Title: Lecture 2 Identifying your stressors and how you handle stress
1Lecture 2 Identifying your stressors and how you
handle stress
- Dr. Paul Wong D.Psyc.(Clinical)
- E-mail paulw_at_hku.hk
- Centre for Suicide Research and Prevention (CSRP)
2This Lectures Overview
- Recap of Lecture 1
- In-class activity - Myths and Facts of Suicide
- Video The aftermath of suicide
- What is Stress?
- Sources of Stress
- Bio-psycho-social Aspects of Stress
- How Stress Affects Health
- Coping with it
3Objectives
- Students will learn the difference between good
and bad stress. - Students will learn to identify signs of stress
in themselves and others. - Students will learn the difference between
positive and negative ways of coping with stress. - Students will identify and choose specific
methods that can reduce stress.
4Myths and Facts of SuicideIn-class activity
5Myth or Fact
- Suicide usually happens without warning.
6Myth
- Research has demonstrated that in over 80 of
completed suicide, a warning sign or signs were
given. - (Coleman OHalloran, 1998)
- Many studies have revealed that the suicidal
person gives many clues and warning regarding
suicidal intentions. This is not to say that all
suicidal people always give warnings. - (Center for Mental Health in Schools at UCLA,
2003)
7Myth or Fact?
- There are no special/certain types of people who
commit suicide.
8Fact
- Suicidal behavior cuts across all socioeconomic
boundaries. People of all ages, races, faiths,
and cultures die by suicide, as do individuals
from all walks of life, all income levels. Most
who die suffer from serious mental illness many
of whom have not been diagnosed some have no
diagnosable mental illness. We have to pay
serious attention to all suicidal talk and
behavior.
9Myth or Fact?
10Fact
- It is simply not true that once suicidal, always
suicidal. Most people who are considering
suicide will be suicidal for a relatively short
period of time. Given proper assistance and
support, there is a strong possibility that there
will not be another suicidal crisis.
11Myth or Fact?
- Many people think about suicide at some
- point in their lives.
12Fact
- 50 to 70 of people have thought of suicide at
some point in their lives as shown in studies
that investigated lifetime suicidal ideation. - (Ramsay et al., 1999)
- In Hong Kong, 29.6 of those aged 15-59 in the
population have ever thought about suicide in
their lives, and 6.7 have suicidal ideation in
the past year. - (Prevalence Study of Suicidality in Hong Kong)
13Myth or Fact?
- People who talk about suicide dont really
- commit suicide.
14Myth
- Of every 10 persons who kill themselves, 8 have
given definite verbal warning signs of their
suicidal intentions. - (Center for Mental Health in Schools at UCLA,
2003) - 50.7 of those who committed suicide had either
implicitly or explicitly expressed their suicidal
plan prior to their death. - (Psychological Autopsy Study of Suicide in Hong
Kong)
15Myth or Fact?
- Suicidal people fully intend to die.
16Myth
- Most suicidal people are ambivalent about dying.
On one hand, they wanted to commit suicide to end
their pain, yet on the other hand, they wanted
someone to be there to help them and listen to
them. - (Center for Mental Health in Schools at UCLA,
2003)
17Myth or Fact?
- Once a person is suicidal, the person is suicidal
forever.
18Myth
- Individuals who wish to kill themselves are
suicidal only for a limited period of time. In
other words, it is almost always a temporary
state.
19Myth or Fact?
- People who threatens or attempts suicide are
merely seeking attention.
20Myth
- 28.2 of all suicide cases in 2003 had an attempt
history. 30.5 of the deceased aged below 25 had
attempted suicide before. - (Surveillance and Monitoring, 2003)
- Compared to the people who are alive, those who
died by suicide were 24.8 times more likely to
have attempted suicide before. - (Psychological Autopsy Study of Suicide in Hong
Kong)
21Myth or Fact?
- Talking about suicide or asking someone if they
feel suicidal will encourage suicide attempts.
22Myth
- There is no evidence that asking an individual
about suicidal ideation will increase the change
that the individual will commit suicide. Most
people thinking about suicide want very much to
talk about how they are feeling and are relieved
when someone else recognizes their pain. To
avoid the subject of suicide is deadly. - (Coleman OHalloran, 1998)
-
23The Aftermath of Suicide People bereaved by
suicide
24Video on People bereaved by Suicide in Hong Kong
25What is Stress?
