A FRESH LOOK AT A FRESH LOOK AT STRESS – (Session 1)STRESS – (Session 1)

Understanding and managing Understanding and managing stressstress

A fresh look at stress – (Session 1)A fresh look at stress – (Session 1)

Understanding stressUnderstanding stress Eustress and distressEustress and distress Allostasis and allostatic loadAllostasis and allostatic load Models of stressModels of stress The impact of stressThe impact of stress Stress and burnoutStress and burnout The role of perceptionThe role of perception Occupational stressOccupational stress ‘‘Fight or Flight’ and ‘tend and befriend’Fight or Flight’ and ‘tend and befriend’

Despite no agreed upon definition, stress is oftendefined as “the response of the body to threats or demands” (Schiraldi & Kerr, 2002:277).

General adaptation syndrome – Hans Selye

i) the alarm reaction – this is the person’s reaction whensuddenly exposed to stressful events (stressors) which are perceived as threat ii) Resistance – the person’s adaptation to the stressor and the subsequent improvement or disappearance of symptoms

iii) Exhaustion – the ability to adapt to a stressful situation is limited, exhaustion will result if the stressor is sufficiently severe or prolonged

EUSTRESSEUSTRESS DISTRESSDISTRESS

PPEERRFFOORRMMAANNCCEE

GoodGood

BadBad

Poor PerformancePoor Performance(Low underaroused(Low underaroused - boredom)- boredom)

Poor PerformancePoor Performance(High arousal – overwhelmed)(High arousal – overwhelmed)

STRESSSTRESS

The Yerkes –Dodson CurveThe Yerkes –Dodson Curve

HomeostasisHomeostasis – The balance needed for an organism to maintain optimum balance

(e.g. – Body temperature, the body’s acid-base balance, body’s oxygen content and the amount of oxygen that reaches the brain)

Allostasis Allostasis – Variable systems that allow us to cope withenvironmental changes.

(e.g. – Heartbeat, breathing, the amount of glucose in blood and the amount of fat)

Allostatic loadAllostatic load – When a person’s stress response system starts to falter and turn against a person

The stress response (allostasis) is a protective system.The stress response (allostasis) is a protective system.It assists us to face a challenge. The protective stress It assists us to face a challenge. The protective stress response is designed for short term activation. When a response is designed for short term activation. When a person is faced with perceived danger, the body preparesperson is faced with perceived danger, the body preparesthe person for the challenge. Such a response is meant tothe person for the challenge. Such a response is meant tobe infrequent. When that person lives out a lifestyle that be infrequent. When that person lives out a lifestyle that overtaxes the inbuilt coping mechanism then health canovertaxes the inbuilt coping mechanism then health canstart to suffer. When this happens allostasis has given waystart to suffer. When this happens allostasis has given wayto allostatic load.to allostatic load. (McEwen, 2002)(McEwen, 2002)

WORLD VIEWWORLD VIEW

EMPLOYMENTEMPLOYMENT

RELATIONSHIPSRELATIONSHIPS

CULTURALCULTURALEXPECTATIONSEXPECTATIONS

SOCIO -ECONOMICSOCIO -ECONOMIC

COMPETITIONCOMPETITION

STIMULUS – BASED MODELSTIMULUS – BASED MODEL

PHYSICALPHYSICAL-Rapid PulseRapid Pulse- High adrenalineHigh adrenaline- Sweat- Sweat

BEHAVIOURBEHAVIOUR-FightFight-FlightFlight-FaintFaint

PSYCHOLOGICALPSYCHOLOGICAL-PanicPanic-Fear-Fear-Sweat-Sweat

RESPONSE – BASED MODELRESPONSE – BASED MODEL

PSYCHOLOGICAL MODELPSYCHOLOGICAL MODEL

INDIVIDUALINDIVIDUALINNER WORLDINNER WORLD(PSYCHOLOGY &(PSYCHOLOGY &SPIRITUALITYSPIRITUALITY

PHYSICALPHYSICAL-Rapid PulseRapid Pulse- High adrenalineHigh adrenaline- Sweat- Sweat

BEHAVIOURBEHAVIOUR-FightFight-FlightFlight-FaintFaint

PSYCHOLOGICALPSYCHOLOGICAL-PanicPanic-Fear-Fear-Sweat-Sweat

INTERACTIVE MODELINTERACTIVE MODEL

WORLD VIEW RELATIONSHIPS

CULTURALEXPECTATIONS

SOCIO-ECONOMICFACTORS

COMPETITON

EMPLOYMENT

INDIVIDUALINDIVIDUALINNER WORLDINNER WORLD(PSYCHOLOGY &(PSYCHOLOGY &SPIRITUALITYSPIRITUALITY

Health costs of allostatic load (stress)Health costs of allostatic load (stress)

