An Ode To Expat Mamas

Friends

This post is one of a particularly personal nature and also one that I am very excited to write. I think it is relevant to the general theme of this blog given that it relates to what it is like to be a mother abroad and the importance of social support for mental health. But mostly it is about friendship and its power to transform the experience of living far from home.

When I first moved to Switzerland, my son was just two months old. I had very little experience parenting in the United States much less parenting in a country where I could not speak the language, did not have a job and was far from the support of my friends and immediate family. I made an effort to reach out and luckily, there were a number of ways to meet other English-speaking parents in Lausanne. I now know that, during this initial phase of acclimation, there can be a tendency to open up to anyone with friend potential and very quickly become socially overextended. But, with lack of sleep whittling away patience, I moved into the phase of being more selective with potential social activities.

I was fortunate to meet and connect with some of the most creative, courageous and smart women from all over the world. Our countries of origin spanned most of the world: Taiwan, Ukraine, Austria, Poland, the Netherlands, Dagestan, Malaysia and the U.S. And despite our differences, we now share a chapter of our lives with one another that we all consider to be one of the most special and unique. We all had our first children around the same time and weathered some of the greatest ups and downs of this new experience together.

As it often happens in the highly mobile expat communities, that chapter is now coming to a close as these women and their families follow opportunities in other countries. Although we always knew the intensity of these relationships would change as our life circumstances did, it is still sad to go our separate ways.

I often tell clients that expat moms get the short end of the stick. In moving to Switzerland, they are usually the ones that experience the most dramatic changes to their living situations and, typically, are tasked with organizing life for the kids. They are immersed in the minutiae of daily life in a foreign country and often juggle a lot of balls. Whether they stay at home or work outside of the home or something in between, expat mamas have to be tough. They enter this life without many certainties about what the future may hold and develop a thick skin that allows them to weather the daily difficulties. They learn how to advocate for their children even if it goes against the grain and how to manage the childcare shortage. Many of these mamas are tireless entrepreneurs who put themselves “into the arena” in a big way. Expat mamas take things in stride, whether it’s the inconvenient laundry room schedule, the train stations without elevators or ramps, the two-hour lunch break from school, or the Sundays where nothing- I mean NOTHING- is open. In short, to be an expat mama, you have to be comfortable with discomfort.

One of the best things an expat mama can do is develop a strong network of genuine social support. Ideally, a playgroup for mother and child-where both moms and kids can enjoy the company of those who understand their experience. I believe that while it is not necessary to have a village to raise a child, it sure is nice to have one. And expat parents are uniquely in a position to enjoy the immense diversity of cultural perspectives while connecting with other parents who share the same fundamental motivation: being the best possible parents they can be.

I do not think I would be the happy and relaxed parent I am today without the influence of my mama friends. Even though moving abroad meant starting over and forging my own way in many respects, I somehow feel like the friendships started here have been there all along. And I am confident that these relationships have left a mark that will last into the future.

(Image courtesy of artur84 at FreeDigitalPhotos.net)

Does Mindfulness Numb our Sense of Social Responsibility?

Mindfulness to emotion helps you to respond more thoughtfully than reactively- and perhaps that means reaching out to connect
Mindfulness increases thoughtful responding to emotion- and perhaps that means reaching out to connect

There has been some interesting chatter in the media discussing the impact of mindfulness on people’s willingness to engage effectively in society. Recently, Suzanne Moore of The Guardian suggested that mindfulness is all about the self and neuters impulses that may be useful for creating positive change in the world. She implied that practicing mindfulness may minimize the distress of the practitioner but does nothing to to directly address the distressing event.

In response, mindfulness practitioner and writer Ed Halliwell suggests in his blog that this criticism of mindfulness is normal given recent increasing attention to this practice in the media, and is actually helpful in furthering a constructive conversation. He notes that practicing mindfulness does not cure society’s many and serious imperfections and that, for those looking at the practice from the outside, it can appear to be something of an “opium for the people.”

For those of us who do practice mindfulness and who bring awareness to our very personal experience of living, we know that this is quite far from the truth. In fact, opening ourselves to the emotions and thoughts and body sensations that may be present in a given moment serves to better acquaint us with distress, sadness and other emotions that usually accompany our appraisal of the difficulties of life. When we open to these emotions, we acknowledge and honor them. Even though these emotions may be painful, we invite them in. Otherwise, the temptation may be to ignore, suppress or deny these emotions because of the automatic or habitual belief that we are helpless to change them or that we will be overwhelmed by their intensity. Yet, with practice and courage, we learn to approach rather than avoid our emotional experience and to just observe what is present in our bodies as we do so.

