Nothing in Common with Your Spouse?

Posted on September 12, 2023 by Alisa Hafkin

So you’ve been married for a while and you realize you have no interests in common. You’re only talking about the kids or work or what needs to be done around the house. While this might seem distressing when you first realize it, it is not uncommon in marriages, including long-term, successful marriages. As a marriage counselor and psychotherapist, I have helped many couples in the New York City area find their way in this new normal and build new experiences together. 

Take inventory

All marriages go through seasons. One or both of you may be shifting a bit in interests, tastes, and abilities, but that doesn’t necessarily mean you’re drifting apart. The key is to find what brought you two together and work from there. Spend time together remembering your early months and years, what attracted you to each other, and reminisce about happy events in your early days. Doing this will help remind you of your bond of love. 

Be honest

Next, be honest with each other about your limited shared interests – not in an accusatory way, but in a way of discovery. Take the time to inventory your interests, opinions, and preferences. Talk about what you share, including the kids and various marital experiences. You may find that you actually do have things in common, they just need to be emphasized or appreciated more. 

Explore each other’s interests

After inventorying, see what things you can get interested in together. For instance, if one is really interested in cars and the other is interested in cooking, try finding out what makes this topic so interesting. Attend a car show together, or watch a cooking show together and choose a fun recipe to prepare as a couple. 

If you’re interested in fitness but your spouse is sedentary, find out if there’s a reason. Maybe your spouse doesn’t feel like there’s enough time in a busy day to exercise. Could you take a nice walk around the block after dinner instead of watching TV? While walking you can talk, listen to a favorite podcast together, or just silently enjoy the fresh air and scenery. Or maybe a bad back makes your spouse hesitant to exercise. If your spouse is willing, work together to find a fitness regime that strengthens other parts of the body. Working out together, even if it’s just stretches, is fun and releases happy hormones that can not only enhance your mood but strengthen your relationship as well. 

You could find a new hobby you both like or develop more shared experiences. Take trips together; pick up ballroom dancing; find a favorite restaurant and try a different menu item each time you visit. Or find out what your spouse likes about an activity and find another activity that includes that element. For instance, if your spouse likes building engines, maybe you could both build something together you’d both enjoy, like a piece of furniture or a series of birdhouses that attract different birds.  

Let it be

A final option is to just let it be. This is a great time to practice acceptance of the other and even celebrate your differences. Just make sure you turn into each other rather than drift apart. If you’d like someone to help guide you as a couple through this time of discovery, give me a call. I can help you navigate to a new place of shared experiences and mutual appreciation.

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Forgiving Yourself and Moving Forward

Posted on September 12, 2023 by Alisa Hafkin

The old saying, “To err is human, to forgive, divine” has a great deal of truth to it. We all make mistakes, both large and small, and most of us have been taught as children to acknowledge our mistakes and ask for the forgiveness of someone we have hurt. We are also taught to be willing to forgive others when they hurt us. However, we are rarely taught to extend that same forgiveness to ourselves. Because of this, by the time we’re adults, most of us have accumulated a significant amount of personal guilt that can affect the way we feel about ourselves and the way we interact with others. 

Forgiving ourselves can seem more difficult than forgiving others. As a psychotherapist with a background in social work, I have helped many people develop the skills it takes to forgive themselves and move on. Below I highlight some basic steps to self-forgiveness. 

Why is forgiving ourselves so difficult? It’s because we believe we have failed in our own self-identity or our strongly-held values. We are angry at ourselves for that failure, but we’re also disappointed, ashamed, even humiliated. When we feel this way, we might try to suppress these feelings in order to cope, or we may constantly play the mistake over and over in our minds, further punishing ourselves. Both tendencies are very self-destructive. 

While you may feel that you deserve to be punished and are thus inflicting that punishment upon yourself, what you actually deserve is compassion – that same compassion that you were taught to extend to others who regret their mistakes.

Face your mistakes objectively

The first step to self-forgiveness and moving forward is to think through exactly what happened that has caused you the regret. Think it through and write it down in a nonbiased, objective way. Include all extenuating circumstances. Do not use inflammatory or emotional terms such as “I then stupidly said…” Keep it objective – “I replied…”

Write down the kinds of thought patterns that you tend to fall into. When certain stimuli occur, do you remember your past regret and start to relive it? Do you start the “I’m such a horrible person” record playing over and over in your head? Do you take a physical action of self-harm, like start to pull on your hair or drink alcohol when you start to feel terrible? Examine your actions, both mental and physical. You may want to keep your notebook handy so you can write down your responses in real-time, next time you have thoughts of regret.

