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

Man in Blue Hoody walking through a field
Taking a brisk walk in nature can help you let go of your worries

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 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 of 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 solution to 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 lightest 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…

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. 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!

Superman figurine standing in a broken half eggshell

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 have a problem that needs to be solved, 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.

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Counselling, Coaching and Therapy in Stockholm

counselling in Stockholm

Counselling, Coaching & Therapy in English

I am currently available for online (Skype) appointments and consultations via Email Exchange. If you would like to find out more about my online services including online therapy and webcam counselling, or for an update on my availability, please contact me. These therapy services are available in English throughout Sweden and in other countries. I’m not currently providing appointments in-person in Stockholm and do not have capacity to meet with new couples at present, however you are welcome to contact me as an individual if you want relationship counselling.

Ask a question or make an appointment now

Check my qualifications and experience

Read more on Forward Therapy Stockholm

Cost of Services and Fee Schedule

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“Tools for Better Living”: 6 English Speaking Coaching Sessions for Expats in Stockholm and across Sweden

This fall I’m offering a flexible course that combines both coaching and counselling in a short series of consultations. These sessions are designed specifically for expats and other English speakers seeking direction. Are you looking for some tools for dealing with change or adjustment? Interested in taking a series of sessions to kick-start your motivation? Read on!

Those of us who have been expats in Stockholm for a number of years know the winters can be tough. Swedes know it too and, although most of them have grown up with the darkness and cold that comes with a Swedish winter, many still struggle. Whether you are in your first few years of living in Scandinavia, or you have lived here all your life, there is good sense in using the autumn to prepare psychologically and emotionally for what is to come.

6 Sessions of Coaching or Counselling, 5 Suggested Themes

This series combines the approaches of Cognitive Behaviour Therapy (CBT), Narrative Therapy, Motivational Interviewing, Life Coaching, Relaxation Strategies, Skills Training (including Stress Management and Communication Training) and Mindfulness. I’ve based it around a presentation of the most common psychological tools I use in my practice but will tailor it to suit your circumstances.

My approach is based on the idea that, through conversation based meetings, we develop ideas and strategies together that neither one of us might have envisaged using before. In this way, you bring your skills and knowledge as a contribution to the sessions and I also introduce theories and tools as possibilities for you to start using. Of course all the sessions and everything you say to me is confidential.

The plan below is a guide only and we can modify it according to your needs.

Want to know more already? Email me!

#1   Who Am I?

Our sense of identity can be quite important to how we manage in new situations or cope with change. Who are you and what has contributed to your sense of yourself, particularly since you moved to Sweden?

The first appointment is a kind of assessment where together we discuss what you would like to cover in the course of sessions and share whatever aspects of your story you would like to tell me. You also have the opportunity to ask me any questions you would like answered. At the end of the session I can give you an interesting identity-based task to take away and complete in your own time, if you like. ‘Homework’ is always optional. Some people want it and some don’t, so you can make the choice.

If you would like to know more about me in advance, read the About Ash Rehn page on this website. And I welcome you to contact me prior to the session if you would like to know anything more about me. It is important that we can work together and for you to feel a sense of comfort during our meetings.

#2   Recovering Energy, Motivation and Establishing Routines

It is not unusual for people to want to meet with a coach or therapist when they are at, or have been at, a low ebb. I’m used to seeing people struggling with motivation, lacking energy or feeling like they have failed. At the same time, it is not always that way. It can be more like chaos that needs sorting out. So part of our work together might be looking at what you want or what you appreciate about your life or what you need. Sometimes this involves considering your ‘vision’ for life. Sometimes people feel stuck, sometimes they feel lost, sometimes they just want me to help them sort through ‘stuff’ or ‘issues’. Whatever the case is, we can discuss it together.

#3   Managing Stress, Coping and Empowerment Strategies

How you deal with change often depends on your past experiences, the techniques you have learned or the resources you have at hand. In our sessions we can consider the skills you are using now as well as what you might need to recover or discover. If you are caught in some Mind Traps (cognitive distortions in thinking) we can identify these and determine alternative psychological strategies to help you escape or re-establish balance. I can also show you some physical practices you can use at any time to reduce anxiety and your stress response.

#4   Career / Relationships / Friendships / Family: Planning and Goal Setting

Would you like to show me what your life looks like now and what your ideal life would be? Often this can be a way of envisaging the future as well. Collaborative consultations can offer the first steps forward to making changes across a number of the aspects of our lives. Together we can explore changes you want to make in any or all of these areas and what might be required for moving forward. It tends to be much easier to do this in collaboration.

