
A Guide to Relearning to Trust Yourself After Narcissistic Abuse
Healing from narcissistic abuse can be an intense experience. You’ve likely endured constant exposure to someone who questioned your reality, minimized your feelings and distanced you from your instincts. Your ability to trust yourself isn’t gone. It’s just buried under someone else’s voice.
Through my work as a psychologist in New York City helping clients heal from narcissistic abuse, I’ve learned that recovery is less about forgetting the past and more about relearning how to trust yourself and clear the confusion that abuse leaves behind.
(Disclaimer: This article does not constitute psychotherapy or a psychotherapeutic relationship with this writer. The following content represents suggestions for self-exploration based on my experience as a CBT therapist in NYC who has worked extensively with people seeking relief from the effects of narcissistic abuse, as well my work with people on the spectrum of narcissism.)
In this article I present an outline representing a plan for healing from trauma caused by a narcissist. Because the process can elicit so many intense thoughts, feelings and memories, I believe it can be beneficial to see the process written in outline form.
I also include three Narcissistic Abuse Recovery Exercises to give you tangible actions to partake along your journey. These exercises may be best attempted under the guidance of a mental health professional, but at least you will see what might be helkpful.
Moving on from the psychological hold of a narcissist involves reconnecting with your own voice and learning to trust it. One eye-opening part of the healing process is recognizing the fictional elements of the relationship while bringing your emotions under control and maintaining a healthy, adaptive perspective.
When you’re able to reframe the relationship and move toward being less triggered as you recall aspects of the abuse, the disorientation and disconnection begin to subside.
If the break from a relationship with a narcissist is recent or if you haven’t tried to heal the wounds of the past, you may be left questioning what’s real, second guessing your thoughts, feelings and memories. When your sense of reality has been repeatedly and painfully denied, challenged, belittled and ignored by someone with narcissistic traits, plugging back in to your own authentic and deserving sense of self requires watering the roots of psychological safety (and, in some cases, physical safety from the narcissist).
The process of learning to trust your mind again doesn’t have a clear playbook since we’re all different people with our own unique, internal influences (e.g., temperament, mood issues, anxiety, attentional factors) and external influences (e.g., prior trauma from having a narcissistic family member or romantic partner, current level of emotional support from friends and family, financial resources). However, I have found that there are universal mental experiences for people who have endured trauma from narcissistic control and manipulation.
Narcissistic abuse usually involves constant questioning of one’s own perceptions. Many people report feeling disconnected from their intuition after enduring a relationship with a narcissist.
Even simple decisions about what’s good or bad for you can be affected, and your ability to launch into self-loving action requires a lot more effort.
I’m going to lay out a few main initiatives to focus on as you learn to trust yourself again. In my experience as a psychologist in NYC helping clients overcome narcissistic abuse, the following goals aid in reducing mental confusion and constant self-doubting resulting from emotional abuse by a narcissist.
How to Move on from Narcissistic Abuse and Relearn Self-Trust
Below is an outline of the plan I use to help my clients overcome the effects of narcissistic abuse. Please note that everyone’s situation varies. This is an ideal plan. I generally assume that professional help will be needed to accomplish many of these goals. This article will cover the first two areas listed below, in addition to a bit about personal values.
1. Education and Awareness
- Begin a journey of self-discovery
- Become an expert in the narcissist’s tactics for manipulation and control
- Improve understanding of the internal conflicts caused by narcissistic abuse, including viewing decision-making through the lens of connection versus confusion and temporary emotional safety versus personal growth
- Start to reframe the narrative of the relationship
2. Safety and Self-Regulation
- Achieve emotional and physical safety
- Build a world of contrast between beliefs about the self and the narcissist’s self-serving accusations
- Identify triggers for emotional dysregulation and the narcissist’s most effective tactics
- Create healthy emotional and behavioral responses to upsetting and confusing triggers
- Strengthen your social connections
3. Deep Healing from Trauma
- Engage in trauma reprocessing
- Reconnect/reintegrate internal parts
- Identify and manifest personal values
Please note that this process is not necessarily stepwise. There are often many overlapping realizations and goals. It can be messy, but this is why an expert in narcissism can help guide you through the process to make it as safe and productive and clean as possible.
I’m now going to use this plan to organize my insights to achieve the goal of improving self-trust and healing confusion after trauma from a narcissist.
Relearn Self-Trust Through a Commitment to Self-Exploration
The process of trusting yourself requires that you begin a journey of discovering who you are outside of the role and tasks assumed inside and outside of the relationship with the narcissist. Essentially, you need to reconnect with what makes you–You.
Narcissists benefit from making people doubt themselves in every way, shape and form. The way you think of your own personality, including the beautiful gifts you offer the world by just being You is likely to be warped and less accessible in your recovery. Learning to trust yourself depends on you beginning to understand and separate from what the narcissist accused you of being.
Self-doubt is the weapon of the narcissist.
The narcissist’s ability to manipulate and control you depends on you remaining in a state of self-doubt. Essentially, the narcissist makes you question everything. and then they fill in the gaps of uncertainty to serve their needs and narrative. In order to behave abusively, they need you to need them, but their influence, both in and after a relationship, reduces when you understand how badly they need you to question yourself. Once you’re convinced that you’re a horrible person by the abusive partner (or parent, boss, sibling, etc.), you start to believe that you’re deserving of bad treatment.
As you become increasingly aware of the abusive and controlling tactics used by the narcissist, it is quite common to feel like you’ve lost trust in your judgment, including what really happened to you, how bad it was for you, whether the narcissist’s love is real (I wrote an article on love and narcissism to help answer this question,) and what you deserve in the future.
My work with New Yorkers who are caught in the fog and self-doubt caused by narcissistic abuse have benefitted from a wholehearted self-exploration of how their mind works and what they can do to defuse themselves from troubling thoughts and feelings related to their relationship with the narcissist.
Think of it as a declaration that you are committed to understanding the impact that narcissistic abuse has had on you and the part of you that the narcissist controlled to keep you from trusting yourself.
Achieve Emotional Safety from the Narcissist’s Influence on Your Thoughts
Whether you remain in a relationship with a narcissist or you’re learning to trust yourself with the narcissist in the rearview mirror, the key is to achieve some degree of personal and psychological safety. It is very hard to break through your mind’s system of protective defenses and ease the hypervigilant mistrust if you don’t feel safe in any way. My hope for you is that if you remain in a relationship with someone with significant narcissistic tendencies, you will strive to create your own reality that contrasts with what the narcissist needs you to believe.
At times, you might have to “play the game” with the narcissist (e.g., if you share a child and need to coordinate childcare or if your boss will remain “the boss” for some period of time). Some people find power and control in knowing they are playing the narcissist. If you make a choice to go along with play along (within limits), but in your mind you are “playing the player,” then the situation can be, at least temporarily, tolerable.
Ultimately, your emotional safety and well-being should come first, especially in the spirit of either shifting the balance of power in a current relationship with a narcissist or healing from prior narcissistic abuse.
If you’re maintaining the relationship, seeing right through narcissist’s tactics and creating your own inner understanding of the narcissist’s intentions helps with feeling less confused and more trusting of your mind.
Become an Expert in the Narcissist’s Manipulation Tactics
Learning to trust your mind after involves making a distinction between your true intentions and the narcissist’s mental manipulation. The anxiety and confusion you feel has served the narcissist’s needs. When you’re chronically kept emotionally off balance and in a fog, you can’t even defend yourself with your full mental capacities. Nor can you accurately trust yourself enough to advocate for yourself based on a more accurate version of reality. This is why psychoeducation is so important as a first step in your process. You need increased perspective to know when you’re being manipulated.
A narcissist’s ability to engage in blameshifting is unbelievable. A variety of methods are employed to avoid accountability and make you question your version of how you remember events. The art of blameshifting needs to be studied with ferocious enthusiasm. It will give you priceless perspective in order to separate from the lies you’ve been fed.
Building out a separate reality and healing confusion requires you to study the tactics of the narcissist (see a list of narcissistic manipulation strategies here). If you can label the behaviors used against you, it removes at least some of their influence. I recommend becoming an expert in gaslighting and its many manifestations. Learn to identify gaslighting when a character with narcissistic traits on a Netflix show is doing it to others. Here is a list of movies and shows containing a narcissistic, main character who gaslights others. Study how it manifests in the narcissist in your life. This knowledge is true power.
Knowing the tactics of the narcissist is crucial, but taking it a step further….you need to know which narcissistic control and manipulation tactics are you the most prone to falling for. Are any of these tactics used in your family? In other words, do you have familiarity with certain narcissistic maneuvers that either get right through your defenses or toward which you’ve already built up awareness and resistance?
Some people enter a relationship with a propensity toward excessive self-judgment and self-doubt and the narcissist capitalizes on this vulnerability. People with narcissistic qualities will turn your natural tendencies against you. They will tax your support to the point where your needs no longer matter.
If you tend to find yourself in the role of the “giver,” the type of person who tends to put aside their own needs for the other, then you’re at high risk for being taken advantage of by a narcissist. Giving and sacrificing in a romantic relationship does require something tangible in return, but your request to have your emotional needs met is likely to have been punished and ignored by the narcissist.
