Contents
Chapter 1 What is stress 3
Defining 4
Demands 4
Internal\External 4
Timescales 4
Goals and expectation 5
Stress Modulators 5
Peoples response to stress 5
Range 5
Optimal level 5
Myths about stress 5
Chapter 2 Stress and your body 6
Physical symptoms 6
Fight\Flight\Freeze 6
Stress hormones 6
Stages of stress response 6
Allostasis 7
Stressful live events and health 7
Stress and immune system. 7
Stress and infectious diseases 7
Autoimmune disease and stress 7
Chapter 3 Stress and Personality 7
Chapter 4 The role of thinking in stress 7
Chapter 5 Is Stress a problem for you 7
Chapter 6 What makes you stressed 8
Uplifts 8
Chapter 7 How do you cope 8
Types of coping 8
Emotional based coping 8
Stress carrying 8
Avoidance based coping 8
Problem based coping 9
Advantages and disadvantages of different ways of coping 9
Chapter 8 Your stress profile and stress management plan 9
Stress management plan 10
Think of area that is causing you the most difficulty 10
Define your goals 10
Choose a technique 10
Stress diary 10
Chapter 9 Changing your stressful thinking 10
Chapter 10 Changing your stress related behaviour 10
Working with avoidance 11
Chapter 11 Stress and Relationships 11
Changing stressful relationships 11
Relationship as system 11
Partner 1 withdraws and seems cold 11
Relationships are affected by the past 12
Expectations play a big part in relationships 12
Chapter 12 Stress at Work 13
Effects of stress at work 13
Problems with communications and stress at work 14
Using the skills: positive or negative challenging 14
Assertiveness, aggression and placatory submission 14
Being assertive in the workplace 14
Day to day coping strategies 15
Unhelpful attitudes 15
Travel stress 15
Chapter 13 organizing yourself and your time 16
Thinking about priorities 16
Planning activities: the value of lists 16
Structure and routine 17
Managing work load 17
Chapter 14 Overcoming barriers and enhancing coping 17
Procrastination 17
Treating procrastination 17
Motivation 18
CBA 18
Action plan 18
Perfectionism and stress 18
Treating it 18
Dealing with worry 18
What keeps worry going? 18
Worry management 18
Worry maintenance cycle 19
Worry metacognitions 19
Task Interfering Cognitions, Task Orientated Cognitions 19
Problem solving 20
Regulating stressful emotions 20
Chapter 15 20
Diet 20
Alcohol 20
Managing alcohol of food for stress management 20
Exercise 21
Sleep 21
Preparing to go to bed 21
Chapter 16 Attending to the positive 21
Build confidence: 21
Chapter 17 Your stress plan revisited 22
Chapter 1 What is stress
Symptoms
1. Emotions
a. Anxiety
b. Depression
c. Anger
2. Physical
a. Tension
b. Illnesses
c. Headaches
3. Behavioural
a. Making mistakes
b. Can’t concentrate
c. Avoid difficult situations
d. Comfort eat\drink
e. Procrastinate
f. Never have time to do things for yourself
Defining
Early ideas about stress were from physics, so how much stress a bridge was under was the indication of load, its pattern, frequency etc.
This then got appropriated in physiology where there was understood a stressful event and a stress response e.g. cortisol. Of course between the event and the response is the appraisal.
Different kinds of appraisal. Lazarus: primary appraisal: Weigh up what’s going on and establish if it’s a problem for you. Some things everyone would think was a problem, others are there may be specific to the person who appraises.
Secondary appraisal is can I cope with it, by myself with help etc.
Stress is when we are under pressure via demands, and not having enough resources to deal with them.
Stress is the response when the demands that are put on us are more than we can cope with
Understanding that there is a problem that puts you under pressure via a demand
And not being able to cope with it
That leads to a stressed response
Demands
Internal\External
Stress can be thought of too many demands on us to allow us to cope. Demands can be thought of internal and external. External I need to work, internal. External demands are things you have to do as another is asking that of you, internal demands are things you think you have to do. So I guess you can have internal and external on a continuum.
External is the demand externally
Job needs to be done
Internal demand comes internally
I need to do x
I need to do an external demand to a certain standard.
Timescales
How long does the demand go on for, acute or chronic?