Next, acknowledge that you are not perfect. You are continually learning, just as we all are. Write down what you wish you had known then and what you know now – specifically, what you learned from this mistake. This infuses the mistake with purpose and gives you the knowledge you need to avoid the same mistake in the future. 

Finally, consider what you might be able to do to make amends. Is there someone you need to apologize to? If you caused physical damage, perhaps by stealing something, can you replace the item? If it’s not possible to make reparation to the particular person or repair the actual damage, can you make a contribution or perform an act of charity in that person’s honor? Think about something concrete that can demonstrate your act of acknowledging your mistake, making amends, and moving forward. 

Once you’ve gone through this evaluation, go through it all out loud. Describe out loud the mistake that you made, acknowledge your emotions, and state out loud the coping mechanisms you have developed around it. State what you plan to do to make amends and what lessons you learned about yourself and about life that you hope to apply in the future. Also, state out loud that you will be gentle with yourself if you fall into this mistake again. This is common when we have a personality weakness, such as anger, which cannot be eliminated overnight. Declare that you will continue to work to learn the opposite virtue, in this case, patience, and what you will do when you fail in the future: immediately acknowledge your mistake, apologize, and grow. 

It’s important to do this out loud. This helps create a definite space in time that you can orient your life around. “On this day, at this time, I acknowledged my mistakes and my feelings and learned to forgive myself.” With this time period as a definite moment in the past, you can begin to move forward. If you have a good friend whom you trust, you can do this with him or her, making the event even more memorable. This is your chance to start turning over a new leaf. 

Ongoing self-forgiveness

You have taken the most important first step. Now you will need to guard against falling back into the patterns of thought and behavior in the future, as you continue to grow and learn how to become the person that you aspire to be. 

Develop the skills to interrupt your negative thought patterns, silencing your inner critic. Show yourself the same compassion that you would show a friend if he or she were in your situation. Take a lesson from mindful parenting techniques, and tell yourself, “I don’t love what you did, but I love you. We can fix this.” 

Speak to a professional. Some people find comfort in speaking to a spiritual authority, such as a priest or other religious leader. This can provide help from a spiritual perspective, which can often lift much of the burden, especially if you feel you need to make amends with God. Even in these cases, following up with a professional counselor is often an important step. 

If you are in the New York City area and you need help with this process or with replacing negative thought patterns with positive, self-affirming thoughts, contact me.

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Is Social Media a Problem in Your Relationship?

Posted on September 12, 2023 by Alisa Hafkin

As a couples therapist in New York City, I frequently hear people complain about the partner’s use of social media: “I’m right here but she’s on her phone.” “He’s always on his phone.” Both men and women are equally likely to spend more time on their phones than their partner would like. 

The ability to carry a computer around in one’s pocket is a sudden, new technology that it has impacted society and culture in ways we are just now beginning to realize. Psychologists, sociologists, and medical researchers are studying this new phenomenon and the impact it has on our mental health, our physical health, our relationships, and our culture.

There’s no question that the smartphone has impacted every aspect of our existence, and in some ways very positively. We have questions answered almost instantly; we have directions to anywhere we want to go at the touch of a button; and we can contact people from all around the world at a moment’s notice, people we may never have known. 

But while social media and the smartphone keep us connected with others far from us, it can also drive a wedge in relationships with those who are closest to us. 

How the cell phone hurts relationships

Whether we’re scrolling through social media, checking our emails, or texting someone, we spend a great deal of time on our phones. Just their presence is a distraction, drawing us away from those nearby.

One fascinating study found that just the presence of a cell phone in a room, even out of a direct line of sight but nearby, significantly and negatively impacted the ability of two people to discuss something meaningful. By contrast, interacting without a cell phone nearby fostered closeness, connectedness, interpersonal trust, and perceptions of empathy. 

A variety of other problems are associated with the smartphone and social media:                 

  • Looking at the phone, responding to a text, or a notification from social media while talking to someone sends the message that whatever is on the phone is more important than the person in front of you.
  • Spending a lot of time on the phone instead of engaging in person can cause people to have lower social intelligence – the ability to “read” people, understand subtle cues, and feel a connection with others. This makes it more difficult to build deep relationships. Because of this, relationships require much more work.
  • People can equate texting someone with actually communicating, thus decreasing in-person contact. Texts can also be used as a substitute for saying the hard things in person that need to be talked out in a loving way.
  • Sharing personal information on social media without your partner’s permission can cause resentment and hurt feelings.
  • Social media triggers insecurities that harm the relationship, particularly with regard to body image in young people. Feelings of dislike of their own bodies can cause young people to have difficulty in relationships and intimacy because of their low self-image.
  • Social media use is linked to increased self-involvement, as well as low self-esteem. Constantly wanting to tweet, post selfies, or share about oneself can perpetuate the sense of lack of value.
  • Social media can provide a dopamine rush, causing quiet moments with a loved one to seem boring and unsatisfying. 

