Creative Responses to Stress:
A holistic approach
by Jay Busemeyer

Stress can be seen as positive or negative. Challenges can be stressful yet growth producing! With too little stress we may become bored with life. As our daily stress increases, it becomes very important to learn how to manage stress to remain healthy and to reach our true potential. In this presentation we will examine the physical, psychological and spiritual factors in stress management. Wellness is within our reach.  
 
step 1) Understanding Stress

Stress can be defined as a feeling of tension that is physical, emotional, or psychological. Individuals react differently to situations that may be perceived as stressful. For example, we might imagine a group of children preparing to ride a roller coaster. For some kids, this is great fun! "Let's sit up at the front, Mom".

For other kids, the middle seat is good enough. And for those timid ones, this situation may be actually be anxiety provoking. The last few seats may or may not be taken… "maybe I'll just sit this one out, Okay Dad?" Same external situation, but very different reactions.

All of us experience unwanted stresses in our lives: traffic jams, unsafe drivers, waiting in line, computer downtime or hang-ups, high caseloads, irresponsible behavior from clients or personality conflicts with co-workers. It is helpful to be aware of some of the warning signs of stress. Awareness is often the first step to making constructive changes either in our work or in our personal lives to reduce stress. * This document was developed in cooperation with the Hamilton County Department of Job and Family

Services and has been used for several employee workshops.

What are some signs and symptoms of stress?

Physical Symptoms

• Headaches (Tension Migraine)
• Back Pain
• Tense Neck and Jaw
• Shoulder Stiffness
• Insomnia
• Fatigue
• Frequent Colds /Bronchitis /Flu
•  High Blood Pressure
• Shortness of Breath
• Grinding of Teeth
• Over Eating
• Loss of Appetite

Mental Symptoms

• Forgetfulness
•  Negating Your Own Ideas!
•  Mental Chatter
• Lack of Concentration
•  Worry
•  Inability to Prioritize

Emotional Symptoms

• Anger /Irritability Anxiety /Fear
•  Depressed /Sad
• Lack of Concentration
•  Worry
• Inability to Prioritize
• Pessimism
• Blaming
•  Feel Inadequate

Personal Behavioral Signs

• Won't Take Risks
• Avoid Change /Challenges
• Poor Love Relationships
•  Alienation
• Critical /Over Reacting
• Lack Compassion
•  Inability to Forgive
•  Life Seems Unfair

Work Behavior Signs

• Rigidity/By the Book
• Low Motivation
• Absenteeism
• Poor Time Management
• Lose Clarity of Goals
• Lose Creativity
• Lack of Respect for Self/Others

 step 2) Reducing or Erasing Stress (Physical Factors)

Get a good night's sleep!

Recommendations:

• • Reduce or eliminate caffeine and sugar consumption.
• • Practice time management skills to plan your day ahead before leaving the
• office if possible. This helps you to build confidence in your ability to
• accomplish those tasks which are top priority for the next day.
• • Do not rely upon alcohol for relaxation or as an aide to sleep.
• • Go to bed and get up the same time each day.
• • Regular exercise during the day helps to promote nighttime sleep.
• • Take time to wind down before sleep. (TV news is not relaxing!)
• • Develop a bedtime routine (reading, herb tea, stretching, relaxation exercises, a warm bath while listening to classical music, praying.

Physical Exercise:

• Inadequate physical activity can result in (by itself) a stressful state for the
• body). Exercise is a natural antidote to stress. It reduces tension and
• dispense pent up energy.
• A consistent program of physical activity can reduce depression, if it exists,
• and add to a feeling of well-being.
• Consider walking, swimming, dancing, singing! Even walking the stairs
• during the day or taking a walk at lunchtime can be very helpful.

A Healthy Diet:

• Promotes a strong immune system needed to overcome stress
• Adds to a positive self image by helping us to feel good about ourselves
• A poor nutritional state can be related to unhealthy food choices, inadequate
• food intake, or an erratic eating schedule.

