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Thursday, March 22, 2018

Breaking the Family Code of Silence in a Dysfunctional Family

One of the hallmarks of many dysfunctional families is that there is a family code of silence about the family's dysfunctional behavior.  This can include enabling addiction, sexual abuse, physical and emotional abuse and other dysfunctional behavior.  Breaking the family code of silence and how psychotherapy can help is the subject of this article (see my article: Dynamics of Adult Children of Dysfunctional Families).

Breaking the Family Code of Silence in a Dysfunctional Family
Children who grow up in dysfunctional families learn relatively quickly that there are certain subjects that the family doesn't discuss, and there are consequences for breaking this code of silence, including being punished, ostracized or identified as "family problem" or scapegoat (see my article: The Role of the Family Scapegoat and Children's Roles in Dysfunctional Families).

Young children have no choice in most circumstances than to go along with the dysfunctional behavior.  After all, they are completely dependent upon the family so that being an outcast is unthinkable.

There are some young children who take the risk of confiding in another adult--like a teacher, mentor or family member outside the immediate family, but this doesn't always lead to positive results, especially since, in most cases the child continues to live in the household and will suffer repercussions for revealing family secrets (see my article: Toxic Family Secrets).

Maintaining a code of silence about dysfunctional family behavior often becomes the norm for these children when they become adults.  Confronting the dysfunction can still feel risky--even if the adult child is no longer part of the household and no longer dependent upon the family.

The inner conflict of wanting to confront dysfunctional behavior vs. the fear of breaking the family code of silence is often a topic for clients in psychotherapy.

Fictional Clinical Vignette: Breaking the Family code of Silence in a Dysfunctional Family
After dating for a year, Megan and John began talking about getting married.  They were both in their mid-30s, they both wanted children and since their relationship was going so well, they agreed that they didn't want to have a lengthy engagement.  They agreed that they would rather plan to get married some time in the following year.

When Megan met John's parents for the first time, she was welcomed into their home with warmth and acceptance.  It was evident that they were happy that the couple was talking about getting married.

Megan knew that the next step would be for her to invite John to meet her family, but she dreaded the thought of John meeting her family.  Although no one in her family would admit it, her father had longstanding problems with alcohol that often resulted in unpleasant scenes at the family dinner table and during holidays.

Even though she and her parents lived nearby in New York City, Megan avoided going home, except during holiday time, and even then she sometimes made up excuses not to be around her family's dysfunctional behavior.

As a child, she loved being around her father when he was sober, which was usually early in the day.  But once he began drinking, he became verbally abusive, and no one was immune to his verbal attacks. She became very attuned to recognizing when her father was drunk and tried to stay out of his way.

She also didn't invited friends over to her house when she was a child because she never knew when her father would be drunk, and it would be too humiliating for her if her friends saw her father's behavior.

As a teenager, Megan summoned the courage to talk to her mother and her older siblings about the father's problems, but they tended to minimize the father's drinking.

Her mother told, "This is the way your father is.  There's nothing we can do to change it." And her siblings told Megan that she was "making a big thing out of nothing."  So, being outnumbered, Megan contained her rage and bided her time until she could go away to college (see my article: Being the "Different One" in Your Family).

After she graduated college, Megan moved into an apartment in Manhattan with a few of her college roommates.  She had one serious relationship with a man named Bill, before her relationship with John, when she was in her senior year of college.  She avoided introducing Bill to her family, but after she met Bill's parents and siblings a few times, she felt uncomfortable not introducing Bill to her family.

Before inviting Bill over to meet her parents, she spoke with her parents and told asked them to avoid serving or drinking alcohol when she brought Bill over.  Her parents were incensed that she would even ask this.  Even though Megan tried to be as tactful as possible, both parents objected to her "dictating" their behavior in their own home.

As a result, Megan nervously explained to Bill why she was avoiding introducing him to her parents. Although Bill said he understood, Megan always wondered after their breakup a few months later whether he was skittish about the possibility of becoming part of a family with such dysfunctional behavior.

Now that she was with John, Megan wanted very much for this relationship to work.  She had never revealed her father's alcoholism because she felt so ashamed about it.

On an intellectual level, she understood that she wasn't doing anything wrong and she didn't have a reason to feel ashamed, but the thought of John seeing her father drunk felt so humiliating.  He came from a relatively healthy family, and she wasn't sure he would understand or want to be around her family's unhealthy behavior.  And, yet, Megan still loved her family and, at that point, she didn't want to completely cut them off.

Breaking the Family Code of Silence in a Dysfunctional Family

So, feeling caught in a dilemma about what to do, she began attending psychotherapy.  Megan provided her psychotherapist with the family history, including the alcoholism, family secrets, the enabling and the family code of silence.

As she spoke to her psychotherapist, Megan began to get clearer that her father's behavior was completely unacceptable to her and, even though she loved him, she didn't want to be around him or have John around him.

Megan decided to try to talk to her mother about it one more time, so she invited her mother to lunch in a nearby restaurant one Saturday.  After the meal, she broached the topic with her mother again.  She told her mother that she loved both her and her father, but her father's drunken behavior was unacceptable to her and she didn't want to be around it.

Megan could see her mother's eyes glaze over as Megan brought up the topic of her father's drinking.  She expected her mother to "check out" during this discussion, but she persevered.  When she saw that her mother was distracting herself by looking at her phone, Megan put her hand over her mother's phone and said, "Mom, do you understand what I'm saying? I won't come over anymore until dad gets sober."

When her mother made a gesture to leave, Megan asked her to stay and to hear her out.  Reluctantly, Megan's mother sat down again and glared at Megan.  Then, her mother's eyes welled up with tears, "I know your father has a little too much to drink sometimes and he says things that he regrets later, but what can I do?"

Megan wanted to tell her mother to stand up to her father, but she didn't want to tell her mother what to do.  So, instead, she focused on herself and told her mother that she couldn't tell her what to do.  She only wanted her mother to know that she was fed up with his behavior, and she would stop coming over if he didn't get help and stop drinking.  She explained that she felt that if she continued to come to the house under the current circumstances, she would be enabling her father's behavior and she no longer wanted to do that.

She also explained that she and John were planning to get married and have children and she didn't want John or her future children to be exposed to her father's drunkeness and the family's enabling of that behavior.  Megan's mother was silent, but Megan could see that her mother was inwardly seething.

A few days later, Megan spoke with her psychotherapist about her lunch with her mother and how frustrated and angry she felt about her mother's reaction.  Despite that it was very difficult for Megan, she also felt freer and lighter after the discussion she had with her mother.  She made a commitment to herself that she would continue to stand up for herself.

Megan also had a talk with John to explain her family's problems.  Although she felt embarrassed, she was relieved that he was so understanding.  She suggested that he could meet her siblings, who were all their own, away from the family home, which he agreed to do.

