How do I find a therapist when I live abroad?

I want help, but I'm tired of explaining myself first.

Therapy with Mark will help you hear what sits under all the explaining, so you can stop doing it.

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At a glance

Looking for a therapist while you live abroad often means wanting help and dreading the hour of explanation that seems to come before it. You want someone who can follow your life without a lecture on where you come from, and who meets you rather than your passport. This article helps you see what to ask, what to listen for, and how to stop translating yourself in the room.

Clinical insights from 22 years in psychotherapy

I’m Mark Colclough, MA, psychotherapist in Copenhagen. Qualified at the Psychosynthesis Education Trust and the University of East London. 22 years of full-time, face-to-face clinical practice.

Kindness is rarely what was missing. Clients who tried therapy abroad before often describe a warm therapist who never quite grasped what it takes to build a life from the outside.
The working language keeps feeling at arm’s length. I notice clients speak more smoothly and feel less in the language they use at work, and the sadness comes when they slip back into the one they grew up with.
Family shapes you before a country does. When partners from different backgrounds fight, I usually find the quarrel leads back to what each home took for granted, far more than to any nation.

Clinical notes: My observations are anonymised and compounded from my session notes since 2004.

Why does living abroad change what I need from a therapist?

Much of the common ground a therapist normally takes for granted is missing, so you end up laying it down yourself, session after session. How school worked where you grew up, what your family does when somebody dies, whether shouting at home was frightening or simply loud: none of this is shared, so you supply it. Supplying it costs effort. It keeps you standing just outside the very thing you wanted to talk about, and you leave tired, blaming the week rather than the hour.

Being articulate hides this well. You have described your own life many times, to employers, to colleagues, to every new acquaintance, and you do it smoothly at precisely the moment you would rather be stopped. A therapist asks something simple about your father, and you hear yourself giving the background of the town he lives in. You are both busy. Nothing moves.

What happens when therapy is in my second language?

The language you speak in a session quietly decides what gets said and how near you let it come. Words learned in early childhood seem to carry the rooms and voices they were first heard in, while the same word learned as an adult tends to arrive with its meaning and much less of its weight¹. That account is still tentative, and it comes from a practitioner overview rather than a single trial. In interviews, therapists who work across languages describe something similar in their own practice: the language chosen affected how emotional subjects opened up, how rapport grew and how differences in culture were handled². It was a small group of 10 therapists in one country, describing their own work, so I treat it as a careful echo of what I see rather than as a measured effect.

A second language can protect you. Embarrassing or painful subjects are sometimes easier to say from a little distance, which is why a thing you have never voiced at home can surface in a language you learned later¹.
A change of language points to the feeling. If your mother tongue returns when your family comes up and English comes back for work, that switch tells us where something lives.
The polished account has a price. A neat summary in your working language is easy to give and hard to feel anything about.

Speaking English with me is not second best. When a sentence only exists for you in another language, say it as it comes, even in one I do not speak, and then tell me what it meant. I would much rather have that than a fluent translation with the warmth taken out.

What should I find out about a therapist’s own life?

Ask directly what they have lived through themselves. Someone who works well across cultures will not be thrown by the question, and the way they receive it often tells you more than whatever they reply.

Life abroad. Have you ever lived outside the country you grew up in, and for how long?
First language. Which language did you grow up speaking, and which one do your dreams happen in?
Untranslated feeling. What do you do when what I feel is in a language you cannot follow?
Family duty. How do you work with it when my family wants something the place I live in does not?
Mixed couples. Do you see couples who bring two different cultures into one home?

You are not checking for the right life story. You are checking whether the question makes them curious. Since you may want to know mine: I was born in London, grew up English, and moved to Denmark as a child, where I was brought up Danish too. I work in both languages and know both cultures from the inside, and I know the particular fatigue of explaining yourself in a place you chose.

What if my partner and I come from different cultures?

The strain between partners from different cultures is real, and it is no proof that you chose wrongly. What usually reaches me first is not a disagreement about culture at all but hurt. One of you feels unwelcome in the other’s family and tenses up before a visit has even been arranged. The other feels torn between their partner and the family that raised them. By the time one of you can put it into words, it has become a theory about the other’s nationality, and the hurt beneath it has gone silent.

Nationality explains less than it seems to. Two people from the same street still clash over holidays, money and how openly you may miss your parents. The difference for you is that a ready explanation is always to hand, and using it stops the conversation just as it was getting somewhere. The partner standing closer to a family that has not welcomed the relationship usually carries more of the strain, and naming that honestly helps more than pretending the load is shared evenly. Sometimes it helps to start alone in online couples therapy on your own before bringing it to both of you.

Can the work continue if I move again?

Yes, because sessions are by video, the work goes where you go, and an ending you plan is far better than one that just happens.

You travel a lot. Video sessions keep the thread while you are on the road.
You are being posted somewhere new. The work carries on from the next country without starting again.
You expect to leave within a year. Mention it at the start, and the work is shaped around that date.
Time zones are tight. Say so early, and we look for a regular slot in Copenhagen time that you can actually keep.

How can I vet a therapist and stop briefing them?

The training behind the word psychotherapist varies a great deal, and when you live abroad you may not know how it is regulated where you are, so the checking is yours to do, openly.

Training. What did you train in, for how long, and where?
Supervision. Are you in regular supervision?
Languages. Which languages do you work in, and what happens if I change language halfway through a sentence?
Terms. What are the practical arrangements, cancellation included?
Confidentiality. What is kept private, and what is written down?
Send the background in writing. How conflict worked in your family, what your parents expect of you, what you left behind to move. Write it down before the first session instead of using sessions to deliver it.
Name the briefing when you hear it. The moment you notice you are reporting rather than talking, say exactly that aloud.

That last suggestion comes from my clinical judgement, not from a study. In my experience the reporting often eases once somebody puts your unspoken background into words, and clients tend to look less braced before they can say why.

These steps are not enough if the answers you get stay vague, if you are still filling in the same background many sessions later, or if what weighs on you is something that was already hard long before you moved. Sharing a background is no replacement for skill with the difficulty you bring. Whether the distance you feel comes from language or from a poor match is hard to judge alone beforehand, and it is fair to raise it directly. A free 30-minute call is one sensible way to try it out.

Book a session

Questions people ask

Can I have therapy with you by video from any country?

Yes, all sessions are by video, in English, wherever you live. We agree a regular time in Copenhagen time that works where you are.

Should I choose individual or couples therapy if living abroad is straining us?

Start where it hurts most, and let me know early on that you cannot decide. Strain that sits mainly between you is reached faster together, while strain that sits in you often needs room of your own first.

Do I need to explain my whole move before we can start?

No, and you are welcome to send me the background in writing instead. Our time then goes on what that history is doing to you now.

Is therapy in English enough if it is not my first language?

Yes, as long as you feel free to switch whenever a word only exists for you in another language. Tell me early, so a switch is treated as useful rather than as a disruption.

Is it worth starting if I might move country again soon?

Yes, and mention it early so the sessions are shaped around your timeline. Because sessions are online, they can continue after the move.

If you live abroad and want to talk in English, my page on online psychotherapy explains how sessions by video work.

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Sources

How this article was written: I choose the subject and the angle. An AI assistant researches and drafts. I read the draft, correct and improve it and stand behind every clinical statement. The professional and clinical judgement is mine.

Would you like support?

I am Mark Colclough, MA, a psychotherapist and EFT couples therapist working online in English with individuals and couples around the world. If this article touches something you are living with, a first 30-minute call is free and you are under no obligation.