Why Neuroscience for Counsellors?

Rachal Zara Wilson is a counsellor, social worker and author of the new Neuroscience for CounsellorsWe caught up with her for a quick chat about the book and why she wanted to write about such a complex topic. 

1.  Who do you think would benefit from reading this book?

Definitely counsellors, but also any other therapists as well.  The book is designed so that it has sections where the neuroscience is explained, and separate sections for counsellors and other therapists with suggestions on how to use this knowledge for the benefit of their clients in the session room.

Families of people who are experiencing mental health dysfunction may also be interested in the knowledge contained in this book, and also in the implications for how they can support their loved ones.

2.  Why did you write this book? Wilson_Neuroscience-fo_978-1-84905-488-1_colourjpg-print

I’ve always been interested in neuroscience; the brain is so fascinating and amazing, and capable of so much more than we’ve always been led to believe.  And of course, as a counsellor working with people, how the brain works has always been top of my mind.  The final motivator was having a child who was experiencing problems with their mental health, and I guess I just hoped to find something that would help him and others in a similar situation during the course of my research.

3.  So what’s so exciting about what you learned?

Probably the most exciting thing would be the brain’s capacity to change itself, known as brain plasticity.  The brain isn’t static, it’s more like a dynamic organ that is constantly changing for better or worse.  And what we do plays a huge part in how it changes.  How much stress we’re under, what we eat, the quality of our sleep, whether we exercise and how much, our living environments, and the presence or absence of early trauma in our lives are some of the things that contribute to the way our brain functions, and to its capacity for change, or plasticity.  I guess the most exciting thing is that we have control over this plasticity to a large degree, and we can therefore improve the quality of our brain function, our health and our lives.

4. Why don’t we know this stuff already?

Because neuroscience is a field in its infancy.  There’s a lot of learning coming through, but much of it’s wrapped up in scientific jargon, making it inaccessible to those of us who are not scientists.  And because there’s lots of different levels of looking at the brain, (both micro and macro,) different neuroscience specialties do not always integrate their specialist knowledge.  I think the benefit of this book is that it integrates the neuroscience into an overall big picture, while also drawing on this resource to come up with practical ways for integrating it into therapy.  It hasn’t been done before because it’s new, because it’s complex, and because integrating neuroscience with counselling and other therapies requires a knowledge of both fields.  I believe that in the future, all practitioners providing talking therapies are going to need to understand what neuroscience offers our professions, or risk becoming irrelevant.

5.  Why put it in a book?

This knowledge is meant to be shared.  All counsellors and therapeutic practitioners want best outcomes for their clients, and the more knowledge we have that can help people make positive change in their lives, the better.

6.  Is it complicated?

The neuroscience is complex, but the book is designed so that people who just want to know what it means for their practice can just read those sections, while those who want to understand how it all works can read up on the explanations for how all the scientific evidence fits together.  The book is written in the plainest English possible, and there is a glossary and diagrams at the back to help you fit it all together.

You can find out more about the book, read reviews and order your copy here.

Browse our latest collection of new and bestselling titles in counselling and psychotherapy

Here are our new and bestselling titles in counselling and psychotherapy. For more information on any of the books inside, simply click the title or cover image to view the full book page.

Starving our Anxiety Gremlins

Kate Collins-Donnelly; therapist, consultant, and author of Starving the Anxiety Gremlin, talks about the rise of anxiety in children. In this article, Kate discusses what can be done to help young people struggling with anxieties and shares a letter from one of the young people she has worked with on her experiences of overcoming problems caused by anxiety.


Anxiety is one of the most common mental health disorders in the UK and worldwide. The UK ONS Child and Adolescent Mental Health Survey published in 2004[1] estimated that 290,000 children and young people nationally had an anxiety disorder, which equated to 2.2% of 5 to 10 year olds and 4.4% of 11-16 year olds. Leading anxiety charity, Anxiety UK, estimate that one in six 16-24 year olds have suffered from an anxiety disorder and five pupils in an average school class will have experienced anxiety[2]. And results form an NSPCC survey published in 2004[3] revealed that 34% of the young people studied felt that they were always worrying about something, with 11% feeling extremely worried.

