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The Many Ways Childhood Trauma Can Affect Adulthood

The Many Ways Childhood Trauma Can Affect Adulthood

We’d like to believe that who we are now is based only on our personalities and current thoughts/life experiences. But a lot of who we are now – how we think, how we feel, and how we process the world – is based on our childhood. Not just our childhood, in fact, but our childhood traumas, which can shape us in ways that we may never realize.

How Our Childhood Traumas Affects Our Emotions and Feelings as an Adult

Research into childhood trauma shows that those that have experienced traumas in their youth are prone to many different long term emotional and psychological challenges, including:

  • Increased Risk Of Developing Mental Health Disorders

Not all mental health disorders are related to childhood trauma. But that doesn’t mean there is no effect. Many of those that experienced childhood trauma also show adult mental health challenges such as depression, anxiety, and PTSD.

  • Difficulty Forming And Maintaining Healthy Relationships

Childhood trauma appears to have an effect on the relationships of others, including attachment styles, how to navigate relationships and marriage, how to respond to conflict, and more.

  • Higher Likelihood Of Engaging In Self-Destructive Behaviors

Substance abuse, sex addiction, and risk-taking behaviors are all more common in those that experienced childhood trauma. A person that experiences these self-destructive behaviors also may or may not be aware that they are linked to their childhood experiences.

  • Impaired Emotional Regulation/Coping Skills

We learn how to cope with stress and anxiety when we’re young. So, when we experience childhood trauma, we may not develop the necessary coping skills and emotional regulation techniques that we need to manage how we feel and cope with what life throws our way.

  • Lower Self-Esteem

Finally, those that experienced childhood trauma may be more prone to low self-esteem and low feelings of self-worth, affecting their ability to feel comfortable and confident with themselves and others.

Addressing Past Traumas, Today

There is a myth, related to a specific type of therapy from Freud, that psychologists and therapists focus solely on your past, your relationship with your parents, etc. That is not the case. Much of therapy is actually focused on the present, sometimes exclusively. Your mental health isn’t just about your past, and sometimes the way you feel is related to things that are happening now – or for no apparent reason at all.

But that doesn’t mean that the past is not worth exploring. There are many situations where your experiences as a child do affect you as an adult and, when that is the case, it is worth determining how your trauma may be affecting you and what we can do to help you fix it.

For more information about trauma therapy in NYC, contact Flourish Psychology, today.

How Behavioral Activation Can Be Used to Manage Mild to Moderate Depression

How Behavioral Activation Can Be Used to Manage Mild to Moderate Depression

Within the mental health world, we tend to broaden how we talk about treatments. We refer to treatments using categories, like “Cognitive Behavioral Therapy” (CBT), when really, there are many specific actions, activities, and treatment styles within these different treatments.

For example, one component of CBT is known as “behavioral activation.” It can be used as part of a treatment for many mental health conditions and is a core component of CBT treatment for depression. We use it often for mold to moderate depression symptoms here at Flourish Psychology in Brooklyn – though it is important to note that it is frequently combined with other components of CBT, along with non-CBT therapies depending on the patient.

What is Behavioral Activation?

Behavioral activation is a term that refers to helping individuals overcome depression by increasing their engagement in rewarding and fulfilling activities. It recognizes that depression often leads to withdrawal, avoidance, and a decrease in pleasurable and meaningful activities, which can further perpetuate the cycle of depression. The goal of behavioral activation is to help individuals gradually increase their activity levels and reconnect with positive experiences.

