STRESS MANAGEMENT ESSENTIALS

Presented by

Rebecca Beaton, PhD

The Anxiety & Stress Management Institute1640 Powers Ferry Road

Building 9, Suite 100Atlanta, Georgia 30067

www.StressMgt.net

What is Stress?

What is Stress?

STRESS occurs when we perceive that the demands we face exceed our resources for dealing with them.

• Stress can be both positive and negative.

• We need a certain amount of stress in our lives because it is stimulating and motivating.

• It gives us the energy to try harder and keeps us alert.

• When we find ourselves in situations that challenge us too much we react with the “fight or flight” stress response.

Yerkes-Dodson Law of Arousal

Fight or Flight Response

Imax Adrenaline Rush Video

SYMPTOMS

• We are programmed for survival first and foremost

• We respond accordingly on every level:–Physiological–Behavioral–Emotional

Fight, Flight . . . Freeze, Flock Response(Sympathetic Nervous System Response)

• Physiological responses – The body shifts all its energy toward fighting

off a life threat or fleeing from an enemy

• The SNS signals the adrenal glands to secrete the stress hormones adrenaline and cortisol, which trigger the following:– Heart beats faster– Respiratory rate increases– Blood vessels dilate– Digestive system shuts down– Glucose levels increase (quick energy)

Possible Physical IssuesResulting from Stress

Cardiovascular System    • Blood Pressure Increases• Tachycardia (rapid

heartbeat)• Palpitations

(uncomfortable awareness of the heart rate)

• Headaches• Cold hands & feetGenitourinary System• Need for frequent

urination• Difficulty becoming

sexually aroused or achieving orgasm

• Difficulty maintaining an erection

Central Nervous System• Apprehensive, aroused

and vigilant feeling • “On edge," impatient, or

irritable• Insomnia• Fatigue  • Poor concentration• Impairment in memory

(Hippocampus Atrophy)

Stress Degenerates the Hippocampus

Fewer HippocampalNeurons

Increased GlucocorticoidSecretion

Destruction of hippocampal neurons

Inability to shut off glucocorticoid secretion

Robert Sapolsky. (2004). Why Zebras Don’t Get Ulcers. N.Y.: W. H. Freeman and Company

Possible Physical Symptoms During Stress (Cont.)

Musculoskeletal System• Tense Muscles • Involuntary trembling of

the body• Tension headaches• Other aches and pains• Pupils DilateRespiratory System• Hyperventilation

symptoms

Gastrointestinal System

• Dry mouth• Difficulty swallowing• “Butterflies" in the

stomach• Pain in upper or lower

intestines • The gurgling sounds of

gas in the intestines• Colon spasms • Diarrhea and/or

constipation

American Psychological Association Survey (2007)

What is Causing Americans to Feel Stress?

• 63% of those surveyed said money issues

• 44% said national security• 31% said job security.

American Psychological Association Survey (2007)

How do American’s deal with Stress?

• One-third of us either eat (22%) or drink alcohol (14%) to cope with stress

• Others rely on exercise (45%) and religious and spiritual activities (44%)

• 14% turn to massage and yoga to relieve stress.

Stress and Your Health

• "75 to 90% of all visits to primary care physicians result from stress-related disorders.” P. Rosch, M.D., American Institute of Stress

• Three 10-year studies concluded that emotional stress was more predictive of death from cancer and cardiovascular disease than smoking.

• A Harvard Medical School study of 1,623 heart attack survivors found that when subjects got angry during emotional conflicts, their risk of subsequent heart attacks was more than double that of those remained calm.

Stress and Your Heart

• A 20-year study of over 1,700 older men conducted by the Harvard School of Public Health found that worry about social conditions, health and personal finances all significantly increased the risk of coronary disease.

• Over one-half of heart disease cases are not explained by the standard risk facts, such as high cholesterol, smoking or sedentary lifestyle.

