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Monday, February 1, 2016

Psychotherapy Blog: Redefining Happiness and Success For Yourself

Developing your own definition of happiness and success for yourself is part of an important personal growth and development process.

Redefining Happiness and Success For Yourself

Throughout the different stages of your life, you could find yourself redefining what happiness and success means to  you as you grow and change.

It's not unusual for people to change what they want, especially as they approach midlife and reevaluate their lives (see my articles:  Midlife Transitions: Reassessing Your Life and Midlife Transitions: Living the Life You Want).

Sometimes, what seemed important at an earlier stage in your life becomes less important later on in life.

Maturity, life experience, losses, aging, surviving a serious illness and other important experiences can contribute to your need to reevaluate your life and what makes you happy.

The following brief fictionalized scenarios are examples of how people change their minds about what's important to them:

Larry came from a long line of doctors in his family.  His great grandfather, grandfather, father and older brother were all doctors.  So, from an early age, his family urged him to follow in his family's footsteps to become a doctor.

Redefining Happiness Success For Yourself

Although Larry was interested in painting, his father urged him to forget about his artwork and concentrate on science and math.

Fifteen years after Larry graduated from medical school, he was a successful cardiologist at a prestigious hospital, but he was deeply unhappy.  Although he cared about his patients, he was disenchanted with all the changes in the health field and he longed to get back to painting.

Burnt out and at his wit's end, he began therapy to explore what he wanted to do with the rest of his life.  Gradually, over time, Larry realized that he allowed his family to dictate what it meant to be successful and happy because he didn't want to disappoint them.  And, although he was good at taking care of his patients, he wasn't nurturing himself.  So, he decided to cut back on his hours to give himself time to paint.

Once he began painting, he felt more emotionally integrated and approached his work as a cardiologist with a new sense of purpose and devotion.  He also began to think about spending more time painting when he retired.

Mary spent most of her adult life in banking.  She started as a teller and worked her way up to a position as a managing director.  Although the work was financially rewarding, Mary felt that something was missing in her life.  She was two years away from retirement and she found herself daydreaming about running a bed and breakfast in the country.

Initially, she pushed these thoughts out of her head because they seemed so far fetched to her.  But, over time, as this daydream continued to occupy her thoughts, she realized that she needed to pay attention to them.

Redefining Happiness and Success For Yourself
When she approached her husband about it, he was surprised at first because Mary had never mentioned this to him before.  But the idea of moving out of the city, living in the country and running a small bed and breakfast began to appeal to him.  Their children were already grown and on their own.  With their retirement savings, they could afford to do it.

The main challenge for Mary was that, since she was in her early 20s, she had defined herself, to a large extent, based on her career in banking.  She was also very successful in her field and she derived satisfaction from being recognized as successful.  Retiring from banking and running a bed and breakfast would be a big change.

As she discussed her daydreams with her therapist, she began to feel more comfortable with the idea of making plans for this major change.

Martin spent his 20s working as a flight attendant.  Although he loved the travel benefits, he found the work uninspiring.

After a close friend died suddenly from a brain aneurysm, Martin began to reevaluate his life.  He realized that life is short and he wanted to do something that had meaning for him.   But he didn't know what he wanted to do.

Feeling lost and confused, he began therapy to explore these questions.  As he opened up to his internal experience in therapy, he realized that he wanted to help others.  Exploring many options by talking to people in various medical and social service settings, he decided to become a social worker.

Redefining Success For Yourself

Although giving up the travel benefits was hard, as Martin began his first internship in the social services field, he knew that he had made the right choice.  Working with children and seeing the difference that he made in their lives was the most fulfilling experience of his life.

These fictionalized scenarios are just a few examples of how people grapple with a need for change and a process of redefining what is meaningful to them.

These types of changes are often preceded with ambivalence and anxiety.  In many circumstances, it can feel like you're stepping into the unknown, which is why people going through this process often find it helpful to work with an experienced mental health professional who can help them to understand and work through the underlying issues, including deep underlying fears, that might be holding them back.

Getting Help in Therapy
Asking for help isn't always easy.  Anticipating change can also be anxiety provoking.

If you're struggling with your own definition of what it means for you to be successful and happy or you identify with one of the fictionalized scenarios above, you could benefit from seeking help from a licensed mental health professional.

Working with a licensed psychotherapist, you can explore your own anxiety and ambivalence about what it means to be successful and happy, and overcome the underlying issues that might be getting in your way.

Seeing a licensed psychotherapist to help you to discover what makes you happy can help you to 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, January 25, 2016

Psychotherapy Blog: The Connection Between Perfectionism and Core Shame: A Clinical Example

In my last article,  I began a discussion about the relationship between perfectionism and core shame by defining core shame and discussing how it often begins in early childhood.

The Connection Between Perfectionism and Core Shame

In this article, which is Part 2, I've provided a fictionalized scenario to show how core shame develops and how it can be overcome in psychotherapy.

Alan grew up an only child in a household with his parents.  They lived in his maternal grandmother's house.

