sress

"The central message...is that in our complex and
demanding world people need to learn how to manage,
maintain and renew themselves. These skills are as
essential to self-preservation and effective work perfor-
mance as the traditional skills of managing people and
resources outside of oneself. Traditional management
training and organizational practices have for too long
neglected the needs of the individual and teaching people
to be sensitive to themselves. As a result, signs and
symptoms of burnout are epidemic."
From Burnout to Balance and

Change creates stress and stress is an everyday fact of life. As
agents of change, leaders must know themselves well and understand
their stress tolerance in addition to having developed a strong
repertoire of stress management skills. This is necessary to
maintain a sense of mastery and control over themselves and
life/work situations to avoid feeling victimized, overwhelmed, or
controlled by pressures and demands.

The necessary prerequisites to managing stress effectively are:
understanding what stress is and where it comes from; being able to
predict life stressors and recognizing symptoms of stress in our
lives; and understanding the complete stress cycle especially the
need to wind down after stressful situations before gearing up
again. Managing stress effectively requires careful assessment of
the situation, that is, careful interpretation and evaluation of
the demand or threat and then choosing the most effective coping
strategy.

Stress in itself is not negative or harmful. It can, in fact, be
very positive. Stress becomes a problem when we don't understand
it and don't manage it skillfully. Stress becomes distress or
disease when individuals lose touch with their personal limits of
stress tolerance and are not able to think clearly and stay on top
of it. This often results in breakdowns in physical and
psychological health. Burnout has been described as a sense of
constantly giving or emptying out but being unable to recharge
one's batteries. It is a sense of wearing out, failing, becoming
exhausted by making excessive demands on energy, strength, or
resources.


ASSUMPTIONS

þ Stress management skills are essential for the
long-term work of leaders.

þ Balance is a key concept in self-care.

þ Personal power is realizing we are the source of
our own power and energizing and taking care of
ourselves.


OBJECTIVES

Participants will:

þ Learn what stress is, where it comes from, their
responses to stress, and symptoms of over stress.

þ Learn and practice specific stress management
skills.


BASIC TENETS OF STRESS AND BURNOUT

þ Stress is the response of the body to any demand made on
it. All of the external demands, pressures, threats,
changes, conflicts, challenges, and difficulties we face
can trigger our body's stress response.

þ Stress is a fact of everyday life. It cannot be avoided.
Since it results from any change we must adjust to, it
comes from both positive and negative stimuli.

þ We experience stress from three major sources:

Our environment--we must cope with weather, noise,
crowding, interpersonal demands, time pressures,
performance standards, and various threats to our
security and self-esteem.

Our body--the rapid growth of adolescence, aging,
illness, accidents, change in diet, sleep, and exercise
habits all represent changes our bodies must respond to.

Our thoughts and expectations--how we interpret and label
our experience, what we predict for the future can serve
either to relax or stress us. Interpreting a sour look
from someone to mean that they are unhappy with something
we did is likely to be very anxiety provoking.
Interpreting the same look as tiredness or preoccupation
with a personal problem will not be as frightening or
stressful to us. Dwelling on worries produces tension in
your body, which in turn creates the subjective feeling
of uneasiness and leads to more anxious thoughts.

þ The majority of our stress usually comes from this third
category--our thoughts and expectations. We manufacture
stress for ourselves when we worry, anticipate the worst,
or create unrealistic demands on ourselves. When we
imagine a stressful situation, our body acts as if the
event is really happening and the stress response is
triggered. Thus we can reduce stress simply by reducing
our negative thoughts and expectations.

þ Several factors are important in determining how much
stress we experience. Our childhood learning creates
patterns and expectations that we carry into adult life.
Feelings about ourselves, our abilities, our expectations
of ourselves and other people can all stem from childhood
conditioning. Each of us learns a style of responding to
challenges and thinking about the world that greatly
affects how safe or threatening the world appears to us.
A person who feels safe and confident will experience
less stress than one who is fearful and full of
self-doubt.


