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Tuesday, February 20, 2018

How Psychotherapy Can Help You to Change Distorted Thinking

In my prior article, I described the various forms of cognitive distortions that often create unhappiness.  In this article, I'm focusing on how psychotherapy can help you to overcome cognitive distortions.

How Psychotherapy Can Help You to Change Distorted Thinking

Psychotherapists are trained to detect cognitive distortions, which, as I mentioned in my prior article, include:
  • Taking things personally
  • Jumping to conclusions
  • Catastrophizing
  • Overgeneralization
  • Fallacy of fairness
  • Blaming or Externalizing
  • Emotional reasoning
  • A need to be right
  • All or nothing thinking
  • Filtering
Aside from bringing these distortions in thinking to a clients' attention, a psychotherapist will often help clients to identify the origin of these thoughts and help clients to change their pattern of thinking so that it is healthier and more effective.

Fictional Clinical Vignette: How Psychotherapy Can Help You to Change Distorted Thinking

Sam
Sam began psychotherapy at the suggestion of his wife after they had another argument where Sam insisted that he was right and his wife was wrong.

Subsequently, Sam realized that they each had a different way of looking at the situation that they were arguing about and, as it turned out, his wife was correct, which disturbed Sam very much.

Sam told his psychotherapist during their initial consultation that he hated to be wrong because it made him feel "stupid" and ashamed.  Although he apologized to his wife, he realized that there were many times when he had arguments with his wife when he insisted that he was right and afterwards he realized that his wife was correct.

In hindsight, Sam recognized that none of these arguments were about anything important.  They were about everyday issues, but he had such strong feelings about being right and it disturbed him greatly when it turned out that he had made a mistake (see my article: Overcoming Your Fear of Making Mistakes).

He realized that his need to be right was having a negative impact on his marriage, and he feared that if he didn't overcome this problem, his marriage might not survive.

During his next therapy session, Sam revealed that his need to be right started when he was a young child.  Growing up with two highly critical parents, Sam learned early on that they became upset whenever he made a mistake, especially his father.

Whenever Sam made a mistake, whether it was at school or at home and no matter how small the mistake was, his parents let him know that they were disappointed in him.  They would withdraw emotionally from him, which led to his feeling ashamed whenever he was wrong.

As a result, whenever there was a possibility of Sam being wrong, he would become highly anxious because he didn't want to make his parents unhappy.  He especially didn't want them to withdraw from him emotionally.

Since his childhood, he felt it was unacceptable for him to be wrong.  Logically, he understood that everyone makes mistakes but, on an emotionally level, he would panic if he thought there was even a possibility of being wrong or making a mistake.

Rather than admit that he might be wrong or he might have made a mistake, he would insist that he was right.  It was like a knee jerk reaction that he had, which was preferable to him than considering the possibility that he might be wrong and all that this implied for him.

This created problems for him in his career as well as in his friendships.  Now, it was creating problems between Sam and his wife because she was fed up with it.

Over time, Sam's psychotherapist helped Sam to recognize that panicky feeling by helping him to be aware of what he was feeling physically in his body at those times.

At first, Sam had difficulty with this because he wasn't accustomed to identify where he felt emotions in his body.  But, over time, using the mind-body connection and a recent memory of having an argument with his wife when he insisted that he was right, Sam's therapist helped him to identify that he felt panic in his stomach.

As time went on, Sam's therapist helped him to make the emotional connection between his current panic and how anxious he felt as a child whenever his parents criticized him for his mistakes.

Sam and his therapist also used EMDR therapy to work through his childhood trauma.

Since EMDR therapy addresses the past, present and future, eventually, Sam was able to work through the past and tolerate being wrong in the present with his wife and others.  He no longer had the need to insist that he was always right, and he and his wife got along better.

Conclusion
Cognitive distortions can create personal unhappiness as well as problems in relationships.

The fictional vignette above addresses a particular type of cognitive distortion, the need to be right, and shows how therapy helps clients to work through the underlying issues involved as well as address current and future circumstances.  A skilled psychotherapist can address other forms of cognitive distortion as well.

Getting Help in Therapy
Even when you have insight into your distorted thinking, it's difficult to change these problems on your own (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist can help you to work through the underlying issues that created the distortions and help you to free yourself from a difficult personal history (see my article: How to Choose a Psychotherapist).

Rather than struggling on your own, you could benefit from getting help from a licensed mental health professional so you can lead a more fulfilling and meaningful 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.

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

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










Monday, February 19, 2018

How Psychotherapy Can Help You to Become Aware of Distorted Thinking

Psychotherapy can help you to become aware of a distorted pattern of thinking, which could be contributing to your unhappiness.  Prior to beginning psychotherapy, most clients are unaware of their particular pattern of thinking.  A skilled psychotherapist can assist clients to change their distorted thinking (also called cognitive distortions).  In Part 1 of this topic, I'm focusing on the various types of cognitive distortions.  In Part 2, I'll discuss how psychotherapy can help to overcome cognitive distortions.

How Psychotherapy Can Help You to Become Aware of  Distorted Thinking 
Distorted Thinking/Cognitive Distortions
There are many ways that a particular pattern of thinking can create problems without people even realizing it.  These patterns are distortions in thinking and often begin early in life.  Another term for distorted thinking or cognitive distortions is errors in thinking.

