Letting Go of Stress

LettingLetting GoGo ofof StressStress CopingCoping withwith ChangeChange atat thethe WorksiteWorksite

PreparedPrepared by:by: BrianBrian LukeLuke Seaward,Seaward, Ph.DPh.D

©2006 Wellness Councils of America 1 OneOne NationNation UnderUnder StressStress •• Corporate Corporate MergersMergers •• Corporate Corporate DownsizingDownsizing •• Stock Stock MarketMarket JittersJitters •• Urban Urban SprawlSprawl •• 24/7 24/7 AccessibilityAccessibility •• Global Global TerrorismTerrorism •• Technostress Technostress •• Health Health CareCare ReformReform •• Pension Pension && BenefitBenefit IssuesIssues •• Global Global WarmingWarming •• Privacy Privacy issuesissues

This slide merely highlights many of the issues specified by people in the American work force.

WorksiteWorksite StressStress Facts:Facts: •• 93% 93% ofof worksiteworksite accidentsaccidents aarere thethe resultresult ofof humanhuman error.error. (National(National SafetySafety Council)Council) •• 47% 47% ofof USUS executivesexecutives surveyesurveyedd inin 20032003 didn’tdidn’t useuse theirtheir vacationvacation timetime duedue toto jobjob pressures.pressures. •• Up Up toto 60%60% ofof allall absencabsenceses areare causedcaused byby stress.stress. •• 72% 72% ofof USUS workersworkers reportreport emotionalemotional stressstress isis pervasivepervasive inin thethe worksite.worksite. •• More More heartheart attacksattacks occuroccur onon MondayMonday morningsmornings thanthan anyany otherother dayday ofof thethe week.week.

This slide sets the groundwork for the need for stress management programs at the worksite by presenting data from several national polls and surveys. The sources for this information can be found at the end of this presentation.

GoodGood Stress:Stress: EuphoriaEuphoria oror joyjoy (also(also knownknown asas “Eustress”)“Eustress”)

It is always a good idea to give examples. Falling is love is an example of good stress. Actually, any situation that makes one feel euphoric could fall in this category. Meeting your favorite movie star or professional athlete would also serve as possible examples.

BadBad Stress:Stress: DistressDistress oror simply,simply, “STRESS!”“STRESS!” (also(also knownknown as:as: anger,anger, fear,fear, despair,despair, panic,panic, worry,worry, anxiety,anxiety, impatience,impatience, frustration,frustration, guilt,guilt, annoyance,annoyance, doubt,doubt, irritation,irritation, rage,rage, embarrassment,embarrassment, intimidation,intimidation, envy,envy, hostility,hostility, andand indignation,indignation, etc.)etc.)

The purpose of this slide shows that there is no shortage of ways to explain the emotions associated with distress. If you wish to include some audience participation, you could ask workshop participants for additional words to include here.

ThereThere areare twotwo kindskinds ofof “Distress:”“Distress:”

AcuteAcute Stress:Stress: VeryVery intense,intense, butbut shortshort livedlived (usually(usually aroundaround 2020 minutes)minutes)

Acute stress is very, very intense but very short lived. Since most everyone can relate to getting a speeding ticket, this makes for an excellent example.

ThereThere areare twotwo kindskinds ofof “Distress:”“Distress:”

ChronicChronic Stress:Stress: NotNot veryvery intense,intense, butbut itit enduresendures forfor days,days, weeks,weeks, months.months.

Examples:Examples: JobJob stress,stress, maritalmarital stress,stress, financialfinancial stress,stress, chronicchronic painpain stress.stress. ©2006©2006 WellnessWellness CouncilsCouncils ofof AmericaAmerica

This slide is self-explanatory. You could ask workshop participants for other examples if you wish.

