1 Stress and Daily Life: How to Stop the World Falling in Around You-Introductions -Start with finding out where each person works and what are the characteristics of the job that increases stress for them. -What would each of you like to get out of today Martin Dorahy Clinical Psychologist University of Canterbury
2 What is stress? Stress is the emotional and physical strain caused by our response to pressure from the outside world. Ongoing external stressors, perpetuating internal (cognitive/thought) drivers. Acute vs chronic anxiety Knowledge about Stress -Start with finding out where each person work and what are the characteristics of the job that increases stress for them. -Define what stress is and put HPA and fact stress is automatic biological response, which we can’t stop but is adaptive (helpful) and we should learn to listen to it and learn ways to regulate it. Also put Yerkes-Dobson – ie., stress helps performance if not too great
3 What is stress? (cont.) Stress is a normal physical response to events that make us feel threatened or upset our balance in some way. When we sense danger – whether it’s real or imagined – the body's defenses kick into high gear in a rapid, automatic process known as the “fight-or-flight” reaction, or the stress response. The stress response is the body’s way of protecting you. When working properly, it helps you stay focused, energetic, and alert. Ask what some dangers might be (no longer do we fear getting eaten by a lion – we might have more existential fears, like have we or are we making enough of our life which put more and more pressure on us to performance and achieve: Other e.gs. include putting unreasonable demands ourselves and having them put on us by others and then feeling if we don’t meet them we’ll be a failure (e.g., having our view of self or others view of us threatened).
4 Yerkes-Dobson Law
5 The Body’s Stress ResponseWhen you perceive a threat, your nervous system responds by releasing a flood of stress hormones, including adrenaline and cortisol. These hormones rouse the body for emergency action. Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. These physical changes increase your strength and stamina, speed your reaction time, and enhance your focus – preparing you to either fight or flee from the danger at hand. Ask about peoples experience of this
6 I want us to go steadily through how stress is produced and how it can effect us. I want to spend some time discussing how stress comes about in our brain and our body. The main point in doing this is to communicate that stress is NOT YOUR FAULT. You can stop stress feelings from happening and the demands put on us by modern life and what we out on ourselves as a result of modern life heighten our stress level. All we can do is learn to manage stress to reduce it’s impact on us
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12 Effects of Stress The body doesn’t distinguish between physical and psychological threats. When we’re stressed over a busy schedule, an argument with a friend, a traffic jam, or a mountain of bills, our body reacts just as strongly as if we were facing a life-or-death situation. If you have a lot of responsibilities and worries, your emergency stress response may be “on” most of the time. The more your body’s stress system is activated, the easier it is to trigger and the harder it is to shut off.
13 Effects of Stress (cont.)Long-term exposure to stress can lead to serious health problems. Chronic stress disrupts nearly every system in your body. It can raise blood pressure, suppress the immune system, increase the risk of heart attack and stroke, contribute to infertility, and speed up the aging process. Long-term stress can even rewire the brain, leaving you more vulnerable to anxiety and depression.
14 Effects of Stress (cont.)Many health problems are caused or exacerbated by stress, including: Pain of any kind Heart disease Digestive problems Sleep problems Depression Obesity Autoimmune diseases/problems Skin conditions, such as eczema Note here that stress has an effect on the mind and body
15 Compassion fatigue Compassion fatigue, also called"secondary victimization" (Figley, 1982) "secondary traumatic stress" (Figley, 1983, 1985, 1989; Stamm, 1995; 1997), "vicarious traumatization" (McCann and Pearlman, 1989; Pearlman & Saakvitne, 1995) "secondary survivor" (Remer and Elliott, 1988a; 1988b)
16 Compassion fatigue is a term that refers to a gradual lessening of compassion over time. It reflects the cumulative impact of being exposed to ongoing trauma and stress by clients (we could also say family members)
17 1. ________ I feel emotionally drained from my work. The purpose of this survey is to discover how various persons in the human services or helping professions view their jobs and the people with whom they work closely. Because persons in a wide variety of occupations will answer this survey, it uses the term recipients to refer to the people for whom you provide service, care, treatment, or instruction. When answering this survey please think of these people as recipients of the service you provide, even though you may use another term in your work. The following are 22 statements of job-related feelings. Please read each statement carefully and decide if you ever feel this way about your job. If you have never had this feeling, write a “0” (zero) before the statement. If you have had this feeling, indicate how often you feel it by writing the number (from 1 to 6) that best describes how frequently you feel that way. Never A few times Once a A few Once A few Every a year or month or times a a times a day less less month week week HOW OFTEN Statements: 1. ________ I feel emotionally drained from my work. 2. ________ I feel used up at the end of the workday. 3. ________ I feel fatigued when I get up in the morning and have to face another day on the job. 4. ________ I can easily understand how my recipients feel about things. 5. ________ I feel I treat some recipients as if they were impersonal objects. 6. ________ Working with people all day is really a strain for me. 7. ________ I deal very effectively with the problems of my recipients. 8. ________ I feel burned out from my work. 9. ________ I feel I’m positively influencing other people’s lives through my work. 10. ________ I’ve become more callous toward people since I took this job. 11.________ I worry that this job is hardening me emotionally. 12.________ I feel very energetic. 13.________ I feel frustrated by my job. 14.________ I feel I’m working too hard on my job. 15.________ I don’t really care what happens to some recipients. 16.________ Working with people directly puts too much stress on me. 17.________ I can easily create a relaxed atmosphere with my recipients. 18.________ I feel exhilarated after working closely with my recipients. 19.________ I have accomplished many worthwhile things in this job. 20.________ I feel like I’m at the end of my rope. 21.________ In my work, I deal with emotional problems very calmly. 22.________ I feel recipients blame me for some of their problems.
