Brain Fog

Fog…

“I’m so, so tired and my brain is just not working as it used to!”, reported Ross* to Liz*, his member care worker.

After serving overseas in fulfilling ministry for over 10 years, Ross and his family have returned to Australia from Peru*.  When he arrived, Ross was halfway through writing up a post-graduate thesis.  Based on his productivity in Peru, Ross fully expected to finish writing it within six months of their return.

Soon after his arrival, Ross commenced an exciting and challenging job.   He reported later:

“My work context was generous with what they asked of me during my first year back in Australia, giving me space to finish the thesis and adjust to the Australian work context.  Our home church was also great! Our minister said, ‘Don’t focus on any ministry here for twelve months or so. Just focus on settling into Australia.’ He took the pressure off us!”

Ross and his family decided to live some distance from his work. Their reasoning seemed sound since the area was close to their extended family, home church and good schools. When considering the extra time this would take out of his day, Ross said, “Most people in Sydney commute don’t they?” 

Unfortunately, Ross found that his productivity levels dropped dramatically after his arrival ‘home’.  His ability to sustain concentration was down.  Despite the slack he thought had been cut for him, he was really challenged to get his thesis in before the deadline.  Other physical and emotional symptoms caused him concern.   Ross’ tiredness increased and he suffered from migraines which became increasingly severe. 

Tiredness was Ross’ constant companion.  When Ross’ wife met up with Liz, she said, “I don’t have much time with Ross. He is completely thin on energy. But I have no energy to help.”

Even after his thesis was handed in, Ross struggled to manage his workload due to his lowered concentration span and the effects of the migraines.  Contrary to his expectations, Ross didn’t have much energy left for his family or his local church community.  He asked, ‘When will it end?’

What would you do or say in this situation?

Analysis

Ross, and his family, are going through ‘re-entry’, which is a form of culture shock.  As is usual during re-entry, they are unfamiliar with aspects of their ‘home’ culture after living overseas for some time. (You can read more about Ross’ experience of re-entry, in the ‘Good Grief!’ blog post which is coming soon.)  Re-entry poses many challenges for returning families including unexpected drops in concentration and productivity (Palmer, 1999).

Brain affect

a frustrating sense of ‘molasses’ clogging your thoughts. A fatigue you just can’t seem to shake. Feeling ‘tired’ or ‘worn-out’ as you search to journey through normal days that simply don’t feel as normal as they should.’ 

Olson (2020)

People’s brains are affected by culture shock.  Olson explains the physical causes of this brain fog:

When someone moves to a completely new culture, many of the ‘autopilots’ your brain uses for thousands of small decisions every day become ineffective…  When this happens, the next remaining option for your brain is to use a second decision-making process that requires far more effort and energy (glucose) to operate. Your body can only supply glucose to your brain at a certain rate – a rate far below what would be required to use this kind of thinking continually. 

Therefore, he argues, during culture shock, the additional thinking required for routine matters typically leaves people with a chronically depleted level of glucose in their brains.  

Olson expands, referring to the first decision-making process as fast thinking, which makes those ‘autopilot’ decisions and doesn’t consume much energy.  He calls the second decision-making process slow thinking, which is not in limitless supply.

Slow thinking is great. It is what allows us to contemplate the significant things of life. To have meaningful conversations. And yet, slow thinking has its limits. You simply cannot keep using it and using it and using it and expect it to continue operating at a high level indefinitely. It’s not designed to do that. Slow thinking is designed to step-in when needed. Run it constantly and – quite simply – the sugar runs out. (In his book Deep Work, Cal Newport cites research that suggests an average adult can handle 4 to 6 hours before exhausting their capacity and requiring sleep for a full recovery.)

Olson, 2020

For someone in Ross’s situation, much of his quota of slow thinking will be consumed in navigating the many new phenomena in his ‘home’ country, not least of which is his exciting and challenging new job. This will leave less of his quota of slow thinking for writing a thesis.  

