Creating Time for Self Reflection: Mindfulness

In a recent conversation that I had with a therapist, who is a friend and colleague, we talked about how, generally speaking, many people seem to value "staying busy" much more these days than spending even a small amount of time on self reflection.

Creating Time for Self Reflection:  Mindfulness 

I believe that this overall decrease in self reflection, in turn, has lead to detrimental health effects, lack of satisfaction with life, a deterioration in important relationships for many people as well as a disregard for the environment and the health of our planet.

In a prior article, Psychotherapy and the Mindful Self: The Benefits of Mindfulness in Therapy, I focused on why I'm a proponent of mindfulness in therapy.

In this article, I'll discuss why I think mindfulness, as one form among many, of self reflection, has overall health and mental health benefits whether you're in therapy or not.

Why Is Self Reflection Important?
I know a lot of people pooh-pooh the idea of taking time for self reflection and refer to it derisively as "navel gazing."

At the same time, people who actually do spend some time each week either practicing mindfulness, meditating, doing yoga, journal writing or coming to therapy to reflect on their lives, tend to express much more satisfaction with their lives than people who focus on just "keeping busy."

There can be many reasons why people keep themselves distracted by "keeping busy" (see my article:  Are You "Keeping Busy" to Avoid Painful Emotions?).

Creating Time for Self Reflection:  Mindfulness

By "keeping busy" most of the time, it's easy to live in a "mindless" way without self reflection or empathy for yourself and others.

Life can feel meaningless, shallow and overly routine as you become more disconnected from yourself, significant people in your life and your environment (both personal environment as well as the environment of our planet).

Becoming Mindful of the Environment of Our Planet

More than ever, I'm hearing from clients in my psychotherapy private practice in NYC that they're feeling an increased sense of loneliness and alienation.

I think there are many reasons for this, including an emphasis on "staying busy," less time for self reflection as well as less meaningful in-person contact with significant others--just to name a few causes of this complex phenomena.

As with anything, there needs to be a balance between spending time on self reflection and taking care of your responsibilities, working, having fun and everything else that is part of a full life.

By "Keeping Busy" Most of the Time, It's Easy to Live in a "Mindless" Way

We can always find something else "to do" that can eliminate time for self reflection, so it's usually a matter of making it a priority and creating the time to do it, much as you would for anything else that you feel is important.

Once you create the time for self reflection and develop this as a healthy habit, it often doesn't take a lot of time to reap the benefits.

Mindfulness and Self Reflection
Mindfulness is one way to engage in self reflection.

Creating Time for Self Reflection:  Mindfulness

Even just 15 minutes a day of mindfulness can help improve your overall health and sense of well being, and these benefits include:

• focusing on the here-and-now rather than focusing on regrets about the past or worrying about the future
• developing a greater capacity to form meaningful connections with others
• developing better coping skills
• cultivating a healthier perspective about life
• improving sleep
• alleviating gastrointestinal problems
• alleviating depressive symptoms
• alleviating symptoms of anxiety
• helping with obsessive compulsive disorder
• lowering blood pressure
• reducing chronic pain
• helping to improve communication in relationships
• developing a healthier appreciation of the environment

These are just some of the many benefits.

When you consider the substantial benefits of mindfulness, isn't it worth spending 15 minutes to help improve your health and overall sense of well being?

In my Self Reflection and Basic Mindfulness Techniques, I'll discuss some simple ways that you can practice mindfulness to get started.

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

Beyond the "Band Aid" Approach to Overcoming Psychological Problems - Part 2

I began discussing this topic in my prior article, Beyond the "Band Aid" Approach to Overcoming Psychological Problems - Part 1.  In Part 1, I outlined the problems of taking a "band aid" (also known as a "quick fix") approach to resolving psychological problems.  In that article, I discussed the problems involved in only taking psychotropic medication (instead of also attending psychotherapy) or only attending a few sessions of therapy to vent and feel better momentarily without resolving the underlying issues related to the problem.

Beyond the "Band Aid" Approach to Overcoming Problems

In this article, I'll expand on this topic by giving a composite scenario, which is made up of many different cases with all identifying information changed to protect confidentiality:

Ted
Ted had a long history of anxiety that began when he was a young child.

