Dealing With Difficult Family Members During the Holidays

The holiday season often brings up a complex mix of emotions. For some, it represents joy, connection, and celebration with family and friends. For others, especially survivors of childhood trauma, it may bring feelings of sadness, resentment, anxiety, guilt or loneliness. It might bring up a longing for the picture perfect family holiday that you’ve never had. Maybe your family holidays were okay, but there was always some kind of conflict or tension to dampen the mood and shatter your expectations.

This blog post is for you if you’ve decided that despite the tension and walking on egg shells, you are going to tolerate going home for the holidays (How to make this decision could be a whole blog post on its own!)

This blog post will cover tips for navigating family gatherings that go beyond “set boundaries and practice self care”. While important, at times these tips feel not enough to really help you navigate through these tricky family gatherings. Let’s review some of my favourite practical strategies for how to manage these tricky situations.

Imagine yourself at your family’s dinner table, sat beside your great aunt who is notorious for her fat phobia and diet culture commentary. You’ve been working in therapy to accept your body and disentangle yourself from society’s idea of the ideal body. You think you might make it through dinner without any mishaps, when suddenly, your great aunt says to you, “Do you really think you should be eating that?”

Here is where you have a choice. You can allow those few words to take you out and undo all of the hard work that you have been doing. Or, you can hit your aunt with this question.

“What do you mean by that?”

Said in a genuinely curious way, this is one of my favourite strategies for dealing with these sorts of inappropriate, passive aggressive comments. This questions typically takes the asker by surprise and forces them to think about and explain what they really mean. If your aunt’s comment was asked as a way to shame your body, she is now being forced to spell out her intentions to you and everyone at the table in why she asked this. Typically, not wanting to make themselves look badly in this process, you will receive a grumbling “Oh, nothing” in response. Putting her on the spot may stop her from making future passive aggressive comments to you. These types of people like to stay under the radar. Remember, keep yourself calm and composed while openly and politely confronting your relative.

Remember that your great aunt is trying to upset you with these comments. By having a big reaction to them, you are giving her what she wants. Keeping calm, cool and collected is the best way to keep yourself out of the game she is trying to play.

Now, let’s be clear. This strategy is best used for those passive aggressive comments, those backhanded compliments, and those statements that are sly manipulations that might even slide under the radar of your other, less observant family members. If a family member is verbally or emotionally abusing you, I would not suggest this strategy. Speak with your therapist to make a plan to help keep you safe.

If you’re interested in more tips for dealing with difficult family members over the holidays, click the link below where I cover an additional bonus tip in my video on Instagram Reels.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a psychotherapy practice located in Brooklin, Ontario. Dana uses evidence based treatment modalities to treat anxiety, obsessive compulsive disorder and disorder eating and complex family relationships.

Therapy For Anxiety

Should I get help for my anxiety?

Anxiety can significantly impact your daily life, affecting relationships, work, and overall well-being. Seeking help for anxiety is beneficial for several reasons. One of the biggest issues with anxiety is the avoidance behaviours that it leads to.

Cycle of Avoidance and Anxiety

The cycle of avoidance and anxiety is a common pattern that many individuals experience. It begins with an initial feeling of anxiety triggered by a particular situation, thought, or event.

As anxiety intensifies, the individual may engage in avoidance behaviours. Avoidance acts as a temporary relief strategy, allowing the person to escape the anxiety-provoking situation. For example, someone might skip social gatherings to avoid feelings of panic or embarrassment. While avoidance can provide immediate respite from anxiety, it ultimately reinforces the original anxiety and leads to long term anxiety growth.

Each time an individual avoids a situation, their belief that the situation is indeed threatening becomes strengthened. This reinforcement creates a feedback loop: anxiety leads to avoidance, which in turn increases anxiety over time. As a result, individuals may find their world shrinking, limiting opportunities for social engagement or personal growth.

Breaking this cycle often requires intentional therapy interventions. Cognitive Behavioural Therapy (CBT) is particularly effective, as it helps individuals confront their fears gradually. By recognizing and challenging irrational thoughts, individuals can reduce their anxiety levels. Additionally, exposure therapy techniques can be employed, where a person is gradually exposed to their fears in a controlled manner, with the support of a therapist.

It's crucial to acknowledge that while the cycle of avoidance and anxiety can feel overwhelming, there are effective therapeutic strategies available to help individuals regain control. By taking proactive steps towards facing their fears, individuals can begin to disrupt the cycle and foster resilience.

Anxiety and avoidance are often best friends. Living with anxiety typically means avoiding many of the things that make us anxious, leading to our world shrinking over time. Going to therapy can help can facilitate a deeper understanding of your anxiety, allowing you to manage symptoms more effectively and enhance your overall quality of life.