Goals and expectation
When personal goals are threatened we become stressed. Stress can be the outcome of when your goals are threatened and you fear disappointment.
Stress Modulators
Control
If you don’t think you have control after a while you get learned helplessness and you stop trying, this then generalises and when you do have control again you stop trying.
Knowledge about the future
Knowing that a traffic jam will only take an hour makes it easier to bear.
Perceptions of control
If you believe you have no control (even if you have) this increases distress
If you believe you have no control what happens to you, as its external forces, i.e., external focus of control then this increase distress.
Stress= (demands * level of importance) –levels of power
Stress
Demand (how and when) * significance =importance
Minus
Coping abilities (abilities * level of control + people to help)
Peoples response to stress
Range
There’s a continuum between adrenaline junkies to people with chronic fatigues. Can’t get enough stress to can’t manage any.
Optimal level
Under aroused (Bored and under stimulated) =perform badly
Aroused=optimal performance
Over aroused=stressed and anxious
Myths about stress
1. Getting stressed means I’m weak
a. So now you are stressed and you insult yourself
b. (everyone gets stressed)
2. Everyone else can cope it’s just me
a. However we compare people’s outsides to my insides.
b. They might look like they’re coping but how do they feel
3. Life is stressful there’s nothing you can do about it
a. You can change the situation, change how you interpret it, change how you respond to stress
Chapter 2 Stress and your body
Physical symptoms
Muscular=tension
Gastrointestinal=IBS symptoms
Cardiovascular=higher blood pressure
Respiratory=shortness of breath
Sexual=lower of libido
General=more colds, weakened immune system
Fight\Flight\Freeze
Our threat response system is developed for physical threat. Emptying bowels means you can run faster. Freeze can be a useful physical response as some animals very good at detecting movement. Muscle tension allows the body to be held still.
Stress hormones
Cortisol and adrenaline
Adrenaline enables fight or flight. To return the body to a resting state then the PNS releases noradrenaline is released.
Cortisol
Acts more slowly than adrenaline. It peaks after 40 mins and then disperses more slowly. Cortisol is used in many day to day maintenance of the body, but PRN then it is used to support the adrenaline changes, e.g. maintaining elevated blood sugar levels.
Stages of stress response
Hans Seyle=General Adaption System
Stage 1: Alarm stage
Rapid decision to fight or flight
Stage 2 Resistance stage
Energy is being borrowed by the on too much stress system from other systems
Stage 3 Exhaustion stage
Body can’t cope with the demands put on it
To maintain long periods of stress, the stress system hasty borrow energy from other parts of the system, e.g. eating\digestive, menstrual system,
Allostasis
Keeping stable through a constant state of change, i.e. minor adjustments for a homeostatic system.
In a stress over aroused state our bodies are constantly trying to get us back into a less aroused, better coping state.
Stressful live events and health
Whilst stressful life events correlated in bad health, it could be that bad health caused stressful life events. It could also be that when stressed, you remember more your bad health.
Stress and immune system.
Changes in the central nervous system, CNS changes how our immune system works. Stress impacts CNS and impacts the immune system. No correlation between breast cancer and stress, causally., or keeping it going. However the behaviours that stress people do, smoking and drinking does correlate with cancer.
Stress and infectious diseases
Infectious diseases are caused by bacteria or viruses called pathogens. You don’t always develop the disease even if you have a pathogen. Chronic stress is related to colds, acute isn’t.
Autoimmune disease and stress
Autoimmune disease is where the immune system attacks good cells: MS, Lupus and rheumatoid arthritis.
Small stress does correlate, acute stress doesn’t.
Chapter 3 Stress and Personality
Omitted
Chapter 4 The role of thinking in stress
Omitted
Chapter 5 Is Stress a problem for you
1. Cognitive symptoms
a. Thoughts=I can’t cope
b. Memory and concentration difficulties
c. Worry\Rumination
d. Self-criticism
2. Emotional symptoms
a. Tense wound up
b. Overwhelmed
3. Physical symptoms
a. Head aches
b. Indigestive problems
c. Sore muscles
4. Behavioural
a. Avoiding situations
b. Drinking\eating too much
c. Losing temper
d. More clumsy
e. Always late
f. Procrastinating
Stress monitor against each heading with severity and frequency.
