The holidays are supposed to be the “most wonderful time of the year,” right? After all, the greeting cards and carols of the season are filled with words like “cheer,” “joy,” “merry” and “happy.”
For many people though, the holidays invite the opposite: dread, deep sadness or a resurgence of anxiety, grief or other mental health issues. Sometimes dubbed the “holiday blues,” the pressure of family gatherings, gift giving, religious traditions and social commitments can be overwhelming.
Therapeutic issues that a client and counselor have been working on throughout the year are often magnified throughout the holidays, says Lauren Ostrowski, a licensed professional counselor (LPC) who works at a community counseling agency in Pottstown, Pennsylvania.
“I have some clients who are upset at the holidays, from Halloween through Valentine’s Day,” says Ostrowski, an American Counseling Association member. “Even New Year’s — it’s a time of new beginnings, and people notice what they don’t have, who’s not at the table and what they haven’t accomplished, and it perpetuates the whole cycle [of struggle].”
For counselors, the key to helping clients through this difficult time of year is to plan ahead and talk about the pressures of the season before they climax, agree Ostrowski and Christian Billington, a licensed marriage and family therapist candidate in Denver. Counselors can offer clients an array of coping mechanisms, from self-care strategies to the realization that they can’t please everyone.
Billington, an ACA member who specializes in grief, loss, couples and families, suggests that counselors work through anticipated stressors ahead of time, “like a rehearsal.”
“Preparation can be important if stressful family events are inevitable,” he says.
For clients who face tense family situations, Billington suggests counselors discuss and identify triggers with the client and develop an “exit strategy” for get-togethers ahead of time. Most importantly, he says, talk with the client to ensure they have a trusted person, such as a spouse, they can talk to and “debrief” with at short notice during the holidays.
Ostrowski says she will work with a client to create a “road map” plan for holiday events and traditions. This way, the client can see all the things they look forward to and use the happiness from those events to counterbalance those that are less enjoyable, she says.
She encourages clients to make sure the things they want to do – perhaps a tradition from their childhood or a favorite side dish for the holiday meal – are included on their road map. At the same time, she tells them they should not feel obligated to continue traditions they don’t like.
“I talk a lot about how it’s impossible to make everyone happy” at the holidays, says Ostrowski.
Janis Manalang, an LPC and owner of counseling centers in Sterling and Alexandria, Virginia, stresses that clients must learn to be honest with themselves and recognize their boundaries, particularly at this time of year.
Clients who like to please others should “learn to draw a line in the sand with families or friends so they do not feel obligated to do something with them or give gifts,” says Manalang, an ACA member who is working on her doctoral dissertation on counseling education and supervision at Argosy University. “It’s always best to be honest with what you can participate [in] … understand that there will be people that we can not control and accept that we can only control ourselves.”
Key takeaways for counselors about this multifaceted issue:
Ostrowski says her rate of client no-shows and appointment reschedules spikes during the holidays. For clients prone to struggling this time of year, missing an appointment tends to make issues even worse.
When appropriate, Ostrowski says she will point out to clients that they said they needed help getting through the holidays but didn’t show up for their appointment. In other cases, she uses her office’s holiday closure as a way to bring up discussions about scheduling and ensuring that clients get as many sessions as they need.
Counselors should also make sure that clients have an emergency number they can call while the counseling office or clinic is closed for the holidays.
Travel and homecoming
Christine Forte, an ACA member and licensed mental health counselor in private practice in Shanghai, China, works to prepare her clients for the emotional impact of traveling home, often after being away for long stretches of time. In such situations, it’s important to remind clients that it is unlikely they will have enough time to see all the people and do all the things they’d like while home.
“What do they really want and what do they find it most important to spend their time on?” Forte asks these clients. “Be realistic in making plans, and allow time for rest and relaxation as well. One thing that I encourage is to be as clear as possible ahead of time to their families about what they will and won’t be able to do. Family and friends can expect that expats will simply slot back into life at home when they return at the holidays, but it simply isn’t the case.”
If the idea of a family get-together with “feuding relatives” is too stressful, Billington suggests that clients keep them off the invitation list or consider hosting separate get-togethers so the client can avoid becoming the middleman or peacemaker.
Forte encourages clients to take a step back and simply observe when family friction arises. “Awareness can be a powerful tool toward change,” says Forte. “I encourage clients to step back and observe as much as possible. Observe the patterns, observe their family member’s behavior, observe how they tend to respond [to one another]. … [Clients] can’t control what their family members are doing, but they can control their own behavior and practice reacting or interacting in new ways.”
Grief or anniversary of trauma
The holidays can be especially hard for clients who have experienced a recent loss and those for whom the season marks the anniversary of a death, crisis or other trauma. Counselors should be intentional about checking in with clients who fall into this category, says Billington.
