Living in another country changes you in ways that are hard to explain to people who haven’t done it. The initial excitement fades, and what replaces it is often more complicated than homesickness. It’s a slow reorganization of identity.
Many expats I work with aren’t in crisis. They’re functional. But “functional” has started to feel like the ceiling rather than the floor, and they want to understand why they feel stuck, disconnected, or not quite themselves despite having built a good life abroad. As an expat counselor, English-speaking counselor, and international therapist, I offer online counseling in English for people living overseas: individuals and couples living abroad.
When you’re abroad and something feels “off”
People often reach out when life looks stable on paper but their inner experience has shifted.
- You feel lonely even when you’re surrounded by people.
- You’re functioning (work is fine) but you feel flat, detached, or unreal.
- You don’t recognize yourself in this version of your life.
- Your relationship is under strain after the move.
- You’re stuck in the same loops and don’t know what keeps recreating them.
Why Expats Look for an English-Speaking Therapist
Therapy works through language, through the specific words you use to describe your experience and the nuances a therapist picks up on. Working in your second or third language adds a barrier that most people underestimate. It's not that you can't communicate in another language; it's that the emotional texture gets flattened. The difference between "I'm frustrated" and "I feel like I'm losing myself" is the difference between surface reporting and actual therapeutic work.
Beyond language, there's the question of cultural context. A therapist who doesn't understand what it means to be a foreigner, to deal with bureaucracies in another language, to raise children between cultures, to feel like a permanent guest, will spend valuable session time on explanations rather than exploration. I understand these dynamics personally, not just professionally. Whether you call it expat counselling, therapy abroad, or simply finding an English-speaking therapist overseas. What matters is working with someone who gets it without needing it explained.
What Expats Typically Bring to Therapy
The themes that come up most often in my work with expats include a persistent sense of not quite belonging. Not in the new country and increasingly not in the home country either, relationships strained by the asymmetry of who made the sacrifice to move, identity questions that were dormant before the move but surfaced once the familiar scaffolding was removed, difficulty forming deep friendships in adulthood and in a foreign culture, the cumulative weight of being "the foreigner" in every interaction, a persistent sense of unease or flatness that doesn't have an obvious cause but won't lift, and the strain of cross-cultural relationships or marriages where assumptions about roles, communication, and conflict don't align.
How I Work with Expats
I don't treat "being an expat" as the problem to solve. The move abroad is the context, but the work is about you: the patterns you brought with you, the ones that developed in response to the move, and the ways they interact. Sometimes the expat experience has amplified something that was already there. Sometimes it's created something new. Either way, understanding the pattern is what makes change possible.
Sessions are conducted online via secure video call, which means your therapy doesn't depend on where you live or how often you move. I work with clients across every time zone, and scheduling is flexible. If you relocate (which many of my clients do) you keep your therapist.
Individual and Couples Therapy for Expats
I offer both individual therapy (60 minutes) and couples therapy (60 minutes, with longer sessions available at pro-rated rates) for expats and international couples. Americans abroad often specifically look for an American therapist online or an American couples therapist who understands the cultural frame they grew up in. Before your first session, we have a brief 15-minute call to see if this feels like the right fit for you.
What the research says about expat mental health
The cross-cultural psychology literature on expatriate adjustment is surprisingly well-developed, and the pattern that emerges is consistent. Longitudinal studies of employed expats typically find that depression and anxiety rates are two to three times higher than for matched non-migrating peers, with the peak around 9 to 18 months into the posting — well past the initial honeymoon but before the person has built enough local roots to feel at home. The classic U-curve of cross-cultural adjustment described by Oberg and later refined by Black and Mendenhall matches this: initial excitement, a sharp dip, slow recovery, sometimes a second dip on return.
A second robust finding is that the strongest predictor of expat distress is not the degree of cultural distance between home and host country, but the degree of mismatch between the person's pre-move expectations and the realities they encounter. Couples where one partner moved primarily to support the other's career (the trailing-spouse literature) report the highest distress, with effect sizes larger than any specific cultural or linguistic variable. The psychological problem is rarely adjusting to the new country. It is adjusting to a version of yourself that you did not know you would have to become.
A third finding, from research on re-entry and trailing partners, is that expats tend to underreport distress for a long time before seeking help, partly because of the pressure to have made the right decision and partly because local social networks are thin enough that no one outside the marriage notices what is happening. By the time people reach out, the patterns are usually months or years into calcification. This is the argument for starting therapy earlier rather than waiting until something breaks.
Related reading
Frequently Asked Questions
Why should I see a therapist in English instead of in the local language?
Therapy works through the nuances of language: the specific words you use and the subtleties a therapist picks up on. Working in a second language often flattens emotional texture, which limits the depth of the work. Therapy in your first language lets you access the full range of your experience.
Do you understand what expat life is actually like?
Yes, personally, not just professionally. I'm an American living abroad, living cross-culturally and raising children between cultures. You won't need to spend session time explaining what it's like to be a foreigner.
What if I move to another country during therapy?
You keep your therapist. Because sessions are online, your therapy doesn't depend on where you live. Many of my clients have relocated during our work together without interruption.
Do you work across different time zones?
Yes. I work with clients across every time zone and scheduling is flexible. We'll find a time that works for your location.
Is expat therapy different from regular therapy?
The expat experience is the context, but the work is about you: the patterns you brought with you, the ones that developed in response to the move, and how they interact. Sometimes the move amplified something already there; sometimes it created something new. Either way, understanding the pattern is what makes change possible.
When in the posting do expats most often need therapy?
Research on expatriate adjustment consistently finds the period of greatest distress falls between roughly 9 and 18 months in — past the initial excitement, deep enough into daily life that the gap between expected and actual experience has become concrete, but usually before the person has built a local social network that can hold it. Many of my clients come at that point. Some come earlier, either because they saw it coming or because something broke fast.
Do you work with trailing spouses and partners who moved for someone else?
Yes, often. The trailing-spouse experience is a specific kind of disorientation — your partner has a job structure, a purpose, a reason for being in this country, and you have the country itself and whatever you can make of it. The distress research on this population is unambiguous, and the therapy work often involves separating what actually belongs to you from what the move has piled onto you. See trailing spouse.