Internet addiction or social media addiction, while not yet listed as an official disorder, is nonetheless a reality that can truly damage a person’s life and relationships. But even if your use of social media and the cell phone is not to the point of addiction, everyone should take steps to limit use, for our own mental, physical, and emotional health and for the health and strength of our relationships. 

Tips to help your relationship grow in the cell phone age

Here are a few steps to responsible cell phone use:

  • Turn off notifications. One study found that smartphone notifications produced a decline in task performance and negatively impacted cognitive function and concentration.
  • Set a time to look at your phone during the day and include a time limit. You may wish to decide to check your phone before work, at lunch, and after dinner for 20 minutes each time. The short period of time means you look less online, limiting the negative mental and emotional impacts while increasing your time spent with others and with healthy hobbies.
  • Choose a time to detox from the phone and especially from social media. Some couples decide not to look at the phone all weekend and focus on each other.
  • Talk with your spouse or partner about boundaries regarding what is shared on social media and when a text can take the place of a call or a visit.
  • Ask yourself some tough questions: What does social media give me that my partner does not? Is it something I actually need? If so, how can I get it from my partner rather than from a piece of technology? 

These steps can be very difficult to take. I can help you work through these important questions and develop new habits of thought and behavior to discover a balance between your or your partner’s use of the cell phone. If you’re in or near the NYC area, call me to see how I can help.

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How to Move Forward After a Pregnancy Loss

Posted on August 18, 2023 by Alisa Hafkin

Losing a child is one of the most devastating experiences any parent can go through. This includes losing a baby before birth. And one of the hardest aspects of pregnancy loss is that friends and family may not understand the depth of your pain. In order to move forward in a healthy manner, you need to process your feelings. Sometimes professional counseling can help you and your partner during this difficult time. Openness and self-kindness are the keys to healing. 

First step: Admit your feelings – all of them

You may feel guilty about moving forward after a pregnancy loss, as if you are somehow being unfair to your child. But moving forward isn’t the same as moving on. Moving on implies forgetting, and putting something behind you. Moving forward means remembering the past, including those you have lost, and moving into the future with them as part of your life. Your baby will always be part of your life. The goal is to integrate your child in a healthy manner so that you can go on living. 

Grief goes through stages of denial, anger, bargaining, depression, and acceptance. You may feel some of these emotions more than others, but recognize them and be prepared to discuss them with your partner or another trusted person. But remember that your partner is grieving too. They may be grieving differently than you, but know that they are. It may be helpful to get some couples’ counseling to help you talk to each other about how you’re feeling and what each of you needs from the other. This is how you will heal, both individually and as a couple, and be stronger together. 

For women, remember that some of your emotions are actually grounded in the hormonal changes your body is going through. Be gentle with yourself and recognize that what you are experiencing could be partly physical. A medical doctor or naturopath may be able to help.

You may find yourself trying to understand “why.” As you do this, you may start blaming yourself, hating yourself or your body. This is an unhealthy road to take. Talking to a counselor who is experienced in pregnancy loss grief will help you avoid this negative thought process. 

Address triggers

At some point, when you are beginning to understand and manage your emotions, you will need to address the triggers that bring you back to painful memories. It may be helpful to do this together with your partner or with a counselor. In order to take the power away from a trigger, you need to address it intentionally – whether it’s a place, a song, a blanket or clothes you prepared for the baby, or the baby’s ultrasound pictures.

Celebrate your baby

Your child will always be a part of your life. Hold a memorial event of some kind, celebrating your child’s life. Invite a few close friends and family, or just keep it between you and your partner. If you have other children, include them in the process if they are old enough to understand.

Create a memorial, speak words of love to your baby, and create a memory that can bring a bittersweet smile to the two of you as you remember your child. Many parents name their child. This process can help you recognize that your child is part of your family, even if he or she was with you for only a short time. Celebrate your child.

Set up boundaries

It may take you some time to reach this point. Therefore, be kind to yourself just as you would be kind to someone else going through a pregnancy loss. Set up boundaries and share them with your friends and family. You may wish to let them know what you’re feeling and that you are not yet ready to talk about it. You may not yet be comfortable being around pregnant women or families with small children. Let them know that it’s not a snub, it’s a part of your grieving process. 

