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Stress management BY SURESH AADI8888

  1. STRESS MANAGEMENT Presented by:- Mr. Suresh Kumar Sharma RN, MSN(PSYCHIATRY)
  2. What do you understand by Stress? • The way our body and •mind react to life changes
  3. HELP ME! WHAT IS STRESS ? Stress is the reaction people have to excessive pressures or other types of demand placed upon them. It arises when they worry that they can’t cope.
  4. I HATE YOU WHAT IS STRESS ? Stress is the “wear and tear” our minds and bodies experience as we attempt to cope with our continually changing environment
  5. DEFINITIO N An adaptive response to an internal & external situation that results in physical, psychological and behavioural deviations Adaptation – a coping up mechanism S=P>R Stress occurs when the pressure is greater than the resource
  7. Adolescents and stress ?  Teens are under more stress  Since adolescence is a period of significant changes  physical,  emotional,  social, and  academic changes many than at any other time of life.
  8. Where does stress come from ? Stress can come from Inside - – INTERNAL STRESSOR:- – Body image – Not happy with the way you look – self-conscious feel everyone is staring at you Stress can come from Outside EXTERNAL STRESSOR:- i.e. surroundings, environment – Family …….. – School …. – Friends /Peers … – Society …. – Others ……
  9. Stresses physical – Prolonged school hours – Over-packed class rooms – Transport – Pollution air, noise – Overcrowding road – Poor ventilation – Bad furniture
  10. Stresses psychological – Bullies, – Changing schools, – Conflicts with teacher, – Forced competitiveness, – Falling grades, – Have to present in class – Learning disorders, – Special recognition
  11. Stress psychosocial  Relationships  Peers – – You want to spend time with peers but without parental supervision – Their opinions more important than that of parents  Conflicts with parents, friends  Media internet  Secret lives ……
  12. How do we react to stress?  Reaction – FFF (Fight – Flight – Freeze) ULTIMATELY how each person reacts will decide how STRESS will affect YOU This means that whether we get “stressed out or not” depends mainly on US
  13. HEALTHY RESPONSE TO STRESS 1. LAS 2. GAS  LOCAL ADAPTION SYNDROME(LAS)- Eg. Wound healing, blood clotting, accommodation of eye to light  Characteristic of stress response-  Localised  Adaptive - stimulation of stressor is necessary.  Natural & protective- catecholamine HR & BP
  17. Signs and Symptoms of Stress Physical  Poor appetite or overeating  Feeing tired and fatigued  Various aches and pains ---headache body ache muscle pain  Nausea & abdominal Pain  Sleep problems  Falling sick very often e.g. fever cough cold diarrhea ( because of lowering of immunity due to stress)
  18. Mental  Feeling low  Nervousness and Anxiety  Excessive Anger  Depression  Being easily upset  Poor self confidence  Low self esteem  Lack of Concentration  Poor performance in studies
  19. Is STRESS good or bad for us ?  Some amount of stress is essential for us to excel in life. This is good stress or “EUSTRESS”  Butwhen stress is too much then it reduces performance. This is bad stress or “DISTRESS “
  20. Stress and Performance: .
  21. Stress and Performance: . Eustress
  22. Stress and Performance: . Distress
  23. Stress and Performance Dealing more effectively with stress improves performance and the quality of life It is like salt and pepper to life
  24. The Stress Model ..
  25. The Stress Model
  26. The Stress Model  TheStress Model helps us understand differently the behavior . The Stress Model states: – All behavior arises from a state of stress. – In between the stress and behavior is the presence of an emotion. – The emotion is either love or fear. – It is through the expression, processing, and understanding of the emotion that we can calm the stress and diminish the behavior.
  27. Stress  We must first be aware of our own stress before we can begin to address the stress in others.  Let’s dissect these situations.  What stresses do you face each day? – Work related? Home related? System related?
  28. Stress  Thinkabout the situations that prompted you to come here today… – What is it about this particular situation that is so stressful? – Where in your life has this situation occurred before?
  29. STIMULUS-BASED MODEL:- (Holmes and Rahes model-1960)  Stress:- a stimulus , a life event, or a set of circumstances that arouses physiologic & psychological reactions that may increase the individual’s vulnerability to illness.