Techniques in Behavioral Activation

Even within behavioral activation, there are specific techniques that therapists may use and implement. Some of these are structured, and will be a part of every treatment. Others may be mentioned or discussed in therapy based on the feedback and information provided by the patient. These include:

  1. Activity Monitoring – The therapist and individual work together to identify activities that the individual used to enjoy or find fulfilling but has stopped engaging in due to depression. They may keep a record of daily activities, including the type of activity, the duration, and the level of pleasure or mastery experienced during each activity.
  2. Activity Scheduling – Based on the activity monitoring, the therapist and individual collaboratively develop a structured schedule of activities that includes both enjoyable and necessary tasks. The schedule is designed to gradually increase the person’s engagement in pleasurable activities and restore a sense of accomplishment.
  3. Behavioral Experiments – The therapist and individual may design behavioral experiments to test the individual’s beliefs or assumptions about certain activities. For example, if the person believes that they won’t enjoy going for a walk, they might be encouraged to try it out and examine their actual experience. This helps challenge negative expectations and promotes the discovery of new sources of pleasure or mastery.
  4. Breaking Tasks into Smaller Steps – For individuals who find it challenging to initiate or complete tasks due to feeling overwhelmed, the therapist may help them break down activities into smaller, more manageable steps. This makes the tasks seem less daunting and increases the likelihood of engagement.
  5. Graded Task Assignment – Tasks are assigned in a step-by-step manner, gradually increasing in difficulty or complexity. This approach allows individuals to experience a sense of mastery and build confidence as they successfully complete increasingly challenging activities.
  6. Problem-Solving – If barriers or obstacles arise during activity engagement, the therapist assists the individual in problem-solving and finding solutions to overcome those challenges. This fosters adaptive coping skills and resilience.

By gradually increasing engagement in rewarding activities, behavioral activation aims to counteract the negative reinforcement cycle of depression. It helps individuals experience positive emotions, regain a sense of accomplishment, and improve overall mood and functioning.

CBT and Behavioral Activation as Treatment for Depression

Behavioral activation is one of many effective ways to start helping those with depression regain their quality of life and promote a healthier mindset. It is very effective, but like other treatments, it is not typically provided on its own. It is combined with other components of CBT, such as cognitive restructuring, and may also be combined with treatments outside of CBT depending on the individual and the therapist.

Whether you and your therapist choose to pursue behavioral activation, or use a different strategy, it is helpful to recognize that CBT is multifaceted and complex. We, as therapists, may talk about CBT as though it is one strategy performed one way, but within it are many different approaches that can all help those with depression – and other mental health conditions – find relief from their symptoms.

Learn more or get started with CBT for depression by contacting Flourish Psychology in NYC, today.

From Shyness to Social Anxiety: Navigating the Challenges of Peer Interactions in Tweens

From Shyness to Social Anxiety: Navigating the Challenges of Peer Interactions in Tweens

Shyness and social anxiety are not the same thing. Many people can be shy and/or introverted, but still not struggle with any significant anxieties or fears when faced with social interaction – nor the symptoms that may exist with children that have social anxiety, such as fear of being judged.

But while shyness is not a synonym of social anxiety, they can be related and interact. This can be especially true for preteens and teens. Many children and young people show signs of shyness without the social anxiety, but can potentially develop social anxiety as a result of some of the challenges that teens and tweens face socially.

Young People and Social Development

Younger children are trying to learn their social place and navigate the world. They’re developing not only their social skills, but their coping skills. They’re trying to understand themselves and how others see them. They are also surrounded by children that are still developing in their maturity.

This can lead to situations where children are judged or bullied because of their shyness. They may appear awkward or “weird” to others in their peer group. This can lead to situations where a child’s shyness becomes something more – something where the way their peer group responds to their shy interactions ends up leading to the development of social anxiety.

As parents and caregivers, we want to make sure that we’re helping our kids navigate these struggles. That means paying attention to the difference between the two, working on ways to build confidence, and helping children maintain a positive self-image.

How to Tell the Difference Between Shyness and Social Anxiety

Both shyness and social anxiety can present in very similar ways. Often, it is the smaller details that make it easier to tell them both apart.


  • Child may have and be satisfied with a few close friends.
  • Child may not express themselves socially, but be capable of being present.
  • Child may “warm up” to some people and be less shy with them.

Social Anxiety:

  • Child looks and acts fearful in social situations.
  • Child may actively avoid them, or show extreme discomfort.
  • Child may describe worry, fear of being judged, and fear of embarrassment.