Here are some of the most common cognitive distortions:
  • Taking Things Personally:  People who tend to take things personally see others' words and deeds as being directed at them when they're not.  For instance, if your boss comes to work in a bad mood and seems annoyed, someone who takes things personally might think that the boss is angry with him.  But, in reality, the boss is looking annoyed because he had an argument with his wife before he came to work, and his mood has nothing to do with anyone else.
  • Jumping to Conclusions:  People who jump to conclusions will make assumptions without having objective facts, and they will assume that they're right.  The example that I gave above about the moody boss is one way of jumping to conclusions.  
  • Catastrophizing: Simply put, catastrophizing is when a person expects the worst in most situations. His fears are usually exaggerated without sufficient evidence for this type of fear. An example of catastrophizing would be if a person hears a weather report that indicates there will be 1-2 inches of snow and makes the assumption that there will be a gigantic snowstorm where he might not be able to leave the house.  The weather report becomes exaggerated in his mind and he becomes highly anxious when there is no objective reason to believe there will be a storm.
  • Overgeneralization:  People who engage in overgeneralization often take one or two instances of something happening and make the assumption that this is how it is always.  For instance, if someone has a negative encounter with a postal employee at the post office and, based on that one experience, he says that all postal employees are rude.  This is an overgeneralization.  
  • Fallacy of Fairness:  Many children grow up thinking that the world should be "fair" and, as adults, when they encounter situations which are "unfair," it contradicts their way of thinking.  Without even realizing it, many people carry this belief from childhood into adulthood.  This type of belief can be very subtle, and it's ingrained in our culture that if you are "good," good things will come to you and if you're "bad," bad things will come your way. As an example, someone who believes that he lives in a world where justice prevails might be disillusioned and confused when someone who assaulted him suffers no legal consequences because of a technicality in the law. 
  • Blaming or Externalizing:  When people have a tendency to engage in blaming others (also known as externalizing), they don't take responsibility for their own thinking, feelings or actions.  Instead of looking at themselves first, they point the finger at someone else to avoid taking responsibility.  An example of this is when someone drives while intoxicated after having an argument with his significant other.  Rather than taking responsibility for using poor judgment by drinking and driving, he blames his significant other for "making" him angry.
  • Emotional Reasoning: Emotional reasoning is when a person assumes that his thoughts and feelings are facts.  An example of this would be a person has strong feelings about a coworker and makes the assumption based solely on his emotions that his feelings are true without having objective facts (see my article:  Discovering That Your Feelings Aren't Facts).
  • The Need to Be Right:  The need to be right involves a need to prove that one's opinion, feelings or actions are correct even in the face of contrary facts.  As an example, a person who needs to be right often won't listen to what her significant other is saying because she "knows" that what she's thinking is right and her significant other is wrong.  The need to be right goes beyond having a different opinion.  This person's shaky sense of self worth is based on being right.
  • Filtering:  Filtering involves paying attention to only certain aspects of a situation and not to others.  For instance, a person who tends to engage in filtering might only pay attention to the negative side of a situation rather than looking at the whole picture which includes positive aspects because the negative side confirms his opinion.  

In my next article, I'll discuss how psychotherapists help clients to overcome cognitive distortions.

Getting Help in Therapy
Psychotherapy can help you to overcome psychological obstacles that are getting in the way of your maximizing your potential (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist helps clients to overcome problems that keep clients feeling stuck whether it's related to a history of psychological trauma or more recent problems (see my article: How to Choose a Psychotherapist).

Rather than suffering on your own, you could work with an experienced mental health professional who can help you to overcome your problems so you can lead a more 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.

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, February 17, 2018

Nostalgia: A Portal to the Past

Nostalgia is defined as a sentimental longing involving memories from the past, as in "the good old days."  Nostalgia is often bittersweet because, even though there might be an immersion into happy memories, there is also a sadness that the people, places or things related to the past are no longer in the present.

Nostalgia: A Portal to the Past

Nostalgia As a Portal to the Past
Nostalgia is a portal to the past--an actual past or, at times, an imaginary past.  Since memory can be inaccurate, nostalgia is often an idealized representation of the past, and it tends to be colored by what's happening in the present.

For instance, if someone is currently single, lonely and longing to be in a relationship, she might look back with fond memories to a time when she was in a romantic relationship.  She might idealize this past relationship and look back on it wistfully as being a completely happy time when, in fact, there might have been serious problems in that relationship.  In order to preserve this ideal, she might forget, without even realizing it, that there were times when she was very unhappy in that relationship.

This idealization often serves the purpose of having the internal experience of a happier time, a time when that can be relived in memory as a person now perceives the past.  So, there can be a psychological compensatory effect to nostalgia.

Book: In Search of Lost Time - By Marcel Proust
There are many ways in which people are transported back into the past, and literature offers many examples of this.

One of the most famous examples in literature is in In Search of Lost Time by the French novelist, Marcel Proust.

In Volume One, Swanns Way, the narrator, Marcel, has a memory of going to bed early as a boy and waiting for his mother's good night kiss.

Later on in the novel, Marcel's early memories are suddenly prompted when he tastes a madeleine cookie that he dips in tea.  Memories of his childhood experiences at his Aunt Leonie's home in Combray (now known as Illier-Combray), France) and other memories of earlier times come back to him in a nostalgic experience of involuntary memory.

