Stress Management - Ananda Marga (PDF)

Stress Management: A Review of Principles Presented by:Wesley E. Sime, PhD./MPH./PhD. Professor, Department of Health and Human Performance University of Nebraska Lincoln This document presents the core concepts of stress management education. It originally developed fom the efforts of Kathy Hellweg and Wes Sime. It has been used as the Body of Knowledge for Certification in Stress Management Education. (June '97) Appreciation goes to Tina Carter for incorporating the sound clips. Table of Contents G Conceptual Understanding of Stressors and Stress Responses G Personality, Perception and Sources of Stress Sound Clips Added G The Psychophysiology of Stress and Relaxation Sound Clips Added G The Physiology of Stress and Relaxation G Stress Pathophysiology and Stress-Related Disorders G Lifestyle Behavior Patterns and the Stress Response G Decision Making Under Stress Sound Clips Added  G Social and Environmental Change Strategies G Cognitive and Behavioral Interventions Sound Clips Added G Strategies to Achieve a Relaxation Response G Teaching of Stress Management (Theory and Practice) G Measurement of Stress Reactions and Relaxation Responses G Stress Management Research and Experimental Design G Professional Conduct and Ethical Practices  You are being forwarded to Wes Sime's new web site. The new URL is http://tc.unl.edu/stress Please update you bookmarks accordingly.   Stress -- A Conceptual Understanding 1. Explain the concepts of stress in physiological terms describing arousal. H Excitement -- emotional reactionwhich elevates cognitive and physiological activity levels H Stimuli — Demands upon the system for physical or cognitive productivity. 2. Identify examples of eustress and distress citing Selye's theory. H Eustress = Positive exhilarating challenging experiences of success followed by higher expectations H Distress = Disappointment, failure, threat, embarrassment and other negative experiences 3. Explain the difference between stress management and stress reduction. H Stress Reduction = eliminating the source of stress making changes, taking action. H Stress Management = coping, recovery, re-interpretation, reframing cognitive restructuring. 4. Discriminate between stress, stressor, stress reaction, and strain. H Stress = General concept describing a "load" on the system, usually external, with humans it is internal. H Stressor = a specific problem, issue, challenge, personal conflict (External/internal) H Stress Reaction = an individual response to a given stressor (physiological, behavioral, emotional, cognitive, signs and symptoms) H Strain = the prolonged impact of a the stressor on the system (overload), fatigue, precursor to illness 5. Define the term stress reactivity noting cardiovascular research. H Hot reactor testing reveals unique physiological profiles of heart and vessel responses. H Monitor HR, BP, cardiac output and peripheral resistance during a stress test H Standardized challenge (mental arithmetic, video game) progressively increasing demands and frustrations. H Those at risk show exaggerated responses to a minimum stress load (over-reactive emotionally) H Research on the risk associated with reactivity is marginally supportive ( not all studies show reactivity to be a risk factor) 6. Define the term stress stereotypy as determined by stress profiling H Stress stereotypy: unique individual response pattern comparable to fingerprinting. H Some are vascular responders (Heart rate, Blood pressure, hypertension) H Some are skeletal muscle responders (EMG — measures muscle tension) H Some respond peripherally (cold, sweaty hands). Blushing or blanching too. H Everyone has some variation in proportion of these responses. H Responses may vary according to intensity of stress and due to personal vulnerability 7. Explain the potential benefits of stress management training for the individual. H Learn to recognize and respond to early warning signs of overload and burnout  (headache and fatigue) H Learn new models of effective stress management and pick those right for you ( lifestyle, symptoms) H Become aware of the immediate physical signs of stress (cold, sweaty hands, nervous tense) H Recognize and respond to emotionally distressing events in your life(change exposure if possible) H Learn to recognize speech patterns that reflect "tension"(rapid, accelerating, staccato, couplets) H Develop more efficient and relaxing breathing patterns to reduce tension (abdominal beathing) H Discover ways to use these warning signs as signals to change work or leisure circumstances to reduce stressors 8. Identify realistic goals/benefits of stress management training for organizations. H reduced turnover (loss of valuable employees costs a great deal of time and money to replace) H reduced sick leave, workers compensation and medical costs H increased morale and decreased conflict, dissatisfaction H enhanced performance, reduced errors, mistakes, accidents 9. Explain the limitations of stress management, noting research issues documenting its effectiveness. H no guarantee that health risks are reduced, however many infectious and chronic diseases can be prevented H no guarantee that medical illness can be cured.(spontaneous remission may be related to stress) H no guarantee everyone responds well to training. (personality, background, habits may obviate success) H potential risk of avoiding other psychological issues.