Contributed by Shauna Larson

Living as an expatriate or global nomad offers exciting opportunities and fosters a diverse cultural identity. This group includes third culture kids and international expatriates who grow up in different cultures. Their experiences create a global mindset, but their nomadic lifestyle can also lead to mental health challenges, such as adjusting to new cultures and feeling displaced. Acknowledging these struggles is vital to offering the appropriate support and ensuring their psychological well-being.

Understanding Third Culture Kids (TCKs) and International Expatriates

Third Culture Kids (TCKs)

Third Culture Kids (TCKs) are born into a reality shaped by their parents’ international careers in diplomacy, military, or corporate roles. This exposure to diverse cultures from a young age molds their unique cross-cultural identity.

International Expatriates

International Expatriates choose to live outside their native countries for reasons like career growth, economic incentives, a better quality of life, or cultural exploration.

Psychological Impact and Coping Mechanisms of TCKs and Expatriates

Cross-Cultural Identity Formation

Cross-cultural identity formation is complex for expatriates, global nomads, and TCKs as they integrate aspects from multiple cultures into a unique identity.

This multicultural identity affects mental health in significant ways, including:

  • Anxiety and Stress: The continuous adaptation to new environments, languages, and social norms can generate high levels of stress and anxiety, intensifying the struggle to feel “at home.”
  • Potential Identity Confusion: A fusion of cultural influences can lead to a sense of not wholly belonging anywhere, causing identity confusion and feelings of cultural homelessness.
  • Emotional Strain: Dealing with regular goodbyes and transitions, coupled with the pressure of ‘fitting in,’ can exert an emotional toll, fostering feelings of isolation and loneliness.

Grief and Loss

Frequent cultural transitions bring grief and loss as individuals say goodbye to loved ones and familiar places. These experiences significantly impact mental health, particularly:

  • Depression and Anxiety: Frequent separation from loved ones triggers sadness and loneliness, predisposing expatriates and TCKs to depression and anxiety disorders.
  • Coping Mechanisms: Effective coping strategies, like maintaining connections and forming new relationships, moderate the impact of loss. Maladaptive methods can worsen mental health issues.
  • Unresolved Grief: Lack of support leads to unresolved or complicated grief, an intense form that hinders normal functioning in individuals facing recurrent loss.

Cultural Adaptability

Cultural adaptability is crucial for TCKs and Expatriates, enabling effective functioning in diverse cultures. It cultivates global citizenship and cultural competence.

However, high cultural adaptability has both advantages and disadvantages:

  • Resilience: Enhanced cultural adaptability can bolster resilience, enabling individuals to cope with change and navigate unfamiliar contexts with increased confidence and flexibility.
  • Struggles with feeling out-of-place: Despite successful adaptation, individuals may grapple with a persistent sense of alienation, feeling neither entirely at home in their original nor host culture.
  • Cognitive Flexibility: Encountering and adjusting to diverse cultural norms can foster cognitive flexibility, a key factor in problem-solving and creative thinking.
  • Identity Conflict: High adaptability may lead to frequent shifts in behavior and attitudes to blend into different cultures, possibly sparking inner conflicts about one’s core identity.

Mental Health Vulnerabilities and Belongingness

TCKs and Expatriates’ mental health vulnerabilities are linked to their nomadic lifestyles, impacting their sense of belonging and increasing disorder susceptibility.

Key areas of concern include:

  • Higher Rates of Anxiety and Depression: The inherent challenges of expatriate life, such as recurrent transitions and separation from loved ones, may contribute to heightened levels of anxiety and depression.
  • Feelings of Displacement: The frequent changes in living environments can result in feelings of displacement, causing a sense of not wholly belonging to any one culture, often referred to as ‘cultural homelessness.’
  • Quest for Belonging: Amid their layered cultural identities, TCKs and Expatriates often embark on a lifelong quest for a sense of belonging, which, if unfulfilled, can exacerbate feelings of isolation and disconnection.

Resources and Strategies for Mental Health Support of TCKs and Expatriates

The Role of Community and Peer Support

Community and peer support play a pivotal role in bolstering mental health among expatriates and TCKs. Expat communities offer a sense of belonging, while school counselors provide tailored guidance. Peer groups provide empathy and comfort, reinforcing resilience and promoting psychological well-being.

Teletherapy and Online Resources

Teletherapy provides flexible and consistent mental health support regardless of location. Coupled with online resources like self-help websites and support groups, it fosters a digital community for expatriates and TCKs, offering valuable information, shared experiences, and coping strategies tailored to their unique needs.

Culturally Sensitive Counseling

Counselors, by acknowledging and appreciating the diverse cultural tapestry shaping their identities, can deliver personalized, effective support. This approach fosters better rapport, mutual understanding, and more fruitful therapeutic outcomes, thus enhancing overall mental wellness.

School-Based Interventions

Effective school-based interventions include the provision of culturally sensitive counseling services, implementing transition programs to ease adaptation, and assisting a supportive and inclusive school climate. Such measures can significantly improve students’ welfare  and academic performance.

Parental and Family Support

Parents serve as the frontline responders, providing reassurance and stability. Equipping families with resources like cultural transition workshops and support groups fosters a supportive home environment, benefiting their child’s mental health.

Self-Care and Coping Strategies

Maintaining routines, practicing mindfulness, and nurturing cultural connections help expatriates and TCKs cope with stress. Engaging in hobbies, physical activities, and health checks reinforce resilience for a balanced global lifestyle.

The Takeaway

The cultural journeys of Third Culture Kids and International Expatriates bring enrichment but also pose distinctive mental health challenges. The complexities involve cultural adaptability, identity formation, grief, and displacement. Effective solutions encompass community support, teletherapy, culturally sensitive counseling, school interventions, parental involvement, and self-care strategies.

However, further research is crucial to better understand and address their mental health landscape. Accessible online and offline resources must be developed to provide targeted support. Recognizing and meeting the mental health needs of TCKs and Expatriates is essential for cultivating a global society that embraces diversity and inclusion.

Author: Shauna Larson

Shauna Larson, a passionate mental wellness advocate. For the last five years, she employs her personal experience and deep understanding of mental health to illuminate the complexities and challenges that many face every day. Her thoughtful insights and relatable narratives have been featured in a variety of publications, cultivating a loyal readership that values her authentic voice and practical advice.

Contributed by Lauren Wells

There’s a conversation that seems to keep repeating; a training that has been continually requested in the past couple of years. It’s on a topic that we recognize is a growing global challenge, but in our Third Culture Kid community seems to be even more weighty. 


As practitioners, we know how anxiety presents and often how to treat it. However, at TCK Training we’ve found underlying causes that are more unique to the TCK community. We believe understanding those causes can help implement an effective treatment plan. At the very least, it can help the TCKs we’re serving to have language for and understanding of the anxiety they’re facing. 

We’re not entirely surprised by the growing rates of anxiety in TCKs. Our 2021 research study on Adverse Childhood Experiences (ACEs) in the TCK population surveyed 1,904 Adult TCKs. In that data set, we found 21% of ATCKs had high ACE scores (four or more out of ten). That’s in contrast to 12.5% of the American control group (a CDC Kaiser study). For highly mobile TCKs who moved locations more than 10 times, the number increased to 32%.

Higher ACE scores are associated with higher rates of mental illness. It was found that “…an ACE score of four or greater was associated with 7.3 higher odds of anxiety or depression compared to those with less than four ACEs.” (Elmore AL, Crouch E.)

So the fact that TCKs experience higher rates of anxiety is not a surprise, but why might this be the case? What about those high ACE scores and the TCK life might lead to the symptoms of anxiety? 

We’ve noticed three trends. 

  1. Settling feels unfamiliar and thus breeds anxiety. We’ve found that TCK anxiety tends to increase when their highly mobile life is halted and they are in one place, with the same people for a longer period of time. This may make it difficult for a practitioner to find a source of anxiety because it might appear that everything is finally settling down in the TCK’s life. There may be more predictability, consistent relationships, opportunity to maintain hobbies, etc. However, for TCKs who have been highly mobile (either they relocated often or the people around them constantly came and went) it is that stable feeling that feels so uncomfortable and that uncomfort can present in feelings of anxiety. The adrenaline that they frequently experienced from huge life upheavals feels familiar, even if they express that they despised the constant change. Their body is used to it and their body responds when the familiarity of upheaval is gone. The COVID pandemic also made this settledness a forced experience for many TCKs and their families and that brought in additional emotions because it was unexpected, laced in fear, and often filled with many unknowns. 
  1. Close, long-term relationships. Even if the TCK you’re working with didn’t relocate frequently, it’s likely that there was a revolving door of people coming in and out of their life because of the transient nature of the expatriate community. This means that TCKs become experts at the first stage of a relationship. They’re often very good at getting to know people and are experts at navigating the getting-to-know you phase. Because of this rhythm, they get used to short-term relationships being the norm and with every new relationship a mental alarm clock begins to tick. When the relationship begins to have longevity, anxiety often surfaces. Sometimes, this anxiety leads them to subconsciously sabotage the relationship. Other times, they’ve come to you because of anxiety and haven’t been able to pinpoint a cause. If they’ve had longer term friends, or have been in a romantic relationship longer than past relationships have typically lasted, that could be an underlying source of anxiety. 
  1. A tall Grief Tower. I’ve written about the compounding nature of TCK grief in my books The Grief Tower and Unstacking Your Grief Tower. We see that TCKs who don’t “unstack” losses and traumatic experiences along the way through processing, often come to a point when they begin to experience symptoms of a tall or crashed Grief Tower. This most often presents as Complex PTSD. They may not have any major big “T” traumas in their life, but instead have a constant stream of losses and grief-inducing experiences that have stacked up. One of the body’s responses to this is often anxiety. In the two books mentioned, I walk through the methodology of creating a Grief Tower Timeline. Many practitioners have found that process to be a very effective way to reduce the symptoms of unprocessed grief, including anxiety. 

How you treat TCK anxiety may not differ significantly from how you would treat non-TCK’s anxiety, but we’ve found that it can be soothing and normalizing for TCKs to have a better understanding of how their unique life could be connected to how their body is emoting. Most importantly, they need to hear that the cause of their anxiety is not their fault AND the management of it is their responsibility. It is unhelpful to look at the TCK life, blame it as the source of anxiety, and stay stuck in the anxiety. But it can be so healing to help your TCK client understand their anxiety, come to terms with how their upbringing may have impacted them, and learn tools for how to live into the wonderful parts of their TCK upbring while managing anxiety in healthy ways. 


Elmore AL, Crouch E. The Association of Adverse Childhood Experiences With Anxiety and Depression for Children and Youth, 8 to 17 Years of Age. Acad Pediatr. 2020 Jul;20(5):600-608. doi: 10.1016/j.acap.2020.02.012. Epub 2020 Feb 22. PMID: 32092442; PMCID: PMC7340577.

Recorded Workshops: 

TCKs and Anxiety

Understanding Your Anxiety as an Adult TCK

Our Counseling TCKs Therapist Training is offered online each spring and fall and is eligible for 6 NBCC CEUs. 

Author: Lauren Wells

Lauren Wells is the founder and CEO of TCK Training and author of Raising Up a Generation of Healthy Third Culture Kids, The Grief Tower, and Unstacking Your Grief Tower. She is an Adult TCK/MK who spent her teenage years in Tanzania, East Africa. She sits on the board of the TCK Care Accreditation as Vice Chair and is part of the TCK Training Research Team focusing on preventive care research in the TCK population. She lives in Georgia, USA with her husband and two daughters. 

Contributed by Paul W. Anderson, PhD

The Problem

Most of what I have left from my childhood are tattered memories and a few pieces of paper; black and white pictures, old, faded letters and such.

I was five years old when I was kicked out of an American kindergarten for painting a kid’s face black. After all, I was about to leave for the Gold Coast (now Ghana) on my parent’s first term of missionary service. I wanted to play “African.” That was the beginning of the chaos.

During the next three years my family and I left and returned to the U. S. of A, rode in cars, trains, planes and ocean liners. I crossed the Atlantic twice: once in a converted DC-3 bomber which did not make it across and had to return because the fuel cap was left off and discovered only miles before the point of no return. We turned back and tried again, on a different plane. On that flight I watched my mother pass out several times due to the cabin being improperly pressurized.

By the time I was eight, I had lost a dog named Spot (the first of many pets) to snake bite, learned a second language, was home schooled through second grade, spent more time learning about life from the “house boys” (the domestic help, as they were called) than from my parents, was molested several times (by a 21 year old male in London while on our return trip to America), got spanked a lot, got saved (as in born again) and still got spanked a lot. Despite trying so hard to be good and obedient, I had to hand over all my Christmas presents from America one dark night in exchange for our lives a few days before the second Christmas we were in Africa. The Gold Coast was in turmoil as it struggled to throw off British colonialism. A white face was a liability.

Perhaps the most important thing I learned from the first term as a missionary kid was that my purpose in life was to take care of my mother emotionally so she could support my dad while he was busy saving souls. My life was not my own.

As subsequent terms of service in Ghana transpired, I quickly learned to adjust – and adapt – to my life. It was simply a matter of fact that without much advance notice I was to be ready to lose my “whole world with the closing of an aeroplane door,” as Ruth van Reken1 puts it.

Without fanfare or formal closure, I was to calmly allow “every pet, every friend, every tree (I) climbed, every secret place (I) hid, every sense of home (I) had known”1 be erased – repeatedly – with each re-entry. These were irretrievable losses. When I returned – to either culture – nothing was the same. The cultural context had changed, my parents had changed, and I had changed. I was expected to start over and do well. None of this lifestyle was at my choosing, or under my control. Very little of this was discussed in or outside the family. It was just the way it “was”.

Family circumstances characterized by the “predictably unpredictable” are emotionally chaotic contexts.

These kinds of chronic dynamics can produce relatively high levels of chronic anxiety in families and family members. An extended emotionally chaotic family context creates more instability than can be sufficiently absorbed and integrated by its members, especially children, so that they are not able to mature and develop in a healthy fashion.

This instability can be generated by any circumstance(s) which disrupts long-term regularity, predictability, a sense of safety, and security for the children. Examples of these situations include family violence, poverty, addiction, upheavals from repeated patterns of relocation, natural disasters, multiple deaths, chronic illness, criminal lifestyles and migration. These are contexts of high chronic stress and anxiety.

The long-term results of these threats and challenges to growth in childhood will obviously vary depending upon the severity of the circumstances. However, in adulthood a variety of symptoms can develop in any area of life; physical, financial, social, interpersonal, emotional, and spiritual. What is known about adult children of alcoholics can clarify the impact on adults who grew up as third culture children.

The research of Claudia Black2 isolated three rules, or patterns, of chaotic family life, which affect the way children from alcoholic homes make decisions and conduct their adult lives:

  1. Don’t talk about the real issues.
  2. Don’t trust others in talking about real issues; and
  3. Don’t feel your own feelings, let alone share them. It isn’t safe.

These interpersonal patterns in a family can leave children with little trust of others and a chronic feeling of being out of control over their circumstance.

The Fix

I was 12 and got in a fight with an African boy my age. He was tormenting my pet donkey, Inky, I was riding.  He kept poking the donkey’s rear end with a long corn stalk. I asked him to stop, repeatedly.  He continued with glee, egged on by his friends. I took my riding whip to the kid.

Turns out, he was the favorite son of a prominent village elder. Mother punished me (read, “whipped”) and told me I had undone all my father’s missionary efforts with the locals. End of talk. My father never spoke of it. Instead, he spent his extra time that next week in the village mending relationships.

Not until adulthood did it occur to me to wonder – why did I have a different standard of conduct than the other boys my age, and how was my bad behavior as a kid more powerful than my father’s good behavior?

Denial, rationalizations, and guessing about what is “normal” become the rule of thought and behavior when real issues are not addressed. How does an adult with a “don’t talk” childhood get the tools to keep a marriage intimate, or a job healthy, if real issues are difficult to identify, let alone discuss?

Likewise, dishonesty, lack of trust and an inability to access true deep feeling can lead to additional troubles in adult relationships, quality of life, and personal authenticity.

In 1983, Janet Woititz published “Adult Children of Alcoholics”. By 1987 it hit the New York Times best seller list and stayed there a year. In her book, Woititz attempted not to label adult children of alcoholics, but to “provide a little understanding of why you react the way you do, of what some of the reasons are for the behaviors that you have not been able to understand.”3 Her goal was to reduce the isolation of countless persons who also thought they were different because of their life experiences.

In a 1990 edition, she stated she has since learned that the material in her book applies to other types of “dysfunctional” families as well.4 She includes families with compulsive behaviors, chronic illness, profound religious attitudes, adoption and foster care. For me, these are but further examples of families with emotionally chaotic, chronically anxious emotional climates of “predictable unpredictability.”

Woitiz’ lists characteristics which describe how adult children from alcoholic homes tend to think and function. I think they can equally relate to the issues confronting adult third culture kids. These are reactions children make to adapt and stabilize in an emotional home environment of low trust and little control.

  • Guess at what normal is.
  • Have difficulty following a project through from beginning to end.
  • Lie when it would be just as easy to tell the truth.
  • Judge themselves without mercy.
  • Have difficulty having fun.
  • Take themselves very seriously.
  • Have difficulty with intimate relationships.
  • Overreact to changes over which they have no control.
  • Constantly seek approval and affirmation.
  • Usually feel they are different from other people.
  • Super responsible or super irresponsible.
  • Extremely loyal, even in the face of evidence that the loyalty is undeserved.
  • Impulsive. This leads to confusion, self-loathing, loss of control over their environment and wasted energy cleaning up the messes.

From my observations as a family addictions psychologist, I have added a few more characteristics which I think also apply to adult third culture kids.

  • Hyper vigilant. Keen, alert observers, especially of social settings.
  • Over-reactive to being slighted, discounted or otherwise maligned or misunderstood.
  • Most immediate emotion beneath the surface is sadness.
  • Can “drop and run”. Thinks releasing connectivity to people, places and things happens easily at will. Does not anticipate the long-term painful consequences to one’s own self of erasing personal history.
  • Resilient and resourceful.
  • At risk of forming compulsions and obsessions of their own.
  • Thinks in black/white, all-or-nothing terms.

Ironically, many of the adaptive patterns formed by an anxious childhood lead to adult habits and lifestyles that create stress and anxiety. The patterns identified by Woititz may provide short term relief and stabilization in childhood. Because they are reactive patterns and not consciously thought out, these ways of coping may eventually manage stress and anxiety less and become maladaptive. The result is cycles of anxiety perpetuated through the generations of families.

What to do about all this as an adult who grew in a home where you were not taught how to talk, trust or feel? Here are some tips:

An Examined Life:

Be willing to live an examined life. Anxiety, low trust, and feeling out-of-control are reduced as a person comes to trust themselves and their own resources to take care of them. To do so, you need to know yourself, know and accept who you are and what works best for you. As children, we are dependent on others to be well cared for and secure. Adults can do these things for themselves. Conscious self awareness and self management reduces the concern and focus on controlling the external environment and other people in it so you can get your needs met.  Manage yourself instead.

Reduce Fear and Increase Safety:

Acknowledge to yourself when you feel low trust and/or loss of control in a given situation. Identify the sources. Look for ways to replace fear with pro-action, not reaction. Practice mindful self-care. Trust yourself and a Higher Power that all your security needs are presently being met. Fear does not kill us. What we do in fear can.

Reveal Yourself:

With people you care about, consciously go as far as you are able to trust, talk, and feel with them about the real stuff in your life. Talk about your difficulty trusting, talking, and feeling. Take appropriate risks to reveal yourself to others.

Practice Balanced Living:

Regularly practice good self-care in all areas of your life, physical, mental, emotional, spiritual, financial, social, and recreational. Nothing reduces chronic anxiety and improves quality of life more than taking good care of yourself. Meet your needs on a consistent basis, even if it makes you feel selfish or guilty. Practice balanced living; living within your means of all kinds – emotional means, social means, etc.

Robust By Design:

Robust by design means we are tougher and more enduring than our feelings at times may lead us to believe. When anxious or experiencing strong toxic, negative feelings, we can be deceived into concluding we are how we feel. If you act in those moments letting how you feel guide your behavior and the choices you make, it is possible to do damage to self and/or a relationship. Feelings are only feelings. They always pass. Don’t let feelings scare you into impulsive, self-defeating behavior.

Get a good Coach or Counselor to companion you as you make these changes.

Talking with a neutral and objective other person adds perspective to any situation.  Coaching/counseling helps remove us a bit from our normal subjective and more emotional stance about a given situation.  With more objectivity we can see options for action we may have missed in the haze of strong feeling.

A competent counselor helps us process consequences, pros/con of various choices. When we decide to act, it is better informed, thoughtful and less likely to make things worse.

I like the Serenity Prayer: “God grant me the serenity to accept the things I cannot change (control); courage to change (control) the things I can; and wisdom to know the difference.”

Acceptance of who you are and what you can do and cannot do brings clarity to any given situation. Clarity keeps you grounded in truth and reality. The truth is you are a person of courage, a creature able to access all the wisdom you need at any moment to be safe and in control of yourself.

You may contact me at or phone: 913-991-2302.


  1. van Reken, Ruth Coping With Loss: The Downside of Being A Missionary Kid,1997, Reality Magazine, Auckland, New Zealand.
  2. Black, Claudia, It Will Never Happen to Me, 1981, Ballantine Books, New York, New York.
  3. Woititz, Janet G., Adult Children Of Alcoholics, 1990, Expanded Edition, Health Communications Inc., Deerfield Beach, FL, page 23.
  4. Ibid., page xi.

Author: Paul W. Anderson, PhD

Paul has been in private practice as a family psychologist and executive coach for over 30 years. Prior to that, he worked in corporate management positions. As a child growing up overseas, Paul developed skills he could use to join diverse groups and cultures at will. As a Third Culture Kid, he learned that reality can be viewed from many perspectives, an awareness that helps him validate each person he works with, even though their views may differ from others. Two things characterized his practice: 1) a strategic, solution focused perspective which, 2) takes context, particularly interpersonal dynamics, into account. With this practical systemic approach, he works with people to develop solutions which not only give them the successes they want but does so in a way that sustains those achievements. He lives in the Kansas City metro area where they raised 5 daughters. Travel, dogs and furniture making keep him busy outside of his professional work.

I recently had the privilege of being invited to participate in an interview with Lindsey Phillips, editor and chief for Counseling Today, as she worked to author a feature article on Third Culture Kids. Not only do articles like this one help bring the Third Culture Kid experience more thoughtfully into the public eye, but they do so in the context of the practice of counseling and psychotherapy. It is also a delight to highlight the International Therapist Directory this way. With permission, I am sharing Lindsey’s article, available in the link below.

“Growing up between cultures” by Lindsey Phillips, published in Counseling Today Vol. 65, No. 02 (August 2022): 35-40, Copyright © 2022, the American Counseling Association. All rights reserved.

All the best,


Josh Sandoz, MA, LMHC received his MACP in 2008 from The Seattle School of Theology and Psychology and currently works in private practice in Seattle, Washington providing individual psychotherapy for children, adolescents, and adults. Specializing in working with those impacted by international mobility, he also curates Josh is a past president of the Board of Directors of COR, Center for Object Relations, and has been deeply involved with the Northwest Alliance for Psychoanalytic Study. Since 2012, Josh has been singing alto on Sunday evenings with The Compline Choir at Saint Mark’s Episcopal Cathedral.

Contributed by 鶴田 みさ Misa Tsuruta, Ph.D

If somebody asks me what the important issues that I would think of in working with expats are, I would definitely list social support among them. Social support is various social resources that you can turn to when you are in need or to reduce your stress, such as your family and relatives, your close and distant friends and acquaintances, your colleagues, your neighbors, etc… Being an expat entails many different challenges: leaving your own home country, leaving your parents behind (usually), saying good-bye to your childhood friends, classmates, teachers, etc…

In our Internet times, distant communication must be much better than pre-Internet days. We can text or video chat instantly, and if you choose to, you can still use emails and telephones. The variety of distant communication is not comparable to what was available before the advent of these technologies. I sometimes wonder how Kūkai, a famous Buddhist priest from the 8th-9th Century in Japan, was able to study everything in just two years in China and to come back to Japan to propagate Buddhism and establish his own sect of Shingon-shū. Or any other missionaries in the following centuries. Perhaps these are the wrong people to compare to. Anyway, after several years of conducting online psychotherapy sessions, I have to say it’s not exactly the same as seeing each other in person. Many must share the same realization after painful days and months of restrictions and confinement due to COVID-19. (I need to add that I keep conducting online sessions because some people need and benefit from them.)

What are the differences? It can be a whole other discussion but chiefly it can come to the body and the space, or lack of those in virtual settings. Online meetings come down to this squarely framed smiley face (bust up), without the whole body and the accompanying space around them. Human existence flattened to the two-dimensional.  But here we can be struck by the wonderful human capacity of languages and communications that allow us to connect despite these horrendous differences.

Yes, it is possible to rely on distant communication tools that are amply available out there in virtual settings. But if the stay is not so time-limited, where the sense of “long enough duration” may differ from person to person, we may have to rely also on local, immediate social networks, not only distant and indirect ones. This may not be an issue for those who are capable of meeting new people and making friends without much effort, but it can be a huge task for those who may feel socially awkward and/or inhibited. What if you never left your own area or social circles before coming to this country? What if you relied on those around you, such as family or close friends, to build a new social connection?

Yet, new people and friends are desperately needed as you move into a new life stage, be it marriage, new job, or parenting. Social support can be especially critical when it comes to child-rearing: as a mother of a teenager, when my own kid was younger, I often had this sense of relief by sharing my own stories with fellow moms, which was a normalizing experience. Parents in isolation can consciously or unconsciously repeat questions like: Is it normal to experience this? Am I doing something wrong? Is there something wrong with my kid? And so on.

In fact, social support is listed as one of the critical factors to maintain health and well-being, be it physical health or mental health. Researchers have said that we need to have different “social bubbles,” because for example, you may not be talking about family and parenting difficulties at work or talking about job-related technical issues at your immediate friends’ circles. Having a variety of social circles allows you to rely on different ones as needed and to turn to another one if one unfortunately fails.

Now I need to mention what I haven’t talked about yet in this article. Languages can play a big role in socialization of expats. If you have competency in the language of the host country or in some of the major languages of the world – English certainly named the primary one – you are lucky. But it still takes some courage and “outgoing-ness” in order to utilize one or more languages with supposedly more diverse people you meet in expat situations.

If, on the contrary, you stay in a small circle of certain expats, you may not have enough air, choices, and freedom. One time, I had a stand-alone online session with a Japanese woman in a local city in Australia. She had a social circle, but it was limited to a corporate-related wives’ circle; yet worse, it was governed by a bossy woman. She was struggling to find way out by attending an external (meaning, English-speaking) yoga class. Hers might be a bit of an extreme situation, but I would imagine that many are in situations that are not too far from ones like hers.

Being in a foreign country can be a great experience. One that can be eye-opening and even life changing. More so if you have courage to take actions to step out of existing comfort zones, and I consider building social support as one of them. But also, it takes facing some difficulties and challenges such as overcoming social anxiety, communication, language skills, realizing your own values and prejudices, uncertainty, etc… Being away from your home country is where you find usefulness of psychology.

Author: 鶴田 みさ Misa Tsuruta, Ph.D

Misa Tsuruta, PhD, studied and got training in psychology in New York City. Originally from Japan, she is now back in her home country and has a private practice in Tokyo. She is a bilingual practitioner (Japanese-English, plus some French not good enough for clinical use) keen in cultural issues.  She works with adults and adolescents with issues such as anxiety, depression, trauma, relational issues, career issues, and cultural adjustment. She is also very interested in creative processes and the arts. 

Contributed by Tina Quick

Third culture kids/global nomads have typically interacted with two or more cultures during their developmental years—those years that shape who they are as human beings. As they go about living their normal highly mobile, cross-cultural lives, they have no clue as to how they are being impacted. But one day they have an experience that wakes them up to the fact that they are different from others. This commonly takes place upon repatriation for college or university when they are surrounded mostly by those who have never ventured away from their home country or culture. What results is the feeling of cultural imbalance, not fitting in, inability to connect with their home-country peers. They feel like a “fish out of water” in their own country.

In 2009 Tina Quick wrote her groundbreaking book, The Global Nomad’s Guide to University Transition, to help these students understand what takes place in re-entry and/or transition and give them the tools and strategies they need to not only survive but to thrive in the adjustment. This was the first book written to and for students who have been living outside their “passport” countries but were either returning “home” or transitioning on to another host country for college/university. Highly popular with teens, parents, educators and counselors, it addressed the common issues students face when they are making the double transition of not only adjusting to a new life stage but to a cultural change as well.

Tina just announced her new and updated second edition of The Global Nomad’s Guide to University Transition has just been released and is now available on Amazon in paperback and Kindle versions.

The Four Pearls: Tina addresses in detail the four most common stumbling blocks TCKs) face in the transition to college/transition that can come as a huge surprise. She strongly believes if all students were aware of them, they would smoother transitions.

  • The transition cycle—Involvement, Leaving, Transition, Entering, Re-involvement
  • TCK identity development—the search for congruence in the sense of who they are as TCKs
  • Unresolved grief—from multiple losses and separations
  • Relationships—how global nomads relate differently from their domestic peers

New in the Second Edition:

  • Articles by guest authors –
    –   Amanda Bates, M.B.A., M.Ed. on diversity, equity, inclusion, and belonging and building a career;
    –   Lois Bushong, M.S. on mental health issues and finding a counselor;
    –   Lauren Wells on dismantling your grief tower and romantic relationships
  • Updates and new stories brought about by 10 years of cultural change and a pandemic.
  • Expanded Parents’ chapter addressing the fallout of common parenting strategies as well as how parents can come alongside their students, prepare them for the journey, and support them throughout this major transition.

Praise for The Global Nomad’s Guide to University Transition, Second Edition

“This book has been written with TCK students and their parents in mind. However, it should also be required reading for senior school counselors, educators, transition-team members and all university personnel – admissions, counselors, academics, educators and carers. Filled with the perspectives of those actually making the university transition, namely TCK students, there are important insights, ‘truths’ and ‘pearls’ to inform optimal transitions-care programs and practices in schools and universities. The updates and inclusions in this second edition are timely and provide an authentic, empathetic and practical resource; a safe place for TCK students to probe, prompt, plan and prepare, and a place to gain perspective and agency to proactively pilot a healthy university transition.”

Jane Barron
Director of Training & Consulting
Safe Passage Across Networks (SPAN)

“Accessible and wide-ranging, this book is an excellent resource for international school students and Third Culture Kids (TCKs) as they prepare for their transition to higher education. Tina provides a comprehensive overview of the intersections between transnational youth, culture, identity and belonging, and provides practical tools that students can use to prepare for and undergo one of the greatest transitions they will ever experience. With real life stories embedded throughout each chapter, this book brings to life the challenges and opportunities faced by young people today. I know from my work that this book has already had a significant impact on TCKs and international students around the globe and I would highly recommend this second edition to students, parents, guidance counsellors, and international student services personnel.”

Katie Rigg
International Advisor for Student Well-being
Council of International Schools

Tina Quick has struck a marvelous balance between practical ‘how-to’ guidance and the reason(s) why it works. The book prepares TCK students and parents approaching the transition to university, but it is every bit as useful to folks who didn’t have the time, opportunity, or awareness to get ready for this type of change. Whether you devour this new edition cover-to-cover, or use parts of it for quick reference, it is a fantastic resource for TCK students, parents, educators, and counselors. I always have a couple copies in my office, and they get used… A lot.”

Brian D. White
Associate Dean of Students and
Director of International Students & Scholars, Lewis & Clark College

“Effective TCK care during the university years is critical for a healthy transition into adult life. Tina Quick has gathered a great deal of wisdom over her years of raising TCKs and helping others to make the jump to university, technical school, or other tertiary endeavors. The second edition of The Global Nomad’s Guide to University Transition is a timely release with extensive collaboration and should be on the ‘must-read’ list for third culture secondary grads!”

Michael V. Pollock
Co-author Third Culture Kids: Growing Up Among Worlds, 3rd ed.
DARAJA Director, TCK Author, Educator, and Specialist

Author: Tina Quick

Tina Quick is an author, cross-cultural trainer, and international speaker who has worked closely with international schools and universities around the world. She has also authored Survive and Thrive: The International Student’s Guide to Succeeding in the U.S. She is passionate about bringing to the forefront issues facing students in global transition and helping them understand how to confront the unique challenges a globally mobile lifestyle can bring.

Contributed by Lois J. Bushong, MS, LMFT

I suddenly found myself exhibiting anxious thoughts and behaviors. I was pacing up and down the short hallway, watching the clock slowly tick down to the hour of my appointment. My hands were sweating. My mind was spinning with statements of self-doubt, even though I was trying to look calm, cool and confident. I tried quieting the barrage of catastrophic statements that were attempting to take over my thinking; “Is she going to say I am not going to make it? Am I as terrible as I feel? Will she laugh at me, or worse yet, tell me I am a failure?” She finally opened the door and invited me into her office. I picked up my notebook, cassette tape and took a seat in front of her desk. Thus began my first supervision session as a graduate school counseling intern with Dr. Weaver as my first supervisor.

It is hard to believe that scene took place over thirty years ago. Dr. Weaver didn’t laugh at my lack of counseling skills or encourage me to withdraw from the program. Instead, she often gave me words of encouragement and provided excellent practical training to help increase my self-confidence throughout the semester as she listened to the recordings of my first counseling sessions. I won’t ever forget my first session with a real client or my first supervisor, Dr. Weaver. We all survived!

“I would hear Dr. Weaver’s voice in my head….”

In my first years as a marriage and family therapist, whenever I got stuck, I would hear Dr. Weaver’s voice in my head, or the voices of later supervisors like Dr. Ruegg, as I gradually developed self-confidence and my own style of counseling. Many years later when I became that “first supervisor” for graduate counseling students in internship, I tried to pass along to my own nervous interns those same words of encouragement that were passed on to me. A couple of my students threatened to have bracelets made with the initials “WWLS” (What Would Lois Say) on them to wear as they worked with their first clients.

As a result of my own first supervision and what I have learned over twenty years as a supervisor of graduate students and licensed therapists, I firmly believe that the first supervisor is a crucial cornerstone for new therapists as they build the foundation for their own counseling styles. My heart wells up with pride when I see so many of them grow and develop outstanding counseling practices and hone amazing skills and knowledge far beyond the basics in this caring profession. The young man who wanted a WWLS bracelet now owns a large practice to whom I often refer deeply struggling couples who need a therapist with extraordinary skills.

“One key was learning the importance of the person of the therapist and doing your own work.”

In the years following my graduate school training, I had some excellent supervisors who taught me so much far beyond that found in any of my counseling textbooks. One key was learning the importance of the person of the therapist and doing your own work. And sadly, I have had a couple supervisors who were not good psychologists; they were unethical, gave bad advice and shook my confidence in my profession. I learned from them what I should not do, as I watched them damage the lives of both clients and impressionable therapists and ultimately lose their licenses to practice. As a result, even after supervision was no longer required of me for my licensure, I continued the important practice of having that other voice, whether it was a supervisor or a peer, so that I could provide the best treatment for my clients and maintain my own self-care as a therapist in private practice.

As I am retiring from the role of full-time counselor this month and focusing solely on coaching and supervising seasoned therapists who wish to specialize in working with Third Culture Kids (TCKs), I have done a lot of reminiscing on the many supervisors and supervisees who have impacted me these last thirty two years. Some of the principles I have learned are:

  • Staffing a case is so helpful when we feel stuck or need that encouragement that indeed we are doing what is needed for this client.
  • We as individuals growing a private practice, as well as those of us with writing, teaching and speaking careers need the input from those who have gone before us so we can flourish and not become overwhelmed in trying to save the world.
  • Maintaining a healthy work/life balance is hard work that never stops. Our own work is a continual work in progress.