> Our stress response

Whenever we perceive something as even mildly stressful, our entire
body swings into immediate action--the muscles tighten, the brain
sends signals to release adrenaline into the bloodstream, blood
vessels constrict, the stomach tightens and secretes acid,
breathing becomes quick and shallow, and we experience intense
emotions such as rage, fear, anger or anxiety. This integrated
response to threat, which evolved eons ago to allow us to mobilize
the tremendous energy needed for survival in a world of change and
predators, can now be as much of a problem as a protector.

Many situations trigger unnecessary stress. We don't always need
the physical arousal and mobilization of energy of this powerful
reaction. Thus, for many situations we need to learn to train
ourselves either to avoid activating the stress response in the
first place, or else, once activated, to learn to turn it off.
Otherwise, we will literally burn ourselves out. The feelings of
exhaustion, depletion, muscle tension, and depression are often
signs that we have repeatedly aroused ourselves via the stress
response with no release.


> Turning stress off

There are relatively few methods to turn off the stress response.
Physically, we can turn it off by taking direct action against the
situation or threat, i.e., fight or flight (flee).

In most of our contemporary stress situations we can turn off the
stress response by actively responding to a situation, or by physi-
cally exercising the stress out of our body. Another quiet method
is through quiet forms of relaxation that activate an opposite
response in the body--the relaxation response. Techniques such as
meditation, progressive relaxation, guided imagery, biofeedback,
and self-hypnosis can all activate this opposing psychophysiologi-
cal state.


> Tension: The pathway to illness and distress

Tension is the build up of unresolved stress in the body. We
experience this as muscle tightness, aches and pains, upset
stomachs, anxiety or depression, feelings of depletion or lack of
energy, emotional burnout, withdrawal, or conflict in relationship.

These symptoms come up when we react repeatedly to stress and when
we do not manage it effectively. Tension is the residue that is
left when:

þ we feel we cannot do something about the stress we are
under
þ we fail to do something about it
þ we deny its existence and mask the signs of stress

Over time, tension signals that our body has worn down and illness
in the form of physical or emotional breakdown is the final result.

In summary, the stress cycle is:

1. The stressors: something happens.
2. We evaluate the threat or demand: we perceive and
interpret the situation.
3. The stress response: our body swings into action.
4. We turn it off: we cope with the stress, deal with it and
then wind down.

Tension or chronic stress is what happens when we stay geared up.


> The effects of stress

When we are under too much stress or we do not manage the stress we
are under effectively, a wide variety of symptoms are experienced:

Physical effects--increased heart rate and blood pressure; shallow
difficult breathing; numbness, tingling, and coldness in the ex-
tremities; queasy stomach; tight muscles; back and head pain; dry
mouth and sweating. Over time these physical responses cause
breakdown of vital organs and serious and chronic disease.

Emotional effects--anxiety, anger, boredom, depression, fatigue,
frustration, irritability, moodiness, tension, nervousness,
self-hate, worry.

Mental effects--difficulty concentrating, poor task performance,
defensiveness, focus on details, sleepiness, mental blocks.

Behavioral effects--impulsive or aggressive outbursts; accident
proneness; restlessness; blaming others; withdrawal and isolation;
problems with drug and alcohol use; smoking; overeating; loss of
appetite.

Organization effects--job burnout; low morale; absenteeism; poor
performance; high turnover; job dissatisfaction; lawsuits and grie-
vances; high use of health facilities; accidents; poor working
relationships.

Excessive stress has negative effects on all dimensions of our
lives, creating physical, emotional, interpersonal, and
organizational distress and damage.


> Coping: Self management of stress

Each of us has ways of coping with stress, some of which are func-
tional and some are not. In successfully coping with stress, it is
first important to be aware of stress being present and to
understand where it comes from. Next, it is important to determine
what we can control, what we are responsible for. Then it is
appropriate to select a coping strategy that best suits the
situation.

The three major categories of coping strategies are:

* Diversion activities such as engaging in a hobby, taking a nap
watching T.V., exercising, listening to music, going out to a play,
etc. It is important to realize that these activities don't
address the stress directly but divert your attention for awhile.

* Relaxation techniques such as yoga, exercise, progressive
relaxation, biofeedback, and creative visualization. These
techniques address the physical stress symptoms regardless of the
cause.

