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7/29/2019 Stress Management Input
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STRESS
MR. NELSON R. MENDOZA
Psychosocial Specialists
Program ManagerNational Mental Health Program
Department of Health
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Promoting Healthy
Lifestyles
Department of Health
2005
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How do you know if you are
suffering from stress? Are you constantly tired?
Do you experience flashes of anger over a
minor problem?
Have you noticed a change in sleeping or
eating patterns?
Do you suffer from chronic pain,
headaches or backaches
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How do you know if you are
suffering from stress? Do minor problems and disappointments
upset you excessively?
Do the small pleasures of life fail tosatisfy you?
Are you unable to stop thinking of your
worries?
Do you feel inadequate or suffer from self
doubt?
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Which of these is stress?
You receive a promotion at work.
Your car has a flat tire.
You go to a fun party that lasts till 2:00 a.m.
Your dog gets sick.
Your new bedroom set is being delivered. Your best friend and his wife come to stay at
your house for a week.
You get a bad case of hay fever.
All of the above.
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ALL OF THESE ARE STRESS
If you are used to thinking that stress is
something that makes you worry, you have the wrong
idea of stress.
Stress is many different kinds of things: happythings, sad things, allergic things, physical things.
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Presentation Outline
Stress
Definition
SourcesEffects
Identification
Management Modalities
Stress Management as Health promotionactivity
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MAN IS:
PHYSICAL MENTAL SOCIAL SPIRITUAL
Feels Thinks
Reacts
Environment Stimuli
Internal External
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Facts About Stress
75-90% of visits to physicians are stress-
related
Stress related disorders are a major causeof rapidly increasing health care cost
Job stress is a major health factor costing
an estimated $150B annually
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More Facts About Stress
70% of people with drinking problemsand 62% of drug users were in full timeemployment
Fatalities at work, related to drug andalcohol use account for 15-30% of allaccident cases
Problematic drug and alcohol users have2 to 4 times more accidents than otheremployees
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Still More Facts About Stress
Problematic drug and alcohol users have2 to 3 times more absences than otheremployees
Problematic drug and alcohol users have2 to 3 times more level of sickness benefitclaims
Some industries have 15-40% of theirdisciplinary cases involving employeeswith alcohol and drug use
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Most Stressful JobsNational Institute for Occupational Safety & Health,
USA, 1994
Licensed Practical Nurse
Public Relations Specialist
Quality Control Inspector
Computer Programmer
Bank Teller
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10 Leading Causes of Mortality
1968 and 1994
Diseases of the heart
Diseases of the vascular
system
Pneumonia
Malignant neoplasm Tuberculosis, all forms
Accidents
Obstructive pulmonary
diseases
Diarrheal diseases
Other respiratory diseases
Diabetes mellitus
Pneumonia
Tuberculosis , all forms
Gastroenteritis & colitis
Diseases of the vascular
system Bronchitis
Diseases of the heart
Malignant neoplasm's
Accidents
Beriberi
Nephritis and nephrosis
Source: Council for Health and Development
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10 Leading Causes of 10 Leading Causes of
Morbidity (2008) Mortality (2005)
1. Acute Respiratory Infection 1. Diseases of the Heart2. Acute lower RTI and Pneumonia 2.Diseases of the Vascular System
3. Bronchitis/ Bronchiolitis 3. Malignant neoplasm
4. Hypertension 4. Pneumonia
5. Acute Watery Diarrhea 5. Accidents
6. Influenza 6. Tuberculosis, all forms7. TB Respiratory 7. Chronic Lower Respiratory
Diseases
8. Acute Febrile Illness 8. Diabetes Mellitus
9. Diseases of the Heart 9. Certain conditions originatingin the Perinatal Period
10. Chickenpox 10. Nephritis, nephrotic syndrome
and Nephrosis
Source: National Epidemiology Center, Department of Health
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Changing times- Need social engineering
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Alcohol abuseDrug abuse
Depression
Violence
High blood Pressure
High Cholesterol
Imbalanced or Over-
Eating
Cigarette Smoking
Weakening of Immune
system
Accidents
Cirrhosis of liver
Suicide
Homicide
Stroke
Heart attack
Cancer
Diabetes
Pneumonia and influenza
Asthma, Emphysema,Bronchitis
MEDIATING PATHWAYS TO STRESS-
RELATED DEATHS
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Mission Impossible?
