Navigating Family Dynamics During the Holidays

Therapists often refer to the holiday season as a “trifecta” of high-risk triggers for young adults in treatment – Thanksgiving, Christmas/Hanukkah, and New Year’s Eve are all typically packed with family gatherings, food and drink… and little downtime in between. 

For family members welcoming their loved ones back home during this season – whether for a long weekend, a vacation, or even a few months – it’s completely normal to experience a confusing array of emotions during this time: excitement and gratitude, but also anxiety, apprehension, and even fear.

“The holiday rush can be very stressful for a multitude of reasons,” explains Amie DiTomasso, LICSW, MPH, Director of The Dorm D.C. “Travel, interacting with family members, and being out of your normal environment are all common challenges for young adults who are in treatment.”

Amie, who leads our psycho-educational Parent Collective group for families at The Dorm, shared that the question of how to prepare for the holiday season when a loved one is in treatment is one of the most common topics for our community members. In the following post, she shares our clinicians’ recommendations for helping clients and their families navigate this time of the year, including practical tips and strategies to cope.

Acknowledge and Validate the Stress

One of the first things our team encourages family members to do is to realize that during and after mental health treatment, it’s beneficial to simply be aware of how difficult returns home can be, for everyone involved. 

This is normal for families with loved ones in treatment – and one of the benefits of group therapy is that it offers family members an insight into others’ experiences in a supported environment. 

Some of the most common challenges we see during the holiday season include: 

• High expectations (“show us all the work you’ve done”)
• Conversation topic stressors (clients not being comfortable sharing about their treatment with various family members, for example)
• Regression into old patterns or family dynamics due to being back in the childhood environment
• Increased anxiety due to being farther from their treatment supports, exposure to relationships (at home friends, for example) that may be unhealthy or have painful histories

“Try to dig a little deeper into empathy, compassion and patience during this time,” says Amie. “This means not only for your young adult, but also for yourself.”

Make a Plan

After acknowledging and validating the stress of this period, our clinicians encourage family members to collaborate with their loved one to put a plan in place, which will include sharing responses to questions like:

• How are we going to spend the holiday? 
• How will we spend the days preceding or after the holiday?
• What will this visit look like? 
• What boundaries will we put in place? 
• What “safety nets” will each of us rely on, if anyone becomes overstimulated, overwhelmed, or has a desire to regress into maladaptive behaviors? 

“Having a plan is important,” says Amie. “We usually suggest that both the client and the family come up with one together.” 

Understanding Family Dynamics: Defining Boundaries and Safety Nets

It’s common for families to fear that returning home to old family dynamics might ‘undo’ any hard work that your loved one has been doing in treatment. While relapse or regression is a normal part of the treatment journey, Amie emphasizes that family members can also rely heavily on their Parent Coach or their loved ones’ treatment plan to put some “safety nets” or pre-established boundaries in place before the holiday season.

This could include: 

• Avoiding or adjusting unnecessary triggering situations during the time home (think: people, places, things)
• Removing, securing or limiting access to medications, money, vehicles, or gaming devices
• Deciding ahead of time whether alcohol or other substances will be available in the home environment or in places you may be visiting
• Creating plans for “breaks” in the schedule for everyone to process feelings or stressors in their own way
• Being prepared with important contact information for your own therapist, support groups, or emergency contacts

With clear boundaries and plans in place, returning to family activities can become a great opportunity for everyone to practice newly-learned skills and behaviors that support recovery.

Supporting Young Adults in Early Recovery from Substances

A focus on drinking, food and parties is particularly difficult during the holiday season, especially for clients struggling with substance use. 

“It’s really beneficial to plan for meetings such as AA or NA, either in person or virtually during the holidays,” notes Amie. “Additionally, having a support person to reach out to, such as a sponsor or friend in treatment, or using techniques like journaling, mindfulness, or setting an intention for the visit can be very grounding.”

Family members can support their loved one by discussing whether alcohol will be part of the picture at home, and how a loved one can find and get to 12-step meetings or other support groups. 

“For individuals in recovery from substance use disorders, there can be a lot to contend with during the holiday season,” explains Amie. “If someone is in early recovery, this is a time when it’s really important they are supported and potential triggers are reduced or limited to prevent relapse or a slip-up.” 

Supporting Young Adults with Disordered Eating

Many families focus on food during the holidays – and gathering over shared meals can be important rituals and traditions. However, placing all of our focus on food or eating during these gatherings can be very difficult for young adults in early recovery from disordered eating. 