That said, don’t allow yourself to withdraw, especially from your partner. You may each grieve differently, but you need to grow stronger together during this period. Couples’ grief counseling can help. 

Take care of your health

It should go without saying, but it needs to be said: take care of your health in order to heal. Get plenty of rest. If you’re having trouble sleeping, look for natural methods, such as relaxation techniques or soothing herb teas, but if they don’t work for you, talk to your medical doctor. It’s important that your brain and body get the proper rest they need to recover physically and mentally. A healthy diet and exercise are also critical. 

If you’re experiencing grief from a pregnancy loss, please do not struggle through it alone. If you’re in the New York City area, contact me. I specialize in couples counseling, infertility counseling, and grief counseling. We can work together to help you deal with pain and grief, and taking the next steps to move forward.

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How to Better Cope with Life

Posted on July 13, 2023 by Alisa Hafkin

Our modern American lifestyle seems to generate a great deal of stress, whether from our jobs, our home life, relationships, finances, or unexpected major life-changing events. Knowing how to cope can help prevent these stressors from causing a feeling of being overwhelmed and a spiral into anxiety, depression, health issues, and relationship problems.

Frustration is often a sign of oncoming stress. It can have external causes, such as traffic or an uncooperative co-worker, or internal causes, such as having a controlling nature or being emotionally sensitive. Frustration is often the entry point for more serious and enduring emotional responses, so if you see or feel frustration coming on, immediately take steps to rein it in. 

Nipping stress and frustration in the bud

The first step is to notice your feelings and acknowledge them. The next is to determine their root source. For instance, morning traffic may cause your temper to rise, but were you already frustrated before you got in the car? Are you concerned about a presentation you’re giving that day? Did you have an argument with your spouse last night? Does any of this result from an interior cause, such as fear of losing your job, low self-esteem, or a need to control? Taking the time to make this deeper evaluation will help you respond with the proper coping mechanisms.

But we don’t always have time to think too deeply when we suddenly feel overwhelmed and it’s about to come out in a snippy comment or poor work performance. So try some of these immediate techniques and see which ones work for you: 

  • Close your eyes, do some deep breathing exercises, turn your mind to a pleasant thought or a relaxing scene in your imagination
  • Center yourself in the here and now. There are numerous techniques, but one easy method is to name out loud three things you can see, three things you can hear, three things you can touch, etc. This interrupts anxious thoughts and helps you begin to calm down. Remember to breathe deeply!
  • Distract racing thoughts by counting backwards. Too easy? Try counting backward by 7s, starting from 100.
  • Grab hold of the negative thoughts you’re experiencing and say the opposite out loud in a truthful manner. For instance, you may think, “I’ll never get this project done! There’s too much and they haven’t given me all the information I need!” Grab those thoughts and correct them. “I will certainly get this project done, though it may take longer than expected. Let me focus on the portions I have enough information for and inform my boss that I need this other information. I will also give her a reasonable timeframe and ask what parts are most critical to do first.”
  • Get some exercise. If you are able, walk away from the stressor, get outside in the fresh air and sunshine, and do nothing for a few minutes. Look at something beautiful or listen to some cheerful music.
  • Count your blessings. Think of at least three things you are thankful for. If you’re really stuck, be thankful for the most obvious – “I’m thankful that I have a brain. I’m thankful that I have legs and they work. I’m thankful for the air. I’m thankful that my allergies aren’t very bad today.”

The techniques above aim to immediately break the power of racing thoughts or negative emotions to allow you to react more calmly to the situation.

Lifestyle changes

Besides stopping anxiety or frustration when something triggers the feelings, look to your lifestyle to see what changes you can make to dial down your emotional level.

  •  Turn off the news and the use of social media – give yourself a time limit daily, maybe 20 minutes in the morning and 20 minutes in the evening.
  • Evaluate what you watch. Does it make you compare your life to other people? Is the content uplifting? Eliminate that which does not support positive emotions.
  • Add moderate exercise to your daily regimen. Moderate exercise boosts your mood because it releases hormones that create positive emotions. It also applies low-level stress to the body, triggering the release of even more hormones which help with stress management. If you’re not big into exercise, take a brisk walk of about 30 minutes a day. Walking with a pet or with a friend makes the walk more pleasant and commits it to your daily routine.
  • Plan time to wind down after work, filling quiet hours with light, sound, and creativity – keeping in mind that the music or art or whatever you choose should not, as stated above, create negative emotions.
  • Connect with loving friends and plan pleasant events with your spouse or partner.
  • Practice self-love and self-compassion. Get into the habit of making positive statements to yourself and allow time for pampering sessions, a good night’s sleep, and healthful food. 

