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27.11.2018
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Expat LifeMental Health

Creating A Location Independent Mental Health Toolbox

What tools do you have inside of your own mental health toolbox? We all have our own set of strategies…

post by Melissa

What tools do you have inside of your own mental health toolbox?

We all have our own set of strategies for coping with the inevitable hard moments in life, but we’re not always aware of what they are. These coping skills are important, wherever in the world we call home, but often we don’t realize that we’re lacking them until we go through a big life transition, such as leaving our home country.

In my first session with my globally mobile clients, I often ask them to make a list of their current coping skills. I tell them to write down whatever comes to mind, whether or not it’s considered “healthy.” I want to know about the exercising and journaling they do, just as much as I want to know about the naps they take when things are overwhelming, or the glass(es) of wine they have after work when they feel stressed.

I want them to see two things:

1) That they already have some strategies at their disposal which means we’re not starting from zero.

2) That sometimes those unhealthy coping tools come from a place of trying to take care of themselves. However, they aren’t the best long-term solutions.

When we finish therapy, my hope is that they’ll have an even greater variety of skills in their mental health toolbox they can take with them, wherever they’re living, to help them deal with whatever curveballs life throws at them. I also hope that, more often than not, they’ll choose to cope in healthier ways (in other words, ways that allow them live a meaningful and enriching life).

Bringing this topic to a bigger audience: The 7in7 Digital Nomad Conference

One of my goals in 2018 has been to start sharing some of the knowledge and tools I share in my 1:1 online therapy sessions with a larger audience. One of the ways I did this was by starting my YouTube channel, but I also wanted to find offline speaking and teaching opportunities. Presenting a workshop with my colleague and fellow online therapist, Dr. Sonia Jaeger, at this year’s 7in7 conference for digital nomads in Medellin Colombia, was the perfect opportunity to do just that.

Sonia and I met earlier last year through a digital nomad Facebook group and since then we’ve created a mastermind group and book club with other online therapists. She was also a big inspiration for me to make my own move to start seeing all of my clients online. Developing a workshop together for 7in7 not only seemed like a great next project to work on together, but it would also give us the chance to finally meet one another in person!

The final product that we presented at 7in7 was a 90-minute workshop titled “Creating Your Location Independent Mental Health Toolbox.” We decided to focus on sharing tools from Acceptance and Commitment Therapy (ACT) that participants could use to cope with life’s challenges, wherever in the world they’re currently calling home.

Sonia and I work with similar clients—expats, digital nomads and other global nomads living around the world, although the majority of her clients are German or French speakers. Not only is ACT a type of therapy that’s supported by a great deal of empirical research, but we’ve also both seen firsthand just how helpful this approach is for the international clients that we work with.

For people who haven’t lived abroad, there’s often an assumption that life outside of your home country is full of constant excitement and adventure. However, those who have actually lived outside of their home country know that there’s a darker side as well. Living a globally mobile life comes with numerous challenges such as loneliness, lack of community, identity questions, changes to routines, professional difficulties, cultural adjustment issues, as well as the challenges that come with returning back to your home country (or making the choice to do so).  Although there’s still limited data on the mental health of digital nomads, research does suggest that another globally mobile group-expats-are at a greater risk of developing mental health problems than their non-expat peers.

The Myth of Positive Thinking

Many people are motivated to move abroad in hopes of finding happiness through a change in their personal and/or professional lives. However, many of them end up discovering that the problems they were hoping to leave at home find a way into their suitcase. This is often because, regardless of where we are in the world, even if it’s the most “instagrammable” place on the planet, we can’t entirely escape painful thoughts and feelings. Constant happiness is just not possible as a human being.

Many of my clients end up feeling disappointed or frustrated with themselves when they experience sadness, loneliness or anxiety abroad because instead of seeing these feelings as a normal part of the human experience, they seem them as a sign that they’re failing at living abroad. There’s a natural reason we want to get rid of discomfort or pain in these sorts of situations. We’re built to survive and avoiding physical pain actually keeps us alive. If I step off the curb and realize there’s an oncoming car, it’s great that my brain can tell me to get out of the way so that I jump back on the curb. However, our brain tends to respond the same way to emotional pain and this leads to numerous problems and maintain psychological distress. After all–that which we resist, persists.