His grandmother was a domineering woman.  Even though his parents were in their 30s when they had Alan, his grandmother treated his parents as if they were children.

She had her own apartment in her house, but she spent most of her time in their apartment overseeing their daily routine, criticizing his parents, and overruling almost all of his parents' decisions.

Alan's father, who was frustrated with the grandmother's behavior, would urge his wife to stand up to her mother.  But even though Alan's mother was furious with her mother's behavior, she was too intimidated by the mother to stand up to her.  So, the grandmother continued to rule the roost with an iron hand.

The Connection Between Perfectionism and Core Shame

Alan tried to stay out of his grandmother's way because he was afraid of how critical she was of him.  By the time he went to school, his grandmother was overseeing his schoolwork and criticizing almost everything that he did.

He really tried to be perfect in everything that he did to ward off his grandmother's criticism.  But, no matter how perfect he tried to be, she was still critical.

Alan developed into a shy, withdrawn child.  He got good grades, but he was afraid of raising his hand in class because he feared being wrong.

His teachers called his parents up to school several times over the years to talk to them about Alan's shyness and lack of self confidence.

Although his parents understood why Alan had developed these problems, they both felt powerless to stand up to the grandmother.

When Alan moved away to college and got away from his home, he began to open up more.  He excelled academically and became more social.  But he still carried a sense of core shame within him that he tried to hide from others, and he was still a perfectionist.

By the time he entered into his first serious relationship after college, Alan's core shame became evident to his girlfriend as she got to know him better.  She also worried about all the pressure that Alan put on himself to be perfect and suggested that he seek help with a mental health professional.

When Alan came for his session of therapy, he thought he was supposed to already know why he was having problems.  He felt deeply ashamed that he had not already figured out the source of his problems.

The Connection Between Perfectionism and Core Shame

When his therapist told him that he wasn't expected to know the source of his problems and, in fact, it was her job to help him discover the source of his problems, he was somewhat relieved.

After the therapist heard Alan's family history, she suggested that they use EMDR (Eye Movement Desensitization and Reprocessing) to help him to overcome his shame and the need to be perfect (see my articles:  What is EMDR? and How Does EMDR Work?).

By processing his early childhood traumatic experiences with EMDR, Alan could feel something shifting in him emotionally.

Rather than blame himself for not being perfect and feeling ashamed about this, he had a deep sense that it was his critical and domineering grandmother and his passive parents who had problems when Alan was growing up.

Alan gradually worked on his anger and fear for his grandmother as well as his anger towards his parents with EMDR.

After processing his early childhood memories, Alan's core shame and need to be perfect were alleviated.

Eventually, Alan felt compassion for his grandmother, who was raised by very critical and abusive parents.  He also felt compassionate for his parents, who were too afraid to stand up to the grandmother.

The Connection Between Perfectionism and Core Shame

By the time Alan completed treatment, for the first time in his life he felt free of the core shame and the need to be perfect which had weighed him down since early childhood.

As I mentioned in my prior article, the need to be perfect often comes from a deep sense of core shame that develops in early childhood.

Most people who experience the need to be perfect often don't make the connection between core shame and perfectionism until they come to therapy.

Experiential therapy, like EMDR, is most effective in helping clients to overcome core shame which is at the root of perfectionism (see my article: Experiential Therapy, Like EMDR, Helps to Achieve Emotional Breakthroughs).

Getting Help in Therapy
Core shame is often at the root of many presenting problems in therapy.

Since core shame is usually unconscious, it's hard to overcome on your own.

Working with a licensed psychotherapist, who has expertise in helping clients to overcome core shame, you can free yourself from the childhood experiences that are at the root of core shame.

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, January 18, 2016

Psychotherapy Blog: The Connection Between Perfectionism and Core Shame

In two prior articles, Perfection vs. Good Enough and Overcoming Perfectionism, I address perfectionism and it's relationship to anxiety.  In this article, I will address the connection between perfectionism and core shame, which develops in early childhood.

The Connection Between Perfectionism and Core Shame

What is Core Shame?
Let's first start by defining core shame.

First, it's important to understand that core shame is different from an appropriate sense of shame, which is adaptive.  An adaptive sense of shame helps children as well as adults learn to behave in ways that are essential to emotional learning.

So, for instance, if a child hits a playmate in anger and he realizes that his action hurt his playmate, he will most likely feel an appropriate sense of shame and remorse about his behavior.  This is part of his emotional learning that his behavior has consequences and the shame is a signal to him that this is not the way to behave.

The shame that he feels is about his behavior and it will help him to learn how to interact with others when he feels angry.  If there are adults to help him, they will teach him that he can do other things that are healthier for himself and other ways to express his anger.

Core shame is a pervasive sense of worthlessness.  There is also usually a fear that others will see that you're worthless and a "fraud" (see my article:  Overcoming Impostor Syndrome).

As opposed to healthy shame, which is about behavior, core shame is feeling ashamed of who you are as a person.

