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Author Archives: Max van der Zee

Categories Expats, Psychiatrist, Psychologist, Therapy for children

Psychological help for expat children

With an ever more globalized world, international business practices, and increasing ease of travel, more and more often in psychological practice we treat expat children. Some have moved abroad at a young age and settled down; others have an almost nomadic existence. Expatriate life has advantages and disadvantages and has a different, often more profound effect on children than on adults.

What are expatriate children?

Expat children are children who grow up in a culture other than that of their parents or their country of origin, for example, because their parents work abroad. Expat children, therefore, often have little connection with the culture of the country they come from, but also not with the culture of the host country. They are characterized by adopting a kind of third culture that is, as it were, in between. Expat children are, therefore, also called third culture kids.

Difference from adult expats

Moving abroad is especially drastic for children because they are still in the middle of developing their identity. Adults have already built up their own identity, certain norms and values, and stable relationships in the country of origin. As a result, they will always feel connected to the homeland and be able to pinpoint a place where they came from. Children do not develop that core identity through expatriate life. This makes being an expat an entirely different experience for children.

What are expat children good at?

Expat children learn things that other children may never learn. They go to many interesting places, meet different people and come into contact with all kinds of cultures. As a result, they develop great adaptability, are resilient and curious, and dare to take on new challenges. They are also good at networking, make friends quickly, have great empathy and quickly include others in their social circle.

Fast maturing

Expat children often mature relatively quickly because of all these experiences. They know a lot about topics such as politics, culture and religion, speak several languages and often get along well with adults.

What risks do expatriate children face?

However, expat life is not easy. Especially when children move several times, a lot of stress, sadness and loneliness can occur. Children struggle with the uncertainty of whether they will make new friends at the new destination. Even if the child does not move, they often have expat friends who move away. The life of an expat child, therefore, consists largely of saying goodbye and starting all over again.

Identity Crisis

Expat children often have a hard time answering where they are from or where they feel at home. This is confusing for them. Moreover, having to continuously say goodbye to a place of residence, friends, school, and regular activities and rituals is akin to losing a certain part of one’s identity. Many expat children describe themselves as a ‘chameleon’: they easily measure themselves against different personas, but do not really know who they really are.

Feeling of guilt

However, expat life is often accompanied by a lot of luxury. The children live in beautiful homes and attend highly regarded international schools. Also, many parents abroad have the option of hiring a nanny full-time. Expat children can, therefore, feel like they can’t complain. After all, they lead a privileged life, right?

Symptoms of grief

What many expat children actually suffer from are symptoms of grief. Saying goodbye over and over again, to a certain environment and with that a part of one’s own identity, simply causes a lot of grief. The cause of the symptoms, however, is not as clearly identifiable as, for example, the death of a loved one. Therefore, the symptoms are often ignored and expatriate children run the risk that this unacknowledged grief will at some point surface in a destructive manner. Expat children are, therefore, at increased risk of developing depression. Therefore, when an expat child experiences psychological problems, it is specifically referred to as Expat Child Syndrome.

Psychological help for expat children

Have you moved abroad with your children? Then make sure to be a listening ear. It is important for children to be able to share their stories and any grief they may have. Even though they may now be living in paradise on earth, that does not mean that saying goodbye to a previous place of residence was not incredibly difficult. Give your child the feeling that that grief is allowed to be there.

A (child) therapist can offer support in this. Many of the therapists affiliated with The Online Therapists live abroad themselves and, therefore, know exactly what is going on with you and your child. Psychological assistance consists of offering comfort and understanding, so that the child can let the mourning process take place. Next, the expat therapist offers help in developing their own identity and building deep relationships and friendships, something expat children often have difficulty with. Children also learn not to let their adaptability get in the way of setting boundaries and priorities.

 

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    Categories Online Therapy, Psychiatrist, Psychologist

    Should I go to a therapist or a psychiatrist?

