Romantic Obsessions and the Thrill of the Chase - Part 2: Getting Help in Therapy

In Part 1 of this topic, I began a discussion about the psychologically and physically addictive problem of romantic and sexual obsessions.  I also provided two clinical vignettes to illustrate two different but related problems involving these obsessions and the thrill of the chase (see my article: Understanding Sexually Addictive Behavior).

Romantic Obsessions and the Thrill of the Chase

In this article, I'm focusing on the first vignette from Part 1 about the fictional character, Ed, to delve deeper into this subject and show how experiential psychotherapy can help people with romantic or sexual obsessions to overcome their problem (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy).

In a future article, I'll focus on the second vignette from Part 1 about the fictional character, Jane, where the symptoms are similar but the outer manifestation of the problem is different.

Clinical Vignette: Romantic Obsessions and the Thrill of the Chase: 
The following fictional vignette is a continuation of Part 1 and it will illustrate how experiential psychotherapy can help:

Ed
In Part 1, I presented a fictional case about someone named Ed, a married man in his mid-40s.  Although the vignette is fiction, the problems involved are real and common to many people who get caught up in romantic and sexual obsessions.

To Recap:
During five years of marriage, Ed had numerous sexual affairs.  Typical for people who become obsessed with the thrill of the chase, Ed got a dopamine high from these obsessions and the anticipation of "catching" the women he was obsessed about.

Even though he loved his wife and he didn't want to jeopardize his marriage, Ed couldn't stop chasing after women--even after one of the women contacted his wife out of anger and sent his wife a videotape, which she secretly recorded without Ed knowing, of one of her sexual encounters with Ed. She also told Ed's wife about his numerous other sexual affairs.

When confronted with the videotape, Ed admitted to his wife that he had been having sexual affairs throughout their marriage. He felt ashamed of his behavior and very sad that he hurt his wife. After he admitted his infidelities, he vowed to his wife and to himself that he would stop chasing other women. Although his wife was hurt by Ed's betrayal, she forgave him when he promised her that he would stop having affairs.

Ed struggled to keep his promise for a short time.  However, he felt himself being dazzled and tantalized by the attractive women he met when he wasn't with his wife, and his struggle turned out to be too much for him to bear. He gave in to his obsessions during a time when he felt bored, and he resumed having secret extramarital affairs with women he met in person as well as on the dating app, Tinder (see my article: Married, Bored and Cheating Online).

The Story Continues:
As time went on, Ed became increasingly obsessed, especially once he began using Tinder to meet women.  Realizing that he could meet hundreds of women online, who were also only interested in hooking up for sex, fueled his obsession.  He rationalized his behavior by telling himself that he was upfront with these women about his marital status so they knew what they were getting into. He also rationalized that he wasn't hurting his wife because he believed he could do a better job of hiding his affairs and what she didn't know wouldn't hurt her.

What Ed didn't realize was that his addictive behavior was not only driven by seeing attractive women--he was also now responding to the pings he heard from Tinder whenever a woman responded to his request for sex. The sound of the pings were now paired in his mind with sexual conquests, and he was unknowingly also getting a dopamine high just from the sound.

One night while he was out to dinner with his wife with his phone next to him on the table, Ed tried to resist responding to the pings from his phone while he and his wife were talking.  But the urge to look at his Tinder responses became overwhelming and he glanced at his phone several times.

Telling his wife that the pings were emails from work, Ed told her that he had to call his office. Then he went outside to look at his Tinder responses.  Once outside, Ed couldn't wait to look at the responses he received.  As he looked through the responses, he felt giddy with excitement as he saw the sexually provocative pictures from these women.  The dopamine rush he experienced was like electricity going through him, and he had to suppress an urge to laugh from the sheer thrill of it all.

He was especially thrilled that one of the women who had initially resisted his responses was now asking for sexually explicit photos of him which, as usual, he was only too willing to provide.  He could feel the thrill of pressing send to this woman's personal cellphone number as he sent her several nude pictures of himself and he requested that she do the same.

Ed was so caught up in responding to his Tinder requests that he didn't realize how much time had gone by while he was standing outside the restaurant.  It was as if he had fallen down a rabbit hole where he lost awareness of time and place.  By the time he looked up, he was shocked to see his wife, Megan, was standing next to him and looking over his shoulder at his Tinder account.

On the taxi ride home, Ed attempted to apologize to Megan, but she refused to talk to him.  By the time they were back in their apartment, he was desperately trying to make amends with her, but she told him to move out to a hotel until she had time to think about what she would do next.  Then, what she said next shocked him, "At least we don't have children!"(see my article: Your Spouse Cheated on You: Should You Stay or Should You Go).

This remark hurt Ed deeply because he and Megan had been trying to have a baby for the last two years.  They both loved children and it had been their dream to have a baby. Prior to this, they had even talked about going for fertility treatment.  Now, Ed felt his marriage to Megan and any possibility of having children was lost.

During the next few weeks, while he was staying at a nearby hotel, Ed reached out to his wife, but Megan refused to take his calls.  He didn't blame her for being upset.  He knew he hurt her again by continuing to have sexual affairs and breaking his promise to her.  He blamed himself and he wished he could go back in time to undo the pain and anger he caused his wife.

Ed also felt deeply ashamed.  For the first time in his life, he considered whether he was in the grips of addictive behavior.  He felt so upset and overwhelmed that he disabled his Tinder account, he stopped seeing the women he had been having affairs with, and he blocked their numbers on his phone.  He had no appetite for chasing women and the thought of it only made him feel more ashamed and angry with himself.

Several weeks later, Megan agreed to talk to Ed at their apartment.  Ed took this as a hopeful sign, but as soon as he arrived, Megan told him that she decided she wanted a divorce.  Upon hearing this, Ed was shocked and he felt like the floor had dropped out from under his feet.  She told Ed calmly that she was very hurt and she didn't trust him anymore (see my article: When Trust Breaks Down in Relationships).

