Stress Management and Prevention Program Resource Guide€¦ · Prevention Stress Management and...

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KAPLAN UNIVERSITY

HW410 Stress: Critical Issues in Management and Prevention

Stress Management and Prevention

Program Resource Guide

K A P L A N U N I V E R S I T Y

Stress Management and Prevention Program Resource

Guide

By

Lola Lurch

Kaplan University

HW410: Stress: Critical Issues in Management and Prevention

October 1, 2013

Table of Contents

U N I T 1 T H E N A T U R E O F S T R E S S

Information to Remember

What is Stress? ....................................................................................... 5

The General Adaptation Syndrome (GAS)..........................................5-6

Types of Stressors………………………………………………………6

Resources: Exercises:

Exercise 1.6 The Wellness Paradigm Revisited………………….……..6

Tools: Journal Writing:

Exercise1.5. Personal Stress Inventory: Top Ten Stressors………....…6

U N I T 2 T H E B O D Y A S B A T T L E F I E L D


How the Immune System Works………………………………………7

Nervous System—Related Disorder. ………………………...………..7

The Stress-Disease Connection .………………..…………….………..7


Exercise3.2 Immediate, Intermediate, and Prolonged Stress Effects7-8


Exercise: 4.1 Physical Symptoms Questionnaire……………………....8

U N I T 3 F E A S T O R F A M I N I N E


The Anatomy of Anger……....................................................................9

The Anatomy of Fear..............................................................................9

Building Blocks of Psychological Stressors….........................................9


Exercise: 6.1 Anger Recognition Checklists………………..…………...9

Tools: Journal Writing

Exercise: 5.1 The Psychology of Your Stress…………………………10

U N I T 4 O N E P L A N E T U N D E R S T R E S S


Personality Traits and Stress………..…………………………….….....11

Self-esteem and Stres...............................................................................11

Human Spirituality……………………………………………….….….11


Exercise: 8.5 Your Personal Value System...........................................11


Exercise: 7.1 Under the Gun: Stress and Personality………………..12

U N I T 5 U N D E R S T R E S S : W H A T N O W ?


Effective Coping Strategies…………………………………………...13

Cognitive Restructuring: Reframing………………………………......13

Time Management for Stress Reduction………………………………13

Resources: Exercises

Exercise: 9.3 Positive Affirmation Statements………………………..13


Exercise: 9.1 Reframing: Seeing a Bigger, Clearer Perspective……….14

U N I T 6 A G E L E S S W I S D O M O F M E D I T A T I O N


What is Meditation? ..............................................................................15

Diaphragmatic Breathing.......................................................................15

Mental Imagery and Visualization………………………………….…15


Exercise: 19.3 Bridging the Hemispheres of Thought……………....15


Exercise: 21.1 I Have a Vision: The Art of Visualization…………..16

U N I T 7 S I G H T , S O U N D , A N D B O D Y W O R K


The Ageless Wisdom of Imagery and Visualization………………….17

Music as a Relaxation Technique……………………………………..17

Diet for a Stressed Planet……………………….…………………….17


Exercise IV. The Art of Calm: Relaxation through the Five Senses…17


Exercise 28.3 The Rainbow Diet……………………………………..18

U N I T 8 T H E W E L L N E S S M A N D A L A


Physical Exercise: Stress Response and Parasympathetic

Rebound Response………………………………………...…………19

Music as a Relaxation Technique……………………………………..19

Steps to Initiate a Fitness Training Program………………………….19


Exercise 28.6 Self-Assessment: Nutritional Eating Habits…………20


Exercise 28.1 Physical Exercise…………………………………….20

U N I T 9 A P P L Y I N G S T R E S S : C R I T I C A L M A N A G E M E N T

A N D P R E V E N T I O N T O Y O U R P R O F E S S I O N A L L I F E


Additional Coping Techniques…………….………………………….21

T’ai Chi Relaxation Technique.…….……………………………….....21

Creating Your Own Stress Management Program…….………………21


Exercise 28.1 Physical Exercise……………………….………………22


Exercise IV. B Relaxation Survival Kit……………………….………22

U N I T 1 0 A P P L Y I N G S T R E S S : C R I T I C A L M A N A G E M E N T

A N D P R E V E N T I O N T O Y O U R P R O F E S S I O N A L L I F E


Historical Perspective of PMR………………………….…………….23

Physiological Benefits of PMR……………………………………….23

Steps to Initiate Progressive Muscular Relaxation……………………23


Progressive Relaxation Audio Companion- CD………………………23


Exercise 28.1 Physical Exercise………………………………………24

A D D I T I O N A L I N F O R M A T I O N

Yoga Therapy………………………………………………………………..25

Anxiety……………………………………………………………………...25

Herbs and Natural Supplements…………………………………………….25

Helpguide for Stress Management………………………………………….25

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Unit 1: The Nature of Stress

Information to Remember:

What is Stress?

There are many definitions for stress:

Tension

Wear and tear on the body (physical stress)

The inability to cope with problems (mental stress)

Loss of emotional control (emotional stress)

Absence of inner peace (spiritual stress)

“Stress is a perceived treat (real or imaged) to your mind, body, spirit, or emotions” (Seaward,

2006).

There are two kinds of stress: Acute (intense and short lived); and Chronic (not so intense, but last

for a prolonged period of time).

The General Adaptation Syndrome (GAS)

There are three general adaption stages:

Alarm Stage: This is the first signal for a call to action. There is a perceived threat and the stress

hormones (cortisol, adrenaline, and noradrenaline) are released for instant energy. If there is

anger (fight) or fear (flight); whichever, choice is made, the body is prepared (Seaward, 2012).

Resistance Stage: This is the second stage that is intended to stabilize the body functions and

return to a normal balance (homeostasis). If the perceived stressful event does not subside, the

body adapts to the condition; and it tries to provide a defense, even if the body has returned to a

balanced state (Seaward, 2012).

