What kinds of treatments do we offer?

Since the start of our clinic in 2014, we have treated over 1500 individual patients. Every single patient has had their own history, complaints and goals for treatment. We want you to have the best treatment for you, which means that we tailor your treatment so that it helps you achieve your goals in the most effective way.

In order to do this, our team of psychiatrists and psychologists work closely together to assess if and how we can help. After the intake, we make a proposal for a treatment plan and discuss which form of therapy suits you as a person and will help with your complaints. Out therapists are trained in the following therapies:

• Cognitive behavioral therapy
This is a therapy that focuses on the relationship between your thoughts, emotions and behavior. It’s a very effective therapy for depression, anxiety and addiction (and more). It focuses mainly on the present: what you think, feel and do in current situations, and therefor can help you notice improvement quickly in the process.

• EMDR
EMDR is an effective therapy for PTSD and other trauma-related complaints. It helps processing negative memories and helps restore self-esteem. • Motivational interviewing Motivational interviewing is a great way to find out what you want in therapy – or life. It helps to way out the pros and cons of behavior and helps set goals.

• Schema therapy
Whenever current complaints seem to be related to (traumatic) experiences in the past, we use schema therapy to gain insight, understanding and better coping.

• Mentalization based therapy
This is a form of therapy that focuses on getting a better understanding of your own emotions and reactions, but also helps to see them in others. It is mainly used for treatment of personality disorders.

• Acceptance & commitment therapy (ACT)
ACT focuses on changing things that you can change and setting goals that matter on one side, and accepting parts of you and the world on the other side. It combines techniques from CBT and mindfulness.

• Interpersonal Psychotherapy (IPT)
IPT is a form of therapy that focuses on improving relationships with others in order to reduce complaints.

• Pharmacotherapy
Pharmacotherapy means: treatment of complaints by using medication, next to psychotherapy (‘talk therapy’). The psychiatrist is responsible for this form of therapy, whereas the other therapies are with one of the psychologists.

Kühler & Partners : your international therapist

Kühler & Partners International Mental Health was founded by psychiatrist Esther Kühler who had the aim and ambition to create tailor-made therapy for (mainly) international patients. With most therapists either having lived abroad or being expatriates in the Netherlands themselves, we get the highs and lows of living abroad and want to combine this experience with excellent mental healthcare.

Some fun facts about our clinic:

- Over the last 6 years we have seen over 1500 individual patients.

- Our youngest patient was 3 and our oldest 80 years old.

- We have treated patients of 78 different nationalities.

- We offer therapy in two locations: The Hague and Amsterdam.

- Our staff consists of therapists from the Netherlands, Germany, Ireland, Chile, China and USA.

- We speak Dutch, English, German, Spanish, French, Japanese and Chinese.

How effective is online therapy?

Online therapy, also known as e-therapy, involves providing mental health services and support over the internet. This can occur through email, text messaging, video conferencing, online chat, messaging or (internet) phone. There are different variations of online therapy, ranging from unguided (no communication with therapist) to guided (communication with therapist) and from a-synchronic (for example e-mail contact and online modules with therapist feedback) to synchronic contact (video calling, phone consultation).

With COVID-19, online therapy has become the ‘new normal’ in mental healthcare. But although online might feel new to you, it is in no way a new phenomenon. People were using phone consultations to provide mental health support as early as the 1960s. But if you define online therapy as offering mental health advice via the internet, you could claim its history started in 1986 with the creation of Dear Uncle Ezra, a Cornell University question and answer forum where people frequently discussed mental health issues. Several notable mental health advice columns and forums followed Dear Uncle Ezra. During the 2000s online therapy gradually became more popular and widespread. Businesses and therapy practices began trying to expand so they could treat thousands of clients at once.

One of the great advantages of online therapy is that it can offer mental healthcare to larger groups of people, including those who for various reasons are not able to physically see a therapist. But many people wonder: is online therapy as effective as face-to-face sessions?

Luckily, a lot of research has been done by this topic in the recent years. One of the leading researchers in the Netherlands is Heleen Riper, who hosted a webinar for mental health care professionals transitioning from face-to-face to online contact with clients. In the various research studies she worked on, the overall conclusion is clear: online therapy for depressive disorder, panic disorder, social anxiety disorder and generalized anxiety disorder is equally effective as ‘treatment as usual’ (face-to-face). Moreover, some research shows that online therapy improves adherence to treatment and was preferred over face-to-face sessions by some clients.

If you want to get the most out of your (online) treatment, or need help with mental health problems? Please contact us to see how we can help!

Source: https://www.heleenriper.nl/ ; webinar by Ehealth Specialists

COVID 19: from face-to-face to online treatment

Since the worldwide outbreak of COVID-19 many things in our day to day life have changed: most of us are working from home, we are no longer celebrating birthdays and weddings, we are taking precautions when we see our friends and family and our leisure time is spent less in public space.

If you are in therapy or are about to start treatment, another aspect has changed as well: you are no longer seeing your therapist in the office, but have adjusted to online contact or doing phone consultations.  This can feel strange at first, but it is our job as therapists to help you get acquainted with this ‘new’ form of therapy and to create a warm and safe therapeutic online relationship.

