When Chaos Feels Familiar: Reflections on Regulation, Meaning, and Music

Experiencing Baseline Chaos

There are times when chaos doesn’t feel like a moment in life, but a baseline. A steady sense of overwhelm, restlessness, or disconnection that can be difficult to name, even internally.

Many neurodivergent adults describe this experience as a feeling of being out of sync — with expectations, with environments, or with themselves. It’s not always dramatic, but it can be deeply tiring.

Understanding Chaos Through the Nervous System

Earlier in my life, I did not yet have language for this. What I understand now is that what felt like “chaos” was also a nervous system responding to sustained pressure and misattunement. Not a failure — but an attempt to cope.

Through both personal experience and my work as a therapist, I’ve come to see that distress is often meaningful. It tells us something about our needs, our limits, and the environments we’re moving through. When those needs go unmet for long enough, the body finds ways to signal.

Finding Regulation Through Music

Music became one of the ways I learned to listen to those signals. Not as a solution, and not in a performative sense, but as a regulating experience.

Rhythm, repetition, and sound can offer containment when words feel inaccessible. This isn’t unique — humans are wired for rhythm and attunement long before language develops.

Music and Creativity in Counselling

In counselling, music and creativity can offer a gentle bridge. They can:

• Support regulation

• Allow emotions to move

• Create space for awareness without pressure to analyse or fix

Importantly, this work is always led by the individual — at their pace and with consent.

You Are Not Broken

If you’re reading this and feel chaotic or overwhelmed, I want you to know that you are not broken. Healing is rarely linear, and it often happens through small, manageable shifts, rather than sudden change.

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Small Steps That Can Help

Some gentle ways to begin:

• Notice what helps you feel even slightly more settled.

• Share a small part of your experience, without needing to explain everything.

• Move at your pace, listening to your nervous system.

• Seek support that feels respectful and collaborative.

Meeting Yourself With Curiosity

You don’t need to have all the answers and you don’t need to make sense of everything right now. What matters is meeting yourself with curiosity rather than judgement. If you feel almost ready to explore this further, I’ll wait to hear from you.

Practicing Self-Compassion + FREE downloadable meditations

During the Mindfulness in Psychotherapy Summit, Dr Susan Pollak held a lecture on mindfulness and self-compassion. It made me go back to basics, thinking about attuning to ourselves and to our needs first before helping others to reduce depression, anxiety, and trauma symptoms and improve our resilience for well-being. 

What is self-compassion?

“The simplest way to think about self-compassion is treating yourself as you would treat a good friend,” says Pollak. What kind of language would you use with them? How would you treat them?

Common misconceptions of self-compassion

There are some misconceptions when it comes to self-compassion such as:

• Self-compassion will make me lazy. I know I will stay in bed all day, not go to work and binge on Netflix. 

• Self-compassion will not make me get ahead in life. I want to succeed. 

• I need to be tough to survive. Self-compassion will make me weak.

Being self-compassionate doesn’t mean that you are lazy or the need to hide from your painful feelings. Self-compassion is about attending to your own suffering and difficulties, motivating you to navigate these hardships, learn from your mistakes, and move forward. It is about wanting health and well-being for yourself because you care. 

Benefits of practising self-compassion

• Helps us to see the bigger picture.

• Can help us to be more caring in relationships and be less selfish. 

• Self-compassion increases well-being and resilience to stress and trauma. 

• Helps us to turn to painful feelings without overwhelming ourselves. 

• Can be a form of emotional regulation as it reduces emotional numbing.

Compassion practices can transform the way we relate to ourselves and others. And by paying attention to our thoughts, feelings and actions, we are open to loving ourselves for who we are, with all our imperfections. 

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Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care. 

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Self-compassion in practice

When experiencing hardships in life, people often feel isolated and disconnected from others. Thinking, that it is somehow unusual or strange to fail, to have weaknesses, or to suffer. This, however, can lead to a question such as “Why me?” causing strong feelings of separation.

And while it might seem obvious that we all go through personal suffering, many of us don’t actually pause to acknowledge our own pain, being too busy judging ourselves or trying to problem-solve. But having compassion for ourselves is about acknowledging the fact that we are all imperfect and going through suffering.

Layers of self-compassion:  

• self-kindness — being kind and understanding toward ourselves during times of difficulty;

• common humanity — seeing our experiences as part of the human condition and not as separate and isolate from those around us;

• mindfulness — awareness of the present experience with acceptance.

Self-kindness

Self-kindness refers to the tendency to be caring and understanding with ourselves rather than being strongly critical or judgmental. But that doesn’t mean that we have to accept ourselves straight away. We can move slowly through the practice of self-kindness, in our own pace. Tweaking the practices to our own needs.

Below, we will look at some techniques on where to start. But being kind to ourselves is about accepting that there is no set way of doing things. We are all different. Therefore, forgiving ourselves when things don’t go as we expected can help ease the pressure we put on ourselves at all times.

Common humanity

Self-compassion honours the fact that all human beings have strengths and weaknesses. It acknowledges the reality that we are imperfect human beings who all experience suffering. 

Being compassionate is about the difference in relating to yourself when not reaching your goals. Forgiving yourself that you did the best you could at a given moment and not exaggerating our own problems. Acknowledging that other people are facing their own hardships and difficulties. Compassion practices help us to create connection, and challenge our assumptions of separation and aloneness from others.

Mindfulness

Mindfulness is an important part of self-compassion. As described above, it is about being in the present moment with all our thoughts and feelings. If we manage to stay in the present, we start creating freedom and openness in ourselves and not get stuck in our past or future worries.

Mindfulness can be adapted to your own needs and what feels comfortable to you. You may feel like standing up or walking feels best for you when learning to attend to your needs. Whatever it is, listen to yourself and your body. Don’t worry about your thoughts stopping, they will be there with you at all times. Learn to notice them, and start to let go.

Give yourself time

Practicing self-compassion requires time and patience but when we start paying attention to the way we speak to ourselves, it can give us a direction in how to move forward. Showing ourselves kindness and accepting our imperfections and flaws can improve our quality of life, and our relationships. Acknowledging that we all have imperfections.

So, take a pause, show yourself some compassion, commit to the practice. In this way you start to create resilience, set a foundation and a toolbox for yourself to begin healing. Because you deserve it. 

If you would like to start exploring how you can start practicing self-compassion towards yourself then book a session with me here and we can start getting curious about it together.

Download Your Free Self-Compassion Meditations Here

Disclaimer: This content is for educational purposes only. If you are suffering from severe trauma, live in an abusive household or are in danger then call 112 or your country’s crisis line, where professional mental health workers will be able to offer you appropriate support.

7 Things to Know About Me as Your Counsellor

1. A shared journey

I work collaboratively with my clients, believing we are co-travellers on your journey. You are the expert on your life and I strive to understand your experiences from your perspective with deep empathy. You deserve to have full autonomy in your counselling, and how you’d like these to be structured. I bring in my own experiences, perspectives, and insights to the counselling process, primarily practicing from these three approaches: 

Psychodynamic counselling

Using a psychodynamic approach helps to get deeper into why some things may feel familiar to you, and work towards bringing these unconscious patterns to consciousness. This approach is less focused on the ‘problem’ and rather being curious about your ways of relating. 

Feminist counselling

I practice from a feminist framework, working within a sociopolitical context. In sessions, I prioritise your voice and support you in creating awareness of how social and cultural contexts are contributing to our therapeutic relationship and the external circumstances of your life. I create a pathway towards healing and empowerment within a socially conscious counselling environment. 

Creative arts therapy

Creative arts therapy recognises that not all emotions can be expressed verbally. This approach is focused on the connection of the mind and body and the felt sense of your experiences. It promotes self-awareness, self-expression, and personal growth. It is a process-focused approach where no previous musical or artistic skills are necessary.

2. Less about finding ‘solutions’ or ‘fixing’

You are not ‘broken’ and need to be ‘fixed’! Your emotions are a natural part of the human experience, even the painful ones. Our society today tends to be pathologising ‘mental health conditions’ that are focused on treating ‘symptoms’ rather than working out the root of the pain and suffering. Digging deeper and finding out insights about yourself can feel SO empowering!

3. Play as an integral part of connection 

Play allows us to interact with others and ourselves in a more spontaneous, authentic, and less guarded way. It often involves the suspension of rigid social rules and expectations, giving way to deeper connections beyond language and cultural differences. Incorporating play allows more room for empathy, shared experiences, self-expression, and emotional regulation. 

4. The counselling relationship in itself can be healing 

Counselling can offer opportunities for corrective emotional experiences, where you can start to explore and experience healthy and supportive relationships that you may have been lacking in your past. This can help to heal old wounds and create new, healthier patterns of relating, which can be SO helpful towards creating a life for yourself that you deserve!

5. I care deeply for my clients

I care deeply about the well-being of my clients and feel a true desire to show up for you in a way that you need. If there is something I think you could benefit from, I always share these resources with you. I consider myself to be a warm, empathic, and genuine person and that’s how I aim to show up in sessions!