We still don’t know the true prevalence rates amongst national and global populations as, like many other mental health disorders, anxiety disorders remain under-reported and under-diagnosed. However, what is clear is that anxiety is a common cause of distress for children and young people today.

Just like for adults, anxiety can come in different shapes and sizes for children and young people too – with some children and young people getting anxious about a variety of things and others only experiencing anxiety in response to very specific situations. Common worries for children and young people include school work, exams, friendships, family circumstances, health, death, bullying, body image, and much more. And children and young people can experience anything from normal occasional worries, fears and nerves to long-lasting and severe anxiety disorders that include generalised anxiety disorder, simple and complex phobias, panic disorder, separation anxiety, obsessive compulsive disorder and health anxiety.

Not only is anxiety common and varied, it also has the potential to be debilitating, especially when experienced on a frequent basis. This is partly because anxiety can bring such a wide range of cognitive, physical, emotional and behavioural symptoms with it, including concentration problems, obsessive thoughts, headaches, racing heartbeat, panic attacks, loss of confidence, avoidance of situations and procrastination to name a few. And it is important to remember that these symptoms can vary from young person to young person. It is also because anxiety can have impacts on all aspects of a young person’s life, including their studies, work, relationships, physical health, mental health and emotional wellbeing, future prospects, motivation and much more.

But thankfully, by learning a range of cognitive behavioural strategies and techniques, children and young people can learn to manage their anxiety and bring it under control. And that is why I wrote Starving the Anxiety Gremlin to highlight to children and young people that by learning how to think and act differently they could starve their Anxiety Gremlins for good! You see, if we all starve our Anxiety Gremlins of their favourite food – our anxiety – they’ll shrink and shrivel away!

And here is a letter from one young person that I worked with to show starving our Anxiety Gremlins really is possible! Well done Chloe! You are an inspiration!

Dear Reader,

When I was six I developed a worry.  At my birthday party I was quite badly sick and from then on I was terrified of vomiting. My worry caused panic attacks, which made me shake and cry; and gave me a runny tummy and nausea, which made me even more anxious. I thought that there was no escape from my worry. I wasn’t even sure what life would be like without it. I found it difficult to be left alone at school. I didn’t like to leave the house because I was scared of being sick or needing the toilet and not knowing where it was.  My worry was taking over my life. I didn’t know how to make it stop and my family didn’t know how to help me.

We went to see the doctor and then some people who are trained to help children with worries.   At first trying to get over my fear of sickness felt like an impossible task but slowly I found ways of fighting my worry. I learned to breathe slowly when I felt panicky and to turn my scary thoughts into sensible ones. Keeping a worry diary and telling my family and friends when I was having a particularly bad day helped too. Unfortunately none of this works over night, but if you follow the steps in Starving the Anxiety Gremlin you will learn to manage your worries. With help, I began to have less panic attacks and suddenly life didn’t feel like this huge burden. One day, it will feel like that for you too.

When I was little I didn’t know of anyone else who was going through similar things so I felt very alone. I thought I was weird. But I wasn’t weird and I definitely wasn’t alone. Lots of people have a worry; just like me, just like you. I know it may feel like there is no way out but one day things will seem a lot easier and life will seem fun again. Never forget that you are strong enough to cope with your worry and that you have the most fantastic brain to help you overcome it.

I am now 17. I still worry sometimes because everyone does but I don’t worry a lot about being sick anymore and I’ve stopped having panic attacks. If you are feeling worried and scared it is really important that you tell people how you are feeling so they can help you. I promise it gets better. Remember that you are not alone in how you feel, you aren’t weird and that most of all you are incredibly brave!