Core shame often results in a strong need to be "perfect," which, of course, is impossible because we're all imperfect as human beings (see my article: Healing Shame in Psychotherapy).

People who feel core shame often feel like they're unlovable and they will be abandoned by others (see my articles: Overcoming the Emotional Pain of Feeling Unlovable and Overcoming Fear of Abandonment).

Feeling unlovable and having a fear of abandonment often result in self perpetuating life events.  So, for instance, people who feel unlovable and who fear abandonment, often shy away from relationships or behave in ways that alienate others.  Often, if they do chose to be in a relationship, they will unconsciously choose romantic partners who are unreliable and who will abandon them.

How Does Core Shame Develop and How Is It Connected to Perfectionism?
As I mentioned earlier, core shame develops at a very early age.

When attachment and bonding go well, babies develop a sense of secure attachment.  But when mothers are unable to provide a secure sense of attachment, usually because they didn't internalize a secure attachment with their mothers, infants will eventually develop insecure attachment which will have repercussions for them as young children and as adults.

The Connection Between Perfectionism and Core Shame

One of the repercussions of insecure attachment is core shame.

Since young children are naturally egocentric, they believe that if their mother is neglectful or abusive towards them, it must be their own fault.  They don't understand that their mother's misattunement is due to the mother's problems.  They're too young to understand that their basic emotional needs aren't being met.  Instead, they believe that, as children, they're unlovable and worthless.

These feelings of being unlovable and worthless develop into an unconscious need to be "perfect."  If this unconscious belief could speak, it would say something like, "I know that I'm unlovable and worthless, but maybe if I'm perfect, people will love me.  So, I must do everything that I can do to be perfect."

This is a very simple explanation to how core shame develops.  A more comprehensive explanation would include the how attachment develops and the various forms of insecure attachment (see my article:  The Impact of the Early Attachment Bond).

In my next article, I'll continue to discuss the relationship between core shame and perfectionism and how these problems can be overcome in psychotherapy.

Getting Help in Therapy
Core shame and perfectionism are common problems that many people struggle with throughout their lives.

If you're struggling with these issues, you can overcome them in therapy with an experienced psychotherapist who has an expertise in these areas.

Rather than struggling on your own, you can get help from a licensed mental health professional so that 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.

I have helped many people overcome core shame.

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, January 11, 2016

Psychotherapy Blog: What is Adjunctive EMDR Therapy?

I've written prior articles about EMDR, including:
What is EMDR?
EMDR Therapy When Talk Therapy Isn't Enough
How Does EMDR Therapy Work?

In this article, I'm focusing on EMDR as an adjunctive therapy.

What is Adjunctive EMDR Therapy?

What is Adjunctive Therapy?
Many clients are seeing psychotherapists who might not do certain types of therapy, like EMDR, Somatic Experiencing or clinical hypnosis.

They will often have a very good therapeutic relationship with their therapist and not want to leave her or him to see a therapist who does another form of therapy.

Usually, they are happy to discover that there is a way for them to remain with their psychotherapist and to see another therapist adjunctively.

This means that their original therapist remains their primary therapist and the adjunctive therapist is the secondary therapist.

As long as the primary therapist is in agreement with this arrangement and, with the client's consent, both therapists can communicate with each other, adjunctive therapy usually works very well.

The adjunctive therapist usually works on a particular issue where she has particular expertise and skill, like psychological trauma, and the primary therapist remains the therapist who continues to see the client as before.

Aside from clients seeking out adjunctive therapy, primary therapists often refer their clients to adjunctive therapists, like EMDR therapists, because they know their clients can benefit from this other form of therapy.

How Does EMDR Work as an Adjunctive Therapy?
In my prior articles, I've written about how EMDR works when it is the primary therapy.

With EMDR as an adjunctive therapy, the client chooses a particular issue that s/he wants to work on with the EMDR therapist, usually involving trauma.

The psychological work can be about developmental trauma, which is psychological trauma that stems from unresolved childhood issues.  It can also be shock trauma (see my article:  ).

It is important that both therapists, the primary therapist and the adjunctive therapist, agree on the treatment plan so they aren't working at cross purposes to each other.

Another important element is that the adjunctive therapist must honor the relationship that the client has with the primary therapist, and it is understood in advance that the adjunctive therapist will not try to see the client exclusively without the primary therapist seeing the client.

The primary therapist must also be respectful of the adjunctive work and if s/he has any hesitation about it, s/he needs to express this to the client beforehand.

The following fictionalized scenario is an example of how adjunctive EMDR therapist can work:

Ted had been seeing his therapist for regular talk therapy for several years.  Although both he and his therapist felt that he had made some progress with unresolved family of origin issues, they both felt that their work had not helped Ted to resolve certain traumatic events in his childhood history, including a history of emotional abuse with his father.

Ted's therapist knew several colleagues who did the type of trauma work that she didn't do, including colleagues who did EMDR.

Since she wasn't trained in EMDR and she knew that EMDR is usually effective for the type of trauma that remained unresolved for Ted, she recommended that Ted have a consultation with one of her colleagues.