He was the oldest of five children in a family who lived from one crisis to the next.  Both parents worked two jobs and so Ted was usually in charge of taking care of his younger siblings.

Ted's anxiety began when he was a child

Ted, who was too young to take care of siblings, often felt overwhelmed.

He never allowed his parents or siblings to see how anxious he was, so he felt alone with his fears and sense of inadequacy.

Fortunately, by the time Ted went away to college, his family's financial situation had improved substantially so his parents no longer needed to each work two jobs, and Ted was free to go away to college.

But even with the improvement in their financial resources, the family was so accustomed to being in crisis that they would often react to common everyday family problems as if there was a crisis.

Both of the parents came from traumatic, crisis-oriented family backgrounds and neither had ever gone for psychological help, so this pattern was deeply ingrained and passed on from one generation to the next (see my article:  Psychotherapy and Transgenerational Trauma).

While Ted was in college, he often received calls from family members who were reacting to everyday problems as if they were crises.  This exacerbated Ted's anxiety to the point where he wasn't sleeping and he had some difficulty concentrating on his schoolwork.

He had problems concentrating on his work

After suffering several weeks with insomnia and poor concentration, Ted came home to see his family doctor, who placed him on an anti-anxiety medication called Xanax.

For a period of time after that, Ted took Xanax whenever he felt anxious and it helped him to calm down.  But it didn't help him to overcome the underlying issues that were creating problems for him.

One of those problems was that Ted continued to feel deeply inadequate.  What started as a sense of inadequacy about himself as a child trying to take care of his siblings continued into his adulthood in every area of his life.  And, although the medication helped to take the edge off of his anxiety, it didn't change the way he felt about himself.

Even worse, he began to realize that he needed more and more Xanax in order to function, and he knew that he couldn't go on this way.

Ted's doctor referred him to a psychotherapist

With the help of his doctor, he titrated off Xanax, he accepted the doctor's referral for psychotherapy to a licensed psychotherapist, and he attended a few therapy sessions.

During those sessions, he felt better after talking to the therapist and he also developed a basic understanding of why he felt anxious.

Once he felt some relief, he decided to leave therapy against the therapist's advice, believing that his problems were resolved.  But having a basic understanding about his problems wasn't the same as resolving his problems (see my article:  Healing From the Inside Out: Why Understanding Your Problems Isn't Enough).

In addition, his anxiety returned after the "feel good" feelings wore off.  So, he went to see another therapist, who advised that Ted remain in therapy to work through the underlying issues that were causing Ted's problems  But, once again, after he began feeling better, Ted left therapy (see my article:  When Clients Leave Therapy Prematurely).

After repeating this pattern several times with the same results, Ted felt frustrated and discouraged.  He wondered if, perhaps, therapy didn't work for him.  But he spoke with a close friend, who told Ted how sticking with therapy helped him and Ted realized that his pattern of leaving therapy after a few sessions was the real problem.

Getting Help in Therapy

Once Ted accepted this and made a commitment in his next therapy to remain until he worked through the underlying causes of his psychological problems, he was able to work through his problems in therapy with a skilled therapist who was empathetic and supportive.

Getting Help in Therapy
"Band aid" or "quick fix" approaches to overcoming psychological problems rarely work.

Overcoming psychological problems requires a commitment to complete the process beyond "feeling good" temporarily.

If you're struggling with problems that haven't responded to your own efforts or to "quick fix" attempts, you could benefit from the help of a licensed mental health professional who can help you work through your problems beyond just "feeling good."

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

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

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

Beyond the "Band Aid" Approach to Overcoming Psychological Problems - Part 1

In most cases getting psychological help should be more than just a "band aid" or "quick fix" approach, especially for people who have a history of trauma or who have complex psychological problems.  

Beyond the "Band Aid" Approach to Overcoming Psychological Problems

Unfortunately, the "band aid" approach has been a trend in mental health for the last decade or so and there's no sign that this will change any time soon.

What Are "Band Aid" or "Quick Fix" Approaches to Psychological Problems?

