Kim's stress managment presentation

What today is about All about stress- what it is, risks of, effects on body,

why we need it, how to recognise it in yourself, why it can be good for you

Stress reduction

Stress, Burn-out and Vicarious trauma

Mindfulness

Stress Reduction

Self care in remote areas

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What is Stress?

The interaction between your coping skills or resources (or perceptions of) and the demands of your environment.

A reaction which occurs when the actual or perceiveddemands made on an individual overwhelm that person’s ability or resources to manage the situation.

What is stress? The rate of wear and tear on the body caused by

living

The situation may involve a gradual build-up of pressure, or it may be a sudden stressful event.

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Why are we here?

Why did you consider this to be a relevant topic today and what would be most helpful??

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DID YOU KNOW THAT EXCESSIVE STRESS…

Doubles our Risk of Heart Attacks

Weakens the immune system

Increases our likelihood of developing serious illnesses like cancer

Can lead to other life-threatening illnesses like diabetes and heart disease

Makes people more susceptible to colds and flues

Leads to ailments from gum disease to osteoporosis

Causes premature aging

What do we know about stress in the moment Slows the thinking part of our brain down (frontal lobe)

So we don’t problem solve very well

We say things we don’t want to – this can wreck our personal relationships and work relationships!

We can’t remember things we really do know- or learn as easily

Immune system diminished

Difficult to make decisions- even if they are simple

Can lead to unhelpful thoughts or conclusions about ourselves and our environment

Makes good people act badly

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Where does YOUR stress sit?At some levels, stress can improve performance. At higher levels,

however, it can be detrimental to performance.

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Symptoms of Stress

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The Fight/Flight Response

When we feel threatened, our bodies are “hard-wired” to either fight or run away

Most modern stressful situations do not offer this choice-perceived threat as demonstrated by brain mapping

Today, our stressors are much more subtle and complex

Evolutionary View of Stress

Not so many physical stressors today

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Selye identified three stages of adaptation which a person goes through in his General Adaptation Syndrome in 1936. They are:

Alarm

Resistance

Exhaustion

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Risks of no stress No fear in your life then

you are not living!!!

New and novel things should make you stressed

Push yourself to your limits and then show yourself you can do it…that builds self esteem (not playing it safe)

No stress leads to poor performance

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Stress Signals

The best way to cope with stress is to recognise when your stress levels are building…

Stress signals fall into 4 categories:

1. Thoughts

2. Feelings

3. Behaviour

4. Physical symptoms

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Perception Stress is unique to each of us

While we often think of stress as the result of external events, the eventsthemselves are not always stressful

It is the way in which the individual interprets and reacts to an event thatproduces stress

The key to stress reduction is identifying strategies that suit you as anindividual

Opportunity knocks How can we turn stress into opportunity

One door opens when one closes

Problem solving

Communication

Conflict resolution for win/win

Learn that can master what you fear by learning new skills and noticing what you do to overcome it

Increases confidence (if you don’t avoid)

Connect with others

Reframe the stress symptoms

Dealing with Stresses in our Lives• When we perceive a threat we tend to react automatically

using one of two ancient doing mind strategies:

• Adrenalin based reactions – saving ourselves from danger by fighting with, running away from, protecting or camouflaging

ourselves...

....fight, flight and freeze.

• Problem-solving processes where we attempt to fix or resolve the perceived problem

Stress Reduction Strategies Self awareness-how do you react to stress

Body Awareness

Breathing

Progressive relaxation

Meditation

Visualisation

Mindfulness

Thought stopping

Coping skills training

Nutrition and Exercise

Goal Setting and time management

Assertiveness training

Vicarious Trauma- related to stress but its different

Compassion fatigue:

Exhaustion and desensitization to violent and traumatic events

Burn-out is non-specific to an event and is gradual.

Definition of Post-traumatic Stress and its relationship to Vicarious Trauma-debilitating symptoms arising from direct personal exposure to, witnessing or learning about an event involving actual or threatened serious harm, injury, death or threat to the physical integrity of oneself or another person

Definition of Vicarious traumaTrauma reactions that are secondary to clients’ traumatic experiences

Debilitating symptoms arising from prolonged empathic work with victims of trauma

Effects of VT Experiences such as a change in beliefs and values and the

way that one looks at the world, intrusive imagery and physical effects are normal consequences of this kind of work.

Violated core assumptions about care and safety- mistrust, cynicism. Apathy and loss of concern, lack of desire and need for intimacy, loss of confidence and sense of control, compromised occupational functioning

Re-experiencing, hyperarousal, avoidance, numbing-symptom onset may be sudden

Physical, emotional, cognitive symptoms, impact on workplace

Factors that influence traumatic stress Degree of unpredictability

Threat to life

Intent to cause harm

Helplessness

Relationship to the perpetrator

Solutions:

Self Care

Organisational Practices

Current research in brain mapping has shown that there are strategies that assist with self care including stress and trauma related symptoms

Approaching our experience and responding mindfully

Monette Saulnier Burns, R.M.T.