26What is Stress?
- It is a stimulus things that stress us, e.g.,
This broadening courses course co-ordinator
stresses me! - It is a response how we react to a stimulus,
e.g., I feel a lot of stress when I an being
asked to answer questions in lectures of this
course - It is a process in which the person is an
active agent who can influence the impact of a
stressor through behavioural, cognitive, and
emotional strategies. E.g., though this
broadening course makes me stress, I can deal
with it by following the suggested ways from this
class.
27So WHAT stress you?
- In-class activity no.2 Hassles in Your life
(Sarafino Ewing, 1999).
28The definition of stress -
- Stress as the condition in which
person-environment transactions lead to a
perceived discrepancy between the physical or
psychological demands of a situation and the
resources of the individuals biological,
psychological, or social system (Lazarus
Folkman, 1984).
29In English
- Stress is the reaction people have excessive
pressures or other types of demand placed upon
them. It arises when they worry that they cant
cope.
30When do we see something as stressful?
- Determined by two components
- Whether a demand threatens our physical or
psychological well-being (primary appraisal) and
- The resources available for meeting the demand
(secondary appraisal). - in emergency situations, i.e., disaster, our
cognitive functioning is impaired during shock,
it is unlikely that appraisal processes play an
important role in the stress experienced while in
that state
31Sources of Stress
32External Stressors
- Physical Environment (Noise, Bright Lights, Heat,
Confined Spaces) - Social Interaction (Rudeness, Bossiness,
Aggressiveness by others, Bullying) - Organizational (Rules, Regulations, Deadlines)
- Major Life Events (Birth, Death, Lost job,
Promotion, Marital status change)
33Internal Stressors
- Negative self - talk (Pessimistic thinking, Self
criticism, Over analyzing) - Thinking errors (Unrealistic expectations, Taking
things personally, All or nothing thinking,
Exaggeration, Rigid thinking) - Personality traits (Perfectionists, Workaholics)
34Types of Stress
- Negative stress (dy-stress)
- Positive stress (eu-stress)
35Note
- Most of the stress we experience is
self-generated. How we perceive life - whether an
event makes us feel threatened or stimulated,
encouraged or discouraged, happy or sad - depends
to a large extent on how we perceive ourselves.
36Note
- Self-generated stress is something of a paradox,
because so many people think of external causes
when they are upset. - Recognizing that we create most of our own upsets
is an important first step towards coping with
them.
37How stress affects our Bio-Psycho-Social Aspects?
38How stress affects our Bio-Psycho-Social Aspects?
- Biological
- During emergencies fight-or-flight response
- Pupils dilated, far vision
- Dry mouth
- Sweaty palms
- Increased heart rate
- Maximum blood supply to muscles
- Digestion inhibited
- When stress prolongs
- GAS (General Adaptation Syndrome)
39What is GAS?
- Three stages
- Alarm Reaction similar to the fight-or-flight
response - Stage of Resistance - If the source persists, the
body prepares for long-term protection, secreting
hormones to increase blood sugar levels. This
phase is common and not necessarily harmful, but
must include periods of relaxation and rest to
counterbalance the stress response. Fatigue,
concentration lapses, irritability and lethargy
result as the stress turns negative. - Stage of Exhaustion - In chronic stress
situations, sufferers enter the exhaustion phase
emotional, physical and mental resources suffer
heavily, the body experiences adrenal
exhaustion leading to decreased stress
tolerance, progressive mental and physical
exhaustion, illness and collapse.
40The Psychosocial Aspects of stress
- Mental
- Behavioural
- Emotional
41Mental Symptoms
- Lack of concentration
- Memory lapses
- Difficulty in making decisions
- Confusion
- Disorientation
- Panic attacks
42Behavioural Symptoms
- Appetite changes - too much or too little
- Eating disorders - anorexia, bulimia
- Increased intake of alcohol other drugs
- Increased smoking
- Restlessness
- Fidgeting
- Nail biting
43Emotional Symptoms
- Bouts of depression
- Impatience
- Fits of rage
- Tearfulness
- Deterioration of personal hygiene and appearance
44Stress Related Illnesses
- Stress is not the same as ill-health, but has
been related to such illnesses as - Cardiovascular disease
- Immune system disease
- Asthma
- Diabetes
- Recurrent headache
- Cancer
45Why some people are more prone to stress, and
some are not?