#5   Improved Communication for Relationships

Frustration and Anger are two of the most common emotions I discuss with people who meet me in Stockholm or online. If our needs are not being met, we can find our emotions about certain events and incidents spilling into other aspects of our life. And that affects our relationships. Taking an alternative approach to your standard way of communicating is one way to lower the frustration you are experiencing. I can show you some other possibilities and we can practice these in the sessions.

#6   Awareness, Acknowledgement, Acceptance and Building Resilience

It is not generally possible to change everything overnight. Meeting and having a conversation about what concerns you can also be a way of tapping into some other perspectives. Part of this work is about holding onto what you have learned or discovered. Part of the coaching can even include awareness-building techniques like Mindfulness. In these 6 sessions, I offer a start to a process that can take you in new directions. You might decide to continue with something new we discover together during our work or you might even decide to continue with me. With your permission, I will follow up by email at least twice over the 2 months following the series. If you want to continue, we can discuss the possibilities to keep going, what you have achieved and what might remain outstanding.

Pay as You Go or Save with a Package of Sessions

This flexible course is offered as pay as you go or you can receive 6 sessions for the cost of 5 if you pre-pay the series. You can attend just the first session and decide if you want to continue with no obligation to pay for more. You are welcome to decide a few days after the first appointment whether you want to pay for the whole series or pay as you go. I do ask for a deposit of 200 crowns for the first appointment but you have 7 days from the session to pay for the balance. Please contact me for further details of the fee.

No Guarantees or False Promises, but Possibilities, Opportunities and Open Dialogue

It would be quite unethical of me to make false promises about how successful this short series of appointments will be for you, particularly when I have not yet met you. So I don’t offer a guarantee that you will achieve everything you ever hoped for in just 6 sessions. But I do offer to be fully present with you for the sessions and to work collaboratively with you in ways you find comfortable.

It is my professional experience that once people start talking, what they are struggling with often changes or even dissolves. It does not happen at the same pace for everyone, but making a start will give you a better understanding of what might be required. I have chosen a framework of 6 sessions as many people find this is just enough to launch them into self-sufficiency. The relief of talking to a professional in a confidential setting can be influential, as can the possibilities for dialogue, acknowledgement, exploration and even confession.

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Ash Rehn QindsmBook Now to Secure Appointment Times

  • A limited number of these sessions are now available daytimes and evenings during September and October.
  • Sessions are available both in-person ‘face to face’ in Stockholm and ‘face to face’ by Skype webcam (or audio-only if you prefer).
  • Possibilities for continuing include the option of email counselling once the course is concluded.

Make an enquiry about available times and fees now through my contact page.

I look forward to hearing from you!

Ash Rehn BSocWk, MA, MAASW (acc.)

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10 Questions to Ask Your Prospective Counsellor or Therapist Who Works In English

Questions for Therapists

Have you reached a turning point in your life and want to find therapy in English?

Do you need counselling for relationship issues, stress or a break-up?

Or would you like to find an English speaking coach to improve life generally?

Here are ten important questions to ask your prospective counsellor or therapist. I’ve provided my own answers to give you a sense of where I fit according to these criteria:

1. How long was your therapy training?

My therapy training commenced when I started training as a counsellor in 1989 and it has not stopped since! Over the last 20+ years I have undertaken Bachelors and Masters degrees in Social Work, specialist narrative psychotherapy training through the Dulwich Centre in Adelaide, Australia and completed many short courses and workshops in a range of therapeutic approaches. These include CBT (cognitive behaviour therapy), mindfulness, psycho-education (including motivational interviewing), stress management, relaxation strategies, problem solving, anger management, therapy for adult survivors of child abuse and couples counselling.

A good therapist does not stop his or her education simply when a qualification is achieved. Professional development must be ongoing. Each year I attend a number of training activities and conferences and regularly share the outcomes of these with my clients.

2. Under which title, coach, counsellor or psychotherapist would you be allowed to work in your own country?

In both Australia and England, I am allowed to use all 3 of these titles: coach, counsellor and psychotherapist. In Sweden the title ‘psychotherapist’ (or psykoterapeut in Swedish) is a protected title and only practitioners licensed by the Swedish National Health and Welfare Authority – Socialstyrelsen – can use that title. I have not applied to be licensed as a psychotherapist in Sweden and instead refer to myself as a samtalsterapeut (counsellor) or narrative therapist in my work. Psychotherapist training in Sweden is limited to certain methods or approaches and applicants for a Swedish license must demonstrate compliance with particularly Swedish requirements. I have found that most of the people who meet with me are far more interested in the benefits of a therapist who speaks their language and understands their culture than they are in meeting with someone who fits precise Swedish requirements or works through the Swedish healthcare system.

