Surviving the Holidays : PACER Integrated Behavioral Health

Buddy. And welcome to today's presentation. Thank you all for being with me. I know this is, you know, we're getting into that holiday season, so you've got a lot of other time demands. And I appreciate you taking time out to be with me this morning. Today we're going to be talking about some tips to survive holiday stress. I'm your host, Dr. Donnelly Snipes. It's important to remember these videos. These live shows are designed to provide you some, you know, overarching concepts. I have playlists that are on the YouTube channel that you can learn more in depth, for example, about how to improve your sleep. So I'm not going to obviously be giving you tools in, in depth to address these issues, but I'm going to be pointing you in the right direction. The PACER method, and I've mentioned it before, but for those of you who may not have been here before, the PACER method is an integrative behavioral health approach, recognizing that our mind and our body interact and we interact in our environment. So PACER stands for physical, affective, cognitive, environmental, and relational. And we will go through it systematically and look how. Look at different things in each dimension that could potentially cause us stress during the holidays, as well as ways that we can address it. And y' all know that I am, you know, super fond of mnemonic devices, so I have tried to create some mnemonics for you as well, and I will share those. The first aspect that we're going to talk about is your physical aspect. Things that can cause physical stress during the holidays, but things that you can do to prevent being physically vulnerable, to prevent being, you know, run down, so you have the energy to deal with life on life's terms. And the mnemonic device for this is nice. I want you to be nice to yourself. So N stands for nutrition. The first thing that you can think about doing is making sure you're normalizing your blood sugar. When our blood sugar gets too low, we tend to get irred or even too high. We tend to get irritable and edgy. So making sure you're normalizing your blood sugar. I know in my family it was always a tradition that on Thanksgiving and Christmas, you didn't eat at all until Thanksgiving dinner or Christmas dinner. And by the time I got there as a kid, I was ravenous and. And I can imagine that other people were probably ravenous as well. So, you know, maybe having a little snack here and there might have been more helpful for normalizing blood sugar. I don't know. Just Hypothesizing moderate sodium. And you may be thinking, what does sodium have to do with stress? Or well, sodium can increase your blood pressure. And when we increase our blood pressure, whether it's because of sodium or cognitive stress, our HPA axis, our threat response system, gets activated. And so it's important to recognize that taking in too much sodium, increasing our blood pressure can actually make us more edgy, more vulnerable to emotional distress. Eat healthfully. You know, that seems pretty common sense, but eat healthfully. Going up to the holidays and through the holidays. The holidays are often a time of, you know, overindulgence on comfort foods, if you will. But it's also important to make sure that you're getting your, your vegetables, your fruits in there and getting plenty of water. It's important to make sure that you are eating healthfully and getting enough calories. Some people really struggle if they've got eating disorders or body image issues, they really struggle around the holidays because there are quote, binge foods that seem to be everywhere. And that is way too in depth for us to cover in this presentation. People with eating disorders have specific stressors around the holidays that they need to develop skills and develop a plan for how to deal with. It's also important to avoid too many stimulants, which can make you edgy and irritable and more, potentially more jumpy. Remember, stimulants increase your blood pressure, which is going to activate that HPA axis and also avoid or minimize alcohol. Alcohol is a disinhibitor. It tends to encourage people, even if they're drinking non alcoholic beverages, if they think they're drinking alcohol. There is a bias when people are drinking something that tastes like alcohol to feel like they can say whatever they want to say. But we do know that there is a significant correlation between people being intoxicated and discord. You know, violence in the, in the household, fights breaking out, you know, lots of distress happening. So alcohol, even though it's, you know, sold as being something to increase happiness and cheer, can also have the exact opposite effect when it comes to illness. And that's the I and nice illness is something we always should be concerned about during the holiday season. I remember when my kids were young, I knew that if we went to see family, we, I used to say we were getting, getting exposed to strange bugaboos, things that we didn't have the immunity built up to because they lived somewhere else and they had a different microbiome where they were at. It makes sense. But you know, when you're going to be around family, it's important to wash your hands and use common sense. If you've got a fever and you're snotting all over the place, don't, don't go to the family gathering. But use common sense to prevent illness, whether it's the flu or a cold or Covid or whatever the case may be. You know, I trust that you've heard all of the ways to protect yourself by now. And when we're sick, we have more difficulty dealing with life on life's terms. When we're sick, we may not enjoy the holidays, which could contribute to stress. And when we're sick, a lot of times in during the holidays, we end up inadvertently spreading it around. And you don't want to be a super spreader. So wash your hands and use