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Friday, November 17, 2017

Becoming Your True Self

Discovering who you are can be a lifelong process, especially since everyone changes over time.  In prior articles, I wrote about the false self from Donald Winnicott's perspective and about living a meaningful life (see my articles: Understanding Your False Self - Part 1,  Understanding Your False Self - Part 2, A Search For a Meaningful LifeA Happy Life vs A Meaningful Life and Becoming the Person You Want to Be).  In this article, I'm focusing on how to become your true self.

Becoming Your True Self
There is so much pressure these days to conform to social norms that you might not feel comfortable with, and by conforming to these social norms, you can develop a false or inauthentic self.

What is the True Self?
Donald Winnicott, a British psychoanalyst, identified the true self as being spontaneous, creative and alive (see my article: Recapturing Your Sense of Aliveness).

Developing a true self is a journey and that you develop over time.  There's no such thing as having "arrived" at developing a true self because, as I mentioned before, it can be a lifelong process.

By discovering who you are and living authentically and consistently with your values, you will have more of a sense of well-being.

There's no one way to achieve authenticity (see my article: Living Authentically - Aligned With Your Values), but here are some suggestions that might be helpful to you:

Suggestions For Developing Your True Self
  • Talk to Loved Ones Who Are Also Developing a More Authentic Self: When you talk to others who are also trying to live more authentically, you develop insights into your own struggles.  You can also feel supported and cared about by people who are going through a similar stage.
  • Read Inspirational Literature About Authenticity: By reading stories about people who have learned to develop a true self or who have struggled with issues around authenticity, you can feel inspired in your own journey.  This includes both fiction and nonfiction (see my article: Reading Literature and the Positive Effects on the Brain).
  • Ask Yourself: What is My Purpose in Life?  This is another area that changes over time as you change.  Asking yourself what your purpose in life is helps you to live in a purposeful way rather than just drifting from one day to the next.  When you live your life with intention, your goals will most likely fall into place because you have an overarching purpose and all major decisions will be made to serve that purpose (see my article: Starting the Day With an Intention).
It's not easy to know if you're living as your true self.  It takes time and effort to think about what's important to you and how you will achieve authenticity.  

Even after you identify your core values, you might feel conflicted and ambivalent about your values.

You might be afraid of disappointing people in your life who might have a different vision for you.  It takes courage to stand up for what feels true and right for you.

How Psychotherapy Can Help You Discover Your True Self
We all have certain unconscious blind spots and it's usually very challenging to discover your authentic self on your own.  

Usually, people come up against the same blocks over and over again and they only get so far on their own.  

A skilled psychotherapist can help you to overcome the obstacles, both conscious and unconscious, that are getting in the way of becoming your true self (see my article: How to Choose a Psychotherapist).

While we're all human and none of us can always be our true self, when you live aligned with your values and what's most important to you, you will feel more fulfilled in your life.

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

I have helped many clients to live more authentically.

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

To set up a consultation, call me at (212) 726-1006 or email me.

Thursday, November 16, 2017

Preparing Emotionally For Major Changes in Your Life

Nothing ever stays the same indefinitely in life.  If you think back on your life over time, you realize how many changes you went through.  Change is inevitable and it can be hard, so preparing emotionally for major changes makes sense (see my articles Midlife Transitions: Reassessing Your LifeMidlife Transitions - Part 2: Living the Life You Want to LiveMaking Changes: Overcoming Ambivalence, Fear of Change and Moving Out of Your Comfort Zone).

Preparing Emotionally For Major Changes in Your Life

There are some changes that happen so suddenly that you might not get a chance to prepare for them emotionally:  A sudden job loss, an unexpected medical problem or the unexpected betrayal of a friend.  But there are many expected changes, like going to college, starting your first job, getting married or retiring that you can prepare for emotionally.

Basic Steps to Preparing For Major Changes in Your Life:
  • Acknowledge to yourself that change can be difficult and that you might be emotionally challenged in unexpected ways.
  • Know that it's normal to feel some anxiety about change.
  • Assess your situation and get as much information as you can before you make the change.
  • Get input and support from trusted friends, family members and people who have gone through this type of change before.
  • Weigh your options.
  • Make a decision and come up with a plan.
  • Take responsibility for making a decision and seeing it through.
  • Take extra care of yourself and expect that the decision making process and the change might take more of a toll on you than you expect, even when it's a change that you consider to be positive.
  • After the change has taken place, reassess your plan and make any necessary changes.
  • Maintain contact with your emotional support system.
  • Get help in therapy if the change is overwhelming or brings up unresolved issues from the past.

Fictionalized Vignette About Preparing Emotionally For a Major Change

Tom and his wife, Helen, had been talking about retirement for several years.

When they first started talking about it five years before, it seemed like it was a long way off.  But now that they were a year away from retirement, it suddenly seemed to loom large for Tom.

They had already decided that they would remain in New York City because they loved the city, especially the cultural events.  They also had most of their family and friends in New York, so they didn't want to leave.

Helen decided that she would get more involved in a charity where she already volunteered.  After retirement, she could spend more time doing what she loved.

