When Chaos Feels Familiar: Reflections on Regulation, Meaning, and Music
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.
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.
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.
5 Self-Care Techniques for Adults with ADHD
Neglecting self-care practices for adults with ADHD can be easy to do, but it might be the most important thing you can do for your mental well-being to help you manage symptoms, reduce stress, and improve your overall well-being.
ADHD (Attention Deficit and Hyperactivity Disorder) affects a significant proportion of the adult population, with more individuals seeking out a diagnosis and understanding. In addition to symptoms of hyperactivity, impulsivity, and inattention, research has also explored ADHD and the connection between certain emotional and cognitive factors, such as higher emotional reactivity, negative thinking patterns, and co-existing conditions, such as anxiety and depression.
Neglecting self-care practices for adults with ADHD can be easy to do, but it might be the most important thing you can do for your mental well-being to help you manage symptoms, reduce stress, and improve your overall well-being. Let's look at these carefully tailored five self-care techniques for adults with ADHD, providing practical ways to maintain balance and daily functioning.
1. Recognising your thought patterns through journaling
ADHD affects thinking, such as focusing more on negative thinking patterns, which may leave you feeling self-doubt, self-criticism, moments of failure, and low self-esteem. Through journaling, your brain will start slowing down, helping you identify when these thoughts arise, how they may affect your mood, and how to process emotions more effectively. You can challenge these thoughts by being curious about where they come from and whether they are true. Thoughts can then be reframed to something more positive. Even if it's difficult to believe and feel these are first, working in such a way takes practice and consistency.
If journaling doesn't work for you, I always encourage people to seek different mediums, such as art-making, music-making, or poetry. Whatever feels more accessible to you, go with that. Be kind to yourself throughout the process and seek further support if needed.
2. Understanding hyperfocus
Hyperfocus is a fixation on an activity for a prolonged period without taking any breaks, losing track of time, and neglecting eating and sleeping, usually engaging in an activity you are interested in. Hyperfocus can deplete your energy and leave you exhausted by its end. Low dopamine levels in the brain are hypothesised to play a role in hyperfocus. Due to this, it can be challenging to get yourself out of the intense focus. Although it can be an excellent asset, it can also decrease productivity and impact your relationships and academic achievements. Recognising your hyperfocus can help you set timers and alarms when working on tasks and use other external cues to manage your time more effectively.
Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care.
3. Listening to music that makes you feel good
Music can significantly increase dopamine in your brain, regulating emotions and offering structure to your day. The rhythm and tempo of songs support attention, focus, and decision-making. You can also use music to complete tasks due to the nature of the length of songs and tracks. It can start by structuring your brushing your teeth in the morning by playing a 2-3 minute upbeat song. Experiment with genres, speed, and instrumentation, and notice how different songs make you feel. Instrumental music may be more supportive due to not having instant associations with the music and lyrics. However, lyrics can be powerful in focusing on one specific mood or situation. Just notice how different tracks and songs make you feel.
4. Finding the right support network
Building a solid support network is essential for individuals with ADHD. Seek out people who understand and empathise with your experiences; it might be someone you know of having the same condition. Talking to people who understand you can be helpful and healing, as well as being heard and validated and feeling like you're not alone in your experiences. Surrounding yourself with a supportive community can provide validation, understanding, and practical strategies for managing ADHD symptoms. Sharing your challenges and successes with others who can relate can be immensely beneficial. It can start with your family, friends, or someone from work with whom you connect and feel safe. It can start from just one person.
5. Self-Compassion
Practicing self-compassion is crucial for individuals with ADHD. Understand that ADHD is a neurodevelopmental condition and that your symptoms do not define you. ADHD is just one part of you. Be patient and kind to yourself, recognising that you are doing your best. When setbacks occur, offer yourself understanding and forgiveness. Listen to how you speak to yourself, and notice to treat yourself with the same compassion and kindness you would extend to a friend facing similar challenges.
Conclusion
Self-care is crucial to adults with ADHD to help manage symptoms, reduce stress, and improve their mental and physical well-being. By incorporating these five self-care techniques into your daily living through journaling, understanding hyperfocus, listening to music to structure tasks, and boosting cognition, finding the right support network, and practicing self-compassion, you will start to understand yourself better and live a more balanced life. Remember that self-care is a personal journey that looks different for everyone, so explore and experiment with different strategies to find what works best for you.
If you need more support in your process or have any questions regarding how therapy could support you, I look forward to connecting with you.
References
Hamdani, S. (2023) Self-Care for People with ADHD. Simon & Schuster.
Nuff, K. (2024) Self-compassion. Available at: https://self-compassion.org/. (Accessed: 15 February 2024).
Volkow, N. D., Wang, G. J., Newcorn, J. H., Kollins, S. H., Wigal, T. L., Telang, F., ... & Swanson, J. M. (2011). Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Molecular psychiatry, 16(11), 1147-1154. doi: 10.1038/mp.2010.97
7 Things to Know About Me as Your Counsellor
Read more on how I show up in sessions as a therapist, and what to expect when working together with me. I hope it resonates with you 🧡
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
Here is a list of six steps that can support you in overcoming self-doubt and boost 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!
Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care.
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.
The Connection Between Autism and Loneliness [in Neurodivergent Women]
When reaching adulthood, many autistic women lack social support and knowledge on how to find available support. Let's find out how to start creating connection to decrease feelings of loneliness.
Research shows that loneliness and autism are interconnected where autistic people experience loneliness more intensely than non-autistic individuals. Despite the general misconception that autistic people prefer to be alone, many are interested in social connections. However, it can be challenging to form new relationships due to experiencing difficulties with social interaction.
