Trauma Therapy: The Therapeutic Benefits of Somatic Experiencing Therapy

As a trauma therapist, I have been using Somatic Experiencing (SE) to help clients overcome traumatic experiences for the last 12 years in my private practice in New York City (see my articles: Somatic Experiencing: A Mind-Body Oriented Therapy and Overcoming Emotional Trauma With Somatic Experiencing Therapy).

The Therapeutic Benefits of Somatic Experiencing Therapy

The Somatic Experiencing Framework: SIBAM

Whereas most types of talk therapy use a top down approach, which focuses only on developing insight, SE and other types of Experiential Therapy, use a bottom up approach that incorporates the mind-body connection to work through trauma (see my article: What is the Difference Between Top-Down and Bottom-Up Approaches to Trauma Therapy?).

The basic SE framework consists of the following:

• Sensation: This includes learning to experience sensations in your body in an emotionally safe way. In other words, if you're not accustomed to feeling bodily sensations as a result of your traumatic experiences, an SE therapist will help you to feel these sensations in a way that feels manageable to you. You will learn how to track internal sensations in your body as you work on issues in SE, including:

• Kinesthetic: Muscle tension patterns
• Proprioceptive: Awareness of your position in space
• Vestibular: Movement, gravity and sense of balance
• Visceral: Sensations from the gut, lungs, heart

• Imagery: The use of imagery is an important part of SE healing. This includes using your five senses:
• Sight
• Sound
• Taste
• Smell
• Hearing

• Behavior: The behavioral aspects of SE include:
• Voluntary gestures
• Facial expressions
• Posture
• Autonomic signals, including
• heart rate
• breathing

• Affect: Affect is how you show categorical emotions, including anger, sadness, happiness, fear and disgust. It also includes sensation-based feelings of attraction and avoidance, which is referred to as the felt sense (see my article: What is the Felt Sense in Experiential Therapy?).

• Meaning: Meaning refers to the words you use to describe your experiences in therapy related to all of the above (sensation, imagery, behavior and affect).  It includes whatever trauma-based negative beliefs about yourself and the world around you that you might have formed as a result of traumatic experiences. It also includes how open you are to positive emotions.

What Are the Benefits of Somatic Experiencing?

Unresolved traumatic experiences, which are held in the body, often cause problems with managing emotions.

The Therapeutic Benefits of Somatic Experiencing Therapy

Traumatic responses include fight, flight, freeze and fawn (fawn refers to people pleasing).  

Somatic Experiencing can help you:

Develop Bodily Awareness: Unlike regular talk therapy, which focuses on developing intellectual insight, Somatic Experiencing and other Experiential Therapy, helps you to develop a mind-body awareness including an awareness of the unconscious mind (see my article: Experiential Therapy and the Mind-Body Connection: The Body Offers a Window Into the Unconscious Mind and Why Intellectual Insight Isn't Enough to Overcome Trauma).

The benefits of bodily awareness include:

• Learning Grounding and Containment Techniques: You learn how to calm your body and mind using various grounding and containment techniques (see my article: Trauma Therapy: Using Grounding Techniques and Trauma Therapy and Containment Exercises).

• Developing Resources and Using Visualization: You learn to develop internal resources so that you feel safe emotionally and physically (see my article: Developing Internal Resources and Coping Skills).

• Learning to Do a Body Scan: You learn how to sense into your body and assess where you're holding onto tension or pain and what you're feeling emotionally in your body (see my article: Doing the Body Scan Meditation).

Transform Emotional Dysregulation into Emotional Regulation

When you become aware of your emotions and how they are stored in your body, including emotional triggers related to trauma, you can learn how to use your bodily awareness, including grounding and containment techniques, internal resources, visualization and body scans, to bring your mind and body into a calm state.

Use SE Techniques on Your Own: The resources you learn in SE can be used at home, including the grounding and containment exercises, internal resources, visualization and the body scan, so that you can calm yourself between sessions and learn to deal with emotional triggers before trauma is processed to completion.

Release Trauma: Over time, as you become aware of the physical and emotional sensations in your body, you can learn to release trauma and reset your nervous system with the help of your SE therapist so you no longer feel affected by trauma from the past.

Conclusion

Somatic Experiencing (SE) is a mind-body oriented Experiential Trauma Therapy.  