* Behavior changes such as improving skills in communicating,
negotiating, expressing feelings, developing assertiveness skills
(including saying "no" when that is what we need to do); managing
time and money more effectively; reducing environmental pressures.


> What is burnout?

The term "burnout" was coined in reference to professionals in
human services--where individuals entered their work with a high
degree of idealism and high expectations of helping people and
doing meaningful work. Yet they encountered demands from clients
that they could not meet, were frustrated by the bureaucracy, and
sensed that their skill and dedication were not appreciated. As a
result, they withdrew emotionally from colleagues and clients,
became apathetic, thought of their work only as a means of making
money, and lost interest, energy, and dedication. They became
burned out.

Burnout has been described as a sense of constantly giving but
being unable to recharge one's batteries. It is a sense of wearing
out, failing, becoming exhausted by making excessive demands on
energy, strength, or resources.

It often starts with being impatient and distancing co-workers and
clients, and spirals to being and feeling overwhelmed and
exhausted, which continues to spiral to more and more rigid
thinking, growing fatigue, less understanding...which continues to
spiral to deterioration of attitudes (home, job, self),
incongruency between self and actions, absenteeism, illness, lack
of self-esteem. Burnout often ends in quitting a job or collapse.


> Resources

The Relaxation and Stress Reduction Workbook by Davis, McKay and
Eshelman, New Harbinger Publications, l980.

From Burnout to Balance by Jaffe and Scott, McGraw-Hill
Publications, 1984.


MANAGING STRESS AND PREVENTING BURNOUT

1. Accept responsibility for the self-creating stress in your life.
(Remember that most of our stress comes from our thoughts and
expectations--how we interpret and label our experience, what we
anticipate and predict for our future, what we worry about, what we
expect from ourselves and others, etc.) Learn new ways of
responding to demands. Use the coping strategies mentioned above:
diversion activities; relaxation techniques; behavior changes.

2. Take good care of yourself:

þ Physically--diet, sleep, exercise, relaxation

þ Mentally--stimulating and challenging your
intellect

þ Emotionally--being aware of and dealing with your
feelings, needs, wants; treating yourself with
love, compassion, forgiveness

þ Spiritually--relating to meaning and life purpose
issues: how what you're doing fits into a larger
context and you with a higher power; doing "that
which refreshes the soul"

þ Intrapersonally - letting go of negative self-talk,
limiting beliefs and negative mental patterns;
using affirmations and creative visualization

3. Look at issues of balancing energy and time commitments: work,
relating to self, relating to family and friends, and play. The
essential concept of self-care is balance; our various needs must
be balanced and our own needs must balance with those of others.

4. Integrate fun, play, laughter, and lightness into your daily
life.

"We are exploring in much greater depth the role of play
and laughter in burnout prevention and intervention. Our
hypothesis is that an hour's laughter is worth a day's
intellectualizing about burnout and how it can be
prevented. We think that the task at hand in wellness
education is re-humanizing ourselves. In pursuit of
greater technological and scientific accomplishments we
have lost touch with that part of us that wants and needs
to laugh and cry, to relate openly, warmly, meaningfully
with others, to play with abandon, to truly enjoy our
work and daily activities, and to dance and sing in
celebration of life. Our losses in such areas are, we
think, the causes of burn-out. It's as if we have become
only half human and the other half is crying out within
our stresses and illnesses."

John Travis, M.D., "The Healing Power of Play"


5. Be aware of rescuing tendencies.

þ Many people believe that helping others is of
paramount importance. This belief can generate
many problems on the part of the helper if you
neglect your own needs.

þ Rescuers burn-out easily because they often become
"victims" and "persecuted" by those they were
trying to rescue. ("But I was only trying to
help.")

6. Develop your support systems. Think about your personal
networks and the support people in your life. Are there some areas
where you would like to increase your resources? Is your support
system up to date? Is it meeting your needs?

Here are some ideas for generating support:

þ Ask for help directly and be receptive when it is
offered.

þ Rid yourself of relationships that are not
supportive or are damaging to you.

þ Think about the people in your life with whom you'd
like to improve your relationship and take one step
toward this improvement.