She said she knew he loved her and she believed him when he first told her he would stop having affairs.  But, she said, all that changed when she discovered that he was continuing to have affairs and she knew now that his problem was much deeper than she had realized before.  She also told him that she had a consultation with a divorce attorney and she had a one-way ticket to fly home to her family in California in two weeks.

When he heard what Megan had to say, Ed felt like his life was over.  Nothing mattered to him if he couldn't be with Megan.  He told her that he realized he didn't deserve it, but he begged Megan to give him another chance.  He promised to get into individual therapy to overcome his problem and he begged Megan to come with him to couples therapy.

During the next week, Megan continued to refuse to give Ed another chance.  As she said she would, she flew out to California to stay with her parents temporarily.  She and Ed talked on the phone, but she was only willing to talk about practical matters like their apartment in Manhattan where Ed was now living alone.  She refused to attend couples therapy with Ed, but she told him she thought he should get help for himself in individual therapy, "Don't do it for me.  Do it for yourself."

Getting Help in Individual Experiential Therapy:
Not knowing what else to do, Ed sought help in individual therapy.  Although he felt desperate to get Megan back, he knew it was pointless to try to persuade her.  Initially, his motivation for individual therapy was to let Megan know that he started therapy so he could convince her to take him back.  But as he continued to attend his therapy sessions and he learned about himself, his external motivation turned into internal motivation to do it for himself.

Romantic Obsessions and the Thrill of the Chase: Getting Help in Therapy

Over time in therapy, Ed began to understand his obsessive and addictive behavior with women.  He realized that he was obsessed with women from the time he was a teenager.  He never thought much about his behavior and his inability to remain faithful before.

When he was a teenager, he told himself, "Boys will be boys" and he used this rationalization to cheat on his girlfriends.  Then, when he got older and he was married, he rationalized his infidelity by telling himself that he wasn't harming her by having affairs because Megan didn't know about it and it didn't change how much he loved her.  Even after Megan found out and he lost his initial resolve to stop chasing women, he thought all he needed to do was to get better at hiding his affairs.

But now that he was on the brink of losing his marriage, Ed began to make connections between his infidelity and his father's infidelity.  Even though his parents never talked to Ed about his father's numerous extramarital affairs, Ed heard them arguing about it late at night.

Ed felt deeply ambivalent about his father's behavior.  Part of him hated his father for hurting his mother.  But another part of Ed admired his father for being "a ladies' man."  And when, by chance, as a teenager, he saw his father in his car with a beautiful woman, Ed felt a rush throughout his body at the thought of being able to have affairs with multiple beautiful women at the same time.

Working Through Early Trauma in Experiential Therapy
As Ed recounted his family history to his therapist, he realized for the first time that he often felt lonely and lost as a child. As the middle child of three children, he longed for his parents' attention.  But they focused on their older son, who excelled academically and in sports, and they doted on his younger sister, who was spoiled by his parents.  They compared Ed unfavorable to his older brother and he often depressed by his parents' emotional neglect (see my article: What is Emotional Neglect?).

As time went on, Ed could see that his feelings of low self worth were temporarily alleviated by his sexual conquests.  But he realized that after the chase was over with each woman, he no longer felt the initial thrill. He also realized that after a while he needed to have numerous sexual affairs in order to feel that boost to his mood, and he could see the addictive pattern.

His therapist recommended EMDR therapy, also known as Eye Movement Desensitization and Reprocessing Therapy, to work through the underlying issues that fueled his addictive behavior, including the emotional neglect he experienced as a child (see my article: Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Prior to EMDR therapy, Ed had always thought, "I love women," but as he delved deeper into his problems, he realized that he also had hostile feelings towards women, especially his mother whom he experienced as cold and emotionally withholding.  He realized over time that with each sexual conquest, he was attempting to prove to himself that he was a lovable person (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

A few months later, as Ed explained to Megan what he learned about himself and how he was working through his sexually addictive behavior.  He revealed to her that he no longer felt a compulsion to see other women.  After she thought about it for a few days, Megan agreed to come back to New York City to attend couples therapy with Ed.  She told him that, although she didn't trust him, she still loved him and she wanted to see if they could salvage their marriage.

Getting Help in Emotionally Focused Therapy (EFT) For Couples
When Megan returned to New York, she moved back into their Manhattan apartment to live with Ed again and entered into her own individual therapy to deal with the hurt, mistrust and anger she felt.  They also began seeing a couples therapist who used Emotionally Focused Therapy for couples, also known as EFT (see my article: How EFT Couples Therapy Can Help Your Relationship).

Putting the Pieces Back Together and Salvaging a Marriage:
Over time, Ed and Megan began to put the pieces of their life together. It took a while for Megan to trust Ed again.  As part of their agreement, she had access to his phone, his texts and all his computer accounts, and Ed remained faithful to Megan (see my article: Broken Promises - Surviving Infidelity).

Conclusion
Romantic and sexual obsessions usually get worse over time due to the physically and psychologically addictive behavior involved.  Since addiction gets worse without help, over time it takes more of the addictive behavior to get the same high--even when the high is fueled by dopamine.

People usually rationalize their addictive behavior, but these rationalizations often fall apart as the consequences to their behavior bring them back to reality. 

To overcome any addictive behavior, beyond stopping, it's important to understand and resolve the underlying issues that fuel the addiction.  These underlying issues often involve psychological trauma (see my article: How Trauma Affects Intimate Relationships).

Experiential therapy, like EMDR therapy, AEDP, Somatic Experiencing, clinical hypnosis, and EFT, which all take a bottom up (as opposed to a top down) approach, is are much more effective in getting to the root of the problem than regular talk therapy (see my article: What's the Difference Between "Top Down" and "Bottom Up" Approaches in Therapy).

Getting Help in Therapy
Overcoming romantic and sexual obsessions takes a commitment to work through the underlying issues involved in therapy.

Developing intellectual insight, while important, usually isn't enough to help people to overcome addictive behavior.  These problems require experiential therapy that helps people to shift on an emotional level and not just on an intellectual level.

If you're struggling with problems that you have been unable to resolve on your own, you owe it to yourself to get help from an experienced psychotherapist so you can free yourself from your addictive patterns to live a happier life.