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STRESS - Definition
The rate of wear and tear within the body
Hans Selye
A state of body disequilibrium.
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Definition
Is an everyday fact of life
All stress is not bad
Is an individual reaction
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Definition
A state where ones coping is not enough
to maintain balance or equilibrium.
Automatic reaction to danger or demandwhich may be physical and psychological,
the resulting state may lead to illness or
death
Duane Hagen
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Definition
A major cause of low productivity, high
absenteeism, bad judgment, misallocation
of resources and poor moral.
Robert Axles
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THE DYNAMICS OF STRESS
SENSATIONS
FEELINGS
EMOTIONS
BALANCE
*Eustress
*Distress
STRESS
PERCEPTION
G.A.S.
BODY IN
ACUTE TENSION
(Temporary Imbalance)
CREATIVE
ACTION
INEFFECTIVE
ACTION
INACTION
PAIN
TRAUMA
DISEASES OF
ADAPTATION
Int. / Ext.
S
T
R
E
S
S
O
R
S (+)
(-)
(-)
MAIN REFERENCE: Selye, Hans. 1974. Stress Without Distress. Signet Books. New York.
+ / -
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(FIGHT OR FLIGHT RESPONSE)
THREAT BODY ALARMS GO OFF
When the body has a demand placed on it or
perceives a threat, it responds physically with the
fight or flight responses
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When a stressful event or situation occurs, the mind quickly assesses its significance and sends
messages throughout the body via the central nervous system. Energy is rapidly distributed
throughout the body by the bloodstream and the body's resources are mobilized to defend itself
against the perceived threat. The level of your stress in a situation depends on the intensity of
meaning you attach to the source of the stress.
Danger/threats
Mind quickly assesses
Central Nervous System
Increased energy
through bloodstream
Bodys resources
Mobilized to defend itself
Stress level increase
Stress
sends messages throughout
the body via the centralnervous system
energy increasedthroughout the body
Blood pressure increases
Sugar pumped to fuel muscles
Adrenalin floods nerve endings
Blood clotting time reduced
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General Adaptation Syndrome
(G.A.S.)
Increase in...
Blood Pressure
Breathing rate
Muscle blood
flow
Heart rate
Blood clotting
agents
White blood count
Body metabolism
Energy to handle
perceived threat
Flight or
Fight Response
SOURCE: Productive Stress Management and Winning Lifestyle. ADB Tape..
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E
F
F
I
C
I
E
NC
Y
0
100%
STRESS
CRITICAL
LINE
TOO
LITTLE
STRESS
JOY
OF
STRESS
TOO
MUCH
STRESS
To find where you are on this graph, simply ask one question: Will the added stress of a new responsibility at work or at ho me ( no matter
how small) increase my efficiency, or decrease it? To make the best use of your energy, make sure your tasks are essential to your health,
wealth, and happiness, and not a waste of time.
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Who is the most vulnerable to
distress? Research shows that all types of people sometimeexperience distress. No one is immune. Yet these alsoare evidence that members of certain categories andgroups are specially likely to encounter distress.
Rates of CHD, CA and suicide are higher forseparated-persons than unmarried people.
Unhappily married people suffer more stress-relatedillness than people who are happily re-married.
All married groups-men and women, over 30 andunder 30 with and without childrenreport highersatisfaction, general good feelings and less stress thanunmarried groupssingle, divorced, or widowed.
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Widows and widowers are more likely than others their ageto become ill and die (especially after the death of theirspouse)
More wives than husbands have felt they were about to havea nervous breakdown, have experience more intense anxiety,and report feelings of inadequacy, depression, and phobia
Compared with non-employed housewives, working wives
are happier, communicate better than their husbands,report feeling better physically and mentally, and are moresatisfied with their marriages and life in general.
Compared with husband of non-employed wives, husbandsof working wives are less happy, experiencing greater jobpressures, poorer health and more dissatisfaction with their
jobs and marriages.
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The ages of greatest stress-related ailments are 15-35and 55-65
The poor are more likely to experience all types ofdistress than middle-class or wealthy persons.
