Tips for Understanding and Coping with Trauma and Grief during the Holidays

You. I'd like to welcome everybody to today's presentation on grief, loss, and the holidays. I'm your host, Dr. Donnelly Snipes. In this presentation, we're going to explore what grief is for those people who aren't familiar with all the phases of grief. Explore the connection between grief and trauma, and look at some of the triggers for grief, trauma and depression, and then obviously, try to explore some ways to deal with them. Trauma results when people feel a lack of control, a sense of disempowerment, and just general unsafeness. When we experience trauma, you know, think about different times that something has been traumatic. I think you can probably assert that at those times you had a feeling of a lack of control, being disempowered and unsafeness. And unsafeness is kind of, you know, perceptual in some ways. For example, when my parents were diagnosed with cancer, you know, obviously I felt a lack of control, and I felt completely helpless. Did I feel totally unsafe myself? No. But there was a part of my mind that went to this place of, well, I don't want that to happen to me either. Grief is commonly associated with a sense of powerlessness over the loss of something important. And that can be people, pets, faith, or even the ability to do things that you think you should or that you want wanted to do. So if I feel like I should be able to go up and down stairs, but I can't go up and down stairs anymore, trigger a grief reaction in me. And so grief is more than just loss of people. And I want you to explore or think about the different things that clients may be grieving during this holiday season with losses of jobs and financial stresses and lockdowns where they may not be able to visit their loved ones like they want. Grief can be traumatic. When we lose something that's important to us, it can be very traumatic. We can feel like we're out of control and disempowered and unsafe. It's not always the case. People who die in the natural course of things and expected death, you know, Great Grandpa was 102 years old and, you know, he passed peacefully in his sleep, may not be nearly as traumatic as, you know, some other deaths that may occur sooner than you expected because of disease or accident or something like that. But it's not really important to try to assess and decide whether grief was traumatic or not. What we want to do is help people regain a sense of personal control over their lives, their thoughts, their emotions, regain a sense of personal power over their life and their thoughts and their Emotions and feel safe physically, emotionally and cognitively. Trauma almost always results in losses that need to be grieved. As you all are probably well aware, grief involves denial, anger, bargaining, depression, and acceptance. We've all been through grief periods before, and, and you know what that denial is like. And remember, with grief, people don't go through it in a nice linear process where once they step out of denial and move on to anger, they're never going to go back again. People really like to jump back to that denial state. And, and it's important to kind of recognize that and be aware of it. If you're going through it, be mindful of where you're at or if your clients are going through it, help them be mindful of where they are in the grieving process. Anger. Well, anger is a response to a threat. It makes sense that if we feel a sense of unsafeness and powerlessness, that we are going to respond with either anger or fear. And a lot of times with grief, it's anger. Then comes bargaining somewhere in there. And, and like I said it, this is not necessarily a linear process, but bargaining revolves around the guilt over shoulda, coulda, wouldas, you know, if I would have been a better person, maybe this wouldn't have happened. If I would have insisted that so and so stop smoking or put their seat belt on, this wouldn't have happened. If I start going to church again, if I start doing this, if you help this person recover, then I will, you know, all of those bargains, contracts, you know, wheeling and dealing you try to do with the universe in order to either undo something that's been lost or prevent something that you're anticipating losing. When that doesn't work, people start to experience depression, that sense of hopelessness and helplessness. And again, hope is, you know, part of the loss of, and, and powerlessness are representative of a loss of a sense of power and control. We want to help people move toward acceptance by again, helping them figure out how to be safe emotionally, mentally, physically, how to cope with their thoughts and their experiences, even when they're being triggered. And the holidays can be huge triggers for people. Signs of grief, somatic complaints, upset stomach, headaches, backaches. When we are stressed, remember that HPA axis is activated, which can increase inflammatory cytokines, which can increase inflammation throughout the body. It can increase depression as a result of that inflammation. It can increase symptoms of autoimmune diseases as a result of that inflammation. So people may have some very present physical complaints. Pain is another one. People start feeling more when they are under stress and sometimes when they're grieving, when, when the HPA axis is activated and if it's activated for a while, the immune system goes a little bit haywire. Inflammation starts to happen because the body's trying to help you repair and fight or flee at the same time. It's kind of like trying to talk on your phone and charge it at the same time. It's not real efficient. But as inflammation goes up, people may feel more pain as the HPA axis is activated. When they're in fight or flee, they've got the excitatory neurotransmitters going on. Serotonin is suppressed. Serotonin is one of our neurochemicals that's associated with our pain tolerance. Serotonin goes down, our pain tolerance may go down. And the HPA axis is really interesting because when it's working well during that immediate stress reaction, what we