Monday, November 23, 2009

A Simple Holiday...

I've always loved the holiday scenes in Louisa May Alcott's, Little Women. Financially impoverished and yet rich in love and mutual support, the March family enjoy a Christmas filled with simple pleasures - carols sung around the piano; oranges, books, and small, token gifts; laughter and leisurely companionship around the fire. Many of us long for just such simple celebrations and yet, year after year, we find ourselves exhausted and struggling under the weight of complicated and expensive holiday seasons.

Why do we continue with traditions that wear us out when we could pare back our activities to create the peaceful and refreshing celebrations about which we dream? Well, partly because we are surrounded with commercial messages to make the holidays as expensive, elaborate and busy as possible. Have you ever seen a TV commercial exhorting you to relax and enjoy the holiday? The economic pressure seems unending, one to which we must respond if we're to make our loved ones happy.

And then there are family obligations. How do we go away to the beach or to mountain cabins when loved ones are ill or dependent upon us for their holiday plans?

And what about our own ambivalence? On one hand, we want a simpler and less commercial holiday and yet on the other hand, we don't want to give up the rich memories and comforts of well loved childhood rituals.

One way to begin looking at this issue is to take a look at our holiday values. What means most to us this year? Just being together at home? Spending time outdoors? Religious rituals? Music? Sharing time, talents or resources with others? Getting some rest and respite? Giving gifts? Travelling to be with extended family or friends? The traditional holiday feast? Do our activities reflect our values? What if we chose the three most important components of the holidays and let the rest go for this year? We could always change back again next year if we don't like the experience.

If we find that one or more of our "top three" is impossible to enjoy because someone is working shift or someone is ill, is there a way that we could still enjoy a part of that experience? (ie Going for a family walk in the park rather than driving to the mountains or having one friend in for a simple lunch rather than 23 for a four course meal.)

Now in many cases, it may be a little late to make major changes in family traditions for this year, unless circumstances demand it, but it might be a good time to start talking about next year. You might want to try discussing possibilities such as one of the suggestions made by Jennifer Louden in The Woman's Comfort Journal:

1. Turn the pressure of corporate America off and declare a no-shopping holiday season. Practice the Native American tradition of giveaways during the holiday by giving away useful or loved possessions instead of buying new.

2. Create new holiday rituals to replace painful or empty ones. You don't have to keep family traditions that don't make you feel good anymore. Try celebrating Winter Solstice.

3. Do something you wish you had done as a child. Organize friends and put on a holiday play. Or have a potluck dinner... with non-traditional foods. Consider serving foods you always wanted to eat as a child.

There are are many options. The important thing is that we tune in to what matters most to each person, then caringly negotiate with family and friends to reduce the annual stress and exhaustion and increase the peace, joy and comfort of the holiday season.

Photo by BigStock Photos

Tuesday, November 10, 2009

The Halfway Night Tradition...

Recently I was reminded in Gretchen Rubin's blog, the Happiness Project, of a tradition I'd learned about many years ago - that of The Halfway Night.

The man who first told me about The Halfway Night was a chaplain to seamen, seamen whose travels took them away from family, friends, community, and culture for months at a time, often in the most rudimentary and bleak of conditions. In a time before cell phones and the Internet, these men often went weeks without news of home or access to the support of loved ones.

In an effort to make these long voyages more tolerable, sailors' families would pack shoebox-sized packages and give them to the Captain or Chief before departure. On the night that marked the halfway point to their destination the Captain would distribute the boxes to the seamen. Each had its own unique gifts and keepsakes - letters from wives and girlfriends, pictures of children, a favourite food, a book to pass the time, razor blades, candy, cigarettes, reminders of activities enjoyed at home. The comfort brought by these packages was immeasurable, both in their usefulness and in their meaning. If you had made it to the halfway point, you were over the worst and could begin counting the days until the voyage was over.

As caregivers, family or professional, we all have long voyages to withstand, be they helping loved ones through painful bouts of chemotherapy or other medical regimens, getting through a particularly trying stretch of night shifts, or tackling a continuing education program after your job has been cut. How nice would it be to have someone turn up on Halfway Night to celebrate and encourage you? And how good would it feel to offer that gift to someone else? Sometimes, all it takes is a little love and acknowledgment to get through even the worst of times.

Photo by BigStock Photos

Wednesday, November 4, 2009

Anniversary Reactions...

