Wednesday, April 22, 2015

The Ups and Downs Of Emotionally Sensitive People


     We all feel emotionally overwhelmed at one time or another. The intensity usually reflects the circumstances we’re faced with—like the death of a loved one, loss of a job, illness or divorce. But some people get overwhelmed by their emotions, whether positive or negative. And the intensity often causes them to react in ways that don’t reflect the reality of the circumstances.Highly sensitive people tend to reflect on things more than usual, and they worry about how others feel or think about them. They also tend to be more upset over mistakes. They’re extremely detail-oriented, lament over making decisions, and are more prone to depression, anxiety and social withdrawal.

     Being emotionally sensitive is not, however, a bad trait. The ability to feel deeply is what allows artists to create masterpieces, authors to write meaningful stories and musicians to play beautiful music. Being emotionally sensitive means we can experience the joys and sorrows of life fully.
Nonetheless, it’s important for the highly sensitive person to work on creating emotional balance.

Here are four tips:

1. Explore your sensitivity. Gain an understanding of its source. Perhaps you feel more sensitive toward a particular person or in a particular social setting. Exploring the details that stir up your emotions helps identify what you need to change to lower your emotional responses.

2. Identify what sets off your sensitivity. Keeping a journal can help with clarifying triggers—and with gaining a more realistic view of the situations that contribute to your emotional sensitivity.

3. Embrace your emotional sensitivity. Acceptance is a big step in modulating intense feelings.

4. Seek professional help if your sensitivity causes too much distress. Therapy can help you develop new ways of thinking and relating to others.


Thursday, March 5, 2015


     A happily married 43-year-old mom, Stacey has three kids and is an accomplished professional. Despite her success, she’s always felt excluded from her family—particularly by her sister and brother, who are overtly hostile and critical. "My siblings were never able to celebrate anything positive in my life,” she says. “Every celebration and holiday turned into a catastrophe, or about them.”

     In sessions, Stacey would comment, "No one communicated directly with one another in my family. So issues that needed to be talked about were expressed in passive-aggressive ways, like shutting down emotionally or gossiping behind someone's back. And since issues were never dealt with head-on, they were never resolved.”

     As a result, Stacey’s family was in a constant state of tension, hostility and conflict. “No one took responsibility,” she says. “I always felt scapegoated, too. My achievements were belittled, minimized or criticized. My parents never confronted my siblings or protected me when they acted blatantly hurtful toward me. They would collude against me, and they still do now.”

     Sadly, Stacey’s family continues to function in this toxic way. “Getting together for events like birthdays or holidays is hard,” she admits. “My family affects me emotionally, to the point where it interferes with being able to enjoy my own family and life on a daily basis. My family causes me to be depressed and anxious all the time."

     Stacey's family is toxic to her attempts to be happy. Having a toxic family makes life difficult, challenging and heartbreaking. We look to our family members to be the ones we can rely on the most to keep us safe physically and emotionally, to love us unconditionally, to watch out for us, to support and encourage us. And when they fail at these things, it can leave a deep wound. Attempts to lessen the emotional damage might include hoping things will magically improve in the future, implementing strategies for damage-proofing family relationships by always acquiescing, and regularly making excuses for family members' negative behaviors.

     What makes a family toxic? Toxic families are made-up of abusive relationships and the majority of communication is expressed in passive aggressive ways. Fear, intimidation, sarcasm and manipulation are used as a means of controlling family members' behaviors and emotions. The toxic family ends up tearing one another down rather than building each other up. Most toxic families have a scapegoat—the one who’s blamed for every problem, picked on, and put down. Fear, intimidation, sarcasm and manipulation become control mechanisms. In reality, though, the scapegoat distracts from the real problems.

     Deciding between completely severing ties with a toxic family and/or figuring out how to maintain some degree of a relationship with a toxic family or family member WITHOUT losing one's sense of pride and sense of self is a challenging feat at best. A toxic family dynamic contributes to depression, anxiety, substance abuse, low self-esteem and many other issues. Figuring out how to cope is crucial to one’s emotional health. Below are five helpful strategies:

1. Give yourself time to mourn. We all want a family that’s supportive, loving and kind. Unfortunately, not everyone can. Processing and accepting this loss is an important step in moving forward.

2. Set limits and boundaries. Make toxic family members aware in advance of what topics you will not discuss. Use discretion in what you share, and limit the time you spend with them.

