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ON FIRE? BURNED OUT? BURNED UP?

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ON FIRE? BURNED OUT? BURNED UP?. STRESS: Can it be dangerous?. THE TWO SIDES OF STRESS. GOOD STRESS EUSTRESS. BAD STRESS DISSTRESS. Stress is essential for: Strength and toughness Growth and development Acquire new skills Meeting challenges - PowerPoint PPT Presentation

Transcript of ON FIRE? BURNED OUT? BURNED UP?

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ON FIRE?

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STRESS: Can it be dangerous?

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Stress is essential for:

– Strength and toughness– Growth and development– Acquire new skills– Meeting challenges– Performing difficult

missions

Stress can lead to:

– Persistent internal distress

– Functional impairment– Misconduct– Substance abuse– Mental disorders

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GOOD STRESS

EUSTRESS

BAD STRESSDISSTRESS

THE TWO SIDES OF STRESS

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Death of a loved oneDeath of a loved oneLoss of a jobLoss of a jobChronic or terminal illnessChronic or terminal illnessMarital conflictMarital conflictFamily conflictFamily conflictFinancial problemsFinancial problemsWork related problemsWork related problemsLife stage changesLife stage changesVictim of any type of traumatic Victim of any type of traumatic eventevent

Understanding and Understanding and Managing StressManaging Stress

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The Stress ResponseThe Stress Response

Pupils dilate to increase the visual fieldPupils dilate to increase the visual field Capillaries near the surface of the skin Capillaries near the surface of the skin

contract to increase the amount of contract to increase the amount of blood available to the musclesblood available to the muscles

Heart rate and blood pressure increase Heart rate and blood pressure increase in order to deliver the blood to the in order to deliver the blood to the muscles fastermuscles faster

The lungs expand to increase oxygen The lungs expand to increase oxygen intakeintake

Sweat increases for cooling purposesSweat increases for cooling purposes Muscle fibers contract to be ready for Muscle fibers contract to be ready for

sudden movementsudden movement The liver releases sugars and fats into The liver releases sugars and fats into

the blood stream to fuel muscle cellsthe blood stream to fuel muscle cells

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The Results of Unmanaged The Results of Unmanaged StressStress

Muscle tension – Primarily in the neck and Muscle tension – Primarily in the neck and shouldersshoulders

Headaches, face feels hot, eyes hurtHeadaches, face feels hot, eyes hurt Twitching and trembling, racy body feeling, Twitching and trembling, racy body feeling,

fidgetyfidgety Dry mouth – difficulty swallowing, tight lips, jaw Dry mouth – difficulty swallowing, tight lips, jaw

clenchingclenching Stomach pain ( this may be the only symptom of Stomach pain ( this may be the only symptom of

stress, especially in children)stress, especially in children) DizzinessDizziness Rapid and irregular heart rateRapid and irregular heart rate Rapid breathingRapid breathing Diarrhea or frequent need to urinateDiarrhea or frequent need to urinate FatigueFatigue Irritability, anger, jumpy, anxiousIrritability, anger, jumpy, anxious Sleep too much or too little – nightmaresSleep too much or too little – nightmares Decreased concentrationDecreased concentration Short term memory lossShort term memory loss

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Over time an elevated unmanaged stress level Over time an elevated unmanaged stress level can lead to morecan lead to more

serious physical and emotional problems serious physical and emotional problems including the followingincluding the following..

High blood pressure( the silent killer)High blood pressure( the silent killer) Heart problemsHeart problems Ulcers - Irritable bowel syndromeUlcers - Irritable bowel syndrome Respiratory problems Respiratory problems Clinical depression (leading cause of suicide) Clinical depression (leading cause of suicide) Panic attacks Panic attacks ParanoiaParanoia New research indicates an increased risk of New research indicates an increased risk of

cancercancer

Long Term Effects of Unmanaged Stress

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Stress ContinuumStress ContinuumREADYREADY

(Green)REACTINGREACTING

(Yellow)(Yellow)IMPAIREDIMPAIRED

(Orange)(Orange)DISABLEDDISABLED

(Red)(Red)