In this article, I’ll focus on the connection between autism and loneliness, discussing what loneliness is, the connection between loneliness and autism focusing on neurodivergent women, the challenges of autism and loneliness, and how to find support that works for you.
1. What is loneliness?
Loneliness is a form of subjective social isolation where a person feels that their current social situation doesn’t align with their social needs and preferences, leading to unpleasant emotions. It is an experience of a lack of fulfilling connections with others such as in intimate relationships, family, friendships or collective loneliness.
‘Many persons in society who are considered to be different and diverse are likely to be exposed to discrimination, exclusion, and (physical, emotional, and psychological) pain from people and institutions with the dominant majority group in society. Such negative treatment can severely impact their levels of trust, self-confidence, fear, anxiety, and future life opportunities’.
- Colin Lago, 2011
2. Loneliness in neurodivergent women
Loneliness is a common experience in neurodivergent women which can lead to mental health difficulties such as low self-esteem, lack of confidence, self-doubt, anxiety and depression. Moreover, the pervasive lack of acceptance and understanding of autism within society can compound the social challenges faced by those with autism, further contributing to feelings of exclusion and loneliness.
It may be that you lack knowledge and understanding of how autism affects you. It may be challenging to find common topics to talk about with others, and you may feel that you don't seem to connect with people in the same way others seem to do. Your interests may differ from theirs which may make having small talk exhausting, creating further feelings of isolation.
3. Gender based misdiagnosis
Given that autism has historically been considered a ‘male’ condition, many neurodivergent women are often misdiagnosed or overlooked. This leads to a gender bias in diagnosis, further creating the connection between autism and loneliness in neurodivergent girls and women. This may lead to you not getting the appropriate support, and struggling to know where to find the help you need.
Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care.
4. Coping skills that may increase loneliness in autism
Masking
Masking and hiding your true self can be painful. It may involve mimicking others’ behaviours so that people won’t find out about your differences. This may involve a fear of being seen as different or being perceived negatively, leading you to try to ‘fit in’ and act in ways that are far from your comfort. However, the more you suppress who you are, the more painful the experience becomes. Autistic ‘traits’ can be experiences that are not considered socially acceptable such as stimming, hypersensitivity to your environment, and not reading social cues according to social standards. Masking these autistic experiences can lead to, or increase feelings of:
Isolation
Rejection
Low self-esteem
Social anxiety
Depression
This creates further disconnection from yourself, trying to conform to social norms. You may feel like you can't be yourself when you're around other people, that you won't be accepted the way you are. Even if your coping skills and strategies may seem to be working in the short term, learning to mask may start from an early age, usually leading to more complex mental health challenges.
Differences in sensory processing
Due to the overwhelming social settings such as being triggered by noise, strong smells, and touch such as clothes not fitting the right way. You may want to remove yourself from these situations but feel like you can’t. This can create a feeling of being frozen, unable to act or respond to a situation. The intense sensations and discomfort can lead to a sense of panic or anxiety, where your body feels tense and your mind races. This is a common experience for those experiencing sensory sensitivities or social anxiety in overstimulating settings. During these times, it is important to be kind to yourself and to recognise that this is your body’s way of protecting yourself. With time, learning about yourself and your needs, creating structures that work for you such as wearing noise-cancelling headphones, removing yourself from the triggering setting or planning for breaks. The goal is to honour your needs in demanding social situations.
Holding conversations
It may be difficult to hold a conversation that doesn’t interest you at all. However, it’s a different story when you connect with someone on a topic that you are knowledgeable about, creating a sense of connection and mutual understanding. For many autistic individuals, having a conversation on a topic that they are knowledgeable about provides a flow of self-expression, fostering a genuine connection.
5. Reframing your autistic experience
Creating awareness
When you start to create awareness around your autistic experience in a safe space, you may begin to understand yourself and others in a new way. Through this, you may start to reframe your experience and to make sense of why it’s been difficult for you. It may not be that you’re anxious but that living in a world that functions differently and that is not adapted to the unique differences creates pressure. You may be feeling exhausted, isolated, and disconnected. However, this is not your fault.
Living in a world that's not designed for you is hard, trying hard to ‘fit in’ to an experience that doesn’t seem to match your needs, however hard you try. Understanding your autistic traits and your experience is a start in learning about yourself, what you like and what you don't like. You can then start communicating that to others and be in spaces that feel right to you. You don't have to suffer and try to fit in just because other people seem to be coping well.
Relearning about yourself
By creating a safe enough experience for you in the therapy room, you’ll begin to find out what you feel comfortable with, and what you don't. By learning about yourself, you start to get to know yourself. You may find that you are better suited for different environments that you are currently in. For example, your job, the people you surround yourself with, your interests etc. Take the time to consider and find out what is important to you and what feels good to you. This can look different from what you witness in your daily life, and that’s okay. Know that there’s nothing ‘wrong’ with you.
Acceptance
Research shows that a lack of autism awareness and understanding causes negative social experiences for autistic adults, including bullying and social isolation. Furthermore, peer rejection can happen due to the lack of knowledge of and dismissing your unique sensory experiences. Such an experience of rejection could lead to feeling 'othered'. However, you are not wrong or bad for others not having the appropriate knowledge.
Differences make us who we are. When the rest of the world doesn't know how to support you, accepting yourself and not seeing yourself at fault can be difficult. Even though it's initially tricky, learning about yourself and listening to your needs will make you more understanding and show compassion and kindness to yourself. Even if it feels right now like you won't be able to heal, there is a way out. You have the strength in you.
