By Ana Good
The holiday season is often painted as a time of joy, warmth and celebration. But for many, it can also bring an avalanche of stress. From juggling holiday gatherings to navigating the pressures of gift-giving and shopping, it’s easy to feel overwhelmed.
Susan Rathmell, Ph.D., a clinical psychologist with 17 years of experience in Alabama, offers a calming presence during this chaotic time. In her practice, Upward Behavioral Health in Vestavia Hills, Rathmell specializes in the treatment of insomnia, anxiety, depression and PTSD, as well as adult ADHD evaluation and treatment.
As president-elect of the Alabama Psychological Association, she’s also focused on improving mental health access statewide.
“There’s a big mental health need in Alabama,” she said, citing the state’s high rates of mental health issues paired with limited access to care. This issue, she explained, is particularly pronounced in rural areas of the state, where mental health providers are in short supply.
“The waitlists are long, and that’s stressful for people,” Rathmell acknowledged. “As for the future of the field, I hope it includes methods to improve access, because that’s what people really need — they need improved access so that the people who know they need mental health care can access that care without a prolonged wait.”
The combination of holiday stress and inadequate mental health care can be toxic. So, this holiday season, Rathmell is offering expert advice to make the festivities less stressful. Boiled down, her message is simple yet powerful: Take time to savor the moments of joy and gratitude, ask for help and make a plan
Rathmell’s Tips for Managing Holiday Stress
1. Set Realistic Goals and Plan Ahead
Rathmell emphasizes the importance of setting achievable goals during the holiday season.
“I always say when I’m approaching any prospective activity, that the things fall into three categories; things that I have to do, things that I want to do, and things that other people want me to do,” she said. “Categorizing possible goals that you could set, possible activities in which you could engage into those areas, and then making your choices is a good place to start.”
She encourages making plans well in advance and putting them on your calendar to avoid last-minute stress.
2. Lean on Your Support System
The holidays often require a lot of logistical work, particularly for parents and caregivers. Rathmell recommends finding ways to share the load.
“Look for ways that you can get help so that it’s not all falling on just you. What can your partner, if you have one, be in control of?” she said. “How can you lean on your village to maybe carpool or share the load of getting the children to their rehearsals or to their after-school activities, so that everyone has as much time as they possibly can while still meeting their obligations?”
Asking for help is key to maintaining balance and reducing unnecessary stress, she said.
3. Prioritize Self-Care
Rathmell stresses the importance of self care, particularly during busy times.
“Making sure you’re sleeping, making sure you’re exercising, making sure you’re making your best food choices, engaging in stress management, like breathing or whatever is helpful to you,” she said, “whether that’s having time to read a book because you like that, or watch a TV show with your child, but things that help you feel more relaxed and more centered.”
4. Practice Joy and Gratefulness
Rathmell recommends incorporating mindfulness practices into your holiday routine.
“This is one I’ve really been emphasizing with clients a lot lately, and that is intentional joy and gratefulness,” she said. “There’s a lot of apps out there that can teach you mindfulness. I do a lot of mindfulness practice with my clients. Practicing that and then using that skill, intentionally reminding yourself to practice it when the joy is happening around you.”
She said that, in moments of stress, it’s important to stop and savor the present moment. “I have to be intentional about reminding myself, ‘Stop for just a second. Smell everything that’s going on in this kitchen, isn’t it wonderful?’ Look at all of the people who are in this house that you don’t get to see enough — they’re all here.”
Mindfulness, according to Rathmell, helps us reconnect with the simple joys of the season, which often get drowned out by stress.
5. Reframe Perspective on Tasks
The hustle and bustle of gift-buying, meal prepping and hosting family gatherings can feel overwhelming. Rathmell advises that reframing tasks as opportunities for connection or gratitude can help reduce stress.
“Another thing that can stress out a lot of us is getting all the gifts wrapped,” she said. “Reminding yourself to be grateful that you are able to provide them, that can get lost if we are not intentional. It doesn’t come to us naturally, at least not most of us. We have to remind ourselves not to forget it, and to really take it in and savor it or else the stress is louder, its voice is louder than the joy.”