Instead, ACT emphasizes the importance of making space for painful feelings so that they don’t hold us back from doing things that are important to us. How different is it to feel lonely and say to yourself “that’s a normal human feeling,” than to say, “there’s something wrong with me and I should be happy right now.” When we are able to observe, accept and self-soothe our painful feelings, they’re more likely to last for less time.

ACT: Helping You Identify Your Values & Unhook From What Pulls You Away

Like I mentioned above, ACT is a mindfulness based therapy that focuses on making space for painful thoughts and feelings that arise (as opposed to avoiding them, or overidentifying with them), so that they don’t hold you back from taking steps that are related to what’s deeply important to you in your life.

The easiest way remember the objectives of ACT is with this acronym:

A—accept the difficult thoughts and feelings

C—commit to a valued direction

T—take action

One of the key parts of ACT is to help clients identify what they want their life to be about, or in the words of ACT, to identify their values. You can find some suggestions for identifying your own values in this blog post I wrote.

Once we’ve identified our values and checked in with ourselves about how much our current lives align with our values, we usually start to notice some discrepancies. This gap between how we’d like to live our lives, and how we’re actually living them, can give us a glimpse at some of the difficult thoughts and feelings that may be holding us back.

For instance, maybe you want to attend an expat meetup in the new city that you’re calling home, but you’re hooked by worry thoughts (“what if I’m the only new person?” “what if everyone judges me?”) and anxiety which are pulling you in the opposite direction. This moment is sometimes referred to as the choice point in ACT. It’s like being at a fork in the road where one direction is aligned with your values and the other is a result of being “hooked” by the stuff (thoughts, feelings, memories) going on inside of you.

(If you’d like to read more about the choice point in the context of choosing whether or not to move home, check out this blog post of mine)

There might be a temptation here to figure out how to get rid of the uncomfortable thoughts and feelings with distraction or positive mantras. After all, these coping strategies may make the discomfort disappear in the short term. However, in the long term, it’s likely to return. So, Instead of waiting until these thoughts and feelings disappear, we need to find strategies to UNHOOK from them. A simple, but powerful one that I often share with clients is “changing BUT for AND”—

Instead of saying:

I would go to the expat meetup, BUT I feel anxious

Say to yourself:

I feel anxious AND I am going to go to the expat meetup

In our workshop at 7in7, Sonia and I shared several other strategies for unhooking from these uncomfortable thoughts and feelings that attendees could add to their toolbox. We also shared a short self-compassion exercise with attendees as all of the ACT exercises are carried out with an attitude of compassion towards oneself. According to ACT, no one is broken, we just get stuck.

Where Will We Present Next?  

We received a great deal of positive feedback from those who attended our workshop at 7in7. It also allowed attendees to feel comfortable to have conversations amongst one another about their own mental and emotional health struggles, even once the workshop was over. Given the fact that there continues to be such a great deal of stigma around mental health, and that silence breeds stigma, we considered these continued conversations a sign of a successful workshop!

Sonia and I are hoping to be able to share this workshop with more global nomad groups around the world whether they’re expats, digital nomads, international school teachers, study abroad students, international entrepreneurs, or anyone else living a globally mobile life. If you know of a group who might benefit from this workshop, please get in touch to let us know.

We’ve submitted an application to present at the Families in Global Transition (FIGT) conference in Bangkok, Thailand in April 2019 and are hopeful that this will be the next group of global nomads that we’ll be able to share these tools with.

2 comments.

2 thoughts on “Creating A Location Independent Mental Health Toolbox

  1. Thank you. Very thought provoking post. I think I need to start accepting more of my negative feelings, even after being an expat for 10 years.

    1. Thanks for the positive feedback about this post. It’s difficult to work on accepting those feelings. You might enjoy reading “The Happiness Trap,” by Dr. Russ Harris. It’s a self help book that’s related to what I describe in this post and it walks you through some different exercises to work on changing the way you interact with those painful thoughts and feelings.

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