Advances in technology are increasingly pushing traditional therapy online or over the phone, offering obvious convenience for both clients and practitioners. For expatriates, however, web therapy can provide much-needed, tailored support for coping with life in a different culture. One company in particular focuses entirely on helping people better adjust to living abroad.
Sean Truman grew up as an expatriate, spending his childhood in Kenya, where his father worked for the United Nations and his mother taught at an international school. Although he's been back in the US for most of the past 20 years, after training as a psychologist he became interested in how the expatriate experience - as rewarding and stressful as it can be - is often not understood by the mental health community. Recognising that good therapists can be hard to come by in some corners of the world and that cultural and language differences can also hamper access, he started the US-based The Truman Group three years ago. The company now offers a team of six licensed mental health providers with experience in working with expats, many of whom have been expats themselves, providing care to people living from the Arctic Circle to South Africa and across the Middle East.
What psychological needs/issues/challenges do expats face that regular, live-in-their-home-country folk do not?
As I am sure you know, there are stresses that are unique to living overseas. The life is incredibly exciting and there are many reasons for people to be drawn to live in places that are dramatically different from their home. That said, being far from home can cut people off from social and emotional supports that they need when they encounter problems. This is compounded by the fact that for many individuals and families, there are frequently moves that occur every two or three years, so there are multiple disruptions that require a lot of adaptation and adjustment. This does not mean that things always go wrong emotionally, but they can, and when that happens it can be difficult to get things back on track. Many people who are assigned overseas are asked to work exceptionally hard, and frequently this involves significant travel away from home. All of these factors can be very disruptive for individuals and families. It is common to see people struggle with anxiety and depression, family stress and marital problems.
Are there any particular themes you can elaborate on, to help expats who are reading feel that they are not alone in the struggles?
People living overseas frequently feel isolated and disconnected, and that feeling makes it seem as though they are the only person who is struggling (or who has ever struggled) in this way. If you are reading this and you think that you are the only person who is struggling and feeling hopeless, helpless or worried, I can assure you that you are not alone. Living as an expatriate is and has always been a difficult thing to do and the strain has emotional consequences. Frequently, people struggle with anxiety and depression, marital problems, substance abuse and traumatic exposure (some of the people we care for are in locations that are militarily active, either because of war or political upheaval). There is not really a "typical" problem that is common throughout the population of people that we see. The one common thread that runs through the people we provide services to is that they are far from home, living in a country and culture that is not their own.
Do you ever treat people who were expats but are back in their home countries? If so, what can you share about their issues?
When people go back to their home countries, we generally recommend that they see someone located in their community. If for some reason people are repatriated home and there is no one for them to see, we can continue to provide care. There is a range of problems that people returning home experience. For many, they don't feel like they quite "fit" and that something about them has changed. Similarly, people frequently report that their life feels "flat" or "boring". Living overseas is an exciting and stimulating life that has a lot of novelty connected to it. For many people, returning home feels like watching a movie in black and white, as opposed to colour. Again, some of this is normal adjustment, but if it is profound or goes on for too long, people should consider getting help.
With their vast range of experiences, it's difficult to generalise about advice to give new expatriates - for example, someone working in a war zone versus the spouse who has recently located from New York to Amsterdam. But they all have issues. Sean Truman of the St Paul, Minnesota-based The Truman Group offers three basic tips on easing the transition to a new life.
Do not withdraw into a shell upon arrival. Say "yes" to invitations and to try new things.
There is frequently a 90-day crash. When people first arrive at a new spot they generally feel excited and exhilarated by the change. After a few months that can change and there is a down period. Don't panic, keep going. If in another month or two things are not getting much better, consider getting help.
Focus on the social and emotional supports that are available. Spend time with family (and friends if there are any in your new location). Make it a priority, and set aside time dedicated to seeing people that will listen and understand what you are facing. Even if they are not able to do anything to change what is difficult, having people to talk to makes a big difference.
The Truman Group charges US$145 (Dh533) per hour, a fee which in some cases can be covered in part by insurance. Go to www.truman-group.com for more information
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