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Managing Stress in ATM EUROCONTROL Managing stress in ATM FOUNDING MEMBER NETWORK MANAGER SUPPORTING EUROPEAN AVIATION Authors: Paola Tomasello Fabrice Drogoul [email protected] TABLE OF CONTENTS ABOUT THIS GUIDE 5 INTRODUCTION 6 PART 1 - BASIC SCIENTIFIC KNOWLEDGE ABOUT STRESS 8 1. What is stress? 9 1.1 The general adaptation syndrome 9 1.2 Transactional models of stress 12 2. Stress at work 16 2.1 Stress is not the same for everybody 17 2.2 Healthy and stressful environments 18 2.3 Stress and reward 20 2.4 Stress and personality 21 2.5 Resilience 22 3. The biological response to stress 24 3.1 Alarm reaction 24 3.2 Stage of resistance 28 3.3 Stage of exhaustion 29 3.4 Conclusions 30 4. What causes stress? 31 4.1 Sources, effects, signals and coping strategies 32 4.2 Personal stressors: life events and Daily stressors 33 4.3 Stressors at work 35 4.4 ATM professional stressors 37 4.5 New forms of stressors 38 4.6 Active and latent stressors 39 4.7 Acute, traumatic and chronic stress 40 3 5. What are the effects of stress? 44 5.1 Reduced performance 44 5.2 Reduced well-being and health disorders 46 6. How can we recognise stress? 48 7. Wrap-up: key features of stress 55 PART 2 - STRESS MANAGEMENT STRATEGIES 56 1. Different types of strategies 57 1.1 Avoiding stressors 57 1.2 Changing your thinking 58 1.3 Learning to relax 60 2. Individual management 62 2.1 The personal stress management process 62 2.2 Organisational dimension 79 4 ABOUT THIS GUIDE For professionals working in safety-critical environments, stress can become a diffi- cult challenge to cope with. This guide is intended to help you recognise stress and identify possible mechanisms to mitigate its effects. It is structured in two parts: The first part presents basic scientific knowledge about stress. It is designed to help you improve your understanding of the sources of stress; it explains how stress can affect your health and performance. It will show you how to detect stress signals in yourself and in your colleagues. The second part gives an overview of practical strategies for stress management. Reading this part will help you gain more insight into what can be done to prevent and reduce stress, both as an individual and on an organisational level. You may find some ideas which work for you and your organisation, and some which do not. Bear in mind that the strategies presented are not meant to be standard solutions. Rather, they represent a set of possible ways of building individual and organisational resilience to stress, serving as a starting point to be customised to your specific situation. 5 INTRODUCTION The workplace of the 21st century is a fast-paced, dynamic and highly stimulating environment, bringing a large number of benefits and opportunities to those who work in it. Nevertheless, the ever-changing demands of the working world can increase levels of stress, especially for those who consistently work under pressure1. In particular, front-line professionals employed in aviation and space organisations have to display high levels of knowledge and expertise, as well as to put into practice specific skills requiring cognitive and interpersonal abilities. Moreover, they have to constantly adapt to an ever-changing picture of ongoing processes with restricted time constraints, all while assuming high levels of responsibility. Although complex and demanding work has its positive side, it is also challenging. If the resulting pressure becomes excessive, it can lead to stress which has negative consequences, such as reduced well-being, and impaired health and performance at work. Individuals are well adapted to cope with short-term exposure to pressure - in fact, this can often be adjusted - but have greater difficulty in coping with prolonged intensive pressure2. From a regulatory point of view, stress is acknowledged as an important safety problem and is included among the essential topics for training and competence assessment on a European level3. 1 Health and Safety Executive (HSE), Work-related stress: a guide, https://www.hse.gov.uk/stress/ assets/docs/eurostress.pdf, p. 1. 2 Health and Safety Executive (HSE), Work-related stress: a guide, https://www.hse.gov.uk/stress/ assets/docs/eurostress.pdf, p. 3. 3 European Aviation Safety Agency (2017), Acceptable Means of Compliance (AMC) and Guidance Material (GM) to Part-ATS: specific requirements for providers of air traffic services (ATS), (ER) 2017/373 GM1 ATS.OR.310 https://www.easa.europa.eu/sites/default/files/dfu/Annex%20 IV%20%28Part-ATS%29%20to%20ED%20Decision%202017-001-R.pdf 6 In this light, it is recommended to adopt stress intervention, mitigation and prevention strate- gies. These include: stress management training for all levels of employees; staff support mechanisms: peer counselling professional support from health practitioners critical incident stress management programmes regular risk assessment of sources of occupational stress and its effects on indivi- duals and operations. The principles provided in this guide are meant to complement the prescriptive approach based on training and policy requirements. 