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Tuesday, February 6, 2018

Taking Risks in Your Therapy

Many clients who are in therapy avoid expressing their reservations or negative feelings about therapy or their therapists.  Some clients, who were discouraged from expressing their feelings when they were children, continue the same pattern without even realizing it in their relationships and in their therapy as adults (see my article: Growing Up Feeling Invisible and Emotionally Invalidated).  

Deep down, they don't feel entitled to their feelings.  Other clients are afraid that they will offend or alienate their psychotherapist by expressing negative feelings.  But in order for the therapy to be alive, meaningful and valuable for clients, they need to take risks in their therapy because, if not, these unexpressed feelings contaminate the therapy and have a negative impact on the relationship between the client and the therapist (see my articles: Why Being Honest With Your Therapist is the Best Policy and How to Talk to Your Psychotherapist About Something That's Bothering You in Therapy).

Taking Risks in Your Therapy 

A Childhood History of Feeling Invisible and Undeserving
Clients who grew up in a family where they were discouraged and, possibly, even punished for expressing their feelings learn quickly to keep their feelings to themselves.  Over time, they also learn not even feel their feelings, so they are unaware of their feelings on a conscious level.

This pattern is often carried over when they become adults in their personal relationships and relationship with their psychotherapist without their even realizing it.

Therapists who recognize this pattern in clients need to provide a safe therapeutic environment (see my article: The Creation of a "Holding Environment in Psychotherapy).

Psychotherapists also need to help these clients to identify their feelings so they can express them.  Many clients, who are having the experience for the first time of expressing negative feelings might begin by having big reactions that frighten them once they begin expressing their feelings, so the therapist also needs to help these clients to manage their emotions.

Learning to express negative feelings after a lifetime of bottling them up can be challenging, so clients need to learn to respond instead of react when expressing themselves (see my article: Responding Instead of Reacting).

A Fictional Clinical Vignette: Taking Risks in Therapy
The following fictional vignette illustrates the points that I've made above and how psychotherapy can help:

Beth
Beth, who was in her early 30s, began therapy because she thought she was being taken advantage of in her two year relationship.

She told her new psychotherapist that her boyfriend, Alex, would often assume that when they went out that Beth would pay because she made more money that he did.  She said that, although she didn't mind paying sometimes, she didn't want to pay for their dinner, movies and theater tickets all the time.  She especially didn't want Alex to assume that she would always pay, which he did.  She felt that, although he made less money than she did, he made enough money to offer to pay sometimes.

Taking Risks in Your Therapy
Beth also mentioned other issues in the relationship where she felt taken advantage of.  When her psychotherapist asked Beth if she ever discussed this with Alex, Beth gave her a blank stare and then she gave all her reasons why she had not spoken to Alex about these issues, "It wouldn't make a difference anyway," "He's just like that--he won't change" and so on.

Eventually, over time, Beth came to see these "reasons" as rationalizations and excuses for her passivity.  But, at this point in her therapy, she believed her rationalizations.

It turned out that Beth had so much bottled up resentment towards Alex over the two years that they were in a relationship that she no longer wanted to be sexual with him.  But, until she came to therapy, she never made the connection between her unexpressed anger and resentment and her lack of interest in having sex with Alex.

When Beth thought about it, she said she had always been a sexual person, and she had been very sexually attracted to Alex during their first year together.

Before discussing this in therapy, she just thought that the decrease in her sexual interest was a normal part of being in a two year relationship. But now she sensed how her resentment and anger contributed to the cooling off of her feelings for Alex.

When her new psychotherapist asked Beth if she had ever been in therapy before, Beth told her that she had been in therapy with several different therapists over the last few years, but she left each of her therapists when they said or did something that she didn't like.

When her therapist asked her if she ever spoke to any of her therapists about her misgivings, Beth realized that she never did--she just left abruptly (see my article: When Clients Leave Psychotherapy Prematurely).

Beth described her parents as being emotionally distant and preoccupied with their careers.  As an only child, Beth spent much of her time alone.  She never saw her parents argue, but she also never saw them being affectionate with each other.

She remembered times when she tried to tell her mother about feeling lonely at home and at school, but her mother never wanted to hear it.

Her mother especially didn't want to hear any complaints from Beth about anything going on at home or about Beth feeling angry towards her parents.  So, eventually, Beth learned to keep her feelings to herself, and she approached her romantic relationships in the same way.

Beth's therapist helped Beth to feel comfortable in therapy and encouraged Beth to tell her if she had any misgivings about the therapy or her therapist.  She told Beth that she wanted her to be able to talk about any problems in therapy rather than Beth just disappearing from therapy as she did in her prior therapies.

As Beth continued to attend her therapy sessions, she got more comfortable with her therapist.  At one point, when Beth felt misunderstood by her therapist, Beth broached this topic with trepidation.  Beth felt that her therapist didn't understand what she was trying to say, so she got up her courage to tell her therapist.

But when she began to talk about it, she felt such uncontrollable rage welling up inside her that she couldn't get the words out.  She felt unable to breathe, her heart was pounding, and it was as if the words were stuck in her throat.

Her therapist helped Beth to calm down enough so she could breathe and feel grounded.  Then, even though she still had difficulty, Beth was able to speak clearly and articulate her feelings.