Preparing Emotionally For Major Changes in Your Life

But Tom wasn't sure what he wanted to do.  He knew that he would enjoy the first few weeks of being able to relax, but he also knew that he would get bored after a while if he just hung around the apartment.

He had already gone to his financial advisor, so he was clear on what their financial situation would be.  He had also looked into their health benefits plan and social security benefits, so that was taken care of already.

He just wasn't sure what he wanted to do with his time, and the more he thought about it, the more worried he got.

His other worry was that he associated retirement with death because his father died shortly after he retired.

Even though he was in good health and younger than his father when he retired, Tom still couldn't get this fear out of his mind.

He talked to his friends and family members, who were either retired or close to retirement.  After talking to them, he felt better for a short time, but then his fear would creep up on him again and cause him to lose sleep.

In the past, Tom had a good experience with psychotherapy, so he decided to return to his former therapist to deal with his anxiety and indecision.

As soon as he sat in his therapist's office, he remembered how comforted he felt in the past during their prior sessions, so he was glad that he returned to her rather than seeking out another therapist.  But he wondered if she would be able to help him with his current fear.

As they talked about how he associated retirement with death, Tom remembered how worn out and tired his father was by the time he retired.  Working a physically taxing job, his father looked at least 10 years older than his actual age.  The job had taken a toll on his health and he died less than a year later, which was devastating for Tom.

When he was last in therapy, Tom came for overcome a specific phobia he had about flying, so he had never talked much about his relationship with his father during his prior therapy sessions.

As he talked about his father's physically demanding job and his subsequent death soon after retirement, Tom broke down in tears unexpectedly.  He was upset about the loss and the fact that his father didn't get a chance to enjoy his retirement.

Then, he verbalized a thought that he had never been consciously aware of before:  If his father didn't get to enjoy his retirement, why should he deserve to enjoy his upcoming retirement?

The overwhelming feelings of guilt and sadness surprised Tom.  Now, he was beginning to understand why he was having difficulty planning what he might want to do with his free time:  Not only was he afraid of death, which was related to his father's death, but he also didn't feel that he deserved to enjoy his retirement because of his father's experience.

Tom thought he had grieved the loss of his father a long time ago, but he felt the loss again as if it happened yesterday.

He had taken care of the practical aspects of his retirement, but he couldn't overcome the feeling that he was undeserving.  And he only realized that he felt this way once he began talking to his therapist.

Tom's therapist helped him to understand that major life changes could bring up issues from the past.  She also explained that Tom was experiencing his grief for his father on another level where Tom had an unconscious identification with his father (see my article: An Unconscious Identification With a Loved One Can Create an Obstacle to Change).

Over time, Tom expressed how he wished he could have done something to spare his father from death.  Until now, Tom had blocked out these feelings about his father's death.  Now, he realized that these feelings that he blocked out for so long were coming up and creating obstacles for him.

Tom also felt guilty that his father worked so hard to put him through college, and maybe if he didn't work so hard, he might have lived longer.  But he also knew that his father was so proud when Tom graduated college, especially since Tom's father never had an opportunity to go to college.

Tom's therapist encouraged Tom to keep a journal between psychotherapy sessions to capture any thoughts, feelings or dreams that might come up (see my article:  The Benefits of Journal Writing Between Therapy Sessions).

He found writing in the journal especially useful because it deepened his understanding of his problems, and he was able to bring in his journal to the next session to talk to his therapist.

During his therapy sessions, Tom realized that he was only remembering the hard times that his father had and not the good time that he had with Tom and Tom's mother.

When he realized that he was mostly focused on his father's hardships to the exclusion of the happy times, Tom decided to write about his father's life.  So, between sessions he wrote short stories about his father, and he shared his writing with his therapist during each session.

As Tom wrote about his father, he realized that his father had many happy times in his life.  He also felt closer to his father than he had felt in a long time.

As he worked through the loss of his father on this deeper level, Tom began to feel lighter.  He no longer felt afraid of dying after he retired because he was able to separate his upcoming experience from his father's.

Preparing Emotionally For Major Changes in Your Life

Tom allowed himself to start thinking about what he would want to do after he retired.  He knew that he didn't want to spend his time playing golf or going to the casino, as some of his friends did.  He wanted something much more meaningful.

As he was considering the possibilities, he received a notice in the mail that the local elementary school was looking for volunteers for their reading program and a light went off in his head:  He loved little children and he loved reading, so this would be perfect for him.

As Tom talked about volunteering for the reading program in his therapy session, he felt a new sense of energy and enthusiasm.  He also realized that he no longer felt guilty about his father.  In fact, he knew his father would be proud of him for working with children.

Whenever you're facing a major change in your life, there are usually practical considerations to address.  But there also emotional issues to address as well.

No matter what type of change you're planning for, the practical considerations might be straightforward or, at least, there might be logical steps to follow.  But preparing emotionally can be more challenging, especially if there are issues that might be unconscious, as they were for Tom in the fictionalized vignette.

These unconscious emotional issues, which can be challenging, are often difficult to resolve on your own.

Getting Help in Therapy
When faced with a major change, whether it's one your chose or one that has been suddenly placed before you, you might be challenged in unexpected ways.