Allostatic load affects people in various ways. The cardiovascular system is particularly sensitive to stress. When stimulated the human body needs extra reserves of oxygen and glucose. In response to these requirements the heart beats faster to drive more oxygen and glucose through the body. When repeated surges in blood pressure occur as in the case for people under constant stress, hypertension can be the result. Hypertension increases the likelihood of heart attack. As part of the process for keeping the body supplied with fuel when under stress, adrenaline and cortisol work together to balance the energy supply. If a person remains under stress and cortisol levels therefore stay high, energy becomes stored as fat. This fat often accumulates along blood vessel walls, increasing the likelihood of atherosclerosis, another risk factor in the likelihood of heart attack (McEwen 2002:68-69).

Health costs of allostatic load (stress)Health costs of allostatic load (stress)

The immune system like the cardiovascular system is sensitive to stress. If stress continues for an extended period of time the immune system can start to falter (Hempel 2003). When stress is present the immune system sends white blood cells to where they are needed. If stress is ongoing and becomes allostatic load, the immune system becomes suppressed and the likelihood of infection increases (McEwen 2002:91). In some people ongoing stress does not suppress the immune system. In these people the opposite occurs and the immune system becomes so sensitive it starts to attack threats that don’t exist. This is the basis of many autoimmune diseases (McEwen 2002:99).

TTVIRUSVIRUS

VIRUSVIRUS

VIRUSVIRUS

VIRUSVIRUS

NPYNPYNPYNPY

NPYNPY

NPYNPY

TT

TT

TT

TT

TT

A stress and burnout comparisonA stress and burnout comparison

StressStress BurnoutBurnout

1. Characterised by over-engagement1. Characterised by over-engagement Characterised by disengagement Characterised by disengagement2. Emotions become over-reactive2. Emotions become over-reactive Emotions become blunted Emotions become blunted3. Physical damage primary3. Physical damage primary Emotional damage primary Emotional damage primary4. Exhaustion affects physical energy4. Exhaustion affects physical energy Exhaustion affects motivation Exhaustion affects motivation

and driveand drive5. Produces disintegration5. Produces disintegration Produces demoralisation Produces demoralisation6. Loss of fuel and energy6. Loss of fuel and energy Loss of ideals and hope Loss of ideals and hope7. Depression: body’s need to7. Depression: body’s need to Depression: grief caused by Depression: grief caused by

Protect itself and conserve energy Protect itself and conserve energy loss of ideals and hope loss of ideals and hope8. Sense of urgency; hyperactivity 8. Sense of urgency; hyperactivity Sense of helplessness and Sense of helplessness and

hopelessnesshopelessness9. Produces panic, phobia and anxiety9. Produces panic, phobia and anxiety Produces paranoia Produces paranoia

disorders disorders depersonalisation type depersonalisation type disorders and detachmentdisorders and detachment

10. May kill you prematurely, you wont10. May kill you prematurely, you wont May never kill you, but your long May never kill you, but your long have time to finish what you startedhave time to finish what you started life may not seem worth living life may not seem worth living

Source: Pryor (1986:7)Source: Pryor (1986:7)

EVENT

EMOTION

BEHAVIOUR

EVENT

EMOTION

BEHAVIOUR

PERCEPTION

BEHAVIOUR

EMOTION

EVENT

PERCEPTION

PAST TRAUMA

BEHAVIOUR

EMOTION

EVENT

PERCEPTION

PAST TRAUMACORE BELIEFS

HenriettaHenrietta

Henrietta is a woman under stress. She is employed asHenrietta is a woman under stress. She is employed asa financial consultant by a major bank. She has been in thea financial consultant by a major bank. She has been in theposition for five years and although the job has been stressfulposition for five years and although the job has been stressfulthroughout that time, increased competition in the financialthroughout that time, increased competition in the financialsector has led to more demands upon Henrietta.sector has led to more demands upon Henrietta.

Henrietta is particularly stressed by what she perceives to beHenrietta is particularly stressed by what she perceives to beunfair expectations upon her. Although others on the bank staffunfair expectations upon her. Although others on the bank staffare under the same burden, Henrietta seems far moreare under the same burden, Henrietta seems far morestressed than the others.stressed than the others.

Henrietta is one of seven children. She was the youngest in Henrietta is one of seven children. She was the youngest in her family and was always looked out for. With the best of her family and was always looked out for. With the best of intentions, Henrietta’s family saw her as the ‘baby’ of the familyintentions, Henrietta’s family saw her as the ‘baby’ of the familywho always needed to be looked after. who always needed to be looked after.

