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Monday, October 16, 2017

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client

In a prior article, I began a discussion about the holding environment in therapy (see my article: The Creation of the Holding Environment in Therapy).  As I mentioned in that article, the idea that the psychotherapist creates a safe therapeutic holding environment for the client was developed by British psychoanalyst, Donald Winnicott (for more on Winnicott, see my article: Books: "Tea With Winnicott" at 87 Chester Square).  In this article, I'm focusing on a particular aspect of the holding environment, which is the therapist's ability to keep the work emotionally manageable for the client.

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client

As an example, it's often the case that clients come to therapy because they're not feeling good about themselves.  This can be a lifelong problem or a new development for a client.  Either way, the client might focus on the aspects of himself that he is unhappy about and miss the fact that he has many strengths.

A skilled psychotherapist will usually see the client's strengths, even when the client is unaware of these strengths.  

The challenge for the psychotherapist is when to talk to the client about his strengths.

Timing is everything.  If the therapist brings up the client's strengths too early in therapy, the client, who has a particularly negative view of himself, will often minimize or dismiss the idea that he has these strengths (see my article: Overcoming the Internal Critic).

Some clients, who are focused on what they perceive as emotional deficits in themselves, might even think the therapist is being disingenuous when she tries to talk to them about their strengths (see my article: A Strengths-Based Perspective in Psychotherapy).  

In many cases, on an unconscious level, these clients are too afraid to consider the possibility that they have strengths.  Rather being overwhelmed by their fear, they protect themselves emotionally by remaining stuck in their denial.

It's important that the psychotherapist not interpret the client's reluctance as "resistance."  This comes across as judgmental.  It would only make the client feel uncomfortable and it's not helpful to the work.

If the therapist doesn't know how to handle the client's fear,  this could lead to the client leaving therapy prematurely to avoid dealing with uncomfortable feelings (see my article:  When Clients Leave Therapy Prematurely).

So, the skilled psychotherapist, who is aware that it would be premature to talk to the client about his strengths, must keep these observations to herself until the time is right.  This requires the therapist to be emotionally attuned to the client (see my article: The Psychotherapist's Empathic Attunement).

Even with self critical clients who are willing to explore the possibility that they have strengths, they might perceive their strengths on an intellectual level but not on a deeper emotional level.

For these clients, the therapist might broach the topic of the client's strengths, let the client know that she (the therapist) sees these qualities and will hold a space for them until the client can accept this on an emotional level.

This is a way for the therapist to create a safe holding environment for the client because the client knows that the therapist holds onto these observations until the client is ready.

Let's take a look at a fictional vignette that illustrates these points:

John had been in and out of therapy for many years.

He usually attended a few sessions with a therapist, and then he aborted therapy because he felt the therapist didn't understand him.

John struggled with depression, including low self esteem, since he was a child.  He grew up in a household where both parents were mostly preoccupied and paid little attention to John, who was an only child.

John's father often criticized him and told John that he would never amount to anything.  His father's critical comments were so frequent that John internalized them and, over time, believed them.  John's mother was depressed and withdrawn, and she was emotionally unavailable to him.

When he was in school, his teachers often told John that he had a lot of potential, but he was not trying.  From John's depressed perspective, he didn't see a reason to try since he believed his father that he wouldn't ever amount to anything.

As an adult, John drifted from one job to another.  Since he never expected to do well, he put little effort into his work, which resulted in disappointment for him.

John also had very low expectations about relationships.  He had a few close friends, but his romantic relationships didn't last beyond a few months.

He would go through long periods when he didn't even try to meet anyone, but then his loneliness caused him to try again with the same low expectations.  It was an ongoing cycle.

By the time John came to therapy again, he felt he was at a low point.  He was already in his mid-30s and he felt he had nothing to look forward to in his life.

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client
He told his current therapist at the start of therapy that he left his prior therapists because they were unable to see him as he was.  He felt that each of them saw him as they wanted him to be, which frustrated him.

He appreciated that his former therapists were "nice people" and they tried to speak to him about his personal strengths, but he didn't believe what they were saying.  He wasn't sure if they were mistaken or if they were intentionally trying to boost his confidence in a false way.  

Either way, whether the therapist was well-meaning but wrong or whether the therapist was only trying to boost his confidence and didn't really believe he had strengths, John found these discussions intolerable and he would abort therapy.

John's current therapist could see how self critical he was.  She also saw that he had many strengths.  But she also heard John loud and clear that he was unable to even consider that he had strengths, and she knew, based on what he was telling her, that if she tried to broach this with him, he would leave therapy, as he did in the past.  So she waited until he was ready.

Until then, his therapist remained attuned to John's experience and reflected back to him what he told her.  In doing this, she showed John that she understood how he felt about himself, and for the first time in his life, John felt that he was finally seeing a therapist who understood him.

In the meantime, his therapist held onto her perception of the many strengths she saw in John over time.  She waited until she saw a possible opening to explore this with him.

Gradually, as John felt more comfortable with his therapist, he opened up more with her, and she continued to let him know that she understood how he felt by mirroring back to him.

One day, John came to therapy in an agitated state.  He told his therapist that his new supervisor complimented John on a project.

John's first reaction was to get angry because he thought his supervisor was lying to him or he was trying to manipulate John in some way.

But as he thought about it, John said that he knew his supervisor wasn't a manipulative person, so he doubted that this was the reason for his compliment.  He said that maybe his supervisor was just trying to make him feel good--like some of John's prior therapists.  

Whatever the supervisor's intentions, John found it difficult to sit there and listen to his supervisor's compliments.  He said nothing to his supervisor but, for some reason, John realized, it brought up a lot of shame and sadness for him.

During the next several sessions, John continued to talk about this because his supervisor came to him again and told him that he really liked his work.  This continued to baffle John.

Over time, John became more open to exploring this issue and his own sadness and shame.  He was able to connect his negative feelings about himself to his critical father.

During that time, his therapist continued to maintain an open and empathetic stance with John, allowing John to draw his own conclusions (see my article: Why is Empathy Important in Therapy).

She knew that if she intervened prematurely, John would shut down emotionally and he might leave therapy.  She had to wait until he was ready.