Exhaustion Stage: At stage three, the stress has become chronic (lasting for a sustained period of

time) and the adaptation energy is depleted. This is the most dangerous stage, because it puts the

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body at risk for serious damage to the nerve cells, tissues, organs, lowers the immune system, can

lead to anxiety and depression (Seaward, 2012)

Types of Stressors

Bioecological Influences are those external stressors from the environment (e.g. sunlight, air

pollution, and gravitational pull) (Seaward, 2012).

Psychointrapersonal Influences make up the largest percentage of stressors (e.g. thoughts, beliefs, values,

Attitudes and perceptions) (Seaward, 2012).

Social Influences include territorial boundaries, political issues, and socioeconomic status, financial

insecurity

and violation of human rights (Seaward, 2012).


Exercise 1.6 The Wellness Paradigm Revisited

It is important to understand the components of wellness. Health is not just the absence of

disease. “Health is a state of complete physical, mental and social well-being and not merely

the absence of disease or infirmity” (WHO, 2003). Disease is a symptom that an out of

balance condition exists. There is an integrated connectivity between mind body, and spirit

which must be in balance for a healthy state of well-being (Seaward, 2011).


Exercise 1.5.Personal Stress Inventory: Top Ten Stressors

You cannot solve a problem until you identify it; and stress is no exception. Once you identify

your stressors, categorize them as mental, emotional, spiritual, or physical. It is important to

know the duration of a stress episode, and whether it causes anger, fear, or both. Taking an

inventory of your top ten stressors provides a snapshot of your challenges. (Appendix A)

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Unit 2: The Body as Battlefield


How the Immune System Works

The immune system remembers what every cell in the body looks like; and it is designed to defend the

body from the invasion of foreign organisms (e.g. viruses, bacteria, fungi, and parasites). When an invader

attacks the body, the immune system will not only recognize this foreign organism, it will remember

it for future invasions. Introducing a small amount of a bacteria into the body (a vaccination) will allow

the immune system to record the identity of this organism and be prepare for an actual invasion (Seaward,

2007).

Nervous System—Related Disorders

The nervous system is in charge of controls and communication for the body. The nervous

system can be divided into two parts: the central nervous system (CNS), which consists of the

brain and spinal cord, and the peripheral nervous system (PNS), comprising all neural pathways

to the extremities(Seaward, 2007, p.37). Nervous system related disorders include tension,

migraine headache, temporomandibular joint dysfunction, bronchial asthma, irritable bowel

syndrome, and coronary heart disease.

The Stress-Disease Connection

The presence of disease in the body is directly associated with either the immune system or the

nervous system. Glucocorticoids are a family of biochemical agents that includes cortisol and

cortisone, produced and released from the adrenal gland (How Stuff Works, 2008).


Exercise 3.2 Immediate, Intermediate, and Prolonged Stress Effects

This exercise is included because it identifies the effects through which the symptoms of physical

stress can manifest. Understanding the durations of these symptoms can help determine the

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possible risk factors associated with each stage (Seaward, 2011).


Exercise: 4.1 Physical Symptoms Questionnaire

Patterns or relationships between stress levels and physical health can be observed when

completing a physical symptoms questionnaire. The frequency, severity, and duration can

determine the best form of treatment; which could range from simple relaxation techniques

to prescribed medication (Seaward, 2011). (Appendix B)

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Unit 3: Feast or Famine


The Anatomy of Anger

All anger is a result of unmet expectations; and unresolved anger is closely connected to chronic

health conditions. Anger is manifested in many ways, Road rage, sports rage, air rage, phone

rage, and gas pump rage, workplace and domestic violence. Feelings of anger are a

result of frustration, guilt, fear, hostility, jealousy, prejudice, impatience, and envy (Seaward,

2012).

The Anatomy of Fear

The six basic human fears are the fear of failure, the unknown, death, isolation, rejection, and the

loss of self-dominance. The five symptoms of fear include anxiety, worry, doubt, paranoia, and

embarrassment. The strategies for overcoming fear are the four fearless living rules: fine-tune

expectations, stop making excuses, stop complaining, and don’t beat yourself up (Seaward,

2012).

Building Blocks of Psychological Stressors

“The building blocks of psychological stressors are: outlets for frustration, social support,

Predictability, control, and a perception of things getting worse” (Sapolsky, 2004). An outlet

for frustration can mean different things to different people (getting involved in a hobby or

going for a bike ride). Everyone needs a confidant, an ear to bend, and shoulder to lean on. At

least the perception of predictability is comforting during a stressful moment. A feeling of being

in control gives the ego a boost; and perception of things worsening causes one to brace

themselves mentally for the worse scenario.


Exercise: 6.1 Anger Recognition Checklists

It is important to be able to recognize the signs of anger or frustration that may creep up during

your daily routine. Raising your awareness of habits and emotion associated with feelings of

anger can alert you to take action when an episode occurs (Seaward, 2011). (Appendix C)

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Exercise: 5.1 The Psychology of Your Stress

During episodes of stress, it is important to be aware of your perceptions, attitudes, and

behaviors. Do you become defensive (I didn’t do it), use projection (she did it), use repression

(I don’t remember doing it), use displacement (he made me do it), use rationalization (everyone

does it), use humor (I can laugh about it now), or other (everything happens for a reason).

This exercise is a helpful tool to analyze the psychology of your stress profile (Seaward, 2011).

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Unit 4: One Planet Under Stress


Personality Traits and Stress

Personality traits could affect the way we handle stress. “Could your personality kill you—or

might it make you live longer? Could it give you heart disease, or protect you from illness

(USNews Health, 2010? Are you type A (impulsive) or type B (relaxed)?

