Stress Management 101

Keeping Your Head Above Water

Stress Management 101., 4/2004, Rev. 4/2005, T240-16-Op

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 Agenda

Introduction

Definitions

M th andd Facts
Myths F t

Sources of Stress

How the Body Deals With Stress

Stress Survey

Stress Management Techniques

Diversion and Distraction
Changing
g g Thinkingg
Changing Lifestyle
Changing the Situation

Closing

2
 Learning Points
Learning Points

• Define stress
• Increase appreciation of individual choice in
stress reactions
• Identify stressors in our daily lives
• Become familiar with our body’s reaction to
stress
• Examine the stress continuum
• Increase awareness of multiple stress
management options
2

Participants will:
• Define stress
• Increase appreciation of individual choice in stress reactions
• Id tif stressors
Identify t in
i our daily
d il lives
li
• Become familiar with our body’s reaction to stress
• Examine the stress continuum
• Increase awareness of multiple stress management options

3
 Definitions
Why Are We Here? Definition

• It’s difficult accepting responsibility for our own

A stressor is an outside stimulus—something
stress levels
we may or may not have control over.
Stress is how we choose to respond to that
stimulus.

• Stress may have addictive qualities

3 4

• A stressor is the stimulus or challenge to which the body reacts; stress is the way you
react—physically and emotionally—to that stimulus or challenge.

• Stressors are the multitude of daily occurrences that call upon you to adapt; stress is
your response as you attempt to make the adjustment. *

• Stress is “the gap between the demands you perceive are being made on you and your
perceived resources to meet those demands.”

*Tubesing, Donald. Kicking Your Stress Habits: A Do-it-Yourself Guide for Coping With Stress. Signet, 1981

4
 Myths We Live By
Myths We Live By
‹ I must never make a mistake.

‹ I must never fail.

‹ I must never look foolish.

‹ I must work very hard at all times.

‹ I must never get angry.

‹ I must always play it safe. 5

What happens to us when we try to live up to these myths?

5
 The Facts of Life
The Facts of Life
• We can’t have everything.
• Things won’t always go our way.
• Life is unfair.
• Some people will never
understand us.
• We can’t please everyone.
• Traffic is slow during rush hours.
6

Using words or images, create a scenario depicting daily life using these facts.

6
 Sources of Stress
Sources of Stress

A stressor is a demand, situation or circumstance that disturbs an individual's

equilibrium
q and initiates the stress response.
p What stressors are yyou dealingg with?

7
 Stress is…
Stress. . .

…is natural
…affects us physically, emotionally and mentally
…comes from positive and negative stressors
…threatens health if unmanaged
…can be managed and used for growth
…is the physiological opposite of relaxation

I know I’m experiencing stress when:

8
 How the Body Deals with Stress

Racing thoughts; snap decisions Pituitary function increases to

stimulate adrenaline production
All senses heightened to
enable quick response
Gritting teeth, clenching
jaw
Red blood cells pump into
bloodstream; more oxygen
reaches brain to stimulate
thinking
Perspiration
increases for heat
dissipation
Pupils dilate to let in more
light to increase visual
acuity
Sympathetic nervous
system activated to
increase alertness and
strength
Stored sugars and fats
pumped into bloodstream
to increase available
energy

Rapid pulse &

increased Digestion stops; blood
breathing diverted to brain &
muscles to prepare for
flight or fight
Blood clotting
mechanism
h i activates
ti t
to protect against
injury
Muscles tense in
arms and legs
Blood diverted from
extremities into trunk and
head to protect internal
Inability to sit
organs
still
9
 Fight or Flight?
Fight or Flight?
Stress Alarm

Healthy: Recuperation
Fight or Flight is essential for survival when dealing with short
term threats.

Typical today:

Chronic stress response compromises physical, mental and emotional

well-being. 9

Short term stress is part of daily life.

Chronic stress
stress—unrelieved
unrelieved pressure and aggravation day in and day out out—wears
wears down
the body and lowers our immunity to infections and disease. Mental health problems and
other equally distressing outcomes can occur.
Your ability to manage this stress is critical to well-being. To do this, you must first
recognize the stressors that are impacting you.

