Swedish Culture Shock: 5 Practical Ways to Deal with Stress

man with stress

Providing counselling services for expats in Stockholm, I’m often helping my clients to manage and find ways to relieve stress. This stress might be related to cultural factors including the difficulty many report in making friends with Swedes or it could be to do with a close relationship or marriage. It can be associated with a combination of factors, for example work pressure, unfulfilled hopes or plans, perceived expectations or the adjustment to a new life in Sweden. The impact of stress isn’t always obvious.

People come to me wanting new ways to think or ‘mental tools’ for dealing with their circumstances. But regularly I meet people who so stressed-up, they can’t think so easily, in new ways or old. This article is about some very basic things you can do to manage stress. If that interests you, read on.

Stressing out? Ask for a consultation now!

5 Ways to Manage Stress

Here are 5 fundamental steps you can take to start getting back in control of the stress in your life. These tips are recommended by doctors, psychologists and major organisations like the British NHS (National Health Service).

1. Eat well.

When we don’t refuel our bodies regularly, our physiology can go into a stressed state and our more subtle cognitive (thinking) capabilities can be adversely affected. It’s much harder to problem solve when hungry, for example. On the flipside, using food to numb emotions can lead to overeating and unintentional weight gain. Aim for a balanced diet and regular nourishment.

2. Ensure you get enough sleep.

Sleep is regenerative and gives us a chance to let go of tension. It’s the body’s passive way of regularly relieving the effects of stress and becoming refreshed by allowing the brain to go into ‘quiet mode’ so we regain physiological balance. Of course sometimes stress can also interfere with sleep, in which case we don’t get the regular physical and mental refreshment we need. If your sleep is affected, develop a routine to support sleeping (google ‘Sleep Hygiene’). Sleeping tablets are not an ongoing answer, but if you are severely sleep deprived, you might need to discuss this with a GP. There are also gentle herbal treatments that some people find helpful.

3. Take regular exercise.

Exercise is a great way to shake out the effects of stress. When we exercise, we are directly working on our physiology and we can reverse the automatic stress response that happens to us when we are under pressure. For those of us from warmer countries, in the winter it can be difficult to find the motivation to exercise in Sweden and not everyone lives in central Stockholm or has access to indoor gyms and fitness centres. But even a short walk can make a difference and is better than nothing.

4. Put some structure in your day.

We all need to offset work with rest and play. Again, this can be difficult for expats without strong social connections. When we are trying to do the same thing for too long each day, the consequences are usually boredom, frustration and irritability or depressed mood. Everyone has chores they have to do (things like shopping, cooking, cleaning, washing etc), but without the balance of imaginative activities, our stress reactions can take over. Planning some exercise, social activities and time for creative interests around your work and non-negotiable commitments will help to make sure you stay on top of stress.

5. Talk about your problems.

It might sound like a cliche, but sharing problems and feelings really is a release valve for stress. It works differently for different people. Writing in a journal or diary can be one way of expressing thoughts and feelings but it doesn’t necessarily give the sense of a listener being present. Talking with friends can provide an outlet for emotions. However many English speakers tell me they find it difficult to make friends in Sweden and you might not have been here long enough to establish trusting friendships. Or perhaps you want to discuss something you feel you can’t share with a friend and need someone who you can be sure will remain impartial and maintain your confidentiality. That is where a counsellor comes in.

Some people tell me they just want to ‘dump’ what is happening for them, to ‘get it off their chest’ or make a confession about something they have been thinking about or doing. Others want a sounding-board (boll-plank in Swedish). Others want to have a good cry and to express how they feel. Some expats ask for help with decision-making or problem-solving. All of these are fine with me. The most important thing is: Don’t keep the problems to yourself!

Vulnerability to Stress and Building Resilience

Our vulnerability to stress and our coping skills for dealing with it can change with our circumstances. For example, people who have experienced trauma or child abuse when young sometimes have a heightened stress response to day to day events. But moving to a country like Sweden and adjustment to a new culture can involve a lot of stress as well. Building resilience to stress takes time. Don’t leave it too late to get help. If you are struggling with stress, make an appointment to discuss ways forward. If you are not sure, but think that managing stress might be a problem for you, contact me to find out how we might work together.