This doesn’t mean that the giver should stop giving and the empath should stop holding the pain of others. It means you need to understand how your tendencies have been weaponized against you. You need to know what the tactics sound like, look like and feel like. This will allow you to begin to make a better distinction between what the narcissist needs you to feel so they can get their way versus the thoughts and feelings that are uniquely yours.
It is important to note that even someone with a healthy sense of self-worth and who is not a giver/empath can be brainwashed by a narcissist into adopting state of perpetual self-doubt.
Each time you recall a negative memory, try to label the narcissistic tactic (e.g., “Ahhh, he’s using false equivalence to justify his actions.”)
Learn Triggers of Self-Doubt in Narcissistic Abuse
Begin to study what your mind sounds like when you’re in a state of self-doubt, typically in the form of sweeping, global, negative statements about yourself (e.g., I am a horrible and neglectful partner….so I don’t deserve to go out with my friends separate from my narcissistic partner).
You can even give a name to this part of you that goes right to self-doubt. Call it by name when it’s trying to steer you away from positivity. This is the part of you that is trained by the narcissist to maintain a sense of safety and connection while in the relationship. This part comes up with the solution of devaluing yourself to avoid danger and disconnection, but it comes at the cost of maintaining any form of a healthy sense of self.
Study the accusations that narcissist relied on to convince you of their beliefs about you. What did they say to you to make you lose your center, to make you question yourself, to make you stop fighting back? What did they gain by you hating and doubting yourself? So many clients say to me, “I wasn’t innocent either. I did legitimately bad things in the relationship as well.” Clients will share self-loathing stories of acting in ways that justify their negative self-concept. Please just know that everyone has unhealthy ways to cope with abuse. Think of these behaviors as heroic strategies for survival in the relationship. They were probably necessary for you to maintain safety and sanity while being abused. You can now commit to creating new ways to cope.
Overcome the Battle Between Connection and Self-Sacrifice
It’s human nature to seek connection with important people in our lives, even when they hurt us. We try to please them, accommodate their needs and adjust our inner world to avoid conflict, especially we’re contending with their punishing, superficial front of strength and certainty. Sometimes we get a window into their wounded ego. They hide from us their fragile send of self, as just below the hard front of their outward personality is a deep pool of fear and low self-worth, a sense of nothingness. It’s in the narcissist’s best interest to make sure people don’t see this side of them.
Your time in the relationship with a narcissist has kept you in a constant state of tension between connection and confusion.
This inner conflict between connection and the fact that the narcissists behavior tends to be inconsistent, contradictory and punishing tends to promote a state of helplessness in the partner. It makes sense that to maintain emotional connection and safety (and avoid the narcissist’s punishment), the best choice of action ends up being giving in to the narcissist.
In your relationship with a narcissist, it’s inevitable that you’ll have to negotiate the inner conflict between temporary emotional safety and personal growth.
We have the human need to feel safe, even if it comes at a cost. During your time with the narcissist, how much have you been able to invest in activities that promote your personal growth? Chances are that the narcissist has invested in sabotaging most of your efforts to grow and prosper as an individual because your emotional and spiritual growth represents a threat, a loss of control for the narcissist.
It’s quite common for partners of narcissists to give up many of the activities and interests that used to feel healthy and growth-promoting. I get it. It’s much more important to feel safe and keep the peace when you’re in the thick of it all.
But think of the sacrifices you’ve made to maintain the peace with the narcissist. This can induce tears and regrets for many survivors of narcissistic abuse. You had to do what you had to do to get by, but now it doesn’t have to be that way. In or after the relationship, you can develop your interests and commit to meaningful activities and values. I recognize that this might enrage the narcissist, but please know that your health is most important. And your health requires that you strive to do what makes life meaningful for you.
Reframe the Narrative of the Relationship with the Narcissist
Narcissistic partners tend to share their opinions with pathological certainty. That is, they tend to speak in absolutes with no room for your interpretation of events. They tell you how it is and they minimize or ignore any facts or opinions that conflict with how they see you. Most importantly, they will make you and your needs are the problem. As long as you buy into their narrative of the relationship, you will think less of yourself. You will adopt their self-serving and manipulative views about yourself. This is how they get their way with you. For example, if you hold them accountable for something bad they’ve done to you, they are likely to convince you that it’s your fault, or you deserved it or they will challenge your memory and tell you that it didn’t happen that way.
The narcissist’s self-serving narrative of the relationship (i.e., their version of reality) is forced upon the people under their influence.
Your memory for events, including who is to blame for the problems in the relationship, become blurry and confusing. If you’ve been repeatedly told, “It’s all your fault,” then you’re likely to come to believe it over time. In the face of abuse, adopting a belief that conflicts with that of the abuser may create more fear and confusion. In essence, the narcissist hijacks your ability to make sense of your behavior. Even your self-loving actions are likely to trigger guilt, shame, self-loathing and confusion because of the harmful treatment you endured.
Narcissists also tend to have a have a cunning way of arguing their point and convincing you of how a memory actually played out. Forget about convincing them of anything. It’s a waste of time. It’s up to you to create your own separate recollection and interpretation of your memories of being in the relationship. My hope for you is that your healing process will include lots of self-compassion and a keen awareness of the narcissist’s tactics and intentions that decreasingly impact your sense of self-worth.
Understand the Narcissist’s Memory Manipulation
Our actions are usually the content of our memories, but these memories are sensitive to manipulation. If we are viewing our existence through the lens of “I don’t deserve love,” for example, then we will only attend to memories and new experiences through this filter and ignore or minimize all other evidence that contradicts this belief.
A narcissist is a master of memory manipulation.
It’s essential that you take time to rethink the narrative of the relationship because the narcissist has manipulated your memory. Much of the abuser’s ability to wear you down and harm you comes from this toxic achievement.
You must know that this is not a sign of weakness on your part. Everyone who has endured a prolonged relationship with a narcissist has had their memory hacked, not just you. It is human nature to have your memories altered by relationship trauma.
They might convince you that you’ve been selfish and neglectful over the course of the relationship. Over time, any abused partner will begin to buy into the distorted narrative that serves the narcissist’s needs and justifies their abusive and neglectful behavior. If the narcissist can accomplish this, then your memories will become distorted to serve the narrative.
You may forget all the good you did.
The narcissist’s distorted narrative will make you believe you are inherently bad, defective or unlovable.
You may forget why your friends are great for you.
The narcissist’s distorted narrative will make you believe you must distance yourself from your support system to make you less influenced by others. A partner’s friends (and family members who don’t agree with the narcissist) are a threat to the narcissist, so they distance you from supportive people who have historically celebrated and grounded you.
You may forget that you deserve true love.
The narcissist’s distorted narrative will make you believe you must not ask for more than they choose to give you. Over time they offer a decreasing amount of loving acts and they punish or ignore your requests for more.
You may forget that you need space to enrich yourself spiritually and emotionally.
The narcissist’s distorted narrative will take away your ability to grow as a person because personal growth is a threat to their security and control.
Reframing your self-sabotaging patterns of thinking and behavior to better understand the impact of narcissistic abuse can grant you layers of perspective, ease the shame and create room for self-compassion.
Update Your Self-Worth and Reject the Narcissist’s Self-Serving Beliefs
What has the narcissist’s pathological certainty about you led you to believe about yourself? In the interest of maintaining control over you, the narcissist has probably convinced you that you’re some version of “too needy, too demanding and too sensitive.” How many times have they told you that your needs are ridiculous, your version of the story is wrong? How many times have they punished you by ignoring statements that make them accountable? These narcissistic manipulations all make you doubt yourself and adopt the least generous version of your worth.
Narcissists are masters of shaping their partner’s self-worth to maintain control.
Narcissistic Abuse Recovery Exercise #1
First, make a list of everything the narcissist has tried to convince you about your own self-worth and goodness. Put some space between each accusation.
Second, after each statement, write the opposite. Create a positive and generous interpretation about yourself in the spirit of connecting with. your own personal truth
Third, list a few of the tactics the narcissist used to convince you of this negative belief about yourself.
Every time you go into a state of self-doubt and fall prey to these manipulations, do this exercise to remind you again of your own truth.
Create Healthier Responses to Triggers Caused By Narcissistic Abuse
When you’re triggered by something the narcissist did to you, it’s necessary to develop a new set of coping responses in addition to what you did to survive the abuse. For example, if you’re suddenly reminded of how many lies the narcissist told you, instead of obsessing about these lies and looking for “evidence” of the narcissist’s wrongdoing, consider calling a trusted friend or family member to talk about how you were triggered. Or journal about everything you’re thinking on the subject without editing, put it away and move on with your day. Another option is to substitute the obsessing with a behavior that represents healthy self-care, such as taking a walk and listening to your favorite (uplifting) band or doing some stretching to motivational music.
Reconnect with Your Social Circle
Relying on friends for support will expedite the healing process. Reconnecting with all that is real and true and good for you requires that you move toward people who are safe for you and who will remind you of your good parts. For many people who are reeling from narcissistic abuse, the hard part about increasing social activity is allowing yourself to be vulnerable with others and/or worrying that you’re “too much” because of the fear of oversharing or acting depressed and “no fun”.
