1. FINDING YOUR RESILIENCE Presented by Cigna Employee Assistance Program

2. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. SEMINAR GOALS 2 Discuss what it means to be resilient Explore factors that influence your ability to be resilient Identify the role that resilience plays in your life Learn strategies to build up your personal resilience Know the benefits of your Employee Assistance Program (EAP)

3. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. WHAT DO WE MEAN BY “RESILIENT”? 3 Fall seven times, stand up eight. -- Japanese proverb A RESILIENT PERSON Doesn’t give up Takes action Faces fears Seeks solutions Is able to adapt Stays hopeful Believes in self Manages stress Quotes, n.d.

4. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. RESILIENCE IS A RESPONSE 4 MINOR STRESSORS Adapt without thought LIFE- THREATENING STRESSORS Automatically seek safety OTHER STRESSORS Response based on interpretation

5. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. WHAT SHAPES OUR ABILITY TO BE RESILIENT? 5 Volume of stress Intersects with vulnerabilities Offset by strengths This equation adds up differently for every individual.

6. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. BEHIND THE SCENES 6 The neurobiology of stress Threat response hardwired for survival Negativity bias overestimates danger Neural connections lock memory to fear Connections to rational brain weaken

7. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. THE RESILIENT BRAIN 7 Rational brain is part of conversation Repetition reinforces positive feedback loop Gradually becomes preferred response Build connections with small steps

8. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. HOW DOES THIS LOOK IN REAL LIFE? 8 Resilience may be signaled in small ways Lack of resilience may look similar to depression Look for strengths used in low grade stress “Tipping point” can show up with intense stressors

9. 9 Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. Resilience BUILDERS Perspective Purpose People Plasticity

10. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. PERSPECTIVE 10 Regain a sense of control with a shift in perspective Let go of shame, blame, self-pity Pull focus out to see big picture Practice attitude of gratitude Remind yourself of capabilities The ability to shift perspective can help you face fears, adapt, and take action. / /

11. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. PURPOSE 11 Find your footing and define a future Embrace who you are Look for meaning in difficulty Set goals; make them realistic Use moral compass to guide The ability to find meaning can help you believe in yourself and not give up. / /

12. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. PEOPLE 12 Turn to others to get and give support Can be a safety net Stimulates “feel good” hormone Find laughter Open your heart The ability to turn to others can help you work out solutions and be more hopeful.

13. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. PLASTICITY 13 Use mindfulness to rewire response Lose the labels Turn down worries Know that the storm will pass The ability to be mindful can help you create new connections and manage stress.

14. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. A FIRM FOUNDATION 14 Be well to be resilient Sleep resets mind and body Food can be friend or foe Exercise changes stress response Don’t forget to keep your emotional and spiritual tanks full as well.

15. Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. 15 RESILIENCE Finding in yourself… a hopeful vision for what will come, belief that you can achieve it, strength to take action to accomplish it, and a willingness to seek compassionate support from others and yourself to take small steps forward. The more you do this, the more you make it so.

16. BENEFITS OF THE EAP 16 Face-to-face sessions Confidential Prepaid Unlimited telephonic consultation Available 24 hours a day, 7 days a week Household benefit Work/life support such as elder care, child care and pet care Financial services Legal services Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license.

17. 17 Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license. American Academy of Sleep Medicine. (2015). Poor sleep quality linked to reduced resilience among veterans and returning military personnel. Retrieved from http://www.aasmnet.org/articles.aspx?id=5618 Aubrey, A. (2014). Food-mood connection: How you eat can amp up or tamp down stress. Retrieved from http://www.npr.org/sections/thesalt/2014/07/14/329529110/food-mood-connection-how-you-eat-can-amp-up-or-tamp-down-stress Cohen, M.A., Fredrickson, B.L., Brown, S.L., Mikels, J.A., and Conway, A.M. (2009). Happiness unpacked: Positive emotions increase resilience. Emotion, 9(3), 361-368. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126102/#R4 Doidge, N. (2007). The brain that changes itself: Stories of personal triumph from the frontiers of brain science. New York, NY: Viking Penguin. Graham, L. (2013). Bouncing back: Rewiring your brain for maximum resilience and well-being. Novato, CA: New World Library. Hanson, R. (2013). Hardwiring happiness: The new brain science of contentment, calm, and confidence. New York, NY: Harmony Books. Kabat-Zinn, J. (1990). Full Catastrophe Living: Using the wisdom of your body and mind to face stress, pain, and illness. New York, NY: Dell Publishing. Kelly, M. (2013). Exercise reorganizes the brain to be more resilient to stress. Retrieved from https://www.princeton.edu/main/news/archive/S37/28/70Q72/index.xml?section=topstories Kuiper, N.A. (2012). Humor and resiliency: Towards a process model of coping and growth. Europe's Journal of Psychology, 8(3), 475-491. Retrieved from http://ejop.psychopen.eu/article/viewFile/464/354 Loder, D. (2015). How to rewire your brain for happiness. Retrieved from http://www.forbes.com/sites#/sites/vanessaloder/2015/03/18/how-to-rewire-your-brain-for-happiness/ McEwen, B.S., & Gianaros, P.J. (2011). Stress- and allostasis-induced brain plasticity. Annual Review of Medicine (62), 431-445. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251716/ REFERENCES

18. Norris, F.H. (2010). Behavioral science perspectives on resilience. Retrieved from http://www.resilientus.org/wp- content/uploads/2013/03/Behav_Science_Perspectives_fn_1309545968.pdf Ozbay, F., Johnson, D.C., Dimoulas, E., Morgan, III, C.A., Charney, D., and Southwick, S. (2007). Social support and resilience to stress. Psychiatry, 4 (5): 35-40. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921311/ Quotes. (n.d.). Japanese proverb quotes. Retrieved October 28, 2015 from http://www.quotes.net/quote/41640 Rock, d. (2009). Managing with the brain in mind. Strategy + Business, (56),4. Retrieved from http://www.strategy- business.com/article/09306?gko=5df7f Ryan, M.J. (2009). Adaptability: How to survive change you didn’t ask for. New York, NY: Broadway Books. Seligman, M.E.P. (2011). Building resilience. Retrieved from https://hbr.org/2011/04/building-resilience Siddique, A. (2013). Exercise still builds stress resilience against anxiety and depression. Retrieved from http://www.medicaldaily.com/forced-exercise-still-builds-stress-resilience-against-anxiety-and-depression-245280 Sippel, L. M., R. H. Pietrzak, D. S. Charney, L. C. Mayes, and S. M. Southwick. (2015). How does social support enhance resilience in the trauma-exposed individual? Ecology and Society 20(4):10. Retrieved from http://www.ecologyandsociety.org/vol20/iss4/art10/ U.S. Department of Health and Human Services (DHHS). (2011). Your Guide to Healthy Sleep. Retrieved from http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf Vaish, A., Grossmann, T., and Woodward, A. (2008) Not all emotions are created equal: The negativity bias in social-emotional development. Psychological Bulletin, 134(3): 383-403. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652533/ Young, E. (2014). Resilience: How to train a tougher mind. Retrieved from http://www.bbc.com/future/story/20140916-how-to-train-a-tougher-mind REFERENCES 18 Use and distribution limited solely to authorized personnel. © 2015 Cigna Some content provided under license.

19. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna Behavioral Health, Inc., and HMO or service company subsidiaries of Cigna Health Corporation. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All models are used for illustrative purposes only. 8808891 10/15 © 2015 Cigna. Some content provided under license. 19