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Manage Stress/Build Resiliency DRAFT Catherine M Bodnar, MD, MPH Michigan Occupational Health Conference September 19, 2015

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Page 1: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Manage Stress/Build Resiliency DRAFT

Catherine M Bodnar, MD, MPH Michigan Occupational Health Conference September 19, 2015

Page 2: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Contents

• Definitions……………………………………………....3 • Strategies for Building Resiliency……………..6 • Personal Power………………………………………..9 • Purpose………………………………………………….10 • Stress Strategy………………………………………..13 • Power of Story………………………………………..14 • Practicing Appreciation…………………………..15 • Values……………………………………………………..16 • Goals……………………………………………………….21 • Management of Personal Energy…………….24

– Stress for Success – Change Stinking Thinking – Automatic Behavior – Dimensions of Health

• Challenge…………………………………………………32

Page 3: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Definitions

Stress : State of arousal with which the body responds to the challenge, stimulus and demands of everyday life. (Pressure, Eustress)

Stressor: External or internal events that create a perception of fear, pressure or conflict.

Strain: Occurs when stress reaches a point in which the body begins to show signs of damage.

Burnout: Individual has operated too fast, for too long, without proper balance--the body and mind reach a state of exhaustion

Rust Out: Under-challenged or bored Resiliency: the ability to adapt positively to stress and adversity, remaining

both realistic and optimistic. Managing stress is in an integral part of building personal resiliency.

Stress Hardiness: ability to deal effectively with stress Can become tougher and stress hardy through encountering stress, coping and

learning from experiences.

Page 4: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Resiliency

•Being resilient does not mean that a person doesn’t experience difficulty or distress. In fact, the road to resilience is likely to involve considerable emotional distress.

•Resiliency is not a trait that people either have or do not have. It involves behaviors, thoughts, and actions that can be learned and developed in anyone.

Page 5: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Why is resiliency important?

Pressures can lead to stress, which can be effectively managed through resilient behaviors. Pressure is necessary for us to grow.

People who are resilient can effectively manage and even reduce the pressures in their lives, resulting in less stress, improved health and improved performance.

Some stress is also necessary, but excess stress can lead to burnout.

Page 6: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Strategies for Building Resilience

Developing resilience is a personal journey. People do NOT all react the same way to traumatic and stressful life events. An approach to building resilience that works for one person might not work for another. People use varying strategies.

Page 7: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Effectively Build Resiliency

• Take care of yourself

• Avoid seeing crises as insurmountable problems

• Accept that change is part of living

• Take decisive actions

• Look for opportunities for self-discovery

• Keep things in perspective

• Maintain a hopeful outlook

• Make connections

Page 8: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Take Care of You!

• Be present in important relationships

• Nutrition

• Physical Activity/Exercise

• Adequate sleep

• No tobacco

• Alcohol: moderation or none at all

• Maintain a safety focus

• Manage Health: manage medical conditions/minimize risk factors

Page 9: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

*Personal Power: Power over Feelings, Power Over Fate

• Lies at the core of your being and enables you to make choices.

• It is the psychological source of your physical and emotional energy.

• When personal power is strong – Other people can affect you, but no one can control you.

– You’re not afraid.

• Elements of personal power: Character, strength, individuality, heart, will, charisma

*Reference: Dan Baker, PhD, “What Happy People Know”

The feeling that there are

options is a predictor of good

mental/emotional health.

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Page 10: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

*Components of Personal Power

• Taking responsibility your life belongs to you

• Taking action do something about it

*Reference: Dan Baker, PhD, “What Happy People Know”

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Page 11: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

“Chase meaning…and trust yourself to handle the stress

that follows. It is better than avoiding discomfort.”

Kelly McGonigal

Kelly McGonigal’s TED talk: How to make stress your friend

https://www.ted.com/speakers/kelly_mcgonigal

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Page 12: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Personal Growth often Occurs Out of Stressful or Painful Experiences

“That which does not kill us, makes us stronger.” German philosopher, Friedrich Nietzsche

• *Survivors of major life event or trauma may have post traumatic growth – Renewed appreciation for life – Adopt a new world view with new possibilities for themselves – Feel more personal strength – Improved Relationships – Feel more satisfied spiritually

• None of us would choose to undergo painful life events or trauma, but personal growth may be experienced during recovery from difficult situations

*Reference: Debbie Hampton, posted on line 17May2012 12

Page 13: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Personal Stress Strategy • Primary: Reduce or eliminate root causes of stress

Control & knowing what is coming have a mitigating effect on stress

• Secondary: Improve the ability to cope & respond to stressors Human Connection: seek support/provide support

Optimize Health

Strength of Purpose

Positive Self Talk

Practice Appreciation

Management of Personal Energy

Mindfulness

Others…

• Tertiary: Focus on preventing further physical or mental deterioration & maximizing quality of life Problem Focused

Rehabilitative

Crisis Response

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Use a combination of strategies that ring true to you.

