1. STRESS TRAUMA GRIEF & LOSS Christine Buckingham, LCPC
World Vision Employee Health Fair
Washington, DC
November 5, 2009
STRESS
TRAUMA
GRIEF &
LOSS
World Vision Employee Health Fair
Washington, DC
November 4, 2009
Christine Buckingham, LCPC
Executive Director
Life Christian Counseling Network, LLC
© Christine E. Buckingham. All rights reserved

2. Hierarchy of stress Stress Adjustment disorders Acute stress disorder
Post traumatic stress disorder (PTSD)

3. Trauma, grief, loss

4. Beyond Stress Counseling/Therapy Medication management
More complicated stress levels such as Adjustment disorder, Acute Stress Disorder, and PTSD, require additional help and resources including
Counseling/Therapy
Medication management

5. Adjustment Disorder
Marked distress in excess of what would be expected in response to a stressful event, or a significant impairment in social or occupational functioning.
The symptoms usually occur within 3 months of the recognizable stressful event and should not last longer than 6 months after resolution of the stressful event or its consequences unless symptoms are in response to a chronic stressor.
Individuals generally return to normal functioning within a few months

6. Acute Stress Disorder
An Anxiety Disorder resulting from exposure to a traumatic event where a person develops anxiety symptoms, re-experiencing of the event, and avoidance of stimuli related to the event lasting less than four weeks. If symptoms persist, a diagnosis of PTSD may be given.

7. Post Traumatic Stress Disorder (PTSD)
An anxiety disorder triggered by a traumatic event. A person can develop post-traumatic stress disorder when they experience or witness an event that causes intense fear, helplessness or horror. Onset can be delayed by as much as 6 months. Symptoms can last less than three months or can become chronic.
Persistent re-experiencing (recollections, dreams, flashbacks, distress at reminder cues, psychological reactivity to perceived cues)
Avoidance of stimuli
Increased arousal
Duration of sx more than 1 month
Clinically significant impairment in social, occupational or other area of functioning

8. Stress
Sources of Stress: GOOD AND BAD SOURCES: environment (weather, noise, traffic); social stressors (relationships, moves, promotions, family, work pressures, deadlines, financial problems) ; physiological (illness, aging, injury, exercise and lack of exercise, nutrition, inadequate sleep); thoughts (flight/flight responses)

9. OR Activating Event -- The STRESSOR STRESS RESPONSE:
RELAXATION
RESPONSE:
Engages the
Parasympathetic Nervous
System --
Three minutes the
F or F burns out &
Systems
return to Normal
STRESS RESPONSE:
Fight, Flight, Freeze
Physiological Arousal
of the Sympathetic Nervous System:
INCREASED: heart rate, breathing rate,
muscle tension, metabolism, blood pressure
Blood diverted away from digestive system
– butterflies in the stomach; extremities
get cold. Pupils dilate OR
CHRONIC STRESS:
Adrenals produce
corticoids
Increased
Vulnerability
to illness
Stressor
Fight or flight or freeze
EVEN IMAGINED DANGER ACTIVATES THIS – fear
Hypothalamus in midbrain activates the Nervous System
Corticoids – adrenaline or epinephrine and norepinephrine: inhibit digestion, reproduction, growth, tissue repair, and inhibit the activity of your immune and inflammatory systems. Your body begins to shut down and are vulnerable to stress related illnesses
Chronic stress can occur whten stressors of life are unrelenting.
YOU activate the Relaxation response – the all clear to the brain.
8. The good news? Your body can learn the relaxation response.

10. Stress Management The good news:
Performance & efficiency actually improve with increased stress
The bad news:
Performance peaks as the stress level becomes too great. And it’s all downhill from there.
Balance = types + amounts of stress for your individual personality, priorities, and life situation.

11. Symptoms of Stress On your body On your behavior Headache
Back pain
Chest pain
Heart disease
Heart palpitations
High blood pressure
Decreased immunity
Stomach upset
On your thoughts and feelings
Sleep problems
Anxiety
Restlessness
Worrying
Irritability
Depression
Sadness
Anger
Feeling insecure
Lack of focus
Burnout
Relationship conflicts
On your behavior
Forgetfulness
Overeating
Under-eating
Over-eating
Angry outbursts
Drug or alcohol abuse
Increased smoking
Social withdrawal
Crying spells
Relationship conflicts
Retrieved from MayoClinic.com

12. Stress Management Physical Spiritual Soul/mind Self care Nutrition
Exercise
Rest/relaxation
Soul/mind
Boundaries
Fun
Thinking patterns
coulda/woulda/shoulda
Spiritual
Relationships
Worship
Inspirational reading
Music
Study
Service
Reflection

13. Let’s Evaluate Holmes-Rahe Stress Scale
Add up the stress factors in your life
you have experienced in the last 24 months
to see how these factors
may be affecting your physical health.

14. The envelope, please… What were your top 5 stressors? And your score
Less than chance of developing a stress related illness
% chance of developing a stress related illness
Over % chance of developing a stress related illness
What were your top 5 stressors?
What are your top 5-8 stressors?

15. how stressed do you feel
Right now?
On a scale of 1 to 10,
how stressed do you feel
right now?

16. RRREEE-LAAAXXXX
Here we go…
Dim lights.

17. Progressive Muscle Relaxation
REEE-LAAAXXXX
Progressive Muscle Relaxation
Head to toe

18. Mindfulness REEE-LAAAXXXX Five things you hear Five things you see
Five things you sense

19. Breathe REEE-LAAAXXXX
Measured breathing: In through your nose, toungue to roof of mouth, out through a straw.
Here we go -- Cleansing breath in and out……………..In ……..1…2… Hold…….1...2… Out……

20. Become aware of God’s presence
REEE-LAAAXXXX
Become aware of God’s presence
As you continue breathing, become aware of your breath as it enters your body –
As you breathe in, aware of God’s Holy Spirit filling you
As you exhale, give him your worries,, cares, upplication

21. Evaluate present stress
On a scale of 1 to 10,
how stressed do you feel
right now?
Did your level change?