English Speaking Therapist | Forward Therapy Stockholm

Tag: Anxiety

  • How to Expose Covert Abuse, Coercive Control and Gaslighting

    How to Expose Covert Abuse, Coercive Control and Gaslighting

    The red-flags for covert abuse, coercive control and gaslighting in a toxic relationship usually take time to notice. We enter into coupledom in a state of vulnerability, with an open heart, and assuming our partner has the best intentions. When things go wrong, we might blame ourselves or start thinking we are unwell. Then we notice the warning signs in the form of patterns of dominating conduct. Becoming aware of manipulation and controlling behaviour in intimate relationships is the first step in managing and ultimately refusing it. Recovering and healing from the psychological harm inflicted by an abusive ex-partner can be better helped by counselling and other professional support.

    Manipulation through Deception and Abuse Erodes Self-Worth

    As an online therapist for English-speaking expats in Sweden and around the world, I work with many individuals struggling with coercive control and gaslighting. Sometimes clients contact me for couples therapy when they are actually looking for a referee or help in escaping the relationship. Often, in their initial emails, my counselling clients outline problematic behaviour by their spouse, sambo or lover that is clearly inconsistent with the signs of a healthy relationship. I’m referring here to the trust, respectful communication, mutual support, shared decision making and commitment to each other’s growth. Most of us are seeking those when we start sharing a life with someone.

    Examples of controlling behaviour in relationships are abundant. Gaslighting, for example, is a specific type of manipulation that leads a person to self-doubt. It could be via outright deception or ‘crazy-making’ (pathologising). I often hear stories from people who arrive in Sweden from to start a new life only to find themselves pseudo-diagnosed by their partner as depressed, anxious, ‘bipolar’, obsessive compulsive disorder, or ‘ADHD’ or as suffering from borderline personality disorder. The effect on my English speaking clients is to undermine their sense of self and distort their reality. They feel sick, wrong or broken. Covert abuse, consistent coercive control and gaslighting can make a person mentally ill.

    Covert abuse, consistent coercive control and gaslighting can make a person mentally ill.

    Self-Worth and the Adjustment to Swedish Culture

    In other cases the controlling behaviour is more subtle. It might include prioritising friends or family over a partner, consistently making unilateral decisions or demanding particular outcomes without any offers or negotiation (also known as ‘my way or the highway’). Some clients are repeatedly infantilised. Their partners are not prepared to accommodate the time it might take a new immigrant to adjust to Swedish culture. In some cases my clients are being ‘abandoned with care’: made important but worthless at the same time through the provision of limited financial support but a disregard for emotional needs. These are all situations that result in an erosion of self-worth.

    What to do when your partner refuses to attend couples counselling

    More obvious abusive relationships involve the denial of autonomy, or monitoring and surveillance of activity. Name-calling, mockery, put downs and other forms of bullying are further examples. Threatening harm to pets, or children, or even violence to the person themselves might be accompanied by a suggestion that the victim would somehow be responsible for the abuser’s behaviour. These are clear signs of abuse that will have a person living in fear. The turning point for my talk therapy clients in Sweden is often the realisation that they can choose not to live in fear and that everyone has a right to an intimate relationship free of dread, coercive control and gaslighting, even when socially isolated in an unfamiliar country.

    Book online for a Skype, Zoom or phone consultation

    Vulnerability to Coercive Control and Gaslighting for Expats in Sweden

    Abusive and controlling behaviour in expat relationships arises in combination with a number of factors. Moving to a new country can be stressful and the person immigrating often leans into their partner for more support in the initial months and years. There are sometimes massive Swedish cultural differences not always apparent when first arriving. Language and communication difficulties can erode a person’s confidence and lead to further reliance on the native partner. Social isolation and financial dependence can play a part in ceding to a domineering spouse or lover. When one partner starts disregarding or disrespecting the other, it often leads to loneliness within the relationship.

    But these instances don’t explain every situation. What about so called Third Culture Kids (TCKs), adults who spend a good deal of their childhood moving countries with their parents? I assist many TCKs via webcam therapy sessions from Sweden other countries. They also often report symptoms of toxic relationships despite often being adept at adjusting to new countries and cultures and having advanced language skills. So what might be happening for TCKs?

    Third Culture Kids (TCKs) often report symptoms of toxic relationships despite often being adept at adjusting to new countries and cultures.