Then, one day John came in and told his therapist that his supervisor took him to lunch.  John was surprised that he enjoyed talking to his supervisor over lunch.  He was also surprised to realize that his supervisor liked him and that his praise really was genuine.

As John opened up more emotionally in therapy, he allowed himself to feel his sadness about being a disappointment to his father.  He wished he could have had a father who was more like his supervisor--a kind and generous man.

As he continued to discuss this in therapy, John became aware that his father was a disappointed, bitter man, and his father didn't feel good about himself.

As he looked at his childhood from an adult perspective, he realized that his father was projecting his own negative feelings about himself onto John (see my article: Looking at Your Childhood Trauma From an Adult Perspective).

This led to John questioning whether his father's perceptions about him were accurate, "Maybe I'm not such a loser after all.  What do you think?"

At that point, his therapist realized that John created a small opening for them to be able to discuss the possibility that he wasn't "a loser" and he might have positive qualities.  She also knew that this was a tentative opening that could shut down if she rushed in because John might get overwhelmed, so she had to be cautious.

His therapist said she observed positive qualities in him, and she explored with him whether he would be open to discussing this.  John responded by shifting in his seat and telling her that it felt uncomfortable but, at the same time, there was a part of him that wanted to talk about it.

Gradually, John was able to explore his feelings.  He trusted his therapist enough to know that she wasn't going to lie, hurt him or try to manipulate him.

His therapist relied on John to tell her whether their discussions about his strengths felt too uncomfortable, and he told his therapist when he felt uncomfortable.  In this way, his therapist was able to maintain an emotionally safe environment for John in their sessions.

The Holding Environment in Therapy: Maintaining a Safe Environment for the Client
Over time, John developed the emotional tolerance to discuss seeing himself in a positive light.  This was new and scary for him at first, but he was starting to feel better about himself.

By being attuned to John, his therapist was able to provide him with feedback about his positive qualities in "manageable doses" for him.  She respected his feedback when he told her that he was beginning to feel overwhelmed, and she would not push him beyond where he could go emotionally.

Working with John in this way, over time, his therapist was able to help John to mourn what he didn't get as a child and to develop more self confidence (see my article: Psychotherapy and Compassionate Self Acceptance).

There are many ways for a psychotherapist to create a therapeutic holding environment for a client.

One way, as I have discussed in this article, is to keep the therapeutic work manageable for the client.

To create a holding environment, the therapist must be emotionally attuned to the client and intuitively sense when the client is ready to explore uncomfortable issues.  She must also ask the client for feedback.

When the client provides a tentative opening, a skilled therapist doesn't rush in.  She helps to facilitate an exploration that is manageable for the client.

In this way, by being attuned and titrating the work, the therapist helps the client to make progress in therapy.  In other words, going slowly in these particular cases, is more effective than trying to get under the client's defenses and overwhelming the client.

From the outside, it might appear that the work is going too slowly, but with regard to the client's internal world the client is developing the internal resources for more in-depth work.  

Not every client has these particular problems, and in many cases the therapist senses that she can make observations early in therapy without jeopardizing the work.  But for clients who aren't ready, premature explorations often lead to premature endings in therapy because the client aborts therapy.

Getting Help in Therapy
Many people, who could be helped in therapy, never come to therapy and struggle on their own without success.

Finding the "right fit" with a particular therapist might be a matter of trial and error as you interview various therapists (see my article: How to Choose a Psychotherapist).  

I usually tell prospective clients to follow their own instincts when choosing a therapist and not to remain with a therapist if their gut feeling is telling them that it's not working out.  However, if you have a long history of aborting therapy prematurely, it might be worth considering that you're avoiding dealing with certain issues in therapy.

Rather than struggling on your own, you could benefit from seeing an experienced therapist who can help you to work through the problems that are keeping you stuck.

By working through problems that are keeping you stuck, you can 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.

I work in an empathetic, attuned and respectful manner with clients to help them to overcome their problems and maximize their potential.

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 9, 2017

Why Your Child Can't Be Your Best Friend

In my previous article, Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult, I discussed how early dynamics between parent and child often get recreated in adult relationships.  In this article, I'm focusing on a particular dynamic between parent and child where the parent sees the child as his or her "best friend" and the child takes on the parental role (also known as the parentified child) and the parent takes on the child role.

Why Your Child Can't Be Your Best Friend

To explore how this parent-child dynamic develops, it's important to realize that the parent who sees the child as a best friend usually was in that same role with one or both of her parents as a child.  In other words, this is often an unconscious repetition, so it doesn't seem unusual to the parent.  On the contrary, it's very familiar because he or she lived through it as a child and considered it to be "normal."

The parent who treats their child as a best friend often didn't get her emotional needs met as a child because of her own role as a best friend to her parent (I'm saying "her," but this is also true of relationships between a parent and a son).

This dynamic can continue to repeat itself intergenerationally, so there can be three or four generations where the children are expected to focus on the emotional needs of the parent instead of the parent taking care of the emotional needs of the child.

This comes at a tremendous emotional cost to the child because she subordinates her emotional needs to the needs of the parent.  On the face of it, this might seem like an impossible task for a child, but many children learn to sacrifice their emotional needs for  their parent's needs, and they become very good at it--to their own detriment.

So, if this is happening intergenerationally, how can a family break this unhealthy cycle?

Well, it often occurs when the child approaches adulthood and struggles to develop a healthy sense of autonomy.  Although this is a healthy sign for the child, it can wreak havoc between the parent and adult child if the parent isn't willing to allow the child to be more independent.

Let's take a look at a fictionalized vignette which explores these dynamics:

Clarissa and Clara
Clarissa started therapy soon after she began submitting her college applications to out of state colleges.

Why Your Child Can't Be Your Best Friend

Clarissa was an only child who was still living at home.  Her mother, Clara, was a single parent.  At the point when Clarissa came to therapy, they were arguing about the fact that Clarissa wanted to go away to college.  Although Clarissa stood her ground with her mother, inwardly she felt deeply ambivalent about leaving her mother.

Not only did she fear that her mother would be very lonely without her but Clarissa knew that her mother relied on her when Clara felt especially depressed and discouraged.