Getting help

One of the most important aspects of coping with stress is knowing your triggers and the roots of the stress. As mentioned in the beginning, it may take a little soul-searching to find the core reasons. You may feel you need some help finding the underlying causes of chronic stress or the reason why certain things tend to “set you off.” If so, reach out to me. I provide a safe and secure environment for people as they seek self-awareness, and I help them develop the motivation to make a change for a more peace-filled, happier life. If you are in the New York City area, contact me to see how I can help you.

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How Infertility Impacts Your Mental Health

Posted on July 12, 2023 by Alisa Hafkin

The stress associated with infertility comes from many different directions. Recognizing the sources of psychological stressors is the first step to combatting them. As an individual or couple struggling with infertility, you have medical professionals addressing your physical health, but you may also need a professional addressing your mental health. 

Can stress cause infertility?

I’m sure you’ve heard the well-intentioned but painful advice, “Just relax and you’ll conceive.” There are certainly anecdotal incidents in which women who cannot conceive during a period of stress are able to conceive when the stress has passed, but this is not always the case.

Studies have suggested, however, that improper functioning of the thyroid and the hypothalamus-pituitary-adrenal axis can lead to an increase in depression and anxiety, which can in turn, impact fertility. Other studies have found an association between depression and abnormal regulation of hormones that control ovulation.

While studies are ongoing, there is enough evidence to suggest that one’s mental health can decrease fertility and therefore should be carefully managed.

Impacts on mental health

Infertility can cause a wide range of emotional responses in both men and women, though they often cope differently. Frequent emotional responses to infertility include:

  • Depression, anxiety, mood swings
  • Guilt or shame, blaming yourself
  • Blaming your spouse or partner
  • Feeling like your spouse doesn’t understand or doesn’t know what to say or do to help you
  • Low self-esteem, feeling defective, inadequate, or a failure
  • Jealousy of people who easily conceive or who have children
  • Stress, hurt, or anger from unsolicited advice, thoughtless words, and misunderstanding among family and friends
  • Anger or hatred of your body 

In addition, infertility treatments and the very process of assisted reproduction can cause significant stress, depression, and anxiety, through a number of mechanisms:

  • Fertility drugs: Hormone treatments to improve fertility or bring about ovulation can impact your mood, cause sleep disruption, anxiety, depression, hot flashes, and other unpleasant side effects
  • Physical pain and discomfort from the medication or medical procedures
  • Juggling appointments, taking medication at just the right time
  • Tracking bodily symptoms, which can make you hyperaware and focused on your body, increasing body anxiety
  • Feeling intimacy has become a project rather than a spontaneous act of love
  • Trauma from frequent failed attempts, especially with IVF 

Protecting your mental health and your relationships

If your mental health, marriage, work, or relationships are suffering from your struggles with infertility, therapy may be a way to alleviate some of the stress. Find a mental health professional who specializes in treating couples dealing with fertility issues.

Your improved mental health may also increase the success of your treatments. Several studies on the effect of cognitive behavioral therapy (CBT) on couples dealing with fertility have measured both a decrease in anxiety, depression, and anger as well as an increase in fertility rates.

As a psychotherapist in New York City, one of my areas of focus is infertility counseling. I utilize psychodynamic and cognitive behavioral therapies to help couples and individuals develop coping skills to manage stress in order to stay healthy while dealing with fertility issues. Contact me today to see how I can help you. 

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Symptoms of Stress and Anxiety

Posted on June 12, 2023 by Alisa Hafkin

Everyone experiences stress, especially in the busy world in which we now live, including New York City – one of the busiest places in which to live. So while we in NYC have many exciting opportunities in our fast-paced city, we may find ourselves dealing with stress more than we would like – and sometimes anxiety as well. While these terms are often used interchangeably, stress and anxiety are very different conditions, and it’s important to know the distinction for your mental health. 

Stress and anxiety can share certain symptoms, and stress can sometimes lead to anxiety, which is why they are often confused; however, there are distinctions. Stress is usually caused by an identifiable, outward stimulus and generally abates when the stressor passes. Anxiety is a chronic condition generally caused by perceived future stimuli and may be rooted in past experiences. Its stimulus is often not identifiable. 

Is it stress or anxiety?