I would argue that this process of emotional awareness, of connecting to emotion in a given moment, actually prompts more action than the alternative. As a result of recognizing what is present for us in our minds and bodies, we may choose to respond in a way that thoughtfully supports our values and the things that we believe in. The motivation to take action is not out of a desire to rid ourselves of emotion but rather to validate our experience, and to connect to meaningful action.

Here is an example. A client described being deeply affected by the death of Robin Williams. She explained that his suicide prompted her to reflect on the suicide of a close friend and that she was experiencing feelings of sadness, grief, hopelessness and anger. She told me that with mindfulness, she could open to these emotions and ride their rise and fall in response to the thoughts she was having. As a result this process, she decided to reach out to her friend’s mother. She told me that they enjoyed a coffee together and reminisced about her friend, sharing a moment of connection to both one another and to the very natural feelings they have about losing her.

My client found that this action did not minimize her own grief but it did help her to feel like she was “in the driver’s seat” of her experience and that she could do something to recognize the loss. Rather than drown in her own suffering, she created a relationship with the pain that allowed her to respond to it in a thoughtful (rather than a reactive) way. And because she was open to her emotions, she was better able to be empathic when talking with her friend’s mother. Ultimately all of these responses supported her values.

Rather than numb our sense of social responsibility and our motivation to change the injustice of the world, mindfulness highlights the feeling and thinking that make it easier to engage in value-driven action if we want to. And as Ed Halliwell points out, even if our practice does not lead us to reach out and contribute to making the world a better place, simply being able to skillfully manage the distress that naturally accompanies membership in this imperfect world is a radically transformative way of breaking the cycle of unproductive suffering.

(Image courtesy of xedos4 at FreeDigitalPhotos.net)

No Place to Land: The Expatriate Experience (Part 2)

Expats have developed strengths that help them to face unexpected difficulties in life
Expats have developed strengths that help them to face unexpected difficulties in life

“Tell me, what is it you plan to do with your one wild and precious life?” –Mary Oliver, 1990 

Life stressors like divorce, health concerns, child educational issues, and caring for aging or sick parents are very difficult no matter the geographical setting. However, when these issues arise for those who are living abroad, they can seem simply insurmountable. I have found that, in general, expatriates are a hardy bunch. They usually feel ready to take on the challenges that living in a non-native country entails. Often they have experience from their childhoods traveling and experiencing different cultures and changing environments. Or they bravely fall in love with someone from a different country and open themselves to the prospect of a multicultural relationship. Sometimes the expat experience beckons to those who are looking for a fresh start and a chance to cast a new die for their lives.

In any case, those who choose this kind of life are usually prepared for the emotional challenges that characterise it. They are not surprised by days that require dealing with language challenges, reaching outside of their comfort zones, and getting lost for hours. But, throw in one or more of the major life stressors mentioned above and these “expat virtues” can be sorely tested.

A client once described to me how living abroad and dealing with a major life stressor left her feeling like she had “no place to land,” that she felt too disconnected from support in her country of origin but also not intimately acquainted enough with support in her adopted country. As a result, she struggled to carry the weight of the stressor by herself, without knowing how to direct the emotional resources she had cultivated through the challenge of living abroad in order to more effectively manage her experience.

Deciding to take the plunge and live outside of your country of origin for an extended period of time is not unlike dealing with a major life stressor. As you consider what life might be like following a major change, it is easy to get caught up in anticipation of the worst-case scenarios or doubt your abilities to manage what might arise as part of this adjustment. However, if this was where the thought process ended, than no one would live abroad. There is a point at which the thinking flips to consideration of all possibilities in a more balanced way. Regardless of how you think about an event, however, there is no certainty about how these thoughts will correlate to the future. So, there is a self-confidence and awareness of an ability to be flexible in the face of the unknown that is necessary in deciding to live abroad.

Once my client could connect to these gained skills and her own quiet strength, she felt more empowered to manage the stressor and was able to develop a plan to deal with it in a way that reflected her values. She came to believe that she could do it, even when there were days when she encountered extreme challenges to this belief. Concurrently, she created a support system that she could turn to for information and empathy. She admitted feeling surprised that increased self-reliance actually helped her to feel better able to seek support, rather than confirming her initial fear that asking others for help would make her reliant upon them. In essence, with hard work and courage, she created a safe place to land for herself.