Even when you recognize that some of your fears are irrational, that's often not enough to banish those fears.

Sometimes the support of loved ones isn't enough or you might not feel comfortable talking to them about the emotional obstacles that are in your way.

Rather than struggling on your own, you could benefit from getting help from a skilled psychotherapist, who can help you to overcome those fears.

Being able to face your fears and deal with them in the light of day can be a freeing and transformational experience, so don't hesitate to get help in therapy.

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

I have helped many clients to prepare emotionally for major changes and to overcome emotional obstacles.

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

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, November 13, 2017

Sexually Compulsive Behavior as a Split Off Part of the Self

Sexually compulsive behavior often involves a split off part of the self that feels like a "not me" part (see my articles:  Overcoming Sexual Addiction in TherapyOvercoming Internet and Porn AddictionSexual Addiction: Is a Compulsion For Viewing Internet Porn Ruining Your Marriage?Infidelity: Married, Bored and Cheating OnlineInfidelity on Social Media SitesThe Counterphobic Defense and Hypersexuality and Rationalization as a Form of Denial and Self Deception).  Often, although not always, that part is the result of an emotionally traumatic history.

Sexually Compulsive Behavior as a Split Off Part of the Self

People, who engage in sexually compulsive behavior, usually seek help in psychotherapy after there have been consequences for their behavior:  a spouse discovers multiple affairs, an employer confronts an employee about viewing online pornography at work, and so on.

Needless to say, there is usually a great deal of shame involved once a spouse or an employer confronts this type of behavior.  Combined with the fact that most people, including spouses and employers, don't understand sexually compulsive behavior and see it as a "moral failing," this just adds to the shame and makes it difficult for people to get help in therapy.

Prior to facing consequences and getting help, people who engage in sexually compulsive behavior often have little awareness of what triggers their behavior or the underlying psychological issues.

In therapy, people with sexual compulsions will often describe their behavior as feeling "split off" or separate from how they see themselves (see my article: Understanding the Different Parts of Yourself That Make You Who You Are and Parts Work in Therapy: Is a Split Off Part of Yourself Running Your Life?).

For the purposes of this article, when I refer to a "split off" part from the self, I'm not referring to multiple personality disorder (now called Dissociative Identity Disorder or DID), although there are people with DID who are sexually compulsive.

To clarify, it's important to understand that dissociation occurs on a wide spectrum with DID occurring at the far end of the spectrum and more common forms of dissociation, like daydreaming, which we all do, as occurring on the other end.  There are some forms of dissociation which are actually helpful (see my article: How Compartmentalization Can Be Used as a Healthy Short Term Coping Strategy).

Between a common form of dissociation, like daydreaming and the other end of the spectrum of DID, there's everything in between.  So, the type of "split off" that I'm referring to is on the spectrum--far less than DID but more than just simple daydreaming.

To varying degrees, everyone has some split off parts that are just outside of their awareness and not considered a major problem. It's a matter of degree.

One of the goals of any psychotherapy is to help clients to become more psychologically integrated in order to bring split off parts into awareness.  The more psychologically integrated a person is, the healthier he or she is.

To simplify matters in the fictionalized vignette below, I discuss a fictionalized male client; however, women also engage in sexually compulsive behavior.

Ken began therapy after his wife discovered that he was watching pornography compulsively at night and contacting women online for sexually explicit discussions after his wife went to sleep.  Based on the computer browser history, she could see that this was a regular activity for Ken.

Sexually Compulsive Behavior as a Split Off Part of the Self

Prior to this discovery, his wife thought that Ken wasn't interested in sex because they had not had sex in many months.  But after she discovered Ken's online activity, she felt very upset, hurt and betrayed by him.  She gave him an ultimatum:  Get help or she would leave him.

When Ken came for his first therapy session, it was evident that he was very ashamed of his behavior.  He could barely look the therapist in the eye, and he had a lot of difficulty communicating why he was seeking help.  After several false starts, he told the therapist that he was there because his wife gave him the ultimatum and, after 20 years of marriage, he didn't want to lose his wife.

During the early phase of therapy, Ken rationalized his behavior by saying that he didn't see anything wrong with looking at pornography online or contacting women he didn't know for "harmless flirtation."  He said that these women lived in other parts of the country and he had no intention of ever meeting up with them, so he didn't see it as cheating on his wife.

As part of his early history, Ken revealed to his therapist that he began secretly looking at his father's Playboy magazines when he was nine years old and left alone at home while his parents went out.  He remembered the first time that he looked at the pictures of naked women in sexually provocative poses and how thrilling it was for him to secretly masturbate while fantasizing about these women.

As he continued to reveal his early history, he told his therapist that his parents often left him alone and, as an only child, he was lonely.  From other details that he revealed, his therapist realized that Ken wasn't just left alone a lot--he was emotionally neglected by his parents (see my articles:  What is Childhood Emotional Neglect? and What is the Connection Between Childhood Emotional Neglect and Problems Later on in Adult Relationships? and Growing Up Feeling Invisible and Emotionally Invalidated).