• According to a Mayo Clinic study of individuals with heart disease, psychological stress was the strongest predictor of future cardiac events, such as cardiac death, cardiac arrest and heart attacks.

Behavioral Symptoms

• Sleeplessness• Restlessness• Social Isolation• Decreased or Increased

Appetite• Avoidance of challenging

situations• Performance failures• Substance Abuse

Emotional Symptoms

• Self-Preoccupation• Irritability & Agitation• Dysphoria• Depression• Mood changes• Feeling unsettled

CHANGING YOUR THINKING

Importance of Self-Talk

The Role of Perception• There is no stress Out There! Out there are

only persons, places, and events. Whether they trigger the stress response or not depends on how we think about them, how we perceive them.

• Need to address SELF-TALK.• Our attitude & our actions are

the only thing we can really control in life.

ABCs of Self-TalkAdapted from the writings of Albert Ellis, Ph.D.’ Robert S. Eliot, M.D. and Dennis L. Breo

Basic Premise – Your emotions are largely determined by how you think and talk to yourself.

A = Activating Event or Activating Experience (external or internal)

B = Belief System (your interpretation of the meaning of the activating event or experience; what you tell yourself, often unaware of this self-talk).

C = Consequences (physical, emotional, and behavioral consequences of A & B)

If often feels as if what happens at A causes C, BUT in fact it is B or what we tell ourselves about what happened at A that determines C.

Cognitive Distortions

• ALL OR NOTHING THINKING: You place things into black and white categories, ignoring the exceptions and subtle shades of gray, “It’s perfect or defective,” “I’m lovable or unlovable,” “I either succeeded or failed.”

• OVERGENERALIZATION: A few (or even a single) bad experiences makes you believe that all similar situations will turn out badly.

• DISCOUNTING THE POSITIVES: Positives are explained away, they “don’t count.” You minimize or entirely disqualify your resources, your ability to cope, possible help from others, alternative opportunities, etc.

Cognitive Distortions (Cont.)

• JUMPING TO CONCLUSIONS:– Fortune Telling: You constantly anticipate and

predict future situations will turn out badly, often despite the absence of facts.

– Mind Reading: You assume that you know why and what others are thinking, feeling and doing, without proof.

• CATASTROPHIZING: You focus on what might be lost and exaggerate either how likely it is to happen or how terrible it will be when it does: “I’ll probably be rejected, and that’s terrible,” or “it’s horrible that I lost.”

Cognitive Distortions (Cont.)

• ABSOLUTE THINKING: A rigid and inflexible type of thinking. Sometimes takes the form of demanding (within yourself) that things should be what they are not. You think with over-simplistic phrases such as – “shoulds, musts, can’ts, have-tos, oughts”. “I have to do my best all the time.”

• SELECTIVE ABSTRACTION: You find and then dwell on negatives. Information that confirms your negative views are seen as proof, while facts that don’t fit are seen as rare exceptions and ignored; “nothing good ever happens to me,” “I will always lose,” “no one cares about me.”

 

Cognitive Distortions (Cont.)

• PERSONALIZATION: You mistakenly believe you are the cause of events and that you’re the reason people act and feel as they do; “I was rejected because of my looks or my job.”

• BLAMING: The opposite of personalization, the reason bad things are happening is because of what another person is doing or not doing. You overlook your own contributions to the problem.

CHANGING BEHAVIOR

Behavioral Changes

• Exercise• Relaxation Training• Meditation• Mindfulness• Assertiveness Training• Sleep & rest• Healthy Diet• Increased Social Support• Humor

• Breathing Techniques

When Anxious, We Tend to Hold Our Breath

. . . This activates our Sympathetic Nervous System and results in more stress.

Breathing and The Relaxation Response

By shifting your breathing rate and pattern, you can stimulate the body's parasympathetic response, termed the “Relaxation Response” by Herbert Benson.

