Can I Build Trust After it has Been Broken?

Trauma, trust, and relationships

Many people come to therapy with difficulty trusting and feeling secure in their relationships. Often this is linked to having been hurt in relationships before, sometimes in traumatic ways. You may have experienced painful rejection, betrayal, mistreatment, neglect, emotional abuse, or violence from someone you thought you could trust. Sometimes this occurs over a long period of time, with an important person (like a parent), and/or at an early age, such that it is formative in the way you see yourself and others.

In healthy parent-child attachments, children develop a sense of safety and security that shapes their worldview in positive ways. They experience themselves as essentially good and others as essentially safe and well-meaning. But people who have experienced trauma in the context of early relationships often feel deep shame, unworthiness, and mistrust. If this sounds like you, developing trust later in life may feel daunting.

And that makes complete sense. We are wired to protect ourselves from pain, and in the face of trauma we naturally develop strategies to survive and seek safety. For instance, you might notice that you tend to depend on others or always put others first in an effort to secure closeness. Perhaps you keep people at a distance or reject others before they can reject or harm you. You might feel uncomfortable talking about yourself or pretend to be someone you’re not when you do.

It is understandable if relational trauma has left you guarded. This actually means you are a resilient person. You’ve survived something painful by learning to defend vulnerable parts of yourself. It is when this becomes thick, heavy armor you are dragging around, even when the dangers are much less or long gone, that your efforts are no longer serving you. Sometimes strategies that were once adaptive gradually become barriers to moving forward with healthier, more authentic relationships.

You might ask “How can I (or why should I) trust after my trust has been broken?” Let’s be honest. Trusting is always a risk. Trust inherently implies that someone has taken a chance, become vulnerable without a guarantee of safety or reciprocity. The hope is that this is not done indiscriminately, but in a measured, thoughtful way, and with reasonable expectations of safety. It will only hurt more to trust someone who would seek to scam or harm you. And I understand that, especially for people with trauma histories, these judgments can be fraught with doubt.

When it feels frightening or impossible to trust anyone, you might consider starting with a therapist. We can reasonably expect that a therapy setting will generally be safe for most people (although it may not feel that way at first, and of course there are exceptions). Ideally, you will be working with a professional who offers ethical, confidential, reliable, and respectful services. Even then, you probably won’t learn whether you feel safe, heard, valued, and accepted without sharing some wounded parts of yourself.

And you might need some time to begin opening up. Here’s how it looks sometimes: You risk vulnerability. I (do my best to) show you that I can be counted on and confided in; that I will respect your boundaries and mine; that I will not judge or retaliate against you for expressing anger or disappointment; that you are a human being who can make an impact on me, another human being. You shed some armor and I do not hurt you. (Of course this is non-linear. You might decide to risk vulnerability after you experience some sense that it will be safe enough to do so.)

Sometimes this can be transformative. Imagine if you were able to take a risk being vulnerable with a partner or family member or friend, something that may have previously terrified you, and it actually went well. How might you feel? When you reveal a true part of yourself to another person and instead of creating distance, it deepens your connection, you have risked and been rewarded. You’ve received evidence that security can be found in relationships, even when you expected something else.

Of course, what if it doesn’t go this way? It won’t always, and it is not always safe or appropriate to make yourself vulnerable. And when you do trust, even people with the best intentions can make mistakes. You can get hurt again. In therapy, we can work on honing your ability to more accurately assess people and situations, so you can get better at knowing who, when, and how much to trust. And we can work on developing your ability to weather relational ups and downs while relying less on old, unhelpful patterns. This takes courage and hard work, and I am honored to support and help empower people who are bravely trying a brand new way of being in the world.

 

The experiences described above may or may not apply to you. Every person and situation is unique. If you have questions about this post or about getting started in therapy, please feel free to contact me. Please also note that this is not psychological treatment or advice. If you are experiencing a crisis or are in danger, call 911 or go to your nearest emergency room.

