A FRESH LOOK AT STRESS – (Session 1) Understanding and managing stress A fresh look at stress – (Session 1) Understanding stress Eustress and distress Allostasis and allostatic load Models of stress The impact of stress Stress and burnout The role of perception Occupational stress ‘Fight or Flight’ and ‘tend and befriend’ Despite no agreed upon definition, stress is often defined as “the response of the body to threats or demands” (Schiraldi & Kerr, 2002:277). General adaptation syndrome – Hans Selye i) the alarm reaction – this is the person’s reaction when suddenly exposed to stressful events (stressors) which are perceived as threat ii) Resistance – the person’s adaptation to the stressor and the subsequent improvement or disappearance of symptoms iii) Exhaustion – the ability to adapt to a stressful situation is limited, exhaustion will result if the stressor is sufficiently severe or prolonged The Yerkes –Dodson Curve Good P E R F O R M A N C E EUSTRESS DISTRESS Bad Poor Performance (Low underaroused - boredom) STRESS Poor Performance (High arousal – overwhelmed) Homeostasis – The balance needed for an organism to maintain optimum balance (e.g. – Body temperature, the body’s acid-base balance, body’s oxygen content and the amount of oxygen that reaches the brain) Allostasis – Variable systems that allow us to cope with environmental changes. (e.g. – Heartbeat, breathing, the amount of glucose in blood and the amount of fat) The stress response (allostasis) is a protective system. It assists us to face a challenge. The protective stress Allostatic load – When a person’s stress response system response is designed for short term activation. When a starts to falter and turn against a person person is faced with perceived danger, the body prepares the person for the challenge. Such a response is meant to be infrequent. When that person lives out a lifestyle that overtaxes the inbuilt coping mechanism then health can start to suffer. When this happens allostasis has given way to allostatic load. (McEwen, 2002) STIMULUS – BASED MODEL WORLD VIEW EMPLOYMENT RELATIONSHIPS COMPETITION CULTURAL EXPECTATIONS SOCIO -ECONOMIC RESPONSE – BASED MODEL PHYSICAL -Rapid Pulse - High adrenaline - Sweat BEHAVIOUR -Fight -Flight -Faint PSYCHOLOGICAL -Panic -Fear -Sweat PSYCHOLOGICAL MODEL INDIVIDUAL INNER WORLD (PSYCHOLOGY & SPIRITUALITY INTERACTIVE MODEL WORLD VIEW PHYSICAL -Rapid Pulse - High adrenaline - Sweat EMPLOYMENT INDIVIDUAL INNER WORLD (PSYCHOLOGY & SPIRITUALITY COMPETITON PSYCHOLOGICAL -Panic -Fear -Sweat RELATIONSHIPS BEHAVIOUR -Fight -Flight -Faint CULTURAL EXPECTATIONS SOCIO-ECONOMIC FACTORS Health costs of allostatic load (stress) Allostatic load affects people in various ways. The cardiovascular system is particularly sensitive to stress. When stimulated the human body needs extra reserves of oxygen and glucose. In response to these requirements the heart beats faster to drive more oxygen and glucose through the body. When repeated surges in blood pressure occur as in the case for people under constant stress, hypertension can be the result. Hypertension increases the likelihood of heart attack. As part of the process for keeping the body supplied with fuel when under stress, adrenaline and cortisol work together to balance the energy supply. If a person remains under stress and cortisol levels therefore stay high, energy becomes stored as fat. This fat often accumulates along blood vessel walls, increasing the likelihood of atherosclerosis, another risk factor in the likelihood of heart attack (McEwen 2002:68-69). Health costs of allostatic load (stress) The immune system like the cardiovascular system is sensitive to stress. If stress continues for an extended period of time the immune system can start to falter (Hempel 2003). When stress is present the immune system sends white blood cells to where they are needed. If stress is ongoing and becomes allostatic load, the immune system becomes suppressed and the likelihood of infection increases (McEwen 2002:91). In some people ongoing stress does not suppress the immune system. In these people the opposite occurs and the immune system becomes so sensitive it starts to attack threats that don’t exist. This is the basis of many autoimmune diseases (McEwen 2002:99). T VIRUS NPY T VIRUS T NPY VIRUS NPY T T NPY VIRUS T A stress and burnout comparison Stress 1. Characterised by over-engagement 2. Emotions become over-reactive 3. Physical damage primary 4. Exhaustion affects physical energy 5. Produces disintegration 6. Loss of fuel and energy 7. Depression: body’s need to Protect itself and conserve energy 8. Sense of urgency; hyperactivity 9. Produces panic, phobia and anxiety disorders 10. May kill you prematurely, you wont have time to finish what you started Burnout Characterised by disengagement Emotions become blunted Emotional damage primary Exhaustion affects motivation and drive Produces demoralisation Loss of ideals and hope Depression: grief caused by loss of ideals and hope Sense of helplessness and hopelessness Produces paranoia depersonalisation type disorders and detachment May never kill you, but your long life may not seem worth living Source: Pryor (1986:7) EVENT EMOTION BEHAVIOUR EVENT PERCEPTION EMOTION BEHAVIOUR EVENT PERCEPTION EMOTION PAST TRAUMA BEHAVIOUR EVENT PERCEPTION EMOTION BEHAVIOUR CORE BELIEFS PAST TRAUMA Henrietta Henrietta is a woman under stress. She is employed as a