6. Bringing my personality to sessions

I don’t believe in ‘blank slates’ and I have found this unhelpful in my own therapy too. I am a human with so many things I have yet to figure out! My wish is to bring the same humanness to sessions by showing my personality, humour, and directness with compassion and sensitivity. I recognise that I too have my limitations, and I am always ready to admit when I don’t know something. I remain curious to work together towards an answer you need. 

7. Living in a way that works for you!

Counselling can be so helpful in figuring out what it is that YOU need. In our daily lives, we can be so overstimulated by other people’s assumptions, opinions and observations. Counselling offers a quiet space from where you can turn towards your inner voice and find out what it has been telling you all along. It’s okay not to have the answers but it may be time to start listening to it, and creating a life that truly resonates with you. 

I aim to keep advocating for counselling as I know how much value it has brought to me. My wish is to carry on sharing that with others. If this is something you are willing to give a go, then I look forward to connecting 🧡

How to Overcome Self-Doubt I 6 Steps to Find Your Confidence

Self-doubt may be standing in your way of personal growth and success. It can be holding you back, and I am no stranger to feeling this way. For me, personal therapy has helped hugely in overcoming my fears and doubts about my abilities. Therefore, I have compiled a list of six steps on how to overcome self-doubt that have helped me find self-confidence (which is still an ongoing process of learning with its highs and lows). I hope that these can support you and act as a starting point in the process of overcoming self-doubt, even if just a little bit. 

What is self-doubt?

Self-doubt is defined as a lack of confidence in one’s skills and abilities which can lead to feelings of incompetence, worthlessness, and unlovability, as well as difficulties in making decisions. It can further be intertwined with a fear of failure, judgement from others, fear of making mistakes.

This may interfere with your personal or professional relationships, and create a block in pursuing and achieving academic and professional goals. But it doesn’t have to be this way. 

How to overcome self-doubt

In this article we’ll cover how to overcome self-doubt and feel more confident in yourself. We’ll cover topics such as developing self-awareness, challenging your negative thoughts, setting manageable goals, finding positive support and taking action. However, it is important to be mindful that this process isn’t easy, so be kind to yourself when going through these. Let’s look at the six steps below. 

Step 1: Recognising and acknowledging your self-doubt

Awareness creates opening. Taking the time to reflect on your thoughts and feelings, and being mindful when self-doubt starts to creep in. Acknowledge, that it’s so common to have these thoughts and feelings and that you are not alone in feeling this way, that self-doubt is part of a human experience. By beginning to recognise these feelings, you can start taking back control, managing your thoughts and feelings in a more positive way. 

Step 2: Challenge your negative beliefs

Self-doubt stems from negative beliefs about yourself and your abilities. This may be related to your childhood and the false beliefs that others and perhaps yourself have been telling yourself. However, overcoming self-doubt does not mean removing these negative beliefs but rather recognising their presence. Take a pause and start to question whether these thoughts and beliefs are true or not. It is about finding more appropriate ways to support yourself, focusing on our strengths that you may have been looking past, recognising your achievements and reflecting on your achievements. 

Step 3: Set realistic goals and celebrate progress

Having goals that are too big may make you feel overwhelmed and like you’re never going to get there (if that’s even possible). Breaking down your goals into smaller, more manageable tasks is an effective way to address self-doubt. You can begin by writing these down and making a visual schedule for yourself. This will help you recognise your capabilities and the progress you’ve made, boosting your confidence and diminishing your self-doubt. Do what works for you and what makes you feel good. Give yourself credit! 

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Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care. 

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Step 4: Surround yourself with positive influences

Our support network is of huge value on how to overcome self-doubt. To be able to lean onto the people that we trust and feel comfortable with will help you overcome self-doubt and give you strength as you’re moving through these challenges. Engage in conversations with people who believe in your abilities and can provide a strong support system. Furthermore, engaging in activities that make you feel good, whether it’s connecting with your interests, educating yourself on new topics or taking up a new hobby, can all be great ways to boost your confidence and inspire you to reach for your goals.  

Step 5: Take action and embrace failure as a learning opportunity

It can be scary to move through your fear. It might be (and probably is) the very last thing you’re interested in doing. However, with appropriate support and encouragement, it is possible. It is about accepting that failure is a natural part of the human experience, and you are not alone in facing it. Acknowledging that stepping through failure helps to build confidence, and act as an opportunity for growth. Mistakes will be a part of that, and that’s okay. Here is an article on resilience.

Step 6: Self-compassion

Most importantly, be kind to yourself through this process of uncovering the thought patterns and ways of being that have been with you for such a long time. Be patient and avoid rushing the process, showing yourself compassion. Allow yourself to experience and acknowledge the emotions that arise, giving them space. This can be either with your loved ones, with people you trust or by finding external support. Finding support is a sign of strength. You deserve to feel good.

How to overcome self-doubt with music therapy?

Music gives a form to our inner feelings that we might be struggling with to express verbally. Bruscia (1989) has indicated that in music therapy, musical experiences are used to restore, maintain and support the wellbeing of the client and to support you in helping to find resources and tools to resolve any difficulties that you may be dealing with and increase your potential for mental wellbeing. Furthermore, Boxill (1985) has expressed that in music therapy, creating musical experiences with the client can help restore, maintain and improve your psychological, mental and physiological health. 

• Research shows that self-selected relaxation music can significantly reduce anxiety and bring the client into a more relaxed state, lowering the levels of stress and anxiety.

• Because music is a means of non-verbal expression, it can create a supportive environment of play where tension is released, reducing stress and giving way to self-expression regardless of one’s skills and abilities.

• Music therapy goals are designed to provide emotional support, decrease stress and anxiety, increase self-esteem and self-confidence, and provide a medium for creative self-expression, providing the client with an opportunity for control and independence. 

Conclusion

This article has covered six steps on strategies on how to overcome self-doubt and boost confidence. Self-doubt is a common challenge that many people face, but it does not have to define who you are. By following and keeping in mind the steps, it is possible to overcome self-doubt and find peace and confidence in yourself. Throughout your process, remember that it takes courage, commitment and self-compassion to work through your challenges but that there is potential to discover your full potential and achieve success in your life. 

If you feel like you’re ready to dive deeper then I look forward to hearing from you.

References

Braslow, M. D. et al. (2012) ‘Self Doubt’ in Social and Personality Psychology Compass 6/6: 470–482, 10.1111/j.1751-9004.2012.0044.

Bruscia, K. E.  (1989) ‘Defining Music Therapy’. Philadelphia. PA: Barcelona Publishers. 

Cohen, R. L. (1999) ‘The effect of music therapy on the reduction of anxiety for myocardial infarction patients. Unpublished Master’s Thesis, Clarkson College.

Ming, S. WU (2002) ‘Effects of Music Therapy on Anxiety, Depression and Self-Esteem of Undergraduates’. In Psychologia, 45. pp. 104-114.

How to Find the Right Therapist?

I have recently got many questions about how to find the right therapist, from friends to family members to clients. I have had these questions myself and have gone through the process several times. And it’s not easy. I have even felt like I’m online dating when trying to find a therapist - how can I possibly decide? What about the different approaches? Gestalt, integrative psychotherapy, psychoanalysis, counselling, music therapy? What do all these even mean? To help you find a therapist in Berlin, I have put together a list of five things to consider.

Consider your goals for therapy 

What are you looking to get from therapy? Are you struggling with a specific situation, looking to improve your well-being, or want to get to know yourself better? Often, we might want to get ‘well’ quick and opt for the short-term option. And it is scary to start therapy. However, finding the right therapist will take time if you are willing to work on yourself. It would be helpful to bring this up with your potential therapist and discuss what might or might not work for you.

Take time to find the right therapist 

It is essential to take your time when finding the right therapist. You don’t have to settle for the first one you meet. It may be helpful to prepare some questions to determine whether a therapist is a right fit for you. You may try out a couple of different therapists. Think of them as job interviews where you can decide who you want to work with.

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Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neuro-affirming and trauma-informed care. 

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Feeling comfortable during your therapy session

Feeling comfortable in a session is important. How do you feel when you are with your therapist? Be aware of your feelings. Do you feel a sense of ease? Are you uncomfortable and anxious? Notice what comes up for you, but be aware that feeling uncomfortable is an inevitable part of therapy, and it is normal to feel that way.

Building a connection with your therapist

Building a good connection is an essential part of therapy. If you settle for a therapist you don’t like, the treatment may not be as valuable as it could’ve been. Do you feel safe and listened to? Is it a non-judgmental space where you can be open?

Finding the right type of therapy

Every therapist is different. We all come with different experiences and different ways we relate to clients. We are human after all. A good therapist will be willing to discuss with you if the therapy is not the right fit, and if some other types of therapy may be better for you. You may even discuss whether you would benefit from a different approach. Talk to your therapist about it - they may be able to refer you to someone else and have connections. Be open to discussion. I encourage you to communicate your feelings to your therapist as soon as possible, as it leads to deeper exploration and a better healing journey.

How can therapy help me? 

Once you find a therapist that feels right for you, you can start working on creating trust. They will be there for you to hear you out, model healthy boundaries, and encourage talking about topics that you haven’t been able to talk about before. You can start getting to know yourself. The therapist will be the mirror and a reflection of yourself. However, the process will not be easy, and there may be times you don’t want to go to therapy. You may feel like stopping altogether. It takes courage to reach out for support and keep going. 

