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We Know Who The Relatives Are That Will Push Our Buttons And We Know How They Will Do It So Why Not Prepare?

“I tend to think of an unhealthy relationship as one that may not be functioning well, but that is salvageable with work from all parties. Toxic relationships are poisonous to your psyche and can’t be reversed. In general, toxic family members are those that you have to avoid to protect yourself. If that isn’t possible, […]

Dr. Nicole Washington, board-certified psychiatrist, author, podcaster, wife and mother.
Dr. Nicole Washington, board-certified psychiatrist, author, podcaster, wife and mother.

“I tend to think of an unhealthy relationship as one that may not be functioning well, but that is salvageable with work from all parties. Toxic relationships are poisonous to your psyche and can’t be reversed. In general, toxic family members are those that you have to avoid to protect yourself. If that isn’t possible, for whatever reason, setting firm boundaries is key.”


I had the pleasure of interviewing Dr. Nicole Washington, board-certified psychiatrist, author, podcaster, wife and mother. She helps high performers with mental health issues move from dysfunctional to dynamic. She emphasizes the importance of mental health as it relates to career performance.


Thank you so much for doing this interview with us! What is your backstory?

Iwas born and raised in Louisiana before moving to Oklahoma for my medical training. I pursued the field of psychiatry, largely due to seeing the effect that mental health issues have on underserved communities.

As I started to practice medicine, I realized that there is a significant knowledge gap when it comes to mental health concerns and that stigma is awful in preventing individuals from seeking services. I am using my platform to provide education on a variety of mental health concepts and to demystify this taboo topic that we often avoid.

I specialize in high performers out of my desire to provide a safe place for physicians to seek treatment. In our country, we lose a few hundred physicians a year to suicide, and those are just the ones who complete the act. What about the ones who continue on suffering in silence?

Stigma associated with being recognizable in your community prevents a lot of professionals from seeking treatment and I am addressing that.

With the holiday season upon us, many people are 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?

Difficult dynamics may cause a mild amount of discomfort or frustration, which would not be expected to linger around much longer than the encounter. An unhealthy situation is one that goes beyond mild discomfort to significant distress in the moment. An unhealthy situation could also lead to increased stress that might begin several days before the encounter and possibly be difficult to move past once the encounter is over.

Families have a large part to play in our overall mental health. While some members may be champions for wellness, others may trip triggers. In families where celebrating separately is not an option, what advice would you give about engaging both types of relatives?

The champion for wellness can be a huge support but can also be draining, especially if they are constantly in your ear being super supportive. I would first remind myself that this person is more than likely coming from a place of love and try my best not to become irritated with them. Because they want what is best for you, I would pull them aside and explain that while you appreciate their support, it makes you a little uncomfortable when they give it in such a large way. Ask if they can be available if you start to have a hard time and want to talk privately.

The best strategy for dealing with the person who triggers you is to be prepared. Typically we know who the relatives are that will push our buttons and we know how they will do it so why not prepare? Prior to the event, think through the recurring themes in dealing with that individual during celebrations of the past and come up with a plan. That may involve strategically finding ways to disappear for a few minutes to engage in medication and breathing exercises or writing out affirmation cards to refer to when your self-esteem takes a hit from dealing with those relatives. It may also require you to set firm boundaries with those relatives when things get out of hand.

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?

I tend to think of an unhealthy relationship as one that may not be functioning well, but that is salvageable with work from all parties. Toxic relationships are poisonous to your psyche and can’t be reversed. In general, toxic family members are those that you have to avoid to protect yourself. If that isn’t possible, for whatever reason, setting firm boundaries is key.

Can you share about a time where you helped someone overcome a challenging family member?

Without violating privacy, I have helped numerous patients who have had repeat encounters with challenging family members. In each scenario, they knew what to expect but found themselves thinking that this year just might be different. But, of course, it wasn’t. They found themselves with low mood and increased anxiety time after time. I worked with these individuals on developing what affirmations they needed for that time and we developed actual note cards with affirmation statements that helped them make it through the event. We also worked on establishing boundaries with those challenging family members with success.

Managing mental health in high stress situations is challenging and although holiday gatherings are only a few days 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?

  1. Schedule the time. You may not be able to avoid participating altogether but you may be able to limit the exposure by being strategic about when you show up and leave.
  2. Get a good night of sleep before the event. It is much easier to handle stressful situations when rested. Being tired can lead to a shorter fuse and a more difficult time dealing with stress.
  3. Practice deep breathing exercises that can be used during the celebration to assist with any increases in anxiety that may occur during the gathering.
  4. Find an ally. Find that one relative with whom you connect even when things get tense. You may be able to talk to that person during stressful moments to help bring you back to center.
  5. Treat yourself afterwards. Have a planned reward in place for making it through the gathering. When it gets hectic, focus on that reward to help decrease some of the stress you are feeling.

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?

I would advise these individuals to reach out to their loved one privately prior to the event and find out what support they need ahead of time. Offer an out in case things get hectic. Let them know that you are there to support them. Just knowing that you having someone in your corner can make a world of difference.

What is your favorite mental health quote?

“The only person who can pull me down is myself, and I’m not going to let myself pull me down anymore.” — C. Joybell C.

Why do you find it so impactful?

Oftentimes we give other people so much power over our emotions. In reality, we have all of the control and I love to help people find that power within themselves.

If you could inspire a movement or a change in mental wellness, what would it be?

Education, education, education. I want people to know as much as about mental health as they do about diabetes or hypertension. I want people to know that mental illnesses are brain diseases and not just behavioral problems. I want to educate as many people as possible, from all walks of life, about the effects of mental illness because it doesn’t discriminate.

How can people support you in this mission?

Reach out to me! Let’s partner on ways we can provide education to the masses and help those with illness feel empowered to seek treatment and improve their functioning.

What is the best way for people to connect with you on social media?

I can be found on all social media @drnicolepsych or on my website www.drnicolepsych.com. Follow me and let’s have ongoing conversation about all things mental health!

Thank you this was so inspiring!

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