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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 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.

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.

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 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.

THERAPY IS NOT READING YOUR MIND:

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.

YOUR THERAPIST IS A REAL (FLAWED) PERSON:

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!

THERAPY IS NOT ELIMINATING YOUR PROBLEMS:

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.’

THERAPY IS A LIVING THING:

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 IS NOT EASY:

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.

THERAPY IS PARADOXICAL:

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.

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 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 Paula Vexlir, Registered Clinical Psychologist

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: expatkidsclub@gmail.com. For more information about Mindfulness in Schools Project, please visit: www.mindfulnessinschools.org.

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.