In the meantime, Megan and her psychotherapist worked on her unresolved childhood trauma related to the effect of the family's dysfunctional behavior using EMDR therapy (see my articles: What is EMDR Therapy? and How EMDR Therapy Works: EMDR and the Brain).

Over time, Megan and her psychotherapist worked through the unresolved childhood trauma with EMDR therapy, but it was neither quick nor easy.

Megan and John planned a small wedding with his family and their friends.  She invited her mother and siblings, but they refused to come because Megan excluded her father.  Although it was very difficult not to have her parents there, Megan knew she made the right decision for herself by not inviting her father.

A couple of years later, Megan was at home when she received a call from her mother that the father was in the emergency room after waking up looking jaundice.  Putting aside her resentment, Megan went to the hospital and stayed with her mother while her father was admitted to the intensive care unit.

The doctors explained to them that it appeared that Megan's father's liver was failing and they would need to do tests.  He explained that this was a very serious medical condition, and they might have to place the father in an induced medical coma.

At that point, Megan's family, including the father, had to confront the seriousness of his alcohol problems and that he might die from liver failure.  The father, who was in a great deal of pain, apologized to the mother, Megan and her siblings for upsetting them.  He held Megan's hand until he was taken away for tests.

It turned out that a medically induced coma was unnecessary, but the father needed surgery and he was warned by the doctors that if he continued to drink, he could die.

After the father recuperated from his medical problems, he agreed to go to an inpatient rehabilitation program for people who abused substances.  After he was in the program for a couple of weeks, Megan, John, her mother and siblings visited the rehab on family day.

They participated in a family education program and then they met with Megan's father and his primary counselor.  During that family session, Megan's father apologized again and made a commitment that he would do a six month outpatient chemical dependency program, attend Alcoholics Anonymous meetings, and get a sponsor so he could work on being sober.

It was an emotional meeting for everyone.  The counselor encouraged the family members to attend Al-Anon, a 12 Step anonymous program for family members who are part of an alcoholic and codependent family (see my article: Al-Anon: Beyond Reciting Slogans).

As time went on and Megan saw that her father was really serious about recovery and staying sober, she and John began attending occasional family dinners.  After many years of experiencing her father's alcoholism, it took Megan a while before she could trust that her father was serious about his recovery.

Breaking the Family Code of Silence in a Dysfunctional Family

But throughout it all, Megan felt confident that she knew what was acceptable and unacceptable behavior to her and that if her father relapsed, she knew what she needed to do to take care of herself (see my article: Is Self Care Selfish?).

Breaking the family code of silence can be a daunting endeavor, especially if you're the only one in your family who is willing to do it.

Years of going along with enabling behavior can numb you emotionally to dysfunctional behavior and cause you to be in denial about it.  But once you've made up your mind to place your own sense of well-being ahead of the family code of silence, you can take the necessary steps to take care of yourself, and psychotherapy can help you.

Getting Help in Therapy
It takes courage to confront longstanding family problems and how these problems affect you (see my article: Developing the Courage to Change).

If you have been struggling with the effects of dysfunctional family behavior and a code of silence around it, you could benefit from attending psychotherapy (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist can help you to identify the problems, take steps to take care of yourself, and work through the unresolved problems in therapy (see my article: How to Choose a Psychotherapist).

My experience as a psychotherapist of 20 years has been that experiential psychotherapy usually works best to overcome unresolved trauma (see my articles: Why Experiential Psychotherapy is More Effective to Overcome Trauma Than Talk Therapy Alone and  Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

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

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

Tuesday, March 20, 2018

Bait and Switch as a Form of Manipulation in Relationships: A Clinical Vignette

In my prior article, Bait and Switch as a Form of Manipulation in Relationships, I identified the signs of this dynamic and it's intentional and manipulative nature.  In this article, I'm providing a fictional clinical vignette to give more details about this phenomenon and how psychotherapy can help.

Bait and Switch as a Form of Manipulation in Relationships

Clinical Vignette: Bait and Switch as a Form of Manipulation in Relationships:
When Amy, who was in her mid-30s, met Ted at her friend, Mary's party, she was immediately attracted to his good looks, charm, intelligence, self confidence and sense of humor.

Prior to meeting Ted, she had not met anyone that she liked for over a year, and she was feeling lonely.  He called her within days of meeting her and asked her out to dinner that same week. Soon they were seeing each other on a regular basis at least 2-3 times per week.  Amy enjoyed his company and she sensed that he really liked being with her too.

She liked that Ted said he wanted to settle down and have children because she really wanted children too.  She was concerned that her "biological clock" was ticking and being with a man who wanted children was very important to her.

After they were dating for six months, Ted told Amy that he was laid off from his job.  He also told her that his lease would soon be up and he wanted them to live together.  Amy told him that she would also like them to take their relationship to the next level and agreed that he should move in.  So, Ted moved into Amy's apartment.

Bait and Switch as a Form of Manipulation in Relationships

Six months after Ted moved in, Amy had a talk with Ted about where their relationship was going (see my article: Is It Time for "the Talk"?)

Ted told Amy that he wanted to be with her for the rest of their lives, so they began talking to Amy about getting married.  They were both enthusiastic about getting married.  A month later, they got engaged and they began planning the wedding.

A couple of months before the wedding, Amy told Ted that she wanted to stop taking her birth control pills so that they could have a baby soon.  This was something that they had talked about before, but they never talked about when they wanted to try to conceive.

Ted seemed anxious when Amy spoke to him about stopping the birth control pills.  He told her that he thought it was too soon, and they should wait until he got a better job with an increase in salary before they had a baby.

Amy knew that Ted was concerned about money, but he never mentioned before that he wanted to wait to have children. After being laid off from his sales job, he took a temporary to get by until he could find a better paying job.

Amy told Ted that they could manage financially on what she earned and his income from the temporary job.  She told him the she didn't care if she was supporting both of them for a while until Ted could get on his feet financially.

She also told him that she was concerned about her age and if she would be able to conceive if they waited longer.  But Ted was adamant that he wanted to wait.  He told her that he didn't think it would be much longer before he had a better job.

Somewhat concerned and disappointed, Amy agreed that they would wait until he got a better job.  She knew that he was doing his best to search for another job and she didn't want to nag him about it.

But one day, he left his email open and she happened to see an email from an employment recruiter.  Out of curiosity, she read the email, which was open.  The recruiter said that he was having a difficult time trying to find Ted a job because he was terminated for poor job performance from his last job and, since Ted's industry was one where people had close ties, word had gotten out about Ted's termination.

Amy was surprised to read this because Ted told her that he was laid off due to cutbacks.  He hadn't told her that he was fired for poor job performance.  She decided she would ask him about it when he got home.

But when Ted got home that night, he told her that he had wonderful news.  He said that he received a a great job offer. The job would involve a lot of travel, and they needed him to start right away.

