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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

Stress Management

Matt Orr, PhD

Department of Family and Preventive Medicine

Modern Stressor

Primitive Stressor


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.


Are you getting 7-9?

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








maintain a solution focus
Maintain a Solution Focus
  • Whatever the problem is think…
  • “What’s one thing I can do to make it better?”
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!
oh well
“Oh Well”
  • Interrupts the cascade of negative thought and emotion
  • Add a shoulder shrug
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

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