Another key principle I have learned and reinforced with my supervisees is that the relationship between the supervisor and supervisee is as important as the relationship between the counselor and the client. You have to experience a rapport with one another. The small book, “Letters to a Young Therapist” written by Dr. Mary Pipher describes what that relationship looks like in actual practice. She talks about the pitfalls and joys of our profession along with being so reassuring to the young therapist. As I read her book, I felt like I was once again sitting in Dr. Weaver’s office. It is truly a bonding experience. Today I love getting together with several of my former supervision students who have become both good friends and trusted colleagues.  I enjoy staffing their TCK cases with them and they have become my referral sources as I passed along my clients when I retired and when I get ongoing inquiries for counseling.

“I have sensed the urgency to pass along this unique specialty to others who desire to work with this growing population.”

Because my specialty is working with adult TCKs,I have sensed the urgency to pass along this unique specialty to others who desire to work with this growing population for several reasons. First, there are currently so few therapists who know how to work well with TCKs. Secondly, I never had the privilege of a supervisor who understood this population or how to do even the basics with them and there are still today few supervisors with this specialty. Thirdly, when I began practicing counseling in 1990, there was not any literature or terminology on this topic, let alone any training. Some therapists find this population fascinating while others simply ignore those childhood/adolescent years of life in other cultures with often frequent moves and many other uniquenesses when counseling the now adult TCK as they have had no training in working with this population. Some do not see the benefit of looking at their global mobility upbringing as a potential significant piece underlying whatever they as adult TCKs are presenting in therapy. Nothing is further from the truth. The identity as TCKs is everything about us (Yes, I am a TCK.) and understanding and working with the challenges and rewards of this unique and very special identity is a major key to helping adult TCK clients with whatever presenting issue they come to counseling for. 

I personally would have jumped at the opportunity to have a supervisor in this field for which I am so passionate. It would have been well worth my investment could I have found such a supervisor. Some of the key topics to address in supervision for those adult TCKs or other therapists who want to specialize in working with this population include the following: How might I be projecting my own TCK history into my work with clients? How or why might I have some blind spots with my young TCKs? What skills need improvement to enhance my work with those whose identity is so global? The theory and practical application of attachment theory and trauma work are additional key skill areas for those who wish to work with TCKs. I adamantly believe it is my responsibility as a therapist experienced in working with TCKs to pass along my knowledge to the next generation. This is why I wrote my book, “Belonging Everywhere & Nowhere: Insights into Counseling the Globally Mobile”! And it is why I continue in retirement to offer supervision to experienced therapists who have a passion for helping TCKs.

I remember when I attended the first Families in Global Transition (FIGT) conference in 1998. ( Although this conference focused on how to help families successfully move and live around the world, there were only two therapists in attendance. The entire field of research on TCKs was just beginning to develop as graduate psychology and intercultural students were exploring the impact of this global childhood on families and on TCKs later into their adult years. 

“Our specialty of counseling TCKs is rapidly growing….”

Today there is a large, very active group of therapists (550 members) involved with FIGT. These therapists have their own Facebook page where new topics are regularly explored, the latest research is discussed and connections are made around the world. It is a most energizing group for a seasoned therapist like myself who was one of the early pioneers in how to work with this population. Whenever I step back and just listen in on their discussion, it brings tears of joy to my eyes and I swell with the pride of a “mother” as I learn so many new things from these young therapists and new movements. Our specialty of counseling TCKs is rapidly growing way beyond my own knowledge and skills, and ever so slowly our various counseling professional organizations are opening up to the possibility that just maybe our growing up among worlds DID impact our lives. It not only impacts the lives of the children, but also the entire expatriate family.

Whose voice is “that other voice” that whispers suggestions or encouragement to you as you work with that TCK or expatriate? Does your supervisor brush off the following statements made by your client as just rambling thoughts, “My passport is now outdated”?  “With the pandemic, I haven’t been able to get on an international flight for six months.”  “I had to turn in my commissary card.”  If you, too, as the therapist seeing an adult TCK don’t understand the significance of these statements, finding a supervisor or colleague who can help you grow in understanding of the TCK will greatly enhance your work with this client population.

Would your supervisor be able to answer these questions: “Can I continue to work with my client when they move to South America?” “Do I need a license to practice in France?” “What do I do if my client in another country becomes suicidal and where can I even begin to look for a therapist that can work with them in Zimbabwe?” “How do I gain the trust of my TCK client? Is this normal behavior for a TCK?” “What do I do if I learn my TCK client is experiencing abuse in another country?”  Would your supervisor know how to help you with these questions as the therapist working with this population:  How important is the flow of care or counseling during this time of transition? How important is it to have a secure internet connection in their particular country? Are there certain words or topics you just don’t bring up over the internet in certain countries? 

We baby boomers are creating a large hole in the therapy world as we are moving into retirement by the scores. Young therapists, I encourage you to learn all you can from these sages through supervision before direct access to their voices is lost to you due to their retirement. 

Here are a couple ideas on where to find a good supervisor specializing in counseling TCKs or adult TCKs :

*FIGT Counseling and Coaching Affiliate” on Facebook

*International Therapist Directory

*Listen to podcasts on Third Culture Kids for the names of counselors or supervisors.

*Email the authors of books on TCKs or expatriates.

*Attend conferences on global living. It never hurts to ask a presenter if they do supervision.

*Several of us are now retiring from practice but are continuing to offer supervision.

When you interview potential supervisors for this specialty area, be sure to ask them…. 

  1. What experience do you have in counseling Third Culture Kids?
  2. How did you learn these skills and what do you do to stay current in this field?
  3. What impact do you think growing up as a TCK could have on their presenting issues today?
  4. Are you a TCK or an expatriate?
  5. What books on TCKs have you read recently?
  6. What is your training in trauma and/or attachment wounds?
  7. What is your fee?

Since I have moved into retirement from counseling and am mainly supervising or coaching, I still pace the floor. I don’t pace the floor with high anxiety as I did with Dr. Weaver. Now, I pace my living room with anticipation as I wait for my zoom time with a young therapist who just wants to pick my brain or staff an adult TCK client case. I feel honored to be their “other voice”. 

Whose voice is “the other voice” you are currently utilizing for supervision or consultation as you work with the highly mobile, global citizens known as TCKs or adult TCKs?

[Note: This piece was originally published on Lois’s Blog and has been re-posted with permission from the author.]

Author: Lois J. Bushong, MS, LMFT

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Lois Bushong, has an M.S. degree and is a Licensed Marriage & Family Therapist, Supervisor, Coach and recently retired as a Counselor. She is the author of the book, “Belonging Everywhere & Nowhere: Insights into Counseling the Globally Mobile”. Lois is the owner of Mango Tree Intercultural Services.

Contributed by Lisa Rogers, MA, LPC, LMFT

You’ve taken the massive step of moving to an entirely new country, and everyone back home is sure you must be living the dream. So why do you feel like something’s wrong?

Expats often perceive themselves as independent people who aren’t afraid of new things. Yet, this same independence can lead to some negative emotions for those living in a new country. Expat anxiety is real, and it is much more common than you might think.

Even if you moved to a new country by choice because you very much wanted to, anxiety could rear its ugly head. Here’s what you should know about expat anxiety and the effects it can have on you.

What Is Expat Anxiety?

Expat anxiety is simply anxiety that one experiences as a result of living abroad. You might not know that you’re experiencing it at first because the signs of anxiety can start subtly. For example, perhaps you find yourself irritable and in a negative mindset when you expect to be happy in your new home.

Anxiety is triggered by fear or worry. Despite telling yourself that you have nothing to worry about, the act of being an expat is enough to trigger concerns. Will you fit in, will you be able to make friends, will you miss your old life? These uncertainties are a part of everyday life for expats, which can take a toll on your mental health.

Everyone Is Vulnerable

You may think that because you are a positive, outgoing person that you are not susceptible to anxiety. But even the most confident people can experience anxiety in their lifetime, and the likelihood of experiencing anxiety increases for expats.

Being away from your social support network of friends and family can be more challenging than you think. Minor problems can seem much more significant when you don’t have your usual support system in place to deal with them. Add in homesickness, the strain of adapting to a new culture, and possibly even having to learn a new language, and it becomes easy to find yourself overwhelmed and anxious.

Often, expats feel ashamed when they aren’t enjoying life in their new country. But, unfortunately, reality doesn’t always live up to our expectations, and we may feel guilty that we’re not happy and thriving in our new home. Some people feel like they must hide these feelings of guilt and self-doubt, which leads to deeper feelings of anxiety and possibly depression.

Signs of Anxiety 

Often anxiety begins as a general feeling of unease. Perhaps you feel irritable and cranky for no apparent reason. You may start isolating yourself from friends and family. Some expats stop reaching out to their loved ones in their home country out of embarrassment or shame over not feeling as happy as they think they should.

Anxiety can easily lead to depression, especially if you ignore the warning signs. If you find yourself struggling to enjoy your new life, don’t wait until you’re in the middle of a mental health crisis to seek help. Unresolved anxiety can be damaging for your mental health and your relationships, too.

How Anxiety Hurts Expats

Unresolved anxiety can strain your relationships, especially if you don’t feel that you can talk to those around you about your feelings. And if you are the partner of an expat who is experiencing anxiety, they may feel unable to explain what they’re feeling. But keeping these feelings inside won’t help anyone.

Anxiety can also inhibit the formation of new relationships. As a result, you may feel insecure and unable to fit in with work colleagues. You may even struggle to find friends outside of work because of your anxiety, making it harder to integrate into your new country, which sets off a vicious cycle of more profound distress.

How To Overcome Expat Anxiety

Overcoming expat anxiety begins with acknowledging your feelings and then talking about them with someone you trust. Don’t expect yourself to be able to just snap out of it and recognize that things aren’t exactly as you thought they’d be.

Try reminding yourself of the reasons why you moved to the new country. For example, are there new places you can explore to rekindle your excitement of being in a new country?

Most of all, reach out to someone. If you’re married or in a relationship, explain your feelings to your partner. You may want to consider engaging in some relationship therapy to help your partner understand how you’re feeling.

Call those friends and family back home who will listen to your worries, but try to avoid the ones that will urge you to ‘just come home.’ That kind of added guilt can make your anxiety worse as it adds undue pressure on you.

Don’t Suffer Alone

Expat anxiety can be debilitating, but it doesn’t have to ruin your new life. Counseling services can help with your anxiety, and you can even get online counseling from someone who understands the unique needs of the expat community.

At Lisa Rogers Counseling, I offer a wide range of therapy and mental health services for several areas. You are not alone in your struggle and neither are your loved ones.  Reach out to me today to make an appointment.

I provide services in:

  • Adult Therapy: Individual, Marriage, Couples
  • Child Therapy: Group therapy, family therapy, social skills, play therapy
  • Adolescent Therapy: Individual therapy, group therapy, family therapy, substance abuse

Current services are all available via Teletherapy now during the pandemic. Contact me for more information. 

[Note: This piece was originally published on Lisa’s Blog and has been re-posted with permission from the author.]

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Since 1993, I have been providing a combination of all my years of training tailoring specific treatments based on the individual needs and challenges of my patients, facilitating healing. I make every effort to accommodate the busy schedules of my patients by offering evenings, weekend appointments and Telemental Health (Online Counseling-Virtual/Video Conference and Phone Sessions) offered in the following states I am licensed in: New York, California, Illinois, Texas, New Jersey, Florida, and Vermont.

David Phipps is a Counsellor working internationally. In his short article he describes how similarities and difference enable us to find a sense of belonging. Something he was not expecting to notice in the two primary client groups he works with, whom on the face of things appear very different, but share similar experiences, needs and difficulties.

Contributed by DAVID PHIPPS – MBACP, AECO, EAC Accred.

In providing therapy to different populations across the world, with particular needs and difficulties, I often notice how similar these particular needs and difficulties are. In this short article I hope to explore the ideas of difference and similarity as a therapist working internationally. To consider the role a person´s feeling and experience of difference or similarity, plays in how we develop our sense of belonging.

I hope that this article can generate further questions, as well stimulate reflection on your own caseloads and what you find yourselves drawn to when working or how you organise your work. How you have found – and shaped – your place of dwelling and belonging? Was it unconscious expression of some desire or avoidance, a matter of fact borne out of need to earn money, or a response to an external demand or offer?

To contextualise this, I need to outline my current working practice. I provide therapy as a white male immigrant now living in Northern Spain, having previously lived and worked as a therapist in the UK until 2018. I am typically approached by clients looking for “ex pat” support and therapy, and I locate myself on the International Therapist Directory Online.

I also work for a Community Interest Company (or “non-profit”) based in the UK, called rareminds CIC. For rareminds I provide specialist therapy and workshops for specific charities supporting individuals (and their family members) impacted by rare, uncommon, often genetic diseases or conditions. It is estimated that 1 in 17 people in the UK alone has a rare or uncommon disease, and indicates that although rare diseases may be individually rare, they are collectively common.

I hope this brief introduction gives insight into my current practice. I mainly work from a psychodynamic perspective, in particular working “in the transference”, as a part of my approach. I am also influenced by the work of Melanie Klein, and others who developed her ideas.

In working with “ex pats” or “immigrants” living in countries not of their birthplace or with “third culture kids” (ie children born to parents in a country in which neither parent is native) a common theme presents itself as a sense of “not belonging”. Whatever the experience of living in the new place, this sense of dis-connection and no feeling “at home” is fairly universal. This sometimes is described as the experience of not being a “part of the furniture”, but instead having found oneself having to adapt to the already assembled room. Often, this leaves people feeling disconnected, alien(ated) and at times anxious and depressed as a result of this lack of belonging and easy familiarity.

Inevitably, one´s history and early attachments, as well developmental experience across one´s life, shape and alter how one adapts to new environments. Often being able to describe this experience of “not belonging” in more detail – and the particular fine detail of the experience of it – is very therapeutic in its own right. This being typical of what tends to be brought to therapy, when working with such a client group. 

In working with clients who have rare and uncommon diseases, it is quite quickly noticeable that this client group share some experiences with my “ex pats” and “immigrants” client group. They too are in touch with their “otherness/difference” from those around them who are not living with the experience and impact of a rare disease or condition in their family.

Given the rare nature of the diseases that the clients I work with have, their conditions (and experiences) are frequently misunderstood, misdiagnosed and misinterpreted. Expertise and familiarity with any one rare disease is often lacking, by its very definition of being rare. Individuals and families often feel unsupported, unheard and isolated. They are not unlike “ex-pats” who have left the comfortable familiarity of “ordinary life” (without a rare disease) and are often from international sub-communities of rare diseases, “ex-pats” across the world who share their particular condition. I am struck by the cross over with my “ex-pats” clients, who often explore how they experience the “thoughts that others will not understand”, and the sense of being out of place, isolated or anxious about being both understood, and understanding.

As a therapist working in a country which is not my own by birth, I too experience a sense of “peripheral belonging”. It is this sense I draw upon with both my client groups, ie of also myself being “other”, an outsider and of not quite belonging or the sense of looking “back” at what has been lost or given up in order to pursue other desires.

I have been struck by the similarities between my two main client groups in a way that I had not originally expected, and especially the features of their experiences as “dwelling on the margins” that feel pretty clear to me now. I now wonder that perhaps the drive to “belong” or feel “at home” is so universal that it inevitably makes itself apparent in some way or another with all client groups.

I hope that in very briefly outlining my work and the two primary client groups I am working with, that I have outlined something of the many crossovers and similarities between the two that may not at first seem obvious. On the face of it, rare disease clients and “ex-pats” were not client groups I expected to share as many difficulties and experiences as they do. In this time of increasing nationalism and individualism it seems all the more important to notice the themes and experiences which we share and unite us, not just those that highlight our differences.

Author: David Phipps, Counsellor

David Phipps is a Counsellor with a background of providing therapy in Therapeutic Communities, Psychiatric Hospitals and National Health Services in the UK. Since 2018 he has lived in Spain and his focus has been on providing online video therapy to “ex pats” and “rare disease patients”. He holds the European Certificate of Counsellor from the European Association of Counselling (EAC), he is accredited by the British Association for Counselling and Psychotherapy (BACP) and Asociación Española de Counselling (AECO).


For further information on rareminds –

With thanks to Kym Winter (CEO of rareminds CIC) and Peter Berry (Supervisor), who both read an earlier version of this article.

Families in Global Transition is a welcoming forum for globally mobile individuals, families, and those working with them. They promote cross-sector connections for sharing research and developing best practices that support the growth, success and well-being of people crossing cultures around the world.

I have enjoyed attending FIGT conferences in the past, and I continue to sponsor FIGT via the International Therapist Directory each year.

In 2018, Daniela Tomer founded the FIGT Counseling and Coaching Affiliate group on facebook which “serves as a platform of communication, to share information that is relevant to our niche in the field of global counseling and coaching. It can be the place to go when a counselor or coach is moving countries and faces new jurisdictions and professional practices; a place where relevant professional education opportunities can be shared; a place to find peer supervision and much more.”

As part of this initiative, Daniela worked with Shellee Burroughs, Tami Nelson, and Kelli Sanness to develop the Counseling and Coaching Coffee series, and they invited me to be a recent guest. I was able to share about my experiences developing and curating the International Therapist Directory and many other adjacent topics.

I really enjoyed the conversation, and I wanted to share it with you here as well.

Thank you, Daniela and company, for such an encouraging time together.


Josh Sandoz, MA, LMHC received his MACP in 2008 from The Seattle School of Theology and Psychology and currently works in private practice in Seattle, Washington providing individual psychotherapy for children, adolescents, and adults. Specializing in working with those impacted by international mobility, he also curates Josh is a past president of the Board of Directors of COR, Center for Object Relations, and has been deeply involved with the Northwest Alliance for Psychoanalytic Study. Since 2012, Josh has been singing alto on Sunday evenings with The Compline Choir at Saint Mark’s Episcopal Cathedral.

Contributed by Lisa Rogers, MA, LPC, LMFT

Moving to a new country can be a wonderful adventure to undertake. But, unfortunately, it can also be a very stressful one to navigate, and many expats are surprised by just how much it can affect their mental health.

Even if you wanted to make a move, you could find that your expectations and reality don’t quite line up the way you expected them to. A brand new life in a new country, no matter how wonderful it is, can also come with some unexpected strains on your mental health.

Whether you’re about to become an expat or you’re currently living as one, here is some important information you should know about expats and mental health.

Why Expats Are at Risk of Mental Health Issues

Thanks to social media, the images we get from those who’ve moved to another country are often curated to show the positive side of life. But in reality, life doesn’t necessarily get better or easier just because you’ve changed geographic locations.

Expats are more susceptible to depression for several reasons. For one, starting over in a brand new country and learning to ‘fit in’ with cultural expectations can be stressful. In addition, you may feel a loss of confidence as you question your new identity in an unfamiliar place. 

Life may be more exciting and interesting, but at the same time, the uncertainty of learning to adapt to a new location can be stressful and intimidating. Compound this with the fact that your closest support network, your friends and family, are far away, and it can take time to establish a new support network in your new country. Sometimes it can even feel impossible to do so.

Signs of Depression

Depression can hit expats unexpectedly, but the signs are often there long before you realize you need help. It can be hard to admit you might be suffering from depression, especially if you feel like you should be happy living in a new country and experiencing all the fantastic opportunities that it offers.

You may feel a sense of culture shock as an expat. At first, everything is new and exciting. You might be too busy enjoying the novelty of living in a new place even to consider how stressful it can be. But once the novelty begins to wear off, the reality of being far from home and different from your new peers can hit you hard.

Homesickness and feeling like you don’t know where you fit in are significant contributors to expat depression. If you suddenly find yourself losing interest in your new home or questioning why you left your friends and family, you could be dealing with expat depression.

How Poor Mental Health Can Affect You

The stress of experiencing depression or poor mental health in a new country can significantly impact your life. You may withdraw from socializing and miss out on opportunities to build a new support network in your new home. You might also begin to shut out your old one.

Although they may mean well, your friends and family back home can sometimes compound your anxieties by making you feel guilty for leaving, whether or not they intend to. They may miss you and take every opportunity to tell you, which can make you feel worse and may even lead to you pulling away from them.

If you’re in a relationship, poor mental health can put a strain on it as well. Often, one partner or spouse gives up a job or career to follow their partner to another country for work or other opportunities. This sacrifice can lead to resentment, especially if the unemployed spouse can’t find a job or other ways to integrate into the new location.

Depression can strain any relationship, but compound it with the stresses of expat living, and it can take a serious toll on the relationship if you don’t seek out help.

How To Get Help as an Expat 

While it’s true that you may never experience depression or poor mental health as an expat, if you do, there is help. You don’t have to give up on your dreams, and you don’t have to suffer alone.

Counseling and therapy are widely available options for anyone struggling with depression, anxiety, or other mental health issues. You may choose to see a therapist based in your new country, or you might decide to engage in online therapy or phone therapy with a therapist from your home country.

You may want to consider marriage counseling, especially if your spouse doesn’t understand why you’re struggling with depression as an expat. If you moved because your spouse is from another country, this could be especially helpful. Your spouse may not understand the strain that expat living can put on a relationship, and therapy can help them see things from your perspective so they can support you better.

Support for Expat Mental Health

Lisa Rogers understands the unique challenges that being an expat can pose to your mental health. She has traveled extensively and lived in many different places around the world. 

At Lisa Rogers Counseling, I offer a wide range of therapy and mental health services for several areas. You are not alone in your struggle and neither are your loved ones. Reach out to me today to make an appointment.

I provide services in:

  • Adult Therapy: Individual, Marriage, Couples
  • Child Therapy: Group therapy, family therapy, social skills, play therapy
  • Adolescent Therapy: Individual therapy, group therapy, family therapy, substance abuse

Current services are all available via Teletherapy now during the pandemic. Contact me for more information. 

[Note: This piece was originally published on Lisa’s Blog and has been re-posted with permission from the author.]

Author: Lisa Rogers, MA, LPC, LMFT

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Since 1993, Lisa Rogers has been providing a combination of all her years of training tailoring specific treatments based on the individual needs and challenges of her patients, facilitating healing. She makes every effort to accommodate the busy schedules of her patients by offering evenings, weekend appointments and Telemental Health (Online Counseling-Virtual/Video Conference and Phone Sessions) offered in the following states she is licensed in: New York, California, Illinois, Texas, New Jersey, Florida, and Vermont.

As a Highly Sensitive-Third Culture Kid (TCK) myself, and mother of two Highly Sensitive TCKs, it feels deeply personal to share the content of this workshop with families who also may be raising highly sensitive third culture kids.

If there is anything the past year has shown us, it is that culturally competent therapists are needed more than ever. A global pandemic, bruising political elections, a social justice reckoning and uncertain economic landscape have brought us here and made it clearer than ever.

Contributed by Aryeh Sampson, MA, BACP

With Covid there has been an increase in financial stress, family pressures, health problems, global economic turmoil and worldwide political unrest. It is no surprise that our era has been called ‘The Age of Anxiety’. We live in very worrying times.

Expats can be particularly impacted due to a lack of a social support and the high pressure of work expectations. This in turn can put greater strain on their intimate and close family relationships.

Recent statistics have shown that fifty-nine percent of people in Britain have experienced anxiety and seventy percent have suffered from stress. The number of antidepressants prescribed has been also been sharply rising…


1. Self awareness.
The first step is to become aware of our thoughts and our internal dialogue, as much of our anxiety exists on an unconscious level. People tend to envision the worst possible consequences coming true. For example, someone worrying about finances may imagine him/herself poor, homeless, and on the verge of a nervous breakdown. This is often combined with the imagination producing stirring images that create a sense of panic and great distress. Memories of similar traumatic events from the past may also be unconsciously projected onto the current situation, which further exacerbates the problem.

Once we become aware of our internal thoughts, we are able to discover the fears that are at the root of the anxiety. A good acronym for fear is: FEAR – False Evidence Appearing Real. Much of our fear may be based on invalid thinking. For example, when a person is having a panic attack, they may misinterpret the physiological effects, and think that they are having a heart attack, thereby further increasing their anxiety.

2. Challenging our thoughts.
By verbalizing our inner dialogue, we can challenge our irrational thinking and start to see the situation more objectively and calmly. This approach is emphasised in cognitive behavioural therapy, which teaches that it is not an actual event but our interpretation of it that determines our emotional response. By becoming aware of our cognitive biases (irrational thought patterns) we can change the way we think about a situation, thus reducing its emotional impact.

To do this one might ask oneself some important questions: Are there other equally plausible ways of seeing and interpreting a situation? Is it possible, even probable, that a dreaded event will not occur? How many situations have you worried about in the past that turned out much better in reality? It is also valuable to explore how one would best cope with the worst-case scenario if it were to occur.

3. Sharing our feelings with others.
Sharing our concerns and worries with a supportive person can be therapeutic, helping to reduce and lighten their emotional impact. It is most effective if the listener allows us to express our concerns fully and doesn’t interject with premature words of advice or encouragement.

4. Taking action.
Facing a difficult situation and taking appropriate action where possible, reduces our fear and moves us from feeling helpless, or a victim of circumstances, to feeling more in control. Behavioural changes often lead to emotional changes; this is a principle upon which behavioural therapy is based. For example, a person who has a phobia of dogs and feels great anxiety around them would gradually increase his/her exposure to dogs until he/she could tolerate them without feeling anxious.

Creating and implementing a plan of action to deal with our area of concern is therefore a vital step. While this often requires courage, avoiding the problem just serves to maintain it. The fear associated with it can paralyse us and produce a negative self-fulfilling prophecy. It is also important to break down this plan into small, manageable steps.

5) Maintaining physical and spiritual well being.
Attending to our physical state helps to reduce stress; this includes getting enough sleep, exercising, eating properly, having time to relax, and medication if necessary. Breathing techniques or meditation can also be very helpful.

It has been demonstrated by much modern research that prayer helps reduce anxiety. A recent study interviewed two hundred and forty-six people before having cardiac surgery. The results showed that those who prayed before the operation were more optimistic and suffered less anxiety.

These five approaches can be used in combination or individually. A person’s particular circumstances, as well as individual character and personal preferences, will determine which approach will be most helpful.

Author: Aryeh Sampson, MA, BACP

Aryeh Sampson, MA is an experienced BACP accredited psychotherapist and certified Imago relationship therapist based in the UK . He has Masters in Counselling and Psychotherapy and has been in private practice since 2009. He is an integrative psychotherapist specialised in couple counselling, anger management and overcoming anxiety.

Contributed by Lauren Wells

In my years of working with TCKs, and being a TCK myself, I have experienced the TCK life at all stages. As I walked with families through their globally mobile life, the question that always lingered between myself and the parents with whom I worked was, “is there a way to help the TCK’s trajectory?” It seemed that the natural route for TCKs was to struggle during the transition to life overseas, thrive for a while, struggle during high school, have some serious challenge during young adulthood, and then see many negative manifestations of their upbringing during mid-adulthood. Seeing this pattern over and over caused me to wonder what more could be done to help them to grow into healthy adults who can maximize the many benefits of their overseas upbringing. It became clear that preventive care was the key. Looking at the challenges that statistics show most TCKs face in adulthood and tracing them back to the points in their life when those challenges were birthed can help us to prevent them from manifesting negatively in adulthood.

My Book, Raising Up a Generation of Healthy Third Culture Kids looks at how parents and organizations can provide practical, preventive care for TCKs during their globally-mobile lives.

In the book, I talk about the TCK life being like an ampersand (&). Thinking about my own experience, it is the best way I have found to answer the question, “What was it like to grow up overseas?” It was an ampersand, a both/and. It was both wonderful and difficult, both joy filled and grief filled, both so good and so hard. For each challenge, there was a contrasting benefit that could be birthed out of the difficulty.

My goal in publishing this book is to provide a practical resource and guide for how to maximize the benefits and decrease the negative effects of the many challenges of raising kids in another culture. In essence, I hope to address both sides of the ampersand. I’ve noticed during my years in this field, that people tend to focus on one side or the other—pointing out all the challenges from a fairly hopeless perspective, or not acknowledging that the challenges exist and only promoting the benefits. Having lived this ampersand life, I know that the experience is not at all black-and-white. It is a complex array of blended colors that include just as many complex emotions.

Most importantly, I wrote the book from a place of hope. I believe that we can raise healthy kids outside their passport countries and that these kids can grow up to be incredible contributors to our world. I also believe that we need to take seriously the challenges that so many face because of their unique lifestyles and be proactive about preventive care for Third Culture Kids. Raising Up a Generation of Healthy Third Culture Kids is filled with practical, encouraging, and easy-to-implement ideas that I pray give families and caregivers a sense of hope and direction as they love and support Third Culture Kids throughout their ampersand lives.

Author Lauren Wells

Lauren is the Founder and Director of TCK Training, Director of Training for CultureBound, and author of Raising Up a Generation of Healthy Third Culture Kids. She specializes in practical, proactive care for TCKs and their families. Lauren grew up in Tanzania, East Africa, where she developed a love for smokey chai and Mandazis (African doughnuts). She now lives in the US with her husband and two children.

Contributed by Christine Forte, LMHC

“What if rather than being disheartened by the ambiguity, the uncertainty of life, we accepted it and relaxed into it?” – Pema Chodron

Wherever you are in the world, you have likely been keeping track of the news about the unfolding spread of novel coronavirus. There are so many questions: how dramatically will it spread across the world? How serious is it? What can be done about it? Exactly how worried should we be right now? A cloud of uncertainty swirls around the spread of the virus, the epicenter focused on China.

Having just returned to the US after ten years living in Shanghai, currently my practice focuses primarily on working online with clients in China. All of them have been impacted by this public health crisis, in a multitude of ways. Even though for the large part the expat community in Shanghai has not been directly impacted the virus, life has changed. For those still present in the city, work and school have been cancelled or moved to online, restrictions set on going to public places, masks are mandatory, apartment compounds are closely monitoring who goes in and out. For those who had been traveling for Chinese New Year outside of China as the illness escalated, many have been unable to return to their Shanghai homes.

Life overseas, and really life in general, is riddled with uncertainty. In fact, we could say that some of the only guarantees we have in life are that we will have to face times of change and uncertainty. There are the more mundane moments of uncertainty: will my visa application be approved, the work contracted renewed, the products that I’d like to have for my new baby found? And then there can be more dramatic moments, when someone is in an accident, or arrested, or conflict breaks out in the area, or in the case of coronavirus, a new illness is identified to be spreading.

It may feel manageable to overcome the uncertainty in the smaller moments, to acquaint ourselves with it, to find ways to calm our anxious thoughts, to relax, to engage in self-care, to, in Pema Chodron’s words, relax into it. But how, when the uncertainty becomes so loud and dramatic, do we manage to do this? How can we manage to quiet the panic that wells within us with each new piece of information or at our lack of control over the situation?

In this time when the uncertainty is so much louder than usual, it is not uncommon for people to have moments where they feel overwhelmed by fear of the coulds and the maybes. This fear that wells up can contain different narratives: it may relate to a fear of the virus itself or it may center around fears related to the measures being taken to contain the virus. Governments and airlines have taken dramatic action to contain the virus, which are themselves great sources of concern for the dramatic impact that they have on daily life and coping, but then on top of this rumors abound for what there could be to come. For example, for many expats still in china, hearing that flights from China to the US had all been cancelled was a strong trigger of anxiety. Even for those who were not planning to leave, hearing that options to do so would be extremely limited was unnerving. Likewise for when consulates have recalled staff. And then there are the internal dilemmas, the moments of wondering if the right decision has been made: for people who have chosen to stay they likely had good reasons for doing so. But it can be hard to stand by these choices when others in their lives are encouraging them to do otherwise.

A first step that can be helpful for those experiencing anxiety around all of this uncertainty is to try to connect to the fact that they are not alone in their experience. Even if they may be physically alone in their apartment at the moment, trying to connect to the knowledge that they are not the only ones who are struggling or suffering. Connecting in mindfulness or in meditation to the fact that there are many others in the world who are struggling or who are afraid or who may doubt their decisions can be a source of comfort and solidarity. We can never accurately compare our struggles or suffering to anyone else’s but we can know that all human beings have times of suffering at some point in their lives.

Another strategy that can be useful in coping with the ups and downs that come with experiencing either the daily life impacts of the lockdowns or fears of the virus itself can be to do some journaling exercises. While I would not presume to say that these offer an immediate resolution to anyone’s situation, I do find that they can be helpful for reducing distress. Writing can be useful to help us to commit more strongly to a new or different way of thinking. When we are trying to reshape a particular mental narrative it can reinforce it. There are a few different ways to approach this.

One can be that in moments of feeling encouraged, write a letter to yourself to read when you’re feeling discouraged or afraid. What would you want that version of yourself to be able to keep in mind? Commit to reading over this for encouragement when you are feeling afraid.

For fearful moments, another strategy can be to write down the things you are afraid of. What exactly are they? What do you fear they could lead to? Get as much to the heart of these fears as you can. Then, with the attitude of a curious scientist, examine them more closely – how likely are they to happen? What are some reasons that you feel pretty certain that they wouldn’t? Or if you do genuinely believe that there’s a chance they could, how would you cope? How do you know that the situation would be temporary and you would get through it? Mentally anchor yourself in this, knowing that you now have thought through how you can and cope with each day, one at a time.

As with any time in our lives we have no way to fully know what will happen next. And so instead of seeking security in certainty about the future, we keep taking the next steps that are needed to care for ourselves and our loved ones, planning for tomorrow where we can. Knowing that overall our certainty lies not in anything external but in our own abilities to cope with each challenge that may arise.

Author: Christine Forte, LMHC

Christine Forte is a counselor and coach to the globally mobile. She works mostly online with a focus on seeing clients based in China, as she lived and worked in Shanghai for 10 years.

Her main areas of specialization are relationships, life transitions, motherhood and finding career purpose.

Contributed by Myra Dumapias, MSW

Discovering my third culture kid identity as an adult has been like a predestined romance waiting to happen before I had the language for it. Yet throughout this love affair, realized in the process of claiming a tribe, I’ve noticed a missing piece: acknowledgement about privilege variances as a tribe.

The intense feeling of being different without a language to internally process it or externally name or explain it has impacted me significantly. I felt like a misfit whenever I attended a school without other third culture kids (TCKs). The consciousness of knowing I was different grew more distinct after I left the international school system: in college, I told a roommate that moving around so much as a kid influenced who I was romantically compatible with, but couldn’t explain why. The longer I was away from my TCK-filled past, the more I felt an isolation I didn’t know how to talk about. I felt like I found myself in an abandoned city with signs of fresh activity but no one there to talk to  (as described in Where Everybody Is: TCKs and the Twilight Zone).

The answers didn’t come until my 30’s, when a colleague called me a “third culture kid”, which led me to The words “third culture kid” were keys that opened new doors for me, most importantly of understanding. As I illustrated in “the significance of words” (page 4 of “Refusing to Be Erased”), discovering the term that explained my experiences and that I was not alone validated that it was an identity I was experiencing and not an abnormality I had to fix.

More personally, the career dream I wrote about in my college applications was to help people who grew up moving around like me. I knew there was a need before I knew there was a language for it. In 2011, within six months after I discovered the term, TCKid, an online community forum created by Brice Royer, became a bridge to that dream when he passed onto me the online community three years after he created the forum. I formalized it as a 501(c)3 non-profit organization. Today, the organization, which now goes by TCKidNOW, has continued helping more TCKs connect and expanding its global reach, and provides trauma-informed educational outreach as part of community care services under development. 