(stress symptoms may be early manifestations of more serious psychological problems like anxious depression) 10. History of stress management training.Describe the historical development of stress management training, including the contributions of individuals such as Cannon, Selye, Mason and Lazarus. H Walter Cannon: "Flight-or-Flight" H Hans Selye: "General Adaptation Syndrome" (arousal, resistance, exhaustion) H John Mason: Challenged "Non-Specific" response & Demonstrated unique specific responses to stress H Richard Lazarus: "Appraisal and Coping" (primary and secondary appraisal) 11. Identify physical signs and symptoms of stress, including but not limited to: increased heart rate; pounding heart; elevated blood pressure; sweaty palms; tightness of the chest, neck, jaw and back muscles; headache; diarrhea; constipation; urinary hesitancy; trembling, twitching; stuttering and other speech difficulties; nausea; vomiting; sleep disturbances; fatigue; shallow breathing; dryness of the mouth or throat; susceptibility to minor illness, cold hands, itching; being easily startled; chronic pain and dysponesis.  12. Identify emotional signs and symptoms of stress, including but not limited to:irritability, angry outbursts, hostility, depression, jealously, restlessness, withdrawal, anxiousness, diminished initiative, feelings of unreality or overalertness, reduction of personal involvement with others, lack of interest, tendency to cry, being critical of others, self-deprecation, nightmares, impatience, decreased perception of positive experience opportunities, narrowed focus, obsessive rumination, reduced self-esteem, insomnia, changes in eating habits and weakened positive emotional response reflexes. 13. Identify cognitive/perceptual signs and symptoms of stress, including but not limited to:forgetfulness, preoccupation, blocking, blurred vision, errors in judging distance, diminished or exaggerated fantasy life, reduced creativity, lack of concentration, diminished productivity, lack of attention to detail, orientation to the past, decreased psychomotor reactivity and coordination, attention deficit, disorganization of thought, negative self-esteem, diminished sense of meaning in life, lack of control/need for too much control, negative self-statements and negative evaluation of experiences 14. Identify behavioral signs and symptoms of stress, including but not limited to:increased smoking, aggressive behaviors (such as driving), increased alcohol or drug use, carelessness, under-eating, over-eating, withdrawal, listlessness, hostility, accident-proneness, nervous laughter, compulsive behavior and impatience. 15. Stress vs. mental and/or physical illnessDistinguish between stress symptoms and those symptoms which may indicate serious underlying physical or mental illness requiring referral to appropriate clinical professionals. H Red flags that indicate chronic symptoms (clinical experience needed) H Check whether medical clearance has been obtained (consult your doctor) H Know your limitations as an educator (caution, caution, caution) H Use experience to guide judgment about contra-indications (reasons not to use it) 16. Recognize cultural, age-dependent and gender- dependent factors influencing susceptibility to stress. H Cultural: self-esteem, values, introversion/extroversion H Age-dependent: children's susceptibility, elderly persons at risk H Males: heart disease, stoicism, anger/hostility H Women: cancer, susceptibility to immune system disorders   Personality, Perception and Sources of Stress 1. Explain the role of self-concept in an individual's perception of stress and ability to cope with stressors. H Self-concept H Self-esteem H Self-worth H Self-acceptance H Self-confidence H Self-actualization H Rudiments of perception - values, heritage, previous experience, trauma, family scripts 2. Identify specific components of the Type A behavior pattern which are associated with coronary risk. H aggression H irritation H anger H impatience H hostility 3. Distinguish between Type A and Type B personality patterns via various traits. H fast speech H impatience H competitiveness H hard-driving H achievement-oriented H verbal sparring 4. Explain the concept of locus of control as it relates to stress responses and stress management. H internal-external dominance (independence) H choice and control versus fate and others in control H under stressful circumstances the intensity of response is related to the feeling of control  or lack thereof 5. Explain the concept of learned helplessness as it relates to stress responses and stress management. H Seligman demonstrated a helpless/hopeless syndrome which impairs survival efforts H Learned helplessness - also produces chemical imbalance, depression and the tendency toward self-destructive thoughts and actions 6. Discriminate between assertive, passive, aggressive and passive/aggressive behavior. H Assertive = standing up for legitimate rights H Passive = acquiescing to pressure (implied or real) H Aggressive = to go beyond legitimate rights to get revenge or to get special treatment or take advantage of others H Passive/Aggressive = failing to be assertive in a direct manner and making covert efforts of aggression (sabotaging efforts or withholding customary rewards). 7. Explain the concept of perception as it is used in the interpretation of stressful events. H Keeping things in perspective H What is the worst possible outcome? H Can we look for unexpected benefit during crises H Make lemonade out of lemons 8. Identify and explain how these factors may influence an individual's cognitive appraisal of a stressor: H Past experience(s). H Personality. H Cultural background. H Moral values. H Family background. H Social support network. H Gender. H Life-style. H Personal belief system. 9. Define cognitive appraisal as it relates to the amount of stress perceived.  