Mindlessness “Mindlessness” (Langer, 1989)

Our tendency to be in “autopilot”:

not focused, reactive mode.

Most of our waking hours are spent in “thinking about” mode:

our default mode of mind.

Two Modes of Self-focus: Conceptual and Experiential

Conceptual

Experiential

/ Direct

Noticing

Labeling

Elaborating

Analyzing

Judging

Goal-setting

Planning

Comparing

Remembering

Self-reflecting

Seeing Tasting Touching

Hearing Smelling

Visceral sensations

Proprioceptive sensing

En

vir

on

men

tal

Inp

ut

Mindfulness: Being With and Approachingour Experience

• Seeing things as they actually are, here and now/in this moment• Bringing a friendly curiosity to our experience, however that is• Investigating the detail of our experience• Non-fixing, not trying to change what’s here. • Choices to respond based on full and current information - rather than habitual reacting.• Opening to a broader view including what is “right” as well as perceived problems.

Mindfulness

Mindfulness is....

”....paying attention on purpose, in the present moment, non-judgementally....”

Jon Kabat Zinn

Being here, in the moment, not in the past, not in the future.

40 – 10 – 50

The % of time our mind is concerning itself with and focused on the:

Past – Present – Future

Background to Mindfulness Courses

Mindfulness has its origins in Eastern, Buddhist philosophy.

It was adapted to a secular, 8 week programme format Mindfulness Based Stress Reduction(MBSR) in the USA by Jon Kabat-Zinn in 1979.

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Noticing Thoughts and Feelings

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Mindfulness – stop struggling Happiness Trapp???

Myths: Happiness is the natural state of all human beings

If you are not happy you are defective.

To create a better life you must get rid of negative feelings.

You should be able to control what you think and feel-whatever you do now don’t think about icecream.

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Common Control Strategies For Flight Response: Hiding, Escaping, Distraction, zoning

out, numbing

For Fight Response: Suppression, Arguing with your own thoughts, Taking Charge of thoughts and feelings eg saying snap pout of it to self, Bullying

These methods of control are okay in moderation, you use them only in situation where they can work and where using them doesn’t stop you from doing the things you value. Eg with run of the mill everyday stress.

What does control have to do with Stress? When we try to feel happy by trying to control what

we are feeling, these control strategies have three significant costs:

1. They take up a lot of time and energy and are usually ineffective in the long run.

We feel defective or weak-minded or crazy because the thoughts and feelings we are trying to get rid of keep coming back.

Some strategies that decrease unpleasant feelings in the short term actually lower our quality of life in the long term

The Costs of Avoidance Write or think about The thoughts and feelings I would most like to get rid

of are…….

Now list the things you have tried in order to avoid or get rid of them eg moving, eating drinking, judging others or self, criticising others or self, denial, blame, affirmations, workshops, work

Now look at list one-what worked? Did you get rid of painful thoughts and feelings in the long run?

What did it cost in time, money, energy, friends, health?

How did it help?

Mindfulness can be cultivated and trained

It has the potential to change your brain and foster your psychological and physiological well-being.

Technique AND a way of being

Mindfulness Practice Is a Radically Different Approach to Living Our Lives and Managing Stress...

• Increasing awareness - We come to realise that we are usually operating on “automatic pilot “ - our tendency for our minds to be more frequently in the past or in the future rather than with our experience in this moment.

• Placing our attention where we want it to be

• Developing a new relationship with our experience (mindfulness meditation).

• Responding to experience based on awareness of what’s actually here rather than habitually reacting

• Formal practice – meditation e.g. bodyscan, mindful movement, sitting practice, breathing

• Informal Practice – awareness of body sensations, thoughts, emotions and sensory input during daily life. Practiced in ordinary activities like eating, washing brushing teeth

Mindfulness is essentially experiential – we practice it

Aspects of Aindfulness Self Awareness- write, draw, talk……

Psychological flexibility- Acceptance and Commitment:

Defusion

Expansion

Connection

The Observing Self

Values

Committed Action

Becoming Aware of our Mind’s Activity.

As we practice mindfulness it becomes apparent that the mind will “have its say” in all that we do.

We will notice:Judgements = liking or dislikingAssociations = memories, stories, comparisonsEmotional inter-relationship with thoughts Thoughts don’t occur singularly or without some

emotional “flavour”.Commentary = our thoughts comment on all our experiences.

…lets have a go!!

