Stress Management B-School

8/8/2019 Stress Management B-School

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Stress ManagementDr. Mahendra P. Sharma,

Additional Professor,Behavioural Medicine Unit,

Department of Mental Health & Social

Psychology,National Institute of Mental Health

And Neuro Sciences (NIMHANS),

Bangalore, 560 029.


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Concept of Stress Early in the 20th century, Walter

Cannons research in biologicalpsychology led him to describe the

fight or flight response of theSympathetic Nervous System SNS)

to threats


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Concept of Stress Hans Selye (19071982) first

popularized the concept of stress

in the 1950s

Selye theorized that all individualsrespond to all types of threatening

situations in the same manner, andhe called this the General

Adaptation Syndrome (GAS)


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Concept of Stress One of the clearest explications of

this complex process of stressor

stimulation and coping mediationwas suggested by Richard Rahe in1974

The word stressor is used for thestimulus that provokes a stressresponse


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Definition of Stress

Stress is defined as an organism's totalresponse to environmental demands orpressures

Stress is a complex, dynamic process ofinteraction between a person and his or

her life. It is the way we reactphysically, mentally, and emotionally tothe various conditions, changes, anddemands of life


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Definition of Stress Also defined as any interference

that disturbs a persons health,mental and physical well being

It is also known as the non-specificresponses of the body to any

demand


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Types of Stress Acute (immediate): which can be a

one-time incident that usuallycomes and goes quickly. Its effecton us can last from minutes orhours to days or weeks. Examples

of acute stress include narrowlyavoiding an automobile crash, or aviolent incident with someone.


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Types of Stress Chronic (long-term): which can be

caused by a continuing string ofstressful incidences, or an ongoingsituation. Examples of chronicstress include a difficult job

environment, caring for someonewith a chronic disease, or a state ofloneliness.


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Levels of Stress

We experience stress in levels

Low levels may not be noticeable,slightly higher levels can bepositive and challenge us to act increative and resourceful ways.


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Levels of Stress High levels can be harmful, worsening

chronic diseases such as coronary artery

disease.

These changing levels occur regularly aswe pass through life cycle transitionslike graduating from high school andcollege, getting or changing a job, orgetting married.


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Causes of Stress

PersonalityStressProneness

BeingConstantlyWorried

Belief SystemsPerception ofStress

Lifestyle,

Working Style

Attitudetowards Others

Priorities


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Causes of Stress

Situational factors

Deaths or births,

Marriage or Divorce,

Altercation with Neighbours,

Illness,

Financial Loss,

Unsuccessful Completion of DailyActivities,

Retirement.


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Causes of Stress

Changing Value Systems

Increasing ambitions

Growing desires and a tendency tobecome more and more materialistic

Struggling very hard to become rich andsuccessful that takes a toll on yourhealth and consequently increasesstress


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The Major Sources of Work

Stress Competence: Are you concerned about

your ability to perform well? Are you

challenged enough, but not too much?Do you feel secure in your job? Jobinsecurity is a major source of stress formany people.

Communication: Workplace tensionoften results from poor communication,which in turn increases job stress.


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Stress Support: Feeling unsupported by your

coworkers may make it harder to

resolve other problems at work that arecausing you stress.

Discrimination: Because of race or sexmay be more stressful in a work

environment because it may beperceived to affect job security orperformance issues.


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Stress Significance: If you don't find your

job meaningful or take pride in it, you

may find it stressful. Environment Stress: working with

hazardous materials, workingwithout proper safety controls, and

this environmental stress may beworse because it is considered arequired part of the job and notwithin the worker's power to change.


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Causes of Work Stress Work overload,

Time pressures and deadlines to meet,

Fear of making mistakes that can leadto serious consequences,

Relationship problems with superiors,

colleagues and subordinates, Unfair assessment from superior,

Discrimination and favoritisms,


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Causes of Work Stress Contradictions in beliefs and values

with those of superiors/colleagues,

Under pressure to do things againstown professional ethics,

Competition and jealousy amongcolleagues,

Uncooperative/incompetent colleagues,

Too much paper work,


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Causes of Work Stress Can not participate in decision-making,

Staff shortage,

Lack of promotion prospects,

Having to do unnecessary tasks orprojects,

Work demands affecting home/personallife,

Poor or lack of social support


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Effects of StressStress affects us in both its acute andchronic forms.

