Is the spectre of Christmas showing up in your consulting room yet? For those of our clients whose culture celebrates Christmas, this can be a season of celebration, optimism and togetherness. But it can equally be a time of increased financial, family and social pressures, with associated spikes in domestic violence and suicide rates. Either way, December is a month when powerful therapeutic work can be done: not for nothing has Charles Dickens’ A Christmas Carol been dubbed the first act of interpersonal psychoanalysis. Here are six ways in which Christmas may be manifesting in your consulting room.
1. The gift of meaning
You will have your own professional attitude to receiving gifts from clients, and your own feelings around it, too. Both are likely to be tested at Christmas, when the giving of gifts is routine, and personal nuances are therefore easier to miss. It doesn’t help that the internet is full of suggested gift lists for psychotherapists, from ‘World’s best therapist’ mugs and t-shirts to pairs of Freudian Slippers. This is a season of prescribed commercial expectation. So we may need to work harder with our clients to identify the very individual meaning a gift will undoubtedly, on some level, hold for them.
2. Open all hours?
Likewise, breaks, which could come at any time in therapy, arrive pre-packaged with powerful associations at Christmas. Therapists who take a holiday may encounter strong fantasies about how they will be spending their time. The cultural emphasis on Christmas as a ‘family time’ can make it especially difficult for clients with abandonment issues. Our anxiety about a client’s capacity to cope ‘without us’ may also be stronger at this time of year, as many support services are less active at Christmas. If your client is struggling, it may be important for you both to find out what support services are open in the area.
3. A season of grief
There is an annual spike in deaths around Christmas – particularly on Christmas Day, Boxing Day and New Year’s Day. For many of our clients, this is a season not of joy but of grief. Christmas can be an especially powerful and precarious time for anniversary reactions, those annual echoes of a loss or trauma. Strong auditory and olfactory triggers are everywhere, waiting to ambush the bereaved. Of course, you don’t have to have been bereaved at Christmas to feel the loss particularly keenly at this time of year.
4. The festive double bind
Christmas can bring a surge in just the kinds of anxieties and emotions that some of us use our relationship with food, alcohol or other substances to moderate. At the same time, it can serve up an endless obstacle course of finger buffets, festive tipples and boozy family lunches. Eating and drinking is social currency at Christmas, with an expectation that we should ‘over do it’, and over do it in company. Some clients may feel they are caught in a difficult double bind.
5. Young, free and… lonely
There is a tendency to assume that older people are most likely to struggle with isolation at Christmas. In fact, research by the mental health charity Mind revealed that millennials are especially prone, with one in 10 people aged between 25 and 34 saying they had no one to spend Christmas with. Young people are also more likely to be impacted by idealised images of Christmas via Facebook and Instagram. If you don’t have a sense of your client’s relationship with social media, this may be a good time to explore it.
6. A ‘good enough’ Christmas?
Over a quarter of people surveyed by Mind felt the pressure to have the ‘perfect Christmas’ – increasing to 48 per cent of those with a mental health problem. As the media intensifies the ideal year on year, it may be helpful for us to think with clients about what a ‘good enough’ Christmas could look like for them. Whether it means focussing on personal safety, or putting presence over presents, when we let go of the unachievable fantasy of Christmas, we may be surprised just how well it turns out.