Stress Management - IIT Kharagpur PDF

Summary

This document is lecture notes on stress management from IIT Kharagpur, covering topics such as the definition of stress, the response of the body to stressors, and the history of stress research.

Full Transcript

EL STRESS MANAGEMENT PT N RAJLAKSHMI GUHA IIT KHARAGPUR EL SCIENTIFIC FOUNDATIONS OF STRESS PT N EL MODULE 1 PT N OUTLINE EL UNDERSTAND WHAT STRESS IS WHY TWO INDIVIDUALS RESPOND DIFFERENTLY DURING PT...

EL STRESS MANAGEMENT PT N RAJLAKSHMI GUHA IIT KHARAGPUR EL SCIENTIFIC FOUNDATIONS OF STRESS PT N EL MODULE 1 PT N OUTLINE EL UNDERSTAND WHAT STRESS IS WHY TWO INDIVIDUALS RESPOND DIFFERENTLY DURING PT A STRESSFUL SITUATION? EXPLORE THE HISTORY AND GENESIS OF STRESS RESEARCH N What is stress? EL Stress can be defined as a response of the body to any demand placed on it PT Stress can be influenced by both external and internal factors N WHY DO INDIVIDUALS BEHAVE DIFFERENTLY DURING STRESS? EL It follows that what is stressful to one person may be a refreshing challenge to another, depending upon his perception of the situation as well as his p perception p of his abilityy to cope p with that situation (Later explained in personality factors and stress) response PT The individual's judgment that a stressful situation exists, initiates a stress Without this appraisal there is no stress in the person's psychological schema N Even though a situation is perceived as a demand or threat it may still not mobilize a stress response if the individual thinks that he is able to cope with it adequately, either on his own or with the help of external resources or support from other people in his life PIONEERS in stress research There are earlier antecedents to the concept of stress. For centuries physicians and patients have made the EL association between adverse life events and illness The links between emotion and sudden cardiac death PT have been repeatedly noted in sources as diverse as the Bible, Bible anthropological texts, texts and clinical experience Manyy contemporary p y cultures regard g illness as the N outcome of being out of balance with the environment and its demands, a manifestation of inadequate coping with diverse stressors PIONEERS…. Walter Cannon (1932) ‐ a Physiologist with Harvard Medical School ‐ first described body’s response to stress EL Ex: walking down a lonely by lane dimly lit, while you are half way down to the p point of no return yyou see a burlyy figure g carrying y g a club standingg on your way. What do you feel? PT  increased heart beat, shortness of breath, increased muscles tense perspiration, tense, and a whole array of changes occur in the body body prepares itself when confronted by a threat to either stand gground and fight g or run awayy N Walter Cannon termed this response as the FIGHT OR FLIGHT RESPONSE PIONEERS…. EL Hans Selye S l (1956) ( 9 6) summarized i d stress reactivity i i PT as a three phase process termed the General Adaptation Syndrome N PIONEERS EL GENERAL ADAPTATION SYNDROME ALARM REACTION – The body shows changes at the first PT exposure of the stressor STAGE OF RESISTANCE – Resistance ensues if continued exposure to the stressor is compatible with adaptation. N The bodily signs characteristic of the alarm reaction have disappeared and resistance rises above normal PIONEERS GENERAL ADAPTATION SYNDROME EL SSTAGE G OOF EXHAUSTION: S O Long continued i d PT exposure to the same stressor depletes the adaptation d i energy and d leads l d to exhaustion. h The alarm reaction reappears, but the i N resistance i phase h b being i absent, b iindividual di id l succumbs to the stressor Ex: fever – immune system’s attempt to fight infectious agents like virus and bacteria EL PT N Greenberg, J. 2012 PIONEERS Hans Selye defined stress as “the the nonspecific EL response of the body to any demand made upon it. it ” That means good things (e.g., a job promotion) PT to which we must adapt (termed eustress ) and bad things (e.g., the death of a loved one) to which we must adapt (termed distress ); both N are experienced the same physiologically PIONEERS Holmes and Rahe (1967) – emphasized the role EL of Life Events in stress They showed that the more significant the PT changes in one one’ss life, the greater the chance of the onset of illness N Lazarus, Delongis and others found that daily hassles are even more detrimental to health than major life changes In one of my papers on Attempted Suicide, Suicide