Teenagers with high-achievement pressures fromparents are specially likely to be hypertensive.
Urban dwellers have more stress related illnesses thanrural dwellers.
Parents with young children report more feelings orpressure and stress than any other age or marital-status group
Blue collar workers experiences more boredom, stressrelated illness and job dissatisfaction than white-collarworkers.
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Depression is up to twice as common amongwomen as men.
Migrants from rural areas to the city are morelikely to experience stress-related illness anddeath than are non-migrants
Families that move a greater deal are speciallylikely to experience suicide, ulcers, separationand emotional breakdown
The unemployed are more likely than the
employed to experience suicide ulcers, divorce,and emotional breakdown.
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Sources of Stress
1) Personal
2) Family
3) Occupational
4) Environmental
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Personal
1) Minor annoyances
2) Adverse life experiences
3) Major life changes4) Extreme life experiences
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Family
1) Spouse/Parents
2) Children/Siblings
3) In-Laws/Other relatives
4) No house help
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Occupational
1) Physical Environment
2) Interpersonal Relationship
3) Organizational
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Organizational
1) Role Demands
2) Task Demands
3) Benefits4) Promotion/Demotion/Stagnation
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Environmental
1) Peace and Order Situation
2) Socio-economic
3) Political
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Life is not a destiny
but a journey to be
enjoyed.Synergy Unlimited
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Challenge energizes us psychologically andphysically, and it motivates us to learn new skills
and master our jobs. When a challenge is met, we
feel relaxed and satisfied. Thus, challenge is animportant ingredient for healthy and productive
work.a little bit of stress is good for you.
the challenge has turned into job demands that cannot be met
relaxation has turned to exhaustion
sense of satisfaction has turned into feelings of stress
stress
stress
stress
But if
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One-fourth of employees view their jobs as the
number one stressor in their lives.- Northwestern National Life
Three-fourths of employees believe the worker has
more on-the-job stress than a generation ago.
- Princeton Survey Research Associates
Problems at work are more strongly associated
with health complaints than are any other life stressor-more so than even financial problems or family
problems.
- St. Paul Fire and Marine Innsuance Co.
Common Costly problem in the workplace:
St i T d ' W k l
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Stress in Today's Workplace
The longer he waited, the more David worried. For weeks he
had been plagued by aching muscles, loss of appetite, restless sleep,
and a complete sense of exhaustion. At first he tried to ignore theseproblems, but eventually he became so short-tempered and irritable
that his wife insisted he get a checkup.
Now, sitting in the doctor's office and wondering what the
verdict would be, he didn't even notice when Theresa took the seat
beside him.
"You got out just in time," he told her. "Since the reorganization,
nobody feels safe. It used to be that as long as you did your work, you had a
job. That's not for sure anymore. They expect the same production rates
even though two guys are now doing the work of three. We're so backed up
I'm working twelve-hour shifts six days a week. I swear I hear those machineshumming in my sleep. Guys are calling in sick just to get a break. Morale is
so bad they're talking about bringing in some consultants to figure out a
better way to get the job done."
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"Well, I really miss you guys," she said. "I'm afraid I jumped
from the frying pan into the fire. In my new job, the computer routes
the calls and they never stop. I even have to schedule my bathroom
breaks. All I hear the whole day are complaints from unhappycustomers. I try to be helpful and sympathetic, but I can't promise
anything without getting my boss's approval.
Most of the time I'm caught between what the customer
wants and company policy. I'm not sure who I'm supposed to keep
happy. The other reps are so uptight and tense they don't even talkto one another. We all go to our own little cubicles and stay there
until quitting time.
To make matters worse, my mother's health is deteriorating.
If only I could use some of my sick time to look after her. No wonder
I'm in here with migraine headaches and high blood pressure. A lotof the reps are seeing the employee assistance counselor and
taking stress management classes, which seems to help. But
sooner or later, someone will have to make some changes in the
way the place is run."
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Job Conditions That May Lead to Stress
Management Style.
Lack of participation by workers in decision- making, poorcommunication in the organization, lack of family-friendly policies.
Example:
Theresa needs to get the boss's approval for everything and the company is
insensitive to her family needs.