On the one hand, Clarissa wanted to be away at college to experience more freedom and have the campus experience before she settled down in a career.  On an intuitive level, she knew this was what she needed emotionally and socially.  But, on the other hand, she felt guilty leaving her mother alone.

When they argued, Clarissa tried not to show her ambivalence because she feared that she would cave in to her mother's wishes and sacrifice her own needs.  But, internally, she was struggling with the possibility of letting go of her role as her mother's best friend.

As Clarissa explored her family history with her psychotherapist, she began to realize for the first time that she and her mother had a similar dynamic to her mother and maternal grandmother.

Similar to the maternal grandmother, Clara was in her mid-teens when she had Clarissa.  They both raised their children without the biological father with the help of their mothers. Clara was her mother's best friend and confidant and they usually did everything together.

When Clarissa revealed to Clara that she wanted to go away to college, Clara was stunned.  She couldn't understand why Clarissa would want to leave their town where their family had roots for many generations.

Clara had always hoped that she and Clarissa would have a similar relationship to the one that Clara had with her mother.  She told her that Clarissa that she considered it a form of betrayal that she would want to move away to college for four years.

Clarissa talked to her therapist about how she grew up listening to her mother's problems.  Even as a young child, she tried to help her mother to overcome feelings of helplessness and hopelessness.

Even though she was only a young child, she felt she did a good job of shoring her mother up emotionally.  But now, she wanted something more--something for herself for a change.  She asked her therapist, "Am I being selfish?"

Over time, Clarissa's therapist helped her to work through her ambivalence to see that what she wanted for herself was healthy and necessary for her well-being.

Being able to look at her situation through her therapist's eyes, Clarissa could see, for the first time, that what was expected of her as a child wasn't healthy for her.  At the same time, she had a lot of compassion for her mother.

When Clarissa felt ready, she asked Clara to come to a therapy session with her.  Although Clara said she "didn't believe in therapy," she came to the session with a wary eye on the therapist.

When Clarissa explained to Clara why she wanted to go away to college, Clara burst into tears.  Although they had had this same talk many times before on their own, Clara realized that Clarissa made up her mind and it was final.

Clara explained to Clarissa and the therapist that she wanted what was best for her daughter, but she felt it would be unbearable for her to be home alone, especially since her mother died the year before.  She would have no one.

Clara idealized her relationship with her mother and told them that, from the time Clarissa was born, she wanted the same relationship with Clarissa that she and her mother had.  She was her mother's best friend and she hoped that Clarissa would be her best friend always.

But now that Clarissa wanted to go away, she saw all of this falling apart for her.  She couldn't understand why Clarissa couldn't go to the local college so they could remain together.  The therapist suggested that Clara could benefit from seeing her own therapist, but Clara brushed this off.

When Clarissa came to her next therapy session, she told her therapist that she felt more confident in her decision, even though she still felt guilty about leaving her mother.

Why Your Child Can't Be Your Best Friend

Eventually, Clarissa went off to college.  She continued to work on the emotional separation process from her mother with a therapist at the counseling center.

Her relationship with her mother remained fraught until her mother began developing her own friendships and interests in her church.

Over time, they were able to repair their relationship.  Clarissa enjoyed her new sense of autonomy and she felt that she was finally taking care of her own emotional needs.

When parents have their own unmet emotional needs from childhood, and especially if they were parentified children with one or both parents, they are more likely to try to get their unmet needs through their children.

This is usually an emotional blind spot for the parent.   In most cases the parent is unaware that she is doing harm to the child.  She's just doing what feels right, often based on her own childhood.

Children will often try to extend themselves beyond their emotional maturity and sacrifice their own needs in order to please their parents.

Even when the child attempts to resist being a parentified child, he or she often feels guilty about not being able to meet their parent's needs.

In order for the child to grow emotionally, the child needs to assert his or her own needs by resisting the parent's attempt to make the child their emotional caregiver.  Resisting the parent is usually very difficult and beyond what most children are able to do.

In order for the parent to grow, the parent needs to mourn that s/he didn't get what s/he needed as a child and find other healthy ways of getting emotional needs met instead of depending on the child.

Getting Help in Therapy
It's often difficult for the child to assert his/her needs for fear of losing a parent's love.  Similarly, it's often difficult for a parent to resist depending upon the child emotionally.

For parent and child, psychotherapy is often helpful to overcome these challenges.

If you're struggling with these issues, rather than struggling alone, you could benefit from getting help in therapy.

A skilled psychotherapist can help you to negotiate these emotional challenges so you can change, 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.

I have worked with adult children and parents, both individually and together, to help them overcome these emotional challenges.

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, October 5, 2017

Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult

People often unconsciously choose a spouse who has similar characteristics to one or both parents (see my article:  Overcoming the Guilt You Feel For Not Being Able to Heal Your Parent's Emotional Wounds and How to Stop Being the "Rescuer" in Your Family of Origin).
Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult
A child, who was the emotional caregiver for a depressed parent, will often unconsciously choose a spouse who is depressed and recreate a similar caregiving dynamic with the spouse.

The following fictionalized vignette illustrates how these patterns are repeated and how therapy can help:

Emma grew up in a loving, nurturing home.  She was the youngest of three children in a close-knit extended family.  Both parents were actively involved in the children's lives, although the father was often away on business.

Emma's mother was well liked by her neighbors for her kindness and generosity.  She was very proud of Emma and Emma's sisters, and she instilled confidence in them.  She encouraged their curiosity and creativity, and she taught them that they could be whatever they wanted to be.

As the youngest, Emma was closest to her mother.  By the time Emma was about to start school, her sisters were already involved in high school activities and out of the house most of the time.  As a result, Emma spent a lot of time alone with her mother.

Emma's Mother: Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult

For a young child, Emma was especially perceptive, and she realized that her mother was depressed--even though her mother was loving and active in Emma's life and she tried her best to hide her depression from Emma and the rest of the family.

Emma worried about her mother, and she spent most of her time at home trying to enliven her mother and make her laugh. There were days when Emma's jokes and funny stories seemed to lift her mother's mood.  But there were other days when it seemed that nothing Emma could do would lift her mother's spirits and Emma felt very sad on those days.

