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Monday, September 29, 2014

Psychotherapy Blog: Reacting to the Present Based on Your Traumatic Experiences of the Past: Part 2

In my last article, Reacting to the Present Based on Your Traumatic Experiences of the Past: Part 1,  I wrote about how past experiences can get triggered in the present and gave short scenarios as examples.

Reacting to the Present Based on Your Traumatic Experience of the Past

In this article, I will give a composite case to show how trauma therapy can help clients in therapy to overcome this problem.

The following scenario, as always, is a composite of many different therapy cases:

Ed
Ed began therapy because he was having a very difficult time at work with a supervisor who was a bully.

Reacting to the Present Based on Your Traumatic Experiences of the Past 

He was aware that many of colleagues also had problems with this boss, but he couldn't understand why he froze in fear whenever this supervisor bullied him.  Ed knew that he was considered one of the company's top employees, and that he wasn't going to be fired.  He also knew that  his supervisor often blew off steam at the expense of employees and after he blew off steam, he would calm down again, as if he never lost his temper.

But knowing all of this didn't help Ed, and he couldn't understand why.  He just didn't seem logical to him.

Ed discussed his early history, which included a father with an explosive temper, who often hit Ed's mother, Ed and Ed's siblings.

Even though he still resented his father for how he lost his temper when Ed was a child, Ed and his father began to get along better after Ed became an adult.

His father got help in therapy when Ed was in his late teens, and his father discovered that he had post traumatic stress disorder (PTSD) from his military experience.  Getting help allowed Ed's father to work through his rage and fear in therapy, so he no longer lost his temper with Ed and his family.

After hearing about Ed's history, I provided him with psychoeducation about trauma, including how past trauma can get triggered in the present as well how intergenerational trauma (his father's PTSD) might have affected Ed and his family (see my article:  Psychotherapy and Transgenerational Trauma).

As Ed described his reaction to his father when Ed was a child and his reaction to his current supervisor  in his current situation, there were obvious parallels.

Reacting to the Present Based on Your Traumatic Experiences of the Past

As we discussed this, Ed could see it, but his new insight about this wasn't enough to stop him from getting triggered whenever his supervisor lost his temper so, as a first step, we worked on developing the necessary coping skills to help calm himself during the supervisor's outbursts.

Developing these coping skills, which included mindfulness meditation and breathing exercises was a good first step to help Ed to calm himself after he reacted to his supervisor's outbursts (see my articles:  The Mind Body Connection: Mindfulness Meditation and Learning to Relax: Square Breathing).

The next step in therapy was for Ed and I to deal with his past trauma using EMDR, a mind-body oriented therapy that was developed by Francine Shapiro, Ph.D. to help clients overcome trauma.

Whereas talk therapy is usually a top-down therapeutic approach, EMDR and other mind-body oriented  types of therapy are a bottom-up approach (see my article:  Mind-Body Psychotherapy: The Body is a Window Into the Unconscious).

Gradually, Ed began to work through his early trauma related to the abuse he experienced and also the abuse that he witnessed as a child.

Once he worked through his personal trauma, although he found it annoying, he was no longer triggered by his supervisor's temper.  He also took positive action on his own behalf and found another job with a healthier work environment.

Getting Help in Therapy
EMDR isn't a "quick fix" and each person will process trauma in his or her own way.  However, EMDR and other types of mind-body oriented therapy, like Somatic Experience and clinical hypnosis, are usually more effective in resolving trauma than talk therapy.

Getting Help in Therapy

If you are struggling with unresolved emotional trauma, you owe it to yourself to get help from a licensed mental health professional who is a trauma therapist.

Once you have worked through your emotional trauma, you can be free to live your life without getting emotionally triggered by your past.

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 an appointment for a consultation, please call me at (212) 726-1006 or email me.

Saturday, September 27, 2014

Psychotherapy Blog: Reacting to the Present Based on Your Traumatic Experiences of the Past - Part 1

All of us, without exception, are affected by our past experiences.