SE is a gentle form of trauma therapy because SE therapists work in a titrated way to help clients to process trauma in a manageable way (see my article: Trauma Therapy: Why Establishing Safety For the Client is Important Before Processing Trauma).

SE also uses a technique called Pendulation which helps clients to manage and cope with distressing emotions. Pendulation is another resource you can use on your own (see my article: Coping With Emotional Distress by Using the SE Techniques of Pendulation).

Many people experience posttraumatic growth after they work through psychological trauma (see my article: Posttraumatic Growth: A Greater Sense of Hope and Meaning After Working Through Trauma).

When to Get Help in Trauma Therapy

If you have been unable to overcome psychological trauma on your own or in other types of therapy, you could benefit from working with a Somatic Experiencing therapist.

Working through psychological trauma allows you to live free of your traumatic history so you can live a more fulfilling life.

About Me

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

I work with individual adults and couples.

I have helped many clients to overcome psychological trauma (see my article: What is a Trauma Therapist?).

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

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

Pets Can Improve Your Mental Health

Millions of people around the world consider their pets to be part of their family.  Not only are pets a source of unconditional love, they can also improve your mental health.

How Can Pets Improve Your Mental Health?

Pets can provide the following mental health benefits:

• Providing Comfort and Social Support: The mutual love between pets and their humans is a source of comfort for most people.  Pets and humans form a bond that helps each of them to feel less alone. 

Pets Can Improve Your Mental Health

• Providing Companionship: The comfort of having a pet can reduce loneliness and social isolation. In addition, taking care of a pet can help you to feel needed and loved.

• Helping to Relieve Stress and Anxiety: Many people who struggle with anxiety experience relief with their pet. Many pets are attuned to their human's stress and anxiety and they provide emotional support.

• Helping to Relieve Depression: The companionship of a pet can help to relieve depression.

• Reducing Work Stress: Pets have a way of building bridges in groups. In most work environments employees come together more easily when there is a pet in the office. Pets also help people to be more productive and reduce stress at work.

Pets Can Reduce Work Stress

• Improving Physical Health: People who have dogs get exercise when they walk them. Daily walks can help with cardiovascular health.

• Providing Structure and Routine: Pets need daily structure to thrive and so do humans. When you have a pet, you benefit from the daily structure as well.

Pets Can Improve Your Mental Health

• Helping to Meet New People: People who have pets, especially dogs, often meet new people in dog parks or on daily walks, so pets can be help to increase your social circle.

• Providing Sensory Stress Relief: Stroking a dog or a cat can help reduce your stress and help to reduce blood pressure. 

• Providing Help With Managing Emotions: Unconditional love from a pet can help people to manage their emotions when they come home from a stressful day and they are met by their loving pet at the door. This interaction can help people to transition from a difficult day to a loving home environment.

• Providing Meaning and Joy: Having a pet can provide meaning and joy, especially as you age and lose connection with loved ones who aren't around any more. A pet can increase your pleasure, give you a sense of meaning and purpose, and increase your sense of confidence and optimism.

Pets Are a Major Commitment

Before getting a pet, make sure you understand that it's a major commitment in terms of time and money.

You also have to be around most of the time to take care of a pet. For instance, if you travel a lot and you're not around, this can be lonely for a pet who doesn't understand where you are or if you're coming back.

You also need to make sure you're not allergic to certain pets.

Before you get a pet, make sure you have the right home environment. For instance, big dogs might not get the exercise they need in a small apartment.  In that case, having a cat might be better since they can thrive in cozy spaces.

Conclusion

Under the right circumstances, pets can help improve your overall health and mental health as well as bring you joy and comfort in many ways.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex 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.

What's the Difference Between Fear and Anxiety?

The words "fear" and "anxiety" are often used interchangeably.  While fear and anxiety often occur together, they're not the same.

What's the Difference Between Fear and Anxiety?
While fear is an emotional response to a known threat, anxiety is more of a vague feeling of apprehension.  Anxiety can also be a response to an unknown threat.  

For instance, with regard to fear, if someone approaches you in an aggressive and menacing way, your response will be one of fear.  This person is a specific, real, present and immediate possible danger.

What is the Difference Between Fear and Anxiety?

Anxiety is often about an anticipated event.  

For instance, if you're afraid of flying and you have an upcoming flight, you will probably feel anxious about the upcoming flight.  When you're on the plane, you will experience fear because it's happening in the here and now.

The distinctions between fear and anxiety might be subtle, but it will help you to be able t distinguish the difference.