Love from your fellow worrier,

Chloe xxx 

You can give Kate’s CBT techniques a try for yourself by downloading free evaluation sheets from her workbooks Starving the Anxiety GremlinStarving the Stress Gremlin and Starving the Anger Gremlin. Download the free evaluation sheets here.
You might also want to try these free activities on building a positive body image, taken from Kate’s book Banish Your Body Image Thief, and encouraging healthy self esteem, taken from Banish Your Self-Esteem Thief.
Starving the Anxiety Gremlin has been shortlisted for the School Library Association Information Book Award 2014. Voting commences on June 18th 2014. If you’d like to find out more about the awards or request a pack for your school, visit the website here.

[1] Green, H., McGinnity, A., Meltzer, H., Ford, T. and Goodman, R. (2005) Mental Health of Children and Young People in Great Britain 2004. London: Office

[2] Anxiety UK, Children and Young People With Anxiety: A Guide for Parents and Carers, available at: www.anxietyuk.org.uk

[3] NSPCC (2004) Someone to Turn To? Who Can Children and Young People Trust

When They are Worried and Need to Talk? London: NSPCC.

Adopting a balanced view

Child and family psychologist and JKP author of the bestselling A Short Introduction to Attachment and Attachment Disorder, Colby Pearce, on maintaining a balanced view when caring for children who have experienced trauma in their early lives.
This article first appeared on The Adoption Social‘s guest blog. 

I was born in January, which is the height of summer here in Adelaide, Australia. As such, I have always thought of myself as a “summer baby” and considered that this is why I enjoy the warmer months as opposed to the cooler months. I have a lifelong aversion to feeling cold and for many, many years I felt below my best during winter. I have questioned many people about this and have discovered that most people prefer either the warmer months or the cooler months. Many of them are just not happy until their preferred season returns.

About three years ago, and with the emergence of joint aches and pains during the colder months, I had the thought that it was a bit of nonsense really to consider myself a “summer baby” and defer happiness until it was warm again. I have always been a keen gardener and have a large hills garden. Looking after my garden is an act of looking after my self. Water is an issue as it is scarce and expensive, my garden is large and summer is hot (As I write this it is the fifth consecutive day of over 40C). So, I bought some rainwater tanks and now I pray for as much ‘bad’ weather as possible during the cooler months. I check the weather radar each day and feel let down if forecast wet and wintry weather blows south or north. I still have my aches and pains and look forward to the warmer months when they trouble me less, but I also look forward to cooler, wetter months now as it is a boon for my efforts to maintain a magnificent garden. And the garden? Well, with the additional water supply it has never looked better.

Strong FoundationsWhat has all this got to do with looking after children; particularly those children who experienced significant adversity in the first days, weeks, months and years of their precious lives? Well, it has to do with how we perceive them and the effects of this; both in terms of our own experience of caring for them and their experience of being cared for by us.
I am particularly interested in the idea of “self-­fulfilling ­prophecies”. In Psychology, these take the following form. I have a thought. My thought induces an emotion. My emotion activates a behavioural response. My behavioural response precipitates a reaction in others. The reaction of others often confirms my original thought.

Let’s try one. Thought: “nobody loves me”. A common feeling associated with this thought: hostility. Common behavioural responses to feelings of hostility: withdrawal and/or aggression. A common reaction to withdrawal and aggression: admonishments. An inevitable result: confirmation of the original thought.
Lets try another. He is damaged by his early experiences. I feel badly for him. I try to heal him. He keeps pushing me away. He is obviously damaged.
And, another: He is such a good artist. I am so proud of him. I support and encourage his interest in art. His skills develop and he is often affirmed for his artistic achievements. He is such a good artist!

Children who have experienced significant adversity at the beginning of their life are commonly referred to as “traumatised”. There is much literature about how early trauma impacts the developing child, including their acquisition of skills and abilities, their emotions, their relationships with others and even their brain. This literature focuses on the damage early trauma does and there is a risk that we, their caregivers, see these children as damaged.

One of my favourite allegories is the one that the author Paulo Coelho tells in his book, The Zahir. Coelho tells the story of two fire­fighters who take a break from fire fighting. One has a clean face and the other has a dirty, sooty face. As they are resting beside a stream, one of the fire­fighters washes his face. The question is posed as to which of the fire­fighters washed his face. The answer is the one whose face was clean, because he looked at the other and thought he was dirty.