Page 14: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

The Power of Story – Jim Loehr

“Your story is your life. As human beings, we continually tell ourselves stories -- of success or failure; of power or victimhood; stories that endure for an hour, or a day, or an entire lifetime. We have stories about our work, our families and relationships, our health; about what we want and what we're capable of achieving. Yet, while our stories profoundly affect how others see us and we see ourselves, too few of us even recognize that we're telling stories, or what they are, or that we can change them -- and, in turn, transform our very destinies… And far too many of our stories, are dysfunctional, in need of serious editing.”

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Page 15: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Practicing Appreciation

• Reprograms the mind & memory by severing fearful self reinforcing thought loops of anxiety inaugurated by the *amygdala & perpetuated by the neocortex o Helps quiet threatening messages from the amygdala.

o Appreciation & fear are mutually exclusive

o Brain, heart & endocrine system work in harmony.

• Appreciation audit – Focus your mind on appreciation of someone or something to

exclusion of all else for 3 – 5 minutes 3x/day

– Can be family member(s), chocolate chip cookies, fishing, skiing, first kiss… it is the quality of the feeling that matters

*integrative center for emotions, emotional behavior, and motivation Source: Dan Brown “What Happy People Know”

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Page 16: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

*Values

• Definition: Individualized beliefs that make you you.

• It’s what you stand for, desire and admire.

• When people identify their values, it gives their lives focus and a sense of security during times of chaos and confusion.

• When people live up to their values, it gives them a sense of purpose, peace of mind and fulfillment.

• When people fail to live up to their values, they feel disappointed in themselves, which may create stress. They may try to fill the gap through money, pleasure, worldly power or other traps such as alcohol or drugs. When these fail, they may feel like victims, feel entitled to more and look for someone to rescue them. When their rescuers fail, they look to blame. Personal power is diminished…

*Reference: Dan Baker, PhD, “What Happy People Know”

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Page 17: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Re-examine Your Values

• Your values provide you direction.

• You don't have to continue living by the same values. They can be consciously changed.

• Are you living up to your values? If yes, great! If not, this may be a source of personal stress.

• Clarifying and prioritizing values help with decision making.

Example: If you are offered a new job which with double the salary, but significantly more time away from family, declining the opportunity allows you to align with your values if time with family is a priority value. If wealth and professional achievement are priority values, then accepting this opportunity is consistent with your values.

*Reference: Dan Baker, PhD, “What Happy People Know”

Page 18: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Determine Core Values (listed on next slide)

• When people live up to their values, it gives them a sense of purpose, peace of mind and fulfillment.

• Be honest and determine your core values. Pick the 5 or 6 that are most applicable to you. (They may all sound good but just pick 5 or 6.) You may add any values of your own to the list – but only pick 5 or 6.

• When people identify their values, it gives their life focus, and gives them a sense of security during times of chaos and confusion.

Page 19: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

What do you value most? Pick 5 or 6 values most applicable to you.

• Adventurousness

• Aggressiveness

• Artistry

• Attractiveness

• Boldness

• Charity

• Charm

• Cheerfulness

• Civility

• Cleanliness

• Compassion

• Courage

• Creativity

• Dependability

• Empathy

• Extroversion

• Faithfulness

• Fitness

• Flexibility

• Health

• Helpfulness

• Honesty

• Humility

• Humor

• Intelligence

• Inventiveness

• Kindness

• Logic

• Love

• Loyalty

• Perceptiveness

• Pleasure

• Reverence

• Security

• Simplicity

• Thrift

• Trustworthiness

• Wealth

• Wisdom

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Page 21: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Personal Goals

• Being true to personal values helps to reduce conflict, stress and anxiety

• Reflect upon your personal values

• Consider your personal goals and record your responses: – Who/What do you care most about?

– What type of person do you want to be – are you living up to your values ?

– What kind of legacy do you want to have/leave?

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Page 22: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Questions to Help Set Personal Goals

• Who/What do you care most about?

– Consider, family, friends, community, professional achievement, financial security, other focus areas…

• What type of person do you want to be – are you living up to your

values?

– I value… – I live up to these values by…

• What kind of legacy do you want to have/leave?

– I want to be considered a person that attends to and cares deeply about…(consider family, friends, community, career, financial status…)

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Page 24: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Management of Personal Energy Time Management and Beyond

• Time management is the act or process of planning and exercising conscious control over the amount of time spent on specific activities, especially to increase effectiveness, efficiency and productivity.

Elements

Creating an environment conducive to effectiveness

Setting priorities

Focus activities around those priorities

Reduction of time spent on non-priorities

• Management of Personal Energy begins with the physical aspects of optimizing energy and adding management of intellectual/mental focus, emotions, relationships and spiritual health.