Symptoms of Anxiety:
Anxiety can cause some or all of the following symptoms:

• muscle pain and tension
• headaches
• insomnia
• chest pain
• excessive sweating
• shaking and trembling
• racing heart
• upset stomach
• irritable bowel syndrome (IBS)
• panic
• dizziness
• feeling faint

Fear can cause anxiety and vice versa.

Fear and Anxiety Produce a Stress Response
Both fear and anxiety produce the fight or flight response.  The reason this is an important automatic response is because if you were in real danger, this response would help you to survive.

For instance, if you were on a path and you saw a snake, your automatic response would be to jump away before you even thought about it.  In times of danger, you don't want to stop to think--you need to react quickly to protect yourself.  Even a microsecond can make a difference in a dangerous situation.

On the other hand, if, after you had the flight response, you realized that what you thought was a snake was actually a stick, your body would start to calm down because you no longer need to flee.

There is also the freeze response which occurs when you can neither fight nor flee (see my article: Overcoming the Freeze Response).

Self Help Tips For Coping With Fear and Anxiety
There are certain things that you can do to overcome fear and anxiety.  See my articles:

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

Getting Help in Therapy
If you're suffering with chronic fear or anxiety, you could benefit from getting help from a licensed mental health professional, who has experience helping clients to overcome fear and anxiety (see my articles: Psychotherapy For Anxiety Disorders and How to Choose a Psychotherapist).

Rather than struggling on your own, you could learn how to overcome your fear or anxiety, so you could lead a calmer, more peaceful life with a sense of well-being.

If your fear and anxiety is related to unresolved trauma, you could benefit from working with a psychotherapist who specializes in treating trauma.

A trauma therapist is a licensed psychotherapist who is specialist trained specifically in helping clients to overcome both trauma related to one-time events as well as developmental trauma, which is repeated trauma and loss from childhood. 

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

I have helped many clients to overcome their fear and anxiety (see my article: What is a Trauma Therapist?).

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

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

Overcoming Dysfunctional Ways of Relating in Your Family

For many people, this is a long-awaited time of positive reconnection where family members get together and enjoy each other's company. For others, it may be a dreaded time for going home to see their family where everyone tends to fall into the same old dysfunctional patterns that they've been playing out for years.

Overcoming Dysfunctional Ways of Relating in Your Family

Here's a typical scenario (a fictionalized account made up from a compilation of many stories I have heard over the years and not representing any one person):

Susan is in her early 30s. She was recently promoted to be the marketing manager at her company with a large salary increase, a big office, and a secretary of her own. Now that she is earning so much more money, she can pay back the $1,000 loan that she received from her parents last year. What a relief that will be. She plans to surprise her parents by handing them a check for $1000 and telling them about her big promotion. She moved away from home after college and only makes visits home once during the summer and also at Christmas.

A week before she takes the flight home, she begins to feel that old anxiety about going home. She begins thinking about how her parents will nag her about not being married yet, how her father will talk to her like she's a teenager, and how her mother will try to convince her to move back home, telling her that she still has her old room, as if she did not have a life of her own here in New York. She thinks they need to get a life of their own so they can stop focusing on her life whenever she comes home. On the flight, her thoughts are immersed in old memories of recurring arguments with her parents and many prior ruined visits.

By the time she is walking up her parent's drive, she is very anxious and angry, anticipating the worst. In the meantime, her parents are also nervously anticipating Susan's visit. They're both reminding each other not to bring up certain topics that usually cause arguments. Within the last year, they've met two new couples in the neighborhood and they've started socializing more, going out to dinner with these couples and having them over for a friendly game of cards in their new game room. It's been the happiest time of their lives.

Both parents are worried about how they will tell Susan that they packed up the things that she left behind and converted her old room to the game room. They feel she is so easily offended that this might cause an argument and ruin another visit. The more they talk about it, the more anxious and irritated they feel.

Susan's father is bracing himself in case Susan wants to borrow more money. With the new renovations that they've made converting Susan's room into a game room, they can't afford to lend her any more money. In fact, he thinks to himself, we could use the money that we lent her last year, but she didn't even bring this up at all during their last phone conversation. This irritates him even more. By the time Susan rings her parents' doorbell, both she and they are primed for re-engaging in old, dysfunctional family dynamics again. Not surprisingly, within a short time of Susan arriving, her mother begins to bring up the subject of Susan's room and Susan flies off the handle, her parents overreact and they're back to their old dysfunctional ways of relating, stuck in an old dynamic, even though external circumstances have changed.

