Understand stress on time and save yourself---its your life and its in your own hands--make and keep it healthy & happy forever! Save this presentation for yourself and study & practice it when you are stressed! All the best!

1. Stress Management
Presented by:
Mangal Kardile
Clinical Psychology
Advocacy - Mental Health Law & Human Rights

2. What is stress
• Defining Stress – Positive & Negative aspects
• Stress factors (social/personal)
• Reaction to Stress
• Stress phases
• Stress – Psychological & Physical problems
• Coping with stress
• Managing stress – various guidelines
(self regulated or training)

3. Defining Stress – Positive & Negative
aspects
• Stress in the biological sense cannot be
eliminated
- Positivity- Without it, the process of life would
cease, for the absence of stress means death
- Negativity- What needs to be avoided is
unnecessary and noxious stress
• The relevant questions are: How great is it? Is
it appropriate to the needs of the situation?

4. Defining Stress – Positive & Negative
aspects
• Stress in control - stress becomes the spice of
life, a challenge instead of a threat
• When we lack this crucial sense of control,
stress can spell crisis — bad news for us, our
health, and our community
• Our decision latitude, our influence over
various aspects of our own lives, is a strong
determinant of whether stress becomes a
spice of life or a kiss of death

5. Stress factors
• Social factors (Community/TV/Networking)
• Environmental (Earthquake/Flood/Terrorist
attack/Trauma)
• Small group factors (Family/work environment)
• Relational factors-Interpersonal
• Internal factors- Health/Finance/Family
- Age factor-
• Childhood, Adolescence, Adult, Elder Adult

6. Stress factors- Personality
• Ego – comparison/Prejudice/over-expectations
- Superiority/Inferiority/competency
Challenges/Goal achievement
• Defense/Offence/Denial
• Unemployment/Business loss/Addiction
• Disaster/Abuse (Physical/Emotional loss)
• Loss of beloved person
• Emergency/Suicide/Murder

7. Type of personality
A + B = balanced personality

8. How stress develops
• When we are exposed to stressors — such as a
lack of control over our lives combined with
excessive demands, unsatisfied needs,
unfulfilled expectations, overstimulation,
under-stimulation, or role conflicts
• most of us experience emotional reactions -
such as anxiety, depression, uneasiness,
apathy, alienation, and hypochondriasis.

9. Reactions to Stress
• Stress also causes behavioral reactions
• Some of us start smoking or overeating
• We seek comfort in alcohol or take unnecessary
risks at work or in traffic
• Aggressive, violent, or other types of antisocial
behavior
• Many commit suicide — or try to
- Many of these reactions lead to disease and
premature death

10. Reactions to Stress
• We also react physiologically
• Example - the employee who has been unjustly
criticized by his or her supervisor
- employee’s typical reactions - increased blood
pressure, increased or irregular heart rate,
muscular tension with subsequent pain in the
neck, head, and shoulders, dryness of throat and
mouth, and overproduction of acid gastric juice
- When long-lasting, intensive, or frequently
recurring, some of these reactions can lead to -
hypertension, myocardial infarction, or stroke

11. Stress curve (Dr. Selye)

12. Stress- Phase 1
Stress hormones elevated (fight or flight)
Blood flow increases
Heart rate speeds up
Digestion slows
Muscle tense
The Alarm Phase

13. Stress- Phase 2
Physiological responses continue
Body attempts to resist or cope
Body vulnerable to other stressors
Annoyed by minor frustrations
Eventually adopt & return to normal
The Resistance phase

14. Stress- Phase 3
Persistent stress depletes energy
Increases vulnerability to physical problems
Body becomes unhealthy as long-range responses
Tense muscles – headache, neck pain
Increased blood pressure - chronic hypertension
Digestive process shut down – digestive disorders
The Exhaustion phase

