Your Body is Smarter Than You Are

Another sentence that comes out of my mouth way too often is: "Your body is smarter than you are." And, while it may be particularly appropriate in eating disorder treatment, it's something important for all of us to realize (and/or remember).

Think about it: our bodies hold the accumulated wisdom of generations - eons - of evolution. They have adapted to perform all of our biological functions efficiently and effectively, without requiring much thought. That's good for (at least) two reasons: it frees up our mental faculties for thinking creative and sophisticated things (resulting in the invention, innovation, art and culture that distinguish humans from other creatures), and it ensures that we don't forget to do important things...you know, like breathe. Yes, while our minds may be capable of amazing feats, our bodies are even smarter.

Someone asked me today, if our bodies are so smart, why are so many people obese? The answer (which applies not only to eating, but to a range of health areas) is that we let our minds override our bodies.

In fact, we're taught to do so from a very young age. For example, if we stick with the example of eating, most of our early eating decisions are based on something other than hunger or fullness. Our parents give us what their minds tell them is an appropriate amount of food. We're told to clean our plates. We're told that some foods are good, and others are bad. We're given food as a reward or celebration, or to comfort or cheer us. Most of us are not taught to eat when we're hungry and stop when we're full, or to notice what our bodies are hungry for. By the time we're adults, eating has become much more cognitive and emotional than biological.

We screw up sleep in a similar way. We stay up too late, we get up too early. We work odd hours and fly across the world. All of these behaviors override our bodies' natural rhythms, leading to a population that is almost chronically sleep deprived.

The bottom line is that, as smart, innovative, and resourceful as our minds can be, we think we can outsmart our bodies. We try to make decisions about our biology based on thoughts and feelings, and are surprised when our thoughts and feelings mislead us.

Instead, I would encourage us all to take the radical step of allowing our bodies to do their job. What if we began to check in with our bodies, to notice hunger and fullness, tiredness and alertness, and all the other cues our bodies give us? I suspect doing so would both benefit our health, and free up our mental space for more important things.

The first step down this path is mindfulness - spending time intentionally checking in with our bodies, noticing sensations and cues, and becoming familiar with everything going on inside us. It is a learning process, and may take some time (especially if you've gotten into the habit of ignoring signals from your body!), but the payoff is well worth it!

Working with Chronic Populations

Many of my clients have chronic mental health problems. Change happens very slowly, and the risk of relapse is high. As a therapist, it can be hard not to feel worn down sometimes, feeling like our efforts are futile. This is particularly the case (at least for me) when clients who have been making progress suddenly relapse, and seem to be back to square one. Whenever one of my clients gets hospitalized, or returns to an addictive behavior - and even sometimes if they're not making progress for what seems like a long period of time - I start to ask myself what I'm doing wrong, or what I could be doing differently, to be a better therapist so that they can get better. Or, at higher levels of care, I feel like the treatment is ineffectual when people need to come back again and again.

This (as I'm sure you've realized) is largely my own countertransference. While there may be a point at which one should question treatment effectiveness, relapse is fairly normal for chronic mental health and addiction issues - after all, change is hard! Negative countertransference when working with these clients is actually pretty normal, too. What matters is how we as therapists manage our countertransference so that it informs but does not negatively influence the work.

A good starting point is giving my ego a reality check: I am not that powerful that whatever I did or didn't do must have caused my client's relapse. I can't save anybody, nor should I. I am a tool for people to work on saving themselves, but a large part of that process is up to them. There are also a lot of other factors in their lives (more significant than I) that influence symptoms - brain and body chemistry, family issues and other psychosocial stressors, etc. Trying to place blame - on myself, the client, or anything else - is not a valid response. A more fruitful response is nonjudgmental curiosity. I want to see what we can all learn from this slip, without implying that anybody should have done something differently this time.

In order to provide this more fruitful response, I need to actively manage whatever negative feelings I have - disappointment, frustration, anger, guilt, etc. I need to do my own work to process these feelings so that they don't leak into my interactions with the client. Supervision or consultation is useful here, or even personal therapy. If a particular population inspires such negative countertransference that management isn't sufficient to turn responses from negative to productive, it might be time to consider a different population (fortunately, the field is so wide that we often do have the opportunity to change populations or settings when we're feeling burned out, or even just bored).

