In a world that's more interconnected than ever, the role of a therapist has evolved to become a unique blend of confidant, cultural interpreter, and emotional guide. The therapy room is no longer just a sanctuary for local clients but a global melting pot, a meeting place for diverse minds and experiences from around the world. This enriches not just the therapeutic process but also the therapist's own personal and professional journey.
As someone who has had the privilege of working with clients from various cultural, linguistic, and emotional landscapes, I've come to appreciate the multifaceted joys and challenges this profession brings (and I'm still learning!). From the deeply personal to the broadly international, each aspect adds a layer of complexity and reward that makes this job unlike any other.
In this post, I'll share 20 things that make being a therapist, particularly for internationals, an incredibly fulfilling experience. These points reflect various facets of the therapeutic experience: emotional rewards (points 1-3), intellectual challenges (points 4-6), personal growth (points 7 & 8), and the diversity of experiences (points 9-10). Additionally, they highlight the unique challenges and learnings that come with navigating the complexities of the global human psyche. Index
It's a privilege to delve into the inner workings of another person's mind. Therapists don't lie when they consider this a privilege. Imagine meeting a stranger on the street and getting to know their life story, family history, culture, and more. It's a fascinating pandemonium that never ceases to intrigue me.
2. Alleviating Suffering
While suffering is a universal part of the human condition, the ability to alleviate or manage it through therapy is incredibly rewarding. Suffering is universal; it's part of the animal condition. Unnecessary suffering is part of the human condition—suffering that could have been avoided.
There's often also laughter and joy, and a steady compassionate intention to minimize or alleviate suffering (see my previous post on dealing with suffering compassionately). It's a choice between looking away or being there with the person, helping them navigate their pain. As Hayes (2016) mentions, "Can the suffering itself be therapeutic rather than problematic? Can having an understanding and resilience to endure suffering be the therapy?" 3. The Power of Vulnerability and the Shadow Within
Creating a space where people can be vulnerable is not just fulfilling; it's transformative. Yes, you might make people cry, and while that could tap into a darker, perhaps even harmful side, it's often a necessary part of the therapeutic process. Carl Jung once said, "One does not become enlightened by imagining figures of light, but by making the darkness conscious." In therapy, this confrontation often happens in moments of emotional openness. It's in these moments that what Jung referred to as the 'Shadow' comes to light, and the real work begins. Allowing a space for such vulnerability can be both a challenge and a reward, but it's where the deepest healing often occurs.
4. Continuous Learning
The field of psychotherapy offers endless opportunities for learning—from clients, studies, articles, books, podcasts. And it's also the inner journey that each therapist undertakes. Your own observations and reflections can often serve as profound lessons, revealing intimate insights that no textbook could offer you. The therapeutic process often serves as a mirror, reflecting not just the client's emotional state but also my own biases and aspirations. This inner journey is as enlightening as any formal study. It's a lifelong journey of discovery. You would need 100 lifetimes to learn it all, and then some.
5. Skill Development
Getting better and more skilled in psychotherapy is not just rewarding; it's a necessity. When things click in a session, it's exhilarating. But when they don't, it's not just disappointing—it's a call to action. Deliberate practice, which involves mindfully focusing on improving your clinical skills, setting specific goals, and measuring your improvement rate, can help you level up your skills. This is a continuous process, one that turns setbacks into learning experiences. For more insights on this, check out my previous post, "Therapy reflections: How to become a better therapist".
6. Cognitive and Emotional Stretching
The profession tests you in various ways—ethical dilemmas, emotional intensity, and even your own transference and projections. Long hours, intense emotions, ethical dilemmas, tests to your integrity, having some (very limited) power and suggestibility over a person, your own transference and projections, a busy workload, at times not knowing what to do, dealing with crises, avoiding secondary traumatization, and the list goes on. It keeps you on your toes, making each day a new challenge.
Being a therapist makes you ponder your own life choices and practices. Allowing others to self-reflect invariably makes you think about your own life choices and what is meaningful to you, not just to them. It's a constant reminder to align your actions with your values.
8. Flow State
Being in the flow is exhilarating. On good days, it feels like being in the zone, and you're fully present. Time passes by fast, and at the end of the day, you leave with a big high. You're simply focused and engaged on the person in front of you, being really present, having an open-beginner's attitude, yet also bringing your common sense (the least common of all senses) and your experience along with you. What can help me get into such a state is just taking 30 to 60 seconds to breathe before entering into a session.
9. Exploring the (embodied) Mind
From interpersonal relationships to neuroscientific studies, the field offers a vast area to explore and understand. The interpersonal relationship you build with your client, attachment styles, maladaptive schemas, IQ tests, personality assessments, process diagnostics (so essential!), neuroscientific studies, body/somatic processes that you get to explore. So much information that you and your client try to make sense of.
10. Diverse Interactions
The profession brings you face-to-face with people from all walks of life, enriching your experience and broadening your perspective. People from different nations, cultural, and ethnic backgrounds come and sit on the same chair. People I would have otherwise never spoken to. The CEO of a big company gets to sit on the same chair as the former homeless addict (and sometimes they're even the same person!).