Going to therapy for your anxiety can help you develop effective coping strategies. Therapists at Cedar Tree Therapy are experts in arming you with various coping mechanisms, including cognitive behavioural therapy (CBT) strategies and dialectical behavioural therapy (DBT) strategies to name a few. These strategies can assist you in navigating challenging situations, no longer avoid what makes you anxious, and helps to reduce your anxiety levels over time.

Engaging in therapy for your anxiety can help you to get to know yourself on a deeper level. Therapy provides a safe space to explore the specific triggers of your anxiety. This exploration helps you develop personalized strategies to address and mitigate these triggers' impact.

Therapy offers a judgment-free zone where you can express your feelings and experiences openly. This supportive environment fosters a sense of understanding and connection. The relationship you develop with your therapist can be an incredibly corrective and healing experience, and can allow you to learn that it is safe to trust others again. By understanding and managing your anxiety, you can improve your interactions with others, leading to healthier and more fulfilling relationships.

When left untreated, anxiety can escalate into more severe mental health issues. Early intervention is crucial to prevent these potential complications.

Many individuals experience anxiety, yet many people struggle to reach out for help. You don’t have to go it alone. Recognizing that we all experience mental health challenges from time to time can empower you to take proactive steps towards your well-being.

Treatment For Anxiety

Seeking therapy for anxiety is a proactive step towards reclaiming control over your life. Engaging with a therapist can be a transformative experience, providing the tools needed to manage anxiety effectively and lead a fulfilling life. At Cedar Tree Therapy, treatment for anxiety typically involves a combination of therapeutic approaches tailored to the individual's needs. Common methods include:

1. Cognitive Behavioural Therapy (CBT): CBT is considered the gold standard treatment for anxiety at this time. This approach focuses on identifying and changing negative thought patterns and behaviours that contribute to anxiety. CBT operates on the principle that our thoughts, feelings, and behaviours are interconnected, and by altering negative thought patterns, we can decrease anxiety and improve our emotional well-being.

2. Acceptance and Commitment Therapy (ACT): Acceptance and Commitment Therapy (ACT) is a therapeutic approach that is increasingly used for treating anxiety. ACT aims to help individuals build psychological flexibility, which is the ability to remain open to experiences, including negative emotions, while actively pursuing valued actions. This shift from avoidance to acceptance can significantly improve one’s ability to cope with anxiety, enabling clients to lead more fulfilling lives.

3. Dialectical Behavioural Therapy (DBT): Originally designed for the treatment of borderline personality disorder, DBT is effective for anxiety as well. DBT offers mindfulness skills, distress tolerance, emotion regulation and interpersonal effectiveness skills. DBT has been shown to significantly reduce symptoms of anxiety, improve emotional regulation, and enhance overall functioning in clients. By incorporating mindfulness and distress tolerance techniques, individuals can develop resilience against anxiety, allowing them to face challenges with greater confidence.

4. Exposure & Response Prevention Therapy (ERP): A subset of CBT, exposure therapy involves gradual exposure to feared situations or stimuli in a controlled manner. Gradual exposure to anxiety-provoking situations is a critical element of CBT. Clients confront these situations in a controlled manner, allowing them to build tolerance and reduce fear over time. This helps reduce avoidance behaviors and desensitize individuals to their anxiety triggers. This form of therapy is the gold standard in treatment for Obsessive Compulsive Disorder (OCD).

5. Mindfulness and Relaxation Techniques: A wonderful addition to the therapy models above, these include practices such as meditation, deep breathing exercises, and progressive muscle relaxation. They help promote relaxation and reduce the physiological symptoms of anxiety.

6. Medication: In some cases, medication may be prescribed alongside therapy. Common options include antidepressants like selective serotonin reuptake inhibitors (SSRIs) or anti-anxiety medications like benzodiazepines, depending on the severity and duration of anxiety symptoms.

7. Lifestyle Modifications: Encouraging lifestyle choices that support your mental health, such as regular exercise, a balanced diet, adequate sleep, and reducing caffeine and alcohol intake, can significantly impact anxiety management.

Each client’s treatment plan is personalized, taking into account the individual’s specific experiences and preferences, ensuring the most effective approach to manage anxiety. If you think you might benefit from having more control over your anxiety, do not hesitate to reach out to Cedar Tree Therapy and book a free 15 minute consultation.

About the Author

Dana Etherington is an Occupational Therapist, Psychotherapist and the Owner of Cedar Tree Therapy, a group psychotherapy practice located in Brooklin, Ontario. Dana uses cognitive behavioural therapy along with other evidence based treatment modalities to treat anxiety, depression, obsessive compulsive disorder and disorder eating.