Once I have my responses in check, I have to decide how to proceed with the client. What might my responses tell me about what the client may be experiencing (for example, might my feeling of guilt or sense of failure be a reflection of the client's feeling of guilt or failure?). I also have to decide what, if anything, of my response to share with the client. Might it be beneficial for the client to her how her/his actions affect others, with myself as an example? Sometimes yes, sometimes no. When choosing to self-disclose in this way, it's important to have a clear sense of how sharing is expected to benefit the client, and to review with a supervisor or consultant.

Then, it's good to make self-care a regular practice, including more reliable sources of mastery than therapy!

Vicarious Trauma

I used to love watching crime dramas; SVU and Criminal Minds were two of my favorites. I don't watch them much anymore, though. It's not that I don't find them interesting - I do. I just don't like how I feel when I watch them. 

This feeling I get - sadness, heaviness, and a hint of disgust - didn't used to happen. I used to feel suspense, nothing more. What changed? I became a therapist.

I think it is the result of what they call secondary or vicarious trauma - the emotional side effect of listening to, and being empathically attuned with people who are suffering. It's most often associated with trauma treatment, with good reason: listening to horrific things that have happened to people, particularly at the hands of other people, shatters our illusions and forces us to confront the cruelty people are capable of. 

However, I don't think vicarious trauma is limited to only explicitly trauma-focused therapy. After all, most people have encountered some form of hardship in their lives, and people who present for mental health treatment are likely to have encountered mistreatment, stigma, and/or oppression in various shapes and sizes. Then there is the trauma of what is happening in their own minds. Most obviously in delusions and hallucinations, but also in problems as mundane as depression and anxiety, psychiatric conditions involve distorted thinking. It can be hard to keep your footing in reality while also experiencing genuine empathy. 

We sometimes speak of the effects of empathic connection with someone who is suffering as a form of countertransference. It's not the traditional, psychoanalytic definition, but it is certainly an emotional response elicited by clients. When I sit with someone who is depressed, I feel like I am under water. When I sit with someone who is manic, I feel like I'm coming out of my skin. I used to feel like my brain might short-circuit when I sat with someone psychotic (before I learned not to follow them too far into the abyss). 

These feelings I get are not problematic, but rather an invaluable source of information. They also stop when the client leaves the office. When I was a student, I wasn't as good at letting go of the feelings, and often felt overwhelmed by the onslaught of my responses at the end of the day. I have learned to let them go, and to compartmentalize, and to protect the core of myself from the wash of other people's emotions, to stay anchored while I step into someone else's experience. I am intentional about self-care to maintain my stability. I almost wouldn't even notice emotional side effects of doing this work...if it wasn't for the crime dramas.

The best explanation I can come up with is that I see and hear enough real-life drama - crime and otherwise - to take all the entertainment value out of those TV shows. It doesn't help me slough off whatever feelings might be left from the day's work, but magnifies them. I just can't enjoy them anymore. (But, of course, it's worth giving up those shows to do meaningful work that I do enjoy).

Have you noticed any ways that your work affects what you do or enjoy in your outside life?

Recharging Your Batteries (Are You an Introvert or an Extrovert?)

Therapy can be draining. It's draining for clients to do the emotional work necessary for change, to "wrestle with their inner demons." However, it may be even more draining for clinicians. Because the therapeutic relationship is unidirectional - for the benefit of the client, not the clinician - energy flows from us to our clients...but not vice versa. We accompany our clients into their emotional struggles while keeping both our clients and ourselves anchored, but do not receive emotional support in the process. Don't get me wrong - there are plenty of rewards to doing this work - but recharging our emotional batteries is not one of them.

Therefore, if we're going to continue lending strength and energy to our clients, we have to find ways to recharge our own batteries. Taking care of our physical needs helps - in other words, getting enough sleep, food, exercise, etc. Getting support also helps; we may get it from colleagues, supervision, friends and family, or our own therapist. However, the degree to which support is helpful, or the degree of support that is helpful, seems to depend quite heavily on whether we are extroverts or introverts.

Pop culture sometimes misconstrues these personality traits, describing extroverts as outgoing, and introverts as shy. In reality, extroversion and introversion have little to do with whether one is willing or able to socialize. Instead, these traits relate to whether socializing feeds or depletes our energy. Extroverts are energized by social gatherings, and leave feeling like their batteries have been recharged. Introverts are the opposite: social gatherings sap their energy, and they leave feeling more drained.

While it might seem logical that extroverts are more likely to become therapists than introverts, I have not found that to be true. I know many people who work in various human services who are introverts - myself included. It does present a challenge, however: work that is already draining may be rendered more draining by its social nature.