my EL colleagues and me found that life events were an important factor pushing an individual to attempt suicide PT N PIONEERS A T W SSimeons eo s ((1961) 96 ) – related e ated eevolution o ut o to EL psychosomatic disease p The human brain (especially y Diencephalon) p has failed to develop at the pace needed to respond to PT symbolic stressors of the twentieth century Ex: when our self‐esteem is threatened, the brain prepares the body with the fight‐or‐flight response. N If the th threat th t to t self‐esteem lf t stems t f from f fear off embarrassment during public speaking, neither fighting nor running away is an appropriate reaction Several researchers have added to the work of EL Cannon, Selye, Simeons, and others to shed more light on the relationship of stress to body processes PT With this understanding has come a better appreciation of which illnesses and diseases are associated with stress and how to prevent these N conditions from developing PIONEERS EL Harold Wolff (1953) – found that a large number of death before release had resulted among inmates of Japanese concentration PT camps as compared to German camps due to the increased amount of emotional stress N EL PT N Greenberg, J. 2012 EL to summarize….. PT In the next module we shall discuss about the sources of stress and how stress can also be helpful to the individual N EL PT Thank you N EL STRESS MANAGEMENT PT N RAJLAKSHMI GUHA IIT KHARAGPUR EL SCIENTIFIC FOUNDATIONS OF PT STRESS N EL MODULE 2 PT N OUTLINE sources of stress EL how stress can also be helpful to the individual PT N Preview… In the previous module we discussed about individuals responding EL differently to stress We spoke about the internal and external factors inducing stress PT Many of you may have wondered what these factors are – to understand these, we must take a relook at stress N A re-look at stress…. The role of stressor, stress reactivity and strain EL STRESSOR - A stressor is a stimulus with the potential of triggering the fight-or-flight response The stressors for which are body was evolutionarily trained were threats to safety – PT This response was required for primitive man for survival - imagine a caveman who sees a lion outside his cave - modern man - may be jumping off the road on the verge of being hit by a car – physiological responses are same as the cave man N Symbolic stressors are stressors that are a threat to the psychological being and not a threat to survival like loss of self esteem, fear of ridicule - imagine when you have an interview to attend – running away or fighting the interviewer would be an inappropriate response The role of stressor, stress reactivity and strain Stressors can be: EL biological and environmental (toxins, heat, cold) psychological (threat to self esteem, depression), sociological (financial loss, unemployment, social isolation), PT philosophical (loss of purpose or goal in life) N One of the most severe stressors is guilt – associated with behaving in a way contrary to one’s moral framework, ex – lying, cheating SOURCES OF STRESS External factors: sociological factors and some environmental factors EL Internal factors: psychological and philosophical factors PT A primary source of stress is the presence of Major Life Events and daily hassles in an individual’s life N Reference to Strain – long term stressor The role of stressor, stress reactivity and strain Stress Reactivity: The fight-or-flight response EL increased muscle tension increased heart rate, stroke, volume, and output elevated blood pressure increased neural excitability PT less saliva in the mouth causing dryness of mouth increased perspiration change in respiratory rate increased serum glucose N increased release of hydrochloric acid in the stomach changes in brain waves Increased urination The role of stressor, stress reactivity and strain Strain - outcome of stress reactivity EL Physical – tension headaches and backaches resulting from excessive muscle tension PT Psychological –ex - fear of being in crowd resulting from contemplating the experience Behavioural – alcohol abuse and getting into fights N Ex: daily hassles increasing stress reactivity leading to strain Our bodies have evolved to respond to stressors with an immediate action EL by altering their physiology for greater speed and strength. When we encounter symbolic stressors, our bodies are altered in the same manner, although we do not use the changed physiology by