þ Put energy into maintaining high-quality
relationships on and off your job.

þ Review your present network and make an honest
assessment of how well it is working for you;
identify areas where you could use some changes.

þ Keep your energy exchange balanced, return favors
and thoughtfulness.


7. Renew yourself; reconnect with yourself. Burnout often stems
from a lack of awareness, consideration, and respect for our
feelings, needs, values, and life goals.

Here are some suggestions:

þ Take time alone for reflection and time out.
Become aware of your personal needs, taking care of
your self-esteem, looking at where you are going
and what you want out of life.

þ Stay in touch with your vision, ideals, dreams and
put your daily activities into this larger context.

þ Awaken and develop your intuition as a personal
resource. This increases creativity in
problem-solving and complements rational thinking.

"The more faithfully you listen to the voice within you,
the better you will hear what is sounding outside."




75 WAYS TO MANAGE YOUR STRESS


1. Work toward congruence. When what you think, feel, and do are
in harmony you are congruent.

2. Gain internal control. Believe that the outcome of your
behavior is within your control. (Internal locus of control).

3. Set priorities, and keep these decisions consistent with your
values.

4. Develop interpersonal support systems--dependable friends.

5. Minimize the amount of stress-producing change at one time
period. (See Life Change Events Scale.)

6. Check out your role expectations for outdated, unrealistic, or
impossible beliefs.

7. Focus on positives. Learn from negative events but don't dwell
on them.

8. Separate the past from the present. Remember you cannot change
the past. We operate in the present.

9. Balance your lifestyle--work, learning, and leisure all deserve
a place in your daily living.

10. Practice altruistic egotism. "Earn your neighbor's love," said
Hans Selye, pioneer in stress research.

11. Have a goal that you can be proud to work toward; maintain
self-respect in things you do.

12. Plan and carry out 5- to 10-minute breaks in your workday.

13. Do something that feels good every day.

14. Prisoners of war during World War II used four techniques to
survive the stress of imprisonment:

Interpersonal support systems (see #4)
Focus on the positives (see #7)
The will to live
Withdrawal


15. Say no. When you say no, you open up opportunities for other
people who may really want to have the chance.

16. Always have a plan B; plan A, your first choice, will not
always work.

17. Admit your mistakes. Apologize and get it over; don't waste
time and energy in cover-ups.

18. Exercise regularly. You will feel better when tense muscles
have loosened.

19. Assess your relationships. Work on improving them or give up
the ones that do you more harm than good.

20. Create a quiet place where you can gain a sense of peace--a
retreat--then use it.

21. Learn to pace yourself. Don't overschedule every minute.

22. Take one step at a time. When faced with an overwhelming task,
before you panic, think about eating an elephant--one bite at a
time.

23. Play, but don't compete. Enjoy the interaction but don't make
winning a consuming and stress-producing obsession.

24. Develop a sense of humor. A touch of humor will take the edge
off in a tense situation.

25. Get satisfactions from all of life. Remember, work, home,
family, hobbies, and volunteer work can be sources of satisfaction.
Do not try to get satisfaction from just one, or you will create
pressure.

26. Talk it out. Good communication skills will help you express
the tension and pressure you feel.

27. Play regularly. Put some fun in your life every day. All work
and no play makes...remember?

28. Express anger safely--talk to an empty chair, pound things that
can't be hurt or hurt you, scream in the shower, run.

29. Give in occasionally--it takes the pressure off.

30. Go easy with your criticism, and make it constructive when you
have to comment.

31. When things are bad, get a balanced perspective by eliminating
unrealistic fears. Ask yourself, "What's the worse possible thing
that could happen?"

32. If you are tempted to take on other people's stresses, ask
yourself, "Is that my problem?"

33. Be efficient in your decisionmaking. Don't postpone decisions
after you've considered alternatives adequately. Don't
procrastinate.

34. Try new things--new games, new food, new friends.

35. Build friendships outside your work. Carrying work-related
problems on into evenings and weekends with co-workers can increase
your stress.

36. Learn to be calmly assertive, balancing your needs with the
needs of others.

37. Use worry control techniques. Do what you can, forget the
rest. Bypass what you cannot change, and put effort where it
counts.