The idea of the looking-­glass ­self (Cooley, 1902), whereby a person’s self-­concept is tied to their experience of how others view them, has pervaded my life and my practice since I stumbled across the concept as a university student. Empirical studies have shown that the self-­concept of children, in particular, is shaped by their experience of how others view them. In my work, this has created a tension between acknowledging the ill ­effects of early trauma and encouraging a more helpful focus among those who interact with so ­called ‘traumatised children’ in a caregiving role.

I am just as fallible as the next person, and I do not have all the answers. But as a professional who interacts with these children and their caregivers on a daily basis I strive to find a balance between acknowledging and addressing the ill­effects of early trauma and promoting a more helpful perception of these children. I strive to present opportunities to these children for them to experience themselves as good, lovable and capable; to experience me and other adults in their lives as interested in them, as caring towards them and as delighting in their company; as well as experiences that the world is a safe place where their needs are satisfied. I strive to enhance their experience of living and relating, rather than dwelling on repairing the damage that was done to them.

Most of all, I see precious little humans whose potential is still yet to be discovered. eyes

Eyes are mirrors for a child’s soul. What do children see in your eyes?

Coelho, P (2005), The Zahir. London. Harper Collins Cooley, C.H. (1902). Human Nature and the Social Order. New York. NY: Scribner

Prepared for The Adoption Social by Colby Pearce (Clinical Psychologist and Author), ©2014
You can read the original blog post here.
You can keep up with Colby’s blog posts on his website, here.
You can also follow him on Twitter @colbypearce


Assessing emotional awareness after trauma

Grasso_Clinical-Exerci_978-1-84905-949-7_colourjpg-webThis extract taken from Clinical Exercises for Treating Traumatic Stress in Children and Adolescents by Damion J. Grasso gives practical guidance to assessing and enhancing a child’s emotional awareness and vocabulary prior to therapeutic exposure.
‘These skills are essential for fully engaging in the therapeutic exposure and for processing the emotional content of the trauma memory.’

Read the extract here


How well do you know yourself?

Bolton_Writers-Key_978-1-84905-475-1_colourjpg-webWe make assumptions about ourselves all the time, but how much do we really know?

As Gillie Bolton says in the opening chapter of her new book The Writer’s Key, ‘The simple action of putting words on a page can begin to help us find out what we think, believe and know’.

This exercise taken from the book is a great way to begin to explore ourselves through writing; our worries, our fears, our hopes, and our aspirations.

All you need to have a go is a pen and a piece of paper. You might be surprised by what you discover!

Download the free writing exercise here



New Video – Sue Cottrell talks to her son Lloyd about learning to control his stammer

In this video Sue Cottrell, author of Can I tell you about Stammering/Stuttering?, talks to her 15 year-old son Lloyd about how his stammer affects his daily life, particularly at school whilst he is feeling stressed about exams. Lloyd reflects on footage of himself speaking as a 13 year-old and discusses how the techniques he has learned since have enabled him to control his stammer and become a more confident speaker.


Identify the signs of OCD at school

Jassi_Can-I-tell-you_978-1-84905-381-5_colourjpg-webAmita Jassi, author of ‘Can I tell you about OCD?’ explains some of the common obsessions and compulsions experienced by people with the disorder and how this could effect children at school.

OCD is an anxiety disorder characterised by unpleasant and recurring thoughts, images, doubts or urges (called obsessions) and repetitive and irrational behaviours (called compulsions). Compulsions, also known as rituals, may be observable behaviours (such as washing or tapping) or mental rituals (such as thinking a good thought to cancel out a bad thought). Compulsions are usually carried out as a way of reducing the distress caused by obsessions. OCD takes many different forms and can range from mild to severe. When children are troubled by OCD they can experience very high levels of anxiety and distress and find that it can take up a lot of their time.

