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Saturday, November 18, 2017

Consider Thinking Twice Before You Get Back With Your Ex

After a breakup, it's common for one or both people to consider whether they should get back together again.  While there are times when the two of you might have been hasty about breaking up, there are definitely times when you should consider thinking twice before getting back with your ex (see my articles: Toxic RelationshipsRelationships: When Love Doesn't Conquer AllCoping With a Breakup When Closure With Your Ex Isn't Possible, and Overcoming the Heartbreak of a Breakup).

Consider Thinking Twice Before You Get Back With Your Ex

Reasons to Think Twice About Getting Back With Your Ex
  • You're Afraid That You'll Never Be in Another Relationship Again:  Related to fear of being alone, a fear that you'll never enter into another relationship can cause you to make a bad decision.
  • You Only Want to Get Back With Your Ex For Sex:  This consideration by itself isn't a good enough reason for getting back together.  You might miss the sex, but ask yourself if it's worth getting back into a relationship where there were serious problems.
  • You're in Denial About the Problems in Your Former Relationship:  Once fear, loneliness and hopelessness set in, it's very easy to fool yourself into minimizing the problems in your relationship.  Denial can be very powerful, and you would be setting yourself up for more heartbreak (Wishful Thinking Often Leads to Poor Relationship Choices).
  • Nostalgia is Clouding Your Thinking About Your Former Relationship:  This is a form of denial (see above).  When you're nostalgic about a relationship that was unhealthy for you, it usually means that you're only thinking about the good times without considering the bad times.  But the reality is that if your relationship didn't work out because of unhealthy aspects, chances are that you're going to be facing those problems again after the initial stage of getting back together.
  • You've Grown Accustomed to an On-Again-Off-Again Relationship:  You might not have liked the nature of your on-again-off-again relationship, but you might be used to it because the breakups happened so frequently.  These kinds of relationships rarely end well.  Even when you're both willing to get back together again, after a while, the unstable nature of the relationship erodes any good feelings.  After a while, even when you're in a "good phase"in the relationship, you know that a breakup will come again eventually (see my article: The Heartbreak of the On-Again-Off-Again Relationship).
  • You're Jealous Because Your Ex is Dating Someone New:  This is definitely not a good reason to get back with your ex.  When you broke up, you each probably knew that you would both move on to seeing other people.  If you get back together with your ex to stop him or her from seeing other people, you're just going to end up back in the same place again.

Consider Thinking Twice Before You Get Back With Your Ex
There are lots of other reasons why you shouldn't get back together again, including emotional and physical abuse.

I think that deep down most people who end an unhealthy relationship know that they shouldn't get back with their ex, but they might not be admitting it to themselves.

When you know that your relationship was unhealthy for you and you still want to get back with your ex, there are usually other underlying reasons that might be out of your awareness.

Getting Help in Therapy
Most people who come to see me about unhealthy relationships have already talked to their friends so many times about it that their friends are tired of hearing about it.

Hearing your friends tell you to "Just don't call him" or "Just don't call her" and hearing the exasperation and judgment in their voices can make you feel very ashamed.

Your friends are probably not going to understand the underlying reasons that are causing you to want to get back into an unhealthy relationship, so it's important to get help in therapy before you make a mistake and get hurt again.

A skilled psychotherapist can help you to understand the underlying reasons and provide you with tools to take care of yourself so you can make better decisions for yourself (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Rather than having conversations with your friends that go in circles or suffering on your own, you owe it to yourself to get help from a licensed mental health professional.

Getting help from a licensed psychotherapist will help you to making healthier choices and feel better about yourself.

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

I have helped many clients to develop insight into their problems, make healthier relationship choices, and develop healthier self esteem.

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

Are You in a Toxic Relationship?

You usually don't get to really know someone that you're seeing until you've been with them for a while.  During the initial "honeymoon" stage of the relationship, everything might seem like it's going well.  But with increased emotional intimacy, core emotional issues begin to come up, and that's when there might be signs that you're in a toxic relationship (see my article: Are Your Fears of Being Alone and Lonely Keeping You in an Unhealthy Relationship?,  Letting Go of an Unhealthy Relationship,  Falling In Love With Mr. Wrong Over and Over Again and Choosing Healthier Romantic Relationships).

Are You in a Toxic Relationship?