I offer online and in-person counselling and music therapy in English and Estonian in Berlin. I look forward to connecting with you.

Healing Relationships in Psychodynamic Music Therapy

You may be thinking, what is psychodynamic music therapy and what does it have to do with your relationships? 

Perhaps you’re struggling with building meaningful connections with others, and yourself. You may be going through a breakup, have challenging relationships with your loved ones or struggling to make and keep friends. In psychodynamic music therapy, relationships are at the core of the therapeutic work. 

When you think about it, music is already an innate part of our development. It is a part of being human from the moment of being in our mother’s womb, the close heartbeat that offers comfort and safety. From these early emotional bonds that are formed in early childhood, the relational patterns will continue to affect your relationships in later life in friendships and intimate connections.

And so in music therapy, these attachment patterns can start to be worked through in verbal and non-verbal expression, modelling early connections through language, body language, and music. It is about being present with another human being from where the therapeutic relationship and trust can start to be formed. 

In this article, we’ll explore further how psychodynamic music therapy can support your relationships, diving deeper about the importance of attachment and attunement, the music in the therapy space, and how you can benefit from it. I’ll also illustrate the work with a short case study to give more of an overview of the process of psychodynamic music therapy. 

Contents

1. What is psychodynamic music therapy?
2. How can psychodynamic music therapy support your relationships?
3. Exploring attachment and attunement in music therapy
4. The music in psychodynamic therapy
5. Who can benefit from psychodynamic music therapy?
6. Conclusion

1. What is psychodynamic music therapy?

Psychodynamic music therapy is a form of psychotherapy that relies on psychoanalytic and psychodynamic principles. The focus of the work is on exploring your past experiences to understand your current behaviours and patterns by bringing conscious and unconscious thoughts and feelings to your awareness. 

The emphasis then is on supporting your emotions and feelings in a safe space through verbal and non-verbal expression. It is about exploring your inner world where the central part of the work is the relationship between your therapist. 

Musical experiences can be used in the process, creating a third element in the space to achieve your goals for therapy such as supporting your relationships, learning self-compassion and emotion regulation. Let’s dive deeper into some of these complex ideas below. 

2. How can psychodynamic music therapy music therapy support your relationships?

As with any therapeutic encounter, the core of psychodynamic music therapy is the relationship between you and your therapist. This will take some time to build, and it is important not to rush the process of creating this intimate bond. Be patient with yourself, share your thoughts and feelings with your therapist and the work will unfold from there. This delicate process will gradually deepen the therapeutic relationship. t It is about forming a secure bond between you and your therapist where you feel seen and heard, and where the healing starts to happen. Through this work, you may start to feel safe enough to create more fulfilling relationships outside of the therapy space too, leading to meaningful connections, higher self-confidence and mental well-being. But what exactly happens in a therapeutic relationship? 

Transference-countertransference

Transference is a process in psychodynamic music therapy where your unconscious thoughts, feelings and dynamics from your past relationships are projected onto the therapist. In contrast, countertransference is the same process in reverse which helps your therapist to gain a deeper understanding of your experiences.These unconscious feelings can then be worked through with your therapist, giving you a deeper insight into your relational patterns and interpersonal dynamics, fostering greater self-awareness and emotional growth. 

Attachment 

Attachment theory focuses on the emotional bond between humans, starting from our very earliest connections to our caregivers. The attachment theorist John Bowlby has stated that attachment is pre-verbal, developing during the first 6 months of our lives. In therapy, this can be worked through with your therapist, forming a solid bond to break through unhealthy habits of relating. Because attachment is pre-verbal, this is especially delicate. 

Attunement

Attunement is a concept developed by psychoanalyst Daniel Stern in 1985. It is the relational way of recognising and responding to another person’s internal experience which is deeply connected to an emotional attachment, mentioned above. It is a non-verbal process of being with another person by which we learn to form close relationships. Through the vulnerability and delicacy of music, in psychodynamic music therapy, music can be used as a safer way to start noticing how we relate to another human being. 

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Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care. 

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3. Exploring attachment and attunement in music therapy

By using music playing in the session, we can re-create an attachment bond in music by attuning to the sound of the voice, call-and-response, body language, and movement. Attunement is the primary vehicle for parents to communicate love and safety to small children. The supportive caregiver, be it in childhood or in later relationships is the basis of being seen in the world, taking up space, engaging in relationships, to feel safe. However, in one way or the other, there will be disruptions of attunement in our lives which can be supported and/or repaired to close relationships with loved ones, strong support networks, mentors or therapists. Either way, healing needs people.

Case study

I was working with Marie (name changed) in psychodynamic music therapy, a 28 year-old woman working in the music industry. She sought out psychodynamic music therapy sessions due to her relational difficulties despite having found success in her professional life. She tended to keep people at a safe enough distance from her, avoiding emotional intimacy. 

In our initial sessions, the focus was on creating a safe space and a trusting relationship where Marie could start to explore the patterns of relating. Through the shared music playing, music listening and open ended conversations, it became clear that the difficulties came from the lack of early attachment needs which left her feeling disconnected from her peers, afraid of commitment and forming secure bonds. Marie had learned to rely solely on herself due to lack of emotional expression in the family and a subsequent divorce.

As the therapy progressed, Marie was able to open up about her intense need for longing connection but not being able to ask for her needs to be met as this wasn’t modelled to her in her childhood. The music served as a medium to process these early attachment wounds in a non-verbal way. Gradually, her self-expression grew louder and more confident in the music as well as in our conversations.

Through guided use of music and open conversations, I was able to create a safe enough space for Marie to start opening up about her emotional guardedness. She was able to start bringing more of the songs that she adored to the therapy space, experimenting with new ways of relating, self-expression and vulnerability. Over time, Marie started to share her courageousness of vulnerability outside of the therapy sessions, the growing ability to trust others and opening herself up to the possibility of fulfilling relationships. 

By the end of our work together, Marie shared a renewed sense of hope and deeper understanding of her attachment patterns. The psychodynamic music therapy process had given her a space to create trust in herself and others, developing more adaptive ways of relating to herself and others outside of the therapy space too. It allowed her to reconnect with her passion for music, using it as a powerful tool for self-expression and personal growth. 

4. The music in psychodynamic therapy

Music creates connection where words fail. Through music and reflection, we can start to explore your inner processes, thereby increasing self-awareness and awareness of others. In psychodynamic music therapy, no previous musical skill or knowledge is required to participate in sessions. Creating music is therefore based on self-expression where the therapist supports the process with you. This creates vulnerability and connection, allowing us to communicate without words. This has unique therapeutic potential for working through dysfunctional relationship difficulties originating from early childhood where the focus is on non-verbal communication. 

What does your favourite piece of music say about your attachment style?

Research shows that the types of music we listen to can give us an insight about our attachment styles. This applies to songs that speak about relationships. Think about your favourite song, or a song that you’ve been currently listening to:

• What is the meaning of the song? 

• What do the lyrics say? 

• Does the message relate to your current inner experiences?

• What is the subjective experience of the song? 

• What could this say about your attachment style? 

5. Who can benefit from psychodynamic music therapy?

Psychodynamic music therapy can support people with a range of mental health difficulties such as:

• Relationships

• Depression

• Stress

• Self-esteem 

• Anxiety

• Trauma

• LGBTQ+

• ADHD and autism

Some of the goals for psychodynamic music therapy may be:

• Raise your self-confidence;

• Support self-expression;

• Support developing meaningful relationships.

Your therapist is there with you to offer you a safe space from where you can start to explore your emotions and feelings together. Additionally, music acts as a bridge between the conscious and unconscious self, giving meaning and expression to your experiences, thoughts and feelings. Since, not everything needs to be or can be expressed in words. 

6. Conclusion

Psychodynamic music therapy is a powerful therapeutic modality that focuses on your internal experiences to gain deeper understanding of your experiences and relationships. 

This process can be challenging and uncomfortable at times as it encourages you to dive deeper into your emotions, thoughts and patterns. At one point, you may even feel like quitting, but something in you is not willing to give up just yet. By committing to the process, showing up for yourself session after session and allowing you to engage with it, you may find that it becomes easier to navigate the uncomfortable moments. The outcome can be so rewarding, witnessing your own healing, strength and growth throughout the process. Let yourself experience that pain that leads you towards a more integrated self, improved self-confidence and more meaningful interpersonal connections. 

It is important to note that psychodynamic music therapy sessions are conducted by a trained music therapist who has a deep understanding of both music and psychological principles. Therefore, please consider this when looking for a therapist. Read more about how to start therapy and what to talk about therapy. 

I am an English-speaking counsellor and a qualified music therapist in Berlin. I am available for in-person sessions in Mitte, Berlin. I also offer online sessions on request. 

For any questions or enquiries contact me on the link below, or email me at arulacounselling@proton.me. I look forward to connecting with you. 

Disclaimer: This article is for educational purposes only and does not substitute a therapeutic relationship with a mental health professional. If you are in a mental health crisis, please call 112 or your country's crisis line, where professional mental health workers can help you. Here are some additional resources.