Although it can certainly be more challenging to deal with major life stressors as an expat, it is not impossible. Those characteristics that often draw people to living life abroad can also be utilized to cope with unexpected difficulties that challenge emotional well-being. The decision to live outside of your country of origin is one that cannot be made without a great deal of courage, hope and belief in your abilities to cope with difficulty. And though we do not get to decide when and how major stressors will arise in life, the same hard-won attributes that help us manage other difficult situations/decisions can be called upon to help us through.

(Image courtesy of smarnad at FreeDigitalPhotos.net)

A Heart in Two Places: The Expatriate Experience (Part I)

The expat experience can be exciting but complicated
The expat experience can be exciting but complicated

As an American, living abroad conjures images of exotic locales and adventure- experiencing sights, sounds and tastes that expand any understanding of how the world works. The expatriate experience can be a marvelous one. The infusion of adventure into everyday life can inspire and challenge. And now, as our global economy expands, more and more people from around the world are taking on the joys and difficulties that comprise expatriate life.

As fabulous as this kind of life experience can be, it is also difficult. It requires adapting to a new culture, establishing a new way of navigating every day difficulties, and managing separation from loved ones at home. Often it entails learning a new language or finding a new job. Of course, these challenges may be part of the appeal of living abroad and the sense of mastery gained by overcoming these obstacles can be very empowering. However, adjustment is a stressful process that can impact health and well-being if there is not consistent and compassionate attention to self-care.

A client recently confided to me that her experience of expat life is complicated by the guilt she feels by being far away from her family of origin. She discussed feeling like her “heart is in two places” and that as much as she feels proud to have established a life for herself in Switzerland, she finds herself feeling paralyzed about future decisions for fear that she might disappoint them.

Another client recounted his deep longing to raise his children in an environment similar to the one in which he grew up, an environment he does not feel like he can access due to his current circumstances living abroad. He reflected on the grief he feels about having to make peace with this reality and his uncertainty about how he will be a parent in a foreign country.

As with most things, the expat experience is not easy to characterize. There are so many variables that influence the adjustment to living abroad and I have found that it is an ever-evolving (almost daily!) experience, one that can feel simultaneously exhilarating and exhausting. It is not unusual to experience difficulties in managing the new challenges that arise when adjusting to living abroad but if you find that the way you are feeling interferes with your mood or with your ability to complete daily tasks (i.e., go to work, maintain hygiene, go out with friends), then it may be a good idea to consult a medical or mental health practitioner for support.  It can be frustrating to find that the life envisioned prior to moving is not the reality but that does not mean that the reality is impossible to manage or enjoy.

For many, life abroad is thrilling from the very first moment. For others, it can take time to settle in and adjust to the many changes. In any case, the courage and hard work required to take this leap into the unknown should be celebrated.

(Image courtesy of Ohmega1982 / FreeDigitalPhotos.net)

Navigating Postpartum Depression and Anxiety as an Expat

Baby_mom

As most parents know, nothing can truly prepare you for what it will be like to bring a child into the world and be charged with raising that tiny, vulnerable creature into adulthood. After reading a dozen books, endlessly questioning my friends with children and buying more baby supplies than anyone could ever need, I thought I was prepared. But, strangely enough, when the nurse put my son in my arms, I couldn’t have felt more unprepared. Somehow, we parents work it out. Our children survive our initially clumsy attempts at diaper changes, feeding and bathing. We navigate the challenges of early parenthood that we could never have anticipated. However, this learning curve is a rocky road, one that leaves many (if not most) feeling overwhelmed, frustrated and perpetually longing for a nap.

Yet, today I write about those parents who feel all of those things but to a degree that is difficult to articulate. Those parents who may, on one hand, feel like what they are experiencing is “normal” adjustment but on the other, suspect their struggle is different from those of their peers, and as such, may be reluctant to voice what they are feeling. It is my hope that this post serves to do a few things:

  • Elucidate differences between the more typical (I want avoid saying “normal” as there really is no such thing) early parenthood experience and symptoms of postpartum depression and anxiety (PPD/A) that might warrant extra attention and treatment
  • Discuss how being an expatratriate might exacerbate early parenthood difficulties
  • Assure any suffering parents that they are not alone- that help exists in the form of effective treatment by a professional or by accessing resources available in our community

Symptoms of PPD/A

Listed below are symptoms that characterize the general experience of postpartum depression/anxiety. Keep in mind that not all of the symptoms might apply or that the symptoms may be somewhat different for you. I provide the list simply to increase general awareness.