(Many(Many definitions,definitions, frfromom manymany disciplines)disciplines)

•• A A lossloss ofof emotionalemotional controlcontrol •• The The inabilityinability toto copecope withwith problemsproblems •• Wear Wear andand teartear onon thethe bodybody •• The The absenceabsence ofof innerinner peacepeace •• Any Any changechange youyou encounterencounter inin youryour lifelife

The purpose of this slide is to show that there are many definitions of stress, coming from various different fields of study (psychology, anthropology, medicine, physics, theology, etc.). Be sure to emphasize that today, the words stress and change are often used interchangeably.

AA commoncommon definition,definition, agreeagreedd byby leadingleading experts:experts:

“Stress“Stress isis aa “perceived”“perceived” threat threat (real(real oror imagined)imagined) toto one’sone’s mind,mind, body,body, spiritspirit oror emotions.”emotions.”

Although there is no agreement on what stress really is, this definition comes close to a consensus.

During this slide, consider passing out the enclosed stress survey. Please allow about 2-4 minutes for participants to complete the survey, and then continue on with the next slide

Although there is no definitive survey composed of 20 questions to determine if you are stressed, burnt out, or just exactly how stressed you really are, questionnaires do help increase awareness that, indeed, there may be a problem in one or more areas of your life. The following is an example of a simple stress inventory to help you determine the level of stress in your life. Read each statement and then either circle the word Agree or Disagree. Then count the number of “Agree” points (one per question) and use the Stress Level key to determine your personal stress level.

Statement Agree Disagree

1. I have a hard time falling asleep at night. Agree Disagree 2. I tend to suffer from tension and/or migraine headaches. Agree Disagree 3. I find myself thinking about finances and making ends meet. Agree Disagree 4. I wish I could find more to laugh and smile about each day. Agree Disagree 5. More often than not, I skip breakfast or lunch to get things done. Agree Disagree 6. If I could change my job situation, I would. Agree Disagree 7. I wish I had more personal time for leisure pursuits. Agree Disagree 8. I have lost a good friend or family member recently. Agree Disagree 9. I am unhappy in my relationship or am recently divorced. Agree Disagree 10. I haven’t had a quality vacation in a long time. Agree Disagree 11. I wish that my life had a clear meaning and purpose. Agree Disagree 12. I tend to eat more than three meals a week outside the home. Agree Disagree 13. I tend to suffer from chronic pain. Agree Disagree 14. I don’t have a strong group of friends to whom I can turn. Agree Disagree 15. I don’t exercise regularly (more than three times per week). Agree Disagree 16. I am on prescribed medication for depression. Agree Disagree 17. My sex life is not very satisfying. Agree Disagree 18. My family relationships are less than desirable. Agree Disagree 19. Overall, my self-esteem can be rather low. Agree Disagree 20. I spend no time each day dedicated to meditation or centering. Agree Disagree

Stress Level Key

Less than 5 points You have a low level of stress and maintain good coping skills. More than 5 points You have a moderate level of personal stress. More than 10 points You have a high level of personal stress. More than 15 points You have an exceptionally high level of stress.

“I’m“I’m anan oldold manman now,now, andand II havehave knownknown aa greatgreat manymany problemsproblems inin mymy life…life… mostmost ofof whichwhich nevernever happened.”happened.” —Mark—Mark TwainTwain

It is always a good idea to read quotes out loud.

©2006 Wellness Councils of America 11 TheThe FightFight oror FlightFlight ResponseResponse AA survivalsurvival dynamicdynamic forfor physicalphysical stressors…stressors… physicalphysical danger.danger.

Everyone has the flight or flight response. In case you are asked, women also have what is known as the “tend and befriend” response, a more nurturing response to stress.

Today,Today, thethe fightfight oror flightflight reresponsesponse isis usedused primarilyprimarily (and(and inappropriately)inappropriately) forfor non-phynon-physicalsical stressors,stressors, andand hereinherein lieslies thethe problem:problem: aa stress-hormonestress-hormone cocktailcocktail thatthat wreckswrecks havochavoc onon thethe bodybody underunder repeatrepeateded boutsbouts ofof chronicchronic stress.stress.