“Anniversaries and holidays can be harder when a loss has been experienced because someone or something is missing and things are not the same,” he says. “This can be particularly triggering. In the context of grief and loss, I encourage clients to be prepared for these triggers and discuss the surrounding anxiety, concerns and worries as a proactive approach to anticipating triggers, almost as a rehearsal.”
Ostrowski suggests that clients mourning the loss of a loved one involve that person’s memory in holiday celebrations, such as making and displaying an ornament that reminds the client of the deceased.
Avoidance doesn’t work
Even clients who make a deliberate choice not to celebrate the holidays will still hear holiday music and see decorations everywhere they go. Reminders of the holidays are unavoidable, says Ostrowski.
“I would much rather [that clients] say, ‘We’re not talking about Christmas until after Christmas,’ and we can work on other issues and have an alliance through the holidays, rather than [these individuals] just isolating themselves,” she says.
For those clients who go into “survival mode” between Thanksgiving and Christmas, Ostrowski has them focus on the fact that the Christmas tree won’t be up for the entire year, the season will pass and there are new times ahead.
Self-care can be one of the most important coping mechanisms for clients during the holidays. This can range from small interventions such as breathing and relaxation techniques to more intensive methods, such as taking a trip away.
Ostrowski worked with one client to help her plan a special day of her own in the middle of the holidays, complete with activities she enjoyed and a favorite meal. Having a special day to look forward to helped offset the stress she felt around the rest of the season, Ostrowski says.
Another intervention Ostrowski suggests for clients is a gratitude journal – an idea she got from Liana Lowenstein, a well-known Canadian social worker. The client records one positive thing or event that happens each day. Ostrowski has clients start the journal before the holidays, when the weather is warmer and the days are longer. During the holidays, clients can then flip back to the start of the journal to remind themselves of a less stressful time.
For clients who feel an increase in depression or anxiety as the weather turns colder and the days become shorter, Manalang recommends the use of a light therapy lamp.
Loneliness and homesickness
Self-care in the form of planned activities can also help clients who are lonely or far from loved ones through the holidays.
Volunteering and participating in community events can be a powerful and rewarding intervention for clients who are lonely, says Billington. He also suggests that clients make a “plan of action.”
“For example, making a list of things the client likes to do, and if the loneliness birds come home to nest, the client can refer to the list and undertake some of these activities,” says Billington. “Taking a trip away can also palliate some of the symptoms of loneliness.”
With clients who cannot travel to see family or loved ones, Forte stresses the importance of preplanning local get-togethers and outings.
“Especially if it’s the first time they’ve spent the holidays away, it can be a time of really strong homesickness,” she says. “I always encourage people to make plans in advance with people from their community who will be around or on their own at Christmas. Having a fun day with friends or a meaningful day doing some type of community service can help to mitigate the sadness that might otherwise be there. I’ve found this helps a lot personally in years that I had to spend Christmas away from my family, and I’ve also found that having the plans in advance helps to dissolve some of the negative anticipation. It won’t be the same as being home with family, but it could be more fun than they think.”
The pressure of holiday gift giving can be a major stressor for some clients, especially if they have limited income.
The task of giving gifts and, in turn, pleasing the recipients can be tied to self-worth, notes Ostrowski.
Billington says he reminds clients that “the objective of any gift is thoughtfulness. … Helping clients understand the thought behind gift giving can help alleviate some of the stress and pressures of this ritual. In fact, making time in a session for a client to practice some art/craft therapy can be a good way to have fun, learn more about the gift recipient and the client’s world, and create a thoughtful gift.”
Talk about the holidays year-round
Ostrowski says she asks new clients if the holidays present a challenging time for them at intake, no matter what time of the year it is. “If you find out the week before Christmas, it’s kind of too late,” she says.
Asking clients about their mindset related to the holidays is comparable to asking them about their sleeping habits as they start counseling, Ostrowski says.
“You find out they’re not sleeping [that way], and they would never volunteer [that information],” she says. “This is the same thing. Clients don’t often tell me without my asking whether the holidays are a difficult time or not.”
On the other hand …
The holidays can also be a client’s favorite time of year. In such cases, a counselor might help the client remember this happy season at other times of the year when he or she is struggling.
“Remember that [the holidays] won’t always be negative [for clients],” Ostrowski says. “The key is to discuss it.”
Ostrowski recommends this page of resources from Psych Central (which she also distributes to clients who struggle during the holidays): psychcentral.com/holidays
From See the Triumph, a blog, social media and research project started by two counselors and ACA members about issues of domestic violence: seethetriumph.org/blog/loneliness-and-the-holidays
Tips for managing the holiday blues from the National Alliance on Mental Illness: bit.ly/1vA4RUw
ACA Counseling Corner article: Holiday depression: Fixable and something not to be ignored: bit.ly/1AIscrC
Tips from the American Foundation for Suicide Prevention: afsp.org/coping-with-suicide-loss/where-do-i-begin/handling-special-occasions
Bethany Bray is a staff writer for Counseling Today. Contact her at firstname.lastname@example.org