Developing Maternal Efficacy While Living in a Second Culture: How EMDR Can Help

Guest Blog Post by Christine Forte, PsyD, LMHC

In 2017 I gave birth to my first child while living in Shanghai, China. I am from the United States originally, and becoming a mother while living overseas, even in a country that I had been living in for eight years already, presented emotional challenges greater than I had anticipated. Even though I had many friends in Shanghai and had joined a network of other expat mothers, I was still very lonely at times during this period, missing home and the close support of family. Fast forward to a few months later when I was determining the research topic for my doctoral dissertation, I had a natural curiosity for researching the lived experiences of other American women becoming mothers while living in Shanghai, China (Forte, 2020).

In this qualitative research I examined how becoming a mother outside of one’s home culture, in a second culture, impacts the development of maternal efficacy. Maternal efficacy is a new mother’s sense of confidence in her ability to care for her newborn, her belief that she will be able to do what is needed even when unforeseen circumstances arise. The theory around this reflects that it is a capacity partly built on one’s own experiences, and on social learning.

What I found was that while this learning may look different from how it would in one’s home country, women do still find ways to develop this sense of efficacy, although usually not without some stressful experiences. On the other hand, some research participants found it freeing to be in China, that they had a sense of autonomy about which practices they wanted to embrace in early motherhood and parenting. In addition, many, like me, also found creative ways to connect to other new mothers through local networks on WeChat (A Chinese messaging platform similar to WhatsApp).

On the stressful side of this life transition were deeply felt experiences of loneliness, social isolation, fear of doing things “wrong,” (i.e., in a way that might be judged negatively by local observers or far away loved ones, and fears of generally not being good enough as a mother, among other concerns.

EMDR addressing present triggers

Following the research, in continuing my clinical practice in Shanghai, I found that EMDR can be really useful in addressing these types of adverse experiences. As with all present triggers that we might work on, it is of course worth using the floatback technique to determine if there are earlier life experiences adding to the distress around these themes and if so, to process those. But in the absence of connected memories or experiences, I have also found that it can be useful to reprocess the present triggers. Using EMDR for supporting the perinatal period of life transition in this way is something that I have continued after relocating my practice to New York City. While some of the context of the experiences has changed, I’ve found that the themes challenging those who become mothers while living in a second culture have not.

Common negative cognition themes

In EMDR work, some common areas of negative cognitions (NC) that I have found it useful to explore and potentially reprocess are the following:

I am alone – I found this to be a common experience for those giving birth far from home starting with prenatal care and the delivery itself. Even if their doctors speak their language, they may be unable to communicate well in the language of nurses or other staff. And unlike those delivering in their country of origin they are unlikely to have extended family members waiting to help care for them when they arrive home. Challenges with breastfeeding or learning how to perform other elements of infant care can feel insurmountable. Adverse experiences with this theme can be important targets. Positive or preferred cognitions (PC) might orient around “I can find the support I need,” or “I do have people to help me.” Often clients will spontaneously think of those they could reach out to in their communities abroad as they work through reprocessing, but if not, these sessions might also be accompanied by counseling around where to find local resources or sources of support.

I’m not good enough/a failure – Difficulties in performing infant care, again challenges with breastfeeding, difficulty helping the infant sleep, adverse events around infant health can all be sources of new mothers experiencing a sense of failure or being somehow a “bad mother.” These moments can be reprocessed with interweaves around the learning process, in moving toward a positive cognition of ‘I am good enough’ or ‘I am a good mother.’

Criticism or negative feedback on parenting style from likely well-meaning local community members can also contribute to this negative cognition. In my research for example, all of the participants had at some point had received unsolicited negative feedback when out in public that their infant was not dressed warmly enough, or even very specifically wasn’t wearing socks, even in very hot summer weather. Some were able to set this aside, but others did experience times where it felt distressing or contributed to anxiety about going places with their infant.

I’m powerless/I cannot protect my child – I found that this negative cognition can particularly be stored with moments of challenge in caring for the child that may involve the broader environment of the host country. For example, when a parent had to seek medical care and the way it was delivered was unfamiliar and stressful, or when the parent was unable to communicate well in the language of the local provider. Another example might be in a situation where something unforeseen has happened, like a hired caregiver is approaching infant care in a way that the parents disagree with, or if there has been an accident. When processing these types of targets, a positive cognition that we might install is ‘I do have power’ or ‘I am learning how to protect my child.’

Self-affirmation through EMDR

As with all areas of EMDR reprocessing, the idea is to always center the individual and not discount their experiences. Certainly becoming a mother in a second culture does present unique challenges, and can be stressful. We want to validate this. However, for mothers navigating identity, belonging, and confidence in a different culture, EMDR therapy offers a powerful path to healing and resilience. Reprocessing present triggers, past experiences, and preparing for the future with EMDR therapy helps clients to mobilize the most affirming parts of the core self and to recognize their strengths.

Christine Forte, PsyD, LMHC is an EMDRIA Certified Therapist and Approved Consultant in private practice in New York City. She works primarily with individuals and couples on issues related to anxiety, depression, trauma, perfectionism, and relationship issues.

References and Resources

Forte, C. (2020). Becoming a mother in Shanghai: Lived experiences of American women. [Unpublished doctoral dissertation] California Southern University.

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Developing Maternal Efficacy While Living in a Second Culture: How EMDR Can Help