experience is a suppression of the immune system, a suppression of inflammation and a suppression of pain because of the release of endorphins. But if that stressor continues to go on as it does in grief, then those beneficial effects actually kind of revert to the opposite. When, when stress continues because of increased HPA axis activation as a result of the threat that is occurring because of the grief, people will experience often sleep disturbances. They may have difficulty getting to sleep, difficulty staying asleep, or they may have nightmares or even dreams about the. If it's a person, the person that they lost. We do want to help people focus on good sleep hygiene during this period of time and help them understand what may be going on with, with their sleep, why they may be having these weird dreams or, or whatever. Encourage them to journal about their dreams so you can talk about what that might mean to them and help them figure out strategies. A lot of times when people lay down to go to sleep and they're grieving or their grief has been re triggered, they may start having these racing thoughts or intrusive thoughts about the person or thing that they lost and that while they're laying there in bed trying to go to sleep, those thoughts come in, which triggers the HPA axis and actually undoes some of the relaxation, so makes it harder to get back to sleep. Guided imagery and progressive muscular muscular relaxation can be very helpful tools for people who are grieving and people who have high levels of anxiety and other things to help them quiet their mind and get to sleep. Consider having people explore those ideas. Appetite changes are very common. Some people will gravitate toward comfort foods, which are very plentiful during the holidays, other people will not have any appetite at all. And part of that is because when we are under that fight or flight, you know, we're not supposed to be necessarily eating at that point in time. It's not time to rest and digest. It's time to fight or flee. So typically when the HPA axis is working well, typically during that acute stress, our appetite is suppressed. However, when the stress goes on, that may alter. And instead of having a suppressed appetite, people may have more. Oftentimes it's not so much hunger but more cravings because their body is wanting to, you know, find something that is going to help them trigger that serotonin and that dopamine. And restlessness can be very common during grief. When people feel powerless, many times they, they want to find something to do. They want to find something that they've got control over. It can be very helpful with people who are grieving to help them identify things that they can do instead of just sitting still to help them with their restlessness. Nature therapy has been shown to be very effective in addressing mood as well as issues of restlessness. The studies have shown that a lot of times when people go out into nature or they focus their attention on nature, even if it's a screensaver, can help them clear their mind more and have more of an open awareness like we talk about in mindfulness, that can help them tamp down that HPA axis. When people are in nature, it actually down regulates the HPA axis and reduces levels of cortisol effectively. When people are grieving, their mood may be all over the place and that's okay. It's important for, to normalize this for people and help them identify and acknowledge and validate their own emotions non judgmentally. It just, it is what it is. If they feel, if they wake up and they feel irritable today and they're cranky and they just don't want to do it, all right, acknowledge that doesn't mean you have to sit in it and steep yourself in it all day long. But acknowledging the irritability, the anger, the frustration, the short temper, Impatience with others is important to know where you are and then having strategies, your toward behaviors so you can look at, okay, what are my options to improve the next moment because I really don't want to sit here and just simmer in irritability all day long. Most of the time people are going to agree with that statement. In children, anxiety can become very prominent especially well, that's not even true when there's grief. When A pet dies when, when a loved one dies, or even if parents are grieving over something like the loss of a job, children can become very anxious. They take their cues in from parents. So we do need to be sensitive to the fact that children are very perceptive little critters. And they may start becoming anxious. They may not know why. They may be grieving because they know that they lost something that was important to them or someone that was important to them. And they may be worried that it's going to happen to their parents or to them. So it's important to understand that children, especially children under the age of 12, have a lot more difficulty wrapping their head around life and death and those things. So it can be extremely anxiety provoking for them, which can trigger even more somatic complaints, sleep disturbances, restlessness, irritability, and, and that can have a ripple effect on parents or caregivers who are already grieving. They may not have the resources emotionally to deal with that at that point in time. Helping families recognize if they've got children that are and the family is going through a grieving process, helping them recognize what the anxiety looks like, giving them tools to talk with their children about what's going on. Because sometimes parents and caregivers just don't know what to say. And providing them resources is really helpful because when we're grieving, our cognitive capacities, our ability to have flexible thinking and out of the box problem solving and all that kind of stuff is diminished. Some fight orf flight means focus on the threat, not try to figure out how to be creatively solve problems. It's important when people are under stress because of grief, because of anxiety, because of trauma, for whatever reason, that they do things to take care of themselves. Cognitively recognizing