common sense. The C in NICE stands for cortisol. That's your stress hormone during the holidays. There's a lot going on and there may be a lot of different reasons you're experiencing different types of stress. Well, that activates your cortisol and your HPA axis. Good to know. Low intensity exercise, that means, you know, not super intense. Doing something like walking around the block, keeping your heart rate, if you're one of those heart rate tracker people, at about 40% of your target heart rate training zone, which you know, for me is like 90 beats a minute or something, you know, you're not doing something where you're having a difficulty talking. But really low intensity exercise reduces cortisol levels and increases something called brain derived neurotrophic factor or BDNF in people with clinical depression. It's been shown that cortisol is too high and BDNF is too low. Low intensity exercise reduces cortisol and increases bdnf. And low intensity exercise is something you can do if even in your holiday clothes you don't have to put on sneakers and you know, expect to get sweaty. That's the beauty of it. You can do it at any point in time. Go out and play with the kids, take the dog on a walk, clean the house. For that matter, whatever it is that gets you engaging in some sort of aerobic exercise that's increasing your blood, your heart rate just a little bit. Aromatherapy and I've linked to the different articles on PubMed aromatherapy. Inhaling these, you don't have to apply them and definitely don't ingest them can also reduce your cortisol levels and even potentially your blood pressure. Lavender, rosemary, ylang ylang and bergamot have Been studied extensively and have been shown to effectively reduce cortisol, salivary cortisol levels in people. Now, you may smell some of these and go, oh, not for me. Bergamot has kind of a citrusy smell. Ylang ylang is very, very sweet. I don't like Ylang ylang myself. Lavender. You know, we all know what lavender smells like and sometimes it's okay. Different, different types of lavender. There's lots of different types of lavender. Different types of lavender. I like other types, not so much. Rosemary is always a winner in my book, so I keep rosemary on hand. Rosemary is smelling essential oil. If you can't, if you don't have the essential oil handy, you know, you can take a rosemary seasoning that you have and boil it and inhale the steam. It's not going to be nearly as intense as the essential oil, but it may give you a little bit of calm and exhaustion. E stands for exhaustion. We want to avoid it. So it's important. Between the shopping and the holiday parties and the planning for trips and baking cookies or whatever you're doing, make time for rest. This is not the time to get worn down. When you're worn down, when you're sleep deprived or you're not getting quality sleep, your immunity is lower, so you're more likely to get sick. Your mood tends to be more irritable, your HPA axis stays activated. There's lots of reasons that sleep sleep is super duper important. The the more stressful the time you're anticipating, the more important getting quality sleep is. And according to the Sleep foundation, most people over the age of 12 still need 7.5 to 10 hours of sleep per night. So saying, well, I don't, I only need five hours of sleep. That's not what the research shows. You know, you may feel fine, but, but you know, a lot of people can get by on five hours of sleep, but then they need caffeine throughout the day to keep themselves going. That tells me if they're needing caffeine or if when they lay down, they fall asleep in under 10 minutes. It tells me they're not getting good quality sleep at night. So nice. Be nice to yourself, pay attention to your nutrition, prevent illness, reduce your cortisol and try not to get exhausted. Make sure you're getting enough sleep. Affectively and cognitively, how we feel emotionally and how we're thinking, oh, there's a lot of stuff we could cover here. And I'm going to go through it really, really quickly. The mnemonic here is phased because you know, if you have these good tools and you prepare ahead of time, theoretically you won't be phased by the holidays. You see where I was going? I struggled with that one. But anyhow, the tools you're going to need will help you deal with some of your emotional reactions around the holidays. A lot of people experience grief during the holidays. And unfortunately my heart breaks. This holiday season may be even more grief inducing for a lot of people because so many people died of COVID and cancer and everything else this year. We had a lot more deaths than usual in the, in the United States and probably in the world. So people are going to be reeling from that. And sometimes people grieve because they're focusing on what they lack. They are grieving the fact that they, they're not having the Christmas that they think they should or they want to. Now, this sounds trite and it is not a solution for grief. It's important to process and work through grief. But in the moment, in order to get you through that Christmas morning or that Thanksgiving dinner, some tools that can be helpful. Can, can be to focus on what you do have. What in, what do you have right now in your life that makes it rich and meaningful? Instead of focusing on what you don't have, focus on what you do have right now that you're grateful for. And in terms of deaths, you know, I just recently went through one myself. And it's important during those periods of time to also focus when you think about the, that person or those people. Focus on the happy memories. You know, it's. Yes, again, I am not minimizing grief. It is agonizing to go through. But focusing on what you do have and trying to think of that person or those people in terms of happy memories can help you get through the moment when you are trying to participate