Be sure to reiterate that the fight or flight response is ideal for physical threats, (e.g. a burning building). It is not appropriate for non-physical threats.

BiochemistryBiochemistry ofof stressstress hormoneshormones releasedreleased duringduring thethe flightflight oror flightflight (stress)(stress) responseresponse include:include: •• Epinephrine Epinephrine (Catacolamine)(Catacolamine) •• Nor-epinephrine Nor-epinephrine (Catacolamine)(Catacolamine) •• Vasopressin Vasopressin •• Aldosterone Aldosterone •Cortisol•Cortisol

ThisThis “stress“stress cocktail”cocktail” is is knoknownwn toto dodo thethe following:following:

This slide had some stress physiology concepts that may look technical, but you will do fine. The purpose of the combined effect of these stress neurotransmitters is to prepare the body for fight or flight by increasing heart rate, blood pressure, and so forth. You don’t have to know much about stress physiology to appreciate all that goes on.

•• Increased Increased heartheart raterate •• Increased Increased bloodblood pressurepressure •• Increased Increased raterate ofof breathingbreathing •• Increased Increased musclemuscle tensiontension •• Increased Increased perspirationperspiration •• Increased Increased metabolicmetabolic activityactivity

AllAll ofof thesethese physiologphysiologicalical responsesresponses areare trtriggerediggered specificallyspecifically asas partpart ofof thethe fightfight oror flightflight responseresponse forfor physicalphysical survival.survival.

This slide is self-explanatory.

TheseThese areare veryvery ineffectiveineffective forfor memental,ntal, emotionalemotional oror spiritualspiritual stressors.stressors.

This slide is self-explanatory as well.

•• Hypertension Hypertension (High(High bloodblood pressure)pressure) •• Chronic Chronic painpain (muscle(muscle tension)tension) •• Suppressed Suppressed immuneimmune systemsystem •• Colds Colds andand flusflus •• Symptoms Symptoms ofof diseasedisease oror illnessillness •• General General sensesense ofof fatiguefatigue •• Insomnia Insomnia •• Depression Depression

The purpose of this slide is to show that when chronic stress persists, with subsequent stress hormone activity, it WILL affect all kinds of health aspects from hypertension to insomnia.

•• Eighty Eighty percentpercent ofof visitsvisits toto primaryprimary carecare physiciansphysicians areare duedue toto chronicchronic stress.stress.

•• The The relationshiprelationship betweenbetween stressstress andand diseasedisease isis nono longerlonger thoughtthought toto bebe anan Association,Association, butbut aa directdirect causalcausal link.link.

This slide cites commonly known facts about stress and disease to share with your participants.

©2006 Wellness Councils of America 18 StressStress andand DiseaseDisease LandmarkLandmark ResearchResearch FindingsFindings Cohen,Cohen, S.S. et.al.et.al. PsychologicalPsychological StressStress andand SusceptibilitySusceptibility toto thethe CommonCommon ColdCold.. NewNew EnglandEngland Jr.Jr. ofof Med.Med. 325:606-612,325:606-612, 1991.1991.

Kiecolt-Glasser,Kiecolt-Glasser, J.J. et.al.et.al. Stress,Stress, PersonalPersonal RelationshipsRelationships andand ImmuneImmune Function:Function: HealthHealth ImplicationsImplications.. BrainBrain Behav.Behav. Immunology.Immunology. 13:61-72.13:61-72. 1999.1999.

Wittstein,Wittstein, L.,L., NeurohumoralNeurohumoral Factors Factors ofof MyocardialMyocardial StunningStunning DueDue toto SuddenSudden EmotionalEmotional StressStress.. NewNew EngEng Jr.Jr. ofof Med.Med. 352(6):352(6): 539-548,539-548, 2005.2005.

These are three of hundreds (if not thousands) of studies to reveal the link between stress and diseases, from the common cold to heart disease.