Fantasizing about the women in the magazine and imagining that he was with them made Ken feel less alone when his parents were out.  It was soothing to him, and he continued to look at porn from that time on with the same effect of feeling comforted and less alone.

Ken never revealed to his wife that he liked to look at pornography.  For him, it was a secret activity that belonged only to him, and he never discussed it with anyone.  He also assumed that his wife wouldn't understand and, based on her reaction, his fears were confirmed.

He somewhat resented that his wife was giving him this ultimatum to get help and he felt she was being unreasonable, "Why can't she just leave me alone about this?  I'm not hurting anyone."

Due to Ken's level of denial about his problems and the effect it had on his marriage, his therapist knew that he would probably leave therapy if she confronted him directly (see my article: When Clients Leave Therapy Prematurely and Clients Struggling With Shame Can Leave Therapy Abruptly).

Instead, initially, she took a more empathic approach and remained close to Ken's emotional experience and, at times, she made observations that she thought he could tolerate.

Although Ken stopped looking at pornography and contacting women at home, he didn't tell his therapist or wife that he used his computer at work to continue engaging in sexually compulsive behavior (although, at that point, he didn't see it as being sexually compulsive).  Ken rationalized to himself that he worked for a very large company with thousands of employees, so he didn't think he would get caught by the IT department.

But a few months later, Ken was called into his supervisor's office where his supervisor and the Human Resources director were waiting for him.  His supervisor told him that the IT department detected that Ken was looking at pornography online and this is against company policy.

He gave Ken a warning memorandum that this behavior wouldn't be tolerated and any other infractions against the company policy could result in termination.  He also recommended that Ken get psychological help.

Ken felt deeply mortified.  He tried to tell his supervisor that someone else might have gone on his computer while he was away from his office, but neither his supervisor or the HR director believed him.  They told him to take the rest of the day off.

Although he felt humiliated about what happened at work, Ken told his therapist about it.  He acknowledged that he had been keeping this a secret from her because he wanted to continue to look at porn and he really didn't see it as a problem.

But as his therapist reflected back to him the consequences of his behavior, Ken acknowledged that he was placing his marriage and career in jeopardy.  This was the first time that Ken didn't try to hide behind his usual rationalizations.

At that point, instead of feeling like he was being forced to come to therapy to appease his wife, Ken became internally motivated to understand and overcome his behavior.  He also agreed to attend a 12 Step program for sexually compulsive individuals and to get a sponsor in that program.

Once Ken became internally motivated, the work in therapy progressed.  His therapist talked to him about cross addiction so that Ken would understand that it was not unusual for people who were trying to overcome a particular addiction to form another addiction as a way to self soothe.

His therapist helped Ken to understand the various aspects that made him who he is, including the split off parts.  This is called Parts work or Ego States work.

Ken and his therapist worked on the underlying issues that triggered his sexual addiction, including loneliness and boredom (Coping With Addiction: Boredom as a Relapse Trigger).

They also did trauma work on early childhood issues related to emotional neglect.

After Ken began making progress in therapy and he was abstinent for six months, he and his wife were ready to attend couples therapy to repair their marriage.

With the advent of the Internet, compulsive sexual behavior has increased dramatically.

This behavior is usually difficult to overcome on your own.

The underlying roots of the problem are often (although not always) related to early childhood trauma.

Similar to any other form addiction, denial plays a significant role because it's usually too painful to acknowledge the problem.

Shame often keeps people who need help from ever seeking help.  They attempt to resolve the problem on their own but, like other forms of addiction, sexually compulsive behavior is progressive if people don't get professional help.

Although many people start therapy because they've been given an ultimatum by a spouse or an employer, the success of treatment is usually predicated on clients become internally motivated.

The work in therapy includes helping clients to develop the internal resources to remain abstinent and to deal with underlying issues, coping mechanisms to deal with triggers, and trauma work to resolve unresolved emotional trauma.

Clients, who have problems with sexually compulsive behavior, need psychoeducation from their psychotherapists about cross addiction so that they don't stop one addiction and revert to another one (i.e., stop watching pornography compulsively online and start another form of addiction like compulsive gambling, drinking excessively, abusing drugs, etc).

Getting Help in Therapy
Although people who engage in sexually compulsive behavior often feel alone and deeply ashamed of their behavior, the best chance of their overcoming these problems is to get help in therapy with a licensed mental health professional who specializes in this area.

Rather than suffering alone, if you've been unable to overcome your problems on your own, you could benefit from the help of a licensed psychotherapist.

Aside from overcoming your addictive behavior, attending therapy can help you to grow and lead 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.

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

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, November 6, 2017

Using Somatic Psychotherapy When the Client Has No Words To Describe the Problem

In prior articles, I've discussed the mind-body connection and psychotherapy (see my articles:  Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious MindClinical Hypnosis and the Mind-Body ConnectionOvercoming Childhood Trauma That Affects You as an Adult, and Experiential Therapy, Like EMDR, Helps to Achieve Clinical Breakthroughs).  In this article, I'm focusing on how Somatic Psychotherapy can be used when the client has no words to describe a psychological problem.