References

Alaei, R., Rule, N. O., & MacDonald, G. (2021). Individuals' favorite songs' lyrics reflect their attachment style. Journal of Research in Personality, 93, 104110. https://doi.org/10.1016/j.jrp.2021.104110 

Kim, J. (2016). Psychodynamic music therapy. Voices: A World Forum for Music Therapy, 16(2). https://doi.org/10.15845/voices.v16i2.2312

McCarthy, G., & Maughan, B. (2010). Negative childhood experiences and adult love relationships: The role of internal working models of attachment. Attachment & Human Development, 12(5), 445–461. https://doi-1org-14cssccv7011b.erf.sbb.spk-berlin.de/10.1080/14616734.2010.501968 

Petrowski, K., Berth, H., Beiling, P., Renner, V., & Probst, T. (2021). Patient's and the Therapist's Attachment Representations, Attachment to Therapists, and Self-Esteem-Change Through Psychotherapy. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.711296

What to Talk About in Therapy: 9 Therapist Tips

"What to talk about in therapy?" is a common question I've heard from clients, friends, and family. Knowing what to talk about in therapy or where to begin can be difficult, and you are not alone. As a therapist, having worked with clients in sessions for many years now, gone through personal therapy, and still learning about myself and others on a daily basis, I’ve put together this article. I will give you some tips and ideas about what to discuss in therapy, so you can feel at ease before your next session. I will also briefly talk about setting goals for therapy, and about how long the process of therapy takes.

Contents

1. What is therapy?
2. How to start therapy?
3. What to talk about in therapy: 9 tips
4. Additional questions you may have
5. How long does therapy take to work?
6. Conclusion

What is therapy?

Therapy is a general term that describes various treatment approaches, such as talk therapy/psychotherapy, cognitive behavioural therapy, family/couples therapy, art/music therapy, and more. The right therapy type depends on your needs, whether you need help coping with challenges, facilitating personal growth, or anything else. In therapy, the client and the therapist work together as a team to help address:

• Emotional and psychological challenges; 

• behavioural challenges; 

• improve mental well-being; 

• and enhance overall quality of life.

In this article, I will discuss talk therapy, specifically, what to talk about in therapy.

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Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care. 

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How to start therapy?

I get it; being in a room with a stranger probably feels weird and uncomfortable. You may have high hopes that everything will flow flawlessly, but it may turn out to be different when actually sitting in the session. Trust me, I have been there. It is common to feel nervous before your first session. After all, you've never even met the person, and your therapist is probably a little nervous, too!

There are a few approaches your therapist might take. Some may be more direct, guiding you and asking specific questions to gather more information about you and your situation. Others leave more room for you to open up and discuss your experiences, exploring what led you to reach out for support now. Both approaches lead to discussions and topics and can be a good starting point for knowing what to talk about. 

What to talk about in therapy: 9 Tips

Therapy doesn’t always have to involve something ‘urgent’ that you need to resolve now. It can also be a place of self-discovery, starting from where you are, perhaps reflecting on how you feel in the present moment. Some of the topics you could to talk about in therapy include:

• Emotions, thoughts, and feelings; 

• what brought you to therapy; 

• your goals for therapy;

• relationships; 

• your upbringing; 

• self-esteem and self-image; 

• life transitions;

• coping strategies;

• self-care and well-being.

Most importantly, therapy starts from building, and establishing a trusting relationship with your therapist with whom you feel comfortable with. Now that I’ve covered some overall ideas for what to talk about in therapy, let’s get into it and look into each in more detail. 

1. Emotions, thoughts, and feelings

The process of therapy involves opening up about your emotions, thoughts and feelings. It is about building trust in a therapeutic relationship to allow space for vulnerability, growth and healing. We may start by exploring and being curious about where your emotions, thoughts and feelings might be coming from, and how they may have been impacting your life. Brené Brown has written extensively on vulnerability, "Vulnerability is about showing up and being seen. It's tough to do that when we're terrified about what people might see or think." But it is a start. 

2. What brought you to therapy?

Starting therapy is not an easy decision to make. Knowing what to talk about and where to even start might be intimidating. To make you feel more at ease, I always start by asking you to explore a bit more about what led you to reach out for support and what you may be looking to achieve in therapy. This could be a great starting point for a conversation in therapy. You deserve to be heard. 

3. Setting goals for therapy

In therapy, we may explore further about how you would like to feel, how you would like to behave with yourself, others and the world around you. This can be helpful in setting goals for therapy together, thinking about how to structure future sessions. It is a continuous journey of self-discovery and personal growth where no path can be compared to another’s. Goals for therapy can be a helpful place for an initial conversation.

4. Relationships

Throughout therapy, you may want to explore any relationship challenges, conflicts, or patterns you have noticed and would like to change or support with. Through reflecting on your relationships and opening up, you can strengthen your communication skills, and discuss how to build healthier connections with family, friends, co-workers, and romantic partners in ways that work for you. As Sue Johnson has said, “To be human is to need others, and this is no flaw or weakness.”

5. Your upbringing and family dynamics

Talking about your upbringing and childhood can be a challenging subject. It is important for your therapist to know a little bit about what brought you to therapy and how your upbringing and family relationships have affected you. However, make sure you give yourself enough time to build a relationship with your therapist first, to feel comfortable enough to talk about these difficult topics. It may take time to be comfortable enough to reflect on your past, so make sure you’re kind to yourself throughout the process.

6. Self-esteem and self-image

Therapy can be a place to explore your thoughts and beliefs about yourself, such as your strengths, but also areas that may be more difficult for you, such as noticing how you may talk to yourself. It is about developing a more compassionate way of being to help strengthen your relationships with yourself and with people around you. It is a crucial part of developing independence, strengthening your sense of self, and increasing your confidence. 

7. Life transitions

Have you recently been through major life changes such as moving to a new country, starting or ending relationships, a career change, or health difficulties? We may begin by exploring any challenges, fears, or uncertainties accompanying these changes, staying curious about any feelings that are coming up for you, and processing these in a safe space. Changes usually bring up grief, it takes time, and that’s okay. During this time, it’s especially important to create a self-care routine that works for you. 

8. Coping strategies

You may want to explore ways of dealing with stress, anxiety, or other challenges, finding out what works and what doesn’t work for you—creating awareness around healthier coping strategies, learning new ways of managing your emotions more effectively. It may be about taking up activities that you used to enjoy doing. Through therapy, you may notice your habits changing, finding new ways of being.

9. Self-care-practices

Exploring your current self-care routine can be a great start. Discussing ways you are already prioritising your mental well-being, or about how to make room for it. The more you are able to be honest with yourself about where you are, the more you can create space for yourself towards the life that you want to live. Your therapist can also support you in developing more self-compassion and kindness towards yourself. You can also read more on self-care for ADHD here.

Additional questions you may have

What should I talk about in therapy?

When you don’t know what to talk about in therapy, there are some specific topics you may begin with:

• Are there any challenges you’re facing at the moment?

• Are there any medications you are taking (if any)?

• What kind of difficulties have you faced before, even if they happened a long time ago? 

• What is your current life situation? For example, have you recently been through a life transition that you feel is affecting you? 

You can tell your therapist about anything, but it doesn't mean you have to. Therapy is a process about showing up and doing the difficult work, feeling your feelings, being curious about them, even though it might be a LOT easier to run away from them and avoid them completely. Remember, therapy is much more of a marathon than a sprint. 

What shouldn't I talk about in therapy?

There are no topics that you ‘shouldn’t’ tell your therapist. However, sometimes, it may take a little longer to feel comfortable discussing complex matters, or perhaps you never get to them. This is YOUR  therapy process, and there is no pressure to talk about anything you’re not ready for. Be kind to yourself - everyone’s journey is different. 

Be mindful of the discomfort that may notice:

• You may never feel 100% ready to talk about the most difficult topics; 

• It is important to build and establish trust first. 

What to talk about in therapy when things are going well?

It is a privilege to be witnessing the growth that you have been working really hard on. You may want to discuss these thoughts with your therapist, perhaps reflecting on the progress you have made throughout your sessions. Therapy is not meant to be ‘forever’ and as much as it might be difficult to do, perhaps it is time to start working towards an ending together. 

Although, when things are going well, it doesn’t have to mean that you need to end therapy straight away. Many people still carry on with therapy, even if the initial goals seem to have been met. 

What to talk about in therapy when you have nothing to talk about?

When you notice that you have nothing to talk about in therapy, it may be worth sharing these thoughts with your therapist to reflect on where you are at. Ask yourself questions like: 

• Is it difficult to trust and to open up to your therapist?

• Am I feeling stuck after working with my therapist for some time now?

• Have I simply run out of things to say?

As therapists, we want you to be able to talk these thoughts and feelings through with us so we can be curious about what might be going on for you and support you in your process.

How long does therapy take to work?

There is no set timeline about how long it takes for therapy to work. Therapy is about challenging yourself and taking small risks. The progress in therapy depends on how willing you are to do the work, to be vulnerable, open and committed to making a change in your life. If you’re finding it difficult to do that, this is a part of the process, and it doesn’t mean that therapy ‘doesn’t work’ and the changes that may seem to other people, are not so small to you. It is important to celebrate all the small wins, and pay attention to your own progress. 