Taking Risks in Your Therapy

With the help of her psychotherapist, she also made connections between her family history of feeling  invisible and undeserving and how this affected her adult relationships.

Over time, Beth gradually became more comfortable taking risks in her therapy. She was able to speak up when she felt misunderstood or something occurred that she didn't like.  Unlike her childhood experiences with her parents, Beth saw that her therapist was open to talking about any problems in therapy and there were no negative repercussions.

Similarly, when Beth felt there was a rupture with her therapist, after she talked about it with her therapist, she also saw that these ruptures could be repaired (see my article: Ruptures and Repairs in Psychotherapy).

This helped Beth to feel more confident in other areas in her life, including her relationship with Alex.  As a result, she was able to talk to him about the areas in their relationship where she had misgivings, which helped to clear the air and also helped them to make positive changes in their relationship.

Conclusion
When clients have problems expressing negative feelings about aspects of their therapy or about their psychotherapist, there is usually a long history of this problem that goes back to childhood.

For these clients, in the short term, it's easier to leave therapy abruptly than take the risk of expressing their feelings and dealing with their fear of rejection or some form of retaliation by the therapist.  This usually results in a string of aborted therapies over time which, in the long run, is usually damaging to the client.

By the same token, these same clients often tolerate inappropriate behavior in their relationships, similar to Beth in the fictional vignette above.  Their anger and resentment have the same effect--they either leave the relationship or the relationship slowly dies because the relationship becomes buried in these unexpressed negative feelings.

If clients, who are reticent about expressing negative feelings, can learn to express these types of feeling in therapy, they can use this skill in their relationships.

At first, it might feel uncomfortable but, over time, clients can become more comfortable expressing themselves, which leads a greater sense of authenticity as well as more authentic relationships.

Getting Help in Therapy
The unspoken and, possibly unconscious, fear that it's dangerous to express negative feelings is very hard to overcome on your own because it's usually so ingrained.

A skilled psychotherapist can help you to recognize and express uncomfortable feelings in an effective way.  She can help you to develop the necessary tools so that you don't feel overwhelmed by your own feelings (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

She can also help you express yourself in an effective way--without your minimizing your feelings or overreacting in ways that would be overwhelming to you or to others and make your communication ineffective.

Rather than struggling on your own, you could benefit from getting help in psychotherapy so that you will eventually feel more comfortable and confident in yourself.

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.

I have helped many clients to take risk in therapy so that they can lead more fulfilling and authentic 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.
















Sunday, February 4, 2018

Books: Call Me By Your Name - Part 2: The Concept of Living Parallel Lives

In my prior article about the book, Call Me By Your Name, I focused on the phrase, "Is it better to speak or to die?," a question that spurred the main character, Elio, to reveal his romantic feelings to Oliver, the graduate student staying in Elio's family's vacation home in Northern Italy.  In my current article, I'm focusing on another concept that came up in the book (but not in the movie of the same name) about living parallel lives--living the life you have chosen as well as the fantasy of the life you might have wanted on some level but did not choose.

Living Parallel Lives

There are many ambiguities in the book as well as in the movie.  But the part about living parallel lives seemed clearer to me in terms of Oliver's and Elio's enduring romantic feelings for each other even many years later.

When I read what Oliver told Elio about his own experience with parallel lives, I thought about how common this is for many people, especially with regard to relationships.

Whenever we choose one person, we are letting go of other possible choices (see my article:  Explorations in Psychotherapy of the Road Not Taken in Life).

Inevitably, many people experience regrets and a sense of loss for their relationship choices--if not immediately, then perhaps later in life.  But most people make choices given who they are and what they know about themselves, information they have about the situation, and options available to them at the time that they are making the choice.

These can be difficult choices.  Letting go of alternatives can be very challenging.  This can lead to the concept of living parallel lives--living the life chosen as well as the fantasy of the one not chosen.

Living in the 21st century, when it comes to relationships, there has never been a time when it was easier to continue to fantasize about the person you didn't choose or who didn't choose you (see my article: Relationships: Obsessing About the "One Who Got Away").

Unlike the 1980s, when Elio and Oliver had their romance, there's so much information now online that you can keep up with what is going on with your ex and continue to fantasize about what your life might have been like if you were still with that person.

Spoiler Alert:  If you haven't read the book, you might want to stop reading at this point.

As I mentioned in my prior article, unlike the movie, the book is written from Elio's perspective, so it's important to keep in mind that his perspective might not be accurate.  Like anyone else, his view could be distorted.

When they met many years later and Oliver talked to Elio about his own experience of living parallel lives--his actual life with his wife and family and his fantasy of what life might have been like if he remained with Elio, Elio seemed surprised that he was still on Oliver's mind all this time later.  Not only is Elio on Oliver's mind, but Oliver keeps track of Elio's career, what is going on in Elio's life, and what has gone on with Elio's parents.

The words "cor cordium" (translated as "heart of hearts") comes up twice in the book.

The first time is when Oliver was staying with Elio and his family as a graduate student and Oliver and Elio were in town to pick up the Italian translation of Oliver's manuscript. Oliver asked Elio if he knew who drowned in that area.  Elio, who was precocious for his age, responded that it was the poet, Shelley.