    Mental health symptoms are not easy to define. If you are dealing with them for the first time and want to seek help, you may also be wondering where to start. Which counselor is right for my symptoms? Do I go to a therapist or a psychiatrist? How does psychological counseling work and how do I get to the right counselor?

    What does a therapist do?

    A therapist holds a university master’s degree in psychology. This may have chosen different majors or specializations, but what therapists have in common is that they focus primarily on the connection between human behavior and mental health. In their treatment, most therapists then use various interviewing techniques or cognitive behavioral therapy.

    What does a psychiatrist do?

    A psychiatrist has studied medicine and graduated as a medical doctor with a specialization in psychiatry. Therefore, a psychiatrist views mental illness more from a medical perspective, considering the health of the rest of the body as well. Because a psychiatrist is a physician, he or she may also prescribe medication. Psychiatrists therefore often treat patients with severe or complex mental health problems, such as patients with schizophrenia, major depression, or psychosis. The treatment is often long-term and intensive.

    Which mental health counselor is right for me?

    If you have never received psychological help before, you will usually first see a therapist. Which therapist can offer you an appropriate treatment, depends on your individual problems and the specialization of the therapist. The Online Therapists employs all kinds of different therapists so that, on the basis of an intake interview, we can match you with the right therapist.

    A counselor for every problem

    For example, a cognitive behavioral therapist is appropriate if you are experiencing behavioral problems or obstructive thought patterns. A couples therapist can help you well with relationship problems. An occupational therapist offers support for work-related psychological complaints. And if you suffer from past trauma, an EMDR therapist may be able to help you.

    Referral

    Together with the therapist, you determine which treatment is right for you. If the therapist thinks it is necessary, you may be put in touch with a psychiatrist. This happens, for example, when the therapist makes a diagnosis for which medication is prescribed, such as autism, ADHD, depression, or psychosis. For treatment from a psychiatrist, you need a referral from a therapist.

    Don’t worry about choosing the right counselor. At The Online Therapists, you will be matched with a suitable therapist based on your story. This is the starting point. If you don’t ‘click’ with your therapist, or if it appears that you need a different treatment, you will easily be referred. So you always get the appropriate help!

     

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      Categories Online Therapy, Psychologist, Tips

      The expat blues: why being an expat doesn’t always make you feel good

      Looking for adventure! More and more people are opting for a new start abroad. Preferably in a place where the sun shines a lot more often, the beach is around the corner and palm trees grow in the garden. That sounds wonderful and it is, but it doesn’t always work out right away. In the first few years, a large number of expats suffer from the so-called expat blues.

      What are the expat blues?

      The fact that life in your new location is by no means always fun has to do with various stress factors.

      Everything is new

      You have a new home, in a new city, in a new country. Perhaps when you arrive you immediately have a new job, with new colleagues. You also have to arrange a lot of things right away: a rental contract, a permit, registering with the municipality, proof of identity, insurance, you name it. And you might even have to buy a new car.

      Putting down roots

      Once the “newness” has worn off a bit, you have to work hard to “get rooted”: make new friends, get to know the culture, and learn a foreign language. A poor command of the language can be frustrating when you want to get things done at government agencies. It can also make it difficult to make local friends. You might find more of a connection with other expats, but often they leave as well. Continuous networking in a different culture with different customs is exhausting.

      Missing family and friends

      And does it sometimes get a bit too much for you? Then you miss the social safety net you used to have: your family and friends. This can cause a feeling of loneliness and isolation. On top of that, your social contacts at home are not always understanding. They expect you to have a great time in that beautiful, faraway country.

      Failure

      That can make you feel like it’s your own fault for being so miserable. After all, you live in paradise on earth, in that city you love so much, or in that cottage near the beach. Or maybe you went abroad for the job of your dreams. So why aren’t you happy?