3. Work on your self-esteem. It's hard not to be influenced by family members; we care what they think about us. But no one can make you feel badly without your permission.

4. Get what you need from others. Make a conscious effort to build relationships that are supportive, positive, loving and reciprocal. Having people you can rely on will help make up for what your toxic family can't provide.

5. Separation and Individuation. This occurs when we make an emotional and cognitive shift away from the way our family views the world and their definition of who we are. In the process, we become individuals with our own perspectives, feelings and ideas.

Thursday, February 12, 2015

Classic Defense Mechanisms:The Good and the Bad

Classic Defense Mechanisms: The Good and the Bad

And the signs of each of the four types.

Defense mechanisms keep us in check and balanced. But, as with most things in life, there are healthy defense mechanisms (which prevent us from acting out in negative ways) and unhealthy ones (which simply make things worse). DMs help us manage our unconscious and unacceptable thoughts and urges, curbing anxiety and the other negative feelings we’d experience if we were more aware of our upsetting thoughts.

Nonetheless, relying too heavily on unhealthy DMs impedes our ability to resolve psychic conflicts. It keeps us “stuck” in a negative cycle and prevents us from living happier and more authentic lives. Dr. George Valliant, a noted psychiatrist, grouped defense mechanisms into four categories, which I’ve broken down here.

Level I pathological defenses are most commonly seen in individuals struggling with psychotic illness. They may also be experienced in dreams and during childhood.

Conversion. When an interpersonal conflict is expressed physically. Think about being so angry that you lose your ability to speak.
Denial. Denial is a common reaction to any real-life crisis that’s too painful and/or threatening to process—like refusing to accept a terminal medical diagnosis or the death of a loved one.
Splitting. Often difficult to pin down, splitting occurs when we’re unable to integrate negative and positive impulses, feelings and/or behaviors. Thinking becomes back and white, and we define experiences, people and circumstances into either “all good” or “all bad.” Splitting hinders nuanced thinking, healthy relationships, and emotional control, making it difficult to tolerate ambivalence and uncertainty.
Projection. Managing extreme discomfort caused by a moral or psychological dilemma by  “throwing it” onto another individual or group.
Superiority complex. When an inflated sense of self obscures feelings of inferiority and poor self-esteem.
Inferiority complex. A rampant overachiever might be fueled by poor self-esteem, self-doubt and feelings of not living up to society’s standards. Those with an inferiority complex are forever out to prove themselves through their accomplishments.

Level II immature defenses are equally common in young children, adolescents and adults. When used in excess, they can interfere with our ability to properly assess reality, maintain and build relationships, and lead fulfilling lives.

Acting out. When unconscious wishes or desires are physically acted upon, rather than expressed.
Fantasy. Retreating into imaginary worlds and daydreams to avoid psychic conflicts.
Wishful thinking. Basing decisions and behaviors on what we’d like our reality to be, rather than going by hard evidence, rationality and reality.
Idealization. One of the most common defense mechanisms, idealization places another person in an overwhelmingly positive light. This creates conflicts in a relationship because it skews our sense of reality, thwarts understanding, and impedes the ability to truly know a person.
Passive aggression. This oft-used term denotes an indirect form of aggression toward others. Common examples include procrastination, sarcasm, hostile jokes, resentment.
Projection. When we foist our unwanted, unacknowledged, unacceptable thoughts onto another person.
Projective identification. Unconsciously acting out the thoughts, feelings or behaviors projected onto us by others.
Somatization. When psychic conflicts are manifested in physical symptoms like headaches, digestive illnesses and chronic pain.

Level III neurotic defenses are most common in adults. And while they may have short-term advantages, coping often suffers in the long term.

Displacement. Shifting unacceptable impulses to a more acceptable and/or less threatening target. Phobias are a prime example, as they involve displacement of anxiety.
Intellectualization. When we use abstract, theoretical or philosophical thinking as a way of controlling or warding off unacceptable impulses or feelings. Someone who recently witnessed a horrifying car accident, for example, might flatly recounting the facts without any hint of anxiety, fear or sorrow.
Rationalization. A form of intellectualization, in which we create reasonable explanations for our upsetting thoughts, emotions and behaviors.
Repression. This complex DM keeps threatening internal thoughts and impulses buried in the unconscious.
Undoing. When an unacceptable behavior, thought, impulse or emotion is countered with a more acceptable thought or behavior. A person may overeat one day, then feel compelled to eat very little the next. Most commonly associated with obsessional disorders.

