I think even just writing this is helping me with my own issues surrounding it. Personally, I get very depressed on my birthday, and to be able to talk about it with someone might make me feel a lot better. There’s no reason the feeling of holiday cheer shouldn’t be able to permeate someone’s normal day-to-day. I feel it could be beneficial for everyone to learn how to facilitate more elating moments from time to time to look forward to, outside of just holidays and special occasions. I think it’s good to make sure we have realistic standards for these kinds of things. I think it’s healthier to not feel like you’re getting napalmed with powerful neurotransmitters on only a few days a year, especially if you treat those days like they are more important than any other, because one good or bad day could have more of a lasting influence, which puts a considerable amount of pressure on the idea that everything must be perfect. I would try to find out what about the day makes them feel the way they do and how to incorporate more of whatever it is they enjoy about it in their life (if positive) and how to deal with whatever is distressing them as an isolated instance, instead of falling into the trap of negative thought spiraling (if negative). If they have intense feelings, then maybe we could talk about spreading those emotions out over time so that they don’t feel so overwhelming the day of- positive or negative. Whatever their answer would end up being, I’d want to look at ways for how to deal with those feelings. Is it just another day to them? Is it something they eagerly count down the months, days, and hours for? Is it something they dread? Why? Do they love it because their family is kinder to them? Do they enjoy getting more attention? Do they dislike getting the attention? Are they treated differently on their birthday do they notice? Do they ignore it as something unimportant because they think it’s a weird social construct? Do they loathe the day because it makes them feel depressed because they feel like they’re obligated to be happy and enthusiastic but for some reason are not? I’d just want them to unpack all of the things they usually don’t consider. I’m not sure if this would be crossing some kind of line (again, not a therapist), but I’d want to know how they feel about their birthday. I’m not sure it’s necessary to change the session too much, other than maybe letting them talk about how their birthday makes them feel, as well as maybe allowing them to lead the conversation a bit more towards their interests rather than the typical things you two talk about. I would make sure to hand it to them while they were leaving so that, no matter what was discussed during the session, they’d be leaving with some modicum of bliss and a sense of being appreciated. I’m not a therapist, but I would give them a card containing an Amazon gift card or something else relatively small and professional-esque to go along with heartfelt words personally relevant to the client.
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