Self-compassion
Having self-compassion is a considerable part of the process of healing. Being kind to yourself and working on acceptance decreases the sense of loneliness. However, this is a challenging process, and there will be ups and downs. But staying with it and staying consistent will help you get through it. Not avoiding the pain but feeling it and working through it with compassion. It may be about giving more time to yourself, such as needing more time to wind down after a social event. It is important to create that space for yourself to recharge and not overload yourself.
Engaging with your community
Seeing other people going through the same things can help us find hope. Engaging with other autistic people can help you feel less alone, find hope and help you see that you are not alone with your symptoms. Finding relationships that feel good to you and with whom you can connect makes a difference. Even if it is just one person that you trust will support you in your process of understanding and healing.
6. Finding support
When reaching adulthood, many autistic women lack social support and knowledge on how to find available support. Healthcare professionals can often make you feel misunderstood. There is a risk of misdiagnosis, increasing the likelihood of feeling isolated and lonely. Unsurprisingly, you may not want to turn to medical professionals to seek support.
You may be feeling hopeless and thinking about giving up. But it’s important to know that there is support available for you. It may be starting therapy with a professional who understands you and your needs, by joining an appropriate support group, adapting your environment to your needs, or engaging in activities that you enjoy doing. Finding a therapist who understands neurodivergence can make processing your experiences a lot easier. Therefore, look for support groups that offer a comforting and inviting environment for your specific needs. Read more on what to talk about in therapy.
7. Conclusion
Autistic people desire friendships and connections as much as anyone. It is about finding value in social relationships, belonging, and feeling heard and understood. Therefore, addressing the connection between autism and loneliness is crucial to improving social and communication challenges in the autistic community. By doing so, we start to create more awareness and can find ways of supporting mental health and well-being.
A safe environment to express yourself and talk about what's on your mind and how you feel can be a great place to start. You don't have to be alone in your experience. Talking to a professional who knows about neurodiversity helps to validate your experience.
Building relationships
Positive view and acceptance of yourself
Social skills interventions
Spending time doing activities you like
Music therapy can offer a safe way to start processing your emotions and feelings through a safer outlet.
I am an English-speaking therapist in Berlin, offering autism support for adults. I see clients both online and in-person.
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
Brickhill, R., et al. (2023). Autism, thy name is man: Exploring implicit and explicit gender bias in autism perceptions. PloS one, 18(8), e0284013. https://doi.org/10.1371/journal.pone.0284013
Davis, H. (2022) ‘Autism is a way of being’: An ‘insider perspective’ on neurodiversity, music therapy and social justice’ in British Journal of Music Therapy, Vol. 36(1) 16–26.
Grace, K., et al. (2022). Loneliness in autistic adults: A systematic review. Autism, 26(8), 2117-2135. https://doi.org/10.1177/13623613221077721
Hadley, S. (2013). Dominant narratives: Complicity and the need for vigilance in the creative arts therapies. The Arts in Psychotherapy, 40(4), 373-381. https://doi.org/10.1016/j.aip.2013.05.004
Lago, C. (2011). Diversity, oppression, and society: Implications for person-centered therapists. Person-Centered & Experiential Psychotherapies, 10(4), 235–247.
Sinclair, J. (1993) ‘Don’t Mourn for Us’ in Autism Network International newsletter, Our Voice, Volume 1, Number 3.
How to Start Therapy [If You Have No Idea Where to Start]
Here’s a step-by-step process we’ve put together on how to start therapy – how to set goals for treatment, financial aspects, the referrals and directories to use, and how to meet potential therapists.
Let's face it: finding a therapist isn't always as straightforward as we hope. Navigating the options can feel simply overwhelming.
From struggling to find a therapist that specialises in your specific needs to determine if they accept your insurance, it's a wonder how anyone chooses one.
As a qualified mental health professional, I've worked with clients for over four years now, supporting people with a range of needs, from depression and anxiety to autism and ADHD.
Therefore, I've put together a step-by-step process on how to start therapy – how to set goals for treatment, financial aspects, the referrals and directories to use, and how to meet potential therapists.
Why start therapy?
You know you need therapy. This is already a major step forward toward achieving better mental well-being and quality of life. But how do you start therapy? What is the process, how do you find the right therapist, and what do you talk about in therapy?
Yes, it can all feel like a daunting process, but it is the first step in prioritising your mental health. Whether you're struggling with a specific issue or want to focus on your overall well-being, therapy can offer invaluable support and guidance. It is a place to work on understanding yourself and others, find new ways of communication, improve your relationships and overall well-being.
By the end of this guide, you'll have the tools you need to start your therapeutic journey and help guide you toward achieving better mental well-being and quality of life.
1. Your goals for therapy
You may have some goals for therapy in mind when starting therapy. These may be helpful when thinking about which approach to consider. Perhaps you've noticed:
Higher anxiety levels or tension that is interfering with your daily life;
difficulties in managing your emotions such as anger or sadness;
frequent conflicts in relationships with friends, family, or co-workers;
difficulties concentrating and decreased productivity;
sleep problems, changes in eating habits, or other physical symptoms.
These types of challenges can all be reasons to start therapy. You may be looking for support in navigating a specific situation, wanting to improve your overall well-being, or simply seeking tools and skills to get to know yourself better. Taking the time to clearly define your goals will make it easier to narrow down your search and find a therapist who can best address your unique needs.