Some common obsessions are:

  • Fears about dirt or contamination
  • Worries about harm coming to yourself or others
  • Unwanted sexual thoughts
  • Thoughts about doing something forbidden or embarrassing
  • Discomfort if things are not symmetrical or even
  • Needing to tell, ask or confess
  • Fears of losing important things

Some common compulsions are:

  • Checking things over and over again
  • Touching or tapping things
  • Seeking reassurance
  • Hoarding or collecting things that are useless
  • Arranging things so that they are ‘just right’
  • Washing and cleaning
  • Counting, repeating and re-doing things

The good news is that OCD can be successfully treated and recent evidence shows that the sooner it is tackled the better the treatment outcomes are likely to be.  The recommended treatment for OCD by the Department of Health is a talking therapy called Cognitive Behaviour Therapy (CBT). It is also recognised that some children may also benefit from treatment with medication from the group called selective serotonin re-uptake inhibitors (or SSRIs). It is clear therefore that young people should not have to struggle with OCD without any support and treatment. The UK’s largest charity for OCD, OCD Action, wants young people, their parents and their school to take action now.

What are the signs of OCD at School?

OCD can affect many areas of a young person’s life, including school life. It is important to remember that OCD affects people in many ways however some of the signs that you may observe in school include:

  • Poor attention and concentration due to distraction from unwanted thoughts or the need to perform rituals
  • Extreme tiredness due to being up late at night doing rituals or the overall exhaustion caused by the constant battle with OCD
  • Frequent or prolonged toilet visits due to completing cleaning rituals
  • An inability to touch objects, materials or other people due to possible contamination fears
  • Excessive questioning and need for reassurance
  • Messy work due to having to repeat rituals such as rewriting or erasing words
  • Repeated lateness as a result of being delayed by rituals
  • Late handing in work due to being slowed down by obsessions and/or compulsions
  • Arranging items on a desk, shelf or classroom so that objects are aligned
  • Repetitive behaviours such as getting up and down from a desk or opening and closing the door
  • Low self-esteem and difficulty with peer relationships
  • Reduction in grades or decline in school performance

It may also be helpful to be aware that OCD can be associated with other disorders such as depression, Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorders (ASDs) and Tourette Syndrome.

Where else can I find information about OCD?

For more information on OCD and young people, see ‘Can I tell you about OCD?’ or refer to the OCD Action website: www.ocdaction.org.uk or OCD-UK: www.ocduk.org



Unlocking potential with dynamic assessment

Lauchlan-Carrig_Improving-Learn_978-1-84905-373-0_colourjpg-webFraser Lauchlan, co-author of ‘Improving Learning through Dynamic Assessment’, explains how the approach was first developed and how using this method of assessment can lead to effective intervention for many children with learning and behavioural challenges. 

I first became aware of dynamic assessment 15 years ago as a doctoral research student. It was very much a new ‘thing’ then, considered cutting edge and innovative, but not a lot was known about it in the UK. Since then it has grown in popularity and is used mainly by educational psychologists when assessing children’s learning and behavioural difficulties. However it is also used by other professional groups such as speech and language therapists and those working in the area of learning support, such as special educational needs coordinators.

Dynamic assessment is based on Vygotskian principles, the Russian psychologist who died in 1934 but whose work was suppressed by the then Communist regime and eventually published in the West in the 1960s and 70s. Vygotsky’s ideas were considered fairly revolutionary and it was little wonder that his work was suppressed. One of his main arguments was that children should be assessed for their intellectual capacity when working with someone, for example an adult or a more able peer, rather than be assessed alone. This view was, and possibly still is, considered controversial, as it is commonly considered that in order to understand someone’s intellectual capacity you must assess what they can do on their own, for example on an IQ or similar test. Vygotsky argued that it is just as, if not more important to see what a child can do with carefully guided assistance. This will give an idea of the learning potential of the child, and where the next steps of learning should be targeted (or the processes of learning), rather than concentrating on the products of that child’s learning (i.e. using a standardised test and focusing on where they are now).

