You may be surprised (or not) at the number of new patients I see right before or during the holidays. In my experience, the holidays can often trigger deep emotions. Such was the case for Clint, my patient and a successful lawyer who “had no reason” to be having anxiety attacks during the holidays. Let me tell you his story:
Clint came to me complaining of anxiety attacks, which had started a year prior. The attacks featured crushing chest pain, restricted breathing, profuse sweating and a sense Clint was going to die. When the attacks became a weekly occurrence and severe disruption to his life — an attack had caused him to leave court numerous times — Clint finally came to see me.
Clint’s main goal was to get rid of the attacks, but in order to do so, we first needed to understand from where the problem was coming — what was causing the attacks? This was a difficult job for Clint. He was convinced there was “no reason. It’s just low testosterone or wacky brain chemicals.”
Indeed, the reason for his panic attacks wasn’t obvious.
Clint had been married 18 years to a successful career woman and they had found a good work-life balance. They had a strong connection to their children, great social ties, and an active sex life. “See, I have a great life, no reason to be having these things.”
Together we uncovered that his attacks had started in early November of the previous year and worsened throughout the holidays. They then lessened through the subsequent months but returned with abandon in early autumn (it was now November again). We dug into the possible influence of the holidays and hit a goldmine.
Clint told me how he and his extended family had an 18-year tradition: Clint would host Thanksgiving for his parents and siblings, and then, everyone would go to his parents’ home for Christmas. This had been the pattern “since day one.” At first he insisted this was a “great” tradition and he was so lucky to still have his parents (his wife had lost hers years earlier). But as he talked about these “great” traditions, I noticed he leaned forward in his chair and started rubbing his hands together. His voice became robotic and he seemed anything but happy.
I encouraged him to talk about it further, exclaiming that 18 years is a long time to adhere to any tradition. “Don’t you have any other wishes for the holidays?” I asked.
Soon he was having mini panic attacks in the office. With gentle prodding, he was able to admit he had a long-standing dream to go with his wife and children to Mexico for Christmas. He went on to list all the reasons why this fantasy was so appealing to him. When I asked why he wasn’t able to carry out his dream trip, he went through a series of guilt-ridden reasons: “My parents would be crushed. My brother doesn’t get to see us any other time. I want my kids to know their cousins.” In other words, he was continuing a tradition — a tradition he wanted to break — for everyone else.
Clint was clearly experiencing excessive guilt that we needed to explore and unpack. I started by challenging his “knowing” everyone’s feelings and wishes. Slowly he felt brave enough to admit he didn’t really know his family’s thoughts. We talked about his fantasy that he was “helping” everyone by holding onto the tradition and he came to accept that he didn’t have the power to control everyone’s feelings and was ok with that. Clint also learned that he wasn’t selfish to have his holiday wish — there’s nothing wrong with dreams or feelings. Now, it might have been selfish if Clint had told his family to pack and get in the car because “we’re going to Mexico this year.” But talking the wish over with someone is not selfish. It’s intimate.
Intimacy is about transparency; it’s letting those you trust the most know you the most.
Clint decided he was ready to do something about his dream trip, so we made an action plan: Clint would share the idea with his wife with phrases such as “I always wanted to,” “I’m not saying we have to,” and “What do you think?” The simple questions revealed that she was surprisingly in favor of the trip. Then Clint asked his kids and they were over the moon about the idea. Even when Clint’s daughter expressed guilt about “not being with Grammy,” he found himself reassuring that she was not responsible for Grammy’s feelings.
This positive result gave Clint the courage to talk openly with his parents about the change of plans. While they expressed surprise and disappointment, they also understood and even said they might come visit for spring break. This touched Clint and he admitted he felt much closer to them after this call then he had in all the years of “sticking to tradition.”
The panic attacks lessened and disappeared as Clint and his family started making decisions that worked for all of them each and every holiday. This often involved airing difficult emotions and compromising, but the end result was much more pleasant “and certainly worth a life without panic attacks!”
To your emotional health,
Dr. Laura Dabney