Anxiety and Stress Optimization (Mild to Moderate)

Transcription

1 National VA/DoD Women's Mental Health Mini-Residency: Building Clinical Expertise to Meet Women's Unique Treatment Needs Crystal City, Virginia August 28-30, 2018 Anxiety and Stress Optimization (Mild to Moderate) Gabe Paoletti, EdD, MAPP Lauren Messina, PhD, LCMFT Consortium for Health and Military Performance Department of Military and Emergency Medicine Uniformed Services University Medically Ready Force Ready Medical Force 1

2 Disclosures The opinions and assertions expressed herein are those of the authors and should not be construed as reflecting those of the Uniformed Services University, Department of the Army, Department of the Air Force, Department of the Navy or the United States Department of Defense. This continuing education activity is managed and accredited by the Department of Veterans Affairs, Employee Education System (VA-EES). Gabe Paoletti and Lauren Messina have no financial interest to disclose. Commercial support was not received for this activity. Medically Ready Force Ready Medical Force 2

3 Learning Objectives At the conclusion of this presentation, participants will be able to: Describe and apply stress optimization strategies to enhance Women Service Member s performance. Assess the right level of energy activation for self and clients for specific performances and construct the thoughts that will lead to those outcomes. Support clients cognitive reappraisal of physiological responses to stress, enabling them to stay in control. Practice physiological modification, like mindful breathing, with clients to increase focus and calmness to effectively manage stress. Illustrate assertive communication with clients to help them avoid stress-related relational pitfalls. Medically Ready Force Ready Medical Force 3

4 Overview What is mild-to-moderate stress? Impact of mild-to-moderate stress Strategies: Cognitive Physiological Relational 4

5 Mild/Moderate Stress versus Anxiety Disorders What s the difference between stress and anxiety? Mild/Moderate stress versus GAD, PTSD, etc. Strengths/limitations 5

6 Sex Differences, Anxiety, and Stress Men Women

7 Stress Optimization Recognizing triggers and signs of stress Making the most of that energy Develop skills that enhance the body s adjustment to stress See stress as energizing 7

8 Stress Response 8

9 Cognitive Strategies Medically Ready Force Ready Medical Force 9

10 ABCs of Stress 10 Based on the work of Albert Ellis

11 Zone of Optimal Functioning Jokela, & Hanin (1999)

12 When are you in your IZOF Pick a stressful performance Describe the indicators that you are in your IZOF: Where is your attention? What emotions are you feeling? How does your body feel? What are you thinking to help you to get these desired consequences? Medically Ready Force Ready Medical Force 12

13 When are you not in your IZOF For the same stressful performance describe what are the indicators that you are not in your IZOF, when you are too activated or not activated enough? Where is your attention? What emotions are you feeling? How does your body feel? What are you thinking? What could you say to yourself to help you to get into your IZOF? Medically Ready Force Ready Medical Force 13

14 Reappraising Physiology 14 Jamieson et al. (2012)

15 Adjusting Stress Mindset Stress is my Enemy Increased constriction and inflammation in blood vessels Increased heart pumping causes damage Causes isolation Avoidance of future challenges Stress is my Friend More relaxation and less inflammation in blood vessels Heart mimics pumping in exercise Promotes connection Enables better preparation for the future 15 Crum, Salovey, & Achor (2013)

16 Physiological Strategies Medically Ready Force Ready Medical Force 16

17 Managing Physiology IZOF 17

18 Mindful Breathing Stimulates the parasympathetic nervous system Promotes full oxygen exchange in the body Stimulates the Vagus nerve Dampens production of stress hormones Lower blood pressure and heart rate 18

19 Belly Breathing Belly Breathing Video on YouTube 19

20 Relational Strategies Medically Ready Force Ready Medical Force 20

21 Managing Social Stressors Stress impacts social interactions Harder to concentrate More difficult to listen to others Social interactions impact stress level Miscommunications 21

22 Mind Reading & Jumping to Conclusions Benefits Drawbacks Connection to stress 22

23 Assert and Be Heard Pick a good time and place I statements Keep it brief 2 positives, 1 negative Listen openly Be curious, first Repeat back in your own words Convey respect 23

24 Human Performance Resource Center One stop shop for evidence-based information and key resources on Online, public facing, purple website

25 Boost your speaking and listening skills

26 Make stress your ally

27 What s your stress mindset?

28 Key Takeaways You can help yourself as well as clients optimize their stress in everyday performances by: Knowing what is the right level of energy activation to excel at each performance (IZOF) and the thoughts that will lead to those outcomes. Reappraising the physiological responses of stress to stay in control stress is my friend. Using physiological strategies, such as mindful breathing, to activate the rest and digest to calm the body down. Use assertive communication to avoid stress spilling over into your social interactions and therefore causing more stress! Medically Ready Force Ready Medical Force 28

29 References Army: Targeting Stress Workbook. (n.d.). Stress Management : A Guide for Senior Leaders Stress and the Mind-Body Connection. Crum, A., Salovey, P. & Achor, S. (2013). Rethinking Stress: The Role of Mindsets in Determining the Stress Response. Journal of Personality and Social Psychology, 104(4), Donner, N. C., & Lowry, C. A. (2013). Sex differences in anxiety and emotional behavior. Pflugers Archiv European Journal of Physiology, 465(5), Ellis, A. (1958). Rational psychotherapy. The Journal of General Psychology, 59(1), Faravelli, C., Alessandra Scarpato, M., Castellini, G., & Lo Sauro, C. (2013). Gender differences in depression and anxiety: The role of age. Psychiatry Research, 210(3), Medically Ready Force Ready Medical Force 29

30 References Hagenaars, M. A., Mesbah, R., & Cremers, H. (2015). Mental imagery affects subsequent automatic defense responses. Frontiers in Psychiatry, 6(JUN), Jamieson, J.P., Nock M.K., & Mendes, W.B. (2012). Mind over matter: Reappraising arousal improves cardiovascular and cognitive responses to stress. Journal of Experimental Psychology 141(3), Jokela, M., & Hanin, Y. L. (1999). Does the individual zones of optimal functioning model discriminate between successful and less successful athletes? A metaanalysis. Journal of sports sciences, 17(11), Leach, L. S., Christensen, H., Mackinnon, A. J., Windsor, T. D., & Butterworth, P. (2008). Gender differences in depression and anxiety across the adult lifespan: The role of psychosocial mediators. Social Psychiatry and Psychiatric Epidemiology, 43(12), Medically Ready Force Ready Medical Force 30

31 References Matud, M. P. (2004). Gender differences in stress and coping styles. Personality and Individual Differences, 37(7), McGonigal, K. (2015). The upside of stress: Why stress is good for you and how you can get good at it. New York: Penguin Random House. McLean, C. P., & Anderson, E. R. (2009). Brave men and timid women? A review of the gender differences in fear and anxiety. Clinical Psychology Review, 29(6), Taylor, E, S., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung, R. A. R., & Updegraff, J. A. (2000). Biobehavioral Responses to Stress in Females: Tend-andbefriend, not Fight-or-flight. Psychological Review, 107(3), Medically Ready Force Ready Medical Force 31

32 Thank you! Gabe Paoletti, EdD, MAPP Lauren Messina, PhD, LCMFT Medically Ready Force Ready Medical Force 32