Then, Oliver asked Elio if he knew what Shelley's wife and friends did when they found Shelley's body.  Elio responded "cor cordium" referring to when Shelley's friend seized Shelley's heart before it was consumed in the fire as it was being cremated on the shore.  The same two words were engraved on Shelley's gravestone.

Oliver's response was to ask Elio, "Is there anything you don't know?"  At that point, Elio saw his chance to seize the moment to reveal to Oliver, rather cryptically, that he had romantic feelings for Oliver.

The second time that "cor cordium" came up was when they met many years later and Oliver revealed that he kept the framed postcard of a place called Monet's berm that he took from Elio's room when he stayed in Elio's home as a graduate student. This is significant because Monet's berm is the place where Oliver and Elio first kissed and Elio revealed his feelings for him.

The prior history of the framed postcard was that a prior graduate student, who stayed with Elio's family, found it at a flea market in Paris and sent it to Elio as a souvenir.  This prior student had written on the back of the postcard, "Think of me someday."  When Oliver left Elio's family home in Italy, he took the framed postcard with him to remind him of the day that Elio revealed his feelings for him on Monet's berm.

Oliver showed Elio that he kept the framed postcard in his office where he saw it everyday.  He said he added his own inscription to the back and hoped to send it back to Elio.

At first, when Elio asked Oliver what he wrote, Oliver told Elio that he wanted it to be a surprise when he sent it back to Elio.  But when Elio told him that he didn't like surprises, Oliver revealed that he wrote "cor cordium" on the back of the card.

The framed postcard of Monet's berm was part of Oliver's parallel life of fantasizing about their romance with Elio.

There is much that is ambiguous about the book and the movie.  Possibly, the author, Andre Aciman, meant the story to be ambiguous because of Oliver and Elio's feelings were conflicted at times.

It is unclear why Oliver chose the conventional life that he did with his on-again/off-again relationship with his then-girlfriend.  One possibility is revealed earlier in the book when Oliver was very conflicted about getting sexually involved with Elio.  He told Elio that they should not talk about such things when Elio lets him know how he feels about him, as if a man loving another man is a taboo subject.

Oliver's emotional conflict was revealed in several other ways:  After they kissed, he told Elio that, until that point, they were "good" (before they got sexually involved) and he wanted to be "good," the implication being that getting sexually involved would be "bad" or wrong.

In addition, since Oliver was about to become a professor, he had more to lose professionally if he were in a gay relationship (this was the 1980s).

He also told Elio that, unlike Elio's parents who were more liberal and accepting of Elio and Oliver's  love for each other, Oliver's father would be alarmed if he knew that Oliver got involved with a man.  Oliver said his father would take him to a correctional facility if he found out.

Then, of course, there's the age difference of 17 vs 24, which at that stage of life made a big difference, and the geographic distance between them with Elio being in Europe and Oliver in New York City at that point.

For all of his bravado and outward appearance of confidence, Oliver lacked confidence at that stage in his life, as Elio's father astutely observed.  So, that in addition to all the other obstacles of remaining involved with Elio, Oliver might not have felt confident enough to be in a gay relationship with all the problems there would have been in the 1980s.

Neither the book nor the movie reveal if Oliver had any prior involvement with men.  My sense is that, even though Oliver might have known he was bisexual, he probably never acted on his feelings for men before Elio.

Or, it was also possible that Oliver never had these feelings for men before (as opposed to Elio, who revealed in the book that he had attractions for men, but never acted on them).

This is part of the problem when the issue is viewed from a gender binary perspective where people are seen as being either gay, straight or bisexual.  When there is ambiguity as there is in Call Me By Your Name, the problem with the gender binary perspective adds to the confusion.

In any case, neither Elio nor Oliver have completely suppressed their feelings for each other, even though this is difficult given that they are not together and they each feel sad about that.

The end of the book was also ambiguous and seemed to hint at a possible sequel.

If there is a sequel, will Elio and Oliver get together years later or will they continue to live separate but parallel lives where they still love each other but are not directly involved in each other's lives?

It's anyone's guess.

I believe the book as well as the movie have great general appeal because, regardless of sexual orientation, the inner conflicts that Oliver and Elio experience about love and loss are universal themes.

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.

One of my specialties is helping people, heterosexual and LGBTQ, to overcome problems in their lives and their relationships.

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.




















Saturday, February 3, 2018

Books: Call Me By Your Name: Part 1: Is It Better to Speak or to Die?

In a prior article, I discussed Andre Aciman's book, Enigma Variations.  In this article, I'm focusing on an earlier book by Andre Aciman, Call Me By Your Name.  

After I saw the beautiful movie, Call Me By Your Name, I wanted to know more about the two main characters, Elio and Oliver (portrayed by Timothee Chalamet and Armie Hammer, respectively, in the movie), so I read Andre Aciman's book by the same name.

Is It Better to Speak or to Die?
Both the movie and the book are a sensual feast: a lush Italian countryside, a beautiful villa, sunshine, a seemingly endless summer, delicious food, an abundance of Italian wine, the scents of flowers and herbs, beautiful music, the warmth of the sun, the beach, and sensual bodies.