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 Stress Vulnerability Survey
Always Frequently Sometimes Seldom Never

_____ _____ _____ _____ _____ 1.

1 I have sufficient friendships to meet my
social and emotional needs.
_____ _____ _____ _____ _____ 2. I have accessible family members on whom I
can depend.
_____ _____ _____ _____ _____ 3. I have sufficient, reciprocal loving
relationships in my life.
_____ _____ _____ _____ _____ 4. I have
h a spiritual
i i l belief
b li f which
hi h provides
id
comfort and offers guidance.
_____ _____ _____ _____ _____ 5. I honor my feelings and express them easily
and appropriately.
6. I am able to directly confront an issue I have
with a:
_____ _____ _____ _____ _____ friend
_____ _____ _____ _____ _____ co-worker
_____ _____ _____ _____ _____ family member
_____ _____ _____ _____ _____ neighbor
_____ _____ _____ _____ _____ 7. I am comfortable with my income.
_____ _____ _____ _____ _____ 8. I am able to manage my debt.
_____ _____ _____ _____ _____ 9. I pay attention to my diet and carefully
choose an appropriate balance of foods from
the basic food groups.
_____ _____ _____ _____ _____ 10. I am able to get to sleep easily and get the
appropriate amount for my age and energy
needs.
_____ _____ _____ _____ _____ 11. I create adequate time for myself.
_____ _____ _____ _____ _____ 12. I follow a regular exercise program that
combines aerobics and strength training.

11
 Stress Vulnerability
St V l bilit
Survey (Continued)

Always Frequently Sometimes Seldom Never

_____ _____ _____ _____ _____ 13. I abstain from smoking.
_____ _____ _____ _____ _____ 14. I abstain from using illegal drugs.
_____ _____ _____ _____ _____ 15. I monitor and control my alcohol intake.
_____ _____ _____ _____ _____
16. I monitor and control my caffeine intake
(coffee, tea, soda pop, chocolate).
_____ _____ _____ _____ _____ 17. I am comfortable with my life balance
choices (work, family, social, personal,
community).
_____ _____ _____ _____ _____ 18. I am in good health for my age and body
type
type.
____ _____ _____ _____ _____ 19. I enjoy my life’s work.
_____ _____ _____ _____ _____ 20. I have adequate support to succeed at my
job.

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 Stress Management Techniques
Stress Management Techniques

Diversion Changing Changing Changing

Distraction Thinking Lifestyle Situation

10

You can learn to master stress through diversion and distraction, by

changing your thinking, making lifestyle changes or changing the situation.

Diversion Changing Changing Changing

Distraction thinking lifestyle situation

Following are some methods that can facilitate that change.

“The only person who likes change is a wet baby.”

—Roy Z-M Blitzer

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 Diversion and Distraction
Quick Steps to Stress Relief Diversion and Distraction
• Deep
D bbreathing
hi

Choose your • Imagery or visualization

response
Assess your
options • Autogenic training
Take a deep
breath
Stop and think • Progressive muscular relaxation

• Music, massage, journal, laughter

11 12

Use the following four-step process to choose how to respond to a stressful situation.
• The first step is to stop and think about the situation; is it worth our time and energy to
become stressed out by it?
• Take a deep breath. When we experience stress our breathing tends to become shallow; a
deep breath helps us relax both mind and body, which helps us make better choices.
• Reflect on our options for handling the situation.
• Choose our response.

Reducing stress in the moment:

• If the body’s automatic reaction to stress is rapid, shallow breathing, then breath slowly
and deeply to relax.
relax
• Imagery or visualization are techniques in which you use your imagination to recreate a
place or scene that is very relaxing.
• Autogenic training allows you to give yourself mental cues to tell your body how to feel
(e.g. “My left arm feels heavy and warm.”)
• Progressive muscular relaxation allows you to feel the difference between tension and
relaxation by tensing specific muscles or muscle groups, relaxing those same muscles,
and concentrating on the difference between the two sensations.
• Get a pet, listen to music or relaxing tapes, get a massage, reach out for help, record your
feelings in a journal, laugh.

Pay attention to your feelings and learn to know when to relax, back off
for a bit, get more sleep and implement stress management strategies.
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 Breathing Exercise

Try the following exercise:

Sit in a balanced position. Settle into your chair so you feel as little strain as possible on
your lower back and abdominal muscles. Imagine a cord attached to the top of your head,
pulling your spine perfectly straight and aligned from the top of your head to the bottom
of your spine. Move your feet around until they are both comfortably placed on the floor,
approximately one and one-half feet apart and with your calves perpendicular to the floor.
Lift your hands and drop them to your thighs. Now visualize the cord being cut and allow
your head to move very slowly to a comfortable position.
a e a deep breath
Take b eat and
a d gently
ge t y and
a d easily
eas y exhale.
e a e.
Allow your next breath to be the one your body takes itself and watch your abdomen
expand as you breathe in and contract as you breathe out.
When you feel settled into your breathing, say to yourself on the in breath, “ I am...” and
on each out breath “… relaxed.” Allow your body to slip into relaxation easily and
comfortably.
Continue this practice and soon you will be able to relax simply by taking a deep breath.