that it's okay to have difficulty concentrating and they can write things, encourage them to write things down, encourage them to use push notifications and have people remind them of things and divest some of their responsibilities as, as they're able allow others to help them. And I'm getting ahead of myself with this, but those are some of the things we're going to talk about when people are grieving. Obviously we already talked about how they may, may experience depression and then those mood swings and sometimes we call them grief bursts because people can be, be bopping along just fine and then all of a sudden it feels like from out of the clear blue they just have this memory or this wave or this something that triggers the, the grief in them to come up again. Kind of like sometimes when you walk outside and in the bright sunlight and you sneeze and you're like, well, what the heck just happened there? Grief bursts are very normal. And it can come out as anger, anxiety, depression, tearfulness. However it comes out, it's okay. And it's important for people to be able to, to validate and normalize this for themselves so they don't feel like, oh my gosh, you know, I'm never getting any, getting any better. One of the things I have my clients do who feel like they're stuck and not moving forward is to keep a daily log of how many grief bursts, how long it lasted, and the intensity. So, and some of them will just do a hash, hash Mark. It's either a yes or no thing. I had one or I didn't. And they count that up. Others want to get more granular. But what we want to look for is a reduction in the frequency, duration and intensity of the grief bursts and the mood swings as they start moving towards acceptance of this new, new normal. Cognitively, it is perfectly normal to have intrusive thoughts. And those. I'm not going to get into great detail of those intrusive thoughts. That's in other grief videos that I've done. But they can have intrusive thoughts about the loss or about the consequences of the loss, such as if they lost their job, they may be sitting there and all of a sudden they think, oh my gosh, we're going to be homeless in six months. And that intrusive thought comes in and it triggers that anger and that anxiety response in them. Those thoughts are going to potentially happen. Helping them figure out how to deal with intrusive thoughts is going to be most helpful. And we've already talked about with concentration, writing things down, push notifications, having people remind them of things, divvying up responsibilities as much as possible so you have less that you have to expend energy on. All of those can be helpful and also minimizing, simplifying. When you are going through grief trauma and, and, you know, a distressful period, sometimes it's important just to get back to basics and go, let's, what is it that I have to do? What is it that I have to do? This holiday season, there are things that I'd like to do, things that other people want me to do. But let's simplify, figure out what I have to do, and then anything I do above and beyond that, you know, I can take on a case by case basis and a day by day basis, because grief does not follow anybody's freaking timetable. I wish it did, but it's important to recognize that it doesn't interpersonally or relationally. Signs of grief include isolation and withdrawal. Sometimes people just can't, especially during the holidays. They just can't tolerate being exposed to the frivolity and the family focused things. If they feel like they have had a loved one ripped away, that's okay. However, we do want to make sure that people do have social supports. We don't want them feeling completely isolated and increasing their depression. If they want to isolate, maybe they want to go on a walk in the, you know, go on a hike or something because they just can't tolerate that much input from other people. Well, that's cool, but we want to make sure that they're checking in and they're safe. In children especially, but sometimes in other people, in, in adults we may see the opposite. We may see clinginess, separation anxiety, neediness after a loss because that is one way of trying to regain control. It's like if I can keep you, you know, in my sight, if I can keep you engaged, that then I know you're still there. We want to recognize this in ourselves, in people, what that might look like and what we can do about it. A lot of times, remember, behavior is communication. What is this behavior saying? If you have a child who was relatively independent, then all of a sudden has become very clingy or has become very, what one of my best friends used to call disorganized, kind of scattered all over the place, high strung, restless, you know, we want to ask what is that behavior communicating? Why is there this sudden change in, in the person's behavior? And sometimes people can vacillate between being clingy and then being wanting. Wanting to be alone and then deciding that being alone feels unpleasant and wanting to be around people. It's a day to day, moment to moment sort of thing. Especially in that first year for, for quote, regular grief and for complex grief, for complex trauma. It can't, this can happen for multiple years. My stepfather lost his entire first family on Christmas Eve in a fire. And you know, he is now 87 and that happened back in 1962 or something. But you know, to this day he still has these occasional grief bursts, especially around the holidays. And you know, I think anybody else in his shoes probably would. He recognizes that they, they are less intense and fewer things trigger him now than they did even 10 years ago. But it is important to be, for our family to, to be sensitive to his needs during this, during the holiday season every year and recognize that, you know, sometimes when grandpa is acting a little bit withdrawn, it's not personal, it's that he is having a moment. What do we grieve? Well, prior losses. Sometimes it's not something that we, we lost right now, but it's something that we lost five years ago, 10 years ago, 40 years ago. Things that are important, you