Managing StressTools for Healthy Living
By Colleen Stanley, LMFT, CEAP
Stony Brook Employee Assistance Program
(631) 632-6085
EAP@stonybrook.edu
Agenda
 Social Readjustment Rating Scale
 Recognizing Stress
 Understanding Stress
 How Stress Effects the Body
 Where Does My Stress Come From?
 4 Steps to Manage Stress
 How Can I Manage My Stress?
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Adapted from Holmes Rahe Social Readjustment Rating Scale
Instructions: - Indicate next to each life event the number of times you have experienced it within the past year.
Multiply the number of times you have experienced each life event by the number of ‘life crisis units’ next to it.
Add up the total of Life Crisis Units.
RANK
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2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
LIFE EVENT
death of spouse/partner/parent
divorce or ending long-term relationship (12+ yrs.)
marital separation or relationship separation
detention in jail or other institution
death of close family member other than parent
major personal injury or illness
marriage
being fired
marital/long-term relationship reconciliation
retirement
change in health or behavior of family member
pregnancy
sex difficulties
gain new family member (birth, adoption , marriage)
major business readjustment
change in financial state
death of close friend
undertaking different line of work
change in number of arguments w/spouse/partner
new mortgage or loan for major purchase
foreclosure of mortgage or loan
change of responsibilities at work
son or daughter leaving home
trouble with in-laws
outstanding personal achievement
partner/spouse begins or stops work
begin or end school
change in living condition
revision of personal habits/routine
trouble with boss
change in working hours or condition
change in residence
change in school
change in recreational habits
change in church activities
change in social activities
loan for major purchase (e.g. car)
change in sleeping habits
change in number of family gatherings
change in eating habits
vacation
Christmas or holiday observance
minor violations of the law
Total Life Crisis Units
Scoring:
0-150
150-200
200-299
300 & up
LIFE CRISIS UNITS
100
73
65
63
63
53
50
47
45
45
44
40
39
39
44
38
37
36
35
31
30
29
29
29
28
26
26
25
24
23
20
20
20
19
19
18
17
16
15
15
13
12
11
____
no significant problem; 10% chance of stress-related illness
mild life crisis; 33% chance of stress-related illness
moderate life crisis; 50% chance of stress-related illness
major life crisis; 80% chance of stress-related illness
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Recognizing Stress
Your EMOTIONS
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Do you feel angry and irritable much of the time?
Do you have dramatic mood swings?
Do you suffer from obsessive thoughts or actions, such as repeated hand washing
or constantly checking whether you have left the gas on?
Do you often feel apprehensive or frightened?
Do you suffer from diminished libido?
Do you have feelings of self-loathing or lack of self-worth?
Do you have suicidal thoughts?
Do you find yourself unable to concentrate?
Do you constantly feel guilty?
Do you experience feelings of paranoia?
Your BODY
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Do you get aches in your back and shoulders?
Do you suffer from insomnia, nightmares, or simply wake up still feeling tired?
Do you suffer from breathlessness?
Do you suffer from frequent indigestion, constipation or diarrhea?
Do you experience muscle twitches?
Do you constantly feel tired?
Do you suffer from pain or tightness of the chest?
Do you suffer from palpitations or a lump in the throat or stomach?
Have you experienced dramatic changes in you menstrual cycle?
Do you suffer from sweaty or clammy hands?
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Your BEHAVIOR
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Do you always say ‘yes’ when you are asked to do more, either at work or by friends and
family?
Do you rigidly stick to routines?
Do you either clench or unclench your fists &/or clench your jaw &/or grind your teeth?
Do you drink large quantities of either caffeine or alcohol?
Are you too busy to relax?
Do you find it hard to make decisions, and feel increasingly frustrated by this difficulty?
Do you set unrealistic deadlines for yourself?
Do you pick fights with people?
Do you work longer and longer to achieve the same or less?
Have you found either that you are overeating or that you have entirely lost your appetite?
How did you score?
Up to 5 “yes” responses: Your stress quotient is 20
Try to identify the person or problem making you feel anxious, and think of ways in which you can
react differently to the pressures – whether to avoid them, confront them or negotiate.
Exercise, diet and other forms of physical relaxation could all help at this point.
Up to 10 “yes” responses: Your stress quotient is 40
Time to take more drastic action. It may be that you simply need a holiday. However, if, after a
break, you don’t feel dramatically better, it may be time to re-evaluate your needs &/or
personal life.