Signs of a Toxic Relationship
  • Controlling Behavior: What might appear to be concern at first might actually be controlling behavior.  If you're romantic partner needs to always know where you are, whom you're with or makes attempts to control your behavior in other ways, this is a red flag for a toxic relationship.
  • Excessive Jealousy:  This often goes along with controlling behavior.  Initially, it might come across as your partner being so in love with you, but excessive jealousy has nothing to do with love--it has all to do with your partner's insecurity.
  • Excessive Judgment and Criticism: Your partner might mask signs of excessive judgment and criticism as "suggestions," but if these so-called suggestions undermine your sense of self worth, it's another red flag that you're in a toxic relationship.  This often goes along with controlling behavior and excessive jealousy (see my article: Is Your Relationship Damaging Your Self Esteem?).
  • Emotional Abuse: Excessive judgment, criticism, name calling, efforts to undermine your self esteem are forms of emotional abuse.  If your partner exhibits these behaviors, you're being emotionally abused.  Needless to say, physical abuse is dangerous and if your partner is physically abusing you, you should get out of that relationship as soon as possible (see my article: Relationships: Why Emotional Abuse Might Seem "Normal" to You).

Are You in a Toxic Relationship?

  • Lack of Emotional Support:  If your partner tends to be unable to be there for you emotionally when you're going through a hard time, this is a sign that you're not getting the emotional support that you need and you're probably in a toxic relationship.
  • Taking and No Giving: Related to lack of emotional support is the romantic partner who tends to want to take emotional support from you but who is unwilling to give you emotional support.  If you're in this situation, your relationship is one-sided and toxic.
  • Constant Drama: Constant drama can be emotionally and physically draining.  There are often other underlying issues going on that you might never figure out.  In any case, emotional drama requires a lot of effort and attention and it often accomplishes nothing.  This is a sign that you're in an unhealthy, toxic relationship (see my article: Hooked on Emotional Drama: Getting Off the Emotional Roller Coaster).
  • Constant Disappointment: If your romantic partner is unable to keep promises and commitments, you're going to be constantly disappointed.  This is a sign that your partner isn't emotionally reliable, and it's a bad sign for a relationship (see my article: Keeping or Breaking Your Promises).
These are some of the major red flags for a toxic relationship.

As I mentioned earlier, these signs usually don't show up until the relationship has become more emotionally intimate because intimacy tends to bring up core issues for people.

Getting Help in Therapy
Recognizing the signs of a toxic relationship is the first step.  Knowing what to do after you recognize these signs is another matter.

It's possible that, even though you recognize these signs, you're ambivalent about getting out of the relationship--even though you know it's unhealthy for you.

You might even be engaged in wishful thinking that your relationship isn't so bad or that you'll change your partner (see my article: Wishful Thinking Often Leads to Poor Relationship ChoicesThe Problem With Trying to Change or "Improve" Your Romantic Partner and Relationships: I'll Change Him/Her After We Get Married).

A skilled psychotherapist can help you to understand what keeps you stuck in an unhealthy relationship and how to take care of yourself (see my articles:  The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Struggling on your own can make you feel worse about yourself.

Rather than struggling on your own or relying on friends who tell you unhelpful things like, "Just get out!," get help from an experienced psychotherapist who has helped other clients to overcome this issue.  Not only will you resolve your problem, but you'll feel better about yourself.

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

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

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

Overcoming Obstacles to Making Changes in Your Life

In prior articles, I've discussed the challenges of making changes in your life--even changes that you really want (see my articles: Fear of Change, Standing at the Crossroad: Fear of Making Major Life Decisions,  Overcoming Resistance to Change,  Making Changes: One Step at a Time, Preparing Emotionally For Major Changes in Your Life, and Developing the Courage to Change).  In this article, I'm focusing on overcoming emotional obstacles that get in the way of making the changes that you want.

Overcoming Obstacles to Making Changes in Your Life

Change is inevitable in life--both wanted and unwanted change.  While it may be logical to you why you resist making changes that you don't want, it might not be so obvious why you're struggling to make changes that you do want.

Let's take a look at some of the most common obstacles to making changes:

Obstacles to Making Changes in Your Life
  • Unresolved Emotional Issues:  Unresolved emotional issues from childhood often get in the way of making changes.  If you have a longstanding belief that you're undeserving or incapable of having good things in your life, you're going to be in conflict with yourself about making changes that you want.  Similarly, if you feel powerless because of unresolved trauma, you will probably struggle to take the initiative to bring about change (see my articles: Understanding Why You're Affected By Trauma From a Long Time Ago and Overcoming Trauma: When the Past is in the Present,  ).
  • Negative Habits:  Unresolved emotional issues often develop into negative habits like: negative self talk, procrastination, disorganization and other similar habits.  These negative habits become so ingrained that it's often difficult for you to see them.  Even when you see them and want to change them, it can very challenging.  For example, if you grew up feeling that you don't deserve positive things in your life, one of your habits might be an internal critic that continues to reinforce these thoughts and feelings.  After a while, these thoughts and emotions can become beliefs that are hard to challenge (see my article:  Overcoming Habitual Negative Thinking and Making Changes: Overcoming the Inner Voice of Negative Prediction).
So, if these are the main obstacles to making changes, how do you overcome these obstacles?  Let's take a look:

Overcoming Obstacles to Making Changes in Your Life
  • Step Back From Your Unresolved Problems and Become Aware of Their Effect on You:  If you've grown up with certain negative beliefs about yourself, you might not even question whether they're true or not.  That's why it's so important to step back so you can become aware of how unresolved problems, especially longstanding problems, are affecting you.  Awareness and acknowledgement are the first steps.  This isn't about blaming your parents or yourself--it's about trying to be more objective.  And, once you've become aware of your problems and acknowledge them, consider whether there are things you can do now to try to resolve them (see my articles: Getting to Know the Only Person You Can Change: Yourself and Looking at Your Childhood Trauma From an Adult Perspective).
  • Be Honest With Yourself About Negative Habits:  Once you've gained some insight into your problems, be honest with yourself about the negative habits that you've developed due to your unresolved problems.  For instance, do you tend to procrastinate when you're fearful of undertaking a certain task or goal?  Does the negative voice inside your head convince you that it's not worth making the effort because you're only going to fail, so why even try?  Once again, this isn't about blame--its about acknowledging what is and trying to find a way to change it.  Maybe you can choose one negative habit that you would like to change and work on that rather than trying to change all your negative habits at once (see my articles: Overcoming ProcrastinationOvercoming the "I'm Too Old To Change" Mindset and Changing Coping Strategies That No Longer Work For You: Passive Behavior).
  • Re-evaluate the Negative People in Your Life:  When you think about who you let into your inner circle, do you have a lot of people who are reinforcing your already negative views about yourself?  In some ways, maybe you feel comfortable with these negative people because they reinforce your already negative views and also reinforce your propensity not to take risks.  But making changes often involves taking certain risks, so be honest with yourself as to how these people are affecting you.  This doesn't mean that you have to get rid of these people from your life (although you might decide to do that).  It could also mean that maybe they're not in the inner circle, and you include supportive people in your inner circle instead.
But you might take these steps and still feel like you're stuck in a rut (see my articles: Getting Out of a Rut - Part 1 and Getting Out of a Rut - Part 2: Taking Steps).  Then what?

It's possible that you might have unconscious thoughts and feelings that are getting in your way.  Since these thoughts and feelings are unconscious, it's hard to detect them on your own.  You might get glimpses of them in your dreams or even in your daydreams, but most of the time they will elude you (see my article: What Unconscious Decisions Have You Made That Are Impacting Your Life?An Unconscious Identification With a Loved One Can Create an Obstacle to ChangeUnderstanding the Different Aspects of Yourself That Make You Who You Are and Psychotherapy: Making the Unconscious Conscious).

Getting Help in Therapy
When you're trying to overcome obstacles to making changes in your life and you're unable to do it on your own, you could benefit from working with a skilled psychotherapist who has experience helping people to overcome these obstacles, especially ones that you're not aware of because they're unconscious (see my articles: The Benefits of Psychotherapy and How to Choose a Psychotherapist).

Overcoming Obstacles to Making Changes in Your Life: Getting Help in Therapy

A skilled therapist can help you to identify these obstacles and provide you with the tools to overcome them.

Rather than struggling on your own, getting help in therapy can help you to make positive changes in your life so that you can lead a happier and more meaningful life.

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

I have helped many clients to overcome the obstacles that are keeping them from maximizing their potential.

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

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

Friday, November 17, 2017

Becoming Your True Self

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I have helped many clients to live more authentically.

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

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

Thursday, November 16, 2017

Preparing Emotionally For Major Changes in Your Life

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

Preparing Emotionally For Major Changes in Your Life

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

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

Fictionalized Vignette About Preparing Emotionally For a Major Change

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

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

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

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

Preparing Emotionally For Major Changes in Your Life

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Preparing Emotionally For Major Changes in Your Life

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Monday, November 13, 2017

Sexually Compulsive Behavior as a Split Off Part of the Self

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

Sexually Compulsive Behavior as a Split Off Part of the Self

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

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

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

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

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

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

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

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

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

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

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

Sexually Compulsive Behavior as a Split Off Part of the Self

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This behavior is usually difficult to overcome on your own.

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

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

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

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

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

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

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

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

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

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

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

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

Monday, November 6, 2017

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The first step is to set up a consultation.

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

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

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