Self-esteem and Stress

Self-esteem is the perception of your own abilities, worth, and values. If you feel that you are

competent, capable, worthy of respect, and have a defined set of values, your self-esteem will be

high. Feelings of inadequacy, incompetence, and worthlessness lead to low self-esteem. Factors

that help shape our self-esteem begin in early childhood relationships with parents, siblings, and

teachers (Mayo Clinic, 2013).

Human Spirituality

Spirituality and religion are not synonymous. “When people hear the word spirituality, many

think of religion. Although spirituality and religion share common ground, they are not the same

thing. Spirituality is inclusive where religions are exclusive” (Seaward, 2012). Human spirituality

can be described as a personal journey in search of enlightenment and connectedness to others,

the environment and the universe.


Exercise: 8.5 Your Personal Value System

It is important to analyze your personal value system; it is the core pillar of the human spirit

that is constantly undergoing renovation. Your values and beliefs influence the way you

handle stress (Seaward, 2011). (Appendix D)

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http://health.usnews.com/health-conditions/heart-health

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Exercise: 7.1 Under the Gun: Stress and Personality

While we may not be able to change our personality completely, we can change personality

traits that tend to promote stress in our lives (Seaward, 2012). The Hardy personality traits

(commitment, control, and challenge) may help overcome the genetic predisposition to illness;

and maintain a positive attitude under stressful conditions. Commitment involves an

investment of one’s values and life purpose to the growth of one’s human potential and is a

direct reflection of one’s willpower; Self-control, or empowerment, helps one overcome

factors and elements in one’s environment so that one does not feel victimized; and see

challenge as an opportunity for growth, instead of a threat to existence(Seaward, 2011).

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Unit 5: Under Stress: What Now?


Effective Coping Strategies

It is important to have the skill sets to turn a negative situation into a positive experience.

Effective coping during a stressful event begins with one’s attitude; change your attitude, change

the outcome. For a coping technique to be effective it must: help increase awareness of the

situation, augment the information processing of stress, help modify any related stress-prone

behaviors, and work toward a peaceful resolution of the stressor (Seaward, 2012).

Cognitive Restructuring: Reframing

It takes skill and focused thought to rephrase a negative statement into a positive one. Cognitive

restructuring can produce a win/win resolution by reframing a statement. “Reframing is a term

used to describe a positive mind frame of a stressful event. It is not denial; but ego detachment

from the unmet emotional expectation” (Seaward, 2012).

Time Management for Stress Reduction

Developing good time management skills can greatly reduce some of the daily stressors.

“Effective time management can be broken down into three skills: prioritization, scheduling, and

execution. Good time management requires you to balance your life between work and leisure.

Remember that balance is essential for optimal well-being” (Seaward, 2012). An evaluation of

time management skills: (Appendix E)


Exercise: 9.3 Positive Affirmation Statements

Positive affirmations can be used as a mantra in conjunction with relaxation techniques and

visualization. They reinforce positive behaviors and boost self-esteem. These thoughts or

expressions lift the spirits and raise the individual’s level of confidence (Seaward, 2011).

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Exercise: 9.1 Reframing: Seeing a Bigger, Clearer Perspective

Although the initial thought may be one of anger and fear, taking the time to rethink and

And rephrase your thoughts or words can change the outcome. It is important to practice positive

reframing to the threatening perception to a nonthreatening perception (Seaward, 2011).

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Unit 6: Ageless Wisdom of Meditation


What is Meditation?

Meditation is a self-directed modality that can employ different methods to calm the mind and

make the mind-body connection. Meditation produces a deep state of relaxation and tranquility.

You focus your attention on the elimination of mental clutter that crowds the mind and causes

Stress. This process results in enhanced physical and emotional well-being (May Clinic, 2013).

Diaphragmatic Breathing

Diaphragmatic breathing is thought to be an effective relaxation technique because it shifts the

breathing process from thoracic (chest breathing) to deep breathing using the diaphragm (lower

abdomen). Deep breathing is controlled and slower than thoracic (shallow) breathing. When the

emphasis of breathing is centered in the lower abdomen rather than the thoracic cavity, a less

sympathetic neural activity is generated, causing a greater relaxation effect (Seaward, 2012).

Mental Imagery and Visualization

Mental imagery and visualization are sometimes used interchangeably; however, they are not

synonymous. Mental imagery involves unconscious thoughts that become conscious; and these

thoughts can trigger the stress response or induce relaxation. Visualization is a conscious thought

process (an exercise) directed toward self-improvement (Seaward, 2012). (Appendix F)


Exercise: 19.3 Bridging the Hemispheres of Thought

It is beneficial to understand how you process your information. Are you left-brain thinker or

right-brain thinker? Left-brain thinking skills are associated with judgment, analysis,

mathematical and verbal acuity, linear thought progression, and time consciousness; right-

brain functioning is associated with global thinking, holistic thinking, imagination, humor,

emotionality, spatial orientation, receptivity, and intuition (Seaward, 2011).

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Exercise: 21.1 I Have a Vision: The Art of Visualization

Perfect the art of visualization, and you can take a mental trip, induce a state of relaxation, or

promote the natural healing process. Visualization can also be used to heal the body by using

your imagination to create a vision of restored health of a specific organ or region of your

body. In fact, visualization is one of the leading techniques in mind-body medicine (2011).

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Unit 7: Sight, Sound and Body Work


The Ageless Wisdom of Imagery and Visualization

For thousands of years ancient civilizations have practiced mind over matter; from Traditional

Chinese Medicine (TCM), Ayurveda (means knowledge of life), to modern western concepts

(e.g. hypnosis and the power of positive thinking) man has utilized this mental energy to manifest

physical phenomena. According to Seaward, “the mind is a powerful ally in managing and

preventing stress. The use of conscious intention as a key part of creative visualization can

empower the human mind by directing “…images on the screen of the mind’s eye…”

(Seaward, 2007).