Bonus: The Relationship
Building a professional and human relationship with clients adds another layer of fulfillment to the practice. Yes, there is a professional relationship (client-to-therapist) and also a human relationship (human-to-human). As Carl Rogers once reflected, "In my early professional years, I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?" This shift in perspective encapsulates the evolving nature of the therapeutic relationship, emphasizing its role as a catalyst for personal growth for both the therapist and the client. 10 More Things I Love About Being a Therapist for Internationals
11. Navigating Cultural Nuances
Working with internationals brings a rich tapestry of cultural backgrounds into the therapy room. For instance, speaking to a high-context Asian client and asking her to mention specific words in her language can open up new dimensions in the therapeutic process. These moments of cultural clarity are not just enlightening for the client but also for me, as they deepen my understanding of the intricate ways culture and psychology are intertwined. For an initial look into Expat Psychology have a read of my previous post.
12. The Linguistic Landscapes
Switching between languages in a therapy session is not just a skill but an art. For example, certain emotions appear to be linked to specific languages and places that the expat has experienced in their past. A phrase in one language can carry a different emotional weight in another, revealing layers of meaning and emotion that were previously hidden. If interested see my previous post on "Why do certain clients not want to talk in their native language in therapy."
13.The Global Mindset & Expatriate Challenges
Helping clients navigate the emotional and psychological challenges of living far from home is incredibly rewarding. For example, speaking to a child who has moved 15 times brings unique challenges and perspectives that enrich the therapeutic process. From dealing with homesickness to adapting to a new culture, the expatriate experience adds a unique layer to therapy. While there are resources like the book "Unstacking Your Grief Tower: A Guide to Processing Grief as an Adult Third Culture Kid" that address migratory and gradually accumulated grief, it's clear that we are just scratching the surface. Much remains to be uncovered in understanding and addressing the complexities of the expatriate journey. In my post on Expat-Informed Psychotherapy I embark on some of the relevant topics regarding cross cultural mental health care.
14. Transcultural Insights
Internationals often bring a complex set of emotions into the therapy room—feelings of rootlessness, identity crises, or even guilt for leaving their home country. Asking a refugee (or any other migrant) to point out on a map how they traveled to get here can make their journey and felt experience more concrete. Another effective intervention is the use of cultural genograms, which map out not just the family structure but also the cultural influences, traditions, and migration patterns that have shaped the client's life. This tool can reveal hidden stressors or strengths that come from the client's cultural background, adding another layer of depth to our understanding and enriching the therapeutic process
15. Continuous Adaptation and Learning
Working with a diverse clientele means I have to continuously adapt my therapeutic approach. Whether it's incorporating cultural rituals into therapy or understanding the nuances of non-verbal communication across cultures, each client teaches me something new. This is a psychological frontier, and the need for more research is immense.
16. Building Global Relationships and a Sense of Belonging
The relationships I build with my international clients go beyond the professional realm; they're a bridge between two individuals who may come from vastly different corners of the world. It's humbling to realize that despite our diverse backgrounds, the core human experience remains universal.
In my practice, I strive to foster a culture where everyone feels they belong. I sometimes tell my clients, "You are welcome here." and look at instances where they felt they belonged. This sense of belonging is not just a feel-good factor; it's backed by research. In a recent academic article colleagues at Erasmus University and I authored, we explored the psychological impact of residential migration on one's sense of belonging and attachment style. The study found that insecure attachment was associated with increased migration early in life and, more generally, predictive of a negative sense of belonging later in life. Read the full article here
17. Practicing Therapeutic Tools
The diversity of international clients allows me to employ a wide range of therapeutic techniques. From mindfulness practices rooted in Eastern philosophies to cognitive-behavioral approaches more common in the West, each client's background enriches the therapeutic toolbox. It could also be a saying, a cultural practice that is unknown to me, or something they learnt from another therapist on a different continent.
18. Ethical Considerations
Ethical considerations take on a new dimension when working with internationals. From informed consent across language barriers to having health care providers across several countries to respecting cultural sensitivities, the ethical landscape is both challenging and enriching.
19. Even more Self-Reflection
Working with internationals amplifies my own self-reflection. It's not just about my life choices anymore; it's about understanding my place in a global community. It challenges me to think beyond my cultural bubble and consider the broader implications of my work.
20. The Frontier of Psychological Research
Though migration is as old as humanity itself, travelling as frequently and extensively as many humans do now, and being more connected across the planet than ever before, feels like standing on the frontier of psychological research. The unique challenges and opportunities presented by a diverse clients make every session an exploration into uncharted psychological territory. It's a constant reminder that we are at the cusp of new understandings and that the need for future research in this area is crucial. This pioneering aspect of the job is not just professionally fulfilling but also personally exhilarating, as it pushes the boundaries of what we know about human psychology. 21. Bonus: Tell Me What I'm Missing
While this list is comprehensive, it's by no means exhaustive. The field of psychotherapy, especially when dealing with international clients, is ever-evolving and full of nuances that one blog post can't possibly capture. So, I turn to you, dear reader: What would you add to this list? What unique joys, challenges, or insights have you experienced in your practice (or travels) that deserve to be shared? Your input could provide a fresh perspective and enrich this conversation for all of us. References
Esters, P., Godor, B. P., & Van der Hallen, R. (2022). Investigating the role of residential migration history on the relationship between attachment and sense of belonging: A sem approach. Journal of Community Psychology, 51(1), 468–485. https://doi.org/10.1002/jcop.22918
Hayes, C. (2016). Is suffering therapeutic? an exploration of Buddhist ideas and Rogers’ six conditions. Person-Centered & Experiential Psychotherapies, 15(3), 245–255. https://doi.org/10.1080/14779757.2016.1188411 Wells, L. (2021). Unstacking your grief tower: For adult third culture kids. Independently Published.