How long therapy takes to work depends on things like: 

• Your current life circumstances

• Your goals for therapy 

• Your commitment to the process

You may not want to do it and face challenges or make a change at first, but therapy will open up space for topics you haven't been able to share with anyone else. Through being vulnerable, open, and transparent, you will inevitably deepen the therapeutic relationship and your process and progress in therapy.

Conclusion

In this guide, I've given some tips and examples about what to talk about in therapy. These insights will help you feel more at ease before your next therapy session. Knowing what to talk about can be difficult, but being open and transparent with your therapist helps. You can discuss your history, where you currently are in life, and what you're looking to achieve or change will support your therapeutic process. You don't have to move through life alone. It can be a difficult start, but talking to a trustworthy friend or professional counsellor to offer you support is already a step forward.

If you’d like further support or have any questions, you can reach me on the link below.

What’s Your Anger Trying to Tell You?

I was talking to a colleague a couple of days ago, and the topic of anger came up. The chat led us to dive deeper into the subject of this powerful emotion, discussing how that may manifest in our daily lives and what we can do to start managing it better. Let's explore this further. 

What is anger?

Anger is a natural and powerful emotion that we all experience from time to time. It is a response to perceived threats, injustices, or frustrations. However, it can sometimes get in the way of expressing ourselves fully and authentically. Understanding and managing it can improve your mental health, relationships and overall quality of life. 

Causes of anger

Being curious about the possible causes of your anger is a starting point in learning about yourself. Recognising where these emotions might be coming from. Here are some of the causes of anger that may lie behind it:

• Frustration

  When we face obstacles or things don't go as planned, it can lead to feelings of anger.

• Injustice

  Witnessing or experiencing unfair treatment, discrimination, or violations of our rights can trigger anger.

• Threats to self-esteem

  Criticism, humiliation, or feeling disrespected can provoke anger.

• Fear or pain

  Anger can be a defence mechanism when we feel threatened or when we're in physical or emotional pain.

• Unmet expectations

  When our expectations are not met, whether in relationships, work, or daily life, it can result in anger.

Can you think of a recent situation where these feelings have been coming up? Pay close attention to how that feels in your body and whether there might be an underlying cause of your anger. Be kind to yourself throughout this discovery process, as it may be more difficult than expected. 

Effects of anger

Anger can appear in many ways in our daily lives, impacting our overall quality of life. Below, I have listed some of the ways in which anger can affect our lives physically and emotionally. 

• Physiological responses

  Anger triggers the body's "fight-or-flight" response, leading to increased heart rate, blood pressure, and adrenaline release.

• Emotional impact

  Anger can cause irritability, frustration, resentment, or even rage.

• Relationship strain

  Uncontrolled anger can damage relationships and lead to poor communication, aggression, or withdrawal.

• Health consequences

  Chronic anger has been linked to increased stress, cardiovascular problems, weakened immune system, and mental health issues.

Managing and expressing anger

How can you start to manage and express your anger differently? 

• Recognise your triggers

  Identify the situations, events, or thoughts that tend to provoke your anger.

• Take a break 

  If you feel anger escalating, step away from the situation to cool down and gain perspective.

• Practice relaxation techniques

  Deep breathing, meditation, music listening, art making, or engaging in activities you enjoy can help reduce anger.

• Communication

  Express your anger assertively, using "I" statements to convey your feelings without attacking or blaming others.

• Problem-solving

  Instead of dwelling on the anger, focus on finding constructive solutions to the underlying issues.

• Seek support

  Discussing your anger with a trusted friend, family member, or professional can provide perspective and guidance.

How can counselling support anger?

It's important to note that while anger is a normal emotion, uncontrolled or excessive anger can negatively affect your well-being, relationships, and overall quality of life. If you find it challenging to control your anger or negatively impact your life, seeking support from a counsellor can be beneficial. 

Counselling can help you recognise your triggers and what might set you off for showing anger. Learning how to manage these can improve your mental health, your relationships and lead to a better quality of life. So, what is it that your anger is trying to tell you? 

If you're ready to explore it further, let's connect over a consultation session here, or email me at arulacounselling@proton.me. I look forward to hearing from you. 

Disclaimer: This content is for educational purposes only. If you are suffering from severe trauma, live in an abusive household or are in danger, call 112 or your country's crisis line, where professional mental health workers can offer you appropriate support. 

Do I Need to Have a Mental Health Issue to Use Therapy?

Have you wondered whether therapy is something for you or if you could benefit from it? Have you been thinking about it for some time but can't seem to take that first step? This article explores the misconceptions about mental health support, who can benefit from therapy and how to know whether therapy is for you. 

What is a mental health issue?

Mental health issues can range from anxiety, depression, bipolar disorder, substance misuse, ADHD, autism, sexual trauma etc. These big words can often be associated with stigma in the wider population. Maybe you don't have a diagnosis but have noticed something is not entirely right. Whatever your situation, you can still benefit from therapy. Not having a mental health diagnosis doesn't mean therapy isn't for you.

Who is therapy for?

To come to therapy, you don't need to know whether you have a mental health issue or not. It may be time to get in touch with a therapist if you:

• are struggling to get through the day-to-day

• are not feeling like yourself

• are feeling overwhelmed and struggling to make decisions

• have difficulties in your relationships

In therapy, you can start to get curious about why you may have these thoughts, feelings and emotions. Simply starting these conversations with a trained professional can give you clarity in what you need and in thinking about the next steps. 

How do you know if therapy is for you? 

Therapy is not only for people who have a diagnosed mental health disorder. You can start treatment whenever you feel stuck or feel like it is time to do something about how you feel. There can still be a stigma associated with coming to therapy, but it doesn't have to be that way. If you have doubts about it, we can start unpacking that and consider why you may feel shame or anxiety when coming to therapy. 

Where to start?

Looking for a therapist can be overwhelming. Give yourself time. You can begin by contacting 2-3 therapists and scheduling a consultation call with them. Talk about whether they could help you with the issue you have. If it's not the right fit, tell your therapist at the end of the consultation, or if you need more time to decide, you can email them. Don't leave your therapist wondering since this is also the basis of healthy communication. We'd like to hear from you even if the answer is no. 

How can therapy help you?

Talking to a friend is an option, but you may not be as open with a friend as talking to a trained mental health professional. In friendships, there may be judgements and other people's feelings involved. We may be projecting our feelings or beliefs onto another person. However, therapy offers you a non-judgemental space where you can explore in a safe space what it is that your feeling is about and start to dive deeper. It is about you finding your own answers and learning about yourself. 

Reasons you may be avoiding therapy

There are many reasons why people delay going to therapy. Stigma is associated with asking for help and seeing a mental health professional. You may think it's not for you since you don't have a serious mental health issue. However, prevention is key to sustainable mental health and to your quality of life. Reasons you may be avoiding therapy: 

• having had bad experiences

• thinking that your life will fall apart

• believing that the problems will go away on their own with time

• not trusting that therapy can help you

These are all valid reasons and fears of why you may be avoiding therapy. However, getting on a consultation call can help you gain clarity and help you in your process of starting to feel better. The first session might be the scariest one and is often anxiety-provoking to both parties, the therapist and the client. It may help to bring that to the space and know that it's natural to feel anxious. It is a new situation, so there will be many unknowns, but you don't have to be in it alone. 

Taking the first step

During the consultation call, we can explore whether we're a match. It's okay not to know. Coming to therapy can prevent having a more profound mental health crisis. It is never too early or late to start therapy. You may have recommendations for a therapist from colleagues, friends, or someone who resonated with you in the online directory. Reach out to them and schedule calls with them. You cannot know whether they're the right fit, but you can give it a go.

Making a decision

Talking with your therapist can help you decide whether therapy is something you're ready to commit to. Get in touch with me if you have any questions or have thought about starting therapy with me. Whatever the question is, we can find an answer together. I look forward to hearing from you.

Please note: This is for educational purposes only and is not to substitute a therapeutic relationship with a mental health professional. If you are in a mental health crisis, please call 112 or your country's crisis line, where professional mental health workers can help you.

What Happens in Music Therapy?

Music therapy is the clinical and evidence-based use of music interventions. Music is a therapeutic tool to accomplish individualised goals within a therapeutic relationship by a credentialed professional. These interventions address goals such as alleviating pain, managing stress, anxiety and physical symptoms, supporting self-expression, enhancing memory, and improving mood and communication (AMTA, 2022). But what really happens in music therapy, and how can you benefit from it?

What happens in music therapy?

In music therapy, music serves as a medium for processing emotions and feelings. As opposed to talking therapy, the emphasis is more on non-verbal expression, working with an embodied approach. Let's look at how we can use music in therapy sessions.

Music listening

Listening to songs that have a special meaning evokes memories. It may be a song from childhood, a song you listened to on repeat during your teenage years, or something that reminds you of home. Another form is discussing the song's lyrics, meaning, and how these songs make us feel. It can significantly impact your understanding of yourself and your mental health, connect you to your culture and make sense of your early experiences.