Music as a Relaxation Technique

Music can produce many different effects on the human condition; and relaxation is one the

positive effects that music can produce. The distinctive qualities of music (e.g. tone, pitch,

timbre and harmony) have an effect upon the nervous system. “Music appears to affect human

physiology directly, through the cerebral cortex and autonomic nervous system; depending on

interpretation (like or dislike), either the sympathetic or parasympathetic nervous system may be

activated (Seward, 2012).

Diet for a Stressed Planet: Americans are overfed and under nourished; the consumption of

fatty, sugary, salty, and highly processed foods have led to obesity and many other chronic

diseases in people of all age groups. Diet and stress are interrelated; stress leads to poor diet and

poor diet leads to stress. Seaward explains the vicious cycle with the domino effect: stress

depletes the body of needed nutrients; poor eating habits promoted by lifestyle, triggers the

stress response that leads to toxic overload (Seaward, 2012). (Appendix G)

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Exercise IV. A The Art of Calm: Relaxation through the Five Senses

List ideas for relaxation for each of the five senses. A sixth category, the divine sense, was

added for any ideas that might be a combination of these or perhaps something beyond the five

senses (e.g., watching a child being born). Describing each experience allows a person to

Associate the experience with one or more of the five senses in a unique and creative way.

List ten for the sense of sight and ten for the sense of smell (Seaward, 2011).


Exercise 28.3 The Rainbow Diet

In the science of subtle energies, each of the body’s primary chakras is associated with a

specific color; therefore the color of a food has more significance than a nice

presentation, each color holds a specific vibration in the spectrum of light. When this is

combined with the nutrient value of food, it can help to enhance the health of the physical

body. It is thought that eating fruits and vegetables associated with the color of various

chakras provides healthy energy to that specific region (Seaward, 2011). (Appendix H)

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Unit 8: The Wellness Mandala


Physical Exercise: Stress Response and Parasympathetic Rebound Response

Although exercise causes the stress response, while one is in motion, when the physical activity

ceases, the body returns to homeostasis. The stress response increases the heart rate, blood

blood pressure, rate of breathing, metabolic activity, muscle contraction, and perspiration.

The parasympathetic rebound response decreases the resting heart rate, blood pressure, rate of

breathing, and causes a quicker return to homeostasis (Seaward, 2012).

Types of Physical Activity

There are two types of physical exercise: Anaerobic work done in the absence of oxygen; activity

that is powerful and quick but does not last more than a few minutes (e.g., weightlifting); and

Aerobic, rhythmic physical work using a steady supply of oxygen delivered to working muscles

for a continuous period of not less than 20 minutes (e.g., jogging). There are six components of

fitness: cardiovascular endurance, muscular strength and endurance, flexibility, agility, power,

and balance

(Seaward, 2012)

Steps to Initiate a Fitness Training Program

The prerequisite to initiating a fitness training program includes a physical evaluation, a fitness

assessment and an exercise prescription which includes frequency, intensity, type, and time.

(FITT). The seven steps of a fitness training program are:” (1) Start cautiously and progress

moderately with your program, (2) pick an activity you really enjoy, (3) select a time of day to

to exercise, (4) exercise using the right clothing and equipment, (5) initiate a support group, (6)

set personal fitness goals, and (7) take precautions to prevent injuries (Seaward, 2012).

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Exercise 28.6 Self-Assessment: Nutritional Eating Habits

Get a clear picture of your eating habits and how they affect your stress levels by keeping score.

List the foods that you ingest that contain caffeine (e.g., coffee, tea, and sodas, chocolate) and the

estimated amounts you consume per day. Describe any other eating habits that you associate with a

stressed lifestyle (Seaward, 2011).


Exercise 28.1 Physical Exercise

Completing this exercise will give you an opportunity to identify your exercise habits; write a

personal exercise prescription, and prepare a weekly exercise schedule. List your favorite

physical activities, your priorities, and the things that motivate you to stay active (Seaward,

2011). (Appendix I)

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Unit 9: Applying Stress: Critical Management to

your Professional Life


Additional Coping Techniques

Additional coping techniques include: information seeking (searching for details concerning a

Situation that is perceived as a threat); taking up a hobby (a pleasurable interest outside the daily

work routine); forgiveness (coping with unresolved anger, where ones feels violated or

mistreated); social orchestration (eliminating environmental stressors or changing one’s

environment); and exercising the power of prayer, showing gratitude, forgiveness, or

intercessory prayer (Seaward, 2012).

T’ai Chi Relaxation Technique

While Western (conventional) health is viewed as the absence of disease, produced by bacteria

and viruses; the Chinese concept of health is based on an unrestricted flow of subtle energy

throughout the body. This subtle energy (Chi) flows through a network of meridians. When these

energy gates are congested, the body is susceptible to physiological dysfunction (Seaward, 2012).

T’ai chi is a meditation of self-defense that produces balance and harmony. It’s is symbolized by

the circular mandala Yin and Yang (equal opposite forces.) (Seaward, 2012).

Creating Your Own Stress Management Program

Creating a stress management program is a personal initiative; there is not set formula or one size

fit all solution. The only secret to a successful stress management program is one’s inner

resources; that personal enter connection and enlightenment. There are some suggestion from

which one can structure their personalized program: (1) make a habit of spending some quality

time each day to get to know yourself, (2) make a habit of reading your emotional barometer,

(3) practice the art of unconditional love, (4) nurture your creativity skills, (5) balance all

components of your well-being and take time to nurture them, and (6) be like a child (Seaward,

2012).

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Exercise 24.1 The Yin and Yang of Life

Here is an opportunity to try the balancing act. T’ai Chi is based on the Taoist concept of seeking

balance and going with the flow. The yin/yang symbol represents two opposite aspects coming

together not in opposition but in union, creating the totality of the whole. The yin/yang symbol

represents the balance of life (Seaward, 2011).


