Now don’t get me wrong I love Christmas; the music, the decorations, the feeling of the world being happier than usual but, as great as I think the holidays are, there are problems that many of us face during these times; especially those of us with mental illness, since problems everyone faces on the holidays can be exacerbated by our symptoms. I once had a panic attack on Christmas day because I was so worried people wouldn’t like the gifts I bought them. I recently listened to a podcast about using DBT to help cope with the holidays and thought I’d share what I learned as well as some of my own ideas.
It’s in the songs and adverts, the push to make this the season to be jolly, the pressure to be happy and have a perfect day with the family. While it is a nice notion, encouraging people to be nicer and happier, it doesn’t consider the realities of life. Mental illness doesn’t decide to take the day off because its Christmas. If you have depression or anxiety the pressure to be normal for family and trying to be happy can just make you feel worse about being sad or scared on the holiday.
When you feel “bad” especially when everyone else seems to be cheerful it can be tempting to push away your emotions and lose patience with yourself for not feeling how you think you should be. I recently wrote about Self validation which is a key part in the treatment of bpd, I do think its useful for anyone as well. A good way of self validating with DBT is to observe your emotions using mindfulness. This allows you to attend to these feelings without judgement or making yourself feel worse by trying to fight them off. After observing you can describe your emotion, how it feels in your body,what triggered that emotion and what that emotion made you want to do. For example, I was home alone and heard a noise this made me feel scared/afraid that someone was in the house. I had butterflies in my stomach as well as a fast heart beat and tense muscles. This fear made me want to hide in my room. I find this skill useful as it encourages me to bring more awareness to how I’m feeling and how that affects me so I can validate my experience.
Above was an example given to me in the dbt worksheet for observing and describing emotions. Here are some worksheets I found online to help you;
If you find that your emotions get too overwhelming the distress tolerance skills can be useful. STOP, which stands for Stop Take a step back Observe the situation Proceed mindfully, is good for when you don’t have a lot of time on your hands and can be used anywhere at any time so if you feel yourself about to react to a situation remember to STOP. TIPP (Temperature Intense exercise Paced breathing Paired muscle relaxation) can help you calm your emotion mind by changing your body chemistry, It may need more time and a way get away from the situation unlike STOP but is just as useful. Safe place visualization can be useful if you can’t physically leave the situation but need an escape.
Some handouts for each distress tolerance skill I mentioned:
As I mentioned before, Christmas is a time that you’re expected to be together with family and be merry with them. However this isn’t always the case for a lot of us with mental illness, family is the root of our trauma so being around them in a place where the trauma likely happened (childhood home or an extended family’s house) can be triggering. Even if you didn’t experience trauma with your family sometimes they can ask you pressing questions, criticise you or start a row all are things you’d rather not deal with especially on Christmas.
So how can you keep your cool when your dysfunctional/ triggering family are surrounding you? There is a skill in DBT called Cope Ahead which is where you sit down and go through in your mind the possible scenarios that may distress and plan how you will cope with them.
For example you may have an aunt who asks a lot of questions about your life and criticisizes/scrutunises you and your responses. This makes you feel judged or like you can’t do anything right. You know you will have to face her on christmas day so you write down possible coping strategies for when the situation arises. You may use distress tolerance skills, plan to excuse yourself from the conversation asap or, if you have to put up with it, think about your accomplishments and practice positive affirmations to make yourself feel better. Once you have decided what will help you best, visualize yourself in that situation again but imagine coping more effectively and feeling like you did well despite the struggles. Below is the step by step method for Cope Ahead from https://bayareadbtcc.com/cope-ahead-part-1/
How to Cope Ahead: 5 Steps
Cope Ahead involves five steps.
1. Describe the problem situation (and check the facts). Are you in your wise mind when you’re looking at this situation? Are you keeping a neutral distance? Name the emotions and actions that you anticipate you will feel that interfere with you responding effectively. For example, will you feel angry if someone criticizes you at work, or panicked if a friend is late for dinner?
2. Decide what skills to use. Which skills do you want to use in the situation? Get specific. Does taking a timeout work if you’re coping ahead with anger? Do you want to distract yourself with another activity when you feel like engaging in an addictive behavior? Or call a friend, or go for a run? Get creative about what exactly you will do to cope.
3. Imagine. Now that you know the situation and the skills, imagine the situation in your mind as vividly as possible. Be sure to picture yourself actually in the situation, not watching it. Imagine it happening in the present, not the past. Bring details to mind: Where are you? Who is around you? What are you thinking or feeling?
4. Rehearse coping in your mind. Once you’re in the situation, practice coping effectively. Picture what you will do. What are your actions and thoughts? What will you say and how will you say it? If you anticipate a potential new problem arising, imagine coping with that as well. Rehearse coping with the things you are really scared of.
5. Practice relaxing after rehearsing. Finally, go easy on yourself after your rehearsal. Doing this kind of mental imagining of a hard situation is stressful on your psyche and body. Relax after you’ve run through all the steps! Stretch, take some deep breaths, or do whatever feels relaxing to you.