For at least two weeks at a time following the birth (or adoption) of a baby, you experience some of the following:

  • Depressed mood (most of the day, almost every day)
  • Inability to find pleasure in the things you normally enjoy
  • Not wanting to eat or overeating
  • Not being able to sleep, not wanting to sleep, or wanting to sleep all the time
  • Feeling physically tired or aching to the point that your level of activity is markedly different from normal
  • Feeling physically wound up so that you feel as if you can’t sit still
  • Lack of energy or fatigue nearly every day
  • Intense feelings of inappropriate or excessive guilt and worthlessness
  • Difficulty concentrating and making decisions
  • Thoughts of harming yourself or someone else
  • Racing thoughts
  • Constant worry
  • Frequent or constant resentment of your partner or child

And most importantly

  • The way you feel consistently interferes with your normal functioning (e.g., decreased socialization, inability to manage responsibilities, decline in hygiene).

The Expat Experience: Feeling Alone in the World

Living in a foreign country far from family and friends can serve to exacerbate feelings of being isolated and alone. There may be fewer sources of support to help you remain balanced and able to care well for yourself in conjunction to you caring well for your baby. There is less access to people who might remind you of your personal resources and help you combat thoughts of worthlessness and hopelessness, people who know how to encourage and praise you when the going gets tough. Not to mention the difficulty involved in simply accessing community resources when you do not speak the native language. Feeling tongue-tied is just one more obstacle to picking up the phone and getting help. Furthermore, expat parents often come to a new country for a work opportunity and having a baby can change or eradicate the existing support network that was provided by simply being at work. Depending on your parental leave situation, all of the sudden, you are out of the office and plunged into life as a mom or dad, which is likely quite different from the work environment.

Just to put things in context, clinical psychologists and other health professionals commonly use a scale called the “Social Readjustment Rating Scale” to measure the degree of stress in a person’s life. To give you a taste, “pregnancy (#12)”, “addition of a new family member (#14)”, “change to a different line of work”, “change in sleeping habits” and “change in working conditions” are among the top 30 most stressful events in life. And this list does not even include “Adapting to a new culture in a different country – far from friends, family, and all that you know”! When a person experiences a certain amount of stressful life events in a year, they are more vulnerable to illnesses. And make no mistake: PPD/A is an illness. It is a condition involving daily suffering from which it can seem like there is no reprieve.

You are not Alone: How to Get Support and Support Yourself

As with any health condition, the best chance you have of it improving is if you take steps aimed at healing. For instance, if you have a cold, you rest, drink fluids and avoid going for a jog in the rain. And just like taking care of a cold, there are treatment options for PPD/A that show excellent efficacy. And the things that work range from intensive psychotherapy paired with medication to the simple implementation of self-care activities that your pre-baby self might have done without thinking. Those self-care activities might include things like exercising regularly, meeting weekly with a friend for coffee and a chat, or ordering take-away food rather than cooking. Doing these things does not make you less of a parent. In fact, taking care of yourself is one of the best things you can do for your child.

When talking to clients, I often refer to the airline safety guidelines requirement that, in the event of an emergency, the adult should put on their own oxygen mask before helping their child put on his. Our children need us to take care of ourselves first because otherwise, we cannot tend to their needs.

It can be unbelievably hard to reach out for help when you have no energy to pick up the phone or feel overwhelmed by cultural differences or believe that you should just grit your teeth and “get through it, it’s normal.” If increasing self-care activities does not diminish the symptoms or if it is just too daunting to embark on these changes alone, it is important to enlist the help of a professional.

To get started, here are some links to online support resources:

To those parents living abroad who are struggling with early parenthood, please know that you are not alone and you are not without hope. There are many parents and professionals who share your experience and who can help you feel more empowered. Enlisting the support of your partner, a compassionate friend, a group of other parents, a medical doctor, a health practitioner or a psychotherapist can transform your experience of parenthood while enriching the relationship you have with yourself and your child.

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

Mindful Work: 6 Ways to Bring More Intention and Value into Your Work Life

It can be tough to clock in when you are mentally clocked out.
It can be tough to clock in when you are mentally clocked out.

