14 Jul 2024
Expats and mental health: YOUR questions answered
Community Expat Support General Counselling

Expats and mental health: YOUR questions answered

Where’s the good in goodbye? This week, our mental health expert, Lysanne Sizoo, responds to a query sent in by a reader on a dilemma that all expats have to face at some time: saying goodbye.


Q2. As an expat, I have made many wonderful, close friendships with other English-speaking expats, which has not only broadened my mind to new cultures, but has been a source of great comfort in Sweden. The problem is, many of them are here for only a short time, or they suddenly leave and I feel bereft and somewhat cheated by having someone close move away. Do you have any advice on how to deal with this?

Dear C.

You are describing a process that has everything to do with grieving and loss, although we seldom think of it in this way. In the article on dealing with a parent’s death, I wrote about the process of grief. In short, grieving is both about finding a new way to fill the aching hole left behind by the death of a loved one, and also about envisaging a new future for ourselves.

When someone close to us dies, grieving is an appropriate and expected response. When it comes to suffering from a loss inflicted by moving away or being moved away from, grieving seems like an overreaction.

And yet, in all the literature about Third Culture Kids, identity issues and grieving are found to be the top two concerns.


Disenfranchised grief

According to Kenneth J. Doka, PhD, professor of gerontology at the College of New Rochelle in New York, the term disenfranchised grief “describes the pain of a significant loss that is not openly acknowledged or socially supported.” Disenfranchised grief can result from a number of situations such as the loss of a pet, a termination, miscarriage, the death of an ex-spouse, etc. Because other people can’t comprehend our sadness, we believe we ought not to be sad and  so we bury our feelings. We may also feel judged, which further discourages us from sharing our feelings. In other cases, you yourself don’t think it’s acceptable to grieve under the given circumstances.

As someone once said to me, “It’s all well and good to say that I am allowed to grieve, but I don’t know how to.” As if grieving is a kind of psychological tap that you can switch on and off.

Grieving is not something you actively ‘do’, it is something that happens to you, whether you want it to or not. You can invite yourself to be part of the process, or you can try to fight against it.


Classic signs of grieving are:

  • a constant feeling of malaise,
  • a tendency to become introspective to the point of self-obsessed,
  • feeling angry and resentful
  • and (as touched on in the original question) somehow feeling cheated out of something that you felt was your due.

We’re often too hard on ourselves, placing the blame on our shoulders and attempting to shrug it off. We tell ourselves that the choices we’ve made have lead to these situations, so there really isn’t any need to cry about it. But wait a second. Are we that tough on ourselves that we can’t explore the pain and discomfort of the beds we’ve made? We make choices, mostly, for all the right reasons based on the information we have at that time. Some work out, with a little pain and adjustment, and some turn around and whack us in the face. Adding guilt on top of grief will only make matters worse.


Hello blue expat, you’re normal

In your letter, you mention a sense of betrayal, as if expectation and reality are discordant. This leads me to wonder whether you’re getting to the stage where, subconsciously, you’re trying to protect yourself from further hurt by avoiding making new connections because you will eventually have to say goodbye to them. Indeed, how hard it is to connect fully to someone while at the same time knowing, and anticipating, that your friendship won’t last? It demands from us that we truly live in the ‘here and now’; in this moment, at this time, this particular person plays a role in my life, and I fully engage while knowing it is not going to be forever.

Just as, in being an expat, we are pushing geographical boundaries, so too are we pushing the boundaries of our emotions.

Were we have the extremes of adventure and excitement, we also have intense feelings of pain; leading us to live our lives with a greater sense of awareness and resilience.


Feelings are there to be felt

So how do you deal with this gradual onset of ‘hello and goodbye’ fatigue? And how do you get to the ‘here and now’ without losing the richness and the depth of a relationship?

To begin with, it helps to take a long, hard look inside and explore all of the feelings of loss that you have been experiencing, both short term and long term. You may want to write a list of everyone who has touched your life as an expat, and write a few lines on what each of them has meant to you (whether you share these thoughts with others is up to you).

I would also invite you to reflect on the nature of different kinds of friendships. There are friends with whom we share deep, long lasting connections that transcend geographical boundaries; friends that we may not have seen for a while, but who are so familiar that we can instantly pick up where we left of; connecting on a level of who we are, rather than what we’re doing. Then there are friends with whom we can easily spend a few delightful hours, but who don’t necessarily get to see the depth of our soul. Sometimes these friendships grow into the kind of intimate, long distance relationships that are not determined by frequency, but by intensity. Being an expat means that part of the grieving process is the realisation that some friendships may have developed into something more meaningful, had they only been given time.

Some people crave friendships that are deep and meaningful, where you can truly reveal all of yourself without having to be afraid. Others are happier with a large crowd of friends, saving their innermost selves for their partners or siblings.

So explore what you are looking for in a friendship, be realistic about the likelihood of it happening with this particular person, and thus enjoy it for what it is. This may help with your sense of betrayal.


Early abandonment

Then there are people who carry a deeper wound, from much earlier in their lives, where loss equalled a sense of abandonment. When these people embark on (or continue) a nomadic life, this unfinished infant anxiety is triggered with every new ‘hello and goodbye’. With permission, I can tell you about a client whose nannies kept changing with every new move. The nannies were her primary caregivers and so their continuous and inexplicable loss would have felt overwhelming to her as an infant. In the meantime, her mother, hardworking and professionally engaged outside the home, was still a part of her life with every move. This led to confusion; after all, she was never abandoned by her mother, so why should she experience abandonment anxiety? Once we put two and two together her ‘abandoned inner child’ could finally be integrated and cared for, and the intensity of her grief at the ebb and flow of expat relationships could match the actual experience, rather than trigger the old.


In summary

The ‘hello and goodbye’ of expat life is part and parcel of a process that is called “disenfranchised grief.” Once we give ourselves permission to experience the natural feelings of grief, the symptoms of sadness, anger and resentment will begin to find their place.

If you’re suffering from ‘too many goodbyes’ exhaustion, you need to weigh up if this lifestyle is still right for you. Assess what you actually want from a friendship, and adjust your expectations to what a friendship is able to offer you accordingly.

And finally, if, as a young child, you experienced a lot of separation, some of your surfacing grief might be old and needs to be worked through in the right context so that you can grieve for what was then, rather than it being triggered by what is now.


Copyright 2013: Lysanne Sizoo

Lysanne Sizoo



These articles are a composite of my personal, my colleagues’ and

clients’ experiences in order to protect recognition. All therapeutic

meetings are Turning Point are confidential, and specific content would

never be shared in a public forum.


If you have any specific problem that you would like Lysanne to consider in her articles, please contact her here (anonymity will always be preserved). 


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Lysanne Sizoo is the founder and director of Turning Point, the only international counselling centre in Stockholm. In 2008 she obtained her psychotherapy license from the United Kingdom Council for Psychotherapy. She has been practising as a counsellor and psychotherapist since 1997, specialising in the field of cross cultural issues, as well as fertility, bereavement, parenting, anxiety and stress management.


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