During a trip to Paris a couple of years ago, I went to visit the Proust Museum, which is Proust's aunt's home in Illier-Combray as he described it in Swanns Way.  Having read his novel, I was quite moved to see the house preserved as the narrator described it in Swanns Way.  Just being able to walk through the rooms and remember various scenes from the book made the story come alive.

Film: Time Regained by Raul Ruiz: Nostalgia as a Psychologically Integrative Experience
Nostalgia can also be evoked by looking at old pictures.

In the beautiful movie, Time Regained, the Chilean filmmaker, Raul Ruiz, adapts the last book of Proust's seven-volume novel starting with a scene of Marcel Proust on his sick bed close to death.

Early on in the film, Marcel asks his housekeeper, Celeste, to bring him pictures that are in a drawer.  As he looks at these old pictures of his friends, family members and romantic partners, he is transported back in his memory to earlier times from childhood to adulthood.  He becomes immersed in these memories as he is slipping away into death.

As Marcel relives these times of joy and sadness, he is having a psychologically integrative experience of his past and present, which is beautifully rendered in the film.

Similar to the process of Life Review for older adults, the experience of nostalgia, especially as it is rendered in the film, Time Regained, highlights another positive aspect of nostalgia, which is a psychologically integrative experience where the past and present come together to add depth and meaning to a life lived.

I recently began rereading In Search of Lost Time and, in rereading it, I'm reminded that when we return to a masterpiece like this, our own life experience affects how we experience a novel when we revisit it more than 20 years later.

I also saw the film, Time Regained, again recently--the first time that I've seen it in almost 20 years.  This was another reminder of how time and memory can affect an experience.

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, February 16, 2018

Walking in Nature Can Improve Your Mood

Research studies have shown that city dwellers who don't have access to nature are more likely to develop anxiety and depression as compared with people who have access to green spaces (see New York Times article:  How Walking in Nature Changes Your Brain).

Walking in Nature Can Improve Your Mood

Research Study: Walking in Nature Can Improve Your Mood
A research study published in Proceedings of the National Academy of Sciences revealed that walking in nature (as opposed to walking on a highway) lowered the volunteers' propensity for brooding (also known as morbid rumination) as demonstrated in the before and after questionnaires that the volunteers took.

According to this study, the volunteers who walked in nature focused less on the negative aspects of their lives (as compared with the volunteers who walked on the highway).

This research suggests that walking in nature can help to improve your mood.

Questions still remain:
  • How much time in nature is sufficient to improve mood?  
  • What aspects of nature are most soothing?  
  • Besides walking, what other types of activities in nature have beneficial effects?
Further research will be needed to answer those questions.

The Other Benefits of Walking
Aside from lifting your mood, a regular walking routine can help you to lose weight.

In addition, walking can help prevent heart disease, high blood pressure and diabetes.  

Walking can also help build strong bones.

Getting Started and Staying Motivated to Walk in Nature
One way to get motivated is to have a walking buddy and to decide in advance how often and what days and times you will both get together to walk in nature.

Having a walking buddy is beneficial for social support.  It also helps on the days when you might want to skip the walk and your walking buddy encourages you to get going.  You can also provide the same encourage to your walking buddy when your buddy might want to slack off.

Always check with your medical doctor before you start any new physical regimen.

Getting Help in Therapy
Walking in nature has been shown to improve your mood, but if you still struggle with depression or anxiety, you could benefit from seeing a licensed psychotherapist (see my article: The Benefits of Psychotherapy).

Everyone needs help at some point in his or her life.

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

Rather than suffering on your own, get help from a licensed mental health professional.

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.





Thursday, February 15, 2018

Having a Dialogue in Writing Between the Different Parts of Yourself

In my prior article,  Are You Approaching Your Problems From an Adult or Inner Child Perspective?,   I discussed how Ego States therapy can help you to become aware of which aspect of yourself is active in any particular situation and how to shift from one self state to another self state that would be more effective.  In the current article, I'm providing another possible way to access self states through writing.  Throughout this article, I'll be using the terms parts, self states and aspects of self interchangeably.

Having a Dialogue in Writing Between the Different Parts of Yourself

A psychotherapist who does Ego State therapy introduces clients to the idea that everyone is made of many different inner parts.

Many people are already familiar with the concept of the inner child as an internal aspect of themselves.  An Ego States therapist furthers this idea to include many other aspects of the self.  For instance, an adult might have an adolescent self who is operating in a particular situation as I discussed in the prior article.

The aspects of self might also be identified by a particular attitude.  For instance, adult aspects might include a judgmental self, a fearful self, a self who becomes emotionally paralyzed/freezes at times, and so on.

Having a Dialogue in Writing Between the Different Aspects of Yourself
Becoming aware of your self states and making shifts between self states is easier when you have a psychotherapist who does Ego States therapy, but not everyone has access to an Ego States therapist, so you can also access your various self states through writing.

Before you can have a dialogue between self states, you need to identify the self states that are involved in a particular situation.

In order to become aware of self states, you don't need to worry about what you call the particular self states.  You can use whatever names that feel right to you or you can even call them Part A and Part B if you're really not sure how to identify them.

