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How to manage your own stress

Barbara Lynch, Psychotherapist, Dublin, Ireland

Way Ahead 2012;16(3):6-7

"We are related to one another.

By taking care of you, I take care of myself,

By taking care of myself, I take care of you,

Happiness and safety are not individual matters."

~ Thich Nhat Hanh

Health and social care professionals would benefit personally and professionally from developing strategies to manage stress and personal well-being and, in so doing, provide good quality care for the people they serve.

Working as health or social care professionals can impact individuals physically, psychologically, cognitively or spiritually. With the demands of delivering the best quality care to people with MS, they can easily lose sight of the need to be self-aware as they operate on 'automatic pilot' to meet the ever increasing demands of caring for people with MS and their extended families. Developing a better understanding of the impact that work can have on well-being can help professionals to ensure personal healthy, self-care practices. They can also find it beneficial to be open minded to new developments in self-help practices to support their general well-being.

To help health professionals to identify personal and workplace stressors and develop personal coping strategies, a stress management workshop was set up. This workshop "How to manage your own stress" was delivered at the MS Trust annual conference in November 2011; and in a shorter workshop at the MS Specialist Nurse meeting in March 2012. It highlighted the importance of looking after oneself when providing care. The participants were given the opportunity to share common experiences and explore reactions to stressful situations. Using a series of practical and contemplative exercises delegates were invited to explore ways to help support themselves back in the workplace.

Benefits of a stress management workshop

  • Increase self-awareness
  • Help to identify stressful situations and how one reacts
  • Share common experiences
  • Develop ideas for coping strategies
  • Help with health professional-patient relationships
    • .

Style of the workshop

Understanding personal reactivity, and learning and sharing experiences from colleagues and peers, can assist in identifying stressors and promote a healthy response, in place of a reactive response, to certain situations.

Mindfulness exercises

The practice of mindfulness is emerging as a widely recognised strategy that supports well-being in our busy daily lives. Mindfulness practices come from the Buddhist meditative tradition, whereby an individual focuses non-judgmentally on the present moment, developing concentration and calm. It involves learning to bring our full attention to our experience moment by moment so that we can be aware of what is really happening in our bodies, our minds and emotions and our environment.

Mindfulness is a skill that can be developed with a little practice, and can then become incorporated into daily life to reduce stress and anxiety and support general well-being.

Mindfulness-based cognitive therapy (MBCT) was used in this workshop to explore how thoughts, feelings, sensations and behaviours are linked and can become like a 'knot'1. This can also help identify common stress responses, including:

  • emotional feelings - fear, anger, doubt and frustration
  • physical sensations - increased heart rate, headaches and disturbed sleep pattern
  • behavioural examples - eating disorders, nail biting orexpressing frustration through swearing, smoking or using alcohol
    • .

The workshop included a mindfulness 'sea of reactions' exercise to discover common reactions, feelings or experiences, helping participants to feel less isolated. The exercise helps to allow thoughts, feelings, and sensations come and go, rise and fall, without attempting to exert control. As this exercise can evoke strong thoughts and intense emotions, this was followed by a three step breathing exercise in the form of a short, standing meditation1. Health professionals can also apply this skill at any time to help with actively managing individual stressful thoughts and feelings in the moment.

To further develop the value of focused attention, the workshop explored the idea of integrating informal methods of mindfulness such as the feeling of water on the skin whilst showering practices2 were also discussed; these include reconnection with the body, controlling thoughts and feelings by applying focused attention and increasing awareness of reactivity in order to move into a receptive, non-judgemental way of being.

Some of the benefits of mindfulness practices2 include:

  • increased immunity and brain activity
  • enhanced emotional intelligence
  • helping to increase empathy and prevent burnout
  • reduced medical errors
  • developing physician/patient communication
  • improving clinician well-being and coping skills.

Improving health professional-patient relationships

Changing direction, the workshop also explored the importance of communication in workplace relationships by discussing the concept of transactional analysis and parent, adult and child ego states3 (Figure 1). This is relevant as, when people are vulnerable, it can be challenging to maintain the adult ego position. This concept helped the health professionals to identify ways to support themselves to maintain an adult ego position when dealing with colleagues, peers and line managers, but also when communicating with patients and families.

Figure 1. Parent, adult and child ego states3

Circles and arrows displaying the parent, adult, and child ego states.

People with MS and their families often experience vulnerability as they meet the demands of handling diagnoses, relapses and managing the unknown. The onus, therefore, is on the health professional to be aware of this and transact from the adult ego position. The hallmarks of this state are to operate from a here and now awareness, engage in logical thinking, demonstrate an ability to negotiate and incorporate problem solving thoughts, feelings and behaviours that are appropriate to the current reality4.

Emotional intelligence and neuroscience

The theory of emotional intelligence and new developments in the area of cognitive neuroscience are growing areas of interest in the field of stress management.

The participants discussed the topic of emotional intelligence and recognised the benefits of being able to perceive, control and evaluate emotions. This included self-awareness, self-management, social awareness and relationship management5.

Information on the advances in neuroscience and neuroplasticity were included in the workshop. Theories were discussed on how the brain is a dynamic organ that can adapt and change throughout life6 and how individuals can interrupt negative emotions by strengthening more positive neural pathways.

The concept of the "Healthy Mind Platter"7 was also examined. This is a method that helps to integrate seven daily essential mental activities into our lifestyle in order to optimise brain matter and create well-being; these include focus time, play time, connecting time, physical time, time in, down time and sleep time. There are no specific amounts of time recommended for this method as everyone is unique and personal circumstances may change. However, it is believed that by regularly participating in each activity, professionals may improve brain function, but also help with connecting with other people, either in the family or community7.

Bringing the workshop to a close

Participants took part in a ten minute sitting meditation in the final stages of the workshop. The meditation dialogue focused on the intention to pay attention, named the fundamental tenet of "not wanting things to be different than they are" and incorporated the foundations of mindfulness by developing calm and concentration2.

Feedback from the workshop

The health professionals who attended the workshop at the MS Trust conference found the workshop incredibly valuable and felt it would help to change their reaction to stress in the future.

"Could have spent a whole day with Barbara, absolutely brilliant."

"Very enthusiastic and realistic in her approach – would like more!"

"Interactive, made to feel comfortable, allowed you to be human!"

"Excellent and helpful session, could have perhaps benefited from more time on coping strategies and practical management."

References

  1. Williams M, Teasdale J, Segal Z, et al. The mindful way through depression: freeing yourself from chronic unhappiness. New York: The Guilford Press; 2007.
  2. Kabat-Zin J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Bantam Dell; 1990.
  3. de Board R. Counselling for toads: a psychological adventure. London: Routledge; 1998.
  4. Garner J. Where's that flip chart? Summer edition. Counselling at work; 2007. www.counsellingatwork.org.uk (Accessed January 2012).
  5. Goleman D. Emotional intelligence and working with emotional intelligence. London: Bloomsbury Publishing; 2004.
  6. Kornfield J and Siegel D. Mindfulness and the Brain: A professional training in the science and practice of meditative awareness. USA: Sounds True Productions; 2010.
  7. Siegel D and Rock D. The Healthy Mind Platter 2011. http://drdansiegel.com/resources (Accessed October 2011).