First, take a chance with the least judgmental person you trust. Don’t hesitate to ask this person when you’re in the throes of grief or self-doubt, “Tell me if I’m off with this, but…..” Let someone give you a much-needed reality check. Talking through your experiences will help you reframe the narrative of what occurred in the relationship
Seek out new groups of people. Start a new hobby that involves a fresh start. A group class can promote healing. Have you been putting off enrolling in a sports, dance, martial arts, improv, acting, craft, religious or spiritual class where you can potentially bond with other people? There’s no better time than the present to go after this if you long for healing from an abusive relationship. Group therapy can also be immensely helpful.
Narcissistic Abuse Recovery Exercise #2
Interview two or three people in your life who have a track record of showing you respect and appreciation. Choose people who make you feel safe. Don’t ask people who remain under the narcissist’s influence.
Ask each of these trusted people the following questions:
Who am I for you when I enter your space?
What do you think is unique about me?
How have I changed under the influence of the narcissist?
Can you tell me a memory or two of when I did something admirable or uniquely me?
Hearing it from other people can reconnect you to how you used to see yourself. I understand that we all have a version of imposter syndrome that pays special attention to the difference between how people see us and how we see ourselves. Pay close attention to how the self-sabotaging, self-doubting part of you aims to distort your sense of self. It is likely to have a field day with information that a trusted friend or family member shares with you about your greatness.
Narcissistic Abuse Recovery Exercise #3
This brings me to my next recommendation. In this type of situation where you spiral into vicious self-judgment, say to yourself, “Whoop, here I go judging again!” Repeat this phrase every time you catch yourself judging yourself, even if it’s 50 times a day. The goal is to put some distance between you and your judgments. I have often written about this intervention, which I learned many years ago from Peter Reznik, a phenomenal mind-body therapist.
A little room between you and your self-judgments goes a long way, as it gives you the ability to edit the judgment in the spirit of self-acceptance and awareness. Constant self-judgment turns your mind against itself. It promotes unease and disease. The narcissist benefitted greatly from this habit of yours in terms of control of your mind.
Again, notice each time you judge yourself, especially when you think of your behavior in the relationship with the narcissist. Following the self-judgment, reframe what happened in the relationship and what the narcissist gained by manipulating you to think in this particular negative way. For example, if you have a sudden recollection of how much the narcissist lied to you and you’re flooded with self-loathing, confusion and regret, say to yourself, “Hmm, here I go judging again. I was manipulated by this person so badly so they can get away with all of their lies.
Judging the narcissist is another story. You will probably need to let yourself do this as you heal. Many people report going through waves of compassion and guilt for how they have hurt of betrayed the narcissist. Compassion for the narcissist has its role in the healing process but guilt needs to be minimized, as it tends to make people feel like they still owe a debt to the narcissist, which is a dangerous idea.
Rebuild Your Sense of Purpose After Narcissistic Abuse
What constitutes a meaningful life for you? Do you have a vision of living true to yourself looks like? What actions in everyday living make you feel like you’re manifesting a well-lived life?
Answering these questions will help you connect with your personal values, which will help you to know when you’re being true to yourself. Values clarity promotes clearer perspective on the difference between what an abusive relationship has taught you to think and what truly matters to you. A value is an ideal that is turned into reality through behavior. If you’ve been punished for manifesting your values in reality, there’s a good chance you’ve grown distant from activities that made you feel grounded.
For example, your partner is threatened by your value of spiritual growth so he sabotages your efforts to go on spiritual retreats or take a class on spirituality. You may have to come agree with the narcissist because you see how much it upsets him. Perhaps he appealed to your doubts about a spirituality class because it’s expensive or the benefits of attending are not crystal clear. The key is to dare to reconnect with this value and get closer to what feels authentic and true to you. You’ve been systematically held back. Spiritual nurturing of any type is great for reminding you of what really matters to you in life.
Your personal growth is a threat to the narcissist.
Another example would be if you used to value investing in and maintaining close friendships, but your narcissistic partner systematically dissuaded you from getting together with your long-time friends who you’ve trusted in the past. The narcissist’s control tactics are likely to make you bitter but self-doubting when it comes to manifesting this value. Maybe the narcissist convinced you that your sibling or close friend is a horrible person, but a part of you still feels like you’ve been pushed away from good people who were there for you in the past. Controlling you is easier without your friends and family around you. Shame, confusion and resentment about the distance you’ve created from these great friends may be holding you back. Well, now that you’re realizing the need to find your own truth, it’s necessary to reconnect with this value (and the friends you’ve lost touch with).
Another example would be if you used to value and act upon your commitment to personal growth (one of my values), but your partner seemed to feel threatened by and judge actions you took to better yourself. As a result, they manipulated you to reduce behaviors aimed at emotional, social and spiritual self-nurturing so that they could control your self-worth by keeping you in a state of personal neglect, helplessness and self-doubt.
I believe it can be helpful to write a list of five or six personal values that constitute a meaningful life. Carry this list with you, perhaps in a note on your phone, and review the list to remind yourself of the direction you’re aiming for.
The third section of the outline, deep healing from trauma, is not part of this article. My intention with this long piece of writing is to give you clarity and direction as you heal from trauma caused by a narcissist. I wish you all the best in your journey. Feel free to contact me with any questions about getting started in therapy for narcissistic abuse.
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Dr. Greg Kushnick is a licensed psychologist serving New York and New Jersey. His offices are located in Chelsea/Flatiron and Wall St./Financial District of New York City. Dr. Kushnick offers concrete tools and practical cognitive behavioral therapy (CBT) techniques. In-person and online appointments are available during morning, afternoon and evening hours. To schedule a complimentary 15-minute phone consultation, email [email protected].
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The Key to Effective Social Anxiety Therapy for New Yorkers
Social confidence can be hard to achieve in New York City. In fact, it’s quite common for New Yorkers to grapple with periods of overwhelming social anxiety and stress in anticipation of relating to other people.
As a psychologist in private practice in NYC, I have come to understand what makes therapy for social anxiety effective. I’m going to share with you what I believe needs to be part of your therapy process in order to maximize your efforts to gain social confidence and reduce anxiety. That is, to feel highly prepared to manage the challenges that arise in social settings and in the time leading up to social events.
When we talk about social anxiety, a.k.a. ‘social phobia’, we’re referring to persistent fear of and intense worry about being judged and/or observed by others in social settings. This fear promotes avoidance behaviors and can be associated with depression, as isolation from the need to avoid promotes a lot of negativity directed toward the self, sometimes including a deep regret for failed or missed opportunities.
I’m going to talk about getting started in the process of improving your social anxiety, but most importantly, I’m going to discuss what actually makes therapy for social anxiety effective for New Yorkers. I’ve been doing this work for a long time as a psychologist, and I believe many people don’t realize what is needed to feel more socially prepared and adept.
Sometimes our social anxiety fears do come true. The very outcome we ruminated about can happen. CBT therapy prepares you for this situation.
CBT for social anxiety can help you identify hot thoughts that keep the vicious cycle of self-judgment and avoidance in motion. By learning to gain control of painful mental images, negative self-judgment and personal rules, you can work on creating small victories in social settings.
But there’s more to that’s required for social anxiety therapy to be effective.
Therapy Key #1: Managing Social Expectations
The very first step toward improving social anxiety is about managing your expectations. (In truth, it’s also about acknowledging that you’re going to need to go outside of your comfort zone to make any appreciable change, which includes a willingness to sit in the discomfort that comes up when facing the embarrassment, shame and self-defeating thoughts and behaviors associated with social anxiety, but more on this in a bit.)
Your expectations determine whether or not you feel pleased or dissatisfied with reality. They can promote avoidance behaviors or push you to try hard things. Expectations of social success in New York can be tainted by all of the influences that NYC throws at you.
For New Yorkers who are sensitive to social failure, models of social success may feel like they are everywhere they go. New York City, particularly Manhattan, bombards its inhabitants with massive exposure to material wealth goes hand in hand with feelings of intimidation, the need to “catch up.” This all starts with what you expect to happen when you aim to grow your professional network, make new friends, find love in the big city or all of the above.
Of course, it’s beautiful to aim for the stars and hope for an amazing social outcome. However, a having healthy social expectations involves being realistic about the time it takes to establish connections in the city and a deep understanding of the impact of who you choose for social comparison on how you view yourself and your chances.
When there is a constant discrepancy between social expectations and your social reality, it can create periods of social avoidance and despair. On the flip side, if you just assume that you’re going to fail and you use evidence of past failures to project into the future, your expectations are also messing with your chances of improving your social anxiety.
So the first step is all about expectations. Try to be open to the idea that what you define as social success might need to be adjusted. The illusion of massive social success is all around us. Social media makes this worse.
Then there are the select few who have amazing social success, but I promise you that you don’t know the whole story.
Ask Yourself These Questions About Your Expectations of Social Success
- Where does my benchmark for social success come from? Is this a realistic goal? Am I willing to look deeper into my standards in an effort to improve my social confidence?
- Does my model of social success match my personality style? (i.e., Extroversion/Introversion)
- Are there teenage experiences of social success or failure that I’m trying to repeat or correct for?
- Am I aware of the extent to which social media plays a role in feeling like a social failure? Which social media accounts make me feel the best/worst?
- Are my expectations for how I feel and act in social situations rarely being matched by reality?
- Are my expectations of social failure too high? Do I recognize the small social wins?
- Do I stay away from taking social chances because I assume I’ll fail?
