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STRESS MANAGEMENT WORKSHOP

What is stress?

Stress is an everyday fact of life, you can’t avoid it.
  • While we usually think of stressful events as being negative, such as the injury, death or illness of a loved one, they can also be positive.
For instance, getting a new home or a promotion brings with it the change of status and new responsibilities. Falling in love can be as stressful for some people as falling out of love.
  • All stress is not bad. Stress is not only desirable, but also essential to life. Whether your stress experience is a result of major life changes or the cumulative effects of minor everyday hassles, it is how you react to stressful experiences that can create a stress response.

YOU EXPERIENCE STRESS FROM THREE BASIC SOURCES:

Your environment; bombards you with demands to adjust. You must endure weather, noise, crowding, interpersonal demands, time pressures, performance standards, and various threats to your security and self-esteem.

Physiological; the rapid growth of adolescence, menopause in women, aging, illness, accidents, lack of exercise, poor nutrition, and sleep disturbances all tax the body. Your reaction to environmental threats and changes also produce body changes, which are themselves stressful.

Your Thoughts; your brain interprets and translates complex changes in your environment and determines when to push the panic button. How you interpret, perceive, and label your present experience and what you predict for the future can serve either to relax or stress you. Interpreting a sour look from your boss to mean that you are doing an inadequate job is likely to be very anxiety provoking. Interpreting the same look as tiredness or preoccupation with personal problems will not be as frightening.
  • Stress researcher Richard Lazarus has argued that stress begins with your appraisal of a situation.
You first ask yourself what is happening and why (causality). Then, to determine the situation’s significance for your well being, you ask yourself how dangerous it is and what resources you have to cope with it. Anxious, stressed people often decide that (1) an event is dangerous, difficult or painful and (2) they don’t have the resources to cope. CHRONIC STRESS AND DISEASE   Primitive man used stress to trigger the "fight or flight" response they needed in order to cope with physical dangers in their lives. During this "fight or flight" response, their bodies experienced a series of biochemical changes that enabled them to take care of dangers such as saber-tooth tigers.
    • These days, when social custom or other limitations prevent you from fighting or running, stress triggers a mobilizing response that is no longer useful. In fact, the chronic fight or flight response can cause physical and/or emotional damage.
Some effects prolonged stress can have on people are:
  1. High blood pressure
  2. Digestive problems
  3. Immune deficiencies
  4. Depression
  5. Agitation
  6. Sleep disorders  
Therefore, some very important bodily functions that normally keep you feeling healthy, shut down. But, if you are aware of and are able to use effective methods of turning off your fight or flight response, your brain can return to normal within a few minutes and perform it’s primary function of keeping your body healthy. Since we all experience stress as individuals, we all cope with that stress in our unique ways. We are going to attempt to define our own sources, symptoms and behaviors that may be stress-related. As individuals, we are likely to find we require a variety of methods to cope with stress in a healthy, affordable manner.                              


SCHEDULE OF RECENT EXPERIENCE

(Adaptation of schedule) Prepared by Thomas Holmes, M.D.,at the University of Washington School of Medicine, Seattle, Washington.

Part A Instructions: Think back on each possible life event listed below, and decide if it happened to you within the last year. If the event did happen, check the line next to it.