During the consultation, Ted signed a consent form so the EMDR therapist could speak with his primary therapist.

What is Adjunctive EMDR Therapy?

Ted was glad that he could do the trauma work with the adjunctive therapist without having to give up his primary therapist.

As the work progressed in EMDR, Ted felt that he was working through his childhood trauma in ways that he was unable to do with regular talk therapy.

During his sessions with his primary therapist, he talked about the things that came up for him during EMDR therapy.  He also talked about other areas in his life that were not part of his traumatic history.

During his sessions with his EMDR therapist, he and the therapist remained focused on the particular traumatic issues.  She remained available to him if things came up between sessions related to the work that they were doing.  However, he was also grateful to be able to speak with his primary therapist because they had a longstanding relationship with a very good rapport.

What is Adjunctive EMDR Therapy?

After Ted successfully completed EMDR, he remained with his primary therapist.  After several months, they talked about the possibility of ending their sessions since Ted was doing so well.

Clients that have an established relationship with their therapist don't need to choose between leaving their therapist to see an adjunctive therapist.

EMDR therapy, as well as other types of trauma therapy, can be done as a primary therapy or an adjunctive therapy.

Although it would involve an additional expense, clients often find that many different types of adjunctive trauma therapy works faster than regular talk therapy so, in the long run, it can help to shorten therapy and reduce expenses.

Getting Help Therapy
If you are interested in exploring EMDR as an adjunctive therapy, it's best to speak with your therapist (if she or he doesn't do EMDR therapy) to explore this option.

If you're both in agreement about the possibility of exploring EMDR therapy as an adjunctive therapy, the next step would be to find an EMDR therapist in your area and to set up a consultation.

As you would with any psychotherapy consultation, it's important to choose a therapist that you feel comfortable with (see my article:  How to Choose a Psychotherapist).

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

I work with individual adults and couples.

I work with EMDR as a primary therapist as well as an adjunctive therapist.

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, January 4, 2016

Psychotherapy Blog: Getting Help in Mother-Daughter Therapy

I've written previous articles about mother-daughter relationships, including: Mother-Daughter Relationships Over the Course of a LifetimeAmbivalence and Codependence in Mother-Daughter Relationships and Mother-Daughter Relationships: Letting Go of Resentment.

Getting Help in Mother-Daughter Therapy

There are times when mothers and adult daughters, who love each other and want to get along, find it too difficult to reconcile their relationship so they come to mother-daughter therapy in an effort to repair their relationship in sessions facilitated by an experienced psychotherapist.

If resentment has been building over time, it can be especially difficult for mothers and daughters to reconcile on their own.

Often, when they try to improve their relationship, they don't get anywhere because each person is entrenched in her own position.  This can lead to even more misunderstandings and hard feelings.

Let's take a look at a fictionalized scenario, which is a composite of many different cases and which illustrates how therapy can be helpful:

Betty and Jane
When Jane was a young child, she and her mother, Betty, were close, especially since Jane was an only child and her father was often away on business.

Their problems started around the time when Jane turned 15.  As a teenager, Jane wanted more autonomy to go out with friends, but Betty preferred that Jane invite her friends over the house rather than going out.  This caused friction between them, and Jane began to rebel by staying out past her curfew.

By the time Jane was in college, she rarely came home to visit her parents.  Jane's father, Bob, accepted that Jane was older now and she wanted her freedom, but Betty felt hurt and angry that Jane only called once every few weeks and only came home on holidays.  This increased the friction between them.

Jane moved back home briefly after she graduated college, but she felt that her mother was trying to control her even though she was now 21 and had already experienced the freedom of being away.  Betty's attitude was, "You're in my house so you need to obey my rules."

There were frequent arguments between Jane and Betty, and as soon as Jane earned enough money to share an apartment with friends, she moved out.

Their relationship continued to be strained throughout Jane's 20s.  Bob tried to be a mediator between them, but nothing he did worked.

After Betty had a health scare, which turned out to be a false alarm, both Betty and Jane regretted the rift between them.  They both wanted to improve their relationship, but they didn't know how to do it.

At that point, Betty's close friend, Pat, told Betty that she and her daughter attended mother-daughter therapy after a rough patch in their relationship and it helped them to reconcile longstanding issues. So, Betty spoke with Jane, who was willing to give it a try, and Betty set up a consultation.

During their therapy sessions together, Betty and Jane learned to listen and empathize with each other.  Betty realized that she was too strict when Jane was growing up and that she could have allowed her more independence as a teenager.  Jane realized that she had been impatient with her mother and, now that she was older, she could appreciate why her mother was so concerned about what could happen if Jane was out with friends.

The therapist gave Jane and Betty exercises to do between sessions where they each took turns expressing their feelings without interruption and then the "listener" had to repeat what she heard.  This involved developing active listening skills where the "listener" focused on what the "speaker" was saying without getting caught up with what she wanted to say to respond.

The "speaker" focused on using "I messages" where she took responsibility for her own feelings and didn't blame the "listener."

