Expatriate Stress – The Psychology of Living Abroad

I have been asked to give advice on a podcast made by an American living in China about personal issues. I have myself given the podcast the working title “Expatriate Stress”  as this seems to be the common denominator in the first four cases I have been presented with. The programmes with voice recordings and discussions will air in the coming months. Watch this space. As for now I will briefly write the cases up as we go, and post my personal notes for the replies I intend to give. My hope is that expatriates living in Denmark may benefit from reading about cases such as the following.  


Case 1:

Vee is 25 years old. Female. Been in China for over two years. Currently experiences a lot of changes. Most problematic one, “my best friend and room mate is moving to another city.”


She has experienced a lot of positive and negative things impacting her psychologically recently including: A new hobby, new acquaintances, painful love rejection, homesickness and the already mentioned loss of a close relationship with a friend. Also she got a new job for the first time in three years, and is putting in a lot of overtime. She has recently experienced harassment from an ex, ending up calling the police. “For the time in my life” as she says. This has obviously been tremendously stressful for her.


She says to summarize: “My trigger point: My only best friend / room mate moving to another city in a couple of months.” Known each other for 8 years. Recently they had got more distant and been in conflicts, some of the fights giving her panic attacks. This she says, she has “never experienced before.”

She goes on saying: “Now I am: Sad, anxious, broken and lonely. I am afraid of the future. Looking for help to ease her anxiety.”

My notes and reply:

First thought – also based on the sadness of her voice, is that she is teetering on some level of depression.


She is obviously suffering from a feeling of rejection and loneliness, not having the quality of connectedness and relationships that she needs. Based on the so called “Self determination theory” we have three basic psychological needs: autonomy, competence and relatedness. As it sounds she has all the autonomy anyone could ask for, and she also sounds competent, although I can’t know that apart from the fact that it obviously takes skills to perform even adequately in a completely foreign culture. Her relationship need sounds critically unfulfilled.

The question becomes how to fix that? That is a good question. She mentions missing family and close friends. And these things you can’t fix overnight. These types of relationships are all about deep roots down into your past and even geography.


And it’s not for want of her trying to establish relationships it seems, she mentions having tried to establish romantic relationships and not having had success. To some extent she also sounds unlucky. Here the best advice may be: Keep trying.

I wonder why she would start having conflicts with her room mate and long time friend? I wonder if she had some stress before the break with her friend, as stress tends to bring us out of balance and more prone to experience conflicts. Perhaps they wouldn’t have had that falling out had they been back in the US. I hope they realize that and forgive each other and work it out. Although sometimes having breaks and pauses in friendships is okay and the way of life.


What should she do about her anxiety attacks? They often result for build tension that gets released in these harmless yet deeply disturbing spasms of the mind. In a sense a panic attack is the just the body recalibrating its energy. Therefore the best way of dealing with them is letting them do their thing without being to worried about what they are all about. My best advice to her would be to google: “anxiety attack work sheets CBT”, there are many free tools online that greatly reduce the discomfort, anguish and worry related to panic attacks.


There is an acute problem: When ever we experience a crisis we tend to need to reduce the amount of inputs we get. It seems that we know deep down that when we are sad and confused we need space to think. In other words: Being in a crisis and beginning a new job with a lot of overtime is a bad cocktail, and may be the root cause of her depressive symptoms. Therefore this is my advice: Dear Vee, I don’t necessarily think that you should call in sick, but do your best to negotiate your overtime down. Say something like this: “In order to get into the job in the best possible way I also need to breathe and digest what I do. I’ll put in plenty of overtime in some months.” Thus buying yourself some time – if at all possible.


My final thoughts would be that I have the utmost respect for people trying to make a living in such a foreign culture so far from home. Vee you have balls.

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Published by thomasmarkersen

Praktiserende psykolog og konsulent i erhvervslivet

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