know, that hurt gets more palate, more copable. What's the word I'm looking for? It's easier to deal with over time, but we still miss things that were important to us. My aunt Chris, I was seven years old when she died. She had cystic fibrosis. And I still occasionally think of her and miss her, even though, you know, I was knee high to a grasshopper when she passed. And, you know, like I said, my, my stepfather still thinks about his first family. We lose people to death, but we can also lose people to empty nest. Empty nest is really hard for caregivers who've grown up with other people in the household, and then all of a sudden those other people aren't there. It can also be, and I think I talked about this a little bit on Tuesday, even grieving and your children growing up, and you love to see them grow up. But in a way it's kind of bittersweet because the things that they did and the way that they appreciated the holidays when they were 6 aren't quite the same when they're 16 or 26. And it's a process. People can grieve a, a person if there's a relationship that ended or even if, for example, their best friend moved away, or in terms of COVID maybe their best friend can't come over now because of lockdown. But it's important to recognize that just because somebody hasn't died doesn't mean it's not a loss to be grieved. And just because it's not a severed relationship, if you spent a lot of time with that person, if you were like joined at the hip, best buds and that person moves, you know, six states away, then there's an adjustment period and there's a little bit of grief involved in that. We can grieve the loss of physical health and abilities, the loss of routine and rituals, a pet, hope and faith, finances or jobs, or the ability to get good gifts like you want. Unfortunately, during the holidays, there is a lot of focus on material possessions. And when people are not able to give gifts like they feel they are, quote, supposed to, it can take a. An extreme toll on their Self esteem, their feeling of self worth as a. A friend, a caregiver, you know, whatever role they're playing. And we can have a. The loss of dreams. People who grow up watching Hallmark movies and Disney movies and yes, I know I pick on them a lot. Those are just. Are the ones that everybody knows, may watch these movies and think, this is what my life's going to be like when I grow up. And then when they grow up, their life's not like that. And they may feel very let down and very angry that they never had that Hallmark holiday. So what are some of our specific triggers around the holidays? Expectations. Expectations can really impact us based on past memories of disappointment. You know, we may expect we're going to have this great Christmas, but then we remember that, you know, every Christmas that we think is going to be great, you know, Uncle Uncle Bob shows up and gets drunk and obnoxious and the cops show up. So we know it's just, we might as well just throw in the towel for having a good holiday. We may grieve the loss of expectations. We think it's going to be a great Christmas. We're all wound up for it and it happens. And it's like, is that all there was? Or reminders of what doesn't exist? Whether it's a loss of a person or, you know, you thought by the time, you know, the end of 2020 rolled around, you would have accomplished these things. And you're sitting there during the holidays reflecting on the year, going, what in the heck happened? And people grieve that. We can have triggers or feelings of grief or anger because we have expectations for how people are going to behave this year. You know, we, we expect that so and so is going to behave themselves this year, or maybe we expect that so and so is going to be the life of the party. And they show up and they're in a bad mood and it's like, well, what happened? You're supposed to be the jolly Santa. All of these are not necessarily huge triggers. Some of them could be huge triggers. Some of them, just like stressors triggers are additive and somewhat exponentially additive. And the more things, more disappointments we experience, the more times we get let down, the more times we're reminded of things that we lost, all of those things start to kind of snowball and can prompt people to experience sort of this overall grief reaction and frustration and sense of hopelessness that the holidays will ever be good. And then they start dreading the holidays, you know, in August, the coming year. So they have this anticipatory grief. They anticipate that they're going to be disappointed in the upcoming year. And we need to help people recognize that and figure out how to deal with it, figure out what aspects are within their control. They can't undo the past. But what does a good holiday season look like to them? What parts of that are within their control and what can they. How can they make that happen? And for some people, a good holiday season means no holidays. It means doing an unholiday thing. And that's really popular around Valentine's Day. But some people also do it during the winter holiday season. And you know, that is a choice. That is a valid choice for people. Other things people may grieve, as we talked about, include deaths or reminders of bad things that happened on that day. Maybe I always pick on Uncle Bob, but maybe Uncle Bob had a heart attack or a stroke that day. He's fine now. But two years ago when that happened, you know, it was very traumatic. And now in this holiday, Uncle Bob's there and you're just kind of walking around on pins and needles going, please don't let that happen again. We need to help people again recognize the current situation. This is not two years ago. This is the current situation. Hopefully Uncle Bob's taken better care of himself now. So in this context at this time, what is the likelihood that that's going to happen? You know, what are the facts supporting the likelihood that that's going to happen? What parts are within your control for how to handle it? And you know, how probable, if you do everything within your control, how probable is it that there's going