For a variety of reasons, including the heavy promotion of psychotropic drugs by pharmaceutical companies who are making huge profits, many more people, who really need more in-depth psychological treatment, are being encouraged to seek "quick fix" solutions to their problems.

Beyond the "Band Aid" Approach to Overcoming Psychological Problems

The "band aid" or "quick fix" solution often involves just taking medication or a "triage" approach to therapy.

The "band aid" approach is usually inadequate for most people because without psychotherapy, clients don't develop an understanding about their problems, nor do they develop skills to overcome these problems.

Psychotropic Medication Alone Isn't as Effective as Psychotherapy For Many Psychological Problems
While it's true that in many cases psychotropic medication might be necessary to help with stabilization, there are also many more cases where clients are encouraged to rely solely on medication when they could benefit more from attending psychotherapy.

In addition, there are often side effects to psychotropic medication that clients are unaware of before they start taking them.  Some of the side effects are mild, but some are more significant.

Also, what happens when clients want to stop medication (hopefully, in collaboration with their doctor)?

Very often, when people stop taking medication and they haven't attended therapy, they return to their former level of psychological functioning without the medication because they haven't learned, beyond taking a pill, what changes they can make themselves to overcome their problems.

So, in many cases, they resume the medication, and it becomes an endless cycle.

Medication Alone Usually Isn't as Effective as Therapy For Many Psychological Problem

This isn't to say that people should stop taking psychotropic medication without consulting with their doctor.  As I've said, there are particular problems (like schizophrenia or bipolar disorder, to name just two) where medication is necessary.  There are also times when medication can be helpful as an adjunct to therapy.

The problem arises when clients only take medication without attending therapy.

Many people, who rely solely on medication, would benefit more from seeing a licensed psychotherapist.

What is the Triage Approach to Therapy?
Aside from just taking medication, triage therapy is where the client comes to therapy in crisis and the therapist helps the client to feel better momentarily in a few sessions without getting to the root of the problem.

Beyond the "Band Aid" Approach to Overcoming Psychological Problems

For some people, like people who are in war-torn countries or who experience natural disaster, who have limited access to therapy, and who are in crisis, triage therapy might be all that is possible.  In those cases, triage therapy is better than no therapy at all.

But aside from these unique circumstances, the problem with this approach is that, while the client might "feel better" momentarily because she or he vented about the problem for a few sessions, the client has no meaningful understanding of the problem.  In other words, aside from "feeling good" for the moment, nothing substantial has really changed.

When this occurs, these clients feel some relief from their psychological problems which, of course is important, but this relief is usually short lived.  And since nothing of substance has changed for them psychologically, they will often return again and again (either to the same therapist or to a different therapist) when the temporary feelings of relief have subsided.

Temporary Feelings of Relief Can Lead Eventually to a "Revolving Door" Cycle 

This can set up a "revolving door" cycle for many clients.  After many of these attempts, they often get discouraged and feel that therapy "doesn't work" for them.  They don't understand, and no one has ever educated them, that there's no shortcut to making significant changes and that while there might be different forms of therapy that tend to be shorter and more effective than others, the "quick fix" approach of only attending a few sessions usually doesn't work for long.

How Can Psychotherapy Help?

When a skilled mental health professional provides psychotherapy services, it can help clients by:

• providing an empathic and supportive environment where clients feel cared about and understood (for many people, this might be their first meaningful experience of feeling really heard and cared about in their lives)
• empowering clients to understand their problems, including dysfunctional patterns that they keep repeating in their lives
• helping clients to develop the necessary internal resources and skills they will need to make and sustain important changes 
• helping clients to work through and overcome psychological problems 

The "band aid" approach, whether it involves just taking medication or a triage approach in therapy, doesn't do this.

In the next article, I'll give an example to clarify why the "band aid" approach usually doesn't work and how psychotherapy can be beneficial (see my article:  Beyond the "Band Aid" Approach to Overcoming Psychological Problems - Part 2).

Getting Help in Therapy
In the meantime, if you've either tried on your own or you've only ever sought a "quick fix" approach to your problems, you could benefit from attending therapy with a licensed mental health professional who will work with you to empower you in a meaningful way to resolve your problems.