2. What type of therapy approach?
If you are looking for short-term therapy to give you tools-based options, Cognitive Behavioural Therapy (CBT) might be a good option for you. If you're looking to understand your patterns and relationship dynamics, a more long-term therapy such as psychodynamic, psychoanalytic, and humanistic approaches may be more appropriate. To get an idea about your specific needs and preferences, take some time to dive deeper into each of these approaches. Moreover, many therapists offer an integrated approach to therapy, which might be the best option for clients. Check the therapist's approach and experience. You can always ask them for more information if anything is unclear. Find more information on different therapy approaches.
3. Insurance or private pay?
When starting therapy, think about whether you could opt for insurance-based therapy or private pay. It is always worth researching whether your health insurance provider covers psychotherapy services. To know more, get in touch with your health insurance provider to ask more about what is covered by them (there's usually more information on your provider's website). They may have some English-speaking options.
When opting for private pay, consider your realistic budget for therapy. How much can you afford to pay? Note that some therapists offer sliding scale fees (cheaper fees for lower-income clients), which you can find out more about by asking whether that's an option for them. Private pay may be a better option if you want to choose your own therapist with whom to work. It can also be a quicker option for care, and you can choose which approach resonates with you the most.
Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care.
4. Referrals from people you trust
You may also find it helpful to reach out to people you trust who have been through this process already. Perhaps they have gone through something similar and can recommend you to a specialist who was able to support them. It's useful to talk to your network; you never know the information they may have. However, be mindful that your needs may vary from the people around you, which means that the same therapist may not be suitable for everyone. Although, knowing about other people's processes can support you in your process of starting therapy.
5. Trusted online directories
Diving into the world of online directories can be overwhelming when knowing how to start therapy. Depending on where you live, there are too many specialties, too many, or too few people to choose from. Since the beginning of my career, I have developed great respect towards It's Complicated therapy platform. Through their search filter, you can make choices depending on location, price, need for support, etc. Additionally, you can find recorded videos of therapists talking a bit more about themselves, which is a great way of getting a feel for the therapist. Choosing a couple of therapists from the list may help you to get closer to the one you'd like to work with. Give yourself time to make the best option for you. However, be mindful of some low-cost online counseling services that may not use professional therapists. Check whether the potential therapists are:
Are they registered with a professional body?
Make sure any potential therapist is properly licensed and registered with appropriate professional bodies. This ensures they have the necessary training and qualifications.
What is their experience?
Look for therapists who have experience treating the specific issues you're seeking help with. Their bios should provide details on their background and areas of expertise.
Do they have the information you need on their website?
Can you find the information you needs such as the cost of a session, format of sessions, location etc. If you’re struggling to find it, reach out to them for further details to help you feel at ease before booking the first session.
Take the time to review a few options from trusted online directories. This will help you get a feel for different therapists' styles and specialties so you can make the best choice for your unique needs and preferences.
6. Meeting potential therapists
It can be helpful to prepare some questions before starting therapy to determine whether a therapist is a right fit for you. Meeting a couple of therapists before starting therapy is a common way to go. Think of them as job interviews where you can decide who you want to work with. You could ask questions like:
How long have they been in the profession?
Is it important for you to work with a professional who has been practising for a while, or would you be okay with a trainee therapist who usually offers a lower fee option?
Do they focus on your specific area of concern?
You can scroll through the therapist's website or online directory profile to gather more information on the type of support that you need.
What qualities are you looking for in a therapist?
What are the qualities that are important to you in a therapist such as their background, culture, language, age, gender. This will help you further down your search in finding a therapist who you could …
Timing of the session
Think about when would be the best time for therapy for you. Is it in the morning before starting your workday? Or before the weekend? It is important to allow yourself some time before and after the session to regulate your emotions and ground yourself before jumping into the next thing.
Therapy is a collaborative encounter, where the relationship between the client and the therapist is considered to be the most impactful part of a successful therapeutic experience. Therefore, take your time to make this important decision for yourself.
7. Making a decision
There is power in making the choice for yourself in how to start therapy and which therapist to see, depending on your unique needs and preferences. This is the first step towards healing. After reviewing your options, try to meet with a few therapists. This will hopefully make your decision a little bit easier. By meeting, you can get a better understanding of their personality, communication style, and their therapeutic approach. Pay attention to whether you feel comfortable opening up to them and if you think you could develop a strong, trusting relationship.
It can also be helpful to discuss your thoughts and feelings with trusted friends or family members. However, getting an outside perspective from a trusted professional can provide clarity and reassurance. Trust your gut instinct - if something doesn't feel quite right, allow yourself time to keep searching. By taking an active role in your healing, it can have profound and lasting benefits on your mental and physical well-being.
8. Building a connection with your therapist
Building a good connection is an essential part of therapy. Research shows the importance of alliance, empathy and expectations for therapy being key parts to change. When starting out, I recommend my clients to start with 12 weeks of consistent therapy and then to do a check-in about what works and what doesn't work for you. If after a couple of sessions you feel like it's not working, talk to your therapist about it. They may be able to refer you to someone else or suggest treatment alternatives that work for your specific circumstances. I always encourage you to communicate your thoughts and feelings to your therapist, as it leads to deeper exploration.
Conclusion
The process of starting therapy is not a straightforward one. It is about thinking about your goals for therapy, whether you're willing to put in the work and if you're able to feel supported by your therapist.
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, build resilience, 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. The decision to start therapy may not come lightly, but it is a huge step toward recovery. Show yourself some kindness in getting this far.
