Stress Management for Busy Professionals: Techniques you can use Lynne I. Wagner, Ph.D. Associate Professor Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Outline of Presentation • • • • Definition of stress Ways stress can affect you Identifying triggers Stress management strategies – – – – – Identifying and altering stress-exacerbating cognitions Stress hardiness Active coping strategies Time management Relaxation techniques WHAT IS STRESS? • Stress is your mind and body’s response or • reaction to a real or imagined threat, event or change. The threat, event or change are commonly called stressors • Internal: thoughts, beliefs, attitudes • External: loss, tragedy, change, job demands NEGATIVE STRESS Distress or negative stress occurs when your level of stress is either too high or too low and your body and/or mind begin to respond negatively to the stressors. Perception of Stress: LOW DEMANDS RESOURCES Perception of Stress: HIGH RESOURCES DEMANDS STAGES OF STRESS 1. Alarm Stage 2. Resistance Stage 3. Exhaustion Stage STAGES OF STRESS: PHYSIOLOGICAL EFFECTS Alarm Resistance Exhaustion Cardiac: Increased heart rate Respiratory: decreased temperature Hormonal: increased stimulation of adrenal glands Fatigue Muscle tension Sleep difficulties Anxiety Tearfulness Agitation Feeling overwhelmed Depression Digestive disorders Hypertension Bruxism Weight gain or loss Hair loss Endocrine disorders Is All Stress Bad? • Moderate levels of stress may actually improve performance and efficiency • Too little stress may result in boredom • Too much stress may cause an unproductive anxiety level EUSTRESS Eustress or positive stress occurs when your level of stress is high enough to motivate you to move into action to get things accomplished. Optimal Level of Stress Yerkes-Dodson law of arousal and performance Identifying Stressors Situations, activities, and relationships that cause ‘trauma’ to one’s physical, emotional, or psychological self Stressors • • • • • • • • • School Work Family Relationships Legal Finances Health/illness Environment Living Situation Work-Related Stressors: NURAP • • • • • • • • • Deadline-driven work environment Time pressures, last minute time demands Stress level consistently high and chronic Conflicts in reporting structure, competing demands Unpredictable and inconsistent work flow Job security Level of responsibility Long hours Lack of control over work quality of colleagues Burnout Physical - Weight gain/loss - Unexpected hair loss - Heart palpitations - High blood pressure - Headaches - GI problems - Sleep difficulties - Fatigue - Muscle aches - Bruxism Emotional - Difficulty concentrating - Mental exhaustion - Mood swings - Anxiety - Depression - Apathy - Anhedonia - Hopelessness - Helplessness - Low self-esteem Identifying Triggers: When there’s smoke, there’s fire - - - Identify signs of stress Trace your steps to identify source Use emotions as clues Anxiety = Threat Anger = Injustice Sadness = Loss Learn your strengths and vulnerabilities Identifying and understanding triggers is half the battle STRESS MANAGEMENT STRATEGIES "You can't always influence what others may say or do to you but you can influence how you react and respond to it." Author Unknown (seemingly smart) Technique: Cognitive Reframing STRESSOR Deadline COGNITION OUTCOME I’ll never finish in time Anxious Overwhelmed Frustrated Helpless X I’ll lose my job No one else can help I’ll get it done, I always do Deadline Can anyone help? I will deal with consequences IF I miss the deadline X Inspired Challenged Hopeful Productive Resourceful Technique: Cognitive Reframing STRESSOR Last minute request COGNITION They always come to me at the last minute X No one respects my job This was intentional Maybe they don’t realize how it affects me Last minute request Maybe it was out of their control I can rise to this challenge OUTCOME Angry Anxious Overwhelmed Frustrated Helpless X Empathic Problem-focused Hopeful Productive Stress Hardy Personality • Research has identified a subgroup of people who • • are more resistant to stress and better able to cope than others Psychologists have identified personality traits that are stress protective – Commitment – Control – Challenge Executives with these traits had 50% decreased risk of stress-related health problems – Susan Kobasa, Ph.D. Active Coping Model STRESSOR: WORK DEADLINE Uncontrollable • Deadline • Colleague’s behavior • Nature of the work Emotion-focused strategies Examples: • Cultivate compassion • Express negative emotions • Seek support • Search for meaning Controllable • Manage cognitions • Break down project into smaller tasks • Develop realistic timeline and goals for accomplishing tasks • Prioritize competing demands • Enlist help of others • Bolster resources by engaging in health-promoting activities Problem-solving strategies Stronger, Faster, Smarter Exercise does more than build muscles and help prevent heart disease. New science shows that it also boosts brainpower—and may offer hope in the battle against Alzheimer's. Newsweek March 26, 2007 issue http://www.msnbc.msn.com/id/17662246/site/newsweek/ Photo illustration by Fredrik Broden for Newsweek By Mary Carmichael Exercise Is a State of Mind Researchers are learning more about how physical activity affects our moods. Is sweat the hot new antidepressant? Newsweek March 26, 2007 issuehttp://www.msnbc.msn.com/id/17662247/site/newsweek/ Donald Miralle / Getty