Someone (possibly Woody Allen) once said that “showing up is 80% of life.” Which makes me wonder- what is the other 20% about? Lugging our bodies into the office or to run our household day after day is necessary and the job usually gets done. But, what about beyond that? It makes sense that having our minds show up a bit more at work can increase our effectiveness as well as other aspects of our work experience.

Many of us do not fully enjoy our jobs or some of the tasks required of us as part of our position. Some of us may feel that the company for whom we work promotes ideas or products that run counter to our values.  These discrepancies between behavior (i.e, showing up to do work you don’t enjoy or don’t believe in) and values (i.e, living a healthy life, doing work that benefits those in need, contributing to the greater good) make us feel uncomfortable. The resulting dissonance can make us question ourselves or even impact our mood. However, I want to suggest an alternative way of thinking about this real difficulty.

Even when your professional position or responsibilities do not match some of your more obvious life values, think about the ways in which your work does support your values. For instance, perhaps you value commitment and loyalty which is satisfied when you do your job and assigned tasks to the best of your abilities just because you said you would- even when you’d rather not. Or perhaps you value family and your job helps for you to support that family. Others may value personal growth and even though your job responsibilities themselves do not feel as if they complement this value, perhaps the very act of continuously showing up, doing something difficult and still living a fulfilling, balanced life in spite of it all is a challenge that helps you to grow.

Connecting to what you value and committing to valued action is one way to bring intention and mindfulness to your work life. It provides the opportunity to “clock in” more fully and bring more of yourself to the activities in which you choose to engage. Ultimately, it brings you out of autopilot and into the driver’s seat of your life.

Here are a few other suggestions for bringing more mindfulness into your daily responsibilities, whether you work in the home or outside the home:

1.) Place a “mindfulness bell” in your schedule. This is a routine cue which reminds you to check in with yourself- like every time you start up your computer or walk to the bathroom or make your coffee. And checking in with yourself just means  finding the breath, seeing what is present in thinking/feeling/the body and then proceeding from a more mindful place.

2.) Take yourself out to a mindful lunch. At least once a week, eat lunch quietly and without conversation. Focus on the sensations of eating and the sensory qualities of the food. Choose foods with different textures or temperatures and whenever the mind wanders, just gently bring it back to the meal.

3.) Try “falling awake” after lunch. During that post-meal period of lowest energy, take 15- 20 minutes to settle into the body and feel the sleepiness in your body. Each time you feel yourself falling asleep, explore that feeling and use that as an opportunity to be mindful of these very vivid and surprising sensations.

4.) Walk mindfully throughout the day. If you have time to walk, you have time to walk mindfully. As you walk around the office, tune in to the sensations of walking including the various parts of the feet involved in the movements of walking. When you sit back down, take a moment to notice the feeling of warmth or looseness that may be present in the muscles after moving.

5.) When you get stuck, zoom out. If you find yourself getting stuck in a particular way of thinking or reacting, take a step back. Close your eyes and just notice what kinds of thoughts are present. Notice how big they feel or how quickly they go racing across the movie screen of your mind. Remind yourself that for the moment, you are simply observing your mind and there is nothing else that needs to be done.

6.) Practice mindful listening. When you want to bring more of yourself to a moment, use the voice of a speaker (whether in a meeting or conversation) to anchor you to the present. Just as you might with the breath, notice when your mind has wandered and gently escort your attention back to the voice.

I hope some of these ideas may help you to bring 100% of yourself into your work life and, ultimately, into any moment.

 (Image courtesy of jesadaphorn / FreeDigitalPhotos.net)

Identifying Emotions

Sometimes a visual reminder is necessaryVisua
Visual cues are useful for planning and problem-solving. But how about using visual cues for emotions?

Practicing mindfulness can help us to get to know and to befriend our experiences, no matter what kind of experience it may be. When first beginning practice, it can be challenging to identify various emotions and their correlated thoughts, body sensations and behavioral impulses.

Identifying emotions is helpful for a variety of reasons. On a physiological level, it transfers energy from the very primal “emotion brain” of the amygdala to the area of the brain dedicated to helping us organize, remember and make sense of information. When we identify and label an emotion, we are essentially activating a part of the brain that can help us to problem-solve, inhibit undesirable behavior or respond more effectively to what we are experiencing. We still may choose to deal with that emotion in a more primal way (say, slamming your fist into the wall) but at least more of our cognitive resources are engaged and this action is more intentional.