These questions represent a small sample of what to start thinking about in any initiative to improve your social anxiety. Going into therapy with a keen eye on your expectations is a good first step, but real, appreciable change in therapy for social anxiety requires an understanding that your anxiety is not all that needs to be targeted in therapy. It will certainly be the primary focus, but to do social anxiety therapy the right way, you need to target “second level” emotions as well.
Therapy Key #2: Embracing Second Level Emotions
Effective therapy for social anxiety will help you feel less in your own head when you’re socializing, networking or around strangers. You will be more in the moment and less preoccupied with how you think you’re being perceived. You’ll be more likely to feel self-expressed and vulnerable. In order to achieve these gains, you not only need to focus on anxiety reduction, but also on how you feel about your struggle with anxiety. I’m essentially referring to how you feel about how you feel.
Anxiety is considered a primary emotion. So is anger, disgust, surprise, happiness and sadness. Primary emotions are more brief and instinctive. Once they sweep in, they start to effect your thought process, which opens the door for secondary or “second level” emotions.
Second level emotions last longer. (I like the term “second level” as a metaphor because it makes me think of a cover or a ceiling that locks in the problem.) These emotions tend to have increasing influence over time and even may be operating out of awareness. While primary emotions are more universal, secondary emotions are specific to the individual. Examples of second level emotions are shame, guilt, embarrassment, frustration, withdrawal, regret and jealousy.
For people with moderate to severe social anxiety, I have found that second level emotions function as the mental glue that keeps social anxiety in place.
In my experience as a clinical psychologist in private practice in NYC, I have come to understand that effective therapy for social anxiety must include an examination of second level emotion. That is, you need to cultivate an awareness of how you feel about how feel.
Second level emotions make the experience of social avoidance much worse. If you decide to stay home and avoid a social situation, you might feel an initial sense of relief as you sit in the safety of your home because you avoided a potentially mentally dangerous situation. You succeeding in avoiding the potentially negative social experience, but this avoidance, if repeated, begets more avoidance. Before you know it, you’re making excuses on a consistent basis to avoid all kinds of social events.
It’s quite common for people to feel a painful sense of shame about their perceived social failures and avoidance. Some people judge themselves intensely for feeling socially anxious, even panicky, being too quiet or having nothing interesting to say.
For example, let’s say you attended a social event and felt so nervous that you could barely speak. You also questioned what you had to offer in various conversations. Maybe with one person you know well you felt fine, but you judge yourself for how you performed in other conversations. Maybe you felt hyperaware of having no hobbies or exciting topics to discuss. Following the event, you felt such negative self-loathing that any positive aspects of the event were canceled by your extremely negative evaluation of your social performance.
The shame you feel might compel you to mentally beat yourself up, question your character and your future. Depression might kick in because you’re grieving what you think you’ll never be able to accomplish.
This shame kind of seals the deal for your social anxiety to maintain control over your choices and self-evaluation. It is the mental glue that keeps your suffering in place because it contributes to a vicious cycle of negative self-evaluation and avoidance. The more you judge yourself about your social anxiety, the more you’re likely to avoid. The more you avoid social situations, the more likely you are to judge yourself negatively. This pattern limits your chances for social success, even little wins that could give you a sense of hope.
When shame and low self-worth are too easily accessible or too dominant relative to other emotions, your social anxiety cannot be fixed with exposure therapy alone.
Effective social anxiety therapy requires a focus on what is triggered in you as you judge yourself for having the anxiety.
Of course, social anxiety therapy does require some form of exposure, as well as the acquisition of new skills so you can feel prepared to handle social challenges. That sense of social readiness is crucial to the success of your social anxiety therapy.
Feel free to reach out with any questions you have about CBT therapy for anxiety. And please click on the link for FAQ about social anxiety therapy.
I wish you all the best!
Greg Kushnick
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Dr. Greg Kushnick is a licensed psychologist serving New York and New Jersey. His offices are located in Chelsea/Flatiron and Wall St./Financial District of New York City. Dr. Kushnick offers concrete tools and practical cognitive behavioral therapy (CBT) techniques. In-person and online appointments are available during morning, afternoon and evening hours. To schedule a complimentary 15-minute phone consultation, email [email protected].
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10 Important Benefits of Cognitive Behavioral Therapy for New Yorkers
Living in New York City can be a challenging experience if you’re not invested in your mental health needs. Depending on how you’re faring here in the big city, cognitive behavioral therapy represents a wonderful option for helping you to get you through life in NYC. When you feel prepared to handle the emotional challenges that NYC presents, the city can be one of the most exciting and rewarding places to live.
Cognitive behavioral therapy’s focus on the here-and-now, as opposed to the emphasis on early childhood experiences in psychoanalysis, allows New Yorkers to experience a more solution-oriented therapeutic experience.
Here are seven reasons why CBT therapy is a wonderful choice for helping you make it in the Big Apple.
1. New York City is the loneliest city in the world.
You may think that it’s easy to connect with lots of people in NYC, but it’s usually quite the opposite. For most New Yorkers, building a community is extremely hard. It is also assumed that it’s so easy to date because of all of the options. In reality, it can be a frustrating process involving painful trial and error and vulnerability. NYC’s culture does not lend itself to building a community that helps you feel valued and supported. Many of us have to do it from scratch. It takes a lot of mental resources to avoid feeling lonely, sometimes even in relationships.
CBT helps New Yorkers acquire tools to better manage social and dating disappointments. We look at troublesome belief systems, including core beliefs and rigid, conditional self-statements that promote social anxiety and a sense of fragility in response to perceived failure. CBT therapy also looks at problematic behaviors that exacerbate and reinforce negative cycles of thinking, such as social avoidance and addictive tendencies.
2. NYC can be unforgiving to people with social anxiety.
The pressure to be socially successful is one of the trademarks of New York City life. This is a terrible burden for many of its inhabitants. For those of us who grapple with social anxiety, NYC presents a constant flow of opportunities for brutally self-devaluing, social comparison. The shame that comes from perceived failure and judgment after a difficult social moment promotes social avoidance, panic and depression. Given how hard it is to socialize without the presence of alcohol (#5 on this list), many people with social anxiety also develop an unhealthy relationship with alcohol.
CBT therapy can work wonders for social anxiety. I’ve been doing this work for over 27 years and I’ve learned a thing or two about how to cater cognitive therapeutic techniques to alter a client’s self-concept and behavior patterns. CBT targets the vicious cycle built into social avoidance. It promotes an ability to cope with symptoms of Social Anxiety Disorder. It aims to achieve small wins with social success, self-acceptance and healthier thought and behavior patterns.
3. Too many options offered in NYC can affect your mental health.
The overwhelming number of possibilities baked into NYC life can effect your sense of what is “good enough,” it can alter your relationship with money, power, success and validation. Many of us are already over-scheduled and psychologically overtaxed. If you’re not careful, the NYC lifestyle will pressure you to overdo it with scheduling activities, which limits your ability to recharge or gain enough psychological distance from your troubles in order to reach a healthy perspective in your downtime.
My CBT approach aids in examining limiting beliefs and behaviors that get in the way of your commitment to important decisions. I help my clients to set goals and stick to commitments that align with personal values. My focus on values also offers a roadmap for navigating difficult choices and staying on course toward manifesting what you consider to be a life well lived.
4. NYC work culture views burnout as a badge of honor.
High-achieving people, especially those with perfectionistic tendencies will find many reasons to push themselves to their breaking point, recover and break again. New Yorkers who come from families that don’t value mental health as a safe topic of discussion often have to reach an extreme state of mental anguish in order to finally take care of their mental health. Many New Yorkers take on jobs with brutally long work hours. Many work cultures, especially in finance and law, promote sacrificing your mental health to reach your numbers and doing anything to avoid reprimand from your narcissistically-inclined boss. Most people are not built to sustain such pressure. Work burnout promotes depression, anxiety and addiction. It changes your priorities, which leads to relationship issues and neglect of one’s physical, mental and spiritual health.
CBT can help you cope with work burnout. The examination of belief systems that promote hopelessness, self-loathing, unrealistic standards and self-defeating behaviors can truly make a difference if you’re under a ton of consistent pressure at work. CBT can be highly effective for combating social withdrawal and motivational outages associated with depression. It also helps with the avoidance behaviors that go with anxiety and panic attacks.
5. Alcohol plays a role in so many social activities in NYC.
In NYC it can be a challenge to socialize with friends without the presence of alcohol. This becomes particularly problematic if you’re trying to limit your alcohol intake and you want to bond with friends. It often takes smart planning and well-developed habits to avoid social situations that center around drinking. What’s more–some jobs in finance promote an unhealthy relationship with alcohol when there’s an obligation to wine and dine clients at night. In addition, long term relationships/marriages (as well as your health) can suffer terribly when one partner doesn’t manage their drinking habits.
I help clients to navigate the social scene in NYC, while keeping track of which social habits create mental suffering and relationship issues. My CBT methods promote calming your mind and establishing your priorities, which can empower you to find alternative ways besides alcohol to quiet your mind and socialize effectively. I am highly passionate about my CBT work with clients who are grappling with social anxiety.