to be a catastrophic end to your holiday? Other triggers and sights, sounds, smells, you know, they're everywhere. And you know, unfortunately or fortunately, depending on how you look at it, the holiday season seems to start earlier every year, like in July. Now, in July, they had holiday stuff out. And that's really hard for people who are struggling to cope with the holidays to start seeing some of those triggers early in the. In the earlier, earlier and earlier in the year. Certain songs can be triggering. I have very strong emotional connections to different songs. And because I listen to them, I listen to the words. But so when I hear songs, they remind me of the past, especially Christmas songs and spending time with my. My dad and. And his family. So songs can be bittersweet. You know, they still represent a happy time, but they represent something that is gone. Encouraging people to figure out how to embrace the bittersweet, because bittersweet means there's good and bad. Reflecting on those happy times, for example, can be something that people can do. They don't, don't always want to do it, but they can. That's something that they can do while we're here. On sensory if you're have someone in your family who has advanced dementia or Alzheimer's, they may have difficulty remembering proximal things. But things from the past are often still well, intact. So during the holidays they may become very nostalgic or you may feel like they're becoming very nostalgic because when they hear songs or smell, smell things that you're baking, you know, sugar cookies or whatever it is that you bake, that may trigger a memory that's still intact for them. And that can be really awesome if it helps them feel happy and engaged. But it can also be confusing to some people who don't understand that the person with dementia or Alzheimer's. It's not that they don't want to remember last year, but. But they can't. So anyway, songs, sounds, things to be aware of that are triggering for you just know them. So you can either avoid them or figure out how you're going to deal with it. If Christmas carols bother you, how are you going to deal with that? Well, listen to a different channel. Could be one. Sites are a little bit more difficult to control because they're everywhere. Snow, for example, may be triggering for you or holiday symbols. So when you see them, it's important for people to have strategies for how to deal with it when they see them. Snow was something that my mother every season when they had the first snow of the season in North Carolina, she would call me and tell me about it and usually email me pictures. When we get our first snow or it starts to flurry here, it always reminds me of that, which again is one of those bittersweet things. But I try, I personally try to focus on the happy memories that are associated with that. But snow is not something that you cannot see if you live in an environment that gets snow. Holiday symbols we can't get away from. They're on the street poles, they're in the stores. So how can people deal with those in a way that helps them cope? And a lot of it may involve distress tolerance. Icy roads can be a trigger if you lost somebody in a car accident or if you had a car accident. And obviously scents like cinnamon and pine and ginger can be triggering for people. Scents are a little bit easier than sites because you can always keep aromatherapy or other scents with you, even if it's just cologne or perfume or something that you can dab underneath your nose or whiff underneath your nose to trigger a different memory or trigger a different feeling. Rituals that can trigger trauma and grief during the holidays include rituals that remind of abuse or loss. Maybe everybody used to go over to so and so's House for the holidays, and everybody there was a big tree decorating party, and that person has passed on, and nobody else has taken up that tradition. So that could be a sense of loss. If you're going over to so and so's house for the holidays, and that was a place where there was verbal, physical, sexual abuse, you know, any of any type of abuse, then going to that place again can be, for those same holiday rituals can be very triggering. And it's important we help people figure out how to be physically, cognitively and emotionally safe. Physically safe, obviously, is paramount, but then how can they deal with the intrusive thoughts and how can they keep their feelings, you know, acknowledge their feelings, validate their feelings, but also not feel overwhelmed by their feelings? Sometimes it's just the focus on a higher power during the holiday season that can be very triggering for people who are angry at. At what has happened, at the losses that they've experienced. And we need to help them figure out how to process that. That is one that's often. Unless you are a, you know, a Christian or a spiritually based counselor, that's often one that I involve or refer out to the person's spiritual leader because they have more expertise there. I'll hear it out. You know, I'll help talk about, talk about it with them. But for, you know, sage wisdom, you know, I always recommend that they talk with their, their spiritual leader about, you know, what it means and how to cope with it during this time. It's also super helpful for people to be able to reach out to support groups, grief support groups, trauma support groups, addiction support groups. Because unfortunately, the holidays are a time of stress and triggers for a lot of people. And when people feel like they are not alone, when people feel like they're not the only one that's struggling and they have that support, it can, you know, go a really long way. Alcohol itself can be a trigger for trauma and grief during the holidays. It's plentiful a lot of times. And alcohol, we know, causes disinhibition. It takes that filter off. So people start saying and doing things that they probably wouldn't normally say or do if they weren't under the influence. And so people can be less sensitive to someone else's grief. And that can be a problem. If the person who's grieving