The movie is a close translation of Andre Aciman's book, but it is, of necessity, more compressed. Even though the movie differs in some aspects from the book, it maintains the same emotional tone.

In the book and the movie, it's 1983 and Elio Perlman, a 17 year old boy, and his family are at their vacation home, a 17th century villa inherited from Elio's maternal grandfather in Northern Italy.  In the book, the story is told in retrospect from Elio's point of view many years after he and Oliver first met.

The Perlman family had a tradition of inviting a doctoral student every year to spend six weeks in the summer at their villa so the graduate students could complete their book manuscripts while enjoying all the villa had to offer.  In return, the students spent an hour or so each week helping Elio's father, who was a classics professor, with his paperwork.

Over the years, these graduate students maintained contact with the Perlmans by writing, sending packages for the holidays, visiting them again and remembering their summer as graduate students in their home.  The Perlmans also had many other interesting guests, gay and straight, from all walks of life, which added to the atmosphere of camaraderie and stimulating conversations at dinner.

When Elio first met 24 year old Oliver, an American graduate student from Columbia University, who was working on a manuscript about the ancient Greek philosopher, Heraclitus, Elio disliked the way Oliver said, "Later!" in such a flippant way whenever Oliver departed.

Even at the young age of 17, Elio was an introspective individual and he found Oliver to be too casual and detached.  At that point, Elio wasn't sure if he liked Oliver or not.  But as Elio continued to observe Oliver, who was a tall, handsome, muscular man, Elio found himself fascinated and obsessed with him.  He also felt an affinity for Oliver because they were both Jewish.

In the book, although Elio had enough self awareness to know that he was bisexual, he was confused by his developing romantic and sexual feelings for Oliver, and he was perplexed as to whether Oliver felt the same way about him.

Is It Better to Speak or Die?

When Oliver massaged Elio's shoulders, which Elio desired, but the feelings that Oliver's touch elicited in Elio also frightened him.  Elio jerked away because he felt himself about to go limp in surrender to Oliver.

Then there is the flirtation when Elio, who was a musical prodigy, played Bach's "Aria of the Postillon" from Capriccio on the Departure of a Beloved Brother.  Oliver was touched when he heard Elio play the aria on the guitar and then on the piano.  When Oliver asked Elio to play the aria again, Elio teased him by playing different variations of it, knowing that Oliver wanted to hear the original Bach rendition.


Is It Better to Speak or to Die?
Time was precious because Oliver would be leaving soon, so when Elio's mother, who seemed to sense Elio's dilemma, read aloud from Marguerite of Navarre's 16th century romantic Hempateron, "Is it better to speak or to die?" about a knight who was in love with a woman but was unable to express his love to her, Elio took this as a sign that he must tell Oliver how he feels.

This is a pivotal moment in the book and the movie because these words, "Is it better to speak or to die," embolden Elio to express his feelings to Oliver.  At that point, he knows that if he doesn't express his feelings, Oliver would leave and Elio would regret not speaking or knowing how Oliver felt.

This is especially relevant for gay or bisexual men and women when they're not sure if the person they're attracted to feels the same way:  Is it better to take the risk to speak or to allow the moment to pass and never know what might have been?

So often in life, for all of us, there are times when we must ask ourselves if it's worth the risk to say how we feel or to allow the moment to pass.  In this story, Elio speaks and, in retrospect, remembers one of the most poignant moments of his life.

I won't give away the rest of the book or movie.  If you haven't read the book or seen the movie, I highly recommend both.

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

I work with individual adults and couples.

One of my specialties is working with the LGBTQ population.

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, February 2, 2018

Writing About Your Mother After Her Death

I've written about grief in prior articles, including grief after parents die (see the end of this article for a list).  In this article, I'm focusing specifically on a mother's death and how writing can help you to heal. Although I'm focusing on mothers, you can, of course, apply what I've written to fathers, brothers, sisters, a spouse or any relatives or close friends.  I'm choosing to focus on mothers in this article because, for most people, it's usually the closest relationship you have from before your birth until death.

Writing About Your Mother After Her Death

Losing a mother is one of the biggest losses that anyone will ever face.  Even if you didn't have a good relationship with your mother, you might grieve for the aspects that were positive, if there were positive aspects to your relationship with her, and also for what you wanted and didn't get from your mother.

If your mother died and you were fortunate enough to say goodbye and express your feelings before she died, afterwards you might remember something you wanted to say and didn't or a question you would have liked to ask.

If you didn't get a chance to say goodbye, you probably feel a need to say goodbye and that much more after your mother died.

Writing About Your Mother After Her Death

It's common to feel regret about unexpressed feelings or questions after the death of your mother, and you might feel despair because you can no longer express these feelings or ask these questions.

But there are other ways to deal with working through grief and dealing with unresolved feelings.  One way is to spend time writing about your mother.

Writing can be an integrating process where your thoughts, feelings, memories, dreams and daydreams come together.