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Page 25: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

“Ultimately, powerful results do not come from grinding ourselves down, burning ourselves

out or using ourselves up. Our best performance comes from working in

harmony with the rhythmic way our brains and bodies want to work.”

Al Lee

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Page 26: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

*Five Steps to Energy Management • Create a list of the things that give you energy

• Stop working marathon hours, and start working in “sprints.”

• After every 90-120 minute “sprint” of work, stop and do an activity from the list of energy-creating activities, to relax and recover.

• Take this pattern of sprint, relax, sprint, relax — and turn it into an unbreakable, sacred ritual.

• Do not multitask during your sprint — stay focused on one activity that demands attention.

*Reference: http://tomonleadership.com/2011/06/15/five-steps-to-maximizing-your-personal-energy/ Sources: Interview with Al Lee “Manage Your Energy, Not Your Time,” by Tony Schwartz and Catherine McCarthy – HBR “Brain Rules: 12 Principles for Surviving and Thriving at Work, Home, and School” by John Medina 26

Page 27: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Support for Managing Personal Energy

• Stress for Success – seek challenges and opportunities for personal and professional growth

• Address “stinking thinking”

• Put automatic behaviors in place that support your personal goals

• Assess dimensions of health

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Page 28: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Stress for Success

Seek challenges and opportunities to promote personal growth in the context of

• Living up to your values (Slide 14)

• Being true to your personal goals (Slides 19 & 20)

• Following the 5 Steps to Energy Management (Slide 24)

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Page 29: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

*The Power to Change “stinking thinking”

• Irrational thoughts or “stinking thinking” that lead to building stress can be changed to rational thoughts or “counter-thinking” that help bust stress.

• Examples: 1. There is a right and a wrong way to do things. There is usually no one clear right and wrong way to do things. 2. I must be in control all of the time. I give myself the right to be out of control once in awhile. 3. It is awful and horrible to be criticized. I will accept criticism and see how I can benefit from it. 4. Life in the workplace must be fair and just. I accept the fact that life in the workplace is not always fair and just. 5. It is too late for me to change, and if you expect it, I won’t be able to do it. It is not too late for me to change.

• When feeling stressed, ask yourself if “stinking thinking” may apply and reframe the way you think about the situation.

*Source: A Rational Approach to Increasing Corporate and Personal Effectiveness by Samuel H.

Klarreich, Key Porter Books, Toronto, Canada, 1988. 29

Page 30: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

*Automatic Behaviors

• The unconscious mind is running us on its automatic pilot mode, 95% of the time!

• The conscious mind provides 5% or less of our cognitive (conscious) activity during the day – and 5% is for the more aware people, many people operate at just 1% consciousness.

• Most of our decisions, actions, emotions and behavior depend on the 95% of brain activity that is beyond our conscious awareness, which means that 95 – 99% of our life comes from the programming in our subconscious mind.

• It takes a lot more than positive thinking to get out of it. Because as soon as you forget to be conscious, the unconscious is back in charge again. Change may be facilitated by:

– Putting new habits/rituals in place – takes conscious practice over time

– Mindfulness and other forms of meditation

*Reference: Dr. Bruce Lipton, former Professor of Medicine, Stanford University 30

Page 31: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Dimensions of Health

• Physical – Fitness

– Nutrition

– Preventive Health/Early Detection

• Emotional – Interpretation and expression of our

feelings and experiences that support

our emotional state

– Proactively take charge of our

emotional well-being

• Intellectual/Mental – Focus

– Continuous Learning

– Skill Development

• Relationships – Family

– Friends

– Community

• Spiritual – Purpose

– Meaning

– Love/Appreciation

– Hope

– Charity

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Page 32: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

The Challenge – Discover “Islands of Time”

• Give your full focus to the task (personal or business) – do not multitask

• Take an energy creating activity break every 1.5 – 2 hours to re-energize

• Make alternating focus on tasks and energy creating breaks a routine part of your day – Make this pattern a habit – be creative & establish new norms

– Focus on all dimensions of health to maximize your physical energy

• Foundation: Key components for maximizing personal energy – Be present in important relationships

– Nutrition

– Exercise

– Adequate sleep

– No tobacco

– Alcohol: moderation or none at all

– Maintain a safety focus

– Manage Health: manage medical conditions/minimize risk factors

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Page 33: Manage Stress/Build Resiliency - MOEMA · ^Manage Your Energy, Not Your Time, by Tony Schwartz and Catherine McCarthy – HBR ^ Brain Rules: 12 Principles for Surviving and Thriving

Optimize Your Energy

• Assess your dimensions of health (slide 29)

• Give attention to areas that need improvement based upon

– Your desires

– Your values

– Your personal goals

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