Email for an appointment time

Life Coaching in English to Turn Your (Swedish) Life Around

motivation and life coaching in Sweden 2013

Not adjusting to life in Sweden? Worried about your mental health? Can’t concentrate and think you have ADD or ADHD? Struggling with the winter? Don’t let the darkness, Snökaos (snow chaos) or winter blues drive you to depression. Whether you choose to do it in-person or by webcam, you might just need a few sessions of life coaching to get back on track.

Here’s how therapy and life coaching with an English speaking coach and counsellor might make a difference to life in Sweden.

Bollplank, Sounding Board or Reflective Surface

Talking with your partner sometimes is not enough. Sometimes we are just too close to someone to offer a different perspective and it can seem like a lot of pressure if a sambo, husband or wife is the only one to talk with. The Swedes have an expression ‘bollplank’ which in English is akin to ‘sounding board’, someone or something we can throw our thoughts against to test them out. (Literally it is a plank of wood for kicking footballs against). In my work I call it the Reflective Surface.

There are many ways to employ a reflective surface: some people keep a journal or diary, video blog, artwork, cooking, craft… In fact any activity that combines structure and imagination with a product can provide a means to reflect your identity and ideas back to you in a positive, affirming way that supports change. A conversation can also be a reflective surface. In my office I use a whiteboard which is a literal reflective surface and sometimes I use it to hold onto the expressions or words that come up in a session. But even without the whiteboard, meeting with a coach serves the same ends because you hear yourself saying things and the coach can hold onto your words and ask you about them. A life coach can help with:

  • Sharing what has been happening
  • Working out what is important
  • Making goals
  • Following through with intentions
  • Acknowledging and celebrating progress.

If everything seems to be going well for your partner but not for you, don’t take it out on your sambo. Make it you New Years Resolution to get your own ‘bollplank’ and let the relationship be what it should be.

Seasonal affective disorder (SAD)

A lot of people approach me thinking they have ADHD because they can’t concentrate at home or work, or both. And there is a lot of discussion at the moment about ADHD, particularly in Sweden where there is a huge expectation that people are on time, focussed and ‘get with the program’. The norms of behaviour in Sweden are very influential. If you have seen preschoolers being marched around the city in pairs, you will get what I mean. This is a society where, to a large extent, cooperation and compliance are unspoken rules. I mention this because it is important to understand that cultural influence and social expectations can play a part in how we feel and how quickly we adjust.

But difficulty concentrating can also be a symptom of depression. When we feel low, unmotivated, frustrated or insignificant, it can be harder to stay on task. In a way this is our instinct or animal side at work, trying to get our bodies moving again. Movement and exercise to treat Depression has been recommended.

Here are some other signs and symptoms that you might not be alright:

  • You are spending all day inside and not going out at all
  • Mood swings or constant irritability
  • Feeling like a zombie or not feeling anything at all
  • Eating constantly and more than you need to (or a loss of appetite)
  • Drinking alcohol everyday or most days on your own
  • Not engaging with friends
  • Ruminating thoughts, ‘overthinking’ and dwelling on failure
  • Less attention to self care or neglecting basic hygiene (not showering, brushing teeth or changing clothes)

The good news is that you don’t necessarily need a psychologist or to go on medication simply because some of these are present. The benefit of working with me is you can tell your friends / family / sambo that you are seeing a coach for adjusting to life in Sweden. You can even meet me online, over webcam or for instant message counselling if you don’t want to take on the snökaos or you are living in Uppsala, Västerås, Nyköping or otherwise on the outskirts of Stockholm. Likewise if you are in Malmö, Gothenburg or Umeå or somewhere more remote, online coaching means you save the travelling time and can get help from the warmth and comfort of your own home.

Of course, if you are at any serious risk or your health is deteriorating quickly, you should not hesitate to consult a GP.