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

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.

Romantic Obsessions and the Thrill of the Chase - Part 1

Romantic obsessions might be funny or entertaining in movies, but they can be very painful and self destructive in real life.  If your pattern is to chase after people, you know just how painful it can be--and yet, you might have a problem changing your behavior on your own (see my article: The Connection Between Obsessive Love as an Adult and Unmet Childhood Emotional Needs and Understanding Sexually Compulsive Behavior).

Romantic Obsessions: The Thrill of the Chase

When life seems boring and routine, "the thrill of the chase" can seem sexy and exciting.

The real thrill in chasing someone isn't about "catching" them--it's about the pleasure of the dopamine high you get from the anticipation.

The more uncertainty there is, the more exciting it is. This is especially true when someone is pursuing a person who is either not interested or comes across as highly ambivalent (see my article: What Makes So-Called "Bad Boys" So Irresistible to Woman? Brain Chemistry Might Be Part of the Answer).

The surge of dopamine can reach euphoric levels, which fuels the obsession and the chase even more.  This behavior can become highly addictive as a person continuously looks for the next dopamine high.

Clinical Vignettes: Romantic Obsessions and the Thrill of the Chase

The following fictional vignettes illustrate how these dynamics often work for both men and women:

Ed

Even though Ed was happily married and he loved his wife, he couldn't resist flirting with every attractive woman that he met. Throughout his five year marriage, Ed, who was in his mid-40s, had dozens of sexual affairs.  Many of the women knew that he was married, and they didn't care.  Like him, they were only interested in having a casual sexual relationship with him (see my articles: The Allure of the Extramarital Affair and Married, Bored and Cheating Online).

Initially, when he met an attractive woman, he was filled with euphoric feelings in anticipation of having sex with her. If a woman didn't respond to his flirtation at first, he would become obsessed with chasing her. He would try to find ways to be where he knew she would be, talk to her, make her laugh and win her over.

Since Ed was very attractive, more often than not he would succeed in winning women over.  But after having sex with a woman several times, his interest would wane, and he would be on the prowl again looking for the next attractive woman and the next high.  This pattern would continue over and over again.

Eventually, one of the women, who wanted something more from Ed and felt used by him, contacted his wife to tell her about the sexual affair. She sent Ed's wife a video she took (without Ed knowing) that was unmistakable.  She also told his wife about many of the other women Ed had affairs with over the years.  

When his wife confronted him with the video, Ed admitted he had numerous sexual affairs over the years.  He was ashamed and felt remorse for his behavior.  Although his wife was deeply hurt, she forgave Ed when he promised her that he would change.

After that, Ed didn't want to hurt his wife again, and he didn't want her to leave him.  So, for a while, he just barely managed to control his obsession for women.  But after a few months, he felt bored, and even though he knew he was risking his marriage, he couldn't resist pursuing attractive women, and he went back to having affairs (see my article: Coping with Addiction: Boredom as a Relapse Trigger).

Jane

Jane, who was in her late 30s, often complained to her friends that she usually wasn't interested in men who were interested in her.  She realized that she tended to become obsessed with men who were emotionally unavailable and who often weren't interested in her.  Even though this made her feel miserable, she felt she couldn't help herself. The more detached and emotionally aloof men were, the more obsessed she became with them. 

Even though her friends tried to warn her about the men that she was obsessed with, Jane said she couldn't stop herself.  She would chase after these men by calling them, texting them and trying to get them to go out with her.  

Just thinking about one of these men all day long would make her feel high. If she dated a man who showed initial interest in her but who ultimately didn't want to continue to see her, Jane would try to persuade him of all the reasons why he should continue to see her--even when she knew he was dating someone else.  

During her last six month relationship with a man who told her that he wanted an open relationship, she tried to force him into making a an exclusive commitment to her.  No matter how many times he told her that he didn't want to be monogamous, she didn't want to hear it.  In the end, when he broke up with her, he told her that he had been upfront with her about wanting to date other women and he couldn't stand her constant complaints that he wasn't meeting her emotional needs.

After numerous similar experiences, Jane's self esteem continued to plummet.  She tried to date men who were interested in her, but she just wasn't attracted to them.  She began to feel a sense of despair that she would ever be in a reciprocal relationship.

Conclusion

A tendency to pursue romantic or sexual obsessions is high risk, addictive behavior.  Even when there is so much at stake, including the erosion of self esteem or the risk of losing a loving spouse, the dopamine high involved can prove too much for many people to resist.

I'll expand upon this topic in my next article:
Romantic Obsessions and the Thrill of the Chase - Part 2: Getting Help in Therapy.

Getting Help in Therapy

If you're struggling with addictive, obsessional behavior in your relationships, you're not alone.

An experienced psychotherapist can help you to overcome self destructive patterns that are ruining your life.

Rather than struggling on your own, seek help from a licensed mental health professional so you can lead a healthier, more fulfilling life.

About Me

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

I work with individual adults and couples.

Currently, I am providing teletherapy sessions, which are also known as telemental health, online therapy or telehealth sessions (see my article: The Advantages of Online Therapy).

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 Accelerated Experiential Dynamic Psychotherapy (AEDP) and How Does AEDP Heal Trauma - Part 2

In Part 1 of this topic, I began a preliminary discussion about Accelerated Experiential Dynamic Psychotherapy (AEDP) and how it works.  In the current article, I provide a clinical vignette to illustrate how AEDP works.

AEDP Heals Trauma

As mentioned in Part 1, AEDP was developed by Dr. Diana Fosha, and AEDP is based on many different disciplines, including:

• attachment theory
• affective neuroscience
• trauma research
• developmental research
• mind-body/somatic therapy
• emotion therapy
• phenomonology (the study of subjective experience)
• transformational studies

Clinical Vignette: AEDP in a Therapy Session
The following clinical vignette is a composite of many different cases where AEDP is used to heal trauma:

Ted
Before Ted sought help from an AEDP therapist, he had been in many different types of therapy over the years.  He explained to his AEDP therapist that, although he developed intellectual insight into his problems in his prior therapies, nothing changed for him on an emotional level (see my article: Healing From the Inside Out: Why Insight Isn't Enough to Heal Trauma).