Images for Newsweek Physical Therapy: Research suggests that exercise can affect the moods and even relieve depression By Michael Craig Miller, M.D. Avoid Maladaptive or Passive Coping Strategies • Maladapative coping strategies provide temporary relief from stressor however do not solve the source of stress – – – – – Excessive alcohol consumption Nicotine use Use of illicit drugs Overuse of prescription medication Over-eating • Passive coping strategies – Excessive sleeping – Social withdrawal – Too much time playing Guitar Hero Boost Resources: Time Management RESOURCES DEMANDS Time Management • Use realistic thinking strategies to address concerns about what could happen if you do not complete everything on time • Let go of unnecessary tasks and limit number of tasks you attempt to complete at one time • Use Daily Activity Form to assess activities completed, planned and desired Managing Your Anxiety and Worry, Craske & Barlow, 2006 Time Management 1. Delegating responsibility 2. Saying “no” 3. Stick to an agenda 4. Avoid perfectionism Managing Your Anxiety and Worry, Craske & Barlow, 2006 Everyone has Good and Bad Times • Find your creative/thinking time and most productive times. Schedule most demanding tasks during this time. • Find your dead time. Schedule meetings, phone calls, and mundane stuff during it. Professor Randy Pausch Interruptions • 6-9 minutes, 4-5 minute recovery – five interruptions shoots an hour • You must reduce frequency and length of interruptions (turn phone calls into email) • Blurting: save-ups • E-mail noise on new mail is an interruption -> TURN IT OFF!! Professor Randy Pausch Cutting Things Short • “I’m in the middle of something now…” • Start with “I only have 5 minutes” – you can always extend this • Stand up, stroll to the door, complement, thank, shake hands • Clock-watching; on wall behind them Professor Randy Pausch Time Journals • It’s amazing what you learn! • Monitor yourself in 15 minute increments for between 3 days and two weeks. • Update every ½ hour: not at end of day Professor Randy Pausch Other Helpful tips • Changing perceptions and expectations • Break jobs/tasks into manageable parts • Set reasonable/realistic goals • Avoid procrastination • Set boundaries • Don’t compromise your values/beliefs • Schedule “me” time TIME MANAGEMENT Avoid the fallacy that you will have more time in the future than you have now: Make Self-Care a Priority! Diaphragmatic Breathing and Relaxation Practice • Diaphragmatic breathing – Triggers the parasympathetic branch of the autonomic nervous system – Practice daily for 5 minutes – Employ breathing technique in response to stress • Relaxation exercises – Guided imagery – Progressive muscle relaxation Relax • Our brain fires electrical waves at 14 or more • • • • • cycles a second. These are beta waves and are great for getting tasks done, but not for learning new things. Taking a few minutes to relax deeply slows your brain waves down. These slower waves are alpha waves. They occur at between 7 and 14 cycles a second Studies show alpha waves improve learning. ----”OnCourse” by Skip Downing Strategies for Mind and Body Relaxation • Yoga • Meditation • Mindfulness • Diaphragmatic breathing • Guided imagery • Progressive muscle relaxation I’M IN CONTROL - DISTRESS RELIEF STRATEGIES Feeling good about yourself can be an effective buffer against stress. Eliminate unnecessary worries. Most worries are either passed on to us by another or conjured up in our imagination. GET PHYSICAL 1. Relax neck and shoulders 2. Take a stretch 3. Get a massage 4. Exercise GET MENTAL 5. Count to 10 6. Control your thoughts 7. Fantasize 8. Congratulate yourself 9. Ignore the problem if appropriate, after evaluation 10. Perform self maintenance 11. Talk to a counselor GET SPIRITUAL 12. Meditate 13. Pray 14. Remember your purpose USE YOUR BODY AND MIND TOGETHER 15. Take a break 16. Try progressive relaxation 17. Try yoga 18. Try aroma therapy 19. Laugh DEVELOP NEW SKILLS 20. Prioritize daily tasks 21. Learn something 22. Practice a hobby Importance of Engaging in Pleasant Events • Adult Pleasant Events Schedule Seven Habits From “The Seven Habits of Highly Effective People: Restoring the Character Ethic” by Stephen R. Covey, Simon and Schuster, 1989 SHARPEN THE SAW This is the habit of self-renewal, which has four elements. The first is mental, which includes reading, visualizing, planning and writing. The second is spiritual, which means value clarification and commitment, study and meditation. Third is social/emotional, which stress management includes service, empathy, synergy and intrinsic security. Finally, the physical includes exercise, nutrition and stress management. 39 RESOURCES • Relaxation and Stress Reduction Workbook (Davis, McKay, & Eshelman) • Mastery of Your Anxiety and Worry, Mastery of Your Anxiety and Panic (Craske & Barlow) • Little Ways to Keep Calm and Carry On (Reinecke) • Mind over Mood (Greenberg & Padesky) • www.healthjourneys.com • http://stresscourse.tripod.com • www.clevelandclinic.org/health/ RESOURCES • Employee Assistance Program – Perspectives, 800-456-6327 • Group-based Stress Management programs • National Association of Cognitive Behavioral Therapists – www.nacbt.org Stress Management for Busy Professionals: Techniques you can use Lynne I. Wagner, Ph.D. Associate Professor Department of Medical Social Sciences Northwestern University Feinberg School of Medicine