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Shalini Varma
Board Certified Psychiatrist
Board Certified Psychiatrist

Shalini's posts

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Don’t try and be happy - it will only make you SAD: Societal pressure to be upbeat makes depression worse

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Today's teens have the same activity levels as someone who is 60, shocking new study finds

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Don’t try and be happy - it will only make you SAD: Societal pressure to be upbeat makes depression worse

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The following article is by Gary Direnfeld, MSW, RSW, and originally appeared on Reprinted by permission of the author.

It’s Difficult for Many People to go to Counseling

January 10, 2017

Counseling remains a viable strategy to cope with or change issues affecting one’s life. However, there are often many hurdles ahead of attending. Those hurdles are related to fears, misconceptions and even horror stories about counseling.

Fears include being labeled crazy or bad as well as fear of others learning you are in counseling. Misconceptions include beliefs that counseling doesn’t help, it takes forever to see results and is therefore too time consuming and expensive. For some, there is the misconception that counseling is a sign of personal weakness. As for horror stories, these are often related to relationships that fall apart despite counseling or having to learn about one’s role in untoward behavior or indeed a poor match between the persons seeking counseling and the methods of the counselor.

While the counselor is not there to label you crazy or bad, the counselor’s involvement will help you to examine your own behavior which with insight, you may feel poorly about initially. To this end, the counselor may also advise you about your behavior, attitudes or beliefs that interfere with or contribute to conflict or other emotional distress.

Learning about one’s own behavior and contribution to distress is meant to open the person up to learning new and more productive ways of managing their issues. As the person learns more effective strategies to cope with life events or manage interpersonal relationships, the person typically feels better about themselves and newfound abilities and the issues that brought the person to counseling in the first place may then resolve.

The length of counseling is often a function of the counselor’s approach and the openness to counseling of the person attending. The more negative a person is to counseling or the more the person feels trapped or coerced into attending, the more difficult and time consuming it can be. However, showing up is at times half the battle. Once in attendance, the resistance shown may dissipate and the skill of the counselor may facilitate a positive experience.

While some people see counseling as a sign of weakness, it should actually be considered a sophisticated means for addressing life’s pitfalls. By comparison, no one would consider it a sign of weakness to need the services of an accountant, dentist or mechanic. These are services available to oneself when one’s own skill set doesn’t match life’s demands. Similarly of counseling. We simply are not equipped to always manage whatever life throws at us. Counseling offers the opportunity to look under the hood, tinker and straighten things out to then move forward more successfully.

As for horror stories, this is true in any profession. Not all professionals are helpful to all persons in all circumstances. Not all cars can be repaired or all teeth saved. We also may not be happy with a tax bill or the cost of preparation. None of these circumstances are necessarily a reflection on the service provider though. So too with counseling. Counseling will not resolve all problems or save all relationships. To add, not all professionals have the same expertise.

Just like you can have a poorly skilled mechanic, accountant or dentist, the same is true of counselors. However, this doesn’t mean you will never get an oil change for your car again or never complete your taxes or address a toothache. It just means you need to choose your counselor with the same bit of wisdom that you would choose any other professional. That includes looking at websites, listening to other people’s experiences with their service providers, seeking a referral from your doctor, looking into employment benefits and/or asking friends or family for a referral.

As for cost, people really have to do their own cost analysis. Certainly counseling is for most a grudge spend, at least to start. Just like no one really looks forward to an expensive car repair bill or troublesome dentist visit for an aching tooth, it is reasonable that people would prefer to not have to attend counseling. Notwithstanding, most people are satisfied with their experience after the fact and appreciate the value of the service having attended.

There is only really one reason why anyone seeks and uses any professional service: to hopefully make things better when all other strategies have been exhausted.

If your life is challenging and you’ve exhausted all other options, before you ditch the car or tie your tooth to a string or think you can just avoid paying taxes, you see a professional. Consider the same of counseling. Sure the thought of going may be difficult, but think of the alternative. What if you don’t go? What if counseling may improve matters? You won’t know until you try.

If you tried it and didn’t like the experience, then try another counselor just as you would another mechanic, dentist or accountant. Sometimes though you may hear the same message delivered by multiple professionals. If this is the case, then it is time to consider the message.

In any case, if your life is not on track, counseling may help, as difficult as it may be to get there. Hopefully though if you need it you get there.

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The following article is by Joseph Sacks, LCSW, and originally appeared on Reprinted by permission of the author Joseph Sacks.

What Is Child-Centered Play Therapy?