Why Do Families Get Stuck in Old Dysfunctional Ways of Relating?
In the scenario with Susan and her parents, it's clear that many external circumstances have changed for both Susan and her parents. There have been new and positive developments in each of their lives that you would think might change their ways of relating to each other. Yet, they're still stuck in the old dysfunctional ways of communicating.

 Part of the problem, as you can clearly see, is that their thinking has not changed. They're all ruminating about old arguments and resentments and anticipating that it will be the same this time--so that before they even see each other, their anxiety, anger and resentments are right under the surface and ready to explode at any moment.

Overcoming Dysfunctional Ways of Relating in Your Family

Old dysfunctional ways of relating to your family are difficult patterns to give up. It's so easy to fall back into feeling like a teenager again and relating to your family in the same way you did then, and their doing the same, even if you're in your 40s, 50s, 60s and older, especially if you're anticipating that this will happen again and again.

Your response to me might be to say, "But my parents will never change. This is how they've always been and this is how they'll always be. Family visits are horrible." And you might be right--maybe your parents will never change, even when you're in your 70s and they're in their 90s. It's also true that you can't control their behavior. But you can change your own behavior. This is often the key to changing family dynamics: If one person changes his or her own way of thinking and behaving, very often, the dynamic changes.

In the scenario above, everyone would have benefited from not allowing their anticipatory anxiety and anger to get the best of them. Going over and over old arguments and resentments in your mind has a way of priming you for the very interaction that you're hoping to avoid. It reinforces the old, dysfunctional ways of relating and doesn't allow room for anything new to occur.

It's like doing a mental rehearsal for the dysfunctional dynamics you're dreading, where the usual cues for old behavior patterns remain just under the surface, waiting to rush in at the first sign of a possible problem. This kind of mental rehearsal and acting out of old behaviors serves to reinforce the same dysfunctional behavior so that you and they get stuck in a rut.

Had Susan allowed her mother to finish her sentence, she might have been surprised to hear that her parents (the same parents she thought would never change) actually made positive changes in their lives. And if her parents had remained calm when Susan got angry and waited for her to calm down, they might have salvaged the day by telling her that there has been a misunderstanding and then explained what they wanted to tell her about her room and that they are now focusing on their own lives. Instead, the conversation degenerated in just the way that everyone was anticipating.

What You Can Do
If you and your family are stuck in old communication patterns that are producing the same dysfunctional patterns that you would like to change, think about what you might be doing to reinforce these old patterns and try to change your own behavior.

You might be surprised to find that one person changing his or her own behavior could make a big difference in the overall way that you and your family relate. (This is often true in family dynamics as well as in romantic relationships, friendships, and work relationships.)

And if it doesn't change the way your family relates to you, at least you can feel good that you've grown and improved your own personal development, you're not going for the bait (or providing the bait) and engaging in the same dysfunctional behavior yourself.

About Me

I am a licensed psychotherapist, hypnotherapist, EMDR, Somatic Experiencing and Sex Therapist in New York City. 

I work with individual adults and couples.

I have helped many clients to overcome dysfunctional ways of relating in 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.

How to Cope With Feeling Left Out

At some point, everyone has had the experience of feeling left out. This can be a passing experience or it can be a chronic problem where you might be unaware of things you're doing that contribute to the problem.

Feeling Left Out 

How to Cope With Feeling Left Out

• Accept Your Emotions: It's normal to feel upset when you feel left out. If you find out that a friend invited other mutual friends out for dinner and you weren't invited, you can feel hurt and excluded. Before you react, take time to accept how you're feeling and that you might not have all the information. For instance, there might have been an unintentional break down in communication or a missed call or text.

• Take a Deep Breath: Take a moment to breathe before you respond without having all the facts.

• Do Some Grounding Exercises: Grounding means getting centered and calm. Using certain mind-body grounding techniques can help to calm your mind and your body (see my article: Using Grounding Techniques).

• Write About It: Journaling can help you to understand what you're feeling and whether what happened might be triggering old feelings from the past, which would add intensity to what you're experiencing in the current situation.

• Talk to Someone Who is Impartial and Outside the Situation: Talking it out with someone you trust can help you to see other possibilities.  You could gain perspective from talking to someone who is objective.