Whether you are already in therapy or about to start, here are a few guidelines to make the transition from face-to-face to online therapy as smooth as possible:

1.       Make sure you are in a safe and private space
Something that is natural when you are in your therapist’s office but not necessarily when you are at home with your family: a place where you can talk, undisturbed and in private. This is an essential part of therapy, so that’s why it’s important to discuss your therapy with your housemates and make sure you can have the time and space to have your sessions without being disturbed.

2.       Think about de-therapy
Many of our clients at Kühler & Trooster make great use of the Vondelpark right after their sessions. Going for a walk is a great way to de-therapy: taking the time to unwind and process your therapy session, so that you don’t immediately rush to the rest of your day. Especially if you are working from home, it can be tempting to squish therapy into your working day. However, processing your therapy is also part of therapy, so make sure you have a bit of time before therapy to prepare, and take a break or walk after your session to de-therapy.

3.       Make sure you are comfortable
Get in a comfortable chair, allow yourself a big class or water or warm cup of coffee or tea so that you are comfortable during your session.

4.       Think about visibility and connection
Check your Wi-Fi connection in advance and consider which part of your house or room is most suitable for therapy. Dark corners or opposite a window can be difficult because your therapist has a hard time seeing your face, and therefore cannot follow your expression and emotion optimally.

5.       Communicate your feelings
Make sure to talk with your therapist about how online treatment is working for you. If you feel uncomfortable, it can be worthwhile to discuss what is bothering you to see if he/or she can help break certain barriers and establish a way that works for you.

Even though online therapy might feel new to you, it has actually been here for decades. Research has shown positive effects, also when compared to face-to-face sessions. For more information about the effectiveness of online therapy: stay tuned for our next blog!

How to spend a non-traditional Christmas

Some people love Christmas, others hate it. Some like the traditional celebration, others prefer to do something more original. But there are also people that don’t have a choice, people who are forced to spend Christmas away from family or loved ones for whatever reason – living abroad, financial problems, conflicts or loss. And lastly, there are also people that simply prefer to spend Christmas by themselves without all the pressures and expectations.

As Angelica Baini put it in her article ‘A beginner’s guide to spend Christmas alone’:

“Christmas is a time of comfort, joy, and a shitload of cultural expectations about family and togetherness.”

If for whatever reason you can’t or don’t want to spend a traditional Christmas or are looking for ways to spend Christmas by yourself, allow us to give you some suggestions:

-          Do something sportive
Even though there are limitations due to opening hours, there are always sportive activities that you can do during the Christmas days. Taking a long winter hike or going ice skating, but also your usual workouts such as running or cycling are good options.
-          Go to the movies
If you are not that interested in the holiday vibe, going to the movies is a great way to escape reality for a few hours and take your mind off things.
-          Do something cultural
During Christmas, some museums are still open so you can go out and enjoy a cultural activity. If you’re more into nature than culture, you could opt to go to the Zoo instead.
-          Take a trip
If you are planning to travel, Christmas day is a good day to start your trip. There are less crowds on airports and chances are your ticket will cost less on this date.
-          Lend a hand
If you want Christmas to be about giving, you could decide to do some charity work during the holidays. There are lots of organizations that offer help for homeless people or the elderly and are looking for extra volunteers to help out during Christmas. This is a great way of giving in this time of giving.

 Source : https://www.buzzfeed.com/rachelwmiller/a-beginners-guide-to-spending-christmas-alone

Tips to deal with holiday stress

Tips to deal with holiday stress

In our previous post we discussed the downside of the holiday season: the holiday blues. Although you cannot prevent stress from happening in this ‘most wonderful time of the year’, you can help yourself reduce stress with some of the following tips:

1. Set realistic expectations
   We all know the idealistic images of big families with beautiful people and happy children around a table full of delicious food. The reality? People busting a sweat in the kitchen to prepare dinner for 18 people, kids who fight and refuse to eat, migraines due to all the noise and getting into an argument with your sister after that fourth glass of wine… When you imagine your Christmas celebration, please have a reality check and realize that chaos and mess is also a part of Christmas.

2. Prioritize
   With so many events and tasks it can be difficult to get an overview. Since every event (school, work, community) seems important, it’s up to you to prioritize: what’s most important, what can you skip in order to have a night off?

3. Be realistic
   Be realistic about what you can and cannot do. This goes for attending events as well as preparing food and buying gifts: are you able to do all of the preparations yourself or can you share your duties with partners or family members?

4. Make time for yourself
   During the holidays, most people spend lots of time with others and very little by themselves. This may also cause you to give up on some hobbies or coping strategies as reading or exercise that would actually be beneficial for you. So make sure to carve out some time to do something just for you, in order to digest and recuperate. 

5. Limit your food and alcohol intake
   Even though Christmas is almost synonymous to unlimited eating and drinking, too much of either those can have a negative effect on your mood. Excessive eating can cause physical discomfort as well as feeling lethargic. Too much alcohol also has negative side effects such as increase in depression, risk of interpersonal problems such as arguments and feeling hungover the day after.