• Distress or impairment

• Anxious, irritable, or sad

• Behavior and attitude change

• More severe or persistent distress or impairment

• Leaves lasting memories

• Overreacting to events

• Stress injuries that don’t heal without help

• Symptoms and impairment persist over many weeks or get worse over time

• Good to go• Well trained• Prepared• Fit and

focused• Cohesive

crews & stable families

Crew LeaderResponsibilityCrew LeaderResponsibility

Caregiver Responsibility

Caregiver Responsibility

CREW LEADER AND PEER RESPONSIBILITY

CREW LEADER AND PEER RESPONSIBILITY

Stressor

Stressor

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Most Important Distinction:Most Important Distinction:Yellow Zone Yellow Zone Reactions vs. Reactions vs. Orange Zone Orange Zone

InjuriesInjuries

Stress Stress InjuriesInjuries

– Damage from stress– Less common– Risk for role failure– Risk for stress illness

Stress Stress ReactionsReactions

– Bending from stress– Very common– Normal– Always goes away

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Many Causes vs Only Four:Many Causes vs Only Four:Yellow Zone Reactions vs Orange Zone InjuriesYellow Zone Reactions vs Orange Zone Injuries

Hard work

Physical

injuries

Minor illnesses Peer

conflicts

Conflicts with boss

BoredomRelationship

problems

Money problems

Loss of privacy

Harsh

weather

Family separation

Loss of possessions

Legal

problemsLack of

sleep

Yellow ZoneYellow ZoneStressStress

Wear-and-tear

Moral injury

Loss

Life threat

Orange ZoneOrange ZoneStressStress

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What Is Damaged in Mind & Brain?What Is Damaged in Mind & Brain?In Orange Zone Stress InjuriesIn Orange Zone Stress Injuries

Life Life threatthreat

LossLoss

Moral Moral injuryinjury

Wear-Wear-and-and-teartear

Ora

nge

Zone

Ora

nge

Zone

Stre

ssSt

ress

Inju

ries

Inju

ries

Damaged in Mind:Damaged in Mind: Damaged in Brain:Damaged in Brain:

Beliefs• In own safety• In own immortality• In own competence

Neuron Circuits• For self-calming• For autonomic arousal• For memory

Attachments• To a person• To a part of oneself• To possessions

Trust• In moral values• In right and wrong• In God and Country

Cognitive Ability• To concentrate• To make decisions• To be flexible

Neuron Circuits• For mood regulation• For concentration,

energy, and motivation11

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Stress ZonesGreenGreen

““Ready”Ready”YellowYellow

““Reacting”Reacting”OrangeOrange

““Impaired”Impaired”RedRed

““Disabled”Disabled”

• Healthy

• Well

• Fit

• Safe

• Connected

• Capable

• Confident

• Drained

• Sore

• Irritable

• Anxious

• Down • Hurt

• Out of control

• Symptomatic

• Distressed

• Dysfunctional

Routine StressorsRoutine

Stressors

Toxic StressorsToxic Stressors

ResilienceResilience

RecoveryRecovery

Cumulative Stress

• Clinically symptomatic

• Impaired

• Worsening

• Disordered

??

RecoveryRecovery

Stress Continuum Stress Continuum TransitionsTransitions

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Life Life ThreatThreat

• A traumatic injury

• Due to an experience of death provoking terror, horror, or helplessness

LossLoss

• A grief injury

• Due to the loss of cherished people, things, or parts of oneself

Wear & Wear & TearTear

• A fatigue injury

• Due to the accumulation of stress from all sources over time without sufficient rest and recovery

Intense or ProlongedIntense or ProlongedDisaster or Operational StressDisaster or Operational Stress

Inner Inner ConflictConflict

• A moral injury

• Due to behaviors or the witnessing of behaviors that violate moral values

Four Causes of Stress Four Causes of Stress InjuryInjury

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SPIRITUAL FITNESS GUIDESPIRITUAL FITNESS GUIDEThis is a This is a self-assessment toolself-assessment tool to help persons consider their spiritual condition . to help persons consider their spiritual condition .

(This is a modified version of a model developed by the U. S. Navy Chaplain Corps) (This is a modified version of a model developed by the U. S. Navy Chaplain Corps)