Stress and anxiety are both functions of our “fight or flight” response, which is a critical response from our sympathetic nervous system that surges hormones into our body to protect us in times of danger. The heart pumps faster, senses become more acute, and we may sweat, breathe faster, and shake a little from the additional adrenalin pumping into our muscles to make them stronger. While this is very helpful if we’re being chased by a lion or trying to exit a burning building, it can be frustrating before a presentation or when dealing with personal conflict. 

After the stressor has passed, the parasympathetic nervous system kicks in and the body calms down and experiences what is often called the “rest and digest” state. This back-and-forth between these two responses of the autonomic nervous system keeps our physical and mental health in balance. 

However, when external stress remains elevated for an extended period of time, or when other life experiences cause us ongoing internal distress, the “rest and digest” is not permitted to activate, leaving us in a state of anxiety. Symptoms of anxiety may include:

  • Persistent feelings of apprehension or dread
  • Difficulty concentrating
  • Worry about non-threatening situations or unlikely scenarios
  • Panic attacks, which can feel like signs of a heart attack: chest pain, nausea, racing heart, feeling choked or chilled
  •  Mild ongoing feelings of panic, such as tightness in the chest or throat, elevated heart rate, nausea
  • Sleep disorders
  • Change in eating habits
  • Irrational fears
  • Thoughts of self-harm
  • Feeling out of control or helpless 

This is not an exhaustive list, and symptoms vary from person to person, which is why it is important to get professional help if you are experiencing sustained feelings of fear, dread, or panic.

Getting help

Anxiety is one of the most common mental health issues in the United States, affecting over 40 million people a year, but less than 40% seek treatment. Anxiety can present itself as generalized anxiety, panic disorder, obsessive-compulsive disorder, social anxiety, phobias, and PTSD. Fortunately, anxiety can be a very treatable condition. 

Whether you are experiencing chronic stress or anxiety, take an important first step by jump-starting your parasympathetic system through mild exercise, deep breathing exercises, nature walks, and techniques that will calm your mind, such as meditation, prayer, soothing music, or a soak in the tub.

These activities will help calm the stress hormones and activate the calming hormones, such as endorphins. Keep in mind, however, that for many people who are experiencing severe stress or anxiety, professional help is needed.

As a psychotherapist practicing psychodynamic and cognitive behavioral therapy with a background in social work, I am uniquely qualified to help people find the underlying causes of their feelings and fears and resolve them in a safe, supportive environment. I will help you uncover automatic thoughts and develop techniques to replace those unproductive thoughts with productive and life-affirming thoughts and feelings. If you’re in the NYC area, contact me to see how I can help you. 

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When Your Toxic Boss Causes You Stress

Posted on June 9, 2023 by Alisa Hafkin

A toxic boss can wreak havoc on your mental health. In order to protect yourself and your career, you may need to make some important changes in order to free yourself from the emotional stress caused by this unhealthy environment. Together we can uncover how you can step out of the line of fire. 

What is a toxic boss?

Sometimes a toxic situation can be created by a boss’ poor management training or a lack of interpersonal or communication skills. Your manager may also be going through a lot of stress, personal or professional, which may be fueling some of their behavior. In these situations, the toxic environment may be unintentional and your boss may be open to discussion. 

Some of your stress or discomfort may be due to personality quirks in your boss that are themselves neutral, but that you dislike. In this case, counseling may help you understand the underlying cause of those feelings to lessen their impact on you. 

But some traits of a bad boss are truly toxic and are signs of a person who is not likely to listen to reason.

Some characteristics of a toxic boss include:

  • Micro-managing and over-monitoring
  • Pushing and rushing employees continuously, creating an environment of constant frenzy
  • Not respecting the employees’ personal time, workload, hours
  • Unreasonable deadlines without providing necessary information and allowing sufficient time
  • Playing employees against each other; gossiping; talking about subordinates to other employees; talking down to employees
  • Humiliating, in public or private; asking inappropriate questions or displaying inappropriate behavior
  • Bullying, lying, shouting, gossiping, emotionally manipulating
  • Threatening your employment, salary, or promotion
  • Over-criticizing the smallest mistakes; bringing things back up as excuses to continue to criticize
  • Being insensitive to the personal needs of the employees
  • Playing favorites; giving undeserved bad feedback to superiors
  • Making promises but reneging later
  • Bragging and promoting oneself, aggrandizing personal accomplishments to the belittlement of others

Finding solutions

Finding a solution to your situation may involve some self-reflection. We can look at your situation and discuss some options by asking yourself key questions. 