We may compensate by spending more of our free time alone or with close others...but introverts, like all people, also need social support, and so we need to spend at least some of our free time nurturing real-life relationships. It can be hard to strike the right balance to support our work, our need for support, and our need to recharge our batteries. Extroverts may face a similar challenge in trying to balance their need to recharge through social contact with the need for self-reflection and centering that therapeutic work also requires. In both cases, it is crucial to pay attention to our own inner state, energy levels, and needs.

Are you an introvert or an extrovert? Do you experience any difficulty striking the right balance between competing needs? How do you recharge your batteries?

Embodiment

This culture has a very strange attitude toward the human body. We're simultaneously obsessed with the illusion of health, and the fulfillment (or denial) of physical desires. A vivid illustration of this mass of contradictions is the simultaneous existence of 1) television ads for almost-magical diet and "health" products...juxtaposed with ads for junk foods, alcohol, and of course, the omnipresent "sex appeal;" 2) the high prevalence of obesity...alongside eating disorders. 

While the last few decades may have marked a new depth of dysfunction in our relationships with our bodies, the origins of the dysfunction go way, way back - actually, as far back as Ancient Greece. There, we find the first attempts to divorce body from mind and spirit - the first expositions on the ideal of a mind unencumbered by the body's inconvenient needs. I suspect that ideal may have contributed to something else we find in Ancient Greece - hedonism, the excessive pursuit of desires for food, drink, and sex.

(Wait, we're starting to sound a lot like those Ancient Greeks, just with more fancy gizmos, and less respect for philosophy)

It turns out that it's really no coincidence that the ideal of physical denial occurs alongside diametrically opposite behavior. Scientists have studied the impact of various degrees of denial (e.g., dieting) on animals and humans, and have found that denial produces a biological impulse to binge on whatever has been denied. It's like the body says, "wait, I'm not sure when I'm going to get this again, so I better take as much as I can get right now!" And, here's the kicker - the body continues to want to overcompensate for past denial for significantly longer than the denial itself lasted. 

That's where dieting often fails - asking your body to function on significantly fewer calories than it needs prompts a biological impulse to binge. 

So, what's the answer? What's the message here? Well, we all - clients and therapists alike - need to recognize that, at least for as long as we're here on earth, we are embodied. There's nothing we can do about that. Instead of shooting ourselves in the (metaphorical) foot by trying to outsmart our bodies' basic needs, what if we try listening to our bodies, and giving them what they need? Our bodies are a lot smarter than we are, and tend to tell us when we need to rest, when we need more protein, iron, or vegetables, when we need more exercise. But we have to be listening - we have to be mindfully aware of our bodies to hear the signals they're sending us. And that takes some practice, and courage. 

It's worth it, though. Take a leap of faith, and embrace embodiment.

An Attack of the "Shoulds"

I'm sick. I should have gotten a flu shot, but what with one thing and another...it didn't make it onto the to-do list this year. So, here I huddle under the onslaught of attacks of dizziness, aches, shivers, and...the "shoulds."

What, you don't remember that last one appearing on lists of flu symptoms? Hmmm. Perhaps it's not a natural part of the flu, but I (for one) believe it to be a frequently co-occurring disorder - for the obvious reason that having the flu knocks us down and keeps us from fulfilling our erstwhile obligations and commitments.

The "shoulds," of course, are the voice in the back of our heads that tells us what we really should be doing (or thinking, or feeling, or whatever). The "shoulds" are widespread, but I suspect those of us who are caregivers by profession may be particularly prone to this ailment. If you're an individual therapist, for example, it's not like anybody else can step in and cover your cases while you're out sick!

For me, this attack of the "shoulds" was brought on by the fact that today is the high-stakes Open House for a new program I'm going to be staffing. Coupled with the fact that I haven't been working there long enough to have sick time, the sense that, as one of only 6 people who will be staffing programs at the new site, I really should be there propelled me to put on skirt, pearls, and heels and drag myself to work. After all, how would it look for me to be conspicuously absent?

Due to thoughts such as these, I was taken aback by the senior manager telling me to go home. Somehow she didn't see my presence as crucial - and she certainly didn't want me spreading whatever I have! It was a reminder that I'm not as important as I think I am...but self-care is more important than many of us give it credit for. What good would I really have been to anyone if I can barely stand?

