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Nightmares Before Christmas: PTSD and the Festive Season

For many clients who are trapped in the past by trauma, December is the most triggering time of the year. Sensory stimuli seem to be everywhere, relational pressures mount and anniversary reactions abound, while the contrast between the idealised picture of Christmas and the trauma survivor’s internal reality only compounds the sense of isolation. Andy Cottom, a psychodynamic psychotherapist who specialises in working with the impact of war and violent crime, contemplates the timelessness of PTSD – and reminds us of the true meaning of trauma.

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Were you lucky enough, like me, to spend Christmas Eve too excited to sleep but knowing that Santa wouldn’t sneak into your room until you did? Do you adhere to your own Christmas traditions with the stickiness of a mince pie? Do the carefully crafted ads from John Lewis or Marks & Spencer make you teary for yesteryear? Timelessness might be the stuff of childhood and dreams – but as we therapists know, it’s never more evident than in the traumatised mind.

The timelessness of PTSD (Post Traumatic Stress Disorder) means some people cannot differentiate Christmas Present from Christmas Past. Thus the 16-year-old and the 60-year-old can again become the 6-year-old. Once traumatised, a simple trigger like the smell of pine needles, the sight of twinkling lights or the sound of Christmas carols can confuse the mind so it experiences a memory as a re-enactment.

These days, the words trigger and trauma are everywhere. Social media is so full of them that it’s hardly surprising my consulting room has this year been filled with YouTube diagnoses. As a culture, we must be more careful not to regard all unpleasant feelings and behaviour as psychologically abnormal – as I often feel obliged to tell my clients lately, feeling hurt when life doesn’t quite go your way is not the same as being traumatised.

In a traumatised state, the brain loses its cognitive abilities and is incapable of thinking logically. The traumatic experience seems to be kept away from the processing power of the cerebral cortex but remains stuck in the limbic system. This is the part of the brain that regulates memory and emotions, and especially how we respond to fear. When we perceive danger, there’s no time for our brains to analyse the risks and calculate appropriate reactions. Instead, the limbic system sends warnings to the body through the autonomic nervous system and through hormones to provoke responses of fight, flight or freeze, and so protect itself.

For some of my clients, lying awake hyper-alert as Christmas approaches, adrenalin doesn’t mean excitement but terror. For a few, the idea of an adult visiting a child at night might trigger them to relive an early psychic trauma again and again. December is also the deadliest month for RTAs, meaning many clients face the anniversary of a traumatic accident over the festive season. And I know from my five years working for Victim Support that Christmas is awash with domestic violence.

I believe we’re getting better at recognising that many people struggle with Christmas – perhaps the first without a loved one, or spending it with a family who’re not as perfect as those in the TV ads. However, if we hyperbolise too many of our experiences to the level of trauma, what words do we have left to acknowledge, and help, those who remain crippled by their Christmasses past?

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Andy Cottom

Andy Cottom is a psychotherapist working at Westminster Therapy Associates, the group practice he founded 12 years ago. Before training as a therapist, Andy had a long career in television news and documentary, often working in the most troubled areas of the world. He calculates that he has recorded some 20,000 interviews with people from all walks of life - heads of state and the public who elect them, celebrities and their fans, masters of industry and industrious workers. He uses this experience to guide his individual clients to better understand their feelings and thoughts and live a more fulfilled life.

For the past two decades, Andy has campaigned for better mental health in society, volunteering at Victim Support and at the UK Council for Psychotherapy to advise the public on how they might take better care of their emotional wellbeing.

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