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Stress Management. Matt Orr, PhD Department of Family and Preventive Medicine. The best way to find yourself is to lose yourself in the service of others. -- Ghandi. Life Happens. It’s all about our sense of …. . CONTROL.

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Stress Management

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Stress management

Stress Management

Matt Orr, PhD

Department of Family and Preventive Medicine

Stress management

The best way to find yourself is to lose yourself in the service of others.

-- Ghandi

Life happens

Life Happens

It s all about our sense of

It’s all about our sense of ….


Stress is the nonspecific response of the organism to any pressure or demand

Stress is the nonspecific response of the organism to any pressure or demand

Stress good bad

Stress – Good & Bad

Stress management

Modern Stressor

Primitive Stressor


Stress response

Stress Response

Relaxation response

Relaxation Response

A state of relaxed, passive attention to a repetitive or absorbing stimulus that turns off the “inner dialogue” thereby decreasing arousal of the sympathetic nervous system.

Focus on the response

Focus on the Response

It is not the problem that needs your focus, it’s your response that needs the focus.

Strategies for stress busting

Strategies for Stress Busting




Behavior the do

Behavior: The DO



Are you getting 7-9?





Laugh play everyday

Laugh & Play Everyday

Cognitive the think

Cognitive: The THINK

Choose your response

Choose Your Response

We are what we think. – Buddha

We Don’t see things as they are,

We see things as we are. – The Talmud

What you think, you become; What you feel, you attract; what you imagine, you create.

  • The Dammapada

Choose your response1

Choose Your Response

The eye is the lamp of the body.

So, if your eye is good, your whole body will be full of light:

But if your eye is bad, your whole body will be full of darkness.

– Matthew 6:22

Stop options


  • “I should be…”

  • “STOP”

  • “What are my options?”

    • What are my coulds?

  • Select activity from list of options

  • Useful for diffusing pressure of obligations

  • Increases sense of control…competence

Stress management





Stress management





Maintain a solution focus

Maintain a Solution Focus

  • Whatever the problem is think…

  • “What’s one thing I can do to make it better?”

Stress management

Most folks are about as happy as they make up their minds to be.

Abraham Lincoln

Explanatory style

Explanatory Style

  • If you are late to class because you could not find your keys or a book are you more likely to say to yourself…

  • “I always do this to myself; I’m going to look so careless”

  • “I’m probably not the only one who’s going to be late”

Explanatory style1

Explanatory Style

  • If you are driving in a rush and find yourself hitting a lot of red lights…

  • “I have the worst luck; nothing ever goes my way!”

  • “Man, today it’s not my day for green lights.”

Explanatory style2

Explanatory Style

Pessimism (A responses)

Optimism (B responses)

  • blame themselves for negative events

  • believe that such events will continue indefinitely

  • let such events affect many aspects of their lives

  • blame others for negative events

  • believe that such events will end soon

  • do not let such events affect too many aspects of their lives

Recovering from set backs

Recovering from Set-Backs

Thought Approach

Action Approach

  • Thought Stop -“Stop”

  • Distraction or

  • Disputation

  • Focus on the “Do”

    • Move to action

  • Pre-programmed response (ICR)

  • No matter how frustrated or angry I get…

  • Go straight into action with that response

Hot buttons

Hot Buttons

  • Make a list of your hot buttons

  • Now list Ideal Coping Responses (ICR)

  • The more you focus on a mistake, the more likely you are going to make it!

Stress management

When angry, count four, when very angry, swear.

-Mark Twain

Oh well

“Oh Well”

  • Interrupts the cascade of negative thought and emotion

  • Add a shoulder shrug

Relaxation the be

Relaxation: The BE

Slow down

Slow Down

Mindfulness is key

Mindfulness is Key

Don’t be this guy!

Mindfulness vs mindlessness

Mindfulness vs. Mindlessness

Being able to:

Be present in the moment

Remember the drive to work

Remember what you just told/gave a patient

Oxygen consumption during sleep and the relaxation response

Oxygen Consumption During Sleep and The Relaxation Response

Change in Oxygen consumption (%)

Pathways to relaxation response

Pathways to Relaxation Response

  • Relaxation Methods

    • Focused Breathing

    • Transcendental Meditation

    • Prayer

    • Yoga, Tai Chi, etc.

    • Autogenic Activities

    • Guided Imagery/Visualization/Meditation

  • Physical Activity

    • How much?

Two basic steps necessary to elicit the relaxation response

Two Basic Steps Necessary to Elicit the Relaxation Response

  • The repetition of a word, sound, phrase, prayer, or image, or muscular activity

  • The passive return to the repetition when other thoughts intrude

Focused breathing

Focused Breathing

  • Diaphragmatic Breathing (aka Belly Breathing)

  • Centering Breath

    • 15 seconds = In for 6, hold for 2, out for 7

  • Notice your breathing – Pace In, Pace Out

Mini relaxations

Mini Relaxations

  • #s in Space

  • #s down (10-0)

  • What’s around me

  • In breath = “I am”; Out breath = “At peace”

  • While stuck in traffic…while waiting…when in pain…while studying…when you can’t sleep

  • The only time they don’t work is when you don’t do them

Guided imagery visualization

Guided Imagery & Visualization

  • Progressive Muscle Relaxation

    • Autogenic Training

  • After the Game is Before the Game

  • Don’t Lose the Anxiety, Move It




  • Youtube has relaxation music

  • Free resources on internet for relaxation techniques

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