Dr. Muhd. Najib Mohd. Alwi najib@kckm.my

1. Stress Management Dr. Muhd. Najib Mohd. Alwi najib@kck.usm.my

2. What is stress? • A certain amount of stress is perfectly normal and in fact – necessary to ensure we are motivated enough and remain focussed to fulfil tasks in hand

3. UNDERSTIMULATION • ZONE • BOREDOM • FATIGUE • FRUSTRATION • DISSATISFACTION • OPTIMUM STIMULATION ZONE • CREATIVITY • RATIONAL PROBLEM SOLVING • PROGRESS • CHANGE • SATISFACTION • OVER- • STIMULATION ZONE • IRRATIONAL PROBLEM SOLVING • EHXAUSTION • ILLNESS • LOW SELF-ESTEEM PERFORMANCE Lifeline Death from Lack of Stress Death from Stress STRESS

4. However, usually STRESS is meant in the negative way : experiencing of unpleasant or uncomfortable feelings

5. Two components of stress: • External component : stressor • Situations, tasks, problems, hassles that causes stress • Internal component : inner reaction • Different people react differently to the same stressor

6. Another form of stress is “self-inflicted” because of demands put on oneself E.g. “I MUST get A in every exam”

7. Management of Stress • Involves: • Working with ourselves (internal component) • Working with events and demands facing us (external component) • In most situations, both components of stress need to be worked at to relieve stress

8. Recognizing Stress • Human mind has the ability to interpret situations and thus provides an infinite variety of reaction to stress • Our responses to stress: • Physical • Psychological • Behavioural

9. Physical Response To Stress • Body response to alarm: • Rapid pulse • Sweating • Palpitation • Tightened stomach • Tense arm, leg muscles • Shortness of breath • Gritted teeth • Clenched jaw • Inability to sit still • Racing thoughts • Compelling emotions Prime us to deal with danger, challenge or other real or imagined demands

10. Inability to concentrate Loss of self-confidence Irritability Insatiable cravings Worry or anxiety Irrational fear or outright panic Difficulty in making simple decisions Psychological Responses Stress

11. Excessive smoking Increased use of medication Nervous tics / mannerism Absent-mindedness Accident-proneness Hair-pulling, nail-biting, foot-tapping etc.  /  eating / sleep Drug misuse Reckless driving Behavioural Responses To Stress

12. Stress Management: Basic Requirements • Awareness • Levels of stress • Presence of stress • Attributes in character that is stress-related • Causes of stress and ways of managing it • Self-acceptance • What you are today is the result of all your life experience • Change is always possible • Important changes don’t happen in an instant • Don’t judge yourself harshly • Accept what you are and who you are • Responsibility • Change begins with you, it’s your own responsibility • You can instigate the necessary changes • Coping skills • Learn adaptive coping skills C A R S

13. Strategies • 4 basic strategies that you can use to manage stress: • Build up general health: proper nutrition, rest, exercise • Change the situation: source of stress • Change your mind: perceptions of and thoughts about the stressors • Learn to substitute: relaxation responses for stress responses

14. Tips on Managing Stress

15. Tips on Managing Stress • Positive Self-Statements • What is it I have to do? • Don’t worry. Worry won’t help anything. • I can meet this challenge. • Relax; I’m in control. Take a slow, deep breath. That’s it…

16. Tips on Managing Stress • Proper breathing: • Practice abdominal breathing (resting 6 - 10/min) and minimize chest breathing (resting 10 – 16/min) • Learn breathing / relaxation exercise, do it regularly

17. Tips on Managing Stress • Decreasing Mental Agitation / Worrying Techniques: • CLEARING • THOUGHT-STOPPING • CREATIVE WORRYING • PROBLEM SOLVING

18. Tips on Managing Stress • CLEARING: • Ensures completion of encountered tasks OR develop a plan for incomplete tasks • STEPS: • Making a list : daily listing of events • Ongoing practice : leave the completed tasks, clear mind daily / weekly • Maintenance of clearing

19. Tips on Managing Stress • THOUGHT-STOPPING: • We are continuously bugged by noise – externally and internally. Some people have too much internal noise (worries, doubts etc.) • Thought-stopping can slow down the internal conversation you carry with yourself. • Cycle: NEGATIVE THOUGHT say, visualise STOP!  inhale, exhale and say CALM  think of a PLEASANT THOUGHT This exercise may have to be repeated several times until the negative thoughts disappeared

20. Tips on Managing Stress • CREATIVE WORRYING: • There are two kinds of worrying: useless worrying and constructive thinking / problem solving (effective worrying)

21. Tips on Managing Stress • CREATIVE WORRYING: • Spend about 30 minutes a day, create a WORRY LIST (5 minutes). • Look at minor worries first, omit those that can be dismissed by direct action. These are concerns not worries. • 10 minutes: spend on useless worrying • 2 minutes of physical relaxation and breathing exercise • 15 minutes: problem solving • Stop on time, continue another day if necessary

22. Basic Problem Solving • Steps: • Relax: single-breath relaxation, say “I am calm” • Define the problem • Generate alternative solutions • Evaluate the alternatives • Implement the solutions

23. Additional Skills • Goal-Setting • Define goals • Visualisation (with relaxation) • Planning life goals • Time Management • Prepare a time budget • Review time log • Review goals and priorities

24. When to Seek Help • When everything else doesn’t work • It’s never too early to ask for help • Look around you, help your friends too

25. Conclusion • Stress management is important in our day to day activity • It is easy to learn BUT perseverance is difficult • Practice makes perfect • Don’t be shy to ask for help

26. Thank You