It's the most wonderful time... isn't it?

It’s that time of the year again: after Sinterklaas has returned back to Spain it’s again time for some sleigh bells jingling, decorating Christmas trees, office end-of-the-year parties and Christmas vacation. December is a jam-packed month full of festivities. For some people it genuinely is the most wonderful time of the year, but many others experience the holiday season as a time of sadness, self-reflection and loneliness.

What causes this holiday blues?
Although sadness is a very personal feeling, there are some specific factors that involve the holiday blues. Depression tends to increase during the holidays due to an increase in demands (perceived as stressful), family issues and being unable to manage expectations.

Increase in demands
In the holiday season there is an increase in the number of activities, tasks, and social events. Shopping and gift-buying can cause financial and emotional stress. Family school and work celebrations take up social, time and energy demands. Traveling to be with family or friends for the holidays can cause a variety of additional stress. If you are experiencing a significant loss or actively grieving, the holidays can be more stressful. School, work, and sleep schedules are often disrupted during the holidays and healthy ways of managing stress like ensuring good nutrition and daily exercise are often interrupted.

Family issues
Christmas is usually seen as a ‘family celebration’, so any issues that a person has with their family will come to the forefront during this time. If there is loss, abuse, addiction or disconnection affecting your family, then there is the likelihood that you will have to manage the emotions that are related to these issues. For someone already managing depression, it is an additional emotional burden. On the other hand, being unable to be with family or friends (for whatever reason) can also be highly stressful.

Managing Expectations
Although the holidays can be a time for celebration and joy, all of the increased demands on our time, energy, patience and flexibility can take a toll. A lot of people experience pressure to have a ‘wonderful Christmas and a happy new year’. These unrealistic expectations – that are reinforced by all the advertisements of happy families at the Christmas table and holiday movies with happy endings – can create even more stress.

The combination of increase in demands and limited reserves can cause symptoms of fatigue, irritability and sadness. But what can you do to prevent getting the holiday blues? Read our tips in our next blog post!

Part 3: Tips for procrastination

Tips for procrastination

So what can you do to stop procrastinating?

1.       Break up tasks in little steps
Sometimes we procrastinate because the work we need to do feels (consciously or unconsciously) too overwhelming. By breaking it up in smaller pieces we feel more mastery over our tasks.

2.       Change your environment
Your workplace can make a huge difference for your productivity. Take a good look around you: is this an inspiring place for you? Are you able to focus, or are there too many distractions?

3.       Manage your distractions
Identify your go-to places for procrastination. Do you check Whatsapp or Facebook? Watch a Youtube video? Make your distractions less accessible by limiting your screen time, setting boundaries and unplugging devices that are tempting for you.

4.       Get a buddy
Since so many of us are struggling with procrastination, you are bound to have someone in your network with ambition but a lack of action. Having a companion makes the whole process much more fun. Both of you will hold each other accountable to your goals and plans.

5.       Tell your friends about your goals
Similar to having a procrastination-buddy, telling the people around you about your goals helps to keep yourself in check about your projects.

6.       Get inspired
Seek out people that have achieved the goals that you have set for yourself, whether it is finding someone in real life or reading about people that have made the accomplishment.

7.       Re-assess your goals
If you have been procrastinating for a long time, you might want to check in with yourself to see if your goals are still relevant for you. Take some distance (a vacation, weekend away, or even a long walk in nature will do) to check in with yourself and see what you want to achieve

8.       Stop overcomplicating and just do it!
Are you waiting for the perfect timing and the perfect circumstances? Then you’ll probably wait forever, because there is no such thing as perfection. At the end, it boils down to taking action. You can do all the strategizing, planning and hypothesizing, but if you don’t take action, nothing’s going to happen.

Part 2: Types of procrastinators

What kind of procrastinator are you?

Before getting into tips on how to beat procrastination, it’s helpful to determine what kind of procrastinator you are based on the triggers for procrastination.

Let’s take a look at the triggers for your procrastination type:

Perfectionist
Being perfect is the main goal of the perfectionist. But this often leads to being too scared to show any imperfections. Because of this, they frequently fail to complete things, as they’re forever seeking the perfect timing or approach. When waiting for perfection, tasks are never completed since in the eyes of the perfectionist things are never perfect enough.
If you are a perfectionist you don’t finish something, but get caught up in a never-ending cycle of edits, additions and deletions.

Ostrich
An ostrich prefers to stay in the contemplation stage. That way, they don’t have to do the work for real and deal with any negativity or stress. Contemplating or dreaming gives this type of people a sense of achievement. In their minds, they envision a big, ambitious plan. Unfortunately for them, this plan will most likely stay a dream, and they’ll never accomplish what they set out for.

Self-Saboteur
A self-saboteur has had a very clear mantra:  ‘if you do nothing, bad things won’t happen.’ Self-saboteurs have developed a fear of making mistakes or doing anything wrong. Their way to avoid these mishaps, is to avoid any situation that might cause failure. As a result they indeed make few mistakes – but they also see few accomplishments.