    The acceptance and tolerance of controlling behaviour often relates back to past relationships. It can evolve due to or childhood experiences or religious trauma. Often my clients realise they have a pattern of abusive relationships that defy transnational migration and transcultural relocation. Interpersonal conflicts re-emerge. The emotional support yearned for is distinctly absent. The awakening to a relationship as controlling is a shock. But moving to a new country represents a new start, a way of leaving a difficult or shameful past behind. Unfortunately it can also mean a replication of the enmeshment or co-dependence that occurred in the family of origin or church along with similar abandonment, isolation, loneliness, and neglect.

    Toxic Relationships: A Pattern from Childhood and Family

    We are usually drawn to people who offer the promise of a missing experience, something we seek in childhood but never receive. Yet the person who attracts us can also be somewhat familiar. Ever heard the expression ‘They married their mother / father’? For those with backgrounds of neglect, abuse or abandonment, where a parent is distant, absent, critical or authoritarian, it can be easy to slip into yet another unsatisfactory and abusive relationship. But if you start to recognise a pattern in your relationships, that they are abusive or mirror somewhat the relationship you had with a parent, it’s important not to give yourself a hard time. Now you can use self-compassion.

    Some clients report a kind of low mood that persists since childhood. They manage go about their lives, appearing somewhat functional, but never feel particularly happy for long. The trauma therapist and Licensed Independent Clinical Social Worker (LICSW) Patrick Teahan refers to this as Refrigerator Buzz Depression. You live with it for so long that it becomes background noise. Processing childhood trauma, and awakening to how bad it is, are integral to recovery but can initially inflame mood disturbances. At the same time, changing one’s life by moving to a new country like Sweden can also bring the realisation that you no longer have to put up with the sadness you have lived with for so long.

    Moving to a new country like Sweden can bring the realisation that you no longer have to put up with the sadness you have lived with for so long.

    Treatment, Healing and Recovery from Coercive Control and Gaslighting in Relationships

    Finding your way out of a controlling relationship involves awareness, accessing support and taking practical action. But it also means trusting yourself. We evolve with emotions for good reason. Noticing your anger, shame, fear or sadness is part of realising that something is wrong. Developing a kinder and less critical relationship with yourself can be the key to accessing a way out.

    The isolation of being in a foreign country like Sweden can cause confusion. If you are struggling to understand how to cope in your relationship, an individual consultation might be better help than couples counselling. For a relationship beyond repair, couples therapy can only involve supporting the relationship to end. An individual session might reveal you have been over-tolerating bad behaviour. You could be in a state of self-blame or toxic shame. You may find it difficult to navigate relationships and deal with coercive control and gaslighting. Getting good with yourself through the encouragement of an English speaking therapist can assist you to manage emotions and develop a course of action. If you are in danger, go to the police.

    Therapy for Managing Controlling Relationships

    Therapy for those experiencing manipulation by their intimate partners can involve:

    • Stress management techniques;
    • Problem solving around boundaries, risk and managing safety;
    • Psychoeducation to understand the signs of coercive control and gaslighting and other forms of covert abuse;
    • Strategies for de-escalating, responding to and eliminating abusive behaviour;
    • Development of a plan around financial independence and social and emotional support;
    • Grief counselling, particularly around the sense of betrayal and emotions that accompany separation.

    Good talk therapy is not simply about venting or offloading your feelings. Being able to talk and be heard are important but an experienced therapist will not only listen, they will assist you to develop your self-agency or your capacity to change your circumstances. They will encourage and support you to take action and reach a turning point. This might involve practising self-compassion, assertiveness or prioritising new habits over fast gratification. In any case, a willingness to take new steps is part of recovery. Even the best psychologist in Stockholm will not be influential if you are not willing to do something yourself about the situation.

    Identifying, dealing with and recovering from a relationship involving coercive control and gaslighting can take time. This is particularly true for those who find themselves isolated in toxic partnerships that resonate with abusive childhood experiences. In the beginning, it can feel overwhelming. But with the right support, it is possible to change your circumstances and recover both a sense of safety and a nurturing relationship with yourself.

    Make an appointment now for therapy online with Ash Rehn

  • How to Reduce Rumination and Stress by Doing More and Thinking Less

    How to Reduce Rumination and Stress by Doing More and Thinking Less

    Ruminating. Catastrophising. Panicking. All describe the breakdown of logical reasoning that happens when we are in such a state of anxiety that our thinking is paralysed. So how is it possible to stop going over and over a source of worry? The answer to reduce rumination isn’t more thinking, it’s more doing.

    Why Can’t I Stop Thinking and Switch Off My Brain?

    The coronavirus has most of the world on edge. It’s limiting our possibilities for movement and making our lives even less predictable challenging us to manage our mental health. And in the social distancing of these new conditions, some find themselves alone and obsessively thinking about the same things over and over, causing them to feel physically sick with worry or having a panic attack. My English speaking clients in this situation plead with me, How can I change my thoughts?