TCKidNOW addresses the question after the initial discovery of the TCK identity: “Now, what?”- the space where intersectionality and privilege are relevant. There have been great discussions around the common TCK experiences, ie. finding home, being a hidden immigrant, etc., but as a tribe, we tend to go back to our individual identity compartments when it comes to aging, sudden disability, racism, economic struggle, etc. Yet our global nomad background can have as much relevancy on these matters as it does on “Where is home?” TCKidNOW recognizes being an adult TCK intersects with other identities, ie. race, gender, class, aging, passport country, citizenship status, etc. TCKidNow designs its services mindful of how the intersection of identities ties into varying levels of access to resources, or privilege.

Privilege – the uncomfortable but necessary conversation:

Privilege can be an uncomfortable topic that can easily cause a little tension or division, but it doesn’t have to.  In expat communities, we do not all usually enjoy the same luxuries, such as paid private school tuition, luxury cars or rich neighborhoods. It’s part of what expats sign-up for. The differences in privilege themselves aren’t a cause for tension. What can be is when a majority of resources, events, accolades, and standards and recognitions of admirable accomplishments and leadership do not acknowledge or include a true diversity of TCKs by the time we’re all adults, such as:

  • individuals from developed as well as developing countries,
  • people who with working or lower income class experiences as well as those from consistently upper middle class or higher background,
  • people of color from all over the world as well as the universally perceived face of the Western World,
  • community-focused work under leadership that has an understanding of the multiple intersections of struggle and marginalization, as well as the cosmopolitan entrepreneur who symbolizes a successful jet-setter lifestyle, and
  • individuals who identify fluidly across these spectrums.

Clarifications on increasing access:

Setting a price for services, having a successful small business, or recognizing a person’s accomplishments aren’t, of course, negative. What would be negative is if we in the field of TCK work don’t collectively work together to widen access to resources, recognition and inclusion. Individuals with experiences from less privileged backgrounds in roles with program and research design decisions and leadership can open new windows of insight.

The professional practice that validates our approach:

Social Work is guided by the core values of: service, social justice, dignity and worth of the person, importance of human relationships, integrity and competence ( TCKidNOW follows these core values along with the systems theory, which explains human behavior as influenced by multiple subsystems, ie. an individual’s school, family, economic class, cultural identity, friendships, etc., that operate interrelatedly within a larger system. Addressing an individual’s problem would then require looking at how the various subsystems are affecting each other as well as the individual directly.

How you can help – the TCKidNOW Community Mental Health Network:

Informed by my less than economically-privileged seasons in my life and stories from other TCKs about limitations in accessing resources, I conducted a survey designed to measure certain privileges. The results of this first community needs survey confirmed class variances within the TCK population, usually thought to be mostly upper middle or upper class. The below  infographic shows some findings and an overview of the TCKid Community Mental Health Network, which aims to gather TCK/cross-cultural focused mental health service providers willing to charge sliding-scale fees according to income/cost-of-living context for TCKs who cannot afford standard rates. Please consider joining the network. We are also seeking donors and businesses interested in sponsoring this program who would like exposure on our TCK and Cross-Cultural Kid social media platforms. Please see more details/register here-

In closing, I want to say that I am so grateful to see how far we’ve come as a tribe since the days when TCKs were still not considered a “valid population”. We all as a tribe did this! The International Therapist Directory has played a major role in healing and I hope that this network will provide an avenue for us all to worker together to spread even more love!

Author: Myra Dumapias, MSW

Myra Dumapias, MSW, (BA English and World Literature) is the CEO of TCKidNOW – please follow them on Facebook or Instagram.  Myra is a 2nd generation TCK, daughter of a 2nd generation career diplomat, and mother of a domestic and international TCK and is a social entrepreneur, writer, photographer, film geek and volunteer first responder. She grew up in in China, Malaysia, Ohio, Indiana, Manila, Germany and Romania and during college years, in South Korea. As an adult, she also lived in Bahrain.


A highlight from this past Fall was meeting with Ray Barrett of the Telehealth Certification Institute. Ray interviewed me about the International Therapist Directory and its role in helping people find a therapist who can think internationally, holding in mind some of the cultural complexities and issues related to making extraordinary transitions that come with a life of international mobility. Ray was gracious enough to share the interview along with some information about the International Therapist Directory on the his website, and I am posting the link to the interview here as well for you to watch and share if you wish.

For anyone interested in learning more about the TeleMental Health Training Certificate, here is some additional information :

The TeleMental Health Training Certificate (THTC) is awarded to dedicated telemental health clinicians who have successfully completed the full THTC program.  The TeleMental Health Training Certificate (THTC) program provides evidence-based, advanced, and comprehensive training which prepares clinicians to offer behavioral health services while in a different location than the client through the use of technology. The target audience for this program is any behavioral health professional, including but not limited to, counselors, social workers, marriage and family therapists, psychologists, physicians, nurses, and chaplains.

There are several other terms used for TeleMental Health such as E-Psychology, Technology Assisted Social Work, Web-Based, Virtual, Distance Counseling, Telebhavioral Health, Telehealth, TeleMedicine, Online Counseling, Skype Counseling, and Tele-Therapy.

Clinicians who have earned the THTC take special consideration of their clients’ privacy as it relates to the use of technology, and the needed effort to ensure that they remain up-to-date on the best practices of providing services remotely.  

The THTC certificate requires completing all of the following courses:

  • Introduction to TeleMental Health
  • Legal Aspects of TeleMental Health
  • Ethics of using Technology in Behavioral Health
  • HIPAA Compliance for Mental Health Professionals
  • Ethical, Legal, and Clinical Aspects of Selecting Technology
  • Emergency Management Planning for TeleMental Health
  • Screening for Fit for TeleMental Health Services
  • Ethical and Clinical Skills of Video and Phone Sessions

The THTC alumni have awarded our program with the top ratings for its high-quality content, delivery, instructor, and customer service.

If you do decide to watch the interview, I hope you enjoy it as much as I enjoyed speaking with Ray in the first place. I am grateful for this opportunity to speak about the International Therapist Directory and its place in helping people find a good therapeutic fit.

Happy New Year!


Josh Sandoz, MA, LMHC received his MACP in 2008 from The Seattle School of Theology and Psychology and currently works in private practice in Seattle, Washington providing individual psychotherapy for children, adolescents, and adults. Specializing in working with those impacted by international mobility, he also curates Josh is a past president of the Board of Directors of COR, Center for Object Relations, and has been deeply involved with the Northwest Alliance for Psychoanalytic Study. To round out these professional activities, since 2012, Josh has been singing alto on Sunday evenings with The Compline Choir at Saint Mark’s Episcopal Cathedral.

Contributed by Dr. Jana Jenkins

For most of us the end of each year leads to reflections and evaluations of the past year and thinking about what the new year will bring. This is no different for those of us who emigrated to a different country including myself.

Perhaps you have always dreamt about relocating to a different country and idolised what the ‘new life’ is going to be. On the other hand, your circumstances may have dictated the move which may mean that your move was not necessarily within your control.  The latter could make your adjustment to becoming an expatriate more challenging psychologically.  However, if you over-idealised the international move, that brings about its own challenges such as language and cultural barriers, leaving the loved ones behind, missing familiarity in multiple contexts and in my case buying a sour milk instead of semi-skimmed!

Adjustment to any life changing events could be stressful and may even lead to clinical depression for some.

Perhaps you are someone who has been putting off therapy for some time and your New Year resolution is to make changes in your life.

I would encourage anyone who can benefit from talking, to give it a try. Everyone and anyone can benefit from therapy, just think of it as a safe space to talk and explore what’s going on for you. 

One of the most damaging preconceptions is that therapy is a sign of vulnerability. I always say to my clients that it is the exact opposite, it takes a lot of courage to be in therapy, look at your fears, hopes and discuss your wish to change. Therapy can be helpful for people from all walks of life.

Thinking about entering therapy can feel daunting, especially if you have no previous experience of seeing a therapist. Many questions may surface in your mind, such as “What if I do not like a therapist?, What if they are unable to help?, What if they do not understand or judge me?”

Please be assured that these worries are very common and understandable. Therapists understand and respect that you are letting them into your internal world and you may be a private person who does not find talking about your difficulties and feelings easy. You may feel embarrassment or even experience shame about asking for help and if funding private therapy, feel guilty about spending money on yourself.  You may be blaming yourself for ‘not coping’ and feeling ‘overwhelmed’.

Good therapy involves treating you as a unique individual with a therapist helping you to making sense of your difficulties in a collaborative way. It may be helpful to think that you are the expert on your difficulties and how they impact on your life whereas your therapist is an expert on how to identify your needs and help you. In therapy you are an active participant and your motivation for change is important.

Good therapy can also increase your self-awareness and provide you with a better understanding of the causes of your distress and which factors maintain or sustain it. It can also teach you coping strategies to manage your distress and build resilience.

In this process, a good therapeutic relationship is paramount, therefore if you are not comfortable with your therapist, you should not hesitate to choose another therapist you feel more at ease with.  My key message is to persevere and find a therapist who can facilitate change.

Another observation that I would like to share with you that sometimes people feel that they do not deserve therapy as they believe that other people are worse off or it is selfish to talk about oneself. What might help you to challenge this belief is to know that human distress lies on a continuum and comparing the intensity of suffering is not helpful.

Many people I meet are initially ambivalent about starting therapy and there are people who “do not believe in therapy”.  However, how do you know that therapy is not for you? Understandably, you may have certain preconceptions and feel unsure or even fearful. My advice is to try one session and see how it is for you.

Author: Dr. Jana Jenkins

Dr. Jana Jenkins is a Chartered Clinical Psychologist and Associate Fellow of the British Psychological Society. She runs her private practice in Correze, south west France and works with English and Slovak Speaking expats. 

Jana had lived in the UK for 25 years after relocating from Slovakia in her mid twenties and also lived in South Africa before moving to the UK.

Contributed by Robert Oleskevich, MA, LMFT

3 truths and 3 misunderstandings about what it’s actually like to go to therapy.

Written by a licensed psychotherapist, here are some common truths and misunderstandings about what actually happens if you decide to see a mental health therapist.

All too often as I’ve traveled around Asia, and especially here in Vietnam, one of the first reactions I get from people when I tell them I’m a psychotherapist is: ‘oh, so you know what I’m thinking right now?’ Of course the answer to that question is: ‘no! I’m not a mind reader.’ I still wonder how that became such a common belief. This is just one example of the different stigmas (negative beliefs) about counseling or psychotherapy. Another stigma in some parts of America, for example, is more about being embarrassed or ashamed of the idea of going to a stranger for help.

I hope at least part of what this article might help to do is bring some awareness to these populations about the realities of therapy. Let’s break this down and take a look at what therapy is, and is not.

In some places, therapy is trendy and cool (eg. California and Argentina). In many other places, not so much.


1) Okay, this one is kind of obvious, but apparently needs to be said: Therapy is not about reading someone’s mind. If you choose to go to therapy, the only things your therapist knows about you are the things that you have already shared. Your therapist is not trying to manipulate you or trick you in any way. Your therapist wants you to feel better and the relationship is transparent (open and honest). Once the relationship between you and your therapist develops, over time, your skilled and qualified therapist will begin to understand more clearly your values, why you make the choices that you do, and how these choices are impacting your relationships. One of the cool things about therapy is your therapist does gain access to your inner world, eventually understands you and your values, and can help you keep things in perspective when you feel lost. One thing you don’t have to worry about is your therapist being somehow inside your head and knowing what you’re thinking. If your therapist could read your mind, would this be such a terrible thing? Yes, ok, you’re right, it would! Anyway, your therapist is on your side and wants what is best for you.


Therapy should feel like a safe space to open up and be vulnerable.

1) A good therapist is authentic, real, and human. Your therapist may make mistakes. Your therapist won’t know everything. Your therapist shouldn’t hide behind a wall of diplomas. Your therapist should know how to say ‘I don’t know.’ or ‘let me think about this.’ Your therapist should be very cautious about giving advice, because what they would do in a situation isn’t necessarily what’s best for you. A qualified therapist will have good intentions and acknowledge their limitations. They won’t ask you to put yourself in a situation that might be harmful or dangerous, and there is always professional boundaries between the therapist and the client. So a therapist likely won’t be attending your wedding (although exceptions are often made), or there won’t be a therapy session over dinner and drinks. The relationship should feel like a professional partnership. Two people authentically navigating this crazy thing called life. Certainly, your therapist should never bargain with you for payment (offer therapy services in exchange for something you might provide), nor should a therapist ever suggest any type of more intimate relationship. If something like that should happen, the client should strongly consider terminating the relationship immediately. It seems like a no-brainer, but just like in any profession, there are some good therapists and some that are not. For example, in California, it is suggested at the beginning of therapy that the therapist give the client a pamphlet entitled ‘Therapy Never Includes Sexual Behavior.’ Crazy!


2) Therapy is not about eliminating a client’s problems. For many therapists, there have been times a client has come to therapy and immediately stopped coming, even after only one session, because they leave the session and nothing has changed. Recently, a client of mine came into the first session and went through the list of things that are wrong, and when it became clear to the client that I had no ways of eliminating these problems, I received the surprised and bewildered look of a deer in the headlights. I can only imagine the client’s inner dialogue in that moment: ‘I’m paying this much money for this and he isn’t going to fix these problems?!’ A therapist doesn’t have a magic potion or isn’t able to snap their fingers and make your problems disappear. What they can do, is help you understand how you’re interpreting these problems, what you’re doing to manage them effectively (or ineffectively), and then help you acquire new perspectives, skills, and tools so you can start feeling better. Freud once said something like: ‘The best possible outcome of therapy is normal human suffering.’


If you are down for adventure, give therapy a try.

2) Therapy should feel alive. Sometimes the most helpful moments are ones that are highly charged (emotional), intense (strong feelings), or thought provoking (gaining insights) . If your therapy experience feels boring and shallow and you’re just talking about your day, or even worse, talking about your therapist’s day (haha), then that’s a problem. A good therapist does much more than just listen with a blank face and ask ‘how does that make you feel?’ Although there is a time and a place for this question (for example, if a client is avoiding certain feelings), a therapist is often more concerned about how you’re functioning than how you’re feeling. In other words, what is at the heart of your relationship challenges? What is beneath your questionable choices? What is this experience bringing up in you? A good therapist should feel like a partner who collaborates with you on how to best deal with life’s challenges. A therapist can be like a guide, offering a roadmap on how you might approach your difficulties. Therapy should feel authentic, raw, vulnerable, and alive!


Therapy ain’t easy bro!

3) Therapy ain’t easy bro! A skilled therapist will likely challenge you with difficult questions that require you to be brutally honest with yourself. In addition, therapy will probably bring up painful feelings and emotions that you would rather not deal with. It is learning how to work with these difficult feelings that is one of the biggest benefits of therapy. Therapy requires work. The therapist may give homework and suggestions that need to be practiced. If a client comes to therapy expecting the therapist to do to the work, the client will likely end therapy too soon and be disappointed in the result (or lack thereof). Some of the most helpful things we can do for ourselves are very simple in nature, but not easy. One of the most healing things that can be done is allowing oneself to be completely vulnerable in the presence of another. This brings up all kinds of things, not the least of which is feeling the vulnerability of intimacy and the fear of rejection. When we can practice acknowledging and learning about these fears and difficulties with a therapist, it allows us to gain the confidence and skill to do it with others.


This photo is taken by a great artist: @thuw.beoo (Instagram). It feels like it speaks to the possibility of acknowledging the different parts of ourselves.

3) A paradox means the opposite of what we think to be true is actually true. In other words, a paradox is a statement (or assertion) that is true, even though it seems to be false. An example might be: to become whole, one must empty oneself (spiritual paradox). Or another example: The way out is through (psychological paradox), which means the way out of the pain is to allow it to move through you (turn towards the pain instead of avoid it). What we’ve learned so often in life is that so many things are out of our control. We try to control our conditions (find the right relationship, get the right house, and the right job), and then we still end up dealing with pain, dysfunction, and relationships that suck. We seek therapy to learn how to surrender to life as it unfolds, instead of clinging to how we think it should be. So it is often in surrender (this doesn’t mean giving up), that we find freedom as opposed to control. Similarly, it is in turning toward difficulties instead of avoiding them that finally opens us up to the parts of us that need attention. Paradox can mean doing the opposite of what we initially think we should do. One of my favorite quotes about paradox is from Carl Rogers: ‘ The curious paradox is that when I accept myself just as I am, then I can change.’

I hope this article is of some use or benefit to you. I am a licensed psychotherapist in California and Vietnam. Please email me if you want to explore how psychotherapy might help you feel better.

[Note: This piece was originally published on Robert’s Blog and has been re-posted with permission from the author.]

Author: Robert Oleskevich, MA, LMFT

Robert is a Licensed Marriage and Family Therapist (MFT) and an on/off member of the California Association of Marriage and Family Therapists (CAMFT). He has a B.S. degree in Psychology and an M.F.A. (Masters) in Clinical Psychology. He incorporates Mindfulness Based Cognitive Therapy (MBCT) into his approach.

Living in Los Angeles, Robert has had the benefit of learning from, and influenced by, some of the most well respected people in the fields of Mindfulness and Buddhist Psychology. Many of those who he considers his teachers are the people who brought Mindfulness Meditation from the East to the West and made it their life’s work to introduce it to the mainstream. He has been fortunate to be part of some of the communities in Los Angeles where Mindfulness and therapy are recognized as powerful and extremely beneficial avenues for relieving suffering and acquiring more happiness.

For more information, his website is

Contributed by Daniela Tomer, MA

The International Therapist Directory was born to serve the needs of the internationally mobile, TCK, and expat community. Not surprisingly many of us, as therapists, are part of this internationally mobile community. Many of us believe that our own stories are powerful bridges which can help us better understand our clients experiences. We help our clients to overcome the challenges that frequently come with this lifestyle but as the wise saying goes: ”The shoemaker always goes barefoot.”

When I left Israel as a well-established clinical psychologist I had to reinvent myself in many ways. One experience I was not prepared for was that of losing both my professional identity and professional affiliation. I was still a psychologist but was no longer part of my local professional communities, which I had established over the years through my studies and the years I worked in different institutions. As a result, I was very much on my own in navigating this new professional life in a new country.

Our need to belong is universal and this need is not any different when it comes to our professional life. I was very lucky to find FIGT ( at this time because I wanted to connect with other people who were in a similar position to me. FIGT, for those who don’t know about it, is a welcoming forum for globally mobile individuals, families, and those who work with them. It also promotes cross-sector connections for sharing research and developing best practices, which continue to support the growth, success and well being of people crossing cultures around the world.

Discovering FIGT resulted in an immediate feeling of finding my personal tribe, and it was also the right platform for me to create my professional tribe. With the support and assistance of Dr. Kelli Sanness, Dr. Tami Nelson and Shellee Burroughs, we launched the online FIGT Counseling and Coaching affiliate in 2018. Our affiliate mission is to create a secure place to learn, share, support and encourage each other in our niche, regardless of our geographical location. In many ways we are aiming to create a degree of stability in our globally mobile life; our location might change but our global network will always stay with us.

We were thrilled to accept the invitation of Josh Sandoz to share with you some of our initiatives :

  • We meet once a month for a Zoom online ‘virtual coffee’ session during which we discuss relevant topics.
  • We usually have a guest speaker who is willing to share their knowledge but it is an open non-formal conversation.
  • Previous guest speakers have included Ruth Van Reken and Lois Bushong.
  • These sessions are recorded and can be seen after the event if the time doesn’t fit with your schedule or time zone.
  • We also have a Facebook group where we post different articles, conferences, and questions, which are all related to our specialist areas.
  • Our affiliate is involved in the annual FIGT conference program and as a result, a variety of mental health sessions are provided by presenters who currently work in the globally mobile community.

If you relate to any of this and would like to join the conversation, please subscribe to our mailing list by sending an email to: and join us on Facebook (

We are happy to welcome you to our globally mobile network of mental health professionals.

And if you are interested in presenting at the FIGT conference please see the details here:

We will be happy to meet you in person!

Author: Daniela Tomer, MA

Daniela Tomer is the Co-Founder and Director of GNW Global Nomad’s World. She is an Israeli and Belgian licensed Clinical Psychologist, a Mediator, Coach and Trainer and serves as FIGT- Families in Global Transition Counseling and Coaching affiliate chair.

Contributed by Ruth E. Van Reken

I would guess most of you listed in this directory have heard some version of the following story in your work as international therapists:

You meet a new client and begin the conversation. “Good afternoon. What brings you to my office (or screen) today?”

“Well, people think I have a lot of friends, but inside I’m lonely. I just don’t feel like I fit in anywhere.”

“I’m sorry to hear that. Can you tell me something more about your story?” you reply.

“H-mmmm. Like what?”

“Like from the beginning.” You respond. “Who your parents are, where you were born, where you’ve lived, and maybe even how you got here.”

“Well, I got here by car but I guess that’s not what you mean.” And you see the twinkle in her eye and think ‘Well, at least she has a sense of humor!’

“OK, then,” and a more serious look comes on her face. “Let’s see. My mom was born and raised in Country A, my dad is a citizen of country B but grew up in 3 countries himself, I was born in Country C, but moved between 7 other countries before I was 18. I enjoyed living in so many places and seeing so many things. I enjoyed my life and have friends all over the world. So why do I often feel this deep sadness or loneliness?”

And from these facts alone, and before you know why she has moved so much, you hopefully already know the basic story: you are working with a cross-cultural kid (CCK)—someone who has lived among, and meaningfully interacted with, various cultural worlds in his or her first 18 years of life.

“So what’s the big deal about that?”, some (not you, I trust!) would ask.

A therapist I met in 1995 in Australia might have an answer for that question.

In those early days, my focus was primarily on trying to learn more about third culture kids (TCKs)—a specific sub-group of what we now call the larger cohort of CCKs. TCKs grow up outside their parent(s’) passport countries primarily because of the parent(s’) career choices. That particular evening I talked on the benefits and challenges of being a TCK and the factors creating these characteristics. An adult TCK (ATCK) brought his therapist along and both asked insightful questions during the discussion.

Afterwards, this therapist approached me and said, “Tonight I learned something. For months, I have treated my ATCK client for PTSD. It is the only method that has worked with him, but I have never understood why. How can he have classic PTSD symptoms, yet not have any of the usual types of trauma my other clients have? Now I understand how, despite the many benefits he also received, the cycles of separation and loss inherent in his TCK experience can create significant trauma in way I never considered before.

“And I think I learned something else. For years therapists and psychologists assumed if a baby was adopted at birth, there would be no different issues for that child than If he was the parents’ birth child. Now we know that the minute we learn that our client is an adoptee, there are certain things we must look for. After hearing about the TCK Profile tonight, I believe it’s the same with those who have grown up in a globally mobile lifestyle. Once we know this is part of their story, there are certain things we must look for and pay attention to.”

What are some of these things to consider when someone with what Donnyale Ambrosine has called a ‘culturally fluid’ story sits before you?

To begin, we can consider the TCK model as something of a ‘petri dish’—a place where for many years we have studied the impact of cross-cultural mobility during childhood. If we understand what we have already learned as basic issues, we can see how what we have learned here might apply in other situations in our changing world, even when the details of the experience are not identical.

As I’m sure you know, there are two basic hallmarks for a traditional TCK experience: a cross-cultural upbringing and a life filled with high mobility, whether it is their own or living in a community whose members also frequently come and go. It is the intersecting of these two factors that create the often paradoxical list of benefits and challenges that David Pollock developed and described as The TCK Profile (now Section Two of Third Culture Kids: Growing Up Among World, 3rd edition). Certainly, this pattern of chronic disruption in the traditional way children formed a sense of identity in a more mono-cultural experience leads to questions of identity and belonging for many TCKs. In addition, the repetitive cycles of separation and loss due to mobility patterns result in matters pertaining to attachment and unresolved grief. Both of these outcomes and why they happen are also explained at length in Section One of Third Culture Kids.

Applying Lessons Learned

Today’s therapists, however, need to consider how the TCK experience has, in fact, turned out to be what sociologist Ted Ward predicted in 1984—a prototype for the future ‘normal’. That time has come. As the world is changing, our understandings and applications of what we know must keep growing with it. Where are some of the new realities therapists must consider?

The Cross-Cultural Kid Model ©Ruth E. Van Reken, 2002, Used by permission.

First, we must remember the many types of cross-cultural childhoods there are in today’s world. The diagram above lists a few of them, but many more exist. For example, foster children or children of divorce who navigate between different family cultures could also be included. Many CCKs ask the basic questions of “Who am I?” and “Where do I belong?” we have heard for years from traditional TCKs.

Second, remember that CCKs are often in multiple categories at the same time. A traditional TCK may also be an international adoptee. In addition to common TCK characteristics, therapists must also look at known themes adoptees also face. Refugee children undoubtedly experience questions about identity and issues related to major loss but what are the traumas related to war they might also know? Often they become immigrants and live as minorities in a new land while going to school in a very different culture from what they know at home. Often such groups also face racism and bullying as they settle in and become immigrants. This growing cultural complexity is a new but often unrecognized ‘new normal’ in today’s world. How do you as a therapist look at the whole picture?

Third, globally mobile adults who began life in a more monocultural situation often present with issues that overlap with those we know from a traditional TCK experience. In the past, we have presumed that they had already established their sense of identity before beginning global pilgrimages so they would not share similar questions about that as TCKs often do. It seems that may not have been an accurate assumption. Many of these adults also seem to arrive at a state of feeling so changed by the experience, they too ask “So who am I now?” “Where do I belong?” In other words, the issues of identity, belonging, and hidden losses are often present for globally mobile adults as well as for their children and, without understanding or resolution, lead to a nagging sense of “What is wrong with me?”

Fourth, never forget that the shifting cultural contexts across our globe are leaving fewer and fewer places as the ‘monocultural’ communities we knew in the past. That means the skills and understanding you have acquired as ‘international therapists’ have put you ahead of the curve for normalizing and giving language to how global changes are affecting local communities around you as well. You have much to offer! May you find joy in expanding what you already know and do to be more effective than ever in our changing world—not only your sake and your clients’ sake but for your profession as well.

Author Ruth E. Van Reken

Ruth Van Reken is a US citizen who grew up in Nigeria as a second generation third culture kid (TCK)* and raised her three daughters in Liberia For over thirty years Ruth has traveled extensively speaking about issues related to global family lifestyles. Currently, she is seeking to understand how lessons learned from the TCK experience can transfer to others raised among many cultural worlds for various reasons. Ruth is co-author of Third Culture Kids: Growing Up Among Worlds,3rd ed., multiple other writings and co-founder and past chairperson of Families in Global Transition.  

Contributed by Robert Oleskevich, MA, LMFT

A great trip overall, however there was one little thing that kept happening…

Recently, I had the amazing good fortune of going to the Ha Giang mountains in Vietnam, on a motorbike adventure with my cousin. The views and terrain were seriously spectacular and breathtaking. This was the second time I was able to explore this part of the country. The winding rivers, lush green mountains, and magical misty views were even more incredible this time around.

However, while on the trip, I found myself several times thinking back to the comforts of my own home and neighborhood. I imagine part of this was because I had a cold and was feeling a bit under the weather. Yet, it was also interesting to notice how during an amazing trip many people only dream of, my thoughts often drifted to how much I wanted to sleep in my own bed, have access to all the foods I’m familiar with in my neighborhood, and not deal with sleeping/lodging in new and strange places. The thing is, this thought train wasn’t just about dealing with the inconveniences of traveling… sometimes my mind really wanted to convince me that I would be better off at home. This might be just me getting old, but I think there’s a bit more to it than that.

Now that I’m home and reflecting on the trip, I’m missing the scenery and the adventure, but more than that I miss the camaraderie and companionship of hanging out with my cousin Paul. There were a lot of jokes and silliness. Like any good adventure, we met many great people, saw a lot of unique beauty, took roads we weren’t sure about, had some very scary moments and a lot of belly laughs! Imagine in the midst of all of this, wanting to be somewhere else!

I bring this up because this trip has confirmed something about my thinking habits that I believe I already knew. Sometimes, regardless of where I am, it can be very challenging to remain present and truly be in the moment. It’s kind of crazy to think that even when I am doing something I love to do, like riding a motorbike in the Vietnam countryside, my mind can simultaneously try to convince me that I belong somewhere else.

My cousin Paul and I in Vietnam.

No matter which moment we find ourselves in, it is the only moment that exists. To not be present for this moment is kind of ridiculous, yet that’s exactly what our minds do: fantasize, remember, dwell, lament, wish for something different, or want more/less of whatever we’re experiencing.

This was all a very good reminder for me. I’m going to spend this upcoming week coming back to my breath as much as possible. It is this simple (but not easy) practice that keeps us tethered to the present. When at least some awareness resides in the body, and not lost in incessant commentary from the monkey mind, we are much more likely to LIVE and experience this moment fully.

So, I leave you with this question: Are you able to reflect on a moment when you’ve been lost in next week’s meeting, or in last years break up with your ex, as opposed to being present in that one precious moment? By practicing noticing when we aren’t present, we are more inclined to be able to let go of unhelpful thinking patterns, and return to the the one and only moment that actually exists. I challenge you to come back to your breath and body at least three times a day this week, for 30 seconds each time. In doing so, you are much more likely to let this moment be alive within you.

[Note: This piece was originally published on Robert’s Blog and has been re-posted with permission from the author.]

Author: Robert Oleskevich, MA, LMFT

Robert is a Licensed Marriage and Family Therapist (MFT) and an on/off member of the California Association of Marriage and Family Therapists (CAMFT). He has a B.S. degree in Psychology and an M.F.A. (Masters) in Clinical Psychology. He incorporates Mindfulness Based Cognitive Therapy (MBCT) into his approach.

Living in Los Angeles, Robert has had the benefit of learning from, and influenced by, some of the most well respected people in the fields of Mindfulness and Buddhist Psychology. Many of those who he considers his teachers are the people who brought Mindfulness Meditation from the East to the West and made it their life’s work to introduce it to the mainstream. He has been fortunate to be part of some of the communities in Los Angeles where Mindfulness and therapy are recognized as powerful and extremely beneficial avenues for relieving suffering and acquiring more happiness.

For more information, his website is

Contributed by Katarina Gaborova, MSc

It was a lovely Dutch morning, as I was driving my older daughter to school, who was 7 at the time. On the way there, we were singing and laughing in the car at some of my “lost in translation stories” related to expat life. I dropped my girl off, wiping off some milk crust from her breakfast residue as I was kissing her on her soft cheeks.

Then continued driving to my practice. I picked her up, later that afternoon. “ So what was the best experience of your day-today?” I asked, my usual question that I adopted from positive psychology. My daughter looked at me, suddenly bursting into tears, telling me that it was the WORST DAY OF HER LIFE. We sat down and chatted about her day, and broke her day into different much smaller parts. When I realized that her day went actually great up until about 10 minutes before I went to pick her up. That was a point when she ended up having an argument with her best friend (a classical cognitive distortion).

Shifting Attitudes

How had she gone from a positive morning experience to such a negative outlook? Well, as therapists we know that we have been given this evolutionary capacity to emphasize the negative rather than the positive (known as negativity bias). It is our inborn critical survival skill to be aware of and to avoid danger. Did you know for example that negative experiences or the fear of them has a greater impact on us compared to positive ones? Or that our attitudes are more heavily influenced by negative news as opposed to the positive? According to a prospect theory (Kahneman & Tversky), we even tend to make choices mostly based on avoiding losses rather than focusing on all the wonderful gains.

Well, coming back to my story, as I was sitting there with my daughter, it suddenly hit me and I got an idea of creating a deck of cards and a book for my daughter where I could show her these tricks that our mind plays on us. More importantly, I could show her some remedies how we can play back by turning the awareness of our own thoughts and feelings into our own benefits. I also thought of how useful it would be if other children, or adults could use these tools as an extra support with whatever they would be going through.

We human beings, can certainly train our mind to consciously start noticing and focusing on the positives in our environment. This is of course not to make someone naively look at the world through pink glasses, but rather sticking to the facts at hand. Not letting our bias opinions create a cloudy view. It takes practice and effort but the result is surely worth it. I do not need to even point out what benefits it brings to our resilience, mood, immune system or relationships within our environment.

So, that is how our See Bee Tee journey started. I met a great artist from Romania Roxana Macovei, who beautifully painted each card by hand for the memory card deck. We researched how to make them interesting, colourful and full of fun (See a couple of examples below).

I was also cooperating with a Slovanian visual artist and a pedagogue Nataša Gruden Pižmoht who illustrated the book (See below).

And then my dear colleague, Ekaterina Evdokimova of PsyCompass, a child psychologist and Expat herself, currently working and living in the Netherlands, tested the tools in her practice when working with Expat children and their families. This is what she wrote about the book & cards as she reviewed them:

“In this interactive tool for children, their parents and professionals, Katarina (psychologist, manages to bring together the essence of two widely-known approaches to therapy: cognitive behaviour therapy (CBT) and mindfulness. The book gives a very clear indication of how the negative thought patterns work, and presents the reader simple exercises to ensure that positive thinking becomes their natural reaction to destructive thoughts and unfortunate events.

The tool has two parts: the book “See Bee Tee” and a memory game card deck with the same title. Both are based on the story of a bee called Tee who was temporarily unable to fly. The story tells how she manages to overcome despair and sadness, and even benefits from the situation with the help of her friend, a wasp called Kevin. The story demonstrates in clear, rhythmic language how Tee’s thoughts developed, how they changed while she was talking to her friend, how new hope arose, and how she ultimately found a way to enjoy the time and new opportunities while she was unable to fly. The story provides a clear model for children and equips them with practical tools to help them deal with their own difficulties. Children also learn how to be less dependent on other people’s opinions and how to be kind to themselves and to others.

At the end of the book and in the instructions to the memory game, there are manuals for parents. The guide is written in clear language and leaves no doubt about how valuable positive thinking is when it comes to dealing with the past, overcoming difficulties in the present or going through desperate times of loss and grief. The manual is rich in information which is useful to both children and their parents. Both the book and the card game have well-balanced combinations of text and illustrations. The colours also correlate with the story and reflect the feelings the characters are experiencing.

The book and the card game can be used by professionals such as psychologists, teachers and care-givers who work with children suffering from anxiety, fear, depression, post-traumatic stress disorder (PTSD), as well as children with special needs and children dealing with the challenges of an international move. Playing with the memory cards, reading the story or colouring the pages of the book can be used by professionals to discuss with children various events in their lives, the effects of certain ways of thinking and possible coping mechanisms. Information presented through play is easier received by children and repetition of the same message ensures that it is instilled in children’s ideas and behaviour. Children also learn other skills: appreciate the smaller things in life, value and maintain friendships, talk about their feelings, focus on the present, and have the courage to step out of their comfort zone.

As a child psychologist I already started using the tools in my practice working with children who have difficulties with self-esteem or who have challenges with emotional recognition.

See Bee Tee is a valuable resource in any practitioner’s toolkit.”

Today my daughter is already 10 years old. Of course that she is still going through her natural ups and downs which are an inevitable part of any cycle of life. However, since then I honestly have not heard her labelling her days as the WORST IN HER LIFE :).

Sending you all warm greetings from Netherlands.

Author Katarina Gaborova, MSc

Katarina Gaborova was born and raised in Slovakia. She studied psychology & psychophysiology in Australia. Currently she works in her practice in the Netherlands. Where she is a licensed psychologist and NLP (neuro-linguistic programing) life coach and member of the ACCESS Counselling Service Network. Her specialties include positive psychology, integration challenges, stress management and more. She is a published author of V!VA Tools for well-being and See Bee Tee products. You can find out more on ;

Contributed by Tina Quick of International Family Transitions

It’s that familiar time of year again. Spring is in full bloom and difficult to voice emotions are being felt by secondary students all over the world. Graduation is looming large and with it come feelings of exhilaration, excitement, and anticipation about their upcoming adventures, but they may also be feeling sadness and experiencing a sense of loss. They may be feeling some distancing or even exclusion as they give up roles and responsibilities they held as high school seniors and turn them over to underclassmen as they move forward toward graduation and leaving. With those responsibilities also go the status, position and identity they enjoyed in their last years of high school. They are most likely reflecting on what it will be like to leave friends and family behind as they head off to college/university. Parents may notice their student’s mood swings between still wanting to be coddled like an infant and screaming for more independence.