  1. A lot more or a lot less trouble with the boss. _______
  2. A major change in sleeping habits (sleeping a lot more or a lot less, or change in part of day when asleep) _______
  3. A major change in eating habits (a lot more or a lot less food intake, or very different meal hours or surroundings). _______
  4. A revision of personal habits (dress, manners,
  5. associations, etc.) _______
  6. A major change in your usual type and/or
  7. amount of recreation. _______
  8. A major change in your social activities (clubs, dancing,
  9. movies, visiting, etc.) _______
  10. A major change in church activities (a lot more or a lot
  11. Less than usual). _______
  12. A major change in number of family get-togethers
  13. (a lot more or a lot less than usual). _______
  14. A major change in financial state (a lot worse off or a lot better off than usual). _______
  15. In-law troubles. _______  
  16. A major change in the number of arguments with spouse (a lot more or a lot less than usual regarding child- rearing, personal habits, etc.). _______
  17. Sexual difficulties. _______
  18. Major personal injury or illness. _______
  19. Death of a close family member (other than spouse). _______
  20. Death of spouse. _______
  21. Death of a close friend. _______
  22. Gaining a new family member (through birth, adoption,
  23. oldster moving in, etc.). _______
  24. Major change in the health or behavior of a family member. _______
  25. Change in residence. _______
  26. Detention in jail or other institution. _______
  27. Minor violations of the law (traffic tickets, jaywalking,
  28. disturbing the peace, etc.). _______
  29. Major business adjustment (merger, reorganization, bankruptcy, etc.) _______
  30. Marriage. _______
  31. Divorce. _______
  32. Marital separation from spouse. _______
  33. Outstanding personal achievement. _______
  34. Son or daughter leaving home (marriage, attending college, etc.) _______
  35. Retirement from work. _______
  36. Major change in working hours or conditions. _______
  37. Major change in responsibilities at work (promotion demotion, lateral transfer). _______
  38. Being fired from work. _______
  39. Major change in living conditions (building a new home, remodeling, deterioration of home or neighborhood). _______
  40. Wife/ husband beginning or ceasing work outside the home. _______
  41. Taking on a mortgage greater than $25,000. (purchasing
  42. a home, business, etc.) _______
  43. Taking on a mortgage or loan of less than $25,000 (purchasing a car, TV, freezer, etc.). _______
  44. Foreclosure on a mortgage or loan. _______
  45. Vacation _______
  46. Changing to a new school. _______
  47. Changing to a different line of work. _______
  48. Beginning or ceasing formal schooling. _______
  49. Marital reconciliation with a mate. _______
  50. Pregnancy. _______

Scoring: Add your responses to get your total score.

The higher your score, the more likely you are to get sick. Stress can be cumulative. So, the higher your score, the harder you should work to stay well.


SYMPTOMS CHECKLIST  

Instructions: Rate the stress-related symptoms below for the degree of discomfort they cause you. 1= Slight discomfort 10= Extreme discomfort.

  • Anxiety in specific situations; _______
  • Tests _______
  • Deadlines _______
  • Interviews _______
  • Other Anxiety in personal relationships _______
  • Spouse _______
  • Parents _______
  • Children _______
  • Other Anxiety, general – regardless of the situation Or the people involved; _______
  • Depression _______
  • Hopelessness _______
  • Powerlessness _______
  • Poor self-esteem _______
  • Hostility _______
  • Anger _______
  • Irritability _______
  • Resentment _______
  • Phobias _______
  • Fears _______
  • Obsessions, unwanted thoughts _______
  • Muscular tension _______
  • High blood pressure _______
  • Headaches _______
  • Neckaches _______
  • Backaches _______
  • Indigestion _______
  • Irritable bowel _______
  • Ulcers _______
  • Chronic constipation _______
  • Chronic diarrhea _______
  • Muscle spasms _______
  • Tics _______
  • Tremors _______
  • Fatigue _______
  • Insomnia _______
  • Sleeping difficulties _______
  • Obesity _______
  • Physical weakness _______
  • Job stress _______
  • Other

Important: Physical symptoms may have purely physiological causes. You should have a medical doctor eliminate the possibility of such physical problems before you proceed on the assumption that your symptoms are completely stress-related.


BODY AWARENESS EXERCISES

BODY INVENTORY
The following exercises promote body awareness, and will help you identify areas of tension. Awareness

  1. First, focus your attention on the outside world. Start sentences with, "I am aware of _______." (E.g. "I am aware of the cars going by outside the window, papers moving, the coffee perking, the breeze blowing and the blue carpet.")
  2. After you become aware of everything around you, shift to focusing your attention on your body and your physical sensations, your internal world (e.g., "I am aware of feeling warm, my stomach gurgling, tension in my neck, nose tickling, and a cramp in my foot.")
  3. Shuttle back and forth between internal and external awareness (e. g. "I am aware of the chair pushing against my buttocks, the circle of light from the lamp, my shoulders hunching up, the smell of bacon.")
  4. Used at free moments throughout the day, this exercise allows you to separate and appreciate the real difference between your inner and outer worlds.
Body Scanning
  1. Close your eyes… Start with your toes, and move up your body… Ask yourself, "Where am I tense?".. Whenever you discover a tense area, exaggerate it slightly so you can become aware of it…. Be aware of the muscles in your body that are tense… Then, for example, say to yourself, "I am tensing my neck muscles…. I am hurting myself…. I am creating tension in my body"..  
  • Note that all muscular tension is self-produced…. At this point, be aware of any life situation that may be causing the tension in your body and what you could do to change it. 