I offer online English and Estonian counselling in Berlin. If you have further questions or would like to go ahead and book a consultation session, I look forward to connecting with you here, or you can email me at arulacounselling@proton.me.
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. Here are some additional resources.
References
British Association for Counselling and Psychotherapy. (n.d.). Home page. https://www.bacp.co.uk/
Crits-Christoph, P., Rieger, A., Gaines, A., & Gibbons, M. B. C. (2019). Trust and respect in the patient-clinician relationship: preliminary development of a new scale. BMC psychology, 7(1), 91. https://doi.org/10.1186/s40359-019-0347-3
Finsrud, I., Nissen-Lie, H. A., Vrabel, K., Høstmælingen, A., Wampold, B. E., & Ulvenes, P. G. (2022). It's the therapist and the treatment: The structure of common therapeutic relationship factors. Psychotherapy Research, 32(2), 139–150. https://doi.org/10.1080/10503307.2021.1916640
Kottler, J. A. (2017). On Being a Therapist. Oxford University Press. https://www.psychotherapy.org.uk/seeking-therapy/how-to-choose-a-psychotherapist/
Spalter, David (2014) How clients choose their psychotherapist: influences on selecting and staying with a therapist. Other thesis, Middlesex University / Metanoia Institute. https://mirep.metanoia.ac.uk/id/eprint/287/1/DSpalter_thesis.pdf
Wikipedia contributors. (2021, July 1). Common factors theory. In Wikipedia. Retrieved May 13, 2024, from https://en.wikipedia.org/wiki/Common_factors_theory
What to Talk About in Therapy: 9 Therapist Tips
Knowing what to talk about in therapy or where to begin can be difficult, and you are not alone. This article will give you some tips and ideas about what to discuss in therapy, so you can feel at ease before your next session.
"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.
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.
Arula Counselling integrates creative, psychodynamic, mindfulness and ACT (Acceptance and Commitment Therapy) approaches with a focus on neurodiversity-affirming and trauma-informed care.
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.
Hidden Struggles: Exploring the Impact of Autism and Depression in Adult Mental Health
In this blog post, we will explore the unique challenges faced by adults with dual diagnoses of autism and depression and the importance of understanding, support, and music therapy in your journey.
As we delve into the complexities of mental health, it is important that we talk about the hidden struggles that often go unnoticed. Autism and depression are two conditions that can profoundly impact your daily life, especially when experienced together. In this blog post, we will explore the unique challenges faced by adults with dual diagnoses of autism and depression, explore the concept of autistic burnout, and the importance of understanding and support in your journey.
Understanding Autism and Depression
Autism Spectrum Condition (ASC) is a neurodevelopmental condition characterised by difficulties in social interaction, communication, and 'stimming’. Depression, however, is a mood disorder that affects an individual’s overall well-being, causing persistent sadness, loss of interest, and difficulties in managing daily activities. When these conditions coexist, they can create a complex and nuanced mental health landscape.
What is Autistic Burnout?
Depression and autistic burnout are distinct mental health experiences that share common symptoms and challenges. Depression is characterised by sadness and loss of interest, while autistic burnout is specific to those on the spectrum, caused by overwhelming environments and stress. The key difference lies in origins and triggers: depression has varied causes, while autistic burnout is linked to how individuals with autism process information. Recognising these differences is important for effective support and therapy.
The Impact on Mental Health
The impact of autism and depression on mental health cannot be underestimated. Adults with autism often face challenges in social situations, which can lead to feelings of isolation, low self-esteem, and difficulties in relationships. The presence of depression expands these struggles, intensifying feelings of hopelessness and despair. The constant effort to navigate social cues and communication can become overwhelming, contributing to increased vulnerability to mental health issues.
Hidden Struggles and Masking
For adults with autism and depression, the ability to mask your struggles becomes a survival mechanism. You may have developed coping mechanisms to hide your difficulties, masking your true needs, emotions, and internal struggles. This constant masking can be mentally exhausting and takes a toll on an already fragile mental health. It also decreases the likelihood of others recognising your challenges and offering you the necessary support.
The Power of Music Therapy
In the face of these hidden struggles, music therapy emerges as a powerful and effective tool for adults with autism and depression. Music therapy provides a safe and nonjudgmental space where you can express yourself, communicate, and connect with others. Through music, therapists can facilitate emotional expression, reduce anxiety and stress, and support you in developing coping strategies that work for you.
Research has shown that music therapy interventions can improve social interaction skills, enhance self-expression, and boost mood in individuals with autism and depression. Playing instruments, engaging in songwriting, and participating in therapeutic improvisation can foster a sense of empowerment and autonomy. The rhythmic and melodic characteristics of music also stimulate neural networks, enhancing cognitive and emotional processing.
Building a Supportive Community
Creating a supportive community is crucial in addressing the hidden struggles faced by adults with autism and depression. By fostering understanding, empathy, and acceptance, we can break down the barriers that prevent you from seeking help and feeling understood. Educating ourselves about autism and depression, promoting mental health awareness, and creating inclusive spaces are tangible actions that can make a difference.
Conclusion
The intertwining of autism and depression presents unique challenges for adults striving to maintain their mental health. Recognising and addressing these hidden struggles is crucial. Music therapy offers an invaluable avenue for self-expression, emotional release, and personal growth. By embracing the power of music and fostering a support community, we can work together to empower and uplift adults with autism and depression, ensuring you feel seen, heard, and understood in your journey towards mental well-being.
If you’re interested in exploring this further, please contact me here or via the button below. 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.