He said he was still struggling with crippling shame that had a negative impact on his personal life as well as his career (see my article: Healing Shame in Therapy).

Ted explained that he was about to turn 45 and he was worried that he would never overcome the shame he had since childhood.  He said he decided to try AEDP because a friend had a very good experience with it.

His AEDP therapist started the consultation by being empathetic and welcoming, which helped to put Ted at ease.  As part of AEDP, she noticed how Ted's facial expression, gestures and body language conveyed the shame he said he was struggling with for many years.

As Ted got more comfortable in the session, he told his therapist, "I'm surprised that I can feel so comfortable with you so quickly.  Usually it takes me at least a few weeks to feel comfortable enough to open up."

Part of the AEDP therapist's role is noticing and emphasizing the somatic markers for positive feelings.  So, to amplify Ted's feeling of comfort, his therapist asked Ted where he noticed that feeling of comfort in his body (see my article: The Body Offers a Window Into the Unconscious Mind).

Ted took a moment to notice where he felt the sense of comfort in his body and then he put his hand over his stomach, "I feel it in my gut."  In response, his therapist asked Ted if he would be willing to stay with that sensation of comfort, and he nodded.

Ted closed his eyes and allowed himself to relax into that sensation of comfort, and his therapist noticed that his whole body relaxed.  Then, after a minute or so, Ted said that along with that feeling of comfort, he was now beginning to feel sad because he recognized that it was so rare for him to feel this way.

Ted's AEDP therapist knew that this is a typical response during the initial stage of therapy for people who have experienced trauma.  The positive feeling often brings up sadness when people compare the positive feeling with the emotional deprivation they experienced in the past.

After a few moments, the feeling of sadness subsided, and Ted's therapist observed that he had just gone through a wave of emotion.  She explained that emotions usually come in waves, similar to waves in the ocean with a surge, a peak and then an ebbing away of emotion.

Ted was able to return to the feeling of comfort and a sense of openness. He said he was usually anxious and guarded in most situations, but he didn't feel that way in this therapy session (see my article: The Creation of the Holding Environment in Therapy).

By the end of the session, his therapist explored with Ted what it was like to have this experience of comfort, which was so rare for him.  Ted said it helped him to feel safe in the session--a feeling that he rarely had anywhere.

Then, his therapist, who understood that AEDP is a relational experience between the client and the therapist and observed Ted's openness, asked Ted what it was like to have this sense of comfort and to have it with her.  Ted responded that he was surprised and pleased. He said he hadn't expected to feel this way with her, especially during an initial therapy consultation.

This type of exploration is called "metaprocessing" in AEDP.  Part of the value of doing metaprocessing is that it brings it brings together both right brain (emotions) and left brain (putting words to feelings) processing.  Another part is that, as previously mentioned, it emphasizes the importance of the therapeutic relationship between the client and the therapist.

Over time, Ted talked about shame he felt as a child with a highly critical father.  His therapist helped Ted to develop the internal resources to deal with the trauma work they would be doing on his shame.  All the while, she continued to pay attention to Ted's emotions and she titrated the work so that it wouldn't be overwhelming for Ted.

During one AEDP session, Ted talked about feeling angry with his father for shaming him at a big family gathering when he was five years old after Ted spilled juice on his clothes. He remembered that his father got very upset and yelled at him for being "so stupid and clumsy." He said this memory was typical of many memories where his father shamed him.

He also remembered feeling so deeply ashamed that he wanted to run and hide.  In addition, even at that young age, he sensed how intimidated everyone was, including his mother, by the father's temper and bullying behavior.

As part of helping Ted to feel a positive experience he could use as a resource, his therapist asked Ted to remember a time when he was feeling proud of himself.  She told him that it could be from any time in his life.

In response, Ted thought about that for a few moments, and then he said he felt proud on the day he graduated from college.  He told his therapist that he graduated with honors, and one of his professors, who was kind and encouraging, helped him to adjust to being away at college.  He recounted how seeing that professor on graduation day made him feel so cared about and proud.

His therapist recognized that Ted was ready to do a "portrayal" (imaginary work, similar to Gestalt chair work) with regard to his anger towards his father, and the professor as well as his sense of pride on graduation day would be good internal resource for Ted.  So, she asked Ted to stay with those positive feelings.

After a few moments, Ted was able to identify a feeling of calm and confidence in his gut as he thought about these positive memories.  His therapist asked Ted to stay with those positive feelings and, after a few seconds, Ted said he felt these positive emotions getting stronger and he noticed that they were expanding from his gut to his throat.

His therapist asked Ted if he would like hold onto that sense of calm and confidence, the image of that professor, and imagine talking to his father in that earlier memory. Ted said he would be willing to do this, so he went back into that memory where his father was berating him at the family gathering.

His therapist helped him to stay within his calm and comforted adult self to look at his humiliated child self, and Ted responded, "I'm looking at that child and I feel sad for him.  I'm also feeling protective towards him.  He didn't deserve to be treated that way.  He was only a child."

With the image of his professor in his mind and the positive emotions he was feeling as his adult self, Ted imagined himself confronting his father, "Stop yelling at him. He's only a child."  He imagined that his father was so surprised and speechless because no one ever confronted him in this way.

Then, Ted imagined taking his child self in his arms hugging him and rubbing his back.  As he did this, his therapist asked Ted to switch his consciousness to being his child self to feel what it was like to receive this comfort and love, and Ted said that, as his child self, he could relax into that hug and he felt protected (see my article: Having a Dialogue With the Different Parts of Yourself).

Afterwards, his therapist helped Ted to process what this experience was like for him, and Ted said he never felt this way before.  He said that he felt comforted and calm, and he also felt happy and strong to be able to confront his father.  He told his therapist that it wasn't nearly as scary as he thought it would be, especially because he imagined coming from a confident stance with his supportive professor with him.  He also said he felt his therapist's presence, which also helped him during this portrayal where he confronted his father.