Getting Help in Therapy in a Meaningful Way

Rather than looking for shortcuts that don't work, you could have a more meaningful experience in therapy so you can overcome your problems and live a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

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

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

Learning to Feel Hopeful in Therapy: Developing a Stronger Sense of Self

In a prior article, Learning to Feel Hopeful in Therapy , I began a discussion about how difficult it can be for psychotherapy clients, who have a history of emotional trauma and who have not been healed by therapy in the past, to allow themselves to be vulnerable enough to feel hopeful in therapy again.

Learning to Feel Hopeful in Therapy:  Traumatized Clients Often Have a Hard Time Opening Up

In that article, I discussed that my experience (and the experiences of many other trauma therapists) has  been that a mind-body oriented approach in therapy tends to be more helpful in terms of healing trauma than regular talk therapy.

I also discussed the ongoing research about the neuroplasticity of the brain, how this research helps us to realize now, more than ever, that the brain can change itself and, as result, there can be a resolution to emotional trauma under the right circumstances in therapy.

For many clients, who have been devastated by emotional trauma and who were unable to trust their primary caregivers as children, the idea that they could expose their emotional hurt and pain to a therapist seems incomprehensible.

From the point of view of many of these individuals:  Why should they trust a therapist when they couldn't trust their primary caregivers who were supposed to love and protect them?

People Who Have Been Traumatized Often Have a Hard Time Trusting in Therapy

Even worse, if they've been to therapy before and they had bad experiences, they're now doubly afraid of opening up again.

As a psychotherapist, I hear this often and I can understand why it would be very frightening for these individuals to open themselves up to be emotionally vulnerable.

Often, these people come to therapy because they're in so much emotional pain and they really long for relief.

At the same time, many of them are so afraid that they're ready to bolt from therapy if, from their perspective, there's a chance of getting hurt again.

Developing Coping Strategies in Therapy:  Developing the Capacity for Emotional Regulation 
When I know that there has been significant trauma and the client is fearful of opening up in therapy, I usually start with helping them to develop the kinds of internal resources and coping skills that will empower them to open up.

Preparation for Trauma Therapy:  Developing Coping Strategies in Therapy

When I help clients through the resourcing phase of treatment, I develop an individualized plan for each client.

Resourcing includes ways that clients can learn emotional regulation, which is so important for people who have suffered trauma, especially early childhood trauma.

Early trauma can leave a child feeling helpless, abandoned and unable to contain the overwhelming emotions related to the trauma.  Often this is because his/her primary caregiver was either unavailable (physically and/or emotionally) or unable (due to her own trauma) or unwilling to help the child to contain overwhelming emotions.

Early Abuse or Neglect Can Result in an Inability Later on as an Adult to Regulate Emotions

As I mentioned in the prior article, early childhood abuse and/or neglect often results in deficits to the orbitofrontal cortex (in the right hemisphere of the brain) at around the time that this part of the brain is developing in an infant.

If there are no other mitigating factors (like another family member who helps the child), this deficit will result in the child's inability to self soothe or regulate difficult emotions.

When this inability to self soothe and self regulate continues into adulthood, which it usually does, the adult often feels bombarded and buffeted by life's many emotional challenges, even if these challenges aren't traumatic per se.

For these children and adults, instead of responding to problems, they automatically react in an impulsive way (see my article:  The Mind-Body Connection: Responding Instead of Reacting to Stress).  This causes many problems in both personal and work-related interpersonal relationships.

So, learning to self soothe and develop a greater capacity for stress is a key component to the initial stage of my work with clients, who never developed these skills, before we do any trauma work.

Although most clients find this very helpful in their lives as well as a preliminary step to doing trauma work, there are some clients who want to begin doing the processing of trauma immediately.

From their perspective, they've been suffering long enough and they want relief now from their emotional problems.

While I understand and empathize with these clients, I also know, based on my clinical experience, that if these clients have little to no tolerance for difficult emotions, they would become too overwhelmed if we began by processing the trauma immediately.