financial consultant by a major bank. She has been in the position for five years and although the job has been stressful throughout that time, increased competition in the financial sector has led to more demands upon Henrietta. Henrietta is particularly stressed by what she perceives to be unfair expectations upon her. Although others on the bank staff are under the same burden, Henrietta seems far more stressed than the others. Henrietta is one of seven children. She was the youngest in her family and was always looked out for. With the best of intentions, Henrietta’s family saw her as the ‘baby’ of the family who always needed to be looked after. The positives of this for Henrietta were feelings of safety and security. The downside was that Henrietta never developed resilience. Henrietta has a deeply held unconscious belief that people should always be there for her. Henrietta’s stress cannot be understood without taking into account this part of her ‘life script.’ STRESSORS THE LIVED EXPERIENCE OF STRESS ‘LIFE SCRIPT’ FACTORS Responsibility = (power + authority) ‘Fight or flight’ and ‘tend and befriend’ A fresh look at stress – (Session 2) Understanding and managing stress The Stress of Life – Session 2 • Diet • Exercise • Psychology • Spirituality • Challenging the dominant paradigm of the self • Some research findings McEwen (2002:15-16) says; For decades scientific research has shown that we can guard against the ravages of stress by following advice our grandmothers could have given us: restful, plentiful sleep, a good diet, and regular exercise, as well as the support of family, friends, religious organisations, and community (isolation is one of the chief contributors to allostatic load), and a sense of control over and contribution to one’s own life – often noticeably absent in those who suffer from heart attacks or depression. Diet Caffeine – Found in coffee, tea, chocolate, coke. It causes the release of adrenaline which in turn increases the level of stress. In moderation caffeine can be helpful in increasing alertness but regular consumption of too much coffee can have the same impact as long term stress. Regular drinking of coke is even worse. Alcohol – In moderation it can be beneficial for the cardiovascular system but overuse of alcohol is a major stressor. In a catch 22 people often drink as a way of coping with stress. Such a strategy actually increases the effect of stress. High levels of alcohol combined with stress are a deadly combination. Diet Smoking – Smoking is attractive for some people because it does work short term. This is the problem with most drugs. Smoking is responsible for a number of cancers, hypertension, respiratory illnesses and heart disease. Sugar – There are no essential nutrients in sugar. The quick input of energy that sugar produces can exhaust the adrenal glands leading to irritability, poor concentration and in some instances depression. High sugar intake also increase the possibility of diabetes. Salt – Salt increases blood pressure, depletes adrenal glands. Avoid junk foods that are high in salt. These include bacon, ham, pickles and sausage. Diet Fat – Fat puts strain on the cardiovascular system and creates obesity. It has also been linked to breast, colon and prostate cancers. Carbohydrates – These are helpful in that they release the serotonin which has a soothing effect. Good sources of carbohydrates are rice, pasta, potatoes and breads. Experts say that a baked potato or a cup of rice is able to relieve the anxiety of a stressful day. Diet Fibre – You should have at least 25 grams of fibre a day. Sources are fruits, vegetables and grains. Great for the digestive system which can be effected substantially by stress. Vegetables – Vegetables like carbohydrates increase the production of serotonin thus assisting in mood stabilising. Exercise Schiraldi and Kerr (2002:143) say that, Moderate, regular exercise is remarkably effective for improving mental and physical health. It measurably reduces muscle tension and other stress symptoms without the side effects of medication. It improves selfesteem, lowers blood pressure, slows resting breathing and heart rates, increases energy levels and stamina, improves the quality of sleep, promotes weight loss, strengthens the immune system, reduces PMS symptoms, and reduces anxiety and depression. Exercise It has been suggested that a half hour walk each day is as effective in preventing relapse amongst post depressive people as is Prozac. In other words, exercise has antidepressant effects. This is due to the way in which exercise stimulates the release of endorphins into the chemistry of the brain. God grant me the serenity To accept the things that I cannot change; Courage to change the things that I can; And wisdom to know the difference. (Reinhold Niebuhr) Goals I will join a social club I will keep in touch with the friends I already have I will sign up to do volunteer work Desires To have lots of friends and never be lonely HEALTHY BEHAVIOUR DRIVEN BEHAVIOUR “Willingness to take risks” “Avoids anything risky” EMOTION “Fear, panic” -ve SELF TALK “Say no, withdraw, get out of it” ASSUMPTION “If I do something new I will fail” CORE BELIEF “I am a failure” Conscious Pre-conscious Unconscious COMMON DISTORTIONS OF THINKING (DOTS) 1. Filtering: You take only the negative (or positive) details and magnify them while filtering out all positive aspects of a situation. 