15. Psycho-physiology - Stress

16. Stress – Psycho-neuro-immunology
• White blood cells-recognize Foreign & harmful bodies
(antigen)
• T cells – helper cells regulate immune response
• B cells - destroy the invading viruses and bacteria
• When we’re stressed, the immune system’s ability to
fight off antigens is reduced
• The stress hormone corticosteroid can suppress the
effectiveness of the immune system (e.g. lowers the
number of lymphocytes)
• That is why we are more susceptible to infections

17. Coping with Stress
- Much depends not only on what we are exposed to but
also on how we cope with the situation
• We can change our environment/share concerns
• we can flee from our problems/examine consequences
• we can ask for help/alter situations
• we can accept things as they are/redefine situations
• by changing our appraisal of our environment (denial)
• Our ability to use humor to defuse situation
- Whatever our choice, it influences our stress reactions

18. Stress - positive aspects
• Positivity- Coping
- mean either altering the situation or (without
doing this) altering one’s perception of, or
adaptation to the situation
Negative or positive -
- Both approaches affect health and well-being
- Psychological health = Physical health

19. Stress Management

20. Stress Management
- There are three basic paths to consider:
• 1. Eliminate or modify the stress-producing
situation or remove the individual from it; find
“the right shoe for the right foot,”
• 2. Adjust the shoe — that is, change the social
situation — to fit the individual’s foot
• 3. Strengthen the person’s resilience to stress, for
example, through physical exercise, meditation
and relaxation techniques, and social support

21. Managing stress- Approaches
• Stress management has traditionally focused on
individual approaches, usually by counseling
individuals or small groups on ways to adapt to,
or cope with, various stressors and their
consequences
• Holistic approach - people’s symptoms and
illnesses, their causes and consequences, are
appraised in medical, psychological and social
perspective

22. Releasing stress
• Stressed posture and position - Stretching
(e.g. yoga)
• Stressed muscles - Progressive muscle
relaxation
• Stressed breathing - Breathing exercises
• Stressed body – Biofeedback/Inoculation
• Stressed emotion - Imagery/positive self-talk
• Stressed attention - Meditation/mindfulness

23. R – states (Relaxation)
• 1. Accepting
• 2. At Ease/Peaceful (Mentally Relaxed)
• 3. Aware/Focused/Clear
• 4. Disengaged (feeling distant, indifferent, far away)
• 5. Joyful
• 6. Mystery (experiencing the “deep mystery” of things)
• 7. Optimistic
• 8. Physically Relaxed
• 9. Quiet (mind still, without thought)
• 10. Reverent/Prayerful
• 11. Sleepy
• 12. Timeless/Boundless/Infinite/At One

24. Psychological Relaxation
• R-Beliefs (relaxation beliefs)-
personal philosophies and spiritual perspectives
• R-Attitudes-
Positive – promote relaxation practice
Negative- interfere with practice
- fears about disengagement, relaxation-induced
anxiety, the possibility of losing control, having an
unqualified trainer, and religious or hypnotic
control

25. Psychological Relaxation
- R-Motivations reflect the desire to experience more
(or less) of an R-State
• IRCs (idiosyncratic reality claims) are
irrational/paranormal/supernatural beliefs
that may enhance certain R-States. The list includes
religious influence;
magic (astrology, crystals, new age beliefs, etc.);
communication with the dead;
Miraculous powers of meditation, prayer, and belief; and
space aliens
- N-states (negative states) are aversive distracting
thoughts, feelings, or sensations

26. Physical relaxation- Dr. Jacobson’s research
• To relax the mind and the body, one must relax all
of the skeletal musculature
• Each stressful situation (“stressor”) everyday –
generates consistent, excessive covert tightening
of the skeletal musculature
• overdrives the central nervous system and
increases activity of the autonomic,
cardiovascular, endocrine, and other systems
• Prolonged, heightened skeletal muscle tension
may result in a variety of pathological conditions

27. Neurophysiology of Relaxation
• Tension is the contraction of skeletal muscle fibers that
generates the tension sensation
• Relaxation is the elongation (lengthening) of those fibers,
which then eliminates the tension sensation
• Progressive muscle relaxation- muscular relaxation reduces
proprioceptive input to the hypothalamus, with a resulting
lessening of hypothalamic–cortical and autonomic
discharges
• lessening emotional reactivity during muscular relaxation
reduces proprioceptive impulses to the hypothalamus,
which then decreases excitability of the sympathetic
nervous system.