The Design of Tasks.
Heavy workloads, infrequent rest breaks, long work hours andshift work; hectic and routine tasks that have little inherent meaning, do
not utilize workers' skills, and provide little sense of control.
Example:
David works to the point of exhaustion. Theresa is tied to the computer,allowing little room for flexibility, self-initiative, or rest.
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Job Conditions That May Lead to Stress
Work Roles.
Conflicting or uncertain job expectations, too much responsibility,
too many "hats to wear.
Example:
Theresa is often caught in a difficult situation trying to satisfy both the customer's
needs and the company's expectations.
Interpersonal Relationships.
Poor social environment and lack of support or help from co-workers and supervisors.
Example:
Theresa's physical isolation reduces her opportunities to interact with other
workers or receive help from them.
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Job Conditions That May Lead to Stress
Environmental Conditions.
Unpleasant or dangerous physical conditions such as crowding, noise, airpollution, or ergonomic problems.
Example:
David is exposed to constant noise at work.
Career Concerns.
Job insecurity and lack of opportunity for growth, advancement, or
promotion; rapid changes for which workers are unprepared.
Example:
Since the reorganization at David's plant, everyone is worried about their future
with the company and what will happen next.
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Job Conditions That May Lead toStress The Design of Tasks
Management Style
Career Concerns Environmental Conditions
Career Concerns
Environmental Conditions
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Ten Major Occupational
Stressors Work overload, under load/stagnation
Ambiguity or rigidity of task
Role conflict
Extreme amount of responsibility Negative competition
Constant changes
Ongoing contact with stress carriers
Containment or emotional reactions
Poor interaction with management
Matters related to corporate work
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Five Basic Reactions to Stress
Share grievance without ignoring the situation
Work longer and harder to reduce overload
Switch to an engrossing recreation to berefreshed
Physical withdrawal, quitting or reducing the
time and energy spent at work
Analyzing the situation, revising strategies and
look for ways to change things
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The interplay of several variables which largely
determines what happens to a person or family whenstressors or problems are encountered.
These variables include:
1) the hardships associated with the condition or event,
2) how the situation is perceived or defined,
3) the inner resources and coping capacities the person orfamily has, and
4) the external resources and supports which the family orperson can mobilize--formal agencies or professionalsand informal networks of kin, friends, and neighbors.
Why be stressed:
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Perception
"Seeing is believing. I wouldn't have seen it if I hadn't believed it."
(Ashleigh Brilliant)
1. Communication
2. Problem-solving
3. Decision-making
4. Stress Management
When humans get data (information) from any of their senses, they
"perceive" it. That is, they make some sense or meaning of it; they interpret;
they define situations and events; they make inferences and draw
conclusions.
Perceptions Affects: individuals and families involved
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What is the most important factor
in PRODUCTIVITY?
The most important factor is clearly our
emotional state during the work situation.
When we are feeling motivated, relaxed,
determined, energized, calm and confident,
high productivity will naturally flow.
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Are all forms of Stress BAD?
Certain amount of stress maybe needed tobe motivated (e.g. working well under
pressure)
EUSTRESSenough stress to be motivated,challenged and productive
DISTRESSunder loaded (boredom) or
over loaded
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EUSTRESS
Eustress or positive stress occurs when your
level of stress is high enough to motivate you
to move into action to get things accomplished.
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DISTRESS
Distress or negative stress occurs when your
level of stress is either too high or too low and
your body and/or mind begin to respondnegatively to the stressors.
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What are the causes of Stress?
ANYTHINGdifferent people (social
status), different stress
Rich & Powerfulgetting richer, more powerful
Middle Classsustenance, future
Poorday to day subsistence
Nobody is spared from, stress
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Basic Causes of Stress:
CHANGEinevitable stressor
e.g. Rapid development., technological
advances, lifestyles, growth & development.
SNEAKING STRESSlittle things that
add up
E.g. being late, traffic, work load, etc.
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PERSONAL TRAITSstress coming from within
(ones personality) E.g worrier type (negative thinker, perfectionist,
unrealistic expectations, low self-esteem)
Remember WORRY is a mental abuse, a self-inflicted
abuse
PHYSICAL ENVIRONMENT Noise, uncomfortable chair, smoke-filled surrounding
undisciplined people, etc.