How to Set Boundaries During the Holidays
How can you start setting boundaries to have healthy relationships and keep yourself safe?
December is here and we are getting closer to the holiday period. For some of us, this can cause anxiety when having to spend time with family. It can bring up triggers that we are not used to in our daily lives. How can you start setting boundaries to have healthy relationships and keep yourself safe?
How to start setting boundaries with family?
Holidays can trigger lots of uncomfortable feelings simply because we are surrounded by family members, which can be triggering old wounds that we haven’t processed yet. However, it helps to know that we don’t have to stay stuck in our old ways of being such as when we were children. As adults, we can decide what is best for us and where we want to put our energy on. But where to start? Below, I have mentioned 5 ways you can start setting boundaries with your family.
Only say yes to events you actually want to attend
You don’t need to attend every event you have been invited to. Know what is best for you and honour yourself. If you know that you are going to be surrounded by people that don’t lift you up or the thought of going to these events drains you, then choose to say no, however difficult that might be.
Don’t tolerate comments about your body or food
Please don’t tolerate comments about your eating habits or the way your body looks. You can politely say that you would rather not talk about these topics or that you don’t feel comfortable discussing these. You can even say, ‘Please don’t comment on the way my body looks or comment on what I eat’. This can be uncomfortable to start with but will be worth the effort.
You can walk away from stressful situations
If something is triggering you, notice how you feel. Know that you don’t have to stay in these situations that cause you overwhelm. If the other person keeps breaking your boundaries then you can choose to walk away with grace. It is okay to leave the situation to keep yourself safe without giving explanations. You can decide whether to engage or not. Ask yourself, ‘Is it worth my energy or not?’
Take breaks during and between holiday events
You can take time off by going for a walk or having a couple of deeper breaths to connect with yourself and come back to it. You have options and you can choose what is best for you. Maybe you arrive by car to the event so you can leave when you want to. Perhaps recharging by doing something that feels good to you in between the events rather than draining yourself.
Spending limits on presents
You can set boundaries with your money too, and know what you can or cannot afford, or what you want to spend your money on. You don’t have to spend money on presents that you don’t want to do. Honour that and know what is best for you.
Leaning into discomfort whilst setting boundaries
It is worth noting, that this is not possible in every culture. Please bear this is mind when starting to set boundaries and do what feels right to you. Have self-compassion whilst setting boundaries since it can be uncomfortable at first. People asking personal questions about your life, or questioning the way you are living your life. If you have a safe person in your family, you can share your feelings and thoughts with them and spend time with them if they make you feel good. You don’t have to stay stuck in conversations that you don’t feel comfortable with, be it about body image or politics.
Take-aways
do what feels right to you
be kind to yourself whilst setting new boundaries
if you have a safe person in your family, choose to spend more time with them
If you’d like to have further support, please contact me via the button below.
How Many Therapy Sessions Do I Need?
This article explores the reasons you may come to therapy, the therapy process and the road to recovery.
This article explores why you may come to treatment, the therapy process and the road to recovery. We discuss what to think about when considering the number of therapy sessions you’d need. Let’s dive in.
What brings you to therapy?
Think about what brings you to therapy and what you need help with. During an initial consultation call, a therapist offers you a safe and non-judgmental space to explore what led you to contact them in the first place. The therapist will help you gain clarity and think about the support you may need. Think about:
is it a specific issue you would like to solve?
has there been something on your mind for a while, and you feel like you need to talk to someone?
Whatever it is, being open with your therapist during the consultation call can help you find the direction you need. Equally, the therapist helps to think about whether you need short-term (6-12 sessions) or long-term therapy. Usually, the first four sessions help determine whether you’d be a match and whether a particular type of therapy fits your needs.
The road to recovery
Therapy is not a linear process. It can be up and down, back and forth. You can feel energised and like you’ve made a lot of progress on some days. On others, you may be feeling anxious and overwhelmed, a sense of having lost direction. And that’s okay. It doesn’t mean that you have fallen behind on your progress or that the steps you have taken are suddenly lost. You don’t need to fix your emotions. Instead, it’s about feeling them and letting go of them. It is part of the process. What matters is that you show up to the sessions and you show up for yourself. You don’t need to have it all figured out. We can figure it out together.
Setting goals for therapy
With your therapist, you can set goals for therapy and assess these throughout the process. You may have come to treatment with one particular issue or question. However, during the process, it may be that something else has come up that you’d need to process and dive deeper. However, having goals in mind can help you keep track of your process. You can always come back to them and reflect on these during the sessions, where necessary.
Checking in with your therapist
Your goals can change throughout the therapy process. If you feel like you have accomplished your initial goals or lack direction, check in with your therapist. It is a collaborative partnership, and your therapist is open to feedback. We are human, too, and we don’t always know whether what we focus on in the session is your most pressing issue. Giving feedback is important, helps to track progress, and strengthens the relationship between you two.
How do I know I’ve made progress?
We will inevitably face life problems, but we don’t suffer because of them. We suffer when we get stuck on the same problem repeatedly. Here are some of the ways progress can show up:
improvement in your relationships
a change in your thought patterns
change in dealing with challenges
being more open in communication
practising self-compassion
saying no
taking time for yourself
nourishing your body
scheduling in exercise
asking for help
Ending therapy
You and your therapist may talk about ending therapy when you both feel like sufficient growth has happened. You feel more content in your daily life and can manage difficulties better. You can apply what you’ve learnt in therapy to life outside the sessions. You can then set an end date and work towards it together. You can also start seeing your therapist fortnightly to reduce the support you need and eventually end therapy.