As Emma got older and she developed friendships and outside interests, she continued to feel that her primary responsibility was to lift her mother's spirits. Realizing that Emma felt overly responsible for her, her mother would encourage Emma to pursue her friendships and interests.  She didn't want Emma to sacrifice her happiness.

By the time Emma graduated from high school, she felt deeply ambivalent about going away to college, even though her parents and older sisters encouraged her.  She worried that her mother would sink into an even deeper depression if she wasn't around to try to enliven her.

She had a hard time adjusting to being away from home during her first year at college, and she took every opportunity to go home on weekends to spend time with her mother.  She would also often bring home friends that she thought would be entertaining for her mother.

In her junior year, she met Tom.  She liked that Tom was a serious philosophy major, who was intelligent, knowledgeable and curious.  Soon they were spending a lot of time together.

Emma's friends at college teased her about Tom because they thought he was dour.  But Emma brushed off their criticism and told them that they didn't know him, they were judging him only from his outer appearance, and they couldn't appreciate all of the qualities that she saw in him.

Soon after they graduated college, Emma and Tom got married and began working. Emma found her dream job working as a journalist.  But Tom was unable to find the type of job he hoped for after he graduated college.  Part of the problem was that he had definite ideas of what he wanted and refused to compromise.  As a result, he did temp work.

Emma and Tom: Caregiving For a Depressed Mother as a Child and a Depressed Spouse as an Adult

Emma was very aware that Tom felt depressed and discouraged about his work situation, so she refrained from gushing about her work.  Instead, she tried to be emotionally supportive of Tom, but he didn't respond well to her trying to lift his spirits.  He would become annoyed with her and mostly wanted to spend time alone.

This left Emma feeling lonely and helpless, and when she tried to talk to Tom about it, he refused to address the problems between them.  He expressed his resentment that she was so happy with her work, and he felt miserable.

Soon, Emma was spending most of her free time with her friends because Tom refused to go out.  She was deeply concerned about Tom and their marriage, but there was nothing that she could do.

As time went on, Emma was promoted into a more responsible position with a big salary increase. She was also given more interesting assignments.  But Tom continued to stagnate.  Emma encouraged him to get help in therapy, but he refused to go.

Two years later, their marriage was over.  Tom moved out to live with his parents across the country, and Emma was in despair.

Shortly after that, Emma began therapy to try to understand what happened and to pick up the pieces of her life.  Her psychotherapist helped Emma to see how she had been in a similar dynamic with Tom as she had been with her mother.

Although Emma's mother and Tom experienced their depression in different ways and had their own unique responses to Emma's attempts at caregiving, they elicited similar responses in Emma.

While she was in therapy, Emma also saw her blind spots about Tom.  Looking back with the perspective of time, she realized that there were signs before she got married that Tom was depressed and rigid in his thinking, but she didn't want to see these traits.  She also saw her role in the demise of their marriage and how she infantilized Tom.

Emma grieved in therapy for the loss of her marriage as she went through the divorce process.  She also learned in therapy that she had a propensity to be a caregiver in a relationship due to her early relationship with her mother, and she would need to be much more aware of this in the future so she would not repeat the same patterns.

Emotional dynamics between parents and children are developed at an early age.

As in the fictionalized vignette above, these dynamics are often unconscious for both parent and child.

When a child grows up feeling emotionally responsible for a parent, this often sets up the possibility for similar dynamics in adult relationships on an unconscious level, which often leads to problems in the relationship for both individuals.

Getting Help in Therapy
Both people in the relationship need to be willing to change these unhealthy dynamics to make healthy changes.

It can be very challenging to overcome these dynamics on your own, even if one or both people are aware of them and willing to change, which is why working with a skilled psychotherapist can be helpful.

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 overcome unhealthy emotional patterns in 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, August 28, 2017

Increasing Your Self Confidence and Resilience By Challenging Yourself

In prior articles, I've written about particular aspects of developing resilience (see my articles: Developing Emotional ResilienceResilience: Bouncing Back From Life's ChallengesDeveloping a More Resilient Self in PsychotherapyNavigating Life's Transitions, and Staying Emotionally Grounded During Stressful Times).  In this article, I'm focusing on how to develop resilience and self confidence by challenging yourself (see my article: The Power of Making a Commitment).

Increasing Your Self Confidence and Resilience By Challenging Yourself

Resilience isn't an all or nothing thing.  If you've survived in life until now, you've built up a certain amount of resilience.  And every challenge that you overcome builds even more resilience (see my article: Moving Out of Your Comfort Zone).

Increasing your resilience increases your confidence to face whatever obstacles might come your way, and it allows you to bounce back from setbacks more easily (see my article: Opening Up to New Possibilities in Your Life).

It's never too late to increase your resilience and self confidence by challenging yourself.

For instance, athletes, who are striving to be more competitive and to win bigger prizes, keep pushing themselves to beat their best score.  Or actors, who want to hone their acting skills, keep working on a part until they're satisfied.

But you don't have to be an athlete or an actor or, for that matter, in any particular field to increase your resilience.  You also don't have to wait until a catastrophe occurs in your life to be challenged.

You can find ways in your every day life to challenge yourself to go beyond where you are now, overcome the obstacles involved and build resilience and self confidence.

Increasing Resilience and Self Confidence in Your Everyday Life:
Here's an example:

Reframing Adversity
Looking back on an adverse situation that you overcame in the past, look at the positive aspects that helped you to learn and grow rather than focusing on the negative aspects (see my article: Developing a Positive Perspective By Reframing and Turning Lemons Into Lemonade During Life's Ordinary Disappointments).

For instance, if you were fired from a job in the past, instead of dwelling on all the negative aspects of that situation, think about what you learned from this challenge and how you grew as a person:

A Fictional Example of Reframing Adversity:
Bob lost his job without warning when he and his coworkers were suddenly called into their boss's office and told that it was their last day due to the company's financial problems.

Bob was just as shocked as his coworkers.  He went home, told his wife and then he was tempted to spend the rest of the week in bed with the covers over his head.

But Bob was determined that he wouldn't allow this situation to make him feel defeated or diminished.