3. How often do you have supervision?

I generally attend supervision at least twice a month and my commitment to supervision meets the recommendations of the AASW and BACP. Supervision for counsellors and therapists is not the same as supervision in a management situation. It means something completely different. It is about discussing professional issues in a structured way and ensuring the counsellor or therapist is taking care of their own well-being. It helps counsellors, psychotherapists, psychologists and social workers ensure their integrity and ethical practice. Counsellors and therapists in private practice will generally be paying for private supervision from a more or equally experienced person. I have such an arrangement with a more experienced practitioner and also engage in regular peer supervision with colleagues.

4. How long have you been practising?

I began practicing as a counsellor in 1989 and have worked across the community, government and private sectors over the years. Since 2005 I have been specialising in mental health counselling and therapy. I commenced private practice as a therapist and mental health counsellor in 2008.

5. What is your theoretical approach?

My practice is informed by a range of theoretical approaches. When undertaking advanced therapeutic work with people, it tends not to be helpful to be limited to a singular technique or method. In Sweden, counselling and therapy is dominated by Cognitive Behaviour Therapy (CBT or KBT) and Psychoanalysis but there are many other ways of working together if these do not appeal to you. I am particularly drawn to dialogical and narrative practices and the work of a number of well-known therapists including Harlene Anderson, Johnella Bird, Art Fisher, David Epston, Michael White. If you would like more information about these approaches, I would be happy to send you some links if you email me for details.

6. Do you offer a 50 or a 60 minute hour?

My standard appointments are 60 minutes but longer appointments (75 minutes or longer) can easily be negotiated. I generally leave at least 15 minutes between appointments and, if I have more time available, I usually don’t mind if we continue a little longer if it is helpful to you.

7. What do the initials behind your name actually mean?

Currently the initials after my name are: BSocWk, MA, MAASW (acc.). They stand for Bachelor of Social Work, Master of Arts and Member of the Australian Association of Social Workers (accredited).

8. Are you an accredited member of a professional organisation?

Yes, as above, I am an accreditated member of the AASW in Australia. This accreditation means I have a qualification awarded by a professional association as a specialist mental health provider and can offer focussed psychological services under the Australian government Medicare program when I am meeting with clients in Australia (similar to the services provided by psychologists that are reimbursed by the government there). The AASW supports my practice in Europe and represents my professional interests, however unfortunately Medicare will not reimburse appointment fees unless we meet in Australia.

9. Do you have insurance?

Yes, I hold both professional indemnity and public liability insurance.

10. Are you registered for tax in Sweden?

Yes, I am fully registered with Skatteverket, the Swedish tax authority and required to invoice moms (consumption tax) on my services in Sweden. If you require your invoice made out to a particular company name, please advise me in advance.

Extra question: How old are you?

Some people want to know how old I am and I am quite open about my age. I was born in 1969 so at the time of writing this, I am 43 years old.

You can read more on the About Ash Rehn page. If you are interested in making an appointment, please contact me by email or phone. I’m happy to answer any further questions you might have.

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Walking Talk Therapy for Mental Health in English in Stockholm

A Park to Walk in Stockholm

The advantages of counselling and therapy shouldn’t just be psychological. Walking while talking is a new approach to talk therapy that benefits the body as well as the mind.

As a therapist who personally enjoys exercise and the positive effects of movement, I was not surprised when I read in the Sydney Morning Herald about research that demonstrated sitting was bad for our health.

I’ve written before about how exercise is important to both our physical and psychological health. Sitting for prolonged periods can reduce lifespan so decreasing our sitting time is just as critical to health as taking exercise. But modern lifestyles have many of us spending long work hours in front of our computers. It can be difficult to remember to take regular breaks let alone to keep moving our bodies.

So I am now also offering counselling, coaching and therapy in English in Stockholm while walking outdoors. This is a unique service for Stockholm that fits with making it easier and more beneficial for people to meet with a counsellor.

The Benefits of Walking Therapy

Taking a walk each day can lift mood, free thinking and help us manage emotions. For some people, it can be a reasonable alternative to medication. But there are other advantages to therapy while walking outside as well. We know sunlight is important for production of vitamin D and general health. Talking with a counsellor while taking a walk treats your whole person, body, mind and spirit. The practice of walking itself can quieten thoughts and relieve anxiety. It’s refreshing, relaxing and the rhythm of a walk can also help to sort out problems.

Like other forms of counselling, Walking Talk Therapy is an opportunity to discuss strategies, get things in perspective, or simply get a sounding board for the changes you know you want to make. Being out in nature is conducive to healing and improved mental health. Expats can speak English during the appointment and benefit both from the change of scene and a compassionate listening ear. People who have experienced disappointment, loss or even trauma may find that time spent in nature is therapeutic in itself. Those seeking to improve their physical health and motivation can find active consultations even better than sessions that are office based. So counselling appointments while you walk offer a combined form of treatment.