What's more important than labeling them is developing an understanding of each self state.  At first, this might be a very basic understanding and, as you continue to work with these parts, you can develop a more in-depth understanding.

Here's A Fictional Example:
Ted
Ted is ambivalent about going back to college.  He has been thinking about it for over a year, and he can't decide what to do.

Sometimes, he feels excited about returning to college to complete his degree and the possibilities that this can open up for him.  But there are also other times when he worries that he won't do well in college and it would be a mistake to return.

His ambivalence has kept Ted feeling confused about what's best for him.  Feeling ambivalent, Ted is at an impasse and he has been unable to make a decision.

Initially, Ted isn't sure what his ambivalence is about.  He knows that there are at least two parts of him that are in conflict about going back to college.  He doesn't know why he's in conflict about it or the root of this internal conflict.

As an experiment, Ted decides to write about this conflict by having a dialogue between Part A, the part that wants to return to college, and Part B, the part that worries that he won't do well and thinks it would be a mistake to return to college.

Having a Dialogue in Writing Between the Different Parts of Yourself

Keeping it simple, Ted begins by giving a voice to Part A and then allowing Part B to respond:

Part A:  I wasn't ready to be in college when I first went a year ago, but now I'm ready and excited to return.  I think it would open up many more job opportunities for me.  I want to go back.

Part B:  I'm worried that this would be a big mistake because you probably won't do well and then it would be a waste of time and money.  It's better not to risk it.

Part A:  I don't understand why you would think that I wouldn't do well.  I didn't leave because my grades weren't good. I left because I wasn't ready to be away from home, but in the last year, I've matured and I'm ready now.  Tell me more about your concerns.

Part B: I'm afraid that if I return, I might get homesick again and want to leave.  Then, I would feel like a failure.

Part A:  I understand your concerns and you might be right, but there are probably ways to address these concerns without giving up on college.

Part B:  Like what?

Part A: If I go away to college and I feel homesick, I can seek counseling at the student counseling center.  I can also choose not to return to the same college.  I could go to a local college instead where I can commute from home.

Part B: Well, those ideas sound like possibilities.  I'm open to considering it.  Let's talk about this again tomorrow.

As Ted continues to dialogue between these two parts of himself that are in conflict, he learns more about the hopes and fears of each part.  He learns the origin of his fears as Part B "talks" about other earlier times in his life when he was afraid to take risks.  In addition, he develops new ideas about how to deal with his fears.

Along the way, he might also identify other parts of himself that are involved in this conflict and gain insight into the role these other parts play.

As he continues to dialogue with these parts in writing and concretizes his various conflicting feelings, he feels calmer about it.  Now that he's writing about it and capturing his feelings on paper, he no longer has these conflicting feelings whirling around in his head in a confused state.  It's all down on paper.

As he gains insight into how his various conflicting aspects of himself are affecting his decision making process, he can address each of these issues by getting more concrete information, talking to others about it, and seeing where he might be catastrophizing about issues that aren't a catastrophe (see my article: Are You Catastrophizing?).

By dialoguing with his various self states, he is able to put his hopes and fears in perspective, and he is in a better position to make a decision.

Conclusion
Having an internal dialogue in writing with the various parts of yourself can help you to overcome problems where you're experiencing an internal conflict.

Being able to reflect on and write about the internal conflict from the perspective of the parts involved helps you to understand yourself better and have more compassion for yourself.

Writing out dialogues between your internal parts can also stimulate more creative ideas for overcoming the conflict that you might not have thought about if you didn't write about it.

Initially, you might feel uncomfortable doing this exercise but, once you're immersed in it, you will probably find it to be a very useful tool.

Getting Help in Therapy
A skilled psychotherapist can help you to understand the conflicting aspects of yourself as well as get to the root of your problems (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

If you have access to a licensed mental health professional, you have an opportunity to work through unresolved problems so you can lead a more 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.

I have helped many clients using Ego States therapy.

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






















Are You Approaching Your Problems From Your Adult or Your Inner Child's Perspective?

As I've discussed in prior articles, everyone maintains within themselves various internal parts of themselves throughout the course of a lifetime, including a child self, a teenage self and an adult self.  At any given time, one of your self states might dominate a particular situation without your being aware of it.  So, it's important to know "who's in charge" at certain times, and how to shift from one self state to another in order to manage your life more effectively (see my articles: Understanding the Different Aspects of Yourself That Make You Who You Are and How Your Shifting Self States Affect You For Better or Worse).

Are You Approaching Your Problems From an Adult or Child's Perspective?

While there's a time and place to enjoy your younger self states, like when you're having fun, you don't want a younger self state in charge when you have to deal with adult problems.

Not only will that younger self state feel overwhelmed by trying to deal with an adult problem, but it won't be mature enough to handle the problem and it won't make the best possible decisions.  For instance, we would ever intentionally ask a three year old to make an important decision about an adult relationship?  Of course not.

But, as I mentioned in prior articles, when a younger self state steps in to try to handle an adult problem, it's an unconscious process.  Often, you're emotionally triggered into this younger self state without even knowing it.

Other people might recognize that you're not approaching your problem from a mature perspective, but it's often hard for you to see it yourself.