starts drinking, alcohol can disinhibit them and they can feel like they are being overpowered by emotions sometimes. And then typically the response is to try to drink more, which ends up badly a lot of times with either strong hangovers or, you know, it's just. Alcohol is generally not a recommended coping skill. Intoxicated people can also be a grief trigger and a trauma trigger for people during the holidays because it can remind people, you know, if they're hanging out with their family and people start getting intoxicated, it can remind them of prior holidays that have been disappointments because people got into arguments, you know, started violence, had the cops show up, what have you. So alcohol can also be a trigger. Sometimes just seeing alcohol, it's like, you know, I walk in, I see all this alcohol all over the place. I know Uncle Bob's gonna show up, and I know it's gonna go bad. And those are the things. And by the way, I don't have an Uncle Bob. Those are the things that are potentially going to trigger that HPA access to set off and make people more hypersensitive and to, you know, negativity that's going around and can potentially trigger some of those memories and feelings that they felt like they had suppressed to, to loose up a little bit. Stress can be a trauma and grief trigger. As HPA axis goes up, as stress goes up, it becomes harder to deal with life on life's terms. So something that would have been just a, you know, kind of a mild trigger, kind of an annoyance when people are stressed or lack sleep or both, then that thing may feel a whole lot more overwhelming because they don't have the resources, cognitive, emotional, physical resources to deal with it. Financial worries can trigger for. For a variety of reasons, you know, can cause people to feel like they may worry that they're going to lose their house. They may also have grief surrounding prior years when they didn't have enough money to get the kid, their kids, the presents that they wanted. And financial worries can also trigger reminders of abuse from their childhood when their parents were stressed and maybe they got angry because they didn't get something they wanted and they experienced abuse from that. So financial, you know, we've got to look at all the different ways that some of these things can be stressful for people and help them acknowledge that and integrate it into their reality and say, okay, yeah, that happened. I can't change it. However, how am I going to deal with it now, how do I want it to impact me now? And what steps can I take to make that happen during the holidays? Shopping can also be, you know, stressful for people. It can trigger trauma. It can remind them of times when they were criticized in the past or abused because they don't know they're trying to get the right present, because they know if they don't get the right present that all heck is going to break loose. So that can be extremely triggering for people during the holiday season. And just being in crowds for some people can be traumatic, whether they've got social anxiety or just being around people. And right now, unfortunately, because of the virus, it is very triggering and very traumatic for people to feel like they are not socially distanced. And it adds a lot of stress to their existence in a lot of cases. Interventions. Well, let's start with the basics. Do what you can to down regulate that HPA axis and to not add additional stress to that HPA axis. This will help with mood immunity and inflammation. You know, those are, those are big ones. Safety. Encourage people to develop a safety plan when they're at home. How can they feel emotionally safe? You know, if they're flipping through the channels and they know that certain types of shows are going to upset them, maybe even block those channels during the holidays or stay on, you know, Netflix or Amazon or something where they don't have to flip through things, they can just stay right on their playlist. So creating safety in their home so they're physically safe, they're emotionally safe as possible. Part of that may also mean developing a list of people that they can call if they start feeling isolated, if they start feeling alone or having those intrusive thoughts. Safety, emotionally, safety cognitively is also important. Sleep encouraging people. And during the holidays, no matter where you are, even if you don't observe Eastern daylight Time or whatever during the holidays, the days are really short and circadian rhythms can get messed up because of that. They can get messed up because of that. Plus going, having all the other demands and not sleeping enough because you're going to this holiday party and this gathering and shopping and what have you. Prioritize sleep. If you are well rested and rejuvenated, you're going to be more efficient at getting your things done, done, and you're going to be able to appreciate things more and have more physical resources and cognitive resources to deal with stress when it happens. Good nutrition, including good hydration. Eat like crap, feel like crap, eat well. You're giving your body the raw Materials it needs to make the neurotransmitters, the hormones, keep the immune system healthy and flush out the toxins. Sunlight. Try to get it. It's difficult in the winter for a lot of people because the days are shorter and in some places in the country and in the world, it doesn't get sunny very often. There are a lot of really cloudy days. Get sunlight. When you can consider bright light therapy, you know, that's just a whole different presentation. But that's another thing to consider. Make sure that you're getting enough vitamin D and talk about that with your physician. Some physicians will recommend taking a vitamin D supplement. Make sure to have me time every day. And that if you're an extrovert, that may be going out with your best friend or friends and you know, having coffee or something. If you're an introvert, that may mean having meditative quiet time. But it's important to make sure that you do things to focus on yourself and you know, recharge that battery every