Should I leave or stay? Even if you can’t immediately change jobs, it’s important to have a clear career plan, understand your personal and professional strengths and accomplishments, and have a solid resume always prepared. It’s sometimes difficult for people to reflect on their own strengths, so we can work together on that. 

What can I do differently at work? We can discuss how you usually respond to your boss’ toxic behavior and find healthier reactions: keeping out of the line of fire; focusing on the work rather than the person; keeping detailed records of unacceptable behavior. We will discuss what not to do: responding in kind, complaining about the boss, and making comments that might hurt your career. 

What personal changes can I make? Sometimes a change of mindset can make all the difference. By keeping in mind that your boss is a human being and probably has problems of their own, your anger may be reduced to a manageable level where you can develop some coping thoughts that help create a more positive environment between your ears. We can work on those strategies together. We will also discuss some soothing practices such as meditation, exercise, and developing and maintaining healthy relationships and activities outside of work so that you are not thinking about the problems in your professional life when you are not working.

Contact me if you need help navigating a toxic work environment. Together we will look at your options and help you develop tools to make sure you stay out of the drama and keep your mental health and your career intact.

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Is Couples Therapy Covered By Insurance?

Posted on April 28, 2023 by Alisa Hafkin

When you start to search for marriage counseling or couples therapy here in NYC, you have a lot of questions, and one of the first questions is usually, “How much will this cost?” It is unfortunate that this is often a critical component in the decision of whether or not to seek counseling or therapy. 

The cost of therapy is also a great concern for couples because in many cases, money is an issue that causes a couple to come to therapy in the first place. So it’s important to me that my clients are comfortable with any out-of-pocket costs they may have. 

Fortunately, things are much better now than in years past. There is a much greater realization among public health experts and insurance companies that money invested in therapy or counseling is money well spent, and therefore, some mental health coverage is usually available. I provide all the paperwork you need to file your claim and obtain reimbursement. 

The nitty-gritty of insurance coverage

Mental health greatly impacts one’s work performance. For this reason, many companies have insurance policies that partially or fully cover various forms of therapy, counseling, or psychiatric help. Nonetheless, some insurers require a medical diagnosis in order to provide mental health coverage, and relationship counseling is not always covered. 

If a doctor diagnoses you with “mental distress, “adjustment disorder,” depression, or another mental health condition, most insurers will cover therapy, and a spouse may be present at sessions as support. This therapy, however, is not specifically couples therapy, although some therapists may use CPT codes 90847 (family/couples therapy with client present) and 90846 (family/couples therapy without client present) to bill insurers. CPT codes are not diagnostic codes, however, and it is the latter that drives reimbursement. The diagnostic code that would determine coverage is the one associated with the mental health diagnosis (like depression), while the diagnostic code for marriage counseling is Z-63.0. 

So the question to ask the insurer is how they cover Z-codes. You may also ask specifically about Z-63.0. If, however, one of you does have a diagnosed mental health issue, you can both benefit by being in session together to understand how to support each other through the healing process. While this is not strictly marriage counseling, such counseling can certainly help your marriage and will likely be covered. 

Other coverage options

Check with your HR department at work to see if your employer provides additional support for employees through their own program, such as an Employee Assistance Program. Medicare Part B covers 80% of couples therapy costs. And if you have an HSA or FSA, you may also be able to use your funds for couples therapy. 

Why it’s worth it

It is human nature to value more that which is more valuable. You are probably more careful with your good china than with the everyday kitchen dishes. This can also be said about counseling. I have seen in my practice that couples who benefit from therapy truly recognize that the value of their relationship outweighs the monetary cost. 

In fact, the cost of marriage or couples therapy is nominal, considering the long-term benefits. Happily married people live longer, have fewer strokes and heart attacks, and are more likely to survive cancer and major operations than single people or those in stressed, unhappy marriages. Besides the physical health benefits, it goes without saying that a happy marriage will support mental health in broader ways.

So please, do not allow the concern for financial costs to deter you from getting marital counseling. Find an experienced marriage counselor near you, or if you’re in the New York City area, contact me to discuss your particular situation to see how I can help you and your spouse grow stronger, healthier, and happier in your relationship.

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Infertility When Everyone Else Is Pregnant

Posted on April 28, 2023 by Alisa Hafkin

Infertility affects 12% to 15% of couples in the United States. The emotional pain caused by infertility can be quite intense and can be triggered by almost anything: the sight of children, a pregnant woman, or an invitation to a baby shower. Well-intended comments may inadvertently add salt to the wounds. I help many clients gain strength as they go through infertility treatment while their friends and loved ones are having children.  