When dealing with anyone, even difficult family members, interpersonal effectiveness skills can be very helpful. FAST is good for maintaining self respect while resolving conflict, it stands for Fair (no)Apologies Stick to values and (be) Truthful. GIVE is good for helping you communicate in a way that settles the other person down in a disagreement in order to keep the relationship if it’s of importance to you. GIVE stands for Gentle Interested Validate and Easy manner. Below is an article providing more details of each skill:
Sometimes you may not even have friends or family to celebrate with, you may be on your own. While loneliness more commonly affects the elderly it can be found in nearly all age groups. No matter the reason for being alone on Christmas day it can be hard not to feel low with all the push for families and friends to get together and be merry. In Dbt there is a skill called ACCEPTS one of the Cs in this analogy is Contribute, if you are spending Christmas alone and have time on your hands you could contribute to the community by volunteering yourself for things like helping in a soup kitchen or being a listener on a helpline for people who are facing similar problems to you, not only can this help you fill up the time but you can also use it as an opportunity to connect with new people with similar problems/interests to you.
If you don’t feel that volunteering is for you and you would rather stay in on Christmas that’s okay too. There is another skill called Accumulating positive events, this skill encourages you to plan ahead to do things that you enjoy and make you feel better. You may use this skill to plan how you could spend your Christmas in a way that’s positive for you, you may want to have a movie marathon, spend the day cozying up with a good book or whatever floats your boat.
Tolerate Distress with A-C-C-E-P-T-S
Loss & Grief
Whether you’ve lost a loved one through falling out, a break up or them passing away, Christmas can be a difficult time without that person there to celebrate with. Although approaches to healing are different for each type of loss, you still grieve the loss of that person or relationship. Depending on your situation you may use different skills, if you’re grieving a break up with a partner it can be tempting to reach out to them during the holiday season, this however may not be good for you or them, a good skill in this case would be opposite action. Opposite action is where you deem the action the emotion is tempting you to do as unhealthy or ineffective, in order to quell the emotion you do the exact opposite of what that emotion is telling you to do. In the case of a break up, you may feel sad or jealous causing you to want to reach out to them or stalk their social media, while Christmas can be a time of goodwill and forgotten trespasses, if you know that reconnecting with your ex could cause some problems for you then here are some opposite action ideas for you:
- Focus on spending time with others you love and care about
- Avoid communication platforms such as text or social media, block/unfollow if you need to.
- Practice gratitude for gifts, people and other things in your life that don’t involve your ex
- Radically accept what has happened and try to let go of that person
- Go out and do things to build your confidence like go to a Christmas party or try something new.
When you’ve had a fall out with a friend or family member what skill you use could depend on your situation as mentioned before Christmas can be a time where people reconnect and if your fall out wasn’t anything too major you may want to reconcile in the spirit of christmas. Before deciding what action to take its best to Check the facts and consider some of the following: Do you value the relationship? Why did you fall out? Is it better for you to make up or be apart from each other?
Depending on the facts and your answers you can either use problem solving skills or opposite action. If you feel that trying to fix the situation is right then here are some ideas to problem solve:
- Reach out to the person and apologise if you were in the wrong
- Use interpersonal effectiveness skills to communicate respectfully
If you feel that reconciliation isn’t an option or you tried problem solving and it didn’t work out how you’d hoped then it may be best to use opposite action to cope with the hurt. Opposite action ideas for fall outs are pretty much the same as what you’d use after a break up: celebrate the good things you have instead of dwelling on what you’ve lost, allow yourself to have fun and build new connections, etc.
Losing someone you love through death can be harder to deal with as there is not even a chance to see or hear from them again and you may not have closure. Grief is normal and trying to suppress it especially at a time you feel that persons absence the most can end up hurting you more. Practicing radical acceptance can help at these times, this means not denying the fact that this person is gone and accepting your feelings of sadness anger or guilt. It doesn’t mean you think that this reality is good without them but it’s about understanding that this is your current reality and it feels like crap instead of pushing away the facts and how you feel about them it can be tempting to pretend that you’re okay and everything’s fine for friends and family on Christmas but not accepting and allowing yourself time to grieve can hurt you and your loved ones more. Some ideas on how to grieve during the holidays are: Visiting their grave, leaving an empty chair at the dinner table, lighting a candle in their memory or talking to others about good memories you shared with your deceased loved one.
It’s no secret that Christmas can be quite a commercial holiday, pretty much as soon as Halloween is over, adverts for gifts and deals start popping up everywhere. If you’re like me, an impulsive overspender, managing your money can be even harder when you feel the pressure to buy gifts for everyone you know as well as “treat” yourself. A useful DBT skill for this can be Wise Mind, this skill requires you to access a part of your mind that is a balance between emotional and rational. Emotion mind is more impulsive and causes you to act based on how you’re feeling which can lead to problems such as overspending. Whereas Rational mind is based on logic and a lack of emotion, an extreme on both sides is not helpful, on the one hand you want to show you care but you don’t want “overdo” your gifts to the point its detrimental to your bank account. Wise mind is the balance of both sides or “the middle path” as its sometimes called, connecting to your wise mind can help you make gift decisions that benefit those you’re buying for while also looking after yourself.
Making Mindful Money Decisions From Your Wise Mind
Thank you for reading, I hope this post helps you if you are struggling with loneliness this Christmas on twitter there will be #joinin which is a hashtag you can use to connect with others over the Internet who are also lonely on christmas. @mhcrisisangels are hosting a “Christmas sanctuary” which is a group chat on twitter for those struggling with their mental health to gain support through Christmas. If you find yourself in crisis the samaritans phone lines are open 24/7 as well as @crisistextline which provide numbers from USA, Canada and the UK which you can text if you need help.