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Friday, August 31, 2012

A Strengths-Based Perspective in Psychotherapy

In recent years, many psychotherapists have become increasingly open to adopting a strengths-based perspective in psychotherapy.  This strengths-based perspective looks at not only clients' problems but also emphasizes clients' strengths and positive qualities.  Social work has had an influence on this trend because it has a long tradition of recognizing clients' positive  aspects.  Over the years, as psychotherapists with social work background have come to dominate the psychotherapy field in NYC, psychotherapy has begun to change to reflect this positive perspective.



I believe there are many advantages to having a strengths-based perspective in psychotherapy, not the least of which is that psychotherapists can help clients to develop increased self confidence as clients  learn to appreciate the strengths they already have.  As it is, most clients come to psychotherapy feeling badly about themselves.  Often, for a variety of reasons, they can't see their  many positive qualities   They dwell mostly on the negative.

Therapists who have a strengths-based perspective can help clients to appreciate what's right about them and not just what's wrong.

Psychotherapy's early history was one of pathologizing clients.  In recent years,  mind-body oriented psychotherapy, which includes EMDR, clinical hypnosis, and Somatic Experiencing, has emphasized helping clients to develop emotional resources as compared to only looking for pathology.  One of the best ways to help clients build emotional resources is to help them enhance the strengths they already have and might not even realize they have.  

Recognizing Strengths and Accomplishments
For instance, a client, who begins psychotherapy due to a history of trauma, might have significant accomplishments, despite longstanding trauma.  S/he might have graduated college, raised a family, and maintained gainful employment.  Many clients don't appreciate their own resilience and ability to persevere despite adverse circumstances.  They often minimize these strengths by telling themselves and others, "It wasn't such a big deal.  I just did what I had to do."  But a psychotherapist with a strengths-based perspective has the objectivity and the mindset to help a client with these strengths to appreciate and build upon these strengths.

A strengths-based perspective in psychotherapy is not a "feel good"or "Pollyanna" approach.  Therapists still need to help clients to overcome their problems and to look at how they might even be contributing to their problems.  A strengths-based perspective isn't a quick fix.  Rather, it's an even-handed, holistic approach that, I believe, in the long run, is much more beneficial to psychotherapy clients.

If you have been considering attending psychotherapy, but you've been hesitant because you fear being pathologized in therapy, I recommend that you find a psychotherapist who has a strengths-based perspective.  Before you embark on the self exploration involved in psychotherapy, I recommend that you ask questions.  Most experienced therapists expect potential clients to ask them about their psychotherapy approach in an initial consultation.  Many therapists also have websites that provide information about their particular philosophy to psychotherapy.  You have a right to be an informed consumer and to trust your instincts.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.  I have helped many clients overcome obstacles so that they could lead 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.

Photo Credit: Photo Pin






Thursday, August 30, 2012

EMDR Self Help Book: Getting Past Your Past

Getting Past Your Past - by Francine Shapiro, Ph.D.
Francine Shapiro, Ph.D., the psychologist who developed EMDR (Eye Movement Desensitization and Reprocessing), has a new book called Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy.  This is an excellent book for people who want to develop better coping skills.

EMDR for Trauma and PTSD
As you might already know, Francine Shapiro developed EMDR in the mid-1980s for people suffering with PTSD (posttraumatic stress disorder) and trauma.  Since that time, EMDR has helped thousands of people all over the world to overcome trauma, including war veterans, people who have been raped or sexually abused, people who have been physically abused, and many other people who have been unable to overcome trauma in traditional talk therapy.

EMDR as Effective Treatment for Trauma
As a psychotherapist who uses EMDR with clients who have experienced trauma, I know how effective EMDR can be.  I especially like that Dr. Shapiro has written her new book, where she teaches coping skills, in an accessible way for the lay public.

When clients come to see me in my NYC psychotherapy practice, I teach clients many of these same EMDR coping strategies as part of the resourcing (i.e., developing coping skills) phase of EMDR treatment, so  I know how effective they are.

Learning EMDR Self Help Techniques
Now, with Dr. Shapiro's new self help book, people can learn to use some of these EMDR techniques on their own.  Many of these EMDR techniques are also effective even if you're anxious or under a lot of stress and not suffering with trauma.  While using these self help techniques won't resolve trauma, they can help you to calm down and get through the day, which can be such a relief.

To find out more about EMDR, go to:  The EMDR Professional Organization.

You can also check out my article called:  What is EMDR?


I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I have advanced training in EMDR and I have used EMDR successfully to help many clients overcome traumatic incidents 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: josephineolivia@aol.com

Also, see my article:  EMDR: When Talk Therapy is not Enough




Monday, August 27, 2012

Taking Control of Your Life

One of the most challenging problems to overcome is to feel that you have little or no control over your life.  Sometimes, there are circumstances (or aspects of circumstances) over which you  have little or no control. Being very sick, dealing with the death of a loved one or your own impending death are examples where there's little or no control.  But, often, feeling powerless is a state of mind that is learned over time.  It's an attitude that can be overcome so that you can take back control and lead a more fulfilling life.

The following is a fictionalized vignette:

Mary:
Mary grew up in a home where her father dominated the family.  As a former Marine captain, her father was used to giving orders and having them obeyed.  Mary's mother was very passive and she went along with whatever her husband wanted without questioning it. Mary never grew up with a sense of what she wanted or even that she was entitled to want anything.

Mary chose a husband who was very much like her father.  He controlled every aspect of their lives, including their money and their social life.

Mary's husband was a successful business man, so Mary never felt worried about money.  Her husband didn't want her to work, so she stayed home, where there was little for her to do.  They had a full time housekeeper, so Mary often spent her days reading or watching TV.

They had no children because Mary's husband had little patience for children.  Whenever Mary saw a mother with her baby, she felt sad.  But she didn't know why she was feeling sad, and she quickly brushed these feelings aside.

Mary loved her husband, and she knew that he loved her.  But, every so often, she was aware that she felt empty inside.  Whenever she experienced this feeling coming over her, she felt ashamed and confused.  She couldn't understand why she felt this way since her husband provided her with everything she needed.  Sometimes, she felt that she was being selfish and ungrateful when these feelings came over her.

Then, one day, after 25 years of marriage, Mary's husband had a sudden heart attack in the office and he was rushed to the hospital.  Mary rushed to the hospital, but her husband was already dead when she got there.  Mary was stunned and she went through the next few months in a kind of stupor.

The family lawyer had power of attorney made most of the important decisions.  He assured Mary that her husband left her well provided for, and she didn't need to worry about money.  But Mary felt in a constant state of panic, feeling adrift and not knowing what to do with her life.  She spent her days wandering from one room to another in her house feeling sad and overwhelmed.

After several months, Mary's friend recommended that she get professional help to overcome her feelings of powerlessness.  This was a tough decision for Mary to make.  Normally, she would ask her husband what she should do, especially before taking such a big step.  But he wasn't around to ask any more, and Mary wasn't sure what to do.  She was pretty sure that her husband wouldn't approve of her going to therapy.  He would just tell her to "buck up" and that she had no reason to feel unhappy.