Amy was surprised and pleased to hear Ted's good news.  He was in such a good mood that she refrained from questioning him about the email from the recruiter.  She told herself that the recruiter must have made a mistake, and she and Ted celebrated the good news.

Ted started his new job a few days later, and he said he had to fly out to California for a couple of weeks immediately.  Although Amy was disappointed that the new job would involve so much travel, she was glad that Ted had a full time job that paid well again.

While Ted was in California, he called Amy to talk briefly.  He said that he couldn't talk long because he had dinner meetings and he wouldn't get back to his hotel room until late.

During one of those calls, Amy brought up having a baby again and Ted got angry, "I just started this job!  Give me a chance to get settled!" and then he hung up.  Amy didn't hear from him for the rest of the week.  She tried calling him several times, but her calls went directly to voicemail and he didn't return her calls.

While he was away, Amy worried about what it meant that he wasn't calling her or responding to her calls.  He had never behaved this way before and she didn't know what to expect.

When Ted got home, he was in a grumpy mood. Amy tried to talk to him, but he went into the study and closed the door.  He didn't come into their bedroom until she had already fallen asleep, and he left for work the following morning before she woke up.

Annoyed and frustrated, Amy made up her mind to ask Ted what was going on.  She couldn't believe that he would still be so annoyed with her.  But an hour before the time that he usually got home, he texted her that he would be in a late night meeting and she shouldn't wait up for him.  It worried Amy that he also told her that he wouldn't be available to talk by phone.

When Amy woke up the next morning, she realized that Ted had not come home at all.  She tried to reach him on his cellphone, but he didn't respond.

Alarmed, she texted him that she would meet him after work in front of his new office building.  Ted texted back immediately that "under no circumstances" should Amy wait for him outside his office building.  He told her that he would be home late due to late night meetings and she shouldn't wait up for him.  Amy tried to call him several times, but he didn't respond to her messages.

By now, Amy was very worried that something was seriously wrong in their relationship.  Not sure what to do, she left work early and, despite what Ted told her, she waited for him outside his office building for more than two hours.  When Ted come out of the building, she tried to reach him again, to no avail.

She asked the security guard in the building if he knew Ted's company and what floor it was on, but the security guard said he never heard of this company.  Amy thought that was odd, and she decided to go back home.

As Amy walked home feeling dejected, she was crushed to see him walking across the street with an attractive young woman on his arm.  They were busy talking and laughing so Ted didn't see Amy.  In tears, she followed them from a distance and saw them go into a residential apartment building a few blocks away.

After that, Amy knew that Ted was having an affair and their relationship was over.  But she wanted an explanation from Ted.

When he got home that night, Ted was in a good mood.  He gave Amy a hug and no longer seemed angry with her.  Hurt and angry, Amy pushed him away, "I saw you today with another woman!  What's going on?  Have you been cheating on me all along?"

Ted stepped back angrily, "What are you talking about?  I don't know who you saw, but it wasn't me."

Amy burst into tears, "Ted, I saw you with my own eyes! Why are you lying to me?  We're going to get married in a few weeks.  What are you doing?  And do you even have a job or have you been deceiving me about that too?"

Ted's manner changed.  He suddenly became cold, "Alright.  Now you know.  Are you satisfied?  I don't have a job.  I just told you that I did. And, yes, I've been seeing someone else.  I tried to protect you from all of this, but you had to be nosy."

Amy was too stunned to say a word, but Ted continued, "Look, you were the one who wanted to get married and have a baby.  I never really wanted to get married and have children.  I was trying to please you, but we're not getting along, so what's the point?  Let's just call it quits."

Amy was shocked.  It was all happening so fast.  She tried to talk to Ted, but he began packing his things, "Amy, it's over.  Move on with your life."

After he packed his things, refusing to talk to Amy, Ted left abruptly slamming the door behind him.  She called their mutual friend, Mary, in tears.

Mary listened patiently and when Amy finished talking, Mary cleared her throat and spoke hesitantly, "I'm sorry, Amy.  I heard from a friend a few years ago that he did the same thing to her.  He moved in with her when he lost his job, he proposed to her and then he left her for someone else.  She said it was like he turned into another person and blamed her.  I was hoping that Ted had changed.  You both seemed so in love, and I didn't want to spoil things by telling you.  I had no idea he would do the same thing to you.  I'm so sorry.  I should have warned you..."

Amy was numb after she heard Mary's words and she hung up the phone while Mary was still speaking.

A few days later, Amy contacted her friends, relatives and the wedding vendors to let them know that the wedding was off.  She gave no explanation.

Soon after that, Amy began psychotherapy to deal with her shock and loss.  Her psychotherapist listened empathically.  Then, she explained to Amy that it appeared that Ted had manipulated her for his own selfish reasons.  She also explained the "bait and switch" tactic that some people in relationships engage in.

Amy found out a few weeks later from an acquaintance that Ted was now living with his new girlfriend, the same woman that Amy saw on his arm.

During the next several months, Amy attended her weekly psychotherapy sessions.  She felt emotionally supported and understood by her psychotherapist.

They used EMDR therapy to work on the trauma of being manipulated and abandoned by Ted and the humiliation and sadness she felt about cancelling her wedding (see my articles: What is EMDR Therapy?How EMDR Therapy Works: EMDR and the Brain, and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Gradually, over time, she began to work through the trauma.  She also began to understand what happened, how Ted had lied to her all along about wanting to get married and have children so that she would take him in and support him.  She also realized that she overlooked certain red flags about Ted's character.  She understood that her loneliness and desire to be in a relationship might have made her more susceptible to Ted's charisma (see my article: Relationships: Falling For Charisma Instead of Character).

After talking to other people who knew Ted, Amy found out that Ted's usual pattern was to get involved with a woman and move in with her when he was having financial problems.  They told her that he was usually unfaithful and began a relationship with a new woman before he left his current relationship.

Gradually, as Amy continued in therapy, she regained her self confidence again.  When she met another man that she really liked, she was leery of trusting him.  But, over time, she lost her fear of being in a relationship again, and she opened up to this new experience.

People who engage in bait and switch tactics are usually very good at manipulating other people.  They can be very charming and take advantage of people.

In some cases, like in the vignette above, they are narcissistic and often engage in gaslighting.  These traits might not emerge until later on in the relationship.

There are often red flags, but the person who is being conned often misses these red flags because of their own state of denial.

The bait and switch can be about anything, as I mentioned in my prior article.

Getting Help in Therapy
Experiencing betrayal and manipulation by someone that you love is a shocking and hurtful experience.  It's a traumatic experience that can make it difficult for you to trust again.

Working with an experienced psychotherapist can help you to overcome this traumatic experience (see my article: The Benefits of Psychotherapy).

Rather than suffering on your own, you owe to yourself to get help from a skilled licensed mental health professional so you can heal (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I have helped many people to overcome betrayal and loss so they can move on with 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.