Level IV mature defenses are the healthiest DMs, simply because they don’t lead to harmful outcomes—nor do they prevent us from developing relationships and being intimate with others. They enhance our sense of fulfillment, pleasure and self-control by allowing us to effectively integrate conflicting emotions, thoughts and behaviors in a positive way. There are many mature defenses, but here are the most relevant:

Patience. Being patient reduces acting-out behavior and avoidance.
Identification. Crucial to any personality, identification is an unconscious modeling of one’s self based on another—usually someone we admire. It also helps us understand and empathize with others. (Note: Identification is only as good as the person with whom you’re identifying, so choose wisely.)
Sublimation. Those who can readily sublimate have no trouble funneling negative impulses, emotions or wishes into positive, socially acceptable behaviors—like when a child confines his aggression to the sports field.
Altruism. Deriving personal joy and gratification from meeting the needs and wishes of others.
Thought suppression/distraction. This hinges on the ability to compartmentalize, pushing unwanted thoughts into the pre-conscious (versus the inaccessible unconscious). This allows us to effectively cope with our current reality by being mindful and emotionally present.

So, how do we know which defense mechanisms are helpful and which ones aren’t? And is avoiding anxiety and other negative feelings really good for us? Doing so can deny us the opportunity to dig deeper in an effort to identify and confront the underlying causes. After all, it’s impossible to fix what we don’t know is broken in the first place.

A big step in the right direction is having the capacity to tolerate unpleasant emotions. Being able to “sit with” frustration, fear, sadness, anxiety and rejection creates the emotional and cognitive space necessary to find effective solutions to our problems. So honing in on the DMs we use to ward off anxiety and other difficult feelings is a valuable tool in our quest to weed out what we’re really struggling with. And it gives us the power to make things better.

In my next blog, I’ll offer tips for recognizing counterproductive defense mechanisms, along with some strategies to help you deal more effectively with negative emotions.

Sunday, November 30, 2014

The Perils of Black-and-White Thinking

The Perils of Black-and-White Thinking

Dr. Paula Durlofsky gives four ways to combat all-or-nothing thinking.

Black and White
Black-and-white thinking—also known as polarized or all-or-nothing thinking—occurs when we process people and circumstances as either "all good " or "all bad.” In such a mindset, tasks must be done in a certain way and lead to a specific outcome. When those lofty expectations aren't met, black-and-white thinkers often see themselves as failures and are unable to put any sort of positive spin on their efforts. Disappointed by their own behavior or that of others, they quickly become upset.
Black-and-white thinkers often misunderstand others, and it’s not uncommon for them to struggle in relationships. They might say things like,  "I'm a failure,” "He's perfect at everything he does, unlike me,” and "I'm unlucky all the time.” It’s an oversimplified version of life. And the more polarized our thinking, the more vulnerable we are to depression, mood swings and anxiety. Some studies even suggest that black-and-white thinking is a remnant of our instinctual "fight or flight" reflex. After all, there really is no room for uncertainty when faced with a life-threatening situation. Such physical and emotional arousal leaves us feeling emotionally wound-up, inhibiting the ability to think and act rationally.
In truth, most events aren’t completely horrible or completely wonderful. They fall somewhere in the middle—in life's gray zone. Slowing down to think and feel in the gray zone can be immensely helpful in countering distress and intense emotional stimulation. Black-and-white thinking puts pressure on us to make snap decisions. But when we allow ourselves to sit back and process things in a "maybe this”/"maybe that” fashion, the pressure is lifted. Clearer thinking is the result, helping us devise more constructive real-life options for solving life's many challenges.