• Avoid Jumping to Conclusions: Before you react, avoid jumping to conclusions. You might have been left out of a group text or email by mistake. So, it's always a good idea not to react before you have all the facts (see my article: How to Stop Jumping to Conclusions and Personalizing Other People's Behavior).

How to Be More Approachable in Social Situations

Sometimes when people feel left out in social situations, they don't realize they're doing things that make them seem unapproachable.  

Feeling Left Out

It can be challenging to look at yourself and think about how you might be affecting the situation where you feel left out.

If you're uncomfortable in social situations, you might be coming across as aloof, bored or uninterested in what's going on around you.  People might also misinterpret your discomfort as annoyance.

The following tips can help:

• Be Aware of Your Body Language: People pick up on social cues by observing body language much more than words.  So, for instance, if you're feeling uncomfortable and you're standing with your arms crossed, you look closed off and, possibly, unapproachable.  

• Develop a More Open Posture:  Standing or sitting without arms or legs crossed with an open posture makes you look more open and approachable.

• Make Eye Contact: When you do get a chance to talk to someone, make good eye contact, but don't lock eyes with someone you're just getting to know. A good rule is to make eye contact about 60% of the time.

• Smile: Although it might be difficult to smile when you're uncomfortable, try to think about something that makes you happy and confident. 

• Avoid Distractions: Your cellphone is a distraction in a social situation. If you're on your phone, people won't want to interrupt you because you don't look open to communicating with them.

• Avoid Blocks Between You and Others: If you're in a social situation, avoid placing blocks between you and others. For instance, if you're sitting on a couch at a party, don't hold a couch pillow against yourself.  This blocks you off from others and signals you're not accessible.

• Avoid Nervous Habits: Fidgeting and other nervous habits might be interpreted as not being open to talking with others. This includes nervously scrolling on your phone, playing with your hair, and other nervous habits that people engage in when they're uncomfortable.

• Stay Attuned to Others: When you're having a conversation with someone, pay attention to what they're saying.  Aside from making eye contact, nod to show you're listening and interested.

When to Get Help in Therapy

Many people who feel left out because they have social anxiety.

According to the National Institute of Mental Health, approximately 12.1% of people suffer with social anxiety, so you're not alone.

A skilled psychotherapist can help you get to the underlying reasons for your anxiety, help you to build confidence in yourself and learn skills to manage social situations that make you uncomfortable.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples, and I have helped many clients to overcome anxiety.

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

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

Overcoming Social Anxiety

People who have social anxiety  find it very challenging to be in social situations. I have worked with many clients in my psychotherapy private practice in New York City to help them overcome social anxiety.

Overcoming Social Anxiety

Here are some examples of situations that can be challenging for people with social anxiety:

• meeting new people 
• being the center of attention
• making small talk
• going out on a date
• eating or drinking in public
• attending a party
• speaking in public
• performing on stage
• taking an exam
• being teased or criticized
• making phone calls
• talking at a meeting
• being called on in class

People who have social anxiety are often excessively self conscious about themselves in social situations.  They often try to avoid social situations because they fear they will embarass or humiliate themselves.  They often become excessively worried weeks or even months before an upcoming social event.  They fear they will be judged by others and that others will notice that they're nervous in social situations.

Overcoming Social Anxiety
When I work with a client who has social anxiety, I tailor each treatment to the needs of the particular client.

So, one way that I might work is that the client and I would develop a hierarchical list of the client's fears.  

So, for example, if the client has an upcoming office party, he or she might include at the top of the list (as the most feared) that he or she will have to talk to the head of the company and won't know what to say.  At the bottom of the list, might be thinking about the office party before actually going.

Using the client's list of fears, I might use EMDR or clinical hypnosis to help the client overcome these fears starting with the least feared item on the list and working our way up the list.  Each time he or she is able to overcome one of the fears in session, we would go to the next one on the list until we worked on the item that he or she most feared.

I also like to give clients tasks to perform between therapy sessions. So, the client and I would collaborate on tasks that he or she would perform between sessions.  This is a useful way to work on other areas in everyday life that the client might fear.

Tips for Coping With Social Anxiety

• Rather than focusing on yourself and your fear of being embarrassed or humiliated in a social situation, pay attention to the others around you.

• Listen intently to what they have to say.

• Remember to breathe (shallow breathing can increase anxiety).