Take time to eat right! Some basic guidelines are:

• Breads, Cereals, Rice, Pasta
• Choose foods made from whole grains—whole wheat, oats, rye and
• barley—more often than those made with refined wheat flour. Try
• organic corn chips or rice cakes for a snack instead of a candy bar.
• Fruits
• Choose fresh fruits, frozen fruits, canned fruits in water or juice or
• 100% fruit juice rather than fruit canned in syrup or drinks made with
• sugar. Be fruitful and your body will thank you.
• Vegetables
• Choose fresh veggies, frozen without sauces, or canned vegetables
• more often than those frozen in sauces or fried vegetables.
• Milk, Yogurt, and Cheese
• Choose skim or 1% (OK, maybe 2%) fat milk products and lowfat or
• nonfat yogurts and cheeses more often than whole milk products.
•  Meat, Poultry, Fish, Beans, Nuts and Soy products
• Choose lean, closely trimmed cuts of beef and pork, poultry without
• skin. Look for the words round or loin when purchasing beef and the
• words loin or leg when buying pork. These cuts are lowest in fat. Or
• consider trying a vegetarian meal for a change. Eat a veggie burger or
• try a blackened tofu burrito!
• Water
• Recommended 8 glasses per day. Try filtered or bottled water and
• you'll likely enjoy it more. Maintaining the body's hydration helps to
• reduce your appetite while sustaining your energy level throughout the
• day.
• Vitamins and herbal supplements

Many people find it difficult to obtain all the vitamins and minerals they need in their daily diet. Vitamins and herbal supplements can help our bodies to maintain strong immune systems and resist illness which may result from prolonged periods of stress ands fatigue.

Step 3) Cultivate Good Relationships (Psychological factors)

•  Stay in touch with old friends and be open and willing to make new ones.
• Relationships are shields that protect us from distress—nurture them.
• Become friends with yourself! Value occasional periods of solitude for things
• your really enjoy!
•  Spend time in nature either by yourself or with a friend. Listen to the sound of
• a running stream, birds singing, or the laughter of a child playing.
• Treasure your family. Make time for recreation.
• Isolation makes us increasingly vulnerable to illness or unable to cope with
• stress.
• Talk to someone you trust, and don't be afraid to laugh or to cry.
• Be assertive. Express your feelings with respect for yourself and others.
• Never miss an opportunity to laugh! Humor is like a pressure valve that
• relieves tension, releases pleasure producing brain hormones, and stimulates
• the immune system.

Step 4) Monitoring our thoughts (Psychological and Spiritual factors)

• Even though we often times do not have control over external events, we do
• have a choice in how we respond to those events. It's what we think about an
• event that causes stress.
• "There is nothing either good or bad but thinking makes it so." – Shakespeare
• We often create our own stress because of faulty perceptions (for example, a
• rope lying in tall grass may be perceived as a snake!)
• The ABC's of stress: Activating event, Belief or Interpretation, Consequences
• (physiological hormones such as adrenaline)
• Problems can be viewed as challenges to growth rather than as negative
• events which are outside our control.
• It takes courage to change what we can, patience to accept and learn from
• those experiences (and circumstances) we cannot change in the present.
• Consider keeping a journal and express your feelings and relieve tensions
• Use affirmations and "positive self-talk" rather than dwelling upon the negative
• Consider the idea that thought creates reality
• Practice relaxation techniques and/or visualizations
• Use prayer and meditation to open ourselves up to spiritual sources of
• strength and inspiration on a daily basis.

The President of the American Institute of Stress (Paul Rosch, M.D.) writes "There is little doubt that having a firm faith, trust, or belief can reduce stress, as well as provide numerous and varied health benefits... the 11th International Congress on Stress will have a particular focus on the role of faith in health and stress reduction." (Note also the Bill Moyers Healing and the Mind PBS series (1993) videotapes available in the library) Herbert Benson, M.D., a Founding Trustee of The American Institute of Stress, is Associate Professor of Medicine, Harvard Medical School; Chief of the Division of Behavioral Medicine at the Beth Israel Deaconess Medical Center; and the founding President of the Mind/Body Medical Institute. A graduate of Wesleyan University and the Harvard Medical School, he is the author or co-author of more than 150 scientific publications and six books. His research results have served to build a bridge between medicine and religion, East and West, mind and body, as well as between belief and science. These interests were reflected in the 11th International Congress on Stress, 2000, mentioned previously. Below is an excerpt taken from Dr. Benson's 1996 publication, Timeless Healing: The Power and Biology of Belief. "…in my thirty years of practicing medicine, I've found no healing force more impressive or more universally accessible than the power of the individual to care for and cure him-or herself…I believe the ideal model for medicine is that of the three legged stool. The stool is balanced by the appropriate application of self-care, medications, and medical procedures. One leg, that which patients can do for themselves, is the most disparaged and neglected aspect of health care today…we'll pay special attention to the self-care leg of the stool…on the inner development of beliefs that promote healing."