If they become too overwhelmed, they could have one of several adverse reactions.  They could:

• leave treatment prematurely because they can't tolerate what comes up in trauma therapy
• dissociate (become emotionally numb) so that they're no longer aware of what's happening in the therapy and no longer present in the room emotionally for processing their problems
• become rageful, overwhelmingly sad and/or avoidant
• feel powerless 
• feel ashamed
• feel guilty because they think they "should" be able to handle their emotions
• become distrustful of the therapist and the therapy so that there is a treatment impasse
• have physical reactions where their overwhelming emotions become somatized due to the mind-body connection (migraine headaches, irritable bowel syndrome, asthma attacks, and so on)

This list represents only a few of the possible adverse reactions that people could have when the therapist allows them to start processing emotional trauma before these clients have developed the internal skills and resources to handle it.

I don't want to make trauma therapy sound like it's dangerous in and of itself.  I just want to emphasize that it's important for clients to be prepared by the therapist before they start processing trauma.  The preparation phase of treatment shouldn't be skipped over no matter how much a client insists.

Often, by developing a greater emotional capacity and tolerance, clients who start out being impatient to begin learn to be more patient.

On the other hand, there are some clients who come to therapy to work on emotional trauma who have done a lot of work either in a prior therapy or on their own so that they come to trauma therapy with a capacity to begin doing work.  But this is something that the therapist must assess clinically before doing the trauma work.

Empowering Clients to do Trauma Therapy
The preparation (or resourcing) phase of trauma therapy, whether the therapy is EMDR, Somatic Experiencing or clinical hypnosis, helps to empower the client to do trauma therapy.

Empowering Clients in Therapy

It's very gratifying and heart warming for me when I see a client develop in this way.

The client might have come in with very little in the way of the capacity for emotional regulation or frustration tolerance.  But as we work on helping him or her to develop these skills, s/he becomes more confident and open to doing the trauma work.

Strengthening the Rapport and Trust Between Client and Therapist
The preparation phase also helps to strengthen the rapport between the client and therapist, which is necessary for any therapy to be successful.

When the therapist helps the client to develop better coping skills, including emotional regulation and self soothing skills, the client usually feels cared for by the therapist.

For some clients, this might be the first time that they've had the experience of being cared about, so this  is an important step.

Strengthening the Rapport and Trust Between Client and Therapist

Knowing that the therapist cares about them and empathizes with their feelings helps clients to develop trust which, in turn, helps them to feel more hopeful and motivated about the therapy.

This is a very individual process and it will be different for each client.

This doesn't mean that the therapy will go forward without any problems between the therapist and the client.

After all, therapists are human and they make mistakes.  What's more important is how these mistakes get resolved.  In other words, there can be ruptures in therapy, due to misunderstandings or mistakes, but the most important thing is how these ruptures get repaired (see my article:  Psychotherapy: Ruptures and Repairs in Therapy).

Even though going through the repair process, after a therapeutic rupture, can be challenging for both client and therapist, it can also be a healing experience.

It keeps the therapist humble.  It also gives clients, who might only have ever grown up with ruptures and no repairs, an experience that interpersonal difficulties can be repaired so that the therapeutic relationship can continue to develop and flourish.

Aside from what I've discussed above, there are many other ways to develop a stronger sense of self in therapy with the help of an experienced trauma therapist.

Mind-Body Oriented Psychotherapy
After the client has developed the necessary skills and a stronger sense of self during the preparation phase, the processing of the trauma can begin.

The Mind-Body Connection

As I mentioned in my prior article, there are various types of mind-body oriented therapy for trauma therapy, including EMDR, Somatic Experiencing and clinical hypnosis.

Some treatment modalities work better for some clients than others.  This is why it's important for trauma therapists to have a repertoire of ways to work to help as many clients as possible rather than relying on only one way.

This topic merits a book rather than a couple of articles.   I hope I've given people, who might be interested, a sense of what works in trauma therapy and how clients (whether they're reluctant to feel hopeful initially or they're prone to jump in too quickly) can be helped by a therapist who is a trauma specialist.