Aside from coming to sessions regularly and doing the between session assignments, one of the most important factors was that Jane and Betty were really motivated and, underneath the tension and conflict, they really loved each other and wanted to have a good relationship.

Getting Help in Mother-Daughter Therapy

By the time they completed therapy, they were getting along much better.  Even though they still had occasional arguments, which is common between any two people who are close, they were able to reconcile these arguments quickly without the resentment that they had before.

It's not unusual for mothers and daughters to have problems in their relationship.

Even when mothers and daughters want to reconcile their relationship, it's often hard to do on their own without help.

A licensed psychotherapist, who has experience helping mothers and daughters to overcome their problems, can facilitate this process.

Getting Help in Therapy
If some of the issues in this article resonate with you, you and your mother (or daughter) could benefit from getting help in mother-daughter therapy.

Rather than allowing resentment and bitterness to continue to grow, you can address your problems with a licensed mental health professional who can assist you to have a more fulfilling relationship.

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

I have helped mothers and daughters to work through their problems so that they could develop a healthy relationship.

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, December 28, 2015

Psychotherapy Blog: How the Defense Mechanism of Idealization Can Get in the Way of Having a Healthy Relationship

It's not unusual for young children to idealize their parents.  A mother or father can seem to be all-knowing or powerful in many ways. It's usually a stage of development that children go through and, in many ways, this idealization helps them to feel safe and secure with their parents.

How the Defense Mechanism of Idealization Can Get in the Way of Having a Healthy Relationship

Over time, as children get older, especially during adolescence, their peers become more important in terms of bonding, influence and achieving a sense of autonomy.

But many people, especially people who have had a traumatic family history, get stuck in this idealization phase to the detriment of their personal growth as adults and also to the detriment of the issues they want to work through in their therapy.  For them, the idealization becomes a potent defense mechanism.

Many psychotherapists have had the experience of hearing a client talk about having "wonderful parents" or a "great childhood," only to discover later on in therapy that the client had a serious history of abuse or neglect as part of his or her family history.

As young traumatized children, who are powerless to move out and who are often too afraid to let anyone outside the household know about abuse or neglect, the early roots of this problem are understandable.  Most children who are being abused or neglected would prefer to believe that it's their own fault than to believe that their parents are abusive people.

It would be too scary to realize that they're in a home environment that is dangerous.  So, it's preferable to idealize their parents and believe that that, as children, they must have done something "bad" to cause their parents to abuse them and that, if their parents are abusing them, it must be because they "deserve it."

When a therapist realizes that a client is using an idealization defense mechanism with regard to his or her family of origin, it's important to be compassionate and tactful.  Being mindful of how the idealization defense developed in childhood helps to be compassionate.   It also helps to appreciate how strong this defense can be and that it requires a nuanced approach in therapy.

It helps both therapists and clients to realize that idealization, as a defense mechanism, like most defense mechanisms, served an important purpose in childhood to keep the children from feeling overwhelmed in a situation where they could not escape.

At the same time, when adult children idealize parents who were abusive or neglectful, as mentioned previously, this defense mechanism gets in the way of their psychological development and can derail their therapy.

Let's take a look at a fictionalized vignette which represents many different cases:

Mike came to therapy a few months after his last relationship ended.

How the Defense Mechanism of Idealization Can Get in the Way of Having a Healthy Relationship

Even though his friends told him that they felt he was not being treated well in his relationship with Ann, Mike couldn't understand what they were talking about--until Ann ended their relationship because she started a relationship with someone new.  Even though they had agreed to be monogamous, she admitted that she was cheating on Mike with this other man throughout most of their relationship.

Throughout his relationship with Ann, Mike was aware that he was the one who wanted a commitment and Ann didn't.  Even though he felt disappointed that two years into their relationship Ann didn't even want to define it as a "relationship," he didn't realize that his needs weren't being met.

He could talk to his therapist about how his friends felt that Ann gave him mixed signals about what she wanted and that she often cancelled their plans or disappointed him in other ways.  But Mike was unable to admit to himself how hurtful this was to him.  He said he thought that Ann just needed more time.

Even after the breakup, when he realized that she had been cheating on him with another man, Mike rationalized Ann's infidelity saying that he thought she was confused and she would come back to him.  But after three months, he had to admit that she was probably not coming back, and that's when he started therapy.

He felt that it was probably his fault that he didn't live up to Ann's expectations, although he was unclear as to what those expectations were because she never told him.

When his therapist asked him about his family history, Mike said he had a "wonderful" childhood that could not have been better.  He spoke about his parents in glowing tones.  He admired his father for being a strong, principled man.  He admired his mother for pursuing her dream to become a lawyer at the same time that she was married and managed a household after Mike was born.

Over time, as his therapist explored Mike's former relationship with Ann, she noticed that Mike made a lot of excuses for Ann's mistreatment of him.  He didn't seem to think that Ann should be held accountable for disappointing him, giving him mixed messages about what she wanted or for cheating on him at the end of their relationship.  Instead, Mike took on the blame.