Sometimes, we're aware of how our past affects our perspective about the present.  But, often, we're not aware that we're reacting to the present based on our experiences of the past because these experiences remain unconscious.

Reacting to the Present Based on Your Traumatic Experiences of the Past

When the effect of past experiences, whether they're conscious or unconscious, has a positive effect, this isn't usually a problem.

But when the effect of past experience is negative, there are bound to be problems.

Why?

Because we're seeing current situations, which might not really be negative, through the lens of our own past negative experiences.

Instead of responding to current situations by reflecting on their meaning in the present, we respond in a negative way because we're getting triggered by the past.

Reacting to the Present Based on Your Traumatic Experiences of the Past

When this occurs, most people are unaware of it and confuse what happened in the past with what is happening now (see my article:  Working Through Emotional Trauma: Learning to Separate "Then" From "Now" in Therapy).

This makes it difficult to reflect on the current circumstances.  And, most of the time, it also makes it difficult to engage in self reflection about what's going on internally on an emotional level.

In a future article, I'll give a composite scenario of how this often plays and how trauma therapy can help.

For now, here is a list of examples of how this can occur in situations:

Examples of Reacting to the Present Based on Traumatic Experiences of the Past:
  • Tom is walking down the street when he sees a woman approaching with her German shepherd on a leash.  Suddenly, Tom's heart begins to pound, he begins to perspire, and without even consciously realizing what he's doing, he is running as fast as he can down the street in the opposite direction to get away from the dog.  When he gets home and calls his older sister to tell her about what happened, she tells him that when he was two year's old, he was bitten by a German shepherd who broke loose from his leash.  Tom has no recollection of being bitten at two and so he can't understand why he would respond this way now.
Reacting to the Present Based on Your Traumatic Experiences of the Past
  • Ray is veteran who served in Iraq and witnessed the atrocities of war.  When he walks down the street, he tends to be anxious and vigilant about what's going on around him.  Suddenly, a car backfires and, without thinking about it, Ray dives for cover.  He is trembling all over, afraid that he'll be hit by enemy fire.   Even after he realizes that he isn't in Iraq, he gets startled when a passerby tries to help him to get up.  He doesn't know that he has posttraumatic stress disorder (PTSD) from his military experiences.
  • Jane gets into a cab to go crosstown to visit a friend.  She tells the taxi driver where she wants to go and she sits back and relaxes as they head in the direction to her friend's apartment.  But as the taxi driver begins to chat with Jane, she has a visceral reaction.  She's shaking and has an urge to jump out of the cab in the middle of the highway, but she doesn't know why.  She feels confused and she can't think straight.  All she knows is that she needs to get out of the car immediately, so she tells the driver to pull over and let her out.  Then, she gets out of the taxi as quickly as possible.  Later on that day, when she arrives at her friend's apartment by subway, she sobs as she tells her friend she doesn't know what happened.  As her friend listens to the story, she makes the connection that Jane didn't remember at that moment:  Jane was raped on a dark street when she was a teenager, but she never saw the man.  But her friend pieces things together and she realizes, based on what Jane told her, that the taxi driver had a similar accent to the man who raped Jane.  This was enough for Jane to have a trauma response.
There are many similar examples where a current situation triggers a trauma situation from the past.

Reacting to the Present Based on Your Traumatic Experiences of the Past

Whether the trigger is known or unknown, the person can have a visceral emotional and physical reaction to the current situation.

It often makes no sense in the present because there's nothing going on in the current situation that would warrant these traumatic reactions.

Even for people who can make the connection between the past and the present, they often don't understand why something from the past should have such a big negative impact on them in the present because they don't understand what it means to get emotionally triggered by the past--whether the past is as an infant or the past was last week.

Getting Help in Therapy
There are times when regular talk therapy isn't effective in helping traumatized clients to work through their history of trauma (see my article:  When Talk Therapy Isn't Enough).

If you suspect that you're having a traumatic response where you're getting emotionally and physically triggered by the past, you can get help in therapy from a licensed mental health professional who has expertise in trauma therapy, like EMDRSomatic Experiencing or clinical hypnosis.

