Stress

Even though most people don’t like it, stress is a normal part of our existence. If we have to give a presentation at work, before we go on a first date and even before we go on vacation many of us experience stress. In these situations, stress helps us: we become more alert and ready to take on a challenge.

But what happens exactly in our bodies at times of stress? Stress is always provoked by something, for example a situation or a thought. This creates a reaction in the amygdala, which in turn sends signals throughout our brain to start producing different hormones. The release of all these chemical messengers will help increase blood pressure and blood sugar and start preparation for (physical) action. The body prepares for fight-or-flight mode by increasing heartbeat and breathing, tension of muscles and therefor a boost of energy.   

In most cases our tension will fall after we have completed our task (finished a presentation, had a good start to that first date and made our flight). The body calms down and we get released from our fight-or-flight mode. But in some cases we are not able to shake off the stress reaction. Perhaps we experienced too much stress for too long. Maybe we (or others) are asking too much of ourselves. Or we experience a lack of support from family and friends. For whatever reason, we can’t seem to relax anymore.

If your feelings of stress continue for too long, you can develop a wide range of complaints such as a lack of energy, sadness, anxiety, sleeping problems, difficulty concentrating and forgetfulness. Since stress is physical reaction, people who are constantly feeling stressed tend to get more headaches, pain in the neck and shoulders, stomach problems and are more at risk to get sick due to low resistance. Due to stress, people also tend to engage in unhealthy behaviors such as drinking, smoking and overeating.

Do you notice any of these signs of prolonged stress and are you unable to deal with it? It is advised to contact your general practitioner to discuss the possibilities for mental health support.

亲爱的在荷学习生活的华人朋友们

无论您是刚刚开始在荷兰的生活对一切还都非常新鲜和好奇，或者您已经在这里生活了很长时间对这里的生活非常熟悉，但是或多或少您都经历了一些在一个外国城市生活的起起落落。想念不在身边的家人或爱人，怀念家乡的食物，更不用说学习荷兰语，习惯荷兰人直接的表达方式，建立社交圈，和融入荷兰社会了。

但是，除了适应和融入，您也许也正经历着其他的一些困难，比如说学习或者工作上的压力有时让人感觉崩溃，人际和亲密关系压的人喘不过气来，或者说您正饱受情绪问题的困扰。而很多时候，当您需要倾诉和被聆听的时候，身边却缺少一个可以信任的人或者稳固的社交圈去分享。如果您感到情绪低落，焦虑，和孤独，但是却没有来自他人的支持和帮助的时候，您是怎么应付的呢？

Kühler & Trooster国际精神卫生的精神科医生和临床心理学家在这里为您提供专业的支持和帮助。我们为一系列的精神或者心理问题提供诊断和治疗，例如，抑郁症，焦虑症，社交恐惧症，睡眠问题，和人格障碍等。针对来访者不同的个人需求，我们设计个性化的治疗方案：心理治疗或/和药物治疗。我们的临床心理学家提供一系列的心理治疗方法：认知行为疗法 （Cognitive Behavioural Therapy），眼动脱敏与再建（Eye Movement Desensitization and Reprocessing），接纳承诺疗法（Acceptance and Commitment Therapy），和图式治疗 （Schema Therapy）等。我们也提供基于正念训练（Mindfulness）的认识治疗小组。

我们认为在心理咨询中能够用母语沟通是很重要的。因此在Kühler & Trooster，我们有一位来自中国的心理学家，王帆博士，可以用中文为您提供服务。王帆出生和成长在中国，从2009年来阿姆斯特丹留学至今已经在国外生活了快10年。我们相信以她的专业训练和个人经历，她可以更好地理解您的困难和需要，并用中文为您提供支持和帮助。

如果您想更多地了解我们和我们的服务，可以发邮件到info@internationalmentalhealth.nl ， 或者拨打我们的电话085-0660500获取更多的信息。

How to increase your cultural intelligence

Most people will experience stress when moving to another country, but the intensity and duration of this ‘acculturation stress’ differs from one person to the next. Cultural intelligence plays an important role in this process, but other factors also come into play: personality traits, your social environment and the amount of contact you keep with people back home will also influence how you adapt to your new culture. The reason for moving abroad also influences your ability to adjust: people who are moving voluntarily generally adjust easier than people who are forced to move.

In a time of globalization, as we expats all know, it is important to be able to recognize and handle cultural diverse situations. As an expat, you need your cultural skills to adjust to a new country. Also, since companies tend to get more and more culturally diverse, you also need to rely on cultural intelligence in order to keep connected at work. This is why a higher cultural intelligence can lead to better job opportunities and increased success in your career.

Cultural intelligence is one of the components of general intelligence. Even though there isn’t a cultural intelligence measuring scale yet, your CQ (cultural quotient) seems to be just as important as IQ (intellectual quotient) and EQ (emotional quotient) nowadays. Even more so than your intellectual and emotional abilities, your cultural intelligence level is seen as a skill that you can train and grow. Here are some tips to increase your CQ:

Improving CQ-Knowledge
Learn about the culture of your new home country. By reading up about the history and current political situation, watching movies and talking to people from your new host country you’ll get better insights to the cultural aspects of it.