Writing About Your Mother After Her Death
  • Keeping a Journal: Keeping a journal of whatever feelings, memories, dreams and thoughts you have is one way to use writing to heal yourself.  The journal would only be for you to see, unless you choose to share it with people close to you or with your psychotherapist.  Write whatever comes to mind and don't censor yourself.  What comes up won't always be loving thoughts.  You might feel angry for things that happened during her life or that you feel abandoned since she died.  You might also have other feelings that you weren't aware of until you start writing.
  • Writing Poetry: If you enjoy reading and writing poetry, you might find it healing to write one or more poems about your mother that capture the essence of who she was and your relationship with her.  The use of metaphor and symbols in poetry can also help to express deep feelings as well as provide a healing experience for you.
  • Writing Letters to Your Mother: If there were things you would have liked to say, but you didn't, writing letters to your mother in which you express your feelings can be helpful.  You can write one letter or a series of letters about different topics.  These letters won't all necessarily be loving.  There might be letters that are angry, sad, frustrating or express whatever feels unfinished to you.  Since your emotional relationship with your mother continues to grow and change over the years, you might have different, even contradictory, feelings at various times.  For instance, at one point, you might write a letter to "tell her" about a happy occasion, like your daughter's wedding and at another point, you might write about something you're experiencing where you wish you had her support, for example, if you're going through a divorce.  You might even imagine what your mother might have said about these situations and write letters from her perspective back to you.
  • Writing a Short Story: If you grew up with your mother and had an ongoing relationship with her, you probably know a lot of stories about her life and your relationship with her.  Some of them might be sad and some might be humorous.  Capturing these experiences in a short story or two can help you to relive those experiences and to heal emotionally.  Even if you have to fill in certain parts of the story because you don't know what the whole story, you can imagine part of it and write about that part of it from your imagination.  
  • Writing a Collection of Short Stories:  If you have many stories that you want to remember, you can write a collection of stories that you either keep for your own private use or share with family members and close friends.  How you use these stories is up to you.  If you write a collection of short stories, it can include stories that you know about from the time your mother was an infant (maybe she told you stories that she heard from her mother about infancy) until her death or you can choose certain significant milestones of her life to write about.  Each chapter can be about a different time in her life.  Although this might sound daunting, you don't have a deadline, so you're not under any pressure to complete this project by a specific date.  You can write these stories whenever you feel like it and you have time.  Once again, capturing these stories in writing can be a healing process.  
  • Writing a Memoir:  Maybe you want to focus specifically on your relationship with your mother from your point of view and your relationship with her rather than about her personal life.  Writing a memoir doesn't have to capture her whole life or your whole life with your mother.  It can include whatever experiences are meaningful to you that you want to write about.  Once again, if you're doing this for yourself, there's no rush and no pressure.
Overcoming Obstacles to Writing
You might read these suggestions and say, "But I'm not a writer..."

Even if you've never kept a journal and never attempted any particular writing project, you can still write.

The problem that most people have with writing is getting started because they think their writing won't be good enough or that it should look and sound a certain way.

But, remember, you're doing this for yourself to help you with your grief, so no one will be judging your writing, except maybe you if you happen to be particularly critical of yourself.

To overcome this obstacle, I usually recommend that people do free associative writing to get the words to start flowing before you begin any of the writing suggestions above.

Just like in free association in the psychoanalytic sense, when you do free associative writing, you're just writing whatever comes to mind and you keep going.  You're not stopping to fix punctuation or grammar.  You're just letting it all pour out.

The intent is to help you to relax and get into the flow of writing.

If you have some time before you get started with your day, the best time to do free associative writing is in the morning before you're completely awake and before your defenses and fears take hold.

If nothing comes to mind at first, choose a word, any word, and write whatever comes to mind.  It can be any word at all, even if it seems trivial at first.  For instance, if you've just woken up and you're staring at your box of corn flakes and you can't think of a word, write down "corn flakes" and keep going from there and don't stop for at least 5-10 minutes.

Don't go back to critique it.  That's not the  point.  What you wrote might appear be a word salad.  That's okay.  Let it be whatever it is.

If you happen to come upon an idea that you want to include in your writing about your mother then, by all means, go back and use that piece.

In Julia Cameron's book, The Artist's Way, she has suggestions about a form of free associative writing that she calls the morning pages.  You can follow this method or any other free associative method that feels right for you.

You might also want to look at a book by Marion Milner (pseudonym: Joanna Field) called A Life of One's Own where she writes about her own personal growth process and how she used a diary for self exploration.

Conclusion
There are many different approaches that you can take, possibly even ones that I haven't included in this article, to express your grief in writing or memorialize your mother.

Writing about grief is usually an integrative process so that it helps you to bring together the many different feelings you have about your mother and your relationship with your mother.

When you're ready to write about your mother, it can be a healing experience that gets you through the mourning process and beyond.

Getting Help in Therapy
As I've mentioned in previous articles, losing your mother is one of the most difficult, if not the most difficult, loss that you will experience.

If you've having problems grieving for your mother or you're stuck in the mourning process, you could benefit from seeing a licensed mental health professional to help you through this process (see my article: The Benefits of Psychotherapy).

Grief and mourning are unique for each person.

A skilled psychotherapist can help you to work through this loss so that you can work through the loss and heal (see my article: How to Choose a Psychotherapist).

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.

I have helped many clients to work through their grief.

