Thursday, September 1, 2022

Visa worries, an expat therapist offers personal insight on how to cope when times are tough.

 

So about our Talent Visa woes: there’s no change yet, but there have been some questions. Next week we lose our permission to work after 25+ years here in Malaysia, unless someone at immigration wields a stamp. The questions have been mostly, “Why aren’t you going nuts?!”

 

I’d love to say it’s because I’m the greatest mental health therapist in the entire world, and my calm is entirely due to my using my knowledge about depression, anxiety etc to flow through this. Yeah, I should lie like a rug and say Hire Me! 😊

 

Truth is, the job does help but it’s also partly experience and personality.

 

The experience says that this is a tough time, but there have been worse times. Nobody is dead. Nobody is bankrupt. Nobody is at death’s door. So the reality is that there is inconvenience and annoyance, but no tragedy. I find that a massive comfort.

 

Next, from my work: when you’re in a tight spot, look to your rock. Your rock is whatever it is that gives you safety. This can be religion, a place, money etc etc.

 

For me it’s money in the bank. I believe that money makes you free. My personal minimum target is if you can do nothing in terms of revenue making for a year and still be okay, that makes you pretty much bullet-proof. I’ve got that, so I’m blessed.

 

Next, it’s working out what absolutely needs to be done. For me that’s Tom who needs another operation at the end of the year, and moving the cats abroad. Everything else is nice but not necessary. I can abandon my books, my things, everything. It’s just stuff. Only Tom and the cats matter. I can arrange their needs, no matter what.  That is a comfort.

 

As for the rock, a safety margin of cash, I’ve even got a plan for that. If it all goes pear-shaped in 8 days, I get on a bus, move to a nearby country, set up temporarily and keep working while I arrange for the next big move. Inconvenient, but with my work being entirely portable, it really isn’t a big deal.  

 

What cements is all is choosing to be happy every day. I know what gives me the feels: petting Target, playing with Tic Tac and Inkie, making very nice dinners and sharing them with Tom while watching old films.

 

So every single day I set aside time to pet and play then I cook and we watch black and white films. Those moments of happiness are mine. They can’t ever be taken away. They’re locked in my mind and they run through the fabric of my life.   

 

And finally, I think personality has a lot to do with calm. It’s tough times but I’m the type who breathes through and keeps moving forward. It’s useful for me and my job, but I get it can be super annoying.

 

With all the drama, I’ve had several mates this week exclaim, “How can you sit there and be so calm!!!!!!!!!!” and advising, “Call immigration! Call the Talent people again!! Write in the newspaper!!! Do something!!!!!!!!!”

 

I really appreciate that love. It’s heaven to know so many people care. But when you’re anxious, action appears to be useful. Reality is that everything that can be done, has been done. And now we just have to wait and see.

Tuesday, August 23, 2022

Is it okay for you and your friend to see the same therapist? What about partners, exes, cousins and so on? Talking about confidentiality and neutrality


Is it okay for you and your friend to see the same therapist? What about partners, exes, cousins and so on? This has come up a few times recently and it’s a great question. 
 
There isn’t a standard answer because there are no rules. Mental health practitioners can see members of the same family, people who work together, sleep together, who know each other on social media etc etc.
What’s key is 1) confidentiality and 2) neutrality. 
 
Confidentiality. Some therapists share their notes in their office with colleagues or staff. I work alone and I prefer to maintain strict confidentiality. 
 
If you see me, I talk to you and to you only. Between sessions, I forget I know you. 
 
If your best friend, cousin, work colleague, or neighbour also sees me, I act as if I don’t know you in therapy sessions. In fact, I won’t even confirm or deny that you’re my client if anyone asks. 
 
So, I won’t talk but if you and your friend want to discuss your sessions, that’s your decision. You know what’s good for you.
 
Neutrality. The therapist helps the client reach their goals. That’s the job in a nutshell. In the session, it’s all about you. 
 
But with cross connections, I often hear the same story from different perspectives. Like if there’s a product launch, I may hear about the event management side from one client and from the product side from another. 
 
Confidentiality means that I can’t let information I hear in one session bleed over into another.
What’s said in a session, stays in that session.
 
This can be a problem when secrets are involved. 
 
For example, client X owns a restaurant chain and client Y works as a chef. Client X tells me that the chain will be firing 10% of all staff. In another session, client Y hopes for a big bonus and plans a long holiday. 
 
Confidentiality means I can’t talk out of session. So when client Y is talking away about holidays, I have to shut off and not warn them the company is actually in trouble. Which is awesome confidentiality but poor client Y, right? 
 