SpirituallySpirituallyFITFIT

SpirituallySpirituallyDISTRESSEDDISTRESSED

SpirituallySpirituallyDRAINEDDRAINED

SpirituallySpirituallyDEPLETEDDEPLETED

POTENTIAL INDICATORS•Neglecting life’s meaning/purpose

•Less hopeful about life/future

•Makes some poor moral decisions

•Difficulty forgiving self and/or others

•Infrequently practices faith disciplines

•Less respectful to people of other faiths

•Neglects core values/beliefs

•Adequately makes worldview adjustments

POTENTIAL INDICATORS•Loss sense of life’s meaning/purpose

•Holds very little hope about life/future

•Makes poor moral decisions routinely

•Unable to forgive self and/or others

•Discounts practices of faith disciplines

•Strong disrespect to people of other faiths

•Disregards core values/beliefs

•Inadequately makes worldview adjustments

POTENTIAL INDICATORS•Claims life has no meaning/purpose

•Holds no hope about life/future

•Extreme immoral behavior

•Forgiveness is not an option

•Abandons practices of faith disciplines

•Complete disrespect to people of all faiths

•Abandons core values/beliefs

•Inappropriately makes worldview adjustments

POTENTIAL INDICATORS•Engaged in life’s meaning/purpose

•Hopeful about life/future

•Makes good moral decisions

•Able to forgive self and/or others

•Routinely practices faith disciplines

•Respectful to people of other faiths

•Engaged in core values/beliefs

•Appropriately makes worldview adjustments 14

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Okay Needs Work Needs Help Enjoy worship Happy with fellowship Happy with spiritual expression Able to give and receive love Appreciating beauty Creative Comfortable with your place in world Connected, peaceful

Less tolerant of different beliefs Feeling distant from God; want to get closer Don’t know how to love or feel loved Feeling distant from others Struggling to understand others Not sure where you fit in Something’s missing

No reverence for anything outside self Alone and wandering aimlessly Spiritually empty Don’t care about others Nothing seems important Feel powerless to change life Out of touch Loss of purpose Lacking a “moral compass”

1. Spirituality 1. Spirituality Creativity, order, connectionCreativity, order, connection1. Spirituality 1. Spirituality

Creativity, order, connectionCreativity, order, connection

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Okay Needs Work Needs Help Sleeping well No bad nightmares Working out regularly Good nutrition Good energy level Good emotional control Able to enjoy life Not troubled by memories Feeling good about self

Trouble getting to sleep Keep waking up Out of shape Eating too much or too little Loss of interest in life Feeling anxious or worried Feeling irritable Painful memories Feeling guilty

Can’t sleep enough Repeated disturbing thoughts Trouble pushing memories out of mind Panic attacks (heart pounding, shaking) Rage outbursts Depressed mood Keep blaming self Thoughts of suicide or homicide

2. 2. Emotional/Mental/Physical Emotional/Mental/Physical

HealthHealthFitness, wellness, self-esteem, controlFitness, wellness, self-esteem, control

2. 2. Emotional/Mental/Physical Emotional/Mental/Physical

HealthHealthFitness, wellness, self-esteem, controlFitness, wellness, self-esteem, control

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3. Relationships3. RelationshipsSpouse, significant other, family, friendsSpouse, significant other, family, friends3. Relationships3. RelationshipsSpouse, significant other, family, friendsSpouse, significant other, family, friends

Okay Needs Work Needs Help Good communication Feeling close Looking forward to seeing Cooperating well Playing well Intimacy Good conversation Affection Openness Responsiveness

Trouble communicating Occasional fights and disagreements Uncomfortable being together Not having fun Staying apart Difficult y with intimacy Complaints from partner Ambivalence Guardedness

Poor comm. Frequent fighting Dreading contact Emotional coldness Lack of intimacy Irresolvable conflict Criticism Contempt Defensiveness Emotionally numb Thoughts of hurting others or self

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Okay Needs Work Needs Help Comfortable in roles Meeting your own expectations in roles Able to balance competing demands Fulfilled Energized

Some strain in roles Not meeting own expectations in roles Not able to fit the pieces together Out of balance Pressured Drained

Pulled apart Too many demands Tension between roles Serious conflict with others over roles Exhausted

4. Roles in Life4. Roles in LifeLeader, coach, parishioner, citizen, providerLeader, coach, parishioner, citizen, provider4. Roles in Life4. Roles in Life

Leader, coach, parishioner, citizen, providerLeader, coach, parishioner, citizen, provider

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Okay Needs Work Needs Help Comfortable in public Appropriate in public Good and careful driver Patient in frustrating situations Calm, even with rude people Friendly No police involvement

Avoiding going out in public Suspicious of strangers Absent minded Getting frustrated easily Impatient Occasionally angry or irritable Driving too fast Driving recklessly

Paranoid in public Road rage Picking fights Rage outbursts in public Panic attacks in public Persistent hyperactive startle responses Arrests

5. Public Behavior5. Public BehaviorDriving, waiting, dealing with public, patienceDriving, waiting, dealing with public, patience5. Public Behavior5. Public Behavior

