Resiliency: Teaching Your Staff to Adapt and Thrive

in an Ever-Changing Healthcare Environment

Presented by

Robert L. Smith, Ph.D.

Director, Medical Staff Assistance Program

The MetroHealth System

Decreased client satisfaction

Decreased quality and increased errors

Staff turnover

Burnout

Resilience is the ability to

overcome adversity

and

continue normal developmentand

experience happiness!!

Goal of Resiliency Training

• Increase your awareness of your stress and the impact of your negative thoughts and emotions upon your wellbeing

• Explain the concept of resiliency and describe its benefits

• Teach specific resilience skills to increase your positive thoughts and emotions

• Recognize the benefits of using resilience skills and share your experience with others

This is a Gift• Decreased depressive symptoms

(and increased well being) 5,1

• Improved psychological well-being 6

• Improved working memory 2

• Improved sleep 3

• Improved immune system function 4

• Improved relationships 5

• Improved coping with emotional upheavals 61.Seligman ME, Steen TA, Park N, Peterson C. Positive psychology progress: empirical validation of interventions. Am Psychol 2005;60:410-21.2.Klein K, Boals A. Expressive writing can increase working memory capacity. J Exp Psychol Gen 2001;130:520-33.3.de Moor C, Sterner J, Hall M, et al. A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma. Health Psychol 2002;21:615-9.4.Petrie KJ, Booth RJ, Pennebaker JW. The immunological effects of thought suppression. J Pers Soc Psychol 1998;75:1264-72.5.Slatcher RB, Pennebaker JW. How do I love thee? Let me count the words: the social effects of expressive writing. Psychol Sci 2006;17:660-4.6.Barclay LJ, Skarlicki DP. Healing the wounds of organizational injustice: examining the benefits of expressive writing. The Journal of applied psychology 2009;94:511-23.

Positive Psychologyand Resiliency Training

Bryan Sexton Barbara Fredrickson Mihaly Csikszentmihalyi Martin Seligman Rick Hanson

Ddu

Duke Univ.Medical Dept.

Resiliency Program

When the facts change,

I change my Mind.

What do YOU do?

Our Mind and Our Brain:A Complex Synergy

Our Mind and Our Brain

• The Brain is physical and involves biological processes. It records and responds to physical stimuli.

• The Mind is not “physical” or “material.” It is what we “think”or experience. The color red does not exist. Our eyes take in reflections of wavelengths of light. We assign a label and give meaning to the color. This is true for all of our emotions, our imagination, etc.

Red!!!

Our Brain

Our understanding

of brain science has

doubled in the last 20 years

Fundamental Facts about the Brain

• As the brain changes the mind changes.

• As the mind changes the brain changes.

Building Blocks of the Human Nervous System - Neurons

Mind-Blowing Facts About Our Amazing Brains

•Brain 3 pounds of tofu-like tissue

•One hundred billion neurons (100,000,000,000)

•2% of our body weight, but consumes 20% of the oxygen and 25% of the glucose

Mind-Blowing Facts About Our Amazing Brains

One hundred billion neurons

Five thousand connections

Five hundred trillion total connections!

Mind-Blowing Facts About Our Amazing Brains

In the time it takes for a single breath,

approximately a quadrillion signals

(1,000,000,000,000,000)

move through your brain!!

First Fact: As the Brain changes, the Mind changes.

• If the Brain has negative changes, the Mind also suffers.

• Example: If a person suffers a shortage of the neurotransmitter, serotonin, which is involved in the regulation of stress, the person may experience depression.

The Second Fact: As the Mind changes, the Brain changes

• The brain changes in response to our thoughts, focus, concentration.

• The brain builds new connections and increases the flow of oxygen and glucose to busy regions of the brain.

The blood vessels in the brain stretch up to 100,000 miles

Thus, as information passes through your brain

it changes the shape and structure of your brain, it leaves a lasting physical trace behind.