responding with some action PT We build up stress products, which include elevated blood pressure and increased muscular contractions, serum cholesterol, and secretions of hydrochloric acid in the stomach N The results are illness and disease EL People who have learned stress management skills often respond to a greater degree to a stressor but return to their resting rate sooner than those not trained in stress management PT Analogy to joggers - heart rate may increase tremendously when they exercise but returns to normal sooner than that one who doesn’t N exercise Exercise – to help identify muscle tension As you begin to read this, FREEZE. Don’t move a bit! Now pay attention to your body sensations and position EL Can you drop your shoulders? If so, your muscles were unnecessarily raising them Are your forearm muscles able to relax more? If so, you were unnecessarily tensing them. PT Is your body seated in a position in which you appear ready to do something active? If so, your muscles are probably unnecessarily contracted. Can your forehead relax more? If so, you were tensing those muscles for no useful purpose. Check your stomach, buttocks, thigh, and calf muscles. Are they, too, contracted more than is needed? N Take a moment for yourself now. Concentrate on just letting as many of your muscles relax as possible. Notice how that feels. Adapted from Greenberg, J. 2012 EL PT N :Patel C, 1991 Not all Stress is bad…. EL PT N EL Recognising your Eustress and Distress PT N EL Summarising it….. Sources of stress with emphasis on stressor, stress reactivity and strain PT Human model of stress Maintaining a balance by identifying eustress and distress N Human performance curve and how stress can be useful EL Thank you PT N EL STRESS MANAGEMENT PT N RAJLAKSHMI GUHA IIT KHARAGPUR EL SCIENTIFIC FOUNDATIONS OF STRESS PT N EL MODULE 3 PT N OUTLINE EL TYPES OF STRESS EFFECT OF STRESS ON MIND AND BODY PT N Review… A few important points to remember about Stress – EL We all experience stress at times feeling overloaded, wound up tight, tense, worried PT sometimes motivates to finish a task /perform well Harmful if over-stressed - interferes with ability to get on with normal living N EL PT N Wheaton, 1994 EL Acute Stress PT N Symptoms…. Acute stress symptoms – easily recognized by EL people in stress PT N A few acute stressors… Failed an exam EL Interview / presentation / submissions around the corner Recent relationship break up Lost a job recently Accident PT Deadline to meet soon Car broke down / maid didn’t come Sudden illness or death of a close one N The exciting part about Acute stress Thrilling events cause acute stress EL Adventure sports Someone jumping on you – startled response – link to F-or F response PT N The disadvantages.. Thrills are exhilarating and fun for short periods EL of time Tiring and draining if continued for long PT N Effects of Acute stress Physiological changes EL Emotional changes Cardio vascular changes PT Digestive changes N EL Acute stress can affect anyone PT It is manageable and can be treated N Chronic stress Grinding stress that wears people away day after day year after year EL War Financial crisis Long term relationship problems Traumatic experiences PT Unwanted career/ job Chronic illnesses Dysfunctional families N - unrelenting demands and pressures for interminable periods of time – LEARNED HELPLESSNESS - From traumatic childhood experiences – internalized as a part of daily life Common signs of chronic stress EL Physical signs: Psychological signs: PT N Effect of stress on performance Effect of stress on Appetite and digestion – “LOST MY APPETITE” – EL Digestion is a Para sympathetic activity During stress, Sympathetic Nervous system - activated making individual vigilant and aroused, but suppresses appetite PT Effect on sexual activity – sexual arousal and reproduction are inhibited by the physiological concomitants of stress – Precludes testosterone release in males N – Reduces concentration of estrogen in females Effects of stress on cognition – chronic stress affects beliefs and views of the world Effect on growth EL sympathetic nervous system  release of various digestive enzymes affected nutrients not absorbed  nutritional deficits  growth affected In adults: PT stress hormones disrupt the processes by which the body reconstructs itself through the use of calcium  Stress is responsible for the disintegration of bone N SUMMARY TYPES OF STRESS EL EFFECT