“Ultimately“Ultimately thethe bodybody becomesbecomes thethe battlefieldbattlefield forfor thethe warwar gamesgames ofof thethe mind.”mind.”

—Brian—Brian LukeLuke Seaward,Seaward, Ph.D.Ph.D.

This slide is self-explanatory as well. (Remember to read quotes out loud.)

AngerAnger isis thethe FightFight EmotionEmotion FearFear isis thethe FlightFlight EmotionEmotion

LeftLeft unresolved,unresolved, angeranger andand fearfear becomebecome controlcontrol issuesissues

This is where you make the link between emotional stress and physical stress (anger/ fight and fear/ flight).

AngerAnger isis thethe FightFight EmotionEmotion FearFear isis thethe FlightFlight EmotionEmotion

LeftLeft unresolved,unresolved, theythey maymay becomebecome chronicchronic healthhealth issuesissues (e.g.,(e.g., Lupus,Lupus, Migraines,Migraines, TMJ,TMJ, RheumatoidRheumatoid Arthritis,Arthritis, Fibromyalgia,Fibromyalgia, ect.)ect.) ©2006©2006 WellnessWellness CouncilsCouncils ofof AmericaAmerica

This is where you make the obvious link between emotional stress and disease or illness. Just a reminder that western medicine is still slow to accept this fact, despite the plethora of research data to substantiate it.

©2006 Wellness Councils of America 22 “No“No problemproblem cancan bebe solvedsolved fromfrom thethe samesame levellevel ofof consciousnessconsciousness thatthat createdcreated it.”it.” —— Albert Albert EinsteinEinstein

This slide is self-explanatory as well. (Remember to read quotes out loud.)

©2006 Wellness Councils of America 23 TheThe bestbest stressstress managementmanagement programprogram addressesaddresses bothboth thethe causescauses ofof stressstress (coping(coping skills)skills) andand thethe symptomssymptoms ofof stressstress (relaxation(relaxation skills)skills) toto promotepromote optimaloptimal wellbeing.wellbeing.

Here you are making a case for a solid approach to teaching stress management programming that involves both effective coping techniques and effective relaxation techniques. Most programs only focus on relaxation techniques.

TheThe purposepurpose ofof effectiveeffective copingcoping skillsskills isis toto increaseincrease youryour awarenessawareness ofof thethe issueissue andand workwork towardtoward aa peacefulpeaceful resolution.resolution.

This slide is self-explanatory.

•• Reframing Reframing •Comic•Comic ReliefRelief •• Time Time ManagementManagement •• Communication Communication SkillsSkills •• Information Information SeekingSeeking •• Journaling Journaling •• Social Social EngineeringEngineering •• Hobbies Hobbies •• Social Social SupportSupport GroupsGroups

This slide lists nine of the most common effective coping techniques. You don’t have to go into a lot of detail about these. Simply mention that despite the differences, they all promote the same means: increased awareness and steps toward resolution.

This slide is self-explanatory.

—Lily—Lily TomlinTomlin

This slide is self-explanatory. (Remember to read quotes out loud.)

TheThe purposepurpose ofof relaxationrelaxation techniquestechniques isis toto returnreturn thethe bodybody backback toto aa sensesense ofof physiologicalphysiological homeostasis.homeostasis.

It is really good to emphasize this point. Homeostasis is the goal for each and every relaxation technique. You may also wish to say that relaxation and sleep are NOT the same thing.