Physical Changes that Occur During the Relaxation Response (Parasympathetic

Response)• Oxygen consumption decreases • Breathing slows • Heart rate slows • Blood pressure decreases • Muscle tension decreases • Growing sense of ease in body, calmness

in mind

Are You Getting Enough O2?

upper chest lower

chest

Thoracic Diaphragmatic

Breathing Techniques

• Diaphragmatic Breathing• Natural Breathing

– Gently and slowly inhale a normal amount of air through your nose, filling only your lower lungs. (Your stomach will expand while your upper chest remains still.)

– Exhale easily. – Continue this gentle breathing pattern with a

relaxed attitude, concentrating on filling only the lower lungs.

Breathing Techniques (Cont.)

• Calming Breath– Take a long, slow breath

in through your nose, first filling your lower lungs, then your upper lungs.

– Hold your breath to the count of "three."

– Exhale slowly (for the count of six) through pursed lips, while you relax the muscles in your face, jaw, shoulders, and stomach.

Relaxation Training

• Progressive Muscle Relaxation• Autogenic Training• Peaceful Place Imagery• Sensory Observation• Breathing• Stretching• Meditation

Principles of Mindfulness

Mindfulness refers to being completely in touch with and aware of the present moment, as well as taking a non-evaluative and non-judgmental approach to your inner experience. The basic principles include:– Awareness– Nonjudgmental Observation– Being in the Present Moment– Beginner's Mind

Heart MathWhat is “Coherence?”

Physiological Coherence

A state characterized by:• High heart rhythm coherence (sine

wave-like rhythmic pattern)• Increased parasympathetic activity• Increased entrainment and

synchronization between physiological systems

• Efficient and harmonious functioning of the cardiovascular, nervous, hormonal and immune systems

Psychophysiological Coherence

A state associated with:• Sustained positive emotion• High degree of mental and

emotional stability• Constructive integration of the

cognitive and emotional systems• Increased synchronization and

harmony between the cognitive, emotional and physiological systems

Managing Stressed-out Employees

• Active listening• Expressing concern • Validating – people want to be

validated more than they want to be “fixed.”

• Don’t immediately assume the role of “fixer.” Ask the person what he/she thinks is in his/her best interest to do.

• Keep communication open

Karpman Drama Triangle

Victim

Rescuer Persecutor

Four Traits That Perpetuate Stress

(Bourne, 2003)

1. Perfectionism2. Excessive Need for Approval3. Tendency to Ignore Physical and

Psychological Signs of Stress4. Excessive Need for Control

Healing from Perfectionism

• Let go of the idea that your worth is determined by achievements and accomplishments

• Recognize and overcome perfectionistic thinking styles (e.g., “should/must thinking,” “all or nothing thinking,” “overgeneralization”

• Stop magnifying the importance of small errors

• Focus on positives• Work on goals that are realistic (acceptance

of personal limitations is the ultimate act of self-care)

• Cultivate more pleasure and recreation in your life

• Develop a process orientation

Healing From the Excessive Need for Approval

• Develop a realistic view of other people’s approval • Become more assertive• Deal with criticism in an objective fashion

– Evaluate the source of the criticism– Ask for details– Decide whether the criticism has some validity

• Recognize and let go of co-dependency– Can you relate to any of the following:

• If someone important to me expects me to do something, I should do it.

• I shouldn’t do anything to make others angry at me.• I should keep people I love happy.• If necessary, I’ll put my own values and needs aside in order to

preserve my relationship with my significant other.

Healing From the Tendency to

Ignore Physical and Psychological Signs of Stress

First and foremost, AWARENESS!

Some indications:FatigueHeadacheNervous stomachTight musclesInsomniaThe symptoms of panic attacks

Healing From the Excessive Need

for Control• Work on acceptance (particularly letting go

of certainty)– Develop a sense of humor– Look at the big picture– Strengthen your “Oh well” muscle

• Cultivate patience (becoming aware of being “in process”)

• Trust that most problems eventually work out

• Find a sense of meaning and/or purpose

“I am an old man and have known a great many troubles – but most of them never happened.”

Mark Twain

Thank You