Saturday, March 17, 2018

"Bait and Switch" as a Form of Manipulation in Relationships

As a psychotherapist in New York City, I see many clients who complain that their significant other made promises to them that they didn't honor and, worse still, never had any intention of honoring.  Feeling confused, upset and betrayed, these clients talk about being manipulated by their significant other with a "bait and switch" tactic, which is the topic of this article (see my article: Keeping or Breaking Promises).

"Bait and Switch" as a Form of Manipulation in Relationships

What is "Bait and Switch" in Relationships?
To be clear, there will obviously be disappointments and frustration at some point in every relationship.  Being human, we all make mistakes.  But those are very different situations from the concept of "bait and switch."

"Bait and switch" isn't a matter of making a mistake or having a change of heart.  It's intentional manipulation.  Someone makes a promise to do something in order get what s/he wants at that point in time--knowing all the while that s/he will never honor that promise.

It's not unusual for the person who engages in "bait and switch" to try to turn the tables on his or her partner by either blaming the partner or denying that s/he ever admitted to a problem or said s/he would change.

This act of turning the tables often involves the "gaslighting" of the partner who is being manipulated and betrayed (see my article: Are You Being Gaslighted in Your Relationship?).

The fact that it's an intentional act is what makes people on the receiving end of "bait and switch" feel so confused, upset and betrayed.  They often say that they feel like they don't even know who their partner is anymore and, maybe, never did.

Examples of "Bait and Switch" in Relationships:
  • A man, who has been unfaithful during the dating phase of a relationship, makes a promise to his significant other that he won't cheat if they get married.  But after the marriage, when his then-wife finds out that he is still cheating, he tells her that he is "just being a man," he has no intention of ending his extramarital affairs, she needs to "get use to it" and stop nagging him about it.
  • A woman, who has mismanaged her finances, promises her fiancé that she will clear up her debt before they get married.  But after they get married, she not only hasn't cleared up her prior debt, but she continues to overspend because she has no intention of changing.  When her husband confronts her about this, she tells him that he is "making a big deal out of nothing."
  • A fiancé, who has unresolved emotional problems that are affecting his romantic relationship, promises his fiancee that he will participate in psychotherapy.  However, time passes and he doesn't make an effort to start therapy.  When his fiancee confronts him about it, he refuses to go to therapy, denies that he ever said he would, and tells her that he sees no reason to do it.  He tells her that she is the one with the problem so she should go to therapy.
  • A significant other promises she will get help for her gambling problem after she and her fiancé get married.  But after the marriage, she denies having a problem, and she accuses him of "imagining things." 
  • Knowing that his girlfriend will not marry him if the rumors that he is the father of another woman's baby are true, a man adamantly denies to his girlfriend that he is baby's father.  He denies even knowing this other woman.  However, after they get married and he gets the results of a DNA test and a court order to pay child support, he tells his now-wife that he is the baby's father and denies ever telling her that he wasn't.
  • A woman, who was charming and loving before the marriage, becomes emotionally abusive to her husband after the marriage.  When he confronts her about it, she tells her husband, who is stunned by the change in her behavior, that he is the one with the problem because he is "too needy" and "too sensitive."  Eventually, the husband finds out that his wife was diagnosed with borderline personality disorder long before they got married, but she intentionally kept her diagnosis a secret from him before the marriage (see my article: Coping With a Spouse Who Has Borderline Personality Disorder).
  • Before getting married, a couple agree that they both want children.   But after they get married, the husband reveals that he never wanted children, and he only told her that he did because he knew she wouldn't marry him if he told her the truth.  He doesn't understand why his wife is so upset with him now.
And so on.

There are many more examples of "bait and switch" in relationships, but I think you can see a pattern in the examples that I've given and note that information is either intentionally withheld and/or lied about.
"Bait and Switch" as a Form of Manipulation in Relationships

In most cases, the person who engages in "bait and switch" is manipulating to get what s/he wants, knowing all along that s/he won't fulfill the commitment.

The person who engages in "bait and switch" often lacks empathy for the partner, which is the hallmark of people with narcissistic or sociopathic traits.

People who engage in this form of manipulation are often very good at deceiving others to get what they want and can switch on the turn of a dime once they have gotten what they want (see my article: A Relationship With a Narcissistic Partner: Where Did the Love Go?).

In my next article, I'll give a clinical example with more detail to illustrate how these dynamics often play out in a relationship, and how psychotherapy can help.

Unfortunately, "bait and switch" in relationships isn't as uncommon as most people would like to think.

It can be very upsetting and confusing once the trusting partner realizes that s/he has been "conned" by the significant other.

Many people who are on the receiving end of the "bait and switch" tactic go through a phase of shock and denial before they fully accept who the partner is and what happened in the relationship.

Getting Help in Therapy
Realizing that the person you love has manipulated and lied to you is a betrayal that most people find too difficult to cope with on their own.

An experienced psychotherapist cannot tell you what to do about your relationship, but she can help you to go through the process of making a decision that will be right for you (see my article: The Benefits of Psychotherapy).

Rather than struggling on your own and feeling trapped, you could benefit from seeking help from a licensed mental health professional who can assist you to work through your problems (see my article: How to Choose a Psychotherapist).

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

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 email me.

Friday, March 16, 2018

What Are the Characteristics of a Healthy Family?

Articles about family dynamics are mostly focused on dysfunctional families (see my articles: Dynamics of Adult Children of Dysfunctional Families). But, of course, there are also healthy, functional families, and I think it's also worth discussing the characteristics of a healthy family, which is the focus of this article.
What Are the Characteristics of a Healthy Family?

There's no such thing as the "perfect family" and the concepts related to functional and dysfunctional families are really on a spectrum with many families falling somewhere in between (see my article: A "Happy Family" Doesn't Mean a Perfect Family and Happy Families: A Strong Family Narrative Can Help to Build Resilience).