Daredevil
A daredevil is a person who believes that deadlines pushes him to do better. Instead of having a schedule and structure to complete their work, they prefer to enjoy time doing their own thing before the deadline comes around.
Daredevils have a strong conviction that starting early will sacrifice their time for pleasure. This is reinforced in their minds and feelings by the many times they manage to get away with starting late and still finishing in time. Often they sacrifice the quality of their work because of rushing it.

Chicken
Chickens handle work by going by emotions instead of ratio. They do what they feel they should do, rather than thinking through what they need to do.
With this strategy, they never prioritize their tasks. Prioritizing tasks is a step that takes extra time, so chickens feel it’s not worth it. Because of this, they usually end up doing a lot of effortless tasks that don’t contribute much to a project. They’re focus their energy on low-impact tasks, but seem unaware of urgent, high-impact tasks.

Source : https://www.lifehack.org/669901/how-to-stop-procrastinating

Part 1 What is procrastination?

What is procrastination?

 Don’t you just love those summer days in the office, when the usual stress seems to have disappeared and you suddenly can take time to do everything in a calm and thorough manner? Or do you suddenly become less productive when you have plenty of time to do things? You check your phone twelve times per hour, get an extra cup of coffee, decide to read that interesting article before you start with your work…

The same thing can happen when you actually tons of work to do. Your to-do-list seems endless, and you can’t seem to figure out where to start. So you decide to start with some coffee, watch the news, do laundry… and suddenly 2 hours have passed and you haven’t been able to cross anything off your list.

I’m sure you – just like all of us – have been there: the procrastination-mode.

When we procrastinate, we put off important tasks we should be doing until it’s too late. And when it is indeed too late, we panic and wish we got started earlier. For some people it’s an incidental handicap, but for some people chronic procrastination can take on serious forms. Delaying, putting off things, slacking, hiding from work, facing work only when it’s unavoidable, then repeating this loop all over again. Procrastination is a bad habit that can cause tremendous stress, anxiety and depression.

Piers Steel, author of the book “The procrastination equation: How to stop putting things off and start getting stuff done” has a clear definition of procrastination:

“Procrastination in to voluntarily delay an intended course of action, despite expecting to be worse off for the delay”

In other words: we do things that are more pleasant first and put off our unpleasant activities – knowing that we will be worse off at the end. If this behavior is absolutely not functional, why do so many human beings do it?

The answer is: human beings have limited self-control. Psychologists from Florida State University have been studying self-control and they found that, just like any muscles, human’s self-control is a limited resource that can quickly become exhausted. When self-control is close to being depleted, human tend to choose what’s more pleasurable– the immediate procrastinated tasks instead of the actual works.

At its core, procrastination is an avoidance strategy. Procrastinators choose to do something else instead of doing what they need to do because it’s much easier to choose pleasure over pain. If you have mild problems with procrastination, you might benefit from the tips in our upcoming blogs. If you feel procrastination is causing serious problems in your life, please contact us to see if we can help.

Source: https://www.lifehack.org/669901/how-to-stop-procrastinating

Dutch mental health care explained

Dutch mental health care (GGZ) explained

 Even though the Dutch health care system is rated as one of the best in Europe (EHCI 2018), navigating through the different institutions, doctors and clinics can be challenging. Especially when you’re struggling with mental health problems, it can be difficult to find the right person to help you.

In order to get your therapy covered by your insurance, you need a referral letter from your GP. The role of the GP in the Dutch (mental) health system is that of a doorman: he or she is the one that assesses your complaints and tries to match it with the right health care provider. Sometimes this means that –similar to a general doorman- sometimes you have to ring the bell twice or thrice to get in.

Another important thing about the Dutch mental health care system is that it’s a stepped care system. This means that different health care providers offer different levels (or intensities) of care. Within the Dutch mental health care system, there are 4 steps:

1.       Anonymous e-health
For some people, making an appointment with the GP and talking about mental health problems is simply too difficult or embarrassing. The Ministry of Health, Welfare and Sport (VWS) still wants to offer these people some form of care or guide them to regular care. Various easily accessible tests and treatments via the internet (anonymous e-mental health)  can provide this kind of help. E-mental health helps to recognize and prevent psychological problems in time, and aims to improve self-management of patients.

 2.       Short-term psychological treatment with POH-GGZ
The GP treats minor psychological complaints him/herself, in collaboration with a so called ‘practice assistant mental health care’ (POH-GGZ). These treatments are usually short-term and last up to about seven sessions.

 3.       Referral to basic mental healthcare (BGGZ)

If your symptoms can’t be treated within the limited timeframe of the POH-GGZ, the GP can refer you to a healthcare provider within the BGGZ. Treatment of mild to moderate mental health problems occurs in BGGZ. Here you can get up to 750 minutes of psychological treatment.

4.       Referral to specialized mental healthcare (SGGZ)
In case of more severe or chronical psychological problems, the GP will refer to the specialized mental healthcare (SGGZ). There are numerous clinics, some offer therapy sessions with psychologists or a combination with a psychiatrist. This more intensive treatment can last up to a year, and has a possibility of extension.