    But the key lies not in changing thoughts but changing activities. When a person’s physical stress response is so high, the logical reasoning part of the brain fails and the survival part of the brain kicks in. This is the legacy of our evolution, an animal instinct to withdraw, like crawling back into a shell for protection. Unfortunately when humans withdraw they stop participating in activities that benefit them such as engaging with others and physical movement.

    Those of us who have been conditioned by work that uses our brains in preference to our whole bodies try to think-through and problem-solve unpleasant feelings instead of addressing them directly through physical means. But the best way to lower the acute stress response is to get physical and use more of the whole body, not just that little part of the brain behind the forehead that is responsible for cognition (thinking, judging and problem solving).

    Book a real time coaching or counselling session for support

    How to Escape the Isolation Chamber and Reduce Rumination

    Ruminating on a problem without the benefit of more information or a different perspective is akin to trying to make a decision from inside an isolation chamber: we have to get out and experience the world through the senses. The way to reduce rumination and ‘catastrophising’ isn’t more thinking, it’s more doing. And specifically doing activities that engage the senses. Not only will doing something physical help you to relax, it will loosen up your thinking and help you gain perspective.

    Exercise is the obvious first go-to. I don’t recommend high-intensity exercise for stress reduction because it can spike the sympathetic nervous system that is responsible for elevating the body’s stress response. But moderate intensity exercise such as brisk walking, light jogging, kicking a ball around, moderate swimming or dancing can help a person to get out of their head and into the body. These activities will help relax the muscles, releasing physical tension. Even in the middle of winter, many Swedes will go out and walk in the brightest part of the day because they know that moving the body and experiencing the world through different senses is key to lowering the stress response.

    The other activities that work well for reducing the stress response are anything that involves hand and eye co-ordination or acts of companionship. Research has indicated that activities involving hand and eye coordination actually repair neural pathways. Sharing time with friends who are experiencing a lower stress response can actually reduce your own anxiety. So what does this look like in practical terms?

    Strategies to Treat Acute Stress Response

    I’m aware that those who have recently moved to Sweden or other foreign countries do not always have much living space or many friends. So hobbies like car restoration, carpentry or bee-keeping might not be possible. Here are some suggestions for activities that don’t require a lot of space or capital outlay and that you can do alone…

    The 5 Fundamentals of Stress Reduction

    Creative activities that engage the hands and eyes will help you relax and also assist with anxiety and depression. For example: painting, drawing, photography, jewelry making, building things with Lego or completing jigsaws, podcasting, making Youtube videos or creative writing. Hobbies like video-gaming, geocaching, collecting antiques, coins, toys or memorabilia, playing chess (even against a computer), learning to program, code or make apps, sewing, knitting, making clothes, cooking, genealogy, learning and playing a musical instrument or learning a language could also take your mind off your worries and reduce rumination. If you only have your work or relationship to think about, is it any surprise that your mind has nowhere else to go?

    Then there are relaxation treatments such as getting a massage, enjoying a floatation tank, playing with pets (your own or someone else’s), walking in nature, colouring-in books or watching comedy videos on a streaming service. Chilling out is a great way to lower stress response.

    And thirdly the companionship of spending time with friends and reaching out to someone you love like a son or daughter or cousin or long-term friend, even if they are in another country, can lead you to feel better. Physically or virtually not being alone is beneficial and it’s amazing how showing interest in someone else can assist you to get out of your head. Try it!

    Creative activities like cooking or playing with Lego can lower stress response, reduce rumination and make you feel stronger and more relaxed.

    Finally, if you are so stressed up that you are unable to exercise or get into a hobby or reach out to a friend or family member, consider consultating a doctor at the Vårdcentral about medication to assist in the first instance. Some people self-medicate with alcohol or recreational drugs but it is better to get professional support to assist you until you are able to take more steps on your own. Any form of medication is only a short-term fix and does not address the cause of anxiety. The use of prescription medication needs to be monitored by a medically qualified person.

    If, after lowering your stress response, you still need to reduce rumination, you can talk to a professional therapist who can guide you through problem-solving strategies.

    To make an appointment for coaching, advice, support or therapy, please contact me.

  • Keep Your Head: Managing Mental Health During Coronavirus in Sweden

    Keep Your Head: Managing Mental Health During Coronavirus in Sweden

    Mental Health has become a buzzword expression around the world since the COVID19 pandemic began. When regulations and public health advice keeps us socially distant, how can go about managing mental health during Coronavirus to keep it together?