38. Remember, perfection is impossible. When time limits the
quality of your activity some things may be worth doing poorly.
Sometimes it's OK to be sloppy. Use good judgment on this one!

39. Use your money instead of your time. When your time is spent
in income-producing work, you may feel better paying for services
you formerly did for yourself, i.e., laundry, cleaning, mending,
mowing, car repairs, etc.

40. Analyze your uplifts. What are some of the things you do that
give you a lift? Use them when you need them.

41. Remember that not everyone has to like you. Pleasing everyone
is exhausting and highly stressful.

42. Work off your tension. The old standbys are kneading bread,
cutting wood, and scrubbing floors.

43. Avoid self-medication. It can prolong and intensify serious
health problems.

44. Do something for someone else. Their appreciation will make
you feel good.

45. Work at a job that:

þ you are capable of performing
þ you enjoy
þ other people appreciate

46. Learn how to deep breathe properly. Never deep breathe
rapidly--there is some risk of hyperventilation.

47. Develop a decompression routine you can use when traveling
between work and home. Deep breathing exercises (see #46) are good
in this case.

48. Loaf a little. Set your overscheduled lifestyle aside
occasionally.

49. Put some things off until tomorrow, especially the ones you
won't worry over. Some things are best done later.

50. Get enough sleep and rest. Find a sleep/rest pattern that fits
your individual needs.

51. Listen to your body; know and react to health warning signals.

52. Have regular physical and dental checkups. Health maintenance
will ease your worries about dreaded diseases.

53. Wear a seat belt. A seat belt will help you relax mentally and
physically.

54. Pamper yourself now and then. Take a bubble bath or sit in a
whirlpool.

55. Stroll. We need to recover the art of strolling. A brisk walk
is stimulating, but sometimes we need to take a relaxing stroll.

56. Listen to relaxing music. A melodic steady beat that moves
slowly and smoothly will be soothing for most adults.

57. Putter. "To busy oneself or proceed in a trifling,
ineffective, or aimless way; dawdle" said Webster. Putter in the
shop, the garden, the yard.

58. Enjoy a hobby. Choose carefully, however. Don't set
completion deadlines. Don't set perfection standards. Take a
leisurely approach.

59. Sing for fun. Sing with others if you're good, sing alone if
you're not.

60. Play an instrument for fun. Play alone or with others.

61. Bake something. If you've never tried this before, you're
missing something. Try a simple recipe that will smell good. Even
the aroma can be relaxing.

62. Interact with children. Talk with them. Play with them. Read
together. Bring some childlike responses into your own lifestyle.
It's refreshing.

63. Dance. Waltz, if that holds good memories. Newer dances will
shake the tension out of your limbs.

64. Enjoy a sunset, or the stars on a clear night. There is
something quite soothing and reassuring about the regularity of the
natural environment.

65. Put up a hammock and use it for restful interludes.

66. Smile at someone. Smiles feel better than frowns.

67. Pray. For believers, the sense of peace and reassurance that
comes from prayer, is powerful.

68. Get a pet. Some studies show that interaction with easy-care,
non-judgmental pets, can actually lower your blood pressure.

69. Learn a muscle relaxation routine, and practice it regularly.

70. Use visual imagery to mentally project yourself to a relaxing
environment.

71. Write in a private journal. Expressing your feelings in this
way is harmless and can be therapeutic.

72. Have a trusted person give you a body message. Massaging tense
muscles feels good and is relaxing.

73. Eat and drink sensibly. Some foods and beverages heighten
anxiety and speed up some body functions.

74. Set realistic deadlines. The American Management Association
indicates that unrealistic deadlines are a source of stress in
business and industry.

75. Get professional help. When you don't think you can make it on
your own, call a counselor, minister, or doctor.


STRESS AND THE AGENT OF CHANGE*


Change creates stress. This fact, often overlooked, is of critical
importance to the change agent. As we know, too, such stress can
produce harmful or painful symptoms. And, all of us have personal
limits of stress toleration which, when exceeded, can cause major
breakdowns in physical and psychological health. This is what we
mean by distress, or more pointedly, by disease.