How the Defense Mechanism of Idealization Can Get in the Way of Having a Healthy Relationship

His therapist pointed this out to him. She also asked him what he would think if his best friend told him similar things about a relationship.  At that point, Mike became uneasy.  His eyes became slightly unfocused and he seemed to be tuned out.

It was clear to his therapist that Mike wanted to avoid seeing how he was mistreated by Ann.  It was also clear that he was not aware of his avoidance.

When his therapist explored prior relationships, she heard similar themes where Mike chose women who were abusive, but he never saw the abuse.  Instead, he blamed himself.

Recognizing that this was a longstanding pattern for Mike, his therapist realized that Mike used the defense mechanism of idealization to ward off the hurt and pain that he surely would have felt if he were not defending against it.  She also surmised that, based on how ingrained it was, this defense mechanism probably didn't start with his relationships with women.

In a tactful and compassionate way, his therapist asked Mike to write about his family history from the point of view of a biographer--so not from his own point of view, but from the perspective of an outsider.  She wanted to see how Mike would describe his family if he had the perspective of an outsider and if Mike was using the idealization defense mechanism with his family.

When Mike came back the next week, he read his description of his family from the point of view of a biographer.  Most of it was still filled with admiration for both parents.  But there were also particular stories about his parents where it was obvious to the therapist that Mike was minimizing problems.

In one particular vignette about his father, Mike described how his father taught Mike valuable "lessons" on how to be "strong." One way that his father did this was to, without warning, take out his belt and wallop Mike unexpectedly every so often from the time that Mike was 10.

Mike told this story with a slightly dissociated look and with no emotion.  He told his therapist that, according to his father, the "lesson" was that Mike had to learn to deal with the unexpected and his father wanted to "make a man" out of him.  As he relayed this to his therapist, Mike said appreciated that his father did this for him.

Mike also described another incident where he fell and hurt his arm when he was 11 while playing baseball.  When he got home, he told his mother, who was the only one home, that his arm really hurt, but she told him that she was too busy with a legal brief she had to write and told him to ice his arm.

Throughout the night, Mike cried in pain in his room by himself.  With his father away on a business trip, his mother told Mike the next morning that she thought he was very inconsiderate for keeping her up all night with his crying and Mike felt badly about this.

When he nearly passed out from the pain, his mother took him to the ER and discovered that Mike had a broken his arm.  The doctor scolded Mike's mother and told her that she should have brought Mike in right after the accident.

Once again, as Mike told this story, he berated himself for being such a nuisance and he was glad that his father had not been home to see him cry.

Mike's therapist could see that Mike wasn't ready to see that he had been both abused and neglected by his parents.  Without realizing it, he preferred to idealize them rather than see how they mistreated him, and this was a pattern that he continued to use in his romantic relationships.

One the one hand, his therapist realized that if she proceeded too quickly, Mike would either be overwhelmed or he might leave therapy rather than acknowledge being mistreated as a child and as an adult.

On the other hand, his therapist also knew that if Mike didn't address his propensity to use the defense mechanism of idealization as a form of denial, he would continue to repeat this pattern in future relationships.

Knowing that Mike was cut off from his emotions, his therapist began to teach him how to become more attuned to how his emotions could reveal themselves in his body.

Using situations that did not involve his family or former girlfriends (so he did not idealize in these situations), she helped him to recognize when and where he felt anger, sadness, and joy, among other emotions.

This was a new experience for Mike, who never really paid attention to how he felt emotions in his body.  He was able to identify that when another driver cut him off on the highway, he felt angry and he felt it in his throat and stomach.  He was also able to identify that when his friend threw him a surprise birthday party, he felt joy and it felt like an expansiveness in his chest.  When an elderly neighbor died, he felt sadness as a weight in his chest.  And so on.

As Mike became familiar with his sense of embodied emotions, he was able to begin looking back at his relationship with Ann and allow himself to feel angry about how she treated him.

Over time, Mike was also able to look back at his childhood and feel the hurt and anger about how his parents treated him.  Rather than idealizing them, he came to a more balanced view of them as well as his childhood experiences with them.

Part of the work in therapy was helping Mike to grieve for his unmet emotional needs as a child.  At that point, because of the prior work he did with his therapist, he was able to tolerate feeling his emotions and allowing himself to grieve for what he didn't get as a child from his parents.

Although he was sad, Mike was also relieved to be able to feel his true emotions rather than suppressing them.

Over time, Mike also learned how to forgive his parents--not because he felt that he was at fault but in order for him to let go of his sadness and anger.

When Mike began dating again, he was much more attuned to what he needed and wanted in a relationship.  He was much more discerning and attuned with regard to the women that he dated.

How Defense Mechanism of Idealization Can Get in the Way of Having a Healthy Relationship

After dating several different women, he met Sally, a woman who had the qualities that he was looking for in a partner, and they entered into a mutually satisfying relationship.

Like many other types of defense mechanisms, idealization is a form of denial.

