had the pleasure of interviewing Thomas Bognanno, president and CEO of Community Health Charities, a nonprofit health expert with more than 30 years’ experience.
Thank you so much for doing this interview with us! What is your backstory?
I have spent all of my professional life in the nonprofit arena, specifically focused on chronic disease, health and wellness. It has been rewarding but also challenging. Over the past several decades, I have been fortunate to witness so much progress; finding cures for deadly diseases and improving the quality of life for millions of Americans. On the other hand, it has been frustrating to realize that there are still disorders that have no current hope of cures and realizing that the most vulnerable in our society continue to suffer from a damning lack of access to quality healthcare and that so many health disparities (or inequities) still exist for at least half of our population.
With the holiday season almost over, many people have been visiting and connecting with relatives. While family is important, some of them can be incredibly challenging. How would you define the difference between a difficult dynamic and one that’s unhealthy?
I think we can relate to “difficult” when it comes to dealing the excesses of the holiday season and all that commonly comes with it when interacting with family members and friends. The paradox is that most of us long for the emotional upswing that the holidays usher into our otherwise busy lives. Those festive times however often are accompanied by byproducts of stress, anxiety and depression.
There is a difference however between difficult and unhealthy. The key is understanding that dysfunctional behavior is the hallmark of a toxic relationship. Large family dinners and holiday trimmings do not magically make dysfunctional behavior disappear. Just the opposite. The bustle of holiday activity and expectations that “peace on earth” should now prevail only ratchet up toxic interactions. The festivities should come with healthy boundaries that do not accommodate inappropriate controlling and manipulative behavior.
Recognize that toxic family members or friends still want to exert control over others, to hold the power in the relationship, whether they are aware of it or not — and most of the time they are not consciously aware of the methods they use to force their will on others.
Families have a large part to play in our overall mental health. While some members may be champions for wellness, others may trip triggers. What advice would you give about engaging both types of relatives?
It is not easy, but most of us can cope with difficult situations during these gatherings with a little patience and self-awareness of our own actions. We can try to accept family members and friends as they are, minimizing our expectations that they need to measure up to our standards. Many a conflict can be scaled down to size by overlooking a sarcastic comment or setting aside grievances until a more appropriate time for discussion. Simply understanding that other family members are subject to the same debilitating effects of holiday stress can help to ensure that “glad tidings” abound. The holiday season is a time for many when emotions become raw and painful memories emerge from deep within to cloud judgements and skew objectivities.
We often hear about “toxic relationships.” Do you believe there is a difference between a toxic family and an unhealthy one? If so, how would you advise someone to handle a toxic family member?
Be especially aware of attempts to belittle you even when it is disguised as “I’m just joking” or “can’t you stand a little ribbing?” It is often not kidding, and it is not a joke. The goal is to keep your self-esteem low so that you don’t challenge their need for control.
“Controlling by intimidation” is an all too familiar tactic by a toxic individual. Given the close confines of family and friends during the holiday season, it is easy to see an otherwise easygoing person fly into a rage over the most mundane of issues or topics. Whether it is a discussion about politics, sports, or life choices, this person will use anger and hostility and provoking words to put you on the defensive and maintain their control.
Toxicity comes in all flavors, but the family member or friend that uses guilt and shame to manipulate and control is the most damaging holiday “treat” to avoid. The guilt-inducer controls by encouraging you to feel guilty any time you do something he or she doesn’t like. Most of us already have to deal with occasional feelings of worthlessness, humiliation, and even the sense of “not being good enough”. Guilt and shame come together like two sides of the same coin, but they are different. Being made to feel guilty is to be made aware of actions that have injured someone else. Shame reflects how we feel about ourselves. Toxic individuals employ both when trying to maintain control of life, especially during the chaos that can prevail during a gathering.
If you want the holiday season to be not only “jolly” but also healthy, then you have to be prepared to calmly, respectfully, but firmly confront the toxic behavior. By tactfully identifying the action or behavior and letting the family member or friend know it is no longer acceptable, you go a long way to helping yourself and, ironically, the other person. This is where we have to rationally think through the situation, step back from the emotional duress, and believe that you deserve to be treated with respect, compassion, and graciousness — and request that. Unless you come to mutual understanding and agreement on how you deserve to be treated, you need to draw the line with that person.
Can you share about a time where you helped someone overcome a challenging family member?