Working through your trauma can help to free you from your history so that you can live in the present and no longer have responses based on your past.

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, September 22, 2014

Psychotherapy Blog: Some Thoughts About Autumn and New Beginnings

My school days are long behind me, and yet, even as an adult, whenever autumn rolls around, I feel the same type of anticipation I felt when I was a student.

Autumn and New Beginnings
I can still remember the excitement and anticipation about starting a new school year and everything involved with preparation for the new year:  getting new outfits for school, buying new pens and pencils, and wondering what my teachers would be like and who would be in my class.

To this day, even though I have a Smart phone where I could schedule my appointments, I still use an academic appointment book that runs from August to September because that's how I still experience the year.

To me, September feels like the beginning of the new year--not January.

As a child, I experienced that last day before going back to school with a sense of wistfulness.  I still feel that way as summer ends and autumn begins.

Up until that last day,  summer seemed to go on forever.

It's interesting how we experience time as children as opposed to how we experience it as adults.  Now, of course, each summer seems to go by faster and faster.  

I had a cousin who would lay around brooding all day long on the day before school started because she wanted to make that day feel like it lasted a long time.

Autumn:  New Beginnings

Somehow, for me, Autumn still feels like it's the time for new beginnings.

After taking it easier during the summer, Autumn brings a sense of starting something new, whether it's new projects, new commitments that we make to ourselves or a new perspective that we hope to develop.

Starting Therapy
After being away for all or part of the summer, along with all the other changes that people anticipate, many people consider starting therapy in the fall.

If you're considering starting therapy, whether it's for the first time or you're returning to therapy, I hope you will enjoy reading some of these articles and that they'll be helpful to you:



About Me
I'm 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 send me an email.
















Monday, September 15, 2014

Psychotherapy Blog: Overcoming Emotional Blocks in Therapy

In my prior article, Working on Emotional Blocks in Therapy, I began a discussion about identifying emotional blocks.  In this article, I'll discuss how you can overcome emotional blocks in therapy.

Overcoming Emotional Blocks in Therapy

As I mentioned in my previous article, emotional blocks can be readily apparent, as when a client says, "I don't feel I deserve anything good" or they can be unconscious.

When they're unconscious, they usually take more time to come to the surface.

The following scenario is a composite of many cases that demonstrates one way that an emotional block can be identified and worked through in therapy:

Karen:
Karen was in her mid-20s.  She had seen several therapists before she came to see me to deal with unresolved trauma from her childhood that made her fearful of getting involved in romantic relationships.

In her prior therapies, Karen learned, on an intellectual level, that she wasn't responsible for her parents' emotional neglect of her, but this didn't make her any less afraid of the possibility of being emotionally neglected or hurt in a relationship.

Her fear of getting hurt was so great that she shied away from men who showed interest in her, even if she was attracted to them.

At the same time, she was very lonely and wished that she could overcome her fear so she could be in a relationship.

She had been in cognitive behavioral therapy before, so she understood that her fears were distortions, but that didn't change anything.

She had also been in psychodynamic therapy and understood that she had underlying unconscious feelings that were part of the problem, but she didn't know what these unconscious feelings were or what to do about them.

Overcoming Emotional Blocks in Therapy

Using clinical hypnosis, we explored her feelings about being in a relationship.

Over time, in a relaxed hypnotic state, she sensed her conflictual emotions--both her desire to be in a relationship as well as her fear.

As we continued to explore her fear using clinical hypnosis, over time, we both realized that she had an emotional block which was that she was "unlovable." Her fear was that after a potential boyfriend really got to know her well, he wouldn't care about her any more.

Despite the fact that she knew that she had close friends who really cared about her a lot, there was still a part of her that felt she was unlovable.

We continued to work with this part of her in hypnosis.

Over time, it became apparent that this was a younger part of her (many people call this part the "inner child").