Most of the changes we experience have been, and continue to be,
brought about by external pressure. People are unintentionally
pressed beyond their personal limits of toleration because we have
not acquired the knowledge of others' capacities for sustaining
stress.

When requirements for performance of a task in a timely manner are
at stake, those requirements and the economic justifications behind
them frequently take precedence over a concern about others'
stress. Because most organizations often lack awareness of
personal stress limits, many individuals, trying hard to excel in
organizations, find themselves experiencing chronic symptoms of
distress. This fact is of major significance because it is clear
that too much stress is not only physically and psychologically
harmful, it is also counter-productive and uneconomical. Still,
stress-producing situations continue to be fostered. Many
organizational leaders unwittingly subscribe to "carrot and stick"
philosophies of motivation without properly understanding the full
ramifications of their actions. The skillful change agent or
manager operates from a different set of assumptions.

> Internal and external change

Most change agents view themselves as individuals who intentionally
stimulate needed changes. Instead of using externally imposed
strategies of the reward/punishment variety, they work to begin
internal changes in others. This involves processes and procedures
that enable individuals to exercise a healthy degree of autonomy
and self-control over the proposed changes. Change strategies must
enable others to participate in and influence the change, allowing
all to identify and stay within personal limits of stress
toleration.

Because change agents induce change intentionally, they must be
aware of the varying stress limitations in others. Experienced
change agents know how to look for stress symptoms in both verbal
and non-verbal behavior. Some of these symptoms, such as strained,
rigid, or impassive facial expressions, frequent squirming or
position changing, withdrawal or non-participation, attacking or
defending behaviors, or excessive rationalizing are typical
examples of increasing feelings of stress.

When stress symptoms become pronounced or reach significant levels
of discomfort, try introducing stress-reducing activities. One
useful concept is to regard emotion and thinking as equivalent to
the hot and cold water taps in your bathtub. If someone is
behaving in an overly emotional way because of stress, the change
agent turns on more cold water (by making thinking or idea-oriented
responses or comments) and turns off the hot water tap by avoiding
emotional responses altogether. If on the other hand, an
individual is engaging in continuous defensive rationalizations,
the change agent can "interrupt" the non-productive behavior by
using feeling-oriented responses, such as "I really am beginning to
feel angry and frustrated by your repetitive statements" or "I
would feel a lot better about you and enjoy you more if you could
tell me what you're feeling now (hot tap on) rather than continuing
those repetitive thoughts (cold tap off)."

The key ingredient for stress reduction, however, lies in the
internalized stress tolerating capacity of the change agent. This
fact, also, has significant educational implications. Virtually
all internal change efforts involve learning, while externally
imposed change calls for adaptation to new roles or regulations.

> Change, stress, and learning

An effective change agent is first and foremost an informal
educator. This is not "educator" in the traditional sense of the
word. Change agent/educators are rather facilitators of learning;
and learning itself involves both change and stress.

Efforts to focus learning objectives on the internal choices of
others frequently require great patience from the change agent.
Outcomes are not fixed or certain, but must be reached through the
processes of interaction and choice. There are many possibilities
for taking unproductive detours or wrong turns.

The change agent/educator can skillfully guide others toward
constructive activity without imposing or "telling them what to
do." Since a supportive environment is necessary for internalized
learning to occur, individuals are encouraged and helped to
discover for themselves appropriate solutions for dealing with the
real or perceived problems in the situation.

A capacity to tolerate the ambiguity of an uncertain and stressful
situation is a competency of the effective change agent.
Toleration of his or her own internalized stress is essential for
a learning environment to be established. By demonstrating the
capacity to internalize and deal with stressful situations with
some comfort, the change agent helps others learn to become more
comfortable with their uncertainty and explore alternatives for
change.

Change agents who learn to be aware of self and others are able to
respond both appropriately and empathically to the thoughts and
feelings of others. Change agents must also have a vision of the
way to proceed to discover answers with others in lieu of having
answers in advance. When a change agent is fully alive and
responsive in this way, the energies and creativity of others is
enhanced. Change becomes a life-sustaining force rather than a
life-threatening phenomena.