When you realize that your three year old self is trying to resolve an adult problem, you can understand why you're having difficulty overcoming your problem.

The important thing is, first, to recognize it and, second, to make the switch in a way that's respectful and compassionate to your various selves (i.e., without berating or denigrating any of the self states).

In my psychotherapy private practice in New York City, when I have clients who tend to approach certain problems from a younger self state which isn't helpful, I teach them how to shift into their adult self state.  I do this by helping clients to be aware of what's happening and then teaching them how to make the switch in a healthy way.

Fictional Clinical Vignette:
Learning to Switch From a Younger Self State to An Adult Self State
The following fictional clinical vignette demonstrates how to recognize when a younger self state is trying to resolve an adult problem and how to switch into your adult state using Ego States therapy:

Tania
Tania, who was in her late 20s, started therapy because she was having problems with her supervisor at work.

Are You Approaching Your Problems From Your Adult or From a Child Perspective?

Although she liked her job as a sales representative, she didn't like getting directives from her supervisor, especially since he tended to be abrupt with her when he was under pressure.  At those times, Tania reacted negatively to him, but she only recognized it after the fact when he pointed it out to her.

Although he acknowledged his part in their dynamic and he said he would try to be more aware of how he came across, her supervisor told Tania that she also needed to change her behavior.

Tania explained to her therapist that when her supervisor was abrupt with her, she would lose her motivation and take off days from work.  Lately, this was more problematic than usual because everyone at work was under additional pressure to meet their sales goals, which was challenging.

Tania told her therapist that her pattern was that after she took off a few days from work, she recognized in hindsight that she was only making things more difficult for herself because she would have to work that much harder to meet her goals.

She was also afraid that, if she kept taking off days from work, she might be fired from her job, so it was critical that she learn how to deal with her problems in a healthier way.

Tania's psychotherapist asked her to describe in detail what happens to her when her supervisor is abrupt.  In response, Tania thought about it for a while and then described a typical scenario:

When her supervisor was under pressure from his director, he would be abrupt with her and the other sales reps.  In hindsight, she realized that her supervisor's behavior stemmed from his own anxiety and he was trying to change, but he wasn't always successful.  Whenever he was abrupt with her, she had an immediate reaction.  She felt angry and resentful and she wouldn't want to be at work.  Then, rather than communicating with her supervisor or looking for another job, she would call out sick for a few days to get away from the situation.  She would spend those days in bed and tell herself that she couldn't deal with her supervisor's attitude when he was under stress.  Generally, this made things worse for her in the long run.

In the next few sessions, Tania revealed that when she was growing up, her father, who was a retired Marine, tended to give her and her siblings "orders" in an abrupt manner, which Tania resented.  When she became a teenager, she rebelled against both of her parents by cutting classes in high school, and her grades suffered.  Fortunately, she was able to improve her grades so she could go to college.

As they continued to discuss these issues, her psychotherapist pointed out to Tania that she was reacting to her supervisor in a similar way to how she behaved when she rebelled against her parents. She explained Tania that it seemed that those old memories of her father being authoritative and abrupt were getting  triggered at work.  Tania thought about it, and she agreed that her behavior with her supervisor was adolescent behavior, and she wanted to change it.

Her psychotherapist provided Tania with psychoeducation about how it is common for people to shift into different self states without being aware of it, especially when they get triggered (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation).

Then, she spoke with Tania about Ego States therapy and how Tania could learn to become more aware of her shifting self states before she reacted and, if she became aware that she was reacting in an adolescent way, how she could shift into an adult self state.

Since Tania tended to approach most areas of her life as an adult, she had many memories of handling tough situations in a mature and effective way.  Using those memories of being mature, Tania's therapist helped her to relax into a light hypnotic state so Tania could go back into those memories and become more aware of how she felt emotionally and physically when she approached challenges from an adult self state.

As Tania thought about a particular memory where she felt proud of how she handled a challenging situation, she was able to feel a sense of pride and satisfaction.  When her therapist asked Tania where she felt this in her body, Tania said she felt an expansiveness in her chest.

Over time, they went over several other similar memories, and Tania became sensitized to what it felt emotionally and physically in her body to approach challenges from an adult self state.

Then, her psychotherapist asked Tania to think about a prior memory where she approached her problems with her current supervisor from an adolescent self state.  This was relatively easy for Tania because it happened several times lately, so she had recent memories she recalled.

When Tania sensed into what she felt on an emotional level when she thought of her response to her supervisor, she said she felt angry, resentful and indignant.  She felt these emotions as a tightness in her jaw, throat and shoulders.  She felt her old sense of rebelliousness similar to how she felt when her father gave her "orders."

Her psychotherapist asked Tania to stay with those feelings and, at the same time, to picture her compassionate adult self sitting next to her wanting to help her adolescent self.

At first, Tania imagined her adult self saying to her adolescent self, "Grow up and stopping acting so immature!"

When her psychotherapist asked Tania to sense into how her adolescent self felt when her adult self spoke to her this way, Tania said that it only made her adolescent self feel more angry and alone.  It also made her adolescent self feel like she wanted to rebel even more.

Her psychotherapist explained that this is why it's important for the adult self to be nonjudgmental in its approach to the younger self state.  Then, she asked Tania to try again with more compassion (see my article: Having Compassion For the Child That You Were).