2. Polarised thinking: Seeing things as black or white, all or nothing, good or bad e.g. you have to be perfect or you’re a failure. 3. Mind reading: You assume that you know what people are thinking and feeling without any evidence. 4. Catastrophising: Making mountains out of molehills. 5. Blaming: You hold other people responsible for your pain, or take the other tack and blame yourself for every problem or reversal. 6. Emotional reasoning: Living on the basis that whatever you feel is true. 7. Global mislabelling: You generalise one or two qualities into a negative global judgement – eg. “I’m a failure” instead of “I made a mistake” 8. Minimisation: Minimising your own or another’s positive qualities – e.g. “I’m hopeless at everything” 9. Perfectionism: I must do a job perfectly or I will look bad and suffer accordingly. 10. Externalisation of self-worth: My sense of worth depends mainly on what others think of me. 11. Fallacy of worrying: If I worry enough, the problem will be solved. 12. Fallacy of ignoring: If I ignore the problem long enough, it will go away 13. Jumping to conclusions: Making up your mind about something without having all the evidence. 14. Entitlement: Expecting special privileges that don’t exist. 15. Justifying: Attempting to defend one’s position by any means available rather than face the issue squarely. SOME COGNITIVE RESTRUCTURING TECHNIQUES: 1. Reattribution: Placing responsibility where responsibility belongs 2. Questioning evidence 3. De-catastrophising: Also called the “what if” technique? 4. Reframing: Putting on “new glasses” 5. Thought stopping: Picture a stop sign, or a bell, or a wall whenever unwanted thoughts start 6. Paradox: Prescribing the problem 7. Normalising: Recognise the “normality” of worry in worrisome circumstances 8. Relaxation and breathing exercises 9. Support group: Joining or forming a regular/sharing group can build much needed bridges, develop trust and restore confidence 10. Risk taking exercises: Daring to get out of one’s “comfort zone” – builds self – esteem FOUR QUESTIONS FOR CHALLENGING MISTAKEN BELIEFS What are the facts and what are my subjective perceptions? What is the evidence for and against my thinking? What distortions or mistakes am I making in my thinking? Are there any other ways of interpreting this situation? DATE EVENT xx/xx/xx Co-worker criticises my work AUTO. THOUGHTS EMOTIONS/ RATIONAL BEHAVIOUR RESPONSE I’m useless. I have to stop others seeing it. I should change job. fear, shame, anger temptation to rip my work up and start again Thought stopping. Who made this person an expert. Actually his work is often questioned. He has a reputation of being a bad worker. NEW EMOTIONAL RESPONSE Find the emotions have settled. I’m calmer IMPORTANCE URGENT & NOT IMPORTANT URGENT & IMPORTANT NOT URGENT & NOT IMPORTANT NOT URGENT & IMPORTANT URGENCY AWARE A – Accept your anxiety. Fighting directly can make it worse. Try and flow with it. W – Watch your anxiety. Become an observer of it. Write about it. A - Act as though the anxiety is not there. Don’t let the anxiety control your life. R – Repeat the steps E – Expect the best – (Choose hope – don’t reduce hope to a feeling) GOD GOD The line of perfection SIN SIN Spiritual ladder Human beings ANXIETY PRODUCING RELIGION Human beings GRACE CENTRED SPIRITUALITY SPIRITUAL ECLIPSE GOD FALSE GOD SUBJECT Confession and forgiveness Part of a helpful spirituality is the ability to major on living by confession and forgiveness. If when we make a mistake and hurt others we confess and seek to make amends, then we remove unhelpful feelings of guilt from our lives. When we strive to forgive others we remove the poison of resentment from our lives. It has been said that “resentment is like drinking poison and waiting for the other person to die” (Malachy McCourt cited in Schiraldi & Kerr, 2002:181). The importance of a “journeying” view of self A Stable and unchanging self to be found and protected Cartesian View “I Think Therefore I am” The self is fluid and changing. The self is a journey and always emergent Vichian View “The dialogical self” Some findings from the research: 1. The problematic nature of ‘call’ 2. The potential for pre-reflective identification to be confused with call 3. The Christian concept of being ‘tested.’ – (I should suffer) 4. Only the women in the study experienced a sense of call internally It’s about knowing, and if I was to talk about my call to ministry now, it’s probably stronger than it ever was but I still couldn’t necessarily find the words to explain it in a very coherent fashion. Apart from, it’s an inner knowing. (Sophie) …in the space of six days, I’d jumped every hurdle. While this is a coincidental thing, in terms of call, I sensed that just the way the process was expedited it seemed to be, it was made remarkably easy. (Ken) Some findings from the research: 1. The problematic nature of ‘call’ 2. The potential for pre-reflective identification to be confused with call 3. The Christian concept of being ‘tested.’ – (I should suffer) 4. Only the women in the study experienced a sense of call internally 5. Stress related to being ‘agents of change’ Some findings from the research: 6. The abuse of Ministers by Congregations – (We hear of abusive Ministers. There are also abusive churches) 7. Discrimination against female clergy – (both overt and covert) 8. The difficulties involved in ‘measuring success.’