7 PART 1 - BASIC SCIENTIFIC KNOWLEDGE ABOUT STRESS 8 1. What is stress? “In the late 17th century, stress, according to the study of physical (mechanical) sciences of the day, was used to describe the relationship between internal forces and the external force, or load.” (Lazarus & Folkman, 1984). In 1932, Walter Cannon, observed that stress seemed to be related to an internal disturbance of homeostasis, possibly due to lack of oxygen, cold, low blood pressure or other factors. He described stress as the fight-or-flight response. Stress is seen as an acute response, a physiolog- ical reaction that occurs in response to a perceived harmful event, attack, or threat to survival. Early models of stress saw it as a negative effect experienced when external pressure on the individual becomes excessive (Selye, 1926 ). Selye identified what he believed was a consistent pattern of mind-body reactions, which he called “the non-specific response of the body to any demand made upon it”. This definition of stress is necessarily rather broad, but, it does incorpo- rate two very important points: 1. stress is a physical or “body” phenomenon; 2. stress involves some “demand” placed upon an individual. Further investigations followed. Selye noticed that the body adapts to external stressors with a biological pattern which is actually predictable, so that the internal balance, or homeostasis, is restored and maintained. 1.1 The general adaptation syndrome The struggle of the body against stress is the main theme of what is known as the “general adaptation syndrome” (GAS). Selye discovered that even if one’s body wants to control or reduce stress, this process still has its limits. The body’s supply of energy to adapt to a stressful environment is limited, and this capacity is even more compromised when the body is continuously exposed to the stressor. 9 Figure 1: fight or flight reaction As Seyle points out: “Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.” In his philosophy, stress affects the human body through aging and other natural body processes which occur as we encounter various stressors in our daily lives (Selye, 1955)4. Overall, the "general adaptation syndrome” stress model thoroughly explains the stress response and how ageing and disease are caused by chronic exposure to stress. 4 Selye, H., “Stress and Disease”, Science, 7 Oct 1955: Vol. 122, Issue 3171, pp. 625-631. DOI: 10.1126/science.122.3171.625 10 The model is comprised of three elements or phases which describe the body’s response to stress: 1. Alarm stage In this phase, the initial reaction of the body to stress is that it labels the stressor as a threat or danger to balance, which is why it immediately activates its fight or flight response system, and releases “stress” hormones such as adrenaline, noradrenaline and cortisol. These hormones enable you to do things which you do not usually do. For instance, when your house is on fire, your body goes into the alarm stage, and stress hormones are released (particularly adrenaline), enabling you to carry heavy objects outside the burning house. However, there is a catch: your blood pressure starts to rise after a minute or less, which can predispose you to damaging your brain and heart’s blood vessels, putting you at risk of a stroke or heart attack. The muscles you have used might also become painful due to tissue damage. 2. Resistance stage Once the body has responded to the stressor, the stress may have been eradicated, or simply reduced. In parallel to the ‘fight or flight’ response, your body’s defences become weaker, as it needs to allocate energy to repairing damaged muscle tissue and lowering the production of stress hormones. Although the body has shifted to this second phase in the stress response, it remains on guard, particularly when the stressors persist and the body is required to fight them continuously, although not to the same extent as it could during the initial response. 11 3. Exhaustion stage During this phase, the stress has been persistent for a longer period. The body starts to lose its ability to combat the stressors and to reduce their harmful impact because the adaptive energy is all drained out. The exhaustion stage can be referred to as the gate towards burnout or stress overload, which can lead to health problems if not resolved immediately. Resistance Alarm Exhaustion Homeostasis Figure 2: GAS All in all, Selye’s general adaptation syndrome model presents a clear biological expla- nation of how the body responds and adapts to stress.
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