Chapter 6 What makes you stressed
Life events: divorce, lose job
Hassles: lose bank card, get parking ticket, traffic etc.
The severity of these is dependent on the appraisal you make of them.
Uplifts
These are the opposite of stresses, things that make you feel good, give you a sense of achievement, give meaning and pleasure to your life.
Do stressors outweigh uplifts, if they don’t then you’re not going to feel good.
Chapter 7 How do you cope
Coping styles
When you’re faced with an extra stressor, someone making a demand on you what do you do.
Exercise not stress level, coping style and effects on stress level.
Types of coping
Emotional based coping
I.e. manage the emotional effect of stress, meditation, exercise
Stress carrying
Find it hard to manage the emotions stress causes, so they end up taking out their feelings on others, e.g. anger. Their response then creates stress for others.
Avoidance based coping
Pretend everything is ok, avoid emotional pain with drink and drugs
Problem based coping
Concentrate on what is causing stress and try to fix it
Advantages and disadvantages of different ways of coping
Emotion based coping: this can help calm you down to enable you to tolerate the stressful situation
However sometimes focussing on the emotions and the problem can lead to rumination
Avoidant based coping= this can lead to physical problems and things building up to outburst.
Problem based coping=this both reduces the problem, and makes you feel more in control. However many problems you can’t problem solve, e.g. traffic jams.
Bottom line is some forms of coping are better for different situations, so having the ability to do all of them really helps.
Chapter 8 Your stress profile and stress management plan
Formulation comprised out of
Stress symptoms
Cognitive, behavioural, physiological, emotional
Stressors
Life events
Hassles
Uplifts
Coping strategies
Avoidant, emotional, stress carrier, problem solving
You get a stress trigger, you get stressed, apply a coping strategy which if it doesn’t work makes the stress worse.
So
Event=>
Primary appraisal=>
Secondary appraisal=>
Stress response=>
(Appraisal, means I’m not coping)
Coping strategy
Sometimes the stress response is then appraised, e.g. I’m not coping
Stress management plan
1. Think of area that is causing you the most difficulty
2. Think about what changes can be made in this area and set a specific goal
3. Work out strategies to achieve this goal
4. Review your plan as it is implemented
Think of area that is causing you the most difficulty
Look at the types of stressors that are causing you most difficulty
Define your goals
Get an achievable one that makes an improvement of your current position
Choose a technique
So this can be from around the formulation NATs, SATs, Different coping response, either type or content, Stress appraisal
Stress diary
Columns
1. Stressor
2. Technique
3. Review progress
Chapter 9 Changing your stressful thinking
Chapter on cognitive restructuring
Sociotrphic, most interest around how loveable\likable you think you are. , so social desirability is a major part of identity
Autonomous most interest around achievement, so achievement is a major part of identity
Chapter 10 Changing your stress related behaviour
We believe what we and others do much more than what they say. If someone says I love you or acts in a loving way then you are more likely to believe the latter. So as much as you challenge thoughts, if you act on them that will really confirm to you their truth even if it feels a bit alien at first.
So ask yourself how you would act if you weren’t stressed and act on that. Ask yourself if you had a twin who didn’t suffer from stress how would they act.
When people are stressed and anxious they avoid stressful situations.
Appraise situation as bad\difficult=>
Feel more stress=>
Avoid=>
Appraisal=>self-criticism=>
More stress
Working with avoidance
Two approaches
1. Shaping :
a. Graded task assignment, take first step, after finishing how do you feel. Take second step
2. Working with the thoughts that make this something to be avoided
a. Test predictions with an experiment
Chapter 11 Stress and Relationships
Factors that correlate with depression for women
1. Mum dies before 12
2. 3 children under 14
3. No occupation outside the home
4. Having no one they feel close to or can talk to
Given relationships can reduce stress, then stress in relationships can be a double whammy.
Assess
Notice the stressful\supportive relationships in your life
How frequently do you see them? Can you reduce the stressful contacts and increase the supportive.
Changing stressful relationships
1. Relationships are systems
2. Current relationships are influenced by previous relationships
3. Problems in relationships are often about hidden expectations each partner has about how the other should behave
4. Problems in relationships can be affected by irrational appraisals
5. Problems in relationships can be cause by not communicating well
6. Problems in relationships by reductions in constructive behaviour
Relationship as system
Partner 1 cold=>
Partner 2 angry
Partner 1 withdraws and seems cold
So the ideas is firstly to see what part you play in the problem, and then change that. Demanding the other change can produce resistance, but changing what you do that they react to is possible
Relationships are affected by the past
Early experience shapes wheat we think of people and how we expect them to react.