His therapist explained that doing parts work, which is working with the various aspects of himself, including the adult self, child self and other parts of himself, is part of AEDP (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

Whenever his AEDP therapist did parts work as part of a portrayal, she made sure that Ted was coming from an internally resourced, strong, confident place within himself first.

AEDP therapists know that clients often felt alone when they were going through the original trauma, so, as therapists, they need to be present and resonate with clients as they are processing trauma to undo that feeling of aloneness.  This allows the client to have a new experience with the memory of trauma so that they no longer feel alone with it.  This is part of reworking the trauma.

Gradually, Ted overcame the crippling shame that held him back in his personal life and in his career.  Not only did he have insight into his problems, but he also felt the healing benefits of AEDP as an experiential therapy.

Conclusion
The goal of AEDP is not just to help clients to develop insight--although insight is important.  The goal of AEDP is to help clients to transform and heal.

The vignette above illustrates some ways that AEDP therapists help clients to heal.

As mentioned in my prior prior article, AEDP is an evidence-based, cutting edge, experiential therapy.  It incorporates many different approaches, and AEDP therapists work in an empathetic and dynamic way.

AEDP interventions are designed to help the client to access a feeling of strength and calm by using positive memories and resources (like the positive memories in the vignette above) as a lens through which to approach traumatic memories.

Getting Help in Therapy
If you have been struggling to overcome problems, you're not alone.  Help is available to you (see my article: What is a Trauma Therapist?).

The AEDP Institute has a directory of AEDP therapists in the US and all over the world.

Rather than struggling on your own, seek help from an AEDP therapist so you can live a more fulfilling life.

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

I work with individual adults and couples.

I am currently providing teletherapy sessions, which are also known as online therapy, telemental health and telehealth (see my article: The Advantages of Online Therapy).

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.

What is Accelerated Experiential Dynamic Psychotherapy (AEDP) and How Does AEDP Heal Trauma? Part 1

Accelerated Experiential Dynamic Psychotherapy (AEDP) is a cutting edge, evidence-based, in-depth therapy that focuses on the healing and transformation of clients' traumatic experiences (see my article: What is a Trauma Therapist?).

What is Accelerated Experiential Dynamic Psychotherapy (AEDP)?

What is Accelerated Experiential Dynamic Psychotherapy (AEDP)?
AEDP was developed by New York City-based psychotherapist and researcher, Dr. Diana Fosha, who wrote the book The Transforming Power of Affect: A Model of Accelerated Change.

AEDP is based on many different disciplines, including:

• attachment theory
• affective neuroscience
• trauma research
• developmental research 
• mind-body/somatic therapy
• emotion theory
• phenomonology 
• transformational studies

How Does AEDP Heal Trauma?
The primary goal of AEDP therapy is to help clients to have a transformative experience in order to  overcome psychological trauma. 

An AEDP therapist recognizes that the original experience of the trauma left clients feeling alone and overwhelmed, so one of primary goals of AEDP therapy is to "undo aloneness" in the therapy (see my article: What is the Corrective Emotional Experience in Therapy?).

In contrast to a more traditional psychotherapists, AEDP therapists are active and dynamic participants in the therapy with their clients.

Active empathy is also one of the hallmarks of AEDP therapy so that clients have a felt sense of being cared about by the therapist (see my article: Why is Empathy Important in Psychotherapy?).

In doing so, the therapist is directly involved with helping clients to bear the weight of overcoming traumatic experiences (see my article: The Healing Potential of the Therapist's Empathic Attunement).

In contrast to many traditional psychotherapists, who tend to pathologize the original strategies clients developed to cope with trauma, an AEDP therapist recognizes that these strategies helped clients to get through overwhelming experiences as best as they could at the time (see my article: A Strengths Based Perspective in Psychotherapy).

There is a recognition that the clients' strategies saved them from being completely overwhelmed by traumatic events.  There is also a recognition in AEDP that, although these coping strategies were the best that clients could do at the time, they no longer serve clients and, instead, they are now obstacles to living a full life.

How Does an AEDP Therapist Work?
AEDP's stance is that from the get-go everyone has an internal capacity to heal.  They believe that this internal capacity to heal is inherent in everyone.  So, an AEDP therapist helps clients to access this inherent healing capacity.

This means that the therapist helps clients to access their self-at-best in order to begin processing trauma (see my article: Developing Internal Resources in Experiential Therapy). So, part of the AEDP therapist's job is to help clients to access these untapped internal resources.

From an AEDP perspective, there are many ways to help clients to tap into these internal resources.  For instance, the AEDP therapist might help clients to remember times when they felt strong and confident, which would be an experience of their self-at-best.

This would include helping clients to have an emotional, embodied experience--not just an intellectual experience--of what it's like to feel strong and confident based on clients' own memories.

This is important because we now know that positive transformation, which is the primary goal of AEDP therapy, occurs on an embodied, emotional level--not just by intellectual insight alone.  In other words, clients need to have a visceral and emotional sense of transformation.

From this experience of feeling strong and confident, clients are able to approach traumatic memories in a more internally resourced way.

AEDP helps clients to overcome obstacles to healing, including maladaptive coping strategies, so that their true, authentic selves can emerge (see my articles: Becoming Your True Self and Living Authentically).

See Part 2 of this topic.

Getting Help With AEDP Therapy
If you have been struggling emotionally, you're not alone.

An AEDP therapist can help you to heal from trauma.

The AEDP Institute maintains an international directory of AEDP psychotherapists in the United States and all over the world.

Rather than struggling on your own, seek help from an AEDP therapist so you can heal from trauma and live a more fulfilling life.

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

I work with individual adults and couples.

I believe that everyone has an inherent capacity to heal from trauma, and the therapist's role is to help clients access that ability to heal.

I am currently providing teletherapy, which is also known as online therapy, telemental health and telehealth (see my article: The Advantages of Online Therapy).

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.