So, even though he considered himself to be a shy person and networking was very difficult for him, he challenged himself to make five phone calls a day everyday to former supervisors and colleagues to reconnect with them and find out if there were job opportunities at their current workplaces or if they knew of anyone who might be helpful.

On most days, Bob found this to be a humbling, tedious and fruitless process.  But he kept telling himself that he needed to keep plugging away.  He didn't have the luxury of not working.

Over time, he also realized that he was getting to spend more time with his wife and children, which he really enjoyed.

He also had time to write the article that he had been meaning to write for months for his professional organization.  He was thrilled when it was accepted for publication.

He also had more time to spend on his hobbies.

By the fourth week, Bob reconnected with a former colleague, Joe, who suggested that Bob call one of Joe's former colleagues, Dan, for a possible job opening at Dan's company.  Joe said he would put in a good word for Bob.

When Bob called Dan, Dan said he didn't know of any openings at his company, but he knew for sure  that there was an opening at another company and since Joe was recommending him so highly, Dan would give his contact, Ed, a call.

Increasing Your Self Confidence and Resilience By Challenging Yourself

Two months later, Bob was in a new job that paid more than the job that he was laid off from.  It also offered him new professional opportunities.

When Bob reflected back on his job search process, he felt good that he remained steadfast in his purpose.  Even though it was very challenging for him to keep plugging away, over time, he felt more confident and he bounced back from setback of losing his prior job.

Looking back on the experience, Bob realized that there were many positive aspects to his having lost his job--including spending time with his family, getting an article published, and working on hobbies that he enjoyed.

He also realized that he was able to overcome the fear and frustration of losing his job to find an even better job by being persistent and not allowing negativity to drag him down.  Not only did this build his self confidence in terms of facing other challenges in his life, it also allowed him to feel that he could bounce back from future setbacks.

Setting an Intention For Yourself and Sticking With It
Setting an intention can be a powerful tool in succeeding in a particular goal.  Sticking with your intention, even when you're tempted to give up, can help you to build your self confidence and resilience, especially when you see the results that you desire (see my article: The Power of Starting the Day With an Intention).

A Fictional Example of Setting an Intention and Sticking With It
Here's an example:

Nina rose through the ranks at her job because of her hard work, diligence and creative problem solving.

At her current level, she was supervising three people, and she hoped that she would be promoted to a managerial position within the next year.

But when a managerial position opened up and Nina applied for it, her director told her that he was very happy with her work, but the managerial position required a Master's degree and she only had a Bachelor's degree.

He encouraged her to get her Master's degree if she wanted to be considered for managerial position.  Needless to say, Nina was disappointed.

Nina looked into various Master's programs that had evening programs because she couldn't afford to stop working.  She hesitated, at first, because she saw how daunting it would be to work full time and attend a Master's program at night.

But she also knew that, whether she stayed with her current employer or left for another job, her lack of a Master's degree would be an obstacle for her.  So, she applied to a Master's program, took out loans, and resigned herself to having very long days and weekends filled with work.

She was surprised to discover that, even though it was a tremendous amount of work and a financial sacrifice, she really liked her professors, her course work and her classmates.

During the time when she was working full time and attending the evening Master's program, she had to turn down many social invitations because she didn't have the time to socialize.  It was lonely.  She also wondered if the debt she was incurring would be worth it in the long run.

There were times when she considered giving up and being satisfied with where she was in her career, but she knew she wouldn't be satisfied for long, so she persevered.

Increasing Your Self Confidence and Resilience By Challenging Yourself

By the time she received her degree, another managerial position opened up, and her director offered her the job.  He also met with her to talk about her career path at the company and other possible promotions if she did well in the new managerial position.

Looking back on the experience, Nina knew that she gave up a lot in terms of socializing, getting enough rest and taking on student loans.  But she felt proud that she was persistent and diligent enough to put aside other concerns so she could accomplish her goal.

Nina also knew that by setting an intention and sticking with her goal, she felt more confident about herself and resilient in terms dealing with future challenges.

What's Getting in the Way of Your Facing Challenges and Accomplishing Your Goals?
Many people, who have experienced early trauma, have difficulty dealing with adversity and accomplishing their goals (see my article: Understanding Why You're Affected By Trauma From a Long Time Ago and Overcoming the Traumatic Effects of Childhood Trauma).

People who have been very traumatized also have difficulty even setting goals.

Early traumatic experiences affect how they feel about themselves.  They often lack confidence in themselves or feel undeserving, telling themselves:  "I'm not good enough" or "Who am I kidding?  I'll never amount to anything" (see my article: How Our Expectations and Beliefs Affect Us).

Often, these are messages they received as children, either directly or indirectly from their caregivers, who might have also felt beaten down by their own early experiences (see my article: Overcoming the Internal Critic).

For people who are weighed down by emotional trauma, it's especially hard to overcome these negative messages that they have internalized from a young age.  This also creates, at times, insurmountable obstacles to facing challenges.

Getting Help in Therapy
There are times when you can't overcome the emotional obstacles that you're facing on your own.  You need the help of a skilled psychotherapist to overcome the trauma that's holding you back (see my article: The Benefits of Psychotherapy and How Psychotherapy Helps You to Open Up to New Possibilities in Your Life).

Many people, who need help, never seek it out.  They feel too ashamed, and they remain weighed down by their early trauma throughout their lives (see my article: Looking at Your Childhood Trauma Through an Adult Perspective).

If you're aware that, despite your best efforts, you've been unable to overcome the emotional trauma that keeps you stuck, you owe it to yourself to get help from a licensed mental health professional (see my article: Overcoming Self Doubt That Keeps You Stuck).

Freeing yourself from a traumatic history gives you a chance to live your life in a more fulfilling way without the obstacles that are keeping you down.

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, August 21, 2017

Resilience: Remembering Your Past Comebacks So You Can Overcome a Current Setback

One of life's many challenges involves overcoming setbacks. One strategy that is helpful to develop resilience and overcome a setback is to remember your past comebacks during challenging times (see my article: Developing Resilience, Resilience: Bouncing Back From Life's Challenges,  Developing a More Resilient Self in PsychotherapyCoping With Frustration, Navigating Life's Transitions and Turning Lemons Into Lemonade During Life's Ordinary Disappointments).