This can be conscious or unconscious. You may be annoyed your partner doesn’t know what you are thinking much like mum used to.
We repeat our childhood patterns as it is safer doing what we know, and we also get the feeling maybe I will be able to put it right this time.
How to find this out
1. Have I been in this situation before
2. What is my earliest memory of being in this situation
So when you realise this is a repeated pattern when you notice the pattern in action ask yourself is this how you want to act.
Expectations play a big part in relationships
For example
1. You don’t need to work at a good relationship
2. My partner should now what’s on my mind
3. My partner should always think about me and him
If the expectations are not met then this causes friction, although they may be unreasonable, your partner might not know your expectations.
Identify expectations
When upset, ask yourself what do you think the other ought to have done and therefore what is my expectation of him. Once identified then question them with are they fair, reasonable, does my partner know about them, are they reciprocal.
Problems in relationships are due to faulty appraisals
You can mind read, or misinterpret behaviour. Then act on the basis of the misinterpretation, which sometimes can start making it true.
Problems in relationships are often affected by faulty communications
Half listening to someone gives them a message about what you think about what they are saying. Interrupting the other again gives messages about what they are saying and its value to you. Do not mind read, you can’t listen, do not listen just to find something to prove a point again you are not listening.
To listen, have the time when you can devote your time and attention to them. Don’t think about yourself, think about what they are saying, Have what you have understood validated by them.
Things to avoid:
Talking too little: Avoiding questions, how do you feel: fine?
Talking too much and not allowing the other person to engage in the conversation.
Talking about the wrong thing, blow up as the milk hasn’t been bought, when actually it’s about paying the mortgage
Talking too much about the same thing: nagging, it’s a veiled criticism in ever more irritated tones.
Don’t let a big gap be between what you say and what you mean, e.g. darling will you with gritted teeth, when you mean look you’re out of order don’t do that.
Things to try
Avoid blaming, criticising or generalising that will mean they become cross or defensive
Timing: Trying new ways of communicating is best done when calm rather than angry or upset.
Being nice to each other
Start of relationship you want to win your partners approval so you say and do nice things and notice their good features. Later you take those good features for granted and become increasingly focussed on the things that irritate you about them.
Chapter 12 Stress at Work
Over working=> Over-tired, reduced pleasurable activities, increase stress
Stress factors at work1
1. Constant change
2. Being used as a political football
3. Threat of job loss
4. Feeling you have no control in your job
5. Feeling you are unsupported by your manager
Just because you’re stressed at work it doesn’t necessarily mean it’s because you can’t manage but rather it can be the nature of the organisation, or you are being given unreasonable demands.
Effects of stress at work
Absenteeism or presenteeism
Either not at work physically or mentally
Health
Work stress affects physical health
Understanding work stress
1. Keep a stress diary and notice the NATs, primary and secondary? and coping response
2. Notice the common themes both in NATs and responses,
Problems with communications and stress at work
Communication skills can reduce stress.
Improving communications:
1. Listen for 6 minutes to a friend without interrupting, then get them to do the same for you
2. Ask open questions, i.e. question that don’t require a single word response
3. Empathise, stand in their shoes and show them you understand something of their concerns, intellectually, emotionally
4. Summarising: demonstrates that you are listening and have understood
5. Being clear about what you say. If you mind is full of fearful thoughts about what the other might react then it might be difficult to put across your point of view. If you’re not sure of what you think then either ask to think about it. Don’t get personal and don’t ramble.
Using the skills: positive or negative challenging
Positive challenging, you look like you’ve been having difficulty doing x, I wonder what’s going on.
Negative challenging, takes away control, you should do x, you need to, if you don’t bad things will happen.
Respect people’s views it’s unlikely that they will be completely wrong.
Before putting your view, say something positive about theirs, that’s an interesting view
A positive statement followed by a but becomes a criticism, use and instead.
Assertiveness, aggression and placatory submission
Assertiveness is about expressing your needs, feelings and what you would like to happen without leaving yourself or another hurt. Assertiveness doesn’t mean you will get what you want.
