Tag Archives: Expatriate Issues

Life Abroad as a “Trailing Spouse”

Instead of
Instead of “trailing” how about “accompanying” spouse?

“Trailing spouse”: It’s a term that makes me grimace. The idea that there is one partner in the relationship that trails (by virtue of the word) behind the other. To me, the term “trailing spouse” brings with it a feeling of having less power, less say, less importance. That this person’s capacity is defined by their relationship to another person, that is, the non-trailing person.

How would you better describe this experience? Is there some catchy nomenclature we could apply that better accounts for the incredible courage and resilience that partners in this position display as they take on great challenges? What snappy term encompasses what it is like to approach the adventure of living abroad without the safety net of a job or post-doc to provide financial, social and professional security and consistency?

Beyond simple wordage, people in this situation encounter many challenges specific to being the partner who does not receive compensation and recognition for the difficulties inherent to living in their non-native country. We already know that people who live abroad are at a higher risk for anxiety, depression and substance use disorders than their domestic counterparts. But we know much less about the subset of individuals that fall within this “trailing spouse” category.

Here are some things we do know:

-Thanks to globalization, more people are living abroad than ever before

-Often, people are moving abroad at the same time when they are contemplating starting a family or are raising young children

-They may be giving up or compromising their own professional trajectories

-They are sometimes in bi-cultural partnerships

-There may be increased stress in the relationship with their partner as a result of moving or the partner’s new work responsibilities

-They have to set up new routines for themselves without a lot of information about what resources are available

-They may have to learn a new language

-There may be more financial stress

-There is less social support (at least initially)

-They may be exhausted from coordinating the move

-They may not know how long they will be living in their new country

-They may have to manage their family of origin’s reaction to their departure (i.e., guilt)

-They may have very little experience living abroad

-They may have felt pressured to move

-They may have a history of a mental health problem

There are many factors that could influence how well someone in this capacity copes with moving abroad. It is an almost infinitely complex experience that requires flexibility, courage and self-compassion along with a healthy sense of humor.

To those “trailing spouses” out there, you are not alone. You may be living in an incredibly beautiful country with more material or financial resources than you have ever had and still feel unhappy or lost. Your friends on Facebook may be in awe of the pictures that you post of your new domicile. In spite of this strange feeling of incongruence, it does not mean that you’re not adjusting or “doing it right.” Moving abroad with your family or spouse is a shock to the system and feels different for everyone. It is my hope that this post normalizes the experience of difficulty that so many experience when they move abroad.

When in doubt, talk to others in your position. Don’t be invisible. Or seek the support of a psychotherapist or other mental health practitioner. Other suggestions for making a smoother adjustment can be found here. It is certainly possible to survive and thrive as a “trailing spouse” but it takes time, self-compassion and courage to do and think about things differently.

(Image courtesy of stockimages at FreeDigitalPhotos.net)

12 Tips for Surviving (and Thriving in) Expatriate Life

Life abroad is equal parts adventure and hard work
Life abroad is equal parts adventure and hard work

Moving to a new country is not easy and can challenge even the most thick-skinned adventurer. As a psychologist, mother and weathered survivor of a move abroad, I hope I can offer you a number of tips that will help you to flourish in your new expatriate home.

1. Keep your sense of humor. This is far and away the most important piece of advice. Without an ability to step back from a situation and laugh at yourself, your time as an expatriate will be difficult. Just yesterday, my son and I used the boys’ locker room at the pool. I did not know the German word for “boy” and there wasn’t a visual representation on the door so after a quick eeney-meeney-miney-mo, we chose one. Luckily it was empty but the lifeguard informed us later of our mistake. After turning a deep shade of fushia, I laughed and vowed to start German lessons.

2. Learn the language. Before moving to the German-speaking part of Switzerland, we lived for three years in the French-speaking part. I found that learning French helped me feel more connected to the community. For instance, once I learned how to properly tell the cashier at the grocery store to “have a nice day,” I relished the smiles I received in turn. However, make sure that your expectations regarding language learning are reasonable or you risk demoralization. Most native speakers will appreciate your efforts and overlook your mistakes.