Characteristics of Functional Families:
The following characteristics describe a functional family:
  • A Safe Home Environment:  All family members feel emotionally and physically safe in the family home.  Each member of the family can express his or her feelings respectfully without fear of being ridiculed, criticized, dismissed or belittled.  There is no emotional, physical, sexual or abuse of any kind.  There is no substance abuse or addiction of any kind.
  • Parents Work Together to Co-Parent:  In a healthy family, parents work together as a team. A parent doesn't try to undermine the other parent or try to get children to take his/her side.  Parents work together to co-parent the children, even if they are divorced (see my article:  Co-Parenting After the Divorce).
  • Siblings Are Encouraged to Cooperate With Each Other: In a healthy family, siblings are encouraged to help one another and cooperate with one another (as opposed to a dysfunctional family where children are often pitted against each other). This doesn't mean that there isn't sibling rivalry or that siblings won't argue.  Basically, it means that the children have each other's back.
  • Healthy Values Are Instilled: Parents who instill healthy values, including respect for others who are different from you, are helping their children to grow into healthy individuals.  These values might be spiritual, a formal religion or an overall ethical view of life.  At the very least healthy values include living by the "Golden Rule" of treating others as you would want to be treated (see my article: Living Authentically - Aligned With Your Values and Becoming Your True Self).
  • Coping Skills Are Taught: As part of their natural development, very young children have low frustration tolerance and very little in the way of coping skills.  As children mature, it's the parents' responsibility to teach children healthy coping skills in an age-appropriate way.  By learning healthy coping skills, children grow into adults who can cope with small and large crises that are a normal part of life.
  • Promises and Commitments Are Honored: For children to have a sense of security, it's important for family members to honor their promises and commitments.  While this might not always be possible, placing a high value on keeping promises and commitments will go a long way to fostering a healthy family environment (see my article: Keeping or Your Breaking Your Promises).
  • Mistakes Are Acknowledged: Whether it's the parents or the children who make a mistake, family members acknowledge, take responsibility and make amends (see my article: The Courage to Admit You Made a Mistake).  In addition, parents raise children who are not afraid to make mistakes--as long as the mistakes aren't harmful to others (see my article: Overcoming Your Fear of Making Mistakes).
  • Healthy Communication is Modeled and Encouraged: Parents model healthy communication with each other.  They encourage their children to talk to them about whatever is bothering them, and children feel safe enough to come to their parents without fear of being belittled or ridiculed.  Parents also communicate to children about changes in the family in an age-appropriate manner (see my article: Talking to Your Young Child About Your Divorce).
  • Disagreements Are Settled in a Respectful WayAll families have times when there are disagreements between family members.  What is most important is how these disagreements are handled and how relationships within the family are repaired if there is a disagreement.  Parents and children respect one another even when they disagree.
    • Time Together is Valued: Family time is valued, including eating meals together as a family as much as possible, celebrating holidays and birthdays together, creating family traditions, and so on.  As children become adolescents, they will want to spend more time with their friends, which is a natural part of being a teenager and wanting more age-appropriate autonomy.  Family time could also include telling stories about extended family and prior generations so that children develop a healthy sense that they are part of a larger family network.
    • Change and Autonomy Are Respected: In a healthy family, parents recognize that their children have their own minds.  As children get older, children might develop values and opinions that are different.  Parents in a healthy family also allow for age-appropriate change and autonomy.  Differences are respected (see my article:  Being the "Different One" in Your Family).
    The concept of a healthy, functional family is on a continuum rather than it being an all-or-nothing issue of being functional or dysfunctional.

    In most cases, rather than worrying to be the "perfect parent," it's important to realize that, to paraphrase Donald Winnicott, a British psychoanalyst and pediatrician, you just need to be "good enough."

    I have included the characteristics of a healthy family in this article.  You might think of other characteristics and, if you do, you can drop me a line at the email listed below.

    Getting Help in Therapy
    Whether you're struggling with unresolved childhood issues that are affecting you now or other problems that you've been unable to resolve on your own, you could benefit from attending psychotherapy (see my article: The Benefits of Psychotherapy).

    A licensed mental health professional can help you to resolve your problems so you can lead a more meaningful and fulfilling life (see my article: How to Choose a Psychotherapist).

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

    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 email me.

    How Your Perspective About Your Parents Changes Over Time

    Like most people, your perspective about your parents will probably change over the course of your lifetime.  Whether your parents are still alive or they have passed away, as you change, your perspective about your parents also changes (see my articles: You Continue to Have a Relationship With Your Parents Even After They Die).

    How Your Perspective About Your Parents Changes Over Time

    Whether you idealized your parents as a child or you resented them, as you get older and develop psychologically, you're able to see things about your parents that you weren't able to see at an earlier stage of your life.

    Depending upon your relationship with your parents and your life experience, this might mean that you no longer idealize your parents because you now see them as ordinary people or your resentment decreases because you now understand what they went through.

    As a child, there might have been aspects of your parents' lives that you didn't know or that you couldn't understand at the time.  But when you're older with more life experience, you will probably see your parents' in a different way.

    A new perspective about your parents allows for a change in your relationship with them.  Whether it brings you closer or causes you to feel more distant from them depends upon your particular circumstances.

    Fictional Clinical Vignette: How Your Perspective About Your Parents Changes Over Time
    The following fictional clinical vignette illustrates how your view of your parents can change:

    Alice began psychotherapy after she discovered an old family secret about her parents' relationship.

    She told her psychotherapist that, after her parents moved out of their house and into an assisted living facility, she worked on gradually clearing out the house so that it could eventually be sold.

    Alice explained that she had a lot of feelings about emptying out the house because it was the house where she grew up and the only home her parents ever had in their long marriage.  Although she was glad that her parents would now live in a facility that would make life easier for them, she also felt sad that the house would no longer be part of her life after it was sold.

    The process of clearing out the house took a lot longer than Alice anticipated because, as she began the clearing out process, she found many old pictures, videos and letters.  She had so many memories to contend with that the process was almost overwhelming at times.

    Alice said that there was one day when she was going through her parents' belongings and she came across an old picture of her father and a woman that Alice didn't recognize.  Her father had his arm around the woman and the woman was gazing lovingly into his eyes.

    The picture was at the bottom of an old chest in the attic that belonged to her father where he kept old photos of his family, and college awards and certificates.

    When Alice turned the picture over to see the back, she was shocked to read a note in a woman's handwriting, "My darling, Rich, you are the love of my life.  Love, Ann."

    Alice noticed that the photo was dated 1962, which would have been 12 years after her parents got married.  She felt like a ton of bricks had just landed on her and she had so many questions whirling around in her mind that she had to sit down and take a deep breath:  Who was this woman and what was her father doing with her?  Did he have an affair?  Why was he holding onto this picture?

    How Your Perspective About Your Parents Change Over Time

    She told her psychotherapist that she sat in the attic for a long time not knowing what to do.  She had always been closer to her father than her mother and she looked up to her father ever since she could remember.

    At first, she placed the picture back where she found it and closed her father's chest.  Then, she took the picture out again and took it with her when she left.

    She was planning to visit her parents later on that same afternoon, but she called them and made an excuse as to why she wasn't coming.

    Then, she sat on her living room couch, looked at the picture and wondered whether to ask her father about it or not.  If she did ask him about it, she wasn't sure how to broach the topic with him.

    She wondered: If she spoke with him, would he get angry?  Would he tell her that it was none of her business?  But then she realized that her father had never been this way with her before.

    When her husband came home, she showed him the picture and he was surprised too.  He knew that it would continue to bother Alice until she spoke with her father, so he encouraged her to wait until she could speak with her father alone to ask him about it.

    Tossing and turning, she barely slept that night.  The mystery about her father and the woman in the picture was eating away at her.  She ruminated about it all night long.