Benefits of Mindfulness It directly impacts our development, health, healing

wellness & behavior- more pre-frontal and less Amygdala9 functions of the mPFC (medial prefrontal cortex):

Bodily regulation Attuned communication Emotional balance Response flexibility Empathy Insight Fear modulation Intuition Morality

Remember- this all Improves with practice

Benefits of MindfulnessPhysiological: Increase activity in medial prefrontal cortex

Decreased heart rate and blood pressure

Improved, more restful sleep

Changes perception of pain

Improved immune function

Mindful Communication 1. Listen: To verbal & non-verbal cues (not in your

own head listening to your dialogue)

2. Mindful inquiry: Ask questions and for clarification with a beginner’s mind (lack of judgement of them)

3. Mindful dialogue: Have respect for other person’s journey. Notice tendency to compare experiences.

Mindfulness In Professional life Fosters presence, compassion and understanding

Facilitates empathetic attitudes, as well as decreased tendency to take on others’ negative emotions.

(Beddoe, A. & Murphy, S. 2004)

Increases self-compassion

Decreases personal stress and reactions

Improves performance

Increases flexibility

Improves creativity

Timeout for Mindfulness practice- What are thoughts/

Stories- neither true nor false-how we see life, opinions, attitudes, beliefs, judgements, beliefs, theories, goals, strategies. Ideals, wishes, values- in mindfulness we are interested in if it is helpful-we it help us/work/life thrive.

The story is not the event

Role of fusion- the thought and the things it refers to –the story and the event become stuck together and we react to works as if the thing or event was present.

Fusion cont… We react to the the words eg “I am stupid” as if its true- B

In a state of fusion it seems as if: thoughts are reality- what we are thinking is actually happening here and now.

Thoughts are the truth-we believe them

Thoughts are important-we take them seriously and give them our full attention

Thoughts are orders

Thoughts are wise

Thoughts can be threats

Some starting practices for mindfulness I’m having the thought that……

I notice that I am having the thought that…

In defusion we recognise:

Thoughts are sounds, words, stories, language

They may or may not be important-are they helpful

They are not orders- don’t have to obey

They may or may not be wise

They are not threats to us – even if disturbing

Other practices include- Musical thoughts

Name your story-eg its all too hard, this will never work- remind – what do you want to attune to?

I am a banana-everybody now

Thanking you mind

Silly voice technique

Reminder – aim of defusion is just that – it does not get rid of thought or even make you feel good-its aim is to disentangle you from unhelpful thought processes. It may not neccesarily change your life.

Other helpful places to start Look whose talking

Close eyes and observe where your thoughts go

Ten deep breaths

Realistic expectations

Defusing an unpleasant image-not traumatic memories – use with unhelpful thinking- tv show-rewind or add subtitles or a soundtrack.

Feelings Emotions originate from the middle layer of the brain-

at the core of emotions is a complex set of physical changes throughout the body that prepare us to take action.

Emotions influence us to act in different ways- egchange voice, body posture and behaviour-action tendency..

Emotions closely tied to thoughts, memories and images. Our emotions don’t control behaviour eg I can be angry but remain calm. I might be scared right now but I remain.

Emotions are like the weather Three phases to emotions:

Event

Getting ready for Action-evaluation-checking out the scene

The mind gets involved-gives meaning to changes

Fight/flight response- IN prehistoric times it was life saving-now our mind often perceives threat almost everywhere- no-one liked out fb page, spouse moody, someone didn’t ring, debt, body image-non of these things are really life threatening-but our brain and body act as if they are.

I just want to feel the positive feelings-struggling with what is We get angry with our emotions eg when we are stressed.

I should feel different.

I will not accept the presence of unacceptable feelings-they distress me and I will have to have another drink to not feel them.

Which of these emotions are good/bad:Fear, anger, shock, disgust, sadness, guilt, love, Joy, curiosity.

What was your life programming re emotions eg which ones are okay to have? Which did you grow up expressing feely. What were you taught about the best way to handle your emotions. What emotional control strategies were role modelled in your life.

Judging doesn’t help- adds to stress. Question- why am I feeling like this may not be helpful. And what have I done to deserve this doesn’t help either-sets you up for self-blame.

What can be helpful? Process of expansion-this involves the observing self-

awareness, attention and focus-

Body Awareness- an exercise in observation

Four steps of expansion-observe, breathe (frontal lobe), create space. Allow, acceptance self-talk

Acceptance imagery-clearing visualisation here.

Connection- with breathing, the environment

Notice yourself noticing

Nature

Job Stress Management What causes job burnout?