day. Exercise can be helpful. Low intensity exercise actually helps reduce cortisol. So that low intensity exercise, walking, you know, go to the gym, watch a show on TV or, or on your, on your iPad, that can be helpful to reducing cortisol levels. Go to somewhere inside that you can walk around. If you can go out in nature and walk around, that can be helpful as well. Set boundaries. Recognize that when you are stressed, when you are recovering from trauma or recovering from a loss and experiencing grief, it's important to be kind to yourself. Do what you can and eliminate the word should. I should go to this party. Well, let's see. Do I have it in me to go to this party today? There's, there's no shoulds. It's on a kind of a minute to minute basis or a day to day basis, depending on whether you need. You're one of those people who needs to plan. What is it that I am able to do today? Remember I said get back to basics so you know what you got to do, but anything else, you know, and when I say got to do, I mean, you know, showering, eating, activities of daily living, maybe going to work if. And, and sometimes that may even be optional if you've got some leave time that you can use. Sometimes you may need to use one of those. What? My what? What I was always taught to call mental health days. Even if you're not physically sick. Allow time for feelings. Acknowledge those feelings, those grief bursts, those periods of melancholy, whatever they feel like to you. Allow time for them. Don't suppress, press them and you know, try to bat them down and keep them down for months on end. It may not be the appropriate time to feel it right in the middle of target, you know, but allow yourself time to sit with your feelings each day. So if you have one of those grief bursts in target or wherever you are, it may be appropriate to use your distress tolerance skills to help you kind of get out of that situation. Check out, you know, get to your car and then breathe. Or maybe you just leave your buggy right where it's at and you know, go have, go have your moment and that's okay. But making time for those feelings and acknowledging that they're real is important because those feelings are trying to tell you something. And just like a little kid that is trying to tell you something and they're pulling on your, pulling on your shirt going, mommy, Mommy, mommy. If you don't acknowledge them a lot of times, they're not going to just go away on their own. You need. And not that I'm saying you should ignore your children. Don't get me wrong, I'm just making the parallel. So please, no hate. But it's important to acknowledge those feelings because they are going to linger until you acknowledge them. Now you may acknowledge them and go, yep, that's bittersweet. All right, moving on. Or you may sit with it for a minute. Ask for help to avoid getting overwhelmed. People actually do want to help a lot of times. And a lot of people I work with feel guilty about asking for help when they're grieving, when they're going through something, and many times when they actually start talking to their significant others, their friends, their family. Those people wanted to help, but they didn't know what to do. They felt powerless. They, they really wanted to be supportive, but they didn't know how. So encouraging people to be assertive to ask for help when they need it. Um, and, and you know, if people don't want to help, then they won't. But it is important it sometimes to give people permission to actually help you because they may be trying to respect your boundaries. Some clients like to make a bill of rights to prevent guilt. For example, I have the right to experience this holiday season. However I experience it, I have a right to my feelings. You know, encourage hardiness and present focus. Remember, hardiness is commitment, control and challenge. Yes, they may have some losses in their lives. Hardiness encourages them to acknowledge that and acknowledge the other things that they do have in their life that are still there and make it rich and Meaningful control is helping them identify what aspects of their current situation they do have control over and how they can improve their next moment. They may not be able to make the holiday perfect, but let's just stay focused in the moment, in the present. If you're feeling unhappy right now, how can you improve the next moment? How can you make it? You know, if you want to think further, you know what parts of making it a good holiday are within your control. Attitude of gratitude Tree ornaments Making tree ornaments or cards during adventures for what you have or whatever you guys call it, you could just do it, you know, starting October 31st, every single day, making a tree ornament or a card representing the things that you do have in your life. And that can be a great family activity. It's kind of like a gratitude activity. If there is somebody that you lost, if you lost a person that's important to you. Sometimes it can be therapeutic to make tree ornaments or stocking cards for the person that you lost. Stocking cards can sometimes be fun if you each person writes on a card a funny or happy memory of that person, and everybody puts their cards in the stocking. And then on the holiday day, obviously if it's a stocking on Christmas morning, you read through those happy stories. The same thing can be modified for Hanukkah and other holidays that I am less familiar with. I'm sure you can have a memory journal or a celebration I remember cards. And every person again writes down some kind of memory that they have about that person, preferably a good one. Focus on what you can control. Turn off triggering shows. Consider taking a break from the media and from the news. You know, sometimes you just need a break from all the stress and the infighting and the turmoil and the what have you. Maybe a day, maybe four hours. If you can't do a whole day. But consider how much watching the media, the news, refreshing Twitter adds to your happiness versus how much of it detracts. And if you take a break, notice how it impacts you. And then