From Therapy for Depression or Adjustment to Coaching for Life Goals

When life seems to be stuck or falling apart, it can help to talk it over, make a plan and have someone to engage with and help you to monitor progress. A lot of people start to meet with me for therapy around a particular issue and end up feeling better to the point that our sessions become more about coaching and moving forward. Recently I have been speaking with people about:

If you have found me through ForwardTherapy.se price and cost of coaching might not be your main concern. You are probably more interested in finding a professional who understands what you are going through and offers the advantage of sessions in English. But just send me an email (preferred) or call and leave a message for a callback if you would like more information about my fees and payment options.

Engelsktalande Samtalsterapeut (English Speaking Counsellor): A Word For Spouses and Sambos

If you think your partner, wife or husband might benefit from coaching, kognitiv beteende terapi / cognitive behaviour therapy with an english speaking coach (kbt på engelska) or just a bollplank with someone other than yourself, feel free to send me an enquiry. I am used to working with people in relationships where one partner is struggling with culture or climate or relocation adjustment and there is some conflict in the relationship as a result. There is more information here på svenska.

Next year I will be relocating my office from Kungsholmen to Södermalm in Stockholm. But you can make a start now and put yourself on a better track for 2013. Start making your New Years Resolutions.

Write to me and I will send you full details of availability, fees and answer any questions you have. Please let me know if you prefer in-person (face to face in Stockholm) or online consultations.

Walking Talk Therapy for Mental Health in English in Stockholm

A Park to Walk in Stockholm

A Park to Walk in StockholmThe advantages of counselling and therapy shouldn’t just be psychological. Walking while talking is a new approach to talk therapy that benefits the body as well as the mind.

As a therapist who personally enjoys exercise and the positive effects of movement, I was not surprised when I read in the Sydney Morning Herald about research that demonstrated sitting was bad for our health.

I’ve written before about how exercise is important to both our physical and psychological health. Sitting for prolonged periods can reduce lifespan so decreasing our sitting time is just as critical to health as taking exercise. But modern lifestyles have many of us spending long work hours in front of our computers. It can be difficult to remember to take regular breaks let alone to keep moving our bodies.

So I am now also offering counselling, coaching and therapy in English in Stockholm while walking outdoors. This is a unique service for Stockholm that fits with making it easier and more beneficial for people to meet with a counsellor.

The Benefits of Walking Therapy

Taking a walk each day can lift mood, free thinking and help us manage emotions. For some people, it can be a reasonable alternative to medication. But there are other advantages to therapy while walking outside as well. We know sunlight is important for production of vitamin D and general health. Talking with a counsellor while taking a walk treats your whole person, body, mind and spirit. The practice of walking itself can quieten thoughts and relieve anxiety. It’s refreshing, relaxing and the rhythm of a walk can also help to sort out problems.

Like other forms of counselling, Walking Talk Therapy is an opportunity to discuss strategies, get things in perspective, or simply get a sounding board for the changes you know you want to make. Being out in nature is conducive to healing and improved mental health. Expats can speak English during the appointment and benefit both from the change of scene and a compassionate listening ear. People who have experienced disappointment, loss or even trauma may find that time spent in nature is therapeutic in itself. Those seeking to improve their physical health and motivation can find active consultations even better than sessions that are office based. So counselling appointments while you walk offer a combined form of treatment.

With my Walking Talk Therapy in Stockholm, you are welcome to request help with the same kinds of goals or concerns you bring to office based appointments. Many people who come to see me talk about depression or anxiety, family and relationship issues. But the areas I specialise in include:

How Does Walking Talk Therapy Work?

Usually we start the first appointment in my counselling rooms on Kungsholmen in central Stockholm. If you decide to proceed with a walking appointment, we can go to Rålambshovsparken or along Norr Mälarstrand by Riddarfjärden. These parts of the island are quite beautiful throughout the year and provide plenty of open space for private conversations while walking. We can hold onto important points by jotting them down or taking an audio note as we go. Walking Talk Therapy is suitable for therapeutic approaches such as CBT (cognitive behaviour therapy) and narrative therapy.

If the weather is bad we can still meet in the office. The Swedish have a saying “there is no bad weather, only bad clothing” but it is always your choice whether we go out for a walk or sit inside and chat over a cup of tea or coffee.