28. Differential Relaxation
• optimal contraction of only those muscles
required to accomplish a given purpose
• Those and only those muscles should contract,
and
• All other (irrelevant) muscles of the body
should be relaxed
e.g. people can often catch themselves wasting
energy

29. Neuro- muscle relaxation
• Muscular events are present during cognition
E.g. During visual imagery, the eyes are uniquely
active
• Imagining lighting a cigarette produces a distinct
covert response in the active arm
• Heightened speech muscle activity in both
children and adults during silent reading;
• Increased speech muscle activity covertly occurs
while individuals are engaged in cursive
handwriting

30. Developing Emotional Control
• Individuals who are excessively anxious often
continually rehearse their grief, worries,
and difficulties with life
- Using PR- If they can acquire control of the
skeletal muscle tensions that key this internal
speech, they can consequently control their
emotions and other negative mental processes
(A trained person can stop, momentarily relax, and
assess a situation)

31. Hypnosis-viable applicability
- sees a series of simple verbal suggestions that result in
relatively spectacular alterations of behavior, thought,
emotion, and perception
• For example, the hypnotized burnt patient lies quietly and
reports no pain, seemingly relaxing while his or her
dressings are changed (a highly painful procedure)
• irritable bowel syndrome
• anticipatory, consequent side effects of chemotherapy
• for addictive disorders
- After 50 years of modern research, the lack of evidence for
any unique psycho-physiological marker resulted into
clinically abandoning the concept of a hypnotic trance

32. Biofeedback
• teaching voluntary control of various physiological functions by
providing instantaneous “feedback” for variations in physiological
activity
• Feedback usually is given in the form of visual and/ or auditory
signals derived from physiological recording devices
• Most other biofeedback methods are designed to control tonic
levels of various physiological functions (e.g., muscle tension, finger
temperature, heart rate, blood pressure, etc.).
• Significant effects of these methods have been found for reducing
blood pressure,
- although the magnitude and consistency have not been sufficient
for the method to gain widespread acceptance

33. Biofeedback Training for stress disorder

34. Stress Inoculation
• Cognitive – Behavioural approach with added
psychological resilience against the effects of stress
• managed program of successful exposure to stressful
situations
1) The Conceptualization Phase – Learn to conceptualize
and re-conceptualize stress
2) Skills Acquisition & Rehearsal Phase - inc. problem
solving, cog. restructuring & guided self dialogue
3) Application & follow through Phase - staff are
encouraged to write ‘coping contracts’ and undertake
homework for their own wellbeing

35. Respiration- stress relaxation
• Respiration is a rhythmic contraction and expansion of the body, as
a result of which air flows in and out of the lungs
• Respiratory efficiency increases when people breathe at about six
breaths per minute (CPM)
• better tolerance for exercise and altitude, with some advantage to
people who have engaged in long-term practice of yoga
• a method for treatment of stuttering based on the breathing
techniques
• breathing therapy for cardiac rehabilitation
- Hyperventilation???? – smokers should always have trained person.

36. Whole body breathing
• breathing is a sensory motor activity that serves
to provide important feedback to the conscious
individual about his or her state
• the sense of freedom of movement or restriction
in space,
• the sense of tension or relaxation within oneself,
the sense of safety or danger within the
environment
• all have much to do with the quality of internal
feedback

37. Breathing - Stress
• breathing movement largely depend on posture,
on mental state (focused or passive), on
emotional or expressive state and on physical
tension state (energy and ventilation
requirement, nervous tension)
- Thus abdominal breathing, diaphragmatic
breathing, and slow deep breathing are common
practices
• This strategy is quite effective in remaining or
becoming quiet and calm and in reducing stress