Aggression may be active, with people being rude, critical or threatening, or it can be passive, where people block your ideas, make life unpleasant without ever admitting this is what they are doing. Both active aggression and passive aggression have the same effect where people feel frightened, attacked and bullied.
Being assertive in the workplace
Broken record, if what you said hasn’t been heard say it again
Be direct and clear
Give the bottom line instead of rambling
Don’t mind read?
Avoid sarcasm, labelling and whys.
Ask for feedback
Practise saying no
Being asked to do something unreasonable:
1. Explain that you haven’t the time\skills\resources to do this at the moment
2. If you’re challenged stick to your point
Day to day coping strategies
1. Take a break, move from your desk and stretch your body
2. Do a stress busting activity such as yoga, swimming or running
3. Have reminders of nice things at your desk
4. Use a stress gadget like a ball
5. How messy\stressful is your environment, if you weren’t stressed what would it look like and make it like that
Unhelpful attitudes
For instance
1. I’m always right and the other is always wrong
2. When you have don’t something wrong do you refuse to own up
3. Do you find it hard to own up to your own problems and tend to blame others
4. Do you try to take over and make everything all right for others rescuing the situation and taking full responsibility?
Travel stress
Some research shows that a long commute is one of the most important factors of reducing overall life satisfaction. People who get a promotion and a longer travel get used to the increase of reward, but the longer travel gets increasingly stressful.
Travel strikes at the three main factors of stress, being helpless, out of control and trapped.
Driving
Keep an emergency kit in case of heavy traffic, take another perspective on the queue, you could have been in the accident, or had your car break down. Notice how your beliefs get triggered, the it’s not fair, things going wrong, feeling helpless, people in my way, feeling like a cog in a machine, people are idiots\angry etc.
1. Negotiate hours with employers so you can avoid rush hour. Work from home more often. Be realistic on how long the journey lasts and allow for it being slightly worse.
2. Bring things to make traffic jams endurable, CDS, podcasts etc.
3. Do physical exercise in the car, Pilates,
4. Meditate in the car
5. Sing along to a CD
6. If someone behaves like an idiot, remember there are lots of idiots in the world and you are not one. Their rage\idiocy is directed at you but it is not about you, it could be anyone. Think of what you put into the world as increasing, kindness will elicit more kindness, anger more anger
Train
We are all used to having our own personal space and not used to public space.
1. Choose the least stressful journey, rather than the quickest
2. Network on the train
3. Make friends on the train
4. Work on the train
5. Leave enough time
6. If you are tense, then notice where and release this
7. Try mindfulness
Chapter 13 organizing yourself and your time
Good time management is for spending most time on what is most important to us.
Thinking about priorities
Draw yourself in a spider diagram, draw key areas for you around these, then around those mark down what you would like to achieve in relation to them. As you do this notice are there things that you spend a lot of time doing that you don’t care that much about. Any areas that you value but you aren’t spending time on?
From looking at the spider diagram, establish your priorities and your goals. Take the goals and split them down into manageable sub goals.
Now log your time for a week and notice where you spend your time and does it fit with your priorities. Then notice the omissions and patterns. Are you avoiding doing things you need to\should. Are you doing too much or too little of one thing?
Use Coveys time management matrix, to understand how to priorities your tasks
1. Important
a. Urgent
i. Fire fighting
b. Not urgent
i. Quality time
2. Not important
a. Urgent
i. Distraction
b. Not urgent
i. Time washing
1. Important\urgent do straight away, not doing them =crisis and stress
2. Important not urgent do them next
3. Reduce where possible distracting tasks
4. Avoid doing time washing
Analyse how you spend your time during the day
1. Did you spend your time doing tasks that were important
2. Did some tasks take longer than they needed? Why
Planning activities: the value of lists
Draw up a to do list for the day ahead.
Efficient lists
1. Write down everything that has been buzzing around your head
2. Prioritise into urgent and important
3. Prioritise into what must be done today and what can wait
4. End of day review the list in terms of whats been done
Structure and routine
When our time management goes out of the window we don’t look after ourselves as our lives get very disrupted, work all night, don’t eat etc. The lack of self care then has an impact increasing the level of stress and haos To counteract this then plan your self care in, create a structure in which to live.
