The Challenges of Expatriate Life and Cognitive Behavioural Therapy
Expatriate life holds many promises; a new environment, new challenges, new friends, new experiences and quite often sunshine and a slower pace of life.
It is easy to believe that changing our environment will change our inner selves. To some extent this is true; to some extent a “fresh start” can invigorate and inform us. What moving country cannot do though is fundamentally change our thinking or indeed our learned behavioural patterns.
We take our “selves” with us; all our thought patterns, all our ingrained beliefs and behavioural nuances. So at home or abroad we remain equally vulnerable to repeating our life patterns in relationships with ourselves, the world and other people.
In many ways we can become more vulnerable; our social network changes, we can easily lose touch with the people we rely on and when things go wrong we can end up feeling very isolated.
A new country means a new culture and all cultures have a base of demands, demands on how we behave and on how we react to situations. If anything, expatriate life for many people can lead to an increased feeling of frustration and stress, especially initially as you learn to live and work in a new cultural setting. In order to live healthily a lot of work has to happen to let go of learned culturally based patterns of thought from your old culture.
In many ways expatriates face heightened stress and problems, not less. Many long-term relationships suddenly face extra pressure and a usually calm partner can become stressed and angry. Unfortunately many partnerships do not survive these stresses. Many people begin new relationships without fully understanding the culture of their partner, leading to relationship problems. Many find themselves victims of crime simply because we have a general idea of values and when and how to trust people. We tend to expect social norms to be the same everywhere; they are not.
When we change our environment we often have to let go and change ourselves; not doing so can lead to misery. What was a healthy belief in our home country may be completely maladaptive in another. A simple example is that of time keeping. Some cultures place a greater emphasis on schedules and punctuality than others. Demanding everyone follow our personal expectations will not make them do so and the drip, drip, drip of everyday disagreements can, if we do not adapt, damage relationships and negatively affect our mental health.
As Albert Einstein said, “We cannot solve our problems with the same thinking we used when we created them.” Thinking is often the real source of our problems.
Many expatriates moving between Asian and Western societies encounter significant differences in communication styles, workplace expectations, social relationships and cultural values. One of the most common sources of stress during international relocation is culture shock.
What is Culture Shock?
Culture shock is a recognisable psychological phenomenon, usually occurring within a few months of arriving in a new culture.
It is a normal reaction to conflicts of social views, norms, and values. It is common for people to feel homesick, disorientated, isolated, anxious, angry and confused when entering an unfamiliar culture.
Psychological research on the matter suggests there are three basic causes of culture shock:
- The loss of familiar social cues such as body language, conversation tone, customs and manners.
- The breakdown of interpersonal communication caused by language barriers, misunderstandings and cultural differences.
- An identity crisis involving feelings of isolation, confusion and loss of emotional and social stability.
The severity of this depends greatly on how different the new culture is from a person’s home culture and on an individual’s cognitive flexibility, in other words the mind’s ability to switch from thinking in one way to another. Persistent negative attitudes towards differences can lead to inappropriate anger, anxiety and sadness.
Some cultural differences may be minor annoyances that build up over time, while others can be more emotionally challenging. Part of respecting and adapting to a new culture is understanding that culture develops over long periods of time. It is shaped by social, economic, environmental, religious, political and historical influences. We are born into these influences, and judging others unfairly without understanding their experiences often leads to frustration and difficulty adapting.
Accepting a culture is not the same as agreeing with it, nor does it require abandoning your own values or identity.
The good news is that with the right attitude and a willingness to adapt, most people gradually feel less out of place. Things begin to feel normal again and the shock to our sense of self passes if we allow it. Research suggests that living in new cultures can, in the long term, increase self-confidence, resilience and personal growth. It broadens our experience of life and can lead to a deeper understanding of ourselves and others.
Modern expatriates may also experience additional pressures that were less common in the past, including remote work arrangements, maintaining relationships across multiple time zones, social media comparisons, and balancing the expectations of life in both their home and host countries. These factors can intensify feelings of isolation or uncertainty during the adjustment process.
Many people turn to Cognitive Behavioural Therapy (CBT) to overcome the challenges they face abroad and at home, reduce stress and ultimately live happier lives.
What is Cognitive Behavioural Therapy?