Resilience: Remembering Your Past Comebacks So You Can Overcome a Current Setback
During setbacks, it's easy to dwell on everything that went wrong.  It's also easy to remain mired in self blame where you're internal critic gets the best of you and paralyzes you (see my article: Overcoming the Internal Critic).

But the important thing to remember during a setback is that you bounced back during prior setbacks, possibly even worse setbacks than what you're experiencing now.

Resilience: Remembering Your Past Comebacks So You Can Overcome a Current Setback

Think of the current situation as a learning experience:

Over time, overcoming setbacks allows you to build resilience.

When you can overcome your disappointment to look at the situation clearly, you will often discover that you have dealt successfully with other challenges in the past, and you can use these same skills to overcome the current setback.

Resilience: Remembering Your Past Comebacks So You Can Overcome a Current Setback
Often, this involves changing your attitude about the setback.  If you're overcome with self criticism and telling yourself, "I knew I wouldn't be able to do it" and "I'm not good enough," you're working against yourself and making it that much harder to overcome the current setback.

But if you can develop a more objective perspective about your situation, step back and recognize that you have bounced back before, you're more likely to open up to new ways to overcome your problem.

In the long run, what's most important is not that you're having a setback, but your attitude and what you do about it.

Unresolved Emotional Trauma Can Have an Adverse Effect on Overcoming a Setback
People who have experienced emotional trauma, especially unresolved childhood trauma, often get triggered by setbacks.

If they grew up feeling powerless, unlovable or not good enough, a setback can seem like a confirmation of their negative feelings about themselves (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

This is very difficult to overcome on your own.

Getting Help in Therapy
If you're finding it difficult to overcome a setback on your own and it's triggering feelings of worthlessness related to unresolved emotional trauma, rather than struggling on your own, you could benefit from seeking help from a licensed psychotherapist, who specializes in helping clients to overcome trauma (see my article: Overcoming Emotional Trauma and Developing Resilience).

A skilled trauma therapist can help you to overcome unresolved trauma that's getting triggered by the current setback.  This can help you to overcome the current challenges as well as future challenges.

Rather than suffering on your own, get the help you need so you can free yourself from your traumatic past to live a more fulfilled life.

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

I specialize in 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 (212) 726-1006 or email me.

Monday, August 14, 2017

Emotional Survival Strategies That No Longer Work: "I don't need anyone"

Unresolved early childhood trauma usually leads to emotional survival strategies that were adaptive during childhood, but they are no longer adaptive for adults.  They also often lead to distortions in self perception.  It's not unusual for adults, who were abused or neglected as children, to become adults who deny their own emotional needs and reject emotional connections with others (see my articles: Understanding Why You're Affected By Trauma That Occurred a Long Time AgoGrowing Up Feeling Invisible and Emotionally Invalidated, Are You Feeling Trapped By Your Childhood History?Overcoming the Traumatic Effects of Childhood Trauma, and Looking at Your Childhood Trauma From an Adult Perspective).

Emotional Survival Strategies That No Longer Work: "I don't need anyone."

These survival strategies and distortions in self perception are unconscious.  Underneath them are a lot of fear, hurt, anger and shame.

One way to avoid feeling these underlying feelings is intellectualization.  When it is used to avoid unconscious emotions, intellectualization is a defense strategy.  More about this later.

These problems can begin early in infancy when the baby's primary caregiver is either shutdown emotionally, continuously misattuned to the baby's emotional needs, emotionally neglectful or abusive.

Even if all of the baby's physical needs are being taken care of, the baby still needs emotional attunement from the primary caregiver in order to thrive and learn to develop healthy attachment.

A baby, who makes many attempts to get a caregiver to be emotionally attuned, eventually gives up and shuts down emotionally.  Not only does the baby feel resignation about getting his emotional needs met, but he also gives up and dissociates.

If this is a pervasive experience in a baby's life, it will affect brain development as well as emotional development.

This survival strategy of dissociating is adaptive at that point for the baby because it would be emotionally unbearable to continue to yearn for love and attention that won't be given by the primary caregiver.

But this survival strategy, as an adult, is maladaptive and usually results in disconnection from oneself and others.

The dilemma for this adult is that he (or she) yearns for love and connection, but he's too fearful of getting his needs met, so he either (unconsciously) connects with other adults who cannot meet his needs or he believes himself to be "independent," someone who doesn't need other people.

As mentioned before, a common pattern for people with this problem is to either avoid relationships altogether by intellectualizing ("I only need my books") to negate the yearning for love and connection.

Fictionalized Scenario
The following fictionalized scenario illustrates these dynamics:

Shortly after Jane was born, she was left with her maternal grandmother when her mother moved from Florida to New York to find work.

Jane's grandmother did the best that she could, but she was often overwhelmed by taking care of her other grandchildren, her responsibilities in the house and running the family business.  As a result, she had little time to spend with Jane aside from meeting Jane's basic physical needs.

The grandmother was raised to believe that if a baby cried, the baby should be left to cry it out rather than being picked up, otherwise, the baby would be spoiled.

How Emotional Survival Strategies Develop in Infancy

So she left Jane crying for long periods of time in the crib.  Eventually, Jane would give up out of sheer physical exhaustion as well as a primitive sense that it was hopeless to keep trying to get anyone's attention.

When Jane's grandmother noticed that Jane was quiet in her crib and was just staring into space, she thought this was good.

To be clear, the grandmother wasn't trying to harm Jane in any way.  She just didn't understand the developmental harm that was being done by not responding to the baby's crying.  And, aside from this, a quiet baby is a compliant baby and was much easier for the grandmother.

When Jane was 10, her mother sent for her to live in New York City.  Even though Jane and her mother had no contact since the mother moved to New York City, when Jane arrived, her mother expected Jane to be affectionate towards her.

But, instead of an affectionate child, Jane's mother encountered a child who showed little emotional reaction to her.  Jane was obedient and passive, but it was obvious that she felt no emotional connection to her mother.

Jane understood that the woman she was meeting after so many years was her mother--she understood it as a fact.  But it had no emotional resonance for her.  She complied with her mother's rules and directives, but Jane remained emotionally disconnected from her (see my article: Adults Who Were Traumatized as Children Are Often Afraid to Feel Their Emotions).

