Just because a patient has anxiety or past trauma does not mean they cannot enjoy this spooky holiday…
Happy Halloween! While this holiday can be filled with tricks and treats, it can also be difficult for patients with anxiety or a history of trauma. How can you as a clinician guide them towards enjoyment rather than fear?
PT: How do you think Halloween impacts patients with high anxiety/stress levels?
Anderson: For many, kids and adults alike, Halloween is an exciting, fun-filled time of the year. It is accompanied by parties, candy, cakes, drinks, and scary movies. Dressing up in costumes allows individuals to try on another persona or become their favorite character for the day.
However, for many with anxiety, stress, or trauma, this holiday can be a nightmare. Those who suffer from panic or posttraumatic stress disorder (PTSD) symptoms (intrusive images, increased anxiety, an exaggerated startle response, increased heart rate and breathing, alternating with numbness, avoidance, disconnection, and dissociation), can find Halloween grueling and intolerable to partake in. Being spooked or intentionally scared can be terrifying for someone with a trauma history, it can trigger panic attacks, cause increased heart rate, and activate traumatic memories from the past.
PT: Should patients with past trauma avoid scary movies/haunted houses? Why?
Anderson: My suggestion for those struggling with anxiety or have a history of trauma is to avoid scary movies and haunted houses all together. They can activate symptoms of panic, PTSD, and cause traumatic memories from the past to resurface. Reliving traumatic experiences re-enforces trauma neural networks in the brain and can be taxing on one’s physical and mental health. It causes distress, fear, isolation, numbness, a lack of feeling safe, and even can trigger suicidal feelings.
PT: Research shows that women are more likely than men to be interested in consuming true crime stories.1 Some suggest this is because women experience catharsis from content like this. Do you think that is true? How much true crime is too much?
Anderson: It is important to be aware that this research presents one such perspective as to why women read true crime stories. Many women avoid reading them altogether because they are too activating for them. One possible explanation for this desire, however, is that there is an element of mastery for those women who choose to consume true crime movies. Some of the stories are solved or resolve favorably in the end. This could bring hope or justice or a sense of control to an otherwise difficult and hopeless situation. Watching or reading about someone else’s experience without going through it directly, could bring a sense of comradery or belonging for some women who feel alone in their experience.
PT: Is there any truth behind the concept of “facing our fears”?
Anderson: Most of the research that supports “facing one’s fears,” is conducted when subjects are feeling in control of their situation, and does not incorporate the element of surprise. It is never forced upon someone and ensures that individuals feel agency about the pace and intensity of the exposure to the overwhelming situation in question. Those who watch crime stories repeatedly sometimes use it to access repressed or dissociated feelings they normally do not have access to. This, however, is not generally recommended by professionals as a useful method of working through one’s traumatic past.
PT: How can patients enjoy Halloween without triggering memories of past traumas?
Anderson: The best way to enjoy Halloween is to be in control of the exposure to scary, deceptive, or frightening events. Many trauma survivors dislike the holiday all together and choose to not participate in it because it commonly brings forth unwanted symptoms from their past. One way to move through the holiday with more ease and levity is to experience it through the eyes of children. Focus on the fun, the innocence, the joy of the holiday, compared to what adults tend to focus on: the horror, the deception, and the jump scares. Halloween can be enjoyable when it does not reflect or trigger one’s trauma or anxiety from the past.
PT: Thank you!
Dr Anderson is a psychiatrist, trauma specialist, and author of the upcoming memoir To Be Loved: A Story of Truth, Trauma, and Transformation (PESI, May 7, 2024).
1. Vicary AM, Fraley RC. Captured by true crime: why are women drawn to tales of rape, murder, and serial killers? Social Psychological and Personality Science. 2010;1(1):81-86.