The positives of this for Henrietta were feelings of safety andThe positives of this for Henrietta were feelings of safety andsecurity. The downside was that Henrietta never developedsecurity. The downside was that Henrietta never developedresilience. Henrietta has a deeply held unconscious beliefresilience. Henrietta has a deeply held unconscious beliefthat people should always be there for her.that people should always be there for her.

Henrietta’s stress cannot be understood without taking intoHenrietta’s stress cannot be understood without taking intoaccount this part of her ‘life script.’ account this part of her ‘life script.’

STRESSORS

‘LIFE SCRIPT’FACTORS

THE LIVEDEXPERIENCE OF STRESS

Responsibility = (power + authority)

‘‘Fight or flight’ and ‘tend and befriend’Fight or flight’ and ‘tend and befriend’

A fresh look at A fresh look at stress – (Session 2)stress – (Session 2)

Understanding and managing Understanding and managing stressstress

The Stress of Life – Session 2The Stress of Life – Session 2

• DietDiet• ExerciseExercise• Psychology Psychology • SpiritualitySpirituality• Challenging the dominant paradigm of the selfChallenging the dominant paradigm of the self• Some research findingsSome research findings

McEwen (2002:15-16) says;

For decades scientific research has shown that we can guard against the ravages of stress by following advice our grandmothers could have given us: restful, plentiful sleep, a good diet, and regular exercise, as well as the support of family, friends, religious organisations, and community (isolation is one of the chief contributors to allostatic load), and a sense of control over and contribution to one’s own life – often noticeably absent in those who suffer from heart attacks or depression.

Diet

Caffeine – Found in coffee, tea, chocolate, coke. It causes the release of adrenaline which in turn increases the level of stress. In moderation caffeine can be helpful in increasing alertness but regular consumption of too much coffee can have the same impact as long term stress. Regular drinking of coke is even worse.

Alcohol – In moderation it can be beneficial for the cardiovascular system but overuse of alcohol is a major stressor. In a catch 22 people often drink as a way of coping with stress. Such a strategy actually increases the effect of stress. High levels of alcohol combined with stress are a deadly combination.

Diet Smoking – Smoking is attractive for some people because it

does work short term. This is the problem with most drugs. Smoking is responsible for a number of cancers, hypertension, respiratory illnesses and heart disease.

Sugar – There are no essential nutrients in sugar. The quick input of energy that sugar produces can exhaust the adrenal glands leading to irritability, poor concentration and in some instances depression. High sugar intake also increase the possibility of diabetes.

Salt – Salt increases blood pressure, depletes adrenal glands. Avoid junk foods that are high in salt. These include bacon, ham, pickles and sausage.

Diet Fat – Fat puts strain on the cardiovascular

system and creates obesity. It has also been linked to breast, colon and prostate cancers.

Carbohydrates – These are helpful in that they release the serotonin which has a soothing effect. Good sources of carbohydrates are rice, pasta, potatoes and breads. Experts say that a baked potato or a cup of rice is able to relieve the anxiety of a stressful day.

Diet Fibre – You should have at least 25 grams

of fibre a day. Sources are fruits, vegetables and grains. Great for the digestive system which can be effected substantially by stress.

Vegetables – Vegetables like carbohydrates increase the production of serotonin thus assisting in mood stabilising.

ExerciseExercise

Schiraldi and Kerr (2002:143) say that,Schiraldi and Kerr (2002:143) say that,

Moderate, regular exercise is remarkably effective for Moderate, regular exercise is remarkably effective for improving mental and physical health. It measurably improving mental and physical health. It measurably reduces muscle tension and other stress symptoms reduces muscle tension and other stress symptoms without the side effects of medication. It improves self-without the side effects of medication. It improves self-esteem, lowers blood pressure, slows resting esteem, lowers blood pressure, slows resting breathing and heart rates, increases energy levels and breathing and heart rates, increases energy levels and stamina, improves the quality of sleep, promotes stamina, improves the quality of sleep, promotes weight loss, strengthens the immune system, reduces weight loss, strengthens the immune system, reduces PMS symptoms, and reduces anxiety and depression.PMS symptoms, and reduces anxiety and depression.

ExerciseExercise

It has been suggested that a half hour walk each day is as effective in preventing relapse amongst post depressive people as is Prozac. In other words, exercise has antidepressant effects. This is due to the way in which exercise stimulates the release of endorphins into the chemistry of the brain.

