Ask A Counselor: Do I need counseling?

photo credit: eflon

Welcome to the first in a new series here at A Life Overseas:  Ask A Counselor!

(It sounds kind of like a game show title.  I feel like there should be flashing lights and funky music.)

Let me tell you just a little bit about myself before we get started this first time.  I’m 48 and have been married to my husband Andy for 27 years.  We have four children, a daughter (25), and three sons (23, 20, 18).  Andy and I are both Third Culture Kids.  Andy was raised in Nepal, Papua New Guinea, and the wilds of North Carolina, while I’ve got Brasil, Nigeria, and Kentucky in my blood.  We met in college, got married, and hot-footed it back overseas as fast as we could go.

We worked on a New Testament translation in the Solomon Islands from 1993-2005.  During those years, Andy medicated his stress with a pornography habit while I suffered from severe anxiety and depression.  I’ve written about this in a memoir called As Soon As I Fell.  After recovery, we lived in Papua New Guinea for a couple of years, and now we’re in the Dallas area.

When we moved back to Dallas, I went back to school for a Masters in counseling.   These days, I’m in private practice.  I really enjoy working with adolescents as well as adults, but if you need couples counseling, I’ll refer you to someone else.  “One at a time, please” is my counseling mantra.

(Here’s a link to my website, where you can read more if you like.)

A while back, some of you wrote in with questions, and I thought I would start with a cluster of questions about counseling in general.

Missionary friends have been asking me this question for years:  “Do I need counseling?”

After hearing this question repeatedly and answering it repeatedly, I finally realized this.

If you’re asking this question, the answer is always YES.

Here’s why:  if you’re just going through life and everything’s dandy, you won’t be asking this question.  It won’t cross your mind!  It’s only when things start to get hairy that you realize (rightly so) that you might need help.

Now, maybe you can wait until your next scheduled visit to your passport country.  Or maybe you need to get help sooner, rather than later.

Here’s the next question: how do you know WHEN you need help?

That decision, I think, is based on your level of FUNCTIONING.  Ask yourself these questions:

  • How are my relationships? 
    • Causes for concern:  lots of conflict, ongoing isolation, a sense of disconnection from others
  • How am I functioning at work?
    • Causes for concern:  frustration, boredom, over-work, putting work above family needs
  • How am I sleeping?
    • Causes for concern:  sleeping too much or too little, insomnia, waking at night, nightmares
  • How am I eating?
    • Causes for concern:  eating too much or too little, being obsessed with food or exercise
  • How is my mood?
    • Causes for concern:  outbursts of emotion (anger, crying, anxiety), numb or shut down
  • How functional is my daily life?
    • Causes for concern:  unwanted habits or addictions, inability to accomplish normal tasks

If you don’t know the answers to these questions, ask a friend.  (See, told you it was like a game show!)  Get feedback.  And listen to the feedback.  It’s not easy to say hard things to other people, so if somebody cares enough to tell you hard things, pay attention.

Now, everybody can have a bad day.  I myself, living in suburbia, have bad days.  The problem is, if all the bad days are getting strung together without a lot of good days in between, that might be a problem.

So if I’m having trouble sleeping, I’m drinking 5 Cokes a day to stay awake, if my marriage is unhappy, if my children are not doing well, if I’m spending 50-plus hours a week working while feeling like nothing is ever good enough for my supporters who don’t pay me enough of a salary to live off of anyway—then I’d say functioning is on the decline.

If you’re not functioning well, you’ll probably be asking this question:

How do I get counseling overseas?

I personally think that it’s hard to get good counseling overseas.  Your options are limited. Even if you have a local counselor, that person may or may not be a good fit for you.

(How do you know if the counselor is a good fit?  You’ll LIKE the person and feel SAFE with them.  It’s really just that simple.)

You can try Skype or phone counseling, but I find that dynamic to be more a consultation than therapy.  You may get good direction and find good resources via distance counseling, but there’s something healing about being in a room with the real, live person.  Just think about how different it is to talk with your mom on the phone vs. seeing her in person after years away.  Therapy is like that, too.  At its best, it should be a very personal, intimate relationship, which I think is best accomplished face-to-face.

Another complication with therapy overseas is that you’re still living in the stressful situation.  Nobody does therapy on the battlefield, because there’s a job that takes priority over the wellbeing of the soldier.  A counselor friend of mine who worked overseas for years said, “Really, the only thing I could do was triage.”

We tend to run on adrenaline, and to not feel how bad it is, while we’re in the situation. Then when we arrive in our passport countries, there are a million other things that take priority over recovery.  It seems like there’s never a time to treat the wounds until they are absolutely septic.

This is a sad, terrible, long-standing pattern in mission work that needs to CHANGE, but I believe that the only way it will change is when individual missionaries start taking responsibility for their own well-being.

It would be nice if your home church would take this on for you, but I don’t see it happening.  It would be nice if your mission board provided great services for you, but again, not a thing I see a lot of.  There are good intentions in lots of places, but extremely weak follow-through.

In the end, you will be responsible for locating and accessing the resources for your own emotional and spiritual care, and you need to be prepared to do so.

Here’s what I wish every missionary would do.

Establish a relationship with the counselor of your choice before going overseas.  Get some recommendations from your church or from friends.  Talk to a few counselors on the phone.  Go visit one or two, until you find someone you like.

Go to several (6-10?) counseling sessions, so that you and your therapist know each other well, and you feel like you’ve processed through your backlog of issues.

Stay in touch with your counselor while overseas, via Skype, phone, and/or email.

Go back to see your therapist every time you’re in your passport country.

Here’s a place you can check for counselors who get it:  International Therapist Directory

What challenges do you face when it comes to good self-care?

What resources have you found helpful?

What questions would you like to see addressed in future Ask A Counselor columns?

Photo credit: Eflon/Flickr/Creative Commons

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Kay Bruner

Kay Bruner was born in Buffalo, New York and grew up in Brazil, Nigeria, and the wilds of Kentucky. She and her husband have raised their four children in Solomon Islands, Papua New Guinea, and currently reside in the great state of Texas. Kay is a Licensed Professional Counselor, and divides her work days between counseling and writing. She is the author of As Soon As I Fell and blogs at She is available for counseling at her office in Dallas or via skype for a reduced rate to clients overseas. For more information go to:

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