in holiday type activities. Depression. A lot of people feel it during the holidays. Holidays are really rough on a lot of people. They are built to be this, you know, super happy time. But for a lot of people, it's the worst time of the year. Some people feel hopeless and helpless during, during the holidays. They feel like, you know, they, their life hasn't gone anywhere. They feel unloved. People may experience PTSD during the holidays and it reminds them of bad things that have happened. I know. Unfortunately, people who have lost, lost loved ones during the holiday period in the past. And so now every time they come up to that holiday, it reminds them of that horrible day that, that they got the call or that they experienced that loss. And some I Mean, obviously there's also people that experience violence and other things on the holidays. And, you know, I don't really want to focus on that a lot right now because there's a lot of stuff that can happen during the holidays. That's what I'm getting at. That can trigger people on successive holidays and it's important for them to be aware of that. And isolation, people who are separated from their family can trigger depression. So how do we deal with it? Hardiness. Hardiness means folk commitment, control and challenge. Identifying those things in your life that you're committed to, that you're grateful for, that are going well, you know, that helps you get a bigger picture instead of focusing on the stuff that sucks right now. Control identifying what aspects of the situation are within your control. And challenge viewing the situation instead of as a problem, as a challenge. You know, if you're feeling isolated, okay, this is a challenge. How do I not feel isolated? How can, you know, get curious? Try to figure it, look at it as a puzzle and try to figure out how you can solve the puzzle. Be mindful and present focused. This is especially true for ptsd. If you are projecting stuff from the past, it's triggering past memories. Being mindful that what you're feeling and what you're thinking about, you know, is painful. However, being mindful of is what is going on in the present. Are you safe in the present moment? How likely is it in the present moment that the same thing is going to happen again? And doing what you can to keep yourself safe, keeping that present focus and recognizing, you know, maybe five years ago, your Uncle Bob had a heart attack on Christmas, you know, heaven forbid, and maybe he survived, you know, whatever, but that was a traumatic event. Now every time you go to Christmas dinner, you remember that it's important to focus on the present and look around and go, okay, everybody's healthy. You know, what is the likelihood that that's going to happen again? And you know, what is the best use of my energy right now and to deal with isolation? Connection is really important. Even if it's virtual, even if you've got to have your tablet with somebody on Zoom or FaceTime or whatever it is you use, that's better than being alone. And some people are not going to feel safe traveling during this holiday season because they are one of those people in a high risk group. And I get that, you know, if you're going through chemotherapy, if you have multiple comorbidities, if you're over 65, you know, there are a lot of reasons Grandparents and even parents may not want to travel. So I, I get that. But it's also important to encourage people to connect in a meaningful way, whatever that looks like for, for them. And thankfully, video chat, it exists now and can help bridge that gap a little bit. It's not the same, but it's better than nothing. When you feel stressed or overwhelmed, identify what must be done. You know, there's a lot to do during the holidays. Identify what must be done. You know, if this doesn't get done, there's going to be bad mojo. You know, there's a lot of stuff you'd like to do, like hang Christmas lights, but if that doesn't get done, you know, the sky will not fall. But what must be done, who can help you? You know, maybe you need to get the shopping done for Thanksgiving dinner, and you've got six other things you need to do. So who can do the shopping for you? Shortcuts that can be taken. You know, maybe you need to do the shopping and you're feeling short on time and you don't know if you'll have time to cook that turkey or, well, order a ham. You know, there are shortcuts that can be taken. Is it how you would have ideally envisioned it? Maybe not. But does it make sense to reduce your stress level so you can breathe? Oh, heck yeah. And then make a plan. And when I say make a plan, when you're stressed and overwhelmed, you need to write it down. Your brain is not ready to try to remember stuff and remember plans. Write it down. That way it's there. You can refer back to it and go, yes, check that off. Got that done. And you don't feel like you're trying to juggle six different balls in your head. Anxiety happens for a lot of people during the holidays. They may fear going to family reunions or things because they fear that, you know, every time we have a family reunion, something bad happens. The cops get called. So that can bring anxiety. Ptsd, you know, also rears its head here, where people may have anxiety about situations and fear of rejection. You know, we want to be loved. But during the holidays, when people feel isolated, it increases their awareness to microaggressions. And they may feel more rejected if they don't get invited to this party or that party or if somebody doesn't get them the present they want or there's a lot of things that people place their feelings of acceptance on. And we talked about some of that yesterday when we talked about love languages. During the holidays, it's really important to remember people's love languages when dealing with anxiety. We're going to go back to my old FCP if you remember