Module 2 - Stress and Coping

1. Module 2 -Stress and Coping

2. Into every life a little rain must fall ….. But what happens when there is a flood? Stress and Coping

3. Learning Objectives • Use the terminology of stress and coping • Describe how people react to and cope with stress • Describe common reactions to loss and grief • Employ guidelines for the provision of psychological support Stress and Coping

4. Stress • A state of physical and/or psychological arousal • Often brought about by a perceived threat or challenge • May be expressed differently by different cultures Stress and Coping

5. Stress Reaction Phases • Acute phase • Reaction phase • Repair phase • Reorientation phase Stress and Coping

6. Acute Phase • Lasts minutes, hours or days • “Fight or flight” response: preparation for physical activity • Narrowing of focus: decreases ability to think properly • Emotional reactions: disbelief/consternation/fear/grief • Rigid behavior: irritability, anger, etc. affects communication • Panic is rare but if present, requires immediate attention Stress and Coping

7. Reaction Phase • Lasts one to six weeks • Delayed reactions: previously repressed or denied feelings will surface • May be overwhelming, bringing feelings of powerlessness Stress and Coping

8. Reaction Phase: Characteristic reactions: • Fear of returning to the site of the event • Dreams or nightmares • Anxiety, restlessness, insomnia • Muscular tension, tremors and exaggerated startle response • Increased irritability and isolation, depression • Disturbing thoughts about survival, relief, guilt and grief • Perceived images of how others suffered in the disaster, i.e. how they died, how they injured Stress and Coping

9. Repair Phase • Lasts one to six months • Reactions are less intense, and not so overwhelming • Feelings of hurt continue, but are more manageable • Renewed interest in everyday life • Makes plans for the future Stress and Coping

10. Reorientation Phase • Approximately six months after a distressing event and continuing • Heightened stress reactions are substantially reduced • Grief reaction may not be resolved but is accepted • Most reactions will diminish gradually • Assessing ongoing needs is important Stress and Coping

11. Coping with Stress • Coping is a way to prevent, delay, avoid, or manage stress • Coping mechanism categories: • Changing the source of stress • Changing the view of the situation • Tolerating the stressor until it passes or becomes less troublesome Stress and Coping

12. Examples of Coping • Seeking help from others or offering to help others • Using natural support systems • Talking about their experiences and trying to make sense of what happened • Hiding until the danger has passed • Seeking information about the welfare of loved ones • Gathering remaining belongings Stress and Coping

13. Examples of Coping (cont.) • Beginning to repair the damage • Burying or cremating the dead • Following religious or cultural practices • Setting goals and making plans • Using defenses like denial • Remaining fearful and alert to further danger • Thinking long and hard about the event Stress and Coping

14. Activity # 6 – What if… • Activity: Break into pairs. Imagine that there is flood in your community. Your family's income is based on farming, and you lose all your crops in the flood. • Take 5 minutes to discuss three (or more) actions, thoughts, beliefs, personal characteristics or strengths or aspects of your culture that would help you to cope with the situation. Stress and Coping

15. Loss and Grief • Loss is a common theme in most disaster settings • Common reactions to loss: • Denial, numbness or shock • Bargaining • Depression • Anger • Acceptance • Reorientation Stress and Coping

16. Loss and Grief – Signs of Trouble • Avoiding or minimizing emotions • Using alcohol or drugs to self-medicate • Using work or other distractions to avoid feelings • Hostility and aggression toward others Stress and Coping

17. Activity # 7 – Another point of view • Activity: Break into small groups of 3-4 people & discuss the situations and possible emotional responses of the following people: • A widow. Your home burned down, the cause is not yet determined. • A parent. Your home burned down and you have lost all your work tools in the fire. • A teenager. Your home burned down and your parents were injured in the fire while rescuing you and your sister. • A recent immigrant to this country. Your home has burned down and it brings back memories of war in your homeland. Stress and Coping

18. Emotional Numbness or Extreme Agitation • Immediate attention is needed • Possible referral for professional care • When referring: • Inform the person of your intention • Recognize that the referral may cause a negative reaction Stress and Coping

19. Guiding Principles in Providing Psychological Support • First protect from danger • Focus on physical and material care • Be direct, active and remain calm • Focus on the “here and now” situation • Provide accurate information about the situation • Assist with mobilization of resources Stress and Coping

20. Guiding Principles in Providing Psychological Support (cont) • Do not give false assurances • Recognize the importance of taking action • Reunite with family members • Provide and ensure emotional support • Focus on strengths and resilience • Encourage self-reliance • Respect feelings and cultures of others Stress and Coping

21. Activity # 8 – Guiding Principles • Give an example of something specific you could say or do in each of the previously discussed principles. Stress and Coping

22. Crisis Intervention • Observe safe practices by showing concern for your own safety • Remain calm and appear relaxed, confident and non-threatening Stress and Coping

23. Crisis Intervention Steps • Assess the situation • Establish rapport • Identify the main problem (s) • Deal with feelings and emotions • Generate and explore alternative coping strategies • Formulate an action plan • Follow up Stress and Coping