However, ending therapy doesn’t mean that you can’t contact your therapist again. We will always be happy to offer you check-in sessions if you feel in need. Equally, it doesn’t mean that you haven’t grown, but it is about giving and allowing space and time for yourself and check-in in with yourself from time to time.
How many therapy sessions do I need?
Therefore, the length of therapy depends on many factors. It is about the process rather than finding a quick fix or solution to your problem, understanding yourself and giving yourself time to look deeper.
I am an English-speaking therapist in Berlin, offering online and in-person counselling. Contact me to schedule a consultation call if you are considering starting therapy. If you have more questions about treatment and the length of therapy, 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.
Do I Need to Have a Mental Health Issue to Use Therapy?
What are the misconceptions about mental health support, who can benefit from therapy and how to know whether therapy is for you?
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.
The Artist's Frame: Let’s Talk about Boundaries
Let’s discuss how to start setting boundaries and define what the word itself actually means.
Boundaries are important for healthy communication and relationships with yourself and others. It is about not carrying others' emotions for them and getting clear on your needs. We can think about boundaries as an artist's frame where we can control only what's on the inside of the frame and how we communicate that to others. Everything else remains outside of us and our control. Before we get into how to start setting boundaries, let's define the word 'boundaries'.
What are boundaries?
Boundaries can either be physical or interpersonal. These can look different for everybody, depending on culture, the relationships we are involved in, and social context. What is comfortable and natural in one culture doesn't necessarily translate into another. Equally, some people are naturally more comfortable hugging, whereas others may need more space. It is also necessary to consider the social context. Boundaries in relationships with our partners or families may look different from professional ones. Therefore, boundaries are flexible and fluid and can look different for everyone, depending on culture, personality and social context.
How to start setting your boundaries?
If you are not used to setting your boundaries and speaking your needs, it can take time to get used to. But like with everything else, the more you practice, the easier it gets. It is important to show compassion to yourself during the process if it doesn't come naturally to you. Consistency is key. Let's dive into some examples of boundary setting:
Self-awareness
Being aware of your needs, what you feel comfortable with, and what not is essential so you can start taking the following steps. Notice how you feel after spending time with people? Do you feel energised or depleted? Is that feeling the same with everyone, or does it differ? Suppose we feel exhausted after spending time with some people. In that case, we may have weak boundaries in certain relationships or with ourselves. These can look different, depending on the relationship we are in. Therefore, be mindful of your thoughts, emotions and feelings since it helps to understand what you might need to feel better.
How do you want to feel when setting a boundary?
Think about how you want to feel when interacting with others. Stay true to yourself and be honest with yourself. Starting to set boundaries can often leave us feeling bad and guilty about ourselves. Know that it won't stay like this forever. It's also worth saying that not everything other people say to us is true. Notice that the next time you are spending time with others. Is this something that resonates with you and you know is true, or does it come from their beliefs? Give this time because this clarity may not come overnight. Keep practising this skill and getting to know yourself throughout the process.
Learning to say no
The ability to say no is easier said than done. It might feel scary to say no to someone at first. It may bring up discomfort since it's not something we are used to. As a child, it wasn't safe for you to express your needs. It might've been seen as a weakness rather than a strength which led you to say yes more times than you would've liked to. As adults, we have control over how we respond to situations we didn't have when we were children. It is about learning to say no with warmth and kindness. If others do not respect these boundaries, it can tell us more about the other person. We can then address this with them.
Moreover, there is no need to explain to the other person why you set a boundary or apologise for establishing one. For example:
'I'd be willing to help you with this task, but not today.'
'I won't be able to make it today. Can we reschedule it for another day?'
Expressing your true feelings
Expressing your feelings openly and respectfully can be daunting, but it comes with practice and is hugely valuable. Being open about what you are or are not comfortable with—being aware of your needs and staying grounded rather than being triggered to a particular situation. If you get triggered, notice that and remove yourself from the situation to keep yourself safe. You always have options.
It is not bad or selfish to express your feelings openly. Sometimes, we are not used to it due to our childhood, where expressing our feelings may not have been allowed.
Being vulnerable can bring discomfort if you are not used to speaking your needs. Don't worry. This is natural and will get easier the more you practice.
Talking about your experiences honestly (in safe spaces).
Addressing problems and conflicts directly with the person involved rather than indirectly with a third person involved.
Talk about your expectations and needs rather than letting other people try to figure out what you need. Unfortunately, we don't read each other's minds and often can only make assumptions about the other person's thoughts. It is worth addressing this directly with another person, however difficult that may be.
Setting emotional boundaries
Emotional boundaries help us feel empowered and to know what we can and cannot take. For example, not setting emotional boundaries within family relationships or a partnership can leave us feeling drained, exhausted, guilty, or resentful. However, having clear boundaries is for the benefit of you and the others involved. Starting:
Think about which boundary you would like to set.
Communicate that to the other.
Don't over-explain yourself.
Why is that boundary necessary for you?
You may feel guilty or selfish when first starting to set boundaries. Notice how you are feeling when you start communicating your needs. Are you saying what you're feeling? Is the other person listening to you? You can bring these feelings into therapy, where we can dive deeper into why you may feel that way.
Final thoughts
Boundaries are like a muscle. They require practice and consistency for us to figure out how to communicate more effectively with those closest to us, as well as in professional relationships. Try not to give up after your first try when it doesn't go as expected. Equally, don't forget to respect other people's boundaries throughout the process when interacting with those close to you, be it in family or professional relationships.
