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 netpsy@netpsychologist.net or phone: 913-991-2302.

Footnotes:

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.

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 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. (www.figt.org) 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

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).

Contact: phippstherapy@pm.me

For further information on rareminds – www.rareminds.org

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

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

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.

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 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 (www.figt.org) 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: counseling@figt.org and join us on Facebook (https://www.facebook.com/groups/429869267542130/)

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: https://www.figt.org/2020-Conference

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 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.

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 www.herosjourneytherapy.com.

Contributed by Lindsey Anderson

[This ITD Guest Post was originally published on www.knowitall.ch.]
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 knowitall.ch, “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
lindseyrome@yahoo.co.uk

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 www.susandellanzo.com for more information.

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 www.kaybruner.com.

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 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.