The most common challenges for those in recovery include: 

• The abundance of food options 
• Food commentary from others
• Pressures to eat or not eat
• Managing feelings of guilt or shame around eating

For our clients with ED concerns, “coping ahead” is vital and may involve: 

• Planning a response to unhelpful food/body comments
• Directing loved ones about what topics of conversation to avoid
• Creating a list of coping skills and helpful phrases to use in the moment 

When it comes to eating, those with eating disorders are encouraged to approach holiday meals like any other, with balanced and consistent meals throughout the day. At The Dorm, we also encourage the use of mindfulness practices, and using “hunger-fullness” scales to check in with your body throughout the day. 

For family members concerned with their loved ones’ triggers, remember – “It’s your job to support whatever your child has worked on in treatment, not solve problems for them,” emphasizes Amie. 

Preserve the Boundaries You’ve Learned in Treatment

Given the proximity to them, the urge to influence and even “fix” your young adult’s behavior is likely to come up during this time. If you notice your loved one engaging in a behavior that concerns you, rather than asking “why are you doing that?,” or coming to the situation with judgement, try:

• “Hey, is everything okay?”
• “It seems like you might be having a hard time. How can I support you right now?”
• “Are you open to my support right now?”

“Remember – your loved one may be in your home, but their use of negative coping skills is not within your control. You may be able to give support, but you are not responsible for your loved one’s recovery,” says Amie. 

Managing Conflict

If conflict arises during time at home, it’s important to remember that while we cannot control the behaviors of others, we are responsible for our own emotional experiences. When tensions escalate, returning to the agreed-upon plan can serve as a helpful anchor. Additionally, there are several ways to approach tough conversations and de-escalate tense situations. 

“Practicing active listening is key, as it allows each person to feel heard and understood. It’s also crucial to allow emotional space, giving everyone the opportunity to process their feelings without pressure. At the same time, families should identify where boundaries need to be firm to protect recovery and emotional well-being,” says Amie.

Quick Reminders for Managing Conflict

• When in doubt – go back to the plan
• Communicate about your feelings
• Model the behavior
• Pick your battles
• Let go of what can’t be controlled 
• Approach, don’t avoid, conflict
• Know when to ask for additional support

Choosing NOT to Return Home for the Holidays

Finally, there are certainly cases where it’s not beneficial for a young adult to return home for the holidays. While this may be a difficult decision for the family, our clinicians at The Dorm consistently encourage looking at the long-term treatment outcomes and considering the “bigger picture” when it comes to decisions during the treatment journey. 

“Returning to a space that may have been dysfunctional to begin with is a very common challenge for young adults in treatment,” explains Amie. “This isn’t to place any shame or blame on the family, but as therapists we know that a part of treatment is re-examining family roles and how a young adult will fit back into the family system. In very early mental health recovery, being inserted back into that system might ultimately be detrimental to the growth process.”

If a young adult hasn’t yet built the coping skills to return home without being re-triggered into maladaptive patterns, it may be best for them to make other plans, such as leaning on a treatment community, or close friend group to make other plans. 

Signs a young adult may not be ready to return home for the holidays:

• In the case of substance use disorders, they have very little time sober under their belt – and haven’t yet had the practice to build new coping skills when confronted with triggering situations
• There is elevated conflict within the family system that hasn’t yet been processed with a clinician or treatment team. 
• In the case of trauma survivors, if the home environment is particularly triggering and they are having anxiety about returning to familiar situations, or even the general hometown environment. 
• If they are in active crisis, psychosis, relapse, or other form of maladaptive behavior 

Reflecting on Growth and Looking Forward to a “New Normal”

In closing, Amie emphasizes that the holiday season is not only stressful for young adults and their loved ones because of food, drink, and travel – it’s also a time where there can be societal expectations around growth and progress.

“The end of a year can bring up a lot of introspection and reflection on questions like, ‘Did I meet the goals I had for myself?,’ or ‘Am I where I want to be in life?’ This can be motivating for some, but difficult for others, potentially bringing up feelings of grief,” she explains. 

During this time of year, it’s important for those in treatment to avoid this type of pressure surrounding the new year, and instead, consistently practice the skills they’re learning with their treatment team and show themselves compassion during moments of doubt. This approach will help pave the way for a “new normal” to emerge for the entire family system, even if it looks very different from the past.