If you feel like you are ready to start therapy, or want to know more about how I work, schedule a consultation call with me below or contact me at arulacounselling@proton.me. I look forward to hearing your thoughts.
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.
How Trauma Affects Our Bodies
How does trauma show up in our bodies and how can we start to heal ourselves, create change and get better?
How does trauma show up in our bodies and how can we start to heal ourselves, create change and get better? Can our bodies really tell what is going on? How can we start paying attention to it?
What is trauma?
Trauma is not something that happened to us, it is what happened in us after we experienced it. A complex childhood environment, neglect, moving countries frequently as a child, abuse, broken relationships, and bullying can all leave us with long-lasting effects. Trauma can show up through physical pain, feeling disconnected, not finding joy in what used to lift you up or having intrusive memories that disrupt your daily life.
Understanding the impact of trauma
Traumatic experiences can leave us feeling overwhelmed, dissociated from ourselves and others, feeling sad, anxious, numb, agitated, or confused. Trauma shows up different in all of us, depending on our environment and circumstances, depending on social structures, race, gender and sexuality. Hence, there is no straight-cut answer to who gets traumatised and who does not and wounds can run deeper than we think.
Can trauma be stored in our bodies?
Trauma can show up as an intolerable felt sense such as psychosomatic pain from emotional and mental stress. It may be a tightness in your chest, neck, or back without any seaming reason. In therapy, we can start to work with these sensations and get curious about why that may be. What are our bodies trying to communicate to us? Hence, relieving the nervous system from hyper-arousal such as feeling anxious or overwhelmed or hypo-arousal, like dissociation, numbness, feeling unmotivated or stuck is vital for our emotional regulation and well-being.
Working with trauma
When we work with trauma on a pre-verbal level, we can start to unlock our painful experiences. Getting curious about our felt senses through breathing, movement and non-verbal expression. Gabor Maté has said that artistic expression itself is not a form of working through trauma. However, working through trauma in a relationship with the other such as in a therapeutic relationship is invaluable in creating change. Someone who can hold space for your thoughts and emotions, be it artistic expression or through words, has a different kind of value. Someone who is there to receive and reflect back on what might be going on for you. For people who have grown up in stressful households since early childhood, the absence of stress can create a sense of unease, boredom and meaninglessness. People may become addicted to their stress hormones, adrenaline and cortisol (Maté, 2003). Therefore, creating new neural pathways and ways of thinking, re-directing you from your old beliefs has immense value. How can we start to create awareness of our bodies and create change?
1. Checking in with yourself:
Use this five-point check-in when you are feeling overwhelmed, anxious, or disconnected:
Mind - notice your thoughts and mental focus
Breath - are you restricting or holding your breath?
Body - notice your body's sensations
Emotions - what about feelings and associations?
Energy - do you feel fatigued or energised?
Emotional regulation plays a big part in how we connect to ourselves. For some clients, breathing can be a great anchor. For some, singing or vocal sounds are the most comfortable in grounding themselves. You can use this check-in throughout the day to notice where your mind and body are—checking in with yourself and your feelings.
2. Finding your community
Having a support network around you who can support you and understand your experiences is good for our well-being and a part of taking the step towards healing. Winnicott has said that there is no such things as a baby, but that we are all related to one another, dependant on one another and we all deserve to have that care and supporting environment.
When living in a city different from where you grew up, the language may be different, the culture may be unfamiliar and you are in an unfamiliar environment. In this case, having a solid support network around you is important. Finding community and the people that support you through your difficult experiences, who can be there for you and understand your experiences.
3. Noticing your environment:
Do you feel safe in your surroundings?
Do you feel supported by others?
Do you have people around you who you can turn to in times of difficulty?
How do you feel when you're around them?
Do they lift you up?
It's okay if you answered 'no' to these questions. The purpose is to just notice where you are and how you feel in your environment. There is no judgment. From this place, we can start to make slow changes. Maybe it is about coming to therapy and finding a safe place there. Perhaps it is about going to nature and finding your safe place there for a start or deciding to make changes about the relationships with people who make you feel good. Meditation and visualisation exercises can also create these places in our minds.
4. Working with the body
Working with the body grounds from our thoughts that may be overwhelming and triggering. Observing your breath and how the body moves and feels through movement, art-making, or music creates awareness. Through these mediums, we can slowly return to our bodies, building connections and starting to feel and see ourselves as a whole. Being more present, mindful, grounded in making decisions, and connecting with others. We don't always have to know what happened to us, but our bodies know. It stays with us. This means that we can change its course. We can take action and responsibility towards healing. We can start to learn about ourselves and show compassion towards ourselves.
Trauma is complex, challenging and a long-term process. And it is even more difficult to be alone in it. But working together with a therapist treating trauma can support healing and understanding yourself. You shouldn’t have to go through it alone. I look forward to connecting with you to discuss your needs and whether I could be of support to you. I am an English-speaking therapist in Berlin, offering online and in-person counselling for adults. You can contact me here or email me at arulacounselling@proton.me.
Disclaimer: If you live in an abusive household, you can find your closest counselling centre in Berlin here. If you are thinking of hurting yourself or others, please call 112, where professional mental health workers can help you.
References
Maté, G. (2003) When the Body Says No: The Cost of Hidden Stress. Penguin Random House.
Siegel, D. (1999) The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Publications.
Winnicott, D. W. (1960) The theory of the parent-infant relationship. The International journal of psycho-analysis, 41, 585–595.