when you go back to it, see if you really missed anything at all. In this day and age of 247 news coverage, we hear the same story like every half hour. So a lot of times you can get your daily briefing from Alexa or something first thing in the morning and you got the highlights. To be an informed citizen. Shop online or ahead of time to reduce stress. Sometimes, you know, they have Christmas in July. Maybe that's when the best time is to shop for you. Start a new tradition. If you miss the traditions that you used to have, or maybe you never had traditions but always wanted them. Well, no time like the present, start a tradition. Some people, like I said, want to unholiday it, and they just want to get, get away. They want to go to a cabin somewhere. You know, I don't know what travel's like this year, but some people just want to get away from the reminders, and that can be okay, too. They can have some mindfulness, time to reflect and rejuvenate on any particular day. Encourage people who are, you know, experiencing distress to make a plan for the day, but also have a plan B. You know, if they figure they're going to get up, they're going to go to the gym, they're going to go to work, and then they're going to go to the office party afterwards, you know, they feel like they can do that when they get up in the morning. And so they're like, okay, that's what I'm going to do. And they get to lunchtime and they're like, oh, no, that's not gonna happen. Being kind to yourself and recognizing, okay, I don't have it in me to go to this office party after work today. What's my plan B? What am I going to do instead? Encourage people to explore things like the loving kindness meditation in order to help them release their resentments. Many families, many, many families have some level of dysfunction, some level of resentment or anger that is being held on to. Maybe it's something that you're, you know, the way your big brother acted to you towards you when you were six or something, and you still hold on to that. It's important to address those resentments and figure out what to do with that anger. But in the short term, practicing something like a loving kindness meditation, sending thoughts of hope, health and healing to people can help you get in a better mental space to cope with people who you expect to be challenging. Like we talked about with the triggers earlier, know your knowledge, particular triggers. Figure out which ones you can avoid altogether and the ones you can't avoid. Figure out how you're going to deal with them. Recognize your, your feelings. Feelings are, you know, yours, and they're valid. And sometimes we actually do want to just sit in those feelings for a few minutes and experience them. That's okay, too. But it can be helpful to set a time limit. So you say, all right, I'm going to allow myself to be depressed for the rest of the evening, but then tomorrow I'm going to get back on the horse, have A friend to call when you are triggered in order to help you deal with that triggering feeling and just make a plan, you know, what am I going to do when I experience this, this particular situation? If you're grieving the loss of a person, whether they are gone physically, you know, they've, they've died or they have, you know, moved out and become grown adults, it's important to reflect on happy memories and all of the good times that you were blessed with being able to have before that change took place. Invite people over who have nowhere to go or who are unholidaying it. So you can't, you know, invite people who have nowhere to go over for to celebrate the holidays. Or you can all get together and agree not to celebrate the holidays. Whatever works for you. Treat yourself as you want to be treated. If you want others to be compassionate and to leave you the heck alone, then, you know, be good to yourself about that instead of, you know, badgering yourself about, well, you should do this and you should do that. Well, if you don't want other people shoulding, you don't should yourself. Love yourself for progress, not perfection. Not every holiday is going to be the same. And some holidays may be harder than others, but it may not be like you expect every single one to get a little bit easier. It's not necessarily how it happens. And being kind to yourself, recognizing that how much progress you have made in dealing with the loss. If you can't be with family and friends, video chat, get involved in activities to keep yourself busy, to distract yourself, that can be helpful. These are all distress tolerance activities. Compare this holiday to past holidays that were worse, to past holidays that were better. To identify things you could do now to improve the moment. Or to others who may be way worse off, which is where volunteering can come in. Contribute, volunteer at a homeless shelter, for example. Do things that make you happy. Practice thought stopping. Just push away those intrusive thoughts when they pop up at inopportune times. Identify alternate things to focus on instead of letting those thoughts, those distressful thoughts, flood your mind. Identify alternate thoughts that you're going to replace them with and drop back and punt is always sensations. Splash yourself with cold water on the face, hold ice cubes, anything that may help you get out of that mental space for a moment and focus on something that you do have control over. Allow people to be be there for you. Rehearse how to answer the question, well, what are your plans for the holidays? And if you want to unholiday it, envision what an unholiday looks like, what parts are in your control, who is and isn't there and what you're doing. Holidays are hard for a lot of people. They can bring up feelings of grief, guilt, loneliness, anger, trauma, and depression. We need to be aware of what our individual triggers are, what those triggers are related to, and have a plan to address them. Vulnerability Prevention those Taking good care of yourself ahead of time is also essential to help people have the energy and reserves to deal with unavoidable triggers and stressors.