Stress Management for Busy Professionals:

Techniques you can use

Lynne I. Wagner, Ph.D.Associate Professor

Department of Medical Social Sciences

Northwestern University Feinberg School of Medicine

Outline of Presentation

• Definition of stress• Ways stress can affect you• Identifying triggers• Stress management strategies

– Identifying and altering stress-exacerbating cognitions

– Stress hardiness– Active coping strategies– Time management– Relaxation techniques

WHAT IS STRESS?• Stress is your mind and body’s

response or reaction to a real or imagined threat, event or change.

• The threat, event or change are commonly called stressors• Internal: thoughts, beliefs, attitudes• External: loss, tragedy, change, job

demands

NEGATIVE STRESS

Distress or negative stress occurs when your level of stress is either too high or too low and your body and/or mind begin to respond negatively to the stressors.

Perception of Stress: LOW

DEMANDS

RESOURCES

Perception of Stress: HIGH

RESOURCES

DEMANDS

1. Alarm Stage2. Resistance Stage3. Exhaustion Stage

STAGES OF STRESS

Alarm Resistance Exhaustion

Cardiac: Increased heart rateRespiratory: decreased temperatureHormonal: increased stimulation of adrenal glands

FatigueMuscle tensionSleep difficultiesAnxietyTearfulnessAgitationFeeling overwhelmedDepression

Digestive disordersHypertensionBruxismWeight gain or lossHair lossEndocrine disorders

STAGES OF STRESS: PHYSIOLOGICAL EFFECTS

Is All Stress Bad?

• Moderate levels of stress may actually improve performance and efficiency

• Too little stress may result in boredom

• Too much stress may cause an unproductive anxiety level

EUSTRESS

Eustress or positive stress occurs when your level of stress is high enough to motivate you to move into action to get things accomplished.

Optimal Level of StressYerkes-Dodson law of arousal and

performance

Identifying Stressors

Situations, activities, and relationships that cause

‘trauma’ to one’s physical, emotional, or psychological

self

Stressors

• School• Work• Family• Relationships• Legal• Finances• Health/illness• Environment• Living Situation

Work-Related Stressors: NURAP• Deadline-driven work environment• Time pressures, last minute time demands• Stress level consistently high and chronic• Conflicts in reporting structure, competing

demands• Unpredictable and inconsistent work flow• Job security• Level of responsibility• Long hours• Lack of control over work quality of

colleagues

Burnout

Physical- Weight gain/loss- Unexpected hair loss- Heart palpitations- High blood pressure- Headaches- GI problems- Sleep difficulties- Fatigue- Muscle aches- Bruxism

Emotional- Difficulty concentrating- Mental exhaustion- Mood swings- Anxiety- Depression- Apathy- Anhedonia- Hopelessness- Helplessness- Low self-esteem

Identifying Triggers: When there’s smoke, there’s fire

- Identify signs of stress

- Trace your steps to identify source

- Use emotions as clues

- Anxiety = Threat- Anger = Injustice- Sadness = Loss

- Learn your strengths and vulnerabilities

- Identifying and understanding triggers is half the battle

"You can't always influence what others may say or do to

you but you can influence how you react and respond

to it."Author Unknown (seemingly smart)

STRESS MANAGEMENT STRATEGIES

Deadline

STRESSOR COGNITION OUTCOME

I’ll never finish in time

No one else can help

I’ll lose my job

AnxiousOverwhelmedFrustratedHelpless

Deadline

I’ll get it done, I always do

Can anyone help?

I will deal with consequences IF I miss the deadline

InspiredChallengedHopefulProductiveResourceful

X X

Technique: Cognitive Reframing

Last minute request

STRESSOR COGNITION OUTCOME

They always come to me at the last minute

No one respects my job

This was intentional

AngryAnxiousOverwhelmedFrustratedHelpless

Last minute request

Maybe they don’t realize how it affects me

Maybe it was out of their control

I can rise to this challenge

EmpathicProblem-focusedHopefulProductive

X X

Technique: Cognitive Reframing

Stress Hardy Personality• Research has identified a subgroup of

people who are more resistant to stress and better able to cope than others

• Psychologists have identified personality traits that are stress protective– Commitment– Control– Challenge

• Executives with these traits had 50% decreased risk of stress-related health problems– Susan Kobasa, Ph.D.

Active Coping ModelSTRESSOR:

WORK DEADLINE

Uncontrollable Controllable

• Deadline• Colleague’s behavior• Nature of the work

• Manage cognitions• Break down project into

smaller tasks• Develop realistic timeline and

goals for accomplishing tasks• Prioritize competing demands• Enlist help of others• Bolster resources by

engaging in health-promoting activities

Emotion-focused strategies

Problem-solving strategies

Examples: • Cultivate

compassion• Express negative emotions• Seek support• Search for meaning

Pho

to illu

stratio

n by F

red

rik Bro

de

n for N

ew

swe

ek

Stronger, Faster, SmarterExercise does more than build muscles and help prevent heart disease. New science shows that it also boosts brainpower—and may offer hope in the battle against Alzheimer's.

NewsweekMarch 26, 2007 issuehttp://www.msnbc.msn.com/id/17662246/site/newsweek/

By Mary Carmichael

Don

ald

Mira

lle / Ge

tty Ima

ge

s for New

swee

kP

hysical T

he

rap

y: Re

sea

rch su

gge

sts tha

t exercise

can

a

ffect the

mo

od

s and

even

relieve

de

pressio

nExercise Is a State of Mind

Researchers are learning more about how physical activity affects our moods. Is sweat the hot new antidepressant?