Do I Need to Feel Comfortable with my Therapist? Comfort versus Safety

Brooklyn Therapy Vulnerability and Safety

My short answer is: of course. Well, sort of. In my opinion, it comes down to how we define comfort. I believe there is an important distinction between feeling comfortable and feeling safe with another person. Especially at the beginning of a new therapeutic relationship, many clients need to feel comfortable in order to share their stories and concerns. But as the relationship deepens, too much comfort can lead to stagnancy and actually interfere with movement and progress. The nature of therapy is that it can at times feel uncomfortable, especially as you are challenging yourself to learn, change, and grow. Safety, on the other hand, is a necessary condition for people to be their full selves in therapy, and to take the emotional risk of working through long-standing concerns and patterns. The experience of safety with your therapist can offer the foundation for doing some of this uncomfortable work.

People come to therapy with diverse histories and a wide range of ability and willingness to trust and open up, especially with a stranger. This can vary by culture and identity, past experiences including trauma, the fit between client and therapist, and other factors. While there is no single recipe that will help all people feel safe in the therapy room, a few key ingredients the therapist can provide include consistency and reliability, authenticity, genuine care and empathy, acceptance, and respect.

If you are someone who struggles to be vulnerable (in therapy or relationships in general), it’s often beneficial to explore what holds you back. Sometimes the process of discovering what is preventing safety (or comfort) in the therapeutic relationship can lead to fruitful insights about intimacy and attachment with others. It can feel quite meaningful to get to this place in the work.

Low-Fee Therapy Resources in NYC

Low-Fee Therapy Resources in NYC

Budgeting for therapy can be difficult, and many people are unsure whether they can afford treatment. In my private practice, I do not work directly with insurance companies, so encourage prospective clients to check their out-of-network benefits with their carrier before their first appointment. We often find that insurance will reimburse a portion of the fee. However, I know that many people are uninsured, have in-network coverage only, or otherwise cannot afford private, out-of-network therapy, and I understand how important it is for mental health care to be accessible for all. Fortunately, in NYC, there are many sliding scale and low-fee resources available. The following list is a partial selection.

Please note that I do not necessarily endorse the resources included in this list, and they should not be considered personalized referrals, or psychological treatment or advice. If you are experiencing a crisis or are in danger, call 911 or go to your nearest emergency room.

Ackerman Institute for the Family
936 Broadway NY, NY 10010
212-879-4900
https://www.ackerman.org/
Couples and family therapy; Sliding scale based on income.

The Brief Psychotherapy Research Program
Beth Israel Medical Center
10 Nathan D Perlman Place
New York, NY 10003
(212) 420-3819
http://www.brieftherapyprogram.com/
Diagnostic evaluation and 20 therapy sessions as part of ongoing psychotherapy study; Low fee, sliding scale, depending on income.

Brooklyn Center for Psychotherapy
300 Flatbush Avenue, Brooklyn, NY 11217
718-622-2000
http://www.newdirectionsbrooklyn.com/
Sliding scale and accepts many insurance plans.

Center for Modern Psychoanalytic Studies
16 West 10th Street
212-228-6036
https://www.cmps.edu/
Intake fee is $40, then sliding scale for sessions.

The Psychological Center at The City College of NY (CCNY)
160 Convent Ave, 8th Floor of the North Academic Center, Room 101
New York, NY 10031
212-650-6602
https://www.thepsychologicalcenter.org/
Intake fee is $30, individual and group therapy fee is $50 per session. Clients may apply for reduced fees based on proof of income.

Institute for Contemporary Psychotherapy (ICP)
1841 Broadway (at 60th Street), 4th Floor
New York, NY 10023
Phone: 212-333-3444
http://icpnyc.org/
Accepts HIP, GHI, Oscar and Healthfirst, otherwise offers sliding scale.

Metropolitan Center for Mental Health
160 West 86th Street NY, NY 10024
212-362-8755
http://www.metropolitancenter.com
Flat fee of $35 for the initial intake evaluation, and $45 flat fee for a psychiatric evaluation (if one is needed). Session fees thereafter are set on a sliding scale, based on proof of income.

