On May 7, 2016, St. Paul's Hospital's Pacific Adult Congenital Heart Disease (PACH) Clinic invited patients and their families to learn more about navigating life as an adult with congenital heart disease. Over 150 participants attended the clinic.

1. Stressed out to chilled Stressed out to chilled
out: tips for managing in out: tips for managing in
a stressful worlda stressful world
Jenni Clark, PhD, DClinPsy
7th May 2016

2. OverviewOverview
• ‘Lowdown’ on stress: what is it and how does it
affect us?
• Introducing the cognitive-behavioural model of
stress
o Thoughts
o Feelings
o Behaviours
• Are there ways of managing that might be more
helpful? How?
• Where to look for more information and support

3. What is stress?What is stress?
• Stress occurs when the demands placed on us by
life threaten to overwhelm our capacity to cope
• ‘Good’ vs ‘bad’ stress
• Short term stress: fight-or-flight response
• Recurrent stress: take less care of physical health,
increase in harmful behaviours
• Long term stress: change in the way you view the
self, world and others

5. Jane walks past you in the street.
Feelings
entertained,
mildly irritated
Feelings
sympathy,
gratitude, worry
Body
calm, relaxed
Behaviour (reaction)
Get on with your day
Give Jane a ring later
Thought
“Jane’s really in a hurry. She
looks like she has a lot on her
mind”
Thought
“Look at that, Jane’s forgotten
her glasses again!”

6. Jane walks past you in the street.
Feelings
angry,
irritated,
indignant
Feelings
sad, anxious,
stressed
Body
tired, exhausted
wired or ‘on edge’
Behaviour (reaction)
Cancel plans for this
evening
Send Jane an angry
message
Thought
“I’ve upset Jane and now she won’t talk to
me”
“What did I do? I always get it wrong”
“I’m a terrible friend”
“Nobody likes me”
Thought
“Who does she think she is, ignoring
me?”
“I’m sick of people treating me badly”

7. Do you take better care of yourself or your Do you take better care of yourself or your
car?car?

8. Back to basics: self care 101Back to basics: self care 101
• Eating well (fuel to function)
• Getting good enough sleep (alert and rested)
• Taking regular exercise (lifts mood, reduce tension
and build stamina)
• Making time for relaxation
o Activity you enjoy e.g. reading a book, spending time with friends
o Progressive muscle relaxation
o Deep breathing
o Guided imagery

9. ShortShort‐‐sighted coping strategiessighted coping strategies
Sometimes we all do things that are actively unhelpful,
or at best short-sighted
•Saying yes because it’s easier than saying no
•Procrastination
•Indulging unhealthy habits
Develop new ‘stress-busting’ habits
•Just say no!
•Problem solving skills
•Take care of yourself in times of stress more than ever

10. Changing perspectiveChanging perspective
• Thoughts are just thoughts
• They are not facts and we shouldn’t treat them as
such
• Mindfulness meditation
o focused on present moment
o non-judgemental stance
towards thoughts
o observing and accepting

11. CognitiveCognitive ‘‘restructuringrestructuring’’

12. Cognitive restructuringCognitive restructuring
• More analytical, challenging the unbalanced
perspective
o Will this bother me in one hour, tomorrow or next week?
o What’s the worst possible outcome? The best? The most
likely?
o What would I tell a friend or loved one who had this
thought? What would they tell me?
o When I’m not so bothered by this, do I see it differently?
How so?
o Am I being critical of myself? Is that helpful?
• Is there a more balanced perspective to take on
this situation? How does that make me feel?

13. ResourcesResources
Apps
•Buddhify: short meditations for a variety of situations
•Headspace: learn to meditate in 10mins per day
•Take a break: work break and stress relief guided mediations
(free download)
Websites
http://www.helpguide.org/articles/stress/stress-management.htm
http://www.heretohelp.bc.ca/wellness-modules
Workbooks
Positive coping with health conditions: a self care workbook
http://www.comh.ca/pchc/ (also links to relaxation audio)

14. Resources cont.Resources cont.
• We are here to support your psychological as well
as physical wellbeing
• Can consult with nursing staff if problems are
becoming longer term, or feel overwhelming
• PACH clinic psychologist may be able to offer an
assessment to help us work out how best to support
you

15. Questions?Questions?
jclark@providencehealth.bc.cajclark@providencehealth.bc.ca