None, and I could have actually been a detriment, It's clear that the only thing that actually deserves our "shoulds" is the axiom to care for yourself before you try to care for others. In every other task and role, the world can carry on without our help for a few days!

Finding a Good "Fit"

Social work, and even therapy, to a lesser extent, are very versatile professions. There are such a wide variety of practice settings out there - different populations, treatment modalities, and work environments. Where does one even begin in trying to find the "right" fit?

First, it's important to realize that there really isn't only one "right" answer to that question. We're not each on a quest to find the single setting and population that fits us perfectly. A) There's probably no such thing - it's an imperfect world, we're all imperfect people, and it's highly unlikely that we'll find a job that doesn't have both positive and negative qualities. So, let go of the anxiety of trying to find that perfect setting, and look for a "good enough" fit - something that you enjoy, that works for you, and where the negative qualities are less salient to you than the positives (for example, if I have a supportive supervisor and colleagues, I'm ok with working early morning or evening hours, because who I work for and with matters more to me).

That said, there are better and worse "fits" out there. Hone in on better fits by prioritizing your needs and work preferences at this point in your life ( knowing that they might change over time - say, if you have a child, or your child leaves home). What are your must-haves, and what are your "it would be nice, but isn't crucial" preferences? Logistical preferences are probably easier to identify (e.g., shifts, days of the week, working from home, total hours, commute, etc.). However, as in my example of people mattering more than shift to me, it's often less tangible things that matter more - feeling like the work is important, for example, or finding some aspect rewarding, or connecting with colleagues, or feeling valued. Some of these intangibles you can plan for (e.g., someone with religious objections to abortion would not find it meaningful or positive to work in a family planning clinic), while others are harder to screen for in a job search (e.g., most agencies don't reveal staff drama during the interview process - you only find out once you're in it what this agency's drama is...knowing, of course, that there is some sort of issue just about everywhere). When things come up as you go along, you have to weigh your priorities and determine if the positives (the reasons you took the job, for example) outweigh whatever the negatives have turned out to be.

To narrow things down further, you'll need some self-knowledge. Insight is not just for clients! We have to recognize our own strengths - and weaknesses - and play to our strengths. We have to know our personalities well enough to know what we can, and can't, do successfully, or satisfyingly. For example, do you enjoy or feel isolated by working alone? Individual therapists tend to spend a significant amount of time alone, with clinicians who work on treatment teams tend to be surrounded by other people most of the time. I know that, for myself, I can spend a portion of my time alone quite happily, but start to feel isolated after awhile. I enjoy the cacophony that can be team work, as long as the team has mostly positive working relationships (I have low tolerance for cruelty, particularly from those in "helping" professions). Therefore, while the treatment modality I enjoy most is individual therapy, I know that I'm happier spending at least part of my time in a milieu setting with other staff.

It's also important to think about what populations suit your style and personality. For example, some people love children, others do not. What groups of people do you feel some resonance with? Those are the people where it will be easiest to develop empathy (not that it's impossible to empathize with other groups, but that it is harder, and you may be more prone to empathic failures when tired or stressed). The work is more enjoyable when you enjoy your clients!

Finally, I want to return to where I started - it's all a lot to think about, but there isn't a definitive right and wrong answer, and it's always possible to change your mind along the way. These days, most people don't stay in one job for their whole career, and many clinicians take advantage of the field's versatility by varying their work over time. Doing so helps prevent burnout, makes room for changing needs at different points in life, and keeps your perspective fresh. Change is almost always an option when the negatives start to outweigh the positives.

What factors do you think are important in finding a field of practice that "fits?" What have you learned about yourself along the way?

Therapists Take Vacations Too

When you're a therapist, taking time off isn't as simple as putting in a request for vacation. Because the primary tool of the trade is the therapeutic relationship, we have to consider the implications of our absence for each of our clients. Of course, that doesn't mean that we should avoid taking time off because of a client's possible reactions - time off is necessary for self-care, to prevent burn out and keep us available to our clients during the many weeks we're not on vacation.

However, it does mean that we should prepare for our clients' possible responses to our absence, using both preparatory empathy (imagining by ourselves how the client may think, feel, and act), and in-session processing of clients' reactions. (And, of course, be sure we have emergency coverage available for clients during our absence).

For some clients, a vacation may cause minimal disruption or anxiety. These clients tend to have a secure attachment style, and are therefore able to maintain a sense of connection even in the therapist's absence. With these clients, there may be some loss of momentum due to the therapist's vacation (a longer time between sessions means less clear recollection of the conversation, and longer breaks may get clients out of the "habit" of self-reflection), but no loss of trust.

