failure and those who do it habitually. So, let's start by defining what an empathic failure is in therapy:

An empathic failure occurs in therapy when the psychotherapist isn't attuned to the client.  This can occur in many ways:

• Forgetting important details about the client's life
• Confusing the client's history with another client
• Forgetting what the client and the therapist discussed in the prior session
• Forgetting an appointment with the client
• Focusing on the psychotherapist's life instead of focusing on the client's problems
• Projecting the psychotherapist's needs, wants, and problems onto the client
• Being dismissive of the client's needs
• Failing to be attuned to the client's emotions and mislabeling these emotions
• Failing to take responsibility for the mistakes that the psychotherapist made in therapy

and so on.

As I mentioned, even the best psychotherapists commit empathic failures at times.  For instance, a therapist, who is usually punctual and organized, can confuse his appointment schedule if the therapist is going through a very stressful time in his life.  If things were going smoothly before that, assuming that the therapist takes responsibility for the mistake, most clients would accept an apology and the therapy would continue (see my article: Ruptures and Repairs in Psychotherapy).

The empathic failures that I'm most concerned about are the ones that occur on a regular basis with a client who might have grown up with parents who lacked empathy for him.

Since this client grew up in an environment with chronic empathic failure, he might not recognize that he is in an unhealthy situation with his therapist.  It might seem "normal" to him because this is all that he knows.

The following fictional vignette illustrates how empathic failure can occur between a client and a therapist and steps that the client can take to take care of him or herself.

Fictional Vignette:  Mistakes Psychotherapists Make in Psychotherapy: Empathic Failure

Mike
Mike began therapy after a recent breakup. He told his new therapist that he felt unlovable and not good enough for most of his life.  This began in early childhood when his mother let him know that neither she nor his father wanted to have children, and Mike was "an accident."

He grew up feeling like he was "an inconvenience" to his parents, who paid very little attention to him.  As soon as he was old enough, they sent him to boarding school, which was a lonely experience for Mike.

When Mike looked up, he saw that his therapist had fallen asleep.  He wasn't sure what to do, so he cleared his throat hoping to wake the therapist up.  The therapist was startled by the sound and woke up with a jolt, "Oh, ah...what were you saying?"

Mike wasn't sure how much his therapist missed, so he started again at the beginning to describe his breakup and his family history.

Over the next few weeks, there were several other incidents.   There were a couple of times when Mike's therapist double booked appointments and Mike had to go home instead of seeing the therapist.

There was an incident where the therapist seemed to completely forget what Mike had told him about his family history and about the breakup, so Mike had to tell the therapist about these issues again.  Then, there was one day when Mike showed up for his regularly scheduled appointment and the therapist wasn't there.  Mike checked his voicemail to see if the therapist had left a message, but there were no messages.

Later that evening, when Mike met his close friend, Larry, and told him what had happened when Mike went to his therapist's office and the therapist wasn't there, Larry asked him questions about the therapy and if there were other problems in the therapy before this.

Mike thought about it for a minute and then told Larry about the other incidents.  While Mike spoke, Larry, who had good experiences in therapy before, listened carefully.  After Mike told him about the incidents, Larry told Mike that he needed to find another therapist because his current therapist seemed irresponsible and not attuned to Mike.

Since Larry knew Mike a long time, he also knew about Mike's childhood history and knew that Mike's experiences with his therapist were harmful.  He told Mike that he thought Mike's therapist wasn't treating him well and gave him all the reason why he thought this.  Mike listened, realized that what Larry was telling him resonated with him and that he probably had a blind spot about this.

When he went to his next session, Mike explained to his therapist why he thought the therapy wasn't working out for him and specifically why he felt he wasn't being treated well by the therapist.  His therapist looked uncomfortable, but he acknowledged that he had made mistakes with Mike.

Mike thought about it and decided that he ought to have consultations with other psychotherapists.  After two other consultations, Mike chose to work with another psychotherapist who seemed much more attuned to him.

He had one more session with his current therapist for closure and then began to meet regularly with the new therapist.  During that therapy, Mike began to understand why he had a blind spot in his former therapy.

He was also able to make connections between his history of emotional neglect with his family and the empathic failure that he experienced with his previous therapist.  This work helped Mike to feel that he deserved to be treated better in all areas of his life.

Conclusion
As I mentioned earlier, I believe that most psychotherapists are empathetic individuals who got into the mental health field to help people.

There can be empathic failures in any relationship.  Ideally, they are few and far between and when they occur, the person who made the mistake is able to admit it so there can be emotional repair.

An occasional mistake can occur in therapy, and the therapist should acknowledge the rupture and make an effort to repair the therapeutic relationship.  But when there are consistent empathic failures in psychotherapy with a particular psychotherapist, the client would do well to address these issues in therapy and to make a decision as to whether s/he wants to stay or find a different therapist.

Unfortunately, clients who grew up being emotionally neglected or abuse often have a blind spot for empathic failures because it seems "normal" to them.

Although this is a blog article and of necessity it's short, I hope it will be helpful to clients who might be experiencing consistent empathic failures in their therapy to become more aware of it and to take care of themselves by finding a therapist who can meet their needs.

Getting Help in Therapy
If you are struggling with an emotional problem that you have been unable to resolve, you could benefit from seeing a licensed mental health professional.

A consultation or two with a therapist (or more than one therapist) can help you to decide if you and the therapist are a good match (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who provides integrative psychotherapy to individual adults and couples (see my article: 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.

What Are Phobias and How Do They Develop?

In my prior two articles, I discussed the difference between fear and anxiety and panic attacks (see my articles:  What is the Difference Between Fear and Anxiety? and Tips For Coping With Panic Attacks).  In this article, I'm focusing on phobias.

What Are Phobias and How Do They Develop?

What is a Phobia?
A phobia is an excessive, irrational and persistent fear of an object or a situation. Most of the time, people who have phobias know consciously that their fear is irrational, but since the fear is in their unconscious minds, it can make little or no difference in terms of the way they feel.

There are many different types of phobias: fear of closed in places, fear of heights, fear of dogs, fear of injections, fear of flying, social phobia, and so on.

How Do Phobias Develop?
Phobias usually develop by some triggering event, which might not be obvious at the time when it occurs.

Phobias are debilitating and, depending on what the phobia is, it often has an adverse effect on a person's personal and work life.

For example, if a person has a fear of flying, and travel is a big part of his job, he will experience a lot of anxiety and possibly panic attacks when he has to travel for business. The same would be true if he had to fly for a family vacation.

There is often a genetic component with phobias.

Conclusion

Overcoming a phobia can be challenging.  That is why it's important for you to get help from a licensed psychotherapist.

Getting Help in Therapy to Overcome a Phobia
Clinical hypnosis is one of the best ways of treating phobias, because hypnotherapy works with the unconscious mind (see my article: What is Clinical Hypnosis?).

Once you're no longer struggling with a phobia, you will live your life with a greater sense of well-being.

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

I have helped many clients to overcome phobias.

To find out more about me, please 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.

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.

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.