These ideas were developed by several developmental psychologists in the 1970s and 80s. For example, the Israeli psychologist Reuven Feuerstein, well-known for his cognitive enrichment programme, ‘Instrumental Enrichment’, developed a dynamic assessment test called the ‘Learning Propensity Assessment Device’. Psychologists in the U.S.A., such as Ann Brown and Joseph Campione, developed a different, more structured approach to dynamic assessment. However, the truth was that in the UK at least, dynamic assessment didn’t really ‘take off’.

Part of the problem, in my view anyway, was that practitioners could not see how dynamic assessment could be easily integrated into practice. When I was trained in dynamic assessment in the mid-1990s, there were few psychologists in the UK trained in the approach, and so training was usually given by psychologists from Israel or the U.S.A. who were not familiar with the working environment of educational psychologists working in local authority settings in the UK. As the years passed it was becoming increasingly clear that professional psychologists in the UK were struggling to put the ideas underlying dynamic assessment into practice.

Improving Learning Through Dynamic Assessment, co-written with my colleague Donna Carrigan, is a culmination of 15 years work on developing the dynamic assessment approach, as both a researcher and a practitioner, and an attempt to bridge the gap between theory and practice. After completing my PhD that investigated the use of dynamic assessment in two different educational settings, I trained as an educational psychologist and worked for 10 years in a local authority setting.  It was as a practitioner, working daily with children who were encountering difficulties in learning, that the idea of putting together our development work in dynamic assessment in the form of a resource textbook first emerged. Donna and I started to document some of the case studies that we were working on, in order to gather together some useful resources and ideas that would form the basis of the book. We were working with children like James (name changed to ensure anonymity) who was referred to me in primary school for assessment as he was having severe difficulties in the classroom with all areas of the curriculum. The school admitted that they were at a loss as to where to go next, and had considered that a move to a special school might be the best option for James, where he would receive more intensive support and a curriculum more suited to his needs. James was from a socially disadvantaged, single-parent family and wasn’t receiving much support at home. His progress at school was certainly slow and the teachers felt there was little else they could do to help. Using dynamic assessment with James allowed me to explore his potential as a learner. He responded extremely well to the help and structured assistance, and was able to ‘internalise’ this support and work independently. James reached a high level on the tasks set. In collaboration with the school, it enabled us to consider the next steps of his learning and the areas that were most urgently in need of support. Having video-recorded the dynamic assessment I was also able to show his teacher and his mother the level that James could achieve. This alone was important in changing the lowered expectations of the teacher. While his learning difficulties did not disappear overnight, he did nevertheless make good steady progress and, most importantly, the teachers felt there was now a plan of how to address his learning challenges in a positive way. James completed his primary school education and went on to secondary school, where he was able to achieve some qualifications, something that would not have been thought possible when he was first referred to me in primary school.

We have written Improving Learning Through Dynamic Assessment to help practitioners, especially educational psychologists, put the powerful ideas of dynamic assessment into practice. The book is a step-by-step guide in how to undertake an assessment and how such an assessment can lead to effective intervention. By doing so, it is hoped that practitioners can help address the learning and behavioural challenges posed by many children, including children like James.

A case study extract from ‘Forensic Music Therapy’ – Working with Conflict

Stella Compton Dickinson, editor

This is an edited extract from Forensic Music Therapy: A Treatment for Men and Women in Secure Hospital Settings edited by Stella Compton Dickinson, Helen Odell-Miller and John Adlam. This case study comes from Chapter 7, ‘Working with Conflict: A Summary of Developments in the Long-term Treatment of a Man Suffering with Paranoid Schizophrenia Who Committed Manslaughter’, by Stella Compton Dickinson and Manjit Gahir.


This chapter describes the process of long-term music therapy over seven years with a man who we shall call “Ewan.” Ewan has given informed consent for case material to be used in telling the story of his rehabilitation; his real name has not been used. Ewan suffered with paranoid schizophrenia and whilst actively psychotic with hallucinations and delusions, he killed a man.