However, many clients have insecure attachment styles. These clients experience more uncertainty and anxiety about relationships, and may therefore have a stronger reaction to the therapist's absence. Clients with dismissive attachments may minimize the significance of the disruption...but may simultaneously demonstrate the disruption by becoming distant, picking a fight, and/or missing sessions. The intervention may be naming the dismissiveness, validating the insecurity the client is feeling about the relationship, and reaffirming the continuity of the relationship in spite of the break.

Clients with preoccupied attachment styles are more likely to become anxious about whether the relationship will withstand an interruption like a vacation. They may appear or express anxiety directly, or may seem less certain of the therapist's availability or interest before or after the break. They may seem needier, with more urgent needs, questions and requests, more frequent calls, and more need for reassurance or encouragement - all subconscious ways to test the strength and continuity of the relationship. The intervention is to name the anxiety, provide reasonable (but not excessive) reassurance, and demonstrate continuity by having established appointments before and after the break, a consistent level of availability and empathy.

Clients with unresolved attachment styles may demonstrate a mix of the above responses, and are the most likely to regress before and after an interruption in treatment (though others may also show some regression). The best response may be to name and validate the mixed response (anger, anxiety, dismissiveness, etc), provide concrete reassurance about the stability of the relationship, and be available, reliable and consistent before and after the break.

How do you handle clients' responses to vacations? Are there responses or difficulties your clients have that I haven't included? What seems to minimize the disruption for clients?

Coping Toolbox

When people seek mental health treatment, it's often because the strategies they've been using to cope with life's challenges - strategies that may have developed over many years - either no longer work, or have begun to cause even bigger problems that the ones they're supposed to solve (think substance abuse, eating disorders, self injury, etc).

A major task early in treatment is developing alternative strategies to manage distress - strategies that are more effective for the client's current difficulties, and/or don't involve risk or cause further problems. There is some trial and error involved in identifying these alternative coping strategies, because each person is unique, and what works for one may not work for another. As my clients begin to experiment with things they're learning in treatment, I often encourage them to start a "coping toolbox" - an actual collection of items and written cues that can be brought out during period of distress.

I've been putting a toolbox together to bring in for "show and tell" in a skills group. Here's what I'm including, by category:

1) Self-Soothing
Self-soothing uses the 5 senses to calm oneself. In my toolbox I have: a sample vial of perfume (scent), a few hard candies (taste), a small stuffed toy and a rock, both with sentimental value, and a stress ball (texture), a relaxation recording and meditation balls that ring (sound), and a pretty object (sight).

2) Mindfulness
I have a miniature finger labyrinth that I use for mindfulness. I also have recordings of progressive muscle relaxation and visualization that I include here.

3) Emotional Awareness
I have a magnet that has various emotions represented as faces, to aid in the identification of the specific emotion. I also have crayons and pen/paper for writing or drawing about the feelings at hand.

4) Opposite-to-Emotion Action
DBT teaches that it's sometimes helpful to counteract distressing emotions that are not helpful in the moment with actions that are associated with opposite emotions. So, I have in my tool box a deck of cards with jokes and riddles on them, and a book of affirmations.

5) Distraction
When all else fails, it can be useful/necessary to take a break from the distress by distracting. I have a card game that can be played by one player, and my ipod that has puzzle games on it.

What would you put in your coping toolbox?

Season of Light?

It feels much later in the evening to me than it actually is. Since sunset today was 4:14pm, it's already been dark for more than three hours. My body thinks it should be nearing bedtime, when in reality it's just past dinner time.

The further you live from the equator, the better you understand this phenomenon (though South of the equator in happens in June) - as the days get shorter and shorter, it wears on our bodies and minds. We're calibrated to need sunlight. Vitamin D is absorbed via sunlight, and associated with bone and cardiovascular health, neurological functioning (e.g., Multiple Sclerosis, Parkinson's, Alzheimer's), certain cancers, and overall mortality. Sunlight also impacts the body's production of melatonin, which regulates circadian rhythms (i.e., the sleep-wake cycle), body temperature, digestion, cognitive function, and mood.

As the earth tilts on its axis, moving our hemisphere away from the sun, we get a lot less sun. There are fewer hours of sunlight each day, the sun is lower on the horizon (right now, the sun doesn't make it high enough to come in through the car's sunroof, even at midday!), and it's cold outside, so we're not out in the sun as often, even when it's shining.