Idealization in and of itself isn't harmful.  For instance, children often idealize teachers, mentors or other role models who are nurturing and helpful to them.  Idealization in this form isn't a defense mechanism.

Idealization is a defense mechanism when it's used to avoid seeing problems with another person or other people, as in the fictionalized example above about Mike.

Idealization as a defense mechanism is an unconscious process so the person who is idealizing abusive parents or an abusive lover doesn't realize that this is what s/he is doing.

Other people, who might see the situation more objectively, can see it.  But the person, who uses idealization as a defense, often won't see it even when other people point it out to them.  If friends or loved ones persist in trying to get this person to see it, s/he often become more tenacious about maintaining the defense.

Experienced and attuned therapists know that it would be counterproductive to try to force the issue prematurely.  Even though they know that this defense has been harmful in many ways, they also know that the idealizing defense protects the client from being overwhelmed.

Therapists must use a more nuanced approach when working with these clients.  One way that is often effective is to help these clients, who are often somewhat cut off from their feelings, to become aware of their emotions in ways that are manageable by educating clients about the mind-body connection.

When clients are able to feel their emotions in an embodied way, starting with situations that are non-threatening for them, they can gradually learn to deal with the more difficult work of letting go of the idealization defense for significant relationships.

Although clients often experience grief at this point, they are also usually relieved to be able to feel their authentic emotions.

Getting Help in Therapy
Idealization as a defense mechanism is common.

If what you've read in this article resonates with you, you could benefit from working with a psychotherapist who has experience working with this issue.

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, December 21, 2015

Psychotherapy Blog: Understanding Your Emotional Needs

In a prior article, Are Your Emotional Needs Being Met in Your Relationship?, I began addressing the importance of having your emotional needs met within your romantic relationship or marriage.  But there are many people who don't understand what their emotional needs are, so I'm addressing this issue in this article.

Understanding Your Emotional Needs

Without being able to identify and understand your emotional, you can't really ask for what you need in your relationship.

Many people who had unmet emotional needs as children grow up to be adults who don't understand what their emotional needs are and how to even find out what they are.

Many of these same people go on to have romantic relationships with people who are, at best, ambivalent and, at worst, abusive, including emotional and/or physical abuse.

In contrast to people, who grew up where their emotional needs weren't taken care of, people who grew up in households where the love and nurturing was "good enough," usually have an intuitive sense of what they need from their romantic partner.  If their partner mistreats them either emotionally or physically, they are much less likely to put up with it than people who grew up with unmet emotional needs.

It's important for you and your partner that you understand what you need emotionally.

Let's start by identifying some of the most common emotional needs that people have.  This list will give you an idea, but it's, by no means, exhaustive, and you might identify other emotional needs that are important to you.

Common Emotional Needs
  • to be seen for who you are
  • to be heard
  • to be understood
  • to be encouraged, supported and nurtured
  • to feel loved
  • to receive affection
  • to have emotional intimacy with significant others (family, friends, partners/spouses)
  • to be allowed to grow and develop as a person
  • to be forgiven
  • to be touched and held
Once again, there are just some of the most basic needs that most people have, but there can be others.  For instance, someone who needs time to him or herself might have a need for a certain amount of solitude.  Or, there could be other important emotional needs, depending upon the individual.

Discovering and Understanding Your Emotional Needs
So, if you haven't had the experience of having your emotional needs met (or, maybe you not even aware that your emotional needs weren't met when you were a child) how can you go about discovering what these needs are?

As a psychotherapist, one way that I find to be very effective is to begin paying attention to what's going on in your body.

Your body contains both conscious and unconscious emotions and memories, so that focusing on what's going on in your body can begin to help you to understand your emotions as well as your emotional needs (see my article: Mind-Body Psychotherapy: The Body Offers a Window Into the Unconscious Mind).

Depending upon how in touch you are with your embodied emotions, this can be challenging, especially if you are dissociated (i.e., cut off) from what's happening in your body due to emotional trauma.

For many people, who grew up in households where they were physically abused or emotionally neglected, as children, it would have been either dangerous or too emotionally painful to be in touch with their emotional needs.

In such situations, children often defend themselves against the emotional pain by suppressing their needs.  This is a common defense mechanism.  This defense mechanism protected them in a way from feeling the emotional pain.  It protected them from feeling too vulnerable.

The problem is that these same children often grow up to be adults who are out of touch with their emotions and don't know what they need emotionally.  Even worse, they often enter into romantic relationships that replicate their childhood experiences.

Let's take a look at a fictional scenario to understand this:

Dina came to therapy because she was confused about her two year relationship with John.

Understanding Your Emotional Needs

Her close friends had been Dina all along that John wasn't treating her well after they moved in together.  Although she trusted her friends and she knew that they wanted the best for her, Dina didn't see it and she wondered if she was missing something.

When she provided her family history, she talked about growing up as an only child and being raised primarily by nannies.  Her parents were often preoccupied with their careers and too busy to spend much time with her.