In acute stress, the body responds to aperceived threat. Your body releaseschemicals that increase your heart rate

and breathing and provide a burst ofenergy. This is known as the stressresponse or the fight-or-flight response.


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Effects of Stress In chronic stress, the body's response

depends on the severity and duration of

the stress and how you respond. Thecardiovascular system, the nervoussystem, and the immune system may beaffected. Chronic stress plays a role inmany health problems, includingcoronary artery disease, diabetes, andasthma.


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Effects of StressHealth Problems Due To Stress

Hypertension,

Heart Attacks,

Diabetes Mellitus,

Chronic Fatigue &Pain,

Asthma, Headache,

Peptic Ulcer

Backache,

Allergies,

Skins Disorders, Cancer,

Immune System

Weakness, Sleep Disorders,

Weight Problems


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The Cost of Stress $200 billion a year is lost to

industry from stress-related

ailments ( George Pfeiffer, Work CareGroup)

Chronic pain, hypertension, andheadache alone account for 54%

of all job absences -all stress-related ailments (Alternative TherapiesJournal, 1996)


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The Cost of Stress 75-90% of employee visits to hospitals

are for ailments linked to stress (American

Institute of Stress) 30% of adults report high job stress

nearly every day. A 1991 study reportedthat more than a third of respondents

were considering changing workbecause of job stress (Northwestern NationalLife Insurance)


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Evaluating Stress We also experience stress

differently; what causes stress for

one person may cause little or no

stress for someone else.

That's because a large part of stress

is a matter of perceptionhow youview a situation determines how

much stress it causes you.


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Evaluating Stress Therefore, you can best evaluate the

amount of stress in your life. A

doctor may measure some of the

physical results of stress, but only

you can decide what you find

stressful and how you react tostress.


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Evaluating Stress

Ask Yourself?1. What factors, such as life cycle

transitions or changes, may be

contributing to my stress levels? A major cause of stress is the need

to adapt to change.

Have you entered a newrelationship?

Had a child leave home? Moved?


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Evaluating Stress

Ask Yourself?2. What job, family, or personal stress

do I have?

Is there a problem in your family or in arelationship? Is there a chronic diseasein your family? Are your children orteens under stress?

How do you feel about your job? If something is not going well and you

are not satisfied, it is probably causingstress.


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Evaluating Stress

Ask Yourself?3. Do I have enough time?

Stress is often caused by time problems;

if you find yourself with little time to dothe things you want and need to do, youare probably under stress.

4. Do I have any of the signs of stress?

How often, how intensely, and for howlong you experience the signs of stresscould tell you something about its level.


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Evaluating Stress

Ask Yourself?5. How am I coping with stress?

Observe your actions and behavior. If

you find yourself talking about aproblem or jumping into an activity orhobby to help you forget something, orcriticizing yourself, yelling at family or

friends, or drinking alcohol and smoking,it may mean you are stressed.

Identifying negative coping strategiescan help you identify and evaluate yourstress.


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Evaluating Stress

Ask Yourself?

6. Does my lifestyle affect my ability to

cope with stress?

Some behaviors and lifestyle

choices can interfere with the ways

your body seeks relief from stress.

For example, as you sleep, yourbody recovers from the stresses of

the day.


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Evaluating Stress

Ask Yourself?7. Am I stress-hardy?

People who are moreresilient in adjusting tochange and thus less affected

by stressful situations have aquality called stresshardiness.


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Evaluating Stress

Ask Yourself? A stress-hardy person has a strong

commitment to self, work, family, andother values; has a sense of control over

his or her life; generally sees change as achallenge rather than a threat; participatesin activities that promote creativity andpersonal uniqueness; and has a strong

network of support and closerelationships.


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Stress Management TrainingFive skills that form the core of almost all

stress management programs based on CBT:

1. Self-observation

2. Cognitive Restructuring

3. Relaxation Training

4. Time Management, and5. Problem Solving


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Emotional Intelligence In a sense the human brain contains

two minds and two different kinds of

intelligence:1. Rational Intelligence

2. Emotional Intelligence (Peter Saloveyand John Mayer, 1990)

These two fundamentally differentmodes of consciousness interact toconstitute our mental life.