Driving, waiting, dealing with public, patienceDriving, waiting, dealing with public, patience

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Okay Needs Work Needs Help Achieving Feeling like a team Mentoring subordinates Getting rewarded Career goals progressing Job satisfaction Enjoying going to work Respected by subordinates

Cutting corners Needing a lot of supervision Animosity toward peers or leaders Being apathetic or unmotivated Unrewarding Stagnating Indifferent

No respect for self or others Defying authority Being a tyrant to subordinates Hostile environment Disorganized/lack of leadership Held back Unsupported Abandoned Abused

6. Work Function6. Work FunctionShop, supervisors, goals, promotion, rewardsShop, supervisors, goals, promotion, rewards6. Work Function6. Work FunctionShop, supervisors, goals, promotion, rewardsShop, supervisors, goals, promotion, rewards

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Okay Needs Work Needs Help Saving money Bills paid up to date Keeping to budget Debt under control Working a financial plan Spending in sync with spouse

Minimal savings Bills past due Financial worries Uncomfortable debt Vague financial plan Conflict with spouse over spending

No savings Collection notices Major financial stress Large debt load Creditors contacting command Total disagreement over spending Financial trouble

7. Money and 7. Money and FinancesFinances

Budget, purchases, credit, bills, savingsBudget, purchases, credit, bills, savings

7. Money and 7. Money and FinancesFinances

Budget, purchases, credit, bills, savingsBudget, purchases, credit, bills, savings

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Intentional Listening & Intentional Listening & LanguageLanguage

(Check & Coordinate, Cover, Calm, (Check & Coordinate, Cover, Calm, Connect)Connect)

GOALGOAL

Stabilize persons by helping Stabilize persons by helping them tell their story, connect them tell their story, connect with you and determine with with you and determine with who else they might need to who else they might need to

connectconnect22

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Intentional Listening Intentional Listening Hints = F Hints = F 33

Focus on the person in front of youFocus on the person in front of you

Follow what the person is sayingFollow what the person is saying

Fixate on what Fixate on what you CAN DO!you CAN DO! Titus Titus 3:1, 143:1, 14(not on what you cannot do)(not on what you cannot do)

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Intentional Listening & Intentional Listening & LanguageLanguage

(Check & Coordinate, Cover, Calm, (Check & Coordinate, Cover, Calm, Connect)Connect)Key Techniques:Key Techniques:

MirroringMirroring = saying it again in = saying it again in theirtheir words wordsWhat I hear you saying is . . . What I hear you saying is . . .

ParaphrasingParaphrasing = saying it as summary in = saying it as summary in youryour wordswords

If I understand you correctly, . . .If I understand you correctly, . . .QuestioningQuestioning = directing to reveal more = directing to reveal more informationinformation

Can you tell me more about . . .Can you tell me more about . . .Zooming Statements Zooming Statements (in & out) = spotlighting (in & out) = spotlighting key key observations about facts, feelings or dynamics observations about facts, feelings or dynamics

You seem to be . . . (or) I think you mean . . .You seem to be . . . (or) I think you mean . . .24

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Intentional Listening & Intentional Listening & LanguageLanguage

(Check & Coordinate, Cover, Calm, (Check & Coordinate, Cover, Calm, Connect)Connect)Key Techniques:Key Techniques:

MirroringMirroring = don’t sound like a parrot = don’t sound like a parrotAre you just repeating everything I am saying?Are you just repeating everything I am saying?

ParaphrasingParaphrasing = don’t jump in to quick or too often = don’t jump in to quick or too often because this can become annoyingbecause this can become annoyingWill you stop interrupting me and let me finish!Will you stop interrupting me and let me finish!

QuestioningQuestioning = don’t become an interrogator = don’t become an interrogatorSound like you are giving me the third degreeSound like you are giving me the third degree

Zooming Statements Zooming Statements (in & out) = don’t zoom too (in & out) = don’t zoom too fastfast

Let me set the pace on how quickly I focusLet me set the pace on how quickly I focus

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Intentional Listening & Intentional Listening & LanguageLanguage

(Check & Coordinate, Cover, Calm, (Check & Coordinate, Cover, Calm, Connect)Connect)

When using questions, start with closed-When using questions, start with closed-ended questions to gain insights and build ended questions to gain insights and build trust then shift to open-ended questions to trust then shift to open-ended questions to allow the person to elaborate and steer the allow the person to elaborate and steer the dialoguedialogue

What have you tried already?What have you tried already?