As a result, before going to school, Dina spent a lot time playing on her own.  She remembered having a young nanny who was kind and attentive for a short while, but her parents fired the nanny after they discovered that she was allowing her boyfriend to come over to spend the night when Dina's parents were away traveling.

Dina remembered waking up one day to find that the nanny that she loved wasn't there.  She was given no explanation until much later when she was an adult.  This was a big loss for Dina that she suppressed and never discussed until she came to therapy.

The new nanny that they hired was somewhat quiet and reserved.  As a result, Dina often felt sad and lonely, and she sometimes went to her parents to try to get their attention.  During those times, her parents scolded her for being "needy," which made her feel ashamed.  Later on, when she was old enough, she was sent to a boarding school far from her home.

Understanding Your Emotional Needs

Shy and sad, Dina had difficulty making friends at boarding school.  There were a couple of students who were more outgoing who befriended Dina, but being at boarding school and hardly seeing her parents was a sad and lonely experience.

By the time she went to college, Dina gave the impression of being "independent."  But it was really a pseudo independence that was a defense against being emotionally vulnerable.

Intelligent and attractive, she attracted the attention of many male students in college, but she dated very little and spent most of her time with a few outgoing friends who initiated friendships with her.

Dina met John in her senior year of college.  Shy and unsure of herself, she initially kept John at arm's length.  But he was persistent and found ways to be around her during college activities.

After John asked Dina out many times, she agreed to go out with him.  Initially, she found him to be very attentive.  Not only was he good looking and intelligent, he was also very funny and made Dina laugh, so she began opening up to him more.

Dina had never experienced anything like this before, and she became captivated by him.  He was her first and only lover, and their love making was very passionate.

After they graduated from college, they found jobs in NYC and moved in together.  By then, they had been together for a year.  At first, looking for an apartment and making plans was fun.

But shortly after they moved in together, Dina realized that John seemed to change.  Whereas before he was very attentive to her, he now seemed to be preoccupied with other things--his job, his male friends, hobbies, and other activities where Dina was not included.

At first, Dina thought that John was adjusting to post college life, but a year later, he was still the same. Whenever she tried to talk to him about it, John became uncomfortable and dismissed what she had to say.

Then, a few months before she came to therapy, Dina discovered an email on John's account from another woman and she realized that when John said he was seeing his friends, he was actually seeing this other woman.

When she confronted John about it, at first, he denied it.  But she showed him the email, he blamed her.  He told her that she had become boring and it was her fault that he looked outside the relationship.  He told her that, as of now, it wasn't serious, but he wanted to continue to see this other woman to see whether it would develop.

At first, Dina took John's words to heart and she blamed herself for his infidelity.  She thought:  Maybe he's right.  Maybe I am boring.  What can I do to change?

When she talked to her close friends about it, they told her that John was making excuses, not taking responsibility, and blaming her for his own behavior.  They told her that John was mistreating her, but Dina didn't see it.  She believed that if she could be more interesting, attentive, and sexy, she could lure John back.  But no matter what she tried to do, he continued to see the other woman and spend most of his free time with her.  He wasn't even coming home at night any more.

When Dina started therapy, she wasn't sure what she felt about John seeing another woman.  She knew she wanted him to be monogamous with her, but beyond that and blaming herself, she wasn't in touch with any other emotions.

By helping Dina to become more aware of what was going on in her body, Dina began to slowly develop more of an awareness of her internal experience.

For instance, she began to recognize that when she felt her stomach muscles clinched, she was either anxious or angry and that when she felt a sinking feeling in her chest, she felt sad.

Over time, Dina began to realize how much she had suppressed her emotions as a child as a way to protect herself from feeling overwhelmingly sad and angry with her parents.  She developed compassion for that younger part of herself that was often left to fend for herself, and she appreciated why she had to suppress her feelings as a child.

But she also realized that she was much more resilient as an adult and she could now handle the emotions that would have been too overwhelming as a child.

Part of the work in therapy involved grief work for her unmet emotional needs as a child.

The work was neither quick nor easy, but eventually Dina was able to feel her anger and disappointment and recognized that John was mistreating her.  She also realized that she needed to feel loved, valued and treated with respected and her needs weren't being met in her relationship with John.  So, she summoned her courage and broke up with him.

Understanding Your Emotional Needs

Several months later, Dina began dating again.  She used her new awareness of her embodied emotions to understand what she needed emotionally in a relationship and she used this awareness to eventually enter into a much healthier relationship.

When children grow up with unmet emotional needs, they often protect themselves emotionally by suppressing those needs.

As adults, they often continue to suppress those emotional needs so that they're unaware of what they need emotionally.

This lack of awareness has consequences for the individual on his or her own and for being able to choose healthy relationships.

When clients are unaware of their emotional needs, one effective way of working in therapy is for the therapist to orient the client to what's happening in his or her body with regard to embodied emotions.

Getting Help in Therapy
Using the mind-body connection to identify your emotional needs is an effective method.

If the issues in this article resonate with you, rather than struggling on your own, you could benefit from being in therapy with a psychotherapist who has a mind-body orientation to doing 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.