Recently, I taught a brief Chronic Sorrow workshop at a local rehabilitation hospital. When I'd scheduled the talk several months earlier, I had been concerned only with pacing my presentations and not overfilling the work week. (Good self care,

Unfortunately, I had forgotten that September 8th was the anniversary of the day my husband stopped his cardiac medication in order to allow his heart failure to take it's natural course. That day hadn't gone well and he had reacted poorly to the new palliative care medication, losing his pain control and becoming very confused. Rather than beginning a peaceful process of dying at home, as he'd wished, he was taken by ambulance to hospital where he died 3 weeks later. It was a horrible, traumatic day though the wonderful palliative care staff at the hospital worked hard to find the right medication combination and gradually made him both comfortable and oriented again.

I tucked away the memory of that day, (or it was subsumed by the grief of the days, months and years that followed), and I rarely thought about it until I went to the hospital to give the Chronic Sorrow presentation on September 8th. I didn't make the anniversary connection consciously, but my body "remembered" for me, leaving me a little breathless, lightheaded, sad and anxious as I walked through the lobby and causing me to briefly lose my train of thought (a "dissociative moment") during the presentation, itself. Fortunately, I was the only one who noticed and I went home to do some detective work, looking through my old journals until I made the connection between the two September 8th's, in hospital settings, focused on the sorrow of chronic illness. I had had an anniversary reaction.

An increase in distress around the anniversary of a traumatic event is known as an anniversary reaction. They can be mild, as mine was, or they can constitute a more severe reaction with significant psychiatric or medical symptoms. These reactions can involve a few days of mild distress or many weeks of anxiety, anger, nightmares, flashbacks, depression or fear. They can be triggered by specific, conscious reminders of the event or they can seem to come out of the blue. Anniversary reactions may begin days or weeks before the anniversary and may continue for days or weeks afterward.

Common anniversary reactions include:

1. Experiencing increased grief and sadness around the anniversary of the death of a loved one. This may be mild or may extend to clinical depression and suicidal thoughts.

2. Symptoms of posttraumatic stress including:

- Re-experiencing symptoms: Reactivation of the feelings, physiological responses or thoughts that occurred at the time of the event. These may occur as dreams or flashbacks or repeated images of the traumatic event and they may be as vivid on the anniversary as they were at the time of the trauma.

- Avoidance symptoms: Avoiding anything that might remind you of the trauma - people, places, situations.

- Arousal symptoms: Feeling nervous and on edge. Having difficulty sleeping. Feeling more on guard. Being more irritable and jumpy.

3. Panic attacks, specific fears or worry about one's own safety or that of loved ones.

4. Physical symptoms like fatigue, pain, headaches, GI disturbances.

5. Guilt reactions including survival guilt.

As you can see, there is no standard pattern to the symptoms of an anniversary reaction. In most instances, they will vary according to the type of traumatic incident, the personality of the person affected and their previous trauma history.

The good news about anniversary reactions is that they are normal responses to trauma and will usually subside over time. If they don't, they provide us with opportunities to do some deeper healing work that will make us stronger and more resilient in the long run. Doing some trauma therapy can make a significant difference to the distress of anniversary reactions. (It is not uncommon for trauma survivors to wait months or years to ask for mental health support because they are ashamed to admit that they "haven't got over it yet". The fact that we're waiting to ask for help can in itself be an avoidance symptom, a signal that we do actually need the help).

There are some things that we can do to to ease the pain of anniversary times:

- Mark important anniversaries on your calendar so you're not taken by surprise.

- Ask for the support you need at anniversary times - family, friends, or professional support.

- Make specific plans for the anniversary date so you have things other than the memories of the event to occupy your mind. Leave quiet periods to acknowledge your feelings if that helps.

- Honour the memory of loved ones with rituals like lighting a candle, sharing favourite memories and stories, sharing a meal with family or friends, visiting the grave, making a charitable donation, helping others, planting a tree, engaging in an activity your loved one enjoyed or attending a worship service.

- If the traumatic event was one shared in the workplace, consider planning an anniversary ritual or further debriefing that the group can share.

- Engage in activities to reduce your level of arousal - meditation, walks in nature, prayer, breathing practices, pelvic muscle relaxation, guided imagery.

Recovery from a traumatic event takes time. With patience and perseverance and support we can gradually reduce our trauma symptoms (including anniversary reactions) and move on to a life of renewed hope and meaning.

Photo by BigStock Photos