Although this was challenging for Tania, she was able to put aside her judgmental attitude to feel compassion for an adolescent self who felt alone and needed help.

Her therapist asked Tania what her adolescent self needed from her adult self, and Tania said her adolescent self needed love and kindness.  She also needed to feel that she was not alone.

Are You Approaching Your Problems From Your Adult or Child Perspective?

As they continued to do Ego States therapy, Tania discovered ways that she could imagine showing kindness and love to her adolescent self.  Over time, she learned to be more emotionally reassuring to her adolescent self.  She also learned to allow her adult self to gently take over when it was necessary.

At the same time, she didn't berate or try to completely suppress her adolescent self in all situations.  She allowed her adolescent self to dominate in situations where that self state could feel alive when she was having fun.

Gradually, Tania practiced in her psychotherapy sessions going back and forth between these two self states so that she learned to make the switch on her own when she needed to do it.

So, for instance, when she sensed herself beginning to feel rebellious with her supervisor, she knew that her adolescent self was trying to take control of the situation, and she consciously made a choice to reassure her adolescent self that her adult self would take over.  Then, she would consciously make the choice to approach her problem from a mature stance.

Once Tania was no longer unconsciously reacting in a negative way to her supervisor, she and her psychotherapist worked on helping her to overcome the underlying issues related to her history with her father so that Tania wouldn't keep getting triggered at work.

Over time, they used EMDR therapy to work on the earlier issues that were at the root of the problem (see my articles: What is EMDR Therapy?How EMDR Therapy Works: EMDR and the Brain, and Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Being able to approach her problems from a mature perspective also allowed Tania to be proactive about finding another job where she was happier.

Conclusion
We all carry within ourselves the various self states from infancy to adulthood.

When we use a younger self state unconsciously to approach a problem that requires an adult self state, this causes problems for us.

Ego States therapy helps clients to become aware of their various self states.

The goals of Ego States therapy is to help clients to become aware of their self states, when they're switching to a self state that isn't helpful and how to make a conscious choice to use a more effective self state for the particular issue at hand.

Once clients become aware of their self states, how they choose them unconsciously in ineffective ways, and how they can make the switch to a more effective self state, many problems can be resolved.

Getting Help in Therapy
Everyone needs help at some point in his or her life.

Having a good emotional support network of family and friends is important to maintain an emotionally healthy self, but there are times when your problems might be beyond what you or your support network can handle (see my article: How Talking to a Psychotherapist is Different From Talking to a Friend).

Working with a skilled psychotherapist can help you to overcome your problems by working through traumatic experiences and finding new ways of coping (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than suffering on your own, you owe it to yourself to get help from a licensed mental health professional.

Being able to work through challenging problems can help you to lead a more 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.

One of my specialties is helping clients to come from their best possible self to resolve their problems by using Ego States therapy.

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

















Wednesday, February 14, 2018

When Just "Moving On" or "Starting Over" Isn't the Answer to Your Problems

There are times when "moving on" or "starting over" isn't the answer to resolving your problems.  The reason why is that, in those instances, there are underlying reasons for your problems, and if you don't understand how and why those problems developed in the first place, you're more likely to repeat the same problems.  I've been writing about infidelity lately, and this is the type of problem that requires a deeper look, so I'll use this as an example in this article (see my articles: Coping With Secrets and Lies in Your RelationshipInfidelity: Cheating on Your Husband Even Though You're Not the Type and Infidelity: Your Spouse Cheated on You. Should You Stay or Should You Go?).

When Just "Moving On" and "Starting Over" Isn't the Answer to Your Problems 

When a problem occurs that makes you feel uncomfortable, it's tempting to want to sweep the problem under the rug by saying you want to "move on" without exploring what contributed to the problem (see my article: Discovering the Unconscious Issues at the Root of Your Problems and Therapy Can Help You to Stop Sweeping Uncomfortable Problems Under the Rug).

This is most likely to happen when you feel ashamed of your behavior, as in the case of infidelity.  But if you brush this problem aside, even if you apologize to your partner, you and your partner are missing a valuable opportunity to discover the underlying reasons for what happened.  You might also be minimizing your partner's feelings of betrayal, sadness and anger.

Without that understanding, you're leaving the underlying issues for the problem in place and there to be activated again in the future.

While no one likes to admit that they made a mistake, taking responsibility for your behavior is part of being a mature adult.

While you might be very ashamed and feel guilty for your behavior and you might think that these feelings alone will prevent you from making the same mistake again, it's more than likely that the problem will reoccur due to the unconscious underlying reasons.

This is why it's so important to get help from a licensed mental health professional, who can help you to discover what the unconscious reasons were and how to prevent this problem in the future.

Fictional Clinical Vignette: 
When Just "Moving On" or "Starting Over" Isn't the Answer to Your Problems: Infidelity
The following clinical vignette illustrates these points using the example of infidelity.  However, there are many other problems, besides infidelity, that are similar in terms of there being underlying issues that need to be discovered and understood.

Ann and Bruce
When Bruce discovered that his wife, Ann, was having an affair with a coworker, he was devastated.

Married for several years and with two children, they knew they wanted to stay together rather than throwing away the life they had together.  But they each had different ideas about how to overcome their problems.