    The coronavirus COVID-19 is a source of stress for many English speakers in Sweden. While health authorities in the UK, Australia and San Francisco enact policies such as of ‘lock-down’, containment, quarantine and ‘shelter-in-place’, the Swedish government proceeds with a business-as-usual approach, emphasising personal freedom and relying on the Swedish culture of collective responsibility. Expats and other English speakers immigrants in Stockholm, Gothenburg and Malmo are understandably worried. When your adopted country follows a policy dramatically different to most others and at odds with many scientists it makes sense that you might feel vulnerable.

    Request a counselling appointment over video or phone

    If you are alone, confused and unsure what to do, the first thing is to focus on what is within your control and let go of what isn’t. That’s part of what I call ‘keeping your head’. Everybody has the capacity to lower their own stress response, although knowing this isn’t enough. We start by becoming aware of what is going on in the body and then act to change how we feel. That takes practice but it is your first step in managing mental health during Coronavirus.

    Symptoms of Coronavirus Pandemic Stress

    Both irritability and withdrawal from contact with others are common signs of acute stress and declining mental health. These parallel the ‘fight or flight’ response that has evolved to protect us. You might be experiencing one or the other or both. The usual symptoms of anxiety and depression – difficulties with concentration or memory, restlessness, panic, a sense of hopelessness or doom, sadness and feelings of worthlessness – might also be present. If you take the time, you will notice their corresponding sensations.

    Take a few moments now to sit in silence and notice what is happening in your body. Where do you feel tension? How busy are your thoughts? What sensations do you feel when you pay attention to your breath or your heartbeat? Try this 3 minute STOP technique to ground to the present moment and recover your awareness.

    Forgetfulness, trouble focusing and an inability to solve problems or know what to do are signs that anxiety has affected your cognition. The Acute Stress Response (also known as ‘Fight or Flight’) has another manifestation: Freeze. This is the kind of paralysis of both thought and action we might experience when a stressor starts to shut down cognitive functioning. To the body, it’s the same phenomenon as an animal might experience when suddenly confronted, like a deer that freezes at the realisation it has been seen or the ‘rabbit-in-the-headlights’ response of a beast on a road at night. When a stressor becomes overwhelming, our capacity to reason and use logic drops away and our animal self reacts in self-protection.

    The Importance of Self Care and Managing Mental Health during Coronavirus

    I work with expats and English speakers around the world and have noticed the impact to mental health is similar whether the person is in Birmingham, Bahrain or Beijing. People are on edge with the ongoing changes to public health ‘rules’ as well as the uncertainty about the virus itself. Many are WTF (working from home), whether by choice or obligation, and this is putting pressure on relationships and disrupting well-being routines that were taken for granted. Even those in the ‘open’ cities of Sweden – Stockholm, Gothenburg, Malmo, Uppsala – are struggling emotionally and physically. As much as the government campaigns might try to convince us otherwise, the coronavirus pandemic and ‘social distancing’ divides us, it doesn’t bring us together. We have to work at staying connected, while managing mental health during Coronavirus, and that takes energy.

    The 5 Fundamentals of Well-Being are:

    1. Adequate sleep;
    2. Regular, nutritious meals;
    3. Regular exercise;
    4. A balance between work, rest and play;
    5. The opportunity to talk about problems.

    How many of those can you tick off? Checking in with yourself is just as, if not more, important as connecting with others. To know what you need from others, you first need to have good contact with yourself. If you have noticed things don’t feel right, take some time to listen to your sensations and see if you recognise your emotional state. You might like to try one of these self-compassion exercises. Your body can guide you to what is important right now. Listening to your body is the first step to keeping your head. And if you are struggling with knowing what you need, a conversation with a supportive professional can help.

    To make an appointment or find out more about my services, contact me.

  • Emotional Self Help Books for Expats and English Speakers in Sweden

    Emotional Self Help Books for Expats and English Speakers in Sweden

    I need help with Anger Management / Distraction / ADD / Overwhelming Emotions…(strike out what does not apply) …can you recommend any self help books for expats to read? 

    Clients are often asking me for book recommendations. While self help books for expats aren’t the same as therapy or coaching sessions, they have their place and can sometimes be useful if reading is your thing. If you aren’t quite ready to attend counselling or want to try some things for yourself first, take a look at the categories below and try some of these titles. That’s also an inexpensive alternative. But don’t leave it too late to ask for human help. Often it is easier to recover when frustration or other emotions are not so overwhelming.

    Here I’ve collected a few of the titles I’ve found to be useful and effective for dealing with anger, distraction, anxiety and out-of-control emotions. Some of these self help books for expats were recommended to me by English-speakers who have come to live in Sweden. Others I discovered myself in the course of professional development.