Are you worried your child doesn’t feel empowered? Does he have behavioral or emotional issues? Does she lack self-confidence or self-esteem? Are you looking for a play therapist in downtown New York City?
Play Therapy - New York, NY - Tribeca Play Therapy
Play therapy is a medical treatment administered by a specially trained professional. Talk psychotherapy with adults treats emotional and behavioral disorders, and this is the same process adopted for children. It meets the child where he is, at his level of communication, instead of asking him to use adult communication that is still unfamiliar. It requires a great understanding and familiarity with the point of view and the mind of a child. Abundant research supports its effectiveness to treat a whole host of child emotional and behavioral issues.

It truly seems like magic how well play therapy works! But, the truth is that there is nothing magic about it, it’s just solid science and proven results.

What Is The Difference Between Play Therapy And Traditional Therapy?

Adults in psychotherapy are working to find solutions and “fix” themselves after the fact. A child, however, comes into therapy with a mostly clean slate, making our work together in therapy much easier.
Play Therapy - New York, NY - Tribeca Play Therapy
Children generally don't have to reprogram, undo or fix unhealthy habits. Although children who have been through inordinate amounts of stress will have some fixing to do, the majority of our work will be focused on building your child’s very self and creating self-respect. Play therapy gives your child the glorious opportunity to get it right the first time, to forge a healthy emotional foundation that will last a lifetime. That is why progress for adults in therapy is measured in years whereas for children it is measured in months. It’s much easier to start out fresh and create a new personality than to undo decades of emotional damage. In addition, therapy in this setting serves to nip your child’s problems in the bud and can prevent issues from developing into full-blown emotional disorders later in life. What requires five years of psychotherapy as an adult may take two years as a teenager and six months of treatment as a child. Together with parenting counseling, is particularly effective.

How Does Play Therapy Work?

In the playroom, your child learns to be honest with his or her feelings and desires. This golden habit can prevent many emotional disorders from developing down the road. Your child’s therapist, called an enlightened witness, notices, identifies, recognizes and reflects any feelings and desires your child experiences in play. As your child hears his experience reflected back, he gains conscious and conceptual awareness of his emotions, giving him the ability to process and resolve them in a healthy way.
Play Therapy - New York, NY - Tribeca Play Therapy
Feelings and desires are automatic and spontaneous. They are not usually a product of conscious choice and fighting against them is futile and often harmful. They are, however, a critical aspect of a person’s self, and moving them into conscious awareness is an essential step in learning to understand and accept who you are. I model acceptance of your child's feelings so he can learn to accept them himself. As your child becomes aware of his or her emotions, he or she can use that information to foster increased growth and self-control.

Children who have practice making decisions and being self-determined grow up into much more decisive, responsible and successful adults but, unfortunately, children are often deprived of just that. At school, they're constantly told what to do and not given choices and sometimes at home as well. However, Child-Centered Play Therapy gives them a feeling of complete control over their situation. It puts them in the driver's seat. The child leads and I follow, accepting and supporting all the child's decisions. This is incredibly empowering, the child thinks, “I can control my life, I can control my destiny.” This is extremely healthy for him and resolves many behavior problems and emotional disorders. He begins to think, “My decisions are important, my choices are meaningful, I can make correct decisions.” This boosts his self-confidence and self-respect tremendously, which boosts his happiness level. And, since most misbehavior is fueled by unhappiness, play therapy results in greatly improved behavior.

Using a technique known as tracking, I describe each play of your child's action and every decision he or she makes. I also track your child’s emotions and, using an empathetic approach, I let your child know that I understand how he or she feels. By showing interest in and acceptance of your child's decisions, he or she gains awareness of them and feels empowered.
Play Therapy - New York, NY - Tribeca Play Therapy
Additionally, play therapy enables your child to process and resolve aggressive and angry feelings. Your child can learn to recognize and understand his anger so he can more effectively manipulate, process and resolve it. I only allow certain, controlled aggressive behaviors in the playroom, and your child learns through these limits how to channel his or her feelings into acceptable, healthy outlets.

Some children may feel bad about themselves, your child may express his or her self-perceived bad qualities and bad behaviors during play. He may act mischievous and misbehave to show me that he really is as bad as he thinks he is. In play, your child displays his meanest, ugliest, most aggressive self and is still liked by the therapist, proving to your child that he's truly likable. When he sees that I accept most of his behaviors – though I may not allow all of them – and I accept him as he is, he thinks, “Maybe I’m not so bad,” that is his self-image gets fixed.