Not knowing what to do, Mary went along with her friend's advice and made a consultation with a psychotherapist.  She thought it couldn't hurt to go for one visit.  But a few days before the consultation, she almost cancelled her appointment.  She picked up the phone several times to dial, but she hung up again.  Finally, on the day of the appointment, after debating it back and forth in her head, she went.

This began Mary's road to taking back control of her life, which wasn't easy.  Over time, she realized that she had been feeling emotionally numb for most of her life, and she didn't even know it.  Making even small decisions was fraught with anxiety for Mary.  Before she could tackle any major decisions, she had to first become aware of her own feelings.

Mary's therapist, who practiced mind-body oriented psychotherapy helped Mary to first become aware of her own body because Mary's emotional numbness also included a physical numbness that Mary had never been aware of before.  Over time, Mary began to be able to identify her emotions based on what she was feeling in her body.  She started feeling alive again in a way she never felt before. At times, experiencing her emotions felt somewhat overwhelming, but Mary's therapist taught her in therapy how to bring herself back into a state of emotional equilibrium early on in their work together.

Mary began to use the emotions she felt in her body to determine what she wanted and to start to make decisions for herself.  It wasn't easy, and she would sometimes feel she wasn't entitled to even want anything for herself.  But she was able to persevere because she liked having a sense of aliveness again, no matter what the feelings were.  To feel something was so much better than to feel nothing at all.

Over time, step by step, Mary overcame the learned helplessness that had been a part of most of her life.  Rather than dreading making decisions, she began to look forward to them as ways to take back control of her life.  She felt sad for all the years she was emotionally adrift in her life.  But she mourned that loss, along with mourning for her husband, and began to look forward.  She learned that there were some things she couldn't control, but there were many other things in her life that she could control.  As she came emotionally alive again, she felt a renewed sense of self and new self confidence.

What Causes You to Feel You Have No Control Over Your Life?
Sometimes, people feel they have no control over their lives because they've been raised under similar circumstances to Mary, and it becomes a way of life for them to have other people tell them what to do.  Other times, a string of unfortunate circumstances creates self doubt and people feel like they're like a leaf in the wind being blown around.

Taking Control of Your Life Often Begins with One Step
Taking Control of Your Life
Whatever the circumstances, you can learn to take control of your life.  Taking back control of your life often begins with taking one step.  That first step is often a decision that you want to feel a sense of control and to reclaim your life.

Getting Help
If you've tried to do this on your own and haven't succeeded, you could benefit from seeing a licensed mental health professional who has helped other clients to gain a sense of control of their lives.   A skilled therapist can help you to feel a sense of agency in your life and, with it, a new sense of aliveness and well being.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with adult individuals and couples.  I have helped many clients to take back control of their lives and feel a new sense of aliveness and well being.

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.

For a related topic, you can read my article:  How Do We Balance Our Owns Needs With Being Responsive to Our Loved Ones?


Photo Credit:  Photo Pin






Sunday, August 26, 2012

Overcoming Lack of Intimacy - Movie: "Hope Springs"


How refreshing it was to see in the movie, "Hope Springs," two older people struggling with the very real and all too common problem in long-term marriages, lack of intimacy.  

These days most movies are geared for tweens and adolescents, so it was great, for a change, to see Meryl Streep (as Kay) and Tommy Lee Jones (as Arnold) portraying a realistic, older married couple in a stagnant marriage that lacks emotional and sexual intimacy.  

Steve Carrell (as Dr. Bernie Feld) plays a credible marriage counselor who provides intensive marriage counseling to address the couple's intimacy problems.

Lack of emotional and sexual intimacy is a common problem in long-term relationships.  Understandably, many couples feel too embarrassed to talk to each other, let alone with anyone else, about their lack of intimacy.

Overcoming Lack of Intimacy in Your Relationship

Often, when couples do come to marriage counseling to overcome intimacy problems, similar to the movie, "Hope Springs," one person in the couple wants to rekindle the relationship while the other would rather sweep their problems under the rug.

Usually, for the more reluctant person, the underlying problem is fear.  Fear of rejection, fear of allowing oneself to be vulnerable, fear of appearing ridiculous, and fear of being accused of being "needy" are among the many reasons why couples often avoid talking to each other about the lack of intimacy in their relationship.  Then, of course, there are all the stereotypes about older people not being sexual or attractive.  Too often older couples buy into these stereotypes about aging, which are perpetuated in the media and all around us.

When there is a lack of intimacy over a period of time, a relationship often becomes dull and unsatisfying.  It can lead to loneliness, resentment, depression, and anxiety as the problem festers, often for years, without either person bringing it up.

Lack of intimacy can erode your sense of self if you think your spouse no longer finds you attractive.  This is a common misperception, but it persists because neither person talks about it.  There is the assumption that if you and your spouse aren't intimate any more, it must be because you're not attractive to him or her.

Lack of intimacy can also lead to infidelity where a new person can appear to be more attractive and exciting.  The allure of an affair can also provide the illusion that the person who feels trapped in a stagnant marriage will feel more exciting and desirable with the new person.

Unfortunately, lack of intimacy, can lead to divorce for marriages that might otherwise have been salvaged in couples counseling.  Even when lack of intimacy doesn't lead to divorce, couples can waste precious years in a stultifying dynamic that could have been overcome if they were willing to seek professional help.

If you're in a marriage where lack of intimacy is eroding your relationship and your sense of self, you owe it to yourself and your spouse to seek professional help from a licensed mental health professional who works with couples.

I recommend "Hope Springs" as an entertaining and thought-provoking movie.

I welcome your thoughts about this movie as well as the topic of lack of intimacy in relationships.  Feel free to comment below.

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

I work with individual adults and couples.

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

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

You can also check out my article:








Friday, August 24, 2012

The Creation of a "Holding Environment" in Psychotherapy

The concept of the therapeutic "holding environment" was developed in the mid-20th Century by the British psychoanalyst and pediatrician, Donald Winnicott, who was a member of the Independent Group of the British Object Relations school of thought in England. Winnicott is one of my favorite psychoanalysts and theorists because of his views about the therapeutic "holding environment."

Donald Winnicott and the "Holding Environment"
Winnicott came to psychoanalysis from a pediatric background, and his ideas were influenced by what he saw as the nurturing emotional environment that a loving mother provides to her child.  From a Winnicottian perspective, a loving mother holds her baby, both physically and emotionally, and she is attuned and attentive to the baby's needs.  Observing this, Winnicott extrapolated his ideas of how crucial it is that a psychotherapist develop a symbolic "holding environment" for psychotherapy clients.

Donald Winnicott, psychoanalyst and pediatrician, wrote books for children and adults
Most psychotherapists today would agree that the therapeutic "holding environment" is a crucial part of psychotherapy.  The "holding environment" in psychotherapy is often subtle.  To create a therapeutic "holding environment," the therapist must be compassionate and empathic to the client.  The "holding environment" starts with the therapist maintaining the therapeutic "frame" in the treatment which, in the most basic sense, means that the therapist is a reliable and consistent individual.

Playing and Reality by Donald Winnicott
By maintaining the treatment "frame," the therapist is consistently there.  She is clear about what is expected, and she maintains appropriate boundaries with the client.  Although these are basic things that most clients come to expect from a psychotherapist, for many clients who come from chaotic, dysfunctional families where parents might have been abusive and erratic, just this alone can be so healing.  For the client whose family was chaotic and dysfunctional, knowing that a skilled psychotherapist is reliable, consistent and trustworthy provides a safe place for the client to come to on a weekly basis.