NewsweekMarch 26, 2007 issuehttp://www.msnbc.msn.com/id/17662247/site/newsweek/

By Michael Craig Miller, M.D.

Avoid Maladaptive or Passive Coping Strategies• Maladapative coping strategies provide

temporary relief from stressor however do not solve the source of stress– Excessive alcohol consumption– Nicotine use– Use of illicit drugs– Overuse of prescription medication– Over-eating

• Passive coping strategies– Excessive sleeping– Social withdrawal– Too much time playing Guitar Hero

Boost Resources: Time Management

RESOURCES

DEMANDS

Time Management

• Use realistic thinking strategies to address concerns about what could happen if you do not complete everything on time

• Let go of unnecessary tasks and limit number of tasks you attempt to complete at one time

• Use Daily Activity Form to assess activities completed, planned and desired

Managing Your Anxiety and Worry, Craske & Barlow, 2006

Time Management

1.Delegating responsibility2.Saying “no”3.Stick to an agenda4.Avoid perfectionism

Managing Your Anxiety and Worry, Craske & Barlow, 2006

Everyone has Good and Bad Times• Find your creative/thinking time

and most productive times. Schedule most demanding tasks during this time.

• Find your dead time. Schedule meetings, phone calls, and mundane stuff during it.

Professor Randy Pausch

Interruptions

• 6-9 minutes, 4-5 minute recovery – five interruptions shoots an hour

• You must reduce frequency and length of interruptions (turn phone calls into email)

• Blurting: save-ups

• E-mail noise on new mail is aninterruption -> TURN IT OFF!!Professor Randy Pausch

Professor Randy Pausch

Cutting Things Short

• “I’m in the middle of something now…”

• Start with “I only have 5 minutes” – you can always extend this

• Stand up, stroll to the door, complement, thank, shake hands

• Clock-watching; on wall behind them

Time Journals

• It’s amazing what you learn!

• Monitor yourself in 15 minute increments for between 3 days and two weeks.

• Update every ½ hour: not at end of day

Professor Randy Pausch

Other Helpful tips

• Changing perceptions and expectations

• Break jobs/tasks into manageable parts

• Set reasonable/realistic goals• Avoid procrastination• Set boundaries• Don’t compromise your

values/beliefs• Schedule “me” time

Avoid the fallacy that you will have more time in the future than you have now:Make Self-Care a Priority!

TIME MANAGEMENT

Diaphragmatic Breathing and Relaxation Practice• Diaphragmatic breathing

– Triggers the parasympathetic branch of the autonomic nervous system

– Practice daily for 5 minutes– Employ breathing technique in response

to stress• Relaxation exercises

– Guided imagery– Progressive muscle relaxation

Relax• Our brain fires electrical waves at 14 or

more cycles a second. • These are beta waves and are great for

getting tasks done, but not for learning new things.

• Taking a few minutes to relax deeply slows your brain waves down.

• These slower waves are alpha waves.• They occur at between 7 and 14 cycles a

second• Studies show alpha waves improve learning.----”OnCourse” by Skip Downing

Strategies for Mind and Body Relaxation• Yoga• Meditation• Mindfulness• Diaphragmatic breathing• Guided imagery• Progressive muscle relaxation

I’M IN CONTROL - DISTRESS RELIEF STRATEGIES

Feeling good about yourself can be an effective buffer against stress. Eliminate unnecessary worries.Most worries are either passed on to us by another or conjured up in our imagination.

GET PHYSICAL1. Relax neck and shoulders

2. Take a stretch3. Get a massage

4. Exercise

GET MENTAL5. Count to 10

6. Control your thoughts7. Fantasize

8. Congratulate yourself9. Ignore the problem if appropriate, after evaluation

10. Perform self maintenance11. Talk to a counselor

GET SPIRITUAL12. Meditate

13. Pray14. Remember your purpose

USE YOUR BODY AND MIND TOGETHER15. Take a break

16. Try progressive relaxation17. Try yoga

18. Try aroma therapy19. Laugh

DEVELOP NEW SKILLS20. Prioritize daily tasks

21. Learn something22. Practice a hobby

Importance of Engaging in Pleasant Events• Adult Pleasant Events Schedule

39

Seven HabitsFrom “The Seven Habits of Highly Effective People: Restoring

the Character Ethic” by Stephen R. Covey, Simon and Schuster, 1989

SHARPEN THE SAWThis is the habit of self-renewal, which has

four elements. The first is mental, which includes reading, visualizing, planning and writing. The second is spiritual, which means value clarification and commitment, study and meditation. Third is social/emotional, which stress management includes service, empathy, synergy and intrinsic security. Finally, the physical includes exercise, nutrition and stress management.

RESOURCES• Relaxation and Stress Reduction

Workbook (Davis, McKay, & Eshelman)• Mastery of Your Anxiety and Worry,

Mastery of Your Anxiety and Panic (Craske & Barlow)

• Little Ways to Keep Calm and Carry On (Reinecke)

• Mind over Mood (Greenberg & Padesky)• www.healthjourneys.com• http://stresscourse.tripod.com• www.clevelandclinic.org/health/

RESOURCES• Employee Assistance Program

– Perspectives, 800-456-6327• Group-based Stress Management

programs• National Association of Cognitive

Behavioral Therapists– www.nacbt.org

Stress Management for Busy Professionals:

Techniques you can use

Lynne I. Wagner, Ph.D.Associate Professor

Department of Medical Social Sciences

Northwestern University Feinberg School of Medicine