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COGNITION VS EMOTION
NORMAL STRESS NORMAL
Th M h i f th
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The Mechanism of the
Physical Stress Response
Stress stimulates the nervous system
The sympathetic and parasympathetic system areactivated
The Sympathetic Nervous System stimulates
catecholamine release of the adrenals .
Flight reactions cause adrenaline secretion
The Mechanism of the
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The Mechanism of the
Physical Stress Response
Aggression or fight reactions cause Noradrenaline
secretion.
The adrenal cortex produces cortisol, to enhance theaction of the cathecolamines.
Increased cortisol may suppress the immune system
causing the body to be susceptible to infection/illness
The Mechanism of the
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The Mechanism of the
Physical Stress Response
The effects of cathecolamines are:
Dilated pupils
Constricted blood vessels of the head
Skeletal blood vessels are dilated Peristalsis reduced
Renal muscles, relaxed, urine secretion decreased
Bladder is relaxed, sphincter closed
Sex organs and genitalia relaxed, blood vessels constricted Mental ability is reduced
The Mechanism of the
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The Mechanism of the
Physical Stress Response
Utilization of energy by the body is increased
Vit. B Com. , C, E & other energy giving nutrients
and minerals are depleted in case of chronic stress
Inc of energy requirement may result togluconeogenesis
Energy burned creates by products--lactic acid,
uric acid, urea and CO2
Excretion of by products is aided by movement
of muscles, circulation of blood & lymph
Th M h i f th
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The Mechanism of the
Physical Stress Response
Accumulated by products cause stiffness & soreness
of the muscles, affecting the gliding action of muscles
Chronically stressed muscles become fatigued causing
loss of elasticity, tone & irritability
On the other hand, constantly relaxed muscles may
loose their tone, elasticity and irritability accumulating
by products that produce frozen joints & knotted
muscles.
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(Signs/Symptoms of Stress)
Physical
Intellectual
Interpersonal Emotional
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(Physical Symptoms of Stress)
Headaches
Sleep disorders (e.g. insomnia, oversleeping, early awake)
Lower back pains, Clenching the jaws or grinding teeth
Constipation, diarrhea, colitis, indigestion or ulcer
Skin rashes
Muscle aches (especially neck & shoulders)
Hypertension or heart attack
Excessive perspiration Appetite change
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(Interpersonal Symptoms)
Inappropriate distrust of others
Blaming others
Missing appointments or canceling them on
short noticeFaultfinding and verbal attacking
Overly defensive attitude
Giving others the silent treatment
I t ll t l S t
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Intellectual Symptoms
Trouble concentrating
Difficulty in making decisions
Forgetfulness
Confusion
Poor memory & recall
Excessive daydreaming
Preoccupation with a single thought or idea
Loss of sense of humor
Decreased productivity,lower quality of work
Increased number of errors
Poor judgment
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(Emotional Symptoms)
Anxiety or worry Depression or cries easily
Mood swings
Irritability
Nervousness
Lowered self-esteem or feelings of insecurity
Increased sensitivity or feeling easily hurt
Angry outburst Aggression or hostility
Feeling emotionally drained or burned out
Unhealthy ways of coping with stress
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Smoking
Drinking too much
Overeating or undereating
Zoning out for hours in front of the TV or computer
Withdrawing from friends, family, and activities Using pills or drugs to relax
Sleeping too much
Procrastinating
Filling up every minute of the day to avoid facingproblems
Taking out your stress on others (lashing out, angry
outbursts, physical violence)
These coping strategies may temporarily reduce stress, but they causemore damage in the long run:
Cognitive Theory of Stress
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g y
(Lazarus)
Primary Appraisal
Harm or loss
Threat
Challenge Secondary Appraisal
Evaluation of Coping Resources
Physical
Social Psychological
Material
Contingencies
FLAMEOUT
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A preventable and treatable condition
which occurs when the need for periodic
rest. Food, exercise and relaxation is
overlooked or ignored.
Also known as Rapid Onset Burnout
FLAMEOUT
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A state of mental, emotional and physical
exhaustion, characterized by changes
attitudes towards work colleagues andclients.
