When to seek professional help in re-entry after being abroad (reverse culture shock)

How’s this for serendipity? I’d been wanting to interview someone about when to seek professional help for dealing with re-entry, but wasn’t sure who to talk to. Then Jill emailed me to chat after the Living Your Ideal Global Life Summit. When I learned about her work as a therapist and her experience as an expat, I knew I had to interview her. To top it off, Jill and I are currently at the same conference and will get to meet in person!

In addition to having lived in London for 12 years, Jill Kristal has been a therapist for 25 years and is specially trained in EMDR, a treatment approach for dealing with trauma. She’s also a certified Kimochis: social-emotional development trainer. She speaks and writes regularly on all aspects of the expat experience and other life transitions. You can contact Jill here.

1. Jill, please tell us a little about your work as a therapist.

I am currently in private practice in Larchmont, New York. We chose this community when we were returning to the States because it’s very international. I love variety and I work across the age range from young children all the way up to teenagers and adults. I also work with couples and do family and parenting work. I really feel that each separate area I work in informs the others and makes me a more effective therapist.

In London, where we lived for 12 years, I was the head of the American counseling center. The a ACC was an initiative of the US Embassy that we transformed into a community counseling center geared toward meeting the needs of ex-pats living in the UK. We were all US trained and licensed therapists. It was there that I began to work with and understand the particular needs of the ex-pat community.

I began to speak and write regularly for international schools, women’s organizations and companies who were moving families abroad. Our company, Transitional Learning Curves was developed following the assistance I gave to a family who was repatriating. I was looking for a way to help the family engage in a fun way around this difficult topic and created a board game for them to play.

2. You mentioned that you lived abroad for several years. What was your re-entry after being abroad experience like? 

My favorite re-entry story is about my son who had lived his entire 12 years of life in London where he attended British schools. After his first week in American sixth grade he came home one day and said, “we had a maths test today: a dime – is that the one that’s worth 10 cents?” That made me realize that for all the education and coaching I had given other people, I really hadn’t spoken to my family much at all about the experience of moving to the United States.

We were at once repatriating but also in a way, immigrating, because though we had visited the United States every year and my kids felt very American, they had never actually lived in this country. And, my husband and I had not really been parents in the US. In a way, this was really helpful because we behaved as though we were totally new to the country and to the place we were living, which in many ways, we were.

Everything we did for that entire first year began with some version of, “I’m new here. I know I sound like I’m from here but I haven’t lived in this country in a long time. Can you please tell me or help me with…” I think this made a huge difference because people really reached out to help and guide us. We didn’t have expectations of ourselves that we should know anything or everything.

There were, though, many frustrations along the way. Beginning my private practice in New York I kept questioning, “does New York, with so many therapists, really need another one?” Also, I had come from a place where I was a big fish in a very small pond. Now I felt like a minnow swimming against the current in an ocean  of  big fish swimming comfortably.

I also was beginning to plan my son’s bar mitzvah. I had just done one in London. I remember getting very angry about all the research that I had to do, starting from scratch, where in London I had my resources and information. It would have taken me so much less time.

My daughter, who was entering high school at the time really went through an identity crisis. She had believed herself to be an American but when she arrived here and started mixing with the local kids, she realized that she wasn’t really American at all. She struggled for the first three years trying to find her place. It wasn’t until she became friends with other international students that she was able to find her group and find herself.

Our son found his group more easily. But I recall his frustration when an English boy with an English accent, who had lived most of his life in the United States, got much more attention and support than my son who sounded more or like everyone else but didn’t know how to get around or what to do.

There were small triumphs, like the day I figured out how to go to two stores in two different directions without having to come home first as I only knew how to get to each place when starting from home. I also recall visiting the canned pumpkin section in my grocery store at numerous times during the year. I always chuckled to see many cans sitting on the shelf no matter what time of year, as securing canned pumpkin in England for Thanksgiving pie was a difficult activity.

