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