Prolonged stress leads to burn-out

Several core characteristics:

Emotional and physical exhaustion

Low self-esteem

Poor job satisfaction

Negative and cynical attitudes towards staff and clients

Insomnia, alcohol and drug use

Relationship and family problems

Nature of Burn Out

Burn-Out rarely happens suddenly- it occurs over time

Protection against Burn-out Ensuring Self-Care:

Set realistic goals-unrealistic goal setting and working so hard to meet them is a “sure path to Burn-out, job dissatisfaction and stress

Managing your time:

Are you completely satisfied with the way you use your time?

If not, why not?

What could be done to use your time more satisfactorily?

Steps to take to achieve Burn Out Erode your resilience:

Give all of your energy and focus to the job

Isolate yourself from others

Don’t take regular breaks

Don’t have a social life

Live unhealthy lifestyle

Fail to act on the situation:

Don’t ask what it is you are meant to be doing and expectations of others

Complain to everyone but those who can help

Stubbornly persist with behaviours that don’t work in the new environment

Fail to identify stressors or to change those that can be changed

Do not use problem solving skills

“Shoulds” or rather that accept what cannot be changed

Fail to use effective coping strategies and see your wellbeing as someone else’s responsibility or use coping strategies that create more problems- or allow self to remain in pain for prolonged periods

Path to burn-out continued Fail to acknowledge human limitations: attempt to

meet excessive demands and place all oher’s needs before your own

Set unrealistic goals and then work hard to achieve them

Be pessimistic-engage in negative self talk

Fail to critically reflect

Issues re working in remote areas Adaptation process – settling in

Lack of privacy- visibility

Lack of boundaries between personal, professional and community

24 x 7 can be an issue

Expectations on workers

Generalist nature in your work

Inadequate orientation and preparation for living and working in environment

Role conflict- needs of community vs those of the agency/funding body.

Workload simply unmanageable-overwhelming sense of responsibility

Turnover of staff-staffing in general

Signs of Burn-out Long work hours with little sense of achievement Work becomes mechanical Exhaustion Other issues in relationships and life Acute stress reactions Emotions all over the place Difficulty making decisions and setting priorities Poor short term memory Sleep difficulties including restlessness Physical- hert, stomach, head Lack of interest in sex

Protection Against Burn-Out Exercise- relieves Stress and burns off the energy

created by stress

Rest and Relax-simple pleasures-walk, read, draw

Relaxation, meditate, grow a garden or a plant-personal investment in dealing with stress.

Have a Life:-regular breaks from community, accept the support of others, good social networks

Admit Vulnerability:-accepting support, isolation is a risk- closing off to the support structures places an individual more at risk

Deal effectively with conflict:-be aware of arousal levels during high levels of demands- plan ahead if possible. Attempt resolution before things get out of hand.

Taking responsibility for actions and behaviours:-set the limit of involvement of work, be positive about the nature of work- why are you there?-be a positive realist rather than an idealist.

Try to change the situation if possible-structures and roles are sometimes easier to change that people’s expectations.

Accept what cannot be changed:

you are unable to control the multitude of factors and events that you are faced with (including the weather and environment and others)

You can control your actions, attitudes and expectations.

Sustainability Maintain resilience and wellbeing: work/ life

balance- time out, networks and healthy lifestyle.

Discuss flower exercise here.

Act on the Situation:

Clarify your role and boundaries, clarify other’s expectations of you, identify sources of stress, skill up, change stressors that can be changed, use good problem solving and de-escalation skills

Be active about managing your stress response: realistic goals and boundaries, opportunities for personal growth, critical reflection

Assisting with people who are facing Stress, Vicarious Trauma or Burn-out Recognise that this can happen to anyone

Indicate that it is a result of prolonged stress or traumatic event

Help the person talk about the event and reactions to it and accept where they are at.

Be willing to listen

Provide resources

Allow time and space

Help with lifestyle priorities

Is the job worth it?

Ten Steps towards Managing your Job Stress

Identify your symptoms of job stress Identify the sources of your job stress:

Lack of control Information Gap Cause and Effect Conflict Blocked Career Alienation Overload Under-load Environment Value Conflict

Ten Steps continued Identify how you respond to your specific job stressors- stressor,

feelings, thoughts, behaviour-what patterns have you found

Set Goals to respond more effectively to your job stressors

Motivate yourself-rewards?

Change your thinking- Mindfulness

Clarify job with manager or organisation-expectations- mission statement for self-and organisation, what are you doing? What additional education do you need? What happens if something goes wrong- future expectations.

When in conflict- negotiate

Pace and balance yourself- when do you work optimally?

Know when to quit- Gambler song.

In any situation what is kindness?

Putting strategies into Practice

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How to Contact EASA8941 1752

1800 193 123

[email protected]

Training and Development – 8941 5661

www.easa.org.au

2nd Floor, Highway Arcade

47 Stuart Highway

Stuart Park