Child psychologists refer me children for Play Therapy!

One of the pillars of mental health is the ability to understand your own desires. I support your child as he or she develops the important skills of recognizing and expressing his or her wishes, needs and desires. As your child gains awareness of how he feels, he learns to respect his needs and himself, giving him the tools to be more decisive and successful. Your child can gain conscious awareness of his desires and think, “My wants and needs are valid and legitimate.” Then he becomes more serious about pursuing them which means more responsibility, decisiveness and self-confidence. Your child may desire many things that he cannot have, but in play he can pretend to attain all of his desires in the presence of an enlightened, empathetic witness and this satisfies him.

Limits are set on behavior in play therapy. In addition to letting your child know what he can’t do during sessions, these limits indicate what he can do. This allows your child to truly and freely express his or her feelings in a healthy, acceptable way. Furthermore, when limits are set in play, your child can learn to recognize his common resentment of, objection to and desire to break the limits. He can see that his feelings are respected, and I provide harmless channels for him to express his feelings in a healthier way that promotes self-discipline, self-regulation and self-command.

In the playroom, all feelings, wishes, desires and fantasies are accepted and validated, helping your child learn to accept them in him or herself. Feelings and desires are natural, automatic occurrences that are out of our control. If your child is criticized for emotions he can’t control, he starts to feel guilty about an essential part of his self. In the process of everyday discipline, your child is often taught that not only are his behaviors unacceptable, but his feelings and desires are as well. However, play therapy draws a clear line between unacceptable behaviors and completely acceptable feelings wishes and needs, thus relieving any guilt he might have felt.

Can Play Therapy Really Help My Child Get Better?
Play Therapy - New York, NY - Tribeca Play Therapy
The focus of discipline at school and at home is often on stopping undesirable actions. The feelings and desires motivating these actions, however, lie unaddressed and unresolved. I work with your child to skillfully uncover the feelings and desires underlying unacceptable behavior. By helping your child gain conscious awareness of these feelings, he or she can learn to process and express them in an acceptable and playful manner. Your child can recognize that others feel the same way he or she does, which can provide a sense of relief. Furthermore, my validation gives recognition to his feelings and removes fears that he is bad for feeling them. Finally, I encourage your child to redirect his feelings into an acceptable pretend activity. Your child can enact scenes of characters expressing anger and its consequences in complete safety while having all of his or her feelings respected.

An adult who's hurt deeply will come into therapy and express his or her feelings in a fiery way. Having these difficult emotions validated, accepted and recognized by the therapist defuses the need to act out his anger and dissipates the intensity of his or her feelings. Play therapy is precisely the child's version of this process of safe expression, validation and increased self-esteem.

You may say, “Can’t I play with my child all by myself at home and accomplish everything that play therapy does?” The answer is yes, you can. It’s called filial therapy, and I can teach it to you in several months of training and study. However, it is a much more complicated process than just casually playing with your child, and very specific techniques are involved.

Child-Centered Play Therapy in My New York City Office Can Help Your Child!

If you are in New York City and would like to have your child experience the magic of play therapy, or if you have additional questions about how this approach can work for your child, feel free to give me a call at 646-681-1707 for a free 15-minute consultation. I look forward to speaking with you!

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The following article is by Joseph Sacks, LCSW, and originally appeared on Reprinted by permission of the author Joseph Sacks.

Are You Struggling With Your Child?
Child Therapy - New York, NY - Tribeca Play Therapy
Does he frequently tantrum?

Is there constant sibling conflict?

You may feel embarrassed by how your child behaves in front of other people.

Perhaps you are tired of the teacher calling to complain.

Maybe he can’t focus on his responsibilities, or refuses to go to bed, bathe or do homework?

Do you just wish your child would listen?

You Are Not Alone!

Many New York City parents struggle with childhood behavior problems. Dozens come into my office complaining about tantrums, sibling conflict, angry or defiant behavior and other challenges. In fact, we are in the middle of an epidemic of child behavior problems. Children are often under stress, such as pressure from school or family conflict, which intensifies their challenges.

The good news is that Child-Centered Play Therapy together with Parenting Counseling with an empathetic, experienced psychotherapist can help you recognize why your child is struggling and what you can do to improve his or her behavior!

Child-Centered Play Therapy At My Lower Manhattan Office Can Resolve Behavior Problems!