Mind-Body Connection: Using Somatic Psychotherapy When the Client Has No Words to Describe the Problem

There are times when, due to the nature of the problem or for a variety of reasons, the client might not have words to describe the problem.

So, when might this happen?  One possibility is that the traumatic event might have occurred when the client was very young so there aren't clear memories or it might have even occurred preverbially (a birth trauma would be an example of preverbal trauma).

With regard to preverbal issues, before a child can speak, she cannot symbolize her problems for herself or others because she doesn't have language, so there are no words.  However, as I've discussed in a prior article, the body holds onto unconscious memories, and it's possible to use mind-body oriented psychotherapy (also known as Somatic Psychotherapy) to work on the problem.  More about this below.

Most forms of psychotherapy rely exclusively on words to resolve psychological problems.  That's the nature of talk therapy.  The client comes to see the psychotherapist, describes the problem as best as she can and they work on the problem by exploring the current situation, getting history, and helping the client to make psychological connections and work through the problem.

But when the problem is outside of the client's conscious awareness, she might only have a vague awareness, if at all, of what the problem is.

At that point, psychotherapists who are trained to use mind-body oriented therapy, like EMDR therapy, clinical hypnosis or Somatic Experiencing, can help the client to explore the problem by using the mind-body connection.

The following fictionalized vignette illustrates how the mind-body connection can help when the client is unable to express the problem in words:

Prior to starting therapy again, Nina had been to several therapists in the past.

Although she liked her prior therapists, she didn't feel she got much out of therapy because she didn't know how to describe her problem.  She only knew that she felt extreme anxiety whenever she went home to visit her grandmother.  Other than going to her grandmother's home, she usually didn't feel anxious.

Talking about her anxiety with her prior therapists didn't help her.  They were only able to get so far, but she continued to have this extreme anxiety whenever she went on these visits.  Even talking about going on one of these visits was somewhat anxiety producing.

Nina chose her current therapist because she read articles that certain types of mind-body oriented therapy are helpful with clients where regular talk therapy hasn't been helpful.

Using Somatic Psychotherapy When the Client Has No Words to Describe the Problem

Nina's current therapist worked with Nina to help her to explore the sensations and emotions that she felt in her body using a technique called the Affect Bridge in clinical hypnosis (also known as hypnotherapy).

Nina was able to tell her therapist that, aside from the anxiety she felt, she also felt a tightening in her stomach when she thought about those visits.

Over time, as Nina and her therapist continued to explore these emotions and sensations, Nina realized that her anxiety about going to her grandmother's house was longstanding--ever since she was a young child.

Further exploration in her therapy sessions revealed that Nina felt most anxious about her grandmother's basement.

Then, gradually, over the course of months, as Nina became more attuned to what she was experiencing, she remembered that she saw a man molesting her cousin, Betty, one day in the basement.  At the time, Nina became so frightened that she ran upstairs and she was too afraid to tell anyone what she saw.

Since memories tend to be unreliable, even memories that are associated with the mind-body connection, Nina called Betty and she began speaking to her about her anxiety when she visited their grandmother's home.

She didn't know how to ask Betty about whether she was sexually molested or not, but she didn't have to because Betty told her that she also felt very uncomfortable going there and then she told Nina what happened:  A handyman who came to do repairs was in the basement when Betty went down there.

He seemed nice at first, but after talking to her for a few minutes, he grabbed her and touched her breasts.  As soon as she was able to pull away, Betty ran upstairs, but she never told anyone what happened--until she had this conversation with Nina.

Then, Nina told her that she recently remembered in therapy that she was on the basement steps when she saw this man molesting Betty, but she was also too afraid to tell anyone, so she ran.

Nina and Betty talked for a long time and Betty was able to confirm the details that Nina remembered in her therapy.  They were also able to be emotionally supportive of each other.

When Nina had her next therapy session, she told her therapist that Betty confirmed the memory.

Her therapist told her that, even though Nina wasn't the one who was molested, that it was emotionally traumatizing to see her cousin being molested.

From that point on, now that they knew they had a valid memory, her therapist used EMDR therapy to help Nina to work through the trauma.

There can be times when, for a variety of reasons, psychotherapy clients are unable to express their problem in words.  In some cases, there are no words and in other cases the issues might be unclear.

Using a mind-body oriented therapy can get to unconscious issues that regular talk therapy often cannot.  The reason for this is that the body offers a window into the unconscious mind.

Mind-Body Connection: Using Somatic Psychotherapy When the Client Has No Words to Describe the Problem

It can take a while before a client becomes accustomed to accessing emotions and sensations through the body, but many clients become adept at this over time.

Clients who are already in talk therapy and who want to remain with their current therapist can have adjunctive therapy sessions with a therapist who uses mind-body oriented psychotherapy (see my article: What is Adjunctive Therapy?).

In that case, the talk therapist is the primary therapist and the mind-body oriented therapist is the secondary therapist.

For clients considering adjunctive therapy, it's best to start by talking to your primary therapist about it.

Getting Help in Therapy
If you're finding that regular talk therapy hasn't been helpful to you, you might consider a form of somatic psychotherapy (How to Choose a Psychotherapist).