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.

Also see:




Thursday, February 1, 2018

Relationships: Is Your Partner's Behavior Kindness or Controlling Behavior?

I've written about relationship issues in prior articles (see my articles: How Your Attachment Style Affects Your Relationship and Fear of Being Emotionally Vulnerable).  In this article, I'm focusing on the difference between kindness vs. controlling behavior (see my article: Changing Maladaptive Behavior That No Longer Works For You: Controlling Behavior).

Relationships: Kindness or Controlling Behavior?

Over the years, I've met many individual adults and couples where the issue of kindness vs. controlling behavior has come up.  Usually, one or both partners in a relationship weren't sure if what they were experiencing from their partner was kindness, controlling behavior or some combination of the two.

Fictionalized Vignette:  Relationships - Kindness or Controlling Behavior
The following fictionalized vignette is an example of this problem and how psychotherapy can help:

Sara and John
Sara and John, who were together for a year, came to couples therapy because they were having disagreements about what Sara saw as John's controlling behavior and what John saw as his being kind to Sara.

Six months into their relationship, Sara took a job where she had to travel internationally a few times a month.

When Sara began traveling, John asked her to provide him with all the information regarding her flights, arrival time, and hotel.  He also asked her to call call or text him when her plane landed.

At first, Sara wasn't completely comfortable with John's request, but she didn't want John to worry, so she provided him with the information beforehand and would usually call him or send a text message to him when her plane landed.

But there were a few times when she was with colleagues and they were in a hurry to get to a meeting with a customer, so she didn't have time to text John immediately.

She felt she always tried to be considerate of him, so she didn't delay more than 10-15 minutes.  But, when she couldn't reach him immediately, by the time she turned on her phone, she already had a few panicky text messages from John wondering if she was okay.

During those times, John would also call her at the same time that she was texting him, and she didn't have privacy to talk because she was with her colleagues.

After this happened a few times, Sara tried to explain to John that she would always try to text or call as soon as she could, but when he panicked and she had to try to calm him down, he was adding to the stress she was already experiencing on the trip.

John told Sara that he felt hurt that she was experiencing him as adding to her stress when, from his perspective, he was being kind and caring.  He said he didn't want to be controlling.  He cared about her and he just wanted to make sure that she was safe.

Since they were getting nowhere on their own with these arguments, they decided to go to couples therapy.

During their couples therapy sessions, Sara told John and their therapist that she appreciated that John cared about her, but she couldn't understand why he needed to be contacted immediately.  She explained that she was often with senior managers on these business trips, and she didn't always have privacy to try to calm John down when he panicked.

She also expressed feeling confused and annoyed that John felt the need to be contacted immediately when nothing bad had ever happened on her business trips.  She couldn't understand his behavior, and she felt it was a boundary issue between them.

As John listened to Sara during their couples therapy sessions, over time he was able to acknowledge that he worried excessively when Sara traveled, and he wasn't sure why.

Sara told their therapist that, other than these business trips, John didn't try to keep tabs on her at any other time.  He never questioned when she went out with friends or went to business meetings locally.

John said that he tried to stay calm, but 10 minutes or so before he knew Sara's plane was about to land, he would become highly anxious.

By arrival time, he was on the verge of a panic attack imaging all the things that could have gone wrong.  So, he felt he needed to hear from Sara immediately when the plane landed to help him to calm down.

Relationships: Kindness or Controlling Behavior?

When he looked back on those times when he was calm, he acknowledged that, even though he still felt that he was being kind, his behavior was excessive, but he didn't know how to calm himself once he began to panic (see my article: Tips For Coping With Panic Attacks).

During one of their couples therapy sessions, John revealed to Sara for the first time that he had a history of panic disorder, and even as a child, he worried excessively whenever his father traveled on business.  He feared that something catastrophic would occur and he would never see his father again.

Since his father was self employed, he was usually on his own, and it wasn't a problem for to call John from his hotel to let him know he landed safely.  All the while, until John got his father's call, he imagined the worst.  But once he received the call, he calmed down.

John said that his parents never took him to see a psychotherapist when he was a child because they thought he was "outgrow" his anxiety.  But he never did and it was a problem in his prior relationships before he met Sara.

John said he felt deeply ashamed of his panic attacks and, as an adult, his shame got in the way of his getting help in therapy.  Even when he was talking about this with Sara and their therapist, his face was red and he didn't make eye contact (see my article: Healing Shame in Psychotherapy).

Since John eventually acknowledged that he had a problem, the couples therapist recommended that John see an individual psychotherapist to work on his anxiety and panic attacks while he and Sara worked in couples therapy to try to resolve these issues in their relationship.

The couples therapist also taught John a few techniques to calm himself when he felt a panic attack coming on (see my articles: Developing Coping Strategies and Internal Resources).

But she said that there were probably deeper issues involved that he would need to work on with an individual psychotherapist.

After John had a few individual sessions to give his family history, his individual psychotherapist recommended that they use a clinical hypnosis technique called the "Affect Bridge" to try to get to the root of his problem.

When they used the Affect Bridge, John remembered overhearing his grandfather talk about a plane accident where the grandfather lost his best friend.