38. Breathing therapy
Tension-related problems without specific cause
• Feelings of tension
• Hyperventilation complaints
• Burnout
• Headache
• Chronic fatigue
• Sleeping problems
• Concentration problems

39. Breathing therapy
Psychological problems
• Anxiety and phobia
• Panic disorder
• Depression
Functional problems of musculoskeletal nature and
breathing
• Lower back, shoulder, and neck complaints
• Shortness of breath
• Chronic pain (e.g. repetitive strain injury whiplash)
• Functional voice disorders – e.g. stuttering

40. Breathing therapy
Tension problems with a specific, somatic cause
• Lung disease (e.g. asthma)
• Heart disease
• Neurological disease (e.g. Hemiplegia,
Parkinson disease)
* Tape instructions????—do not just follow tape
instructions- training required at beginning

41. Visual Imagery
- Guided Imagery is a convenient and simple relaxation technique
• Get into a comfortable position as for meditation or self-hypnosis
• opt for a cross-legged position, or recline in a comfortable chair
• Use diaphragmic deep breathing and close your eyes, focusing on
breathing in peace and breathing out stress
• Imagine yourself in a wishful situation (relaxing)
• Try to involve all of your senses. What does it look like? How does it
feel? Make your vision so real you can even taste it!(e.g. sea shore)
• Stay here for as long as you like. Enjoy your ‘surroundings’, and let
yourself be far from what stresses you
• When you’re ready to come back to reality, count back,
• when you get to ‘one’, you’ll feel serene and alert, and enjoy the
rest of your day

42. Exercise therapy
• Exercise therapy (also known as walk/talk
therapy) is the practice of combining a program
of exercise with traditional psychotherapy
• Therapeutically, brisk activity (such as walking
side by side with the client) is helpful in breaking
down barriers and subtly helping clients engage
in difficult topics of conversation
• The walking helps to stimulate both the client
and the therapist to be alert and creative in the
problem-solving process

43. Mindfulness meditation
• also referred to as “insight meditation” or “Vipassana practice,”
contribute to therapeutic growth and personal development
• Although all meditation techniques cultivate the ability to focus and
manage attention,
• mindfulness meditation primarily cultivates an ability to bring a
nonjudgmental sustained awareness to the object of attention (e.g.
breath)
• Not on a word or mantra, as occurs in concentrative meditation
• traditional mindfulness meditation practices, mostly based in
Buddhism
• Western cultures trained in Asian countries - Tibetan meditation
practices on emotional and physical self-regulation (Dalai-Lama)
• Thai Theravadan tradition, Burmese traditions

44. Mindfulness meditation
• involves the cultivation of moment-to-moment, nonjudgmental
awareness of one’s present experience,
• whether narrowly or more broadly focused
• The goal of these practices is to cultivate a stable and nonreactive
awareness of one’s internal (e.g., cognitive–affective–sensory) and
external (social–environmental) experiences
• stable attention and nonjudgmental awareness that mediates the
much wider range of effects, including physical relaxation,
emotional balance, behavioral regulation,
• changes in self-judgment, self-awareness, and relationship to
others
• Improvements in each of these areas of functioning may then
decrease the experience of stress

45. Other resources
• Music therapy
• Yoga therapy
• Eye Movement Desensitization
• Pharmacological treatment

46. • Stress continues to remain………on
the hit list…….

47. Stress- single component
• The amount of physical, psychological, social
destruction

48. Stress world statistics (WHO)
An estimate made in a World Health Organization
- indicates that such “diseases of lifestyle” are the cause
of 70 to 80% of premature deaths in industrialized
countries
- This insight was expressed in three summarizing
sentences about these “modern killers”:
• We are killing ourselves by our own careless habits
• We are killing ourselves by carelessly polluting the
environment
• We are killing ourselves by permitting harmful social
conditions to persist

49. “In the end, it's not the years in your life that
count. It's the life in your years.”
- Abraham Lincoln

50. Thank you