If you are experiencing strong emotions, depression, or relationship problems due to your infertility, please seek out the help of a therapist who specializes in infertility counseling. One of the main focuses of my practice is helping both individuals and couples who are experiencing infertility, and I can provide strategies and communication skills to help heal the hurt and improve your relationships while you work towards building your family. 

Dealing with family and friends

In my experience, I have found that many individuals and couples are reluctant to discuss their situation with family and friends, which can increase feelings of depression, anxiety, and loneliness. This can be very triggering, especially if you’re getting comments like “So, when are you going to start having kids?” 

Your family, if you feel they are there for you, is your natural support system, and your friends are your chosen support system. Don’t leave them unaware of the most important issue you’re dealing with right now. They will want to know how to support you and what to say and not say.

Here are a few suggested conversations you can have with those closest to you:

  • Please recognize the intensity of the emotions I am feeling and do not try to minimize them with statements that are intended to be helpful but diminish our struggle. Statements like “Just relax and it will happen” or “Well, at least you get to do what you want without a baby to deal with” will only make me feel worse. Comments like “I’m so sorry you have to go through this” and “Please let me know how I can help” are helpful to me and make me feel loved and supported.
  • Please don’t compare me to other people by telling me what worked for your friend. I’ve probably heard it all, and I already know there are cases of people who get pregnant right after they adopt, by “just relaxing,” or after taking certain supplements. If I ask you, please share what you’ve heard. If not, please know that I’m trying everything already.
  • If you’re pregnant or have been pregnant, please don’t complain or say “You’re so lucky you don’t have to deal with morning sickness/swollen ankles/hormone fluctuations/stretch marks.” I would gladly endure all those things.
  • Please don’t talk too much about other people who are having lots of babies or gush over the latest newborn. Yes, if my sister has a baby, I’m happy for her, but it will probably make me feel sadder for myself, so please don’t overdo the discussion in my presence, because it will feel like “rubbing it in.” Please don’t be offended if I can’t bring myself to go to a baby shower. I will send my love and a gift, but an extended celebration of someone else’s baby is too painful.
  • At the same time, please don’t shut me out of the family because you want to spare my feelings. Please invite me to things. I want to be there. I will judge for myself based on how I’m feeling if I can attend, and believe me, I am trying to work on my emotions so that I have a healthy emotional outlook and can comfortably attend events and rejoice in other people’s families as I work to build my own. But understand that it will take time. 

These are some suggestions to get you started interacting honestly with the people who are most important to you in your life. 

Dealing with co-workers

You do not owe any information to co-workers. If you receive off-hand comments such as “So when are you having a baby?” You can choose to be polite and tell them, “This is a sensitive topic for me and I prefer not to talk about it.” For a person who tends to be rude or obnoxious and whose opinion will not affect your job, you can just tell them it’s none of their business. 

If a co-worker is pregnant, congratulate her. If she is talking a great deal about her pregnancy or showing ultrasounds, try to politely extract yourself, or tell her that while you are happy for her, it is difficult for you, and you are probably not the most appreciative audience. Suggest she talk to another co-worker who you think would appreciate her stories and pictures.

If your direct superior needs to okay your frequent doctor appointments or breaks for medication, you may give him or her just the basic information necessary. Otherwise, do not share any details with co-workers, even friends, because things tend to get around the office. 

Dealing with your own inner voice

We often don’t recognize our own self-destructive patterns of thought without the help of a trained therapist. In my practice, I utilize psychodynamic and cognitive therapy approaches to help people understand their unique thought processes and help them make more conscious choices with regard to their emotions and their lives. 

Women who experience infertility often experience depression or anxiety or blame themselves for past mistakes that they believe caused their infertility. They may feel “unworthy” to be a parent. They may allow themselves to develop resentment or envy toward pregnant women or mothers with young children. When these feelings are directed toward family members or friends who are able to conceive, the feelings are extremely destructive. Please reach out for help. 

Men also have strong emotions about infertility, which differ from those of women. They can become angry, feel guilty, or feel like their virility or “manhood” is in question or diminished by infertility. Men are less likely to show these feelings, so they may bottle them up which might affect their marriage or their work. 

Besides addressing the emotions of the individuals, I help couples find ways to communicate their needs to each other and find things they can enjoy together that strengthen their bond, irrespective of children in their lives. 

By taking the time to work through your own interior struggles you will grow closer as a couple, be less triggered by people and events around you, and be able to handle the fertility treatments with more peace in your heart. You will be stronger as a couple, as you look forward to the future hope of being a strong family. Reach out to me to see how I can help you.

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