A Therapist's Empathic Attunement to Clients:
Beyond maintaining the treatment "frame," the creation of a therapeutic "holding environment" also includes the therapist's empathic attunement to the client.   When a therapist is compassionate and empathic, on the most basic level, the client feels cared about by the therapist in a way that maintains appropriate boundaries between client and therapist.  This is crucial for any successful therapy.

Empathic Attunement
For clients who come from families where they were abused, either physically or emotionally, it might take a while for them to be able to trust that their therapist cares about them.  After all, when you grow up in a family where you feel that your own parents don't care about you, it's hard to believe and trust that anyone else would care.  It often takes time for these clients to develop this trust in their therapists.  Most of the time, there's no substitute for time in these cases for the therapist and client to develop a therapeutic rapport.  Without a therapeutic rapport, it's hard to accomplish anything worthwhile in therapy.

For some clients, who were abused as children, being with a compassionate and empathic therapist allows them to feel safe and supported in the treatment.  They will feel, often for the first time, that someone is there who puts their needs first.  This can be a very healing experience.  This is also generally true for clients who grew up with narcissistic parents who neglected them emotionally, who were not willing or able to meet their children's emotional needs.

For clients who might not be sure how to choose a psychotherapist, I usually recommend that, beyond choosing any particular treatment modality, that clients focus on whether they feel a therapist provides an emotionally supportive environment.  This might be difficult to assess in the initial consultation when most clients feel anxious.  But, over time, most clients can discern if the therapist is emotionally attuned to them and whether it's a good therapeutic match.  I urge clients to trust their instincts about this and to continue their search for a therapist until they feel it's the right match.  

You can also read my article: "How to Choose a Therapist". 

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I also provide psychodynamic 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.

photo credit: scatterkeir via photopin cc

photo credit: AJC1 via photopin cc

photo credit: AlicePopkorn via photopin cc




Wednesday, August 22, 2012

Mind-Body Psychotherapy: Healing Trauma with New Symbolic Memories

Trauma can create emotional scars that can last a life time.  For many people, who suffering with trauma that occurred years ago, the emotional effects can feel as strong now as they did when the trauma originally occurred. 

Mind-Body Psychotherapy: Healing Trauma with New Symbolic Memories

Often, talk therapy is of limited help to overcome trauma.  You can gain an intellectual understanding about the trauma, but talk therapy doesn't always heal the trauma.  This often causes psychotherapy clients to feel that there's something wrong with them because they're still feeling traumatized even after they've completed talk therapy. Some forms of mind-body oriented psychotherapy can heal trauma by helping the client to create a new symbolic memory.

Clinical hypnosis, Somatic Experiencing, and Psychomotor therapy are among the forms of mind-body psychotherapy that help clients to overcome trauma through the creation of new symbolic memories.   Each of these treatment modalities approaches the creation of new symbolic memories in a different way.

At first glance, the idea of creating a new symbolic memory might sound strange, and you might wonder how someone would go about doing this.  But, in reality, it's not strange at all.  But, first, before I explain what new symbolic memories are, I want to stress that creating a new symbolic memory is in no way negating the original memory.

In other words, the purpose of creating a new symbolic memory is not a way of saying that the original memory never occurred.

Mind-Body Psychotherapy: Healing Trauma with New Symbolic Memories

When we work on creating a new symbolic memory, the purpose is to providing emotional healing.  The client and the therapist are aware at all times of what originally occurred in the trauma.  The new symbolic memory, which is created in collaboration between the therapist and the client, is a new embodied experience, which often includes imagining helpful allies (either real or imagined) and other helpful aspects that were not available in the original traumatic memory.

The following composite vignette, which is a combination of many different cases with all identifying information changed to protect confidentiality, illustrates how trauma can be healed through the creation of a new symbolic memory:

John:
John came to therapy because he never mourned the loss of his father, who died when John was 16 years old.  He loved his father very much and missed him, but he never allowed himself to grieve for his father, who died very unexpectedly.

Healing Trauma with New Symbolic Memories: John Never Grieved For His Father

John remembers coming home one afternoon, after hanging out with his friends, and finding his mother crying in the living room.  His mother told him that his father had a massive heart attack at work and he died immediately.  John was shocked.  He felt the tears welling up inside him, but before he could shed a tear, his mother said to him, "Now, John, you can't cry.  You're the man of the house now, and you need to be strong."

From that moment on, John felt the emotional burden that was placed on him, and he stopped himself from crying as he braced himself to be "the man" in his family.  He didn't want to disappoint his mother, and he felt he had to be "strong" for his younger brothers and sisters.

Years later, as an adult, John realized that his mother, although well meaning, had placed an unreasonable burden on him.  After all, he was only a boy at the time.  He also realized that not mourning had kept him in a kind of emotional limbo with regard to the loss of his father.  In the past, he attended talk therapy, hoping to finally release the feelings he had been holding onto for more than 20 years.  But, although he gained intellectual insight into what happened, he still couldn't allow himself to cry and mourn.

After taking a personal history and working on resource development (i.e., coping skills), John and I worked on his memory of the day his father died.  Using a combination of Somatic Experiencing and clinical hypnosis, we went back to the original memory.

  Memories

Throughout the process, John was in control at all times.  He said he felt alert and in a very relaxed state.  He was aware of what he felt in the  original memory as well as everything that was going on in the therapy room in the here-and-now.  This is called having a dual awareness (an awareness of the memory as well as the here-and-now), and this is essential for this type of work.

When we got to the part when John's mother told him that he shouldn't cry because he had to be "the man" in the family, I asked John who he would have liked to have with him at the time to help him.  I asked him to choose someone, either real or imagined, who could have helped him at that point to feel his feelings and to advocate for him with his mother.

John thought for a moment, and then he chose his Uncle Paul, his mother's brother.  He said his Uncle Paul was a very kind man and he had always felt close to his mother's brother.  He also knew that his mother admired her brother very much and he had a big influence on her.  So, when we went back to the part when his mother told John not to cry, John imagined what it would feel like to have his Uncle Paul standing next to him with his arm around him.

To make this experience as vivid as possible, we slowed down the process and I asked Paul to sense what it feels like to have Uncle Paul's arm around him on a physical and emotional level.  We took a few minutes to develop and amplify these physical and emotional feelings so Paul could experience fully the support he was getting from his uncle.

While John was sensing into this experience, he and I worked closely together to ensure that he felt safe and secure at all times.  He agreed to let me know if he became uncomfortable in any way.  I also observed his body language as well as his breathing, facial expression, changes in color, and other signs to ensure that he was comfortable in the experience.  I noticed that as he settled into the experience of his uncle being there for him, he looked more relaxed and he was breathing more easily.

When the therapist observes the client in this way, it's called "micro tracking" and this is an important part of the work.  The therapist must be attuned to what's happening with the client throughout the process.

Once John felt fully in the experience of being emotionally supported by his Uncle Paul, I asked him what he would like his uncle to say to his mother so that John would be allowed to feel his feelings.  John thought about this for a moment, and then said, "I'd like him to talk to her and tell her to let me cry--that it's normal, whether it's a teenage boy or anyone else, to cry when you lose your father.  He's he only one that my mother would listen to."