OF STRESS ON BEHAVIOUR COGNITION SEXUAL ACTIVITY PT DIGESTION AND GROWTH N EL THANK YOU PT N EL STRESS MANAGEMENT PT N RAJLAKSHMI GUHA IIT KHARAGPUR EL SCIENTIFIC FOUNDATIONS OF STRESS PT N EL MODULE 4 PT N OUTLINE EL – ROLE OF PERSONALITY FACTORS IN STRESS – ROLE OF CULTURAL AND ETHNIC BACKGROUND – RESILIENCE AND BOUNCING BACK FROM STRESS PT N What is personality? Personality refers to individual differences in characteristic patterns of thinking, feeling and EL behaving These are developed through interaction with PT our environment over time - values, attitudes, personal memories, social relationships, habits, and skills N How does it affect stress? PERSONALITY AND STRESS Individual differences EL cognitive reaction to a situation - appraisal of the nature, importance and implications of the event, and by your ability to effectively manage or cope with the event PT emotional responses to a situation - determined by appraisal of situation and coping abilities Ex: “I can handle this,” – planning ways to handle the N situation “This is terrible. I’m going crazy” - quitting, getting more anxious Factors of Personality related to stress EL Locus of control PT Self esteem Personality Type Hardiness N Genetic makeup EL influences health and behavior All human beings face stress when dealing when faced with making a PT difficult or frustrating decision Some individuals may have a heightened level of arousal in the central nervous system, causing them to react more excitedly to events and adapt more slowly N Locus of control Locus of control refers to the degree of control which individuals think they have over what happens to them EL Internal locus of control - Persons who see themselves as having control over their environment less likely to be disrupted by stress PT External locus of control: They do not believe they have control over their lives what happens to them determined by others or by outside events Stressors have much influence on their lives N Learned Helplessness (Seligman ,1975) EL This loss of control over the environment is exemplified by the many accounts of healthy natives who, having had 'bones' pointed at them PT by a witch doctor, have died within hours N Common among Kurdaitcha – Australian Aborigines Personality and locus of control EL Studies show that people will learn better and use their past experience to greater advantage if they believe that their success or failure is determined by their skill rather than by luck PT There is also evidence that people will experience less stress in aversive situations if they believe they have some personal N control over the outcomes of the situation Self esteem - individual’s self-perception of his/her abilities, skills, and overall qualities that guides and/or motivates specific cognitive processes and behaviors EL Self-esteem has also been reported to predict stress in individuals with chronic disease Lazarus - a potential stressor (e.g. external event) causes people to undergo two cognitive appraisal processes PT primary appraisal - focuses on the nature (positive, negative, or neutral) and respective level of threat an event presents secondary appraisal - determines one’s available coping abilities and resources N are sufficient to overcome the stressor Lazarus and Folkman (1984) Individuals with low self-esteem may lack the coping resources necessary to regulate environmental stressors Schneiderman et al., 2005 low self-esteem - with negative life outcomes, including substance abuse, delinquency, unhappiness, depression, and EL worsened recovery after illnesses Leary and McDonald, 2003 High self esteem - happiness and longevity PT Baumeister et al., 2003 In studies of aging, a positive self-concept and internal locus of control predict successful aging, predicting independence, cognitive stability, and general health N Baltes and Baltes 1990 PERSONALITY TYPES AND STRESS EL History: Two California cardiologists, Meyer Friedman and Ray Rosenman, observed differences in patterns of behavior of their cardiac patients, differences they related to types of cardiac problems PT Beginning in the 1980s, health care professionals sought to identify these individuals in order to intervene and prevent the N development of coronary problems Main Characteristics of Type A Behavior A sense of time urgency and hostility 1. Time urgency - This is the feeling that there is not enough time to do all the things that we believe should be done