H Assessment of the situation (immediate need?) H Factor in past experience with similar problem H Determine the potential sequences (worst possible outcome) H Consider problem-solving options (take action) H Make a decision regarding action vs. acceptance 10. List Attitudes that are at high risk for burnout. "High Risk for Burnout" sound clip (aiff format - 1.6 Mg) H Having very high ideals H Always getting impatient/annoyed with others H Feeling only your ideas are RIGHT! H Blaming yourself ("shoulding on yourself") H Having a tendency to always blame others H Feeling like you have to do every job for yourself H Feeling equally upset with minor hassles, etc. vs. something more serious H Feeling you have more and more to do and less and less time to do it in H Accepting social obligations that you know you will not have time for later H Spending more time and energy on trivial tasks while avoiding the more difficult ones 11. Define Stages of Burnout. "Stages of Burnout" sound clip (aiff format - 1.0 Mg) H Stage 1: Early Stress Arousal H Stage 2: Struggle & Resistance H Stage 3: Exhaustion & Breakdown 12. Describe the concept of hardiness as it relates to the perception of a stressful event. 13. Explain how attentional focus and/or level of concentration can distort one's perception of a stressor. H Attentional Focus = visual/auditory monitoring of events, circumstances or internal thoughts H Fully attended focus on a neutral event prevents one from being affected by other stressors H Failing to concentrate fully upon a central topic allows one to over-estimate the impact of a stressor  14. Describe how self-efficacy influences stress response. H Efficacy = capacity to accomplish tasks H Self-efficacy = perceived capability to handle problems, to overcome hardship H Stress is minimal among those who look upon problems as opportunities to overcome adversity and to gain new experience H a crisis can be a challenge or an opportunity for a change to something better (oriental philosophy) 15. Identify the major types of stressors: H Psychological: Attitude, personality, self-esteem, ethnicity H Give an example how one of these caused stress H Physical: Environment, nutrition, drugs/chemicals H Describe a situation where one caused added stress H Role: Role conflict/ambiguity, multiple roles H Describe a situation where one caused added stress H Sociological: Political, economic, ethnic, cultural background Describe a situation in which one of these has influenced your stress level H Physical Illness/Residual Disability: Birth defect/chronic illness H Biomechanical Stressors: Job site design flaw (ie. carpal tunnel syndrome, repetitive motion) H Stages of Human Development: Birth, adolescence, adulthood, maturity, death 16. Explain the concept of secondary stressor. H Indirect effects spin-off from higher order source H Loss of job = shortage of $ = "hand me down" clothes = embarrassed child under stress 17. Describe the impact of change in life events H Disruption of usual pattern of behavior H Anticipation of future problems H Accumulation of several difficult adjustments 18. The role of uncertainty causing stress. H Some individuals have need for control H Uncertainty leaves one feeling "out of control" H Lacking control is a threat to some people 19. Overload and Burnout at Work (Stress Arousal Stage)  H Persistent irritability and anxiety H Bruxism and/or Insomnia H Occasional forgetfulness and/or inability to concentrate 20. Overload and Burnout (Stress Resistance Stage) H Absenteeism or tardiness for work H Tired and fatigued for no reason H Procrastination and indecision H Social withdrawal with cynicism H Resentful, indifferent, defiant H Increased use of coffee, alcohol, tobacco, etc. 21. Overload and Burnout (Severe Exhaustion Stage) H Chronic sadness or depression H Chronic mental and physical fatigue H Chronic stress related illnesses (headache, stomach ache, bowel problems, etc.) H Isolation, withdrawal, self-destructive thoughts 22. Self-generated stressors: unnecessary worry H Making mountains out of mole-hills H What other statements describe this phenomenon? H Give examples of unnecessary worry H Describe the stress responses you observed 23. Factors causing maladaptive stress H Losing sleep worrying about problem H Overeating or failing to eat due to worry H What other factors have you seen? 24. Intensity, duration and frequency of stressful event H Intensity - the level, degree, extent of upset H Duration - short, moderate, long (second to years) H Frequency - how often does the issue arise 25. Distinguish between defense mechanisms and coping mechanisms  Usual Defense Coping Strategy Repression (blocking out) Letting go of the past Denial (refusal to accept) Maintain hope for the better Displacement (take it out on others) Take it out on a punching bag Projection (blaming others) Help others get over it Rationalization (excuses) Re-structure the incident  Psychophysiology: the body's response to emotional states 1. Autonomic Nervous System H Involuntary, vegetative functions H Heart rate, blood pressure, blood flow.... H Influenced greatly by cognition/thoughts 2. Sympathetic vs. Parasympathetic Dominance H Battle=accelerator vs. the brake H Emergency response and recovery 3. Skeletal/Muscular System H Facial muscles: expression/mastication H Jaw Clenching (can lead to bruxism -- teeth grinding) I "Jaw Clenching" sound clip (aiff format --370 K) H Neck/Back: alignment,support,balance 4. Central Nervous System H Control of skeletal muscle system H Contraction beyond functional needs H Dysponesis, bracing and spasm H Sense of touch, temperature and heat 5. Endocrine System H Hormones in prep for battle/injury H Immediate, intermediate response 6. Respiratory System H Ventilation: oxygen/CO2 exchange H Hyperventilation: disrupted rate and depth