Most misbehavior is fueled by a low happiness level. Children are bored, frustrated and feel powerless, and misbehave in a desperate attempt to relieve their unhappy situation. Therefore raising their happiness level on a regular basis completely resolves the problem! Play Therapy accomplishes just that. You see, many children misbehave because they are unhappy or frustrated with a lack of control or self-determination over their lives. They are constantly being told what to do at school and at home. During child therapy, I let your child have complete control of the session. He makes all his own decisions about how to play, and I support and validate those activities. This gives him and exhilarating sense of control over his own life, leading him to not mind being told what to do so much outside of the session! In addition this raises his self-esteem and self-confidence, helping him feel happier and better about himself. And, since most misbehavior is fueled by unhappiness, your child’s increased self-esteem results in improved behavior.
Child Therapy - New York, NY - Tribeca Play Therapy
Increasing self-respect!

In the playroom, I show so much respect for your child that he learns to respect himself! I show her how important her chosen activities are to me, and she thinks, "Joseph thinks the things I do are important, therefore I must be important." This makes her feel so great about herself that she becomes much more pleasant to deal with outside of the session!

Processing overwhelming emotions!

In play I use the amazing technique called tracking, where, similar to a sportscaster describing a game, I reflect back to the child each action made, decision taken, and feeling expressed. This gives the child a conscious awareness of all of his important accomplishments, leading to improved self-worth. In addition my verbal recognition of her feelings gives her the ability to master and process them, so her previously overwhelming emotions no longer cause behavior problems.

Support Your Child With Parenting Counseling At My New York City Office
Child Therapy - New York, NY - Tribeca Play Therapy
We, as parents, are the most important factor in our children’s lives. We possess tremendous power to influence their well-being, behavior and overall emotional health. By taking steps to improve our parenting, even slightly, we can effect great changes in our children’s situation. Parenting counseling provides a safe space where you can receive and discuss professional parenting advice tailored to your specific situation.

During parenting counseling, I ask you to recount everything that happened leading up to a tantrum or other misbehavior. By understanding the triggers that may be leading to behavior problems, I can provide specific instructions for how to change the way you interact with your child so you can reduce challenges or prevent the problem from happening in the first place!

I provide attainable strategies to help you increase your child’s happiness and fulfill his or her emotional needs. You’d be surprised how small changes in the limits we set and the things we allow can make your child much more agreeable and easy to manage!

Many children misbehave because they are frustrated by their parents saying no too often or giving too many commands. I work with you to develop a specifically tailored plan for when to say no to your child and when to say yes. You can recognize that your child can only handle so many orders, and you can reduce and tailor your commands so your child is more willing to comply.

Many New York City parents seek therapy for behavior problems from a child psychologist or a play therapist!

Play therapy and parenting counseling go hand in hand, and they are a very effective team for resolving almost any child behavior problems. If your child is defiant, it is likely caused by his feeling bossed around and like he is not in control of his life. Play therapy makes your child feel like the boss and gives him control. Parenting counseling, on the other hand, helps you understand how many commands your child will be comfortable receiving. It helps us, as parents, to fulfill our children’s emotional needs so they will feel more content and confident.

It truly seems like magic how well play therapy and parenting counseling work! Fully 80 percent of the children I see report significant improvement in behavior and emotional health in just 3-6 months of child therapy.

You may feel like child therapy can help, you but many New York City Parents still have questions…

Therapy is expensive and I’m not sure it’s worth the money...

Play therapy and parenting counseling are early interventions. We nip the problem in the bud and make sure it doesn’t develop into a larger, full-blown problem when your child gets older. Investing in 3-6 months of child therapy now can save you from years of costly treatment in the future. Considering the tremendous benefits to your child’s emotional health, success and well-being, therapy now is a steal!

I’m ashamed I haven’t been able to fix things on my own...

The truly wise person is the one who is always seeking to learn more, and who is brave enough to ask for help from an expert when needed. Why should you and your children suffer from mistakes when you can be guided by someone who’s been through it and can teach you how to avoid all the pitfalls!

What if people I know find out my child is in therapy and he is bullied or believes there is something wrong with him?

Your treatment is strictly confidential. I am prohibited by law from revealing to anyone without your permission the fact that your child is in therapy or any of the details. I have space between all scheduled appointments so you don’t run into other clients in my office.

You Can Improve Your Child’s Behavior!
Child Therapy - New York, NY - Tribeca Play Therapy
I have been working with young children for my entire life. My mother owned a Montessori school in New York City and I worked with her growing up and throughout college. I was a teacher for many years before becoming a child therapist, and I understand how young children think and what they feel. I have been through many challenges raising my own four boys, and I have the experience to help you work through your child’s thorny issues.
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