1. STRESS MANAGEMENT Dr. Patricia Sherman May 14, 2008

2. What causes you stress?

3. Some causes of stress Employment Family Change Chemicals – drugs, pesticides, additives Emotions Commuting

4. Decisions Social life Physical – lack of sleep, poor nutrition, injury Disease – chronic illness Pain Environment Media Terrorism Finances

5. Interpersonal stressors Poor communication Unexpressed anger Lack of physical contact Financial pressures Low self-esteem Guilt Loneliness Boredom

6. Professional stressors Poor time-management skills Inability to delegate Lack of motivation Noise Unrealistic goals and targets Drab surroundings Unsupportive supervisor/co-workers Lack of recognition

7. How is stress manifested?

8. General stress symptoms Muscular tension Lack of zest for life Insomnia, poor quality of sleep Difficulty focusing Lowered libido Recurrent infections Poor appetite

9. Mental and emotional stress symptoms Anxiety Panic attacks Depression Lack of confidence Indecision Rapid or unpredictable mood swings Inability to “switch off” after work

10. Physical symptoms of stress Indigestion Heartburn Diarrhea Constipation Tension headaches Hyperventilation Palpitations Dizziness/lightheadedness

11. Measure stress using pain scale

12. Time management

13. HOW MANY HOURS IN A WEEK?

14. SLEEP MEALS COMMUTING ERRANDS FAMILY TIME GROOMING CAREGIVING RECREATION MAINTAINING RECORDS MEETINGS UPGRADING SKILLS COMMUNITY SERVICE SPIRITUAL/RELIGIOUS PRACTICES

15. WHERE DOES THE TIME GO? On average, how many hours do you sleep in each 24 hour period? Multiply answer by 7. Subtract from 168.

16. WHERE DOES THE TIME GO? On average, how many hours do you spend in meal preparation and eating in each 24 hour period? Multiply answer by 7. Subtract from previous subtotal.

17. WHERE DOES THE TIME GO? On average, how many hours do you spend commuting each week? Subtract from previous subtotal.

18. WHERE DOES THE TIME GO? On average, how many hours do you spend running errands each week? Subtract from previous subtotal.

19. WHERE DOES THE TIME GO? On average, how many hours do you spend in family time each week? Subtract from previous subtotal.

20. WHERE DOES THE TIME GO? On average, how many hours do you spend on chores (cleaning, home maintenance, paying bills, etc.) each week? Subtract from previous subtotal.

21. WHERE DOES THE TIME GO? On average, how many hours do you spend carrying out grooming and dressing activities in each 24 hour period? Multiply answer by 7. Subtract from previous subtotal.

22. WHERE DOES THE TIME GO? On average, how many hours do you spend with friends each week? Subtract from previous subtotal.

23. WHERE DOES THE TIME GO? On average, how many hours do you spend at work each week? Subtract from previous subtotal.

24. WHERE DOES THE TIME GO? On average, how many hours do you spend in meetings outside of work hours each week? Subtract from previous subtotal.

25. WHERE DOES THE TIME GO? On average, how many hours do you spend on upgrading skills activities each week? Subtract from previous subtotal.

26. WHERE DOES THE TIME GO? On average, how many hours do you spend in community service each week? Subtract from previous subtotal.

27. WHERE DOES THE TIME GO? On average, how many hours do you spend on caregiving each week? Subtract from previous subtotal.

28. WHERE DOES THE TIME GO? On average, how many hours do you spend on spiritual/ religious practices each week? Subtract from previous subtotal.

29. WHERE DOES THE TIME GO? On average, how many hours do you spend relaxing in each 24 hour period? Multiply answer by 7. Subtract from previous subtotal.

30. WHERE DOES THE TIME GO? Subtract any additional time expenditures you have from previous subtotal. Any time left?

31. Burnout quiz

34. Stages of Burnout

35. Prevention of Burnout

36. SETTING PRIORITIES WORK FAMILY FRIENDS COMMUNITY SPIRITUAL/RELIGIOUS RELAXATION HEALTH

37. GOAL SETTING: WHAT DO I WANT AND WHY DO I WANT IT? WHEN THE WHY GETS STRONGER, THE HOW GETS EASIER GOALS NEED TO BE SPECIFIC,DOABLE, and MEASUREABLE

38. GOAL SETTING GOAL REASON Objective #1 Objective #2 Objective #3 Example: Improve health in order to have more energy – Exercise 30 minutes 4 times/week – Lose 1.5 pounds/week for a total of 25 pounds – Eat 1800-2000 calories/day

39. GOAL SETTING WORK – Goals Objectives FAMILY – Goals Objectives FRIENDS – Goals Objectives

40. COMMUNITY – Goals Objectives SPIRITUAL/RELIGIOUS – Goals Objectives RELAXATION – Goals Objectives HEALTH – Goals Objectives

41. SUCCESS QUESTION WHAT CAN I DO TODAY THAT WILL HELP ME TOWARDS MY GOAL? What can I do for exercise today? What can I do today to enhance my relationship with my partner? What can I do today to nurture myself?

42. How do you cope with stress?

43. Some stress reduction techniques

44. progressive muscle relaxation Lie down or sit comfortably and close your eyes Tense the muscles of a particular body part Hold the tension for about 10 seconds Let go of the tension quickly, letting the muscles go limp Repeat Go on to different muscle groups

45. Stretch Massage – self; partner Shake it out Shower or bath Breathing Aromatherapy Exercise Hypnosis

46. Animal therapy Gardening Spiritual practices Expressive therapies Acupuncture/acupressure Homeopathy Self-help groups Any other pleasurable activity

47. Imagery – guided exercise

48. Time management Write down weekly goals, plans activities, and objectives Prioritize tasks according to importance Plan schedules in an organized manner by using calendar or appointment book Schedule demanding tasks during periods of high energy Eliminate time wasting activities

49. Delegate authority and tasks Finish one task before starting another Write it down Learn to say “no” Leave some of your schedule open Develop and keep deadlines Don’t put off making decisions Improve reading and writing skills Develop an effective reminder system

50. Irrational beliefs - ellis It is a dire necessity for adult humans to be loved or approved by virtually every significant other person in their community. One absolutely must be competent, adequate and achieving in all important respects or else one is an inadequate, worthless person. People absolutely must act considerately and fairly and they are damnable villains if they do not. They are their bad acts.

51. It is awful and terrible when things are not the way one would very much like them to be. Emotional disturbance is mainly externally caused and people have little or no ability to increase or decrease their dysfunctional feelings and behaviors. If something is or may be dangerous or fearsome, then one should be constantly and excessively concerned about it and should keep dwelling on the possibility of it occurring.

52. One cannot and must not face life's responsibilities and difficulties and it is easier to avoid them. One must be quite dependent on others and need them and you cannot mainly run one's own life. One's past history is an all-important determiner of one's present behavior and because something once strongly affected one's life, it should indefinitely have a similar effect.

53. Other people's disturbances are horrible and one must feel upset about them. There is invariably a right, precise and perfect solution to human problems and it is awful if this perfect solution is not found.

54. Rebt – albert ellis A – activating event or potentially stressful situation B – beliefs, thoughts, or perceptions about A C – emotional consequence that results from holding these beliefs A potentially stressful situation + your perceptions = your stress level

55. Plan of action Stress diary Stress dots Stress reduction program Fifteen things to add to quality of life Ten habits of highly effective stress managers