With my Walking Talk Therapy in Stockholm, you are welcome to request help with the same kinds of goals or concerns you bring to office based appointments. Many people who come to see me talk about depression or anxiety, family and relationship issues. But the areas I specialise in include:

How Does Walking Talk Therapy Work?

Usually we start the first appointment in my counselling rooms on Kungsholmen in central Stockholm. If you decide to proceed with a walking appointment, we can go to Rålambshovsparken or along Norr Mälarstrand by Riddarfjärden. These parts of the island are quite beautiful throughout the year and provide plenty of open space for private conversations while walking. We can hold onto important points by jotting them down or taking an audio note as we go. Walking Talk Therapy is suitable for therapeutic approaches such as CBT (cognitive behaviour therapy) and narrative therapy.

If the weather is bad we can still meet in the office. The Swedish have a saying “there is no bad weather, only bad clothing” but it is always your choice whether we go out for a walk or sit inside and chat over a cup of tea or coffee.

So why not combine therapy and some exercise? It’s healthy, refreshing and better for both of us! For daytime appointments until 5pm you are welcome to choose a 50 or 75 minute consultation depending on how much time you have available.

My goal is to make it easier for people to see me so, of course, if you prefer to sit comfortably and talk we can still do that. I still offer a range of options including online counselling over webcam from Stockholm or anywhere in Sweden.

Call now on 08-559 22 636 and leave a message if I don’t answer.

Or contact me through the form on my website for more details.

I look forward to us walking together!

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Adjustment to Life in Sweden and Therapy in English

Image of a man with stress associated with cultural adjustment

For most expats, relocating to Sweden means adjusting to a different culture. Reactions associated with the stress, uncertainty and the upheaval of relocation to another culture are very common for those from English speaking countries. These reactions can include experiences of anxiety, withdrawal, low mood, depression and other mental health difficulties.

In my therapeutic work with people who have moved to Sweden, we often talk about how unexpected these reactions were. After all, Sweden appears to be an orderly place and most people, particularly younger people and those Swedes living in the large cities, speak English. At first it was easy to imagine that life here could be easy and that it would not take long to settle in.

But the expats I talk with tell me they were unprepared for the differences in culture and climate they encountered. They describe low mood, difficulty sleeping, anxious thoughts or constant worries as well as the impact of such feelings on their relationship with partners.

Some people confess a lack of energy or enthusiasm or say they are finding it hard to enjoy life. Some people increase their use of alcohol to help them manage these feelings then find drinking causes further problems or takes them away from what they want from life. Occasionally people tell me they have an unexplained sense of panic they want help to overcome.

So what can you do if you are experiencing difficulty adjusting to life in Sweden?

5 Ways to Take Action and Get Help to Adjust to Living in Sweden

If you are struggling with feelings associated with depression or anxiety after moving to Sweden, here are a few things to keep in mind.

1. Share your feelings

Talk about your feelings instead of bottling them up. Trying to contain or hide emotions can be useful at times but, when they aren’t released, emotions can become explosive or leak out in inappropriate situations.

2. Connect with others

Talking to your girlfriend or boyfriend or sambo might not be enough. The emotions around cultural adjustment can also be a pressure on relationships so it is important to share your experiences with people other than your partner. The language barrier can be difficult but there are also a number expat groups, particularly in Stockholm. Remember that there are plenty of others who have been through similar hard times after moving to Sweden and if you can connect with them it can be helpful to hear other perspectives on how to make it through.

3. Exercise regularly

Particularly as it gets colder, the freezing temperatures and darkness can have us slowing down, staying inside and not being as active. But thoughts and emotions and even sleeping patterns can be positively affected by physical activity. Whether it is bodypump or working out at the gym, football, a regular yoga class, swimming or just a long, brisk walk everyday, keeping up exercise can help.

4. Try to find balance

If you are indoors a lot, make sure you get outside regularly. If you are only spending time with your partner or on your own, make an effort to engage with others. If you are working or studying, give yourself some downtime doing things that are fun or relaxing. If you aren’t working or studying, look into some volunteer work to give yourself a regular meaningful activity.

Trying to adjust to a new culture sometimes has us putting most of our energy into the familiar aspects of our lives but this can result in imbalance. Generally, the Swedes understand balance through the concept of ‘lagom’ and will be more understanding if you tell them you are trying to find balance in your life.

5. Do something today and stop delaying

The most important thing, in my professional experience, is to start to take action right now and not just hope the feelings will go away. They might go away, in time, but they are more likely to disappear when you are expressing how you feel, involved in activities with others and looking after your body and mind.

If you are stuck, meeting with a counsellor, coach or therapist is one way to get on track with the changes you are making. Make a start today on doing something to improve your life in Sweden. Call me now on 08- 559 22 636 or send an email through the contact page. Usually we can meet within a week.