When it comes to dating, divorce and so on, secrets and confidentiality can really complicate matters.
 
So, I have this approach for taking on new clients:
If you know each other, that’s fine by me. Work colleagues, cousins, neighbours… it’s all fine.
If you think the relationship is very close and you’re thinking about neutrality or confidentiality, tell me and we talk it over. 
 
Generally speaking, if you are happy together and want help for two different things, like one wants to talk about anxiety and the other wants to talk about career happiness, I’m fine with that. 
 
If you’re close family or in a relationship and both of you want individual sessions to talk about your relationship, that may be tricky.
With two new clients, especially those living together, I usually suggest they see a family or couples therapist.
If one is an existing client and the one is new to me, I usually suggest the new one sees someone else. It’s just easier.
Should that not be an option for some reason, we can discuss it. Depending on what’s going on, I may say yes or no. 
 
(Hint: if you have options, like lots of other professionals around, I usually say no. If you have few options, like you’re LGBTQ in the Middle East, or poly in the West, then I may say yes)
Of course, this is when all the info is out there and up front. 
 
Sometimes relationships aren’t clear at the beginning or they change. 
 
For example, I learn once we have started sessions that client A is the ex that client B is telling me about, or that client Q works in the same company as client P. Sometimes, client J is delighted with a new friend and I discover the new hottie is my client L.
 
Usually, it’s all good. I listen, hold the session and then forget until the next time.
 
The one curiously tricky situation is when I discover that two clients who I thought were individual one-off clients are actually partners. 
 
If I’m lucky, they tell me in session and then we can talk it over. But if they don’t, and I don’t know if they know their partner is in therapy, it’s an issue because I can’t ask without breaking confidentiality. But that’s a discussion for another day 😊

Image by Pretty Sleepy Art from Pixabay

Monday, July 11, 2022

Expat Life: Staying Sane During Visa Application And Renewal

Digital nomading sounds so glam. Working on your laptop by a sunny pool, in December, freshly squeezed guava juice at your side. What could be nicer?

While it's lovely to travel, working abroad also means endless paperwork for visas. I'm doing ours at the moment, and so it's at the top of my mind.

Here are some thoughts on how to stay sane during this challenging time.

Stress #1 Control, Agency and Importance
The visa directs where you live and for how long, so it's important. But, you have very little control over when or whether it's granted. As human beings don't do well with helplessness, this will be a primary stressor.

Mental Health Cope: Acknowledge that feeling stressed because you are helpless and uncertain is actually a sensible reaction. Breathe through it. Practice self-care.

Practical: You're doing this for a reason, so treat it like a project and set goals for success and failure. Do you want the visa because it looks good on the CV? Because of the income you make? Some other reason?

Whatever it is, put a value on it and figure out how much effort you are willing to spend to get it. Then make a failure target so that you know when to walk away.

For example, "Getting the visa means an international credit on my CV and will net me $1500 a month more in income for two years. I'm willing to invest one month and $5000. If there's no positive by date X or they ask for more money, I walk."

Stress #2 Backup plan
There are usually options, so make a list of alternative destinations and jobs. Maybe you stay home, go home, or try another country.

Most importantly, make sure you work out a timeline! You don't want to be stuck in one country with paperwork that's running out, or having trouble with the revenue stream, on top of being unsure of where you're going.

Stress #3 Confusion and Conflict
Visa bureaucracy typically involves several government departments, all of whom have different agendas. They likely don't talk to each other. If you've applying for a new visa, you may spend all your time dealing with people who are as new to this as you are.

Mental Health Cope: Acknowledge that feeling stressed because you are helpless and uncertain is actually a sensible reaction. Breathe through it.

Mental Health Cope: remember why you're doing this! See the stress as partial payment for what you're going to get out of it when you succeed.

Stress #4 Time Budget
Be certain you have a time budget set aside. As it typically takes several dozen hours of labour of which collecting documents is the simplest part, treat this like a major project with milestones.

Practical: devoting a block of time regularly can be more useful than jumping to respond. Me, I do my paperwork in a one morning block, and devote a whole day to visiting a department. If I finish early, I treat myself to time off and pat myself on the back.

Stress #5: Follow The Basics
Eat properly, get decent sleep, eliminate small stresses and exercise. Yes, obvious, but without veggy, protein and sleep your body can't work. So be certain you don't sabotage your health.

My personal mental health cope: I get off social media and reread favourite books. The lack of notifications lower my overall alert level and the old favourites are a throwback to old comfortable times.  Try it and see!

Stress #6: Rope in Friends
A problem shared is a problem halved, but apart from the emotional support, talking to a local friend will help remind you why you like to stay.