      Disappointment

      It’s sometimes hard to admit, but the destination can simply be disappointing too. Going somewhere on vacation is really different from living somewhere permanently. You may not feel welcome in the neighborhood, you may have trouble finding work or get paid little, the facilities may be disappointing, etc. And, at some point, you even get used to the glorious weather day in and day out. In fact, in the summer it is actually just way too hot.

      Loss of identity

      If you have left everything behind and are starting all over again abroad, you may also experience an unexpected loss of identity. Who are you without your familiar job, semi-detached house, nice car, friends, hobbies, and favorite activities? It is then necessary to reinvent yourself and that comes with a lot of uncertainty.

      Consequences of the expat blues

      All of these stressors can soon produce burnout symptoms. You are tired a lot, sad or irritable, you have headaches or are easily sick, or you feel empty and gloomy. This can even develop into an anxiety disorder or depression. Did you move with your partner because of his or her job? Then it is possible that you are struggling with ‘bore-out’: the feeling of not mattering because you cannot find work or are performing below your level. This in turn causes tension in the relationship.

      Online expat therapist

      The good news is that all of these symptoms are perfectly normal. You have turned your whole life upside down! It’s not surprising that you don’t feel like yourself for a while. Online therapy can support you in this process. The Online Therapists is specialized in expat problems because many of our therapists live abroad themselves. You can therefore come to us for therapy in different languages, in your time zone, and from your home wherever that is.

      Benefits of the expat blues

      You may not see it that way yourself yet, but the expat blues also have advantages. You really get to know yourself at this stage in your life and can completely reinvent yourself. It’s scary, but it also offers the opportunity for tremendous personal growth and self-development. What kind of person have you always wanted to be and what kind of life does that person have? An online therapist helps you to answer these questions in an accessible way, so you can start taking steps in the right direction.

       

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        Categories Online Therapy, Tips

        Monitor your mental health during the Coronavirus pandemic

        Since the outbreak of the COVID-19 pandemic, public health has been a hotly debated topic. But in addition to the physical consequences for those who contract the virus, everyone is dealing with the mental impact of the situation. We all seem to react to it differently: some are afraid of getting sick, others have little concern. Some go into hoarder mode, others into caregiver mode. Many are concerned about the health of loved ones, their own financial situation, or the effect of the Coronavirus on the economy.

        Quarantine measures and mental health

        And then we all have to stick it out at home, too. It is still unclear how much effect the outbreak of the Coronavirus will have on our collective mental health, but it is widely known that social contacts are essential in times of crisis. And those social contacts are now largely being taken away from us. Some are isolated all by themselves and need social contact more than usual, while others are now stuck with family members 24/7 and are missing out on time for themselves.

        It turns out that no less than 65% of people suffer from anxiety or stress symptoms and half of them feel gloomy. One in ten even says they experience severe anxiety and are afraid to go out. There are various causes for this:

        • This is a completely new situation, to which everyone reacts differently. You have not been able to prepare for it and may not know how to deal with someone else’s reaction. Some people get frustrated and get irritated and angry quickly, while others shut down completely and withdraw.
        • In a limited number of square meters, small things come under a magnifying glass. As a result, partners get irritated with each other more quickly but also when you are sitting at home alone you can suffer from this. Without distractions, it is very easy to overthink certain small things and make them bigger than they are.
        • A lack of control and routine causes nervousness in even the most unstructured people. Maybe your job and thus your daily schedule has completely disappeared, or you suddenly have to babysit the kids all day. And what do you do with your time now that you can no longer go to the gym or your favorite Italian restaurant is closed?
        • The uncertainty about how long this situation will last means that you can’t prepare for it and can’t make plans. If you know for sure that the situation will return to normal in a few weeks, you also know what the state of affairs is regarding your work, finances, the children’s school, that booked vacation, etc. You can then take this into account and possibly adjust your plans. Now that this is not possible, many people feel aimless and powerless.

        How do you keep yourself mentally healthy during a pandemic?