How to Talk to Your Partner About Sex - Part 2

I began a discussion on how to talk to your partner about sex in my prior article with suggestions, including do's and don'ts to introduce the topic with your partner. In this article, I'm providing a clinical vignette to illustrate typical sexual problems in a relationship and how a couple is able to work through these problems in couples therapy.

How to Talk to Your Partner About Sex

A Common Problem: It Can Be Hard to Talk About Sexual Problems With a Partner
As an experienced therapist who works with individuals and couples, I have found that many people have difficulty talking to their partner about sex, especially when there are problems.  Even in relationships where people have been together for many years, they often feel shy or awkward to talk about sex with a partner.

Why Is It Hard to Talk About Sex With a Partner?
There are many reasons why people feel uncomfortable and avoid talking about sex, including:

• Cultural or Religious Taboos: It's not unusual for people, who were raised in a particular religion or culture where talking about sex is taboo--even with a spouse of many years, to experience difficulty in expressing their sexual needs or talking about sexual problems.

• Family History: For people raised in a family where sex was seen as "dirty" or secret, talking about sexual problems can be challenging. Also, in families where there were poor boundaries around sex (e.g., parents walking around naked in front of children or having sex in front of or within earshot of children), these children often grow up to be adults who experience problems with sex in their relationship.

• Sexual Trauma: When there is unresolved sexual trauma (for either a man or woman regardless of sexual orientation), it's often difficult to separate out the traumatic experience from the current relationship.  The act of being sexual in the current relationship can trigger memories of being sexually abused, which makes it hard to talk about sex or to even engage in sexual activities with a partner.

• Body Shame: Many people, especially women, feel ashamed of their body. There are many reasons for this, including a history of being shamed about their body, sexual abuse, popular and unrealistic images of men's and women's bodies, etc. So, talking about sex, which involves the body, feels too embarrassing.  

• Fear of Being Rejected: For many people the idea of initiating a discussion about sex with their partner brings up fears of being rejected. Their fear might involve an outright rejection of them or a fear that their partner might also have things they don't like about them with regard to their sex life. This fear often inhibits people from bringing up the topic of sex.

There are also countless other reasons why people avoid talking about sex with their partner.  This avoidance ensures that the problem probably won't be resolved with the possible effect that the couple grows apart (see my article: Relationships: How to Get Closer When the Two of You Have Grown Apart).

Clinical Vignette: How to Talk to Your Partner About Sex
The following fictional vignette is a composite of many different cases so that there are no identifying features of any one person or couple. This case illustrates the sexual presenting problem, the effect of the problem on the relationship, and how it gets resolved in couples therapy.

Amy and Joe
By the time Amy and Joe came to couples therapy, they were already considering divorce.  In their mid-40s and married for 20 years with children, they decided to try couples therapy to see if they could salvage their relationship before they filed for divorce.

Just like many other couples who come to couples therapy, Joe and Amy told their couples therapist that they had "communication problems."  For many couples, presenting their problem to the couples therapist as a communication problem takes away some of the shame and awkwardness they feel about coming to couples therapy (see my article: Mental Health Awareness: Reducing the Stigma of Going to Therapy).

Their couples therapist recognized that, in a general way, they did have communication problems, but this description of their problem was too vague.

Knowing that many couples come to couples therapy because they're either having problems with sex or money (or both), the therapist normalized this by asking each of them specific questions, including questions about their sexual satisfaction in the relationship.  She had already informed them, when they called for the consultation, that a sexual assessment was part of the initial stage of therapy, so they were aware that they would be asked these questions.

Initially, both Amy and Joe hesitated before they responded.  They looked at each other awkwardly as if to get a response from the other as to what they should say.

In response, the therapist told them that problems with sex is a common reason for coming to couples therapy for many couples.  Once again, this was a way of normalizing the topic of sex by letting them know that it's a common problem for many couples.

In response, Amy laughed nervously, "Gee. I didn't know that. I always assumed that everyone else is having 'swinging off the chandeliers' sex every night."

With a reddened face and looking down at the floor (rather than at Amy or the therapist), Joe said, "So, you think everyone else is having more and better sex than we are?"

Amy just looked away rather than respond, so Joe, who was sitting right next to Amy on the therapist's couch, said, "You're not saying anything, so I'm guessing that you have a problem with our sex life that you haven't told me about. Is that right?"

Looking away from Joe, Amy winced, "Well..."  And then she stopped and looked at the therapist as if for guidance.

So, the therapist stepped in at that point and said, "It seems to me that you both still care about each other--otherwise, you wouldn't be here. When you contacted me for the consultation, I mentioned to you that I get a sexual history from each person in the relationship for every couple that I see.  Why don't we start with me getting a sexual history from each of you" (see my article: Why It's Important to Talk to Your Therapist About Sexual Problems).

Based on the sexual history assessment that the therapist did for Joe and Amy, she found out the following salient facts:

• Neither Joe nor Amy had much sexual experience with each other or with others before they got married.
• Despite their limited sexual experience prior to marriage, each of them assumed, before they got married, that their sex life would work out on its own without having to talk about sex and without having to put in any effort.
• Both of them felt awkward talking about sex with each other and would prefer to avoid it if they could.
• Amy's family was very religious and neither parent ever talked to her about sex. Sex was considered a taboo subject in her family. She found out about sex by reading books when she was a teenager, but she never discussed what she read with anyone.
• Amy didn't get her period until she was almost 14 years old. She was self conscious at school because all the other girls had already developed breasts, but she was "flat chested" (her words). As a result, the boys in her junior high school often teased and body shamed her about this, which made her feel even more ashamed. She never told anyone about this until now.
• Joe's family was the opposite of Amy's family: His parents had very loose boundaries. They often walked around naked in front of Joe and his siblings.  They would also have sex in the living room after they thought Joe and his siblings were asleep.  But, in fact, Joe and his brothers and sisters would hear them and feel uncomfortable and embarrassed.
• Ever since he entered into puberty, Joe felt ashamed of his penis size.  When he was in high school, the other boys in the locker room would brag about having big penises and about their sexual conquests. This made Joe feel ashamed.  The few times that he was sexual with other women, before he met Amy, he never wanted women to see his penis, so he always insisted on having sex in the dark.  He secretly feared that, due to the size of his penis, he couldn't satisfy women sexually, which contributed to his shame about sex and his sexual awkwardness--even with Amy.
• Both of them denied a history of sexual trauma or abuse.
• Joe had a vague sense that he wasn't satisfying Amy sexually, but he felt too ashamed to talk to her about it.
• Amy often "zoned out" during the rare occasions when she and Joe had sex. She rarely had an orgasm, and she usually couldn't wait until it was over.
• Neither of them felt comfortable talking about sex initially, but answering the therapist's questions from her sexual assessment made each of them realize that they weren't the only couple who had these problems.
• Both denied any extramarital affairs during the marriage.
• Both of them eventually admitted that they were dissatisfied with their sex life together, but both felt too ashamed to discuss it before coming to couples therapy.

