The Awesome Metalcore Therapy Case

If you are reading this it’s probably because you have read the Awesome Metalcore Therapy Case in The Practical Handbook of Hearing Voices, we hope you enjoyed it.   We’ve put a bit of extra information in here because we ran out of words and there are some copyright type restrictions on putting certain things like lyrics in published works (but we’ve snuck a couple of bits in here for demonstration).  The full awesome metalcore therapy letter contained lots more songs and lyrics than the one in the chapter.  Here is the playlist for all  the songs that featured in the full letter.  There’s also a cool video of Sam Carter’s speech at Ally Pally that we refer to in the letter, on YouTube.


A little bit more of the awesome metalcore therapy letter (we’ve taken out some of the more ‘personal’ bits):


Dear Danny

We have been meeting up for some time now, and over the course of our work together have talked about loads of things, probably too much to mention here. However, in the spirit of trying to summarise it somehow, so you can have a record of it in case it is useful in the future, I’ve come up with a few points (okay, more like an essay!).  Thanks for providing the corresponding music and lyrics to it…I definitely know more about metalcore now than I ever did before, and am better off for it, of course.

We first started meeting up about 18 months ago, when you were referred to our team from CAMHS. You had been through CAMHS a couple of times before, but admitted that you had talked your way out of carrying on seeing them because you didn’t feel it was helpful.  When we first met you told me that you had some struggles with your mood being lower than you would like, and that there was an issue with hearing voices.  However, you also said that you didn’t really like talking to people or opening up to them, especially about the voices, so for ages we didn’t really discuss that.  We spent about 6 months trying out a structured therapy approach called CBT, which involves looking at how your thoughts, feelings and behaviours are linked together.  However, we had some problems with making this stick, because you didn’t really do your ‘homework’ and didn’t always come to the appointments.  Eventually you told me that you thought things were better, and I agreed to discharge you.  Looking back, I think we both realise that maybe the CBT wasn’t really suiting you and that you had talked your way out of carrying on with the appointments again, like what happened with CAMHS.

Then, you did something that I think was kind of brave really, for someone who finds it hard to open up. You contacted me and said that you were struggling and wanted to come back.  When we met up again we thought really hard about what didn’t work last time and how we could make it better.  And then we kind of invented a way of working together that we both thought was worth a try.  I guess it was a happy coincidence that we both like metal music, as this has definitely been something that you felt you could talk to me about even when other stuff was too hard to say.  I think the first proper ‘breakthrough’ that we had was when we decided to start using playlists and lyrics from music that you like, it was certainly the first time that you did any ‘homework’!

We started to talk through important aspects of your life using music bits that were relevant at the time and meaningful in relation to your experiences:




“Ever since this began, I was blessed with a curse” – Bring me the Horizon (BMTH from now on)

Something difficult happened in my life when I was 8 years old.   I don’t trust people because I trusted someone who then fucked me over, I think that’s the main reason why I’m here (i.e. in services).

“You, took what you wanted and left, like locusts
Everything I gave to you, everything that we’ve been through
You, bled me dry and then went, like leeches
Go, you got what you came for now leave, like vultures”

I found some old notebooks from when I was 10 that said that I wanted to die and pictures of hanging myself.  I didn’t speak to anyone about what was going on or how I was feeling.

“We won’t witness anymore freedom.
Where is anybody? Do we need ’em?
I would rather fight,
Than let another die.
We’re the problem,
But we’re also the solution
All hope is gone!

If you want you cannot take it from me
If you think you can, you still don’t know me
Let me tell you, when I said it, I meant it
And I will always have the right to defend it”
– Slipknot

I started cutting age 11, because I felt like shit all the time because of what was happening.  I discovered metal music after this and it made the cutting less, without music I don’t think I would be alive.  I cut most of the way through high school up to 2017, on a weekly basis, I had low mood through this time.

