Diary of a Global Therapist: Third Entry

It is 5 pm in Madrid and 10 am in the United States city where the person with whom I have a session today is. It's my "tea time" and her morning coffee.

Today's session is a follow-up session with an employee of a multinational company in the Gas & Oil sector, she is an expatriate in this American city and today's session is not so simple.

Mrs. X has been going through a difficult emotional situation for months but it was three weeks ago when she summoned up the courage to ask for help and that is why we are here today, in our third session together.

Mrs. X arrived more than a year ago at her new destination; she was traveling alone since after two months her partner with whom she had a relationship for 5 years would join her.

As she told me in the first session in which we met and began the evaluation, the first two months were difficult since she had to adapt to new tasks and in a language that despite being proficient was not her mother tongue, she also felt considerably alone outside of work. Still, Mrs. X was encouraged thinking that her partner would arrive soon and they could explore the area and make all the plans together that she was organizing.

Days before the first two months in that new destination, she received the news that her partner wanted to end the relationship, he had not felt the same for a while and these two months had helped him to understand that he no longer saw Mrs. X as the person with whom to share his life.

Since then her mood and well-being went through ups and downs but it is especially since three months ago that Mrs. X feels daily sadness, sleep issues at night and the need to spend the day in bed, she has altered her patterns of physical activity and eating and all this is affecting her work performance.

From the department of international mobility, they have told her about the possibility of returning to Spain if she continues like this since there are days when she does not go to work and if she feels hardly concentrate and very irritable with her colleagues.
What I have just described, the alterations in routines, mood, sleep, and concentration are clear symptoms of a depressive episode but I consider much more interesting the thoughts and emotions that are feeding these symptoms and that we have explored in previous sessions.

Thoughts related to decision-making to travel to the destination where she is since she would have preferred another project that was offered to her in another country where she knew the team and was more interesting to her, but she chose this American city since it made it easier for her ex-couple could travel with her. She is disappointed with the situation and with herself for having made this decision but also for the possibility of having to return before having learned and grown everything she expected.

Thoughts on the other hand related to guilt and comparison at a social level since she had previously had two similar breakups and the idea of ​​“What is wrong with me? ; "The same thing always happens to me." Adding to this an absolute feeling of loneliness since most of her coworkers lived in family and she felt out of the plans they were making and without the possibility of having a support group.

All these emotions and thoughts of guilt, sadness, loneliness and disappointment with herself and with the situation make Mrs. X live on a roller coaster of constant decisions (which has a lot to do with the alteration of rest and concentration) on whether to going or staying and what to do in both cases. It seems like every time she makes a decision a voice flares up in her head in favor of the opposite and she ends up feeling hopeless at the feeling that whatever she does she won't feel better.

I began this post by saying that it was not a simple session since, on the one hand, it may not be time to make a decision taking into account your mood but on the other hand the well-being and health of the employee and being in a place where she feels alone, without her family and in a stressful environment is not the ideal environment for her mental health.
These types of sessions also produce a waterfall of emotions in me, not only because of concern for Mrs. X's health but also for others like empathy.

Although each experience is unique and personal I think that all of us who have lived outside at some point have had similar thoughts and emotions such as nostalgia, the feeling of loneliness, guilt for not enjoying as much as we should, the comparison with the experiences of other ex-pats and disappointment with certain situations.
I have also experienced weeks in which those monsters in my head did not stop appearing at the least opportune moments and I have also had the feeling of changing my mind several times a day regarding my future.

Of course, almost all of us have also felt anguished after a breakup and blaming ourselves for what happened, thinking about what we have done wrong.

But not all the emotions that appear in me during the session are so difficult, I also feel curious and comfortable.

Mrs. X, like many other clients, has our sessions from home and unless I am in Sinews' office, I usually do them from mine as well.

I see behind her a set of different photos framed in what looks like three white-painted weathered wood frames, they are symmetrically arranged and especially beautiful. In them I can see Mrs. X in what seems like different trips, in one of them she is skiing with some mountains and snow-covered pines behind her, in another she seems to be in a swamp doing a kind of water skiing and in another, I think she is with a group of people. It is curious that although I have asked her in our sessions about her interests and hobbies she has not mentioned any of these activities.

But she can also learn a little more about me on a personal level after these sessions. Even though I try to have a neutral and distraction-free environment when I work from home, there are things that we cannot avoid such as the appearance of my dog, a mastiff as large as it is affectionate during sessions whose head is common to appear or one of his huge legs asking for love. I have also seen the dogs and cats of different clients over the past few years and have occasionally heard relatives or Amazon dealers calling home in the middle of the session. At first, this made me a little uncomfortable, nowadays and as long as it is not a great distraction, I think that these details humanize us, help us to get to know each other and connect us much more despite the distance.

Besides, doing the session from our home, with our favorite tea and mug and the comfort of a rug or the wood under our feet creates a feeling of safeness and self-care very optimal for therapy. Today at the beginning of the session Mrs. X tells me that she wanted to have it, that this morning she returned to do a little exercise, she had breakfast and made a coffee with her favorite vegetable milk to take it with me in session because she has thought that this is a morning that she wanted to dedicate to herself and to take care of herself physically and mentally. This attitude on the one hand surprises me and makes me very happy and on the other it makes me feel similar, comfortable with her, and willing to share and work together during this hour.

We will work together on the importance of normalizing certain emotions, of giving them space but trying not to give them all our attention, we will talk about emotional regulation and we will begin to carry out certain practical exercises and we will also try to incorporate behaviors and activities very little by little and progressively that she used to enjoy.

It is still too early to know how Mrs. X will progress and experience tells me that it is better to be cautious and go step by step, but we will try to learn from this experience and finally decide what to do.

We finish our time together and I send her by email different materials to practice, that, and the invitation to the next session.

See you next week for our next coffee/tea time together. Thank you for sharing so much with me, Mrs. X.