God grant me the serenityGod grant me the serenityTo accept the things that I cannot change;To accept the things that I cannot change;Courage to change the things that I can;Courage to change the things that I can;And wisdom to know the difference.And wisdom to know the difference.

(Reinhold Niebuhr)(Reinhold Niebuhr)

Goals Desires

To have lots of friendsand never be lonely

I will join a social club

I will keep in touch withthe friends I already have

I will sign up to do volunteer work

CORE BELIEF“I am a failure”

ASSUMPTION“If I do something new I will fail”

-ve SELF TALK“Say no, withdraw, get out of it”

EMOTION“Fear, panic”

DRIVEN BEHAVIOUR“Avoids anything risky”

HEALTHY BEHAVIOUR“Willingness to take risks”

Unconscious

Pre-conscious

Conscious

COMMON DISTORTIONS OF THINKING (DOTS)COMMON DISTORTIONS OF THINKING (DOTS)

1.1. Filtering:Filtering: You take only the negative (or positive) details and You take only the negative (or positive) details and magnify them while filtering out all positive aspects of a situation.magnify them while filtering out all positive aspects of a situation.

2. Polarised thinking:2. Polarised thinking: Seeing things as black or white, all or Seeing things as black or white, all or nothing, good or bad e.g. you have to be perfect or you’re a failure.nothing, good or bad e.g. you have to be perfect or you’re a failure.

3. Mind reading:3. Mind reading: You assume that you know what people are You assume that you know what people are thinking and feeling without any evidence.thinking and feeling without any evidence.

4. Catastrophising:4. Catastrophising: Making mountains out of molehills. Making mountains out of molehills.

5. Blaming:5. Blaming: You hold other people responsible for your pain, or You hold other people responsible for your pain, or take the other tack and blame yourself for every problem or take the other tack and blame yourself for every problem or reversal.reversal.

6. Emotional reasoning:6. Emotional reasoning: Living on the basis that whatever you Living on the basis that whatever you feel is true.feel is true.

7. Global mislabelling:7. Global mislabelling: You generalise one or two qualities into You generalise one or two qualities into a negative global judgement – eg. “I’m a failure” instead of “I made a negative global judgement – eg. “I’m a failure” instead of “I made a mistake”a mistake”

8. Minimisation:8. Minimisation: Minimising your own or another’s positive qualities – e.g. “I’m Minimising your own or another’s positive qualities – e.g. “I’m hopeless at everything”hopeless at everything”

9. Perfectionism:9. Perfectionism: I must do a job perfectly or I will look bad and suffer I must do a job perfectly or I will look bad and suffer accordingly.accordingly.

10. Externalisation of self-worth:10. Externalisation of self-worth: My sense of worth depends mainly on My sense of worth depends mainly on what others think of me.what others think of me.

11. Fallacy of worrying:11. Fallacy of worrying: If I worry enough, the problem will be solved. If I worry enough, the problem will be solved.

12. Fallacy of ignoring:12. Fallacy of ignoring: If I ignore the problem long enough, it will go away If I ignore the problem long enough, it will go away

13. Jumping to conclusions:13. Jumping to conclusions: Making up your mind about something without Making up your mind about something without having all the evidence.having all the evidence.

14. Entitlement:14. Entitlement: Expecting special privileges that don’t exist. Expecting special privileges that don’t exist.

15. Justifying:15. Justifying: Attempting to defend one’s position by any means available Attempting to defend one’s position by any means available rather than face the issue squarely.rather than face the issue squarely.

SOME COGNITIVE RESTRUCTURING TECHNIQUES:SOME COGNITIVE RESTRUCTURING TECHNIQUES:

1.1. Reattribution:Reattribution: Placing responsibility where Placing responsibility where responsibility belongsresponsibility belongs

2. Questioning evidence2. Questioning evidence

3. De-catastrophising:3. De-catastrophising: Also called the “what if” Also called the “what if” technique?technique?

4. Reframing:4. Reframing: Putting on “new glasses” Putting on “new glasses”

5. Thought stopping:5. Thought stopping: Picture a stop sign, or a bell, or Picture a stop sign, or a bell, or a wall whenever unwanted thoughts starta wall whenever unwanted thoughts start

6. Paradox:6. Paradox: Prescribing the problem Prescribing the problem

7. Normalising:7. Normalising: Recognise the “normality” of worry in Recognise the “normality” of worry in worrisome circumstancesworrisome circumstances

8. Relaxation and breathing exercises8. Relaxation and breathing exercises

9. Support group: 9. Support group: Joining or forming a regular/sharing group Joining or forming a regular/sharing group can build much needed bridges, develop trust and restore can build much needed bridges, develop trust and restore confidenceconfidence

10. Risk taking exercises:10. Risk taking exercises: Daring to get out of one’s “comfort Daring to get out of one’s “comfort zone” – builds self – esteemzone” – builds self – esteem

FOUR QUESTIONS FOR CHALLENGING MISTAKEN BELIEFS

What are the facts and what are my What are the facts and what are my subjective perceptions?subjective perceptions?