    She thought about how in 1962, she would have been 11 years old, and she tried to think about what was going on in her family during that time.  But she couldn't remember anything unusual.

    By the next morning, Alice said, she decided to visit her parents at the assisted living facility.  As it turned out, Alice's mother was in the beauty salon, so Alice had time alone with her father.  As she thought about how to broach the topic with her father, she suggested taking a walk around the grounds.

    Her father was in his usual cheerful mood and talked about he and Alice's mother were making friends at the assisted living facility.  Then, as they took seats at an outdoor table near the pool, he asked Alice how the clearing out process was going.

    All along, Alice felt her heart pounding and her throat constricting as if she were about to burst out crying.  Not knowing how to approach the topic with her father, she took the picture out of her pocket and wordlessly placed it in front of her father.

    Her father looked down at the photo for a moment and then he pushed it back in Alice's direction, "I knew there was something bothering you, Alice, the moment I saw you, but I didn't know what it was.  Is this what's bothering you?"

    Alice could barely speak, "Dad, who is this woman?"

    Her father looked away and stared out into the distance, "Alice, it was a long time ago. Let sleeping dogs lie.  Your mother and I worked this out years ago."

    Alice burst into tears, "Is that all you're going to say?  I've looked up to you all my life.  Do you know how shocking it was for me to find this picture?"

    Alice's father let out a long sigh and looked into Alice's eyes, "I'm sorry to disappoint you.  I'm sorry I haven't lived up to your image of me.  Your mother and I were going through a rough patch at that point and I had an affair with another woman, but I never stopped loving your mother or you.  I told your mother about the affair when Ann threatened to confront your mother about the it.  She wanted to me to leave your mother and I wouldn't do it--I wouldn't leave your mother and you, so she started threatening me.  Your mother and I eventually worked it out and decided to stay together.  The affair last a few months and there never was a another woman before or after Ann.  We never wanted you to know about our problems.  I'm sorry you found this picture.  I forgot that I even had it."

    Alice's thoughts were so confused that she didn't know how to respond, so they sat in silence for a while.  Then, Alice said that she needed to leave and she would see him and her mother soon.  Before she left, she hugged her father and kissed his cheek perfuctorily and then she rushed to her car.  A few days later, Alice made an appointment to see the psychotherapist.

    As she sat in her psychotherapy session, Alice told the psychotherapist that part of her felt like a child again who wanted to keep looking up to her father, but another part of her felt like an angry adult who felt betrayed (see my article: Are You Approaching Your Problems From an Adult Perspective or From an Inner Child Perspective?).

    She wasn't sure how she felt about her father now.  In a way, since she found the photo, she felt like he was different from the person that she had always known him to be.

    Alice met with her psychotherapist once a week to try to work out how she felt about her father.  There were times when she felt that if her parents worked out this problem all those years ago, she should forgive her father for making this mistake.  But then there were other times when she felt angry and hurt.

    She also saw her mother in a different way.  For most of her life, she thought of her father as being the more nurturing and loving parent and she saw her mother as the more practical, stoic parent.  Now she felt much more compassionate towards her mother, and she wondered how much of her mother's stoicism was related to her efforts to deal with the affair.

    Alice also felt confused about her childhood since she found the photo.  She had always thought that she had a happy childhood and that she was from a stable, loving home.  But now that image of the happy family was marred by the discovery of her father's affair.

    A week later, Alice's mother called her and suggested that Alice come visit.  On the drive there, Alice wondered if her father had mentioned anything to her mother and if this was the reason why her mother wanted to see her.

    When she arrived, Alice found her mother alone sitting out by the pool.  As soon as she saw Alice, her mother waved for her to come sit next to her.  As Alice approached the table, she had already made up her mind not to mention anything to her mother about the photo if her mother didn't bring it up.  She felt there was no need to upset her mother about this issue all these years later.

    When Alice sat down, her mother reached across the table and put her hand over Alice's hand, "Your father told me."

    They sat in silence for a few seconds, and then her mother squeezed Alice's hand, "I know you're upset about this, but try not to be too hard on your father.  I've made peace with that affair a long time ago.  I hope you can too.  Your father is a good man who made a mistake."

    After a long silence, Alice told her mother that she never would have thought that her father would ever do something like this.  In response, Alice's mother smiled, "I know, dear.  I felt the same way back then, but your father and I were going through a difficult time.  We tried to keep it from you  because you were too young to be burdened by this.  He made a mistake.  I think he found some consolation with Ann, but he would never leave you and me.  He loved us too much to ever leave."

    Alice and her mother talked for the rest of the afternoon.  Throughout their conversation, Alice went back and forth from feeling like an 11 year old girl to feeling like an adult.

    When she saw her parents together again, they looked happy and, as always, they were affectionate with each other.  She told herself that, even though the affair was news to her, her parents had more than 50 years to reconcile their relationship.

    Alice continued to attend her weekly psychotherapy sessions and talk about her disillusionment.  Over time, she realized that, until she found that photo, she still saw her father through a child's adoring eyes and her idealization of him wasn't realistic.  She grieved in therapy for the loss of that idealization.

    How Your Perspective About Your Parents Changes Over Time

    Over time, Alice was gradually able to accept on an emotional level that her father is human and he made a mistake at a time when her parents were going through a difficult time.  As she continued to work on this in therapy, she was able to see her parents from an adult perspective--kind and loving people who  had their flaws just like everyone else.

    As Alice accepted that her father made a mistake and he had made amends with her mother, she felt even closer to each of her parents.

    There are many ways that your perspective about your parents can change over the course of a lifetime.

    Whether you discover family secrets or you develop new insights into your parents, as you change and grow, your perspective of your parents can also change and grow.

    Getting Help in Therapy
    There are times when problems arise and you're unable to resolve them on your own.  Rather than struggling on your own, you could benefit from seeking help from a licensed mental health professional (see my article: The Benefits of Psychotherapy).

    A skilled psychotherapist can help you to work through your problems so that you can move on with your life (see my article: How to Choose a Psychotherapist).

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

    I work with individual adults and couples.

    One of my specialties is helping clients to overcome trauma.

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

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

    Thursday, March 15, 2018

    Discovering and Giving Voice to Previously Disowned Parts of Yourself

    One of the benefits of attending experiential psychotherapy is that you can discover and give voice to previously disowned parts of yourself (see my articles:  Ego States Work: Is There a Split Off Part of You Running Your Life?Reclaiming a Lost Part of Yourself and Understanding the Different Aspects of Yourself That Make You Who You Are).

    Discovering and Giving Voice to Previously Disowned Parts of Yourself

    Unlike other forms of psychotherapy, experiential psychotherapy provides an opportunity to delve beyond secondary emotions to understand primary emotions, which are often disowned aspects of yourself (see my article: Why Experiential Therapy is More Effective Than Talk Therapy Alone to Overcome Trauma).