We know so much more now about the connection between the mind and the body than we ever knew before, and psychotherapists who use various forms of somatic psychotherapy usually know how to help clients to access unconscious issues.

Rather than suffering on your own, you could benefit from getting help from a psychotherapist who uses somatic psychotherapy.

The first step is to set up a consultation.

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 (212) 726-1006 or email me.

Saturday, November 4, 2017

How Psychotherapy Helps You to Become More Self Reflective

In a prior article, Discovering That Your Feelings Aren't Facts, I discussed that many clients begin psychotherapy with an inability to distinguish between their feelings and objective reality.  It's as if they're looking through a distorted lens based on their own feelings.

How Psychotherapy Helps You to Become More Self Reflective

I also discussed that psychotherapy provides an opportunity to become more self reflective, objective and emotionally aware, which often leads to a more fulfilling life.  In this article, I'm going into more detail about how clients in therapy can learn to develop these skills.

The Observing Ego, Clinical Hypnosis and Hypnoprojectives
In psychotherapy there's a term called the "observing ego," which is the ability to stand both inside your experience as well as outside your experience at the same time.

It's as if there were two of you--one that feels your internal experience and one that stands just a little behind and above you that can experience your internal experience, see yourself and observe the external circumstances of your situation.

As a hypnotherapist, there is a hypnoprojective exercise that I sometimes use when I use clinical hypnosis with clients that helps them to enhance their observing ego and ability to self reflect.

I ask the client to imagine herself seated in a movie theatre.

The client arrives just before the movie starts and finds a comfort seat as she waits for the movie to begin.  Everything else--the temperature in the movie theatre and the general atmosphere--are comfortable.

As the movie begins, she realizes that it's about a character who is similar to her in many ways and who has the same presenting problem that brought the client into therapy.

The Observing Ego, Clinical Hypnosis and Hypnoprojectives

At the same time that the client is seated and watching the movie, there is another part of her that is in the projection booth who is observing the part of her that's seated.  The part in the projection booth also has a view of the entire theatre and she is watching the movie.

The benefit of using a hypnoprojective is the client often develops insight into her problem by externalizing the problem to the movie screen and making it concrete.  By making the movie about someone else, the client has an opportunity to be more objective.

Also, the relaxed state of hypnosis allows the client access to unconscious information that she normally wouldn't have access to in a fully awakened state.

With regard to our discussion about an ability to self reflect and developing the observing ego, the part of the client who is in the projection booth is an observing ego.

This part has the unique perspective of having both the internal and external experiences and has a full view of everything.  The part in the projection booth is also watching the part seated in the theatre and often develops insight into that part of herself.

During the debriefing after the hypnoprojective hypnotic exercise, clients will often say that they're surprised that they were able to see their problem and the solution with much more clarity (see my article: The Unconscious Mind: The "Symptom" Contains the Solution).

Mindfulness Meditation
I often recommend that clients practice mindfulness meditation as another way to become more self reflective and develop an observing ego (see my article: Psychotherapy and the Mindful Self).

Mindfulness Meditation As a Way to Become More Self Reflective and Develop an Observing Ego

For beginners, it's often easier to follow a mindfulness recording, like the recordings developed by mindfulness expert Jon Kabat Zinn, as a way to start.

Aside from helping you with emotional regulation, mindfulness meditation also helps you to develop and improve your self awareness.

With regular practice, mindfulness meditation can help you to reduce stress, improve your autoimmune system, improve concentration and memory, and increase emotional intelligence.

The Observing Ego: The Ability to Remain Rooted in Your Experience At the Same Time As You Stand Just Outside Your Experience
Hypnoprojectives and mindfulness meditation are two ways to develop an observing ego.

Aside from these powerful tools, being open to your therapist's observations can also give you a new perspective beyond your subjective experience.  It allows you to consider an alternative to your subjective state at the same time that you're rooted in your own experience.

This is one of the benefits of being in therapy (see my article: The Benefits of Psychotherapy).

Consider the Following Fictionalized Scenario About the Observing Ego in a Psychotherapy Session:
Ella comes to therapy in a bad mood.  She tells her therapist that she's feeling pessimistic about a new relationship because the man she's dating seemed preoccupied and distracted when they spoke last night.

Based on her pessimistic feelings about the relationship, Ella's thoughts are off the races:  She just knows that he's going to break up with her, and if he breaks up with her, she won't meet anyone else as nice as he is, and then she'll be alone for the rest of her life.

How Psychotherapy Helps You to Become More Self Reflective
Her therapist recognizes this as one of Ella's recurring patterns that creates problems in her life: Ella  assumes that her feelings are facts.

So, her therapist asks Ella a series of questions to help Ella to develop a more observing ego:  Did anything negative happen between her and her boyfriend?  Did he say that he didn't want to date her anymore?  What other evidence is there to support Ella's feelings?  What makes Ella assume that her feelings are facts?

Ella reflects upon her therapist's questions, and she becomes aware that she is projecting her own anxiety and negativity onto her boyfriend.  She realizes that she has no objective reason to believe that her boyfriend will break up with her.