All graduating students are firmly implanted in what the late Dr. David Pollock called the ‘Leaving Stage’ of his transition model, but for Third Culture Kids (TCKs) it can be a very conflicting time. A lot of denial may actually be going on as they find it difficult to imagine that they really are going to be leaving the place they have called “home” for so long. The leaving stage is characterized by a loosening of emotional ties and distancing from family, friends, and relationships. This behavior is quite unconscious and is a form of self-protection – from their own feelings – and it will be displayed in a variety of ways. I watched as each of my three daughters went about this typical withdrawing in their own style.

My normally jovial, sweet, loving, eldest daughter became so irritable and downright annoying that I was convinced she was demon-possessed. She must have, somewhere in the deep recesses of her mind, thought that by acting out, her family would be relieved to see her finally leave home to go off to college, thereby, making her departure easier on us.

My middle daughter handled it quite differently. She spent the entire summer before college hanging out incessantly with her friends. She didn’t loosen any ties with them, only her family. In fact, if anything, she and her secondary school buddies became even tighter over the summer than they were in the years they spent together before graduation. She was pleasant enough when she was around, but that wasn’t very often.

My youngest became a recluse at home. She came home from school or sports practice and went directly to her room. Her only appearance to spend time with family was mealtime. I would always find her in her room reading or doing homework. She used to sit at the kitchen table to do homework so we could chat as I prepared dinner. When I pointed out her long absences, she sighed and replied with a hint of sadness, “I’m sorry. I don’t mean to be distant.” I then realized this was her way of disengaging and separating from us, her parents.

A TCK’s globally mobile lifestyle (whether they are the ones who are moving around or the one who is always staying put) means that they have experienced a lot of separations and loss. When we lose people and things we need to be able to grieve them. Leaving a beloved host country is no exception. Dr. Pollock used to say that “TCKs need to grieve well to leave well.” Grief validates all the good in our lives. Grieving well means:

  • Recognizing and naming the loss(es).
  • Mourning the loss(es) – however that may be for the student, i.e. journaling, art, music, poetry, photography. (Some of the most amazing pieces of art I have seen were done by TCKs dealing with grief.)
  • Accepting the loss.
  • Coming to closure, and
  • Moving forward to the next developmental stage.

Dr. Pollock also used to say that “In order to enter well, one must leave well.” In other words, how a person leaves one place will have a profound effect on how well he enters the next.” He went on to develop a model anyone going through transition could use to help them leave well. He used the RAFT acronym which stands for Reconciliation, Affirmation, Farewells, and Think and Talk Destination.

Reconciliation – Do not leave a place with broken relationships, undone issues or unfinished business. Try to resolve issues and resentments and reconcile your relationships. Think about who you need to say “I’m sorry,” to or who you may need to apologize to. Broken relationships can hinder making new ones.

Affirmation – Just as giving and receiving forgiveness liberates and heals you, so does affirming people that have been important to you. Telling others (friends, teachers, coaches, pastors, mentors) how much you appreciate and respect them makes you and them feel better about saying good-bye.

Farewells – Saying proper good-byes helps bring closure. Be sure to say good-bye not only to people but also places, pets, and your possessions!

Think and Talk Destination – Find out as much as you can about the college/university you will be attending, the town or city it is in, the state and the country before you get there. Even if it is your ‘home’ country, treat it as a new one! Find someone you can ask questions of. And think about all the things you will need to bring with you. Plan ahead and be prepared so you are not caught totally off guard.

Some third culture kids will be going back to their home or passport country but it may not really feel like home to them. Some will be continuing on to another host country/culture for the university experience. Regardless, all TCKs will be stepping out of that ‘third culture’ or expatriate culture they have been enjoying for so long and may not take into consideration how their international experiences have made them different. They often do not discover they are different until they hit their campuses and are suddenly surrounded by people with whom they have no shared experience. In all the TCK interviews I did for the book, “The Global Nomad’s Guide to University Transition” the most common concern I heard was, “I don’t fit in…I don’t belong…I can’t connect with anyone.” It’s because the TCK’s life experiences have been very different from someone who grows up in a basically stable, traditional, mono-cultural community. I always encourage them to remember they have not had the same experiences as their peers so they need to find common ground on which to connect. I also tell them Naomi Hattaway’s “I Am a Triangle” story. It’s too long for me to write about it here but it is a foundational concept that truly explains the TCK experience. I encourage every reader to read about it at Wishing you and your students every success in their upcoming adventure.

Author: Tina Quick of International Family Transitions

Tina Quick, author of The Global Nomad’s Guide to University Transition and Survive and Thrive: The International Student’s Guide to Succeeding in the U.S. is a cross-cultural trainer, writer and international speaker. She is an adult Third Culture Kid (ATCK) and has raised her own TCKs across four cultures and continents. She has served as Program Chair on the Board of Directors of Families in Global Transition (FIGT) and on the Advisory Board for TCKid. Tina works closely with colleges and universities, domestic and international schools.

Contributed by Ava Senaratne of TCK Town, Multicultural Stories from Around the Globe

I’ve had this conversation with a few times with some friends already (and you might have too): not one country really does mental health “well”. From what I’ve seen through my journey as a TCK, we still haven’t cracked the code.

In Tokyo, the record is abysmal for healthy working practices. On the way to work on rainy days, it became second nature to leave earlier than usual because desperate salary men and women threw themselves in front of trains when the weather turned grey. And don’t even get me started on how harmful gender stereotypes are over there. From what I’ve experienced from the older members of my family who grew up in Sri Lanka, there really hasn’t been much awareness at all about good mental health practices to pass down to our generation (my grandfather’s favourite phrase, unfortunately, is “steel your mind!!”). In Melbourne, although there is some relief (my friends, colleagues and I can openly talk about issues regarding anxiety, depression and seeing our therapists), it’s not good enough yet. I am still haunted by our ridiculous “vote for gay marriage” questionnaire that would have shattered the mental health of many who have already struggled for years under the many burdens that come with LGBTQ+ identities.

Despite the downfalls and disappointments, I have learned. One of the invaluable traits of being a TCK is my ability to sort through the chaff and store away the golden pieces of wisdom I’ve found. I’ve developed the skill of adopting ways of thinking that suit me best without being prejudiced by where those ideas came from.

Here’s my TCK collection of good mental health practices that I hope serves you as well as they have served me:


When you’re not okay, and someone asks, “How are you?”, tell the truth. I’ve made a big effort to commit to this over the last two years and have found that the people around me have been receptive and supportive every single time I haven’t answered with, “Fine! You?”

If you’ve been feeling lethargic and unmotivated for more than a week or so, check in with your GP, and see if you need to get on a mental health plan. In the same way you can’t fix a broken leg on your own, you need the support of a therapist when something doesn’t feel right. Motivational internal dialogue and ‘sucking it up’ can patch the problem up but it won’t fix it. In the same way that letting that leg ‘heal on its own’ instead of putting it in a cast could have you limping for the rest of your life, not addressing the state of your mental health now will have repercussions later, and how you’re feeling is not just going to ‘go away with time’.

Ask your friends for help. It can be for big things like, “Can you help me pack before I move?” Or, “Can you check in on me over the next few days? Need a bit of support.” It’s embarrassing, but if you have good people in your life, it will never go astray. (If you’re not sure if you have good people in your life, this is a great way to get rid of the crap ones!)

Show up. Is your friend upset and stressed out about law exams? Is someone you know having a hard time with their family? Make them dinner, ring their door bell, drop the food off and say you wanted to do something to help them out through this difficult time. Or catch up for a 20 minute coffee in the morning before work. Calls and texts in this time of connectivity are awesome but in my experience, it can mean we take the necessity of intimate and genuine connection for granted.


Grooming is not a form of vanity, it’s a form of self care. While you don’t have to put on a full face of makeup or wear a suit before you head to work, make time for applying nourishing oil on your skin after your morning shower, or a bit of wax in your hair to elevate your look. It will make a difference to how you start your day.


Get away from the city whenever you can. I’m not a hiker and I don’t drive so trekking through mountains or cross-country road trips were never an option. I’d visit temples with dense foliage to block out the busyness of Tokyo, or huge gardens like Shinjuku Gyoen, where you can only see the tops of neighbouring buildings. New environments will help you gain new perspectives, especially if something has been worrying you for a while.

Food is nourishment. Whether it’s nourishing your soul (put your take-out on a nice plate, grab you cutlery and pour yourself a glass of wine next time you order dinner) or your body (make the effort to add one serving of something healthy to each meal), showing up for yourself in small ways reinforces that you are worthy of love and nurturing. As lovely as some humans can be, we are still not very good at practicing these sorts of kindnesses for ourselves, which in turn affects the way we treat others. Start small, and it will eventually spill over into other areas of your life.


If you only take one thing away from this article, try and make it this: Practice mindfulness. No, that doesn’t mean sitting in the lotus position and humming in your bedroom. On the way to work, when you’re getting dressed, when you’re flicking through Instagram, check in with yourself. The digital communication era has given us a million ways to numb ourselves to what’s going on internally, and I think many of us have subscribed to more of it than we think. Here’s an easy way to start:

How am I feeling physically? – “My feet are cold on the bathroom floor. My hands are wet and my lips are tingling from the toothpaste. The back of my shoulder blades are a little tense.”
Look at your physical experience in more detail – “I think my shoulder blades are tense because I’m a bit stressed out.”

Look again – “Why am I stressed out while I’m brushing my teeth?! Oh, because of the presentation I have to do at lunch.”

Look again – “I’m uncomfortable because I misinterpreted the brief yesterday and I don’t want to be on the wrong track with this preso again today. That would be really embarrassing.”

Sit with how you feel for a bit and don’t try to ‘resolve’ it – “Yup, it makes sense that I’m nervous. I’ve only been working here six months. And I tend to be pretty hard on myself when I mess up.”

I find that bringing the subconscious into the conscious and then practicing acceptance about how I’m feeling (instead of “don’t worry, it will be fine!”, which is a great way to negate your experience) often acts like a release. I’ve acknowledged what’s wrong and that means my body and mind are not internalizing the stress. It’s out in the open so that I can get on with my day instead of holding all of it in. With practice, you’ll get much faster at it and be able to work through this train of thought anywhere.

What small (and big) mental health practices have you learned from your countries? Comment below. I’d love to learn more and add to my collection!

[Note: This piece has been re-posted from TCK Town with permission from the author. Comments are open on the original post.]

Author: Ava Senaratne of TCK Town, Multicultural Stories from Around the Globe

Ava Senaratne is the Editor-In-Chief of, a journal which celebrates cross-culturalism with raw and real stories from around the world. Ava is from Australia, was born in Sri Lanka, grew up in the Middle East and has lived in Tokyo too. Her many homes have made her a passionate advocate for diversity and connection, values she tries to live everyday.

As I began to prepare my annual goals for curating the International Therapist Directory in early 2019, I felt a bit of a jolt run through me when I stopped and did the math, realizing that I first launched the initial version of this online resource a full decade ago. The site was much different back in 2009, originally housed under the umbrella of Interaction International, the nonprofit organization founded by Dr. David Pollock. Since that first version, the ITD has been through multiple iterations, and I can think of no better way to celebrate the Ten Year Anniversary than by launching a brand new version of the site with lots of new bells and whistles designed to benefit users and members alike.

If you have had this resource on your radar for very long, you have probably noticed the massive change in the look and functionality of the site in recent weeks. On March 1st of 2019, after almost two years of behind the scenes work with a web developer, the newest version of the International Therapist Directory went live online. It has been an exciting (and nerve-racking) step, implementing this many changes at once, and there are many new features that I am thrilled exist.

For example:

– members can now submit bio images and additional information about their practice and edit the information by logging in and editing whenever they wish
– the site is now mobile-friendly, making it easier to read on smaller screens
– the site is much easier to search by location, languages spoken, and clinical specialty
– listings are linked to Google Maps, making it easier for clients to find a listed therapist’s office
– the ITD Blog is now more prominently featured on the front page for easier access

However, a massive update of this scale does not come without some growing pains. Along with all that has gone well, search engine optimization takes some time to catch up, and we also have been discovering some rough edges here and there that need fixing and refinement. The work continues, and I would invite you to contribute in this process. If you are using the site and run into something that seems off, please let me know. I look forward to building on the improvements and making this site increasingly useful for the internationally mobile community for many years to come.

For the moment, however, let’s just pause to celebrate. It is satisfying to stop and reflect back on the last decade of International Therapist Directory work, while also looking forward to the next ten years, imagining what may lie ahead. Thank you for being part of the journey.

Happy Anniversary!


Josh Sandoz, MA, LMHC received his MACP in 2008 from The Seattle School of Theology and Psychology and currently works in private practice in Seattle, Washington providing individual psychotherapy for children, adolescents, and adults. Specializing in working with those impacted by international mobility, he also curates Josh is the current president of the Board of Directors of COR, Center for Object Relations, and chair of the Alliance Ambassador Committee at the Northwest Alliance for Psychoanalytic Study. Since 2012, Josh has been singing alto on Sunday evenings with The Compline Choir at Saint Mark’s Episcopal Cathedral.

Contributed by Robert Oleskevich, MA, LMFT

You’ve heard countless times about fight or flight and we all think we know what that means… but did you know that as a culture, going back generations, our nervous systems have been wired to be in fight/flight almost continuously? Our ancestors were always on guard to protect their clan from dangers, whether it be another tribe or a wild animal. This adaptive response has been passed down from generations, except now it’s often maladaptive. It’s not always the dramatic and intense way of being that you may think of it. It can be low levels of feeling ‘something’s not right, I need to do something, this needs to be fixed, or I need to get rid of this feeling/experience’…We don’t typically think of these modes as fight/flight, but that’s what they are. We are anticipating danger and prepping for it (even if the ‘danger’ means someone is insulting us, we are trying to appear competent, or we are defensive and clinging to our stories of how things ‘should’ be, etc.).

Each of our bodies have an individual story. Yes, our ancestors had to constantly be on alert for survival, and that has been passed on, so we do come into this world wired to be on alert. So, the nervous system is scanning for reasons to fight or flee (or freeze). Yet, each individual body has a story that also contributes to this stress response. Especially if you have trauma and conditioning that has solidified this as an adaptive response. I mean, it is a highly intelligent response, right? Our nervous system detects danger, and sends messages for our heart rate to increase, our muscles to contract and the blood pumping, so we can defend ourselves appropriately… However, this response, if there is no danger, is problematic.. and often there isn’t any danger! When we are defended but no real danger exists, we can feel combative, disconnected, and separate from those we are engaged with.

Because we are typically living from the neck up, being so identified with and consumed by the stories we tell ourselves, we can actually trick ourselves into thinking there is something wrong… There’s something I need to defend, avoid or engage with aggressively, even when this is often not the case. However this is our habit.. fight/flight/freeze. What we want to practice is: as Tara Brach says, Attend and Befriend. This is the way to activate the rest and digest part of our nervous system.

The limbic brain, or the oldest part of our brain (reptilian) is responsible for the fight/flight reaction. It detects the danger (real or imagined) which triggers fight/flight. The most recent evolution of our brain is the frontal cortex, responsible for emotional regulation and wise/skillful reasoning. If our frontal lobe is communicating effectively with our limbic brain, we can usually manage stressors with some degree of effectiveness. However, for many of us, these two components of the brain don’t communicate well, because of our family/cultural conditioning and past traumas. So, if you’re always reactive, and defensive, it’s not really your fault. This is your nervous system doing what it thinks is best.

It can be helpful to know that you are not to blame for your angry, aggressive, withdrawn, avoiding, defensive, and disappointed reactions. This was adaptive at one time. This is how we handled our fears. However, it is your responsibility to learn how to work with them. When you’re living in your limbic brain (you’re wrapped up in your stories, your conditioning, and your habit reactions), there are ways to shift and train yourself to activate your frontal lobe and your rest and digest response. From this place, you are able to choose a response (different from a reaction) that is much more compassionate (towards yourself or others) and skillful. When we are in fight/flight, we are unable to connect with others and unable to feel integrated and whole within our own being. This is why we must learn how to work with it. When we are grounded, centered, and responsive (not reactive), we are much more able to connect in loving and compassionate ways to others and ourselves.

So, 1st), recognize and become aware of gravity. How do we know that gravity is doing what gravity does? We become aware of the feeling of our feet touching the ground, our butt on the chair, our glasses touching the nose, or the way our shirt feels against our skin. This is part of getting grounded and out of your head.

2nd) Exaggerate you exhales. I mean, reallllly extend them. A deep inhale for an in-count of 1-2-3-4, and then a much deeper exhale for an out-count of 1-2-3-4-5-6-7-8…Doing this 3 or 5 or 10 times sends the message to our brain that everything is ok, because once again, who breathes like this if everything is not ok? This is activating your rest and digest (parasympathetic nervous system) and deactivates the fight/flight (sympathetic).

3rd and finally, engage in some self-talk. You can ask yourself, is this really a crisis? Is this really danger? It can be helpful to remember that our thoughts are not always facts, and they certainly are not always true. More supportive self talk: ‘I’ve been through this before, I can do it again.’ ‘This is just anxiety, I know how to manage this.’ Nurturing, compassionate self talk allows you to soften into the moment, respond flexibly, and choose to respond in ways aligned with spirit over ego.

[Note: This piece was originally published on Robert’s Blog and has been re-posted with permission from the author.]

Author: Robert Oleskevich, MA, LMFT

Robert is a Licensed Marriage and Family Therapist (MFT) and an on/off member of the California Association of Marriage and Family Therapists (CAMFT). He has a B.S. degree in Psychology and an M.F.A. (Masters) in Clinical Psychology. He incorporates Mindfulness Based Cognitive Therapy (MBCT) into his approach.

Living in Los Angeles, Robert has had the benefit of learning from, and influenced by, some of the most well respected people in the fields of Mindfulness and Buddhist Psychology. Many of those who he considers his teachers are the people who brought Mindfulness Meditation from the East to the West and made it their life’s work to introduce it to the mainstream. He has been fortunate to be part of some of the communities in Los Angeles where Mindfulness and therapy are recognized as powerful and extremely beneficial avenues for relieving suffering and acquiring more happiness.

For more information, his website is

Contributed by Jennifer Patterson, MA, LMFT

The first few months of living in a new country are full of excitement, discovery, and most likely a healthy dose of frustration. Adaptation, the act of adapting, is also known as adjustment to different conditions, and sets in around 6–12 months after The Big Move. Some things are no longer as difficult or frustrating, or you’ve given in to the idea that even though you show up when the office opens to get your ticket, you’ll probably still be there for a few hours (if not all day). You probably understand cultural norms a little better and are feeling more connected to the language and local community.

Maybe you’ve started nesting with more intent; you’ve switched to local products and are no longer wishing someone would come visit to bring you that thing you can’t live without. At the one year mark many people have a pretty good idea of whether or not they are starting to set down new roots. Do you still think about yourself as an expat, or have you started to identify as an immigrant? There is a lot of discussion about what these identifiers actually mean… many people see the term expat as referring to people who are transient, on specific job contracts, digital nomads, professional gypsies, or people who are planning to return to their home country. Immigrants are seen as those who plan to become permanent residents of the country they are living in.

No matter how you identify, the fact is that if you are still feeling like a bit of an outsider, you’re probably experiencing the growing pains of Year One. The flurry of visitors has died down, but people still pop up and you get a little annoyed that you have to explain that even though you live in this “exotic” locale, you are not on perpetual vacation. You still have work and rent and bills to pay attention to. Perhaps it feels confusing when people come to visit, because after living outside of your home country for a year, you see things with a different perspective. Sometimes when our lens changes it makes us feel unsettled and caught between different worlds. This can have a big impact on our sense of who we are and where we fit.

Life abroad is a constant balancing act between approaching things in a practical or matter-offact problem-solving way and waves of nostalgia or longing. Luckily for this writer, here in Portugal there is a word for this type of longing, called saudade. Saudade has no actual single definition, but refers to a collection of feelings that induce heartfelt melancholy, wistfulness and yearning for something that may or may not exist. As a therapist I fully embrace a word that essentially describes all the feels. But experiencing all the feels while missing your crew and feeling like your language skills are one step forward, three steps back even when you’ve been studying and going to class can be really hard.

The best way to manage this type of complex homesickness of being happy where you are but still missing something is to do your best to embrace it. The things and people that you miss are a part of who you are and it’s completely normal to feel sad and lonely. Finding a way to meet yourself where you are at and practice self-compassion is essential to your mental health and well-being. BUT HOW? That’s also complicated, because everyone is different and has different needs.

Some things you can do include celebrating any and every accomplishment, no matter how tiny. Take the time to reflect on these accomplishments, make lists of what you have done and try not to get stuck in what you haven’t done. Find out your language learning style, do your best to not compare yourself to other people (ugh! So hard!), and attempt to remember that trying is so much better than not trying. Keep up with the hobbies that you loved in your home country. Finding the supplies or places could be a hilarious adventure, and you might connect with like minded people. Make the time for the things that make you feel good, are grounding, and foster your creativity.

No matter where you live, being human is hard. Feelings are hard. But these things are also wonderful all at the same time. Feeling like you are in a struggle for balance and identity and having a schedule when you aren’t living a traditional life is a real thing. Do your best to embrace it all. And if you need help, ask for it. Talk to your fellow adventures, we are all full of stories and resources. And if you need a little more than a buddy to talk to, there are English speaking therapists and counselors in most major cities around the world, as well as a handful of online therapy sites.

[Note: This piece has been re-posted from the Jennifer’s website with permission from the author.]

 Author: Jennifer Patterson, MA, LMFT

Jennifer Patterson is an American trained and licensed psychotherapist and board-certified art therapist living in Lisbon, Portugal. Information about her practice can be found at



Special Announcement: ITD Listserv

I am proud to announce the establishment of a brand new members only listserv for our ITD community. This email group is an electronic mailing list for members of the International Therapist Directory. What follows is a succinct explanation for the listserv purpose, how it works, and some community guidelines.

ITD Listserv Purpose

The creation of this ITD Listserv is in service of the major secondary purpose of the International Therapist Directory: to assist the listed professional mental health therapists (you and me) both identify and connect with one another for peer support and professional development.

The main idea here is that this gives us a group email address, and whenever an email is sent to that address, everyone the group receives the email. This will allow us to share referral requests, training and resource ideas, professional inquiries, etc… to assist one another in our work.

How the ITD Listserv works

Joining the ITD Listserv: If you are already an ITD Member, I need your active consent to opt in to the ITD Listserv if you wish to participate. This consent must be specific and verifiable.

If you wish to actively consent to participate in the ITD Listserv, please email me at:

In the subject line you can write:

ITD Listserv Consent

In the email (cut and paste if you like):

As an ITD Member, I would like to opt in to participate in the ITD Listserv.

Once you have joined: You will be sent instructions for how to send an email to all of the ITD members who are part of the listserv. On your member’s management page you can choose from three options about when messages are sent.

– Immediately: All messages sent to the group are immediately sent on to you.
– Daily Digest: Holds all messages sent to the group and once a day sends you a digest email.
– Pause All Messages: Stops sending you messages indefinitely but you will still remain a member of the group.

Of course, if you wish, you can also Opt Out of being included in the list at any time. If you do opt out and later wish to be part of the list again at some point, please write to to request being included again.

ITD Listserv Posting Guidelines

Subject Lines: When writing your posts, please be as specific as you can (without being too lengthy) in your subject line. This will allow members to search the message archives more easily for previously posted information.

Referral Requests: Many of you may have clients who move to a different part of the world, and you might wish to provide them with a referral. A use of the listserv can be to ask for referral recommendations. Feel free to include gender, general age of the patient, preferred locations and insurance requirements. Please refrain from including any identifying details about the patient. If you feel more information is required to make an appropriate referral, please ask for interested parties to get in touch with you individually.

Clinical Inquiries: Please feel free to use the listserv as a resource to ask other clinicians about how they might address a clinical situation you are encountering in your practice. When doing so, please be careful to use as few identifying details as possible regarding the case and/or your patient.

Practice Related Issues: Use the listserv as a resource for your practice. For example, if you are in need of a consulting group, training opportunities, or have questions about practicing in a certain part of the world, the listserv is a great way to support your practice.

Announcements of Community Related Events: If you or someone you know is hosting an event that might be of community interest, please use the listserv to get the word out. Please limit announcements to events related to the practice of mental health therapy.

Posting for Non-ITD Colleagues: While membership on the listserv is restricted to ITD members only, ITD members may post messages to the listserv on behalf of non-ITD member colleagues.

Confidentiality: Whenever making a post to the listserv, please honor our requirements of confidentiality by posting as few clinical details as possible when describing a case or patient.

Response Guidelines

Please note this group is currently set up such that when you reply to any posted message, your reply goes only to the person who sent the original email. If you’d like to have your response read by the entire community, respond by using the “Reply All” feature. If you do “Reply All” to respond to a posting, please be sure that your message pertains to the ‘subject line’ of the original post. This means, do NOT post a message on a new topic by clicking “Reply All” to a message on a different subject. Instead, initiate your topic as a new email with a unique subject line by sending a new email to the ITD Listserv email address.

If you post as suggested, it will create a nice chronological ‘thread’ of everyone’s responses on a given topic- a truly sequential dialogue. Everyone’s comprehension level will increase, and it will be visually easier to keep track of individual messages and conversations.

Thanks for your participation in this community!


Josh Sandoz, MA, LMHC
Seattle, Washington, USA

Contributed by Robert Oleskevich, MA, LMFT

Often frustrated, disappointed, or angry? Learn how shifting your expectations can create more peace and well-being.

Let’s talk about expectations. You’ve recently moved to a new country, or perhaps you’re an expat already well adjusted to living abroad. Do your expectations influence your day to day experience? Do your expectations impact how you respond to the daily difficulties and joys of being human in a new culture? The answer is probably, yes, of course they do.

When people in a new country stare at you because you look unique or different, does that bother you? Did you expect this not to happen? When you get asked 10 times a day about your job, or if you’re married, how do you respond to that? Were you expecting people to act differently towards you? Where did that expectation come from? Maybe you are a student, and your peers are relating to you much differently than they did back home. Can you adjust your expectations to make room for this new reality?

I think it’s important that we examine how our expectations are playing a part in our daily responses. Another way to frame this is looking at our reactions versus our responses. When we react, we are operating from our past conditioning and our expectations that people/conversations/events play out a certain way. When it doesn’t happen like that, we can become frustrated, angry, or disappointed. Is this response beneficial? Maybe yes, probably no.

On the other side of the coin, when we respond, we are taking a moment to choose how to proceed. The response is usually more thoughtful, skillful, and wise. Taking a moment before responding allows us to consider how our expectations might be influencing how we perceive this moment. Thus, one might even decide that not responding is the best response in this situation. We might think about this through the lens of becoming a ‘pauser.’ Taking that extra moment to pause, soften, and relax around this experience, so as to make emotional room for it to exist just as it is, not how you think it should be. In fact, if you notice yourself often using ‘should’ as you think about things, this is your red flag that your expectations may be ruling your experience.

William James, who some consider the founder of American psychology, has said that ‘the art of being wise is the ability to know what should be ignored.’ This connects neatly to how we might think about expectations, and that is the key- thinking about/being mindful of our own expectations.

So here are three simple (but maybe not easy) things we can do to play around with how our expectations might be influencing our experience:

  1. Notice any patterns related to people, events, or situations that seem to trigger feelings of disappointment, frustration, anger, or any other feeling/emotion. This includes ‘should’-ing. Often just noticing that pattern can be enough. For example: Ohhh, I often get frustrated with the teenage girl on the motorbike cuts me off in traffic without looking where she’s going. She *shouldn’t* f-ing be driving like that! This is one of mine, but you can think about what triggers you in your life.
  2. Reflect on your expectation. For example: I believe that the person/event ‘should’ be other than it actually is. Is that realistic? I grew up in America, where people are taught to drive cautiously, and more often than not, yield to others in the name of safety, and certainly look over our shoulder when driving to check the blind spot. However, in Asia, at least in Vietnam, people don’t drive that way. Can I make emotional room for that reality? Can I expect to be cut off when driving, and adjust my driving style accordingly (more defensive driving)?
  3. Practice shifting your expectations once you’ve noticed and reflected which expectations are impacting your sense of peace and well-being. You might take a moment each morning to set the goal to become a ‘pauser,’ or to respond instead of react when your triggering event inevitably takes place. For example: Ok, when I get cut off today, I’m going to take a deep breath, try to remember that is the norm here in Vietnam, and that this teenager wasn’t taught how to drive safely and considerately.

In psychology, this is called ‘response flexibility.’ We are training ourselves, when appropriate, to think about things and respond to people and situations that are more beneficial for ourselves and others. William James said ‘The art of being wise is the ability to know what should be ignored.’ This can mean having the ability to mentally reframe a situation, by noticing the ‘should’ thought, and learning how to choose to let that thought go.

One final note, it is not suggested here that we need to learn how to let go of all expectations surrounding events and people that make us uncomfortable. Sometimes the wise and skillful choice is to take appropriate action so that our (or other’s) health, well-being, and safety is the priority.

Thanks for reading!

[Note: This piece was originally published on Robert’s Blog and has been re-posted with permission from the author.]

Author: Robert Oleskevich, MA, LMFT

Robert is a Licensed Marriage and Family Therapist (MFT) and an on/off member of the California Association of Marriage and Family Therapists (CAMFT). He has a B.S. degree in Psychology and an M.F.A. (Masters) in Clinical Psychology. He incorporates Mindfulness Based Cognitive Therapy (MBCT) into his approach.

Living in Los Angeles, Robert has had the benefit of learning from, and influenced by, some of the most well respected people in the fields of Mindfulness and Buddhist Psychology. Many of those who he considers his teachers are the people who brought Mindfulness Meditation from the East to the West and made it their life’s work to introduce it to the mainstream. He has been fortunate to be part of some of the communities in Los Angeles where Mindfulness and therapy are recognized as powerful and extremely beneficial avenues for relieving suffering and acquiring more happiness.

For more information, his website is

Contributed by Daniela Tomer, MA

I should probably begin by explaining where am I coming from.

I am a clinical Psychologist who worked for many years as a therapist in an “in person” traditional psychodynamic setting. Ten years ago, I started my second global nomadic adventure at the time where online therapy was just an experimental idea. While this idea continued to grow, I couldn’t imagine myself working without sitting in the same room with my clients. It took me years, numerous life experiences and, most of all, overcoming my own resistance to dive into the developing world of online coaching.

Still, until not so long ago, I had my inner preference of meeting people at the same place, in the same time zone, getting a closer look, reacting with all my senses and not being nervous about losing the internet connection in the middle of an emotional session. Therefor it was very natural for me to ask clients, at the first session: “So why would you like to do the sessions online?”

The most common answer is related to language. Most of the global nomad clients who choose to work online are doing so because they can’t find a professional who can speak their language in their location. It is very understandable, crossing cultures is complicated enough; so seeking for the comfort of communicating in your mother tongue is very natural.

During this last ten years, I was forced to challenge many of my basic assumptions about the nature of helping people and the cycle of adjusting to a new culture. The language barrier was one of them.

But, what do we really mean by language?

Some time ago, during a first meeting with a potential new client, as usual, I asked about their online service preference. The client was a native English speaker, living outside of her passport country but in a place where professionals in her native language were available. As English is not my native language, it seemed to make sense to offer to connect her to some colleagues in her location. It was here, in that moment, that I learned a very meaningful lesson.

Following my offer, she explained: “ I am a ATCK (Adult Third Culture Kid). I moved around during my childhood and as a result, I chose an adult lifestyle that forces me to move around very often. Everywhere I went, if I felt the need, I contacted a professional to help me cope with my challenges at the time. They were all good but I couldn’t take them with me and they didn’t really understood my culture.” When I asked her to clarify what does she mean by “ my culture” she said: “ I want to have an emotional home that I can take with me wherever I am; one that speaks the language of the ones who cross nations and cultures, that understands what it means to transition. I picked you because you work online, you moved around and according to your bio, you know many of the places I lived in. So we speak the same international  language.”

She was very convincing and she was right. A language is more than a vocabulary  of words; it is a vocabulary of emotions and experiences. For her, knowing that wherever she will be, I will be available and that we both speak the language of a third culture; the language where all the commonalities of those living a global nomadic life is shared. This is our “mother tongue”.

When using the term “third culture” I refer to the term that was coined by Ruth Hill Useem, a sociologist from Michigan State University, in the late 1950’s. Useem called it “third culture or “interstitial culture”. In her work the term first culture refers to the home or passport culture of the parents. The term second culture refers to the host culture to which the family has moved. The term third culture then refers to a way of life that is neither like the lives of those living back in the home culture nor like the lives of those in the local community, but is a lifestyle with many common experiences and feeling shared by others living in a similar way.

This moment was one of many learning moments I had from a TCK. In her wonderful book: “Belonging Everywhere & Nowhere”, Lois Bushong lists her top tips for counseling TCKs:

“Listen and learn for they have much to teach you.

Do not assume anything about their world.

You are closer to their world if you view them as internationals”

I learned my lesson that day and we embarked into a meaningful journey for both of us.

An international professional path can be challenging at times but one of the big clear advantages is that you never stop learning. I embraced the online technique as the leading one in my practice as oppose to my former preference of “in person” coaching. And, when occasionally people seem to be confused with my accent and I am asked about my mother tongue, I answer: “It is complicated…. How much time do you have?”

If they insist I say: “ I speak four languages but I am most comfortable in the common language of the third culture, the language of the ones that moved around.”

Author: Daniela Tomer, MA

Daniela Tomer is the Co-Founder and Director of GNW Global Nomad’s World. She is an Israeli licensed Clinical Psychologist, a Mediator, Coach and Trainer and serves as FIGT- Families in Global Transition Program Chair leading their global annual conference.

Contributed by Jennifer Patterson, MA, LMFT

You’ve up and done it! You’ve moved away from your home country to shake things up, follow your dream job, pursue a romance, have a great adventure, and see the world. It’s an awesome, awe-inspiring, bold move, and quite unfathomable to some people. As you settle into your new home and start nesting, it’s exciting to realize that you aren’t on vacation, and you don’t have to leave. You meet the days’ challenges of buying groceries and finding your favorite treats with enthusiasm. You start language classes with loads of energy and come up with a study schedule. Everything is new, and exciting, and this is exactly how you wanted it to be!

And then after the month or two, you might find yourself a little cranky. Maybe you feel a little more frustrated, you’re annoyed with yourself because you aren’t picking up the language as quickly as you think you should (more on that later). Going to the butcher shop and the market down the street feels hard and exhausting so you just order a pizza – online, so you don’t have to talk to anyone. You’re tired of not understanding how things work… you finally figured out that you have to take a ticket when you go somewhere that involves a line and waiting, but how do you know if it’s the right ticket?!?!?!

This is the culture shock phase of adjusting to life in a new place. There is a specific cycle of ups and downs that people experience as they adjust to their new home country. Even if you think, “I can handle it, I’m adaptable, I know what to expect”, there is a pretty high chance you will still in some way feel like a fish out of water. Communication issues and feelings of isolation are the most common challenges that people experience, and because we aren’t always good at paying attention to our emotional well-being, these stressors can show up as anxiety and depression. Physical symptoms of these potentially overwhelming feelings include headaches, insomnia, upset stomach, muscle pain, and exhaustion.