6. The exposure to extreme wealth in NYC can promote an unhealthy relationship with money and success.
For the ambitious New Yorker, no matter what you have — the money you’ve earned or the job title you’ve achieved — the influence of other’s people’s money and achievements can make you feel not good enough. So many New Yorkers sacrifice their mental health to chase a dream, but the dream may not be grounded in the awareness of the price paid for striving to achieve a goal. In NYC, if you’re not careful, the goal hijacks the mind and the journey, which makes up the bulk of your time, is minimized. Many New Yorkers live in a state of self-imposed deprivation. “If I make Vice President, life will be good.” “When I can afford to buy this material good, people will notice me and see me as successful.”
I help clients to establish a healthier perspective with regard to their definition of “success.” People rarely stop to consider their “money wounds,” which promotes suffering and replicating unhealthy aspects of your relationship with money. Cognitive behavioral therapy can assist you in altering unhealthy patterns of behavior associated with irrational beliefs around money and success. Of course, you should chase your dreams, but you also need strong mental hygiene to enjoy the fruits of your labor.
7. NYC attracts people with narcissistic tendencies.
The reality that makes many people uncomfortable to talk about is that many highly successful people have narcissistic tendencies. NYC attracts ambitious people who have “made it” in their respective field. Chances are that at some point in your time working in NYC, you will have a narcissistic boss or romantic partner. One relationship with a narcissist has the power to gut your mental health.
I employ CBT to help my clients recover from narcissistic abuse. I am an expert in narcissism and narcissistic abuse. If you’ve been mistreated by a narcissist before, then you have some idea of the awful effects of their manipulation and controlling behaviors. Your sense of reality becomes altered, your sense of trust is shattered, your access to own personal value is reduced to nothingness. Cognitive behavioral strategies can be effective in helping you distance yourself from thought patterns that narcissistic abuse has instilled or exacerbated in you.
8. NYC can be a mental minefield for people grappling with panic attacks.
People who score high on measures of both achievement and control are more likely to suffer from panic attacks. NYC attracts this type of personality profile. The city is also full of common triggers for panic, such as theaters, crowded trains, and tight social spaces. Ambitious New Yorkers with Panic Disorder are likely to find themselves having anxiety and shame about the panic attacks they’ve endured in business or school presentations.
Since the presence of panic attacks usually includes the avoidance of settings that trigger panic, CBT with an exposure component to the treatment of panic attacks can be effective. As a Manhattan psychologist I do this work often. CBT targets the underlying issues promoting anxiety and shame about panicking. It helps people to feel more prepared in the face of panic.
9. Many New Yorkers are chronically overwhelmed and long term relationships suffer as a result.
Ambitious New Yorkers are chronically overwhelmed as a result of being constantly “on” at work or school with little time for relaxation. When there’s time to unwind, it’s often done by retreating into a their phones, which is ironically a very poor way to recharge. Because New Yorkers frequently find themselves in “survival mode,” it’s natural to choose disengagement and disconnection over engagement and connection with a partner.
My approach to CBT with an emphasis on values promote the establishment of healthy routines and communication patterns in long term relationships. CBT focuses on underlying issues that get in the way of healthy communication patterns. I also help clients to overcome resentment, judgment and pathological certainty to feel more connected in their relationships.
10. An unpleasant commute to and through New York increases stress levels.
Your patience may be tested if you have to deal with public transportation, which may add stress to your day. Finding peace of mind can be challenging. For people with less-developed anger management skills, NYC is a potential landmine of triggers that cause anger outbursts.
CBT can help you with stress and anger management so you can feel more prepared to cope with challenging moments in traffic, with strangers and other random, inevitable incidents. One key for sound mental health in NYC is to learn to stay connected to people, develop your empathy muscle and avoid stereotyping and snap judgments.
I offer CBT therapy as a clinical psychologist in New York City. I work with clients on a variety of personal, professional and family issues. Please feel free to reach out to me with any questions.
All the best!
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Dr. Greg Kushnick is a licensed psychologist serving New York and New Jersey. His offices are located in Chelsea/Flatiron and Wall St./Financial District of New York City. Dr. Kushnick offers concrete tools and practical cognitive behavioral therapy (CBT) techniques. In-person and online appointments are available during morning, afternoon and evening hours. To schedule a complimentary 15-minute phone consultation, email [email protected].
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FAQ – Narcissistic Abuse Recovery and Therapy
Recovery from Narcissistic Abuse – Common Questions
Can I recover from narcissistic abuse?
Yes. It is certainly possible to recover from narcissistic abuse. However, a full recovery requires a good deal of personal discovery, as well as an essential reduction in the narcissist’s access to you. Therapy is not required to recover, but it certainly makes a huge difference to have an experienced therapist guiding you through the recovery process. There are many other factors that will impact your healing process, including any past history of abuse at the hands of a narcissist (e.g., childhood abuse, prior abusive partners), a readiness to help yourself/ the right timing, the severity of the current or recent abuse and the extent to which you can achieve physical and psychological space to heal.
I offer CBT therapy for narcissistic abuse. For 25+ years I have worked as a psychologist in NYC helping people who have been victimized by narcissists. If you’re committed to the process, real healing can occur.
How do I recover from narcissistic abuse?
The process of recovering from narcissistic abuse requires some form of personal and psychological distance from the narcissist. It doesn’t absolutely necessitate that you have zero contact with the narcissist, but a lack of contact will probably expedite your recovery. Of course, some people simply must have contact with the abuser, such as in the case of sharing children with the narcissist or remaining committed to trying to make a long-term relationship with a narcissist work.
Assuming you can first achieve some form of space to heal, you will need to deepen your understanding of the tactics the narcissist uses against you. You will also need to learn how to cut off their narcissistic supply or give it strategically by choice if you must have contact. In addition, because narcissists tend to strip people of their own separate identity, you need to discover who you are separate from the relationship, including your wants and needs, values, interests and self-worth separate from your relationship with the narcissist.
The process of healing also involves gaining a deep understanding of the narcissist’s tendency to blame you (or others) for most or all of their problems in life. The narcissist maintains the upper hand as long as you’re in a perpetual state of doubting yourself.
Can I heal from narcissistic abuse if it occurred many years ago?
Yes. Therapy for abuse that occurred in past relationships or in childhood can be effective. Quite often, the therapy aims to help you heal from past abuse while assisting you in avoiding problematic relational patterns in adulthood that you learned as a child. Sometimes the work focuses on someone who has passed away, so the remnants of the abuse interact with a grieving process.
What is the best therapy for narcissistic abuse?
There is no single therapeutic approach for healing from narcissistic abuse that would be considered “the best.” You can achieve results with a skilled therapist who understands the nuances of narcissistic abuse. Cognitive behavioral therapy (CBT) represents one approach to healing from trauma and abuse, but there are other wonderful methods. Somatic therapy and EMDR represent two other approaches.
I have found that my clients tend to appreciate my enhanced CBT approach to healing from narcissistic abuse, which is primarily guided by a cognitive behavioral framework, but also informed by other helpful approaches that can be catered to the client’s way of viewing life. Since each individual views themselves, their relationships and the world as a whole in different ways, a flexible therapeutic approach can be extremely beneficial to the client.
CBT allows for more of a focus on your here-and-now experience. It enable you to handle and dispute irrational and troubling beliefs, and it aims to help you feel prepared to handle future difficult emotions and moments.
I must say though that the rational side of your mind only represents a part of your thought process. Much of human thought does not involve logic and reason. This is why I incorporate other methods of therapy — to help you to understand and manage the visual side of your mind. I like to think of it as the videos you play in your mind that don’t lend themselves to logic. Healing must involve sensations in the body, your fantasies, hopes and looping images that come to mind.
How do I deal with mental abuse from a narcissist?
The first step is to gain psychological (and, in some cases, physical) protection from the abusive individual. The therapeutic work is limited in its effectiveness if you don’t give yourself the space to process and heal. If the narcissist is actively harming you, it’s important to gain safety.
Because narcissistic abuse alters your sense of personal value, what you believe you deserve, your accountability/who is to blame, guilt, shame and so much more, you need outside perspectives from trusted individuals, as well as a better sense of who you are outside of what you’ve been told by the narcissist and possibly other abusive or neglectful individuals in your past.
The worst thing y0u can do is keep the abuse to yourself and avoid seeking support from trusted friends and family. It’s nearly impossible to recover from narcissistic abuse on your own. You need people- outside perspectives, preferably from friends AND a mental health professional.
Managing mental abuse from a narcissist must also involve learning to set boundaries with this individual and others in the future.
Should I do therapy after narcissistic abuse?
Therapy with an experienced therapist is likely to expedite your recovery from narcissistic abuse.
What is brain fog in the context of narcissistic abuse?
Brain fog refers to a sense of confusion, self-doubt and disorientation that sometimes results from prolonged narcissistic abuse. Many victims of abuse report feeling like their mental sharpness has been taken away, like they can’t trust themselves. Sometimes when some distance from the narcissist is achieved, there is a sense of derealization, as though the freedom isn’t real.
What are the four D’s of narcissistic abuse?
The four D’s relate to people who are married to a narcissist. The first three D’s represent the likely behavior of the narcissist, and the last D is the expected outcome.
DENY: The narcissist tends to behave abusively and then denies that it ever happened or changes the narrative.
DISMISS:The narcissist tends to minimize any response you have that makes them accountable. They can make you doubt your own judgment, opinions and memory of events.
