Solo & Small Firm Conference 2015 Stress Management for Attorneys

Transcription

1 Vermont Bar Association Seminar Materials Solo & Small Firm Conference 2015 May 14, 2015 Basin Harbor Club Vergennes, VT Faculty: John O Brien, PhD Attorneys in Balance

2 Stress management for Attorneys John M. O Brien, Ph.D. Senior Consultant, Attorneys in Balance May 14, Objectives: By the end of this workshop, participants will be able to: 1.identify sources of general life stress as well as the specific stressors from work as an attorney. 2.discuss the physiological changes that occur as stress levels increase. 3.implement practical skills for managing stress effectively. 2 A. Stress defined Stress is the nonspecific response of the body to any demand made upon it. Selye (1974) Any change that we must adapt to. Distress: reaction to a negative change Eustress: reaction to a positive change 3 1

3 A. Stress defined Anticipatory stress: stress that comes from worry thoughts over the future Situational stress: the stress of the moment Chronic stress: the stress that builds up over time with some ongoing difficulty Residual stress: the stress over past hurts 4 A. Stress defined Yerkes-Dodson Law: performance is best when stress levels (arousal) are moderate 5 A. Stress defined *the most common experiences that contributed to stress among people with a great deal of stress in the last month : too many responsibilities overall ((54%), problems with finances (53%) work problems (53%). Stress in America (2014) 6 2

4 A. Stress defined Stressors for Attorneys (Top 10) 1.High stress 2.Long hours 3.Job dissatisfaction 4.Debt 5.Competitive Job Market (Kane, undated) 7 A. Stress defined Stressors for Attorneys (Top 10) 6.Client pressures 7.Changing Legal Paradigms 8.Technology 9.Legal Process outsourcing 10.Poor Public Image (Kane, undated) 8 A. Stress defined Stressors for Attorneys (Others?) Business issues (practicing with others) Dual Relationships Professional isolation in rural/solo practice 9 3

5 B. Stress Response Biology of stress General Adaptation Syndrome Alarm Stage Fight/Flight/Freeze/Submit Tend/Befriend Resistance Exhaustion Seward (2015) 10 C: Physiological changes that occur under stress Neuronal cognitive response Limbic system Amygdala Hippocampus Seward (2015) 11 C: Physiological changes that occur under stress Hormonal response HPA Axis Adrenaline/Noradrenaline Cortisol Stress-response Stomach Glucocorticoids Seward (2015) 12 4

6 D: 50 common signs and symptoms of stress Consult the list in your packet. Do you see yourself in any of these symptoms? Source: American Institute of Stress 13 E: Stress reactivity Stress reactive people think differently. Stress reactive people often are unaware that their perception is out of line. Stress reactive people shrink from civic dialogue E: Stress reactivity Watching Television: Immersion in media (shows,blogs, websites) and activities that emphasize an "us-againstthem" mentality: One of the most dangerous ideas is believing that you or your group are better than other people

7 E: Stress reactivity Holmes-Rahe Stress Scale: Scoring Less than 150: low susceptibility : 50% chance of major health issue in the next two years 300+: 80% chance of major health issue in the next two years 16 F: Skill: Abdominal breathing Information: g hing.cfm Video: KrQDM 17 G: Nutrition Food recommendations: Please see the enclosed handout and general guidelines. More information can be obtained at:

8 G: Nutrition Portion control: Mindless eating and drinking Mindless Eating Myth 1:People Know How Much They Want to Eat (and drink) Mindless Eating Myth 2:People Know when They are Full (had enough to drink) (Wansink, 2009) H: Sleep hygiene: Sleep recommendations Adults (18-64) : 7-9 hours Adults (65+): 7-8 hours Source: National Sleep Foundation H: Sleep hygiene: Avoid napping Avoid stimulants Exercise Food choices Ensure adequate exposure to natural light. Establish a regular relaxing bedtime routine. Associate your bed with sleep National Sleep Foundation

9 I: Relaxation response Your personal ability to encourage your body to release chemicals and brain signals that make your muscles and organs slow down and increase blood flow to the brain. Benson (2001) 22 J: Aerobic exercise Notice the exercise recommendations on your handout. Compare your exercise with these guidelines. Consider whether you need to adjust your weekly exercise to meet these guidelines K: Mindfulness Mindfulness: paying attention in a particular way; on purpose, in the present moment and nonjudgmentally. (Kabat-Zinn, 1994) Mindfulness: a form of awareness and attention that enables us to peer into the truth of this moment. (Altman, 2011)