It's no surprise, then, that so many people suffer from seasonal depression (or "Seasonal Affective Disorder" - SAD). On top of holiday stress and family dramas, our bodies are just not getting the sunlight they need to function optimally. Wikipedia reports that SAD occurs in 9.7% of New Hampshire residents, but only 1.4% of Florida residents (presumably because Florida is much closer to the equator and does not lose as many hours of daylight during the winter).

Perhaps because of all of this wear on our bodies and minds, each of the December holidays centers in some way on light. Chanuka celebrates the lamp that did not go out for 8 days during the Maccabean revolt by lighting candles for 8 days and nights. The Advent season leading up to Christmas is marked by adding one candle each week to the Advent Wreath (not to mention the less-religious lighting of trees and houses). Kwanzaa celebrates African American heritage by lighting candles for 7 days. And at least in the contemporary world, the New Year is marked with fireworks, and the dropping of a giant lighted ball suspended on top of a tall structure.

Are all these light-based rituals coincidental? I think not. I think they are our collective attempt to cope with too little daylight by 1) making it meaningful, and 2) "undoing" the darkness with symbolic lights. These rituals give us hope, and something to look forward to when our outer world seems barren. At least for me, the season of light sustains me through the dark December, holding the real bleakness of winter at bay for another month.

After December, we have to turn to other sources of hope - the days slowly getting longer, for example. With all of our science, we can also turn to other methods of meeting our body's needs: Vitamin D comes as a supplement. Sitting by a full spectrum light in the morning (or blue spectrum, per recent research), and/or taking melatonin supplements at night can help to re-regulate circadian rhythms. Any or all of the above can fight SAD and improve mood.

What do you do to cope with the shorter days during winter? How do you understand or celebrate this "Season of Light."

Holiday Commercialism and the "Blues"

It's starting already: after weeks of seeing Christmas decorations on store shelves, the first of the official Holiday sales are well underway. Stores across America are advertising "pre-Black Friday" deals. The mall is already chaos. And instead of the traditional early-morning promotions the day after Thanksgiving, many retailers are opening at midnight on Thanksgiving! Seriously?

Now, there are many reasons the winter holiday season is associated with increased depression - fewer hours of daylight, more contact with extended family...but a major factor is unrealistic expectations (of ourselves and each other). We try to measure our own value in how perfectly we can prepare holiday food, decorations, and wrappings. We try to quantify love in the number and value of gifts that we give...all while trying to pay less for them than they're worth (because we don't want to BUY less, even if finances are tight, lest people think we love them less!).

With this "scoring" system, it's very hard for any of us to come out ahead in the game, but there are many ways to end up feeling like the loser: We could have gotten a better deal. We got something for someone who didn't get us something (or vice versa). We gave someone a higher/lower value gift than they gave us (do they love us less/more?). We got something someone already has, or is the wrong size/color, or they just plain don't want (and vice versa). Someone ruined the surprise, or messed up the wrapping.

Yes, the whole thing can leave a bad taste in your mouth...along with feelings of disappointment, hurt, frustration, and anger (and that's not counting the stress and frustration of braving those sales I mentioned at the beginning!).

Beating the holiday "blues" is best accomplished not by coping more effectively with disappointment, hurt, and frustration after the fact, but by setting ourselves up to have a better holiday by lightening some of the expectations we (and our families) may hold.

For example, many people in my extended family only see each other on Christmas. However, for many years, everyone exchanged presents with everyone else. As a result, people got things they didn't want, were offended that others didn't know them any better than that, and had spent a lot of money that would become a stress for the next few months. Someone had a meltdown every year.

Then, one year my mom announced that she would not be exchanging presents. She decided to donate the money she would have spent, and instead instituted a "white elephant" exchange. Everyone brings one gift (and the rule is that it has to be something you already have laying around the house), picks a number out of a hat, and each in turn can pick from the wrapped presents, or "steal" from others who have already picked. People still got things they didn't want, but everyone left feeling good, and there were no meltdowns. Why? Because people didn't come expecting to get something they wanted, but to have fun in the process of getting something they didn't want.

Now is a good time to think about how to shift expectations in your life to take some of the pressure out of having a "perfect" holiday, and enjoy it more in the process. What have you or people you know done to plan for a truly happy, rather than perfect, holiday?