“We are disturbed not by events, but by the views which we take of them.”— Epictetus
Cognitive Behavioural Therapy (CBT) is one of the major approaches used to help people overcome emotional problems and achieve personal goals. It is supported by extensive research into the role of behaviour and thought patterns in the development and maintenance of emotional difficulties.
Clinical studies support the effectiveness of CBT in the treatment of a wide range of psychological conditions, including depression, bipolar disorder, anxiety, eating disorders, obsessive disorders, substance abuse, anger management, pain management and trauma. It has proven effective with children, adolescents and adults in both individual and group settings.
CBT works on the premise that we learn ways of thinking and behaving that may become unhelpful over time, and therefore these patterns can also be unlearned.
CBT does not promote simple “positive thinking.” Instead, its goal is to help people develop more realistic and constructive ways of interpreting situations. Life experiences are not always positive, but interpreting them as proof that we are inferior, bad or worthless often leads to even greater emotional distress.
We tend to believe our own thoughts automatically, yet two people facing the same situation may think about it very differently and therefore react differently. CBT aims to identify beliefs that may be causing distress and encourages people to challenge automatic negative thoughts by examining the evidence for and against them.
In many ways CBT takes a person’s thoughts to court. We are often very good at prosecuting ourselves and others, but we frequently forget to consider the defence.
Collaborative in nature, CBT involves the therapist and client working together to understand the relationship between thoughts, emotions and behaviour. The focus is usually on problems in the “here and now.”
Timeline for Therapy
Unlike some forms of therapy that may continue for years, CBT is generally considered a time-limited approach. Research suggests that many people experience meaningful improvement within a relatively short period of time, although the number of sessions required varies depending on the individual and the issues being addressed.
Progress is often accelerated through practical exercises and homework assignments that encourage people to apply what they learn between sessions. Clients are encouraged to become their own therapists, developing skills that help them evaluate situations more realistically, reinterpret experiences in a healthier way and implement lasting change.
As Shakespeare wrote:
“There is nothing either good or bad, but thinking makes it so.”
Accessing Mental Health Support in Indonesia
Today, expatriates living in Indonesia have far greater access to mental health support than was available a decade ago. English-speaking psychologists, psychiatrists and counsellors can be found in major cities including Jakarta, Surabaya, Bandung and Bali. Many international hospitals and clinics now offer mental health services, and online counselling has made it easier for people throughout Indonesia to access professional support regardless of their location.
Many multinational companies also provide Employee Assistance Programmes (EAPs) that offer confidential counselling services for employees and their family members.
Seeking professional support should not be viewed as a sign of weakness. Relocation, cultural adjustment, career changes, family pressures and social isolation can create significant emotional strain. Speaking with a qualified mental health professional can help expatriates develop practical coping strategies and improve their overall wellbeing.
Whether through Cognitive Behavioural Therapy or another evidence-based approach, support is available for those who need it.
Frequently Asked Questions
What is culture shock?
Culture shock is the emotional and psychological adjustment process that occurs when a person moves to a new cultural environment. Common symptoms include frustration, homesickness, confusion, anxiety and feelings of isolation.
How long does culture shock last?
The experience varies from person to person. Some expatriates adjust within a few months, while others may experience challenges for a year or longer. Factors such as language ability, family support, previous international experience and cultural flexibility all influence the adjustment process.
Is Cognitive Behavioural Therapy (CBT) effective for expatriates?
Yes. CBT is one of the most widely researched psychological therapies and is commonly used to help people manage anxiety, depression, stress, relationship difficulties and adjustment challenges associated with relocation.
Can I find English-speaking therapists in Indonesia?
Yes. English-speaking psychologists, psychiatrists and counsellors are available in major cities such as Jakarta, Surabaya and Bali. Online counselling services have also expanded access to professional support throughout Indonesia.
When should an expatriate seek professional help?
If feelings of anxiety, depression, stress, loneliness or relationship difficulties begin interfering with daily life, work performance or family relationships, it may be beneficial to seek support from a qualified mental health professional.
Originally contributed by Ellie Donnelly, BA MSc, Cognitive Behavioural Therapist.
Updated by the editorial team in June 2026 to reflect current information and modern expatriate life in Indonesia.