Productivity challenges

Diminished productivity is common for people during re-entry according to literature regarding missionary, corporate and army repatriates.  A GP, mission organisations’ medical officer (Selby, 2005), corporate repatriate expert (Szkudlarek, 2010; Chiang et al, 2018) and military repatriate experts (Institute of Medicine, 2013) all identified that difficulty with job performance and reduced productivity were common factors and stressors for people during re-entry.

Normalisation

If Ross becomes aware of this research and understands that a drop in concentration is ‘normal’ for someone in his situation, it may reduce his anxiety about what he is experiencing.  Normalisation can allow Ross, and other recently returned missionaries, to adjust to their ‘new normal’.  Normalisation could also help Ross be more understanding of his family members who may also be suffering from brain fog. (You can read more about normalisation and its benefits in the ‘The New Normal’ blogpost.)

Expectations

Unrealistic expectations are an impediment to readjustment, increasing stress levels.  Ward, Bochner and Furnham (2001, pp. 76–77) emphasise the importance of realistic expectations during transition.  Are Ross’ expectations for his life during reentry, particularly regarding productivity, out of alignment with reality? 

Being aware of what is ‘normal’ for people in his situation could facilitate Ross to adjust his expectations.  If Ross reduces his expectations regarding his productivity, he may be able to make changes to his life situation to reduce future stress.   

A story to consider

Now Elijah the Tishbite, from Tishbe in Gilead, said to Ahab, “As the Lord, the God of Israel, lives, whom I serve, there will be neither dew nor rain in the next few years except at my word.”

Then the word of the Lord came to Elijah:  “Leave here, turn eastward and hide in the Kerith Ravine, east of the Jordan.  You will drink from the brook, and I have directed the ravens to supply you with food there.”

So he did what the Lord had told him. He went to the Kerith Ravine, east of the Jordan, and stayed there.  The ravens brought him bread and meat in the morning and bread and meat in the evening, and he drank from the brook.

Some time later the brook dried up because there had been no rain in the land.  Then the word of the Lord came to him:  “Go at once to Zarephathin the region of Sidon and stay there. I have directed a widow there to supply you with food.”  So he went to Zarephath. When he came to the town gate, a widow was there gathering sticks. He called to her and asked, “Would you bring me a little water in a jar so I may have a drink?”  As she was going to get it, he called, “And bring me, please, a piece of bread.”

“As surely as the Lord your God lives,” she replied, “I don’t have any bread—only a handful of flour in a jar and a little olive oil in a jug. I am gathering a few sticks to take home and make a meal for myself and my son, that we may eat it—and die.”

Elijah said to her, “Don’t be afraid. Go home and do as you have said. But first make a small loaf of bread for me from what you have and bring it to me, and then make something for yourself and your son.  For this is what the Lord, the God of Israel, says: ‘The jar of flour will not be used up and the jug of oil will not run dry until the day the Lord sends rain on the land.’”

She went away and did as Elijah had told her. So there was food every day for Elijah and for the woman and her family.  For the jar of flour was not used up and the jug of oil did not run dry, in keeping with the word of the Lord spoken by Elijah.

1 Kings 17:1-16

After an intense time of service, God provided Elijah with a time of rest and recuperation.  Elijah wasn’t always super productive!  In the desert, God sent some ravens to provide for all Elijah’s physical needs.  Later, God used a widow to supply Elijah with food and water.  God’s practical provision for him also benefited the widow and her son.

What happened? How was this missionary cared for?

Liz (the member care worker) met up with Ross and his wife to touch base regularly.  She listened to them talk about the challenges they were experiencing, as well as praying with them. 

When the topic arose, Liz talked with Ross about how re-entry is typically associated with lowered concentration levels and productivity. She referred to research she had read recently in this regard.  Ross responded that while he found this information surprising, it was reassuring to hear that his experience was ‘normal’.  Although his disappointment over his lowered concentration hadn’t eased, and his deadline for the thesis and work demands remained the same, normalisation had been helpful in reducing his anxiety about what he was experiencing.  It also allowed him to adjust his expectations and his plans for the foreseeable future.  Having more realistic expectations may have reduced his stress levels.