Jane's mother thought of Jane's emotional distance as Jane being willfully disrespectful of her.  She had no understanding, as many parents wouldn't, that Jane's aloofness was an unconscious survival strategy that she developed at an early age to cope with the lack of love and connection from infancy.

Meanwhile when she was at school, Jane's teachers noticed that she tended to isolate herself from other children.  While other children were playing during recess, Jane sat in the corner by herself reading a book.

When Jane's teacher told her mother that she was concerned that Jane wasn't interacting with the other children, Jane's mother dismissed the teacher's concerns, "My daughter is here to learn.  She's not here to make friends.  It's better for her to read than to play."

Throughout high school, Jane's mother discouraged her from dating, "There will be plenty of time for that after you graduate from college."   Jane didn't mind because she felt no need to date boys or to make friends, "I have my books.  I don't need anyone."

During her first year of college, Jane kept to herself. At first, her classmates tried to befriend her, but when they saw that Jane wasn't receptive, they thought that Jane thought of herself as being "too good" for them.  Their friendliness turned to scorn, and they laughed and ridiculed Jane.

Although Jane pretended not to notice, she saw and heard their criticism.  Sometimes it would bother her, but most of the time, she pushed down her discomfort and told herself that she didn't care what they thought, "I don't need anyone."  Then, she would study harder in an effort to avoid feeling her loneliness, anger and hurt.

Jane graduated college with a 4.0 GPA, which she was very proud of and so was her mother.  But she didn't get any interviews from the college recruiters at campus.

Jane applied for many jobs after she graduated college, but she received no responses.  She wasn't  aware that many companies looked not only for good grades--they also wanted to see that students were involved in college activities, and Jane avoided any activities while she was in college.

Eventually, Jane found a job as a part time bookkeeper, which didn't require a college degree.  She worked in a small office by herself.

After a year, Jane found a full time bookkeeping job.  This allowed her to move out of her mother's home to become a roommate in an apartment with three other young women.

Jane didn't really want to have roommates, but she couldn't afford to have her own apartment.  Even though Jane had no interest in making friends with her roommates, one of them, Cathy, went out of her way to be friendly with Jane.

To her surprise, Jane realized that she didn't mind being around Cathy because Cathy did all the talking when they were together and all Jane had to do was be polite and pretend to be interested in what Cathy was saying.

After Cathy asked Jane many times, Jane agreed to go with Cathy to a silent meditation retreat.  Jane thought, "How bad could it be?  All I have to do is be silent."

But when Jane began the silent meditation at the meditation center, she was surprised to discover that she felt upset and emotionally overwhelmed, and she didn't know why.  She asked the center director if she could read books instead, but she was told that she had to focus on meditation.

After a couple of days of silent meditation with no other distractions, Jane felt so emotionally overwhelmed with sadness that it was unbearable.  She felt ashamed to leave early, but she couldn't bear being so overwhelmed.

When she got home, Jane tried to distract herself from her sadness by immersing herself in her books and going online but, no matter what she did, she still felt engulfed by sadness and she didn't know why she was feeling this way and why she couldn't distract herself.

After experiencing overwhelming sadness for a couple of weeks, Jane knew she needed help, but she wasn't sure where to turn, so she sought help from her medical doctor.

Although she felt very ashamed of her feelings, especially since she couldn't think of any reason for her sadness, her fear that she was "going crazy" got her to talk to her doctor.

Jane's doctor explained to her that there was nothing physically wrong with her and that she needed to address these psychological issues in psychotherapy.  Then, he referred her to a psychotherapist.

Getting Help in Therapy For Emotional Survival Strategies That No Longer Work 
Over time, Jane learned in therapy that, as an infant, she developed an emotional survival strategy of disconnecting from her environment as a way to deal with the environment that she grew up in.  Her therapist explained to her that this is called dissociation and it's what babies do when they are being raised by a caregiver who neglects or abuses them.

Jane learned from her therapist that this early emotional survival strategy was adaptive at the time because to continue to yearn for love and attention when none was forthcoming would have been even more emotionally painful when she was an infant.

Her therapist explained that Jane continued to use this emotional survival strategy as an adult.  Jane used books and other intellectual pursuits to distract herself and dissociate from her environment, but it was no longer adaptive in Jane's life--in fact, it was getting in the way of developing healthy friendships and relationships.

When Jane went to the silent meditation retreat, her psychotherapist explained, and she wasn't allowed to distract herself with books, her sadness about years of emotional neglect and disconnection came bubbling up to the surface, and this was what Jane was experiencing now.

The feelings were so strong that Jane could no longer push them down so, rather than trying to suppress them, Jane needed to engage in trauma therapy in order to heal.

She could no longer remain in denial about not needing anyone, which was a defense against feeling her longstanding sadness.  Jane saw this defense mechanism for what it was--an emotional survival strategy and distortion in self perception that was now maladaptive.

The psychotherapist talked to Jane about EMDR therapy. She also took a thorough family history and helped Jane to prepare to do EMDR (see my articles: Overcoming Trauma With EMDR Therapy: When the Past is in the Present and EMDR Therapy: When Talk Therapy Isn't Enough).

The work was neither quick nor easy (see my article: Psychotherapy: Beyond the Bandaid Approach).

But by the time Jane and her therapist began processing her early trauma, Jane trusted her therapist and, eventually, she was able to free herself from her history to lead a fuller life.

When infants are neglected or abused, they're able to develop survival strategies, on an unconscious level, that are adaptive at the time to ward off the devastating emotions that are the result of neglect and abuse.

Although it was adaptive at the time, these emotional survival strategies are no longer adaptive as an older child, teen or an adult.  These strategies keep people cut off from their feelings and in denial about their emotional pain.  It also keeps them cut off from other people.

Although they might believe that they really don't need anyone, this emotional survival strategy and distortion in self perception takes a lot of energy to maintain.

People often distract themselves from difficult underlying emotions with intellectual pursuits, drinking excessively, abusing drugs, gambling compulsively or engaging in other addictive and compulsive behavior.

When someone can no longer distract himself, these underlying emotions often come to the surface in a powerful way so that these emotions can no longer be denied.

