Mental Healthcare in Switzerland: Options for Finding a Psychologist

Finding the right support in a foreign country can be challenging
Finding support in a foreign country can be challenging

Given this recent study from Oxford University which shows that mental health conditions can influence life expectancy in the same way that heavy smoking does, I am reminded of the importance of access to effective mental health services. It can be challenging enough to find a psychologist or psychiatrist or even a knowledgable general practitioner in your country of origin. When abroad, that challenge is increased by the daunting prospect of making appointments in another language and consulting your health insurance to see what kind of coverage is provided for psychological care.

Given Switzerland’s unique geographic location, currently lucrative economic position and excellent reputation for providing high caliber post-secondary education, it is a country highly frequented by increasingly mobile individuals from around the world. It is a small country with 25% of its workforce comprised of foreigners, which makes this land-locked alpine nation a truly international mileu.

Despite its picturesque setting, expatriate life here can be difficult. Those who move here often do so at great personal cost- leaving behind social support networks, established careers, and affordable childcare. Given the stress of the transition, these individuals are at higher risk of developing adjustment reactions or other mental health issues, including but not limited to major depression (often with postpartum onset) and anxiety disorders. Moreover, coverage of mental healthcare is expensive here, requiring the purchase of a “complementary” insurance plan that most families do not buy. For non-native residents, finding affordable mental healthcare providers with legitimate qualifications and that fluently speak their language is an almost impossible task.

However, the organization in Switzerland that regulates psychologists (basic training) and psychotherapists (specialty training to provide psychotherapy) provides a search engine to help you find someone that matches your language needs and location. It can be found here.

Although this regulatory body is necessary, there are also a number of therapists and counselors from other countries who provide psychological services. Usually the services they provide are lower cost as they will not reimbursed by the complementary insurance plans. In selecting one of these providers, proceed with caution. Ask about their training and credentials. Ask them why they have not obtained FSP certification.

In some cases, like my own, the training provided in North American universities to licensed psychologists/psychotherapists is not easily translated into Swiss standards given that the American and Canadian training structure is more targeted and applied versus the Swiss graduate training structure. As of yet, there is no treaty between North America and Switzerland/Europe to facilitate easy recognition of the academic credentials of psychologists.

However, the need for native-English speaking psychologists is plainly there, particularly in the French-speaking part of Switzerland and in Zurich where an international workforce thrives. If you are searching for support to address a mental health issue, the “fit” between therapist and client is critical. Research indicates that people who participate in therapy overwhelmingly benefit from it, especially when there is this good fit between the therapist and the client. Part of this good fit is feeling understood and connected to the provider and the odds of this are increased when the provider fluently speaks a language in which you feel comfortable expressing your thoughts and emotions.

Finding psychotherapy when living in Switzerland is difficult but not impossible. Given what is at stake, it is worth the effort needed to find an effective and reputable mental healthcare provider.

(Image courtesy of Kittikun Atsawintarangkul / FreeDigitalPhotos.net)

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Working with Difficulty: Mindfulness and Grief

Grief is unavoidable but how we respond to it influences its impact on us.
Grief is unavoidable but how we respond to it influences its impact on us.

“Only people who are capable of loving strongly can also suffer great sorrow, but this same necessity of loving serves to counteract their grief and heals them.”

― Leo Tolstoy

As long as we love and care about things in our lives, we open ourselves up to the possibility that these things could end. In loving people, places, pets, and circumstances, we are vulnerable to grief when they are lost or change. However, these attachments are part of what makes humanity work. We have evolved to be creatures that have the ability to form these bonds and connections, and ultimately this ability increases our chance of survival.

You might say to yourself, “Yes, yes, sure- I’ve got it. Grief is necessary. But it still sucks.”

Just like pain, grief is unavoidable. However, the way in which we choose to respond to or engage with grief can have a significant impact on the degree to which it impairs our functioning or makes us more reluctant to cultivate future attachments. Oftentimes, it is the thinking that almost automatically accompanies pain or grief that keeps the suffering alive. For instance, the idea that this suffering is intolerable, undesirable or that is it unfair. These kinds of thoughts can unintentionally kindle secondary emotional processes, like anger or anxiety. And this muddies the emotional soup of grief.

Imagine bringing mindfulness to grief. What would it be like to invite the grief in to your “guest house” and to experience it as it is- just in one particular moment? Is it possible to cut down on the clutter of thinking that surrounds that particular emotional event and to simply ride the wave of the sensations associated with grief? Perhaps your grief feels like burning in your stomach, or tension in your chest, or numbness. There is no correct way to grieve or appropriate timeframe for moving on; there is only one certainty:  the only thing you can really experience is the current moment and the myriad sensations that abound. So, why not stay with it as it is without projecting backward or forward with thinking?

Today on my commute, there was an announcement in the train station that the train would be delayed due to “an event involving a person.” In Switzerland, that is terminology used when an individual has fallen or jumped in front of a train. On the platform, you could feel the collective horror as people went silent, shifting uneasily on their feet, looking at the floor. My stomach twisted and I experienced an unusual sinking feeling that indicated to me that I was feeling grief.

In that moment on the platform, I imagined that we commuters shared a common emotional experience. And that shared humanity in the face of difficulty was a reminder that grief and our symmetric capacity to love unites us all.

(Image courtesy of David Castillo Dominici / FreeDigaitalPhotos.net)

Driving while Mindful

Have you ever driven while under the influence of mindfulness?
Have you ever driven while under the influence of mindfulness?

A few people have recently remarked that they feel most mindful during their morning commute.  And these thoughtful admissions have caused me to reflect on what it is about driving to and from work that facilitates mindfulness…

There is the solitude (if you don’t carpool) and the freedom of being in your own space.

There is the routine of it all.

There is the endless forward momentum of the vehicle, an inertia which can often match the cadence and speed of our own thoughts.

There is the inability (unless you are multi-tasking) to impulsively act on any thoughts, in order to remain focused on the road and the task at hand.

There is a requisite heightened awareness to the moment that persists until you pull off the road and as a result, sometimes our vehicles can be environments where emotions are more fully present than in other parts of the day, where distraction is more available.

All of those variables combine to make commuting a surprisingly organic environment in which to practice mindfulness. While driving, you have a chosen point of focus: the road and the complexity entailed in responding immediately and effectively to a particular stimuli. You are intentionally reorienting yourself to this chosen point every time that your attention shifts elsewhere, and likely you do so without judgement. You simply notice you were too caught up in something that was a distraction and bring yourself back into the chosen activity of the moment.

The routine of the weekly commute also makes this an excellent opportunity for placement of a “mindfulness bell,” wherein you are reminded each time you start the car or put on your seatbelt to check in with yourself and with that moment. It can be a cue to come out of automatic pilot and engage fully with that moment, starting a habit that may give your daily routine an infusion of intentionality and well-being.

And for those of us that commute via other forms of transportation, do you find this a good time to practice mindfulness? If you, like me, are surrounded by people busily moving about during your commute, can you still find a connection to your body, your breath, and the moment? I find that it is possible, although more challenging than when inside the personalized interior of my own car. However, now that it has become a habit to be mindful on the metro, I feel out of sorts if I go the trip without practicing- like I would if I did not take my morning shower or skipped breakfast.

Whether you go about your day via train, plane or automobile, why not give a mindful commuting a try? You may find that establishing a regular mindfulness practice is easier  and more accessible than you imagined. Bonne route!