When the grandfather was telling the story to John's parents, none of them knew that John was nearby listening to the conversation, so they talked about the accident in a detailed way that they would not have if they knew that four-year old John was listening to them.

Afterwards, John and his individual psychotherapist talked about what came up during the Affect Bridge.  He said he had completely forgotten about that memory and he was amazed that it was at the root of his panic attacks when Sara traveled.

His individual therapist explained that John was getting emotionally triggered whenever Sara traveled abroad and his fears stemmed from that earlier memory.

She explained that, even though John didn't witness the plane accident that his grandfather talked about, the story was told in such vivid detail that it was almost as if John had witnessed it and he became traumatized by it (see my article: Overcoming Trauma: When the Past is in the Present).

His individual psychotherapist recommended that they use EMDR Therapy to help John to overcome the trauma that was getting triggered whenever Sara traveled.

Gradually, as John processed the memory of hearing his grandfather's tragic story, he began to be able to separate out that memory from the times when Sara traveled (see my article: Working Through Emotional Trauma: Separating "Then" From "Now").

In the meantime, Sara felt much more compassionate towards John after she realized he was getting triggered.  She told John in their couples therapy that she now understood why he would become so upset.

Until John could work through the original trauma that was getting triggered, Sara continued to call or text John so he wouldn't worry.  But when she couldn't contact him immediately, John used the techniques he learned in his therapy to stay calm.

Relationships: Kindness or Controlling Behavior?

Over time, when John worked through the original trauma with EMDR therapy, he no longer kept tabs on when Sara's plane landed and he no longer panicked.

After a while, when he was no longer symptomatic, John told Sara that it was no longer necessary for her to contact him--he could wait to hear from her whenever it was convenient for her.

Conclusion
Sometimes, it's difficult to distinguish between kindness and controlling behavior.

There are times when what is meant to be kind also has elements of controlling behavior.  Sometimes, there are more than just elements--it's mostly controlling behavior and the person who is engaging in it has little to no insight into it.

The vignette above is one example of this kindness vs. controlling behavior.

There are many other examples:
  • The overprotective boss who gets involved in her employees' personal problems and tries to resolve these problems.  When an employee, who feels the boss is being intrusive, tells the boss tactfully that she doesn't want to talk to her about it, the boss becomes offended.  From her perspective, she only wants to help.
And so on.

Getting Help in Therapy
Although you have a right to set boundaries with the other people, setting boundaries can be difficult, and these situations aren't always easy to work through on your own, especially if the person who thinks s/he is being kind takes offense to boundary setting.

If you find yourself in this type of situation and you've been unable to resolve it on your own, a skilled psychotherapist can help you to discern what's going on and how to deal with it (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than struggling on your own, you could get help from a licensed mental health professional, who has experience assisting clients to overcome these problems.

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 business hours or email me.



























Wednesday, January 31, 2018

Movies: Infidelity, Triangulation and Betrayal in "Lover For a Day"

The last film of the Philippe Garrel's French trilogy, Lover For a Day, deals with many of the same themes of his prior films, including emotional intimacy, infidelity, triangulation, jealousy and betrayal (see my articles about these topics, including: The Connection Between Infidelity and the Need to Feel DesirableRelationships: Coping With InfidelityCoping With Secrets and Lies in Your Relationship and Getting Involved in a Love Triangle).

Movies: Infidelity, Triangulation and Betrayal in "Lover For a Day"

After a breakup, Jeanne, portrayed by the filmmaker's daughter, Ester Garrel, who also appears in Call Me By Your Name, leaves the apartment that she shared with her boyfriend.  Distraught, she heads to her father's nearby apartment because she needs a place to stay.

When she arrives at her father's apartment, Jeanne assumes that her father, Gilles, is alone. She tells Gilles, portrayed by Eric Caravaca, about the breakup.

Then, she is surprised to see a woman's makeup case on her father's kitchen table.  A little thrown by this discovery, she asks her father if she has come at an inconvenient time.  Gilles, a loving father who is a philosophy professor, responds by with reassurance that she is not disturbing him, he makes up the couch for her and tells her to try to get some sleep.

The next morning after Gilles leaves for work, Jeanne meets Gilles' girlfriend, Adriane, portrayed by Louise Chevillote, who is a student at Gilles' college.

Both Jeanne and Adriane are the same age, 23, and Adriane asks Jeanne if she minds that her father is with a woman who is the same age as she is.  Although Jeanne says she doesn't mind, this questionable based on her actions later on in the film.

Adriane tells Jeanne how she seduced Gilles, even though he resisted at first.  She also reveals that she has been living with Gilles for a few months, and they are keeping their relationship a secret at the college where Gilles is a professor.

Thus begins a triangle between Jean, Gilles and Adriane that raises questions about gender issues, infidelity, family loyalty, betrayal, secrets, and infidelity.

Both Jeanne and Adriane keep each other's secrets from Gilles in what appears to be a friendly alliance between the two women.  But appearances are deceiving.

Are the betrayals in the film conscious or unconscious on the characters' parts?

It's difficult to say, and the characters in the film might not know themselves.  Such is the power of the unconscious mind that motivates behavior that might only be clear after the fact, and maybe not even then.