• Develop short-term strategies to help you cope when you feel overwhelmed by social anxiety (e.g., stepping outside for a few minutes to calm yourself before going back into the social event).

Getting Help in Therapy

If you suffer with social anxiety, you know how challenging it can be for you to be in social situations.  You also know that isolating doesn't work.  

If you would like to overcome social anxiety, seek help from licensed psychotherapist who has successfully helped clients to overcome social anxiety.

There are no quick fixes for social anxiety, but working with an experienced therapist to become free of social anxiety can be one of the best gifts you give yourself.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing therapist and Sex Therapist.

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

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

Understanding How Parental Conditional Love is Connected to Perfectionism and Shame

If you struggle with perfectionism, you might not understand why.  This article is about growing up with parents who give conditional love, and the connection between conditional love, perfection, and shame.

What Causes Perfectionism and Shame?

The feeling that you need to be perfect and the shame that comes with that are often linked to conditional love based on your accomplishments or being gratifying to your parents (see my article: The Connection Between Perfectionism and Shame).

Conditional Love, Perfection, Shame

Since there is no such thing as a perfect human being, these individuals grow up feeling ashamed whenever they're not perfect.

The roots of perfectionism and shame often include some of the following factors:

• The parents' excessive demands for high achievements with conditional love based on those achievements

• The parents' criticism as well as shame-inducing and controlling behavior when the child doesn't live up to the parents' perfectionistic standards

• The parents' All or nothing thinking 

• The child's feelings of inadequacy, low self esteem, shame and guilt for falling short of the parents' expectations

• The parents' excessive praise for achievements which they believe reflect well on them (conversely, if the child doesn't meet the parents' expectations, the parents feel this reflects poorly on them, which is why they often become angry and withhold love from the child).

This dynamic sets up an ongoing negative cycle of:

• Parents making demands of the child for perfection
• The child trying to be perfect for the parents but usually falling short (no one can be perfect)
• Parents withholding their love because the child hasn't met their demands
• The child feeling unlovable and ashamed
• Then cycle begins again

During those times when the child meets the parents' expectations (e.g, the child gets all A's on their report card), the parents are excessive in their praise, which sets up the child, who wants to be loved, to try to meet those standards every time to get the praise.

The demand for perfection can occur in many areas of a child's life:

• Perfect grades in school
• Perfect performance in sports
• Perfect eating habits
• Looking perfect, as defined by the parents' standards
• Getting the highest grades in the class
• Being chosen as the valedictorian
• And so on

Perfectionism and Shame in Adult Romantic Relationships

Children who grow up with parents who demand perfection as a condition for love will usually go above and beyond to try to meet their parents' expectations.  

Later on, as adults, they often choose emotionally unavailable partners who reinforce that they're only lovable or, more often unlovable. This is because these partners provide conditional love--like the parents did.  Usually the conditional love includes gratifying the partner's narcissistic needs.

More often than not, people who are perfectionists have internalized their parents' conditional love at such a deep level that they might not see the emotional abuse they endured with their parents or, as adults, with their romantic partners.

You might wonder why someone who was raised under these circumstances would choose a partner who was so like their parents. The answer is that these choices are made on an unconscious level as these individuals gravitate to partners who are familiar to them.

Clinical Vignette

The following clinical vignette illustrates the long term consequences of growing up in a home where parents demanded perfection.  This vignette is a composite of many cases with all identifying information removed. It is typical of many clinical cases where a person grew up with conditional love based on his achievements.

Ron

When Ron was a child, he often heard his father say things like, "If you can't do it right, don't do it at all," which made Ron anxious when he tried to do something new.  If Ron didn't understand it immediately, his father became impatient with Ron and yell.  

During those times, Ron's mother would withdraw because she was intimidated by the father. So, she wasn't able to defend Ron or provide him with emotional support.

Ron's father was the Little League coach for Ron's team.  Whenever Ron was at bat, he would be so nervous because he knew his father would yell at him in front of the other children if he missed the ball.  

After several incidents where Ron felt humiliated in front of his friends, he quit the team.  Then his father criticized him for being "a quitter," but Ron preferred that to having to deal his father's anger and disappointment every time he was at bat.

By the time Ron was in his mid-teens, his friends began dating girls. Ron felt too self conscious and ashamed to talk to any of the girls at school.  He acted like he didn't care about dating.  He pretended to be so busy with schoolwork that he didn't have time for girls. But, inwardly, he felt ashamed and annoyed with himself for not being able to talk to the girl he liked.