So, we went with that, and John imagined his Uncle Paul gently telling his mother that it's okay for John to cry.  John imagined Uncle Paul being gentle but firm about it.  Since John's mother admired and respected her brother, it was believable that she would listen to him.  John took a moment to feel this and he was able to tell me that he felt a great burden lifted from his shoulders and a tightness that was released from his chest.

Then, he told me that, in his mind's eye, he saw his mother back off and allow John to feel his feelings.  He felt like he was on the verge of crying, but something was holding him back.  I sensed that John might be concerned that his mother also needed someone to comfort her, but rather than suggest this to John, I asked him to sense into his body and ask himself what he thought might be holding him back.

I could tell, from watching him, that John was thinking about it rather than sensing into his body to find the answer.  So, I guided him to ask his body what was needed.  Now, this might sound strange, but it's no different than asking someone to use their intuition or to tap into their unconscious to sense what's needed.  The point is for the client to find the answer inside rather than just giving an answer that seems logical.  Certainly, logic has its place, but logic alone will often only get you so far, especially when dealing with trauma.

After a few minutes, John said he didn't feel he could allow himself to cry unless his mother was also being supported by someone.  So, I asked him who could be there for his mother.  He considered this for a few moments, and then he said his mother would be most comforted by her older sister.  So, we brought his maternal aunt into the scene, and he imagined his aunt sitting with his mother and comforting her.

Once John felt that his mother was being taken care of as well, and John had his uncle to comfort him, he allowed himself to cry in the session for the loss of his father.  This was the first time ever that John was able to cry.  All the emotion that had blocked inside of him came pouring out.  But rather than feeling overwhelmed, as he had always imagined he would feel if he allowed himself to cry, John said he felt a great sense of relief.  He felt secure and supported in the treatment room with me and he felt supported in the new symbolic memory by his Uncle Paul.

Afterwards, when we were talking about the experience, John said he could still feel his uncle's love and emotional support.  He knew that this new symbolic memory was not the original memory and that we were not saying we were in any way changing the original memory.  But he had a new, healing experience of that time.

In days and weeks that followed, we checked back in with the original memory.  I wanted to make sure that the work we did was more than just a one-time "feel good" experience and that John had actually internalized the new symbolic memory on an emotional as well as a visceral level.

Healing Trauma with New Symbolic Memories: John Internalized the New Symbolic Memory

John told me that the original memory no longer felt traumatic to him.  He felt loved and supported, as if he had actually gotten what he needed at the time.  He was also relieved to mourn his father.  From there, we worked on internalizing his father in other ways, including remembering all the good times he had with his father.  Prior to healing the trauma, John was too stuck emotionally to feel these positive experiences.

Getting Help in Therapy
As always, I want to emphasize that clinical hypnosis and Somatic Experiencing are not "magic bullets."  Often, trauma can have many layers and it's not centralized in one memory.  Also, in order to do this work, the client must have the emotional resources to begin the trauma work.

In the example that I gave, for the sake of simplicity, I provided a vignette where the new symbolic experience worked in one session.  But this isn't always the case.  There can be many obstacles in doing this type of work that might need to be worked through.  This can take time.

Everyone is different, and there's no way to know in advance how a client will respond.  In the example that I gave, John was able to maintain dual awareness of the here-and-now as well as the memory.  If he was someone who became very dissociated during the experience, we might not able to work in this way or we might need to modify the work.

For some clients, who are naturally resilient and have strong internal resources, only a few sessions might be required for resource development prior to working on a new symbolic memory.  For other clients, who might have a long history of multiple traumas with little in the way of internal or external resources, it might take months of resource development.

It's also essential in this kind of work that the client and therapist have a good therapeutic rapport.  Clients with traumatic backgrounds often take a while to be able to build trust with a therapist, especially if they experienced serious breaches of trust or boundary violations as part of their personal history.

Resources
To find out more about Somatic Experiencing and clinical hypnosis, you can visit the following professional websites:

Somatic Experiencing:  http://traumahealing.com

Clinical Hypnosis:  http://ASCH.net.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, Somatic Experiencing and EMDR therapist.  I have helped many clients to overcome trauma.

I work with individual adults and couples.

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

To set up a consultation, call me at (212) 726-1006 or email me: josephineolivia@aol.com.

















Monday, August 13, 2012

Overcoming Self Doubt That Keeps You Stuck

Self doubt can keep you stuck in your life for years.  You might have many hopes and dreams for yourself for what you want in your life but, if you let it, self doubt can keep you from ever making them come true.


Overcoming Self Doubt That Keeps You Stuck

There can be many reasons for self doubt, including, possibly, depressive or anxiety-related symptoms.  But often, people just can't figure out why they're so plagued with self doubt that they can't even take the first step.

Whatever the reasons, you might find that year after year goes by, you're still stuck and you're unable to overcome your self doubts.  What you desire for yourself remains only fantasies in your mind.  It can be even more frustrating to see other people that you know making progress with their goals, while you remain stuck.

Often, the hardest part is taking the first step.  If you can overcome your self doubt enough to take the first step, you could gain some confidence to take another step and then another, especially if you can keep yourself from worrying too much about the final outcome.

But the problem for many people is that, instead of focusing on the beginning, which is where they are, they try to project themselves to the end and get stuck there, before they've taken any steps.  Then, they begin worrying about how they'll ever be able to get to the end.

At that point, it becomes overwhelming and they give up before they've  even started.

Negative self thoughts or inner voice of negative prediction can keep you frozen in your tracks before you take the first step.  "Old tapes," possibly from a critical parent, might play over and over again in your mind, taunting you and predicting that you'll fail.  So, then you think:  Why bother?

These negative self thoughts, which often come in the middle of the night to keep you up, can feel so powerful--until you begin to challenge them in the light of day:  Is there any objective truth it?  Where's the proof?

Your negative self thoughts can be very persistent providing all kinds of pseudo "objective proof" where none really exists.  It's like the "Bogey man" or "ghost" you thought you saw in your room when you were a child.  When you turn the light on, there's nothing there.

These self doubts and the negative self thoughts that fuel them are often like that.  When you "turn on the light" of objective reasoning, there's nothing there of any substance.

One of the saddest things is for a person to look back at the end of her life and say, "I wish I would've..." (you fill in the blank).   Very often, she can see, with the advantage of hindsight and life experience, where she could have accomplished her dreams if she would have persisted and overcome her self doubts.  But, at that point, it's too late.

Getting Help
If your own self doubts are keeping you from being or having what you want and you're unable to overcome these obstacles on your own, you owe it to yourself to seek the help of a licensed mental health professional.  Letting year after year go by, with your fears getting the best of you, is just wasting precious time you'll never get back.  

Overcoming Self Doubt That Keeps You Stuck:  Getting Help


A licensed mental health professional can help you to overcome the emotional obstacles so that you can lead a more satisfying life.

I'm a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.  I've helped many people to overcome emotional obstacles so they can lead 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: josephineolivia@aol.com.