Occupational Therapists Apply Psychotherapy to Real Life

October is Occupational Therapy (OT) month! This blog post will cover the role of Occupational Therapists in mental health treatment and why they are the best person to have on your treatment team when seeking support for your mental health challenges. With our unique expertise in promoting independence, Occupational Therapists provide valuable insights and interventions to help you manage and overcome your mental health challenges. Occupational Therapists play a crucial role in supporting individuals with mental health conditions. Read on to learn more.

An OT brings something different to the table than standard therapist. OTs believe that healing comes from doing, so we are naturally drawn to concrete, actionable goals. Whether it be engaging in an activity you really used to enjoy again, or working up the courage to order a coffee. Our therapy is based in doing.
One of the primary goals of occupational therapy in mental health treatment is to enhance your ability to engage in meaningful activities and participate in daily life. By focusing on a person's occupations (the things you do every day), occupational therapists can address the physical, cognitive, emotional, and social dimensions of mental health conditions.

An Occupational Therapist will frame your treatment around how your problem is getting in the way of the things you want and/or need to do. The things you want and need to do could be anything, from the little tasks such as getting dressed in the morning, to the bigger tasks of having family over for a dinner party. 

Occupational Therapists are unique practitioners in that goals are set collaboratively with the client and they tend to be concrete and action oriented. Although action orientated goals may sound intimidating, like jumping off the deep end into something you are scared to do, the tasks are always scaled to be just the right challenge. Not too hard and not too easy. We focus on the building up small successes to attain the client’s larger goal. 
To begin the treatment process, Occupational Therapists conduct comprehensive assessments to understand the unique needs and abilities of each individual. These assessments may involve evaluating cognitive and executive functions, analyzing daily routines, and assessing social interaction skills within various contexts.

Based on the assessment findings, occupational therapists collaborate with you to develop personalized treatment plans. These plans may include a variety of interventions, such as:
1. Activity Analysis: Occupational therapists break down daily activities into smaller components to identify potential barriers and develop strategies to overcome them. By modifying activities or adapting the environment, you can build confidence, enhance your coping skills, and restore a sense of accomplishment. This may look like analyzing food related activities such as grocery shopping, meal planning, eating, cooking in order to help manage the anxiety surrounding them for someone with an eating disorder.
2. Skill Training: Occupational therapists provide guidance and support in developing new skills or relearning lost ones. This may involve focusing on self-care activities like dressing, grooming, or cooking, as well as leisure pursuits or work-related tasks. Through skill training, individuals can regain independence and improve their overall well-being. Regaining skills or learning new ones helps in the process of self discovery and exploring self outside of mental illness. An important part in the recovery process is engaging in meaningful activities. 
3. Coping Strategies: Occupational therapists teach you practical techniques to manage stress, anxiety, and other emotional challenges. These may include relaxation exercises, guided imagery, deep breathing techniques, and time management strategies. This could also involve learning cognitive behavioural therapy (CBT), dialectical behavioural therapy (DBT) or other psychotherapy based tools. By equipping you with effective coping mechanisms, occupational therapists empower you to navigate your mental health journey more effectively.
4. Environmental Modifications: Occupational therapists assist you in creating supportive environments that foster positive mental health outcomes. This may involve rearranging living spaces or workstations to optimize functionality, promoting safety, and reducing potential triggers for anxiety or depression.
5. Social Skills Training: Occupational therapists facilitate social skills development teaching assertiveness skills, anger management skills, and boundary setting to name a few. By nurturing healthy relationships and enhancing communication skills, you can increase your social support network, which is vital for mental well-being.

Occupational Therapists in mental health treatment also collaborate closely with other healthcare professionals, such as psychologists, psychiatrists, and social workers, to ensure comprehensive care. This interdisciplinary approach fosters a holistic understanding of your mental health needs and enables a more integrated treatment plan.
Throughout the treatment process, Occupational Therapists regularly evaluate progress and adjust interventions as needed. By providing ongoing support, education, and empowerment, occupational therapists empower you to take an active role in your mental health recovery.
In summary, Occupational Therapists play a fundamental role in mental health treatment by using our expertise in enhancing the functional independence and overall well-being of individuals. Through a range of interventions, we help individuals overcome challenges related to daily activities, develop coping strategies, and create supportive environments, all with the aim of promoting positive mental health outcomes.

ABOUT THE AUTHOR

Dana Etherington OT Reg. (Ont.), Psychotherapist is the owner of Cedar Tree Therapy, a psychotherapy practice for young adults that is located in Whitby, Ontario.