 At Kühler & Trooster, we offer treatment in the Specialized Mental Healthcare. Our services are aimed primarily at internationals, offering treatment in English, Dutch, French, German, Spanish, Chinese, Italian and Japanese. If you are interested in starting treatment here, please contact us or ask your GP about a referral. 

How to beat your post-vacation blues

Do you know that gloomy feeling after a great vacation, where you return home and everything seems so incredibly normal? That your usual life suddenly feels boring and you lack energy to go out and make something of your time? If you do, you’re not alone! Many people who travel find themselves experiencing post-vacation blues. Having to get back into the routine of work, studies and daily life can be a source of discomfort, distress and disorientation. But however unpleasant it may be, the post-vacation blues can be overcome with a couple of tips and tricks.

1.       Adjust your sleep schedule ahead of time
If your holiday destination is in a different time zone, chances are that you’ll suffer from jet lag when you return. With sleep deprivation, chances are that you’ll be less able to handle the transition to home life. If you can adjust your sleep schedule already while on vacation, you’ll make the transition easier for yourself. There even are apps to help you adjust to your specific time difference (for example time shifter and jet lag rooster).

2.       Stick to your healthy habits while on vacation
It might be tempting to stop your workout routine, eat everything you want and end each day with a couple of sundowners during your vacation, but you’re actually doing yourself favor by minding your health on vacation as well. Exercise helps to reduce stress and release endorphins. Going for healthy food options and having a couple of alcohol-free days will prevent unnecessary weight gain and  fatigue.

3.       Schedule your return trip a couple of days ahead to acclimatize
When planning your vacation, you might feel like you want to use every minute of your time. But since getting back into your normal routine can be quite stressful, it helps to give yourself a couple of days before returning to work or school.

4.       Practicing gratitude: actively enjoy the memories you made
Some people say: buy experiences, not souvenirs. Some people use their vacation to do things they usually don’t do. These experiences and the memories usually last longer than the average souvenir from the gift shop. You can print some of the photographs you have taken and hang them at home or at work, so that you get reminded from time to time.

5.       Implement something from your vacation into your daily life
With these experiences, such as activities, sports, food or rituals, you have a chance to incorporate something from your vacation into your daily life. While on vacation, try to be mindful of the things you find pleasant and think of ways how to bring a bit of that pleasantness to your normal life.

6.       Know what to expect when you return
For many people, part of the discomfort of returning to work is the stress that comes back after being away. Help yourself adjust to your work by scheduling ‘admin-time’ the first hours upon returning, so you can catch up on your e-mails. Another option is to call or e-mail a colleague before returning to work, so that you’re informed on the important developments at the office.

Befriending the Dutch

When moving countries, one of the most important (but also trickiest) aspects of feeling a sense of home is creating a social circle. For most people, having friends and sharing experiences is a very important part of life. Unfortunately, the Dutch are not well known for their openness to new friendships.

In fact, according to research the Netherlands is one of the most difficult countries in the world to make friends. This is apparent from a large international survey among expats. Of the 68 countries included in the survey, the Netherlands is in 56th place when it comes to 'finding friends'. That is striking, since the the country is doing better in other areas such as quality of life, leisure and travel.

On average, the Netherlands is in 16th place in the list of 'best countries for expats'. This is mainly due to a good score for our quality of life, the work that can be found here and the ease of living with children.

The best country for expats is oil state Bahrain. An Indian expat says in the research: "I don't feel like an expat here. I feel at home here." 53 percent of all residents of Bahrain come from abroad, which probably contributes to the pleasant business climate. The worst performing country this year is Kuwait, where expats report unpleasant experience in almost all areas of living.

The survey, the 'Expat Insider', is held every year among thousands of expats. In the last survey (2018), Sweden is one of the big droppers. The country plunges 24 places in the list. "It is very difficult for non-Swedes to fit in. They are not as social here as in other countries, and less inclined to connect to people they don't know well," one writes.

Chances are that this is also the reason that expats find it hard to befriend Dutch people as well. The Dutch culture resembles that of Scandinavian countries in certain respects.

Source : https://cms-internationsgmbh.netdna-ssl.com/cdn/file/2018-09/Expat-Insider-2018_The-InterNations-Survey.pdf

4 tips for intercultural relationships

Any relationship takes work, but when you are merging two cultures, navigating new customs and norms, all while trying to stay connected and in love with your partner, the stress can be daunting. But the trick here is to pinpoint and remember just exactly what each of you need and want from one another. In an intercultural relationship, you are bound to meet a few of these challenges, but if you keep your head up and face them as a couple, you can avoid creating a barrier between you and your love.

1. Norms – Remember that dating and relationship norms differ

Different cultures can mean completely different dating and relationship habits. This can range from casual dating and multiple sex-partners, to chaperoned dates and arranged marriages. And of course, these habits are bound to clash when you have an intercultural relationship. While one partner could be used to dating a different person each month, the other partner could have never experienced a relationship more serious than a middle school romance, and could quite possibly still be a virgin. These differing habits can lead to pressure very early in the relationship. To avoid a lot of stress early on, be honest with each other. As a couple, you need to carve out what works for both of you, and what doesn’t. The sooner you tackle the basic dating and relationship sphere that you will be working within, the better!