Letting go of Your Body

  1. Lie down on a rug or firm bed and get comfortable…
  2. Pull your feet up until your feet rest flat on the floor…
  3. Close your eyes …
  4. Check yourself for comfort …
  5. This may require shifting your body around …
  6. Become aware of your breathing …
  7. Feel the air move into your nose, mouth and down your throat and into your lungs …
  8. Focus on your body and let all of the parts come into your awareness spontaneously …
  9. What parts of your body come into awareness?
  10. What parts are you less aware of?
  11. Become aware of which parts of your body you can easily feel and which parts of your body have little sensation …
  12. Do you notice any difference between the right and left side of your body?
  13. Now, become aware of any physical discomfort you are feeling …
  14. Become aware of this discomfort until you can describe it in detail..
  15. Focus and be aware of what happens to this discomfort. It may change
  16. Let your body do whatever it wants to do …
  17. Continue this for five to ten minutes … Allow your body to take over 

  STRESS AWARENESS DIARY   Some parts of your day are more stressful than others, and some stressful events are more likely to produce physical and emotional symptoms than others. Certain types of stressful events often produce characteristic symptoms. It is useful to keep a record of stressful events as well as symptoms that may have been a stress reaction. Keep a stress awareness diary for two weeks. Make note of the time that a stressful event occurs and the time you notice a physical or emotional symptom that could be related to the stress The following is an example of a Monday for a department store clerk:     TIME STRESSFUL EVENT SYMPTOM   8:00 Alarm doesn’t go off, late slight headache rushing 11:00 Customer is rude & insulting Anger, tightness in stomach
  • As you can see, the diary identifies how particular stresses result in predictable symptoms. Interpersonal confrontations may characteristically be followed by stomach tension. Rushing may be causing vasoconstriction (tightening of the blood vessels) for this individual, and therefore results in irritability and headaches.
  • You can use your stress awareness diary to discover and chart your stressful events and characteristic reactions.
  • After using the body awareness exercises, you will begin to recognize where your body stores muscular tension. When you allow yourself increased awareness, you can find ways to let go of the tension you discover.
  • Along with the release of tension, you will experience increased energy and a sense of well-being
  • After your stress awareness diary has helped you identify your reactions to stress, you should continue to record your progress with other relaxation techniques.
  FIND WHAT WORKS FOR YOU AND USE IT AS YOU NEED    

** If your reaction to stress involves physical symptoms such as frequent headaches, stomach problems or high blood pressure, get a check-up first. Tell your doctor that you intend to practice relaxation techniques, and ask him/her to determine whether your physical symptoms are caused entirely by stress, or if there are physiological causes as well. Once you start, consult your physician if you experience any prolonged physical ill effects.


PROGRESSIVE RELAXATION

From the book "Progressive Relaxation", published by Dr. Edmund Jacobson in 1929.

This technique is based on the premise that the body responds to anxiety-provoking thoughts and events with muscle tension. This physiological tension, in turn, increases the subjective experience of anxiety. Deep muscle relaxation reduces physiological tension and is incompatible with anxiety. The habit of responding with one blocks the habit of responding with the other
  • Progressive relaxation provides a way of identifying particular muscles and muscle groups and distinguishing between sensations of tension and deep relaxation.
Four major muscle groups will be covered:
  1. Hands, forearms and biceps
  2. Head, face, throat and shoulders, including concentration on forehead, cheeks, nose, eyes, jaws, lips, tongue & neck. Considerable attention is focused to your head, because from the emotional point of view, the most important muscles in your body are situated in and around this region.
  3. Chest, stomach and lower back.
  4. Thighs, buttocks, calves & feet
  Can be practiced lying down or in a chair; each muscle grouping is tensed or flexed from five to seven seconds and relaxed from 20 to 30 seconds. This procedure is repeated at least once, but if an area remains tense, you can practice up to five times. You may also find it useful to use relaxing expressions when untensing:     E.g. Let go of the tension Throw away the tension – I am feeling calm & rested Relax and smooth out the muscles Let the tension dissolve away.   BREATHING
  • Breathing is essential for life; proper breathing is an antidote to stress.
We all breathe, but few of us retain full breathing experienced by an infant or primitive man.  
  • Full, deep breathing:

Leads to proper purifying/ oxygenating of blood Aids in proper digestion & nutrition for your entire body Therefore, aids in maintaining good physical & mental health. Improves coping skills                    

Symptom Effectiveness:  

  • Breathing exercises have been found to be effective in reducing anxiety, depression, irritability, muscular tension & fatigue.
  • They are used in the treatment and prevention of breath-holding, hyperventilation, shallow breathing and cold hands & feet
  • While breathing exercises can be learned in a matter of minutes, and some immediate benefits experienced, the profound effects may not be realized until months of continuous practice have passed.
  • After you try these exercises, you can easily include them in your daily routine.

  The Relaxing Sigh;

A sigh is usually a sign that your body isn’t getting enough oxygen. Sighing/ yawning is your body’s way of remedying the situation. A sigh releases some tension & can be practiced as a way of relaxing.

  1. Begin by sitting or standing up straight
  2. Inhale a complete natural breath
  3. Hold this breath for a few seconds
  4. Exhale a little air with force through a small hole in your lips, as though you are blowing through a straw, stop, and then exhale more air. Repeat till all air is exhaled in small puffs
  Tap Away Tension; This exercise will help you feel relaxed & alert.
  1. Stand or sit up straight
  2. Slowly, inhale tapping your chest with fingertips; constantly move your hands around till you’ve tapped all areas of your chest. Women may choose not to tap their breasts.
  3. When you’ve inhaled as much as feels comfortable, hold your breath & pat your entire chest with your palms. Again, women may choose not to pat their breasts.
  4. Exhale, using the purifying breath.
  5. Practice a few more purifying breaths, then repeat the exercise         

SOME PROVEN STRESS RELIEVERS
  1. Get up a few minutes earlier in the morning; the morning mishaps will be less stressful.
  2. Prepare for your morning the evening before, set the table, lay out the clothes you plan to wear, etc.
  3. Don’t rely on you memory; write important information down.
  4. Practice preventative maintenance, your car, your appliances; home and relationships will be less likely to "fall apart" at the worse possible moment.
  5. Eliminate or restrict the amount of caffeine in your diet
  6. Avoid procrastination
  7. Set up imaginary contingency plans in case anything goes wrong with your original plans.
  8. Relax your standards if needed, the world won’t come to an end if the grass doesn’t get mowed this weekend or the sheets don’t get changed till Sunday
  9. Use "Pollyanna Power". For every one thing that goes wrong, there are probably 50 or 100 blessings or things that go right. COUNT YOUR BLESSINGS.
  10. Say "no" to extra projects, social activities, and invitations you know you don’t have time for. Value yourself enough to allow yourself quiet time to relax and be alone.
  11. Get enough sleep. If necessary, set an alarm clock to remind yourself to go to bed.
  12. Create order out of chaos; organize your home and workplace so that you always know exactly where things are. Put things away where they belong, and you won’t have to go through the stress of losing things.
  13. Writing your thoughts and feelings in a journal or on paper to be thrown away, can help you clarify things and give you a needed perspective
  14. Inoculate yourself against a feared event. Just as a vaccine containing a virus can protect you, if you expose yourself to one or more of the dreaded aspects of an event beforehand, you can often mitigate your fears.
  15. When the stress of getting a job done gets in the way of getting the job done, diversion-a voluntary change in activity, for a few hours, may be helpful.
  16. Learn to live one day at a time.
  17. Everyday, do something you really enjoy
  18. Talk it out. Discussing your problems with a trusted friend can help clear your mind of confusion and help make problem solving possible.
  19. Do something that will improve your appearance, looking better can help you feel better.
  20. Become more flexible, some things are worth not doing perfectly, and some issues are well to compromise upon.
  21. Eliminate destructive self-talk. "I’m too old to…. "I’m too fat to…" etc.
  22. Learn to delegate responsibility to capable others.
  23. Don’t forget to take a lunch break. Get away from your work area in your body and mind, even if it’s just for 15-20 minutes.
  24. Have a forgiving view of events and people. Accept the fact that we live in an imperfect world.

J Benshoof 11/99