After Bruce discovered pictures of Ann having sex with her coworker, Jim, on Ann's phone, he was devastated.  He trusted Ann completely, and the thought that Ann would cheat on him never crossed his mind, so he was shocked and upset when he found the pictures.

He told Ann that he wanted to forgive her and to remain in their relationship, but he didn't think he could without understanding why this happened.  And since Ann, who expressed her regret and shame, said she didn't know why she got sexually involved with another man, Bruce told her that they needed to go to couples counseling.

Ann resisted the idea for several weeks after Bruce discovered the affair.  She told Bruce that she thought they should "move on" rather than talk about these issues in couples counseling.  She tried to reassure him that she would never cheat on him again, but Bruce wasn't convinced.

After a few weeks where they were barely talking to one another and realizing that this was affecting their two young children, Ann agreed very reluctantly to go for couples counseling.

Bruce sought the couples counselor and made the appointment.  He left his office early on the first day of their appointment and waited for Ann, who was 15 minutes late.

The psychotherapist obtained basic information from them, including the nature of the presenting problem and why they were seeking couples counseling.  Bruce provided most of the information while Ann sat looking sullen.  She barely made eye contact with Bruce or the psychotherapist.

When the therapist asked Ann why she was there, Ann said that she came because Bruce wanted to do couples counseling, but she didn't see the need for it.  As far as she was concerned, they should "just start over," especially since she acknowledged her mistake and made a promise not to do it again.

When Just "Moving On" or "Start Over" Isn't the Answer to Your Problems

The therapist could see that Ann was very ashamed and this was getting in Ann's way of being open and honest in the session.

She provided Ann and Bruce with psychoeducation about couples counseling and discussed some of the ground rules--speaking from your own experience, not interrupting the other person when s/he is speaking, and showing up for regular weekly appointments (see my article: Why It's Important for Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

Then, the therapist explained why it's important to discover the underlying issues involved in the infidelity, and she stressed that there are always underlying reasons.

She also emphasized that discovering the reasons is not the same as condoning or justifying the infidelity.  Rather than condoning or justifying, knowing the reasons for the infidelity would provide them with a chance to make changes in themselves as individuals as well as making changes in the relationship.

At the end of the session, they talked about scheduling their next appointment, but Ann said she didn't bring her work appointments with her, so she would need to wait until the next day in order to be able to make an appointment.  She made a commitment to call the therapist on the following day with information about when both she and Bruce would be available.

But the next day came and went without Ann contacting the therapist.  When Bruce asked Ann about it, she told him that she forgot to check her work schedule, so she would have to wait another day.  She knew she had a few tentative meetings at work and a possible upcoming business trip, so she wanted to wait until she had more information about these work events before she contacted the therapist.

Bruce expressed his frustration to Ann.  He felt that Ann was procrastinating and putting her work life ahead of their marriage.  He was also concerned because the man that Ann had an affair with still worked with Ann.

After they argued, Ann contacted the therapist the next day with a sense of resentment, and she made their next appointment.

During their next appointment, Ann was surprised that their therapist asked her what she got out of having the affair--what made her happy about it?  Ann hesitated to answer, and Bruce squirmed in his seat.

Seeing they were uncomfortable, the therapist explained that even though she understood that Ann felt remorseful for the affair and made a commitment that she would never cheat again, it was still important to understand what Ann felt she gained from the affair in order to discover why it happened and what changes could be made so it wouldn't happen again.

After the therapist explained the importance of understanding this issue, Bruce said he understood and, although he was uncomfortable, he realized that he had the same questions, but he didn't know how to ask Ann.

Ann hesitated a few seconds before she answered and then, looking down at the floor, she said she wasn't proud of her behavior.  In fact, she said, she felt very ashamed, which is what was making it difficult to talk about it.

She explained that her coworker, Jim, had been flirting with her for a while before they got involved. At first, she made light of Jim's comments or she laughed it off.  But then they were thrown together on a project, so they had to work closely together.

Over time, she explained, she felt flattered by Jim's attention and she began to feel attracted to him.  After a while, she began flirting back with him and she liked how their flirting made her feel.  She hadn't flirted with anyone in several years, and it made her feel sexy and attractive (see my article: The Connection Between Infidelity and the Need to Feel Desirable).

Then, in the middle of Ann telling her story, she stopped and said to the therapist, "I want you to know what I told Bruce after he found out about the affair.  He's been a wonderful husband and father.  He's been very good to me.  I love him and I know he loves me.  The affair isn't his fault."

Taking a deep breath, Ann continued:  After a few weeks of spending time with Jim and flirting, she realized that she missed him when she wasn't around him, so she would find reasons to text or email when they weren't at work.

After a while, Jim was texting her on a regular basis when they weren't together and she would respond to his flirty texts.  Soon after that, they went on a business trip together.  After a few drinks, "one thing lead to another and we slept together."

She expressed feeling very guilty and ashamed, but she also wasn't ready to stop having sex with Jim.  When she was with him, she felt attractive, free and sexy--something she had not felt in her marriage for many years.  At the time, she liked the way she felt with Jim, and she didn't want to give it up.  She never intended to hurt Bruce.

She thought she had hidden the pictures they took of themselves having sex.  In hindsight, she realized that this was a reckless thing to do but, at the time, it felt like fun.  Had she known that Bruce would find these pictures, she never would have agreed to taking them.