Many people also assume that social anxiety is related to introversion. While that may be true at times, social anxiety can also occur in the extroverted. That is because anxiety is what holds them back socially, not a desire for being alone. If anything, the presence of social anxiety indicates a desire for social situations that is more common of extroverts, not introverts.

Taking Steps to Prevent Shyness from Becoming Social Anxiety

If your child already displays signs of social anxiety, a child therapist can help. Working with your child, they can develop their social skills and self confidence, while also addressing some of the child’s negative self-talk.

But if your child is just shy, this is still an age where it is useful to try to support your child socially in ways that help prevent social anxiety from forming. Social anxiety can impact self-esteem, friendships, the ability to obtain social support, and the social experiences that can help them later in life. Preventing this can be beneficial for their long term development.

How to Support Shy Tweens and Prevent Social Anxiety Development

Therapy for children and teens can help young people that are struggling with shyness. Therapists know how to support children with skill straining, coping, and relationship development. But parents can also help prevent shyness from turning into social anxiety by:

  • Helping Them Create a Core Group of Friends – Social support is one of the most powerful tools for building confidence and coping with social stressors. If your shy child doesn’t want to interact with many kids, see if you can connect them with a few friends they truly appreciate, and then encourage them to build on those relationships. This can help give them the social support they need to withstand awkwardness.
  • Let Them See You – Seeing you socially can help them socially. They learn to navigate some of the complexities of relationships and understand more about how to maintain conversations by watching how you interact with others in your life. It helps to normalize the experience and make it seem less foreign or fear inducing.
  • Teach Social Skills – Your child may not desire to be that social, but they still need to learn social skills. Talk with them, play with them, and teach them how to talk to others so that they’re ready if a situation presents itself.
  • Build Their Self Image – Make sure that you are always working on building their self-esteem and self-image. It is one of the most effective ways to help your child be resilient in the face of any negativity or emotional discomfort.

Shyness is not at all guaranteed to become social anxiety. But the experiences that young people have while shy can still affect them. Learning how to address these issues head on can help, and – if you find that your child has developed social anxiety – speaking with a therapist in Brooklyn can provide added support that your child may need.

Are We Still Grieving and Affected by The Pandemic?

Are We Still Grieving and Affected by The Pandemic?

The pandemic, at least as far as the government is concerned, is officially over. Though the virus is still circulating, and many of us still wear masks or allow the COVID-19 to affect our decisions (for example, attending a packed event), many others have moved on, and the government programs that were initially designed to help provide resources and reduce society’s risks have all ended.

It has now been over three years. For many, life has moved on. Many people are going back to work, spending time with many friends, and taking fewer precautions than they did before. But while it’s easy to see how life has gone back to normal, a question remains: is it still affecting us, even now?

No Time to Cope – The Fast Pace of Life

  • Many of us lost people during the pandemic.
  • Many of us remember what it was like to live in fear.
  • Many of us developed habits, like drinking alcohol, that still continue to this day.
  • Many of us still worry that we or someone we love could be ill at any moment.
  • Many of us lost friendships, relationships, or trust in ways that haven’t come back.

The pandemic may be “over” on a government level. It may even be over as far as our own personal precautions (though not for everyone). But one way that it is not over is that we, both here in New York and as a country, have never really had an opportunity to grieve. We haven’t been given an opportunity to process trauma. We haven’t been able to recognize all that has been lost, from time with friends to our children’s education. We haven’t had many chances to examine how the stress has affected us.

Some of us have been able to move forward. But many others are still struggling with minor and major issues, including anxiety, depression, and grief, that we haven’t had an opportunity to process. We may be forced into a situation where we have to pretend like life is back to normal, but those 1, 2, and 3 years that were dramatically altered by the pandemic can still cause very real, longstanding issues even today.