Sunday, August 12, 2012

Aging: Making Peace with the Aging Process

Making peace with the aging process isn't always easy.  Several months ago, I was with a friend (I'll call her Betty, which isn't here real name).  Betty, who was about to turn 60, showed me photographs of herself when she was in her 20s and 30s.  She was reminiscing about those earlier days, lamenting  the aging process, and wishing she was a young, slim and attractive as she appeared in her earlier photos.  

A week later, we were together for her 60th birthday bash.  Surrounded by her husband, family, and friends, Betty was beaming with happiness and appreciation.  One by one, her husband, daughters and friends stood up and made toasts to her.  

Then, Betty's 85 year old mother, Joan, stood up to make a toast.  Still vibrant and in good health, she made a poignant toast to Betty, thanking her for being such a wonderful daughter, wife, mother, and friend to everyone at the party.  Then, she also talked about how happy and grateful she felt to be alive, in good health, curious and still learning new things almost every day.

Making Peace with the Aging Process
Afterwards, I spoke to Joan to find out more about her wonderful attitude towards life in general and the aging process in particular.  She told me that she approached every day with a sense of openness and curiosity.  She remained involved in her hobbies and interests, and she maintained close friendships.  She let go of petty resentments and forgave people who had hurt her.  She hardly spent time thinking about getting old.  Of course, she had lost her husband and many dear friends along the way, which was hard, so she wasn't in denial about her age or that she would die one day.  But she felt she still had a lot to look forward to and a lot to offer, so she didn't want to waste her time worrying about getting older and death.

Living in a culture that's obsessed with youth and good looks, it's hard not to be affected by worries about the aging process.   This is why I was so impressed with Joan's positive attitude about aging and her philosophy about life.  I thought how wonderful it would be if we could all approach the aging process with such openness and grace.   

I recently had a chance to speak with Betty about her party and, in particular, what her mother had to say about aging.  Betty said she had also been reflecting on it.  She said she also realized how much she had to be grateful for.  She had a loving husband and family, good friends, and good health.  She was  gainfully employed and loved her work.  After hearing her mother speak at her party, Betty said she made a commitment to herself to stay focused on how lucky she is and to appreciate all the inner resources and strengths she developed over the years.  She said when she was in her 20s and 30s, she was filled with self doubt and apprehension about the future.  It wasn't until she was in her 40s that she began to develop a degree of self confidence.  She told me that she wouldn't go back to how she felt when she was younger for anything in the world.

Remembering our self worth as mature adults can be challenging when we're bombarded on a daily basis by messages that it's better to be young and good looking.  Sometimes, we need good friends or supportive family members to remind us of who we really are inside, where it counts the most.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.

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

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

Photo Credit:  Photo Pin



Saturday, August 11, 2012

Coming Out as Gay While You're in a Heterosexual Marriage

Coming out as gay, lesbian, bisexual or transgender can be a challenging process for people who have considered themselves to be heterosexual for most of their lives.  It can be even more challenging and confusing if you're already in a heterosexual marriage.  


"Coming Out" as a Gay Person While You're in a Heterosexual Marriage

The following composite vignette, with all identifying information changed to protect confidentiality, illustrates some of the challenges as well as hope and new possibilities for someone who "came out" while in a heterosexual marriage:

Martin:
Martin and his wife, Sally, were married for 10 years.  They mutually decided not to have children before they got married.  Before they got married, Martin told Sally that he had a few sexual encounters with men while he was in college.  But he told her that these were just part of his youthful explorations   as a young college student, and he definitely considered himself to be heterosexual.

Sally thought of herself as an open-mind person, and she had no doubt in her mind that Martin was heterosexual.  She believed Martin when he told her that he had no sexual interest in men.

After 10 years of marriage, their sex life had waned,  It was never very passionate, but neither of them minded.  Martin often came home so exhausted from work that he usually fell asleep before Sally.  They spent their weekends either socializing with friends or family or going out together to one of their favorite museums, restaurants or to the theatre.  Overall, they were both happy in their marriage--until Martin met Paul, a new business client at work.

Paul was a very handsome "out" gay man who was well liked by his business associates for his talent in business as well as his outgoing personality.  Martin's boss considered Paul's company to be an important account, and he wanted Martin to make Paul's company a priority.  As a result, Martin was expected to take Paul out from time to time to work on projects.

Martin felt comfortable with Paul.  It didn't matter to Martin that Paul was gay.  He enjoyed working with him and enjoyed his company.  After a few dinners and over more than a few drinks, Paul asked Martin if he had ever been sexual with a man.  When Martin looked  uncomfortable, Paul apologized and said, "I'm sorry.  I hope you don't mind my saying this, but when I first met you, I was sure you were gay. "  Martin told Paul that he was happily married to Sally, and he definitely considered himself to be heterosexual.  Martin made light of the Paul's comment, and then he tactfully changed the subject.

But, as he drove home, Martin was shaken by Paul's comment.  He wasn't as much offended by his remark as he was confused.  He wondered what Paul might have seen in him to make him think he was gay.  When he mentioned Paul's remark to Sally, they both laughed about it.  But Martin found it difficult to fall asleep that night, and he couldn't stop thinking about it for days.

When it was time for Martin to meet Paul again for dinner, Martin felt anxious.  But he also realized that he was looking forward to seeing Paul.  This made him feel uncomfortable.  He wasn't sure what this was all about.  He knew that he had always enjoyed Paul's company in the past, but there was something different about this.  He tried to invite one of his other colleagues to the dinner, but no one was available on such short notice, so he had to see Paul on his own.  He thought of canceling the dinner, but he knew his boss wouldn't like this, so he met Paul for dinner.

They talked about the business project, which had been going well.  All the while, it was beginning to dawn on Martin that he was physically attracted to Paul.  He rationalized to himself that Paul was a very handsome and charming man, so most people, whether they were gay or heterosexual, would find him attractive. But it bothered him that he felt this way.

After they finished talking about work, Paul mentioned that he was in a long-term relationship with his partner, Tom.  He explained that he and Tom were in an open relationship.  They considered themselves to be primary to each other, but they each saw other men from time to time, mostly for sexual encounters.

Martin talked to Paul about his relationship with Sally, but all the while he felt distracted and confused about his growing attraction to Paul.  After a few drinks, Paul placed his hand gently on Martin's hand.  Martin didn't move his hand away.  He was as surprised by Paul's gesture as well as his own reaction to it.   By the end of the evening, Martin, who had drank quite a bit, went back with Paul to his hotel room and they had passionate sex.  It was the most exciting sex he ever had.

Martin was deeply troubled by his sexual encounter with Paul.  He told himself that he loved his wife, he wasn't gay but, for some unknown reason, he was very drawn to Paul.  He told himself it was something in particular about Paul.  He rationalized that he had much too much to drink that night and he wasn't thinking clearly.  But he had to admit that he enjoyed having sex with Paul, and this bothered him a lot.

When he met Paul for dinner the next time, he refused to drink.  He also told Paul that he made a terrible mistake by going back to his hotel with him--that he was a happily married man, he wasn't gay, and he didn't want to cheat on his wife.  But by the end of the evening, Martin allowed himself to be seduced again and he went back to Paul's hotel.

