STRESS MANAGEMENT Matt Orr, PhD Department of Family and Preventive Medicine

The best way to find yourself is to lose yourself in the service of others. -- Ghandi

Life Happens

It’s all about our sense of …. CONTROL 4

Stress is the nonspecific response of the organism to any pressure or demand

Stress – Good & Bad

Modern Stressor Primitive Stressor “Threat!” 7

Stress Response 8

Relaxation Response A state of relaxed, passive attention to a repetitive or absorbing stimulus that turns off the “inner dialogue” thereby decreasing arousal of the sympathetic nervous system.

Focus on the Response It is not the problem that needs your focus, it’s your response that needs the focus.

Strategies for Stress Busting Be Think Do

Behavior: The DO

Sleep 13 Are you getting 7-9?

Nutrition

Socializing

Laugh & Play Everyday

Cognitive: The THINK

Choose Your Response We are what we think. – Buddha We Don’t see things as they are, We see things as we are. – The Talmud What you think, you become; What you feel, you attract; what you imagine, you create. - The Dammapada

Choose Your Response The eye is the lamp of the body. So, if your eye is good, your whole body will be full of light: But if your eye is bad, your whole body will be full of darkness. – Matthew 6:22

Stop-Options  “I should be…”  “STOP”  “What are my options?”  What are my coulds?  Select activity from list of options  Useful for diffusing pressure of obligations  Increases sense of control…competence

ANTs Automatic Negative Thoughts

NUTs Nagging Unfinished Tasks

Maintain a Solution Focus  Whatever the problem is think…  “What’s one thing I can do to make it better?”

Most folks are about as happy as they make up their minds to be. Abraham Lincoln 24

Explanatory Style  If you are late to class because you could not find your keys or a book are you more likely to say to yourself… A. “I always do this to myself; I’m going to look so careless” B. “I’m probably not the only one who’s going to be late”

Explanatory Style  If you are driving in a rush and find yourself hitting a lot of red lights… A. “I have the worst luck; nothing ever goes my way!” B. “Man, today it’s not my day for green lights.”

Explanatory Style  blame themselves for negative events  believe that such events will continue indefinitely  let such events affect many aspects of their lives  blame others for negative events  believe that such events will end soon  do not let such events affect too many aspects of their lives Pessimism (A responses)Optimism (B responses)

Recovering from Set-Backs  Thought Stop -“Stop”  Distraction or  Disputation  Focus on the “Do”  Move to action  Pre-programmed response (ICR)  No matter how frustrated or angry I get…  Go straight into action with that response Thought ApproachAction Approach

Hot Buttons  Make a list of your hot buttons  Now list Ideal Coping Responses (ICR)  The more you focus on a mistake, the more likely you are going to make it!

When angry, count four, when very angry, swear. -Mark Twain

“Oh Well”  Interrupts the cascade of negative thought and emotion  Add a shoulder shrug

Relaxation: The BE

Slow Down 33

Mindfulness is Key 34 Don’t be this guy!

Mindfulness vs. Mindlessness 35 Being able to: Be present in the moment Remember the drive to work Remember what you just told/gave a patient

Oxygen Consumption During Sleep and The Relaxation Response Change in Oxygen consumption (%)

Pathways to Relaxation Response  Relaxation Methods  Focused Breathing  Transcendental Meditation  Prayer  Yoga, Tai Chi, etc.  Autogenic Activities  Guided Imagery/Visualization/Meditation  Physical Activity  How much?

Two Basic Steps Necessary to Elicit the Relaxation Response 1. The repetition of a word, sound, phrase, prayer, or image, or muscular activity 2. The passive return to the repetition when other thoughts intrude

Focused Breathing  Diaphragmatic Breathing (aka Belly Breathing)  Centering Breath  15 seconds = In for 6, hold for 2, out for 7  Notice your breathing – Pace In, Pace Out

Mini Relaxations  #s in Space  #s down (10-0)  What’s around me  In breath = “I am”; Out breath = “At peace”  While stuck in traffic…while waiting…when in pain…while studying…when you can’t sleep  The only time they don’t work is when you don’t do them

Guided Imagery & Visualization  Progressive Muscle Relaxation  Autogenic Training  After the Game is Before the Game  Don’t Lose the Anxiety, Move It

Recommended   Youtube has relaxation music  Free resources on internet for relaxation techniques