Stress ManagementScott Plymale, LCSW, PhD
Community Health Resource Center
San Francisco, CA
CHRCSF.org
CHRCSF.org
CHRCSF.org
The Community Health Resource Center (CHRC) is a non-
profit organization under section 501 (c) (3) of the IRS code,
and also a public charity under sections 509 (a) (1) & 170 (b)
(A) (vi) of the IRS code.
Since 1984, CHRC has provided the Bay Area with innovative
and low cost:
- Nutrition Counseling
- Health Screenings
- Health Education
- Behavioral Health Services
CHRCSF.org
Learning Objectives
Part I: Information & Education
What is Stress?
Multiple and Complimentary Perspectives
The Origins of Stress
Healthy Stress
Health and Wellness Model
Part II: Strategies for Everyday Living
A Mental Frame for Health & Wellness
Body Scan - Identify Where Stress Roots Itself and the Type of Stress
Relaxing the Body
Deep Breathing
Fitness
Relaxing the Mind
Sensory Integration
Relaxing Our Emotions
Art as a Healing Agent
Music (active stance & calm stance)
CHRCSF.org
What is Stress?
An unavoidable consequence of life (Hans Selye, the “Father of Stress”)
Transactional-Interaction Model Perspective (Lazarus & Folkman, 1984)
Bio-Medical Perspective
Systems Perspective
What is Stress?
Lazarus & Folkman (1984)
Stress occurs as a result of an imbalance between demands on a person, and their resources.
There is a Transaction-Interaction between the Person and the Environment
When internal and external demands go beyond internal and external resources.
Thus, we become stressed when demands (pressure) exceeds our resources (our ability to cope and mediate stress)
Coping Ability
The ability to manage internal and external demands.
This can be learned and practiced to increase internal resources.
Cognitive Appraisal
Perception of Stress
What is Stress?
What is Stress?
Bio-Medical Perspective
A flood of stress hormones by
the CNS following a stressor
Process
Individual perceives a stressor
Hypothalamus sends a chemical
message to the pituitary gland
Pituitary Gland sends a new
chemical message from the
brain through the blood stream
to the Adrenal Glands (sits on
top of the kidneys) to produce
Stress hormones.
What is Stress?
Systems Perspective
Strain and Tension on…
Mental
Emotional
Physical
Spiritual Self
Origins of Stress
The Origins of Stress
Internal Stressors
Self-Imposed
Pressure/Demands
Our Own ‘Standards’
Thoughts, Feelings
Fears, Worries, Uncertainty
Beliefs, Attitudes, Opinions,
Expectations
Self-Talk – what you tell
yourself
External Stressors
Events, Situations
Demands Imposed by Others
Interpersonal/Social/Family
Relationships
Profession/Job
Unexpected Life
Events/Changes
Types of Stress
Types of Stress
Acute Stress (transient episodic)
Body’s immediate reaction to a significant threats, challenge,
or scare.
Response is immediate and intense, could be thrilling.
Fight, Flight, or Freeze
Chronic Stress (ongoing)
Ongoing Stress
Subtle, effects may be longer-lasting
Types of Stress
Types of Stress
Types of Stress
Types of Stress
Low Stress ------ Medium Stress ------Too Much Stress
The Effects of Stress
The Effects of Stress: Stress Response
When you encounter a perceived threat, your
hypothalamus sets off an alarm system in your body.
Adrenal Glands release a surge of hormones:
Adrenaline – increases heart rate, elevates blood
pressure, boosts energy supplies.
Cortisol – increases glucose in the bloodstream,
enhances the brain’s use of glucose, increases
availability of substances that repair tissue, curbs non-
essential functions (digestion, reproduction, growth,
immune system).
Also communicates with areas of the brain that control
mood, motivation, and fear.
The Effects of Stress
The Effects of Stress
When Overwhelming and Poorly Managed, then negative effects appear.