Committed to hospital for an indefinite period after being convicted of the offence, Ewan spent ten years in high secure detention without undertaking therapy until he requested a referral to music therapy, “to learn to play the violin” as his grandfather had done. He engaged in music therapy as his main psychological treatment. The intervention and its impact were new to the clinical team who had to adjust to the fact that internal changes were starting to happen for a patient who they had known to be static for many years. Thus their own past experiences, their judgments of Ewan in the face of fear when he had erupted with violent outbursts, and their perceptions for his future were all challenged.

Music therapy

Ewan’s fundamentally chaotic presentation was marked by fixed perseveration, which is typical of schizophrenia. Notable in his early musical improvisations were repeated, stuck, desperate, and stabbing sounding attacks on the piano keys. This represented exactly his situation and offence: angry, locked in, stuck, as if he had nowhere to turn. The therapeutic work required orientation to the here and now, rather than unlocking too much past material at once. Nevertheless, Ewan recognized how he could receive rather than reject my non verbal musical support. This elicited a maternal transference. Towards the end of the second assessment session, Ewan rushed from the room, having exclaimed his recognition within our musical improvisation that “you are supporting me! I have not felt like that since I was with my mother.”

The significance of this was central to the therapy as Ewan had been unable to mourn the death of his biological mother. He returned explaining that this experience had “brought a tear to my eye.”

Starting the treatment process

Ewan had never experienced any previous psychological therapy at all, so the same weekly place and time was an entirely new experience for him, which he almost religiously observed. As the therapy progressed, he became more proactive in ensuring that regular physical health appointments were not timetabled to coincide, as nothing had to come between him and his music-making. Over time, as he became more trusting in the continuity of his life and less fearful of sudden abandonment, he gradually extended his range and felt safe to play the piano on his own rather than with me. Ewan began to take responsibility for his own actions rather than remaining over-identified with his own victim self-state.

The mother–child dyad and symbolic musical representations

In session 12, Ewan elucidated on his feelings of stupidity and how he played on these as a childhood strategy. He said he had taken to “acting stupid” whenever he felt threatened by his father. The mother–son relationship was enacted symbolically as a maternal transference developed. The merged relationship that developed between Ewan and his biological mother during childhood was cemented when both mother and son cowered from the violence and physical abuse of the father. This relationship was represented musically in session 2 in which initially Ewan played mournfully on the recorder, copying my choice of instrument, then merging with it and introducing a sensual, rocking rhythmic pulsation which indicated an as yet unconscious underlying erotic transference. The music then became violent and angry as Ewan repeatedly hit a small glockenspiel as if he was a frustrated child waiting for dinner. This had a direct correlation to verbal material in which Ewan described the intimacy and frustrations that he felt with his mother. After this the music became mournful and sad although it finished in a resolved, harmonious fashion.

The index offence: developing victim empathy

In reference to the man who he had killed, Ewan attempted to make an offering in musical terms by sitting at the piano to play a piece which he entitled “Requiem.” At the time this felt sincere but also very sad, as I perceived that Ewan felt very clumsy and inadequate in trying to address such a huge and tragic event. From this state, the first expressions of remorse at the magnitude of his violent act began to emerge. Perhaps the fluctuations between reflecting on his offence and reflecting on his childhood suggested how Ewan was trying to make links in understanding why he had committed his offence.


The individual music therapy was characterized largely by a positive transference. Ewan completed his mourning process in the following two years of group therapy where he discovered how to be part of a “family,” as well as how to feel included and valued by others. He remains in custodial care at a lower level of security. At his care program review as the therapy closed, he described his recovery process in music therapy as “akin to the raising of Lazarus.” This biblical reference to Christ’s greatest miracle probably says at least as much about Ewan’s internal morbid state of loss, including loss of hope prior to engagement in music therapy, as it does about his creativity and ability to express himself and to develop through music therapy in a way which, after ten years of stagnation, he may have felt was miraculous.

Copyright © Jessica Kingsley Publishers 2012