    (Commissions may be earned on purchases of linked products)

    Anxiety, Concentration, ADD and Mindlessness

    Researching your condition on the Internet can hazardous! On many occasions I’ve been contacted by expats or other English-speakers who, after surfing around the net, fear they have ‘Adult ADD‘ (aka Attention Deficit Disorder). They talk of being easily distracted, having difficulty staying on task or constant forgetfulness. But neither ADD nor ADHD suddenly begin in adulthood. Unless you had serious problems with your schooling as a child, it’s more likely you are suffering from something associated with anxious states of mind or you just need to tone up your mindfulness.

    Books for Improving Concentration and Attention (especially if you are worried about ADD or ADHD)

    Your Brain at Work by David Rock can assist to understand how the brain works with respect to distraction and frustration

    Your Brain at Work: Strategies for Overcoming Distraction, Regaining Focus, and Working Smarter All Day Long by David Rock.

    This book provides, in simple terms, an in depth understanding of how the brain works and how to optimize use of your brain. Rock also discusses how and why the brain gets overwhelmed. If you are interested in getting a scientific understanding that can help you get back in control of your brain, this book could be helpful to you.


    We live in a world with ever increasing distractions thanks to the Internet and technological revolution it has brought. This is no less true in Sweden than elsewhere. Modern communication seems to demand we are more accessible. Increasingly we find our attention divided between tasks. Rock exposes the effect of these demands on the brain. This is cognitive neuroscience, fairly detailed stuff, but explained in conjunction with practical tips.

    Regaining Focus and Balance through the Strategy of Mindfulness

    The Mindful Path to Self-Compassion by Christopher Germer contains mindfulness strategies to assist with emotional self help regulation

    The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions by Christopher Germer.

    Many of us are in jobs that require us to use our intellect all day long. For some, the best way to tackle an overwhelmed mind is not by using our intellect to understand the science of the brain but to live more in the present. That starts with being kind to ourselves and also means listening to the body and allowing it to tell us what it is experiencing and what it needs. When we spend most of the day in our heads, we can lose touch with the rest of our body. Mindfulness involves strategies that can be learned. This book will assist you get back to the present and find a new balance.

    Germer’s book is an easier read than Rock’s, and his approach is different. It’s less about understanding neuroscience and more about connecting with and awareness of sensations and emotions. If you see yourself more as a ‘feeling’ type of person than a ‘thinking’ type of person, this is probably the better book for you.

    The Chimp Paradox by Dr Steve Peters is a self help book for expats for coaching to deal with emotions

    The Chimp Paradox: The Mind Management Programme for Confidence, Success and Happiness by Dr Steve Peters.

    The Chimp Paradox is really about managing emotions (a product of our inner ‘chimp’) and using reasoning (our ‘human’ quality). Peters is a psychiatrist who specialises in sports performance and he is concerned with helping people to understand and manage their emotions and thoughts. This is quite a quirky book that lies somewhere between the drier science of Your Brain at Work and the warm, feel-good The Mindful-Path. Peters teaching skills are clear: the book is full of diagrams and metaphors. His models are easy to understand and fun to read.

    If you like the idea of being coached, and you are ready to take up a new perspective on your performance, The Chimp Paradox might be one of the best self help books for expats. It has been described as a ‘mind programme’, so be prepared to start reprogramming the way you respond to your emotions!

    Self Help Books for Expats for Developing Calmness and Responding to Anger

    Wildmind by Bodhipaksa is a good book for anger management and step by step guide to meditation

    Wildmind: A Step by Step Guide to Meditation by Bodhipaksa

    People often ask me if I do ‘Anger Management’. Well the first step in managing Anger is awareness of it and the emotions which precede it. Meditation provides one of the best ways to develop awareness of emotions. Despite what some people say, anyone can learn to meditate. It doesn’t involve ‘blocking out thoughts’ as such but the practice of focussing. If you are willing to try focussing according to a set procedure, you will find that you are meditating.

    I’ve had the pleasure and good fortune to have met Bodhipaksa (a Scotsman and veterinary science graduate formerly named Graeme Stephen) and can vouch he is a very decent chap! He has been practising meditation for over 20 years and teaching for over 10 years. This is one of the simplest and easiest to follow step-by-step guides to meditation by an excellent teacher. It will tell you how to do the fundamental practices that help develop calmness and positive mental states towards others. These are proven techniques to respond to and reduce the influence of Anger and other emotions.

    Guided Meditations for Stress Reduction is a CD by Bodhipaksa to help reduce stress response

    Guided Meditations for Stress Reduction also by Bodhipaksa

    This isn’t actually a book but a set of guided meditations on CD. There is also an audio-book version if you prefer that. So if you aren’t much into reading and prefer listening to a voice guiding you, you can use these audio tracks to help reduce your stress response.