•• PhysicalPhysical ExerciseExercise •HathaYoga•HathaYoga •Tai•Tai ChiChi •• Meditation Meditation (Centering)(Centering) •• Diaphragmatic Diaphragmatic BreathingBreathing •• Progressive Progressive MuscularMuscular RelaxationRelaxation •• Guided Guided MentalMental ImageryImagery •• Music Music TherapyTherapy

This slide lists several types of relaxation techniques. Some points to make: • Physical exercise helps flush the stress hormones out of your body. • Hatha yoga is perhaps best described as muscle stretching with breath work. • Tai Chi is a Chinese form of exercise that works with the universal life force of energy. • Meditation is a means to clear the mind of the ego’s mental chatter. • Diaphragmatic breathing is belly or abdominal breathing. • Progressive muscular relaxation is a systematic way to reduce muscle tension throughout the body (Muscle tension is THE number one symptom of stress). • Guided mental imagery is the use of relaxing images to calm down. • Music therapy is listening to calming music (instrumental music works best).

©2006 Wellness Councils of America 30 “I“I cannotcannot andand shouldshould notnot bebe curedcured ofof mymy stress,stress, butbut merelymerely taughttaught toto enjoyenjoy it.”it.” —Hans—Hans SelyeSelye

This slide is self-explanatory. (Remember to read quotes out loud.)

•• Stress Stress (change)(change) is,is, andand mostmost likelylikely willwill be,be, partpart ofof thethe worksiteworksite environment.environment. WeWe mustmust learnlearn toto adaptadapt toto change.change. •• You You cannotcannot fightfight oror fleeflee fromfrom mostmost 21st21st CenturyCentury stressors.stressors. •• Chronic Chronic stressstress isis nownow lilinkednked toto manymany illnesses.illnesses. •• Unresolved Unresolved angeranger and/orand/or ffearear becomebecome controlcontrol issuesissues thatthat onlyonly perpetuateperpetuate stress.stress. •• Effective Effective StressStress ManagemenManagementt programsprograms includeinclude bothboth effectiveeffective copingcoping skillsskills andand relaxationrelaxation techniques.techniques. •• To To seesee balancebalance inin youryour life,life, considerconsider strivingstriving forfor somesome goodgood stressstress everyevery nownow andand then.then.

These final thoughts serve as the conclusion of your slide show. Read through each one slowly to reinforce the content you have presented.

Books:Books: •• Carlson,Carlson, R.,R., Don’tDon’t SweatSweat thethe SmallSmall StuffStuff.. HyperionHyperion Books.Books. 1997.1997. •• Luskin,Luskin, F.,F., Pelletier,Pelletier, K.,K., StressStress FreeFree forfor GoodGood.. HarperSanFranciscoHarperSanFrancisco Books.Books. 2005.2005. •• Ruiz,Ruiz, D.M.,D.M., TheThe FourFour AgreementsAgreements.. AmberAmber AllenAllen Books.Books. 1997.1997. •• Seaward,Seaward, B.L.,B.L., AchievingAchieving thethe Mind-Body-SpiritMind-Body-Spirit ConnectionConnection.. JonesJones andand Bartlett.Bartlett. 2005.2005. •• SeawardSeaward B.L.,B.L., QuietQuiet Mind,Mind, FearlessFearless Heart.Heart. JohnJohn WileyWiley && SonsSons.. 2005.2005. •• Seaward,Seaward, B.L.,B.L., StressedStressed isis DessertsDesserts SpelledSpelled BackwardBackward.. ConariConari Press. Press. 1999.1999. •• Seaward,Seaward, B.L.,B.L., TheThe ArtArt ofof CalmCalm.. HealthHealth CommuniCommunications,cations, Inc.Inc. DeerfieldDeerfield Beach,Beach, FL,FL, 1999.1999. •• Tolle,Tolle, E.,E., TheThe PowerPower ofof NowNow.. NewNew WorldWorld Library.Library. 1999.1999.

Websites:Websites: UnusedUnused VacationVacation TimeTime http://www.braunconsulting.com/bcg/newsletters/winter2004/ winter20044.html

AmericanAmerican WorkWork timetime http://www.findarticles.com/p/articles/mi_m1282/is_n3_v44/ai_11882284

StressStress FactsFacts http://www.timelessnow.com/factsaboutstress.html

All photography by Brian Luke Seaward, Ph.D.