Four strategies for changing black and-white thinking: 
  1. Be conscious of the words you use to describe or express your feelings. “Always," “impossible," “ruined,” “never," “perfect," “terrible” and “disastrous" are absolutes and not at all helpful in understanding relationships or situations that are dynamic , complex and grounded in reality. 
  2. Work on becoming less rigid in your thinking. Challenge your thoughts. Ask yourself,  "Is it possible to be a generally intelligent person but not proficient in everything?” or, "Can what I’m facing be difficult now but get better in time?" 
  3. Accept the fact that no one is perfect. We’re all human; we all make mistakes. Try to see the value in learning from those mistakes.
  4. Learn to physically relax and cognitively slow down. Black-and-white thinking spikes when emotions are high. Relaxation techniques like slow breathing help to curb emotional arousal, allowing our more rational selves to take over. 
About This Blog

Dr. Paula Durlofsky is a psychologist in private practice in Bryn Mawr, whose practice focuses on psychological issues affecting individuals, couples, and families.
Dr. Durlofsky treats a wide variety of disorders and has a special interest in issues affecting women. She is affiliated with Bryn Mawr Hospital, Lankenau Hospital, the Women's Resource Center in Wayne, and the Psychoanalytic Center of Philadelphia. In addition to her practice, Dr. Durlofsky is a workshop facilitator and blogger.
If you have questions or feedback for Dr. Durlofsky, please don't hesitate to reach out to her via email at

Friday, November 7, 2014

Demystifying Narcissistic Personality Disorder


     Most are familiar with the story of narcissus, the Greek myth about a man who falls hopelessly in love with his own reflection seen in a pond where he stops to get a drink of water after a day spent walking through the woods. The myth has a variety of endings. One popular ending describes narcissus dying from starvation and thirst because he can not tear himself away from his own reflection. I find this particular ending to be most helpful for describing narcissistic personality disorder ( NPD) since at the core this disorder is an inability for one to receive or give love; in essence individuals with NPD are starving themselves of affection.

  The term narcissist or referring to one as having NPD is commonly said today. And narcissism may truly be on the rise as a result of our culture's obsession with social media, youth and physical appearance.

To be diagnosed with NPD a person must meet five or move of the following symptoms:

-has a grandiose sense of self importance. Exaggerates achievements and talents and expects to be recognized as superior without commensurate achievements.

- is preoccupied with fantasies of unlimited omnipotence, success, intelligence, beauty and ideal love.

- believes that he or she is special or unique and can only be understood by or should only associate with other special or high status people or institutions.

-requires excessive admiration

- has a strong sense of entitlement. Have unreasonable expectations of receiving favorable treatment or automatic compliance with his or her own expectations.

- is exploitative of others by taking advantage of others to achieve his or her own goals.

- lack empathy. Is unable and unwilling to recognize or identify the emotional needs and feelings if others.

- is often envious of others and or believes that others are envious of him or her.

- regularly behaves in arrogant and hairy ways.

NPD affects more men than women, is seen in approximately 7% of the general population and can range from mild to severe. It is thought that both biological and psychological factors contribute to the disorder. In regards to biological factors, studies suggest that individuals with NPD are more emotionally sensitive in temperament. Studies investigating psychological factors contributing to NPD indicate several psychosocial factors. The main ones being abuse or neglect in childhood, excessive praise for good behaviors and excessive criticism for bad behaviors in childhood, overindulgence and over evaluation by parents and or peers, unpredictable and unreliable caregiving and learning manipulative behaviors from parents and caregivers.

It is important to recognize that individuals with NPD struggle with profound feelings of shame, fear of rejection and feel emotionally threatened when criticized. Individuals with NPD often react with intense rage, hostility and aggression to any criticism, real or imagined. This type of reaction causes others to retreat or distance themselves from them, all of which inhibits people with NPD from having genuine and meaningful relationships.

Although NPD is a treatable disorder, most people with NPD do not voluntarily seek treatment because they are unable to acknowledge their self-destructive behaviors and thoughts. Psychoanalytic-Psychodynamic therapy, cognitive and behavioral therapy and group therapy have all been shown to be effective treatment approaches for treating NPD. As with all therapy, building a strong and positive therapeutic relationship is key for successful treatment. When an individual with NPD develops a therapeutic relationship that is secure and safe he or she can work through his or her profound feelings of shame and rejection without feeling emotionally threatened. One important therapeutic goal is to help the person with NPD develop the ability for self-compassion, compassion for others, and empathy; all necessary skills for developing meaningful relationships and for having the ability to give and receive love.

If you or a loved is struggling with NPD consider an evaluation with a mental professional. There is hope and help out there for you.

Tuesday, October 14, 2014

Do You Text and Tell? Flirty behavior through technology can lead to deception, secrets and betrayal.