The following year there was another girl he had a crush on.  She liked him too. She was assertive so she asked him out and they became boyfriend and girlfriend until they each left for different colleges.  

By the time Ron sought help in therapy, he was in his early 30s and he had been in two serious relationships.  He was a little more confident than when he was a teenager, but most of the time the women he liked were the ones who pursued him.

Ron knew his perfectionism and shame were holding him back and it was surfacing in all areas of his life--his relationships, his work and in his friendships.

Whenever he was given a new task to do at work, he would get anxious because he was afraid of making a mistake. He could almost hear his father's voice scolding him for not doing the task perfectly (see my article: Overcoming Your Fear of Making a Mistake).

His therapist recommended that they do Ego State Therapy, which is a type of Parts Work similar to Internal Family Systems (IFS).  Ego States Therapy was developed by John and Helen Watkins in the 1970s, '80s and '90s.  

She asked Ron to remember a recent time when he felt he had to do something perfectly and where this was accompanied by shame (see my article: Shame is at the Root of Most Emotional Problems).

Ron remembered something that came up at work when he was attempting to solve a technical problem for the first time.  He remembered feeling that sinking feeling in the pit of his stomach and a heaviness in his chest as if his father was watching him and being critical.

When Ron was immersed in the memory along with the emotions and related bodily sensations, his therapist asked him to go back in time to the earliest time when he felt this way (this technique is called the Affect Bridge).

Experiential Trauma Therapy 

Ron's earliest memory of feeling this way was when he was four years old. His father was teaching him to play a board game for the first time and Ron wasn't understanding it.  He had the same emotions, sinking feeling and sense of heaviness.

Then, his therapist asked Ron to imagine someone who could have been there for him and who would have been an ally.  She added that it was clear there had been no one there for him at the time, but she wanted him to use his imagination.

After thinking for a bit, Ron said he would have wanted his first grade teacher, Ms. Simms to be there. This technique of imagining a nurturing figure who would have been helpful is called an imaginal interweave (for an explanation of imaginal interweaves and other forms of internal resources see this article I wrote).

His therapist asked what Ms. Simms would have done if she had been there and saw his father criticizing him and making Ron feel ashamed.  Ron said she would told his father in a polite, tactful way that this was not the way to talk to a child.  He also said he knew his father had a lot of respect for Ms. Simms so he would have listened to her.

Experiential Trauma Therapy

Ron and his therapist continued to work this way and, over time, Ron was able to work through his shame and his need to be perfect.  

Along the way, he also realized his paternal grandfather behaved in the same way with his father, so it was no surprise that Ron's father internalized this way of being and perpetuated it with Ron (see my article: Intergenerational Trauma).

Gradually, Ron overcame his traumatic experiences with experiential trauma therapy.

Conclusion

The vignette above is an abbreviated summary of one way an experiential trauma therapist would work with trauma (see my article: Why Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma).

The effect of perfectionism and shame show up in many different ways.  The vignette above is just one way.  

As mentioned before, many people, who grow up under these circumstances, often pick romantic partners who are similar to their parents, who demanded perfection.  These partners usually have narcissistic qualities that they have no insight into.

A person, who grew up being shamed for not being perfect, has a blind spot with regard to picking narcissistic partners.  

These narcissistic partners usually withhold their love if the individual isn't gratifying enough or doesn't make them look good in some way.  And, typical of people with narcissistic traits, they lack empathy for the partner they are shaming. This is because they don't relate to their partner as if the partner was a separate individual--as opposed to an extension of themself.

The Affect Bridge allows clients to connect emotional experiences they are having in the here-and-now with their origins from the past.  

The imaginal interweave, like was the first grade teacher, Ms. Simms in the vignette, gives clients a new healing experience that gets internalized (see my article: Developing Internal Resources and Coping Skills).

Imaginal interweaves are used throughout the course of experiential trauma therapy to counteract the effects of growing up with messages about perfection and shame. 

When to Get Help in Trauma Therapy

If you feel held back in your life by unresolved traumatic experiences, you could benefit from working with an experiential therapist who does trauma work (see my article: What is a Trauma Therapist?).

Once you're free from your traumatic history, you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am an experiential trauma therapist who works with individual adults and couples. I have helped clients to overcome trauma.

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.