Have you considered other options?Have you considered other options?

How does that make you feel?How does that make you feel?

Can you tell me more about that?Can you tell me more about that?

What seems to hurt the most right What seems to hurt the most right now?now? 26

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Intentional Listening & Intentional Listening & LanguageLanguage

(Check & Coordinate, Cover, Calm, (Check & Coordinate, Cover, Calm, Connect)Connect)

Special things to listen for:Special things to listen for:

Suicidal or homicidal ideations or Suicidal or homicidal ideations or actionsactions

Ask: Have you had thoughts about Ask: Have you had thoughts about hurting yourself or some else?hurting yourself or some else?

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Characteristics of Characteristics of Suicidal StoriesSuicidal Stories

1. Unendurable psychological pain1. Unendurable psychological pain 2. Frustrated psychological needs2. Frustrated psychological needs 3. The search for a solution3. The search for a solution 4. An attempt to end consciousness4. An attempt to end consciousness 5. Helplessness and Hopelessness5. Helplessness and Hopelessness 6. Constriction of options6. Constriction of options 7. Ambivalence7. Ambivalence 8. Communication of intent (3 themes): Verbal, 8. Communication of intent (3 themes): Verbal, Behavioral, Behavioral,

SituationalSituational 9. Departure9. Departure10. Lifelong coping pattern10. Lifelong coping pattern

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Suicide Warning SignsSuicide Warning Signs“IS PATH WARM”“IS PATH WARM”

II DEATION DEATION. Thoughts of suicide expressed, threatened, written or . Thoughts of suicide expressed, threatened, written or hintedhinted

SS UBSTANCE USE. UBSTANCE USE. Increased or excessive alcohol or drug useIncreased or excessive alcohol or drug use

PP URPOSELESSNESS. URPOSELESSNESS. No sense of meaning or purpose in lifeNo sense of meaning or purpose in life

AA NXIETY. NXIETY. Anxious, agitated, or unable to sleep. (Or sleeping all the Anxious, agitated, or unable to sleep. (Or sleeping all the time)time)

TT RAPPED. RAPPED. Feeling trapped, like there is no way outFeeling trapped, like there is no way out

HH OPELESSNESS. OPELESSNESS. Feeling hopeless about self, others, the future.Feeling hopeless about self, others, the future.

WW ITHDRAWAL. ITHDRAWAL. Withdrawing from family, friends, usual activities, Withdrawing from family, friends, usual activities, societysociety

AA NGER. NGER. Rage or uncontrolled anger, seeking revenge for perceived Rage or uncontrolled anger, seeking revenge for perceived wrongswrongs

RR ECKLESSNESS. ECKLESSNESS. No regard for consequences, risky behaviorNo regard for consequences, risky behavior

MM OOD CHANGES. OOD CHANGES. Experiencing dramatic changes in mood. Experiencing dramatic changes in mood. 29

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Suicide Awareness Program AcronymsSuicide Awareness Program AcronymsRACE

Recognize distress Note changes in • Personality, emotions, or

behavior. • Withdrawal from co-

workers, friends and family. • Eating and sleeping

patterns. Ask • Calmly question about the

distress you observed. • If necessary, ask the

question directly: “Are you thinking about killing yourself?”

Care • Actively listen, don’t judge. • Peacefully control the

situation; do not use force; keep everyone safe.

Escort • Never leave your buddy

alone. • Escort to chain of

command, chaplain, medical, or behavioral health professional.

Ask • Calmly question

about the distress you observed.

• If necessary, ask the question directly: “Are you thinking about killing yourself?”

Care • Actively listen, don’t

judge. • Peacefully control

the situation; do not use force; keep everyone safe.

Escort • Never leave your

buddy alone. • Escort to chain of

command, chaplain, medical, or behavioral health professional.

ASK•Don’t be afraid to ask

CARE•Listen, offer hope, don’t judge

TREAT•Take action, get help, follow up!!

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ACE ACT

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Intentional Listening & Intentional Listening & LanguageLanguage

(Check & Coordinate, Cover, Calm, (Check & Coordinate, Cover, Calm, Connect)Connect)

REFER to Resources:REFER to Resources:National Suicide Hotline = 1 (800) - National Suicide Hotline = 1 (800) -

suicidesuicide1 (866) 273-TALK1 (866) 273-TALK

Call: 9-1-1Call: 9-1-1

Take to the CLOSEST medical facility/E.R.Take to the CLOSEST medical facility/E.R.

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