Later that day, Ella's boyfriend calls her and apologizes for being distracted on the phone the night before.  He tells her that he was worried about a work problem, but that problem has since been resolved and he is feeling better.  When they see each other later that night, her boyfriend is his usual affectionate, attentive self.

How Psychotherapy Helps You to Become More Self Reflective
When Ella returns to her next therapy session, she tells her therapist that she realizes that she fell back into her recurring pattern of believing that her feelings were facts.  She feels frustrated that she continues to regress into this old pattern from time to time.

But, at the same time, Ella also recognizes that she doesn't fall back into this old pattern nearly as much as she used to before she came to therapy, so she is aware that she has made progress in therapy.

Ella made a commitment to her therapist to increase her mindfulness meditation practice and to also practice stepping outside her experience when she's tempted to project her negative feelings again.

The ability to self reflect is essential to being a self aware adult.  Without the ability to self reflect, you're more likely to look at yourself and others through the distorted lens of your own perceptions.

One of the benefits of psychotherapy is that it helps you to develop the ability to self reflect by developing an observing ego.  This is often a one-step-forward-two steps-back process as you develop this skill (see my article: Setbacks Are a Normal Part of Psychotherapy Along the Road to Healing).

The more you practice developing an observing ego, the better you'll get at using it.

Getting Help in Therapy
We all have our blind spots (see my article: Overcoming Your Emotional Blind Spots).

Often, we don't realize that we have a particular blind spot until we're able to stand outside our experience and reflect on it.

Psychotherapy provides a unique intersubjective experience where an attuned therapist can help you to overcome your blind spots, negative projections and your confusion about your feelings being facts (see my article:  The Psychotherapy Session: A Unique Intersubjective Experience).

Rather than struggling on your own, you can get the help you need with a skilled psychotherapist (see my article: The Psychotherapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Psychotherapy can help you to free yourself from recurring negative patterns that are keeping you stuck.

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

I have helped many clients to lead more meaningful lives.

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

To set up a consultation, call me at (212) 726-1006 or email me.

Discovering That Your Feelings Aren't Facts

There are many clients who begin psychotherapy believing that their feelings are facts--whether it's their feelings about themselves or others.  For those clients, psychotherapy offers an opportunity to develop an ability to self reflect so they can stop confusing their feelings with facts and develop emotional intelligence (see my articles:  Developing Emotional IntelligenceCreating Time For Self ReflectionGaining a New Perspective in Psychotherapy About Yourself and Others, and The Benefits of Psychotherapy).

Discovering that Your Feelings Aren't Facts

Intuition and gut feelings are certainly important, and this isn't what I'm referring to when I say that feelings aren't facts.

I'm referring to believing that distorted feelings and thoughts are facts and the need to develop an ability to take a step back from your feelings to question whether what you feel is objectively true.

When you don't self reflect and question whether you're being objective, you run the risk of attributing meanings to yourself and others that are false, which can create problems in your life.

Examples of Feelings Not Being Facts:
  • Tom noticed that his supervisor had an angry look on his face when he looked in Tom's direction.  As a result, Tom assumed that his supervisor was angry with him, and he avoided his supervisor for the rest of the week.  At the end of the week, Tom's supervisor told him that he realized that Tom was avoiding him and he wanted to talk to him about it.  During that same conversation, his supervisor told Tom that he was angry because their director was making unreasonable demands of him.  At that point, Tom realized that his supervisor's angry look had nothing to do with Tom and that Tom's original feeling about the situation was inaccurate.
  • Lynn had a feeling that the new woman, Jane, in her book club was arrogant and standoffish.  One day one of the other women in the group invited Lynn and Jane for coffee.  During their conversation, Jane mentioned that she tended to be shy and quiet, especially around people that she didn't know well, and this often caused people to think that she was standoffish.  Jane said she welcomed the opportunity to join them for coffee to get to know them better.  After that, Jane was much more friendly in the group, and Lynn realized that she misinterpreted Jane's quiet demeanor for arrogance.  She realized that her original feelings about Jane weren't true.
  • After her boyfriend ended their relationship, Rena had a strong feeling that she would never be in another relationship.  She assumed that she would be alone for the rest of her life because no one else would want to be with her.  This made her feel lonely, sad and hopeless.  But a few months later, Rena met a man at her friend's party and they began dating.  As their relationship developed, Rena realized that, even though her feelings had been strong that she would never meet anyone else and that she would be alone for the rest of her life, these feelings weren't objectively true because she was now in a new and wonderful relationship.
As in the examples above, feelings--even strong feelings--are often disproved by life's circumstances.  But a change in circumstances doesn't always occur, and people who believe that their feelings are facts remain convinced.

Discovering That Your Feelings Aren't Facts

When people have strong feelings and beliefs that make them unhappy, they often come to therapy to deal with their unhappiness.

One of the goals of therapy is to help clients to step back from their feelings, reassess their feelings objectively and develop insight.  By developing the ability to step back to self reflect and stand outside of personal feelings and beliefs, clients in psychotherapy can develop emotional intelligence.

This can be very challenging for clients when their beliefs that feelings are facts has been longstanding.  They might have learned to identify with their feelings so strongly that it becomes difficult to see beyond these feelings.