nothing, no other tools. I think FCP works a lot of the time, not all the time, but a lot of the time for a lot of situations. What are the facts of the situation that are prompting your reaction? What are the facts? So we want to get away from emotional reasoning. What aspects of this situation can you control in order to prevent disaster? In order to, you know, manage the situation? And if you do the things that are within your control based on the facts in the current situation, when what's the probability that the worst case scenario is going to happen? You know, so following it, facts, control and probability. FCP guided visualizations can also be helpful. Just envisioning, you know, some people get stressed out before they have to go to an office party or something because they're introverted or, you know, they're shy, have social anxiety. Guided visualizations can be helpful to help people envision themselves going to that party, getting through it and, you know, not. And hopefully enjoying it. And esteem is really important during the holidays. People are very caught up on themselves, unfortunately. I mean, a lot of times in our culture we're caught up on ourselves anyway. But during the holidays, people are really worried about what others are thinking of them and what they need to do. They have a hard time a lot of times being empathetic. And sometimes people can feel rejected. And it's important to address that anxiety of rejection and abandonment by developing your own self esteem. So you can say, you know what, I don't need Sally to give me gifts all the time. I don't need, you know, Joe to be giving me words of affirmation all the time to know that I am lovable and worthy. When we feel lovable and worthy, it really buffers against some of those other stress feelings and anger about or resentments at family or other people. So that's our other main distress feeling that we may experience. Know your anger triggers and your warning signs. A lot of times during the holidays, there's going to be at at least some point where your anger gets triggered. And knowing your anger triggers can help you prepare for them. So you know that if I, I'm going to go to this family reunion and I know that Uncle Bob always, you know, just pokes the bear and, you know, tries to get me upset. All right, well, you know, that's an anger trigger. So how can you prepare for that ahead of time? What can you do? So you Know, you can get through that situation when you start feeling triggered. You know, maybe you're at that family reunion and you start feeling that spidey sense going, yeah, I'm about over it. What can you do? Notice your warning signs early. Be mindful so you can take steps to prevent it from becoming a thing. Practice psychological flexibility regularly. Ask yourself, what is the best use of my energy right now to move toward my goals? You know, maybe Uncle Bob is poking that bear. Well, you could get angry and start screaming and, and try to win the argument this year. Is that a good use of your energy? Is that going to stop Uncle Bob from poking the bear? And for those of you who aren't familiar with that phrase, that means trying to irritate somebody when you talk about poking the bear. But, you know, is getting upset going to change Uncle Bob's behavior or more likely, reinforce his behavior because he gets a rise out of you? So is that a good use of your energy? Is ignoring it a good use of your energy? Well, that's probably something that you might want to try is assertiveness, you know, telling Uncle Bob to knock it off. Is that a good use of your energy? Well, most of the time in those sorts of situations, it may not be the appropriate time or place, and it may not change Uncle Bob's behavior. So is that a gamble you want to take right now, or is it a better use of your energy in this context, you know, the family reunion, in this context, to just ignore it. And then after the family reunion or holiday dinner or whatever it is, maybe, you know, call up Uncle Bob and go, hey, this doesn't work for me. And use your assertiveness skills and practice distress tolerance. Distress tolerance is super helpful because whenever you start feeling those overwhelming emotions bubbling to the surface, distress tolerance skills can help you tolerate the moment. Remember, distress tolerance is not about avoiding dealing with those issues. It's about helping you not feel overwhelmed by those feelings so you can use your wise mind to make the best choice about how to proceed. So the mnemonic device for affective and cognitive aspects of, you know, preparation is phased. Psychological flexibility, hardiness, awareness of how you're feeling, social support, esteem and distress tolerance, and finally, environmental and relational aspects. Sometimes you may be going to a place that triggers bad memories. Maybe you don't like being in, you know, crowded environments like holiday parties. So have a plan for wherever you're going to create safety. Create a bubble of safety for yourself. You need to feel physically and emotionally safe. Some things that can go into your plan Include getting away from people who are intoxicated and possibly more likely to start, start an argument. You know, just get away from that so you don't even get sucked into it and or excuse yourself from triggering or overwhelming situations. Go to the bathroom or, you know, go outside and get some fresh air. There have been times in, in my past where, you know, all the hubbub has gotten overwhelming and I've just needed to go out on a walk for a minute and, you know, that is okay. It's okay to take care of yourself, you know, you know, generally you want to tell the host that you're going to go get some air or something so it doesn't feel like you just disappeared. But it is okay to set boundaries and take a little time out relationally and environmental and