More than 10 “yes” responses: Your stress quotient is 100
Time to seek professional help. You need to change your life-fast-and counseling may help you to
do so. Psychological burn-out is a real danger.
Call the Employee Assistance Program we can help.
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Understanding Stress
If you drew a picture of your stress, what would it look like?
Stress – “It is our mental, emotional and physical responses to the irritants,
challenges and threats – individual and accumulated – in our lives.”
Texas Heart Institute, Heart Owner’s Handbook
The World Health Organization calls job stress:
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A “worldwide epidemic”
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America’s # 1 health problem
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Costs an estimated $200 billion annually
What happens:
Positive Stress
Negative Stress
Body produces adrenaline to help
spur you on to concentrate, focus
and perform. Once the event is over,
your body relaxes and readjusts.
Occurs when you stay “geared up”
and do not or cannot relax after
meeting the challenge. It can leave
you tired, angry, frustrated and
depressed.
You may feel:
Excited and challenged
Under pressure
No time to relax
You may think:
“I can handle this” attitude
You are able to assess, prioritize,
focus, and act
Things are out of control
You have to rush to try to keep up
You may see others:
As a support network for you in
managing stress
As unwilling or unable to support
you
You may act:
You spend time developing interests
You may isolate yourself from your6
support network activities
How Stress Effects the Body
Physical
Psychological/ Emotional
Behavioral/Cognitive
Headaches
Anxiety
Overeating
Muscle aches
Racing thoughts
Impatience
Frequent colds
Feeling helpless
Avoiding responsibility
Skin eruptions
Feeling insecure
Isolation
Tremors
Hypersensitivity
Argumentativeness
Increased perspiration
Feelings of gloom/doom
Burnout
High blood pressure
Felling keyed up/on edge
Loss of appetite
Fatigue
Feeling trapped/no way out
Procrastination
Change in appetite
Embarrassment
Withdrawal
Feelings of warmth
Confusion
Quickness to argue
Dizziness
Lethargy
Increased substance use
Indigestion
Forgetfulness
Increased smoking
Insomnia
Depression
Change in relationships
Back pain
Feeling hopeless
Change in religious practices
Weakness
Defensiveness
“I can’t do it”
Tight and dry throat
Slowed thinking
“People are looking”
Grinding teeth
Isolated
“I can’t go alone”
Clenched jaw
Criticized
“I can’t breath”
Chest pain
Inability to concentrate
“What if I make a fool of myself”
Shortness of breath
Difficulty sleeping
“I could faint”
Pounding heart
Irritability
“I’m trapped”
Rashes/skin conditions
Sadness
“Get me out of here”
Anger
“I’m going to die”
Fear
“I’m not going out”
Panic
Compulsive behaviors
Excessive worry
Poor self-care
Unease
Legal problems
Loss of control
Difficulty controlling
Rejection
Impulses
Impatience
indebtedness
“Fight/Flight” response – a habitual learned or genetic response to a fear of danger from situations. It
is a survival instinct to help us to fight off or to flee the danger.
Your automatic physiological response to stress:
 Muscles tense and heart rate increases
Blood pressure elevates and rapid breathing
Hands get cold and clammy and perspiration increases
Increased mental alertness and sensory capacity
Rush of adrenalin and pupils dilate
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Where Does My Stress Come From?
Please identify the STRESS in your life.
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Job Stress
Your work environment, the demands and pressures of your job,
your job or career expectations, the kind of work you do, events at work
______________________________________________________________________________
_______________________________________________________________________ _______
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Environmental Stress
Noise, crowding, pollution, untidiness, dirt or other distractions
______________________________________________________________________________
______________________________________________________________________________
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Survival Stress
When your survival or health is threatened, when you are put under pressure,
when you experience some unpleasant or challenging event
______________________________________________________________________________
______________________________________________________________________________
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Internally Generated Stress
Your expectations, your self-talk, an anticipation or anxious worrying, a tense, hurried
approach to life, an ‘addiction’ to or enjoyment of stress, perfectionism, chronic anger
______________________________________________________________________________
______________________________________________________________________________
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Chemical and Nutritional Stress
What you eat, your tendency to diet to excess or to overeat, use or overuse of caffeine,
nicotine, alcohol, drugs (including prescription medications)
______________________________________________________________________________
______________________________________________________________________________
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Life Changes
Marriage, divorce, death in the family,
having a child (refer back to the Social Readjustment Rating Scale)
______________________________________________________________________________
______________________________________________________________________________
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Other Factors
Your age, your health, your financial situation, your satisfaction with your life in general
_____________________________________________________________________________
_____________________________________________________________________________
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How to Manage Stress
Stress Management: Is the effort you make to control or manage your stress;
to keep yourself at a healthy and enjoyable level of stimulation.