Build in breaks in work for rest and pleasure, you will be less efficient if you don’t.
Managing work load
1. Delegate
2. Say no. Don’t make excuses, say sorry I cant, but I cant.
Chapter 14 Overcoming barriers and enhancing coping
Difficult stress based behaviours:
1. Worrying
2. Procrastination
3. Perfectionism
Procrastination
This increases stress as putting things off leaves their need, and you can worry about them more and intensifies their distress. Procrastination can be motivated by emotional reasoning, I don’t feel like doing it now, or Im not in the right mood to do it properly. Procrsatinationj can also be driven by perfectionistic and punishing working regimes, so you put it off as it will be painful. Procrastination can also be encouratged by a fear or uncertainty, if you start something you are uncertain how it will turn out so best to not start. Procrastination can also be fuelled by a fear of failing and this can underpin perfectionist tendencies. Procrastination can also be about not wanting to be controlled, so someone else owns the task and you don’t want to od it as you don’t want to be controlled by them.
Summary
Reason for procrastination
1. Waiting for the right mood to come
2. Fear of failure
a. Perfectionist
b. Too low expectations
3. Feeling controlled by others
4. Lack of assertiveness
5. Lack of interest
Consquence short term stress relief at the cost of long term increase.
Treating procrastination
1. Notice procrastination
2. Notice thoughts that support it
3. Challenges the thoughts
4. Notice how its easier to motivate yourself to continue doing something than to motivate yourself to start
5. Do a pros and cons of starting it or putting it off
6. Break task down into small parts
Motivation
Motivattion works in a circular fashion in that in motivates action and action increases motivation. Sometimes its hard to get things started but if you wait to be motivated you may wait a very long time
CBA
So do one on procrastinating and one on starting the task today.
Action plan
Write what the problems are and how to solve them or solutions
Perfectionism and stress
Studies show that perfectionists tend to get more stressed in challenging situations than others. They can fear criticism, they see the non perfect as a failure, they might see if they are not perfect they will be punished, or it will be dreadful. Perfectionism can also be tied up with the desire to please people, if I do well people will like me, so if I do really well, they will really like me. So perfectionism can be a way to deal with low self esteem as it can be a away to get yourself to like yourself.
Treating it
1. CBA of being one
2. Noticing should musts etc.: what are their effects, no room for error, bossy, stress, and demotivating you wouldn’t talk to someone else like that
3. Test out your worst fears of not being a perfectionist
4. Noticing striving for perfection means you are less likely to achieve it
Dealing with worry
Is it a hypothetical or real worry? Can you do something about your worry. If your worry is productive it should quite quickly lead to solutions
What keeps worry going?
1. Reassurance seeking
a. Worry builds anxiety up, reassurance brings it down but it doesn’t deal with the process of worrying
2. Checking
a. Worry builds anxiety, checking there isn’t a problem brings it down but doesn’t deal with the act of worrying
3. Struggling with uncertainty
a. People find not knowing what will happen difficult, then they make negative predictions that leads to worry
Worry management
1. Worry diary, noticing triggers
2. Challenging thinking errors in worry
3. Challenging probability that your worry will come true
a. The more you worry the more likely you think it is that it will happen
b. How good are you at predicting
Worry maintenance cycle
Worrying increases your belief in the probability that bad things will happen that makes you worry more
Reduce sense of probability:
1. Will I be worried about this in a week
2. If a friend had this worry, would I say to them
3. What’s the likelihood of this worry coming true, how many have my last ones come true
Worry metacognitions
Worry can be useful or worry can be harmful
-ve beliefs
1. I can’t control worry
2. Worry causes stress and then heart attacks
+ve belies
1. Prevents bad things happening
2. Prepares me for bad things
3. Shows I care
Test this by having a worry\no worry day and see what happens, does worrying help?
If worry is really difficult to stop as you have been doing it for so long, then use a worry diary, with worry time. Your worry time should be 15 mins long and not 2-3 hours before bed.
Task Interfering Cognitions, Task Orientated Cognitions
TIC\TOCs
TICs: I will do it later, I can’t be bothered, I will never get it done
TOCs: The sooner I will start, the sooner I will finish. Doing something makes a start.
TICs what kind of thinking gets in the way of tasks, TOCs what kind of thinking helps you do tasks.