This was the beginning of Martin's sexual affair with Paul.  Whenever he thought about his wife, Martin felt deeply ashamed.  He didn't want to hurt her, and he didn't want to leave her.  He especially didn't want to think of himself as a gay man.  He didn't even want to think of himself as being bisexual. He told Paul that he didn't understand what was happening to him.  But he had to admit to himself that having sex with Paul was the most exciting sex he had ever had in his life.  He told Paul that he didn't want to put any "labels" on what they were doing.  No commitments.  No promises.

After a few months of getting together with Paul nearly every day, Martin was becoming increasingly unhappy and ashamed.  He didn't like that he was leading a secret life and lying to Sally.  His sex life with Sally had come to a complete halt.  He kept telling her that he was too tired to have sex, and she didn't seem to suspect anything.  He felt highly conflicted about what he was doing.  Each time he told himself and Paul that he wouldn't continue with the affair, he broke his own promise to himself.

When Martin found himself spiraling into a depression, he contacted a therapist who specialized in working with men who considered themselves heterosexual but who were sexually involved with gay men.  It wasn't an easy decision, but he knew he needed to do something.  He couldn't keep leading a double life.

Over time in therapy, Martin was able to accept that he really preferred men.  He realized that his sexual attraction to Paul was not just about Paul--it was about all men.  He also realized that his sexual encounters in college frightened and confused him, which caused him to deny his own feelings for men.  He still loved Sally, but he knew he couldn't keep living a lie.

Soon after that, Martin "came out" to Sally.  He told her about the affair he was having with Paul.  Sally was very shocked and upset.  They both cried.  After the initial shock, Sally was remarkably understanding.  She was hurt and angry that Martin cheated on her, but she knew she needed to let him go.  She loved him enough that she wanted him to be happy.

Martin joined a "coming out" group for men in heterosexual marriages.  He found a lot of support in the group.  He also heard stories that were very similar to his own.  He learned that "coming out" would be a process, and he had to take it one day at a time.

Over time, Martin accepted that he preferred men.  He and Paul ended their affair, and Martin met a man online that he fell in love with.  He continued to face challenges in terms of "coming out" to friends, relatives, and colleagues, but these challenges were easier to face with the support of his therapy and his support group.

The Challenges of "Coming Out"
The vignette above is one of many different scenarios that people face when they are "coming out" while in a heterosexual marriage.

Some people continue in their heterosexual marriage and never fully admit that they are gay or bisexual, not even to themselves.  They live painful, compartmentalized lives because they can't come to terms with their sexual orientation.

Other people tell themselves, as Martin did, that they're really not gay--it's just something in a particular person that they're drawn to.  Others have gay affairs all their lives while remaining in a heterosexual marriage.  They live double lives, ashamed and angry with themselves, always fearing that they'll get caught.

Living in a limbo state can be very painful.  Only you can decide what your sexual orientation is, but an experienced mental health practitioner can guide you through the process of self discovery in an unbiased, nonjudgmental way.

Getting Help
If you're in a heterosexual marriage and feeling ambivalent or confused about your sexual orientation, you owe it to yourself and your loved ones to get professional help with an experienced licensed mental health practitioner.

If you live in NYC, you can find support groups at the NYC LGBT Center

You can also contact the GLBT National Help Center

I am a licensed NYC psychotherapist who has experience helping adults who are struggling with issues around sexual orientation.

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: josephineolivia@aol.com.



















Coping Strategies in Mind-Body Psychotherapy: Remembering Your Happiest Memories

Mind-body oriented psychotherapy, like clinical hypnosis, EMDR or Somatic Experiencing, usually begin with "resourcing," which is another way of saying developing coping strategies before any work on trauma or other issues begins.  One of the most common ways of beginning resourcing is for the therapist to ask clients to bring in 10 happy memories. 

Depending upon which mind-body psychotherapy method is used, the therapist helps clients to amplify and integrate these experiences so that clients can call upon them as part of their coping strategies in the work.  This helps clients by giving them tools to use either in their daily lives or in session if they come to a particularly difficult part of working through a problem or memory.

As a psychotherapist in NYC, I use all three treatment modalities (EMDR, Somatic Experiencing, and clinical hypnosis) in my work with clients.  After the initial consultation and getting some history about the problem as well as family history, I usually begin by teaching clients the Relaxing Place meditation, which is a place (either real or imagined) that they choose.  I help them to get into a light meditative state and then I assist them to experience their relaxing place with as many of their five senses as possible.  Then, usually, if they feel comfortable, I ask them to visualize themselves "anchoring" the experience somewhere in their bodies so they can call on this relaxing place whenever they need to help themselves to relax.  I usually ask clients to practice this meditation at home so that it becomes second nature to them to call on it when they need it.

Happy Memories as a Resource in Mind-Body Psychotherapy
Usually, after I teach clients to do the Relaxing Place meditation, we work on their happiest memories.  These memories, which are chosen by the client, can be from any time in their lives:  from early childhood to the present.  The entire process is collaborative. Clients choose which memory to begin with in our session.

To give you an idea of how this works, I've included the following fictionalized vignette:

Linda - During the Resourcing Stage of Psychotherapy Work:
When Linda came to therapy to work through issues related to an abusive childhood.  She had been in talk therapy before and she made some progress on these traumatic issues. But she discovered that her traumatic childhood was still having a negative effect on her ability to be in a romantic relationship.

After the initial consultation and history of the trauma and family history, we worked together on the resourcing phase of treatment.  She had never done meditation before, so she was somewhat concerned about whether she would be able to do the Relaxing Place meditation.  But with my support and encouragement, Linda came up with a place in the country that she experienced as peaceful.  I guided her into a light meditative state and helped her to use her five senses to experience this place on a deeper level.

Everyone has different abilities with regard to his or her senses.  Some people can closes their eyes and visualize in detail, while others have a better sense of hearing (like when you "hear" a song in your mind).  Others have a better sense of smell or tactile sense.  It doesn't matter whatever abilities you bring to this experience.  The most important thing is to be able to experience the relaxing place on some level.

The next step involves using your imagination to take this experience and imagine placing it somewhere in your body, sensing that you're storing in your body--wherever it feels right to you.  So, some people picture themselves storing it in their hearts or in their stomachs.  There's no right or wrong with this.  It's whatever works for you.  Practicing the Relaxing Place meditation at home helps you to consolidate this experience.

When it was time to work on her 10 happiest memories, Linda had some difficulty.  She came up with two memories to start, so we work on those.  The first happy memory was about the first time she performed at a dance recital when she was 10 years old.  Although she had been nervous before she went on stage, once she began to dance, she felt completely in the flow of the dance.  She felt light as a feather as she relied on the body memory of the dance to carry her along.  She felt unbelievably happy at that moment, and the dancing felt effortless.

We worked on this memory by getting Linda to re-experience these feelings in her body--the flow of the dance, the muscles in her legs as she moved, the feeling of lightness in her torso, and so on.  We worked on this as if she were re-experiencing it in slow motion so that she could experience it in a very nuanced way.

We also focused on how happy she felt and where she felt this happiness in her body.  She said she experienced the happiness as an expansiveness in her chest and in her shoulders and arms. We spent time with these sensory experiences so she could amplify them.  So, whereas in her original experience, she might have been barely aware of these feelings because they passed so quickly, we spent time to allow them to deepen.  Then, I helped Linda to use her imagination to "anchor" the experience in her body so that she could call on this experience at any time.  She chose to "anchor" it in her heart.  As she was doing this, she was also aware that, with her eyes closed, she was seeing a deep royal blue color.  Her association to this color was that it was a powerful color for her, so we incorporated it in this "anchoring" process.