This part didn't respond to the logical explanations of cognitive behavioral therapy or psychodynamic interventions because it was such a young part, possibly preverbal.

So, we worked in therapy to help this young part of Karen to develop the internal resources that she needed to nurture this part of herself.

We worked to help Karen internalize positive experiences that she had with various friends and mentors in her life on a deep level.

Prior to working this way, even though Karen experienced her friends' love for her, her feelings were fleeting and she never internalized them in a deep way.  The challenge in our work together was to help Karen to internalize these positive experiences on a deeper level.

By remembering individual positive experiences in hypnosis and making these feelings come alive for her on an emotional and physical level, over time, Karen began to have a sense of being a lovable person.

This work wasn't quick, but by enriching these memories during hypnosis, she experienced these positive experiences not only in an explicit (conscious) way--she also learned to have an embodied experience of them on an implicit (unconscious) level (see my article:  Mind-Body Psychotherapy: Healing Trauma With New Symbolic Memories).

Overcoming Emotional Blocks in Therapy

By doing this work, Karen was able to enhance the positive experiences that she had with nurturing individuals so that these memories became a bigger part of her awareness on a conscious and unconscious level, which is different from just having an intellectual understanding:  She actually felt and believed it.

Getting Help in Therapy to Overcome Emotional Blocks
Emotional blocks are common problems for many people.

They're often difficult to overcome on your own.

Rather than struggling against these blocks by yourself, you could benefit from getting professional help from a licensed mental health practitioner who can help you to overcome them.

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.



























Sunday, September 14, 2014

Psychotherapy Blog: Working on Emotional Blocks in Therapy

An emotional block can sabotage therapy for even the most motivated psychotherapy client.  Most people who come to therapy experience some degree of ambivalence about change, even when the change is something that they really want.  But an emotional block isn't just about ambivalence.

Working on Emotional Blocks in Therapy

What Are Emotional Blocks?
Emotional blocks usually develop due to past negative experiences and unresolved emotions.   This includes emotional trauma.  Emotional blocks are usually unconscious self-limiting beliefs that can lead to self sabotage.

They are part of unconscious defense mechanisms that people use (without realizing it) to ward off their fears.

These blocks usually involve some aspect of a client's belief about him or herself that can undermine the therapy if the therapist and client don't realize what's going on and work to help the client overcome this distorted belief.

Examples of Emotional Blocks:
"I don't deserve to be happy."
"I'm an unlovable person."
"Feeling good is selfish."
"I'm a bad person and I deserve to suffer."
" I should put everyone else's needs before my own."

Identifying Emotional Blocks in Therapy
Listening for emotional blocks often requires a therapist to be attuned to the underlying, unconscious content that the client communicates in sessions.

Sometimes, the content of what's communicated by the client isn't hidden at all--it can be stated in a direct way, like the examples that I've given above.

There are also other ways that a therapist can detect emotional blocks in clients.

So, for instance, when clients come to see me for a psychotherapy consultation, I usually ask them if they've been in therapy before and what their experiences in therapy have been.

When clients tell me that they've been to many different therapists, but no one has been able to help them at all, I know that there can be many different reasons for this:
  • On the one hand, there could have been a mismatch between client and these therapists; the therapists might have lacked the skills to help the client with the particular problem; a client might have left therapy too soon before completing the work, and so on.
  • On the other hand, I'm also aware that the problem could involve an emotional block that keeps the client stuck and undermines the therapy.
As the treatment unfolds with each client, the origin of the problem usually becomes apparent.

Why Is It Important to Work Through Emotional Blocks in Therapy?
If the problem is an emotional block, it's important that it is identified and worked through or the client will probably remain stuck and, as I mentioned earlier, the work in therapy will be undermined.

In many cases, when emotional blocks go undetected, the therapy can feel like it keeps looping around in a circle without progress.

In my next article, Overcoming Emotional Blocks in Therapy, I address these issues with a composite case to show how emotional blocks develop and how therapists, who are skilled in dealing with these blocks, can help clients to overcome them.