Getting Help in Therapy
If you've been unable to work through your problems on your own, you could benefit from working with a licensed mental health professional who has experience helping clients to overcome difficult emotional problems.

Getting Help in Therapy

Clients, who have worked through their emotional trauma, often describe a sense of freedom with more energy to focus on what they want in their lives.  They often go on to have more fulfilling lives once they're no longer struggling with emotional difficulties.

Rather than struggling on your own, you owe it to yourself to get professional help from a licensed therapist so you too can live a more fulfilling life.

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

One of my specialties is helping 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.

Learning to Feel Hopeful in Therapy

For many clients who start psychotherapy to deal with trauma, especially longstanding trauma stemming from significant unmet emotional needs from childhood, it can be difficult to feel hopeful that therapy will make a difference and help them to change their lives.

Learning to Feel Hopeful in Therapy:  Clients with Trauma Can Find It Difficult to Feel Hopeful

As a psychotherapist in NYC, I've found this to be especially true of clients who have been in many different types of psychotherapy before and who have experienced no resolution to their trauma.

Psychotherapy Clients with a Fear of Being Vulnerable and Only a Glimmer of Hope
Often, clients come to see me because they know that, in addition to using talk therapy, I'm also an EMDR therapist as well as a hypnotherapist and Somatic Experiencing therapist.

These clients usually come to see me because they've haven't experienced relief from their emotional trauma in traditional talk therapy.  And although there might only be a small part of them that brings them back to therapy, often they feel too emotionally vulnerable to really allow themselves to feel a sense of hope that things could change for them.

Clients with Longstanding Unresolved Trauma Can Feel Too Afraid to be Hopeful in Therapy

This is, of course, understandable when you consider that they've been disappointed too many times in their life, including disappointments in therapy.  It becomes hard for them to trust others and, often, hard for them to trust themselves.

It's also not unusual for people to come to therapy and not even know that they've been emotionally traumatized.  This is especially common if they've experienced complex trauma or they've lived their lives since childhood experiencing one crisis after another.  They might be too emotionally numb to feel a lot more than fear, anger and apprehension.

They might only know in some vague way that they feel "stuck" in their lives, but they don't make the connection between their current problems and their personal history (see my article:  When You Just Don't Feel Right and It's Hard to Put Your Feelings Into Words).

Psychoeducation in Therapy
Knowing this, I usually provide clients with psychoeducation at the start of therapy about the different types of treatment modalities that I use and any research about the efficacy of these modalities.

I also tell them about my own evolution as a psychotherapist who originally trained in psychoanalysis and psychodynamic psychotherapy and who went on to train in different types of trauma therapy, like EMDR, clinical hypnosis and Somatic Experiencing.

I can also tell new clients what I have observed in my psychotherapy private practice with regard to the different types of therapy and how it has been my experience over the years that a mind-body orientation in therapy tends to work better and faster for most people as compared to regular talk therapy.

Intellectual Insight in Therapy Usually Isn't Enough to Heal Trauma
This isn't to say that psychoanalysis, psychodynamic therapy and cognitive behavioral therapy don't work.  However, most of the time, these forms of therapy don't resolve trauma.

Clients in talk therapy often develop intellectual insight into their problems, which is important, but their trauma often remains unresolved.

Intellectual Insight in Therapy Usually Isn't Enough to Heal Emotional Trauma

Clients, who have developed only intellectual insight, often feel that there must be something really wrong with them because their insight doesn't bring about change.

Clients, who have a history of trauma, often carry within themselves the burden of guilt and shame to begin with because of their trauma.  They blame themselves for what happened to them.

So, when therapy only brings insight and not healing, they often blame themselves for that too which, in many ways, is a retraumatization.

But the problem usually isn't with them--it's a problem with the therapy that doesn't get to the core of their problems.

Overcoming Emotional Trauma:  Interpersonal Neurobiology Points the Way
Due to the relatively new field of interpersonal neurobiology and the work of professionals like Allan Schore, Ph.D. and Daniel Siegel, MD, we now know that early childhood emotional trauma and attachment problems with the primary caregiver can cause deficits in the right hemisphere of the brain, specifically the right orbitofrontal cortex and that regular talk therapy often doesn't help to heal these deficits (see:  Affect Dysregulation and Disorder of the Self by Allan Schore, Ph.D. and Healing Trauma: Attachment, Mind, Body and Brain by Dan Siegel, MD, which are both part of the Norton series on interpersonal neurobiology, as well as The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk, MD).