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Components Of Emotional

Intelligence2. Managing emotions: Having appropriate

emotional reactions is a capacity that

builds on self-awareness. The ability tomodulate negative affects such asanxiety, anger, and depression is a crucialemotional skill. Emotional resilience helpsone to prevail over life's inevitablesetbacks and upsets; those who lackemotional self-regulation are continuallybesieged by feelings of distress.


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Intelligence3.Motivating oneself: Being able to focus on

a goal is essential for a range of

accomplishments. Emotional self-controlsuch as delaying gratification or controllingimpulsivityis crucial in working towardssuch life goals. Individuals who can harnesstheir emotions, and maintain hope and

optimism despite frustrations, are generallymore productive and effective in theirundertakings.


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Intelligence4.Recognizing emotions in others:

Empathy, another skill based in

emotional self-awareness, isfundamental to interpersonaleffectiveness. Those who are wellattuned to subtle social cues thatindicate what others feel are moresuccessful in personal andprofessional relations.


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Intelligence5. Handling relationships: The

art of relationships requiresskill in managing others'emotions. Social competenceunderlies popularity,leadership, and interpersonaleffectiveness.


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Self-observationy Self-Observation is one of the

most effective ways of helpingindividuals become moreaware of how they respond toproblem situations

y Self-observation is effective forseveral reasons


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Cognitive Restructuring A major thrust of cognitive-

behavioral therapy approaches to

stress management is on helping

participants to become aware of and

to change their maladaptive

thoughts, beliefs, and expectations


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Identifying Stress-producing

ThoughtsLearning to identify and interrupt these initialthoughts and interactions can help us handlesituations more effectively

Identifying stress-producing thoughts(specific to general) and changing thinkingis not simply positive thinking. It involvesrealistically looking at all aspects of a

problem--positive, negative, andneutral--and developing a more balancedapproach


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Stressor Cognition Emotion

Painful medical procedure I know I won't be able to Fear

tolerate the pain

Argument with a friend She will never speak to me Discouragement

again

Co-worker injured on the job It is my fault. I should have Guilt

warned him about the danger

Late for a deadline It's hopeless, I'm always Depression

messing things up

Spouse criticizes you He just doesn't get it. He will Anger

never understand what I

am trying to do.

Stress-Related Negative Thoughts


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Common Thinking Errors1. Magnification/ Minimization: Am I

overemphasizing/underemphasizing one

aspect of the situation?2. Polarization: Am I using black and white

thinking? Are there shades of gray?

3. Personalization: Am I taking the situation

personally and ignoring the total picture? What

would I say to a colleague in the same

position?


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Common Thinking Errors4. Stress-producing language: Am I using

words such as should, have to, must, need

rather thanwould like, want?

5. Pessimistic Thinking: Am I thinking of thesituation as permanent, pervasive, andpersonal rather than temporary, specific, andrelated to factors beside myself?

6. Catastrophizing: Is this unfortunate incidenta catastrophe? If the bad outcome happened,what would/would not be the consequences?Could I handle them?


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Key Questions for Challenging

Dysfunctional Automatic Thoughts

Is there an alternative explanation?

What is the evidence that this thought is

true?What will be the effect of continuing tothink this way?

What is the best outcome, worst outcome,

and most realistic outcome?What is the likelihood that this willhappen?


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Modifying Stress-producing

ThoughtsApply key questions to your ownnegative thoughts

Select one or two questions thatare useful in identifying theunderlying logical problems in your

thinking


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Dysfunctional Thought Rational Response

I have no control over this situation. It's true that I can't change what happened, but I can

control how I respond.

I can't return to my old job, I am Even though I may not be able to do the same kind of

worthless. work, there a number of other jobs that I may be able

to do.

It's not fair that I am being treated Life is not always fair, sometimes things go my way,

this way other times they don't.

I am a burden on my family. My family has had to give me more support lately, but

do a lot of things for them as well.

No one really cares about me. There are people in my life (e.g., spouse or child) that I

can turn to for support and love.

Dysfunctional Thoughtsand Rational Responses


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Relaxation TrainingRelaxation is defined severalways; as a psychophysiologic state

characterized by parasympatheticdominance of multiple visceral andsomatic systems; the absence of

physical, mental, and emotionaltension; the opposite of Canon'sfight-or-flight response.