    Our thoughts affect our bodies both in terms of the sensations we feel and the emotions we experience. And what we feel in turn affects our thoughts. This cycling can leave us in a state of hyper-arousal or acute stress response (aka ‘fight-flight-freeze’). Focussed awareness can reverse this and bring us back to the present-moment experience. If you are struggling with stress, guided meditation could be a way forward for you. Try the CD and consult myself or a meditation teacher if you continue to experience difficulties.

    CBT Self Help Books For Expats

    Change your Life with CBT by Corinne Sweet is one of the easiest to read self help books for expats suffering from anxiety

    Change Your Life with CBT by Corinne Sweet

    CBT means Cognitive Behaviour Therapy and it is ‘flavour of the month’ in Sweden right now. It’s not particularly new, having it’s roots in the 1950s and rising to prominence in the 80s and 90s, and is regarded as a ‘2nd wave’ therapy (we’ve experienced 2 more ‘waves’ since!). But psychoanalysis used to be the only talk therapy with credibility in Sweden and CBT is quite easy to justify through research evidence so more people have heard of CBT than Narrative Therapy. That’s not to say Cognitive Behaviour Therapy isn’t effective, because for many people it is. To an extent, CBT is also very favourable to self-help so there are a lot of books on the market to choose from.

    I picked up Corinne Sweet’s book a few years ago on my way back to Sweden at the bookstore at Gatwick Airport. It is basic but I think it is one of the most accessible and easy to read texts on CBT. If you are suffering from mild anxiety, ‘catastrophising’ or various negative thoughts, this is a great starter for you to find out how to reduce fear and develop more happiness.

    Think Good Feel Good by Paul Stallard is a CBT workbook for children to help promote calmness and relaxation

    Think Good – Feel Good: A Cognitive Behaviour Therapy Workbook for Children and Young People by Paul Stallard.

    I don’t work with children these days but a colleague showed me her copy of this book and I’m not surprised that it is a best-seller. There’s not much around in terms of CBT workbooks for children and this book also provides very helpful guidance to parents and clinicians. I’ve had parents contact me to ask if I will work in English with their kids. I usually send them to a child specialist because I am an adult specialist. If the CBT model interests you, I’d recommend getting a copy of this workbook, reading it yourself and then using it with your children. Sure it costs a bit more than the average book, but it is packed full of helpful activities and will provide you with an excellent grounding in CBT if you decide to see a therapist or counsellor in person. Obviously, if the difficulties are very serious or urgent, it is always best to seek help from a practitioner as soon as possible. In that case, get in touch with a ‘BUP’ (child and youth psychiatry) clinic directly or through a GP at Vårdcentalen.

    One last suggestion… This summer, get yourself an Amazon Kindle. Okay, I admit it I am biased. I am a Kindle convert! But it is so much easier than travelling with a stack of books. You can read all of these self help books for expats on Kindle plus novels or other non-fiction books as well and the latest version even works in bed with the lights out! If you don’t have one already you can buy a Kindle at this link.

    Amazon Kindle pic

    I hope to post again with some more book recommendations for inspiration, motivation and commencing a new life in Sweden. Just send me an email if you would like to be informed of new articles. I’m also available for consultations online over Skype webcam, by phone or email exchange. In the meantime, happy summer reading!

    *As an Amazon Associate, I earn from qualifying purchases.

  • Anxiety Therapy in Stockholm: Walk and Talk or Talk and Tea… You Choose!

    Anxiety Therapy in Stockholm: Walk and Talk or Talk and Tea… You Choose!

    Treatment for Anxiety is now attracting the same attention given to Depression over recent years. And it’s no wonder. Many people are unaware that Anxiety is affecting their lives and as a result become confused as to how to better approach their symptoms. Talk therapy can offer new ways of responding to Anxiety, and you don’t even have to do it sitting down!

    Expat counselling brings me into contact with a wide range of people and personalities. I meet bankers and barmen, teachers and tradies, researchers, roadies and radio journalists. Some come to Sweden for relationships, some for money and some for recognition. It isn’t easy being an immigrant in Scandinavian culture regardless of how advanced Swedish society seems to be. Relocation, cultural differences and relationships are stressors and how we respond to stress affects how well we adjust and how happy we are.