I won't give away the rest of the plot because I think this movie is worth seeing.

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 business hours or email me.






Monday, January 29, 2018

How to Avoid Last Minute "Doorknob Comments" at the End of Your Psychotherapy Session

In prior articles, I discussed common issues in psychotherapy, including: How to Make Your Psychotherapy Sessions a Part of Your Life Between Sessions,  Psychotherapy as a Co-Created Process Between You and Your Psychotherapist and How Psychotherapy Helps You to Expand Your Inner Emotional Awareness.  In this article, I'm discussing another common issue, "doorknob comments" at the end of the therapy session, the problems with these comments, and how to avoid them in order to get the most out of your therapy (see my article: Getting the Most Out of Your Psychotherapy Sessions).


How to Avoid Last Minute "Doorknob Comments"

What Are Doorknob Comments?
Doorknob comments got their name from clients who literally have their hand on the doorknob as they're leaving their psychotherapist's office when they make a last minute comment, which is sometimes a "bombshell" comment ("I've decided to end therapy, so today is my last session" or "I was fired from my job and lost my insurance, so I can't continue in therapy").

Sometimes these comments are things that clients say at the end of their session in a vague way when there's no time to talk about it.

Why Do Clients Make Doorknob Comments?
Client who make doorknob comments are often too anxious or ambivalent to talk about these issues when there's time to discuss it, like at the beginning of their session, so they bring it up at the last minute as a parting comment.

Some clients, who make doorknob comments, are either consciously or unconsciously testing the boundary of treatment frame to see if their psychotherapist will give them more time beyond the therapy hour.

How Do Psychotherapists Handle Doorknob Comments?
There's no one standard way for psychotherapists to handle a comment that the client makes as s/he is walking out the door.  That being said, most experienced psychotherapists will recommend that they discuss the issue at the next session, including an issue about ending therapy.

There are a few very good reasons why it's best to maintain the treatment frame by not extending the therapy session:
  • On a practical level, many psychotherapists see clients in back-to-back sessions, so if they extend the therapy hour for one client, they would keep all subsequent clients waiting for their sessions.  This isn't to say that there aren't rare instances when a therapist might exceed the time limit but, for the most part, it's not fair to the other clients.
  • On a clinical level, it's not helpful to the client making the doorknob comment to extend the therapy hour because s/he doesn't get an opportunity to talk about a topic that requires more time.  Also, the client doesn't learn to communicate in an effective way with his/her therapist.
  • Equally important, the psychotherapist and client need time to explore the underlying issues which led to the client waiting until the last minute to bring up something important:
    • Was s/he anxious or afraid to bring up the topic?
    • Is there a problem in the client-therapist relationship? Is this problem a pattern in other relationships?
    • Is there a connection to the client's family of origin issues?

How to Avoid Last Minute Doorknob Comments
  • Think About the Issue Before the Therapy Session:  If you know you have a topic to bring up in therapy that you feel uncomfortable talking about, think about the issue beforehand.
  • Prepare to Talk About Issue in the Therapy Session: If it's an especially difficult subject for you, you would probably find it helpful to make notes before the session and bring your notes to the session.  You might not need the notes, but they're handy to have in case you get too anxious and forget what you want to say.
  • Bring Up the Topic at the Beginning of the Therapy Session:  You're spending your time and money to attend psychotherapy, and you deserve time to discuss an issue that's important to you rather than shortchanging yourself by bringing it up at the end of the session when there's no time to talk.  If it's a big issue ("I just found out that my mother has cancer"), you might be discussing this issue for many sessions.  If it's a matter of you're wanting to end therapy, there is such a thing as the "termination process" where, depending upon how long the client has been in therapy with his or her therapist, the client and therapist spend at least one or more sessions talking about ending therapy, summarizing the work, talking about whether the client met the goals that s/he might have set at the beginning of treatment, discussing the therapeutic relationship, and so on.

Conclusion
Last minute doorknob comments are common in therapy, especially with clients who are anxious or ambivalent about the topic.

Often, it's a matter of the client not knowing how to bring up the topic and waiting until the end of the session to blurt it out.  This is especially true for clients who are new to therapy.

Some clients, knowingly or unknowingly, try to test the boundaries of the treatment frame with regard to the end time for the session by making last minute vague comments or dropping "bombshell" comments.  In most cases, when this occurs, experienced psychotherapists will usually recommend that they talk about the issue at the next session.

When you wait until the end of the session to bring up an important issue, you're shortchanging yourself by not allowing enough time to discuss the issue at length.

Often, aside from anxiety and ambivalence, there can be earlier underlying issues for the client that are related to making last minute comments.

These underlying issues need to be explored by the client and therapist to understand the origin of the problem and how best to resolve it.

Getting Help in Therapy
Asking for help can be difficult (see my articles: Tips For Overcoming Your Fear of Asking For Help).

Psychotherapy provides an opportunity to free yourself from problems that are preventing you from maximizing your potential.

If you've tried on your own to resolve your problems and you've been unable to do it, you could benefit from working with a licensed mental health professional who can help you to work through your problems (see my articles: (see my article: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

When you have worked through the problems that keep you stuck, you can lead a more fulfilling and meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist 

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.