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Relaxation Techniques1. Jacobsons Progressive Muscles Relaxation

(JPMR)-Relaxation is achieved by using a

series of exercises involving tensing andrelaxing different muscle groups.

2. Abbreviated Progressive Muscle Relaxation-Jacobson's techniques were adapted,notably by Wolpe (1958) and Paul (1966), andmodified in the 1960s to form part of thebasis for several behavioral treatments,including systematic desensitization.


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Relaxation Techniques3. Breathing Training-A variety of techniques to

induce relaxation through the modification of

breathing4. Autogenic training- involves a set ofexercises targeted at various physiologicalend-organs whereby a state of relaxationmight be induced

5. Biofeedback- Monitoring rates of bodyfunctions and using data to influence andgain control over autonomic functions


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Relaxation Techniques6. Meditation-It refers to a family of mental

exercises that generally involve calmly

limiting thought and attention. Suchexercises vary widely and can involve

sitting still and counting breaths,

attending to a repeated thought, or

focusing on virtually any simple external

or internal stimulus.


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Relaxation Techniques7. Hypnosis- The state of inner focus

(which is almost invariably, though not

always, associated with feelings ofcalmness and physical relaxation) is

what nowadays most practitioners

appear to mean by a "trance.


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Time Management Step 1: Personal Goal Setting - Planning toLive Your Life Your Way

Step 2: List What Needs to be done thisWeek in Order to Reach Your Top PriorityGoals

Step 3: Observe How You Spend Your Time

Step 4: Make a Master Schedule of FixedActivities for the Week.


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Time Management Step 5: Keep a Running List of Assignments

/Things you need to get done this

week.

Step 6: Make A Things-To- Be-Done List

Every Day

Step 7: Review Your Things-To- Be-DoneList


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Problem Solving Training Problem solving training aims to teach

a process for approaching problems

and achieving goals.

Training in problem solving skillsinvolves following a specific sequence

of steps (D'Zurilla & Goldfried, 1971).


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Purpose of Problem

Solving Training To make decisions more rationally and

wisely.

To recognize that we really do have a choiceabout many important things in our lives.

To avoid making decisions sloppily or bydefault.

To avoid a variety of irrational ideas, falseassumptions, fears, needs, and otheremotions that block good decision-making.


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Steps of Problem Solving1. Define the problem

2. Generate possible solutions to the problem

3. Evaluate the solutions

4. Select the best solution(s)

5. Accepting the best choice... Letting go of

the unselected options.6. Plan on how to implement the solution(s)

7. Review problem solving plan at a later time


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Step 1: Define the problem Get different opinions about the nature of

the problem

Define the problem or goal in behaviorallyspecific terms

If the problem is shared by more than oneperson, make sure each one agrees on the

definition


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Step 2:Generate possible

solutions to the problem Brainstorm as many different solutions

as possible

Do not evaluate any solutions at thistime

Be creative and include "wild and

crazy" ideas


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Step 3:Evaluate the

solutions Consider the advantages and

disadvantages of each solution for

solving the problem Systematically evaluate one solution

at a time

Avoid settling on one "best" solutionbefore reviewing all solutions


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Step 4:Select the best

solution(s) Select the solution that seems most

likely to be effective

Consider how difficult the solution willbe to implement

Choose more than one solution if they

can be easily combined

Step 5:Accepting the best


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Step 5:Accepting the bestchoice... Letting go of the

unselected options Accepting the best choice... Letting it

sink in... Stop obsessing about the

decision... Letting go of the unselected options.

After making a decision, it takes alittle time to reprogram your thinking,to fully commit yourself to the chosencourse of action.


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Step 6:Plan on how to

implement the solution(s) Consider what resources are needed to

implement the solution (e.g., money, skills,information)

Anticipate possible obstacles toimplementing the solution

Establish a time frame for implementing the

solution(s) If more than one person is involved,

establish specific tasks


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Step 7:Review problem

solving plan at a later time Plan a time to evaluate whether the

problem solving plan was successful

Do additional problem solving andmodify the plan if the desired goal hasnot been obtained

Praise all efforts at solving theproblem, even if the problem is notentirely resolved


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Remember There are certain problems for which

there is no solution

This problem can not be solved

..This is also a solution!


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ThankYouVery

Much

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Stress Management B-School