DEVALUE: The narcissist wins when you are doubting yourself and making you feel badly for what you’ve done. They put you down to keep control over you.
DIVORCE: It is very common for marriages to end as a result of one partner having narcissistic tendencies.
How do I support someone who has been abused by a narcissist?
The goal is to make it safe for them. Be a sounding board for them but don’t force your version of reality. It takes time to heal. People need patience and understanding from their support system. If someone is in physical danger, then immediate action is needed (National Domestic Abuse Hotline -Tel. 1-800-799-7233).
Can narcissists be helped?
While there aren’t many former narcissists, some progress can be made in therapy, even for people with narcissistic tendencies. However, the prognosis is usually not great. Ideally, the motivation for seeking help would be intrinsic. When narcissists get help based on an ultimatum, usually progress is possible but limited to the extent to which the person can take responsibility for the actions. Where I’ve seen the most success is when narcissists feel like they have something major to lose, the timing is right and there is at least a shred of an internal push to take responsibility and become a “better” person.
All the best to you on your journey,
Greg Kushnick
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One of the Keys to Managing Depression
If I had 30 seconds to explain the key to getting over a bout of depression, I would offer one piece of advice that represents essential self-treatment for depression.
Depression can have so many manifestations ranging from mild and fleeting waves of melancholia to severe and debilitating months or years of suffering. With that said, among the many ways to combat depression, a commitment to practicing this one rule can speed up your recovery from any form of depression and catapult you toward happier days.
How do you overcome depressive experiences at a more rapid pace?
When you feel depressed, move toward people as opposed to withdrawing into your own world of social avoidance.
Strive to build a muscle of social approach within your depressive experience.
It will shorten the amount of time you suffer even if being around people seems to make you more depressed! For the best results, keep practicing social approach in between depressive phases.
You don’t have to love your time with your support network. Just allow yourself to be supported. Let your friends give you perspective, test your depressive reality and encourage you to think and behave in ways that pull you, even momentarily, from your depressive reality.
Your Social Approach and Depression
Your success with building a habit of social approach depends on two factors: (1) you how choose to design your time with friends and family, and (2) your willingness to talk about what your going through.
If socializing guarantees that you’ll drink or do drugs excessively, than you’re not going to help your cause. Alcohol and recreational drugs also lengthen the amount of time you will suffer, so try to create social situations that promote thoughtful, peaceful and sober bonding. Getting together with a friend to exercise, engage in a hobby or listen to music is gold in the fight against depression, especially if you agree to hold each other accountable to keep your shared commitment.
The maximum benefit can be gleaned when you’re willing to share what you’re going through. If opening up is hard for you, choose someone who seems less judgmental or who has experience with depression. Sometimes an in-person conversation about what you’re going through can make a dramatic difference in how you feel.
The social approach strategy means that you’ll have to fight the temptation to cancel plans. Everyone loves to cancel plans these days. It’s now become more socially acceptable to ghost your friends, but this is only the formula for unhappiness. Resist the desire to cancel plans if you want to overcome your depression, unless your low mood is extreme…I’m talking a 9 or 10 out of 10. When this happens, push yourself toward in-person support as soon as possible.
You might feel compelled to retreat into your own world of suffering when you’re depressed. This emotional cave certainly has its function when life feels overwhelming or when being around people feels intolerable. After a long and tiring day of pretending to go with the flow of work, school or parenting, I can understand why you’d would want to be left alone to watch your DVR in peace, but in most cases avoiding people will only elongate depression.
An introvert who is naturally inclined to withdraw from people (to stay in his or her comfort zone) might find it less helpful to move toward people when he or she is depressed. I work with a lot of introverts in my private practice and I’ve learned that even introverts with depression can greatly benefit from accessing their support system.
An uptick in social support will probably compel an introverted and depressed person to rapidly withdraw from people at certain points. That’s totally fine as long as people are seen as a source of strength, perspective and comfort in the battle against depression.
In this case, I would recommend a rapid oscillation plan. That is, you withdraw because you need to, but then get yourself in front of people and open up about what you’re going through.
If you have extroverted tendencies, you’ll probably have an easier time practicing social approach during a depressive phase. With that said, no matter how much you enjoy your social circles, depression compels most people to avoid social contact due to a decrease in motivation and energy.
The choice to move toward people and resist the muscle of withdrawal and avoidance can help you in so many ways, such as giving you a place to test your reality which depression tends to distort. Friends or family can offer alternative ways to view your problems, your relationships and your future. Social support also allows you to step outside of your suffering and have a neutral to enjoyable time. Most of all, the people who support you can make you find a tiny seed of hope and an ounce of meaning when depression makes you feel devoid of both.
So many people make the mistake of thinking that they can overcome their depression alone.
Just know that if you choose to avoid people when you’re depressed, you’re asking for a slow, uphill battle. Social avoidance creates a greater disconnect from purpose and hope. It distorts the way you view your relationships.
Your depression feeds off of social avoidance and an over–reliance on messaging as a source of support.
Please note that when I talk about accessing support, I’m not referring to messaging or emailing people more often. Digital communication can be helpful up to a point.
(Published on HuffPost)Dr. Gregory Kushnick is a licensed psychologist with a private practice in Manhattan’s Chelsea and FiDi neighborhoods. He strives to provide the most actionable tips on the web and in person for relieving emotional distress. He has successfully treated hundreds of people who struggle with depression, anxiety, trauma, panic, addiction and relationship issues.)

The Starting Point for Managing Anxiety
As a psychologist in New York City who has conducted thousands of sessions helping clients manage their anxiety, I have come to understand that there is one key to managing your worries. This key unlocks your ability to gain a sense of control over anxious moods and thought patterns. What I’m proposing also helps with an intense fear of something specific, such as a work presentation, medical test results or childbirth.
Just to clarify, when I use the term “anxiety,” I am referring to persistent worry and severe concern in response to an event that may or may not happen, the very uncomfortable anticipation of negative things to come. Anxiety involves a response to something in the future that is less likely to happen. Sometimes we feel anxious without any conscious awareness of what we’re anxious about.
We can all relate to the looping repeat of uncomfortable thoughts that accompany anxiety. Anxious moods steal our ability to focus on work, relax, bond with loved ones and get sound sleep.
My success with helping clients who are grappling with anxiety has depended on establishing the proper starting point for gaining a sense of mental control. In essence, the stage must be set before the band can start playing a relaxing tune.
Managing Anxiety Starts Here
The key to managing anxiety is gaining a sense of hardiness, or faith in your ability to cope with the unknown. Having this faith allows you to know that you’ll be ok no matter what happens. Hardiness is not easy to achieve, but the presence of just a drop of faith goes a long way.
How do you build up your hardiness? It starts with telling yourself 50 times a day, “No matter what happens, I will be ok.” If fear of a specific event is overwhelming you, try gently picturing yourself in the feared scenario and then tell yourself this message 50 times as you look around experience the sights and sounds of this event.
See yourself as making it through the event if you can picture what you fear. Say to yourself, “I made it.”
If this kind of imaginary exposure feels like it’s too much for you, that’s ok! Just feed yourself the reassuring message without imagery.
Faith in your ability to cope can come from a variety of sources. There’s faith in your mind, which refers to a sense of being able to control your thoughts and a sense that you’ll be ok if you lose control of your mind. The chaos doesn’t last. It’s time limited.
You actually do have at least partial control over some things that make you anxious. For example, if you’re getting a procedure done in the hospital, can you decide which doctor will perform the procedure, or the music you listen to, or who will be with you when you’re recovering? Focus on the choices you actually CAN make. The ability to choose some of the minutia of the feared scenario really helps.
The other side of building hardiness is to accept that there are some things you can’t control, which necessitates even a mild commitment to letting go and trusting in yourself, even if you know you will suffer for a period of time. This is where faith comes in. Faith in doctors, faith in God, faith in your efforts to take care of yourself, faith in people to make good decisions and do what’s best for you.
Building Faith in Your Mind
Your ability to control stress and anxiety ultimately depends on how much you believe your mental health can absorb a difficult event.
Sometimes faith in your ability to cope has to do with recognizing what your body can do for you without conscious effort. You were built to cope and return to a comfortable baseline of body functioning. Your body always resets to achieve as close to a sense of balance and equilibrium as possible. For example, if your heart rate soars in anticipation of a catastrophe, you need to remind yourself of your body’s ability to return to a comfortable state. Mental suffering generally comes in waves or cycles, as opposed to a permanent, unrelenting negative experience.
A sense of hardiness is also connected to your immune system. If you tell yourself that you can handle something, your body can have a stronger immune response. Of course, this is not true in ALL scenarios, but feeling hardy certainly gives you a physical boost of strength. Feeling like you can’t handle something is likely to elevate your cortisol levels, which weakens your body’s healing response.
Tips for Managing Anxiety and Building Hardiness
Below are a few hardy suggestions for learning to manage your anxiety.
- Start by sharing your experience of anxiety more authentically with a trusted person in your life. Remind yourself that you have this person to lean on if needed.
- Make sure you go at least one step outside of your comfort zone. It’s ok to be a bit uncomfortable if your behavior is in the spirit of striving toward something.
- Spend time identifying what’s important to you. What are the values you live by? What kind of person are you striving to be for the world? Judge your behavior based on these commitments. Knowing your values and who you are striving to be serve as a guide for difficult choices and personal boundaries.