10 K: Mindfulness Mindfulness exercise 25 Balanced Living for Attorneys: A primer L. Perception: Beck s Cognitive Model: sees the mind as an information processing system Automatic Thoughts: thoughts that come to mind when we are on auto-pilot. Problematic patterns can develop and manifest reflexively in situations, especially stressful ones Herman and Reinke (2015) 26 Balanced Living for Attorneys: A primer L. Perception: Problematic thoughts patterns: All-or-Nothing thinking/overgeneralization: thoughts that include always and never Moralization: thoughts that include should Catastrophizing: thoughts that include awful/terrible when these are exaggerations of what is happening Personalization: interpreting an event as directed at us Mind reading: we assume that we know why people are acting a certain way Fortune telling: making negative predictions about the future

11 M: Social Support Benefits: Improved p immune system function/fewer colds/flu and less chronic illness Lowered blood pressure and better cardiovascular function Lower rates of disease and death Seward (2015) 28 N. Skill: Progressive Muscle Relaxation The CALM Exercise Chest: Chest/torso sinks back into the chair Arms: Shoulders and arms sag, hands rest in lap Legs: Loose and flexible, not crossed Mouth: Jaw drops slightly (Robinson & Reiter, 2007) 29 Stress Management Plan Personal Goal Setting

12 Questions? 31 Thank you for coming! John M. O Brien, Ph.D. Attorneys in Balance (207) jobrien@attorneysinbalance.com 32 References Altman, D. (2011). One minute mindfulness. Novata, CA: New World Library. Benson, H. (2001). Mind-Body Pioneer. Psychology Today, 34(3),

13 References Herman, K & Reinke, W. (2015). Stress management for teachers: A proactive guide. New York: The Guilford Press Kabat- Zinn, J. (1994). Wherever you go, there you a re: Mindfulness meditation in everyday life. New York: Hyperion Books. Kane, S. (undated). Ten worst things about a career as a lawyer. Retrieved from on 1/18/ References Robinson, P & Reiter, J. (2007). Behavioral consultation and primary care: New York: Springer Science and Business Media. Seward, B. (2015). Managing stress: Principles and strategies for health and well-being. Burlington, MA: Jones and Barlett Learning. Wansink, B., Just, D. R., & Payne, C. R. (2009). Mindless Eating and Healthy Heuristics for the Irrational. American Economic Review, 99(2),

14 Food and Exercise Recommendations Food: Five to seven fruits/veggies per day Drink enough water Take vitamins (as indicated by your PCP). Limit intake of caffeine, alcohol, sugar and processed foods. Enjoy food but eat less. Make half your plate fruits and vegetables. Source: United States Department of Agriculture: Physical/Exercise How much physical activity do you need? 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on 2 or more days a week or 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms). Definition: Aerobic activity: Moderate Walking fast Doing water aerobics Riding a bike on level ground or with few hills Playing doubles tennis Pushing a lawn mower Definition: Aerobic activity: Vigorous Jogging or running Swimming laps Riding a bike fast or on hills Playing singles tennis Playing basketball Source: Centers for Disease Control and Prevention Intervale Road New Gloucester, ME attorneysinbalance.com

15 Life Change Index Scale (The Stress Test) Event Impact Score My Score Death of spouse 100 Divorce 73 Marital Separation 65 Jail Term 63 Death of close family member 63 Personal injury or illness 53 Marriage 50 Fired at work 47 Marital reconciliation 45 Retirement 45 Change in health of family member 44 Pregnancy 40 Sex difficulties 39 Gain of a new family member 39 Business readjustment 39 Change in financial state 38 Death of a close friend 37 Change to a different line of work 36 Change in number of arguments with spouse 35 Mortgage over $20, Foreclosure of mortgage or loan 30 Change in responsibilities at work 29 Son or daughter leaving home 29 Trouble with in laws 29 Outstanding personal achievement 28 Spouse begins or stop work 26 Begin or end school 26 Change in living conditions 25 Revisions of personal habits 24 Trouble with boss 23 Change in work hours or conditions 20 Change in residence 20 Change in schools 20 Change in recreations 19 Change in church activities 19 Change in social activities 19 Mortgage or loan less than $20, Change in sleeping habits 16 Change in number of family get-togethers 15 Change in eating habits 15 Vacation 13 Christmas approaching 12 Minor violation of the law 11 Total Directions If an event mentioned above has occurred in the past year, or is expected in the near future, copy the number in the score column. If the event has occurred or is expected to occur more than once, multiply this number by the frequency of the event.

