Challenges for Foreign Service and Military Families Impacting Mental Health

Proud, Competent…Stressed

“I don’t know how you do it,” outsiders may say to their military friends. They see the packing and unpacking, the finding of new houses and schools, the negotiating of new languages, cultures, healthcare systems, friendships, and the emotional disruptions of geographical distance. They imagine the stress. Or can’t even.

“You just get used to it,” is a typical response.

Many foreign service employees and their partners are proud of the life they’ve chosen. They’re happy to support their country. They respect their own competence in maintaining family life in the face of frequent, sometimes international moves. Heartswell understands these intricacies and offers therapy for foreign service and military families to help with relationships and mental health issues.

Military families are often high achievers with a purpose and they know it.

At the same time, there can be hidden costs.

Some well known features of military life coincide with well known psychological and emotional stressors. These include:

  • Culture shock
  • Social readjustment
  • Language barriers
  • Geographical separation
  • Reunification

Without support, there can be emotional fallout, such as:

  • Relationship distress
  • Adjustment issues
  • Isolation and loneliness
  • Unhelpful coping behaviors
  • Infidelity/betrayal

Reserve Spouses and Their Challenges

Trailing partners who choose to follow a spouse in their deployment or to stay at home to support their kids may feel completely committed to their decision AND ambivalent about its effects on their identity. 

For one, it’s likely that a spouse’s deployment significantly impacts the supporting partner’s work. A 2019 survey shows that of the reserve spouses who held a job during their husband or wife’s recent deployment:

  • 58%  took time off from work. 
  • 31% reduced the number of hours worked
  • 7% left their jobs

Whether they work or not, the trailing spouse becomes first responder for most decisions about their child’s safety, care, and emotional stability. Frequent moves mean time-sapping logistics, including: 

  • setting up good school situations, 
  • managing transportation 
  • finding new doctors
  • facilitating new friendships
  • negotiating language barriers
  • soothing sadness over missing the deployed parent

Geographical Separation Brings Inevitable Stressors

It takes emotional independence for partnered individuals to live apart–sometimes an ocean apart and for many months at a time, It takes complex communication skills to stay connected through such distance. Couples may have to negotiate:

  • time zone differences
  • finding privacy to talk or video chat
  • maintaining a sexual connection
  • navigating boundaries and emotions
  • making difficult parenting decisions and enforcing them as a united front
  • infidelity or betrayal, actual or considered

Reunification is No Honeymoon

Partners returning from deployment may be looking forward to drinking alcohol again and enjoying romantic time with their spouse. Yet It’s often not possible to break from the day-to-day workings of family life. 

Frequently, the reserve partner has gotten used to managing a household alone. It can be difficult to suddenly start vetting decisions, compromising, or even just sharing information in real time. 

The experiences both partners have while separated can change them in unexpected ways. Getting back in sync takes work. If there has been betrayal, processing feelings on both sides can seem like climbing a mountain.

Loneliness and unhealthy behaviors

Without go-to stress relievers, when living in a new location apart from loved ones, folks may be more likely to turn to easy but not necessarily healthful relationships. Overeating and other addictive behaviors may surface which can disrupt and sometimes fracture relationships.

In the face of loneliness, common examples of wishful thinking include, “If I could just…

  • find someone
  • get my partner to understand
  • feel at home again

These thoughts can signal the need for more support.

Mental health and military service personnel

More than 6% of the U.S. population have served or are serving in the military. PTSD, depression, and substance use disorders rank highest among the mental health challenges facing service members, with research suggesting that 14%-16% of U.S. service members deployed to Afghanistan and Iraq are affected. This does not account for the reverberating effects on family members.

Mental Health Effects of the Pandemic

A 2021 survey of 1,184 randomly selected expats in the UK, USA, Australia, the Emirates and Hong Kong suggests that the pandemic has added to the stress they experience. 

  • around 38% have seen their mental health decline since the start
  • 12% reported this deterioration as significant. 
  • Anxiety and depression are a common theme in self reports. 
  • Isolating in a foreign country compounds the already stressful effects of social distancing

Barriers to treatment

According to a recent Department of Defense (DOD) report, 60 to 70% of those employed by the military do not seek mental health services even when they feel they need them. Barriers include: 

  • Fear of stigma
  • Concerns about confidentiality
  • Doubt about how it might affect security clearance
  • Lack of confidence about local providers

Access to treatment

Recognition of the stressors on military families is growing, however, particularly since the pandemic and many service options exist. 

The official website of the military health system offers helpful links to help individuals in the military research concerns they might have about reporting their therapy work. Coaching (as different from therapy) does not need to be reported.

These sites also help people to understand how seeking counseling may or may not affect their security clearance:

We understand the challenges military families face.

On staff at Heartswell, we have therapists in the military and those who have traveled overseas. Based in DC but offering Telehealth as needed, with English speaking and Spanish speaking providers, we make it easy for military service personnel and expats to check in from wherever they are.

Additionally, our services include: 

  • Emotionally Focussed Therapy (EFT) and sex therapy
  • In-person sessions and weekend intensive workshops in the DC area.
  • Individual therapists and a couples’ therapist working as a team
  • Relationship coaching (for personal and relational development–not to treat psychopathology).
  • Out of network and private self pay services but with licenced providers often reimbursed by private insurance. 

Heartswell offers a free 15 minute consultation which can be booked online.

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