Getting Help in Therapy
If you think you're stuck because of an emotional block, you could benefit from working with a licensed mental health professional who is skilled in helping clients to overcome these blocks.

Getting Help in Therapy

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.





Thursday, September 11, 2014

September 11th: We Will Never Forget

To all the families and friends who lost loved ones on September 11th, a heartfelt wish that you are with loving friends and family on this anniversary to ease the pain of your loss.  

Let us all remember the lives that were lost in that senseless attack and honor those lives.

After the September 11th World Trade Center attack, I met with many spouses and family members who lost loved ones on that shocking day.

Anniversaries such as September 11th can stir up a lot of emotions.  If you're experiencing a flood of emotions for your loss, be especially kind to yourself on this anniversary.

If you know someone who lost a loved one on September 11th, find out how they're doing and be compassionate.

Life goes on, but we will never forget.

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

To find out more about me, visit my website:  http://josephineferrarotherapy.com.

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


Monday, September 8, 2014

Psychotherapy Blog: Learning How to Connect With the Quiet Place Within Yourself

In my last article, Discovering the Quiet Place Within Yourself, I discussed what the "quiet place within yourself" is and the various other terms that are used to identify this part, including core self, authentic self, true self, the center, and the inner world.

Learning How to Connect With the Quiet Place Within Yourself

I use these terms interchangeably.

I also discussed why many people have fears about spending quiet time connecting to their inner world.

In this article, I'll discuss some of the benefits of connecting to your inner world and also give some tips on how to do it.

Benefits of Connecting With the Quiet Place Within You
Among the many benefits of connecting to your inner world, you may find that you can:
  • cope better with challenges that come up in your life 
  • develop an increased sense of self awareness
  • develop an increased sense of self confidence 
  • make decisions and problem solve more easily
  • de-stress more easily 
  • develop greater compassion for yourself and others
  • develop emotional intelligence
  • become more intuitive
  • go to this place as an emotional "inner sanctuary" 
Tips on Connecting With the Quiet Place Within Yourself
Keep in mind that, aside from the suggestions that I'm giving, there are many ways to connect with your inner world, including meditating, doing yoga, practicing mindfulness, journaling, and going to therapy (to name just a few).

If you've never attempted to connect with your inner world without distractions, be aware that it takes practice and, with practice, it usually gets easier to do.
  • Start by finding a quiet place where you won't be interrupted or distracted (turn off your phone).  If you can't go to a peaceful place outside, just find a quiet place in your home.  If you live with family members, tell them that you'll need about 20 minutes to yourself.
  • Close your eyes and take a few deep breaths.
Close Your Eyes, Take a Few Deep Breaths and Slow Down Your Breathing
  • Slow down your breathing.
  • Relax as much as possible by consciously allowing the muscles in your body to relax and soften.  This can be done in many ways.  One way is to do a mental body scan where you sense into your body to see where you're holding onto tension.  Start from the crown of your head and go slowly down the rest of your body.  Wherever you sense tension in a particular area, imagine sending your breath to that place and allowing the muscles to relax.
  • If you have a negative thought or an uncomfortable feeling, just allow it to come up and see it in your mind's eye as floating away like a cloud.
If You Have a Negative Thought, Let It Float Away Like a Cloud
  • To sense into your inner world, focus on the area between your throat and your lower abdomen and just see what you notice.  Just notice what comes up, don't analyze it or interpret it--just notice it.
  • Keep a journal to write down your observations and reflections afterwards about what you experienced.
Practice Connecting to the Quiet Place Within Yourself
If you've never engaged in any practices that put in touch with your inner emotional world, you'll need to practice this exercise in order to get better at it.

Learning How to Connect With the Quiet Place Within Yourself

Keep in mind that connecting to your inner world is a skill, so don't get discouraged if, at first, you have  a hard time staying focused, as many people do, or if you're not sure what you're sensing.

Many people who practice get better at it over time and discover that the benefits that they derive from connecting to their inner world is well worth the time and effort.

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

I work with individual adults and couples.

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

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