16 Scoring The Life Change Index The body is a finely timed instrument that does not like surprises. Any sudden change stimuli which affects the body, or the reordering of important routines that the body become used to, can cause needless stress, throwing your whole physical being into turmoil. The following chart will give you some idea of how to informally score yourself on Social Readjustment Scale. Since being healthy is the optimum state you want to achieve, being sick is the state of being you most want to avoid. Life Change Units Likelihood Of Illness In Near Future 300+ about 80 percent about 50 percent less than 150 about 30 percent The higher your life change score, the harder you have to work to get yourself back into a state of good health. T.H.Holmes and T.H. Rahe. "The Social Readjustment Rating Scale," Journal of Psychosomatic Research. 11:213, 1967.

17 50 common signs and symptoms of stress: Check the ones relevant for you 1. Frequent headaches, jaw clenching or pain 2. Gritting, grinding teeth 3. Stuttering or stammering 4. Tremors, trembling of lips, hands 5. Neck ache, back pain, muscle spasms 6. Light headedness, faintness, dizziness 7. Ringing, buzzing or popping sounds 8. Frequent blushing, sweating 9. Cold or sweaty hands, feet 10. Dry mouth, problems swallowing 11. Frequent colds, infections, herpes sores 12. Rashes, itching, hives, goose bumps 13. Unexplained or frequent allergy attacks 14. Heartburn, stomach pain, nausea 15. Excess belching, flatulence 16. Constipation, diarrhea, loss of control 17. Difficulty breathing, frequent sighing 18. Sudden attacks of life threatening panic 19. Chest pain, palpitations, rapid pulse 20. Frequent urination 21. Diminished sexual desire or performance 22. Excess anxiety, worry, guilt, nervousness 23. Increased anger, frustration, hostility 24. Depression, frequent or wild mood swings 25. Increased or decreased appetite 26. Insomnia, nightmares, disturbing dreams 27. Difficulty concentrating, racing thoughts 28. Trouble learning new information 29. Forgetfulness, disorganization, confusion 30. Difficulty in making decisions 31. Feeling overloaded or overwhelmed 32. Frequent crying spells or suicidal thoughts 33. Feelings of loneliness or worthlessness 34. Little interest in appearance, punctuality 35. Nervous habits, fidgeting, feet tapping 36. Increased frustration, irritability, edginess 37. Overreaction to petty annoyances 38. Increased number of minor accidents 39. Obsessive or compulsive behavior 40. Reduced work efficiency or productivity 41. Lies or excuses to cover up poor work 42. Rapid or mumbled speech 43. Excessive defensiveness or suspiciousness 44. Problems in communication, sharing 45. Social withdrawal and isolation 46. Constant tiredness, weakness, fatigue 47. Frequent use of over-the-counter drugs 48. Weight gain or loss without diet 49. Increased smoking, alcohol or drug use 50. Excessive gambling or impulse buying Source: American Institute of Stress: Intervale Road New Gloucester, ME attorneysinbalance.com

18 Stress Management Personal Goals Name: Date: Instructions: Write down at least two activities you would like to integrate into your day to support self-care and stress management. Be specific. ** Example: Going to bed between 9:00 and 10:00 PM Monday to Friday. Practicing mindfulness at least once/day between 10:00 AM and 5:00 PM Activity 1: (list specific activity and frequency) Activity 2: (list specific activity and frequency) Activity 3: (list specific activity and frequency) **Please note that you should have two copies of this form and an envelope. If you wish, copy your goals onto both forms. Then take one copy of your goals and put the in the envelope. Seal the envelope and self-address it. We will mail it to you in 3 months as follow up to this workshop Intervale Road New Gloucester, ME attorneysinbalance.com