So you’ve figured out that you’re stressed out from being exactly where you want to be. Now what? Self-care is the most important thing you can do to help yourself feel more grounded in a place where you are most definitely not grounded. What are the things that you like to do? How can you adapt them to your new home? Find the neighborhood yarn store, and ask if they have a knitting group. Join the local gym and connect with locals there. Use the internet for good, and find the English bookstore in your city and see if they have a book group or other events. It’s important to find out what’s happening in your neighborhood, so you can create opportunities to click with the local culture. It’s hard and scary to put yourself out there, especially when you don’t have a lot of conversational skills in the native tongue. But the more you show up at the local watering hole, café, or restaurant, the more you will be seen by those around you.

Most people who work in the local shops, once they’ve connected that you are living here too, are very kind and patient with your attempts to speak their language. Honing your charades and pantomime skills go a long way and can be a great icebreaker. Don’t be afraid to feel silly! Have a sense of humor about your attempts! And that idea mentioned earlier, that you should be further along in your language skills? Put that to rest. Meet yourself where you are at. Understand that every day is different. Yesterday you may have been really proud of yourself for how well you managed with the language, and today is really hard. That’s okay.

Learning to meet your frustrations with a sense of humor is like accepting the grammar rules in a different language… sometimes it doesn’t make sense, but you agree to remember it and move on to the next lesson. Embrace the quirks, the charm, the quaintness, and the things that are different from what you are used to. And if you need help, ask for it. Every other expat is in some stage of their adaptation and is a great potential resource. And if you need a little more, there are English-speaking therapists and counselors in most major cities around the world.

 Author: Jennifer Patterson, MA, LMFT

Jennifer Patterson is an American trained and licensed psychotherapist and board-certified art therapist living in Lisbon, Portugal. Information about her practice can be found at

Contributed by Daniela Tomer, MA

Identity formation, is the development of the distinct personality of an individual, it includes a sense of continuity, a sense of uniqueness from others, and a sense of affiliation. From research we learned that it is complicated enough to get a comfortable sense of who you are even if you live in one place, but what if you are exposed to several cultures and influences?

Cultural identity is the identity or feeling of belonging to a group. It is part of a person’s self-conception and self-perception and is related to nationality, ethnicity, religion, social class, generation, locality or any kind of social group that has its own distinct culture. Many of us thought that if we keep globalizing our economy and liberalizing our politics we would create an ideal world. The political debates and changes around the world are telling us that the current divide is shifting to Global vs. National, or Global  vs. Local. We are experiencing growing divisiveness.

Nationalism comes with the expectation of loyalty. We expect loyalty in order to own this identity and by that being recognized as part of the group. Nationalists believe in a single monolithic identity. It does create a problem with people who want to divide their loyalty, people who feel loyal to more than one nation. In a world that is divided by nations you are born into a community that immediately gives you a strong identity just by the act of being born in a certain geographical location. You are being recognized as part of the group. But why do we adopt it? What need does it serve? The need of belonging. The human need to be an accepted member of a group. This desire is so universal that the need to belong is found across all cultures and different types of people.

Abraham Maslow was one of the pioneer thinkers who wrote about it in his pyramid of needs. Other theories have also focused on the need to belong as a fundamental psychological motivation. All human beings need a certain minimum quantity of regular, satisfying social interactions. Inability to meet this need results in loneliness, mental distress, and a strong desire to form new relationships.

Human beings are social creatures, we need to belong to our group, we are given an easy immediate identity by the physical place in the world we were born, we immediately cover to some extent some of the need to belong. But all this comes with a price: The expectation of loyalty. Nations differ in the level of expectation, and the level of pride.

What about Globalization? Globalization is the main drive of global mobility, and the number of people who live out of the country of birth is constantly growing.

Prior to WWII, most people grew up and lived in stable, not highly mobile, monocultural communities. Now days, we are exploring a growing number of people around the world that are living out of their country of birth. The United Nations released data showing that 244 million people live outside of their countries of birth. Migration became much easier than decades ago. This change is the main driver for the creation of complex cultural Identities.

In other words: More globalization means more complex identities.

What are complex identities in this particular context? These are identities that are shaped by multiple cultural experiences.

Who are these 244 million people or more? Are they all the same?

They are immigrants, refugees, Global Nomads, SIE self initiative expats, CCKs, TCKs, What do they all share in common?

They are living or lived part of their life out of their country of birth. Which means that by definition their complex identity was shaped by more than one culture.They are very different in the number of passports they hold, the number of languages they speak, the type of cultures they were exposed to and the nature of the experiences they went through. And yet, because of the one dominant shared experience they can find a common ground with each other. They share the common language of global transition. The circumstances and locations can be very different but they share the psychological experience and cycle of the transition.

When the world was opening up embracing the idea of globalization, to be a citizen of the world could be describe as a desirable wish.Through the globalization of the economy we saw a growing demand to bring diversity into big corporates and organizations, and this kind of complex identities seemed to be welcomed .

Why were they welcomed? One way to look at it is to look at the TCK characteristics:

Researchers and writers like Ruth Van Reken and David Pollok have shown that this lifestyle can be a natural laboratory to grow people that will have:

•           Cross-cultural skills

•           Observational skills

•           Social skills

•           Linguistic skills

•           Adaptability

•           Expanded Worldview, thinking “outside of the box”

•           The capability of mentoring others because life experiences have been varied

•           The potential of being less judgmental, less prejudice

•           The ability to being independent and autonomous, blending in

All these are qualities that support the needs of a growing global society.

At the same time they are also considered to have these challenges:

•           Might have complex identity or less strong typical feelings of national affiliation

•           Confused loyalties

•           Painful awareness of reality

•           Unsureness or ignorance of the home country culture

•           Different sense of nationalism

•           Different integrated cultural identity

•           The potential to be rootless and restless

These challenges are typically in conflict with high expectation of loyalty in more nationalist environment.

Political changes can influence our identities or the way we feel about them in certain circumstances. Having complex identities can put you in a constant risk of not representing well enough the nationality you are living in.

TCKs have the ability to act as a chameleon with guilt and emotional instability. The way they tell  their life story can give a hint on the hierarchy of loyalty they hold. But is this hierarchy stable? After all, the story can be told differently according to the geographical location or political situation. How do people with complex identities solve the psychological conflict and need for belonging? Can we offer becoming a Global citizen?

Can global nomads become a nation and provide the sense of belonging?

As it is seen in the news: for leaving the EU, British Prime Minister Theresa May declared: “If you believe you are a citizen of the world, you are a citizen of nowhere.” Or as Trump told on a rally in December 2016: “There is no global anthem. No global currency. No certificate of global citizenship.”


We are witnessing some attempts to do so, groups on social media, organizations around the world. We hear TCKs saying they feel “at home” with people that they never met but share the mobile lifestyle.

In order to become a Nation you have to be recognized by others, you can not belong to an entity that has no boundaries or recognition. We need it for communication.

For communication purposes being a global citizen is not yet well understood; neither are terms like TCK or CCK. So we tend to still summarize our complex identities by nationalities.

We are crossing countries, nations and cultures taking our identities with us. When we thought we achieved the right balance things may change again.

One thing we do know about history: it is constantly changing. It is possible that future generations will have a different cultural identity, more complex and vague.

From the news it might look like we are moving toward Nationalism, but as we can see, we are also moving towards Globalism. If this is the case, and the 244 million will keep growing in numbers, we might find the national cultures as we know them today will change too; we might be moving toward what can be seen as one global culture.

As therapists, we should be aware of this very particular growing population of people who feel that they own complex identities. In times when the political divide may challenge even more the unstable balance of multiple cultural identity we could consider them a culture of their own that is worthwhile to study and explore.

Author: Daniela Tomer, MA

Daniela Tomer is the Co-Founder and Director of GNW Global Nomad’s World. She is an Israeli licensed Clinical Psychologist, a Mediator, Coach and Trainer and serves as FIGT- Families in Global Transition Program Chair leading their global annual conference.

Contributed by Clara Blázquez Booth

“To have another language is to possess a second soul.”
– Charlemagne

If you asked people whether they would like to be bilingual I think most people would say “Yes” without even thinking about it. Bilingualism is now generally considered something positive and highly desirable but this has not always been the case.

Until relatively recently it was thought bilingualism could be detrimental to a child´s learning and general development and there are still many myths surrounding the subject. Some people might think “how confusing for a child to have to learn two languages, poor thing!”

However, recent studies have painted quite a different picture. It has become obvious that a child can cope with two (or more) languages and even adults can learn and use a language other than their mother tongue, although, unfortunately, as we all know, this entails a bit more effort. As we also know, we live in a globalised world, where speaking more than one language is becoming ever more necessary, with thousands of people studying languages, high mobility rates within countries and many mixed couples bringing up their children bilingually. It may well be that in the future being bilingual will be a common occurrence, which hopefully will lead to a better understanding of the issue.

So what has changed in recent years, what do we now know about bilingualism? There have been a series of studies which have helped to see bilingualism in a more positive way.

Even though it is not yet known exactly how the brain stores different languages, recent studies have shown how bilingual people perform in different tasks. It seems bilingualism promotes the individual’s creativity and ability to solve problems, by enhancing mental flexibility, and enables situations to be perceived in a different way. It is thought that increased metalinguistic awareness creates a way of thinking that is more open and objective. However this improved mental flexibility that
develops in bilingual people influences more than their problem solving or linguistic skills; language appears to change the way the world is perceived in individuals that speak different languages.

What is more, new research explains how speaking more than one language may translate to better mental health as some recent studies have correlated bilingualism with the delayed onset of dementia for as long as 5 years. It could be that being bilingual can offer protection from the symptoms of dementia and this would also suggests that the increasing diversity in our world populations may have an unexpected positive impact on the resilience of the adult brain.

From a cultural and social point of view the advantages are also obvious. It is not just speaking more than one language; it is also the opportunity to participate in different cultures, being able to speak to people from different parts of the world and also the understanding of their literature, songs, cinema or traditions. This means that bilingual people are usually more open-minded, listen better and are more appreciative of different cultures; think of all the things you can access by not having that language barrier when travelling abroad.

It is also clear that nowadays speaking more than one language can be very useful when searching for a job either in your own country or for finding work opportunities abroad. It has become an asset which makes a candidate stand out from the rest and in other cases it is an essential requirement for the job.

Although there are many positive aspects about being bilingual, undoubtedly it is not always easy to achieve, especially when a family is not bilingual and a child does not learn another language from an early age. Even in the case of bilingual families we must remember that language is something that is alive, dynamic, constantly changing and expanding but unfortunately it can just as quickly deteriorate or be forgotten if not used. Language depends on the circumstances and situations you find yourself in and the need to use it. So if you are bilingual it is important to continue to reinforce all your languages and if you are not,
why not start learning a new one! Remember,

“If we spoke a different language, we would perceive a somewhat different
– Ludwig Wittgenstein

Author: Clara Blázquez Booth

Clara Blazquez-Booth is a Speech Therapist working at Sinews Multilingual Therapy Institute. Her multilingual upbringing has permitted her to acquire English, Spanish and French at home from birth and has given her a special insight into language acquisition as well as an understanding of the needs of children exposed to more than one language from a young age.

Contributed by Steve Vinay Gunther

People generally seek therapy is as a result of some kind of disatisfaction with their life. Something is uncomfortable, unworkable, painful or stuck, and they come wanting help. International relocation often creates dislocation internally, and also in relationship. Lives that were previously relatively stable become disrupted, and cracks in marriages often get bigger in the process. Even if incomes increase and there is more help available, unfinished business and resentments tend to come to the surface.

There are many different approaches in therapy to providing help for people. Some are goal oriented, and involve an analysis of ‘what is the problem, what is the solution, and how can we get there’. This seems straightforward, and can indeed be of value.

The approach I find useful takes a different tack. Gestalt therapy is based on is based on the Western philosophy of Existentialism, and the Eastern philosophy of Taoism. In this orientiation you dont get to the goal of change by pointing directly at it. This is because often the reason you are stuck is not through lack of effort of trying. Think pf diets – many people try hard to lose weight – and it seems very straightfoward: eat less, exercise more. But people can get caught in cycles of ‘trying to change’: making progress, then slipping back, ‘despite oneself’. In that sense, good intentions and powerful techniques are not enough.

The Gestalt approach that I favour utilises awareness; more specifically, awareness of ‘what is’. In ordinary terms, this means a focus on who you are – not who you could be, should be, might be, or want to be. Who you are is about your uniqueness, incorporating both your strengths and limitations. Who you are also includes the unique personal context you come from – the family and culture you were raised in.

Helping you to know yourself more deeply makes you more available to yourself (strong self support, a clear inner compass), and clearer on being in relationship. You are able to know and express your boundaries – what you are and are not available for. You are also able to step into deeper intimacy, as self awareness results in having more to offer in relationship.

This leads to an increased capacity to live authentically. The result is a greater sense of meaning and purpose, self direction, and inner power. Living more fully with awareness can be understood as the goal of the Gestalt orientation. Change may occur as a result; however, it happens naturally, as an expression of ‘who you are’ rather than coming from the outside.

Another aspect of this  Gestalt way of working is that the therapy process is not so much about the therapist ‘working on’ helping the client improve. Its a journey which involves deepening relationship. The therapy relationship reflects the experience of other relationships, and through the clarity and steadiness of the therapist, this can be a healing process. Familiar road blocks are likely to arise; in this case, they can be worked through, clearing the way for this process to occur in other relationships in the client’s life.

This requires self knowledge and awareness on the part of the therapist, and a willingness to also be transparent. The therapist is not a receptacle of expert knowledge, as much as a companion and guide on the journey. This is challenging for therapists – to not just facilitate and ask questions, but to also reveal themselves in order to bring the experience of shared humanity to the process.

In this work with awareness and relationship, I also bring to bear a kind of ‘creativity of the moment’. Rather than using preset ideas, techniques or formulas (great as they might be), my interest is in developing unique ‘experiments’, where we explore new ways of doing things in the session itself. This moves us beyond ‘talk therapy’, into experiential learning. The therapist’s role is to balance support and challenge, to maximise the opportunity for client learning.

I also pay attention to ‘the field’ – the larger systems that we are all embedded in. Understanding interconnectedness (for instance, the influence of generations of family patterns) helps to make sense of current behaviour, feelings and thoughts. Most of us lose our balance at times, behave strangely or inappropriately for the circumstances. When you look at context, such behaviour makes sense. So Gestalt therapy addresses not only individual expreience – I also want to understand the ways in which family, culture and religion might influence a person. This is also a component of the awareness approach to self development.

I also apply this orientation to working with couples. A couple is not just two individuals, its also a system, with its own history, and ‘personality’, including unique strengths and limitations. So I pay attention to the ‘how’ of a couple in terms of their interaction, much more than the ‘what’ of the content of their issues. In this way, I can help increase awareness of their process, which takes the focus away from individual tendencies to blame and point the finger. It removes me from the role of judge and jury, or expert advisor, and instead allows me to work with the couple in terms of understanding their uniqueness, and exploring together ways to strengthen the undeveloped aspects of their interactions.

I find this orientation constantly refreshing – I never get bored, tired, or lose interest. I feel like I am on the journey with clients, and their discoveries are just as delightful for me. This is a result of another aspect of Gestalt: the ‘creative void’, or in Taoist terms, the ‘Wu Wei’, the ‘effortless effort’. Whilst this sounds somewhat mystical, in fact it simply refers to an ability to be still, to be with things as they are without the need for change or reform. It requires me to be open, interested and attentive, without trying to fix or solve anything. It frees me to enjoy the process, and frees the client from any kind of pressure to change. I find this approach takes us very deep, very quickly, and the resulting explorations involve us working together as co-explorers of awareness.

Author: Steve Vinay Gunther

Steve Vinay Gunther is an international Gestalt trainer, teaching in Asia (Japan and China),  South Africa, Mexico and the US. He ran a professional Gestalt program in Australia for several decades, and now offers the training in China.

He wrote a best selling book for men about relationships with women (Understanding the Woman in Your Life). He works as a therapist in the fields of Gestalt, Family therapy, Career Coaching and Family Constellations.

Steve has practiced and studied meditation, spirituality and psychotherapy over a 40 year period, and has brought these topics together in a integrative meta model. He is currently Professor of Spiritual Psychology at Ryokan College, Los Angeles.

With his wife, he has pioneered an arena of relational psychology termed The Unvirtues. He is currently enrolled in a doctoral program in Social Ecology, researching the topic of the interpersonal psychology of power.

Contributed by Lauren Wells

I first heard the term Third Culture Kid or “TCK” in high school, and simultaneously found out that I was one. While many reject being labeled, I personally found much solace in finally feeling like something explained the rootlessness and lack of belonging that I felt. I have always worn the TCK label proudly and have, for better or for worse, lived up to the typical TCK expectations- moving often, having difficulty developing deep friendships, feeling restless, not wanting to settle down. However, three years ago, my husband and I moved to Portland, Oregon. This three year stretch has been the longest period of time that I have lived in one place since elementary school, and the scariest part? We have no intention of leaving anytime soon.

I write a lot about TCKs and settling. I have said that, “The healthy TCK realizes that they have a need for change and knows that they are more comfortable with the adapting process than with the settled life. However, they have learned how to control the need for change instead of letting it control them. They are willing to be somewhat uncomfortable so that they can live a settled life in the necessary areas.”

In the past three years, I have learned to “settle in the necessary areas.” I believe that this has made me a healthier and happier individual, but, it has also brought a deep, unknown fear to light- the fear of becoming less of a TCK. 

This fear surfaced when we bought our house about a year ago. While I knew it was the best decision for us, in the back of my mind I kept thinking, “But TCKs don’t do this!” I would remind myself that we were calling it a “5 year house” and could go anywhere in the world after that (even though 5 years still seemed like a ridiculously long time). Part of me felt like the purchase of our house signaled the death of part of my TCK identity.

Shortly after buying our house, my husband and I were at a craft fair and found this little wooden sign that said “Home” with the “O” in the shape of Oregon. Something inside me said, “You need to buy this. You are learning to settle.” So we purchased the sign and it now sits on a shelf in our living room. Every time I look at it, I feel a slight pang of guilt. “TCKs don’t have a home. Especially not one in America. I am loosing my TCK-self.”

I recently came across a quote from David Pollock and Ruth Van Rekken that says, “While parents may change careers and become former international business people, former missionaries, former military personnel, or former foreign service, no one is ever a former Third Culture Kid. TCKs simply grow into being adult Third Culture Kids because their roots grow out of the lives planted in and watered by the third culture experience.”

I think that perhaps, for many adult TCKs, the fear of settling doesn’t just stem from the uncomfortableness of wading into that uncharted water, but also from the fear of loosing part of their TCK identity. We subconsciously think, “If I can see myself happily staying in one place (especially in my passport country) for a long period of time, I must not be a TCK anymore.” Thankfully, I have found that this is not entirely true.

My life overseas shaped me in countless ways, many of which are similar to the tendencies of other TCKs. Those experiences will always impact my life, but as I am learning to settle, I am learning that I need to let go of some of my TCK identity. The part that says, “You will always be rootless”, “You will never have a home”, “You will never have deep friendships with non-TCKs.” In the past three years, those beliefs have begun to be chiseled away at bit by bit. Allowing myself to settle here in Oregon is not betraying my TCK-self, nor does it make me less of a TCK. In fact, as I look around my house, I can see fingerprints of my overseas upbringing in so many places- my world map on the wall, my cupboards full of African foods and Indian spices, my African-themed guest room, the shuka (Masaai fabric) that I take as a play-mat/picnic blanket/towel/blanket for nearly every outdoor activity, African carvings and books in Swahili all around my living room. My third culture experience has played a role in shaping the way that I think, the things that I enjoy, the areas that I am passionate about, and what want to spend my life pursuing.

Settling and adapting does not undo my TCK identity, it just allows it to show up in different ways. In many ways, it surfaces in healthier, less destructive patterns. I am learning to let go of my fear of being less TCK, and learning to let the ways that my TCK-self comes out change and shift as I grow and learn to adapt and to settle.

[Note: This piece has been re-posted from the TCK Training Blog with permission from the author. Comments are open on the original post.]

Author: Lauren Wells

Lauren Wells is a Third Culture Kid (TCK) who grew up in Tanzania, East Africa. Her experience as a TCK fuels her passion for working with globally mobile families. Lauren is the TCK Program Director for Worldview Ministries in Portland, Oregon. In her role at WorldView, she developed and now runs a program for children and teens that equips them with the skills they need to learn new languages and embrace new cultures when they move overseas with their family. She blogs regularly at

Contributed by Liz Rice

I was nine months old when my American family landed in Seoul, South Korea, in 1966, the youngest of four children. My parents were social justice oriented people, called to divided places. They moved to South Korea as missionaries to try and help a country that had lived through a devastating century.

I was too young when we arrived to go through culture shock or deal with acculturation as my parents did. I was too young to know what it meant that we were leaving the country of my passport behind. Going to Korea is something I don’t remember. I woke up to life there. And over sixteen years, Korea, its history and its ways, became my reference point.

I learned to speak Korean as I learned to speak English. For the first four years of my life, as my parents were attending language school and beginning to work, I was in the daily care of Koreans, soaking up language, culture and the customs of one of the most Confucius and homogenous cultures in the world. I went to Korean nursery school, soaking up even more. Up until the age of five, when we first visited the US, Korea was all I remembered and knew. My family was American, but the US was a foreign country. For the next sixteen years, Korea was, simply, home.

And if the story ended there, it would be a story of a complicated and rich childhood in a place of contrasts and contradiction, in a humble, ancient nation far away from the home of my ancestors. A story of a girl, part Korean, part American, and always something in between. But something happened after my family left Korea.

It was in the U.S. that I first learned what culture shock felt like. I began to suffer from depression and a feeling of deep dislocation. We lost contact with the lady we called Ajumoni, a woman as dear to me as a grandmother. I began to grieve the loss of all of it as if I was grieving a death. Without any language to understand my situation, I went through that grief alone. I lived life as a half-self, trying to start from scratch in a culture I didn’t fully understand but was expected to. I didn’t feel American. And I didn’t look Korean. And I was beginning to understand that in leaving Korea, life as I had always known it was over.

While psychologists at that time understood concepts like culture shock and acculturation for adults who moved “overseas,” few understood the effects of reverse culture shock, especially for children who had been raised away from their passport countries. These days there are numerous books and resources for something called “Third Culture Kids” – children who are raised in a culture other than their parent’s culture for a significant number of their development years. Third Culture Kids are said to carry the influence of their parents’ culture and the culture of the country or countries in which they were raised, but don’t have full ownership of any one culture. TCKs, it turns out, often experience some period of cultural rootlessness when they return to their passport countries.

Eight years ago I began to write Rituals of Separation as a love song to a cross cultural childhood and as an exploration of the complexity of issues of loss, belonging, and cultural identity. I wrote to give a voice to people with complicated cultural identities, who have lived stories we can’t always see in their faces. As novelist Chimamanda Ngozi Adichie says, “There is a danger in telling a single story…to show a people as one thing, and only one thing over and over again, and that is what they become…The consequence of the single story is this: It robs people of dignity.”

Writing the book was a “ritual of separation” for me – not to separate from Korea – but to memorialize that time, to make record of and acknowledge the lasting impact of Korea and its history and people on my identity – to say the names of those that I could not forget – the people I carried with me from Seoul to Middlebury to Boston to Seattle. I wrote to record and remember what happened in Korea at that pivotal juncture in the country’s history, when Korea was recovering from a horrific war that divided the nation into two, industrializing at a rapid pace, and seeing the burgeoning of a democracy movement that would eventually lead to the toppling of a line of dictators. I wrote to understand the deep impact of my parents’ involvement in the Korean democracy movement on my understanding of the world. And I wrote to help me better understand from what matter I, and we, are culturally formed –  and the role of Korea, and my hidden bicultural identity, in that struggle. Over eight years, with each chapter, I peeled away another onion skin of belonging.

As I state at the end of the first chapter of Rituals of Separation, “After we left Korea, I balanced precariously between two lives, unsure how to go back and unable to move forward. I had to come to terms with all I had seen in those years. I had to look into the ways of the people and places that formed me and find myself, like a pebble sorted from rice. And I learned to pick up the pieces of an unrooted adulthood time and time again. For what is lost can’t always be recovered. Sometimes the only way to move on is to learn to let go, to be deeply grateful for what we had, to know we will never be the same for what we have seen. To learn that maybe, just maybe, our fractured parts do, after all, make a whole.”

Writing allowed me to begin to fully answer the seemingly simple question that so many global souls come to dread…“Where are you from?” With each chapter I took one more step in finding healing and answering that question.

Author: Liz Rice

Elizabeth spent most of her first sixteen years in Seoul, South Korea as the youngest child of socially progressive Presbyterian missionaries. After her family moved to the U.S., she received her undergraduate degree from Middlebury College and a Masters in Public Administration from the University of Washington. She spent many years working in the NGO sector, serving as administrative director for a public health nonprofit for immigrants and refugees in the Twin Cities and working in grassroots community development organizations and nonprofits in Seattle, Mississippi and Zambia. Elizabeth is currently living between Costa Rica and Vermont. Rituals of Separation is her first book.

Contributed by Kim Roberts

If you’ve spent time living abroad, you have probably experienced some level of culture shock. Life as an expat expands your horizons, and also exposes you to new ways of being in the world. Culture shock is a well-known phenomenon that occurs when our existing set of beliefs clash with the current environment. It takes time to adapt to strange customs. But not as readily discussed is the trauma many experience after coming home—reverse culture shock. Returning to our country of origin can be more challenging than leaving home in the first place.

As an American, I experienced this acutely on my return from my first trip to India. For some inexplicable reason, I chose to visit a friend in Arkansas just a few days after I landed.

I remember looking into the eyes of one shop clerk, then watching his mouth move, trying with all my focus to hear what he was saying. My ears had become accustomed to South Indian pidgin English, and his Southern country drawl was absolutely incomprehensible.

This is a superficial version, but many features of reverse culture shock are far more deep rooted.

You’ve moved on, while others have stayed put.

You’ve moved on to live a different lifestyle, but your friends and family have stayed in the same place, so they cannot understand what you’ve been through. They may not ask questions, or may appear bored when you share stories. It can feel alienating.

You’re on your own.

This can be lonely experience. I remember at a certain point I realized that no one human would ever completely understand me, because of all the time I’d spent as an expat, and in so many different countries. Each experience leaves its imprint, and we are the fruition of all of our imprints. But this also means that what your view is unique.

Reverse culture shock is disorienting.

You might start to question reality and wonder what is true. Learning to get along in a different culture expands your repertoire and sometimes we bring back habits and customs that resonate. Then we get back home and realize people may be looking at us funny. We wobble our head sideways to mean yes, instead of no. Or we place our dinner roll directly on the table instead of the bread plate and take to cleaning our teeth with a toothpick at table or, heaven forbid, start eating with our hands. We cringe when someone points their feet toward us, or offers us food with their left hand. We get half way through a turn at an intersection and forget which lane we’re supposed to be driving in. Suddenly “appropriate behavior” seems completely random and unfathomable.

Here are 6 tips to handle the transition:

1.  Give it time.

This too shall pass. Slow down your need to fit back in to your homeland society. This transition period can be rich with insights and in my experience, it is where most of the learning happens. When we get some distance from the unique experiences we’ve lived, we are finally able to digest and integrate the lessons learned.

2.  Become an observer.

Become selective about what you share, and don’t look for any particular responses from people. Rest in the knowledge that you have experienced something they might never understand.

Make it a practice to listen to people and hear what they have been going through. Their lives may sound mundane to you after having seen so many new things, but for people who have stayed home, this is still the fabric of their lives. Give them the respect of listening, as you would also like.

3.  Release expectations.

People may not listen with interest to the stories you bring home. For a variety of reasons, people may not be wired to acknowledge that life may exist differently, elsewhere. Rather than judging or trying to understand why people are behaving the way they are –even if this behavior once upon a time made perfect sense to us—try adopting a new mantra. The mantra? “Well, isn’t that different!” It can actually be quite humorous to realize that what we once held to be hard facts about existence are actually just fabrications of our cultural mindset.

4.  Forgive people for not understanding.

It’s not their fault, nor is it a downfall. The fact is that some people are simply not interested in seeing the world, and have no desire to hear about it. As hard as that may be to understand for those of us who thrive on international travel, if you want to facilitate your re-entry, it is important to recognize and respect this.

5.  Find a creative outlet.

One of the best ways I’ve learned to process my experience and the sometimes lonely phases of re-entry is to write. I have kept a journal for decades now. I journal every day to remind myself of events, places, and people. But especially after my return from a journey, I journal to refine the story. We humans thrive on good stories. Stories inform how we make choices in our lives. By envisioning your adventure from the perspective of a good story well told, you elevate the experience to art. And then it may become more palatable to people, allowing you to share the experience.

6.  Keep in touch with friends from your overseas life.

One of the beautiful things about the internet is that we have access to friends across the globe. You might want to schedule a weekly Skype call with a colleague you left behind, or commit to writing on a regular basis.

Fortunately, reverse culture shock is a temporary phenomenon. You may have permanent shifts that result from your overseas experience, but the shock eventually wears off. Until that happens, be gentle with yourself and do what you would do in any extreme health situation: take lots of rest, drink plenty of water and eat nourishing foods. Go for walks in nature if you can.

Remember all the positive experiences and know that they will lead you to new and exciting adventures, perhaps in your own motherland.

Author: Kim Roberts, MA

A graduate of Naropa University’s M.A. Contemplative Psychology program, Kim Roberts has been a devoted student of Ashtanga yoga and Dharma since 1992. She spent 15 years living in South Asia and now divides her time between Crestone, Colorado, and Santa Fe, New Mexico, where she offers live and online counseling. She writes a weekly blog sharing tools and practices for managing emotions. Learn more at

Contributed by Cécile Buckenmeyer, Jungian Psychotherapist

The interview

On a September morning, in suburban Manchester, I meet Yoko and her two-year old son. We sit in a conservatory furnished with plain, Ikea-style table and chairs; I accept her offer of a glass of water. I came to interview Yoko about her experience of moving to the UK. She arrived four months ago. “My husband was sent to the UK for two or three years”, she says. When I ask her what helps her cope with this transition, she explains that food is very important for her and that, as long as the food is OK, she feels that she can live here: “If I can eat, I feel OK”.

A month later, at our second interview, we discuss what helps Yoko feel comfortable in the UK. She replies that she switches the Japanese TV on in the morning and listens to the news: “I don’t fall behind; I keep up with the Japanese news.” She also uses Facebook, which gives her a sense that she is in touch with friends. She does these things mindlessly, knowing that “they don’t serve any purpose for her life in the UK”.

When, two months later, I go for a third and last interview, Yoko is more confident speaking English and asking questions. She has been able to have short conversations with her daughter’s teacher. As we say goodbye, Yoko tells me that she has appreciated my visits: “I don’t have contact with people from outside the house. So, one week is long. I find myself waiting for Saturday when I can be with my children and husband. It was good to have a bit of change in my daily life. ”

Gaman vs resilience

Yoko’s story reflects interviews that I conducted with six Japanese women who recently moved to the UK ; it describes the experience of many spouses of Japanese expatriates. I was amazed by the level of gaman that these women show. Gaman is a typically Japanese attitude which combines patience, endurance, tolerance and self-denial. When a child feels cold waiting at a bus stop, his mother might say “gaman shinasai” – be patient, the bus will soon arrive. Equally, when a young employee is doing well but is not rewarded or promoted, their boss might say “gaman shinasai” – be patient, you will get a promotion in a few years time. When a Japanese trainee comes back to exactly the same domestic job after one year in Europe, they may also be told “gaman shinasai” – you had a nice time abroad, what are you complaining about?

Yoko is not told “gaman shinasai” by anyone. Her husband is very supportive and would listen to any concern she has, but like many people in Japan, “gaman shinasai” has become part of her personality. She has a strong capacity to be patient – to wait until the next Saturday or until she goes back to Japan. She is able to convince herself that as long as her very basic needs are fulfilled – as long as she can eat – she feels OK.

Expatriates and their families need to be tolerant when in a foreign country. Often, they just need to “get on with it” (another good translation for gaman): an expat in Japan needs to swallow the odd sea slugs; a Japanese expat in Europe needs to bear the occasional sight of people blowing their nose in handkerchiefs… They need to have reasonable expectations – there are always difficult moments and disappointments.

But it can be counter-productive to have too much gaman, especially if it stops people wanting to improve their situation. In addition to the stoical tolerance of gaman, expatriates need (and can never have too much) personal resilience. I define resilience as ‘what you still have when you feel that you have lost everything’. It is made of self-esteem, self-confidence and a capacity for self-care and self-development (Al Siebert, The Resiliency Advantage). Whilst people with gaman readily sacrifice today for the sake of (a hopefully better) tomorrow, resilient people are able to make today as tolerable and as enjoyable as possible, despite difficult circumstances.

Gaman helps people survive, which is sometimes all they can do: eat, drink, find shelter. But too much gaman can mean, like for Yoko, locking oneself away from “people from outside the house”, holding on to old habits that “don’t serve any purpose” and living a shallow, unfulfilling life. Developing resilience involves recognising a broader range of needs and recognising one’s own skills, strengths and many other resources that can help people make the transition from gaman to enjoyment.









でも、あまりにも我慢をしすぎるのは、建設的ではありません。特に、状況を改善したいと思わなくなってしまう場合に、それが当てはまります。我慢というストイックな寛容に加えて、駐在員には、しなやかな強さが必要です(これはいくらあっても「過剰」ということはありません)。英語で言うとレジリエンス。私はこれを、「何もかも失ったと思える時に、まだ自分に残されているもの」と定義しています。この折れない強さを形成するのは、自尊心と自信、それに自分をいたわる包容力と自己開発の能力です(Al Siebert著「The Resiliency Advantage」より引用)。我慢のできる人は、明日のために(願わくばより良い明日のために)今日を犠牲にすることができます。一方、しなやかな強さのある人は、難しい状況にありながらも今日をできるだけ楽しみ、それほど悪くない一日にする力を持っています。


Author: Cécile Buckenmeyer, Jungian Psychotherapist

I am a Jungian psychotherapist in private practice in Lancaster, UK and a cross-cultural consultant working with expatriates, TCKs, international students – and the professionals who support them. I have lived in France (where I was born), Japan (for 5 years), the USA and the UK. I speak French, English and Japanese and regularly work in these languages.


Contributed by Dawn Purver, Diploma Psychotherapeutic Counselling

In the early hours of a morning I waved goodbye, once again, to my two eldest sons; one journeying back to UK, and the other beginning his own adventure in Bolivia.

As the vehicle disappeared into the darkness, my heart broke and the tears flowed once again as I embraced the feelings of separation, and acknowledged those all too familiar feelings of loss of being a family together.

As cross cultural workers; endings, separation and loss are a frequent part of choosing this path.  The pain that accompanies saying goodbye is often fresh and frequent.  We learn to negotiate transition and letting go, perhaps more than in many other types of work.

Occasionally we can plan our goodbyes, and sometimes we cannot.  Easier to prepare for an airport goodbye, but difficult with a friend dying from aids in Africa, and impossible for a loved one gunned down in Syria.

Endings are part of this path……….

How important it is then to take time to consider and process our feelings that accompany our work.  Endings are often painful, separation hurts, loss is distressing.  Being strong, trying to stay strong can lead to burying our emotions, and this can lead to unprocessed feelings of sadness, anger or fear which if buried, can reappear in other ways when we might least expect: physical illness, depression, anxiety are just a few. Just as we look after our bodies, we need to look after our mental and emotional health as we walk the path of working and living overseas.

If we don’t give ourselves time to stay with our feelings and experience mourning, we can limit our capacity to reach those we are living with, and working amongst.  Treating ourselves tenderly when we face endings, in fact enables us to be human and touch others with tenderness and compassion.

We need to take the time and space to be with ourselves.  Through journaling, music, art and poetry, we can give expression to, and welcome our pain.