Furthermore, once an emotion is identified, you have more information to work with. Rather than trying to slog blindly through a muddy and sort of icky, disconcerting experience, we can instead be more aware of what we’re experiencing, how long it might last, and what kinds of things might be able to make the experience more manageable. That being said, emotional events do not consist only of the “negative” stuff. Greater awareness of joy, pride, wonder, love and all those positive (for most people) feelings can be very useful as well. When we make note of a good feeling, we are essentially saying, “Hey, this is good stuff. I am going to pay attention.” And the more we cultivate emotional recognition, the better we can be at catching and enjoying a similar emotion in the future.

Mindfulness to emotion can be a tricky topic to introduce. We humans are generally great walking cascades of emotion from one moment to the next so pinpointing what is happening takes practice. Plus, we are collections of learned emotional associations that can be triggered by very subtle or even subconscious stimuli, for instance: a barely noticeable but familiar smell -> memory of your first love -> feelings of nostalgia.

One useful tool I’ve found for helping people to practice takes the form of a handy little device, called “Feeling Magnets.” The founders recently offered me a chance to test this little metal box and its myriad magnets with mindfulness class participants. I found it to be a very useful. It is not very technical- always a plus for me- and due to its portability and discretion, facilitates regular emotional checking-in. Plus, it gives the user an opportunity to put words to their emotional experience, explore emotion/behavior patterns and ultimately, to step back and respond to emotions in a more mindful way. Seeing the emotions you are experiencing written in front of you can help to strengthen the neural connections that will ultimately contribute to the building of a new habit: checking-in, recognizing and validating your emotional experience, and choosing how to proceed.

Simple but effective, "Feeling Magnets" help with mindfulness to emotion.
Simple but effective, “Feeling Magnets” can increase mindfulness to emotion.

As a big fan of visual reminders and cues,  I recommend this simple but effective tool to mindfulness enthusiasts and those who are curious about their emotions. Anything that helps us to witness and wonder at the incredible capacity of our mind gets a gold star from me.

(Image courtesy of Stuart Miles / FreeDigitalPhotos.net)

Is Mindfulness Indifference?

It is normal to have lots of questions about practicing mindfulness.
It is normal to have questions about practicing mindfulness

During this weekend’s introduction to mindfulness class, a very useful question came up: Does being mindful mean being indifferent to our experience?

This question struck me as being particularly useful in that it helps to capture and put words to the challenge of being non-reactive to our experience. From our first days, our reactions to our physical and emotional experiences are reinforced: a baby cries when he feels hungry and is fed. As we mature, we learn that not every experience requires action, and not every experience means something about the past or future. For instance, as adults, we know that the sensation of hunger does not mean that we will die if we do not eat immediately. Awareness + maturity = wisdom.

Purposeful attention to what is present in a particular moment is mindfulness. Jon Kabat-Zinn describes “non-judgment” as one of the attitudes that provides a foundation for practicing mindfulness. When we notice an experience, be it physical, behavioral, emotional or cognitive, it is very common to judge that experience as important or unimportant, worthy or unworthy, or even desirable or not. And judgment leads to action- whether it means simply putting a thought into a certain mental category or engaging in some behavior. Mindfulness teaches us how to simply notice our experience fully, without being dominated by the habit of judgment or action.

If we mistake the equanimity extended to our various experiences for indifference, we risk missing out on a lot of information. We pass up the opportunity to cultivate discernment in our judgments about experiences and make a balanced response to the full range of events unfolding in a particular moment. Indifference implies that the information we gain during an experience is not important and, therefore, not worthy of our attention. In addition, most of us are not naturally indifferent to our thoughts- quite the opposite. So, it is likely that obtaining indifference to our experience would require striving for a different mind state.

Rather, mindfulness helps us to open ourselves equally to all experiences (whatever our judgment about them) exactly as they are. Being mindful helps us to recognize and validate what is present for us in a given moment (even if it does not make any sense or fit with our values), and to respond to that moment with compassion and acceptance. In practical terms, it has the capacity to create some space around our deeply ingrained mental habits, thereby opening up opportunities to do things differently in life.

It is difficult to describe what is like to relate to yourself in this way, which is why the practice part is so important. Although the concept of mindfulness is not technical or metaphysical, we English speakers do not possess the language to easily describe the experience. It is best left to experience to show us how opening to the abundant richness of any particular moment- and letting it unfold exactly as it is- can help in forging a different relationship to thoughts, feelings, behaviors and body sensations.

(Image courtesy of digitalart / FreeDigitalPhotos.net)

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)

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)