Coping: Managing the discrepancy between the demands of the situation
and available resources
How well do you COPE?
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Try to see the positive side of each situation
Try to step back from the situation and be more objective
Pray for guidance or strength
Sometimes take it out on others when I feel angry or depressed
Get busy with other things to keep my mind off the problem
Read relevant material or asked other people for solutions, and considered
several alternatives
Take some action to improve the situation
How does your thinking define your reality?
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In uncertain times, I usually expect the best
If something can go wrong for me, it probably will
I always look on the bright side
I’m always optimistic about my future
I hardly ever expect things to go my way
Things never work out the way I want them to
I’m a believer In the idea that “every cloud has a silver lining”
I rarely count on good things happening to me
Overall, I expect more good things to happen to me than bad
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Four Steps to Managing Stress
1)
Awareness
-Listen to your body
-Identify the events in your life that create stress
-Keep a “stress diary”
Managing STRESS is all about determining what really does come first,
and letting go of the insignificant
2)
Develop a Positive Attitude and Lifestyle
-Use positive thinking and self-talk (self-talk leads to success or failure)
-Develop and use a support system
-Exercise
-Practice good nutrition
-Get enough rest and relaxation
-Balance your home life with your work life
STOP THOSE NEGATIVE THOUGHTS!
Picture a red STOP sign
Say “STOP”
Look straight ahead and take a deep breath in
As you breath out, say “RELAX”
Repeat this 3 times
On the 4th inhale, clench your fist when you breath in
On the exhale, let tension out of your fist
On the 5th inhale, tighten and relax your feet and toes
On the final inhale, tighten and relax your shoulders and neck
3)
Use Relaxation Techniques
-Remember to breathe!
-Take a deep breath and count to 10
-Practice deep breathing, stretching or meditation
-Make a daily soul connection
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Deep Breathing can help relieve stress
When you feel stressed or frustrated, try this:
Lie down or sit upright and get comfortable
Place your hands on your lower abdomen
Exhale first
Then breathe deeply, focusing on drawing your breath from your nose through your lungs
Down through your diaphragm (lower abdomen)
As you practice deep rhythmic breathing, you want to be aware of your breath slowly, calmly,
like a cloud moving through the sky – effortlessly.
You will begin to notice that when you concentrate on your breath, you begin to let go of
unneeded thoughts, habits, patterns that no longer serve you.
Be patient!
4)
Empower yourself
-Your attitude is your choice
-Remember that your state of mind is only temporary
-See the gifts in problems and opportunities in crises
-Avoid blaming, denial and catastrophic thinking
Empower yourself!
Your ATTITUDE is YOUR CHOICE.
Remember that, no matter how controlled you feel, you always retain the ultimate human
freedom to decide what stand you will take.
Ten Popular Meditation Techniques
1. Repeat a meaningful word or phrase, known as a mantra
2. Follow or count your breaths
3. Pay attention to the sensations in your body
4. Cultivate love, compassion, forgiveness, and other healing emotions
5. Concentrate on a geometric shape or other simple visual object
6. Visualize a peaceful place or healing energy or light
7. Reflect upon inspirational or sacred writings
8. Gaze at a picture of a holy being or inspirational person
9. Contemplate the beauty to be found in nature, art, music
10. Bring mindful awareness to the present moment
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How Can I Manage My Stress?
Please identify some solutions for each of the stressors you identified earlier.
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Job Stress
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____________________________________________________________________________
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Environmental Stress
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____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Survival Stress
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Internally Generated Stress
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Chemical and Nutritional Stress
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Life Changes
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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Other Factors
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
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My Personal Action Plan to Manage Stress
As a result of today’s workshop, I am committed to beginning the work I
need to do the reduce stress in the following areas:
1._________________________________________________________________
2._________________________________________________________________
3._________________________________________________________________
The specific actions I need to take to begin this process are:
1._________________________________________________________________
2._________________________________________________________________
3._________________________________________________________________
I will hold myself accountable by reassessing my program on:
1._________________________________________________________________
Thank you!
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