“I bleed for this and I bleed for you
Still you look at my face like I’m somebody new
Toy nobody wants anything I’ve got
Which is fine because your made of
– Slipknot

When I was 12 years old I moved somewhere else – I was fuming with the world for quite a long time. This reflected in my behaviour at school.  I got less bothered about moving schools all the time though.  I remember going on holiday and listening a lot to Sempiternal by BMTH, I was in a weird place (mentally) but it kind of grounded me, and I realised how important music was to me.  I started hearing the odd laugh or scream from like a demon ‘like my head was in hell’.

“I’m scared to get close, and I hate being alone

I long for that feeling to not feel at all

The higher I get, the lower I’ll sink

I can’t drown my demons, they know how to swim”  BMTH – Can you feel my heart


“Everybody wants to go to heaven

But nobody wants to die

I can’t fear death, no longer

I’ve died a thousand times

Why explore the universe

When we don’t know ourselves?

There’s emptiness inside our heads

That no one dares to dwell”   BMTH – Hospital for souls


When I was 14 someone I knew very well ended their life. Neck deep was one of his favourite bands.

“The world’s a fucked up place but it depends on how you see it”’  Neck Deep

I started hearing his voice, it was a comfort thing and helped a bit, but in some ways it made it harder, cos I used to see him. I couldn’t accept that he was dead.  Sometimes I feel he isn’t real or that I can’t remember him properly anymore.  I still hear his voice sometimes.  The tattoo that I later got for him helped a lot, it was a bit like closure, and I haven’t really seen him since like I used to.

“I heard a knock upon my door the other day
I opened it to find death staring in my face
The feel of mortal stalking still reverberates
Everywhere I go I drag this coffin just in case

My bodies trembling, sends shivers down my spine
Adrenaline kicks and shifts into overdrive,
Your secrets keep you sick your lies keep you alive
Snake eyes every single time you roll with crooked dice
I felt the darkness as it tried to pull me down
The kind of dark that haunts a hundred year old house
I wrestle with my thoughts I shook the hand of doubt
Running from my past I’m praying feet don’t fail me now!”  
– Falling in Reverse


I behaved badly in secondary school but didn’t actually get kicked out, I was put in the ‘interventions’ classes. Because of moving house I attended 3 high schools.


“But until you’re broken
you don’t know what you’re made of

I feel my heart caving in
this line I’m walking is paper thin
and it’s hard to hide the scar beneath the skin
Because I’ve been burned and broke
And I wanted out, but I’m better now
And I know I won’t be giving in”
Danger Kids


Things carried on in terms of my low mood and voices for a while, and I started hearing more voices, some of which were nastier than my first voice. At this time I came into services.  Later my friend tried to kill himself, he survived but it brought a lot of the stuff back and things were difficult for a bit.

Do you think you’re the only one who feels the way you do?
We’re all fifty shades of fucked up!
Well join the club, yeah, join the club!

I realised that I tend to take on a lot of other people’s problems, I’d rather be hurt than let others get hurt. I don’t care about myself

I don’t want you to cry, I don’t even want you to care
Don’t you dare, pray for me, no
There’s things I bury inside, to keep away from the light
Don’t you dare, pray for me
–  Asking Alexandria


What brings me back round when my head goes off….

Seen as we had used music and lyrics as a way to describe things that had happened in your life, we wondered about if this would also be useful as a way of thinking about things that might be helpful for managing some of the struggles that you are facing. You particularly identified that the Architects have been a specific source of helpful ideas you said that in particular you started really listening to the album Holy Hell and reading into what the lyrics meant for you.  We’ve picked a couple of examples from their music.

I think architects are part of the reason now why I’m still alive

“A single spark can start a forest fire”

One of the issues that we have talked about a lot is that you sometimes have big emotional responses to things that happen in your life, or as you put it ‘the littlest thing can start the biggest problems’ and that this can tip you ‘over the edge’. This sense of being up and down all the time can be really difficult to manage especially when you are in the middle of experiencing a lot of difficult feelings.


