Mental, emotional, and behavioral symptoms of stress include decreased concentration and memory, indecisiveness, anxiety, depression, irritability, and changes in eating and sleeping. Common causes of stress include life events, daily hassles, unrealistic expectations, negative thinking, and conflicting beliefs with others. Beliefs can lead to stressful behaviors if they promote overwork, neglect of self-care, or inability to delegate responsibilities. Changing one's thinking, managing expectations, addressing situations causing stress, relaxation, social support, and professional help can all help reduce stress.

1. What are Common Psychological
Symptoms of Stress?
• Mental: decrease in concentration
& memory, indecisiveness, mind
racing or going blank, confusion,
loss of sense of humor.
• Emotional: anxiety, nervousness,
depression, anger, frustration,
worry, fear, irritability, impatience,
short temper.
• Behavioral: pacing, fidgeting,
nervous habits (nail-biting, foottapping), increased eating,
smoking, drinking, crying, yelling,
swearing, blaming, throwing
things, hitting.

2. What are Common
Causes of Stress?
External stressors or triggers:
• Physical environment: noise, bright lights, heat,
• confined spaces.
• Social / interaction w/ people: rudeness, bossiness
• or aggressiveness on the part of someone else.
• Organizational: rules, regulations, "red tape," deadlines.
• Major life events: death of a relative, lost job, promotion,
• new baby.
• Daily hassles: commuting, misplacing keys, mechanical breakdowns.
Internal (self-generated) stressors:
• Lifestyle choices: caffeine, not enough sleep, overloaded
schedule.
• Negative self-talk: pessimistic thinking, self-criticism,
over-analyzing.
• Mind traps: unrealistic expectations, taking things personally,
all-or-nothing thinking, exaggerating, rigid thinking.
• Stressful personality traits: Type A, perfectionist, workaholic,
people-pleaser.

3. Stress Can Result from
Beliefs / Value Systems
• We hold thousands of premises & assumptions to be the true :
o "You can't fight City Hall."
o "The customer is always right."
o "Men shouldn't show their emotions."
o "Children should make their beds."
• We have many unconscious beliefs about how things are, how people should behave,
& about ourselves .
• When unaware of our unconscious beliefs - give them more power over our
emotions & our lives.
• When we are aware of them – we can make conscientious choices.

4. Beliefs Can Lead to
Stressful Behavior
• Some beliefs lead to lots of effort &
decreased relaxation & self-care:
o Work should come before pleasure
Work harder & have less leisure time.
o People should meet the needs of others
before they meet their own 
Neglect yourself to some extent.
o If you want something done right, have to do
it yourself  Don’t delegate & get overloaded.
• Uncover unconscious assumptions behind our
actions that prevent us from decreasing stress 
so we can change our behavior.

5. When Beliefs Conflict with
Those of Other People = Stress
• Most assumptions & preferences are not truth but opinions.
• May want to revise beliefs or admit that beliefs held by others
person may be just as valid.
• When beliefs conflict – can agree to disagree.
• Choose your battles wisely & compromise.
• Be willing to lose the battle in order to win the war!
• Beliefs ≠ Behaviors / Choices.

6. Change Your Thinking to
Reduce Stress
• Look at things in more
balanced way - more positively.
• See problems as opportunities.
• Refute negative thoughts.
• Put things in perspective –
Look at the big picture.
o How important will this be in
one week, a month, or a year
from now?
• Let go of things that you have
no control over.
• Focus on the things you can do
something about.
• Keep a sense of humor.

7. Reframing Our Thoughts
• The age-old question: Is the glass half
empty or half full?
• The answer: both or either, depending on
your point of view.
• If you see the glass as half full, it will feel
better than seeing it as half empty.
• There are many ways to interpret the same situation
& there is more than one meaning to the same reality
 Might as well pick the one you like.
• The way we feel almost always results from the way we think.
• Change the way you look at things in order to feel better
about them.
• See the positives in a negative or challenging situation.
• Focus on what is right vs. what is wrong.

8. Reframing Other Peoples’ Behavior
• How do we attempt to understand the behavior of other
people?
• Ask Yourself: Why you think people do what they do?
• For example, Joe’s boss was acting critical & domineering
towards him. What are some possible explanations for the
boss’s behavior?:
o He is probably insecure.
o He is under a lot of pressure.
o He is having personal problems.
• Step outside yourself to look at other possible interpretations
of others’ behavior.
• Others behaviors feels less personal  Decreases upset.
• May feel more compassion than anger for the person who is
bothering you.
•Reframing does not change the external reality.
•Can still acknowledge the validity of the initially stressful
interpretation.
•Can view things differently & therefore, less stressfully.

