psychotherapist tyler ong

helping you help yourself

Anniversary effect

on November 30, 2012

Time is a powerful factor in the experience of psychological problems. Whether chronic (long-lasting) or acute (sudden surge), how often in a week or a month symptoms are observable, and onset (when symptoms first started), time impacts the severity and pervasive diffusion of a problem. One time factor that must be continuously monitored and prepared for is called “anniversary effect“. From its name, this phenomenon can mean:

1. the recurrence of symptoms every year at the approximate time of its first onset.

2. the recurrence and worsening of symptoms at special times of the year, every year.

From the first definition, problems arise every year at the “anniversary” (thus, the name) of when the problem first started. The most obvious example is that of  death anniversaries of loved ones. Let’s say the wife of Person A died in May in a vacation accident. Thus, every May for an indeterminate period of time, Person A would experience grief symptoms as if his wife just recently died. Memories of the accident, memories of good times spent together, depressive symptoms, and behavioral changes can be experienced anew every May. Notice also that the definition only requires “approximate time”. This is because Person A might experience symptoms not specifically on the very day his wife died, but might experience them weeks before or even after the exact time. This varies every year, and further varies per person. How severe the symptoms are might also fluctuate every year. A less severe example might be the re-experiencing of sadness or anger every year around the time you and your significant other (for example, spouse, lover, or committed partner) had your worst fight. This might mean a sudden feeling of irritability toward your significant other which you can’t explain, or you might notice that conflicts with your significant other during this time seem more intense and frequent.

From the second definition, there are certain times of the year in which one should be especially careful of since these points are especially stressful. For instance, Christmas is coming. Christmas might not be associated with stress for most people, but instead is considered “happy” or “fun”. But one has to remember, stress is not always negative. There is the concept of eustress (the “good” kind of stress such as the nervousness experienced by a bride before she walks down the aisle) and also distress (the “bad” kind of stress such as clashing with your boss at work). Christmas, among all other holidays, is a type of eustress. Unfortunately, this is not true for all people. Families with unresolved issues find that these holidays tend to increase conflict and heighten their symptoms. Since Christmas and other holidays of note (such as Valentine’s Day, birthdays, etc.) occur every year (therefore, another meaning for “anniversary”), problems occur in cycles. There is the slow rising of dread as the holiday approaches and everyone feels tense but don’t understand why they’re feeling that way. Then the actual explosion of conflict and everyone feels that the holidays have been ruined, starting a “blame game” (for example, “She’s always depressed during the holidays, ruining everything for us! Everyone has to coddle her and walk on eggshells so she doesn’t become crazy. It’s so exhausting. My holidays are ruined because of her!”). Then as the holidays end, the problems slowly dissipate as the family system re-balances itself to normal before another cycle comes up next year.

Exhausting, isn’t it?

The worst thing is that these are all unconscious, meaning that nobody deliberately “wants” this to happen, but everyone does something without becoming aware of their actions and thoughts that they are building up the conditions for another horrific holiday gathering. Everything is automatic, as if your movements are driven by an evil auto-pilot. Another bad thing about this is that EVERYONE does something to set up the fight or ruined holiday, without meaning to. One relative could have “good” intentions to reconcile two warring family members by inviting both to the family gathering, thereby causing the entire family to suffer the drama of the clash of these two bitter members during the gathering itself. Another relative might try to comfort the “good” intentioned-relative by saying what she did was right, reinforcing this relative’s behavior to try to do it again. Thus, the seeds of a new family fight are planted for the next year, all because of a not-well-thought-out “good” intention.

During holidays, people with diagnosed disorders must also be well-monitored. Why? Isn’t this supposed to be a “eustress” event, where people are happy? Any kind of stress – whether eustress or distress – is not GOOD for people with certain disorders. It triggers the feeling of pressure and unpredictability. People with depression for example might feel pressured to act happy, pushing themselves to exhaustion (people who are depressed get tired very easily). People with paranoid symptoms, because of the gathering of large numbers of people, might feel that they are being talked about. Anxious people cannot handle being in the same place with more than eight to ten people at a time, and this might heavily tax their ability to endure conversations and make them misinterpret nonverbal behaviors of other people (for example, “Why are people smiling at me and while talking to others? Do they know about my panic attacks? Do they think I’m crazy?”).

Lastly, families can experience BOTH definitions of anniversary effects every year. It does not mean that people only experience either the first or second definitions stated above.

SOLUTIONS

While it is normal practice among therapists to assess and provide strategies for anniversary effects every year, you as a client must also be proactive in bringing up this topic with the therapist. Asking things like “I’m not sure what Christmas would be like now that my son is diagnosed with this disorder. Do I tell the other family members? What if they ask? I don’t think it’s any of their business, but if I don’t tell them they might be upset that I don’t trust my own family.” Don’t be afraid of bringing up feelings of fear, anxiety, anger, sadness. Your therapist is there precisely to help you sort through them and help you come up with solutions. Don’t be afraid of voicing out negative emotions about your family members to your therapist. Remember that many – if not most – of our problems can be tied back to our families as they are our first social environment and we have genetic links to them. During the holidays, a lot of heavy intense feelings come up upon meeting relatives and family members. This is normal and expected. After all, no one has shared that much history and experiences with them as you. It is only understandable that you develop very strong feelings toward them, and not all of them are good strong feelings.

On your own, take some time to reflect about your family’s traditions. What have you noticed every year? Reflect on those points where conflicts seem to be more frequent. Ask yourself questions like:

1. Does conflict occur in an explicit way, or does conflict manifest more implicitly such as a sudden change in conversation or everyone falling silent suddenly?

2. What topics seem to be “off-limits”? Why?

3. Which relatives seem to always be at odds with one another? Why are they at odds?

4. What are the rules regarding invitations in your family? Who makes them? What expectations are there in your family regarding attendance?

5. Who usually decides regarding gatherings in your family? Does it end well? Or are there people who grumble at the sidelines but put on a plastic smile in front?

6. What is the feeling of gatherings every year? At the end of gatherings, do you feel tired as if you exerted too much effort to be happy? Or do you feel fulfilled? Is this due to meeting certain members of the family either you are especially close with versus those you don’t like?

Awareness of these things can help you spot unconscious thoughts and behaviors not only of others but also yourself. When you are able to spot them, you can do something to stop the “evil auto-pilot” of your behaviors and thoughts. For instance, when you notice that this one uncle of yours is playing the leader again for the hundredth time causing his other siblings to frown and backbite him, you might be able to diplomatically and explicitly say, “What about you Aunt So-and-so, what can you suggest so that this year we might have something different?” instead of just thinking evil thoughts about your uncle and joining your other uncles and aunts in backbiting him.

A warning however: traditions and rules in a family are not easily changed. If anyone attempts to change them, the system will fight back because it loses its usual balance and wants to reclaim the previous state of balance. Thus, be very careful about how to negotiate and be diplomatic. If needed, seek help from a therapist who is knowledgeable about systems perspectives.

Most of all, understand that you alone have the power to choose whether to be happy or not during the holidays. Choose to be happy!

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