Prior to any student’s departure on his or her first solo trip abroad, common offhanded reminders may include not to get homesick, to brace oneself for culture shock or to not get carried away by the newfound freedom. Sometimes these are easier said than done: when these seemingly minor concerns escalate beyond our control, this guide aims to offer a starting point for those in need of advice.
The Italian Situation
The saying, ‘i panni sporchi si lavano in famiglia’ (don’t air your dirty laundry) captures to an extent the cultural mindset held among Italians when it comes to discussing mental health – keep shtum. Since psychotherapy in Italy was legally recognised in 1989, this sceptical attitude has evolved with psychologists working alongside schools and hospitals, GPs recommending patients to therapists or psychiatrists, and the younger generation more willing to discuss mental health and seek help.
Mental health and the young
Whether there’s an actual rise in cases, or young people are more capable of identifying problems sooner, in 2017 the Italian National Institute for Statistics (ISTAT) revealed that 75 per cent of mental disturbances are manifested in the first 25 years of life.
Traditionally, university is an environment which harbours anxiety, what with familiarising to a new setting and friends, being burdened with financial concerns and post-graduation fears. According to American psychologist Dr. Mary Ann Bellini, about 42 per cent of students will encounter a form of anxiety, and about 36 per cent depression, followed by relationship and sexual identity issues.
While those diagnosed in the past are more vulnerable during their time overseas, Canadian therapist Elizabeth Connolly remarks that “study abroad is the best medicine for somebody that struggles with anxiety because, through the experience and the support, you can learn to control the anxiety rather than having it control you.”
Common triggers for both anxiety and depression include:
Homesickness and FOMO (Fear of missing out) – Though you’ve likely lived away from home, being an ocean apart from your loved ones, especially mum, can be psychologically tough, as well as facing the fact you’re on your own when dealing with daily problems. Equally frustrating is leaving a partner or close friend behind and wondering if the distance and different time zones will affect these relationships. Staying connected through social media can sometimes paradoxically do more harm than good.
Culture shock – Transitioning is always disorientating, from adapting to social behaviours to missing out on a particular lifestyle, such as having a part-time job or being involved in certain sports or activities. Finding yourself with plenty of time on your hands and without a set routine can adversely affect your sense of control.
Travel – This leads to a popular pastime among students: travel. With most of Europe easily accessible from Pisa or Bologna, it’s understandable why many are quick to adopt the jetset life. But what they are unaware of is that boarding a plane every weekend contributes to an overwhelming sense of disorientation. With no permanent base, Florence just becomes another stop-off.
‘Shot culture’– In stark contrast to the local aperitivo philosophy, the college culture of binge drinking increases student risk factors considerably. While excessive alcohol consumption can more easily be monitored within the confines of the campus bubble, this security does not by default apply when in Florence. Since it is not part of the culture here, those exhibiting this behaviour can be easily “othered” by the Florentine population, creating resentment amongst locals and consequently exacerbating any existing mental health issues.
Sexual Assault – With the widespread momentum of the #MeToo movement, dialogue surrounding this always-relevant but long-avoided issue is on the rise. Connolly still deals with at least one survivor of sexual assault every semester.
English-speaking therapists & insurance
Most universities will provide students with a handbook detailing their on-site counsellor or psychologist’s contacts. For private consultation, American psychologist Dr. Mary Ann Bellini is well-known in Florence’s international community and specialises in student counselling, CBT and hypnosis (Lungarno Cellini 25, tel. +39 3395705988). Canadian therapist Elizabeth Connolly also works closely with the college population, practicing individual therapy, and offers FaceTime consultations following students’ return home (piazza di Santo Stefano 2, tel.+39 3466577690). Connolly also collaborates with Dr. Anna Choub (tel.+39 3395687775), who she highly recommends for meeting the psychiatric needs of students.
Mental health services are covered by health insurance companies such as GeoBlue and CISI (AXA’s Emergency Travel), with the consultant’s fee automatically transferred from the chosen provider. Depending on the school, on average this will cover weekly consultations that should last until the end of the semester, and often offers students a level of service they wouldn’t be able to access back home.
If already on prescribed medication, you are advised to bring enough for the duration of the semester. Otherwise while in Florence you can access anti-depressant or anti-anxiety drugs you are currently taking by presenting a prescription with your and your doctor’s name at a pharmacy. You can also access medication by visiting an English-speaking psychiatrist or use the Medical Service’s walk-in clinic (via Roma 4, tel. +39 055475411).
The Medical Service also provides 24-hr home visits all year round. SPDC Santa Maria Nuova offers a 24-hr psychiatric security ward (piazza Santa Maria Nuova, 1, tel.+39 05569381), while Careggi Hospital (largo Brambilla 3, tel. 055794111) has psychiatrists on call. Careggi has also recently opened a special trauma unit (tel.+39 055794 7493).
Types of Therapy
Cognitive Behavioural Therapy
CBT explores dysfunctional thoughts and behaviours experienced in daily life. During the sessions, patterns of negative thinking associated with the feelings of oneself are identified in order to develop coping strategies to deal with them. It is a goal-oriented approach used in tackling a range of issues, questioning how the patient would like their situation to change.
Hypnotherapy uses our natural capacity to enter in a state of trance and is used in handling anxiety, panic attacks and also in achieving regression, particularly when dealing with trauma. In the case of post-traumatic stress, which can often be compared to being trapped in a trance, hypnosis reorients attention to positive memories prior to and after the event. Hypnotherapy is Dr. Bellini’s specialty, having trained at the Italian School of Ericksonian Psychotherapy and Hypnosis in Rome.
Mindfulness, Yoga and Meditation
The “mindfulness” catchword has been increasingly appearing in recent years, with the expansion of colouring books for adults, practical guides and classes. It refers to a state of awareness, of your body, mind and surroundings, which can in turn help you shift your attention away from obsessive thoughts. Yoga and meditation on the other hand are traditional exercises (through which Mindfulness can be practiced), which people often use to de-stress and ground themselves.
Hirono Yoga offers free meditation sessions every Monday night (via delle Cave di Monteripaldi 36, tel.+39 3283415699). Yoga Garage is located centrally in an old palazzo near piazza San Lorenzo, and offers student membership discounts, including drop-ins at 10 euros (borgo degli Albizi 16, tel.+39 3468698803).
Alternative Therapy *
From the creative arts (dance, art, community theatre) to holistic and even pet therapy, a whole article could easily be dedicated to Florence’s alternative therapies. While verbal therapy aims to define the reasons for a state of being, treatments such as music therapy attempt to deal with the existential and emotionally expressive dimension of the issue at hand. Music therapist Davide Woods describes his sessions as a contagious listening process (Centro Studi Musica and Arte, via Pietrapiana 32). He considers many mental issues stem from an unwillingness to listen to unconscious feelings, which can be exposed within the setting of improvising music together.
(*) alternative therapies are not to be taken in place of traditional therapy, but to be paired with them.
Our Experts’ Top Tips
-Ground yourself. Before jetting off on another European city-break, develop a routine and get involved in the city, from simply finding your local shops, making your room homely and not losing sight of the activities you care about.
-Be patient. Living abroad is going to present certain challenges and will take time to adjust, so be realistic and keep conscious of shifts in mental health, and consider reaching out for help.
-Avoid the ‘party-drinking’ cycle. It may be hard to resist but be mindful of the risks of substance abuse, as it will affect you experiencing other elements of your trip, such as creating relationships and memories.