Exercise IV. B Relaxation Survival Kit

Create a relaxation survival kit with select comfort items to treat a stress attack. Keep it well

stocked with things that nurture or sustain your personal sense of homeostasis—in this case,

homeostasis that comes from pleasing one or all of the five senses. Just like a first-aid kit, be

sure to replace any items that have been used—such as chocolate (taste)—so you are always

prepared.

(Seaward, 2011).

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Unit 10: Applying Stress: Critical Management

to your Personal Life


Historical Perspective of PMR

Dr. Edmund Jacobson observed the connection between muscle tension and disease in his

in his patients in the early part of the twentieth century. He concluded that if muscle tension

was reduced or eliminated, these somatic diseases may decrease or completely disappear.

He created a simple relaxation technique called progressive muscular relaxation (PMR).

(Seaward, 2012).

Physiological Benefits of PMR

The practice of progressive muscular relaxation reduces muscular tension and raises the

awareness of its existence. This technique has proven effective in managing anger, tension

headaches and dealing with the smoking cessation (Seaward, 2012).

Steps to Initiate Progressive Muscular Relaxation

This relaxation technique can be performed lying down or sitting. It is advised that beginners

lie on a carpeted floor, wearing comfortable clothing. The objective is to contract

a muscle group hold the tension for 5-10 seconds and then completely relax the entire body.

Breathe in on the contraction and exhale on the release. Concentrate on the muscle tension in

your body (Seaward, 2012).


Progressive Relaxation Audio Companion- CD

This exercise is a guided visualization of progressive muscular relaxation, set to peaceful classical

music (Jones and Bartlett, 2013).

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Exercise 25.1 Progressive Muscular Relaxation

This is an important exercise because muscle tension is the number one symptom of stress.

Muscle tension can affect the muscles of your jaw (known as temporomandibular joint

dysfunction, or TMJD), the muscles of your shoulders, and perhaps most commonly the

muscles of your lower back. Typically, it is the muscles on the back of the body that are most

affected by neural tension and stress (Seaward, 2011).

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Additional Information

Anxiety: Everyone experiences some degree of anxiety on a daily basis. It can actually be an

alert to danger or protection from being overly confident. However, a persistent state of

anxiety that interferes with routine daily functions (e.g. work, school, sleep) may indicate a

serious disorder. “Generalized anxiety disorder (GAD) is characterized by consistent

worrying about major or minor concerns” (Mayo Clinic, 2011), secondary source.

Mosby’s Handbook of Herbs and Natural Supplements, by Linda Skidmore-Roth, is a

secondary source of herbs and natural supplements listed in an A-Z format. This book has

been reviewed by nurses and herbalist alike. It is an excellent resource and reference book

(Skidmore-Roth, 2010).

Yoga Therapy: The modern Yoga techniques that focus on meditation and relaxation have

been effectively incorporated in our Western medical practices. The mind, body, and spirit

concept is reversed in Yogic philosophy because the objective is to disconnect from the

physical world (people and things) and connect with the inter self and ultimately the highest

Deity (McCall, 2012) secondary source.

Helpguide.org is a valuable resource for reducing, preventing and managing stress. This

website offer tools and step by step strategies for effective stress management (Helpguide,

2013).

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References

Essence of Stress Relief (n. d.). Hans Selye’s general adaptation syndrome. Retrieved

from http://www.essenceofstressrelief.com/general-adaptation-syndrome.html

Google Images (2013). Neuro-behavioral.ning.com. Retrieved from http://www.google.com/imghp

Helpguide.org (2013). Stress management: How to identify, prevent and cope with stress. Retrieved

from http://www.helpguide.org/mental/stress_management_relief_coping.htm

How Stuff Works (2008). Immune system. Retrieved from

http://health.howstuffworks.com/immune-system1.htm

Mayo Clinic (2011). Adult health: Self-esteem check: Too low, too high or just right?

Retrieved from http://www.mayoclinic.com/health/self-esteem/MH00128

Mayo Clinic (2011). Generalized anxiety disorder. Retrieved form

http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS0050

Mayo Clinic (2013). Meditation: A simple, fast way to reduce stress. Retrieved from

http://www.mayoclinic.com/health/meditation/HQ01070

McCall, T., M.D. (2012). Yoga therapy and the mind-body connection, part 1. Retrieved from

from http://www.yogajournal.com/for_teachers/2621

Sapolsky, R. M. (2004). Why Zebras don't Get Ulcers (3rd ed.). New York, NY: St. Martin's Press.

Seaward, B.L. (2006). Essentials of managing stress: Definition of stress. Jones and Bartlett

Publishers

Seaward, B.L. (2007). The ageless wisdom of imagery and visualization: Essentials of managing stress:

Jones and Bartlett Publishers

Seaward, B.L. (2007). How the immune system works: Essentials of managing stress. Boston, MA:

Jones and Bartlett Publishers.

http://www.essenceofstressrelief.com/general-adaptation-syndrome.html

http://www.google.com/imghp

http://www.helpguide.org/mental/stress_management_relief_coping.htm

http://health.howstuffworks.com/immune-system1.htm

http://www.mayoclinic.com/health/self-esteem/MH00128

http://www.mayoclinic.com/health/generalized-anxiety-disorder/DS0050

http://www.mayoclinic.com/health/meditation/HQ01070

http://www.yogajournal.com/for_teachers/2621

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Seaward, B. L. (2011). Exercise 1.5.Personal stress inventory: top ten stressors: The art of peace

and relaxation workbook. Retrieved from

http://online.vitalsource.com/#/books/9781284048476/pages/78460357

Seaward, B. L. (2011). Exercise 1.6 The wellness paradigm revisited: The art of peace and

relaxation workbook.

