Stress Management for Busy Professionals: Techniques you can use

1. 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

2. 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

3. 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

4. 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.

5. Perception of Stress: LOW

6. Perception of Stress: HIGH

7. 1. Alarm Stage2. Resistance Stage3. Exhaustion Stage STAGES OF STRESS

8. STAGES OF STRESS: PHYSIOLOGICAL EFFECTS

9. 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

10. 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.

11. Optimal Level of Stress Yerkes-Dodson law of arousal and performance

12. Identifying Stressors Situations, activities, and relationships that cause ‘trauma’ to one’s physical, emotional, or psychological self

13. Stressors School Work Family Relationships Legal Finances Health/illness Environment Living Situation

14. 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

15. 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 Burnout

16. 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 Identifying Triggers: When there’s smoke, there’s fire

17. "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) • STRESS MANAGEMENT STRATEGIES

18. Technique: Cognitive Reframing STRESSOR COGNITION OUTCOME I’ll never finish in time No one else can help I’ll lose my job Anxious Overwhelmed Frustrated Helpless X X Deadline I’ll get it done, I always do Can anyone help? I will deal with consequences IF I miss the deadline Inspired Challenged Hopeful Productive Resourceful Deadline

19. Technique: Cognitive Reframing STRESSOR COGNITION OUTCOME They always come to me at the last minute No one respects my job This was intentional Angry Anxious Overwhelmed Frustrated Helpless X X Last minute request Maybe they don’t realize how it affects me Maybe it was out of their control I can rise to this challenge Empathic Problem-focused Hopeful Productive Last minute request

20. 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.

21. Active Coping Model STRESSOR: WORK DEADLINE Uncontrollable Controllable • Deadline • Colleague’s behavior • Nature of the work • 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 Emotion-focused strategies • Examples: • Cultivate compassion • Express negative • emotions • Seek support • Search for meaning Problem-solving strategies

22. 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. By Mary Carmichael Photo illustration by Fredrik Broden for Newsweek Newsweek March 26, 2007 issue http://www.msnbc.msn.com/id/17662246/site/newsweek/

23. Exercise Is a State of Mind Researchers are learning more about how physical activity affects our moods. Is sweat the hot new antidepressant? By Michael Craig Miller, M.D. Donald Miralle / Getty Images for Newsweek Physical Therapy: Research suggests that exercise can affect the moods and even relieve depression Newsweek March 26, 2007 issuehttp://www.msnbc.msn.com/id/17662247/site/newsweek/

24. 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

25. Boost Resources: Time Management

26. 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

27. Time Management Delegating responsibility Saying “no” Stick to an agenda Avoid perfectionism

28. 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.

29. 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 aninterruption -> TURN IT OFF!!

30. 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

31. 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

32. 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

33. Avoid the fallacy that you will have more time in the future than you have now:Make Self-Care a Priority! • TIME MANAGEMENT

34. 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

35. 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

36. Strategies for Mind and Body Relaxation Yoga Meditation Mindfulness Diaphragmatic breathing Guided imagery Progressive muscle relaxation

37. 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

38. Importance of Engaging in Pleasant Events Adult Pleasant Events Schedule

39. 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.

40. 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/

41. RESOURCES Employee Assistance Program Perspectives, 800-456-6327 Group-based Stress Management programs National Association of Cognitive Behavioral Therapists www.nacbt.org

42. 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