9. Having Realistic Expectations to
Minimize Stress
• A common source of stress is unrealistic or unmet expectations.
• When expectations are realistic :
o Life feels more predictable & more manageable.
o Can plan & prepare yourself (physically and psychologically)
 Feel more in control.
For example: If you know in advance when you have to work
overtime or stay late, take it more in stride than when it is
dropped on you at the last minute.
• Unrealistic expectations can put unnecessary pressure on
you to feel something you do not feel.
For example: Jason berated himself & felt guilty because he did
not love his stepdaughter as much as his own biologic
children. Where did he get the idea that he would love his
second wife's children as if they were his own?
• Managing expectations of others  Expect less from people
who cannot give you what you want. It makes it easier - not
great, just less upsetting.

10. Change Stressful Situations to
Reduce Stress
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Leave the situation or work toward leaving.
Time and money management.
Problem-solving.
Assertive communication.
Express how you feel in a thoughtful, tactful way.
Talk about your needs & concerns to reduce stress & negative
feelings.
Learn to say no or “I’d love to help but I cannot lend you money,
help you move, stay late at work tonight. etc”
Prioritize life now.
What are your top 5 priorities?
Rank them in order of importance.
When overwhelmed or stressed, revisit these.
Simplify life.
What do you put up with or take on that can be eliminated?

11. Use Time-outs to Reduce Stress
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Take time-out (anything from a short walk to a vacation).
Get away from the things that are bothering you – at least temporarily.
Give yourself a break = a chance for stress levels to decrease.
Return to deal with issues feeling more rested & in better frame of mind.
A mid-morning break, lunch, a mid-afternoon break & dinner divide the day into
roughly two hour segments.
Includes power naps, meditation, daydreaming, a social interlude, a short walk, a
refreshment break, a change to low-concentration tasks or listening to music.
Can be inconvenient to take time-outs but a good investment of time that pays itself
back quickly  increased productivity & reduced stress.

12. Time Outs – Start with Pacing
• Pacing has two components:
1) Monitoring your stress and
energy level.
2) Pacing yourself accordingly.
• Keys - awareness & vigilance
• Know when to extend
yourself & when to ease
up.
• Act on information your
body gives you.
• Monitor where you are on
human function curve on a
daily basis & take
appropriate action (either
speed up or slow down).

13. The Key To Pacing Ourselves –
Periodic Healing Breaks
• Too many people go far too long without breaks.
• We need a short recess every couple of hours throughout the day.
• We have cycles through the day w/ peaks of energy & concentration
interspersed w/ troughs of low energy & inefficiency.
• Watch for these troughs & take 20 minute "ultradian healing breaks“
versus working through them & building up stress.

14. Work – Leisure Balance
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Leisure time & levels of distress are inversely
proportional - the less leisure, the more stress.
We can chart work / leisure ratio.
Chart time (excluding sleep time) in four compartments: work, family,
community and self.
What % of time & energy in an average week goes into each part?
No “normal” range but likely to be off balance when work is over 60%
&/or when self is less than 10%.
• We all require time to meet our own needs (self-care, self-nurturing, etc.)
• Self directed activities include exercise, recreation, relaxation, socializing, entertainment &
hobbies.
• “Leisure” is derived from the Latin word licere which means "permission."
• Main reason so many people do not have enough leisure is that they
are not giving themselves permission to make the time to enjoy it.
• It is not selfish to engage in leisure, some is essential for stress
management.

15. Relaxation Techniques to
Master Stress
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Inherent ability to put our bodies into a state of deep
relaxation - "the relaxation response"
Neutralize stress energy producing a calming effect.
Physiologic events in the stress reaction are reversed:
Pulse slows, blood pressure falls, breathing slows &
muscles relax.
Brought forth by intention – Requires behavior change.
Ways to generate this state: sitting quietly by a lake or
fireplace, gently petting the family cat, lying on a hammock,
taking a hot bath.
We can learn and practice specific relaxation skills:
Paced Respiration
Meditation & Self-Hypnosis
Guided imagery & Visualization
Progressive Muscle Relaxation

16. Develop a Strong Support System
• Ask for help right away!
• “A problem shared, is a problem halved.”
• Support from family, friends, & community
impacts how stress is experienced.
• A strong network of family friends 
managing stress better & a healthier life.
• Surround yourself with people who are
positive, encouragers, caring,
empathic, & trust-worthy.
• Lean on family, friends, coworkers, or
associates through hobbies or other
interests.

17. Tap into Community Resources
to Strengthen Support System
• Pastoral counseling or a
member of the clergy.
• Employee assistance
program (EAP) at work .
• Support groups – helpful if
stress caused by a specific
situation.
For example: caregiver for
someone who is elderly or
has a chronic illness.

18. Getting Professional Support
Professional counseling :
•Release heavy & unnecessary unburdens
•Safe place to be heard & validated
•Ventilate & express emotions
•Trusted & empathic listener
•Private & Confidential
Cognitive Behavioral Therapy:
•Learn to be aware of how you perceive stress
•Understand that the way you think about stress
affects your response to it
•Create and use skills to deal with stress
•Individualized assistance w/ problem-solving