18 COMPASSION SATISFACTION AND COMPASSION FATIGUE (PROQOL) VERSION 5 Hudnall Stamm, 2009)When you [help] people you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days. 1=Never 2=Rarely 3=Sometimes 4=Often 5=Very Often 1. I am happy. 2. I am preoccupied with more than one person I [help]. 4. I feel connected to others. 5. I jump or am startled by unexpected sounds. 7. I find it difficult to separate my personal life from my life as a [helper]. 8. I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help]. 9. I think that I might have been affected by the traumatic stress of those I [help]. 10. I feel trapped by my job as a [helper]. 11. Because of my [helping], I have felt "on edge" about various things. 13. I feel depressed because of the traumatic experiences of the people I [help]. 14. I feel as though I am experiencing the trauma of someone I have [helped]. 15. I have beliefs that sustain me. 17. I am the person I always wanted to be. 19. I feel worn out because of my work as a [helper]. 21. I feel overwhelmed because my case [work] load seems endless. 23. I avoid certain activities or situations because they remind me of frightening experiences of the people I [help]. 25. As a result of my [helping], I have intrusive, frightening thoughts. 26. I feel "bogged down" by the system. 28. I can't recall important parts of my work with trauma victims. 29. I am a very caring person. The Burnout and compassion fatigue (secondary trauma) subscales from the Professional Quality of Life Scale (30 items; Hudnall Stamm, 2009). The compassion satisfaction items have been ommited due to space.
19 Stress tolerance factorsYour support network – quality not quantity is key Your sense of control – How can this be increase (?thoughts, behaviours)? Your attitude and outlook – How do you increase optimism and humour? Your ability to deal with your emotions - How do you manage your emotions? Your knowledge and preparation – can these be increased? Your support network – A strong network of supportive friends and family members is an enormous buffer against life’s stressors. On the flip side, the more lonely and isolated you are, the greater your vulnerability to stress.Your sense of control – If you have confidence in yourself and your ability to influence events and persevere through challenges, it’s easier to take stress in stride. People who are vulnerable to stress tend to feel like things are out of their control.Your attitude and outlook – Stress-hardy people have an optimistic attitude. They tend to embrace challenges, have a strong sense of humor, accept that change is a part of life, and believe in a higher power or purpose.Your ability to deal with your emotions. You’re extremely vulnerable to stress if you don’t know how to calm and soothe yourself when you’re feeling sad, angry, or afraid. The ability to bring your emotions into balance helps you bounce back from adversity. Your knowledge and preparation – The more you know about a stressful situation, including how long it will last and what to expect, the easier it is to cope. For example, if you go into surgery with a realistic picture of what to expect post-op, a painful recovery will be less traumatic than if you were expecting to bounce back immediately.
20 Affect regulation and managing dissociationarousal danger zone: panic, feeling out of control safety zone / window of tolerance: mental level allowing for effective functioning Small group exercise: Between what levels is your window of tolerance? What happens when you are below it? What happens when you are above it insufficient level of arousal zone: e.g., numbing time / exposure Van der Hart, Nijenhuis, & Steele, 2000
21 Window of Tolerance Group exercise:What things can you do to help stay in the window? Take a shower Take a walk Timetable enjoyable activities Safeplace (imagery) – if time do this
22 Blind men and the elephantWe always need to take perspective of the things that make us stressful. In addition if we share with others we may also see that our stress is one part of a bigger thing (i.e., ourselves and our life) – we aren’t stress, it’s a (greater or lesser) part of us.
23 The overwhelmed carer