    When people come to me, they have often already researched their symptoms on the Internet and tried to diagnose themselves. So what is actually a stress response has been interpreted as ADHD, or OCD, or Depression, or Aspergers Syndrome, or Bipolar. These are the most common diagnoses people are concerned about. It is quite common for Depression to be preceded by Anxiety. However misdiagnosing yourself with the help of the Internet can mean using an ineffective treatment for the condition or falling into a sense of hopelessness. Some even come to the conclusion they have a genetic fault or biological deficiency that cannot be fixed.

    I reckon that most people have come to these understandings because we don’t hear enough about Anxiety and how we can respond more effectively to it. Hopefully that is about to change. However this brings another danger: the idea that there is a ‘quick fix’ to Anxiety. My experience is that those suffering from Anxiety are also susceptible to promises about ‘fast results’ or ‘cures’. Taking medication can sometimes help but some drugs are addictive and only worsen the problem. A promise of complete recovery can be much more appealing than the idea that we might have to work at reducing Anxiety or even learn ways to live with it.

    Click Here to Ask a Question or Make an Appointment

    How Can I Reduce Anxiety?

    Firstly, most people with Anxiety know that it can affect how their physiology works including changing the way they breathe, their heart rate and the feeling of control over their body. But not so many have learned that the reverse is true as well: you can lower physical and psychological Anxiety through consciously changing your breathing, using relaxation techniques and getting back in touch with your physical being. It is much easier to read about these methods than put them into practice. So getting the help of a therapist to try them out can make a huge difference. Let’s talk about the acute stress response of flight / fight / freeze and how important it is to drop out of that if your really want to get a handle on Anxiety.

    Mindfulness Book
    Secondly, the practice of Mindfulness. Mindfulness is about being right here, right now. Not in the fear of the future or the regret of the past, but physically present in the moment. It is about focussing attention, without judgement, in calmness and clarity. It is not new but at least 2500 years old and it has stood the test of time. Mindfulness offers you a way of observing your feelings and emotions (including Anxiety) without being pushed around by them. It is highly effective but requires work and practice. This is where the therapist or counsellor can support you by explaining the practices of Mindfulness and helping you monitor your progress. If you are interested in reading about Mindfulness and Stress reduction, I recommend A Mindfulness-Based Stress Reduction Workbook available here on Amazon.

    Thirdly you can work with your thoughts. This is why Cognitive Behaviour Therapy (CBT or KBT in Swedish) has become so popular. It can be effective but so much depends on how the therapy is undertaken, the relationship between you and the therapist and, most importantly, whether you are outside of the stress response enough for your cognitive capacities to function properly. There are other approaches to working with Thoughts as well. Deconstructing ideas and concepts and working out how the thoughts arose in the first place can be a significant aspect to talk therapy. Again it requires a degree of trust is established between you and your counsellor.

    Walking Talk Therapy

    I offer a unique approach to working with Anxiety which I call ‘Walking Talk Therapy‘. Of course, you are always welcome to take a comfortable armchair in my consultation room and chat over a cup of tea (including herbal tea), coffee or glass of water. But if you prefer to walk and talk, we can do that and get some exercise at the same time. It is generally well known that exercise helps alleviate many forms of Depression but it can also be effective for Anxiety. This is at least partly because we are using our whole body when we walk and we can work with the breath in different ways as we walk. These are the most effective means to reduce an acute stress response. It can help us to access a more relaxed sense of ourselves, feel more free and clear our thoughts so we have capacity to think differently.

    We aren’t all the same and some of us respond better to some Anxiety treatments than others. So apart from face to face appointments in my consultation room and Walking Talk Therapy, I also offer therapy for Anxiety over the Internet through Skype webcam, Instant Message and Email Exchange. So it doesn’t matter where you are in Sweden or anywhere else in the world, through web technology we can communicate and work cooperatively to reduce Anxiety and change your response to stress.

    If you are ready to make an appointment or if you want to know more about my availability and fees, contact me now and let’s make a start. There is more information about me and how I work in these pages but if you have any questions I would be happy to answer them directly.

    Did you appreciate this blog post? Please consider making a link to it from your site, tweeting it on Twitter or liking on Facebook.

    I look forward to hearing from you!

    Ash Rehn.

  • Life Coaching in English to Turn Your (Swedish) Life Around

    Life Coaching in English to Turn Your (Swedish) Life Around

    Not adjusting to life in Sweden? Worried about your mental health? Can’t concentrate and think you have ADD or ADHD? Struggling with the winter? Don’t let the darkness, Snökaos (snow chaos) or winter blues drive you to depression. Whether you choose to do it in-person or by webcam, you might just need a few sessions of life coaching to get back on track.

    Here’s how therapy and life coaching with an English speaking coach and counsellor might make a difference to life in Sweden.