Improving CQ-Strategy
It is important to realize that culture shock is a clash between two cultures: your own culture and a new culture. By realizing your own cultural baggage, you’ll be prepared and better able to handle encounters with a new culture. Try writing down which norms and values are important to you from your own culture. How do they differ from the new culture?

Improving CQ-Action
Practice, practice, practice! The more intercultural encounters you’ll have, the smoother they will go. Small faux-pas in the beginning? Neven mind, be gentle with yourself and allow yourself some time to practice.

Lastly: try to keep a mild attitude towards new cultures. Differences aren’t necessarily good or bad, so see if you can observe these differences without judging. If you can let yourself be amazed instead of annoyed by them, you’ll probably find the adjustment to your new home much easier.

Cultural Intelligence

Thinking of Dutch culture, some typical things stand out: we are direct and straightforward, not afraid to speak our minds. We appear to be greedy, which even lead to the term ‘going Dutch’ - indicating that everyone in a group pays for themselves. We used to be good at soccer. At first, we seem very sociable and easy going, but sooner rather than later most foreigners feel they hit a wall when trying to befriend a Dutchman.

Some of these cultural characteristics are very well-known. This allows foreigners visiting or moving to the Netherlands to prepare. Worldwide there are a number of cultural rules that seem to be part of general knowledge: we know men and women do not touch publically in most Middle Eastern countries, in Japan we wouldn’t talk with a loud voice and in Italy you don’t drink cappuccino after breakfast or you will look like a cultural barbarian.

Within the field of psychology, the capability to relate and work effectively across cultures is called cultural intelligence. The term cultural intelligence was first introduces by Ang and Van Dyne in their research to measure and predict intercultural performance. They also came up with the term cultural quotient (CQ), which indicates the level of cultural intelligence. CQ is made up out of four capabilities:

1.  CQ-Drive is about interest and confidence when it comes to cultural diverse settings, how much joy you get out of engaging in intercultural contact.

2.  CQ-Knowledge is about how much you know about cultural differences and similarities, for example when it comes to economical systems, religious beliefs and language.

3.  CQ-Strategy is about how aware you are when it comes to intercultural experiences, so knowing your own culture, in what way you plan to handle an intercultural encounter and how you check with yourself if you have any assumptions or prejudice.

4.  CQ-Action is about your ability to adapt you verbal and non-verbal behaviour to different cultures.

Interested in increasing your cultural intelligence? Read our next blog!

Winter depression

A very common struggle for expats living in the Netherlands is getting through the dark and cold winter days. Even though the Netherlands has a good standard of living, there are plenty of job opportunities and there is a lot of cultural heritage to explore, our climate seems to be a hardship for many people. But what is winter depression and what can you do about it?

Seasonal affective disorder
The official term for winter depression is seasonal affective disorder (DSM V, 2014). The term seasonal affective disorder (SAD) was first introduced by South African psychiatrist Rosenthal, who  described the phenomenon in a journal in 1984. Symptoms of SAD are a decrease in energy, sadness, low concentration, more need for sleep (but less quality of sleep), increase in appetite (mainly in high caloric food) and weight gain.

It’s the season
Usually the complaints start during autumn or early winter and disappear when spring arrives. Sometimes, symptoms arise during the summer when the weather is bad for a longer period of time. One of the key criteria for SAD (instead of depression) is that it always occurs during a certain time of the year and there is also a period of remission during the summer. In some cases, there is even a manic or hypomanic episode during the summer.

Cause of SAD
It is believed that the cause of seasonal depression is a disturbed biological clock. Through our eyes our body receives sunlight, which leads to chemical processes in the brain. These chemical processes induce the production of hormones such as melatonin, that regulate our biological clock. Everybody produces melatonin the evening in order to sleep, but patients with SAD produce it in large quantities during the day. The high melatonin level also has an effect on our ‘happiness neurotransmitter’ serotonin, which is why people with seasonal affective disorder suffer both from a lack of energy and a depressed mood.

Treatment
There are a number of treatment options, such as exposure to light (both natural light and light therapy), regular exercise, supporting psychological treatment and pharmacotherapy.

Tips to cope with the cycle of change

In our previous blog you could learn about the cycle of change, which describes the emotional rollercoaster of an expat’s journey to adaptation to living abroad. Even though the manifestation of the different phases will differ per person, almost everyone who moves to another country will encounter every one of these stages.

But what to do with this knowledge? First of all: knowing that these changes and feelings will occur when you move to a different country is the first step. But how can you still make the most of your first year(s) and take good care of yourself during this rocky time?

- Think about what makes you happy. What kind of hobbies did you have back home? What is your usual pick-me-up when you feel down? Try to think of five activities that bring you joy and make a plan on how to do them in your new environment. In some cases you need to be creative, because your past hobbies might not be easily accessible in your new environment.  But keep in mind: doing things you love, even in times of sorrow, will lighten up your overall mood.