Getting Help for Pandemic Stress

It’s okay to still be affected by the pandemic. It’s okay to have emotional and psychological issues that developed as a result of this lost, stressful time. Here in NYC, where the early part of the pandemic hit us all incredibly hard, it is understandable that we still have little things that may be affecting us as a result of those challenging times.

If you feel like you are still affected, let Flourish Psychology help. Our therapists understand your struggles, and we’re here to help you adjust and feel more closely aligned with your pre-pandemic self – or better. Contact us today to get started.

Major Depressive Disorder vs. Persistent Depressive Disorder – Understanding Symptom Differences

Major Depressive Disorder vs. Persistent Depressive Disorder – Understanding Symptom Differences

There is more than one type of depression, according to the diagnostic manual that therapists and psychologists in Brooklyn use to diagnose depression. As we review your symptoms and try to gain a better understanding of your struggles, we’re often looking at both subtle and clearer differences between these disorders in order to determine how to effectively treat them.

Major depressive disorder (MDD) is a more urgent, more powerful form of depression with symptoms considered to be severe. Persistent depressive disorder (PDD) is a “milder” but no less problematic form of depression. It was previously referred to as “Chronic Depression” or “Dysthymia.” These conditions have many similarities, and it is possible to cycle in between the conditions – showing symptoms of major depression at times, and persistent depression at others – but they are distinctive conditions.

Diagnostic Differences

Before we get into the symptomatic differences between the two conditions, let’s talk about the diagnostic ones. Persistent depressive disorder can only be diagnosed if the patient has struggled with it for over one to two years depending on the patient’s age. It is the term for a low level of chronic depression that is essentially constant throughout the day and night.

Though the symptoms are considered less severe compared to MDD, their long term presence puts patients at higher risk for self-harm the longer they struggle with it. Major depression, on the other hand, can be diagnosed in as little as two weeks and “episodes” are often severe in nature, which makes treating it more urgent.

Symptomatic Differences Between MDD and PDD

It’s easy to say “less severe than major depression” or “low level of depression.” But because depression is always a struggle, it important to identify what “less severe depression” means.

Both PDD and MDD will have feelings of helplessness, negative self-talk, loss of interest in pleasurable activities, and depressed mood. But what makes them different is the following:

  • Function – Patients with PDD are typically able to function in some form with most of their daily tasks. They may not be able to give activities their full energy, or enjoy those activities, or focus as easily as those without depression. But they can typically go to work, address some of their family’s needs, and take care of a pet. Their ability to function may be compromised, but they are capable of it. Patients with Major Depressive Disorder often find depression so debilitating, it dramatically interferes with their ability to function.
  • Intensity – Patients with persistent depression will describe a low mood and feeling “down.” They may show changes in appetite, sleep, energy, and concentration, but they are more capable of pushing through it with a bit of effort. Patients with major depressive disorder typically are *extremely* sad or down to the point of being overwhelmed by it. Engaging in daily tasks feels nearly impossible, and in some cases may not be possible. They feel impaired by their condition with more persistent thoughts of self-harm.

While someone with PDD may feel “low” and unhappy or passionless and tired throughout the day, a patient with MDD could, depending on the severity of their symptoms, be unable to even leave their bed. Despite MDD being more severe, however, it should be noted that chronic depression can both cycle into MDD at times, and also lead to significant life alterations that cause people to consider self-harm in the future, especially as they no longer experience joy for such a long period of time.

Patients with PDD also may experience what is sometimes called “Double Depression.” These are more severe forms of depression that resemble MDD that come at different times or after different triggers. These periods of “Double Depression” can increase the risk of self-harm considerably. But they may not qualify as MDD because they may not last the requisite two weeks or display all of the same symptoms.

How Does Recognizing These Two Different Conditions Affect Treatment

Therapy for depression – both MDD and PDD – can be very similar. Both benefit from many of the same therapeutic techniques, such as CBT. Both benefit from treatment from an experienced therapist. Both respond well to professional intervention. Many of the same techniques are used as well, such as cognitive restructuring and behavioral activation.