step 5) Relaxation Exercises

The 23rd psalm* revisited, relaxation reminders God is my Shepherd; there is nothing I shall want. Fresh and green are the pastures where Spirit gives me repose. Near still waters I am lead to revive my depleted energies. * the inclusive language used here is my own wording

Physical recreation is of course optimal for relaxation, but even if we cannot spend regular periods of time out in nature, we can practice visualization and deep breathing exercises which can be very helpful. Photographs placed in convenient locations for viewing in your office can be gentle reminders of the need to relax and let go even for a few minutes. Screen savers and "wallpaper" for your PC can be a useful aide as well.

The President of the American Institute of Stress (Paul Rosch, M.D.) writes "There is little doubt that having a firm faith, trust, or belief can reduce stress, as well as provide numerous and varied health benefits... the 11th International Congress on Stress will have a particular focus on the role of faith in health and stress reduction." (Note also the Bill Moyers Healing and the Mind PBS series (1993) videotapes available in the library)

Herbert Benson, M.D., a Founding Trustee of The American Institute of Stress, is Associate Professor of Medicine, Harvard Medical School; Chief of the Division of Behavioral Medicine at the Beth Israel Deaconess Medical Center; and the founding President of the Mind/Body Medical Institute. A graduate of Wesleyan University and the Harvard Medical School, he is the author or co-author of more than 150 scientific publications and six books. His research results have served to build a bridge between medicine and religion, East and West, mind and body, as well as between belief and science. These interests were reflected in the 11th International Congress on Stress, 2000, mentioned previously. Below is an excerpt taken from Dr. Benson's 1996 publication, Timeless Healing: The Power and Biology of Belief. "…in my thirty years of practicing medicine, I've found no healing force more impressive or more universally accessible than the power of the individual to care for and cure him-or herself…I believe the ideal model for medicine is that of the three legged stool. The stool is balanced by the appropriate application of self-care, medications, and medical procedures. One leg, that which patients can do for themselves, is the most disparaged and neglected aspect of health care today…we'll pay special attention to the self-care leg of the stool…on the inner development of beliefs that promote healing."

Deep Breathing and Affirmation

Sit in a comfortable chair, relaxed and with your back straight. Focus your eyes on a beautiful scene such as the one pictured above, then gently close your eyes. Image yourself seated just downstream from this waterfall*, absorbed in the sights, smells and sounds of this beautiful scene. Begin by exhaling slowly the "stale" air from your lungs, then inhale slowly and deeply through your nose to a count of three to five. Initially expand your abdomen, then your chest will rise naturally as you inhale (deep abdominal breathing is best for relaxation). Hold the breath for a few seconds. Then slowly exhale while gently squeezing your abdomen and pursing your lips to a count of about 5 to 7 (a little longer than the inhalation)

Repeat this deep breathing 2 times. Then take a 3rd deep breath, but this time on the exhalation say to yourself "I am completely at peace" or some other phrase which feels right to you. Some additional suggestions: "I am feeling fine", "all tension falls away from me", or perhaps a spiritual affirmation such as "divine light is in me". It is good practice to do this exercise several times daily, even if you are not feeling stressed out! Then the mental association and feeling of relaxation will gradually build up for you and become more effective when the need to relax is more pressing. The same principle, of course, is true for regular meditation practice and/or prayer. On the lighter side… another useful tool as an aide in relaxation, even if only a few minutes, is music. If possible during periods of routine work, or at lunchtime, put on a CD and listen to a favorite short selection (with headphones, of course). Close your eyes briefly and imagine you are viewing a live performance! This is an easy way to refresh yourself mentally and emotionally when tired or feeling frustrated.