Over time, Linda began to realize that she had other happy memories that she had not thought of in a long time.  This wasn't surprising to me because it often happens that people who think they have few happy memories will come up with other happy memories once we begin the process.  We also used those happy memories as part of the resourcing process with Linda "anchoring" those experiences in her body too.

After we completed the resourcing phase of treatment, which was about three sessions in her case, we began to work on the trauma.  Linda was able to use her Relaxing Place meditation and the happy memories we worked on whenever she felt she needed to, both in session as well as between sessions.

Remembering Your Happiest Memories as a Resource in Psychotherapy
Everyone is Unique When it Comes to Coping Strategies and the Resourcing Phase
Everyone is different when it comes to the resourcing phase of treatment.  Some people start with strong internal and external resources that they developed before they started treatment, so they don't need as much time in the resourcing phase.  Other people haven't developed adequate resources, so they need more time in this phase.

Some clients come to treatment wanting to start working on their trauma on Day One.  Often, they have  been dealing with the repercussions of their trauma for a long time, so it's understandable that they would want to work on it as quickly as possible.  But rushing into trauma work isn't a good idea.  Clients need to be adequately prepared to be able to deal with whatever might come up, and doing resourcing first is an essential part of that work.

The resourcing phase helps to ensure that clients are more likely to have an emotionally safe experience in therapy.

All of the mind-body psychotherapy treatment modalities that I've discussed have their own professional websites, so that you can find out more about them:

Clinical hypnosis (also known as hypnotherapy):  American Society of Clinical Hypnosis

Somatic Experiencing:  EMDR Professional Organization - EMDRIA

EMDR:  http://EMDRIA.org

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

I work with individual adults and couples.

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

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

For a related topic, read my article:
EMDR Self Help Book: Getting Past Your Past




photo credit: Khatleen Minerve (Sakura) via photopin cc

photo credit: *Leanda via photopin cc







Tuesday, August 7, 2012

Are You Feeling Lonely in Your Relationship?

Everyone feels lonely sometimes.  It's not unusual.  There are different kinds of experiences of feeling lonely.  Usually we associate feeling lonely with being alone.  But it's not unusual to feel lonely from time to time while you're in a relationship.  You and your partner or spouse aren't always going to feel emotionally attuned.  But when you feel lonely most of the time while you're with your partner, this is a different kind of loneliness and can be indicative of problems in the relationship.

Feeling Lonely in a Relationship

There are many reasons why you could be feeling lonely or emotionally estranged from your partner.  Assuming that you and your partner spend time together and that you're not away from each other for significant periods, it's important to determine what's causing you to feel lonely and if your partner is feeling the same way.

Are one or both of you withdrawing emotionally when you're together so that you're in the same room but you're not connecting with each other on an emotional level?  Are you bored?  Has your sex life waned?  Have you grown apart?

The following vignette is a fictionalized composite that illustrates a particular cause of loneliness in a relationship:

Alice and Peter:
Alice and Peter were married for 15 years.  They had two sons, who were 11 and 12.  They both had successful careers.  When they first got married, they had a very passionate relationship.  But in the last few years, they focused most of their free time on their sons' various activities, including sports events.  Their once passionate sex life had waned to nearly nothing.  

After their children went away to sleep away camp for the first time, they found themselves together and alone for the first time in a long time.  Before their sons left, they each thought they would enjoy having time to themselves for a change.

But after their sons were gone, they both felt awkward around each other and somewhat at a loss as to how to spend their time together.  Both of them felt too uncomfortable talking about it, so they each dealt with the awkwardness and loneliness they felt on their own.  They each found individual projects to work on in their spare time, and they tried to avoid the emotional awkwardness by spending their time apart.

As the weeks passed, they each felt more emotionally estranged from each other.  Finally, when it became too uncomfortable for her, Alice broached the topic with Peter, feeling embarrassed and shy, but  deciding that it was better to talk about it than to keep sweeping it under the rug.

So, over breakfast, before they went off to their separate projects, Alice told Peter that she was feeling lonely.  There was an awkward silence, which increased Alice's embarrassment and feelings of awkwardness.  Then, Peter looked away and said he was feeling the same way.

They talked about how they never realized, while the children were around, that they had lost sight of their relationship.

They acknowledged to each other that they still loved one another, but their sex life had waned to nothing.  This was a difficult conversation to have, but it was a relief for both of them to stop avoiding each other and the so-called "elephant in the room" of the loneliness that they each felt around each other.

Peter and Alice realized that they needed to get to know each other again.  They loved their sons very much, but they realized that they needed to spend more quality time with each to rekindle their relationship.

But they didn't know how after all this time, so they sought the help of a marriage counselor.  In marriage counseling, they learned to re-engage in the activities that they used to enjoy--going out dancing, going to the theatre, and reading aloud to each other.

To rekindle their sex life, they rediscovered how to be sensual with each other and, eventually, becoming sexually intimate again after years of not being sexual at all.  When their sons returned, they made sure to continue to find time for each other by going out on a "date" at least 3-4 times per month to maintain the emotional and sexual intimacy they discovered with each other while their sons were away.

Loneliness and Estrangement Can Develop Over Time in a Relationship
The scenario above is only one example of how loneliness and emotional estrangement can develop in a relationship over time without the couple even realizing it.

There are many other examples, too many to discuss in one blog post.  One common complaint I hear from couples in my NYC psychotherapy private practice is that one or both people are continually preoccupied with a Blackberry or iPhone.  This could be a topic unto itself.  Another common complaint is that one or both people have outgrown each other.

Getting Help in Therapy
The main point of this blog post is that if you're feeling lonely in your relationship, you owe it to yourself and your partner to communicate this before it's too late.

You're not alone.  There are many individuals and couples that experience this problem.

If you're unable to work on it on your own by rekindling your relationship, you can seek the help of a licensed mental health professional who  specializes in working with couples.

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

I work with individual adults and couples.

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

To set up a consultation, call me at (212) 726-1006 or email me: josephineolivia@aol.com.






Sunday, August 5, 2012

Overcoming the Morning Blues

If you struggle with the morning blues, you're not alone.  Millions of people wake up in the morning and want to go right back to sleep because they find it hard to face the day.  Assuming you've gotten enough sleep, the temptation to go back to sleep can be a way to avoid facing the day.  For many people who are confronted with the morning blues, their attitude is "Why bother?"  They have a sense of purposelessness.  But you can overcome the morning blues by changing the way you approach the start of your day.


Overcoming the Morning Blues

One way to overcome the morning blues and that negative inner voice that can be so self defeating is to start each day with something that will inspire you.

Overcoming the Morning Blues

You'll need to plan this ahead of time so that when you wake up, it's available to you when you wake up.  For each person this will be different.  It can include:

Read an Inspiring Passage:
Many people find it uplifting to read an inspiring passage, whether it's spiritual material from one of the many One Day at a Time books or other reading material.

