Monday, November 19, 2012

Holidays and Stress

For most of us, our memories of the holidays are warm and positive. The holidays are a time to share gifts and good will with friends and family. For many children in the Child Welfare system, however, the holidays mean something different, and they trigger painful memories of trauma, chaos, lost relationships, and unfulfilled wishes. For them, the sights and sounds of the holidays elicit unconscious physical responses of fear, anxiety, and grief. How can we help these children cope with these painful responses? How do we give these children a positive holiday experience and help them overcome their negative bias?

Adoptive parents, teachers, and child care workers will often try to indulge their children with parties, activities, and gifts to make up for the negative holidays of the past. But this might hurt the children rather than help them; the problem is that the changes in environment and schedule activate a child’s stress response system. As the body responds to these new stimuli and attempts to restore equilibrium, it remembers the sensations, feelings, and behaviors associated with traumatic holidays of the past. This can lead to overwhelming emotions and a general sense of helplessness and hopelessness, and results in an increased risk for either aggressive, impulsive behavior, or for the desire to disconnect and withdraw from the external world and escape into an internal one (this behavior is called “dissociation”). Both of these behaviors are an attempt to cope with feelings of distress (triggered by holiday-related stimuli), and both behaviors interfere with the child’s and adult’s ability to enjoy the holidays.

Children who associate the holidays with traumatic memories are also likely to avoid anything that might trigger these painful responses. By avoiding these triggers, children reduce their feelings of anxiety; however, such behavior also interferes with the child’s ability to heal. Research has consistently demonstrated that, in order to recover from past trauma, the individual must be gradually exposed to the anxiety-producing stimuli. Gradual exposure allows the victim to increase their tolerance level and to develop healthy coping strategies.

Therefore, the best way to help children who have traumatic holiday memories is to gradually expose them to anxiety-producing stimuli, but do so in the context of physical and psychological safety and with positive relational support. For caregivers to accomplish this, they must remain attentive and attuned to the child’s arousal levels, and they must provide co-regulatory support to help the child remain with their window of tolerance. The biggest challenge for caregivers is to be aware of their own holiday associations; an adult who associates the holidays with positive memories can be blind to the needs of the child with negative memories.

To foster a safe holiday season for you and the children in your care, please remember the following guidelines:

  • Be aware:  What do you associate with the holidays? How might that differ from the children in your care? Be aware that what is a positive experience for you might be a negative experience for your child.
  • Plan ahead: Know what to expect. Unpredictability generate anxiety.
  • Stay connected: Be aware of, monitor, and influence your child’s arousal levels. Help them stay within their window of tolerance.
  • Know your children’s stress tolerance: Structure recovery times before they become overwhelmed. It may be a special time of year, but our stress tolerance levels remains the same.
  • Structure quiet relational times: Verbally process the day’s events.
  • Communicate changes in structure: If your children can anticipate transitions, they will be better able to cope with anxiety.
  • Be prepared: Now is the time to make sure you know your child’s triggers and have a number of coping skills available for you and your child. (Remember: behavior is an attempt to master anxiety.)
  • Sleep well, Eat properly, and Exercise: The more energy you have, the better you are able to cope with stress. Be sure that you and your child remain physically healthy.
  • Change what the holidays mean: Begin new positive rituals, but be sure to respect your child’s ability to tolerate closeness and be aware of their fear of abandonment.
  • Create narratives: Clarify distortions and misconceptions and create new memories.

And finally, remember: “Simple and successful is better than overwhelming and painful. Always build upon success!

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Your comments and questions are welcome. Please feel free to post below or to contact me directly at jerry@denvercac.org