Christmas Gifts: A Medical Analysis

Author: Kamiar K. Rueckert and Lydia Boyette

As a child, I had a marvelous time during Christmas. I ate cookies, marzipan and lebkuchen until I decided to play outside in the snow. My Christmastime schedule consisted of snowball fights and sledding which was in stark contrast to the math or German classes of a typical day. This carefree time could only be improved by the prospect of presents, and so they appeared! Parents and grandparents gifted things of which I could only dream. In return, everybody enjoyed my macaroni picture or self-drawn family portrait.

To be honest, I doubt my holidays were as nice as I claim in my introduction. Children recognize the distress of overworked parents, sense the added conflict of a visiting family member and feel disappointment when parents cannot participate in every moment of the seasonal joy due to work responsibilities or other duties like Christmas shopping. I am sure that I also experienced these events. Luckily, I could repress, intellectualize and playfully idealize my past to form the memories I preferred.

As we grow older, we often idealize our childhood and repress negative experiences. In psychiatry or psychotherapy, these idealizations and repressions are referred to as defense mechanisms.[1] They are normal, protective processes and are often utilized during the holidays. Often, a good childhood leads to mature mechanisms[1] such as sublimation, humor and anticipation: while negative experiences inhibit childhood development and lead to the persistence of immature defenses[1] such as splitting, projection, idealization and devaluation. As we study psychiatry and psychology through didactics and rotations, we may begin to question the subtleties of the Christmas holiday, especially gift giving.

Christmas is regarded as a day of peace in Western society, and gifts[2] are symbols that accompany this tradition and externalize our wish for harmony. They often represent the kindness of our parents, and we seem to never lose this wish to externalize goodness due to establishment of a symbolic attachment.

From birth, we are expected to unconsciously play our roles within the rules of the holidays we celebrate.

When we grow older, we follow the footsteps of our parents. We learn that gifts are methods of expression such as to show appreciation for a child’s good behavior or as a display of love to a partner or family member. By the time we reach medical student age, we know that giving gifts as part of this role is commonplace.

First, we must explore Christmastime. Though we prefer Christmas to be a time of peace, it can still be a heated period of family conflicts, distress and excessive consumer spending. This is apparent in the questions “Have you finished your Christmas shopping?” and “To whom are you giving gifts?” We are caught in this hectic routine to fulfill the wishes of ourselves and others.

A gift is “something voluntarily transferred by one person to another without compensation.”[3]

Gifts always fulfill a wish which is best seen in the wish list of children. A true gift is one that fulfills the receivers’ unique wishes and therefore their otherness. It symbolizes acceptance of the other’s alterity without the expectation of a return. A true present is one that is given without expectation of reciprocity. However, the gift also fulfills an internal preference.

Recent research has analyzed two types of gifts that others bestow to their families and friends: giver-focused and receiver-focused. Interestingly, giver-focused presents are those that reflect the desires of the giver. The gift can depict grandiosity which reflects on the gift givers magnificence. Sometimes, these gifts are chosen with the purpose being to elevate the status of the presenter. On a personal level, the gift can be a public display of gift givers success and usually results in them being showered with adoration from the receiver. Some may say that it fulfills the wish to be adored due to underlying shame – the subjective feeling of being bad.

Overwhelmingly, the research has indicated that most people desire to give recipient-focused gifts.  This may be due to a certain self-imposed standard. They may select these gifts to give in order to showcase a desire for a stronger relationship with the receiver[2]. These gift-givers purchase presents with the recipients[4] in mind and often will specifically choose an item that the recipient has mentioned previously in a favorable way. Though it is more desired, one could analyze it as a form of reparation due to unconscious guilt – the feeling of having done something bad.

Interestingly, those who purchase gifts as receiver-focused and giver-focused idealize [2]. The former one may focus on showcasing grandiosity and receiving adoration while the latter may be determined to highlight the relationship with the recipient [2].

Contrary to popular belief, it was found that relationships are strengthened when people receive a giver-focused gift.

“Overall, the present results suggest that, contrary to most peoples’ intuitions, giver-centric gifts can have stronger relational benefits than recipient-centric gifts. Note, however, that giving recipient-centric gifts are not necessarily detrimental to relationships and may in fact be quite beneficial when they do successfully reflect the recipient. Yet in light of the benefits of giver-centric gifts, giving a gift that reflects the self appears to be an effective and underutilized strategy for fostering social connection.”

In Germany, most medical books contain the capitalized word “CAVE” to highlight a warning; therefore, I would not consider this article as a genuine publication for medical students without it.

CAVE: Internal reflection may potentially help us to analyze our motives as gift givers, but we should perform the analyses with caution. In our pursuits to become physicians, we may sometimes subconsciously attempt to diagnose others motives; however, conflicts tend to occur with our close friends and loved ones rather than with strangers. After all, love and relationships are impossible without at least some degree of ambivalence. This should remind us to refrain from being overly critical in our analyses of other people’s gift giving patterns and to only do so as an interesting intellectual exercise. As medical students, we focus on others’ challenges and illnesses. However, simply enjoying a symbol of friendship and kindness is rewarding.  It is better to give and receive with gratitude than to contemplate our own or our loved ones’ motives behind giving gifts.


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Article sources:

[1] Granieri A, La Marca L, Mannino G, Giunta S, Guglielmucci F, Schimmenti A. The Relationship between Defense Patterns and DSM-5 Maladaptive Personality Domains. Front Psychol. 2017;8:1926. Published 2017 Nov 2. doi:10.3389/fpsyg.2017.01926

[2]  Cathy Goodwin, Kelly L. Smith, and Susan Spiggle (1990) ,”Gift Giving: Consumer Motivation and the Gift Purchase Process”, in NA – Advances in Consumer Research Volume 17, eds. Marvin E. Goldberg, Gerald Gorn, and Richard W. Pollay, Provo, UT : Association for Consumer Research, Pages: 690-698.



Photo sources:

Cover picture – Photo by rawpixel on Unsplash

  1. Photo by Ben White on Unsplash
  2. Photo by coincidence on Unsplash
  3. Photo by Kira auf der Heide on Unsplash
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