Step 6) Use of Symbols in Visualization

Some people find it useful to imagine an abstract symbol such as this six pointed Star* radiating light, love and beauty in all directions. The symbol of the Star can be seen, felt and thought of—engaging both heart and mind—as helping you as an individual to find perfect balance and inner strength in the midst of life's challenges. The thought projection of the Star and its inner light can be done for the purpose of helping a group or particular work that is for the benefit of humanity. This can easily be used in conjunction with the deep breathing and affirmation exercise outlined above. An Exercise in Positive Relaxation Imagery Let's begin with deep breathing. Add music from CD or tape if available (ocean waves, bird sounds)… Gently close your eyes and feel the slow, deep inhalation and exhalation of your breath, like the waves of an ocean rolling across the small stones, shells and sand of a beautiful beach. Take a slow, deep breath and feel the refreshingly warm, moist air as you breathe in and out with the sound of the waves. As you ontinue with the slow, rhythmic breathing, become aware in your imagination of golden sunlight sparkling upon the clear, blue water near the edge of the beach. Feel the sunlight on your face calming your mind, letting go of any tensions or problems as you simply allow yourself to be fully present in this wonderful moment of relaxation. Imagine this peaceful golden sunlight entering your body, and in your heart center this inner light forms a perfectly balanced six pointed Star, radiating it's healing energy to every cell of your body. Say to yourself, "I am completely at peace in this golden light." Rest in this thought, continuing with the slow, rhythmic breathing for one minute of silence… Now let's open our eyes when we are ready and return to our normal awareness feeling deeply relaxed and refreshed.

Internet Resources for Meditation and Guided Imagery

http://www.here-and-now.org/IMSOC/old/TNH.page.html

Thich Nhat Han, the Vietnamese Buddhist Zen Master was nominated in 1967 by the Rev. Martin Luther King Jr. for a Nobel Peace Prize. His book The Miracle of Mindfulness is universally recognized as one of the classic introductory manuals on meditation, concentration, and relaxation. * from The Book of Star Light, The White Eagle Publishing Trust http://www.healthjourneys.com/guidedimagery.asp

Since 1991, Belleruth Naparstek, a psychotherapist & author, has produced and distributed the Health Journeys audio series. The Health Journeys series is a physician-endorsed, carefully researched group of guided imagery audiotapes. Her book, Staying Well with Guided Imagery, serves a good introduction to the topic.

Scientific Research in the area of Stress Reduction Psychologist, author and researcher Jon Kabat-Zin, PhD, is the founder of the Center for Mindfulness in Medicine, Health Care, and Society. The Center is affiliated with the University of Massachusetts Medical School. Kabat-Zin has developed pioneering workshops such as The Power of Mindfulness in the Workplace. Mindfulness can be described as being fully in the present moment, without judgement, with relaxed concentration and awareness. In other words, paying attention moment by moment both to ourselves and our environment. This helps us to see things more clearly and to respond in the most appropriate manner.

The approach developed by Kabat-Zin is called Mindfulness Based Stress Reduction. Over 13 thousand people have completed the MBSR program, an 8- week course consisting of 8 weekly classes and one daylong class.

RESEARCH FINDINGS

"Published research related to the work of the Stress Reduction Clinic documents that a majority of patients report lasting decreases in both physical and psychological symptoms as well as increased ability to relax, greater energy and enthusiasm for life, improved self esteem, and increased ability to cope more effectively with both short-term and long-term stressful situations. Research from our corporate programs indicates that these programs can have similarly dramatic effects. Corporate program participants display changes in a variety of physical and mental behaviors and attitudes that are directly related to positive changes in work-related performance. These include enhanced ability to consciously respond to situations rather than simply react, to bring greater concentration and focus to their work, and to monitor their level of stress and take effective steps to address it." —Quoted with permission from the Center for Mindfulness brochure titled The Power of Mindfulness in the Workplace.