BURNOUT
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Dont waste your Health to
gain WEALTH otherwise atthe end you will loose all
your wealth to gain backyour HEALTH.
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Your problems are not yourproblems. How your problem
affect youyour attitudeis
your problem. Fix that and yourproblems are no problem.
Unhealthy ways of coping with stress
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Smoking
Drinking too much
Overeating or undereating
Zoning out for hours in front of the TV or computer
Withdrawing from friends, family, and activities Using pills or drugs to relax
Sleeping too much
Procrastinating
Filling up every minute of the day to avoid facingproblems
Taking out your stress on others (lashing out, angry
outbursts, physical violence)
These coping strategies may temporarily reduce stress, but they causemore damage in the long run:
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Shift Hours
L o n g H o u r s
Publ i c Scr ut i ny OrganizationalStress
The Police Officers Paradox
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To function effectively in our job, you must
annihilate, smother, and suppress normal
emotions like fear, anger,
revulsion, andeven compassion. To
do other wise is to
invite overwhelming
doubt or hesitancy when
decisive action is required.
The penalty for your achieved
competence is a mind set thatmight as well be a foreign
language to your social
contemporaries.
We are..victims of our own success. When
these same normal and appropriate
emotions..surface in personal
relationships, we automatically shut down
and wonder why, over time, that the people
we care about the most complain that we are
aloof, cold, and uncommunicative.
Lt. Al Benner, Ph.D.
San Francisco Police
ff
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Alcoholism: Myths and Realities
Myth: Once an alcoholic, always an alcoholic
Reality: Alcoholism is a disease for which recovery is guaranteed ifthe alcoholic begins and sticks
with a recovery program. If not, whats guaranteed is premature death.
Myth: Alcoholism is caused by a lack of willpower, immorality, weak character, or police stress.
Reality: No one really knows what drives a person to drink. Studies alternately have implicated physical,
genetic, psychological, environmental, and social factors.
Myth: All alcoholics are skid-row drunks.
Reality: Many alcoholics hold high-level jobs and function well at work for years before their performance
is noticeably affected by drinking.
Myth: If an alcoholic can stop drinking, he or she doesnt have a problem.
Reality: Abstinence is not a sign that someone is free of alcoholism. Alcoholics Anonymous (AA)
calls these abstainers dry drunks because they have no real understanding of their condition,
no new ways to cope, and are almost certain to fall off the wagon.
Myth: Alcoholics drink every day.
Reality: Alcohol abuse patterns vary. Some people get drunk daily, and others only on the weekends.
Some stay sober for months and then go on a long binge.
From E. Kirschman, I Love a Cop: What Police Families Need to Know, 1977.
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Depression
Significant lossactual or threatened
Substance abuse
Previous suicide attempts or threats
Marked change in personality
Giving things away Reckless behavior
Anniversary reactions
Reunion fantasies
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Domestic Abuse
Domestic abuse exists along a continuum from verbal abuse tophysical violence.
All controlling behaviors are reasons for concern and for the potentialvictim to seek help.
Domestic abuse is not about anger. All couples get angry and fight.
Domestic abuse may be related to PTSD, substance abuse, poor coping
or personality.
It is the abusers responsibility to control his/her behavior and gethelp for stress or substance related problems. It is the victimsresponsibility to look after his/her own safety and the safety ofhis/her children.
Toll free national hot line is 800-799-SAFE.
7/29/2019 Stress Management Input
88/89
Awareness of job-
related stress
factors and
the ability to
recognize
stress.
A family
structure
with
clearly
defined
roles and
responsibilities.
Conflict
resolution
and
problem
solving
skills.
Social Support system:
Family
Friendsinside/outside
police work.
Religiouscommunities
Social groups Each other
Organizational Support For
Family Friendly Policies.
Mental health benefits
(EAP) Peer Support Program CIS intervention resources Police Chaplains Flexibleassignments Rotation policies Child care
7/29/2019 Stress Management Input
89/89
Strengthening Your Couple Connection
Spend time alone, without children, regularly every week.
Keep this time sacred and free from interruption.
Decide how you want to spend this time. If you disagree, problem solve so thatyou both win.
Use this time to actively listen to each other.