Overcoming the Morning Blues: Read an Inspiring Passage, Write Down Your Dreams, Set an Intention for the Day

Starting your day by reading an inspiring passage can change your attitude for the day and challenge your negative self thoughts.

Write Down Your Dreams:
Rather than giving in to that "Why bother?" negative inner voice, wake up with the goal that you'll write down your dreams.  The best time to write down your dreams is when you first wake up.  If you keep a pad and pen by your bed and tell yourself before you go to sleep that you want to remember your dreams, you're more likely to remember your dreams.  Your dreams can provide you with interesting insights into yourself.  Some people discover that they become more in touch with their intuition once they start paying attention to their dreams.

Set the Tone with an Intention for the Day:
This is something you can decide before you go to sleep.  Alternatively, you can give yourself the suggestion before you go to sleep that you want to wake up with an intention for the day (see my article:  The Power of Starting the Day with an Intention).

Either way, having an intention for the day gives you a sense of meaning and purpose.  For instance, if your intention for the day is to be more compassionate, you can observe yourself throughout the day:  Are you getting impatient and angry with your coworkers?  Are you getting irritated with other drivers on the road?  Instead of being impatient and irritated, how might your attitude be different if you were more compassionate and put yourself in the other person's shoes for a moment?

Practice Morning Meditation:
Taking even just a few minutes every morning to start your day with morning meditation can change how you feel when you wake up and your attitude throughout your day (see my article: Wellness: Safe Place Meditation).

If you're new to meditation, there are many meditation CDs or downloads that can lead you through a guided meditation if that's what you would prefer.  You can also just spend a few minutes with your eyes closed observing your thoughts.  Whenever a negative thought comes to mind, just see it go by like a cloud passing in the sky.  Don't hold onto it.

Practice Yoga:
Whether you go to a yoga class to begin your day, which I highly recommend, or you do a few yoga poses on your own, beginning your day with yoga poses can be an uplifting way to start your day.  Not only will you quiet your mind, but you will feel more relaxed and refreshed.

Volunteer in Your Community:
When you wake up with the intention of helping others, you're less likely to be consumed with negative self thoughts.
Overcoming the Morning Blues: Volunteer in Your Community

There are many nonprofit organizations that need volunteers.  Not only is it a good feeling to be helping others, but you also can often feel gratitude for what you have in your own life.

Keep a gratitude journal:
Before you go to sleep each night, you can write down things you feel grateful for in your life.  They don't need to be big things.  They can be about the simple things in life that you might usually overlook:  finding a parking space without having to drive around for a long time, hearing from a good friend, eating a delicious meal, and so on (see my article: Journal Writing Can Help Relieve Stress and Anxiety).

Overcoming the Morning Blues: Keep a Gratitude Journal

If you get into the habit of writing down at least three things every night, you'll begin to sensitize yourself to all the things you can feel grateful for in your life.  When you do this before you go to sleep, it can set the tone for when you wake up.

Overcoming the morning blues can be challenging, but not impossible.  Often, it's a matter of overcoming habitual negative thinking.  In other words, it's possible that the morning blues has become an unconscious habit that can be overcome with new positive habits.

Getting Help in Therapy
These are some ideas about how you can overcome the morning blues.  If rather than the morning blues you're feeling depressed, these ideas can be helpful.  But if they're not and your feelings of sadness and purposelessness last more than two weeks, you should seek the help of a licensed mental health practitioner who has experiencing working with clients who are depressed.

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.

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

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

Photo Credit:  Photo Pin












Saturday, August 4, 2012

What's Holding You Back From Achieving Your Goals?

Does this sound familiar?  You've thought about your goals.  You've written them down.  Maybe you've even set a time line for when you want to accomplish your goals.  Everything looks good on paper.  But when it comes to actually taking steps to implement your plans, you feel like something is holding you back.  You're stuck.  Whenever you try to take steps to begin your plan, you're stymied.  Then, you feel frustrated and confused as to what's holding you back.

It's frustrating and confusing to feel held back from achieving your goals.

There are many people who come up with great goals for themselves.  They're great at coming up with ideas, writing them down, and organizing their ideas. But when it comes to actually taking the necessary steps to accomplishing their goals, they freeze in their tracks.

There can be many reasons why someone gets stuck when it comes to taking action.  The reasons are as varied as the individuals who have this problem.

The following is a composite vignette about someone who has problems taking steps towards his goals:

Barbara:
Barbara dropped out of college when she was 20.  She spent most of his freshman year in college partying.  Although she did very well in high school without having to make much of an effort, all of her partying and cutting classes caused her to be on academic probation in college.  She realized she wasn't ready to be in college, so she dropped out.

Barbara felt very ashamed that she left college and that she had been on academic probation. She had always been an "A" student. She felt that she had let down his family.  They were shocked to hear that Barbara had problems in college.

Not knowing what else to do, Barbara found a job in a retail store.  After a year of being a sales associate, Barbara was very bored at work.  During that time, she learned to be more responsible and she began to yearn for more intellectual stimulation.  She realized that she could probably work her way up in the retail business, but she wasn't interested.  So, she did some soul searching, talked to her family and friends, and she realized that she wanted to become a teacher.  In order for her to become a teacher, she needed to return to college.

As part of her goal setting, Barbara made a list of everything that she needed to do to reapply to her college.  She obtained all the information that she needed from her college, and all she needed to do was fill out the forms.  But whenever she tried to sit down to fill out the forms, she hesitated.  She kept finding other things to do, none of which were important.

With the deadline for submitting her paperwork looming, Barbara realized that her continued procrastination would cause her to miss the fall semester and she would have to wait another year to reapply.  Even the thought of remaining in her boring job didn't spur her on to take care of the necessary paperwork. She tried talking to her friends and family.  Her best friend offered to sit with her for moral support.  But Barbara found that she just couldn't do it.  Every time she sat down and attempted to complete the paperwork, the result was always the same.

Finally, Barbara's mother suggested that she get professional help because time was passing, and it was clear that she had some sort of emotional block.  Barbara chose to see a psychotherapist who was trained in clinical hypnosis and Somatic Experiencing.  Working with hypnosis and Somatic Experiencing, Barbara discovered and confronted her shame and fear of failing again. She was able to build her confidence and overcome her procrastination.

When she returned to college, Barbara had a new appreciation for being there.  She felt she had a purpose and  she was able to work on her goal to become a teacher without feeling fear or shame.

Fear and Shame Can Hold You Back:
Fear can be a powerful emotion that can stop you in your tracks if you don't know how to overcome it. The combination of fear and shame can be even more powerful.

Getting Help:  Talk Therapy Might Not be Enough
Often, talk therapy only gets you so far in overcoming the emotional obstacles that hold you back from accomplishing your goals.  For many people, mind-body oriented psychotherapy, like clinical hypnosis or Somatic Experience, is much  more effective for overcoming these emotional blocks.

To find out more about clinical hypnosis and Somatic Experiencing, you can visit the professional websites for these treatment modalities:

Clinical hypnosis:  ASCH: American Society of Clinical Hypnosis

Somatic Experiencing: Somatic Experiencing Treatment Institute

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

I work with individual adults and couples.  I've helped many clients overcome the emotional blocks that keep them from leading 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.

Photo Credit: Photo Pin