15
 Changing Attitude or Thinking
Changing Thinking

• Separate worries from concerns

• Express gratitude

• Develop stress-busting thoughts

• Change internal dialogue

• Give yourself positive reinforcement

13

• Separate worries from concerns.

• Express gratitude for one new thing every day.

• Developp “stress-busting”
g thoughts
g to reassure yyourself; this comes from the “rational
you,” the you that thinks its way through life’s events.

• Change your internal dialogue.

• Give yourself positive reinforcement for even the smallest

accomplishments.

Thought Substitution Exercise:

Thought Substitute

“I can’t do this.” __________________________________

__________________________________

“This is awful; I can’t believe it.” __________________________________

__________________________________

“What a horrible mistake.” _______________________________

_______________________________ 16
 Changing Your Lifestyle
Changing Lifestyle

• Eliminate daily minor irritations

• Develop support systems

• Create regular rituals

• Do something for the “kid” in you

• Make a relaxation technique into a new habit

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• Avoid hassles to eliminate some of the daily minor irritations that lead to
chronic negative stress.

Already doing_____ Tried and didn’t work_____ Want to try _____

• Develop support systems which give you other people with whom to share your
feelings and experiences, helping you learn you’re not alone.
Already doing____ Tried and didn’t work_____ Want to try_____
• Develop a sense of control through regular rituals and create expectations about how
the day will progress; this activity, besides developing a sense of purpose, helps frame
your life.
Already doing_____ Tried and didn’t work_____ Want to try_____
• Do something for the kid in you every day.
Already doing____ Tried and didn’t work_____ Want to try
• Develop a new habit out of a relaxation technique that works for you.
Already doing_____ Tried and didn’t work_____ Want to try_____

Remember, you’re not the manager of the universe.

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 Changing the Situation
Changing the Situation
Moderate Change
• Reduce importance of event
• Prioritize
• Say “no”
• Eliminate, minimize, react differently
• Eliminate “shoulds”

Complete Change
• Create a change plan
• Separate/divorce
• Quit job; change careers; become stay-at-home parent
• Return to school
• Move 15

Moderate Change Complete Change

• Reduce the importance of the event by • Create a change plan:

putting it into perspective with your goals What would you change?
and focusing on the quality of your How can yyou break it into
performance. manageable pieces?
• Decide to separate or seek a divorce.
• Prioritize to better manage your time;
have backup plans. • Quit your job.

• Wait a few minutes before saying “yes” • Change careers.

careers
to requests for your time and attention.
• Decide to become a full-time, at- home
• Ask yourself how you can eliminate or parent.
minimize the situation or react differently
to it.
• Become a full-time student.
• Ask yourself what “shoulds” you can
eliminate. • Move:
To a new community
From the city to the country
From an apartment to a home
To a farm

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 When tto T
Wh Talk
lk tto a
Professional Counselor
When To Talk To
A Professional Counselor

• Emotions feel unwieldy

• Use of drugs/alcohol to cope
• Reckless behavior
• Decrease in work performance
• Interpersonal difficulties
• Disrupted sleep and appetite patterns
• Suicidal thoughts

10

Any of these experiences may signal the need for the help a professional counselor
can provide.

• Emotional mood swings

• Angry outbursts
• Prolonged crying or weeping
• Using drugs or alcohol to cope
• Reckless behavior
• Anxiety or panic
• Inconsistent work performance
• Interpersonal difficulties
• Withdrawal
• Low energy or chronic fatigue
• Change in sleep patterns
• Diminished or increased appetite
• Feelings of despair or hopelessness
• Diminished capacity for pleasure
• Suicidal thoughts