  30. SRRS(SOCIAL READJUSTMENTS RATING SCALE)  43 life changes or events.  Both positive & negative in nature.  Considered stressful.  Identify the Effect of stressor in person’s life.  If stressor is more in short period(1-2yr) then more likely physical illnesses, mental disorders or other stress response will follow.
  31. SRRS MEASURING  SRRS SCORE STRESS HIGH  SRRS SCORE STRESS LOW  But results are depends on mediating factor – Eg. Coping strategies, – Role of stressor, perception of individual etc.
  33. TRANSACTION-BASED MODEL (LOZARAS, 1966)  Cognitive, affective & adaptive(coping) response that arise from person-environment tractions.  Environment & person is not separable.  Environment changes person responds with coping response.  Different individual show different reaction to response. Eg. Illness respone one denial, another anxiety, still another depression
  34. Applying The Stress Model  Absolutely, the first step when we are triggered in our stress is to ACKNOWLEDGE our stress! BREATHE!  Stress causes us to: – React from the past – Obsess about the future – Take us out of the present
  35. Applying the Stress Model  Acceptance – we must develop an accepting relationship with individual. We must also teach the parents about acceptance and model this for them.  Understanding – this is really seen in our perception of the child’s behavior. If we see anger, we do not truly understand this child. What is your child trying to communicate through their behavior?
  36. Applying the Stress Model  Empathy – Defined as the ability to experience and identify with the emotional state of another person. Empathy and reflecting feelings does not mean we have to agree. It means that we get what is going on.  Patience – We ourselves must be emotionally regulated in order to exercise patience.
  37. Applying the Stress Model  Trust – Our children trusting us may be more important than our trust in our children.  Love – Takes effort, love is in the action of doing all the things above. – This is the opposite of fear. We must know love in order to teach and model love. This is what we want to replace fear.
  38. Applying the Stress Model  Training – “form habits, thoughts, or behaviors by discipline and instruction”  Affection – physical contact can be calming  Structure – chaotic vs. organized- home vs. school?  Expectations – be clear and communicate them, clarify that the child understands
  39. Applying the Stress Model  Time-In – “I see that you are in need of something, come and sit beside me until you feel better.” When we think a child is acting out to get attention, it is because a child needs attention.  Mentoring – connect this child to another adult outside the parent/child relationship.  Awareness – Early identification of stress  Containment – keep the child in a space of more direct proximity to the teacher than what may be needed for other students.
  40. Applying the Stress Model  Team – the power and importance of a team working with this youth is vital.  Reduced Peer Interaction – match the developmental needs of the youth.
  41. Applying The Stress Model  Reacting versus responding – Flexibility versus Rigidity – Windows of Tolerance  Trauma – Our relationship blueprints are affected by the trauma we experience.
  42. Summary  Understanding our own stress before we engage with a child is sure to help reduce the child’s stress.  A child’s behavior is a way of communicating that he/she is stressed and needs regulation.  Adults are responsible for teaching and modeling regulation.  Understanding the stress underlying the behavior assists us in helping a child change his/her behavior.
  43. Is STRESS good or bad for us ? All stresses can be GOOD So all efforts should be to convert all stresses into EUSTRESS –This can be achieved by stress management techniques
  45. STRESS TRIANGLE Psychological Physical behavioural
  46. STRESS MANAGEMENT MANAGE AT ALL THE THREE LEVEL – PSYCHOLOGICAL LEVEL: MEDITATION, REASSESSING OUR THOUGHTS & FEELINGS – PHYSICAL LEVEL: EXERCISES, YOGA, PHYSICAL ACTIVITIES – BEHAVIOURAL LEVEL: RESPONDING WITH EQUANIMITY AND CALMNESS IF the distress crosses the threshold level medical problems like Depression, Anxiety disorders, Hypertension etc. sets in. seek medical help from a qualified medical practitioner
  47. SUGGESTED COPING STRATEGIES  Take life the way it comes  Stop blaming others  Develop your own inherent potential  Live in the present & Work for the future  Maintain harmonious relation with others  Learn to be happy & cheerful
  48. SUGGESTED COPING STRATEGIES  Respond to situations with equanimity, detachment, courage, determination  Avoid negative emotional reactions like anger, grumbling, worrying and apprehensions.  Create a supportive climate  Redesign and enrich the job content*  Reduce conflict & clarify roles  Seek professional counseling
  49. Meichenbaum’s approach to stress management 1. Teaching individuals that negative self- evaluation increase stress 2. Monitoring one’s own self-defeating strategies – teaching new cognitive strategies 3. Teaching new skills like relaxation 4. Providing real life homework assignment that become increasingly difficult to carry out
  50. CONCLUSION  Stress is manageable -It needs efforts  Engage truthful thinking  Modulate your behavioral pattern  Lead a well balanced life of satisfaction.  Assert control on self in terms of thinking & action ADAPTABILITY IS THE “MOTHER KEY” TO CONVERT DISTRESS TO EUSTRESS
  51. Stress Management Tips  Making little changes in your life can really add up to a big feeling of relief.  Learn to recognize when you are feeling stressed and simple ways you can relax.  Take a break. Have a cold drink, get some fresh air, or close your eyes for a minute to refocus.  Stay positive to help friends and family cope with stress.  Let others know you're feeling overwhelmed and tell them how they can help.  Allow yourself to simply say "no" to friends and family when you know you cannot meet their demands without becoming overwhelmed.