or that we wish to do. EL It leads to the following symptoms: – Rapid movements: The afflicted person usually walks, talks or eats fast. PT – Impatience: There is a feeling that the rate at which most events take place is too slow. Frequently there is an attempt to hurry the speech of others by saying very quickly over and over again, ''Uh huh, uh huh," or "Yes, yes, yes," or interrupting before people finish their sentences N – Anguish at waiting in line or waiting to be seated in a restaurant. Avoids repetitive tasks - making out bank deposit slips, writing checks, and washing and cleaning dishes Main Characteristics of Type A Behavior Tension: finds it difficult to sit and do nothing. Feels guilty when relaxing He often has a characteristic facial tautness expressing tension and anxiety EL Restlessness: knee jiggling, rapid tapping of the fingers, head nodding, rapid eyebrow lifting while speaking, sucking in air while speaking, tongue- to-front-teeth clicking during conversation, or tuneless humming PT Preoccupation: Inattentive to others. Unable to detect mental and physical fatigue while engaged in a task. Fails to observe seemingly unimportant unrelated things N 2. Hostility – a predisposition to evaluate people or events negatively, often in a suspicious, distrustful, cynical, and paranoid fashion There is a generalized aggression or excessive competitive drive Hostile expressions: Sarcastic during conversations: Accentuating various key words in talking, even when there is no real need for such emphasis EL Always plays a game to win Clenching the fists, pounding the table, or forceful use of the hands and fingers Preoccupation and irritation with the trivial errors of others PT excessively critical of oneself and others - Characteristic facial expression of aggression, hostility, and struggle, habitual clenching of the jaw or grinding of the teeth N Tendency to swear or use obscene language CHARACTERISTICS OF TYPE A PERSONALITY Competitiveness - Belittles achievements of others in efforts to feel superior. Perceives other group members as adversaries EL Resentment - Harbors feelings of ill will toward others Deterministic worldview - Believes self to be a pawn of the environment, rather than active determiner of fate. Short-term perspective - Deals with problems from the view of immediate consequences. PT Impatience - Belief that success has been due to the ability to get things done faster than others, and fear of ceasing to do things faster and faster. Perfectionism - Believes, "I can do it best so I will do it." Unable to delegate N authority. Punctuality - Always on time Tendency to be critical - Ruminates over a past mistake Type C The Type C personality has difficulty expressing emotion and tends to suppress or inhibit emotions, particularly EL negative ones such as anger. Such individuals also display ‘pathological niceness’, conflict avoidance, high social desirability, over-compliance and over-patience PT While there’s no clear-cut evidence that these personality characteristics can actually cause cancer, they influence the progression of cancer and, hence, the N survival time of cancer patients Weinman, 1995 Type D personality Traits Type D personality - the joint tendency to experience negative emotions and to inhibit these emotions while avoiding social contacts with others EL experience increased negative emotions across time and situations and tend not to share these emotions with others, because of fear of rejection or disapproval PT Gloomy, anxious, and socially inept worrier Have fewer personal ties with other people and tend to feel less N comfortable with strangers J Denollet, 2000 Type D personality Traits EL has a high risk of cardiac disorders Has a high risk of emotional disorders like depression PT N Hardiness – Protective factor In 1981 Illinois Bell Telephone (IBT) downsized from 26,000 to half EL Dr. Salvatore R Maddi and his team studied - 400 + supervisors, managers and executives at IBT (before and after downsizing till 1987) PT 2/3 employees suffered significant performance, leadership and health declines heart attacks, strokes, obesity, depression, substance abuse and poor performance reviews N 1/3 thrived - under same conditions maintained health, happiness and performance and felt renewed enthusiasm What made the two groups so different? EL Dr. Maddi found that those who thrived maintained three key beliefs PT that helped them turn adversity into