    For example, underneath anger there are often other disowned emotions, like sadness, shame, fear of abandonment and so on (see my article: Anger as a Secondary Emotion).

    Fictional Clinical Vignette: Discovering and Giving Voice to Previously Disowned Parts of Yourself
    The following fictional clinical vignette illustrates how experiential psychotherapy provides an opportunity to discover and express a disowned aspects of a client in therapy:

    When she began psychotherapy, Tania complained that her husband, who refused to come to couples therapy, was usually too preoccupied with his work to pay attention to her when they were at home together.

    Tania told her psychotherapist that, although she complained to her husband that she felt neglected by him, she saw no change in his behavior.  After telling him several times that she didn't like when he came home and worked without consideration for her, she would lose her temper and yell at him.  Then, they would argue and end up being more estranged from each other than ever.

    Her husband usually responded to her anger by shutting down and "stonewalling" her (see my article: Relationships: Are You a Stonewaller?).

    This would lead to an escalation of Tania's anger where she tried in vain to get her husband to understand how angry it made her to feel ignored by him.

    She explained to her psychotherapist that on the rare occasions when her husband responded to her anger, he told her that she was so unpleasant when she got angry that he didn't want to be around her, which only increased Tania's anger.  So, they were caught in this negative cycle, which was only getting worse.

    Tania said that their relationship wasn't always like this.  In the early years of their courtship and marriage, her husband was considerate and attentive.  He wanted to spend time with her and he didn't put anything else ahead of their time together.

    But once he started his own business a few years ago, all of that changed.  He worked day and night and even on weekends.  He said he was doing it for them, but she continued to feel neglected and unloved by her husband.

    To make matters worse, Tania grew up in a home where she was emotionally neglected by parents who were preoccupied by their work.  Most of the time, her parents passed her off to her nanny and spent little time with her leaving Tania feeling unlovable (see my article: What is Childhood Emotional Neglect? and Overcoming the Emotional Pain of Feeling Unlovable).

    She told her psychotherapist that one of the reasons why she fell in love with the man who eventually became her husband was that he was so attentive and nurturing, which made her feel that she was special to him--a feeling she had not experienced before meeting him.

    Now, she felt taken for granted.  She felt that her husband would prefer to work and spend time on the phone with his customers rather than spend time with her.  And, no matter how much she complained to him about it, he wouldn't change.  In fact, she felt that things were getting worse between them.

    Tania's psychotherapist sensed that there were underlying issues beneath Tania's anger.  She sensed that anger was a secondary emotion and that underneath the anger, Tania had primary emotions that she wasn't dealing with.

    Once Tania and her psychotherapist established a good therapeutic alliance and Tania learned the necessary coping skills to do the work, her psychotherapist recommended that they do experiential therapy so they could explore her emotions.

    Using a technique from clinical hypnosis called the Affect Bridge, Tania's psychotherapist asked Tania to remember a recent incident where she felt angry with her husband because she felt he was neglecting her.

    Tania remembered an incident that occurred a few days before where she and her husband were at home at night, and she watched him go into his home office immediately after they ate dinner.

    As she felt her blood boil, she tried not to confront her husband because they weren't getting along, but at a certain point she couldn't hold back anymore and she rushed into his office to complain to him.  Rather than respond, her husband paid no attention to her and kept working, which left her feeling even more angry.

    Her psychotherapist asked Tania to sense where in her body she felt her anger now as she spoke about that evening.  Tania responded that she felt her chest tighten, her throat was constricted and she felt her shoulders were tight.

    Then, her psychotherapist asked Tania to sense underneath her anger to see what else she might be feeling.  At first, Tania had a hard time getting beyond her anger, but she stuck with it and she eventually sensed her sadness, hurt and shame--the same way she felt when she was a child and her parents neglected her.

    As Tania and her therapist continued to talk about this and Tania allowed herself to feel her underlying emotions, Tania was open to seeing the dynamics between her and her husband from her husband's point of view.  She realized that the more she angrily demanded that he pay attention to her, the more distant he became.

    Tania's psychotherapist validated Tania's need to be loved and paid attention to by her husband.  She also began exploring with Tania how Tania might approach her husband to explain what she was feeling.

    At first, Tania was hesitant to make herself so emotionally vulnerable.  She feared that if her husband ignored her after she opened up to him emotionally that she would be devastated, so Tania and her psychotherapist continued to explore her feelings and how she could change how she communicated with him.

    Tania waited until she and her husband had a quiet evening when he wasn't working.  As she discussed with her therapist, rather than berate her husband, she decided to talk to him about how much she missed him.

    To her surprise, her husband responded affectionately to her and told her that he also missed how close they used to be with each other.  He also apologized for not spending more time with her, and told her that he would make more of an effort not to bring work home with him so they could have more time together.

    In addition, to Tania's amazement, her husband agreed to go to couples therapy to work on their marriage.

    After they were in couples therapy for a while, her husband told her in session that during the times when she yelled at him, he felt so overwhelmed that he shut down emotionally.  Tania learned that when it appeared to her that her husband didn't care, he was actually feeling emotionally feeling "frozen" and "paralyzed" inside, especially since their arguments triggered earlier childhood issues for him (see my article: Coping With Trauma: Becoming Aware of Emotional Triggers).

    When her husband learned that Tania's early childhood neglect was also getting triggered when she felt neglected by him, he was compassionate and understanding.  He told her that he wanted to work out their issues.

    Tania continued to work with her individual psychotherapist to work on whatever came up for her in her marriage and in her couples therapy sessions.  Whenever Tania was tempted to disavow her deeper emotional feelings, her psychotherapist helped to express them and feel less vulnerable.

    Gradually, as the dynamic between Tania and her husband improved and Tania felt less overwhelmed, Tania and her psychotherapist used EMDR therapy to work on the root of her problems--the early childhood emotional neglect (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

    As Tania progressed in her EMDR therapy, she and her husband got along better because she got less triggered when he had to work at home.

    Also, since Tania and her husband were able to talk more openly with each other and express their emotions without fear, Tania was more understanding when her husband had to work and she didn't feel neglected by him because they made it a point to spend quality time together.  She was learning to separate her traumatic past from the issues in her marriage (see my article: Working Through Emotional Trauma in Psychotherapy: Separating "Then" From "Now").

    It's not unusual for people to have unconscious aspects of themselves that they have disavowed without being aware of it.

    Experiential therapy, which allows clients in therapy to get to the underlying issues, provides an opportunity to discover and express those disavowed parts so that clients can feel more emotionally integrated.

    Getting Help in Therapy
    It's very difficult to discover disavowed aspects of yourself on your own (see my article: The Benefits of Psychotherapy).

    Working with an experiential psychotherapist, you can work gradually and safely to understand and express the parts of yourself that are at the root of your problems (see my article: How to Choose a Psychotherapist).