Playing in therapy 

Playing together enhances connection and improves our well-being. For example, playing a rainstick or a handpan can create relaxing and soothing sounds that can be especially effective with ADHD. I have noticed that sometimes clients need a little encouragement when starting. When they listen to me playing a few chords on the piano or the guitar, clients may feel more relaxed and at ease in playing together and experimenting with sounds. Beginning to let go of anxious feelings that may arise. Playing together gets easier the more we play. It is about having fun with it and letting go of any expectations you may have for yourself. 

Writing songs

Writing can be a great way to express yourself. You are putting your thoughts and feelings on paper and finding a sound and a melody that matches the song's emotions. In music therapy, you can participate in one-to-one or group sessions. Meaning you will be in a relationship with others who will support you along the way. Songwriting supports connection and communication and helps to express thoughts and feelings creatively. 

Musical meditation

If feeling too overwhelmed, doing a simple breathing exercise to ground ourselves and let us come back to our bodies can have a significant effect. Listening to instrumental music, or music played live by the therapist, supports stress and anxiety and relaxes us into the present moment. It can be effective when working with complex and overwhelming feelings.

Drumming 

When drumming together, we can experiment with different sounds and dynamics, such as playing louder or quieter and trying out different rhythms. After playing, we can reflect on the playing and what happened in the music. Drumming helps us get more into our bodies and out of our thoughts. When overwhelmed by your thoughts and emotions, drumming can create distance between them and alleviate anxiety.

Online music therapy

Online music therapy emphasises working with the body, verbal expression, meditations, and vocal sounds since we won't be able to play simultaneously. There might not be access to instruments, but we can still work together in an embodied and musical way. Technology continues making connections and finding creative ways of expressing ourselves. 

Who can benefit from music therapy? 

Music therapy suits every age group, from infants to older adults. I specialise in working with trauma, substance misuse, depression, anxiety and neurodiversity. I use music as a tool to facilitate attachment and human connection. However, the techniques mentioned above are not necessarily used in sessions at the same time. By working together, we can explore what works for you. These are only some of the techniques that may be used. 

If you feel disconnected from yourself, struggle to make and maintain relationships, and make sense of your experiences, I look forward to hearing from you. You can contact me here or email me at arulacounselling@proton.me. 

References

AMTA (2022) American Music Therapy Association. 

Playing in Therapy

Play is a natural part of us. It lets us be creative and in flow with our whole beings. We begin to play from an early age, being curious about the world through sound, smell, taste, and touch. As we grow up, the ability to play may diminish, depending on our experiences in the world. When we are unable to play, or the ability to play is disrupted, something is holding us back. Something is telling us that we are not safe to express ourselves fully, that it is not safe to be 'ourselves'. 

The importance of play

British child psychiatrist D. W. Winnicott (1971) has said,

‘It is in playing and only in playing that the individual child or adult is able to be creative and to use the whole personality, and it is only in playing that the individual discovers the self’.

It is about getting in touch with the younger part of us that we may have been trying to ignore and suppress for a long time. Showing compassion towards that part of us, giving them attention, showing them that it is safe to be in the world. We can begin to get curious about that part through art, which can act as a safe space to have feelings in.

Free improvisation

One of the foundations of music therapy is free improvisation. It is based on the subconscious principle, where music informs what is happening inside the person. Improvisation helps to connect us to our past experiences, integrate them with the present, and bring up memories or feelings we may not have been aware of. In therapy, we can start to better understand these experiences and work through them verbally and musically.

Principles of free improvisation:

1. Using creativity in therapy

No previous musical skill, such as knowing how to play an instrument or sing, is necessary to benefit from music therapy. What's important is to participate in the musical exchange and express yourself in a way that feels right to you. There is no right or wrong way of doing that. Through playing within the therapist-client relationship, you can start to gain clarity about your internal processes and behaviours since sometimes we cannot put our feelings into words. Some experiences are more somatic and challenging to describe. Hence, through non-verbal and free expression, you can start to make meaning of your felt senses. 

2. Authentic expression

As sometimes it is easier to hide behind words, you can start to let yourself free from these defences through free improvisation. The way you play and use instruments may give us a glimpse of what might be going on for you, connecting your body and mind. It takes time to feel and be comfortable in our bodies and learn how to express ourselves in a new way. It may be connected to our self-esteem, anxiety, fear of being seen, or fear of making mistakes. By slowly working through these feelings in a safe space, you begin to make room for yourself.

3. Expressing yourself in a non-verbal way

Humans are preverbal. We all have rhythm and sound before we have words. Therefore, expressing yourself musically can connect you to your early life experiences when you didn't know any better. We can now start to make sense of that and show ourselves compassion. Expressing emotions, thoughts and feelings in words can sometimes be difficult. Through improvisation, we have an opportunity to give them space. This provides another layer of expression and helps us better understand our emotions and work through them.

Working with a client through play

In client work, improvisation can be used anywhere in the session, depending on the client's needs. The intense feelings that are difficult to express in words can be expressed through music. In working with a client of mine, I offered to choose an instrument that described their feelings in the moment. They chose a small harp and started to play delicate and fragmented sounds on the instrument. After listening for a little while, I started playing the guitar with some soft chords. The sounds melted into each other, creating a safer environment for the client to express what they felt. Afterwards, we reflected on the music where they were able to translate their experience into words. We were able to unpack what was happening in the room and make sense of it. As a result, they felt more at ease and relaxed which wouldn’t have happened by only using words.

Connecting with your inner child through play

We are all surrounded and connected to play. It gives us information about how we interact with other people, play with the world, and express ourselves. It is important to show self-compassion towards us when this doesn't come naturally to us. Connecting with your inner child may be difficult at first but where can we begin? Here are some questions you may ask yourself:

• What does play mean to you?

• Do you allow yourself to play?

• Do you feel stuck or unable to play at times?

• Do you feel self-conscious whilst playing?

• What are the blocks, if any, that are holding you back from expressing yourself fully?

Doing that in a safe space and in a relationship with the other supports having shame around it. We can start to interact and connect to ourselves in a way that we may have forgotten or never experienced before. This way of working with play can fluctuate between verbal and musical expression. However, improvisation is not a substitute for the verbal expression but rather an indirect medium of expression where difficult material can be explored and an interpersonal relationship can be strengthened. 

Get in touch with me

I offer online and in-person counselling in Berlin. If you would like to participate in therapy with me, please contact me here or email me at arulacounselling@proton.me to arrange a consultation call. The first call is to get to know each other, explore the possibilities of music therapy and assess your suitability for treatment. After that, if you would like to continue with therapy, a consent form will be filled in, and a start time will be agreed upon. I look forward to hearing from you.

References

Eno, B. (2022). Apple Music podcast with Zane Lowe.

Rogers, P. (1992). Issues in working with sexually abused clients in music therapy. Journal of British Music Therapy, 6(2), 5-15.

Winnicott, D. W. (1971) Playing and Reality. London: Routledge. 

ADHD - Finding Peace in the Midst of Chaos

October is ADHD (Attention Deficit Hyperactivity Disorder) Awareness Month. Therefore, we will discuss the symptoms of ADHD and focus more on ADHD in adults. How does ADHD influence us, what about getting assessed, and how can therapy support an adult diagnosed with ADHD? If you’re looking for ADHD support for adults in Berlin, here is how counselling can help.

What is ADHD? 

ADHD is one of the most common neurodevelopmental disorders in children and adolescents, with symptoms present in 3-10% of school children. ADHD is three times more common in boys than girls and is usually passed on into adulthood. However, diagnosing ADHD in adults is more difficult since they have learned to mask their symptoms. 

ADHD symptoms

ADHD is characterised by poor impulse control, difficulties concentrating, restlessness, fidgeting, tics, and hyperactivity. Dr Gabor Matè has stated that ADHD is not a disease, but a byproduct of not getting our attachment needs met in childhood. Genetic risk, metabolic diseases, immune disorders, infections, physical trauma, toxic environment and neglect may contribute to ADHD. It may be associated with other mental health conditions such as depression, anxiety, dyslexia, learning difficulties, developmental disorders, and speech and language disorders. 

Early childhood environment

For young children, there is a need for attention and emotional regulation, the importance of attuning to the child, being present with them and offering physical and emotional security. Children are more vulnerable to environmental stressors, sensitivity to the environment, and not being soothed when distressed. A stressful childhood environment with no consistency or predictability creates a lack of trust, possibly leading to zoning out or a 'freeze' response as a coping mechanism, making the pain more bearable. 

Moreover, schools or other systems we operate in may be trying to fit children with ADHD into society's norms, ignoring their needs that are different from the 'norm'. However difficult it may be for the teacher or other professional to attend to everyone's needs, it always comes a long way. Including parents or caregivers in treatment plans is equally important, offering the child the appropriate support for healthy development. 

ADHD in adults

Untreated ADHD can impair work performance, damage self-esteem and interfere with relationships. It can also reduce the chances of success and satisfaction in life, leading to substance misuse and distracting yourself with other activities rather than sitting with the pain. Studies show that the brain retains neuroplasticity throughout life. The brain continues to develop new pathways and synaptic connections to environmental stimuli. Meaning without the change in the environment, the brain cannot create new circuits of the mind relating to self and the world. Having ADHD doesn't mean there is a flaw in one's personality. There may be distress, loneliness and confusion that the adults may be unable to express. Separation of the mind and body, where the mind keeps wandering in another direction. Sometimes, the person can be highly interested in certain motivating activities. 