-  Make sure your days remain structured: get up early and make sure you have a combination of fun, meaningful and useful activities to do during the day. If you are a joining partner and not have to work it might feel like a vacation, but this is not a holiday – it’s your life.

-   Engage in new activities. Now that you are in a new environment, you can also think of skills that you always wanted to learn (such as language) or take on new hobbies (yoga, cooking class, creative course). Sometimes, being in a new place also gives you more time because you don’t have the same obligations to friends and family. Using this time for your own personal development can give you a great sense of accomplishment.

-  Find out how you can meet new people, maybe even looking for people who are in the same boat. Make sure you surround yourself with positive people: complaining might feel good for an hour, but meeting people with a positive energy will be more likely to pick up your spirits as well.

-   Even if you and your partner are not on the same page, make sure you have an open and honest communication about how you are feeling. Even more so because being a working expat and joining spouse can create tension in a relationship, it is very important that you keep each other informed about the stage you’re in and what he/she can do to support you.

If you feel you could use some professional help to cope with adjusting to living abroad, please contact us so that we can help you get proper treatment: info@internationalmentalhealth.nl

Cycle of change

Living abroad has many different charms and challenges. Being confronted with a new culture, new people and possibly new languages can both be exciting and overwhelming. No matter how near or far you have moved away from your previous home, you will most likely notice a difference between your old and your new life.

Some people find it easy to adjust to their new environment, whereas others struggle with adjusting and finding a sense of home. Some expats face problems related to moving, such as homesickness and finding new meaningful daily activities. Other expats are confronted with problems they have had for a long time, such as dealing with depression, anxiety or self-esteem issues.

Even though everyone handles the adjustment to a new country in their own ways, there is a cycle of change that almost all expats go through before really settling in and feeling grounded. According to the U-Curve Theory of Adjustment (Lysgaard, 1955) all expats go through four stages of adjustment:

1. Honeymoon
The first stage is the honeymoon phase, where expats see their new country through rose-tinted glasses. The mindset they adopt is like that of a tourist: everything is new and exciting and people are keen to explore their new environment. 

2. Culture shock
When the newcomers have to deal with real conditions on a daily basis (setting up house, possibly finding a job, building a social network, language problems), the second stage kicks in: culture shock. This stage is characterized by feelings of isolation and frustration and can also trigger physical (stress) symptoms. In some cases, the feelings expats experience are similar to symptoms of depression.

3. Adjustment
The third stage is the adjustment stage, in which the expat is gradually adapting to the new country and is able to act more appropriately. For some people during this stage there is a tendency to ‘compare to complain’: while settling in there is a constant tendency to compare the new environment to the life they had before.

4. Mastery
In the last stage, which is called the stage of mastery, the expat is able to function effectively in the new culture.

The duration of the cycles most expats go through differ greatly from person to person. The average time to adjust to a new culture (and go through all of the stages) is thought to be around nine months. It is very common for the joining spouse to experience more difficulties in adjusting than the working expat, since the working expat is more likely to be engaged in work while the spouse has to deal with more of the daily troubles of running a household.

Want to learn how to cope with this cycle of change? Read our next blog!

Mindfulness

On my way to work, which is a 15-minute bike ride, I’m confronted with a non-stop flow of images, sounds and impressions. Traffic lights, cars, parents on cargo bikes hurrying to drop their kids off to school. Nonetheless, every morning I manage to make it to work without even consciously noticing all those things. Instead, my mind takes me to places that are completely irrelevant at the time: a conversation I had with a friend last week, phone calls that I need to make, a recipe that I want to try soon…

By the time I get to work, my mind has been filled with a number of irrelevant thoughts, worries and images. And on top of that, I had to juggle traffic in order to get to work safely and on time. It’s no wonder that, even though my day has just begun, I feel a level of stress as if I have been working, running and talking simultaneously for 24 hours straight.

Can you relate? You’re not alone. Many people struggle with this phenomenon, where they are engaged in an activity, but their minds wander off to completely different places. A lot of the times, we are not even aware of what we are thinking: our minds just race from one place to the next, one image after another, one worry at a time. This process of not being aware of the present and not being connected to what you do, feel and think can be stopped by a very helpful skill: mindfulness.

Mindfulness means: to be completely aware of your current experience. To be mindful means to be able to focus on the present and open to whatever is there at that moment. By improving your mindfulness skills, you will notice signs of stress earlier and you will be better able to deal with negative thought patterns. There is a higher level of awareness and you can better guard your boundaries. With mindfulness you live more intensely and consciously.

Mindfulness teaches you how to focus on the present and therefore experience less distress from negative thoughts and emotions. It has proven to be effective for people with a wide range of psychological problems and can generally help to improve the quality of life. As Jon Kabat-Zinn, the founder of the mindfulness training, has said:

“You can't stop the waves, but you can learn to surf”

Are you interested in seeing what mindfulness can do for you? Please contact us at info@internationalmentalhealth.nl or 085-0660500 to get more information on our 8-week mindfulness course starting March 5 2019.

New Blog

Kühler & Trooster International Mental Health will start publishing a blog.