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

    I work with individual adults and couples, and I specialize in working with trauma.  I tend to work in an experiential way with integrative psychotherapy.

    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.

    Wednesday, March 14, 2018

    Before and After Psychological Trauma

    Many clients who start psychotherapy to deal with unresolved psychological trauma talk about life before and after their trauma.  Psychological trauma often changes a person's self perception as well as his or her perception of the world.  Whereas the person might have been self confident and the world around him or her made sense before the trauma, after experiencing trauma, self doubt and a feeling that the world is a precarious place can set in (see my article: Trauma Often Creates Negative Expectations For the Future).

    Before and After Psychological Trauma
    Assuming that a client was functioning at a high level before the trauma, one of the goals of trauma therapy is to help a client to get back to his or her former level of functioning.  If the client has other underlying trauma, like unresolved childhood trauma (also called developmental trauma), resolving these underlying issues is usually a goal of therapy (see my article: Working on Developmental and Shock Trauma in Therapy).

    Fictional Clinical Vignette
    The following fictional clinical vignette demonstrates this before and after effect of psychological trauma and how trauma-informed psychotherapy can help:

    Cassie started psychotherapy due to her recurring nightmares about her friend's fatal accident, which occurred more than a year ago.

    Cassie explained to her psychotherapist that her friend, Nina, drowned while they were on vacation in New England on a beach that had no lifeguards.  They had been to this beach many times before.  They especially enjoyed that there were relatively few people on the beach early summer.

    She told her therapist that Nina, who was a stronger swimmer, went for a swim while Cassie napped on their blanket.  Suddenly, Cassie was woken up when she heard Nina calling for help before she disappeared underwater.  Cassie said she ran into the water to try to save her friend but, she couldn't find her.

    In a panic when she couldn't find Nina, Cassie ran back to the blanket to call the police on her cellphone.  Minutes later, help arrived, but they were unable to find Cassie.  The rescue team searched into the night and the next morning, but there was no sign of Nina.

    A day later, the police came to the bed and breakfast where Cassie was staying and informed her that Nina's body washed up on the shore.  They told her that Nina was probably overcome by a strong undertow.

    Cassie told her psychotherapist that she was devastated and, since that day, she had nightmares almost every night.  She said these recurring dreams were mostly the same:  She was in the water frantically trying to find Nina, calling her name, diving under the water to try to find her, yelling for help, but no one came (see my article: Understanding Shock Trauma).

    She said she would wake up panting and in a cold sweat, and the effect of the nightmares tended to stay with her for the rest of the day.

    Cassie said she kept replaying in her mind the minutes after Nina told her that she was going for a swim.  She remembered having the thought that Nina shouldn't swim by herself, especially because the water was rough, but she didn't say anything to Nina about this.  She assumed that Nina would be alright because she was such a good swimmer.

    Now, all she could do is berate herself for not saying something to Nina or going with her for a swim so Nina wouldn't be alone, "Why didn't I tell her not to go in the water. I should have, at least, gone with her.  Why didn't I do it?"

    Cassie said that, before her friend's fatal drowning, she was feeling optimistic about her life, looking forward to starting a new career, happy to be in a new relationship, and making plans for the future.  But, after Nina died, her whole world changed.

    Even though she started her new career and stayed in her relationship, Cassie felt like she was just going through the motions.  On the surface, she tried to appear "normal" (her word), but beyond the facade she was trying to maintain, she felt confused, sad, and guilty.

    Cassie was aware that her perception of herself and the world around her had changed dramatically since her friend's death, and she was tired of pretending that she was alright.  And, most nights, she was afraid to go to sleep because she dreaded her recurring nightmares.

    When her psychotherapist asked Cassie about her family background, she described a loving family with no major traumatic incidents when she was growing up.  She felt emotionally supported by her family and her boyfriend, but she felt no one really understood what she was going through.

    Based on Cassie's information about her family background and her description of the traumatic incident when Nina died, her psychotherapist concluded that there was no developmental trauma, so their work would be focus on helping Cassie to overcome the shock trauma related to the Nina's drowning.

    Cassie's psychotherapist provided her with psychoeducation about trauma and explained that what she was experiencing were common reactions to a traumatic incident.  She also explained that trauma therapy, EMDR therapy in particular, could help Cassie to overcome her traumatic symptoms (see my articles: How EMDR Therapy Works: EMDR and the Brain and EMDR Therapy: When Talk Therapy Isn't Enough).

    After they completed the preparation phase of EMDR therapy, Cassie and her psychotherapist worked on the traumatic memory of her friend's death, how helpless Cassie felt, and the guilt that remained with her.

    Before and After Psychological Trauma

    During the course of their EMDR work, Cassie revealed that, although a part of her wanted to feel better, another part of her felt she didn't deserve to feel better.  She was surprised at how strong the part was that felt she was undeserving.

    Cassie's psychotherapist normalized this part that felt undeserving by informing Cassie that it wasn't unusual to feel this way under the circumstances.  She also explained to Cassie that they needed to do Ego States therapy (also known as Parts Work) to work with this particular part of her or it would create an obstacle to their work.

    Cassie and her psychotherapist did Ego States work for the next couple of months to help soften this punitive part that felt Cassie was undeserving of feeling better.  After that, they were able to resume EMDR therapy and it went more smoothly.

    The trauma therapy was neither quick nor easy, but her psychotherapist knew that experiential work, like EMDR therapy and Ego States work, is usually more effective and works faster than regular talk therapy (see my article: Why Experiential Therapy is More Effective to Overcome Trauma).

    By the time Cassie completed therapy, she still felt sad about her friend's death, but she no longer felt responsible and guilty.  She regained her former self confidence and positive outlook on life.  She also felt worthy of making plans for the future and enjoying her life.  She also stopped having the recurring nightmares.

    Most clients, who experience psychological trauma, report that they notice a difference in how they feel about themselves and the world around them after a traumatic experience.

    It is as if there were a line that divides their experiences before the trauma vs. after the trauma.

    As is often the case in trauma work, there can be a certain amount of ambivalence about getting better when an aspect of a client feels that s/he doesn't deserve to feel better.  This can present an obstacle to doing trauma work if it is not dealt with.

    Fortunately, Ego States work, which involves the therapist and client dealing with this particular aspect of the client, helps to overcome this ambivalence so that regular trauma processing in therapy can resume and resolve the trauma.

    Getting Help in Therapy
    Psychological trauma doesn't usually resolve on its own, and ignoring it or hoping it will get better on its own usually makes the symptoms get worse over time.

    If you're struggling with unresolved trauma, you could benefit from getting help in trauma therapy with an experienced trauma therapist who uses experiential therapy, like EMDR therapy (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs and How to Choose a Psychotherapist).

    After you have resolved your traumatic experiences in psychotherapy, you can live a more meaningful and fulfilling life.

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

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