By shifting our mindset and focusing on the positive aspects of holiday tasks, Rathmell said we can approach them with a greater sense of peace and contentment.
A Career Inspired by Family
Rathmell’s path to psychology began with a powerful source of inspiration — her mother.
“I have to give credit to my mom for my career in psychology,” she said. Her mother, a school psychologist, would often leave psychology textbooks on the bookshelf in their den, sparking a fascination in young Susan.
“They looked so impressive and like something that a really smart person would use,” she reminisced. “She would let me play with them. Once I was old enough to begin to grasp what I was reading, it was love at first sight. I always knew that I would go on to work in mental health.”
Her passion for mental health only deepened during her time at the VA Medical Center in Birmingham.
“I was very fortunate to be offered an internship at the VA Medical Center here in Birmingham for a clinical psychologist,” she said.
“The VA is one of the top-notch trainers in health care, whether it’s mental health or any other area of health care,” she said. “It was really fortuitous for me, and my time with the VA allowed me access to gold-standard training, specifically in evidence-based therapy. That is where I fell in love with evidence-based therapy.
It is not enough to come up with a treatment idea, start using it and find that it works with a few clients, Rathmell explained. Evidence-based therapy protocols, she said, have been subjected to repeated quality research and have years of data backing through numerous studies.
Some examples of evidence-based therapy protocols include cognitive behavioral therapy, eye movement desensitization and reprocessing, dialectical behavioral therapy, and Interpersonal psychotherapy.
“Evidence-based therapies generally have been around for years, often many years, and have amassed considerable, robust research basis that prove that these approaches work,” Rathmell said.
The data backing helps offer her clients hope, she said, hope that their mental health can improve if they commit to the process.
A typical client, she said, referred to her for insomnia, for example, will remain in care with her for an average of 12 weeks, as most evidence-based psychotherapy protocols are built around that timeframe.
Successful completion of treatment means clients see a way forward without her.
“I always say, I think I may have the only job in the world where my goal is to be fired,” she said with a laugh.
Making a Difference in Alabama
As a native of Alabama, Rathmell feels connected to the people she serves.
“Since I am native to the state and have spent so much time with Alabamians, it’s easy for me to speak what I call ‘Southernese,’” she said. “I speak the language of my clients.”
Rathmell believes that this connection is vital for successful therapy, especially when clients are at a low point.
“Generally, if you’re meeting with me, things are not going great,” she said. “I am meeting people when they are at a low point, and that nervousness, that apprehension is to be expected.”
As the newly elected president-elect of the Alabama Psychological Association, Rathmell’s said she is eager to get to work.
“I want to make sure that we are serving our state’s psychologists. There are not nearly enough of us in the state, and I want our psychologists to have engaging opportunities to get together and strengthen our relationships,” she said.
The position is a six-year commitment, Rathmell said, and she’s committed to offering programming and advocacy throughout Alabama and across various types of practices.
This includes addressing provider burnout, which is a growing concern in the mental health field.
“Health care, particularly mental health care, has a very high burnout rate,” Rathmell said. “It makes sense when you consider how stressful it can be, how many challenges there are. But evidence has shown that one of the best ways to prevent burnout is for providers to feel like they are making a difference.”
As Rathmell looks to the future of mental health care, she is optimistic.
“While stigma is still a concern, I see it trending in the right direction,” she said. “I think more and more people are getting comfortable discussing mental health, how it relates to their life and their family’s life.”
For Rathmell, this is not just a career — it’s a calling.
“I think I would be hard pressed to name a better feeling than seeing someone improve their life,” she said. “It’s definitely why I love this job. “It is a fantastic, wonderful, affirming feeling.”
Whether through her work with clients, her leadership in the state association or her commitment to improving mental health care, she is dedicated to helping others find healing and hope, especially during a season that can so easily become overwhelmed by stress.