an advantage COMMITMENT, CONTROL AND CHALLENGE ATTITUDES N Hardiness – Protective factor Hardiness comprises the three Cs: COMMITMENT – involve oneself in whatever one is doing EL to approach life with a sense of curiosity and meaningfulness The Commitment attitude led them to strive to be involved in ongoing events, rather than feeling isolated CONTROL – related to Rotter’s (1966) locus of control PT individual differences in people’s beliefs regarding what controls events in their everyday lives The Control attitude led them to struggle and try to influence outcomes, rather than lapse into passivity and powerlessness N CHALLENGE – a tendency to believe that change is normal in Life to anticipate change as an incentive to personal growth and development rather than a threat to security The Challenge attitude led them to view stress changes, whether positive or negative, as opportunities for new learning COMMITMENT AND CONTROL associated with good health CHALLENGE is not always necessary EL FEELING HELPLESS (NOT IN CONTROL) and being UNCOMMITTED FIND THEMSELVES IN STRESSFUL CONDITIONS OPTIMISTIC OUTLOOK TO LIFE - HEALTHIER PT Hardiness moderates the stress–illness relationship by reducing cognitive appraisals of threat, and reducing the use of regressive coping N Funk, 1992 Cultural/ethnic background competitiveness and striving for achievement are common goals in capitalist societies, but probably not in more traditional, communal ones Penny, 1996 EL the physical and mental health of African-Americans is worse than that of whites, especially in terms of the spread of AIDS and hypertension. While this is partly due to the direct negative effects of poverty, such as PT poor diet, low levels of education and poor medical care, there are many psychological and social stressors involved as well Although these are extremely difficult to measure, especially across cultures: N … there is little dispute that blacks in North America and Europe face a unique kind of stress – racial discrimination Cooper et al., 1999 Stress itself as a cause of stress Once emotional responses begin to build up, people will start responding in terms of their perception of these emotional EL changes as well as to the context So emotional problems cause stress too, particularly feelings of inferiority, conscience and emotional conflict PT Ex: person who feels inferior under pressure, since every contact, every event in his life is a cue for the activation of this N sense of inferiority Highly moral person - imposes unattainable demands on self  failing to meet them causes stress EL STRESS MANAGEMENT PT N RAJLAKSHMI GUHA IIT KHARAGPUR EL SCIENTIFIC FOUNDATIONS OF STRESS PT N EL MODULE 5 PT N OUTLINE EL STRESS IN COLLEGE LIFE PT N Case vignettes: EL Case 1: AC- “I have low grades” PT Case 2: BD – “I can’t understand the language” Case 3: EG – “I can’t balance my academics and N family” Developmental tasks during college years Achieving emotional independence from family EL Choosing and preparing for a career Preparing for emotional commitment and family life Developing an ethical system PT Managing these transitional changes requires college students to develop new roles and modify old ones, and that can result in a great deal of stress N Chickering, A. and Havighurst, R. , 1998 Chronic stress in college life Younger student / fresher: EL Leaving home - Life style changes - Adjustment to new place, food, climate, people Grades and performance PT Communication skills getting involved in College activities balancing academics and other social involvements N Senior student: EL Career decisions relationship issues family responsibilities PT meaning in life N Stress signals Here are a few common indicators: Difficulty concentrating EL Increased worrying Trouble completing assignments on time Not going to class Tension Headaches PT Short temper or increased agitation Tight muscles N Changes in eating habits (e.g., “stress eating”) Changes in sleeping habits Effects of stress Sleep disturbance Avoidance behaviour  Absentism EL Poor academic performance Internet / computer addiction Social isolation Alcoholism and substance abuse Obesity PT Tension headache Irritable bowel syndrome N Clinical depression Anxiety Disorders Suicide Resilience studies on college settings EL PT N Resilience studies… EL PT N EL Resilience studies in College settings In India PT N EL THANK YOU PT N

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