Breakout Session 101: ENHANCING RESILIENCE Lizza Robb, MSW

POP Model for Purposeful Action Purpose: Why is this important? Why is it a valuable use of my time and energy? Outcomes: What do I hope to accomplish? Process: How am I going to do it? The POP Model for purposeful action comes from Robert Gass’s work through the Social Transformation Project

Purpose: Why is this important? Constant pressure within a rapidly changing healthcare system and culture Demands continuously outpace our capacity to deliver Chronic stress diminishes our capacity, health and happiness Cultivating resilience is a critical leadership competency; the better we feel, the better we think!

Relationships with family and friends Top ten factors related to resilience - American Psychological Association From: Top Five Regrets of the Dying by Bonnie Ware Relationships with family and friends  Avoid seeing crises as insurmountable problems Accept that change is part of living Move toward your goals Take decisive actions Look for opportunities for self- discovery Nurture a positive view of yourself Keep things in perspective Maintain a hopeful outlook  Take care of yourself I wish I'd had the courage to live a life true to myself, not the life others expected of me. I wish I hadn't worked so hard. I wish I'd had the courage to express my feelings. I wish I had stayed in touch with my friends. I wish that I had let myself be happier.

Outcomes: What we hope to accomplish Discuss why resilience is a critical leadership competency Explore practices for cultivating resilience (daily practices and resilient coping strategies) Participants will leave each breakout session with a personalized resilience portfolio and actionable intentions for cultivating resilience

Process: How we’ll get there Topics: Sources and effects of chronic stress Resilience Format: Teaching Discussion Activity Collaborative Learning Environment; Group Agreements

Comfort Stretch Panic Panic Zone Stretch Zone Comfort Zone Eustress v distress Acute stress v chronic stress

What contributes to chronic stress in our lives? What’s the difference between acute stress and chronic stress?   [Hear from several.] Chronic stress is the grinding stress that wears people away day after day, year after year. Chronic stress destroys bodies, minds, relationships and lives. It’s the stress of unrelenting demands and pressures for seemingly interminable periods of time.  The worst aspect of chronic stress is that people get used to it. They forget it’s there. People are immediately aware of acute stress because it’s new; they ignore chronic stress because it is old, familiar, and sometimes, it almost becomes comfortable. What contributes to chronic stress in our lives? [Capture a list of contributors on a flip chart.]

mgma.org/polls

and respond to the prompts Write down the numbers and respond to the prompts as I read them. Write them ALL! I’m going to read a series of numbers and writing prompts. Write down every number and respond to the prompts as I read them.   Everyone have a blank sheet of paper and a pen ready? [Read quickly with increasing speed.] 2, 9, 15, 27, 3, 43, 25, 46, 960, 10, 27, 332, 68, 649, 70, 72, 94, 248, 602, 93, 25, 38, 623, 703, 3076, 43, 95, 297, NAME A COLOR, 319, 2045, 2840, 32, 1, 3, 25, 47, 62, 93, 352, 641, 2057, 326, 478, 204, 633, 203, 6631, 1010, 2040, 4958, NAME A GENIUS, 31, 5, 29, 92, 441, 19, 6937, 20, 7312, 21, 52, 940, 3030, 2075, 26, 843, 3892, 946, 88, 9040, 30, 994, 4060, 489, 56, 82, NAME A PIECE OF FURNITURE, 62, 33, 743 Raise your hand if you wrote blue. A primary color. What other colors? But no one wrote [insert obscure color that no one said like chartreuse] right? What about furniture? Raise your hand if you said chair, sofa or couch. What else? But no one said [insert something like a tuffet or 19th century fainting couch] right? And raise your hand if you wrote down Einstein. [Usually lots of people will have said Einstein and there’s laughter.] What other geniuses did people write down?

About 80% of people who do this write down blue, chair or sofa and Einstein.   Plenty of people write other things, but you never hear a really creative or unusual response. This activity is designed to replicate the impact on our brains of chronic stress. And here’s the point: when our brains are under stress, we reach for the simplest solution possible. The immediate reaction. The least creative solution. The fight, flight or freeze response. And what are you aware of right now? What do you feel in your body? [Hear from several.] A great way to quickly counteract stress is with the breath. Bring both feet to the floor and sit up straight in your chair. Shoulders wide. Head high. Neck long. Hands on your thighs. Now inhale as fully as is comfortable for you and hold your breath for a few seconds. Release with a long, slow exhale. And again. A full deep inhale. Filling your lungs to capacity. Hold. And a long, slow exhale. Breathe like this on your own for one minute. You may want to close your eyes. Really concentrate on filling and emptying your lungs. [Time one minute.] Okay, let’s come back together. What are you aware of?