  52. Stress Management Tips  Be prepared for unexpected problems such as traffic, a lost pet or a family emergency.  Prioritize. Take control of your "to do" list by deciding what's really most important on your list.  Write down feelings of sadness, frustration or anger to get a clearer perspective of your emotions.  Enjoy life's simple pleasures like colorful flowers, dancing, music, and social outings, etc.
  53. Stress Management Plan  Exercise regularly.  Have healthy eating habits never skip breakfast  Reduce sedentary activities like TV Video games etc.  Eat healthy nutritious food. Avoid Junk food .  Avoid excess caffeine intake eg tea coffee chocolates and cola drinks  Do NOT TAKE QUICK FIX REMEDIES like alcohol tobacco and drugs ‘as they have long term and very harmful effects on your body and mind ‘’.
  54. Stress Management Plan  Practice time management  Learn relaxation exercises.  Rehearse and practice situations.  Learn practical coping skills.  Decrease negative self talk.  Learn to feel good with a workable result – Don’t be a perfectionist.  Build a network of friends.
  55. Stress Management Plan: Relaxation Techniques Breathing Awareness – Abdominal Breathing – Sigh Breathing Progressive Muscle Relaxation Visualization  Meditation  PETS  MUSIC
  56. METHODS OF ACHIEVING RELAXATION:- 1. Deep-breathing exercises:-  Oxygen inserted so tension released.(sobel & ornstein,1996)  Reducing anxiety, depression, irritability, muscular tension and fatigue.  It can be done at anywhere and at any time.  3 0r 4 time a day or whenever feels tenseness.
  57. 2. Progressive relaxation 3. Modified (or passive) progressive relaxation 4. Mental imagery 5. Biofeedback 6. Physical exercise
  59. ABC STRATEGY A = AWARENESS What causes you stress? How do you react?
  60. ABC STRATEGY B = BALANCE There is a fine line between positive / negative stress How much can you cope with before it becomes negative ?
  61. ABC STRATEGY C = CONTROL What can you do to help yourself combat the negative effects of stress ?
  62. Stress Management Techniques  Change your thinking  Change your behaviour  Change your lifestyle
  63. Change your Thinking  Re-framing  Positive thinking
  64. RE-FRAMING Re-framing is a technique to change the way you look at things in order to feel better about them. There are many ways to interpret the same situation so pick the one you like. Re- framing does not change the external reality, but helps you view things in a different light and less stressfully.
  65. Positive Thinking Forget powerlessness, dejection, failure Stress leaves us vulnerable to negative suggestion so focus on positives;  Focus on your strengths  Learn from the stress you are under  Look for opportunities  Seek out the positive - make a change.
  66. Change your Behaviour  Be assertive  Get organised  Ventilation  Humour  Diversion and distraction
  67. Be Assertive Assertiveness helps to manage stressful situations, help to reduce their frequency. Lack of assertiveness often shows low self - esteem and low self - confidence. The key to assertiveness is verbal and non - verbal communication. Extending our range of communication skills will improve our assertiveness.