So why not combine therapy and some exercise? It’s healthy, refreshing and better for both of us! For daytime appointments until 5pm you are welcome to choose a 50 or 75 minute consultation depending on how much time you have available.

My goal is to make it easier for people to see me so, of course, if you prefer to sit comfortably and talk we can still do that. I still offer a range of options including online counselling over webcam from Stockholm or anywhere in Sweden.

Call now on 08-559 22 636 and leave a message if I don’t answer.

Or contact me through the form on my website for more details.

I look forward to us walking together!

Can Depression that Started in Sweden be Treated with Exercise?

man running

man runningImprovement to mood is one of the most obvious effects of exercise. But can exercise actually be used as a treatment for depression?

An article recently featured in the Stockholm daily newspaper Dagens Nyheter says it can.  Jill Taube, a Swedish psychiatrist, has written a book about how exercise can help to cure mental illness. She points to studies that show the effects of exercise not only last longer than those of antidepressant medication, but physical activity appears to prevent the recurrence of depression better than antidepressants.

Exercise: A Prescription for Depression

Taube’s exercise ‘prescription’ echoes what the health and fitness experts have been saying for at least 20 years: a combination of cardio and strength activities for 30-45 minutes, at least 3 times a week. Obviously those who have not been exercising need to take it easy to begin with and build up to this. But the idea that there is something people can do themselves about depressed mood is great news for those who want to recover from depression and need more hope in their lives (although it might depress the drug companies!).

Antidepressent Use in Sweden, an Increasing Trend

What makes this research so remarkable is that Sweden has one of the highest rates of antidepressant prescription. According to OECD statistics, Sweden has the 3rd highest consumption rate of antidepressants in Europe (after Iceland and Denmark). And antidepressant prescription is on the rise in Sweden. The National Board of Health and Welfare (Socialstyrelsen) has issued guidelines to try to cut the rise of prescribed depression medication and encourage the use of talk therapy. But these changes will take time because the culture around prescribing antidepressants needs to change. A survey of GP attitudes from 2004 indicated that most doctors considered drug treatment with antidepressants alone was effective and sufficient in most cases of depression. Less than half the doctors thought that psychotherapy was required as a complement. This is despite reliable evidence of the effectiveness of talk therapy against moderate depression and the combination of counselling with medication being considered best practice. There is also evidence that effectiveness of antidepressant use really depends on the therapeutic relationship between doctor and patient.

Relief for Anxiety and Depression through Exercising

As a doctor, Taube is concerned with biochemical explanations of how exercise actually works and the article in Dagens Nyheter explains some of this. For the layperson it’s enough to know that it does work. Therapists are familiar with the way depression often goes hand in hand with anxiety (I often describe them as hanging around together, like schoolyard bullies) so it’s no surprise that exercise appears to help relieve anxiety as well.

Taube, who has herself experienced depression, is a dancing enthusiast but explains that other exercise like taking a walk or spin class can give the mind a break from Anxious Thoughts. We know that mental health difficulties can generally lead to poor physical health not only because problems like anxiety and depression stop us from getting out and enjoying life, but because the drugs that are prescribed for them have a slowing down effect on those who take such drugs. So people who are taking medication because they are affected by anxiety, depression and other mental health problems often gain weight and suffer cardiovascular difficulties or musculoskeletal problems because they don’t move themselves as much. Of course it is important to still seek the help of health professionals, particularly if you are experiencing a severe depression or having thoughts of wanting to end your life. Talking together regularly with a doctor, counsellor, therapist or psychologist is a better alternative to just taking drugs on your own.

In 2012 I will be continuing Walking-Talk Therapy  for those who want to have therapeutic and coaching conversations ‘on the go’. Going for a walk together through Rålambshovsparken, along Norr Mälarstrand or around Riddarfjärden is a great physical alternative to sitting down. Of course, if you prefer to talk inside, we can still meet over a tea or coffee in my private consulting room at Fridhemsplan. And for those who are outside of Stockholm or prefer more privacy, online counselling is always available over the internet.

Send me an email or call me on 08-559 22 636 and leave a message if you would like to make an appointment.

Jill Taube’s book “Själ och Kropp” is widely available from book retailers and online, but unfortunately only in Swedish at this stage.