National Institute for Psychotherapies (NIP)
250 West 57th Street
212-582-1566
https://niptherapy.org/
Sliding Scale

Open Path Collective
Numerous locations, searchable by zip code
https://openpathcollective.org/
In-office psychotherapy between $30 and $60 per session (between $30 and $80 for couples & family sessions)

William Alanson White Institute
20 West 74th Street
212-873-0725
http://www.wawhite.org/index.php?page=clinical-services
Sliding Scale

Is Therapy Right for Me? Barriers to Getting Started

Brooklyn Heights Therapy

Whether you are a first-timer, returning to treatment after a gap, or looking for a new provider, you may be wondering if therapy is right for you. While you are ultimately the best judge, here I share my perspective on a few common barriers to starting therapy, and how some people are able to overcome them.

Anxiety, Ambivalence, and Fear

I have worked with many clients who are anxious or ambivalent about entering treatment. This is completely understandable. Some people fear what may emerge in therapy, and whether they (or the therapist) will be able to handle it. While certain feelings or experiences that come up in sessions may feel temporarily distressing or overwhelming, your therapist can serve as a guide or partner to help you bear the burden and weather the emotional storm. Part of my skillset, for example, is the ability to hear, hold, and try to understand distressing thoughts and feelings that may be too difficult to access or process on your own.

Time and Budget

Finding the time and money for therapy can be difficult, and many people are unsure they will be able to make the time or financial commitments needed. You certainly will want to ask yourself if and how these investments could pay off for you, and whether therapy is worth prioritizing at this time. (You may decide that it’s not, or, on the other hand, you may find value in therapy that makes it well worth the investments.)

Regarding cost, many people with health insurance have out-of-network benefits that can be applied to healthcare costs from providers who do not accept their insurance plan. This kind of coverage is usually reimbursed after the fact, which means that you would be responsible for payment up front. I generally encourage clients to discuss their coverage and expected out of pocket costs with their insurance company before their first appointment. If you are uninsured or otherwise cannot afford private, out-of-network therapy, there are many low-fee resources in NYC. I share a partial list here.

Prior Negative Experiences

Perhaps you have had a negative experience with a prior therapist and are worried about feeling hurt (or frustrated, or not helped, etc.) again. These concerns are valid, and worth exploring in therapy.  Often, problems in relationships with former therapists have been left unresolved, and may impact your expectations for what future therapy will be like. I find voicing these concerns to be very helpful in the work. Still, getting started may require you to step out of your comfort zone and take a risk trusting someone new. Keep in mind that if it is not a good fit (I’d give it at least a few sessions to get an initial sense), you are (a) allowed to advocate for yourself and (b) not locked in.

Sharing with a Stranger

Green Lights

It can feel uncomfortable to be vulnerable with a stranger, especially for some people of certain cultures and identities. You may feel more familiar speaking with a partner, trusted friend, family member, or community or spiritual leader, and those social supports are wonderful. For some people, however, processing painful issues (especially things that bring up anger or shame) with a trained professional outside of your everyday world can offer the safety, confidentiality, and freedom to be as honest and to go as deep as you need to. And over time, there is potential for that relationship to become quite connected.

Am I Bringing Enough? Too Much?

You may wonder if your concerns are “enough” to warrant therapy, or on the other side of the coin, whether your problems are too serious and if you can be helped. These are not questions I can answer in any universal way, but excellent concerns to raise in an initial consultation. As far as the former, I generally believe it is better to be proactive and preventive than to wait for a crisis (when this is possible). At the same time, therapists tend to understand that motivation to reach out can be fairly low when you’re functioning adequately. As for the latter, sure, there are certain concerns that are best addressed by particular specialists or in specific settings. Try not to let that stop you from reaching out to ask about fit; if they are not right for you, most therapists will try to make appropriate referrals. For most people and concerns, however, whether a particular therapist can help you is in part a question of experience – are your needs in line with their qualifications and scope of practice? – and, perhaps more importantly, one of fit – do you feel the potential for a safe and trusting relationship (even if it is not fully realized right off the bat)?

Maybe therapy is not among your top priorities at this time. That is okay. Even when you are ready, it may still feel like a leap of faith, and there is a wide range of how tolerable that uncertainty feels for people. I encourage my clients to maintain an open dialogue about how the process is going, to raise any concerns about the therapy in therapy, and to explore how we might adjust our work to better address their needs and concerns.

Naturally, the above information may or may not apply to you. Every person and situation is unique. If you have questions about getting started, please feel free to contact me.