Like almost everyone reading this article, I have had many experiences with “challenging” family members during the holiday season. Some were siblings, others extended family members, and most commonly, a spouse, a child, or even me. There is one constant regardless of the family relationship in question, and that is that conflict is almost always going to rear its ugly head when the “perfect storm” of holiday stress gathers on the horizon. Most experts will tell you, and I believe this to be true in my experience, to confront the conflict rather than pretend it isn’t there. The situations that have been most challenging for me personally have been when there are contributing factors such as substance abuse, disease, or explosive life changing issues such as divorce or child custody. In those situations, I have had to do a reality-check first with myself to determine where I am emotionally, physically and spiritually. It is an old adage but nonetheless true that you aren’t much help to anyone else when you are not in touch with your own emotional state of mind.
Managing mental health in high stress situations is challenging and although gatherings are only a few times a year, they can make a major impact on overall wellness. What 5 strategies do you suggest using to maintain mental health when faced with an unhealthy family dynamic?
All these steps I’m sharing are common sense — tried and tested — but even though we often know what we should do, these strategies get buried in our consciousness when the stress levels are raised and we are dealing with our own emotional baggage. I know that I have to “practice” in advance of family gatherings with this list, whether that means writing them down in a journal or asking my spouse to hold me accountable — but gently!
Regardless of your religious beliefs or training, I hope everyone can agree that St. Francis of Assisi had it right when he admonished us to seek first to understand rather than to be understood. Stephen Covey used that as the cornerstone of his Seven Habits.
In a conflict situation, it is wise to invite the other person to explain their perspective first without being defensive, countering or correcting.
That is one of the hardest things for me and most of us, but nearly as hard as the next strategy of “active listening” — giving that person your undivided attention.
When we really listen — with our minds and our hearts — we can hear the emotion that the other person is trying to convey, and not just the words or specifics. Understanding that the other person is tired, hurting, frustrated or just plain angry helps us to give that emotion the space it needs to defuse itself. Asking questions for more information also signals that we care, not just about our side of the issue, but genuinely, wanting to resolve the conflict or issue. By listening, we can learn how to help resolve the conflict. The answer many times is just to listen, to let others feel heard — and understood. Finally, and this is the largest hurdle to climb, we have to do what we rarely see or hear done in our current political climate. We need to admit our errors and what we have done to contribute to the tension. St. Francis might remind us to add in a request for forgiveness as well.
With all that said, it’s important to ensure you’re managing your mental health before holiday gatherings.
- If you feel alone, intentionally find community by attending civic and religious events, volunteering, or reaching out to coworkers, friends and others to get together.
- Focus on real-world relationships not social media and the internet which can be negative, focused on polarized politics, and detrimental to well-being.
- Take a walk and get moving, especially outside in the sun. Our partner NAMI (National Alliance on Mental Illness) has helpful tips for managing the holiday blues!
- For the over 43 million Americans who serve as unpaid caregiversfor loved ones, whether children or parents, you may need extra support. Take the Caregiver Stress Check and review stress management tips as well as a caring calendar from the Alzheimer’s Association. Be cognizant of burnout and review the ALS Association’s solutions for coping with caregiver burnout as well as resources from The Arthritis Foundation which offers solutions for nine common caregiving challenges, including exhaustion and stress.
- For those who are already struggling with mental health challenges that gatherings may exacerbate, take steps. Review mental health resources and take advantage of them. Community Health Charities has compiled helpful resources such as checklists, crisis help lines, and more from our more than 2,000 charity partners.
What advice would you give to family members who are allies of someone struggling with mental illness at these gatherings? How can they support strong mental health without causing friction with other members of the family?
Again, the most important thing you can do is to listen and be aware of what others are going through. If needed, separate family gatherings can be helpful, so everyone isn’t together in one place. Other times, it can help to create separate activities — a movie in one room for people to watch, a board game or puzzle in another room, a family walk to the park after the meal. Preparing ahead of time or ordering food so everyone isn’t stressed trying to prepare the meal can also help. Focusing on people in need is another great way to get outside yourself and the challenges in your own family. You can go caroling at the nursing home, visit a light display or school pageant, deliver gifts or food to those in need, or collect and donate gently used household goods. The whole family can get involved.
What is your favorite mental health quote?
My favorite mental health quote: “Day by day, what you choose, what you think and what you do is who you become.” Heraclitus, a Greek philosopher from Ephesus.
What is the best way for people to connect with you on social media?
@tbognanno1 on Twitter
Thank you this was so inspiring!