During our second year in the US I realized how totally occupied my brain had been with settling in and starting afresh. On different occasions in the second year, I met people who said they had met me during my first year here. I often had no recollection of having met them. When everything is new, there is only so much that your brain can incorporate.

3. Re-entry after a life-changing experience abroad can be challenging, whether you were abroad for a few weeks or several years. Resources provided by study or volunteer programs, expat organizations or websites like SmallPlanetStudio.com can be very helpful, but sometimes working with a professional therapist is more appropriate/helpful. What are some “signs” that someone in re-entry should seek professional help?

As you well know, Cate, repatriation is a very much under-acknowledged piece of the whole expat experience. Coping with a difficult time is so much easier if you have an idea of what to expect. Knowing there is a process with a beginning, middle and end, that that process takes time to navigate, and that it will include up days and down days makes it easier to deal with. There doesn’t tend to be a single moment or aha experience that indicates, “I’ve settled; I’m through this adjustment.”

Typically, it’s more a recognition over time that things aren’t as hard as they had been; maybe a feeling of having a bit more energy at the end of the day or perhaps an awareness that your family isn’t spending as much time together as they had been because your kids now have a few friends, and you have some activities.

So what’s the appropriate time to seek professional help? I think when you have given the process time and used many of the available resources but find you’re feeling stuck; that you still aren’t moving forward in creating your new life, you aren’t enjoying life or that things just aren’t getting any easier, then it’s time to seek help.

Also, sometimes we get stuck in the lives we had been living. And there’s always a transition time but if the focus continues to be on what you had and not what you have it’s also a time to seek help. And all of this is true for adults and children as well. Because we don’t consider repatriation to be difficult or something we have to adjust to or deal with, we often don’t recognize when, or that, it’s getting in the way of the rest of our lives. Sometimes too, repatriation can trigger some other unresolved issue in our lives.

When you’re struggling and none of your typical resources work, or you find yourself behaving in ways that aren’t typical for you, it’s a good time to seek some professional help.

4. How can working with a professional help someone struggling with re-entry after being abroad or reverse culture shock? 

Working with a professional can help initially to normalize the painful repatriation experience and the oft-felt sense of not being understood, accepted or known. The loss of identity that can accompany ‘coming home’ can be profound. A professional can help the person understand what is happening and why; how the process of adjustment and transition is impacting their life and functioning.

Relationships, particularly the pre-expatriation ones with family and friends, can suffer and an experienced counselor can help navigate the difficulties. Overall, a professional can help you to develop effective strategies for coping and moving through the rougher parts of the transition.

Importantly, a professional will be able to recognize when other, seemingly unrelated, life issues may be interfering with the repatriation process. Often, it just takes a few sessions to recognize the impact that repatriation is having on your life; perhaps there is a bit of grieving to do about the life left behind or a need to acknowledge the difficulty of the life you’re trying to build.

5. Is there advice you’d like to share with those in re-entry after being abroad or dealing with reverse culture shock, either from the perspective of a therapist or a returned expat?

While most therapists work with transition, it is really important in this situation to find a therapist who has specific knowledge and experience working with expats and the process of expatriation and repatriation. There are aspects of these situations that are unique and not easily recognized or understood by those who have not had the experience themselves or worked with those who have.

I offer counseling/coaching, as does The Truman Group and The International Therapist Directory.

Finally, know and accept that repatriation is hard. It is a physical and emotional re-adjustment that is often more difficult than the initial adjustment to living abroad. It is much more than simply ‘coming home; there is really no such thing. The experience of living abroad changes who you are. Repatriation forces you to adapt your new identity to the one you left behind.

If you are moving back to a place where you’ll be surrounded by family and friends, they will likely want you to reject the person you have become for the person you were; and for you, that typically isn’t an option that will work.  Seek out those who have been through what you are going through; they will understand you as no-one else can. Use the many available resources and if you continue to struggle, reach out for professional help.

Living abroad is a gift; coming home should allow you to find ways to incorporate and use it.

Thanks, Jill!