And sometimes, other feelings emerge, maybe from previous traumas, we can find it difficult to understand what is happening and why we feel as we do – we may want to seek additional help to facilitate this process.

Seeking out a place where we can take some time out to experience peace and care from another who will sit with us and provide a safe space to explore difficult feelings and make sense of deep distress. When we are confused, or unsure, having the opportunity to talk with someone who is experienced to help, and not involved with our everyday life on the mission field, programme or project, can provide an oasis.  A chance to rest awhile, to unburden our feelings and provide an opportunity for a fresh understanding of who we are and a deeper level of acceptance and acknowledgement of our pain, or struggle.

Recently someone reminded me of the Japanese art of ‘kintsugi’; the use of gold dust in the resin to mend a broken vase; turning an ugly break into a beautiful fix so that it can continue to be used.  For me it mirrors the healing and refreshment through finding a quiet place to be with a trusted other.

Author: Dawn Purver, Diploma Psychotherapeutic Counselling

Dawn Purver is a qualified psychotherapeutic counsellor, based in UK but travelling several times a year to Albania supporting individuals, and a variety of projects across the country.  She also works closely with organisations and volunteers working with refugees.

Together with her husband and four TCKs, she has 25 years of living overseas, across 3 continents.

Dawn is available and has a great deal of experience counselling via Skype.

Contributed by Viktoria Ivanova, M. Ed., Expat Therapist

Moving to a new country by yourself can be both exciting and difficult. Moving to a new country with your spouse and kids can exaggerate these associated emotions even more. The new challenges that you face as you journey together through this change can often make or break a relationship.

Presenting Concern

As a therapist for expats, I quite often meet with men and women who share the same confronting struggles. These are people who choose to accompany their spouses to a foreign land where a great job opportunity is presented, and effectively rendering themselves a stay-at-home partner.

Upon arrival, they find themselves limited to the roles of a parent, a homemaker, and a spouse. Quite often, the non-worker in the relationship feels a loss of identify as the diversity of their roles in life diminish. For many, moving abroad meant quitting a job or resigning a career, and at the same time removing themselves from a social structure that comforts them. Basically, this meant their career-related creativity, productivity, and skills had to be packed in a box and put in storage along with their other cherished belongings.

Through my practice, I also meet with stressed and over-worked partners who feel overwhelmed by their new professional positions, who are often confused by their spouses’ frustrations and complaints, making them feel like outsiders in their own family.

Relationship Cracks

Although we have been working hard for the last 100 years to create greater fluidity and flexibility in our gender roles, becoming an expat family can sometimes feel we are back at the starting point – the bread winner and the stay-at-home-parent.

And while there are people who are absolutely happy and content with these roles, for many, it’s a difficult concept to adopt. As a couple is settling into their new home and country, these roles can start off as a fun and novel change, but over time it can start polarizing their relationship into a rigidity that both despise. As the working spouse focuses on the work, his/her attention often becomes more and more diverted from family matters. And as he/she steps back more and more, due to their demanding work, the non-working spouse has to step in more and more, left on their own to make decisions about child-rearing and home.

This shift in responsibilities becomes a continuous cycle, as the more one person under-functions in one area of their life (e.g. taking care of the kids), the more the partner has to step in. Without our conscious awareness of this pattern, we can continue sliding further and further into this stressful dynamic. It is also important to know that while working partners have a purpose and occupation, they are also stepping into their new social circle as they begin their new working role. It is always easier to make friends with people we see every day at work and have already so much in common with, like an annoying boss perhaps.

For a stay-at-home spouse, creating supportive social connections is another challenge. Not only have they left their familiar and reliable social support back home, building a new one will take time and effort, and will require opportunities that for a non-working parent are hard to come by.

It’s not a surprise that many relationships start to suffer under these conditions. Relationships function like a lightning rod, as they absorb all stress and tension that the couple is under. These polarized gender roles can create resentment and arguments, resulting in a further distance and isolation for the stay-at-home partner who is likely already feeling isolated. This pattern also comes at a high price for the working partner as he/she can feel that they are not as much part of the family and that they are missing out on valuable experiences and moments with the kids. It might be difficult for some people to be outspoken about the isolation they live in, and they might cope with it by further focusing on their work.

So, how to make it?

It sounds like this dynamic is no fun for either spouse. But don’t despair. While the picture I am painting is quite gloomy and intense, it doesn’t represent every couple with a working mate. The picture simply shows a pattern that couples might be sliding towards, unintentionally and without much awareness. The responsibility for this dynamic and the power to change it lies with both parties.

Many couples find creative and innovative ways to maintain satisfying and close relationships. Their secret lies in being aware of difficulties to come, recognizing unhealthy patterns early on, and turning to each other at times of distress, as opposed to turning away like many people do.

The key is being mindful of the role you assume and why. For example, as a woman, you might have agreed to the job of taking care of the kids while your husband is working. You might absolutely love your job, but if we work 24 hours a day at anything, even being a mother, we will burn ourselves out. Be mindful that you don’t work overtime and take away the opportunity for your partner to interact with the kids. You might be the one waking them up and taking them to school, which gives your spouse a perfect opportunity to put them to sleep and make lunches of their desire for the next day. Sure it might be challenging for both of you, for one to step back and for another to step in. But it is important to challenge ourselves and our partners, so our relationship grows and deepens.

If you are not sure how to make these steps on your own, connect with me for a free consultation at my global, online support service, Expat Therapy with Viktoria.

Can’t wait to start making changes? Visit my blog and check out my YouTube channel, Tea With Viktoria, for bite-size wisdom ideas you can apply in your life straight away.

Author: Viktoria Ivanova, M. Ed., Expat Therapist

Viktoria is a Registered Clinical Counsellor and Certified Canadian Counsellor & Psychotherapist who specializes in human relationships.

Her mission is to share with people an essential life skill – how to build healthy relationships and transform challenging ones. To make that a reality, she created a global, online practice – Expat Therapy with Viktoria.

For more information about Viktoria and her practice visit

Viktoria can be easily reach at

Visit Viktoria’s YouTube Channel – Tea with Viktoria

Contributed by Lindsey Anderson

[This ITD Guest Post was originally published on]
As the festive season approaches, it can be a tough time for many people, especially expats who don’t have the benefit of family nearby to draw upon for support.

Even those with a vast network of family and friends can feel lonely at Christmas as everyone seems far too busy with their own festive preparations to concern themselves with other people’s worries.

At times like this, it can be helpful to call upon the services of a professional therapist, trained to help clients manage the wide range of daily issues that can prove particularly challenging, not just at Christmas, but on other occasions throughout the year as well.

One English-speaking therapist, who was recently recommended to us, and has a special interest in relationship issues in the home, family and at work, is Lindsey Anderson.  Having been married, divorced, a working mum, a stay-at-home mum, self-employed and re-located several times herself, Lindsey knows how difficult it is to juggle the roles of parent, partner, professional, wage earner and non-earner.

Lindsey told, “I know how difficult it is to be your true-self when you’re juggling so many different roles and conflicting emotions. sometimes it just gets too much and you need someone to help you untangle yourself.”

After completing her MSc in Organisational Behaviour and Post Graduate Diploma in Counselling, Lindsey set up her own practice from home in Switzerland in 2013, with the aim of providing an English-speaking therapy service to people living in the Vaud area.

Having lived and worked previously in South Africa, Kenya, Italy and then Switzerland, she particularly wants to provide a professional emotional support service to people living away from home, family and friends.

Asked what makes her service different to other counselling practices in the region, Lindsey told us, “From my combined training in person-centred and solution-focused therapy, I’m basically an empathetic and practical counsellor who can really listen and understand but at the same time can use tools and techniques to help in a practical way.

“We’re all so used to being a certain way in the multiple life roles we play, it’s important to hear your own voice – unedited – in a place where you feel safe and with someone with whom you feel un-judged, so you can connect to yourself and begin to feel relief. Understanding how you communicate your needs, respond to conflict, view intimacy and express yourself can help you feel better, and lead to change and a way forward.”

I also touch on how the client is sensing and experiencing the feelings and thoughts in their body. Although not formally trained in this, I believe that mind and body are interconnected and that it’s important to acknowledge these sensations so that the client can work with their whole self.”

Lindsey helps clients deal with a wide range of issues, but her main areas of support include:

  • Break-ups, separation and divorce
  • Relationship and communication difficulties
  • Change and transition
  • Loss, grief and bereavement
  • Relational trauma
  • Work stress, abuse of power and burn-out
  • Anxiety and depression

Lindsey’s clients are typically English-speaking men, women or young adults facing difficulties and needing a safe, confidential and professional person to talk to, helping them through the difficulties and to move forward.

To give you an idea of how Lindsey relates to her clients, one person sent this recommendation to us recently, “As an expat living alone in Switzerland for the past 6 years and having faced three of the toughest years of my life, Lindsey Anderson Counselling offered me a place of peace, honesty and openness. In a time of panic, despair and helplessness, her compassion, patience, analysis and guidance helped me understand my situation, engage with my emotions and start my recovery process. Since seeing Lindsey, I feel a huge difference emotionally, physically and mentally, regaining my self-worth and integrity. I am not ‘out of the woods’ yet but draw comfort in seeing the progress I have made.

“Lindsey helped me work through a series of very difficult questions I was facing in my personal and professional life. Her approach is deeply empathetic and educational, and our sessions were a safe place for me to express myself and begin the complicated work of looking for solutions and ways to move forward. I heartily recommend Lindsey’s warm, insightful, and non-judgmental approach.”

Lindsey Anderson Counselling

Contributed by Dan Martin, MS Psych

Preparing the family for a move may conjure images of stacks of boxes and phone calls to utility companies. While those logistical matters are a key part of making sure that the move goes smoothly they only address a portion of the necessary tasks. I’m reminded of Maslow’s Hierarchy of needs from the days when I used to teach Psychology to university undergraduates. For those who missed that class the idea behind his theory is that we all have different levels of needs as individuals for us to survive or thrive. Some of the basic levels focused mainly on physiological needs e.g. food, shelter, water and the like. The next level moved on into safety. The more advanced levels addressed things like emotional and social wellbeing. When preparing for a move we may follow a similar path. We may secure housing, sign up for water and electrical service. Once we have that sorted the next task may be to obtain insurance so our precious belongs are protected against loss. The final area to address may be the tasks necessary to assure our emotional and social wellbeing at the new location.

Why is preparation important?

A recent study that was done in Denmark serves as a strong reminder that it is not a luxury to tend to the social and emotional needs of the family when planning a move. The study collected data over 25 years for about 1.4 million people. They found that children who had more frequent moves had the poorest outcomes later in life. The rates for mental health problems, suicide, substance abuse, crime, as well as premature death were all significantly higher for people whose families had moved the most.

This isn’t to say we should never move if we have kids. Moves happen. The key is to be aware of the impact it can have on the family especially the little ones. Once you are aware of the areas of your lives that may be impacted the most you will need to work out a plan to shore those areas up.

How can you prepare?

Find what you love

For some of those life areas it may be possible to find a version of what you really enjoyed in your new location. For example, if your little one has a very close group of friends they will be leaving behind it could be very important to get them connected to others in their new school as well as staying in touch with their old friends. If volunteering or participating in team sports is a big part of your typical routine you could start seeking out those opportunities as soon as possible after you relocate or even before.

Practice Self-care

There are also general self-care tasks that we can do to improve our overall emotional resilience. We should pay particular attention to these things when we are going through times of stress like a big relocation. These are the things we all hear about being important e.g. adequate sleep, nutritious diet, regular exercise, and involvement in social activities. You could add in some form of relaxation practice that works for you as well whether that is mindfulness, mediation, yoga, reading, etc. These sorts of self-care activities will serve as an anchor for you as you face the winds of change.

Be Social

For many expats they may find the loss of their social support system as one of the biggest challenges when relocating. This is as true for those who have only a couple true blue friends as it is for the social butterflies who prefer to surround themselves with others whenever possible. It will be important to invest some effort in seeking out some new connections. How you accomplish this may vary from location to location but some of the sorts of things to research would be clubs, groups, or associations.

If there is a neighborhood association, or an association for your particular home country that could be a great place to find some folks you could relate to. Joining professional associations for whatever it is you do may be useful personally as well as professionally.

Clubs may be another avenue whether that is the local health club, book clubs or some civic club they may all offer some forum for meetings or opportunities to get to know other members.

Joining groups may be another pathway to getting connected. You may find sites like Meet-up that lists groups on all sorts around the globe a useful resource. For example, if you are a coffee lover who enjoys a good debate there may be a local group for you. If you prefer to try new restaurants or travel there are groups out there for those interests as well.

These sorts of positive actions will prepare you for being able to explore your new environment and start enjoying the fun and adventure that comes with a major relocation. You may even have a couple new besties to share these with you. By putting some thought and planning into the emotional and social aspects of your relocation you will not just survive but thrive.

Author: Dan Martin, MS Psych

Dan Martin MS Psych, is a Psychologist who has expertise in expat adjustment; couples counseling; stress and anxiety; drug & alcohol counseling; career planning; post-separation parenting; as well as depression.

If you would be interested in reading other posts by Dan please visit:

For those interested in reading the original research mentioned above it is available here:

Image: flickr

Este Directorio Internacional de Terapistas (DIT) Blog ha sido creado para resaltar miembros del DIT. Estos son terapistas, consejeros, psicólogos y psiquiatras interesados en proveer tratamiento y cuido que es culturalmente sensitivo a la comunidad emigrada internacional de hispanohablantes. Estos terapistas han expresado interés en ser destacados en este “post” y están organizados geográficamente.


Paula Vexlir, Registered Clinical Psychologist
Buenos Aires & Worldwide Online
Paula Vexlir, psicóloga clínica. Trabaja de modo online y presencial ayudando a expatriados y migrantes a través de sesiones individuales, de pareja o familia así como también con entrevistas de Orientación a Padres enfocadas en ayudarlos a apoyar a sus hijos, TCKs o chicos interculturales en sus transiciones. Ha desarrollado cursos online diseñados para mejorar la experiencia de expatriados y migrantes. Lleva adelante  un blog para contribuir con la comunidad a la que sirve. Más información en su web o su blog


Cristina M. Fandiño, Doctorado en Educacion, Master en Educación, Ed.D.; M. Ed., Lic. en Psicología
Toronto, Ontario
Estudios: Psicología Clínica, Psicología Transcultural y Psicología de la Adaptación. Universidad de Toronto; Universidad de Buenos Aires. Trabajo con adultos, de manera individual, así tambien como con parejas y familias. Me he especializado en choque cultural, transiciones; depresión y ansiedad; estrés,  mantener el equilibrio del trabajo y la familia; autoestima y crecimiento personal; separación o divorcio. Nacida en Buenos Aires, Argentina, estoy radicada en Toronto, Canada desde hace 30 años. Viajo constantemente por todo el mundo. En mi práctica privada, proporciono a expatriados psicoterapia y asesoramiento en persona y a distancia a través de Webcam y teléfono.


Nereida Gómez, MS, Master in Clinical, Legal and Forensic Psychology, Graphologist
Psicóloga clínica y psicoterapeuta especializada en Terapia Breve Estratégica. Bilingüe español e inglés. Trastornos de ansiedad, depresión, trauma, trastornos de alimentación, trastorno obsesivo compulsivo, problemas sexuales, miedos y fobias. Adultos, niños, y terapia de pareja/familia.

Estados Unidos

Lois Bushong, MS, LMFT
Indianapolis, Indiana
Lois Bushong creció en América Latina y ofrece su servicios de consejera en español. Trabaja en la oficina de Quiet Streams Counseling, Fishers, Indiana. Puede ponerse en contacto con ella en ljbushong@gmail o en su website.

Lic. Mariana Iurcovich, Clinical Psychologist from Argentina (Licensed: 15984) and Life Coach (QSCA)
Boulder, Colorado & Worldwide Online
Para aquellos que eligen el desafio de vivir en otra cultura, muchas veces, el lugar de destino no es lo esperado….los colegas nacionales tienen un estilo de trabajo diferente, las expectativas no se asemejan a la realidad. Que sucede con las parejas y familias de quienes optamos por una vida diferente ? quiza en el pasado en algunos destinos ha sido mas facil establecer una vida social, conocer familias con los mismos valores, pero si esto no ocurre, cuales son las consecuencias en la vida personal ?

He trabajado en 23 paises, conozco la diversidad cultural, y las dificultades de adaptacion personales y familiares. Ofrezco 30′ de consulta sin cargo para conversar y definir las necesidades.

Gabrielle Seekely, M.Ed., LPC-S, BCPC
Houston, Texas
Mi formación y mi experiencia durante más de dos décadas es en el Autismo, la Diversidad Neurológica, el Trauma, la Adopción, y las Personas y Familias Expatriados. Yo trabajo en colaboración con un amplio espectro de clientes a centrarse en sus capacidades y desarrollar aptitudes. Mi enfoque de tratamiento se adapta a cada cliente la distintiva de las necesidades y objetivos individuales.


Sheena L Flynn, LCSW-R, MA
Trabajo en In Touch Community Services en las Filipinas como pscicologa ofreciendo psicoterapia individual, grupal y de pareja. Mis especialidades incluyen: Trastornos de Ansiedad., Trastornos de Estres Posttraumatico, Depresion, Manejo de Estres, Estres por aculturacion, Codependencia Emocional, Violencia Domestica, y asuntos de dolor y perdida con individuos y parejas. Ofrezco consultas personales y profesionales en persona y atraves de internet o por telefono. Se que todos tenemos el derecho de recibir apoyo y alivio para transformar nuestras vidas.

Países Bajos

Camila Marques, MSc. Psychology
Somos un grupo de profesionales altamente calificados y con experiencia en el área del bienestar psicológico. Tenemos una visión moderna y holística de la psicología, dando orientación individual, familiar y a organizaciones a través de sesiones de training, coaching y terapia psicológica. Entre nuestros puntos de fuerza está la capacidad de ofrecer nuestros servicios en inglés, español, portugués italiano y holandés. Acompañamos a los expats y a sus familias de Rotterdam, La Haya y Leiden en convertir a Holanda en su “segunda casa.”


Lic. Rachel Chevallier Faustino, psicóloga clínica, certificada por la Federación Suiza de Psicólogos y Psicoterapeutas
Ofrezco asesoramiento a indivíduos, parejas y familias confrontadas a depresión, ansiedad y otras dificultades tales como vivencias traumáticas, enfermedades crónicas, relaciones conflictuales y dificultades de integración.

Contributed by Paula Vexlir, Registered Clinical Psychologist

So you have moved overseas, you have managed to find a new home, a school for your children, to start learning the new culture; and you have supported your children through transition. You have helped them name their feelings, you have allowed them to navigate the paradox of having an amazing life and yet missing some of the things you have left behind. So, in the first place, if you have managed to do all this let me say: Wow! Congratulations, superhero!! And if you haven’t: Congratulate yourself anyway since you are a normal person trying to do your best at a particularly stressful time of your life.

You have arrived. You have adjusted (or are still doing so) and regained a sense of stability in your daily life. So now is a good time to talk about how you can help your children with their relationships with their grandparents, uncles, aunts, other relatives and friends back home. So I will be using the grandparents example but feel free to replace it with any other relative you like. Read more

Contributed by Susan Dellanzo

Many people perceive the life of an expatriate as exciting, glitzy and glamorous when, in fact, it often is not. Global living can be both positive and negative, as with everything else in life. In the same way a magnet is always positive and negative, so is everything else and one of the greatest illusions people fall into is the search for pleasure without pain, praise without reprimand, or nice without mean, etc.  Ironically, it is in looking for those imagined one-sided events in a two-sided universe that we experience so-called ‘suffering’.

Some expats experience loneliness, isolation, and even frustration with what they perceive to be ‘missing’. However, often, nothing is, in fact, missing from their lives – it has just been transformed. Unless you ask the right questions, you will constantly be living in a state of stress and disempowerment which can, in turn, effect your health, wellbeing, relationships, family dynamics and even wealth building.

People often live by a certain ‘Hierarchy of Values’, and yet many don’t know specifically what theirs are, so they end up minimizing themselves and living according to the values of someone else, which can be overwhelming. Being overwhelmed has several parts to it, but being in conflict about who we are, what we’re doing and/or what we have in life is sometimes a factor.  Stress can also occur when we feel there are more negatives going on in our lives than positives and signifies an inability to adapt to a changing environment or country.

I’ve come to believe that there are seven areas of life and any area you are not empowered in, someone else will overpower you. You will never have support without challenge, nor challenge without support. Life is a beautiful balance of pleasure and pain, yet many people live in a world of illusion and fantasy, rather than one of balance and presence. Dreams go hand-in-hand with nightmares and I have seen many examples of this in the expat and global community. This is why it’s so important to ask the right questions in order to dissolve the perceived challenges rather than live in world of pain or negativity and become a victim of our own thinking and perceptions. We will tend to blame others, our spouse, society, the rules and regulations of the host country, etc., rather than take control of our own lives and our own thinking.

This leads me to the next mistake I often see with expats, particularly the trailing spouse. They don’t have a plan for their lives. I believe that if you don’t have a plan for all seven areas of life – if everything is just what comes up today and if today isn’t a good day, and you don’t have a plan to move it in the direction you want it to be – then you’re kind of wayward and dependent on other people’s lives and other people’s decisions and plans which are out of your control. If you live your life according to other peoples’ plans and those plans go wrong, then you have no way of correcting them. In fact, if you don’t know where you’re going, you will end up somewhere else and if that’s abroad in a country you didn’t actually really want to go to deep down, there could be tremendous repercussions in the long run.

I was quite shocked to hear recently how so many people are on antidepressants and drugs. What does that mean? It means they are perceiving themselves in such pain and/or depression, and they have a sense of hopelessness about their lives that they feel they need drugs in order to deal with it, when in fact a lot could actually be as a result of imbalanced perceptions, comparing their lives to fantasy lifestyles, which if we really look at it in depth, are neither realistic nor attainable. People often also put unrealistic expectations not only on themselves but on others as well.

I have known many expats who are lonely and not finding their own strengths. They are living in the past comparing what they used to do or used to have and/or where they used to live. They have no direction in their lives and Parkinson’s Law states if you don’t fill your day with high priority things, it will automatically get consumed with low priority things.

An excerpt from the book Stop Not Till The Goal Is Reached (Maha Sinnathamby) sums it all up: “Way too many people are living a life that is not theirs to live. They live their lives according to what others think is best for them, they live their lives according to what their parents (or spouse) think is best for them, to what their friends, their enemies and their teachers, their government and the media think is best for them. To what society thinks is best for them. They ignore their inner voice, that inner calling. They are so busy with pleasing everybody, with living up to other people’s expectations that they lose control over their lives. They forget what makes them happy, what they want, what they need… and eventually they forget about themselves”.

If you want to live a fulfilled life and make the most of your global experiences, wouldn’t it be wise to balance out all those imbalanced perceptions causing you so much pain? The quality of your life is based upon the quality of the questions you ask. What will it cost you ultimately in your health, wellbeing, relationships, family dynamics, work situations and wealth building if you don’t?

[Note: This piece has been re-posted from Global Living Magazine with permission from the author.]

Author: Susan Dellanzo


Photography by Wendy K Yalom

Susan Dellanzo is an International Relationship, Health & Wellbeing Specialist dedicated to empowering and inspiring her clients to new levels of life fulfillment by reducing stress, resolving conflict, finding their true identity, improving relationships as well as optimizing physical health, wellbeing, beauty and vitality. Born and raised in England, Susan has had a life-long interest in personal development, universal laws, health and beauty, and the mind-body connection. She has lived in various countries including Belgium, Canada, Italy and the Middle East. She speaks several languages and presently lives in Switzerland. She has also travelled the world as an International Business Consultant. Visit for more information.

Contributed by Lois J. Bushong, MS, LMFT

It is a fit! As a Third Culture Kid and in the light of my natural giftedness as a counselor, I selected a vocation that is a perfect fit.

When I was in college in the 60’s, I only knew of one TCK who had become a therapist. Dr. S. was a mess! As he valued another TCK and me for an overseas assignment, he made a most obnoxious comment to us: “Anyone who ever went to a boarding school has severe psychological problems today”.

I stopped listening to anything else he said. He had lost all credibility with just that one flippant declaration. For many years, that TCK psychologist was one of the reasons I did not want anything to do with the world of psychology. If his statement was part of the evaluation, I certainly flunked the test.

Psychology has become much more accepted by the general public since that day. Psychologists have changed and become personable. Well, most of them have. And the research on TCKs has proven Dr. S’s declaration regarding boarding schools to be mostly inaccurate. Yes, there are some TCKs who were badly messed up by their boarding school experience.

Yet I believe Dr. S. was projecting onto others his own negative experiences at a boarding school that had gained a reputation for being very hard on their young TCKs.

Sadly, there are some TCKs out there who make lousy psychologists or counselors. They have not worked through their own baggage and so end up placing it on the shoulders of their clients, especially other TCKs. But I believe the majority of TCKs are wonderful counselors and psychologists. They have faced their own demons and conquered them. They are well trained, very compassionate with their clients, and have excellent skills in working with all levels of society.

Last year, I stumbled on to an article on why Third Culture Kids make good therapists. After rummaging through my files and doing some Googling, I cannot find the source of those original thoughts. So here goes my own list, with apologies to the originator of the idea of WHY TCKs make good therapists.

1. We have learned to be observant of all that is taking place around us.

2. We are good at jumping quickly in and out of deep relationships. We do not mess around with superficial chitchat.

3. We are use to saying goodbye and moving on with life after an intense relationship.

4. We adapt quickly into the culture (joining) of the client.

5. We naturally have compassion towards those who feel marginalized.

6. We are comfortable with all levels of society.

7. Many of us have been in life and death situations and can therefore relate to clients who have been traumatized.

8. We know how to live a simple lifestyle. (Our career is not lucrative.)

9. Many of us are fluent enough in several languages to be able to listen to a client who needs to express his or her emotions in another language.

10. Most of us are very creative in our skills as a therapist.

I may have left out a few other reasons why we make good therapists. I would love to hear your comments.

It always amazes me how people land in careers that are a natural for their personalities. For example, the introvert/detail person gravitates towards the accounting job, the extrovert lands in the position of the Activities Director of the cruise ship, and the caretaker blooms in the role of Director of the Day Care center.

Years ago, I met a lady called Elsie Purnell who was a regular attendee of the Missions and Mental Health Conference at an Indiana State Park. Elsie had served for years as a missionary in Thailand and led several support groups for adult TCKs in California. She loved ATCKs and she loved therapists who worked with TCKs. At the conclusion of each conference until her death, Elsie would ask all of the former ATCKs who were now therapists to pose for a picture. The first year, our group was quite small. But over the years, the group grew. It was a source of pride for me to be in this growing band of ATCKs who were now working as therapists. And our numbers continue to grow.

I fit in this profession as a counselor who happens to also be a Third Culture Kid. I hope you too have landed in a vocation where you feel you can use those unique characteristics you posses as a TCK as well. It makes going to work something to look forward to each day. And I might even get to do it in Spanish!

[Note: This piece has been re-posted from Mango Tree Reflections with permission from the author. Comments are open on the original post.]

Author: Lois J. Bushong, MS, LMFT

Lois J. Bushong, author of the recently published book Belonging Everywhere & Nowhere: Insights into Counseling the Globally Mobile, ATCK, Licensed Marriage & Family Therapist, writer and international speaker.

Contributed by Anastasia Piatakhina Gire, Member of IIAP

There are places I’ll remember all my life.

I was born in a small Russian town, a very cold and dirty place.

This was one of the first things Anna shared about herself in a long introductory email reaching out to me for online psychotherapy.

In this description of her native town, I could sense her sad childhood: a lack of emotional warmth and possibly some neglect.

The way people describe their early surroundings usually tells something significant about their life story.

We developed early bonds with our caretakers, but also with a place. We end up internalizing the qualities of the landscape or family house where we grew up.

Can we ever detach ourselves from our original place? Does it not persist inside us, long after the physical building has been knocked down?

Anna had left her native town early, to study and work in Moscow, and then she had moved abroad. Her departure had been more of an escape: eager to leave, she had barely said her goodbyes. Since then she had changed countries several times, and finally landed in London. But the original “coldness” and “dirtiness” had followed her, as a malevolent shadow from her past.

It was only our second session, and I was experiencing Anna as frozen and difficult to reach out to. She complained that no town ever felt good enough to her: “too cold” or “too dirty.” Through the videoconferencing, I could have a glimpse of her current London interior, which looked unsurprisingly impersonal and rather messy.

Anna’s restlessness was partly due to her conscious desire to find a more nourishing environment, but this was conflicting with a deeper sense of hopelessness and despair: she believed that such a place did not exist for her.

Even in a warmer and more welcoming country, she would always feel alienated by a feeling of guilt—as if betraying her birthplace, her motherland. That felt deeply wrong.

But at the same time, she could not feel belonging to this new and “better” place, she felt painfully “different.”

Deep inside she kept being “a girl from a dirty and cold place,” her life stained by it forever.

As often happens with expatriates, something shifted when Anna went back home for a holiday. We had an online session whilst she was there. As her face appeared on my screen, I was struck by how different she now looked: instead of her usual impeccable jacket, she was wearing a loose t-shirt; her hair was messy; and without make-up she looked younger.

This was a unique opportunity to accelerate the process.

She was staying at her parents’ flat—the very one where she had grown up, and was certainly getting in touch with some early emotional experiences of her childhood.

Internet connection is always bad here, so maybe we will need to switch-off the video at some point. She warned me, preparing a retreat in case the session triggered too much shame. She was also reminding me how “imperfect” her childhood place was.

Shame was indeed around for the whole hour, but Anna was brave enough to stay with it, and we managed to navigate through this experience together.

Using her laptop’s webcam, Anna finally showed me around. This was a real risk-taking, and I could appreciate how exposed and vulnerable she felt. The place was indeed muddled, and was a testimony of an un-nourishing childhood environment.

Anna’s mother, born just after the war, had been stockpiling all sorts of things, an aversion to discarding possessions which qualified her as a “hoarder.” Understanding her mother’s struggle helped Anna make sense of the level of messiness she grew up with, and the shame she was feeling about it.

That “back home” session actually was a turning point in my work with Anna.

She realized how much she was actually attached to her birthplace, with a painful loyalty that did not let her leave it completely behind.

Making a better sense of her mother’s mental condition, Anna was now able to re-evaluate her own relationship with her family home and her native town. This place was not her. It did not define her; it was rather a sum of her experiences, which had started in that town, but did not have to end there. And the latter was her choice—such an empowering realization.

Maybe a warmer place existed somewhere for her after all…?

[Note: This has been re-posted from with permission from the author.]

Author Anastasia Piatakhina Gire, Member of IIAP

There are many different models of counselling and psychotherapy available today and it is easy to get confused. The main quality of the Integrative approach I practice is its relational value. Every hour we spend together is your own time and space, where nothing is expected of you, except for the commitment to being honest and willing to share. I will always strive to be fully present and available for my clients. Throughout my time as a therapist I remain in regular supervision with a fully qualified Psychotherapist.

Contributed by Judy Hansen, MA, LPCC

Do you ever wonder how non-TCKs and TCKs get along much less have lasting relationships?

Do you find yourself jealous or slightly cynical of those who seem to have close friendships and wonder how they got there?

Do you question how TCKs in relationship with non-TCKs have managed to reconcile their different worldviews and ways of thinking?


I’m a Third Culture Kid married to a monocultural man…

I live in both worlds: I’m a TCK married to a monocultural man from Colorado, where we’ve raised four children, all born in this beautiful state. You might benefit from hearing how I have learned to juggle both ways of thinking, perhaps you will glean something from my experiences and observations and how my life has become richer for it.

Searching for the common thread

My basic premise is that if we, as TCKs, approach the world looking at how much we have in common rather than how much we differ, would go a long way in resolving some of our relational difficulties. We would see that everyone longs to be heard, understood, be in relationship, have friendships and feel valued. With that in mind then, as we look for opportunities to establish common ground, we will find the world to be a richer place.

Why do we fail to connect?

Many TCKs express a longing to connect, but feel they fail miserably, claiming fear of rejection and abandonment. In the following paragraphs, let us look at some practical ways to implement the ideas of connection, friendship, and relationship.

Practical ways to implement:

1. Are you judging their “narrow-mindedness“?

When we instantly judge someone because we don’t like their narrow-mindedness or because they do not appreciate how big the world is and think only of their own “petty” interests, we create an instant barrier and cease to be open-minded ourselves.

2. “You can’t understand.”

Conversely, when we firmly and stubbornly believe that no one could possibly understand us, we have already created a situation that precludes anyone entering our world.

I often think TCKs complain of Americans’ superficiality without really getting to know them as individuals. I know I did. I compared my global lifestyle to what I perceived as their dull, shallow way of thinking. On the one hand, it’s hard not to make those comparisons and complain, especially when Americans can present us with many opportunities to object to their way of thinking! At the same time, I have discovered friendships here in America that are deep, meaningful and rich.

3. Laying aside our prejudices

Granted, it took some time to develop those friendships. First, I had to learn to lay aside my own prejudices, my own knee jerk assumptions and arrogant reactions in order to listen to their hopes and dreams. I discovered that many had the same aspirations I did: connection, significance and hope for the future.

4. Everyone has something to contribute.

When we as TCKs set out to approach life with the worldview that everyone has something to contribute to our knowledge and growth, no matter how initially aggravating they may seem to us, we will find our journey on this earth much more pleasant and far less isolating.

[Note: This piece has been re-posted from Power For Living with permission from the author. Comments are open on the original post.]

Author Judy Hansen, MA, LPCC

Judy Hansen was raised in Brazil and Portugal of American missionary parents. She held a dual nationality, American and Brazilian until the age of 18. She is a mental health therapist located in Denver, CO and enjoys helping all those who are struggling with transitions.

Contributed by Anastasia Piatakhina Gire, Member of IIAP

“You are so resilient!” – said with a shred of admiration and with some (more subtle) envy underneath. I have heard that so many times. And every time, even though I feel grateful that the person appreciates my striving, it irritates me slightly.

But what may cause this irritation? I have the impression that some part of me, well hidden under the resilient and adaptive part, somehow gets missed. To be resilient, in other words “bouncing back” from difficult experiences, is a strength often found with expats. But it comes at a price. One loses other things on the way.

Neglected Roots

Let’s look at an experiment I have been running, as it happens, with my terrace plants. I love my earthy pots and my lavender, my pine tree, and my yucca. They are fellow travellers and they have bravely followed me around the world for the last ten years. Right now they are happily sweating on our Madrid terrace.

So what happens when we keep replanting a plant again and again? If we take care of it, water it, and respect its initial basic needs (light and water, in varying proportions), it will eventually strive. Its leaves will look bright and green, and it will even flourish sometimes. Not always at the right time, or not every year, because the adaptation to the new soil and a different climate can impact its capacity to grow flowers for a year or two. The plant will be resilient and will end up adapting to the seasonal changes, but how do these changes in environment impact the state of its roots? They will become weaker, not dig deep enough into the soil; they just do not get enough time to do so.

The Cost of Adaptation 

Working as a therapist with expats, I have become more and more aware of how similar adaptation strategies generally are. As children expats often were repeatedly exposed to the necessity of fitting in a new environment, adapting to a new school, a new neighborhood, and possibly a new language.

No matter how big the parents’ efforts were to make every move a bearable and even an exciting experience, for a child it can easily result in a multitude of stressful situations.

Our natural emotional response to feeling different from others, or less skilled (for example in a new language or when practicing a locally specific sport), is shame, a frequent coping strategy. And the most socially adaptable response to shame is to move forward to others in a pleasing way. When this psychologically tricky situation is repeated many times during a nomadic childhood, we grow to be extremely empathic and attuned to others.