However, there are differences as well. First, duration and frequency of therapy may change. MDD may require more immediate and frequent meetings to help address the episode in the moment and reduce the risk of worsening symptoms. PDD may benefit from ongoing treatment that helps continue to address its symptoms over time.

In addition, In MDD, CBT often focuses on identifying and challenging negative automatic thoughts and cognitive distortions that contribute to the development and maintenance of depressive symptoms. The emphasis is on modifying maladaptive thinking patterns during acute episodes and targeting specific negative thoughts related to the current episode. In PDD, cognitive restructuring may also be utilized, but the focus is broader and may involve addressing deeply ingrained negative beliefs and schemas that contribute to the chronic nature of depressive symptoms.

Similarly, in MDD, CBT may include specific techniques to recognize early warning signs of relapse and develop coping strategies to prevent future depressive episodes. In PDD, since the condition is chronic, relapse prevention may involve ongoing monitoring and management of symptoms to minimize their impact and prevent exacerbations.

While the therapy techniques are similar, the way that they are approached is different.

If you feel like you’re struggling with depression, contact Flourish Psychology in Brooklyn today to learn more.

Cyclical Relationship Between Sleep and Depression

Cyclical Relationship Between Sleep and Depression

An important part of treating our mental health is understanding how our behaviors and experiences contribute to worse mental health symptoms.

For example, if you have a fear of spiders, and you purposefully avoid situations that might cause you to see spiders, your fear of spiders gets worse. This is the psychology of avoidance, which we mentioned in a past article. Or, if you have panic attacks, the way you breathe when you have panic disorder can actually trigger future panic attacks.

Our brains are complicated structures that work in equally complicated, often cyclical ways.  

We also see this with depression, and one of the most common ways that this manifests is with the relationship between depression and sleep. Depression can cause sleeping issues and, to make matters worse, sleeping issues can cause depression. Understanding this relationship can help you make better decisions in order to help address your depression and also understand why you may feel the way you feel.

How Depression Causes Sleep Issues and Disturbances

Depression itself causes issues with sleep, both quality and frequency. Depression can cause both insomnia (inability to sleep) and hypersomnia (excessive sleep). Some of the scientific findings that relate to depression’s affect on sleep include:

  • Depression reduces REM sleep and affects how the body goes in and out of sleep stages.
  • Depression dysregulates melatonin, which his the hormone that regulates sleep/wake cycles.
  • Depression increases the likelihood of waking up in short bursts during sleep.
  • Depression reduces deep sleep time.
  • Depressed people tend to take longer to fall asleep at night.

These are all findings that implicate depression as a cause for possible sleep related problems.

How Sleep Issues Can Contribute to Depression

So, we know that depression can cause sleep issues. But where challenges arise is that science has shown that sleep issues can cause depression. Examples of these findings include:

  • Sleep deprivation studies have shown that even one night of poor sleep can cause depression-related symptoms, or exacerbate symptoms in those that already have depression.
  • Sleep disturbances cause abnormalities in regions of the brain that are linked to mood regulation and negative bias, increasing the frequency of negative thinking.
  • Sleep quality issues can alter the portions of the brain that are responsible for good decision making and stress coping.

Numerous studies have linked poor sleep, chronic insomnia, and a host of sleep issues with the development and maintenance of depression, although exactly how they are linked is not always clear. Nevertheless, it is clear that sleep issues can both cause depression and increase depression related symptoms.

Breaking the Poor Sleep/Depression Cycle

Sleep is not the only cause of depression, nor is depression the only cause of poor sleep. But the cyclical nature of the two – where poor sleep leads to depression and depression leads to poor sleep – is still very important for those with depression to recognize and understand, as they can help explain symptoms and experiences, and also help improve decision making about when to rest.

This is one of many examples of the ways that our mental health is more complicated than many of us believe. It is also why, by treating depression, we can improve our sleep quality which may also improve or depression. If you feel like you’ve been down or sad, reach out to a therapist and start receiving the support you need to improve your mental health.

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