Healing Trauma with the Mind-Body Connection

The Neuroplasticity of the Brain
Not long ago neuroscientists believed that, over time, brain cells died and the brain just continued to lose cells without being able to regenerate cells or to make changes (hence the old saying, "You can't teach an old dog new tricks").

Fortunately, we also now know about the neuroplasticity of the brain.  Neuroplasticity refers to the brain's ability, under the right circumstances, to reorganize itself throughout the life cycle.

The Neuroplasticity of the Brain

So, even in circumstances where there have been deficits in the right orbitofrontal cortex (right hemisphere of the brain) due to childhood trauma of early abuse or neglect, the adult brain can still change later in life to make up for these emotional deficits.

The discovery that the brain can change itself was a very hopeful discovery (see:  The Brain that Changes Itself: Stories of Personal Trauma from the Frontier of Brain Science by Norman Doidge, MD).

The Mind-Body Connection in Therapy
To heal these trauma-related deficits, a treatment modality that takes into account the mind-body connection is required, like Somatic Experiencing, EMDR or clinical hypnosis, among others (see my article:  Mind-Body Psychotherapy: The Body Offers a Window into the Unconscious Mind).

The Mind-Body Connection in Therapy

Of course, there are no guarantees that therapy is going to resolve a particular person's problems.  So, while I'm enthusiastic about the different types of therapy that I use, I'm also honest that there's no way to predict in advance if therapy is going to work.

Over the course of a therapy, I often use a combination of mind-body oriented treatment modalities because no one form of therapy works for every single client.

Also, even when a particular treatment modality is working for a while, there can be a treatment impasse and, in order to overcome an impasse, I'll switch to a different modality that is better with that particular obstacle in treatment.

Sometimes, the switch to another modality might only be temporary to overcome the impasse, and other times the client might prefer it so we continue with it (see my article:  Overcoming an Impasse in Trauma Therapy).

Emotional Trauma and Hopelessness
Getting back to clients' problems with feeling hopeful:  There are different types of challenges that clients face with regard to feeling too afraid to feel hopeful, including:

• feeling powerless
• feeling unlovable or unworthy (see my article:  Overcoming Emotional Pain: Feeling Unlovable)
• having early, and possibly later, experiences of being physically and/or emotionally abandoned
• feeling despair
• feeling helpless
• experiencing social isolation
• experiencing cognitive distortions (for an example of this see my article:  Overcoming All or Nothing Thinking)
• feeling depressed
• feeling anxious and overwhelmed
• being unable to identify and express how they feel
• unconscious decisions (see my article:  What Unconscious Decisions Have You Made That Are Impacting Your Life?

and so on.

In an upcoming article, I'll discuss how clients, who come to therapy feeling too afraid to be hopeful, can overcome this challenge.

Getting Help in Therapy
If you're feeling overwhelmed by your emotions, whether your problems are related to longstanding unresolved trauma or more recent emotional problems, you're not alone.

Getting Help in Therapy

Although you might find it difficult to ask for help in therapy, you can attend a consultation with a licensed mental health professional to see if you and the therapist are suited for each other (see my article:  How to Choose a Psychotherapist).

Rather than continuing to suffer on your own, you could benefit from working with a licensed mental health professional who is knowledgeable about mind-body oriented therapy.

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

One of my specialties is helping clients to overcome emotional 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.

Overcoming Guilt and Shame About Feeling Depressed: Part 3

This article is Part 3 of a series about overcoming guilt and shame about feeling depressed.  Part 1 and Part 2 of this series introduced the topic by discussing the symptoms and common misconceptions about major depression and how these misconceptions can create or exacerbate shame and guilt.

Overcoming Depression:  Overcoming Guilt and Shame About Feeling Depressed

Fear of Showing a Vulnerable Emotional Side Can Lead to Guilt and Shame in People Who Are Depressed

Many people who feel guilt and shame about being depressed feel that they're the only ones who feel this way.