What can therapy offer for adults with ADHD?

Therapy offers a safe space to explore any difficult feelings or triggers. It allows you to explore your patterns and behaviours and make sense of your inner experience. It is important to note that a therapist is not qualified to assess you for ADHD but can guide and support you in your process. 

How can music therapy help with ADHD?

Oliver Sacks, neurologist and author of Musicophilia, has said: "Nothing activates the brain as extensively as music". Music helps to relieve tensions and express yourself through play. Sometimes, there is no need for words. Music has its own pulse, rhythm, breathing and movement. As music evokes different emotions, you start to gain clarity about the processes within yourself in a safe environment and by reflecting on your experiences with a therapist. 

This type of therapy involves cognitive, emotional and social processes. The treatment uses musical interventions to support concentration, self-expression and social skills where the relationship between client and therapist is at the centre of therapy. However, creative activities such as free improvisation, listening to music, songwriting, movement and art can be used alongside words. Through these activities, the therapist guides the client towards specific therapeutic goals. 

1. Providing structure

Providing a framework through regular weekly sessions creates predictability and safety that you may lack in your daily life. It forms a boundary from where you can start to explore your emotional and behavioural patterns with the therapist. The client's self-confidence and sense of achievement can be supported and enhanced through goal-oriented activities. 

2. Safety and self-expression

Feeling safe is vital for growth and healing. From this environment, you can start to understand yourself better. Moreover, self-expression is one of the core values in music therapy. Music is a way to express yourself and convey and understand your emotions. Sometimes, expressing yourself through non-verbal means is safer and more accessible than words, finding new ways of relating and having fun with it. Expressing yourself in a way that feels comfortable and right for you. 

3. Supporting focus

Playing music or other forms of self-expression supports attention skills, where we pay attention to the body and mind. Listening to music activates the whole brain compared to speaking. Purposefully playing a musical instrument, writing songs, singing or listening to music can help you concentrate better and help make new neural pathways in your brain. 

4. Supporting social skills

Music and the arts offer opportunities to support communication and find new ways of interacting. Creative activities help to communicate in a more accessible way where no words are needed since we don't all communicate in the same way. Making yourself heard, validated and accepted in a therapy space helps you implement these skills outside the therapeutic relationship. In therapy, looking at and understanding your parental relationships and family history helps to make sense of your experience and create awareness. 

Getting assessed for ADHD as an adult in Berlin 

ADHD assessment is done by a psychiatrist or professional with the appropriate qualifications. Getting a diagnosis can be a source of relief and helps to validate your experience. Although some people prefer not getting an assessment for ADHD because of stigma or personal reasons. However, a diagnosis will help you get the appropriate care you need and enable you to adapt your school or work environments according to your needs. 

Conclusion

Not everyone's brain works in the same way. Offering compassion, listening and being valued for who you are goes a long way. In addition to learning about your emotional and behavioural needs and patterns in therapy, we may also explore parental relationships and family history. It can be terrifying to sit with your mind but doing that in a safe and trusting space can make all the difference. 

Contact me here if you think you or your loved one would benefit from counselling or music therapy.

Please note: If you are in a severe crisis, thinking of hurting yourself or others, then call 112, and professional mental health workers will be able to help you. Arula Counselling is not designed to offer help in immediate mental health crises.

Building Resilience

How can you build resilience in your life to cope with the difficulties that life throws at you? You may want to run away in these moments to hide from conflict or anything else that requires your attention. During the current climate crisis, the war and rising cost of living make finding peace in and around all of us even more complex. How do you stay grounded during these times to protect yourself from hardships and move through life? 

What is resilience?

Resilience is surviving and thriving from stressful experiences while building defensive skills to manage future difficulties. It is about successfully adapting to complex or challenging life experiences and finding ways to rely on your resources. However, building resilience requires a skill set you can work on and grow over time. Let's look at what these might look like. 

Dissociation from difficult feelings

When you confidently face difficult emotions instead of shutting them down, you can integrate your thoughts and feelings and make sense of them. Nonetheless, because it is difficult and uncomfortable to sit with painful feelings, you may try to get further away from them. This leads to dissociation from your emotions. You may start to numb yourself with alcohol, food, other substances, or social media, creating a distance between your mind and body. Additionally, this builds a loop of endless distractions rather than having to focus on your inner feelings. It may also be by avoiding conflict and expressing how you really feel. This can be extremely difficult, but when getting comfortable with being uncomfortable, that's where growth lies. 

How to build resilience?

When leaning into the feeling of discomfort, you may notice that there is emotional and intellectual movement. Slowing down, focusing on your breath, seeing what comes up and being curious. Below are some of the ways you can start to build resilience during difficult times. 

1. Self-awareness

Self-awareness is about being aware of your thoughts, emotions and feelings. It is about noticing the way you behave or react to something. To begin seeing your reactions, think about why you might've reacted the way you did? Were you actually feeling hurt, rejected or abandoned? You can then think about what you really need. It may be that something needs to change in your life that is not making you feel fulfilled. Maybe you need some more time to focus on yourself and your needs. We all need to look after ourselves first before helping others. You may turn to your community and be open and vulnerable about your needs, even though this may be the hardest thing to do. 

Ask yourself: 

• How is my relationship with myself?

• Do I show kindness and respect towards myself?

• Am I able to regulate my emotions?

• Am I able to speak about my needs?

When you open yourself up to the possibility of showing your deeper feelings, people can start to understand you better and offer help and guidance where needed. 

2. Nurturing relationships

How are your current relationships with others? Do you feel supported and connected to them? In relationships, we feel more empowered and worthy when developing more prosperous and meaningful relationships. To care for others and be cared for. Nurturing relationships takes time and commitment. When you engage in secure relationships, it enhances your intellectual development, sense of worth, sense of competence, empowerment, and sense of connection. However, sometimes making and keeping relationships is complex, and you may not know why that is. Together with me, we can start to unpack your relationship patterns by creating a trusting and safe therapeutic relationship. These learnings can then be transferred from sessions to your relationships outside therapy. A sense of trust will always be at the centre of relationships. 

3. Relationship with your external environment

Do you feel comfortable, safe and at ease in your surroundings? If not, what makes you feel uncomfortable? How do you express yourself if you live in a city different from where you grew up? What led you to live in another town? Having a solid support network with people who value you for who you are can significantly impact how you see yourself and move through life. Living in a city with lots of noise and busyness, we may start to feel disconnected, burnt out and drained. Notice your environment. If it doesn't make you feel good, what can you do to make yourself more at ease? Going to nature and taking long walks? Perhaps you need to change your living situation to make you feel better? Take it one step at a time, and don't rush the process.

4. Trust

Sometimes, it is frustrating to sit with our feelings and emotions. Trusting that this will create the change or transformation you are trying hard to see or reach. A movement starts happening when leaning into it, allowing yourself to feel your feelings and sit with the discomfort without thinking of the outcome. Letting go of control, change begins to occur in your body and mind. 

Questions to ask yourself: 

• Am I getting enough sleep?

• Am I going outside?

• Do I eat healthy meals?

• Do I numb myself with food or alcohol?

• How much time do I spend on social media?

• Am I kind to myself?

• If I have people close to me, do I try to connect with them?

• Do I ask for what I need?

Resilience in therapy

In therapy, growing resilience might mean coming to the sessions when you feel your lowest. Still showing up when you don't want to and feel like there is no point in coming to therapy. You take accountability for yourself when you show up weekly, creating strength. Learning from your patterns and behaviours and creating awareness. This allows you to make changes, be aware of your thoughts and emotions and not fall into the same ways that might feel familiar.

Therapy facilitates emotional catharsis and empowerment. It connects to others and strengthens concepts of the inner self, addressing trauma and creating hope for the future. Bringing these complicated feelings to the space allows us to work through them, developing resilience. It will enable us to manage these emotions in the longer run, where we adapt more quickly. It gives us trust that these feelings will pass and that we can move forward in life. However, resilience requires work and commitment and doesn't happen overnight. 

Building resilience together

Having mental health strength doesn't mean that you have to be alone in it. It is okay to ask for help and to talk to someone you trust. Everyone is different and requires different care, and reconnection with yourself takes time. Allow yourself to heal and give it time. This can be through noticing our feelings and physical symptoms in our bodies. Leaning into these feelings through play, awareness, connection and taking care of yourself first. There is always a way out, even if you don't feel it right now.

I am an English-speaking therapist in Berlin, offering online and in-person counselling. You can reach me here or email me at arulacounselling@proton.me. I look forward to connecting with you.

References

Fava, G. A., and Tomba, E. (2009). Increasing psychological well-being and resilience by psychotherapeutic methods. Journal of Personality, 77(6), 1903-1934.

Fonagy, P. and Campbell, C. (2017) Mentalising, attachment and epistemic trust: how psychotherapy can promote resilience. Research Department of Clinical, Educational and Health Psychology, University College London, London. 

Scrine, E. (2021) The Limits of Resilience and the Need for Resistance: Articulating the Role of Music Therapy With Young People Within a Shifting Trauma Paradigm. Frontiers in Psychology, 12.