For a more detailed review of recent research, please see http://www.healthjourneys.com/hotresearch.asp . Do a search (use Edit, Find) on Kabat-Zinn for a summary of 2 well documented studies. Numerous studies have also shown that Transcendental Meditation has been found effective in the treatment of hypertension and in the reduction of stress related hormones. These studies have been published in the American Heart Association's journal, Hypertension, 1995 and 1996.

step 7) Tai Chi Chuan: Movement Meditation

"…the first quality to be developed in T'ai Chi is that of strengthening one's concentration, or what is referred to in the martial arts as being centered. The ability to center the mind is really that of keeping the mind interested and involved in the experience of the present moment. This is understood to be the foundation of T'ai Chi because from this state of attention comes the possibility to change, correct, and heal. " — Ron Perfetti, Director Of the Hawaii T'ai Chi Ch'uan Association .
Tai Chi Chuan (A Brief Demonstration followed by discussion). Many people are finding Tai Chi classes to be a very helpful way to relax and relieve mental and bodily tension. Northern Kentucky University Community Education is a great way to start if you are interested in learning Tai Chi Chuan.

step 8) Yoga and Simple Stretching exercises

Many people find Yoga to be a wonderful way to relax and relieve tension. Like Tai chi, Yoga is an ancient form of exercise with many levels of experience and personal benefits. Many introductory classes from qualified teachers are now available in the Cincinnati area.

What follows here is a brief description of a few simple stretching exercises (this is not Yoga!) which can be done in the workplace or in the privacy of your home. Please consult with your doctor before beginning a stretching or yoga practice, and listen to your own body and its limitations. The contents of this document are presented for informational purposes, and readers are solely responsible for their own personal use of this information. Stretching Exercises

Shoulder Stretch

• Inhale deeply, hold your breath for a brief moment while stretching out your
• arms to full extension at the level of your shoulders while interlacing your
• fingers.
• Exhale slowly while pushing your palms outward and lowering your chin to
• your chest.
• Continue to hold this position while breathing slowly for about 10 seconds
• Repeat these steps 3 times.
• Back Stretch
• Inhale deeply, while standing straight, then gently and slowly lean forward
• while exhaling from the abdomen and let your arms fall just below your knees
• (stretching only as far as you are comfortable)
• Hold this position for about 5 seconds.
• Inhale and slowly come up to vertical position, then lean past vertical to
• slightly backward with your hands on your hips. Be very careful not to strain
• your back or your neck.
• Hold for 5 seconds.
• Come back to your normal standing position.
• Repeat this sequence 3 times. Your stretch will gradually lengthen, so please
• don't push too hard! Just stay within your body's comfort zone ?

step 9) A Personal Plan for Positive Change

We are planting positive seeds for change… normally a slow process. Be patient with yourself!! Review of major steps to Stress Management Wellness is within our reach by practicing the following: restful sleep, regular exercise, a healthy diet, cultivating good relationships, monitoring our thoughts, developing a firm faith or belief, learning stress reducing relaxation exercises such as deep breathing and affirmations, Mindfulness of breath with guided meditation, Tai Chi, Yoga or simple stretching.

Areas to Improve                              List Your Goals

Physical exercise                     Take a walk at lunchtime

                                                    Take the steps instead of the elevator.

                                                    Practice the simple stretching exercises

Monitor thoughts                        Practice daily deep breathing and positive affirmations     

Cultivate good relationships     Spend Sunday afternoons with family or for

                                                     personal recreation

Restful sleep                               Buy or check out the library for a good

                                                     relaxation tape

Spirituality                                   Establish a daily meditation and/or a prayer

                                                     routine

Healthy diet                                 Reduce caffeine and sugar intake

Step 10) Keep a positive outlook on life.

Gratitude helps us all to create healthy minds and bodies. Positive thinkers seek out the positive, look for things to be thankful for, and use the talents they have been given. Remember that relaxation is one of the best things you can do for one of the most wonderful human beings you know—you!

Step 11) Learn more about stress on-line and how to manage it

Here is one recommmended site loaded with good information:

http://holisticonline.com/stress/stress_home.htm

Step 12) Additional recommended reading

The Miracle of Mindfulness: A Manual of Meditation by Thich Nhat Hanh
A Gradual Awakening by Stephen Levine
Wherever You Go There You Are by Jon Kabat-Zinn, Ph.D.
The Book of Star Light by The White Eagle Publishing Trust
Timeless Healing, The Power and Biology of Belief by Herbert Benson, M.D. 

The author Jay Busemeyer has a website offering further suggestions and opportunities for unscrambling your busy life and finding your center of inner peace. holisticstressrelief.com