When the necessity to fit and to be accepted turns into a question of survival, social inclusion can get prioritized over one’s own needs, we adapt again and again, and do not grow our own roots.

I can see myself developing this pattern; this ability to guess others’ needs and easily connect with their desires. Have you not noticed expats very skillful in this, navigating with ease social events where they do not know anybody, evolving in an unfamiliar ground as if it was their own territory?

As a result of this adaptation, it may become extremely difficult and painful to get in touch with our own vulnerability, as we gain in resilience.

Green Thumbs, Red Sofas

Coming back to the plants, the best strategy I found for my ‘portable’ garden is to move each plant together with its own container and soil so it has its own environment travelling around and the roots system stays preserved.

For us, humans, it also can be a relevant solution. We also make sure our own environment travels with us: our family, friends (occasionally), our furniture and our books.

I remember feeling very uneasy when my husband suggested selling my favorite red Italian leather sofa before one of the moves. It made sense: it is heavy and not that new anymore, but it is a part of my story, part of my familiar environment.

Astute gardeners keep these little care labels planted in the pot alongside the plant. Its role is to remind oneself of the plant’s preferences are regarding its life conditions.

Sometimes we focus so much on being resilient and adaptive that we forget about our simple basic needs. Why not to make a little reminder – a care label – just to remind yourself what kind of care you really need, which roots really matter for you?

For example, I was born in a snowy Saint Petersburg, but have spent most of my time in Southern Europe. So, sometimes I need to get in touch with those wilder and rougher roots from that cold climate. In order to feel fulfilled, I also need a lot of light, my friends’ company, healthy food, and, as an occasional special treat, an art exhibition, an opera or a ballet.

The Other “You”

In the end we are much luckier than the plants: with an Internet connection, we can reach out to our original forests, which are nowadays just one click away.

Our expat resilience is one of our well-earned assets indeed, and we worked hard enough in order to integrate it to our personality. Our vulnerability is only the other side of the coin, though less socially appreciated (I bet you have never been complemented with “You are so vulnerable!”). Travelling around the world some of us have being practicing being resilient for a very long time, so that we forgot about the price we have paid to acquire it. To get back in touch with our vulnerability can be a real tribute to our journey!

[Note: This piece has been re-posted from Expats Therapy Blog with permission from the author. Comments are open on the original post.]

Author Anastasia Piatakhina Gire, Member of IIAP

There are many different models of counselling and psychotherapy available today and it is easy to get confused. The main quality of the Integrative approach I practice is its relational value. Every hour we spend together is your own time and space, where nothing is expected of you, except for the commitment to being honest and willing to share. I will always strive to be fully present and available for my clients. Throughout my time as a therapist I remain in regular supervision with a fully qualified Psychotherapist.

Contributed by Kate S. Berger, MSc, Child & Adolescent Psychologist

Expatriate children deal with a laundry-list of stress factors that are associated with the dynamic lifestyle they live – e.g., packing, unpacking, saying goodbye to loved ones, time differences, new schools, new friends. And after one has made it through those stressors there is the difficult process of adjustment where the child realizes s/he is totally our of their comfort zone, has no firm ground to stand on, and must find a way to adapt to the local culture.

However, despite the challenges associated with this cycle of life events, expat kids can – and do – achieve success because they are uniquely qualified for leadership positions in society (due to their vast experiences from living in different contexts, their exposure to diverse thinking styles and their capacity for resilience). That said, the road to success isn’t always easy because of that nasty thing called – you guessed it – “stress.”

Stress gets in the way of learning.

Professionals working with children see that the stressful-adjustment process expat kids face can have an immensely negative impact on learning. One of the reasons that stress impedes learning is that the automatic, physiological reaction that takes over in response to stress inhibits executive functioning skills in the brain – things like concentration, memory, creativity, and logical thinking. When these skills are impacted, learning capacities diminish.

Stress harms the body.

In addition to stress impacting the learning process, it is also negatively impacts the body. In fact, many researchers are now suggesting that the physiological reaction that occurs in response to stress plays a huge part in the development of cancer, diabetes, and heart disease and is thus THE biggest health concern tin our society.

Our risk

Society is missing out if we don’t make efforts to counteract the negative impacts of stress for expat children, as we risk the possibility that these kids will become crippled by stress and therefore will not fulfill their leadership capacities. If this happens, we all lose.

There is good news!

It is 2014 and – voila! – we are able to enhance childrens’ capacity to cope with stress effectively, and in the process of doing so help them to build skills that allow them to have greater compassion for themselves and for those around them. How? Drum roll… Mindfulness.

What is Mindfulness?

Mindfulness is based on traditions practiced throughout history, and is a secular approach to learning that teaches individuals to focus on the present moment, and shift their attention inward, with kindness.

Many kids today are very externally focused (playing internet games, chatting on social media, etc.), so teaching them to look the other way around does require practice, but research is showing that there are tremendous benefits for doing so. In the process of turning inward, kids who practice mindfulness build increased capacities for empathy and openness. And it gets even better:

Bodies of research looking at the impact of teaching mindfulness to kids are showing positive impacts on emotional well-being, learning, and physical health. Neuroscientists are literally able to see how practicing mindfulness changes the physiological reactions to stress, and kids who have participated in mindfulness programs have shown significant decreases in depression, anxiety, ADHD, aggression, oppositional behaviors, and sleep difficulties; and improvements in concentration abilities, memory, self-awareness, optimism and positive emotions.

And you don’t have to take my word for it

It seems that everyone is getting on board the mindfulness movement these days. In the UK, the Mindfulness in Schools Project is at the forefront of educating teachers so that mindfulness can become part of mainstream day-to-day curriculum in schools. Globally, there are numerous publications sharing information about the positive impact of mindfulness – The Guardian, The Huffington Post, The New York Times, and Time Magazine (who called it “The Mindful Revolution”) to name a few. And guess what? Mindfulness isn’t just for dealing with the difficulties in our personal lives: government agencies, military personnel, corporations and famous athletes have started using mindfulness practices in the work-place as a way to improve performance and enjoyment (and decrease stress!). This is B-I-G.

Is it the golden ticket for expat kids?

I make no promises here that mindfulness will eliminate stress, because that is not the point (or realistic). Expatriate life can be tough, and if mindfulness gives expat kids effective tools to cope with (the inevitable) stressors, to enjoy life more, and become better equipped to effectively contribute their unique insights and experiences to society at large, then we can’t really afford to not join the “revolution,” can we?

[Originally published in the ACS International Schools e-newsletter.]

Author: Kate S. Berger, MSc, Child & Adolescent Psychologist

Kate Berger is a Child and Adolescent Psychologist and certified Mindfulness instructor, specializing in working with expatriate children and their families in her private practice, The Expat Kids Club. Kate is actively involved in networking within the expatriate community as a way to spread awareness about the benefits of mindfulness for kids and teens. She strongly believes that practicing mindfulness is a way to create stronger connections with those around us, and the greater community.

For more information about the research mentioned here, or with questions or comments, please contact Kate directly: For more information about Mindfulness in Schools Project, please visit:

Happy New Year!!

As 2015 dawns, I want to take a brief moment to reflect on the substantive year of growth that was experienced over the course of 2014.

Perhaps most notably, updates were made to each of the following sections:

Albania, Australia, Belgium, Canada, China, Colombia, England, Germany, Greece, Kenya, Netherlands, New Zealand, Singapore, Thailand, USA, and Worldwide.

In fact, the Netherlands section experienced so much growth that it was reorganized to provide individual pages listed by province.

Several guest ITD Blog posts were posted over the course of the year, and I want to express special gratitude to Kate Berger, Kay Bruner, Lois Bushong, Judy Hansen, Mari, L’Esperance, Kim Roberts, and Paula Vexlir for each of their very thoughtful contributions.

The purpose of this directory remains the same:

– To help TCKs, adult TCKs, expatriates, repatriated expatriates, and otherwise internationally mobile individuals/families in search of mental health therapy identify accessible mental health therapists who self-profess to have an understanding of the common experiences of those who have lived and/or live an internationally mobile lifestyle.

– To assist the listed professional mental health therapists identify and connect with one another for peer support and professional development.
I’m looking forward to the upcoming year of curating the directory, hoping to see increased expansion and community building in the many months and years to come.

To each of of you, wherever you find may yourself ringing in the new year, I wish you all the best as we take these next steps together.


Josh Sandoz, MA, LMHC

Contributed by Judy Hansen, MA, LPCC

“Did you know there are flies that lay eggs under your skin?!” my friend exclaimed. I was horrified to learn this truth when I was a kid growing up in Brazil. I had seen tarantulas, spitting frogs, seen hairy multicolored caterpillars, tried to catch geckos by their tails and been bitten by more bugs than I cared to know. But this news really grossed me out. “Really?” I said. “Ewww.”  My friend went on to tell me they had seen this odd growth, gone to the doctor, who lanced the wound and then flies emerged.

I liken the eight types of grief and mourning to those fly eggs that get under the skin. It takes identifying and acknowledging so the wound can heal. I will define each one so you can recognize them, and begin to be free from their effects. (I wish to acknowledge Lois Bushong’s book, “Belonging Everywhere and Nowhere“, 65-66 as the source for some of the following concepts).

1. Abbreviated Grief and Mourning

This grief is real, but it is short lived. It occurs when there is no perceived time to grieve, the loss might be minor, there is no strong attachment to the loss, or it is seen as a gain.

This occurs in many situations. For example, if you were moving from a very small town to a big city, you might view the move as exciting and adventurous. You will no longer be able to eat at the local diner, but you don’t mind exchanging that for the culinary delights you will experience in the big city.

Perhaps where you are going the styles are different, but you don’t care because you didn’t like the local styles that much anyway. Or maybe you won’t be able to buy a certain brand of your favorite ice cream, but you look forward to the new flavors.

Sometimes grief in this situation occurs because the move happened so quickly, there was no time to think about being sad, much less process it. Perhaps guilt creeps in because you think you should feel something, but instead feel nothing.

2. Anticipated Grief and Mourning

Grief of this type is when you know the move is coming and are already dreading the goodbyes. You would rather avoid them altogether, hoping that by pretending the move isn’t really going to happen, dealing with the grief also won’t occur.

Teenagers and young adults often experience this when they hear they are moving to a new school, city or country. It happens when they are nearing graduation from high school or college. Some may miss their favorite coffee shop even before the move.

Sadness creeps in, as well as irritability and anger. It is really tempting to try to shut off all the emotions in order to cope with the stress of upcoming change.

3. Ambiguous Grief and Mourning

Ambiguity in any situation means it is hard to pin down exactly what is bothersome. When it comes to grief and mourning, it means the losses are hard to define and therefore also hard to identify. It could mean never playing in a certain park again, or never going back to the ocean. Perhaps it means going down that street where you played as a child is not possible. Or maybe the store you loved to shop in has been demolished.

Ambiguity makes it hard to fully grieve the loss because it seems so inconsequential and insignificant. But those losses accumulate and you burst into crying jags, temper tantrums or go into emotional shut down.

4. Delayed Grief and Mourning

In a move, delaying grief seems the most logical thing to do. “I don’t have time to be sad or depressed, I’ve got a house to pack!” Perhaps a student learns that a loved one has died, but then protests, “It’s finals and graduation is next week, no time to think about the loss!”

Only later does the grief hit them, and it may be in the middle of the best day they’ve had. All of the sudden, there is an overwhelming desire to cry over the most trivial loss, such as an earring or a button.

5. Exaggerated Grief and Mourning

This type occurs when there is a cumulative effect of losses. Perhaps your dog died, you lost your job, and you had to move to another city, all in a short time. It could also happen when you’ve had a lifetime of losses, unprocessed grief over many years, often due to frequent moves.

Then comes a day when you feel overcome by sadness, grief and mourning. Depression may set in. Crying jags occur. Having difficulty getting simple tasks done, and focus is gone. Anger may be a constant companion, and life seems unfair.

6. Inhibited Grief and Mourning

If the losses are not processed, they will show up as headaches, stomachaches, and unexplained illnesses. Stress is hard on the body, and stuffing the grief, shoving down the pain, only increases the likelihood that it will show up somewhere in the body as a physical ailment.

7. Normal Grief and Mourning

Processing grief is different for everyone, taking anywhere from 3-24 months. Since everyone processes grief differently, each family member may be at a different stage in their grief. Allowing for those differences is an important part of healing. It may also depend on each one’s perception of the loss. For one the loss may feel minor, for another much more tragic.

8. Unresolved Grief and Loss

This occurs when the history of losses has not been processed. It is prevalent among those who moved frequently as children and then as adults they feel the cumulative effect of those continuous changes. Difficulties forming lasting relationships, feelings of rootlessness, underlying anger and resentment may be evident in their lives.

What To Do About It

We all process things differently. Some are verbal processors, talking about the issue until the subject is exhausted. Others like to write in their journals, some like to express themselves through some art form. I suggest picking a particular time in your life you believe has not been processed and use one of the above ways and begin to express it.

Processing grief and mourning should not be done in isolation. We need each others’ love, care, attention and compassion to help us heal. However you process, be sure you share it with someone who cares about you.

If you find that your grief remains firmly lodged within you, you may need to seek the help of a therapist. Don’t hesitate to contact me, I can help. 720-201-5030.

[Note: This piece has been re-posted from Power For Living with permission from the author. Comments are open on the original post.]

Author Judy Hansen, MA, LPCC

Judy Hansen was raised in Brazil and Portugal of American missionary parents. She held a dual nationality, American and Brazilian until the age of 18. She is a mental health therapist located in Denver, CO and enjoys helping all those who are struggling with transitions.

Contributed by Kay Bruner, MA, LPC

“I feel awful. Something inside me is squeezing me so bad I can hardly breathe.”

With those first words of Letters Never Sent, Ruth Van Reken spoke straight to my TCK heart. It was 1988, I was a senior in college, the book was brand-new, and for the first time in my life, somebody besides me was willing to say that being a TCK was not all about climbing up sunshine mountain.

By the time I read Letters, I was already married to another TCK and we were well on our way to our own overseas career in Bible translation. My own experience, confirmed by Letters and by the quiet conversations I had with other TCK’s I met, made me absolutely determined to care for my children and their emotions carefully and attentively, to minimize the damage that previous generations of TCK’s had endured.

When that great revelation of research by David Pollock and Ruth Van Reken, Third Culture Kids, was published in 1999, I practically memorized chapter 13 on transition. I could recite the RAFT model for family transition in my sleep. Over a 15-year period, we RAFTed religiously from the Solomon Islands to Papua New Guinea to America and back again. In one particularly hellish phase, we moved internationally 5 times in 3 years, and two of those were crisis moves, as in, “You have 15 minutes to leave the country. Go.”

I was trying so hard to make it okay for my kids, to support Andy in the translation project, to be the teacher to four grade levels and four temperaments, to be the family doctor, therapist, Sunday school teacher and chief logistics officer for whatever happened to be happening.

Meanwhile, I was spiraling down, down, down into depression, feeling like I was the only one struggling, because everybody else looked so happy on their prayer cards. I didn’t know that Andy was addictively looking at pornography while we all smiled for our prayer cards.

The Big Crash came in 2003, with two years of intensive recovery following. We went back overseas for a while, then moved back to Dallas permanently in 2007. I went off to grad school for a masters in counseling, and started a little blog to pass the time during the never ending story of my internship.

On the blog, I started to put out little bits and pieces of our story, and every single time I did, someone would write to me and say, “Thank you for saying that!  I thought I was the only one!”

I started to realize that there was not really a voice for this story:  a story about depression and despair and recovery in a mission setting. It was, however, a story that resonated with a lot of people, even people who aren’t missionaries.

This past year, I got my story into book form and self-published. My intention in writing this book was to pass along the gift that Ruth Van Reken gave to me: the gift of a voice, of community, of hope on the long road Home. 

So, if depression and despair and healing sound like things you’d be up for reading about, it’s your lucky day! As Soon As I Fell is available in Kindle format and in paperback at Amazon.

[Note: This piece has been re-posted from A Life Overseas with permission from the author. Comments are open on the original post.]

Author: Kay Bruner, MA, LPC

Kay Bruner was born in Buffalo, New York and grew up in Brazil, Nigeria, and the wilds of Kentucky. She and her husband have raised their four children in Solomon Islands, Papua New Guinea, and the great state of Texas. Kay is a Licensed Professional Counselor, and divides her work days between counseling and writing. She blogs at

Contributed by Lois J. Bushong, MS, LMFT

The recent suicide of Robin Williams, a much-loved comedian and actor, has brought about a great deal of discussion on severe depression. With all the focus on depression, I worry about TCKs who have repeatedly gone to a therapist’s office seeking help for depression. Will they feel, like Robin Williams did, that there is no way out of their deep dark pit labeled severe depression? Will they conclude that the world of therapy and/or psychotropic medications cannot help them escape this prison? Will the therapist be a good match for them and understand their world?

The TCK, who is depressed, may not know why they are depressed; all they know is they are miserable.  As therapists walk through the symptoms of depression with the TCK or gives them the Beck Depression Inventory, the client might certainly fit into that diagnosis. But rather than making the TCKs current situation as their only focus, such as what we do when we do Brief Therapy, here are some other areas we, as therapists, might explore.

A major problem in trying to understand what might be causing depression for those who have been globally mobile is one simple fact, the consequence of their highly mobile lifestyle. Their lives are often so rich and filled with privilege; they and those around them don’t see how they could have a reason to be depressed. Many don’t have the usual markers (family history of depression, a traumatic event, ongoing stress) that often seem to precipitate a diagnosis of depression. As a therapist, we can easily become distracted by their life of adventure that we want to just brush it aside and believe their history or globally mobile life is irrelevant to the depression and search for some “big reason” in their current world, or some past abuse, to which we can attribute their despair.

We cannot ignore the fact that for those who grow up as TCKs, their lives are filled with chronic cycles of separation and loss. Obviously, such cycles are part of the experience for everyone. But for the globally mobile, the cycles are chronic and often relatively sudden and severe. They not only lose a friend here and there, they lose a whole world along with those they love. When these losses are not acknowledged it becomes unresolved grief. Grief that is not acknowledged and left to fester deep in the recesses of the soul becomes depression, anger or anxiety.

As a therapist or a friend of the TCK, the best skill you can employ with your depressed client is sitting and listening to them talk about their losses. You may need to help them in naming those losses. I many times will ask them to divide their losses into categories such as friends, pets, places, senses, relatives, homes, stores, geography, etc. If you attempt to reframe their losses into gains, the result is feelings of shame and withdrawal or anger. If you attempt to defend the system that sent their parents abroad, they will shut down and internalize that you don’t understand them. Yes, there are two sides to their experiences and it can be a challenge to embrace both the positive and negative of each of these events. But before they are willing to consider any positives, they have to experience comfort in their world of grief and loss. Ultimately, they will recognize their history is a weaving of gains and losses.

Besides the layers of unresolved grief, the TCK may be experiencing depression due to their feelings of isolation in their current situation and struggling in forming meaningful relationships in their current environment. They may not have the emotional energy to walk through the process of making friends and small talk, but yet they long for a more in-depth relationship with someone within their community. They often fear the other person will reject them or they fear they will have to once again tell another friend good bye and it just does not seem to be worth it. They may not know how to make and keep a long-term friendship with someone who has not moved or traveled beyond the borders of their state or country and is always there in real life. For many TCKs their “eyeball to eyeball” friendships have only been for two to four years, as someone always moves to another part of the world. They just do not know how to maintain a long-term friendship.

How can we as therapists, help the depressed TCK? We can help the TCK by flushing out those hidden losses and celebrating those wonderful joys and experiences in their history, guide them in long-term relationships, utilize various techniques of grief therapy and Cognitive Behavioral Therapy, encourage them to engage in an exercise program and healthy eating. Some are good candidates for medication or alternative forms of treatment such as yoga, meditation and acupuncture. But the most important thing that you as a therapist or as a friend can do is LISTEN WITHOUT JUDGEMENT to your TCK as they share their world with you.

Henri Nouwen, a Catholic priest from the Netherlands and a well-respected author, once stated “When we honestly ask ourselves which person in our lives means the most to us, we often find it is those who, instead of giving advice, solutions, or cures; have chosen rather to share our pain and touch our wounds with a warm and tender hand.”

[Note: This piece has been re-posted from Mango Tree Reflections with permission from the author. Comments are open on the original post.]

Author: Lois J. Bushong, MS, LMFT

Lois J. Bushong, author of the recently published book Belonging Everywhere & Nowhere: Insights into Counseling the Globally Mobile, ATCK, Licensed Marriage & Family Therapist, writer and international speaker.

Contributed by Kim Roberts, MA

Is it any wonder that anxiety and panic disorders are on the rise? Technology almost dictates that we live in a “need it yesterday” mindset, interrupted by instant messaging, late for our next appointment, struggling to clear out cluttered inboxes, figure out how to send our files, and generally keep up with a world speeding forward on information overload. Add to this the frequent travel required of most expats, international communication and keeping up with family and events on the other side of the planet, and you’ve got a recipe for stress.

That’s why it is more important than ever for expats to learn to relax! By learning to rest and quiet the mind, you have choices about how and where to focus your awareness.

Trying to keep up with life in 2 (or more) different cultures and time-zones can be overwhelming. You can shift your mindset to recognize the larger perspective in the grand scheme of things, and learn to ally with the spaciousness of the present moment instead of getting caught up in the stream of busyness. When I notice my stress levels heading into the red zone, I have a few tricks to help bring me back to earth–my tools to manage anxiety and stress. Try them yourself:

1. Breathe

Your breath is with you always, no matter what country you find yourself in. Make a habit of checking in with it. Notice your breath when you are on the computer, in the middle of an intercultural misunderstanding, or at the departure gate. Get to know what it is that stresses you out, and then bring mindfulness-and conscious breathing– to that activity.

2. Check your environment

This may sound obvious, but is your new environment contributing to overwhelm? When I lived in Hong Kong a few years ago, I was breathing in so much pollution that it was a challenge to get enough oxygen to my brain. I had trouble sleeping because of the constants buzz of neon and the all-day-long interaction with technology. Eventually I had to admit that the environment was causing me more stress than I could handle. I shifted my career path and moved to an island in Vietnam.

3. Settle the mind and learn to dis-identify with thoughts

From a yogic perspective, anxiety is a disturbance of the “winds,” the subtle energy channels in the body. Think of a jar filled with sediment when it is shaken: the sediment swirls around clouding the water. A calm and grounded state of mind is characterized by clarity. The practice of sitting meditation is the most direct way to achieve this settled state of mind. When you ally with the spaciousness of the mind instead of the contents of the mind (thoughts) you automatically shift your perspective. Enter your email on my website for a free audio-guided introduction to sitting meditation.

4. Nourish

No matter how many times I’ve done it, when I’m about to fly overseas, I get a bit anxious. I keep a supply of calming herbs for stressful situations. Kava kava, valerian, chamomile tea, passionflower, lavender, hops, and lemon balm are all great aids to inducing calm. It’s not a permanent fix, but it helps in the short term.

Don’t underestimate the power of eating well and getting enough sleep. Eliminate or reduce all stimulants (coffee, tea, chocolate, garlic, excess sugar, alcohol) from lunchtime onward and notice the effects.

Nourishment also comes in the form of supportive relationships – not always easy when living outside your mother country. Set regular Skype appointments with close friends from home, initiate expat social groups or consider talking to an expat counselor if you need more intensive emotional support. Suffering alone increases the stressfulness of anxiety. Sharing your feelings with others can lift a huge burden, and also help you recognize that you are not alone – everyone struggles with issues from time to time.

Even if you already practice yoga or meditation, working with a therapist helps address issues from a practical perspective so that you can let them go. Practitioners often believe mindfulness will sort out their emotional issues, but in fact the opposite is often the case. Deep practice may stir up old issues, and unless there is a container for these unruly emotions, it can be tempting to “let go” of old issues before they are resolved, which creates a muddy stew in the mind. Anxiety can be a sign there is something trying to come to the surface to be worked with.

5. Organize and schedule in down time

It’s so easy to get caught up in the communications technology that is available these days so that we never actually take a break from being “on.” Especially when most of your people are in other time zones, it can feel like the computer takes the place of social support.

Not everything has to happen NOW. Batch tasks and do them together so that you’re not running all over the place, scattered, unfocused, wasting your energy. Set parameters on certain activities so they don’t consume you.

I try to go offline completely at least one full day a week, and limit computer use to certain times, and NEVER before breakfast! That’s just my own thing; mornings are sacred to me. By limiting computer use until after my practice helps me check in with my inspiration to start the day.

Try scheduling monthly or even weekly mini holidays to refresh and get back to your original nature. Spend the afternoon at your favorite park– or go on an Artist Date, as described by Julia Cameron. Or, try this novel idea: go and actually visit your friends in person!

6. Rest

When the going gets rough, the tough take viparita karani. This is my all-time favorite yoga posture, and my quick-fix remedy for just about everything from jet-lag to overwhelm, from exhaustion to anxiety. It’s the best way I know how to relax quickly and deeply. Follow it with child’s pose for a nurturing restart to your afternoon or evening.

Viparita Karani – the quickest way I know to relax

Child’s Pose

Panic and anxiety are not purely mental events–they are physiological events, so they can’t be treated with the thinking mind only. You need to learn to BREATHE deeply, and train yourself to come back to the breath on a regular basis. Mind and breath are intimately connected. If you can calm your breath, your mind will follow.

Here’s your one line panic advice: relax and enjoy!

Author: Kim Roberts, MA

Kim Roberts earned her Masters degree in Psychology from Naropa University, where she was originally trained as a Contemplative Psychotherapist. She was one of Richard Freeman’s original students in the US, and earned authorization to teach Ashtanga yoga after spending a year studying with Pattabhi Jois in Mysore, India. Author of Ashtanga Yoga for Beginner’s Mind, Kim divides her time between Northern Thailand and Colorado, developing a private practice mostly online. She is launching a new Ecourse, How to Make a Fabulous Living Teaching, Travelng (and Saving) the World, for yoga teachers who wish to take their message to a wider audience. Her website is: Tools For Evolution.

Contributed by Mari L’Esperance, MA, LMFT

[Note: I interchangeably use the pronouns “she/her” and “he/his/him”.]

I didn’t become aware of the term Third Culture Kid until a colleague who is also a TCK introduced me to it, along with Ruth Van Reken’s co-authored book Third Culture Kids: Growing Up Among Worlds, just a couple of years ago. Suddenly, it was like the projectionist at the movie theater had adjusted the lens and my life suddenly came into focus in a way it hadn’t before. For the first time, I not only had language for certain feeling states—grief being primary among them—but I was aware that others shared them, too, and for similar reasons.

As a psychotherapist who works with Adult TCKs and cross-cultural/multiethnic adults, I have spent considerable time reflecting on my own experiences growing up among worlds, even as I continue to learn about the singular experiences and presentations of TCKs and how to most effectively work with this growing population. It’s been especially helpful for me to read the stories of TCKs and other clinicians’ words about TCK grief and complex grief.

Along with the “world” of TCK experience, another world I’ve been immersed in for 10 years is that of “psychotherapist,” which has its own attendant culture, subcultures, values, and codes. As a psychodynamically trained therapist who was supervised by psychoanalysts, I’ve long struggled with the issue of self-disclosure when working with clients who are TCKs. How can I reconcile, on one hand, my clinical training, which taught me to limit self-disclosure, with the world of engaging in therapy with TCKs, where the understanding is that clients work best with, and feel most seen and understood by, therapists who are themselves TCKs? What to share openly and what to conceal/withhold is the ongoing question for me as a therapist who happens to also be a TCK. Writing this guest blog post, then, is an exercise toward alleviating the internal conflict between my clinical superego and my authentic, “whole” self, which is, ideally, what I bring into the room when I sit with clients.

Yet another “world” I inhabit is that of a mixed-race, cross-cultural woman who was raised in a multiethnic household in California, Micronesia, and Japan in the 1960s and 1970s. Often I’ve struggled with disclosing or not disclosing my racial/ethnic background (which isn’t immediately visible to many—I often “pass”), in particular with multiracial/multiethnic clients. I wonder to myself: is disclosure of use to the client, or is it about my ego, anxiety, etc.? Do I withhold this information and allow the client to project what he needs to, or is there a way that sharing it with the client fosters healing, integration, and self-acceptance? This is something I often consider. I’m continually negotiating the internal “borderland” between my cultural/ethnic identities (Japan and California, primarily) and how it informs my work with clients.

Which brings me to the issue of pathologizing, an (in my view) unfortunate phenomenon that seems to come with the territory with Western psychology and psychotherapy. From the time we enter our graduate programs, the Western clinical model teaches us that the client is broken, wounded, maladjusted, “disordered,” etc., and comes to us to be put back together again. When it comes to TCKs, I prefer to consider the individual as intrinsically healthy and whole. If the client’s had retraumatizing experiences in the mental health system (i.e., she’s not been “seen,” acknowledged, and understood as a TCK) on top of what she’s experienced with unenlightened schoolmates, teachers, relatives, etc., she becomes symptomatic.

Although it’s not a new concept, what if it’s conventional society with its binary lens and a poorly informed mental healthcare system that are “disordered” and not the TCK? It’s all the more important, then, that the constancy and safe holding of the therapeutic relationship provide what the client didn’t get when he was growing up mobile and among worlds. Over time, we can help the TCK to develop a more cohesive and positive sense of self, one that’s also been enriched and deepened by his diverse experiences growing up as a TCK. In this way, we can avoid the trap of pathologizing him and meet him where he is.

Finally, when working with clients with complex TCK identities, I feel it is absolutely essential that we as therapists have done our own work in therapy to become more conscious, to process and mourn our losses, and to accept ourselves and our unique experiences as TCKs. Only then can we be fully present and available to our clients in the way they need us to be for their own development and healing.

Author: Mari L’Esperance, MA, LMFT

Mari L’Esperance, MA, LMFT is a relational, depth-oriented psychotherapist, counselor, and California Licensed Marriage and Family Therapist in Pasadena (Los Angeles County), where she works with adult individuals of all ages and specializes in working with Adult Third Culture Kids/Global Nomads and cross-cultural/multiethnic adults on issues related to unresolved grief, identity, belonging, connection, relationship difficulties, and other life challenges. You can read more about Mari’s practice at

Contributed by Kate S. Berger, MSc, Child & Adolescent Psychologist

“What do you want to be when you grow up?” “How do you spend your time?” “What are you passionate about?” “What’s important to you?” and my personal favorite – “Where do you see yourself in five years?” are questions that take some understanding of personal identity in order to answer. I am an expat – or a “culturally diverse individual” – and know first hand that answering these questions is not always easy because it depends who is asking, where I am when answering, and what I am doing when being asked.

Having a sense of self is supposedly grounding because it is the platform from which we step off of to interact with, and impact the world. For culturally diverse individuals, expats or third culture kids (“TCK’s” including intercultural and “global nomads”), this sense of self may not be formed as easily when the context(s) in which they live are changing. Why is this intercultural lifestyle a challenge to identity, and how can we support TCK’s to develop a (more stable) sense of self?

How is identity formed?

Having a sense of self is an individual putting meaning to their existence in a contextual manner. From very early on in development until middle age, an individuals’ brain tries to make sense of all of the information coming in from the outside world. It does this through a process called mylenation, in which basically the brain sorts a whole bunch of input, and the most important/useful/meaningful/relevant information is turned into knowledge that can be applied in a practical way. This process is the mechanism behind language acquisition or learning how to hit a baseball, and also what drives development of sense of self. Many things, including security, environment and stress, can impact it.

What influences identity?

The mylenation process in TCK’s gets the added bonus of complexity due to moving (changing environments). So any sort of habitual processing of information – e.g., developing an understanding of “Who am I” – actually becomes impacted by the relocation. What are the compounding factors?


Security is obtained in different ways at different points in our lives – studies show that babies will feel more secure when basic needs (like food, warmth, protection) are met; older kids and teenagers feel more secure when reciprocal communication needs are met (e.g., they need to feel like others are listening, and care about what they have to say). A sense of security seems to be pretty important when looking at how an individual is motivated to try new things and take risks, which are characteristics that can define one from the group (e.g., “Am I a risk-taker?” “How do I handle conflict?”).

For TCK’s, a sense of security is often at risk when they are in a new setting because they don’t necessarily know what their support system looks like, and they have new friendships that may not be completely reciprocal, at least initially (kids need to get to know one another first!).

I remember feeling pretty alone in the early days of living in Holland. My friends didn’t know me well enough to know that when I say, “I’m fine” what I really mean is, “Come over right away and cheer me up!” It has taken years (and even more effort!) to be able to explain that I’m this way, and feel that I have a real support system that is responsive to my needs. One can imagine how this sort of scenario would be challenging for a child with perhaps less verbal repertoire to even acknowledge and describe his/her needs in the first place. It can feel like the new environment is not responsive and as a result can affect the way a child engages with his/her surroundings.


You can’t have a conversation about identity in changing contexts for TCK’s without looking at how stress is involved. Things like saying goodbye to friends and family, starting at a new school, and having to adapt and re-learn cultural norms are stressful processes that these kids go through. The way in which an individual deals with the stressors is a factor in defining a sense of self – e.g., I am resilient, flexible, anxious, avoidant, etc. General perception equates being able to effectively handle stress with capability, but kids don’t come prepackaged with EQ (Emotional Intelligence) and coping skills, and need to develop these over time with support. So for a TCK that gets the message that he/she may not be adequately dealing, it can have a pretty negative impact on sense of self (e.g., “I can’t handle this” “I am not capable”).


Research is pointing to another compounding factor in this sense of self-discussion. Mindsets are the various perspectives and attitudes that an individual can operate from. Humans have the unique ability to make use of more than one, however research is showing that switching mindsets actually taxes executive functioning skills. What the heck does that mean?

It means, let’s say you spend a year in a monastery. Can you imagine the mindset – or state of mind – you’re in? Relaxed, few distractions, an internal focus perhaps. Now imagine you decide to relocate to New York City and BAM! there’s another sort of mindset needed (Sounds! Movement! People all around!). Through brain imaging studies and personal account we actually now know that switching mindsets effects the way an individual is able to deal with life: things like staying calm under pressure, making decisions, and even concentration abilities. So some of the ways in which this manifests, for example, is that individuals have big temper tantrums or emotional outbursts, they are unable to make choices, and have difficulties in academic settings. For TCK’s these executive functioning deficits can have a very big impact on day-to-day existence, and again can lead to an individual understanding of who he/she is in various contexts.

How can we support TCK’s so that they are able to gain a more stable sense of self?

  1. Create an enhanced sense of security. One of the most effective ways to do this is by giving TCK’s a platform or voice to share their experiences and express any frustrations (and accomplishments!) that they are dealing with. Being a good listener, asking questions and trying to take perspective are great ways to be supportive in this regard. Families and schools can make sure there is a structure to the support provided by having time set aside to address challenges.
  2. Teach kids skills to effectively deal with stress, because stress isn’t going away any time soon! Mindfulness based stress reduction is becoming a popular way to teach kids how to have present moment awareness to be able to effectively decide how to react in stressful situations. Research shows that this type of awareness not only enhances and an individual’s ability to react in the best possible way (to achieve most desirable outcomes, rather than acting on “auto-pilot” or in defense, for example) but also changes the way the brain engages and responds to stressful circumstances. It is as simple as taking a moment to turn the focus inward (asking yourself, “What am I thinking?” How am I feeling”) and the impact is great. Kids who have learned these types of techniques report feeling more relaxed, more empathic (towards themselves and others); and in a school setting there have been dramatic improvements seen in concentration and creativity skills – these kids actually perform better (as measured by standardized test scores).
  3. Limit the need to switch mindsets throughout the day. Schools can do this by effectively grouping certain activities/classes, and providing “switching space” where executive functioning skills are supported, e.g., take a 10-minute break in between study blocks to do something relaxing – research has long-supported this type of idea in the workplace (think about how business have allowed for exercise time, employees can bring pets into the workplace, etc.).