Unfortunately, no one had challenged Ross’ expectations regarding his plans which assumed an unrealistic level of productivity during re-entry.  Preventative member care would have encouraged Ross to take more rest as Elijah did after his service. 

Liz could not fix Ross’ problems.  However, she could provide companionship on the journey and encourage Ross to seek others to walk alongside him and his family.  Liz asked,

 “Would you be interested in catching up with other ex-missionaries for mutual encouragement?”.

Ross and his family did organise to catch up with a returned missionary family who had lived on the same continent, providing informal opportunities to talk about their shared experiences.  Both families were very busy, however, so this only happened infrequently.  When they did get together Ross, reported that it was an encouraging time for both him and his family.  

As Ross’ story unfolded, Liz asked,

“Would you be interested in talking about these struggles with a counsellor?”  

Since Ross was interested in seeing a counsellor, Liz offered him contact details of a couple of counsellors.  This enabled Ross to choose one who was a reasonable fit, both theologically and culturally.  Ross’ organisation’s member care process included an expectation that all members have an independent debrief during re-entry.  Therefore, Ross had already met with one of the counsellors offered (Sophie*), for an independent debrief. 

Ross chose to see the counsellor, Sophie, since he already had a relationship of trust with her.  He told Sophie about the stresses he had faced since he had returned from Peru and the responses he had observed in himself.  Ross asked, 

“Is this normal in the circumstances?” 

Sophie was very reassuring and emphasised that Ross was reacting quite normally to his situation.  Ross found her reassurance very helpful.  It didn’t change the circumstances he was in, but it did significantly reduce his anxiety about what he was experiencing.  It answered the question of whether he was normal or abnormal.  

Ten years later Ross reported:

“Normalisation was very important for me. You [Liz] said that concentration levels are often lower during re-entry and that was helpful.  Sophie normalised my stress reaction, causing the physical and emotional symptoms I was experiencing.  That was very important.

It was a very stressful period for the first couple of years after we returned to Australia, and particularly the first twelve months. After three years I started to feel more settled and more competent.”  

* All names of people and places in this blog have been changed to provide anonymity.

Acknowledgements

Thank you to Ross for granting permission for me to write this blog post about him and also for his input, which provided additional strength.  

Thank you also to Megan Withers for her editorial assistance.

Suggested Reading

Olson, P. (2020) ‘Covid and culture shock feel the same to your brain – and here’s why’, A Life Overseas: A Cross-cultural Conversation, 25 August. Available at: https://www.alifeoverseas.com/covid-and-culture-shock-feel-the-same-to-your-brain-and-heres-why/.

Knell, M. (2006) Burn Up or Splash Down: surviving the culture shock of re-entry. Downers Grove, IL: Intervarsity Press.

Other References

Chiang, F. F. T. et al. (2018) ‘Repatriation: what do we know and where do we go from here’, The International Journal of Human Resource Management, 29(1), pp. 188–226. doi: 10.1080/09585192.2017.1380065.

Institute of Medicine (2013) Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families. Washington, DC: National Academies Press.

McNutt, J. M. (2005) Work adjustment of returning Army reservists: The effect of deployment and organisational support. Alliant International University.

Morgan, M. (2015) Spiritual Health Victoria – Review of LiteratureSpiritual Health Association. Available at: https://spiritualhealth.org.au/download/Morgan-2015.pdf.

Palmer, A. (1999) ‘Issues Facing Returning Missionaries and How Spiritual Direction Can Help’. Spiritual Growth Ministries. Available at: https://www.sgm.org.nz/uploads/2/0/1/6/20165561/issues_facing_returning_missionaries.pdf.

Selby, S. et al. (2005) ‘Re-entry Adjustment of Cross Cultural Workers: The Role of the GP’, Australian Family Physician, 34(10), pp. 863–4, 878.

Ward, C., Bochner, S. and Furnham, A. (2001) The Psychology of Culture Shock.

One thought on “Brain Fog

  1. Pingback: Good Grief! – Member Carers

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s