    Bollplank, Sounding Board or Reflective Surface

    Talking with your partner sometimes is not enough. Sometimes we are just too close to someone to offer a different perspective and it can seem like a lot of pressure if a sambo, husband or wife is the only one to talk with. The Swedes have an expression ‘bollplank’ which in English is akin to ‘sounding board’, someone or something we can throw our thoughts against to test them out. (Literally it is a plank of wood for kicking footballs against). In my work I call it the Reflective Surface.

    There are many ways to employ a reflective surface: some people keep a journal or diary, video blog, artwork, cooking, craft… In fact any activity that combines structure and imagination with a product can provide a means to reflect your identity and ideas back to you in a positive, affirming way that supports change. A conversation can also be a reflective surface. In my office I use a whiteboard which is a literal reflective surface and sometimes I use it to hold onto the expressions or words that come up in a session. But even without the whiteboard, meeting with a coach serves the same ends because you hear yourself saying things and the coach can hold onto your words and ask you about them. A life coach can help with:

    • Sharing what has been happening
    • Working out what is important
    • Making goals
    • Following through with intentions
    • Acknowledging and celebrating progress.

    If everything seems to be going well for your partner but not for you, don’t take it out on your sambo. Make it you New Years Resolution to get your own ‘bollplank’ and let the relationship be what it should be.

    Seasonal affective disorder (SAD)

    A lot of people approach me thinking they have ADHD because they can’t concentrate at home or work, or both. And there is a lot of discussion at the moment about ADHD, particularly in Sweden where there is a huge expectation that people are on time, focussed and ‘get with the program’. The norms of behaviour in Sweden are very influential. If you have seen preschoolers being marched around the city in pairs, you will get what I mean. This is a society where, to a large extent, cooperation and compliance are unspoken rules. I mention this because it is important to understand that cultural influence and social expectations can play a part in how we feel and how quickly we adjust.

    But difficulty concentrating can also be a symptom of depression. When we feel low, unmotivated, frustrated or insignificant, it can be harder to stay on task. In a way this is our instinct or animal side at work, trying to get our bodies moving again. Movement and exercise to treat Depression has been recommended.

    Here are some other signs and symptoms that you might not be alright:

    • You are spending all day inside and not going out at all
    • Mood swings or constant irritability
    • Feeling like a zombie or not feeling anything at all
    • Eating constantly and more than you need to (or a loss of appetite)
    • Drinking alcohol everyday or most days on your own
    • Not engaging with friends
    • Ruminating thoughts, ‘overthinking’ and dwelling on failure
    • Less attention to self care or neglecting basic hygiene (not showering, brushing teeth or changing clothes)

    The good news is that you don’t necessarily need a psychologist or to go on medication simply because some of these are present. The benefit of working with me is you can tell your friends / family / sambo that you are seeing a coach for adjusting to life in Sweden. You can even meet me online, over webcam or for instant message counselling if you don’t want to take on the snökaos or you are living in Uppsala, Västerås, Nyköping or otherwise on the outskirts of Stockholm. Likewise if you are in Malmö, Gothenburg or Umeå or somewhere more remote, online coaching means you save the travelling time and can get help from the warmth and comfort of your own home.

    Of course, if you are at any serious risk or your health is deteriorating quickly, you should not hesitate to consult a GP.

    From Therapy for Depression or Adjustment to Coaching for Life Goals

    When life seems to be stuck or falling apart, it can help to talk it over, make a plan and have someone to engage with and help you to monitor progress. A lot of people start to meet with me for therapy around a particular issue and end up feeling better to the point that our sessions become more about coaching and moving forward. Recently I have been speaking with people about:

    If you have found me through ForwardTherapy.se price and cost of coaching might not be your main concern. You are probably more interested in finding a professional who understands what you are going through and offers the advantage of sessions in English. But just send me an email (preferred) or call and leave a message for a callback if you would like more information about my fees and payment options.

    Engelsktalande Samtalsterapeut (English Speaking Counsellor): A Word For Spouses and Sambos

    If you think your partner, wife or husband might benefit from coaching, kognitiv beteende terapi / cognitive behaviour therapy with an english speaking coach (kbt på engelska) or just a bollplank with someone other than yourself, feel free to send me an enquiry. I am used to working with people in relationships where one partner is struggling with culture or climate or relocation adjustment and there is some conflict in the relationship as a result. There is more information here på svenska.

    Next year I will be relocating my office from Kungsholmen to Södermalm in Stockholm. But you can make a start now and put yourself on a better track for 2013. Start making your New Years Resolutions.

    Write to me and I will send you full details of availability, fees and answer any questions you have. Please let me know if you prefer in-person (face to face in Stockholm) or online consultations.