Gradually, Amy and Joe were able to open up more about their sex life in couples therapy.  Amy was the first one to broach the topic of their almost nonexistent sex life in the last several years.  After hearing Amy speak, Joe said, "I thought you didn't want to have sex, so I didn't want to bother you."  In response, Amy turned to Joe and said, "That's weird--because I thought you weren't interested and I didn't want to bother you about it."

Over time, they were able to talk about being somewhat satisfied with their sex life when they first got married.  Each of them acknowledged that this changed after they had their second child.  They often felt too exhausted to have sex and they also stopped prioritizing their sex life--until it dwindled to having sex, on average, once every few months.

The more they were able to talk about their sexual history, the freer each of them became to talk about the problems in their sex life.  Prior to this, they weren't sure what caused them to drift apart (leading to talk about a divorce).  Each of them just assumed that the other wasn't interested in the marriage anymore.

They each said that they still felt sexually attracted to the other.  They also agreed to go away on a relaxing vacation to rekindle their relationship.

When they returned, they seemed much closer. They also told their couples therapist that they made love several times while they were away on their weeklong vacation.

Amy talked about being bold enough to bring sex toys on their vacation, which they had fun using. She said she had more consistent orgasms while they were away.  In addition, she told their couples therapist that she had developed a new appreciation for her body, including her small breasts, and sh realized that Joe still found out attractive.

Joe talked about being more sexually adventurous about exploring different sexual positions.  He also discussed that they engaged in oral sex for the first time, both fellatio and cunnilingus, and they found it fun and enjoyable.

Using Emotionally Focused Therapy (EFT) For Couples, their therapist helped them to identify and change the patterns in their relationship that were causing problems for them.  They continued to make progress and they each made a commitment to save their relationship by continuing in their couples therapy.

Conclusion
Regardless of sexual orientation, age, race or other identifying factors, sexual problems are common in many relationships.

There can be many factors that contribute to the problems, which can be addressed and overcome in either individual or couples therapy.

The fictional vignette presented above gave a particular set of problems, but there are many other types of sexual problems.

Getting Help in Therapy
If you and your partner are having sexual problems, rather than avoiding the problems, you owe it to yourselves to get help.

Resolving the sexual problems in your relationship can rekindle and salvage your relationship.  So rather than waiting, get help from an experienced therapist who works on these issues so you can have a more satisfying relationship.

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

I work with individual adults and couples.

I have helped many individuals and couples overcome problems related to sex, including sexual trauma.

I am currently providing teletherapy, also known as online therapy, telemental health and telehealth (see my article: The Advantages of Online Therapy).

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

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

How to Talk to Your Partner About Sex - Part 1

Let's face it--talking to your partner about sex can be hard, especially when you're not satisfied with your sex life. But the basis of any good relationship is good communication, whether it's about sex, money, changes in your life or anything else that's significant (see my articles: Have You and Your Spouse Stopped Having Sex?,  What is Sexual Desire Discrepancy? and Overcoming Sexual Desire Discrepancy).

How to Talk to Your Partner About Sex

You know that not talking about the problem isn't going to make it go away. If anything, this problem usually gets worse because your needs aren't getting met, the dynamics aren't changing, and you're probably becoming increasingly resentful about the problem.  

Since the problem isn't going to go away by itself, it's better to address the problem instead of avoiding it, as many couples do. If anything, talking about improving your sex life can bring the two of you closer together.

Talking to Your Partner About Sex: Do's and Don'ts:

• Be Sensitive to the Timing of Your Discussion: Don't talk to your partner about problems in your sex life during or after sex. Bringing up a discussion about the problems in your sex life either while you're having sex or just after you have sex is bound to make your partner feel defensive and hurt.  Instead, find a time when you're both getting along--possibly over dinner if you have privacy or some other neutral time.

• Don't Start Out Angry, Criticizing or Blaming: One of the worst things you can do when you want to talk to your partner about sex is to start out by accusing your partner of not loving you, blaming your partner for sexual problems (after all, there are two people involved) or accusing your partner of having an affair (unless you have good reason to believe this and then this should be a separate conversation).  If you start out angry, blaming or criticizing, as many people do out of their own anxiety about the topic, you're not going to resolve the problem, and you will probably create even bigger problems. 

• Don't Throw the "Kitchen Sink" Into the Discussion: Limit your conversation to your sex life. Now isn't the time to list all your grievances about the relationship. Not only is that counterproductive to getting the problem resolved, it also complicates the discussion with too many problems to tackle at once.

• State the Problem in a Positive and Tactful Way: Instead of saying something like, "I think you don't love me anymore because we hardly have sex," state the problem in a positive way, "When we have sex, I feel closer to you. What can we do to have sex more often?" This doesn't mean that you demand sex when your partner is exhausted or has had a bad day. That will, rightfully, come across as selfish and uncaring. Instead, part of the discussion might be the best times for the two of you to have sex when you're both ready for it and have the privacy for it.