Retrieved from http://online.vitalsource.com/#/books/9781284048476/pages/78460362

Seaward, B. L. (2011). Exercise 3.2 Immediate, intermediate and prolonged stress effects: The

art of peace and relaxation workbook. Retrieved from


Seaward, B. L. (2011). Exercise 4.1 Physical symptoms questionnaire: The art of peace and

relaxation workbook. Retrieved from


Seaward, B. L. (2011). Exercise 5.1 The psychology of your stress: The art of peace and

relaxation workbook.


Seaward, B. L. (2011). Exercise 6.1 Anger recognition checklist: The art of peace and relaxation

workbook. Retrieved from


Seaward, B. L. (2011). Exercise 7.1 Under the gun: stress and personality: The art of peace and



Seaward, B. L. (2011). Exercise 8.5 Your personal value system: The art of peace and relaxation









28


Seaward, B. L. (2011). Exercise 9.1 Reframing: seeing a bigger, clearer perspective: The art of

peace and relaxation workbook. Retrieved from


Seaward, B. L. (2011). Exercise 9.3 Positive affirmation statements: The art of peace and



Seaward, B. L. (2011). Exercise 19.3 Bridging the hemispheres of thought: The art of peace and



Seaward, B. L. (2011). Exercise 21.1 I have a vision: the art of visualization: The art of peace and



Seaward, B. L. (2011). Exercise 24.1 The yin and yang of life: The art of peace and relaxation



Seaward, B. L. (2011). Exercise 25.1 Progressive muscle relaxation: The art of peace and relaxation



Seaward, B. L. (2011). Exercise IV The art of calm: relaxation through the five senses: The art of

peace and relaxation workbook. Retrieved from

http://online.vitalsource.com/#/books/9781284048476/content/element/16682








http://online.vitalsource.com/#/books/9781284048476/content/element/16682

29

Seaward, B. L. (2011). Exercise IV B Relaxation survival kit: The art of peace and relaxation



Seaward, B. L. (2011). Exercise 28.1Physical exercise: The art of peace and relaxation workbook.


Seaward, B. L. (2011). Exercise 28.6 Self-assessment: Nutritional eating habits: The art of peace

and relaxation workbook. Retrieved from


Seaward, B. L. (2011). Exercise 28.7 The rainbow diet: The art of peace and relaxation workbook.


Seaward, B. L. (2012). Additional coping skills: Managing stress: strategies for health

and well-being. Retrieved from


Seaward, B. L. (2012). Cognitive restructuring: reframing: Managing stress: strategies for

health and well-being.


Seaward, B. L. (2012). Creating your own stress management program: Managing stress: strategies

for health and well-being.


Seaward, B. L. (2012). Diaphragmatic breathing: Managing stress: strategies for health and

well-being. Retrieved from


Seaward, B. L. (2012). Diet for a stressed planet: Managing stress: strategies for health and








30

well-being. Retrieved

from http://online.vitalsource.com/#/books/9781449665159/pages/37005567

Seaward, B. L. (2012). Effective coping strategies: Managing stress: strategies for health and

well-being. Retrieved


Seaward, B. L. (2012). Human spirituality: Managing stress: strategies for health and well-

being. Retrieved


Seaward, B. L. (2012). Mental imagery and visualization: Managing stress: strategies for health

and well-being.


Seaward, B. L. (2012). Music as a relaxation technique: Managing stress: strategies for health

and well-being.


Seaward, B. L. (2012). Physical exercise and activity: Managing stress: strategies for health and



Seaward, B. L. (2012). Physiological benefits of progressive muscle relaxation: Managing stress:

strategies for health and well-being. Retrieved from


Seaward, B. L. (2012). Progressive muscular relaxation: Managing stress: strategies for health and








31


Seaward, B. L. (2012). Steps to initiate a fitness training program: Managing stress: strategies

for health and well-being. Retrieved from


Seaward, B. L. (2012). Steps to initiate a progressive muscle relaxation program: Managing stress:

strategies for health and well-being. Retrieved from


Seaward, B. L. (2012). The anatomy of anger: Managing stress: strategies for health and well-

being. Retrieved from


Seaward, B. L. (2012). The anatomy of fear: Managing stress: strategies for health and well-

being. Retrieved


Seaward, B. L. (2012). The general adaptation syndrome: Managing stress: strategies for health

and well-being.


Seaward, B. L. (2012). T’ai Chi Ch’uan: Managing stress: strategies for health

and well-being. http://online.vitalsource.com/#/books/9781449665159/pages/37005499

Seaward, B. L. (2012). Time management for stress reduction: Managing stress: strategies for

health and well-being.


Seaward, B. L. (2012). Types of physical exercise: Managing stress: strategies for health and








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Seaward, B. L. (2012). Types of stressors: Managing stress: strategies for health and well-being.


Seaward, B. L. (2013). Audio files: Managing stress: strategies for health and well-being.

Retrieved from http://health.jbpub.com/managingstress/6e/audio.cfm

Skidmore-Roth, L, (2010). Mosby’s Handbook of Herbs & Natural

Supplements, Fourth Edition: St Louis, Missouri: Elsevier Mosby

US News Health (2010, September 22). How your personality affects your health. Retrieved

from http://health.usnews.com/health-news/family-health/heart/articles/2010/09/22/how-

your-personality-affects-your-health

World Health Organization (2003). WHO definition of health. Retrieved from

http://www.who.int/about/definition/en/print.html



http://health.jbpub.com/managingstress/6e/audio.cfm

http://health.usnews.com/health-news/family-health/heart/articles/2010/09/22/how-

http://www.who.int/about/definition/en/print.html

33

Appendices

Appendix A

EXERCISE 1.5.Personal Stress Inventory:

Top Ten Stressors

It is time to take a personal inventory of your current stressors—those issues, concerns,

situations, or challenges that trigger the fight-or-flight response in your body. The first step to

resolving any problem is learning to identify exactly what the problem is. Take a moment to list

the top ten issues that you are facing at the present moment. Then place check marks in the

columns to signify whether this stressor directly affects one or more aspects of your health

(mind, body, spirit, emotions). Take note of how many of your stressors affect more than one

aspect. Then, next to each stressor, chronicle how long it has been a problem. Finally, check

whether this stressor is one that elicits some level of anger, fear, or both.