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 Further Reading and
Additional Resources
Books
Basco, Monica Ramirez. Never Good Enough: Freeing Yourself From the Chains of
Perfection. Simon & Schuster, 1999.
Benson, Herbert; Klipper, Miriam Z. (Contributor). The Relaxation Response. Wholecare,
2000
Carlson, Richard. Don’t Sweat the Small Stuff—And It’s all Small Stuff. Hyperion, 1997
Conte, Yvonne Francine. Serious Laughter: Live a Happier, Healthier, More Productive
Life. Amsterdam-Berwick Publishing, 1998
Copeland, Mary Ellen. The Worry Control Workbook. New Harbinger Pubns, 1998
Crum, Albert. The 10-Step Method of Stress Relief: Decoding the Meaning and Significance
of Stress. CRC Pr, 2000
Cunningham, J. Barton. The Stress Management Sourcebook. Lowell House, 2000
Davis, Martha; Eshelman, Elizabeth Robbins; McKay, Matthew. The Relaxation and Stress
Reduction Workbook. Fifth Edition, California: New Harbinger Publications, 2000
Girdano, Daniel A.; Dusek, Dorothy; Everly, George S. Controlling Stress and Tension.
Allyn & Bacon, 2000
Heller, Barbara L. 365 Ways to Relax Mind, Body & Soul. Storey Books, 2000
Kundtz, David. Stopping: How to Be Still When You Have to Keep Going. Conari Pr 1998.
Kindred, Teresa B. the Knot at the End of Your Rope. Harold Shaw Pub., 1999
Lee,, David. How to Thrive in a High
g Stress
S World. 1999
W
McGuigan, F.J. Encyclopedia of Stress. Allyn & Bacon, 1998
Olivier, Suzannah. Stress Protection Plan. Collins & Brown, 2000
Sapolsky, Robert. Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress-related
Disease and Coping. W. H. Freeman & Co., 1998.
Seaward, Brian Luke. Stressed is Desserts Spelled Backwards. Conari Pr, 1999
Selye H.
Selye, H Stress Without Distress
Distress. Philadelphia,
Philadelphia PA: JJ. B
B. Lippincott
Lippincott, 1984
Sobel, David S. and Ornstein, Robert. The Healthy Mind Healthy Body Handbook. New
York: Time Life Medical, 1996
Tubesing, Donald A. Kicking Your Stress Habits: A Do-It-Yourself Guide for Coping with
Stress. USA: Signet, 1981
Wilson, Paul. Calm at Work. Plume, 1999

Web Sites
Institute of HeartMath, www.heartmath.org
http://www.stress.org/ 20
http://drkoop.com/wellness/mental_health/stress/
 Appendix
A di A
Types of Stress

• Bio-generated stress is most likely when we experience the “fight or flight”

sensation. It’s our body’s reaction to a perceived disagreeable challenge or threat to
our well-being. Fatigue is also a bio-generated stress that may be experienced when
demands exceed our resources or when we take on too much—professionally or
personally.

• Psycho-generated stress is the stress we create within ourselves. Examples include

trying to exercise control over things we have no control over (weather conditions,
bus schedules, other peoples’ lives), making unhealthy life or relationship choices or
choosing to place ourselves in the middle of stressful situations.

• Social-generated stress includes our workplace or living conditions. Neighborhood

concerns impact our home environment; fluorescent lights, noise levels, privacy or
lack of it factor into workplace stress.

• Positive stress, also referred to as eustress, helps with concentration, focus,

pperformance and reachingg peak
p efficiency.
y With positive
p stress we perceive
p situations
as opportunities instead of threats and feel motivated, energized, aware of our options
and challenged. One of the key elements to positive stress is the relaxation response
which allows us to build up the physical and emotional reserves necessary to meet the
next challenge.*

• Negative
g stress,, also referred to as distress,, is staying
y g “geared
g up”
p and the
unwillingness or inability to relax after meeting a stressful challenge. It’s what we
experience when we don’t get what we need or when we feel tense, anxious, angry,
depressed, withdrawn or frustrated. It can damage our health and well-being. *

• Job stress results from high

g jjob demand and minimal control over work.