- Take time to evaluate your personal boundaries with others. Who makes you do things you don’t want to do? Who makes you feel badly about yourself? Consider reading the book Set Boundaries, Find Peace to get a wonderful introduction to setting healthier boundaries.
- Evaluate your expectations for how an anxiety-inducing situation is supposed to go. Do you need to spend time learning to be less perfectionistic? Do you expect too much of yourself or other people? Setting reasonable expectations promotes feeling less shocked by negative outcomes.
- Pay attention to how you use your phone to self soothe. Are you over-reliant on your phone or should you commit to bringing uncomfortable thoughts under control without a screen?
Please feel free to reach out and ask a question or if any of this information feels like something you want to work on in therapy.
Good luck to you and your hardiness!
-Dr. Kushnick
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How to Find the Best Psychologist in NYC for Your Mental Health Needs
Dr. Gregory Kushnick, Licensed NYC Psychologist
Tel. 917-566-7312
138 West 25th St., Suite 802-B4, New York, NY 10001
Finding the best NYC psychologist for your needs can feel like an impossible task. I’ve put together a list of some great strategies for finding a therapist. So many current and prospective patients have shared with me how daunting it feels to find a psychotherapist in New York area. I hope this guide will make your search easier.
Tips for Your NYC Clinical Psychologist Search
1. Cross reference your findings from therapist listings with Google searches.
Don’t stop at the information offered on New York therapist listing sites such a Psychology Today. Find a therapist by going a step further to learn what potential mental health clinicians are really about. Has the psychologist written anything of interest or reported on the latest research? Do they seem modern, worldly and knowledgeable based on their online presence? Do they have impressive reviews on Google? What about their website? Do they talk in a relatable way or do they sound cliche?
2. Pay attention to your first reaction to the picture of the therapist’s face.
There’s so much valuable information in your gut reaction to how he or she looks. Does his or her face make you feel at ease or stressed out. Is it a face you can trust?
3. Ask your friends if they had a psychologist they enjoyed working with.
A referral from a trusted friend is gold. Don’t be afraid to share your need for mental health therapy. Getting the help you need is a sign of strength. Friends who will judge you for needing therapy may not have your best interests at heart and are probably not very evolved.
4. Interview 2–3 prospective clinical psychologists unless you’ve found your match with the first one.
Don’t hesitate to ask questions about what matters to you. Call or email the therapist and ask away. If they don’t make time to answer your questions, then stay away.
5. Seek to understand the psychotherapist’s theoretical orientation/ their approach to therapy to see if it matches the style of therapy you’re looking for.
This one also requires a call or email. Ask them to explain how they conduct therapy and what guides their approach. If they can’t answer clearly, don’t choose them. Do you want a more collaborative CBT experience? Structured? Traditional/psychoanalytic? Existential? Don’t be afraid to ask.
6. Speaking of the phone call, see how you reach to the therapist’s voice.
Does his or her voice soothe you? Is it harsh? That voice has to calm you, but also potentially motivate you.
7. Do some research on the different types of mental health clinicians in New York City.
Are you looking for a psychologist (who is likely to have more formal schooling/training on diagnosis and treatment), a clinical social worker (who could potentially have even more extended training than a psycologist, but you have to ask or google), a marriage and family therapist (who specializes in couples therapy but can still be an amazing individual therapist), a mental health counselor, etc?
8. Many New York City psychotherapists specialize in something or have developed a special skill based on the types of clients they attract.
Most NYC therapists list anxiety, depression and relationships as their specialty. That doesn’t tell you much. Ask your prospective New York psychologist with whom do they work best work? Patients with anxiety? Addiction? For example, I don’t have a specialty per se, but my practice has attracted clients grappling with certain problems, such as panic attacks, social anxiety and work stress, which has prompted me to develop my skills further to give them a great healing experience.
Feel free to contact me if you have any questions about this article or if something is unclear. I love what I do and I want you to find the help you need.
I have created other articles on the topic of finding a NYC psychologist if you want to read more. Please take a look at some of my other psychology articles on HuffPost to learn more about my philosophy.
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On Anger, Depression and the Need to Be Right
How Much Do You Need to Be Right or Point Out Other People’s Faults?
Why do we invest so much time and effort watering the roots of the relationships that make us happy, yet when we’re grappling with a sour mood, our ability to see the world from someone else’s eyes feels impossible? Does this ever happen to you?
The man or woman you love so much is sitting right in front of you, but all you can think about is how you won’t give in until they not only acknowledge how you feel, but tell you that you’re also RIGHT!. You’re even willing to ruin a date night, sabotage an opportunity for intimacy, or avoid talking to them for days until they submit. You’re furious and you can’t step out of it.
We’ve all been there. We usually reserve this type of behavior for the ones we love the most or have known the longest. If we are feeling unheard or misunderstood, we may forget to listen. If we feel accused of wrongdoing, we may dodge responsibility at all cost and focus on convincing the accuser that they’re wrong.
If a deep-seated insecurity fuels the need to be right, then the fight to prove rightness can potentially go on for days, weeks, months, and even years. The need to be right and the tendency to make others wrong tends to promote long-term resentment and animosity in relationships. This state of mind may suppress the immune system and invite illness into the body, and it is likely to limit our repertoire of problem-solving behaviors.
I find that an overinvestment in being right tends to promote more frequent states of dissatisfaction in relationships and with life in general. Depression may promote the need to be right (and vice versa). When we feel low, the act of making other people wrong can give a temporary lift to our sense of self-importance. The problem with this kind of lift is that it only lasts for a brief moment, and as soon as the high of asserting our rightness passes, we either sink back into a depressed state, or we feel even lower than we did before we made a heavy investment in making someone wrong. In more intense states of depression, we often lack motivation to perform the activities that we usually enjoy. Our energy is devoted to completing the most basic of tasks, as we do our best just to get through the day. In this state of decreased motivation, the mental energy available for entertaining the perspective of others is often quite limited.
The truth is that we are all forced to endure depression at some point, although its severity, duration and impact on our functioning varies from person to person. Depression typically involves periods of sad mood, decreased motivation, and a heightened tendency to avoid feelings and situations that normally brings us a sense of connection, purpose, and fulfillment.
When we are feeling significantly depressed, we may experience anger that is directed inward toward the self, or outward toward other people or the world as a whole. These angry feelings may take the form of an “addiction” to making other people wrong. In such a state of mind, our world becomes very small. We see with blinders on. There is only one way and it is our way. Hence, when anger takes over, our ability to see things from someone else’s point of view can become severely compromised, especially if our tendency is to cope with our anger by punishing others (and giving ourselves the illusion of ridding ourselves of negative feelings) by making them feel as we feel. An openness to entertaining multiple perspectives may also be limited if we typically handle our anger by withdrawing and avoiding conflict, which tends to minimize opportunities for rectifying disagreements.
Anxiety is similar to anger in its influence on perspective-taking abilities, as it can promote a narrowing the lense of our perspective at the expense of appreciating alternative vantage points. When we are anxious, our mental resources are channeled toward coping with the belief that we must prepare for a feared event. This preparation creates a self-preserving state of mind that narrows our perspective to a limited number of possible outcomes. We repeat to ourselves in one form or another the idea that “I will not be OK if this event happens.” When we are gripped by high anxiety, predicting a catastrophe requires a huge amount of mental energy, which deprives us of the energy required to appreciate someone else’s perspective.
Would you like to achieve lasting states of positive emotion? Would you like to feel more strongly connected to your loved ones, and to your world in general? If so, cultivate your ability to see someone else’s perspective, and recognize the impact that your words and actions have on the ones you love; this will tame your innate human need to be right. Your willingness to acknowledge the perspective of others, even if you disagree with their stance, is one of the most important mental muscles to build.
How to Build Empathy and Improve Perspective-Taking Skills
Here are a few brief suggestions for assessing and improving your ability to appreciate the perspective of others.
1) Conduct an honest assessment of how invested you are in making people wrong, especially the people closest to you. Ask a trusted friend or family member to give their opinion on this. Try to be open to their feedback, especially if you are both emotionally invested in the relationship. When it comes to how often we feel the need to be right, we are usually poor self-evaluators.
2) Practice the art of listening without interrupting. Avoid telling others how they should feel. Try to listen well enough to be able to convey to the speaker what you just heard them say, and then share what you learned from them.
3) Try to embrace the idea that there are “two rights” in every disagreement between two people.
4) Seek professional help if you determine that your need to make others wrong significantly interferes with your relationships, or if you can see that depression, anger, or anxiety present obstacles to appreciating others’ perspectives.
5) Practice doing gratitude exercises. This is one of the most powerful ways to cultivate the ability to appreciate others’ opinions and struggles. There are many self-help books available to assist you with this.
6) When you are sitting in a restaurant or coffee shop, or another setting conducive to “people-watching,” imagine what life might look like from the eyes of someone you are observing. Try to get in touch with what this person might be feeling, even if you are guessing . Do this exercise at least once a week.
7) If you recognize that you are particularly depressed or angry on a given day, take a pause in each interaction with the people you love and acknowledge to yourself (or to them) how your negative mood may be making you more argumentative or less understanding. Sometimes our loved ones deserve this “heads up.”