Getting Help in Therapy
Various forms of trauma therapy, like EMDR therapy, clinical hypnosis or Somatic Experiencing are effective in helping people to overcome emotional trauma.

Rather than suffering on your own, you owe it to yourself get the help you need from a skilled psychotherapist who specializes in helping clients to overcome trauma.

By freeing yourself from a traumatic history, you can 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.

I specialize in 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 (212) 726-1006 or email me.

Monday, August 7, 2017

How Suppressing Emotions Can Lead to Medical and Psychological Problems

Many people avoid dealing with their emotions because they think it will be too emotionally overwhelming (see my articles:  Allowing Yourself to Feel Your Feelings so You Can HealUnderstanding and Expressing Your Emotions in a Healthy Way, and Working in Therapy to Accept Your Emotions).  Instead of allowing themselves to feel their emotions, they defensively suppress their emotions or numb themselves in order not to feel the unpleasant feelings.
How Suppressing Emotions Can Lead to Medical and Psychological Problems

Since we know so much more than we ever have in the past about the mind-body connection, we now know that these suppressed or numbed feelings don't just disappear--they often take a physical toll and result in serious medical problems.

Suppressed grief can also result in compulsive and addictive behaviors, like excessive drinking, abuse of drugs, compulsive gambling, compulsive spending, overeating, smoking as well as other psychological problems such as problems with anger management, depression and anxiety.

Fictionalized Vignette:  How Suppressing Emotions Can Lead to Medical and Psychological Problems:
The following fictionalized vignette illustrates how suppressed emotions can manifest in medical and psychological problems:

Bill grew up in a family where no one dealt with unpleasant emotions, except anger (see my article: Psychotherapy Can Help You to Overcome the Effects of Growing Up in a Family That Doesn't Talk About Their Feelings).

When he was 16, his paternal grandfather, who lived with Bill and his family, died unexpectedly.  Bill found out about his grandfather's death when he came home from school and his father told him that his grandfather died unexpectedly from a massive heart attack.  The emergency management technicians were just taking the grandfather's body out as Bill arrived.

Bill and his grandfather were very close.  As he heard the news from his father, he began to cry, but his father scolded him and told him not to be "such a crybaby."   He told Bill that he needed to "be a man" and "stop acting like a girl."

Hearing his father's words, Bill stopped crying and tried to follow his father's example.  Throughout the funeral, Bill watched his mother and sister sobbing, but the men in the family remained stoic.  From their examples, Bill learned that this was what it meant "to be a man."

At age 38, Bill went for a physical exam to find out the cause of his headaches.

After his doctor ruled out any other medical causes for Bill's headaches, he told Bill that his headaches were probably due to psychological problems, and he should see a psychotherapist.

How Suppressing Emotions Can Lead to Medical and Psychological Problems

When Bill went to therapy, as part of his family history, he also revealed that the men in his family, especially his father, never expressed any unpleasant feelings, except anger, because it was considered "unmanly."

Bill gave many examples of times when he felt very sad, including when his grandfather died, when he was told that he needed to "be a man" and stop crying.

Bill told his therapist that it had been many years since he had been aware of unpleasant feelings--except anger, and he often felt angry and would sometimes lash out at his girlfriend and family members.

Bill's therapist told him that he had learned from a young age to suppress most of his unpleasant feelings and suppressing his feelings had medical and psychological consequences for Bill.

His therapist explained the mind-body connection to Bill to help him understand why he was having his current problems (see my article: The Body Offers a Window Into Unconscious Mind).

His therapist used Somatic Experiencing to help Bill to overcome the emotional numbing that he was experiencing (see my article: Understanding the Mind-Body Connection and Somatic Experiencing).

The work that Bill did with his psychotherapist was neither quick nor easy.  It took time.

Gradually, over time, Bill learned that allowing himself to feel his emotions and express them in a healthy way was not "unmanly."

Over time, Bill grieved the loss of his grandfather and other losses in his life that he never allowed himself to feel.

How Suppressing Emotions Can Lead to Medical and Psychological Problems

As Bill learned to allow himself to feel all his feelings, he no longer got headaches.  He was amazed that he had so much energy now that he wasn't using a lot of energy to suppress his feelings.

Although the vignette above is an example about a boy who suppressed his emotions and continued to engage in this behavior as an adult, this problem is not limited to men--it happens to women too.

Young girls and women are often told by well-meaning family members that they have to be "the strong ones" in the family to help others through difficult times.

The rationale behind this misguided advice is that the women are "supposed to be" the nurturers and caregivers in the family, so they can't allow themselves to feel or express their emotions, especially sadness, because they have to take care of everyone else.  As a result, this suppression of emotions is equally destructive for women too (see my article: Overcoming the Need to Be Everyone's Caretaker).

People who have never been to therapy often think that "not suppressing emotions" means that they just "let it out" however it comes out.  This is definitely a misunderstanding of what it means to feel and express emotions.

The key is to feel and express emotions in a way that is healthy to the person with the emotions as well as the people around them.  So, it doesn't mean that they allow themselves to act in ways that are abusive to others or to themselves.

Cultural or family behavioral patterns are often factors that play a role in the suppression of emotions.  For example, as in the fictionalized vignette above, if a boy is told over and over again that "being a man" means that boys and men never allow themselves to feel or express sadness, this is a learned behavior that usually needs to be unlearned in therapy and replaced by healthy behavior.

Getting Help in Therapy
Whether you're numbing yourself emotionally or you're engaging in other self destructive behavior to suppress emotions, you can get help in therapy before your self destructive behavior results in serious medical or other psychological problems (see my article: Starting Psychotherapy: It's Not Unusual to Feel Anxious or Ambivalent).

Anxiety and depression are often the result of pushing down emotions that people either fear or find unacceptable in some way.

A skilled psychotherapist can help you to understand the root of your problems, work through unresolved trauma, and learn how to replace self destructive behavior with healthy ways of coping (see my article: How to Choose a Psychotherapist).

Rather than struggling to overcome these problems on your own, you can work with an experienced psychotherapist who can help you to 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.

I have helped many people to overcome self destructive patterns so they can lead healthier and more fulfilling 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.