It's easy to confuse feelings with facts, especially when you have strong feelings about yourself or others.

Rather than being swept up by feelings and taking action based solely on your feelings, you can learn to become more self reflective.  By being more self reflective, you have an opportunity to be more objective.  And by being more objective, you can see yourself and others in a more accurate way.

Developing this ability on your own can be difficult, especially if you've been in the habit of believing that your feelings are always objectively true.

A skilled psychotherapist can help clients to become more aware of their feelings and beliefs so that they become more self reflective and objective.

Getting Help in Therapy
Most people come to therapy because they feel stuck in some way.

People who believe that their feelings are objectively true have an opportunity in therapy to develop more insight into how they think and how their feelings and thoughts are affecting them.

If you feel stuck in your life, you owe it to yourself to get help in therapy with a skilled psychotherapist who can help you to overcome the obstacles that are getting in the way of your having a fulfilling life.

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

I have helped many clients to develop insight into their thoughts and feelings so they can change their lives.

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

To set up a consultation, call me at (212) 726-1006 or email me.

Monday, October 30, 2017

Comfort Objects From Infancy Through Adulthood

In prior articles, I've discussed Donald Winnicott's contributions to the field of psychology (see my articles: The Creation of the Holding Environment in PsychotherapyBooks: Tea With Winnicott at 87 Chester SquareUnderstanding the False Self and On Being Alone).  As a pediatrician and psychoanalyst, Winnicott also contributed the idea of the child's need for comfort objects (also called transitional objects).  But comfort objects are not only for babies--they play an important role throughout our lives.

When Donald Winnicott discussed transitional objects in the mid-20th century, there was little understanding of these concepts among pediatricians and mental health professionals.  The field of child psychology was still relatively new and many people saw children as little adults rather than children who had their own emotional and developmental needs.

According to Winnicott, the baby is comforted by an object, usually a blanket or a soft toy (like a teddy bear)) that is soothing to the baby to hold.

The transitional object helps to soothe the baby when the mother is not holding the baby.  These transitional objects also help the baby, as the baby is developing, to create a transitional space between the times when the baby is with the mother and other times when she is not.

As I mentioned before, transitional objects are usually associated with children, but we all benefit from having transitional objects throughout the life cycle.

Let's explore these concepts further in a fictionalized vignette:

As a baby, Alan liked to hold onto his favorite blanket as he was falling asleep.  Sometimes, his mother would watch him fall asleep while he was gently chewing on the blanket or a soft toy.

Comfort Objects From Infancy Through Adulthood

Whenever Alan's mother tried to take the blanket from him to wash it, Alan would cry so hard that she would give it back to him.

When she asked Alan's pediatrician about this, he told her that this is a common reaction that babies have at this stage.  He explained that the baby likes to hold, smell, and chew on the blanket (or whatever comfort object the baby prefers) and likes it just the way it is--smells and all.  So, he told her not to worry about it.

When Alan was about three years old, he had a teddy bear that was his comfort object.  He dragged that teddy bear all over the house with him.

When he was in his room, Alan would listen to his mother in the kitchen washing the dishes and talking to her friend.  At this stage of his development, it was enough for Alan to hear his mother and know that she was only a short distance away even though he couldn't see her.  He had his teddy bear to comfort him.

Alan did well when he started school.  He got along well with the other children and he really liked his teacher, Ms. Jones.

Towards the end of the school year, Ms. Jones began talking to the children about all the wonderful things they would learn next year.  She also told them that they would have a different teacher.

Until then, Alan hadn't thought about not being in the classroom with Ms. Jones and the idea of not being with her frightened him.

When he got home, he told his parents that he didn't want to go to the next grade because he wanted to remain with Ms. Jones.  His parents understood that this was a common reaction that children have, especially if they really like their first teacher, so they tried to comfort him by telling him that Ms. Jones would still be around and he would see her in school.

Ms. Jones also knew that Alan and many of the children in her class were unhappy about not having her as a teacher the following year, so they continued to talk about this in school.  She assured them that she would be around and told them where they could find her during the day.

On the last day of class, Ms. Jones took pictures with each student and allowed them to keep them.

Alan carried around his picture with Ms. Jones throughout the summer.  He also kept it in his shirt pocket on the first day of class.  Even though he missed Ms. Jones, he felt comforted by looking at the picture.

As Alan matured into a young adult, he made friends and he became more independent from his parents.  Although he continued to be close to his parents, he spent more time with his friends.

Like most people, Alan had other transitional objects throughout his lifetime.  After he graduated college, he wore his college ring.  And after his grandfather died, Alan wore his grandfather's watch.

Comfort Objects From Infancy Through Adulthood

Eventually, Alan got married.  His wife took a temporary assignment out of state for a few months.  Whenever he felt himself missing his wife, he would look at a picture of her that he kept on his nightstand and that helped him to feel a little better.

People use comfort objects, also known as transitional objects, throughout their lifetime.

Comfort objects help to soothe people during times of transition or stressful times.

A comfort object is a very personal thing and each individual will choose the objects that are most soothing to them.

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

I work with individual adults and couples.

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

To set up a consultation, call me at (212) 726-1006 or send me an email.