- Social Support?
- A sense of personal control?
- A Hardy personality?
- Hardiness include control, commitment, and
challenge.
46Coping with STRESS
47- Coping is the process by which people try to
manage the perceived discrepancy between the
demands and resources they appraise in a
stressful situation. - In English people come up with ways to either
reduce demands or increase resources or both.
48Two major functions of coping
- Emotion-focused coping
- Problem-focused coping
- In-class activity no.3 Your Focuses in Coping
- Billings and Moos, 1981.
49Two major functions of coping
- Emotion-focused coping is aimed at controlling
the emotional response to the stressful situation - Problem-focused coping is aimed at reducing the
demands of the stressful situation or expanding
the resources to deal with it. - Please see examples of ways of coping from handout
50Stress Management Techniques
- Change your thinking
- Change your behaviour
- Change your lifestyle
51Change your Thinking
- Re-framing
- Re-framing is a technique to change the way you
look at things in order to feel better about
them. There are many ways to interpret the same
situation so pick the one you like. Re-framing
does not change the external reality, but helps
you view things in a different light and less
stressfully. - Positive thinking
- Stress leaves us vulnerable to negative
suggestion so focus on positives - Focus on your strengths
- Learn from the stress you are under
- Look for opportunities
- Seek out the positive - make a change.
52Change your Behaviour
- Be assertive
- Get organized
- Ventilation
- Have a sense of Humour
53Be assertive
- Being assertive involves standing up for your
personal rights and expressing your thoughts,
feelings and beliefs directly, honestly and
spontaneously in ways that dont infringe the
rights of others. - Assertiveness helps to manage stressful
situations, and will, in time, help to reduce
their frequency. Lack of assertiveness often
shows low self - esteem and low self -
confidence. The key to assertiveness is verbal
and non - verbal communication. Extending our
range of communication skills will improve our
assertiveness.
54Equality and Basic Rights of being Assertive
- 1) The right to express my feelings
- 2) The right to express opinions / beliefs
- 3) The right to say Yes/No for yourself
- 4) Right to change your mind
- 5) Right to say I dont understand
- 6) Right to be yourself, not acting for the
benefit of others - 7) The right to decline responsibility for other
peoples problems - 8) The right to make reasonable requests of
others - 9) The right to set my own priorities
- 10) The right to be listened to, and taken
seriously
55Get Organized
- Poor organization is one of the most common
causes of stress. Structured approaches offer
security against out of the blue problems.
Prioritizing objectives, duties and activities
makes them manageable and achievable. Dont
overload your mind. Organization will help avoid
personal and professional chaos.
56Time Management
- Make a list
- What MUST be done
- What SHOULD be done
- What would you LIKE to do
- Cut out time wasting
- Learn to drop unimportant activities
- Say no or delegate
- Plan your day
- Set achievable goals
- Dont waste time making excuses for not doing
something
57Ventilation
- A problem shared is a problem halved
- Develop a support network through friends or
colleagues to talk with. Its not always events
that are stressful but how we perceive them. - Writing a diary or notes may help release
feelings but do not re-read what has been
written.
58Change Your Lifestyle
- Diet
- Smoking Alcohol
- Exercise
- Sleep
- Leisure
- Relaxation
59Benefits of Exercise
- Uses up excess energy released by the Fight or
Flight reaction. - Improves blood circulation
- Lowers blood pressure
- Clears the mind of worrying thoughts
- Improves self image
- Makes you feel better about yourself
- Increases social contact
60Alternatives (less evidence, though)
- Conventional Medicine
- Counselling psychotherapy
- Relaxation
- Meditation
- Massage
- Yoga
- Acupuncture
- Aromatherapy
- Floatation
- Herbalism
- Biofeedback
- Homeopathy
- Hypnotherapy
- Osteopathy
- Pet Therapy
- Reflexology