  68. Equality and Basic Rights 1) The right to express my feelings 2) The right to express opinions / beliefs 3) The right to say ‘Yes/No’ for yourself 4) Right to change your mind 5) Right to say ‘I don’t understand’ 6) Right to be yourself, not acting for the benefit of others
  69. 7) The right to decline responsibility for other people’s problems 8) The right to make reasonable requests of others 9) The right to set my own priorities 10) The right to be listened to, and taken seriously
  70. Being Assertive Being assertive involves standing up for your personal rights and expressing your thoughts, feelings and beliefs directly, honestly and spontaneously in ways that don’t infringe the rights of others.
  71. Assertive People  Respect themselves and others  Take responsibility for actions and choices  Ask openly for what they want  Disappointed if ‘want’ denied  Self - confidence remains intact  Not reliant on the approval of others
  72. Assertive Skills  Establish good eye contact / don’t stare  Stand or sit comfortably - don’t fidget  Talk in a firm, steady voice  Use body language  ‘I think’ / ‘I feel’  ‘What do you think?’ ‘How do you feel ?’  Concise and to the point
  73. Benefits  Higher self-esteem  Less self-conscious  Less anxious  Manage stress more successfully  Appreciate yourself and others more easily  Feeling of self-control
  74. Get Organised Poor organisation is one of the most common causes of stress. Prioritising objectives, duties and activities makes them manageable and achievable. Don’t overload your mind. Organisation will help avoid personal and professional chaos.
  75. Time Management  Make a list What MUST be done What SHOULD be done What would you LIKE to do  Cut out time wasting  Learn to drop unimportant activities  Say no or delegate
  76.  Plan your day  Set achievable goals  Don’t waste time making excuses for not doing something
  77. Ventilation ‘A problem shared is a problem halved’ Develop a support network through friends or colleagues to talk with. It’s not always events that are stressful but how we perceive them. Writing a diary or notes may help release feelings but do not re-read what has been written.
  78. Humour  Good stress - reducer  Applies at home and work  Relieves muscular tension  Improves breathing  Pumps endorphins into the bloodstream - the body’s natural painkillers
  79. Diversion and Distraction  Take time out  Get away from things that bother you  Doesn’t solve the problem  Reduce stress level  Calm down  Think logically
  80. Change Your Lifestyle  Diet  Smoking & Alcohol  Exercise  Sleep  Leisure  Relaxation
  81. Diet  Healthyeating habits  Caffeine (Stimulant)  Salt
  82. Smoking and Alcohol  Moderate your consumption
  83. Exercise  Uses up excess energy released by the ‘Fight or Flight’ reaction.  Improves blood circulation  Lowers blood pressure  Clears the mind of worrying thoughts  Improves self image  Makes you feel better about yourself  Increases social contact
  84. Sleep  Good stress reducer  Difficult to cope when tired  Wake refreshed after night’s sleep  Plenty of daytime energy
  85. Leisure  Interest  Gives you a ‘break’ from stresses  Provides outlet for relief  Provides social contact
  86. Relaxation  Lowersblood pressure  Combats fatigue  Promotes sleep  Reduces pain  Eases muscle tension
  87.  Decreases mental worries  Increases concentration  Increases productivity  Increases clear thinking
  88. Alternatives  Conventional Medicine  Herbalism  Counselling &  Biofeedback psychotherapy  Homeopathy  Relaxation  Hypnotherapy  Meditation  Osteopathy  Massage  Pet Therapy  Yoga  Reflexology  Acupuncture  Aromatherapy
  89. Stress Management Plan: How to seek help to destress Talk and confide to a person whom you trust : friend, parent, teacher, relative, etc. If you feel that you are not able to cope with your distress do not hesitate to go to your - school counselor /family doctor/ adolescent pediatrician
  90. How do you recognize that you need professional help ?  Deteriorating school performance  Inability to sleep or excessive sleep  Losing or gaining weight  Feeling low or tired all the time  Mood swings : crying, getting angry  Not wanting to talk to anybody
  91. The only difference between a diamond and a lump of coal is that the diamond had a little more pressure put on it. – ANONYMOUS
  92. KEY POINTS STRESS is very common Use stress in a positive way – Limit NOT eliminate stress. – Use it to improve your performance. Learn Coping Skills
  93. Research on stress:- Problem statement:- “ A STUDY ON STRESS MANAGEMENT OF WORKING WOMEN IN COIMBATORE DISTRICT” DR. M. DHANABHAKYAM*; V. ANITHA** *Assistant Professor, Department of Commerce, Bharathiar University, Coimbatore - 46. **Ph.D Fulltime Scholar, Department of Commerce, Bharathiar University, Coimbatore - 46.