It’s easier to list TOCs in non-stressful situations, then they can be recalled in stressful situations.
Problem solving
1. Define the problem, be as specific as possible
a. Break problem down into small pieces
2. List all possible solutions
3. Choose a solution
a. Put pros and cons
4. Make a specific plan
a. Break the task into manageable steps
5. Do it
a. Review outcome
i. Use feedback to adjust the plan if necessary
Regulating stressful emotions
1. Meditation
2. Activities
a. Exercise
3. Create different emotions
a. Watch an emotionally powerful movie, funny\scary etc.
4. Distract your mind
a. Count backwards from 1001 in 3s
Chapter 15
Diet
No such thing as bad food stuffs, but you need balance. You need fuel for the body, if you get overweight that will add another stress.
Four types of fat
1. Polyunsaturated
2. Monounsaturated
3. Saturated
4. Transfat
Poly\Mono unsaturated fat are found in oils of vegetable origin, these are healthier than those of animal origin, e.g. saturated fats. High saturated fat diets are correlated with CHD. Transfat which is found in processed food, which is vegetable fat is hydrogenised to harden it is associated with heart disease.
Too much\too little salt is associated with high blood pressure.
The sugar high and crash is a myth. Glucose is finely regulated and always you have one teaspoon of glucose in the blood
Alcohol
Reduces symptoms of stress when drunk but reduced coping when hungover. Reduces quality of sleep so reduces recuperating.
Managing alcohol of food for stress management
1. Realise triggers, put in some other options
Exercise
Best stress management tool: creates endorphins, stretches tensed muscles. Improved blood flow: improved concentration.
If you enjoy your exercise you will do it more often: fun exercise can be really helpful.
Sleep
Stress can make you sleep worse, which then adds to stress.
The thought I won’t cope with sleep can be challenged, you can cope with a lot less sleep than you think, junior doctors do it, parents of young children do it. Research shows sleep deprivation affects dull repetitive tasks strongly but not those that require our attention.
Don’t look at the clock, you are reminding yourself how bad the problem is, which is creating distress which gets in the way of sleep.
Problems can seem worse at night, as night time historically was a time of threat, Problems doing the day don’t seem as bad as you can do things about them. So you can have a rule, anything you think at night doesn’t count, it’s just nocturnal anxiety kicking in.
Distracting yourself can help from your worries, count backwards from 1001 in 3s.
If you can’t sleep, don’t stay there worrying get up and do something boring until you feel tired enough to go to sleep. Don’t associate your bed with not sleeping.
Preparing to go to bed
Alcohol can help you get to sleep, but makes you more likely to pee in the middle of the night. ~Alcohol affects your quality of sleep.
Don’t exercise within 2 hours of bed time.
Don’t watch TV computer within 2 hours of bedtime as the light is very bright and tells your brain that its midday.
Make your bedroom a haven.
Have a bedtime ritual\routine.
~PMR works like a pendulum the further you go one way the further you will go the other.
Chapter 16 Attending to the positive
Self efficacy has two parts:
1. Think of solutions to problems
2. Belief in your ability to carry the solutions out
Build confidence:
1. Keep positive data log
a. Moving from one stressful problem to the next, means you don’t pay attention to what you have achieved
b. Data
i. What you achieve, things going better than expected
ii. Learning new things
iii. Getting praise, gratitude
iv. Recognising good qualities that you act on
v. Recognising when you do things that you value
2. Create a more positive image of yourself
a. Go through and rate yourself against a list of positive qualities
b. Ask someone you know well to do the same
c. Notice how often these qualities appear on your PDL
3. Create a resourceful self
a. Think of a problem you are trying to deal with, notice how it makes you feel, physically and emotionally
b. Now imagine yourself at your best, how would you be feeling, acting and thinking.
c. Bring this imaginal self more into reality, bit by bit.
4. Reward yourself
a. Give yourself rewards for tackling stress.
Chapter 17 Your stress plan revisited
Stress plan
1. Identify stressors
2. Identify goals and sub goals
3. Choose techniques to help
a. Thought challenging
b. Using best coping responses
c. Taking care of yourself
d. Time management
e. Worry management
4. Monitor your plan, its activity and progress
5. Revise the plan in light of the monitoring
Notice any thoughts that give you permission to stop your stress plan.