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*Reprinted with permission of Krames Communication Company, Hugh Byrne, Vice President, 1100 Grundy Lane, San Bruno,
CA, A Guide to Managing Stress
 Appendix
A di B
Common Symptoms
Though we most commonly associate symptoms of stress with physical manifestations,
stress
t actually
t ll impacts
i t us multi-dimensionally.
lti di i ll

Physical Emotional
• Rapid pulse The emotional effects of stress can
• Dry mouth make us edgy, hostile, anti-social,
• Perspiration d
depressed,d angry, ffrustrated
t t d or
bored. It becomes difficult to
• Nervous stomach, stomach cramps
function, we get lethargic and feel
• Nausea defeated; we feel alienated and
• Indigestion, appetite disruption paranoid.
• Constipation, diarrhea • Nervousness
• Pounding heart, chest pains • Anxiety
• Shortness of breath • Depression, sense of despair
• Trembling hands • Boredom
• Headaches; migraines • Apathy
• Clenching the jaw, gritting teeth • Moodiness
• Chills, increased susceptibility to colds • Feelings of inadequacy or failure
• Cold
C ld hands
h d or feet
f t • Irritability, impatience
• Flushed face • Easy to anger, hostility
• Hives • Lack of humor
• Muscle pain; aches and pains without • Attitude change from positive to
apparent cause negative; easily demoralized
• Skin disorders • Feelings
g of ppowerlessness
• Fatigue • Heightened worry or fear response
• Lower back pain • Increased or intense emotional
• Difficulty sleeping expression
• Hypertension

22
 Appendix
A di B
Common Symptoms (Continued)

Mental Social
The changes that take place in the brain as • Increased isolation or alienation
a result of the stress response interferes • Disrupted relationships
with higher functioning ability, i.e. the • Increased vulnerability to hurt
ability to think, reason, evaluate and make feelings or resentment
choices. • Lowered trust
• Problems with memory
• Inability to concentrate
• Inability to maintain an accurate Behavior
perspective; pessimistic view of life • Increased hyperactive gestures or
• Increased errors in judgment movements
• Inability to think clearly • Increase in chemical use
• Reduced analytical ability • Aggressive behavior
• Slowing down of thought processes • Increase in impulsive or reckless
• Mental blocks behavior

Spiritual
• Sense of hopelessness
• Meaninglessness
• Emptiness
• Distrust or abandonment of spiritual beliefs
• Reduced confidence
• Lack of connectedness

23
 Appendix
A di C
The Work/Relaxation Pattern

Our bodies alternate between resting and activity. If we dissect a normal work day with
its regular built-in coffee and lunch breaks, we can see a regular work and relaxation
pattern emerge. If we don’t pay attention to that pattern, our bodies and minds will force
a break through fatigue, inability to concentrate or focus, increased errors, urges to
socialize with co-workers and the need for movement. If we observe this pattern, we may
find restlessness set in every couple of hours.
hours We may be able to periodically push
ourselves beyond the normal work/relaxation pattern; however, at some point our work
mode will collapse and force us to take a relaxation break.

24
 Appendix D
St
Stress B
Busters:
t
Ten Ways to Reduce Your Stress

1. Focus on one task at a time.

2 Set limits when you need to.

2. to

3. Allow extra time for tasks and appointments.

4. Get help with jobs you dislike.

5. Set realistic expectations for yourself.

6. Find enjoyable ways to exercise.

7. Express your feelings.

8. Schedule more fun and breaks into your day.

9. Practice deep breathing.

10. Laughh as often

f as you can.

25
 Appendix
A di E
Five Ways to Relax

There are five simple things you can do to get instant relief from tension:

1) Pause: Pausing changes the state you're in. It assists you in breaking the tension.
Preoccupation with a problem locks you into a process that reinforces your tension;
pausing unlocks the process.

2)) Breathe: Concentrate on breathingg slowly

y and deeply.
p y When yyou breathe,, focus on
the four phases of deep breathing:
• Feel yourself inhale
• Feel yourself pause
• Feel yourself exhale
• Feel yourself pause again

Next practice belly breathing. Sitting in a chair, put your hands on your belly. As you
inhale, note whether your belly is rising or falling. It should be rising but often it isn't
because, when you're tense, you may tighten your stomach muscles. Relax your
muscles and continue monitoring your breathing for at least a minute, feeling the rise
and fall of your belly.

3)) Move: Stretching,

hi walking
lki andd even yawning—all
i ll these
h help
h l reduce
d tension.
i

4) Take a break: The very best thing you can do when tense is to take a break. While
you're on a break, check for tension spots in your body:
- Eyebrows arched? -Squinting?
- Teeth clenched? - Staring?
- Neckk tight?
i h - Stomachh tight?
i h
- Shoulders hunched? - Chest muscles constricted?
- Biting the inside of your mouth?

5) Progressive Relaxation: Start at the top of your head and proceed to your toes,
focusing on each body part. Tense each part, holding for a count of three; relax for a
count of three.
three Practice deep breathing throughout the exercise
exercise. This can be done
several times throughout the day.

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