Stress Reduction


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  • Today we will talk about stress- something we all feel from time to time and don’t really want to have much to do with. We’ll go over a bit about the risks of excessive stress, treating excessive stress, and what to do about it personally.
  • Stress Reduction

    1. 1. Less Stress Please…... Richard Harvey, Ph.D . VA National Center for Health Promotion and Disease Prevention (NCP)
    2. 2. Stress is Risky Stress is the “Hidden” risk factor
    3. 3. Stress as a “hidden” risk factor <ul><li>It may or may not be an independent risk factor; may co-vary with smoking, unhealthy diet, sedentary lifestyle. </li></ul><ul><li>Stress is often associated with exacerbation of disease states rather than being the primary etiology. </li></ul>
    4. 4. Stress as a “hidden” risk factor <ul><li>Patients don’t often complain about stress until it reaches crisis levels; it may be socially frowned upon and may imply personal weakness. </li></ul><ul><li>Physicians may not get as much training on stress as a risk factor as other behaviors. </li></ul>
    5. 5. Stress as a “hidden” risk factor <ul><li>Stress is transitory </li></ul><ul><li>Stress is not easily measured; it is “hidden” because you can’t see it </li></ul><ul><li>“ Objective” psychological assessment takes time </li></ul>
    6. 6. Treatment of Stress Problems <ul><li>Physical Methods: </li></ul><ul><ul><li>Medications- antidepressants & anxiolytics </li></ul></ul><ul><ul><li>Relaxation training/Meditation/hypnosis </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Nutrition </li></ul></ul><ul><ul><li>Rest/sleep hygiene </li></ul></ul><ul><ul><li>Massage </li></ul></ul>
    7. 7. Treatment of Stress Problems <ul><li>Cognitive Methods: </li></ul><ul><ul><li>“ Cognitive restructuring” </li></ul></ul><ul><ul><li>Systematic desensitization </li></ul></ul><ul><ul><li>Stress innoculation </li></ul></ul><ul><ul><li>Flooding </li></ul></ul>
    8. 8. Treatment of Stress Problems <ul><li>Behavioral skill training: </li></ul><ul><ul><li>Assertive skills, social skills </li></ul></ul><ul><ul><li>Problem solving skills </li></ul></ul><ul><ul><li>Time management skills </li></ul></ul><ul><ul><li>Pleasuring skills </li></ul></ul>
    9. 9. Treatment of Stress Problems <ul><li>Miscellaneous methods: </li></ul><ul><ul><li>Arranging for getting some help with caretaking duties, financial problems, etc. </li></ul></ul><ul><ul><li>Changing one’s situation (e.g., leaving one’s job, divorce, getting away for a while, etc.) </li></ul></ul>
    10. 10. STRESS - UGH! Don’t Want it, Don’t Need it! <ul><li>Life is just too short for this. </li></ul><ul><li>“ God only gives us one thing, and that is time….. It is how we spend that time, with whom we spend that time, and how we share that time that makes life worth living.” </li></ul><ul><li>“ Whatever you do, do it with a sense of joy…” </li></ul><ul><li>From the film “Dimensions” </li></ul>
    11. 11. Five Critical Stress Skills <ul><li>Thought control skills </li></ul><ul><li>Relaxation Skills </li></ul><ul><li>Assertiveness skills </li></ul><ul><li>Pleasuring skills </li></ul><ul><li>Time management skills </li></ul>
    12. 12. What Can We Do about Stress? <ul><li>“ KNOW THINE ENEMY!” </li></ul><ul><li>Monitor yourself with the </li></ul><ul><li>“ Stress-o-meter”. Be aware of your stress level on a scale of 1-10. </li></ul>
    13. 13. What Can We Do about Stress? (Cont.) <ul><li>Take internal control of your thinking. Get rid of “ Stinking Thinking ”! </li></ul><ul><li>Recognize that you always have a choice about what to think. You are the only one that has control of your mind! </li></ul>
    14. 14. What Can We Do about Stress? (Cont.) <ul><li>Identify your negative, exaggerated, over-reactive, unrealistic, and self-defeating thoughts. Ask yourself “ Exactly WHAT am I thinking?”. </li></ul><ul><li>Ask yourself “How realistic, sensible, accurate, and helpful are these thoughts?”. </li></ul>
    15. 15. What Can We Do about Stress? (Cont.) <ul><li>Ask yourself “What evidence do I have for this thought?” </li></ul><ul><li>Ask yourself “Am I just making this up?” </li></ul><ul><li>Ask yourself “Is this thinking good for me?” </li></ul>
    16. 16. What Can We Do about Stress? (Cont.) <ul><li>Recognize the error in your thinking. </li></ul><ul><li>Make yourself substitute sensible, realistic, accurate, and positive thoughts in their place. Do this again and again, as often as needed! </li></ul>
    17. 17. Examples of sensible, positive thoughts <ul><li>“ If I allow myself to feel stressed, its ME who suffers! So hey, drop it….” </li></ul><ul><li>“ I don’t have to like everything that happens- I just have to get through it. I can get through this.” </li></ul>
    18. 18. Examples of sensible, positive thoughts <ul><li>“ I am going to keep my dignity…., not make a fool of myself”. </li></ul><ul><li>“ Nobody promised that life would be fair”. </li></ul><ul><li>“ I CHOOSE to live each day to the fullest and enjoy that day”. </li></ul>