3. Find a group. I found that taking language classes was an important way to meet other people who could share my experience of being abroad and learning something new. Connecting with people helps to ease the feeling of isolation that naturally occurs after moving abroad. If you have a baby or small child, see if there is a teacher willing to provide lessons to you and a friend at your home. Sharing a teacher cuts costs. Taking lessons is activating, creates routine and contributes to the development of a social support network, which is crucial for most people to maintain their mental health. If you already speak the language, joining a running group, church or parenting group may be something else to consider.

4. Find your niche. What did you do in your home country that helped you feel like yourself? Are you a gym rat? A coffee house aficionado? Are you a movie buff or an animal lover? Sports fan? Do you enjoy volunteering? Find a place in your new location that supports pursuits where you can connect with those parts of your personality. Perhaps it is a special park or museum or even the public library. Integrate a visit into your routine so that it can be a place to check in with yourself on a regular basis.

5. Be aware of your personal risk factors. Prior to moving abroad, I had no idea how much the weather could impact my mood. As a native Floridian, I never had the opportunity to see how three weeks of gray weather would affect me. And now I know. When I feel edginess or low motivation coming on during a spell of bad weather, I have a plan for managing it. And other factors can also impact how you feel you are handling your expatriate life, such as hormones, stress, loneliness, change in physical activity level, change in diet, lack of sleep. Know your triggers and how to work with them.

6. Cultivate friends with whom you can both brag and whinge. There is a tendency in the early years of life abroad to join any social opportunity that presents itself but at some point, it may be important to select which relationships to focus on in order to cultivate more quality than quantity. I would recommend finding friends with whom you can both brag and “whinge” (whining binge). These are people who can celebrate small victories with you because they recognize that life is difficult and can also listen nonjudgmentally to you when you just need to vent.

7. Give yourself a year- or more. A client once reported to me that she was having a “bad Switzerland day” after experiencing a number of incidents that she felt illustrated the worst part of the country’s cultural values. These days will occur a lot in the first year and into the following years. Resist the urge to make any big decisions on these days and start fresh the next day. Beyond that, the mounds of PAPERWORK and reorganization involved in moving abroad often takes an ENTIRE year before it is settled. However, take your time and monitor your stress level. It will get done.

8. Resist culture blaming- you’ll just feel more isolated. We expatriates are in a unique position to compare our own native cultures to our host culture. There are some things that work better and some things that may not work as well. When you notice yourself tallying all the things that do not work as well, resist the tendency toward all-or-nothing thinking. When you start to feel like the culture itself is flawed, you will only feel more alone. Let the thoughts and emotions pass and recognize that you may feel differently the next day. Cultivate a gently curious “let’s see how I feel tomorrow” mindset.

9. Be aware of resentment in your partnership. This is an insidious scourge of expatriate relationships. Often, one partner is relocated abroad while the other goes along. When things are not working well for the partner who does not have the benefit of routine and socialization provided by employment, it is easy to hold the other partner responsible. Be open about how you are feeling with your partner so that resentment does not fester. Recognize that acculturation is hard and ask your partner for extra support and patience while you attend to self-care. Your relationship will be better for it, even if it means spending more money or time to get what you need.

10. Establish a routine but leave room for spontaneity. Following a major life transition, routine and predictability are very important. Setting in place a rhythm can help you to increase your resilience to the small and large bumps in the road that will inevitably occur. Even small routines like going for a walk every evening, or visiting your favorite coffee shop each week, or buying an English newspaper will help you to establish a sense of order. However, avoid clutching rigidly to routine- if an unexpected opportunity for joy or long-term gratification occurs, seize the moment.

11. Keep your traditions but adopt some new ones. At our house, we have established a “Swiss-giving” tradition (no turkey, just a big chicken!) that helps me to tap into holidays that are important to me and to teach my son about his American heritage. Advocate for those traditions that help you and your family connect to what is important for you. It may not look exactly the same but the intention itself is affirming. On the same token, partake in the local traditions and try them on for size. Is there space for you and your family to integrate them into your way of life? If so, new and unexpected pleasures await you.

12. Get support in your native language. Need a little extra support as you adjust to life abroad? There is no shame in finding a professional who can help you to figure out your own plan for flourishing, whether a medical practitioner, psychologist, yoga teacher, midwife or priest. If possible, finding someone who speaks your mother tongue as a native speaker is ideal but otherwise make sure it is someone with whom you can freely utilize the richness of language to describe how you are feeling and doing.

(Image courtesy of khunaspix at FreeDigitalPhotos.net)

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)

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)

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)