  94. Objective:- (i) To study the kind and level of stress faced by working women in the study area. (ii) To identify the sources of stress of working women. (iii) To identify the impact of stress of working women. (iv) To identify the physical reactions faced by the working women due to high level of stress.
  95. •RESEARCH DESIGN  descriptive research design.  data collection from the primary sources. sampling techniques :- Non -probability convenient . sample :- 300 working women Population:-  among the working women of Coimbatore District.
  96. Tools for Data analysis:-  (a) Percentage Analysis:-  (b) Henry Garrett Ranking:-  (c) Two way table ANOVA:-
  97. CONCLUSION:-  Finally this study concluded that the information technology supported and fast  growing work environment, stress is an inevitable one. Working women population has also in  the growth stage. Working women face stress in managing their personal life with work life.
  98. PROBLEM STATEMENT:-  Stress management: a randomized study of cognitive behavioural therapy and yoga. Granath J, Ingvarsson S, von Thiele U, Lundberg U. Source Department of Psychology and Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden.  In this study, a stress management program based on cognitive behavioural therapy principles was compared with a Kundalini yoga program.
  99. Sample & sampling tecnique:-  26 women and 7 men from a large Swedish company were divided randomly into 2 groups for each of the different forms of intervention.  a total of 4 groups.  . The groups were instructed by trained group leaders and 10 sessions were held with each of groups, over a period of 4 months.
  100. FINDINGS  Psychological:- self-rated stress and stress behaviour, anger, exhaustion, quality of life.  Physiological:- blood pressure, heart rate, urinary catecholamine, salivary cortisol.  measurements obtained before and after treatment showed significant improvements on most of the variables in both groups as well as medium-to-high effect sizes.
  101. Conclusion:-  However, no significant difference was found between the 2 programs. The results indicate that both cognitive behaviour therapy and yoga are promising stress management techniques.
  102. Thank You

Notes de l'éditeur

  1. Sources of Adolescent stress or Adolescent Stressors are again varied – but if we try to organize them in groups – I hope this is a good workable plan – although I am a very poor organizer – but I do not know how I could do it nicely - I feel all of us should have a very clear understanding of these stressors, as only then we can eliminate them from our dear adolescents. - Let us see them one by one - PSYCHIATRY DEPARTMENT BVCON PUNE
  2. As If a boy has gone for a outing with her GF and they met an accident, and girl has broken her leg, now the boy has to inform her parents, his own parents, deal with the police, deal with the local public etc… just imagine the amount of nervousness – specially if his/her parents are like me – who have very fixed ideas about children and talk very little, similarly how impatient a girl or a boy is before his first dating. And if on the first date the girl asks for a dinner in a five star hotel, that too in a taxi to Dr Bansal’s son who hardly has 100 bucks in his pocket – think about his self image – it will certainly go down (does it mean I should keep 1000 in his pocket so that he can entertain many GFs not only one !) This decreased low self image coupled with nervousness and impatient behavior will lead to frustrations and this can be manifested either by depression when after returning he will not talk to any one – will sit very quite – looking in sky – or to the vacant wall – as if he is trying to count brush marks on the wall. Or he will start reacting violently – throwing objects and taking even the trivial remarks as very serious assaults on his personality. PSYCHIATRY DEPARTMENT BVCON PUNE
  3. Stress is a term we use to describe an imbalance between the demands of life and that person’s ability to meet those demands. Stress, like anything else, can follow typical developmental stages. Children usually pick up on our moods quickly. They are usually the first to know something is not right. Then they begin to worry and assume that the thing wrong is their fault. PSYCHIATRY DEPARTMENT BVCON PUNE
  4. Talk about the difference between feelings and emotions. Anger versus Fear
  5. 90% of our behavior is unconscious. What if…my child doesn’t clean his room, he’ll be messy for life.
  6. D.H. Meichenbaum, “Cognitive Modification of Test Anxious College Students”, Journel of Consulting and Clinical Psychology, vol.39, 1972, pp 370-378