    19. 19. Examples of sensible, positive thoughts <ul><li>“ I CANNOT CONTROL other people’s behavior! I just have to deal with my own reactions…” </li></ul><ul><li>“ My life is too short for this”. </li></ul><ul><li>Think The Serenity Prayer. </li></ul>
    20. 20. What Can We Do about Stress? (Cont.) <ul><li>Instead of beating yourself about mistakes, vow to learn from them. </li></ul><ul><li>Believe that “life is what I make it”. </li></ul><ul><li>Act accordingly. </li></ul>
    21. 21. What Can We Do about Stress? (Cont.) <ul><li>Do not “SHOULD” on yourself, or others. </li></ul><ul><li>Avoid “Awfulizing”. </li></ul><ul><li>Strive to have a positive optimistic attitude! </li></ul>
    22. 22. What Can We Do about Stress? (Cont.) <ul><li>Use “Calming Thoughts”. E.G., “I am at peace with myself and the world around me”, or “My mind is quiet and still”. </li></ul><ul><li>Use “Self-Instructions” like “Slow down, just relax”, “breathe slowly”, or “Just forget it”. </li></ul>
    23. 23. What Can We Do about Stress? (Cont.) <ul><li>Use “Mental Rehearsal”. </li></ul><ul><li>Find things to laugh about. Be with people who laugh! Read humorous books, rent funny videos….”laughter is the best medicine”. </li></ul>
    24. 24. What Can We Do about Stress? (Cont.) <ul><li>EXERCISE ! EXERCISE ! EXERCISE ! </li></ul><ul><li>Get enough rest…. </li></ul><ul><li>Eat a healthy low fat, high fiber diet. </li></ul><ul><li>Have someone give you a massage. </li></ul>
    25. 25. What Can We Do about Stress? (Cont.) <ul><li>Take a hot bath or shower when feeling stressed. </li></ul><ul><li>Take a few slow, deep breaths. </li></ul><ul><li>“ Put on a happy face” “Fake it ‘til you make it!” </li></ul>
    26. 26. What Can We Do about Stress? (Cont.) <ul><li>Escape from stressful situations for a while. Take a break! </li></ul><ul><li>Have some quiet time for yourself each day. </li></ul><ul><li>Learn the relaxation response and practice it daily. </li></ul>
    27. 27. What Can We Do about Stress? (Cont.) <ul><li>Act assertively. Speak your mind- respectfully, with your thoughts, feelings, ideas, beliefs, needs, and wants. </li></ul><ul><li>Talk with someone you respect about your worries and concerns- do not hold all that inside. </li></ul>
    28. 28. What Can We Do about Stress? (Cont.) <ul><li>Make SURE you plan time to do things you enjoy. Have a “passion”. Put lots of PLEASURE into your daily life! </li></ul><ul><ul><li>Plan pleasurable experiences. </li></ul></ul><ul><ul><li>Become acutely aware of numerous small daily pleasures. “Stop & smell the roses”. </li></ul></ul>
    29. 29. What Can We Do about Stress? (Cont.) <ul><li>Listen to music. </li></ul><ul><li>Write out what you are thinking and feeling. Make a “stress diary”. </li></ul><ul><li>Pray, if that helps you feel relief. </li></ul>
    30. 30. What Can We Do about Stress? (Cont.) <ul><li>Write out a daily priority list of things you want/need to do. </li></ul><ul><li>Write out a plan each day for your time. </li></ul><ul><li>Plan ahead to avoid stress about being late by allowing more time than you expect to need. </li></ul>
    31. 31. What Can We Do about Stress? (Cont.) <ul><li>Break big tasks into little ones. </li></ul><ul><li>Get started with stuff! Do not procrastinate and let things pile up on you.. </li></ul>
    32. 32. Is There More We can Do about Reducing Stress? YES...
    33. 33. The Relaxation Response
    34. 34. The Relaxation Response <ul><li>Has no doubt been a part of human experience since the beginning of time. </li></ul><ul><li>Was first written about by Dr. Edmund Jacobson in 1938 (Jacobson, Progressive Relaxation, 1938) </li></ul><ul><li>Was popularized through research and writing by Dr. Herbert Benson from Harvard in 1976 (Benson, The Relaxation Response, 1976) </li></ul>
    35. 35. The Relaxation Response <ul><li>The “relaxation response” is very simply a state of reduced autonomic (sympathetic) arousal. </li></ul><ul><li>Blood pressure, heart rate, muscle tension, etc. all attenuate during relaxation. </li></ul>
    36. 36. The Relaxation Response <ul><li>It is probably a useful technique for dealing with all stress-mediated physiological and psychological problems. </li></ul><ul><li>Among those problems where relaxation has been shown to have effectiveness are: </li></ul>
    37. 37. The Relaxation Response <ul><li>Tension headache </li></ul><ul><li>Migraine headache </li></ul><ul><li>Mild hypertension </li></ul><ul><li>Insomnia </li></ul>
    38. 38. The Relaxation Response <ul><li>Chronic pain </li></ul><ul><li>Irritable bowel syndrome </li></ul><ul><li>Performance anxiety </li></ul><ul><li>Other anxiety disorders </li></ul><ul><li>(From Goldberger & Brenitz, Handbook of Stress, 1993) </li></ul>
    39. 39. Various Methods to Induce Relaxation <ul><li>Progressive muscle relaxation </li></ul><ul><li>Biofeedback, of various sorts </li></ul><ul><li>Hypnosis </li></ul><ul><li>Yoga </li></ul><ul><li>Meditation </li></ul>
    40. 40. Let’s Relax <ul><li>So now….. </li></ul><ul><li>Sit back, get comfortable, let go….. </li></ul><ul><li>And RELAX……. </li></ul>
    41. 41. That is All Go in Peace...