“What will be will be. Every river flows into the sea’

We talked about how you use the idea that everything leads to a ‘bigger picture’ so it is good to hold this in mind when experiencing difficult emotions, as these often pass in a short time. Instead, it is important to think about the bigger picture and what you are aiming for long term. This can be the same with voices, they are experiences that can represent difficult feelings but we can relate to them differently if we keep in mind the bigger picture.  You said that now your voices are more like a ‘background noise’.


‘If this is living the dream we’ve hit an all-time low’

You identified this song as being particularly important because it reminded you about all of the people who have low mood at times, including ones that are famous! Or as you put it ‘he’s a rock star so if that’s what he feels like….’.  We talked about how highs and lows of mood can be part of the human experience and knowing that other people are also going through difficulties can make you feel less alone.


One of the best things that you came across was this speech that Sam Carter made at a concert, it’s kind of long but worth it!

“I had a conversation today and I lady asked me ‘when you lay in bed what do you think about?, what do you worry about?’ I paused cos that’s a fucking hard question to answer. But what I said was ‘in a world that we live in right now, when every day you wake up, and you look at your phone, on your laptop, you read a newspaper. You are filled with the worst kind of shit you could possibly read, you are filled with negativity, from the moment you open your fucking phone’. And I said to her, I said ‘I’m scared of people giving up, I’m scared of people losing that fire in their fucking heart, because you are born an empathetic human, you are born someone who cares about your brother or sister, it is society that pushes that out of you, it is society that pushes hate upon you’.  So what I’m saying to you right now, is that it’s okay to feel scared in this world that we live on, what is not okay is to feel alone, because you are not alone, you are not alone in your empathetic state of mind, you are not alone in how much you care, you are not alone in how much fire is in your fucking stomach. If you want to make a difference, you fucking can, and I’m telling you this, we who live every day, we are lucky to see every day. But when you see something that is wrong, whether it’s sexism, homophobia, racism, or just outright hate towards anyone, don’t be a fucking sheep, stand up, and stand up for what is fucking right. Don’t be the person that goes home wishing they did something, be their person that goes home proud that you stood up for somebody and you showed them love, and you showed them compassion, because love will always fight over hate, and it will always fucking win.”


We talked about how you found this speech to be really powerful and that it highlights a lot of things that you connect with ‘he’s a smart guy!’. We discussed that it’s kind of about continuing to fight for things that are important to you and again this idea of moving forward with the bigger picture in mind.  I was telling you about one idea in psychology where it can be helpful to have a ‘compassionate ideal’ person in mind when thinking about how you respond to yourself, especially if you criticise yourself.  We wondered if Sam was kind of similar to how you would want this person to be.  We also noticed how positive this speech was compared to some of the ideas that you may have if feeling lower in mood, and that in a way this is like challenging that way of looking at things.

As we come to the end of our time together, we talked about how things are now and the ways that you have learned to cope with things. I think we both realise that things might not ever be ‘perfect’.  However, you said that you now ‘move past shit in my own way’ and a lot of this is about being able to clear your head by re-focusing or re-directing your attention.  As you might expect, music can be a big part of that, but you also said that it helps you to watch or listen to something you are familiar with, that this fills you head with things that you know you like.  In particular where this is an ‘opposite’ action to how you are feeling (so happy stuff when you feel sad) this can work sometimes.  We also talked about how talking things through can be helpful if this is with someone that you know will understand, which is a big step for you as you find it hard to talk to people at times.  You also said that you still use the playlists that you made in the beginning that described different emotions.  As part of this it seemed apt to have a playlist that goes with this letter with all the songs in it that you mentioned 🙂


I am okay to me, wouldn’t say that I’m not okay.

I wanted to say thank you for working so hard in the sessions, talking through stuff that was difficult and helping me to understand what’s going on for you through the awesome medium of metalcore! I hope that you continue to find the things helpful that we discussed and I wish you all the best for the future…..

Oh – and thanks for helping me invent heavy metal therapy 🙂