2. Family and friends – Doubts and expectations

The doubts and expectations of your partner’s family and friends,  as well as your own, can weigh heavily on your relationship. Outside influence impacts all relationships, but it can be particularly overwhelming when you’re trying to merge two cultures. The diversity of values, priorities and attitudes can cause additional stress as you try to maneuver around doubts and expectations. The doubts can start flooding in very early in a relationship when your family and friends reveal their first impressions. They may announce the eminent failure of your love, or rave about how cute your mixed babies will be.

They may even drop suggestions such as, “As long as you are happy”, and then further down the road, “Are you sure this is what you want?” And all this may lead to an information overload that will end with you questioning different parts of your own relationship.
To make it harder, there are also family expectations, such as whether both of you plan to get married or not, and if so, in which country? How many children will you have? Will you live abroad? What side of the family will you live closest to?

In order to steer clear of any major disagreements with your partner’s family and friends, and with your own, learn to communicate quickly. Of course, if you’re truly happy, and if your family and friends are genuinely supportive, they will recognize that you are just fine with your mix of cultures, and should let you go on your way.

3.  Balance – Perfecting the balance of each other’s food and traditions

This seems like a superficial stress but you will encounter completely different traditions, especially when it comes to food. Food fuels us, and each culture has perfected their own balance of flavors, aromas and textures. You might be faced with particularly potent dishes, or extremely spicy sauces. But whatever your preference, and level of adventurism, you need to connect with your partner (and their family) over food. You try theirs, and they try yours.

While you’re trying a few new dishes, why not check out the arts scene, listen to a new artist, and try to learn a traditional dance? Not only does it show interest and commitment, you also get to learn some neat and unique stuff, and make your partner feel special for being the one to show you!

4.  The future – planning for the years ahead

What comes next? Most couples fear this question but as an intercultural couple, you have a few additional things to think about. The cultural expectations and doubts of family and friends, who hold varying opinions of your love, could impact the discussions and decisions about your future. You will have to face particularly difficult choices such as where to live, how to communicate all of your goals and dreams to each other and your families, and how to plan basic necessities such as careers and money. Money is approached in different ways in many cultural circumstances. As for careers in different cultures, there are a variety of expectations for each partner. This can easily place pressure on your relationship and your future together if you’re not working as a team. You should prioritize your goals and dreams as individuals, and as a couple, and strive to meet them together.

The most important piece of advice for intercultural relationships

The bottom line in any relationship is that you will face obstacles, whether from external or personal pressures. Yet, when you are navigating through two completely different cultures, the challenges can often be harder to understand, and seem near impossible to overcome.
But, before you become overwhelmed by it all, be truly honest about what each person needs and wants from the beginning. If you can, you will be able to build a relationship that is especially your own, each need and want determined by your partnership, regardless of any additional pressures. You can stumble through the cultural differences together, and strengthen your relationship along the way!

Original article : https://www.lovepanky.com/love-couch/better-love/intercultural-relationships-5-thoughts-to-remember

Mindfulness course starting September 17: limited spots available

We live in an incredibly busy world. The pace of life for most people is frantic, keeping up with work, social life, health and family – and at the same time keeping track of everything that happens in our digital world. Our brain is doing overtime to keep up with all these developments, not getting any rest until we crash into our cushion late at night. And even then, most of us have a hard time falling asleep because we still need to process all the things we were exposed to during the day.

So ask yourself this: when was the last time you did nothing? And by nothing, I mean: no-thing. No TV, no book, no phone. No eating or drinking. No worrying, reminiscing about the past or making plans for the future. Simply doing nothing. Just 10 minutes of giving that busy mind of yours a break.

If you are like most people, you have to think really hard and even then probably cannot remember 10 minutes of doing nothing. How amazing is that: our mind, which is such an important instrument and that we rely on to make important decisions, never gets a break. After an intensive workout routine we take care of our body: we make sure to stretch, have a healthy meal and go easy on ourselves the next day. But the mind has to perform top-level, every day.

Do you want to learn how to take care of your mind, and therefore yourself, properly? Learn what it means to do nothing: to be mindful of whatever comes into your awareness, look at yourself from a distance and letting go? Then improving your mindfulness-skills might work for you.

Kühler & Trooster is organizing an 8-week mindfulness group course starting September 17. In 8 weeks you will learn how to focus on the present and notice signs of stress earlier. As a result, you will be better able to deal with negative thoughts and emotions, you will be able to focus better and relax more easily. The mind becomes calmer. There is a higher level of awareness and you can better guard your boundaries.  

For more information and registration, please contact us at info@internationalmentalhealth.nl or 085-0660500

Intercultural communication: the language of love?

Nowadays, the world is more accessible than ever. Endless opportunities for travel, study or work make us feel like we literally have the world at our feet. Lots of people take the opportunity and jump into an adventure abroad. So it’s no surprise that the number of intercultural relationships has risen over the years.

Intercultural relationships face highs and lows of their own, in addition to the usual challenges any couple faces. A big challenge is a difference in communication. Even though intercultural relationships don’t always mean different languages, they very well can. Communicating with someone of another native language can be challenging. Firstly, there is the verbal content of communication. Within different languages, sometimes translations don’t match the meaning or energy behind a word. But different cultures also use non-verbal clues, emotions and body language in different ways in their communication.