Finally, an important – if not the most important – thing to consider is that in this process of understanding a sense of self we need to remember that we are all individuals. Rather than trying to group others and ourselves inside our defined boxes of what’s “normal,” let’s make perspective-taking our goal in each and every interaction. By walking a mile in another man’s shoes we will be able to learn more about who we really are.

Author: Kate S. Berger, MSc, Child & Adolescent Psychologist

Child Psychologist Kate Berger, MSc, founded the Expat Kids Club, a private psychology/consulting practice that aims to help young people in the midst of transition. Typical areas that are addressed in practice include challenges relating to relocation, difficulties “growing up,” changes in family dynamics/relationships, confidence and cultural identity, as well as behavioral difficulties. In addition to standardized therapeutic models, Kate incorporates mindfulness-based cognitive therapy into practice. While assisting young people in their expatriate lifestyles, Kate intends improve the quality of life for the entire expatriate family, thereby increasing positive interactions with Dutch society and promoting successful international relations.

Contributed by Judy Hansen, MA

“Sometimes I feel like I don’t belong in my own family!” I recently said to a friend. This may sound strange to some, but to my friend, she got it immediately because she too had felt the same dissonance. What causes this? It’s when someone who grew up in many cultures starts to parent, and then realizes that the experiences are so different, it is hard to connect. It’s like learning a new culture all over again.

For example, I had to ask my kids about prom and homecoming. I had grown up in an entirely foreign school system. What were the rules and expectations? Dress code? What was the proper time to show up? When should I expect to pick them up? Hidden costs? Oh so many questions, I felt embarrassed asking them! I was the adult, I should know… yet I didn’t know who to ask without feeling stupid.

Then of course there were questions my kids could not answer for me: What was the role of PTO or PTA and what was the difference? If my kid was bullied, what were my recourses? What did Boosters do and what did it mean if I got involved? Should I let my daughter be a cheerleader, or were there aspects of that subculture that would create body image problems for her?

Then there was the whole global perspective. When my kids would tell me they met someone at school who was from Africa, I’d say, “Which country?” They’d give me a blank look, a “not this question again” look, because like so many North American kids, Africa is a country.

When they began studying history, we would have conversations on how each country writes history from their perspective. It told them it was important to learn, but with the knowledge that there is always at least two sides to the story.

I knew this, because I studied Brazilian history in Brazil. From that perspective, the Portuguese exploited Brazil’s natural resources, tried to rule over them and make laws from across the ocean; how they fought and won their independence.

Then I moved to Portugal and studied that same history from the Portuguese perspective. Now the history was that the Brazilians didn’t know how good they had it, they were selfish and ignorant. The Portuguese had given them so much. According to them, the king’s son who had grown up in Brazil, was a traitor because he fought for their independence. It was eye opening to read those two perspectives, both claiming to have the “real” truth.

I could go on and on about all the things related to raising kids in a culture in which I did not grow up. Many immigrants face similar issues. So much of culture is taken for granted, so no one really thinks to explain it. Because I spoke flawless English and looked American, I was automatically expected to know the American school system and all its culture. When I did not, I would get strange looks and suddenly feel like an “outsider” with a twist: I was an “insider” until I opened my mouth and asked questions. So I often tried to figure it out on my own.

As I reflect on my experiences, I expect my struggles are shared by many parents who grew up in another culture. The school system is a subculture that has its own rules, governance, expectations, and dress code. If the kids’ parents are foreigners, be it an immigrant, Third Culture Kid, Military Brat, or any number of other cultural backgrounds and experiences, they may be unaware of the new rules, and a culture clash ensues. I wonder how often disciplinary problems, homework issues, or lack of parental involvement could be alleviated by having a “Welcome to Our School” day, a shortened version of  “welcome week” at colleges and universities. This would be open to all who wanted to learn more how the school functioned, expectations, definitions of words that only schools use, like PTO and PTA, Boosters, and others. It could include a breakout session on making a good transition from the old to the new system. Perhaps out of this a resource panel or group could be formed, a place where the newcomers could go to get their questions answered without feeling stupid.

Does anyone else think this is a good idea? Would parents and schools benefit from this?
(Click link to comment. Comments welcome on Judy’s blog.)

[Originally published online at]

Author: Judy Hansen, MA

Judy Hansen was raised in Brazil and Portugal of American missionary parents. She held a dual nationality, American and Brazilian until the age of 18. She is a mental health therapist located in Denver, CO and enjoys helping all those who are struggling with transitions.

Contributed by Lois J. Bushong, MS, LMFT

March 21-23, 2014, I attended the Families in Global Transition (FIGT) conference in Washington DC. The conference is always a highlight for me as I learn about the latest studies on TCKs and the expat, pick up new books, interact with other professionals (i.e. counselors) on how to improve my skills in the counseling office, and just sit and talk with my old and new friends. This year was not any different, except the buzz of excitement seemed to be louder. It could have been because I was not distracted with giving a workshop this year; the new board was filled with positive energy or the larger number of new attendees. The days seemed shorter, and I left with my little iPad chucked full of ideas.

As I think back over those three days, the session that impacted me the most was a seven-minute talk given in the Ignite Sessions by Julia Simens, the author of “Emotional Resilience and the Expat Child.” Julia’s presentation was titled, “Beloved Stranger: Hired Help or Much Loved Reference Person”. Julia shared many stories and pictures of individuals from the host countries who had a big impact on her family. These were primarily the nannies of their two children.

My mind wandered back to my own stories and relationships with maids or housekeepers who lived in our home as I grew up in Central America. Although the countries and sectors were different for the Simen’s family, the bonding experiences were the same. A few of the women from our host countries who impacted my life as a child were Teresa, Amparo and Hermelinda. Teresa taught me how to use proper Spanish, rather then the choice words I was learning on the streets from my peers. Amparo demonstrated how to care for a small parrot and teach it to sing and talk as it sat on its small perch on the porch. Hermelinda quietly showed me the skills of making many of our favorite local foods that I continue to enjoy today. All taught me how to listen and withhold judgment with everyone who shared their workspace. These women were BELOVED strangers in our family tree. But to our family they were not strangers. They were wonderful friends and mentors.

The audience was with Julia as she talked and shared pictures of each of these important members of her family. We were like one group, listening and breathing together as she smoothly transitioned from one beloved stranger to another. That is, until she got to THAT picture.

It was a picture of a young person sitting who was fading into a brick wall. The photo is actually one from Brad Spencer’s collection of  “Amazing Brick Sculptures”. Here she began to talk about how the memory of the “Beloved Stranger” can begin to fade for the adults, but for their children they will not fade as they were among their important attachment figures. She talked about how these nannies and housekeepers must also grieve as they see “their” children whom they have come to love as one of their very own, move away, knowing they will probably never see them again. That was when I had to put down my iPad and dig out a Kleenex from the bottom of my book bag. Throughout the remainder of Julia’s talk, the adult TCKs were in tears while the expat parents were rapidly taking notes.

Once again, it affirmed in my mind what I already knew. Grief and loss is huge among the TCKs with whom we work. When we think we have tapped into all of the grief that has been buried there, we run into another deep vat of grief and loss. I have experienced this myself as an adult TCK over and over again.

I knew that I missed Theresa, Hermelinda and Amparo. But that afternoon I walked out of that session thinking, “Who helped Theresa, Hermelinda and Amaparo walk through the tremendous loss they must have experienced when my parents moved back to the U.S.?” ”How could we as a family have helped all of us in our goodbyes”? “Why did I not make it a point to go back to see all of them before they died”?

What picture or story comes to mind as your ATCK thinks back on that host country person who lived with them over the years? What are the feelings that are awakened? What values did they instill in you that you still claim? And what can you do to honor them today? Do my ATCK clients relate to the term “beloved strangers”? Thank you, Julia, for allowing me the space to stop, remember, and feel these much loved women who left a strong imprint on my life.

Author: Lois J. Bushong, MS, LMFT

Lois J. Bushong, author of the recently published book Belonging Everywhere & Nowhere: Insights into Counseling the Globally Mobile, ATCK, Licensed Marriage & Family Therapist, writer and international speaker.

Contributed by: Paula Vexlir, Registered Clinical Psychologist

As expats we tend to understate grief. Maybe because there is so much to get done that you feel that there is no time for sadness, maybe because you need to show yourself strong in front of the children or your spouse, maybe because you have such a great opportunity (or better lifestyle) so who are you to complain, right? But grief doesn’t go away for lack of acknowledgement, instead it gets deeper inside ourselves.

Grieving is the normal reaction to loss. When we consider expat life there is always loss: it might be a specific place you liked, or a job, or close friends, relationships, food, weather, language, even smells could be felt as losses.

When we hurt our body we don´t hide the wound, we don´t cover it and just continue with our lives. If we leave it unattended chances are it might become infected and we could end up with a much more painful experience. When we pretend everything is fine and we hide our pain, our grief, we are doing exactly the same thing. We are encouraging an infection.

Grief is a normal emotional response to a loss and expat life is full of them. Unfortunately, among expat communities there is not much “permission” to talk about this. Unresolved grief is commonly found among expat communities. Sometimes it could be due to lack of awareness, maybe some hidden losses, or lack of permission to grieve, a lack of time to process, etc…

It is crucial that you allow yourself to go through the grieving process. This does not mean to be negative about your new life but to allow yourself to find out whatever you might be feeling about things left behind.

Acknowledgement means a lot more than it seems to. Recognition and validation of our feelings are crucial for resilience. Placing words on our emotions is important for the healing process to begin. Allow yourself to mourn your losses, accept the sadness, whatever your might be feeling, give yourself permission and embrace it. Grieving is tricky; all the unresolved grief comes back to you with each new loss.

So the holiday season becomes even more complex since we tend to look back, analyze how the year went, our gains and our losses and plan for the New Year. What could be better than a fresh start, right? But we need to cry for our losses to get one. There is no way to go through the experience “unmarked”. Back to the wound example, with the appropriate treatment, we can prevent the infection. The scar will not disappear. That´s right, you will still have those marks but it doesn’t hurt anymore. Just as in our body, our expat life can shape us. It is an experience that might change us but we will not necessarily be traumatized by it. Acknowledge of losses and grief will allow us to live a more fulfilled and enriched experience.

[Originally published online at Expatriates Magazine.]
[Article also available in Spanish.]

Author: Paula Vexlir, Registered Clinical Psychologist

Paula is a Psychologist that supports the Spanish-speaking expat community worldwide. For more than ten years she has been providing counseling to expats for their acculturation processes (cultural adjustment, parenting issues and trailing partner´s challenges) and for any other situation they could be facing. By offering an online service she can support Spanish-speaking expats worldwide.

To learn more, check out Paula’s ITD listing, website, and facebook page.

As you may have noticed, for as much growth as the overall ITD site saw this past year, the Blog portion was quite in 2013. For the most part, that was largely due to those energies being redirected toward coordinating the quarterly ITD Newsletter for Members. Now, while those have been quite well received, it has been a fundamentally behind the scenes kind of effort.

I have enjoyed what the Blog portion of the site has been able to facilitate in the past, and there is nothing quite like a New Year to help frame my dreams for its revival. What follows is the introduction of a structure through which ITD Members can contribute guest ITD Blog posts throughout the year, seeking to further build community and highlight the work of various internationally minded therapists around the globe. Here are the details…

If you are a current ITD Member, you are welcome to contribute a guest ITD Blog post to be published here on the site.

Guest posts are to meet the following specifications:

– theme is to be directly related to TCK and/or International Expatriate matters

– length is to be no more than approximately 1,000 words

– a short 2-3 line author bio is to be included

– contributions are to be emailed to in Word

– contributions will undergo a review process as needed

– contributing content for a guest post does not guarantee publication

Those guidelines in place, I believe this invitation holds all kinds of promise for 2014 and beyond. I’m looking forward to interacting with Members over contributions and keeping the ITD Blog portion of the site active with new content over time. Further, the opportunity to make comments will be facilitated through the ITD Forum portion of the website, starting right here.

Cheers to 2014!!

This month marks an important transition for the International Therapist Directory. While non-profit sponsorship enabled the ITD to get up off the ground, it has been running independently for over two years now and has been growing steadily along the way. Growth is exciting, and it takes many forms. However, the current form of growth is more about maturation than numbers. Yes, the ITD is growing up!

The ITD has been, and always will be, about providing a service to the internationally mobile community. Mental health therapy is a service-oriented profession, whether that profession takes the form of an independent business, an agency practice, a ministry, or some kind of hybrid model. The ITD itself is designed to be an outpouring of that service mindset. It is a resource. And like any resource worth its salt, relevance and sustainability are vital.

That in mind, the ITD is moving to a Membership Model. What this means from a bottom line perspective is that listed therapists will more formally agree that they meet the stated requirements to be listed in the directory and they will pay a nominal fee of $35 (USD) annually to have their information listed in this important online resource.

For those of you curious about more than just the bottom line, read on…


The new Membership process asks ITD listed therapists to formally agree that they are “a professional mental health therapist with a therapy practice who is credentialed at a masters level or higher in a psychology/counseling related field with a thoughtful understanding of the TCK and international expatriate experiences.“ It is still true that those compiling the directory offer no specific endorsement of any of the mental health therapists listed and do not claim responsibility for the accuracy of the information provided, simply cataloging entries as self-reported by each therapist. However, the ITD has a specific focus, and this more formal membership agreement is intended to help further clarify how important the integrity of each listed mental health therapist is to maintain the stated ITD standards and purpose.


In reflecting on the years past and the anticipated years ahead, one of my key goals in making the ITD increasingly sustainable is to create a working budget. While the past two years witnessed a strong foundation laid out of my own personal resources, I believe more can be accomplished with some additional partnership. There are many ways to generate funding. I have elected to ask listed therapists to directly partner with my efforts. That said, the price-point for membership is intentionally set quite low. For less than $3 (USD) a month, therapists can have their information cataloged in the directory. The reason for the low price-point is that I do not want finances to be a barrier for qualified therapists who want to be listed. However, setting any price-point at all does ask listed therapists to take their listing more seriously. My hope is that with this investment comes increased motivation to keep listed information current. It also asks listed therapists to directly support the site, helping to cover operational costs and contribute resources to allow for future ITD promotional efforts. It is my sincere hope that the financial support generated this way will free me up to invest even more of my time and energy into enhancing the site and promoting the ITD globally.


Another kind of service the ITD has been providing is to make way for internationally minded mental health therapists themselves to connect, encourage one another, and develop professional relationships. To this end, a beginning has been made through efforts with the ITD Blog, the ITD Forum, and the initial stages of some regular ITD Newsletters. However, this is just the beginning. There is tremendous room for growth in this area, and it is my hope that moving to a Membership Model will greatly enhance opportunities for developing these efforts. The past has been solid, and the future is bright for the International Therapist Directory. If you are a mental health therapist reading this now who meets the qualifications for being listed in this online resource, I hope you will register, support the site, and support the TCK and internationally mobile community with your listing. It’s an important service, and together, we can have even greater impact.

To leave comments, please visit the link in the ITD Forum here.

Harriet Cannon is a licensed Marriage and Family Therapist and Mental Health Counselor with 25 years experience in the US and internationally. She helps individuals, professional groups, and organizations create satisfying connections in their intercultural relationships, and success in their professional environments. I had a chance to interact with her recently about some of her exciting work. What follows is our brief interview…

Josh Sandoz: Harriet, you have an extensive history working as a mental health therapist in the United States and in other parts of the world. Can you share a little about your background in that work?

Harriet Cannon: I believe that insight about how our historical-cultural-socio-political context affects us is key to our relationship success. My parents were from diverse regions and religious backgrounds, although they were both born in the US. My family experience greatly affected my choice to become a marriage and family therapist and to be involved in intercultural work. I have over 25 years experience as a therapist in the US and in South America. In the last 15 years I have been working primarily as a therapist with people in multiethnic and multicultural relationships in private practice and with corporate clients expatriating and repatriating all over the world.

JS: In recent years you have transitioned into providing services as a consultant and trainer specializing in multicultural, multiethnic identity, and relationship dynamics. What is that work like, and how is you enjoying it?

HC: Raising my own daughter in Chile for some years peeked my empathy for immigrant parents. We lived on the economy with very few native English speakers to interact with. About 10 years ago, I decided to do some anecdotal research. I interviewed 47 immigrant mothers and their adult daughters looking to get insight on mother’s experiences raising a daughter in a culture not her own. I was so taken by the stories that I gave a presentation on my findings at the annual International Family Therapy Congress in 2005. That was the beginning of my shift to a focus on presenting, teaching, and writing about multicultural relationships. I am having a blast.

JS: From your experience, who might best make use of your services, and how would they go about contacting you?

HC: I take referrals for individuals, couples, and families in cultural transition; expatriating and repatriating. I also give presentations for mental health professionals, individual or group consultation for mental health professionals, schools, and community groups. I will create a training tailored especially for a group.

JS: Do you have any upcoming seminars on the horizon?

HC: Yes there are three full day workshops with CEU’s for mental health professionals.

My colleague, Rhoda Berlin, M.S., LMFT, and I have two upcoming trainings for mental health professionals in 2012:

‘Family History and the Immigrations Story in Therapy’

May 19, 2012 in Renton, Washington

‘21st Century Faces; Multiethnic Families and Identity’

September 21, 2012 in Seattle, Washington

I also  have a solo training:

‘Global Families and the Immigration Story’

October 17, 2012 in Santa Barbara, California

To contact me:



Telephone: +206 780 3843

JS: As we finish up, are there any exciting resources you often find yourself recommending to others who are interested in developing their thinking around multicultural, multiethnic identity, and relationship dynamics?

HC: My favorite recommendation is to choose the genre of fiction you most enjoy and read books where the story theme is intergenerational relationship dynamics or multicultural relationship dynamics. For example, anything by Amy Tan. Her books take into account many perspectives rather than MY story memoirs. Memoirs are great but don’t have a variety of relationship perspectives. Also movies, for example: ‘Real Women have Curves’, ‘Grand Torino’, ‘Lost in Translation’.

For non-fiction, a few favorites are:

‘Working across Cultures’ by John Hooker

‘American Nations: the history of 11 Rival Regional Cultures of North America’ by Colin Woodard

‘The Geography of Thought’ by Peter Nisbett

‘Cosmopolitan Communications: Cultural Diversity in a Globalized World’ by Norris and Inglehart

Rhoda Berlin and I are working on a book on Multicultural couples. We’ll let you know when it is ready for publication. Hopefully before the New Year.

JS: Thanks Harriet, for the work you are doing and for sharing more about it with us today.

As the number of families and individuals who live outside of their passport culture(s) continues to grow, the arena of Cross-Cultural Transition Consulting is a needed and developing area of focus. Like with any subject matter, some professionals active in the work really stand out as champions in their field. Libby Stephens is one such consultant.

I’ve had the privilege of working alongside Libby for a number of Third Culture Kid Transition Seminars over the years, and we recently took the opportunity to swap interviews. You can follow this link to a short video with the two of us from this past Spring, and then keep reading what follows to listen in on a few additional questions I asked of Libby right here. Enjoy!

Josh Sandoz: Can you share with us what kinds of services you provide for the TCK and internationally mobile community?

Libby Stephens: Josh, my goal is to be able to help anyone in the globally mobile community understand and humanize their transition experience. This includes individuals, schools and businesses. For example, I regularly visit international schools around the world working with departing students and conducting in-service programs for their faculty and staff. Each summer I am involved in two weeks of orientation for teachers who are new to living internationally and working in international schools. And of course, one of my favorite assignments is teaching alongside you Josh as we work with TCKs who have returned to the US for university or high school! The rest of my year is pretty much a non-stop research project around all aspects of transition and TCKs so that I ensure I am relevant the rest of the year.

JS: How did you become so passionate about TCKs and matters concerning transition?

LS: I grew up highly mobile. Though I never left the US until I was 17, I always knew what it was like to be the new kid in school. Along with that, my parents often hosted international students and TCKs, though we never knew there was a name for them, in our home. I loved hearing their “and then we went to” stories and often felt some of the same sadness when they talked about missing all the places where they had lived.

Shortly after my university studies in Behavioral Science and Counseling, I began a job at a boarding school in Europe. And that was it. I was hooked. TCKs became my passion. I met David Pollock in my second year there and began working with him at Transition Seminars every summer. Even now, after returning to the US in 2002, I look forward to working with TCKs every summer as they begin life in the US.

JS: Are there any exciting projects or initiatives you have been involved with recently or have coming around the bend?

LS: This past Spring I was involved in a three day Think Tank on Third Culture Kids. The small group of about 12 people began thinking through the TCK Profile and the issues TCKs face in the 21st century. I am looking forward to refining some of our thoughts and findings. This of course means more research needs to be done.

Another exciting project that I have the honor to be a part of is The Transition Institute. This initiative is still on the drawing board but I have great hopes that along with author Debra Rader (New Kid in School) and Shabbi Luthra of the American School of Bombay we will conduct transition and TCK training for educators. We are planning this for the summer of 2012 in Tuscany.

JS: If a group or organization would like to hire you as a speaker or consultant, how can they be in touch?

LS: Josh, it is my passion to come alongside schools, businesses, governments, families and individuals on issues surrounding transition, the Third Culture Kid and cultural adjustment. Anyone who is interested can go to my website,, check my calendar for availability and book me through a simple form there.

JS: Libby, thanks so much for sharing some thoughts with us here today. As we finish up, I wanted to ask, what makes you such a strong advocate of the International Therapist Directory?

LS: I am a strong advocate of the International Therapist Directory. It is important to mention that people can get help with some of their cross-cultural adjustment issues, TCK issues, and family adjustment issues without having to return to their passport country. Many times the struggles that are faced in the first year can be dealt with quickly if they just have someone to talk to. For far too long, parents have felt helpless when trying to find help for their families. Marriages have suffered as couples have tried to successfully live internationally. I am so very glad you had the vision to put the International Therapist Directory together. What a gift for the international community!

JS: Thanks Libby! Those are kind and thoughtful words. All the best in your work!

Tina Quick is a cross-cultural trainer and international speaker. Founder of International Family Transitions, she specializes in helping students who have been living outside their passport countries successfully manage their transition to university, whether they are returning to their home country or going on to another host country. Tina also works with individuals, families, schools, agencies, and organizations that support TCKs and international students through providing seminars and consulting services.

Accordingly, Tina has written an excellent book, published in the spring of 2010, called The Global Nomad’s Guide to University Transition. I highly recommend her book, as it is full of thoughtful anecdotes and sound practical advice, a fun and informative read. I recently had the honor of asking Tina a few questions about her work and her experience writing, and you can find her interview here after the break:

Josh Sandoz: Would you mind sharing a little about how you came to be so passionate and thoughtful about the TCK experience?

Tina Quick: Sure! A good friend who is a psychologist that works with transitioning missionary families first indicated that I might want to pay attention to my family’s upcoming repatriation since it is sometimes more difficult going back home than going abroad. She reinforced what I had heard years earlier about TCKs through the tutorial she gave me. That’s when I read Pollock and Van Reken’s Third Culture Kids: Growing Up Among Worlds for the first time. Once we were back in Boston I began running into many TCKs I had known from our family’s overseas postings who were attending the various colleges and universities in the area. I was hearing the same familiar, but sad themes over and over again from these bright, talented and gifted students – feelings of not fitting in, not connecting with their peers, feeling like a fish out of water, alienation, isolation and sometimes severe depression.

JS: You’ve recently written a book, The Global Nomad’s Guide to University Transition, published summer of 2010. Great book! What convinced you that this book needed to be written?

TQ: In talking with one TCK college student after another, I was woken up to the fact that these kids really are very different from their home country peers. They often don’t realize they are different until they step out that third culture where they enjoyed a sense of belonging with others of shared experience. They don’t realize it is their life experiences that make them different from most of the people they are surrounded by on their college campuses. Once they understand this they are then able to embrace their differences and use them in positive ways in their lives, on their campuses and in their futures.

JS: What was the writing process was like for you?

TQ: I did a lot of research, reading and talking to the experts before starting my business and taking transition/re-entry seminars into international schools. Sadly, the seminars were not as well-attended as I and the school administrators had hoped. Many students truly felt they did not need to be told how to go “home.” So I decided to put my seminar into a book that parents or others could place in their students’ hands as they were leaving for college. It would serve as a useful handbook for their transition whether they read it in full or only turned to when in dire straits. Since I already had the seminar in full swing, the first draft went rather quickly.

JS: Who do you hope reads this book and what do you hope they come away with after reading?

TQ: There are several categories of people that would benefit by reading this book.

–       My hope is that students who have been living outside their passport country and are returning for college or even high school will read it. While it goes into a lot of the practicalities of college life, the psycho-social/emotional issues are relevant to both high school-aged and college-aged students.

– Students who have been living outside their passport country but are transitioning on to another host country for college will have the same experiences because of the fact that they have stepped out of that third culture and will be surrounded mostly by those with whom there is no shared experience.

–       Even students who are moving to a new culture for the university experience will find this useful as they will go through the same stages of transition as TCKs and the book will help them understand that the stages are predictable and normal.

–       There is a chapter that has been written specifically for the parents to help them  prepare and support their global nomads in the university transition.

–       And lastly, my hope is that institutions that either send or receive these students on either side of their transition will read it to understand what their challenges are and how they can help students either leave or enter well, whichever the case may be.

JS: Outside of writing, in what other ways are you involved in the lives of TCKs and the internationally mobile?

TQ: I spend a lot of my time trying to spread awareness of the TCK experience amongst institutions of higher education, international schools, agencies that send families abroad and mental health counselors by giving talks and workshops as well as presenting at conferences. Another sphere of my work involves serving as a resource consultant for relocation companies that give cross-cultural training to families that are either expatriating or repatriating. I am often called in to talk about international parenting and third culture kids. And lastly, I am serving, along with you, Josh, on the advisory committee of TCKid, a non-profit community of over 21,000 members dedicated to help Third Culture Kids connect and find a sense of belonging.

JS: Thanks Tina! It’s an honor to know and work with you. I wish all the best to you and International Family Transitions as you continue working to serve the global TCK community.

In my last post, I highlighted IMHPJ, a professional support network for expatriate mental health therapists living and working in Japan. Since I believe that quality support networks are important for mental health therapists, I wanted to highlight IMHPJ as a network that has established a good working model for others who may wish to develop something similar in their own part of the world.

A shining example, Shanghai International Mental Health Association (SIMHA), is one such group! Founded in 2008 by Dr. Lauren Muhlheim, SIMHA has directly modeled their association after IMHPJ, having adopted the same Constitution, Code of Ethics, and Mission Statement.

To my delight, SIMHA’s founder, Dr. Lauren Muhlheim, and current president, Barbara Shaya, agreed to answer a few questions, that we may all be enlightened by their experiences with leading SIMHA. Further, Lauren is listed here and Barbara is listed here in the ITD.

The interview follows:

Josh Sandoz: How did SIMHA get started?

Lauren Muhlheim: I arrived in Shanghai in January 2008, and by February I had started working part-time at the community center. In May, I also took a job with Parkway Health. My appointments were booked by a call center so I couldn’t screen my clients to make sure that they were appropriate for my practice. I tried to identify other English-speaking clinicians in the community with whom I could consult or refer patients to.  Every school and organization had a different list of clinicians and most of the lists were out of date due to the high turnover of expats. I met other clinicians both through my affiliation at the community center and randomly at other events such as my child’s soccer game and a pearl stringing class. I became preoccupied with creating an accurate and thorough list of who was really practicing psychotherapy in Shanghai. At the same time, I was working with a student at an international school who was moving to Japan. The school counselor at that school stumbled upon the IMHPJ website and told me about it. I convened the first meeting of therapists practicing in Shanghai on October 29, 2008. The turnout was great; 17 practitioners who were all excited to connect. We then formed a steering committee to build the organization.

JS: What are the core purposes of SIMHA?

Barbara Shaya: To improve the quality and accessibility of mental health services to the international community in Shanghai by: verifying to the extent possible the credentials of professionals, providing a forum for networking and professional workshops, maintaining an up-to-date database of practicing mental health professionals in Shanghai.

JS: How important was your interaction with IMHPJ as you began your process?

LM: Our interaction with IMHPJ was critical. First of all, it gave us a model for our organization. I doubt that we would have formalized the organization beyond a networking group if we didn’t have their lead to follow. In addition, they were very supportive of our efforts and shared their advice and 10 years of experience. Lastly, they allowed us to copy and modify for our own use their mission statement, constitution, and ethics code, which saved us a lot of work.

JS: What is your vision for SIMHA’s future?

LM: It is my hope that SIMHA will continue to be a resource to the foreign community in Shanghai. By helping clinicians get integrated into the counseling community and make them available to clients who need their support.

BS: Having other professionals with which to connect is critical in our field. Working in isolation is detrimental to the ability to provide continuing care to the community. SIMHA helps clinicians ‘hit the ground running’. My personal experience is that when I was preparing to move to Shanghai, I found the SIMHA website and contacted Dr. Lauren Muhlheim. She encouraged me to join SIMHA and referred me to some select individuals within the community so I would get an idea of what needs and resources were in the community and how I might best fit in. By the time my shipment arrived and I got my office set up, I had referrals waiting. I jumped right in.

JS: Any advice for other expatriate therapists in other parts of the world who may wish to establish their own local network of mental health professionals?

BS: Yes, you don’t have to start from scratch. There are others (like IMHPJ and SIMHA) who have gone before you and are willing to help you get started. Within the expat communities there is a significant need for mental health services – the faster people can find you, the better!

JS: I want to thank you both, Lauren and Barbara, so much for your time, thoughtfulness, and generosity in engaging these questions. SIMHA, along with IMHPJ, have set a standard, and I’m grateful for your leadership and ongoing example.

As practicing clinicians, we at the International Therapist Directory know firsthand the importance of having a supportive professional network of fellow practitioners available to grow alongside while engaging in clinical work. However, for therapists living the expatriate lifestyle themselves, finding such a network can be a real challenge.

In light of that reality, International Mental Health Professionals Japan (IMHPJ) have been pioneers in developing a professional support network for expatriate mental health therapists living and working in Japan.

Though the wonders of the Internet, I had the opportunity to interview Reggie Pawle, a past IMHPJ president and member since 1999.  Reggie is also listed here in the ITD.

Josh Sandoz: Reggie, in brief, how did IMHPJ first come to be formed in 1997?

Reggie Pawle: IMHPJ was formed as a result of services provided by psychotherapists to victims of the Hanshin Earthquake in Kobe, Japan, in 1995. During the process of assisting people in need, which continued for quite a while after the earthquake, psychotherapists in the area came in contact with each other. They realized their services would be improved by an organization that would facilitate continuing education, case discussions, and networking.

JS: What are IMHPJ’s core purposes?

RP: According to the IMHPJ website, they are:

– Maintaining an up-to-date database of professional therapists
– Providing a forum for discussing and making co-ordinated joint efforts related to important issues or events
– Encouraging a high standard of ethical and professional performance for mental health professionals
– Providing opportunities for continuing education for members
– Facilitating peer support and networking among members and with related Japanese mental health organizations

JS: What have been some of the benefits of establishing and maintaining IMHPJ over the last 14 years?

RP: One of the prime benefits has been to create a community of English-speaking therapists in Japan, so therapists are not isolated while working in a foreign country. Another benefit is expanding a referral network for both receiving clients and referring clients with specialized needs to qualified professionals. A third benefit is to provide credibility and standards for English-speaking clients who are seeking qualified, ethical psychotherapists. A fourth benefit is having a website, which really helps both therapists and clients find each other and coordinate services in this internet age.

JS: What have been some of the challenges?

RP: One of the challenges has been ethics, as some psychotherapists in Japan had been practicing with ethics that created problems with clients. Another challenge has been motivating psychotherapists to participate and contribute efforts to the functioning of the organization. A third challenge has been trying to decide what defines a “qualified” psychotherapist, because the standards of certification vary greatly around the world.

JS: What advice would you offer expatriate therapists in other parts of the world who might wish to emulate your association by establishing their own network of mental health professionals?

RP: I would say be gentle and persistent, and don’t compromise on your standards. It is important to offer benefits, like a website that helps get clients, and to offer quality psychotherapy events that draw people to attend and participate.

JS: Reggie, thank you. We appreciate your time and the efforts of IMHPJ. When it comes to establishing expat therapist networks, IMHPJ is an inspiration. Thank you for helping the rest of us to learn from your experiences.

The International Therapist Directory team is growing into… well, into a team!! For the past two years I’ve largely been pioneering this effort on my own, with lots of great support and encouragement along the way. However, I am thoroughly delighted to announce today that a local friend and colleague of mine, a Seattle-based therapist already listed in the ITD, has come on board behind the scenes to roll up her sleeves and help the ITD reach new potential.

Talitha traveled extensively throughout both her childhood and adult years, and her commitment to the internationally mobile community is reflected in both her counseling practice and in how she plans her yearly calendar. I am thankful for her keen interest in the ITD and in seeing quality mental health services become increasingly available for expatriates the world over.

To celebrate the reality of team, our initial joint effort, and the ITD’s next step toward increasing our online presence, was launched last night. That’s right, the ITD now has its very own facebook page. Please visit, “like,” and spread the word accordingly. Your partnership will lead to important further growth, as this is just the first of several new site upgrades planned for 2011.

Will you join us?

Since launching the International Therapist Directory, I have interacted with many professionals who have services to offer the internationally mobile community outside the scope of mental health therapy. One such service is the field of international educational consulting, and one such consultant is Rebecca Grappo (M.Ed., C.E.P.).

Rebecca has been an educator for over 20 years and has been an active supporter of the International Therapist Directory. In addition to her native United States, she has lived in Italy, Switzerland, Luxembourg, Costa Rica, Nicaragua, Portugal, Jordan, Oman (twice) and the United Arab Emirates. She speaks English, Italian, Spanish, Portuguese, French, and German.

I had an opportunity to ask Rebecca a few questions via email recently to gain a broader understanding of how international educational consultants can be of support to both internationally mobile families and therapists alike. Here is how that conversation went…

Josh Sandoz: For those who don’t know, what is the role of an educational consultant?

Rebecca Grappo: The international education scenario is unique in various ways that all of us who are expats know and understand. By working almost exclusively with TCK students and families on a wide variety of issues related to making informed educational choices, this is a population I understand well. Many of these challenging issues include working with kids who struggle, whether it is academically, socially, or with a mental health issue.

I can help a family to evaluate various schools and programs that meet the student’s individual needs, from traditional boarding schools, boarding schools with learning support, or therapeutic schools and programs. I have visited several hundred schools and programs around the United States and approach each student’s situation as one that is unique.

JS: In what ways can an international educational consultant be of service to TCKs and the internationally mobile community?

RG: Very often, the resources available for learning support and/or mental health support in the international setting are extremely limited. Or, I see kids who have been in the hands of an excellent therapist but the issues need more support than is available in the international school setting. After all the options overseas have been tried, if things are not improving, then we need to look elsewhere. Relying solely on the Internet for a complex situation can be downright dangerous.

So families and therapists alike rely on the experience and guidance of someone who has visited or placed students in various schools and programs. Furthermore, when I have a student in a program, I remain in touch with the program therapist over the course of the treatment. Therefore, I have many opportunities to discuss the characteristics of TCKs, and suggest probing questions that the therapist might use with a student to help understand the complexity of issues they are facing.

JS: How can it be helpful for a practicing mental health therapist to know about the services that international educational consultants provide?

RG: Many of my students are referrals from other mental health professionals. We work as a team to understand the situation and issues, then help the family to make informed decisions about what might be best for the child or adolescent. It’s not imperative, but I think it’s in the best interest of a client if we all remain in touch