If you're looking for tips, chat to someone from your own country who recently and successfully managed the process. If you're lucky, there may be a shortcut or two you didn't know about.  

Mental Health Cope: remember the points of stress #1 Control, Agency and Importance

I speak from the heart. This is my fifth country, and I'm in the middle of applying for my fifteenth? Eighteenth? Gazzilionth visa. I used to work visas for expat engineers in other countries too, so all in all, I've processed more than a hundred visas over 30 years.

The biggest takeaway is that I've learned that all countries are hostile to expats. You can have politicians moaning they need workers, or raving about luring you in with special promotional paperwork, but it's not them doing the actual visa processing.  

So try not to talk it personally. Decide if it's for you, and if it is, go do it.   

Finally, if you need mental health support, book a session with me. I'm nice and affordable as I live in a developing nation. And I'll know what you're talking about.

Friday, May 13, 2022

Do you qualify for a discount? And are discounts racist? Talking about mental health costs and discounting frameworks

 

Remember how last October I decided not to increase my rates? Well, it seems to be causing some confusion. It also caused a fight, and therefore I'm doing some thinking.

Let me explain, and tell me what you think.

In my therapy work, I am based at home and online, so I pass on these savings to clients. As I'm in Malaysia where living is cheaper than in Europe, I'm very affordable, charging just US$35 per session.  

In addition, I offer a discount rate to clients in Malaysia. Why? Because Malaysia is a developing nation, and a lot of the people, especially young people, are quite poor.

As I've said before, I'm okay with working a little harder in order to give the people in my community a little bit of a break.

So I charge a local rate of RM100.

From time to time I've had people living in first world nations asking for discounts and saying they can get third parties to pay the local rate.  The answer is no.

I'm willing to work a little harder to help my community, but there's a limit. Even my top rate, US$35, makes me significantly cheaper than my peers. I also need to earn my living, pay back for the 7 years tuition that is needed to enter work as a therapist, and prepare to look after myself in old age when I can no longer work. 

Some four or five years ago, before I had two separate rates, clients picked the payment method that worked for them. But my pricing structure has changed, so that no longer applies. I now have a two-tier system.

It is also true that some of my younger local clients who started with me while in college in Malaysia and then moved abroad kept the low rate. I closed one eye and let them stay on this as a courtesy because emigration is expensive and mentally challenging. 

And yes, I've also let a few families overseas in trouble in cheap.

Most people are okay with this. However, others misunderstand or resent this flexibility. I got some very nasty responses from one individual recently.

Hence the thinking.

Discounting is always controversial because it's natural to love a discount and to feel bad when you don't get one. Even so, charging different rates is common in mental health practice, mainly because so many can't afford the service but need it.

Typically, practitioners use means testing, where they offer a discount depending on your income. Mostly, they ask to see wage slips. 

I refuse to do this for several reasons. 

I find it intrusive. I don't need to know what you make, and I certainly don't want to get into how you spend your money. For all I know, you're making peanuts and have a rich relative who pays your bills. Or you earn a bomb, and are keeping your huge family. It's none of my business.

Also, as many people link income and personal worth, it may hurt or worry to discuss this topic. I won't do that to my clients. 

As for asking to see wages slips - OMG, that says you don't even trust people to be honest! I'm so not going there. I actually make a point of invoicing after the session, to show I trust my clients.  

I don't say means testing is wrong. But given the issues, it's not for me.

So, is my system of discounting based on geographical location racist? 

It's not racist because I don't ask people about race, but it's probably something 'ist'. Locationist, maybe? My thinking is based on local salaries and local purchasing power. I think that's practical, and although it's not foolproof or ideal, it's the best I can come up with. 

No, I don't want to apply special rates to various countries based on average income. I'm happy to help my community but I'm not a saint. I am running a business, not an NGO. Also, practically speaking, I'm not going to research other economies every time I get a client from a country that's new to me, either.

So there you go. That's my thinking. If I'm wrong, tell me how and why, and I will reconsider.

As for now, I love what I do, but I don't want to fight about money. So here are my rules, clearly and concisely.  

If you're living in Malaysia, you get the local rate. If you're not, you don't. No exceptions.

I'm putting my foot down, establishing my boundaries 😊

Will I adjust my rates for the clients abroad who get a low rate out of courtesy? 

Honestly, I'm in several minds about this. Part of me says that they should not be affected because I'm annoyed by the rantings of some entitled twit. But another part of me says that really, if they're now established in first world countries, they should move to the other structure. Maybe I'm a bit too soft there?

I won't make a hasty decision. I'm going to sleep on it. And if you have an opinion, please do share. I'd like the insight.