A very important error that is frequently made in intercultural communication is forgetting that when you translate a word from your own language to another, it can have a different meaning. Once you make the mistake of not translating well, not just the word itself but the entire energy behind them changes. A word that is neutral in one language, might have a negative undertone in another language. This can lead to an attribution error: you put a negative association to the personality of the person saying the word(s), whereas in fact it’s just a communication mistake.

Some communication styles differ per culture, and they can stem from deep values within a culture. It‘s important to know your own values and those of your partner, and where they come from, to understand why you speak and act the way you do. Once you're conscious of these things it's easier to be flexible about them, in order to deal with conflict.

Aside from differences, there are also some emotions universally recognized in every culture: anger, fear, happiness, sadness, disgust and surprise. Every culture and every language is different, with many aspects that can be perceived as positive and negative – depending who looks at it. That’s why it’s important to avoid the idea that your culture is superior to your partner’s. Always keep in the back of your mind how your communication style can be perceived. Think about your choice of words and gestures and try to avoid slang and expressions, which get lost in translation.

Some personal qualities make for more successful intercultural communication:

Patience : give your partner the time to explain what he/she means, when a communication error arises.

Tolerance : the better you can handle any frustration without verbalizing, the better chances that a miscommunication won’t lead to an argument but that you can talk openly about your differences.

Objectivity : the more you can see your situation and communication from a distance, the better you can also notice your own difficulties in expressing yourself.

Empathy : if your communication hurts or affects your partner – intentional or unintentional- be mindful of their feelings and acknowledge how they feel.

Respect : respect both cultures and both languages, as each has its good and bad sides and are equally worthy.

Expats: building a social life

Having been an expat myself, the biggest challenge I can remember is setting up a social life away from home. When I had just arrived in India, I was struck by the fact that really everything seemed different than back home: the cars, the streets, the buildings - nothing looked even remotely like the Netherlands. Yet the biggest obstacle was the fact that the people were different. My trusted Dutch friends and my family members were missing in my new life.

Determined as I was to gather new friends around me as quickly as possible, I decided to socialize fanatically: I went to every party I could find, joined several expats meetups and attended every ‘expat ladies coffee mornings’. Immediately upon entering an event I scanned the room: is there a friendly face somewhere? Which ladies and gentlemen would be potential friends, perhaps have the same interests as me? On top of that there was always the pressing question: how long will this person stay in India before he or she is transferred to the next destination?

For many expats this is recognizable: when you start to build up your life in a new country, new friends are also part of it. The first period abroad can be a lonely time due to the lack of friends and family. These feelings of loneliness make you more vulnerable and more insecure when approaching other people. Asking someone to have lunch together can therefore feel as if you are entering the dating market and you are asking a potential lover on a first date.

Social contacts and building a network can make an important contribution to a pleasant time abroad. But how do you do this?

1. Don't think, just do it!
Because you may feel vulnerable when you first talk to a stranger, you may have a tendency to think a lot about yourself, what you’ll say and how you come across. This makes it more difficult to have a relaxed conversation and can even prevent you from going to meetings in the first place. Therefore, try to be aware of the fact that you may be nervous and insecure, but don't let it stop you from talking to that friendly-looking person.
(If you are experiencing a lot of anxiety in social settings, please read our next blog to see if you match the criteria for a social anxiety disorder.)

2. Be active
Instead of meeting up with potential new friends for a cup of coffee, you could also get together for an activity. This eases the pressure to fill the time talking. Explore your new hometown together, take up a language course, engaging in sports or do something together with the children. In this way you get to know each other in a more relaxed way. By undertaking activities in a group you get to know more people in an easily accessible way. For example, you can become a member of a sports club, artistic or excursion group or other expat networks in your host country.

3. Be open, but critical
Many expat communities are close social structures. Expats are often dependent on each other, certainly in countries where there is a big cultural difference with the host country or – like in the Netherlands- the locals aren’t very open to starting new friendships. Therefore, try to be open to others, but also be aware of your preferences: you don't have to become friends and meet up with everyone. Stay in touch with your feelings and put your energy into people and friendships that make you feel good.

7 things you need to know about mindfulness

1.      Mindfulness is not obscure or exotic. 
Even though mindfulness sometimes has a reputation of being either very up in the coulds-y or the new hipster trend, it’s actually very down to earth and has been with us for ages. When reading a clear definition (see our last blog), you might realize how simple it really is. It’s familiar to us because it’s what we already do, how we already are. It takes many shapes and goes by many names, but what it comes down to is: we are already here, but we need to be present in order to be mindful.

2.      Mindfulness is not a special added thing we do. 
We already have the capacity to be present and it doesn’t require us to change who we are. But we can shape and improve these innate qualities with simple, scientifically proved practices to benefit ourselves, our loved ones, our friends, the people we work with and the institutions we take part in.

3.      You don’t need to change. 
Solutions that ask us to change who we are have failed us over and over again. Mindfulness recognizes and cultivates the best of who we are as human beings.