Thank you for taking the time to read this post. If you commit to improving your ability to adopt another person’s perspective and avoid the habit of making other people wrong, I am confident that you will like the way that it makes you feel. It might even bring you closer to the people you love.
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Why a New York City Psychologist Has the Best Job in the World
(As seen on Huff Post)
If you’re considering a career as a psychologist AND you plan to practice in New York City, you’re in luck.
Serving the mental health needs of New Yorkers as a psychologist in private practice is more than just great…it’s the most rewarding career path available. Of course, I’m just a tiny bit biased, but I stand by my assertion and you’ll learn why I feel so strongly about it.
Keep in mind that I’m generally referring to what it’s like to be a New York City psychologist in private practice as opposed to working in a hospital, school or clinic setting. You can also have a rewarding career as a psychologist outside of the private practice setting, but running your own show takes the experience a hundred levels higher. And even if you want to be in private practice, you almost always have to train and work in other settings before you can practice independently
All I will say to qualify my bold statement is that a career as a psychologist can only be so profoundly amazing if the following are true:
- You can handle the uncertainty of lacking a regular, predictable paycheck.
- You don’t worship money.
- You have exceptional listening skills, you tend to root for the underdog, you have the humility to take responsibility for your actions in interpersonal conflict and you don’t unravel when you hear about extreme mental suffering.
Yes, this is a gross oversimplification of what makes a solid psychologist, but it will have to do for now.
The Life of the NYC Psychologist
- First and foremost, you get to meet the most intelligent, dynamic and talented group of people in the world. Can you imagine how enjoyable it would be to spend your day enhancing the lives of the movers and shakers of the world? It’s wildly exciting to help younger generations who have the drive, talent, creativity and mental ability to change the world. A typical day may involve working with an ambitious student, then a programmer, then a talented finance or professional, then an entertainer, then a C-suite executive. It’s amazing! I learn as much from my patients as they do from me.
- You learn how to mix art with science to enhance the lives of people who are the world’s best artists and scientists. The best therapy is one that mixes objectively proven techniques with artful, interpersonal maneuvers. Psychologists, especially skilled ones, take mental health care to the next level by offering much than what a book or manual can teach. They mix art into their approach, which adds an intangible element that promotes personal transformation.
- You feel like you’re making a difference in the world on a daily basis. Since New York attracts such a unique type of individual, it can feel like you’re having a profound effect on society by improving the lives of people who make things happen for the world. As your skillset grows, so will your ability to create significant changes for your patients, which in turn, will make them more effective in their influence on the world.
- You become an expert in New York City culture without trying. Imagine being constantly taught about the subtleties of city life, the latest trends, memes, metaphors, fashion, art and everything that makes NYC so unique. It gives you the sense that you have your finger on the pulse of the Center of the Universe, the world’s largest think tank. Clients will incorporate their vast array of cultural opportunities into their therapy. For example, you will get to talk with clients about Hamilton after they see the show, or an art installation, gala or tech convention.
- Investing in self-improvement becomes a thunderclap of wellness that spreads across the city. If you read about an interesting concept, you’re suddenly equipped with a powerful metaphor to use with certain clients. Take on the task of reading a self-help book or attending a seminar and your clients will indirectly benefit from what you personally reap.
- You make your own hours which gives you a invigorating sense of freedom.While everyone else is counting vacation days, imprisoned within a cube city and reporting to a boss, you get to do whatever you feel like. Even with a full roster of patients, there’s still tons of time to play in the city. This can be problematic if you’re undisciplined or you crave the structure offered by a regular paycheck. To be honest, I would give up the predictability of a regular paycheck in a heartbeat for the freedom to walk outside on a two-hour break between sessions to sit in a wonderful coffee shop and write a blog post, take an hour-long stroll and soak in the city’s spirit and beauty, schmooze with New Yorkers or casually browse through a magic shop or a used book store.
- You’re exposed to the most diverse group of people and ideas on the planet. In a single day, you might work with people from six different countries, or help someone manage the stress of the inner city right after assisting someone with managing the stress of running a large company. You get to talk with people with high aspirations, people from backgrounds unlike your own who care about the world and want to make it a better place.

11 Things You Need to Know About Starting Therapy in NYC
The decision to start therapy in New York City can be scary as hell.
After all, it’s hard to know what to expect before you actually begin your sessions.
I’m going to take some of the confusion out of the decision-making process. I’m also going to give you an idea about what to expect in the first session, even though the way the start of therapy is structured varies from therapist to therapist.
The insights shared below are based on my experiences as a Manhattan psychologist who has worked with thousands of New Yorkers.
My ultimate goal is to make you feel less anxiety about the decision to begin therapy and more primed for success with the process.
A quick note…If you’re reading this as you prepare to start therapy under my care, please feel free to ask me any questions about what I’ve written below. I want you to get the most out of the first session and beyond.
Preparing for the First Therapy Session
So here it goes, 11 thoughts about starting therapy in NYC that you need to know.
1. Once you sit down on the couch and start talking, it will be the greatest relief you’ve felt in a long time, nothing like the anxiety you experienced around the decision to enter therapy.
Most people feel immense relief after the first session at least partially because they experience a release of a buildup of emotion they’ve been holding on to for days, weeks or months. This benefit is wonderful, but the most impressive emotional gains are made once you roll your sleeves up and get deeper into the intervention.
2. It can be helpful to write down what you’ve been struggling with before you begin the first session.
Taking a few notes ahead of the initial appointment is by no means necessary, but very often people have a hard time articulating what they want to work on. Writing is a great way to organize your thoughts heading into therapy.
3. Most, but not all, therapists will ask you in the first session what you hope to accomplish in therapy.
4. The blistering pace of modern life makes therapy a necessity.
If you’re living in a bustling city, therapy is the ultimate place to combat the stress and pressure you feel on a daily basis as a result of the lifestyle you’ve signed up for. We are evolving as a culture to fill up every potential moment for self-reflection with our screens. Therapy offers an opportunity to check in with yourself and a good look at what needs to be worked on.
5. Insight alone rarely produces significant improvement.
Your willingness to test reality and make cognitive and behavioral changes is the real spark. Amazing insights gained through therapy can be mind openers, but not game changers. Therapy that relies on insight as the dominant force of transformation takes much longer to produce substantial changes. In my experience, therapy designed to create new insights, which is fortified by active interventions, such as disputing irrational beliefs, is much, much more effective. This is why I’m big on CBT therapy. As a cognitive behavioral therapist in New York City, I strive to offer tools for clients, in addition to insight. Tools + insight = better outcomes.
6. Some people are raised to view therapy as unnecessary or hocus pocus. Your therapist will probably prove them wrong.
From the outside looking in, it’s hard to see the potential benefits of therapy. The nature of emotional suffering is such that it can be hard to imagine feeling substantially better just by talking to a therapist. Most therapists do more than just talk to you. They are trained in applying specific interventions to alleviate suffering and they know how to build a strong therapeutic relationship that will predict a positive outcome for you.
7. If you’re therapist considers himself or herself a psychoanalyst, expect to do most of the talking. If the therapist identifies with CBT as the primary mode of therapy, expect him or her to be more active in the process.
The truth is that most therapists do not take a single approach to conducting therapy. Feel free to ask your therapist-to-be how active he or she is in the sessions so there are no surprises. With that said, like most therapists in New York City, I tend to do much less talking in the first session because I’m asking questions and planning my intervention. Therefore, it’s hard to use the therapist’s engagement level in the first session to determine how collaborative the therapy will be.
8. Don’t expect your therapist to force things out of you.
Therapy tends to go at a pace set by the patient. Your therapist is likely to be sensitive to your signals that certain topics are off limits until you’re ready to go there. Just know that a seasoned therapist will pick up on what is omitted from your story. You don’t have to do anything about that.
9. The trend among newer generations of therapists is to act more “real” with patients.
Unless you’re in the market for 3-times-a-week, lying-on-the-couch psychoanalysis, you can safely assume that your psychologist won’t present as a tabula rasa, the latin phrase for “blank slate.” In other words, he won’t strive to remain 100% nonreactive, cold and neutral. In my experience, most patients appreciate realness from a therapist, which doesn’t mean that he will be constantly sharing about his own personal experiences. Rather, it means that his reactions will seem genuine and empathic. Another wonderful consequence of your therapist being real with you is that it can feel like you have a coach in your corner, which most patients enjoy.
10. Therapy is not as helpful if you don’t a bit of take time between sessions to reflect on what was discussed in session.
If you want to get the most out of your sessions, consider actively applying what you’ve learned in sessions to your life. Feel free to challenge your therapist to help you plan for testing in real life any lessons learned during sessions.
11. Therapy will be helpful to the extent that you’re open to change and willing to look at your contributions to your own suffering.
This is a tough one to really, truly understand for most people. Success in therapy involves a willingness to examine some of your most uncomfortable thoughts, feelings and experiences. If someone is pushing you into therapy kicking and screaming, then chances are it’s not going to be very effective. You need to want to make changes irrespective of what someone who cares about says you should do. If you tend to blame other people for your problems, you’ll be limited in how much you’ll get out of your sessions. That doesn’t mean that a little parent blaming here and there doesn’t feel super relieving. It just means that entering therapy with a sense of personal responsibility will predict success with the process.
Good luck with your therapy.