Stressor Mental Emotional Spiritual Physical Duration Anger

Fear

1. Overanalyzing everything

2. Fear of failure

3. Expectations of others are

too high

4. Fear of taking test/quiz

5. Expectations of self are too

high

6. Constantly thinking of

agenda (projects)

7. Struggling to adjust to a

daytime schedule

8. Rude drivers

9. Deceitful people

10. Physical fitness exercise

34

Appendix B

EXERCISE 4.1 Physical Symptoms Questionnaire Please look over this list of stress-related symptoms and circle how often they have

occurred in the past week, how severe they seemed to you, and how long they lasted.

Then reflect on the past week’s workload and see whether you notice any connection

between your stress levels and possible stress-related symptoms.

How Often? How Severe? How Long? (Number of days (1 = mild; (1 = 1 hour; in the past week) 5 = severe) 5 = all day)

1. Tension headache 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

2. Migraine headache 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

3. Muscle tension (neck and/or shoulders) 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

4. Muscle tension (lower back) 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

5. Joint pain 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

6. Cold 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

7. Flu 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

8. Stomachache 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

9. Stomach/abdominal bloating/distention/gas 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

10. Diarrhea 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

11. Constipation 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

12. Ulcer flare-up 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

13. Asthma attack 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

14. Allergies 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

15. Canker/cold sores 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

16. Dizzy spells 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

17. Heart palpitations (racing heart) 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

18. Temporomandibular joint dysfunction (TMJD) 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

19. Insomnia 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

20. Nightmares 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

21. Fatigue 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

22. Hemorrhoids 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

23. Pimples/acne 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

24. Cramps 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

25. Frequent accidents 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

26. Other 0 1 2 3 4 5 6 7 1 2 3 4 5 1 2 3 4 5

(Please specify: _______________________)

Score: Look over this entire list. Do you observe any patterns or relationships between

your stress levels and your physical health? A value over 30 points most likely indicates a stress-

related health problem. If it seems to you that these symptoms are related to undue stress, they

35

probably are. Although medical treatment is advocated when necessary, the regular use of

relaxation techniques may lessen the intensity, frequency, and duration of these episodes.

Comments:

36

Appendix C

EXERCISE 6.1 Anger Recognition Checklists He who angers you, conquers you.

Elizabeth Kenny

The following is a quick exercise to help you understand how anger can surface in the course of a

normal working day and how you may mismanage it. Please place a check mark in front of any

of the following that apply to you when you get angry or feel frustrated or upset. After

completing this section, please refer to the bottom right hand corner to estimate, on average,

the number of episodes of anger you experience per day.

When I feel angry, my anger tends to surface in the following ways:

_____ anxiety _____ threatening others

_____ depression _____ buying things

_____ overeating _____ frequent lateness

_____ starting to diet _____ I never feel angry

_____ trouble sleeping _____ clenched jaw muscles, TMJD

_____ excessive sleeping _____ boredom

_____ careless driving _____ nausea, vomiting

_____ chronic fatigue _____ skin problems

_____ abuse of alcohol/drugs _____ easy irritation

_____ exploding in rage _____ sexual difficulty

_____ cold withdrawal _____ sexual apathy

_____ tension headaches _____ busy work (clean, straighten)

_____ migraine headaches _____ sulking, whining

_____ use of sarcasm _____ hitting, throwing things

_____ hostile joking _____ complaining, whining

_____ being accident prone _____ cutting/mutilating myself

_____ guilt and self-blame _____ insomnia

_____ smoking or drinking _____ promiscuity

_____ high blood pressure _____ helping others

_____ frequent nightmares _____ other? Speak in a low tone

_____ tendency to harp or nag _____ other? Become quiet

_____ intellectualization _____ swearing or name calling

_____ crying _____ upset stomach (e.g., gas, cramps,

IBS)

_____ muscle tension (neck, lower back)

* My average number of anger episodes per day is ___.

37

Appendix D

EXERCISE 8.5 Your Personal Value System

We all have a personal value system—a core pillar of the human spirit that is constantly

undergoing renovation. What does your value system currently look like? Perhaps this diagram

can give you some insights and, in turn, help resolve some issues that might be causing stress.

The circle in the center represents your core values: abstract or intangible constructs of

importance that can be symbolized by a host of material possessions. It is believed that we hold

about four to six core values that constitute our personal belief system, which, like a compass,

guide the spirit on our human journey. Give this concept some thought and then write in this

circle what you consider to be your current core values (e.g., love, happiness, health).

The many circles that surround the main circle represent your supporting values: those values

that lend support to your core values (these typically number from five to twelve). Take a

moment to reflect on what these might be and then assign one value per small circle. Inside

each small circle, include what typically symbolizes that value for you (e.g., wealth can be

symbolized by money, a car, or a house). Finally, consider whether any stress you feel in your

life is the result of a conflict between

your supporting and core values.

Spirituality

Health

Love

Wealth

38

Appendix E

EXERCISE 15.1 The Time-Crunch Questionnaire

The following is a survey based on the traits of the codependent personality. Please answer the

following questions with the most appropriate number.