What is the evidence for and against What is the evidence for and against my thinking?my thinking?

What distortions or mistakes am I What distortions or mistakes am I making in my thinking?making in my thinking?

Are there any other ways of interpreting Are there any other ways of interpreting this situation?this situation?

DATE EVENT AUTO.THOUGHTS

EMOTIONS/BEHAVIOUR

RATIONALRESPONSE

NEWEMOTIONALRESPONSE

xx/xx/xx Co-workercriticises my work

I’m useless.I have to stop othersseeing it.I should change job.

fear, shame,angertemptationto rip mywork upand startagain

Thoughtstopping.Who made this personan expert.Actually hiswork is oftenquestioned.He has areputationof being abad worker.

Find theemotionshave settled.I’m calmer

URGENCYURGENCY

IMPORTANCEIMPORTANCE

URGENTURGENT && NOTNOTIMPORTANTIMPORTANT

URGENTURGENT &&IMPORTANTIMPORTANT

NOT URGENTNOT URGENT && NOTNOTIMPORTANTIMPORTANT

NOT URGENTNOT URGENT &&IMPORTANTIMPORTANT

AWAREAWAREA – Accept your anxiety. Fighting directly can make it worse. Try and flow with it.

W – Watch your anxiety. Become an observer of it. Write about it.

A - Act as though the anxiety is not there. Don’t let the anxiety control your life.

R – Repeat the steps

E – Expect the best – (Choose hope – don’t reduce hope to a feeling)

GOD GOD

SIN

Spiritual ladder

The line of perfection

Human beings

SIN

Human beings

ANXIETY PRODUCINGANXIETY PRODUCINGRELIGIONRELIGION

GRACE CENTREDGRACE CENTRED SPIRITUALITYSPIRITUALITY

SUBJECT

GOD

FALSE GOD

SPIRITUAL ECLIPSESPIRITUAL ECLIPSE

Confession and forgivenessConfession and forgiveness

Part of a helpful spirituality is the ability Part of a helpful spirituality is the ability

to major on living by confession and to major on living by confession and forgiveness. If when we make a forgiveness. If when we make a

mistake and hurt others we confess mistake and hurt others we confess

and seek to make amends, then and seek to make amends, then

we remove unhelpful feelings of guilt we remove unhelpful feelings of guilt

from our lives. from our lives.

When we strive to forgive others we When we strive to forgive others we remove the poison of resentment from remove the poison of resentment from

our lives. It has been said that our lives. It has been said that

““resentment is like drinking poison resentment is like drinking poison

and waiting for the other person to die” and waiting for the other person to die” (Malachy McCourt cited in Schiraldi & (Malachy McCourt cited in Schiraldi & Kerr, 2002:181).Kerr, 2002:181).

The importance of a “journeying” view of selfThe importance of a “journeying” view of self

Cartesian View“I Think Therefore

I am”Vichian View“The dialogical self”

The self is fluid and changing.The self is a journey and alwaysemergent

A Stable andunchanging selfto be found andprotected

Some findings from the research:Some findings from the research:

1. The problematic nature of ‘call’

2. The potential for pre-reflective identification to be confused with call

3. The Christian concept of being ‘tested.’ – (I should suffer)

4. Only the women in the study experienced a sense of call internally

It’s about knowing, and if I was to talk about my call to ministry now, it’s probably stronger than it ever was but I still couldn’t necessarily find the words to explain it in a very coherent fashion. Apart from, it’s an inner knowing. (Sophie)

…in the space of six days, I’d jumped every hurdle. While this is a coincidental thing, in terms of call, I sensed that just the way the process was expedited it seemed to be, it was made remarkably easy. (Ken)

Some findings from the research:Some findings from the research:

1. The problematic nature of ‘call’

2. The potential for pre-reflective identification to be confused with call

3. The Christian concept of being ‘tested.’ – (I should suffer)

4. Only the women in the study experienced a sense of call internally

5. Stress related to being ‘agents of change’

Some findings from the research:Some findings from the research:

6. The abuse of Ministers by Congregations – (We hear of abusive Ministers. There are also abusive churches)

7. Discrimination against female clergy – (both overt and covert)

8. The difficulties involved in ‘measuring success.’