Managing ReactionsManaging ReactionsDealing with Stress, Anger and Dealing with Stress, Anger and

Depression and Finding HappinessDepression and Finding Happiness

Dr. Elena KlawDr. Elena Klaw

Raymond McDonald Raymond McDonald Captain, US ArmyCaptain, US Army

Goals for TodayGoals for Today

Warriors ethosWarriors ethos

Warriors and happinessWarriors and happiness

Survival response effectsSurvival response effects

Addressing anxietyAddressing anxiety

Addressing angerAddressing anger

Addressing depressionAddressing depression

When to get professional helpWhen to get professional help

Is a Warrior Allowed to be Is a Warrior Allowed to be Happy?Happy?

Warriors have a learned tradition of Warriors have a learned tradition of stoicismstoicism Repression of emotionRepression of emotion Indifference to pleasureIndifference to pleasure Indifference to painIndifference to pain Indifference to external things beyond our Indifference to external things beyond our

control control

Man or woman, how does the masculine stoic Man or woman, how does the masculine stoic archetype (the ultimate warrior) influence archetype (the ultimate warrior) influence attitudes and behaviors?attitudes and behaviors?

Stoicism isolates:Stoicism isolates: From selves? (mind from body)From selves? (mind from body) From others?From others? From our environment?From our environment?

Stoicism helped get through this

At what cost? Happiness?How hard are you on yourself to live these values?How hard are you on others to live these values?

There is another way…

No Mission Too Difficult.No Sacrifice Too Great. Duty First.

Motto of the First Infantry Division (“The Big Red One”)

Stoicism: The Warrior Ethos*Stoicism: The Warrior Ethos*We leave the military…but the military never leaves us We leave the military…but the military never leaves us

(McDonald,2011)(McDonald,2011)Military ValuesMilitary Values

DutyDuty

HonorHonor

CountryCountry

LoyaltyLoyalty

CommitmentCommitment

RespectRespect

Selfless ServiceSelfless Service

Integrity (Say-Do Integrity (Say-Do Correspondence)Correspondence)

ExcellenceExcellence

Personal CouragePersonal Courage

Military StrengthMilitary Strength*the fundamental character or spirit of a culture

The warrior has been defined by stoicism and The warrior has been defined by stoicism and sacrifice (McDonald, 2011).sacrifice (McDonald, 2011).

Historically, the warrior placed self apart from society.Historically, the warrior placed self apart from society.

SelflessnessSelflessnessSelf-sacrifice/Martyrdom; Moral Self-sacrifice/Martyrdom; Moral SuperioritySuperiority

Problems:Problems:

Dissociation: Mind separate from bodyDissociation: Mind separate from body

Contempt for non-warriors; isolation (loneliness)Contempt for non-warriors; isolation (loneliness)

Anger: inability to be with others or alone with oneAnger: inability to be with others or alone with one’’s s self.self.

The Warrior Suffers AloneThe Warrior Suffers Alone

Survival Response Effects

General Adaptation Syndrome•Alarm (Fight, Flight, or Freeze)•Resistance (Stoicism – separate mind-body)•Exhaustion

– Engineering: When do things break? When the applied load (stress) exceeds the design strength.

– prolonged stress leads to plastic change.

Brief periods of warrior stoicism followed by periods of recovery can be adaptive;prolonged or repeated periods of stress and/or insufficient recovery is maladaptive and can lead to changes in the mind and body e.g. memory, focus, cardiac, digestive, sleep.

Accepting and Overcoming Accepting and Overcoming Anxiety ReactionsAnxiety Reactions

Resilience - overcoming stressorsResilience - overcoming stressors

Systematic Desensitization – gradual Systematic Desensitization – gradual habituation to triggering stimulihabituation to triggering stimuli

In-vivo Exposure – immersion or In-vivo Exposure – immersion or confrontation with the real stressor, pair confrontation with the real stressor, pair with relaxation or rewardwith relaxation or reward

Imaginal exposure – training to tolerate Imaginal exposure – training to tolerate memories without having threat responsememories without having threat response

Results in less avoidanceResults in less avoidance

Anxiety TreatmentAnxiety Treatment

Think about your triggers for anxiety or Think about your triggers for anxiety or overreactionoverreaction

Pair imagined steps or repeated exposure Pair imagined steps or repeated exposure with relaxationwith relaxation

After multiple attempts, body will be less After multiple attempts, body will be less reactivereactive

Steps for Dealing with AngerSteps for Dealing with AngerUse an anger ruler (thermometer) to identify Use an anger ruler (thermometer) to identify feelings and levelfeelings and levelIdentify attributionsIdentify attributionsIdentify physical responsesIdentify physical responsesIdentify one’s own behaviorIdentify one’s own behaviorUse I statementsUse I statementsDonDon’’t blame others for one’s reactionst blame others for one’s reactionsTake a physical or mental time outTake a physical or mental time outUse physical activityUse physical activityGet helpGet help

Steps for Dealing with Steps for Dealing with DepressionDepression

Identify Identify maladaptive pattern of thoughts maladaptive pattern of thoughts (“stinking thinking”)(“stinking thinking”)

Global/stable/internal – depressive triadGlobal/stable/internal – depressive triad

Identify Attributional ErrorsIdentify Attributional Errors Dichotomous thinkingDichotomous thinking Catastrophic thinkingCatastrophic thinking Overgeneralization from a single incidentOvergeneralization from a single incident

Challenge the evidence for the thought..Challenge the evidence for the thought..

What else could you think??What else could you think??

When to Seek Professional When to Seek Professional HelpHelp

If you experience significant distress or If you experience significant distress or impairment (in daily life, work, relationships, or impairment (in daily life, work, relationships, or physical health) as a result of your symptomsphysical health) as a result of your symptoms

If you feel unsafe, “crazy,” or overwhelmed as a If you feel unsafe, “crazy,” or overwhelmed as a result of your symptomsresult of your symptoms

If coping strategies may or do lead to harm to If coping strategies may or do lead to harm to self or othersself or others

If you have suicidal or homicidal thoughtsIf you have suicidal or homicidal thoughts

If others that care about you feel afraid or If others that care about you feel afraid or worried as a result of your coping patterns e.g. worried as a result of your coping patterns e.g. substance abusesubstance abuse