Often this occurs because they feel too vulnerable emotionally to talk about their depression and they isolate themselves from others who could be helpful to them.  

Many people who are depressed are also painfully aware that, despite all we know these days about depression and brain chemistry, a stigma about depression and mental health problems in general still exists among certain people who aren't informed about depression.

Men who are depressed were often raised to feel that "big boys don't cry" and they need to be "strong" when they're men.  The implication is that to be considered "strong," they can't show their more emotional or vulnerable side, and they especially can't show that they're feeling depressed.

Women who are depressed, especially women who are in male-dominated professions (like law enforcement, medicine, engineering and so on) often get the message that if they want to excel in their profession, they have to "act like men," which means that, like men, they also shouldn't show their more vulnerable side and they shouldn't reveal that they're depressed.

Feeling Depressed and Alone: Social Isolation

People who feel depressed often isolate themselves from others, especially when they're at the point when they can't pretend any more to be happy around others because it's just too emotionally and physically exhausting.

Social isolation often makes people who are feeling depressed feel worse because they're not getting the  emotional support they could be getting from loved ones who could be helpful.

Social isolation can also make them feel that they're the only ones who have ever felt depressed which, of course, isn't true.

Getting Help in Therapy

Educating yourself about depression and becoming aware of the symptoms are the first steps in getting help.

If you've tried on your own to overcome depression and you haven't succeeded, continuing to feel ashamed and guilty will only make your situation worse.

It's important to seek out the help of a licensed mental health professional who can help you to overcome depression as soon as possible. 

A licensed mental health professional can help you to overcome depression so that you can lead a more fulfilling life.  

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works 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.

Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 2

In my prior article,  Overcoming Guilt and Shame About Feeling Depressed - Part 1, I began this discussion by discussing the most common depression that people experience.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

In this article, I'm focusing on how guilt and shame about feeling depressed is often based on misconceptions about depression and how these misconceptions can get in the way of your recovering from depression.  Some of these misconceptions are popular in our Western culture.

Let's start by looking at some of the misconceptions about depression.

Misconceptions About Depression:

• If people really want to overcome depression, all they need to do is "snap out of it" to feel better.
• If people are depressed, they don't want to feel better.
• If people who are depressed just "stayed busy," they'd stop feeling depressed.
• People who are depressed aren't trying hard enough to get better.
• People who are depressed have "no reason" to be depressed.
• Other people, who have it worse, aren't depressed.
• People who are depressed have only themselves to blame for their depression.
• People who are depressed are "lazy."
• People who are depressed are "failures."
• People who say they're depressed are just trying to get attention.
• People who are depressed are self centered.
• There's no such thing as depression.  There are only people who say they're depressed and who are faking it.
• You're life is good--what do you have to be depressed about?

I'm sure you could come up with many other misconceptions about depression and people who are depressed.

The point is that these misconceptions, whether they're coming from the person who is depressed or people around him or her, serve to exacerbate the depression and often cause the person who is depressed to feel guilty and shamed.

Depression:  Overcoming Guilt and Shame About Feeling Depressed

If you're feeling depressed, blaming yourself will only make you feel worse.

Becoming aware that these ideas are misconceptions is the first step in overcoming guilt and shame about feeling depressed.

If your loved ones are the ones who are talking to you about your depression by trying to convince you about one or more of these common misconceptions, you need to take care of yourself and stop giving credence to these ideas.

Overcoming Guilt and Shame About Feeling Depressed

If you're the one who is engaging in negative self talk about your depression, be aware that you're doing the equivalent of kicking yourself while you're down.

You need to recognize these thoughts for the distorted thoughts that they are and get professional help from a licensed mental health professional.

In my next article, Part 3, I'll continue this discussion.

Getting Help in Therapy
In the meantime, if you or someone you love is suffering with depression, it's important to take it seriously and seek help from a licensed mental health professional as soon as possible.

Getting Help in Therapy

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

Also see:  Depression: Overcoming Guilt and Shame About Feeling Depressed - Part 3