• Take the Awkwardness Out of Talking About Sex: If you feel comfortable enough with your partner, instead of approaching your discussion in a stiff and constricted way, depending upon what the problems is, you can be seductive. For instance, if you want your spouse to kiss you in a certain way, you can suggest it in a playful, seductive way, "I just love it when you kiss my neck. It really turns me on.  Can we try that?"

• Take Responsibility For Your Part in the Sexual Dynamic: There might be aspects of your sex life that your partner isn't pleased about.  So, when you open a dialogue about your sex life, be open to hearing things that your partner might want to change. Don't get defensive or angry. Just be open and curious to listen to what your partner tells you.  

• Be Aware That There Can Be Physical or Trauma-Related Problems Involved: Sexual problems aren't always about a lack of desire. Sometimes there are physical problems that might need to be addressed.  For instance, some men have a low libido due to low testosterone levels, which might need to be addressed medically.  Similarly, some women experience sexual intercourse as painful for a variety of reasons, including: problems with lubrication or vulvodynia (painful intercourse due to yeast infections or pelvic inflammatory disease). A history of sexual abuse for either partner could also be a factor. If there are physical issues that either you or your partner haven't addressed until now, seek medical or psychological help.

• Be Aware That Talking About Sex Isn't a "One and Done" Discussion: If you want to have a good sex life with your partner, having open and honest communication about sex is an ongoing dynamic.  Even if you resolve your current problems, things change. This doesn't mean that you have to talk to your partner about sex everyday.  But having a discussion about sex periodically can make it easier to talk about sex.  For instance, you or your partner might want to try something new in your sex life, like adding sex toys, different sexual positions, and so on. As mentioned earlier, the two of you might even find fun and sexy ways to talk about sex that will spice up your sex life.

• Be Aware That Religion, Culture or Family History Might Be an Obstacle to Talking About Sex: In many religions, cultures and families, sex is a taboo issue.  If your partner was raised in an environment where it was considered wrong to talk about sex, you'll need to be aware of and sensitive to this.  You might even preface your discussion by acknowledging that you're aware that your partner was raised to believe that talking about sex is taboo.  Even if your partner no longer believes that sex is a taboo subject, s/he might still feel some guilt or shame about talking about it.  It's better to acknowledge this so you can get it out in the open. Then, you and your partner can try to find a way to talk about your sex life in the context of being in a loving relationship and wanting your relationship to succeed.  

In my next article, I'll provide a clinical vignette to illustrate some of the problems mentioned above and to show how these problems can be resolved (see my article: How to Talk to Your Partner About Sex - Part 2).

Getting Help in Therapy
Some couples are unable to resolve sexual problems in their relationship, and they need help to be able to talk about sex.

An experienced couples therapist can help you to improve your communication about your sex life.

Rather than avoiding the problem, seek help with a licensed mental health professional who works with couples.  

Resolving problems in your sex life can help you to have a more satisfying sex life and a happier relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing therapist and Sex Therapist.

I am a sex positive therapist who works with individual adults and couples (see my article: What is Emotionally Focused Therapy (EFT) For Couples?).

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

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

     




     

The Benefits of Laughter For Your Health and Mental Health

You've probably heard the saying, "Laughter is the best medicine" which hints at the physical and mental health benefits of laughter.  In the past, I wrote an article, Humor Can Be Helpful in Psychotherapy, which explored how humor can sometimes increase the effectiveness of therapy.  In this article, I'm focusing on how laughter benefits both your physical and mental health.

The Benefits of Laughter For Your Health and Mental Health

The Benefits of Laughter For Your Health and Mental Health
Laughter is beneficial for your mind and your body because it:

• strengthens your immune system
• elevates your mood
• reduces pain
• protects you against the harmful effects of stress
• inspires hope
• helps you to connect and bond with others
• keeps you grounded
• relaxes your body
• eases stress and anxiety
• strengthens resilience (see my article: Developing Resilience)
• diffuses anger
• reduces inhibitions
• helps you to feel recharged and energized
• increases your ability to use your imagination and increases creativity (see my article: Using Positive Imagination to Cope)

Adults Need to Seek More Opportunities For Laughter
Most children tend to laugh many times a day.  However, adults tend to be more serious, and they don't laugh as much as children. Therefore, adults, who want the health and mental health benefits of laughter, need to seek out more opportunities to laugh.

You can seek out these opportunities to include more laughter in your life by:

• watching a funny movie or TV show
• watching standup comedy
• playing games with friends
• spending time with people who are funny
• playing with your pet
• reading a funny story
• sharing a funny cartoon with friends 
• engaging in laughing yoga
• being grateful for what you have
• being "silly"
• taking an improv class
• sharing true stories about yourself with others (see my article: The Psychological Benefits of Storytelling)

Examples of How to Bring More Laughter Into Your Life

Sue
After realizing that she wasn't having as much fun as she used to, Sue decided to join an improv class, which was recommended by a friend. She had never taken an improv class before and, initially, she felt intimidated. But on her first day of class, she discovered that most other people in the class had never done improv or any type of comedy before, and they were feeling just as inhibited as she was feeling. By the second class, she realized she really liked her instructor, who made learning improv fun easy.  So, after a while, Sue opened up more and allowed herself to just have fun. She realized that she had not laughed so much in years, and she decided to take the next improv class when it was over.

Jim
Although he enjoyed painting in his free time, Jim found it to be too solitary an activity, especially since he already spent a lot of time on his own as an online editor.  He didn't look forward to spending even more time alone doing his artwork.  However, at the suggestion of a neighbor, he offered a free art class to the children in his apartment building, and while he was working with the children, he realized that not only were they having fun, but he was also having fun with them.  This group activity with children helped him to feel energized, and it allowed him to spend time alone doing his own artwork.

Conclusion
As mentioned above, there are many physical health and mental health benefits to laughter.

Sometimes, you need to experiment with different activities to find one that you enjoy.  If you approach this exploration with a sense of curiosity and playfulness, you'll discover an activity that's just right for you. In addition, you'll begin to experience the benefits of laughter.

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

I provide teletherapy, also known as online therapy, telemental health or telehealth for clients (see my article:  The Advantages of Online Therapy).

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

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