Common Effects of chronic stress Cognitive Memory problems Inability to concentrate Poor judgment Seeing only the negative Anxious or racing thoughts Constant worrying Emotional Moodiness Irritability or short temper Agitation, inability to relax Feeling overwhelmed Sense of loneliness and isolation Depression or general unhappiness Physical Aches and pains Diarrhea or constipation Nausea, dizziness Chest pain, rapid heartbeat Loss of sex drive Frequent colds Behavioral Eating more or less Sleeping too much or too little Isolating yourself from others Procrastinating or neglecting responsibilities Using alcohol, cigarettes, or drugs to relax Nervous habits (e.g. nail biting, pacing) And what else does chronic stress do to us?   What stands out to you from this list? [Hear from several.] What about the impact on relationships? Source: helpguide.org

Demands will continue to outpace our capacity to deliver We need healthy and resilient people in order to have healthy organizations and achieve great results. Unfortunately, the stressors we mentioned a few minutes ago aren’t going anywhere anytime soon.   Demands are going to continue to outpace our capacity. So what do we do? This is where resilience comes in.

Positivity by Barbara Fredrickson What are we talking about when we talk about resilience?   [Hear from several. They will likely say things like “our ability to bounce back.”] Right. Resilience is connected with our ability to recover. To bounce back after difficulties. There has been a massive amount of research over the last several decades on happiness and positivity and hundreds of books written on the subject. I highly recommend Positivity by Barbara Fredrickson at University of North Carolina. She and Martin Seligman at the University of Pennsylvania have done incredible work to further the field of Positive Psychology and bring it into our everyday conversation. What we now know is that we tend to overestimate the long-term positive effect of good things that happen to us. If I just get married, if I just get this job, if I just get this promotion, if I just get this new house, if I just whatever… I’ll be happy. We also overestimate the long-term negative effect of bad things that happen to us (divorce, losing your job, loss, accidents). Now, there are certain things that many people never recover from; we know that to be true. But most things we do. How do we know this? What usually happens a year later to someone who wins the lottery? [Hear from a few.] Right, they have a big spike in happiness and after about six to twelve months they’re back where they started. Research has also shown the same to be true for people who experience the loss of physical ability in an accident. Within 12 to 18 months, they often return to their level of happiness before the accident or even experience what’s called post traumatic growth and their long-term happiness level actually increases. So if we know that winning the lottery isn’t likely to make us happier. And we know that even experiencing an accident that robs us of our physical abilities isn’t necessarily going to devastate us. What accounts for our happiness if it isn’t these big good or hard things? If it isn’t the things that happen to us? Like our weight most of us have a lifetime happiness range. We tend to fluctuate within this range but rarely get too far above or below it. Positivity and optimism are NOT products of good fortune or results of success, they are predictors of success. Now, the question is what can we do to stay at the higher end of our range? Or to return to equilibrium after a difficult experience? That’s where resilience comes in. Positivity by Barbara Fredrickson

Building Resilience Cultivating a set of consistent practices that build a solid foundation for well-being and resilience Identifying healthy go-to coping strategies for maintaining resilience under challenging circumstances The good news is that resilience is something we can cultivate in our lives.   Building resilience is about two things: creating a set of practices that you do regularly and consistently to build a solid foundation; and identifying healthy go-to coping strategies for moments of stress.

Individual Reflection Current regular activities that I know support my overall sense of well-being and resilience My healthiest coping strategies for managing moments of intense stress

Debrief reflection capture

Experimentation & Intention Complete the experimentation and intention sections of your handout Experimentation What are some additional resilience practices you’d like to explore? Additional coping strategies for managing stressful moments? Intention What is one specific thing you commit to doing this week?

In pairs Share your intention. Be specific. Why is it important? What excites you about it? What might get in your way?

Relationships with family and friends Top ten factors related to resilience - American Psychological Association From: Top Five Regrets of the Dying by Bonnie Ware Relationships with family and friends  Avoid seeing crises as insurmountable problems Accept that change is part of living Move toward your goals Take decisive actions Look for opportunities for self- discovery Nurture a positive view of yourself Keep things in perspective Maintain a hopeful outlook  Take care of yourself I wish I'd had the courage to live a life true to myself, not the life others expected of me. I wish I hadn't worked so hard. I wish I'd had the courage to express my feelings. I wish I had stayed in touch with my friends. I wish that I had let myself be happier.