Strategies for Surviving Holiday Gatherings

Tips from primary care physician, Dr. Lucy McBride

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Let’s admit that while the holidays can be a magical time for families, they can also be stressful. Food and alcohol abound. Parents want the perfect holiday for their kids. Grandparents want their adult children to relax; they also want the perfect holiday for their grandkids. Then comes the spiked eggnog to kick off uninvited comments about other people’s weight, job prospects, or political leanings.

But fear not! 

Today, I sat down for a conversation with Lucy McBride, MD, primary care physician, author of the Substack newsletter, Are You Okay?, and podcast host of Beyond the Prescription, for her top tips on getting through the holidays with grace. 

ON LETTING GO AT THE HOLIDAYS

Me: What's the balance between indulging around the holidays and completely letting go to the point of actually causing harm?

Dr. McBride:

Great question. It’s of course normal to celebrate and let your guard down during the holidays. So, it’s important to be kind to yourself when you stray from your internal script about being “good.” It’s okay; you’re human. 

That said, it’s important to treat our bodies with kindness and respect. The holidays can take a toll on our mental and physical health. Last week I wrote a Holiday Survival Guide - Part 1 to help people prepare for the following holiday inevitabilities: 1) COVID, 2) alcohol, 3) food, 4) sleep, 5) exercise, and 6) socializing. If there’s one piece of advice I give my patients (and myself) this holiday season, it’s to have a plan before you end up in a pickle!

ON THE RELATIONSHIP WITH FOOD AT THE HOLIDAYS

Me: Lucy, for your patients who struggle with disordered eating, how do you advise them NOT to pass this condition onto their children?

Dr. McBride: 

Let’s acknowledge that many people struggle with their relationship with food, especially at the holidays. So, for people with disordered eating, it’s first important to recognize that they are not responsible—nor are they to blame—for every aspect of their children’s thoughts, feelings or behaviors around food. 

That said, our kids observe everything we do. They watch how we eat. They hear how we talk about food, bodies, and weight. They see us glancing in the mirror and skipping dessert. Whether they admit it or not, our children look to us for ideas of what to do—and what not to—around food.

So, I suggest being honest with yourself about your own relationship with food, your body image, and the ways in which diet culture might be informing your choices of foods and words. And then to make corrections where able. Better yet, talk with your children about your own vulnerabilities around food and eating. Without burdening them with our dirty laundry or making them anxious, being honest with our kids builds trust and opens the door to non-judgmental conversations.

ON PERFECTIONISM

Me: How do you see perfectionism playing out among your adult patients, in terms of their health this time of year?

Dr. McBride:

Perfectionism is a negative coping tool that people use (often subconsciously) to manage fear of rejection or criticism, even from themselves. The inherent problem is that nothing in life is perfect! And trying to create a perfect holiday or even a perfect cheese board is an exercise in futility. It only breeds anxiety and angst. And for some people, the constant state of vigilance around a moving goal-post of imagined “perfection” can make them sick. Hyper-alertness and “vigilance” is a state of increased stress hormones, with cortisol and adrenaline peaking. That stress lives in our body and can cause symptoms such as racing thoughts, insomnia, and an accelerated heart rate. 

How to beat perfectionism? Start with self-compassion. You are doing the best you can! Just because your neighbor’s holiday lights or your friend’s holiday outfit look snazzier than yours doesn’t mean you’re “failing;” it means you’re human! Step two is identifying and challenging negative thoughts associated with perfectionism. Step three is rewarding yourself for letting things go—and witnessing the fact that the world still spins on its axis (and your heart rate is a little calmer) when you turn the volume down on your internal critic. Of course, if perfectionism significantly impacts your health and well-being, it’s important to consider seeking support from a therapist or counselor who can provide guidance and strategies.

ON ANXIETY

Me: Can you talk about the stress response in an adult body and physiological ways to let your system know you’re safe?

Dr. McBride:

It’s important to recognize that stress not only affects us emotionally; it also has physical, behavioral, and cognitive ramifications, too. We are wired for survival, so when we’re faced with a threat, our stress hormones (adrenaline and cortisol) increase. As a result, hearts race and palms sweat. Our sleep and our digestion become more irregular. We gravitate toward comfort foods and drinks. Our thinking becomes distorted. We marinate in “What ifs” and “Oh my God”s and worry about our health. 

Of course stress is a normal part of life; but when stress hormones are released inappropriately and/or they are activated for long periods of time, we become wired and tired and sometimes get sick. 

To regulate the nervous system, it’s first important to understand what’s happening in your body, and to realize it’s normal. Next, I suggest things like taking deep breaths, getting outside in nature, moving your body, and distracting yourself by snuggling with a pet or taking a warm shower. It’s also important to talk back to anxious thoughts, fact-checking them with reality, and to ask for help if needed. 

ON THE POWER OF UNCONDITIONAL LOVE

Me: What are the surprising things you have learned as a primary care doctor about how we can positively affect our kids’ health?

Dr. McBride:

As someone who sees young adults as patients, it’s always impressive to me how resilient they are—and, at the same time, how valuable it is for them to feel unconditionally loved. In my experience, having non-judgmental support from parents and caregivers is a key ingredient in a young person’s health. 

Of course it’s normal for parents to worry about their kids. (Trust me, I do it well!) The problem is when our worry conveys a message to our child that we don’t trust them or that they’re ill-equipped to handle hard things. And while it may be true that we might not fully trust them and/or we would do things differently, providing our kids with non-judgmental support allows them the opportunity to try and fail and try again. As psychologist Stella O’Malley suggests in her book What Your Teen Is Trying to Tell You, signaling to your child that you’ve got their back without a specific agenda can open the door for communication—and actually wanting your advice!— down the road. 

Happy holidays to you and yours.

Warmly,

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