In other words, if you focus your thoughts

you can stimulate a region of the brain

and you will strengthen it.

Consider How Water canCarve Out a Canyon

The repeated flow of water over the rock leaves a lasting physical trace.

Very few thoughts on this road!

Positive thoughts pick up and this paves the way for a new road!

By focusing on positive thoughts we create a superhighway!

Field of Conscious Awareness

• If your Mind focuses upon thoughts of resentment, regret, remorse, self-criticism, hopelessness, helplessness, despair….,

• Your brain will reinforce and strengthen the structures that promote depression, pessimism, anxiety, shame, low self-worth, etc.

We can use our minds to gradually change our brain

causing ourselves emotional pain. Or ...

Field of Conscious Awareness

• On the other hand, if we stay with good facts and dwell on those positive experiences – sharing, supporting, working together, family, friends, etc…. guess what???

• We will gradually reinforce and strengthen the areas of the brain that promote happiness, contentment, relaxation, joy, serenity, etc.

We can use our minds to change our brain

for the better and make a better life.

We choose.

Exercise

• Reflect upon an event, where you fed the “negative” wolf.

• What was the impact upon your thoughts, feelings and actions, as well as those you love, as you went forward?

• What could you do differently today?

• Finally, identify someone in your life with whom you can share the story of the wolves tonight.

Homework: Three Good Things

• What went well today?

• What was your role in making it happen?

• What is the positive emotion that best fits how this good thing made you feel?

• Amusement, Awe, Gratitude, Inspiration, Interest, Joy, Hope, Love, Pride, Serenity, or another emotion.

General Instructions

• Complete at a time when you are able to relax and reflect: meal time, bedtime, etc.

• Use the form provided: describe the three good things, select an emotion or write one in, and indicate your role in the event.

• Record your three good things every day for four weeks and discuss at our next meeting on October 18th

• You may do this with your partner, children, etc.

Three Good Things - Practice

• Pull out your handout and complete the questions listed.

• Turn to the person beside you and share your three good things.

• What was your reaction to the things shared with you?

• What was it like for you to share your three good things?

• What was the mood during the discussion?

Common Experiences

• First week is “hard” – need to remember each night, struggle to remember three good things, may be somewhat superficial at beginning

• Second week is “easier” – routine is established to write each night, the three good things are more meaningful

• Third week is “fun” – find yourself watching during the day for good things to list at night

• Fourth week is “powerful” – find that you have more than three things and you need to decide which three to list. Emotions are more easily identified and last beyond the event.

Gratitude

and Resilience Writing

Gratitude Definition

grat·i·tude ˈgratəˌt(y)o͞od/ noun noun: gratitude

The quality of being thankful; readiness to show appreciation for and to return kindness.

Two key components:

We begin with an affirmation of goodness. We affirm that there are good

things in the world, gifts and benefits we’ve received.”

“Second, we recognize that the sources of this goodness are outside of

ourselves. We acknowledge that other people have given us many gifts, big

and small, to help us achieve the goodness in our lives.”

Robert A. Emmons, Ph. D., is Professor of Psychology at UC Davis.

The Gratitude

Letter

The Gratitude Letter

Seligman, Steen, Park & Petersen, 2005

Depre

ssiv

e S

ym

pto

ms

The Gratitude Letter

Seligman, Steen, Park & Petersen, 2005

Happin

ess

How to be grateful?

Like any positive emotion, it helps to be:

Open,

Appreciative,

Curious,

Kind,

and,

Above All,

Sincere!

Gratitude

Think of someone who has done something amazing for you, this person can be alive or no longer with us. This person contributed to your well-being in a big way.

Spend the next minutes writing a note, telling this person what they did, how it impacted you, and the benefits you have received. Be genuine, kind and appreciative in your note.

Share Your Letter

•Pair up with the person next to you and take turns sharing your letters.

• This is your “dry run” to practice sharing your emotions and gratitude to your special person.

Questions and Answers