Using Music to Relieve Stress and Anxiety

What is anxiety? 

Anxiety is a feeling of unease such as worry, fear, stress, restlessness, tension or overthinking. These are all healthy responses to stressful situations where your body releases cortisol (a stress hormone) to respond to them. When we feel threatened, cortisol is valuable in protecting us, creating a fight-flight-freeze reaction. Fight or flight prepare our bodies to fight against the threat or to escape the situation. Your breathing gets quicker; your heartbeat fastens; muscles tense — your body is ready to react quickly. In freeze response, we feel like there is no opportunity for us to escape, which numbs our feelings physically, emotionally and mentally.

Common types of anxiety disorders

People with anxiety disorders experience repeated episodes of these sudden feelings, which may lead to anxiety, disrupting daily tasks. There are many anxiety disorders, the most common ones being generalised anxiety disorder and social anxiety. Let's look at these below.

1. Generalised anxiety disorder 

   In generalised anxiety disorder, there is constant worry or fear that the person cannot control. You could have sleep difficulties, the tension in your muscles, restlessness, problems focusing, fatigue, or irritability. 

2. Social anxiety

   In social anxiety, you may feel anxious when having to be at the centre of attention, perform or socialise with others. Because of the intense feelings you feel around people, you may start to isolate yourself from these stressful situations to relieve your triggers. However, some performance and social anxiety are standard, which doesn't necessarily mean you have social anxiety. 

Common symptoms of anxiety

Anxiety symptoms can range from:

• having restless thoughts

• difficulties falling asleep

• thoughts of worry

• overthinking

• tension in muscles

• shallow breathing

• sweating

• sense of unease

How can music help to relieve stress and anxiety? 

Studies have shown that music can lower our cortisol levels, reducing stress and anxiety. Music connects us to ourselves, being aware of our emotions, and processing our feelings. When we start accepting our anxiety, leaning into it and letting go of control, we may begin to notice how the feeling is something to be curious about. Music addresses our cognitive, emotional and social needs. Below, I have listed some musical techniques to use when feeling overwhelmed and stressed. These can be used in your own time and adjusted to your needs. 

Active music-making 

In active music-making, we use instruments or our voices to create sounds and music in real-time. This involves active participation from your side and may be more exposing. Below, I have listed three active music-making techniques to relieve stress and anxiety.

• Vocal breathing

  We breathe at all times, but it is the quality of the breath that counts. Notice your breathing pattern – is it slow or fast? Is it surface level, or do you breathe deeply from your diaphragm? Once you are aware of your breath, begin to take deeper breaths, closing your eyes if this feels comfortable, placing one hand on your belly and one on your heart. Inhale from the nose, exhale through your mouth, relax your shoulders, placing both feet on the ground. As you exhale, let a sound out with your voice. It might feel uncomfortable initially but trust the process and be open to whatever happens. You are safe.

• Songwriting  

  Think about something that you are struggling with at the moment. Is it a question that you are curious about? Are you delaying a task that you'd rather not complete? Maybe you're feeling confused and need some clarity. Write down anything that comes to mind. You then have a topic that you can use for your songwriting. Start picking out some words that capture your attention, creating a map of these and grouping lyrics together. You may add music to these. Writing down words that reflect your current state can help to create awareness of your emotions and process your feelings. 

• Playing an instrument 

  If you have an instrument at hand or anything else that makes a sound, you can start experimenting with them. These can be quiet on a guitar, or maybe you want to express your anger on the drums. Get familiar with what comes out. There is no need to think about it, but just leaning into the task and letting go of your thoughts can be a great way to release any stale emotions. Voice can be another one to experiment with and is accessible to most of us. 

Music listening 

Music listening is a passive form of using music to relieve stress and anxiety. This can be either listening to your favourite song or putting on a relaxing playlist that helps you ground yourself. Let's look at some of these techniques.

• Putting on a song that reflects your current mood

  How do you feel right now? Is there a song that you associate with your current mood? Does it have any lyrics? If so, what is the message of the song? This may be your favourite song you are listening to on repeat, or you might shuffle your playlist and see what comes up. Whatever it is, trust the process and notice the lyrics or the melody. Do they reflect your current state of mind? Is it the complete opposite? Is there perhaps a feeling that you've been avoiding? Listening to a song that reflects your mood can be a great way to gain awareness of your emotions.

• A curated playlist to keep your mind calm and grounded

  I have added here a list of songs that I have used in my sessions to help my clients calm their minds and stay grounded in the present moment. You can either sit down on your chair or lie down. Try to find a comfortable position that suits you. Close your eyes and put on the playlist. You can focus on one particular feeling, or let your mind wander. Don’t worry if you get distracted by your thoughts. Just notice it, let go of them and come back to the music, to your breath.

• Creating a playlist

  You can begin creating your own playlist that resonates with your identity and feelings. You can start by listening to songs that come up and see whether you feel a connection to them. Spotify also suggests songs that sound similar to the songs in your playlist. You may find certain themes coming up. Trust the process and note these songs down. Give them a listen in a comfortable space. Notice if these songs have lyrics or are they instrumental? Are they fast or slow? These playlists are unique to us and can help us find a connection to ourselves.

Do what makes you feel good

Start by picking one technique that feels most comfortable. Perhaps you find that breathing exercises work best for you? Maybe writing is your thing? You can try out some of them and then decide. What is important is that you are curious about your emotions and feelings and what comes up. 

I am an English-speaking online counsellor in Berlin. You can contact me here or via email at arulacounselling@proton.me. I look forward to connecting with you. 

Benefits of Online Therapy

We have been living in such uncertainty and unknown for the past two years. Aside from the coronavirus-related anxieties around physical health, it has equally affected our mental health. We may be experiencing higher levels of isolation, loneliness, stress, depression, and anxiety.

What are the benefits that online therapy has to offer?

Some of us may be going through agoraphobia (fear of leaving the house) or may be fearful of being in contact with another. However, this should not limit our access to mental health support, where starting with online therapy may be a great option. Research has shown that online treatment can be as effective as in-person therapy. Let's look at some benefits online therapy has to offer, what happens in online music therapy and what the benefits of in-person therapy can be.

Accessibility

One of the main benefits of online therapy is that you can access sessions from anywhere with a good internet connection. Either from the comfort of your home or a space where you feel safe. You don't have to travel long distances to get to the therapist's office anymore. Equally, if you live in a remote area, have physical limitations or disabilities, which makes it harder for you to travel, online sessions may be a more suitable option. 

Flexibility

Online therapy offers flexibility to fit your schedule. If you cannot attend therapy and need to cancel a session in time, the therapist may be able to provide you with an alternative time that fits your timetable. There is also flexibility in accessing the right specialist who will be able to help you with your specific needs. Whether you want to access a therapist who speaks your mother tongue, or someone who can relate to your experiences of living abroad, finding the right therapist is no longer a limit. 

Structure

Online therapy offers a weekly structure to take time for yourself and attend to your needs. With your therapist, you can explore what might be going on for you and make sense of your experience. You may be able to attend sessions more regularly when feeling down since you don't have to leave your house, and therapy may still be an option to offer you mental health support during these difficult times. It may be vital to come to therapy exactly then to be able to work through the most challenging emotions and feelings.

Creating distance

Compared to in-person sessions, working with a therapist online may help to open up more quickly. It may reduce the intensity of the sessions since the therapist is not sitting across from you, which can make you feel more at ease when talking about your experiences. The comfort of your home may already be the catalyst to creating the safe space you need - another benefit of online therapy.

Presence

Because online therapy applies the same principles as traditional face-to-face therapy, it may be more suitable for your pace of life. The therapist's presence can facilitate the flexibility of thought, thinking through details, and identifying patterns. Additionally, the relationship supports the ability to make connections and feel connected to your feelings in the session, thereby creating change. Research confirms that online therapy services can have the same mental health benefits.

Benefits of online music therapy

In music therapy, online therapy services may look slightly different from in-person sessions. Because of the latency in video calls, we won't be able to play together and share the same musical space. Still, we may be using listening to music for relaxation, guided imagery, or art-making. We may take turns in playing music if instruments are available to you and if that's what you want to explore. However, this is not a requirement and will not define whether you benefit from therapy or not. 

Benefits of in-person therapy

Virtual therapy may not be suitable for everyone. Going out to a therapy practice may be essential when you live in a home where you don't feel safe or where it is difficult to find a quiet space. Bringing that up with your therapist or family doctor is essential to provide the best care for you. In-person therapy is still recommended if you have suicidal thoughts, psychosis, severe addiction, or complex symptoms of a mental health condition. Having a weekly routine of going to therapy may offer a secure structure and get you out of the house, which may be a step towards your recovery.

Conclusion

If you are struggling with completing daily tasks, feeling anxious or low in mood, then working together with a therapist can help you talk and express your needs and figure out what you might need to help relieve your pain. We are all different and require a unique kind of care. If this resonates with you, I look forward to connecting with you. I offer online and in-person therapy in Berlin. You can contact me here or email me at arulacounselling@proton.me. 

Please note: If you are in a severe crisis, thinking of hurting yourself or others, then call 112, and professional mental health workers will be able to help you. Arula Counselling is not designed to offer help in immediate mental health crises.