As Bruce listened, he began to cry, "You and I haven't had sex in more than a year.  With all the stress that you've been under with your job, taking care of our kids, and all other responsibilities, I thought I was being considerate of you by not pressuring you for sex.  It's not that I didn't want it--it was just that I thought you weren't interested in sex anymore.  You can't even imagine how hurt I feel knowing that you were having sex with another man and feeling sexy and attractive with him when I was getting your tired, irritable self" (see my article: Have You and Your Spouse Stopped Having Sex?).

At that point, Ann got up to leave, but the therapist urged her to stay and talk about what was going on for her at that moment.

Ann sat back down and looked at the floor, "This is torture for me and for Bruce.  I know you said it's important to understand the underlying reasons that contributed to the infidelity, but I'm having a very hard time with this."

In their next session, Bruce talked about how he wanted to have back the sexual wife that Ann had been when they first got married.  He talked about how they used to have sex almost every day when they first got married and then, gradually, the sex diminished until they got to a point when they weren't having sex anymore.

Ann explained that she felt like a different person when she was with Jim.  She didn't have to think about the kids or her responsibilities at home.  She felt free for the first time in a long time.  She also felt like "a new woman."

They talked about what changes they could make as individuals and as a couple so that they could improve their sex life.  Bruce had a few suggestions about allowing his parents to take the children more often so they would have time to themselves to rekindle their sexual relationship.

But Ann wasn't open to this.  She said she didn't like the idea of sending the children to their paternal grandparents, even though they liked to visit their grandparents and their grandparents would love to have them over more often.  So, they were at an impasse.

After a few more sessions where Bruce came up with more ideas for them to rekindle their relationship, including going away together without the children, and Ann coming up with reasons why Bruce's suggestions wouldn't work, Ann refused to continue in couples therapy (see my article: When Clients Leave Therapy Prematurely).

So, Bruce came on his own.  When Bruce returned to therapy on his own, he was still hopeful that he and Ann could rekindle the passion between them.  But, as time went on, he told the therapist that Ann went back to being "shut down."  Now, she refused to talk about their problems and she didn't even want to have the occasional sex that they once had.

As time went by, Bruce felt increasingly disheartened.  Ann refused to come back to therapy and she also refused to discuss things between them.  She went back to saying that she thought they should "move on" with their lives and she promised she would never cheat on him again.

Several months later, Bruce discovered texts between Ann and Jim that began a month before.  It was also clear that they had resumed their affair.  When he confronted Ann about it, she tried to deny it at first.  But when Bruce showed her the texts that he found, she admitted that she resumed the affair with Jim, and she apologized again.

But Bruce was too hurt and angry to remain in the household, so he moved out.  He needed time to think on his own.  He also asked Ann not to contact him while he was deciding what he wanted to do.

When Bruce spoke to the therapist about it, he realized that he no longer wanted to be with Ann.  He knew he couldn't trust her anymore, and he wanted a divorce.  They talked about how he would tell Ann and how they could both approach their children.

A few weeks later, Bruce told Ann that he wanted a divorce.  She begged him not to leave her, but he told her that it was too late.  He still loved her, but without trust, he couldn't stay with her.  Soon after that, he hired a divorce attorney and recommended to Ann that she do the same.

Bruce continued in therapy to work through his feelings of betrayal, anger, sadness and loss.  Even though he would have preferred to have nothing to do with Ann ever again, he knew they would need to have at least a civil relationship because of the children, so he also worked on this in his therapy.

Conclusion
There are some problems that require delving below the surface to understand the unconscious reasons that contributed to the problem.  Infidelity is one of those problems.

All too often either one or both people in the relationship want to sweep the problems under the rug.  Shame often is a big contributing factor.

Making a decision to "move on" or "start over" doesn't change the underlying reasons for the problem.  That decision only pushes down those underlying factors.  It doesn't get rid of them.

With infidelity, in particular, men and women often cheat on their partners because they get to experience themselves in a different way when they are in an affair--attractive, sexy, carefree, unencumbered by the day-to-day issues involved in maintaining a relationship and a family.

Although this might sound superficial, for the person who has the affair, it represents a renewed sense of self, a sense of self that all too often has disappeared.

Even when you make a commitment to yourself and to your partner that you won't engage in infidelity again, these underlying reasons become compelling factors in continuing or resuming an affair--unless you work in therapy to understand them and find ways to try to create an atmosphere in your relationship where you can experience that sense of yourself--even though it can be challenging.

This doesn't mean that every person who has an affair will cheat again.  But when you don't address the underlying issues on both sides that contributed to the affair, chances are that these underlying reasons will get activated again and result in a continuation or resumption of infidelity.

Getting Help in Therapy
Shame keeps many people out of therapy (see my article: Overcoming Shame: Is Shame Keeping You From Starting Therapy?).

It takes courage to ask for help (see my article: Developing the Courage to Change and Overcoming Your Fear of Asking For Help).

If you've tried unsuccessfully to work out your problems on your own, you owe it to yourself to get help from a licensed mental health professional (see my articles:  The Benefits of Psychotherapy and How to Choose a Psychotherapist)..

Getting help sooner rather than later is often the key to resolving problems.

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.