4.      Anyone can do it. 
Mindfulness practice is available to anyone and does not require you to change your beliefs. Everyone can benefit and it’s easy to learn.

5.      It’s a way of living.  
Mindfulness is more than just a practice. It brings awareness and caring into everything we do and it cuts down needless stress. Even a little bit of mindfulness can make our lives better.

6.      It’s evidence-based. 
Various evidence-based studies have demonstrated the positive benefits of mindfulness to our health, happiness, work and relationships.

7.      It sparks innovation. 
As we try to deal with our world’s increasing complexity and uncertainty, mindfulness can lead us to effective, resilient and low-cost responses to problems that seem too hard to handle.

Source: www.mindful.org

Kühler & Trooster will organize a new mindfulness group course, starting September 17 2019. More information about the course can be found here.

Mindfulness: new course coming up September 2019

Last month Kühler & Trooster’s first mindfulness training finished. During 8 weeks, the participants of the course learned the practical skills of mindfulness. But what exactly is mindfulness and how did the course help them?

What is mindfulness?
Even though mindfulness is a pretty straightforward word, there are plenty of definitions and assumptions going around. Should your mind be blank, or focus on one specific thing? The word ‘mind-ful’ suggests that the mind is fully attending to whatever is happening, to what you’re doing, to the space you’re moving through. That might sound easy, but often our mind takes flight: we lose touch with our body and pretty soon we’re stuck in obsessive thoughts about something that just happened or worrying about the future. And that makes us anxious.

Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us. (www.mindful.org)

What did participants of the mindfulness course learn?
The participants learned how to focus on the here-and-now and cope with negative thoughts and emotions that might arise. Through different exercises, both meditation and elements of CBT, they learned how to deal with stress. By practicing and sharing as a group as well as daily practice at home, the participants were able to be present and aware, without feeling overwhelmed. One participant described the benefit of the course as follows: ‘ (I learned to) get distance from stimuli, thoughts, so I can see them for what they are instead of being dragged unwillingly into immediate reactions/reactive behaviors. This helps me remain calm, be less anxious and be caring for myself and others.’ Another participant shared that being in a safe, nurturing environment and learning simple and useful tools helps him to integrate the practice of mindfulness into his daily life.

Practical information
Kühler & Trooster will organize a new mindfulness group course, starting September 17 2019. The course will take up 8 sessions in September, October and November (no sessions during school holidays), Tuesdays 5:00-7:00 PM. Location is Koningslaan 35 in Amsterdam.

More information about the course can be found here. To sign up, please send an e-mail to: info@internationalmentalhealth.nl or call 085-0660500.

Hello, goodbye: expat friendships

Why, why, why, why, why, why, do you
Say "Goodbye, goodbye, bye, bye".
Oh no.
You say "Goodbye" and I say "Hello, hello, hello".
I don't know why you say "Goodbye", I say "Hello, hello, hello".
I don't know why you say "Goodbye", I say "Hello".

For most expats, setting up a social life is an important part of feeling more at home. But at the same time there is a lot of turmoil in expat friendships, with a constant stream of hello’s and goodbye’s due to the nomadic expat lifestyle. It seems to be inherent to life as an expat: you meet lots of new people, but at the same time you are always saying goodbye to friends who are leaving.

Building a social network is not easy, but when you do have a click with someone you share something special together. You are in the same boat: the same foreign country, the same adjustment problems, the same journey of finding your way and new routine (shopping, sports, leisure). But finding the right people can be challenging. Who can I call when I’m down, to drink coffee with and poor my heart out? Who can I ask if I am bored and want to do something fun? With whom can we organize family holidays?

This ever going cycle of building a social network and saying goodbye sooner rather than later is experienced twice in expat families with children. Because not only do you as parents have to say goodbye to your friends, your kids will miss their friends as well. How can you deal with your own feelings of loss when you have to say goodbye? And how do you guide your kids get through the pain of saying goodbye?

1. Allow yourself the feeling of missing
The process of saying goodbye often starts long before the moment of actually saying goodbye. This is part of the process. Do not put these feelings away, but acknowledge and accept that you are preparing for the moment of saying goodbye. Also discuss this with your child: he or she may feel sad about the approaching farewell.

2. What will you miss?
It is often difficult and painful to think about what you are going to miss about the other person. Yet these feelings and thoughts are also real and it is important to reflect on this, also in conversation with your children. What was so nice about this person? What did you share? Knowing what you will miss can help you prepare for the actual miss.

3. Plan a happy farewell
Saying goodbye is not a happy activity, but you could alleviate the goodbye by doing something together that you both enjoy. Did you used to eat out together, or did you practice a sport together? Then let that be a nice ending. Did your child always play a certain game together with a friend? Then let them play that on their last play date.

4. Staying in touch

Perhaps there is a desire to stay in touch in the future. This feeling can become very strong, certainly when the approaching farewell comes closer. Yet it is important to be realistic about how and how intensively you want to keep in touch and to manage expectations, especially with kids. It’s important not to promise anything that you cannot fulfill and to set realistic goals about how to stay in touch.