1 = rarely 2 = sometimes 3 = often

1. I tend to procrastinate with projects and responsibilities. 1 2 3

2. My bedtime varies depending on the workload I have each day. 1 2 3

3. I am the kind of person who leaves things till the last minute. 1 2 3

4. I forget to make To Do lists to keep me organized. 1 2 3

5. I spend more than two hours watching television each night. 1 2 3

6. I tend to have several projects going on at the same time. 1 2 3

7. I tend to put work ahead of family and friends. 1 2 3

8. My life is full of endless interruptions and distractions. 1 2 3

9. I tend to spend a lot of time on the phone. 1 2 3

10. Multi-tasking is my middle name. I am a great multi-tasker. 1 2 3

11. My biggest problem with time management is prioritization. 1 2 3

12. I am a perfectionist when it comes to getting things done. 1 2 3

13. I never seem to have enough time for my personal life. 1 2 3

14. I tend to set unrealistic goals to accomplish tasks. 1 2 3

15. I reward myself before getting things done on time. 1 2 3

16. I just never have enough hours in the day to get things done. 1 2 3

17. I can spend untold hours distracted while surfing the Internet. 1 2 3

18. I tend not to trust others to get things done when I can do them

better myself. 1 2 3

19. If I am completely honest, I tend to be a workaholic. 1 2 3

20. I have been known to skip meals in order to complete projects. 1 2 3

21. I will clean my room, garage, or kitchen before I really get to

work on projects. 1 2 3

22. I will often help friends with their work before doing my own. 1 2 3

23. It’s hard to get motivated to get things done. 1 2 3

Total Score

Questionnaire Key

0–25 points = excellent time management skills (keep doing what you are doing!)

39

50–26 points = fair time management skills (time to pull in the reins a bit)

75–51 points = poor time management skills (time to reevaluate your life skills)

40

Appendix F

Guided Imagery:

Find a comfortable and quite place to sit or you may lie down.

Make sure your clothing is loose, remove your shoes and any restrictions Take a few slow and deep breaths

When you feel relaxed, close your eyes, and see yourself lying on a beautiful beach.

Picture a clear blue sky above, soft white sand between your toes, hear the sound of the waves, and smell the salt water.

Notice the taste of a refreshing tropical drink as you bring it to your

mouth. Stay in this scene for as long as you like.

Notice how relaxed and calm you feel. Enjoy the feeling of relaxation as it spreads throughout your entire body.

Notice how far away you feel from anxiety and stress. When you are ready, slowly count backward from 10.

Open your eyes, feeling relaxed but alert.

41

Appendix G

EXERCISE 28.2

Self-Assessment: Nutritional Eating Habits

1. Do you regularly consume caffeine? Yes No

2. List the foods that you ingest that contain caffeine

(e.g., coffee, tea, sodas, chocolate) and the estimated

amounts you consume per day.

Type of Food with

Caffeine

a.

b.

c.

d.

e.

f.

Amount

per Day

3. Do you take vitamin supplements? If yes, what kinds?

Multiple Vitamins; Vitamin D; Potassium Yes No

4. Do you frequently use table salt? Yes No

5. Do you eat one or more meals that are prepared

outside the home daily? Yes No

6. Do you consume junk food (from vending machines or

convenience stores) regularly? Yes No

7. Do you eat cereals that contain sugar? Yes No

8. Do you drink a lot of soft drinks? Yes No

9. Do you find that when you are stressed you tend to eat

more? Yes No

10. Do you find that when you are angry you tend to eat

more? Yes No

11. Do you eat a wide variety of fruits and vegetables? Yes No

12. Do you eat foods (e.g., fish and nuts) with the

essentials oils (omega-3 and omega-6)? Yes No

13. Do you tend to eat quickly (e.g., to wolf down your

food)? Yes No

14. Do you tend to drink alcohol as a means to relax? Yes No

15. List your top five comfort foods: 1.

2.

3.

4.

5.

16. Describe any other eating habits that you associate

with a stressed lifestyle:

42

Appendix H

EXERCISE 28.3 The Rainbow Diet

Food color is more important than just having a nice presentation on your dinner plate. Each

color holds a specific vibration in the spectrum of light. When this is combined with the nutrient

value of food, it can help to enhance the health of the physical body.

In the science of subtle energies, each of the body’s primary chakras is associated with a specific

color (see accompanying chart). It is thought that eating fruits and vegetables associated with

the color of various chakras provides healthy energy to that specific region. For example, women

with urinary tract infections (root chakra) are encouraged to drink cranberry juice (red). Diabetic

people with macular problems are encouraged to eat blueberries and take the herb bilberry

(blue). Moreover, recent research suggests that the active ingredients in fruits and vegetables

that give them their color, called bioflavonoids, help prevent cancer. Regardless of Eastern

philosophies or Western science, the bottom line is to eat a good variety of fruits and vegetables.

The following table identifies the seven chakras, their respective body regions, and the color

associated with each chakra or region. List five fruits, veggies, or herbs for each color.

Chakra Body Region Color Food Choices

7: Crown Pineal Violet/White Ginger, Bermuda onions,

Garlic, Plums, and Turnips

6: Brow Pituitary Indigo

Blueberries, Blackberries,

Raisins, Elderberries, and

Figs

5: Throat Thymus Aqua blue

Purple Cabbage, Purple

Potatoes, Blue Grapes, Blue

Plums, and Eggplant

4: Heart Heart Green

Brussels Sprouts, Spinach,

Broccoli, Kiwi, and

Asparagus

3: Solar plexus Adrenals Yellow

Pineapple, Lemon,

grapefruit, Yellow Squash,

and Sweet Corn

2: Navel Spleen Orange

Carrots, Sweet Potatoes,

Mangoes, Oranges, and

Pumpkin

1: Root Gonads Red

Raspberries, Pomegranates,

Tomatoes, Beets, and

Cherries

43

Appendix I

EXERCISE 28.1 Physical Exercise Sketch out a quick weekly program of exercise, including days to work out,

time of day, and activity. Allow intermittent days for recovery.

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

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