Long-Term Activation of the Stress-Response System, could impact your body and put you at-risk:
Heart Disease
Sleep Impairment
Digestive Problems
Depression
Obesity
Memory Impairment
Skin Conditions
The Effects of Stress
Chronic Stress in a PTSD+MDD PopulationPhysical Changes to the Brain
The Effects of Stress
The Effects of Stress on the Whole Self
On Your Body:
headaches, back/neck aches, sleep impairment, teeth grinding, upset stomach, frequent infections, fatigue, fluctuating appetite, high blood pressure.
On Your Thoughts:
impairment in concentration, difficulty with learning new information, racing thoughts, difficulty making decisions, impaired memory.
On Your Feelings:
anxiety, worry, guilt, nervousness, irritability, anger, frustration, depression.
On Your Behaviors:
over-reactions, reduced work productivity, communication problems, social withdrawal, trouble getting along with others, increased smoking, alcohol/drug use.
Relaxation
Part II: Strategies for Everyday Living
You’ve Got Power
What Can I Do? It’s a Process.
Your Philosophy
GOALS
Ambitions
SELF-
ESTEEMSELF-
EFFICACY
VISION&
FAITH
FITNESS SLEEP NUTRITION
Develop a Health &
Wellness Model
Philosophy.
Map Out
Success.
Social Support System
Your Philosophy
Managing Stress: Mind-Body & Social (Health & Wellness Model)
Mind
Self-Esteem (confidence, self-talk)
Self-Efficacy (motivation, grit)
Vision/Faith (what is your goal?)
Body
Fitness
Sleep Nutrition
Nutrition (hydration)
Social Support System
Family, Friends, Community
Relaxation
So Many ways to Unwind & Relax
PMR – Progress Muscle Relaxation
Breathing
Visualization & Guided Imagery
Meditation
Exercise, Fitness
Yoga, Tai-Chi
Listening to Music
Massage
Hobbies, Fun & Enjoyable Activities
Attentive Listening
The Power of Intuition &
Body Listening
Take a moment, and think about what is causing you stress at this time? Where in your body is it? [Body Scan]
Now... Focus on what you CAN control
Is there anything you can change about the situation? [keep it in perspective]
How can you change your RESPONSEto the situation?
How can you change the way you think about the situation?
What can you say “no” to?
What can you say “yes” to?
Relax the Body
Progressive Muscle Relaxation (PMR)
After a Body-Scan, identify and focus-in on that area
Example: hands/fists
Squeeze -- Tighten and HOLD…
Example: close your hands/fist, squeeze, tighten, hold
Count to Five (5) while still squeezing
Super Slow-Motion Unfurling and Release
Example: slowly unfurl your hands/fist, as slowly as possible.
Relax the Body
Breathing Technique
KEY to Breathing
for Relaxation is
in the EXHALE, in
the LETTING GO,
in the PUSHING IT
OUT.
Relax the Body
Fitness
Cardiovascular
Activities in the
Outdoors is an
excellent Stress-
Buster
Hikes
City Walks
Running
Swimming
Taking the Stairs
Social Fitness
Relax the Mind
Sensory Integration
Sensory Integration to gain Clarity, Stop Ruminations, and Stop Obsessive Thoughts & Worries
When people say, “Don’t think about it!” using your sense may be the most helpful.
Relax the Mind
The World of Art
Consider Adult Coloring Books to create chunks of relaxation and self-care time in your schedule.
Relax Your Emotions
Turn Chunks into Bits
Stress Response System when Overwhelmed
30 Day Worksheet
Make a Plan – when stress strikes, it impairs planning abilities.
Consider chunking items on your To-Do List into Smaller Bits.
Example:
Clean the Kitchen – CHUNK
Can you Turn it into BITS?
Day 1: Get Cleaning Equipment Out
Day 2: Wipe the Counters
Day 3: Declutter 2 Cabinets
Day 4: Wipe the Stove
Day 5: Wipe the Oven
Relax Your Emotions
Visualization with Music – Meditation
Active Meditation & Calming Meditation
Take a Moment to Settle In
Begin to Flesh Out the Scenery based on what you hear
Pour as much detail as you can into that image. Imagine the Colors, the Layout, the Smell, the Sensations Around You
Imagine yourself stepping into that image. See yourself reaching out to touch something in that scenery. Notice the air and it’s impact on you.
Relaxation
Visualization with Music - Meditation
Thank You