        The longer the quarantine measures last, the greater the effect on mental health. It is, therefore, important to increase your mental ‘resilience’. Normally, you probably already have some techniques for this. For example, you may feel better by seeking distraction, taking time for yourself, or helping others. Many people now slip into one of these stress reactions. So be aware of how you react to this situation and what you can do to improve that stress reaction.

        Do not be ashamed to seek help. A therapist can help you very effectively with this. The therapists affiliated with The Online Therapists also have all the necessary experience with remote therapy. Through online therapy, a therapist helps you to create awareness of your own behavior. Based on this, you examine together what works well for you in this exceptional situation. Then you build up a new rhythm. This starts completely with the basics: what time do you go up? What do you eat? How do you keep moving? If you no longer have a job, therapy helps you set new goals so that you can give meaning to your days again. You also learn to deal with negativity from the news and social media, and any fears or stress that may arise from this.

        So you keep yourself mentally healthy even in these times!

         

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          Categories Online Therapy, Psychiatrist, Psychologist

          Seeing a therapist for depression: the options

          Depression is one of the psychological disorders that affects the most people. Many people are affected by it at some point in his or her life. Therefore, it is important to seek help immediately if you have depressive symptoms. A therapist can help you prevent or cure depression.

          How do I know if I am depressed?

          To diagnose psychological disorders, therapists use the Diagnostic and Statistical Manual (DSM). This manual describes the symptoms of a variety of disorders, including depression. According to the DSM, depression occurs when you suffer from at least one of the two core symptoms and at least five of the seven other symptoms for at least two weeks.

          Core symptoms

          • a dejected mood (most of the day or all day)
          • a decreased interest in almost all activities (most of the day or all day)

          Other symptoms

          • eating problems or (as a result) weight fluctuations
          • sleep problems
          • flattened emotions or just irritation and restlessness
          • fatigue or reduced energy
          • feelings of worthlessness or guilt
          • difficulty concentrating or indecisiveness
          • suicidal thoughts

          If your symptoms do not fully meet the description of depression, but some of these symptoms are present, then the diagnosis of ‘sub-clinical depression’ is often made. We then speak simply of ‘depressive symptoms’. If you are not sure whether you have depression or depressive symptoms, it is still (or perhaps most definitely) important to visit your doctor or a therapist. Early intervention helps to prevent the development of depression.

          How does a therapist help?

          A therapist will write a treatment plan based on your symptoms, your specific situation, and your wants and needs for the future. This treatment plan consists of conversations, in which cognitive behavioral therapy is used. In many cases, you will also be given very practical homework assignments. For example, you may be asked to keep a diary, do relaxation exercises, or undertake specific (social) activities.

          If you feel comfortable with this, or if it is simply more practical, these conversations can easily take place online. Online therapy via Skype or FaceTime offers you the opportunity to talk to a therapist from the comfort of your home. It is, therefore, ideal if you prefer not to go to a practice, or if you live abroad, but want to follow therapy in your own language.

          In many cases, eight to ten sessions are sufficient. If this is not the case, then a new approach can be chosen in consultation with the family doctor or another practitioner. For example, you may be referred to a psychiatrist, who may also prescribe medication.

          What do I learn in therapy?

          In cognitive behavioral therapy, you learn to influence your emotions through thoughts and behaviors. For this, it is necessary to learn to see yourself and your environment from a different perspective. Depression is often not so much related to external factors, but to the way you look at them and deal with them. One person can lose his or her job and apply for a new job the next day in good spirits, while another falls into a depression because of it. In therapy, you learn how to deal with these kinds of setbacks or other ‘triggers’, so that you can counteract depressive symptoms and prevent them altogether in the future.

          Almost half of the people with depression or depressive symptoms recover within three months. In others it keeps coming back. We then speak of a recurring depression. By seeking psychological support, you keep as much control as possible over your symptoms and you increase the chance of dealing with them better or even recovering completely.

           

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