     Emotional affairs often start out as innocent friendships. Email, texting, instant messaging, and social media sites are never "closed for business" so communicating with others is a 24 hour /7day a week opportunity. This makes it easy for innocent friendships to heat-up fast. Once casual communications turn into flirty texting banter, obsessions develop around the next communication with this person, feelings of marital dissatisfaction are discussed, and these communications are kept secret from your partner, the line between innocent friendship and emotional affair has been crossed.
An emotional affair is an "affair of the heart" and is predicated upon the attachment two individuals create outside their marriage or relationship. A deep attachment develops by sharing intimate thoughts, feelings, and vulnerabilities and by relying on one another for emotional support and companionship. Many people convince themselves that because sex is not involved, they are not having an affair. But they are. Affairs, whether emotional or sexual, involve secrecy, deception and betrayal. The more emotional energy put into the other person the less there is for your partner and your relationship. Often the most devastating aspect of an emotional affair is the deep attachment that develops with this other person. This attachment is tough competition for your marriage or relationship.

     Emotional affairs generally happen when something is lacking in our relationship or within ourselves. In regards to relationships, not feeling important, desired or understood is often a trigger. Being able to connect with another person who seem to fill these voids feels good, and it's these good feelings that keep the emotional affair going. On an individual level, the emotional affair may be warding off feelings of low self-esteem and inadequacy. It's important to note that most affairs, sexual or emotional, do not end well. And when given the chance to be legitimate, often do not survive.

Below are 4 tips for healing from an emotional affair

1. Take responsibility for the emotional affair by being honest with yourself and your partner. We all make mistakes and do things we may regret. Once we no longer deny we are engaging in behaviors that are hurtful and damaging to us, genuine change, healing and understanding can take place.
2. Terminate the relationship. This will be difficult because an attachment has been made. Emotions and thoughts associated with mourning and loss should be expected. And as with any significant loss, will take time to heal from.
3. Be open to marital therapy. Marital therapy can help identify what is missing in your present relationship and the steps you can take as a couple to make your relationship better. Marital therapy can also help with exploring whether to continue or terminate your relationship.
4. Consider individual therapy. Underlying and unresolved issues surrounding intimacy can contribute to one's vulnerability to becoming involved in an emotional affair. Whether repairing your present relationship or considering a new relationship; exploring and understanding the underlying factors associated with the emotional affair will help with achieving genuinely satisfying and fulfilling future relationships and maybe even affair proof ones too.

Monday, September 1, 2014

Speed Bump Ahead! Tips for Making A Smooth Transition To Hectic Fall Days

     Transitioning to the hectic schedule of fall from the lazy, hazy days of summer can be just as stressful for parents as it is for kids. It is not uncommon for people and families to experience a growing sense of anxiety over getting back into the busy school and work routine.  Change of any kind can create anxiety so it is not unexpected that huge changes in our schedule would make us feel anxious too.

     Transitions are hard; they represent the reality that our lives and circumstances are continually changing, evolving and transforming. And when there is change there is also loss, the loss of what it is we are leaving behind.  Children get older and so do we. Many families for the first time this fall will experience a child going off to kindergarten, high school, college, and some will be first time empty nesters. When we process loss we gain the ability to fully embrace life’s inevitable changes and processing loss prevents us from feeling “stuck” or “stalled” in our lives as well.

     Many people and families experience loss at the start of a new year related to spending less time together, having less personal freedom and having a less flexible schedule. Becoming aware of situations and events that are likely to increase your and your families stress levels will help to actively manage anticipated anxiety and promote healthy coping behaviors. Learning to plan ahead and being able to discuss your emotions about change and loss with loved ones is important since chronic stress and depression negatively impacts our emotional health and contributes to depression, substance abuse, and even physical illness.  

Below are tips for making your transition to fall smoother:

1.      Get a full night’s sleep. A minimum of 7-8 hours of sleep per night helps to regulate mood, decrease anxiety and depression, and improves concentration.

2.      Set realistic goals for you and your family. Avoid over scheduling your family and you. Ease into active days by slowly adding activities for both your child and you as the year progresses.

3.      As a family sit down and openly discuss concerns about the up-coming year. This may include sorting out conflicts with schedules, carpools, and mealtimes.

4.      Make sure to schedule consistent “family time” during the busy week. Maintaining a deep sense of connection with those we love combats stress, depression and anxiety. And it’s a great way to add love and laughter to your new year.

5.      Give yourself a break too! Set aside time for relaxing and decompressing from the busy, hectic days of fall.