relations kind of go along because a lot of the stress is involved about the holiday revolves around relationships, critical people or hot button topics. I. You knew I'd get there. So let's talk about critical people. That person who always has to have a dig for you. Well, there are a lot of different ways to handle that in the moment. Now outside, you know, of the holiday gathering, you may want to have a discussion with them that is, you know, your choice to use your assertiveness. But in the moment, if somebody, you know, digs at you, you know, maybe you spent all day cooking and your mother in law says this turkey is awful dry. Oh, I tried so hard and she had to criticize it. Okay. And that's not my mother in law, by the way. My mother in law is a saint. But, you know, maybe they are, you know, unhappy for some reason. Find three other explanations why they may have felt the need to say that. You can also view it as coming from a place of love. They're trying to be helpful, letting you know that maybe next time you don't need to cook the turkey for as long. Or they, if they don't like your outfit, you know, maybe they're just trying to share with you that they think there's a different outfit that would be more appropriate or your parenting or whatever it is. There's lots of criticism that happens at family gatherings. Take what's helpful and leave the rest. A lot of times there's a nugget of help in some things people say, not necessarily everything they say. So let them say it. And especially if you can envision it as coming from a place of love. All right, they're trying to be helpful. I got it. Listen to what they have to say. If it's Useful, great. Take it. If it's not useful, let it roll off your back like water off a duck and have social support on standby. This is super important and it's great now that we've got mobile devices and we can be texting our friends. I remember there was a time in the not so distant past where we had something going on and my stepsister was just being horrendous and I would not have survived it, I don't think, and, and not lost my cool without having my best friend basically on, you know, permanent standby on text where I could excuse myself, take a moment and text my friend and go, okay, you know, I just need to decompress here. And you know, she would do all that being consistent, responsive, validating, empathetic and supportive. You know, she was great craves and, and that was super helpful. And my husband was there too, and whenever he was around, he was great at, at being a buffer. But even if you don't have somebody there in person that can be a buffer, you know, make sure you have somebody that you can reach out to that can just hear you, validate you and help you, you know, cathart for a second. And finally, these hot button topics, and there are a lot of them this year, avoid them. You know, be assertive. If somebody starts wanting to talk about COVID or mask mandate or the election, you know, politely either excuse yourself or suggest that maybe that's probably not the best conversation to be having right now because people are already exhausted and on edge. People can take things very personally. And I know right now we're not even really in the holiday season. And whenever those topics come up, people seem to get extremely defensive. And you combine that with other stress and an audience where some one person may feel like they've got to defend themselves and it can escalate very quickly. You know, just like other times where you may avoid topics like politics and religion. Well, you know, at least during the holidays, avoid politics and Covid. You know, religion is, you know, a lot of times a central focus of the holidays, but you, you know what I mean? So safety during the holidays, emotional safety, physical safety means protecting self. And that means making sure you have a safety plan. E stands for explanations. Find alternate explanations besides somebody trying to be hateful, you know, why, what might be going on in their head that is prompting them to act like this. L stands for love. Try to embrace criticism as coming from a place of love. Filter. Filter it out. Take what's useful and leave the rest. Recognizing that, you know, what works best for you. So I went through a lot of stuff and I know this is a longer presentation than usual, but, you know, I kind of couldn't, couldn't stop myself from coming up with different things. What questions comments do you have? What things about the holidays stress you out that you might be either dreading or or what might be causing you to dread the upcoming holidays? So while y' all are thinking, I'm going to go back through our mnemonics. Nice. Be nice to yourself. That stands for good nutrition, illness prevention, cortisol reduction, and exhaustion prevention. Emotionally or affectively and cognitively with good tools, you won't be phased. P stands for psychological flexibility. H stands for hardiness. A stands for awareness of yourself, S stands for social support, E stands for esteem, self esteem, and D stands for distress tolerance. And finally, safety means protecting self. S have that safety plan. E Explanations Find three alternative explanations for why someone might be snippy or critical. You know, they just may be stressed and that's how they react when they're when they're stressed. L envision it as coming from a place of love and filter. Filter out what people say. Take what's helpful and leave the rest. Alrighty. Thank you for being here today. Thank you for being so attentive and I look forward to seeing you tomorrow. As always, remember, you can make suggestions for different topics that you want me to cover in the comments section below. And please remember to hit that like button and subscribe so you get a reminder every morning or every weekday morning when I go live at 9:30, 9:30 CST 10:30 estimate.