It s An Inside Job. Lisa Holland, PhD. Licensed Marriage and Family Therapist. South Carolina Municipal Attorneys Association Annual Meeting

Transcription

1 !1 It s An Inside Job Looking Within Ourselves to Create New Coping Strategies for Managing Stress Lisa Holland, PhD Licensed Marriage and Family Therapist South Carolina Municipal Attorneys Association Annual Meeting Columbia, South Carolina December 2, 2016

2 !2 It s An Inside Job Looking Within Ourselves to Create New Coping Strategies for Managing Stress Course Goal This class will examine an integrative method of processing stress that has a direct effect on the psychological and physiological demands on the attorney. Through case study and questionnaire the participant will learn how internalized beliefs can create patterns of anxiety and defense and how these patterns of emotion can become internalized stressors. The attorney will create at least one new coping strategy to help reduce their internal feelings of stress. Contact Information Lisa Holland, PhD, LMFT 1237 Gadsden Street Suite 200 J Columbia, South Carolina lisa@lisahollandphd.com

3 !3 Overview 1. Internal vs. External Stress 2. Case Study: Joe 3. How You Process Stressors Hans Selye: General Adaption Syndrome Alarm Reaction, Resistance, Exhaustion Fight, Flight and Freeze 4. Joe s Stressful Situation 5. Core Beliefs 6. Getting to Your Core Beliefs 7. Example: Joe How Joe s Core Beliefs Were Formed 8. Connecting Core Beliefs and Stress 9. Conclusion 10. References 11. Choosing a Therapist

4 !4 Internal vs. External Stress According to Folkman and Lazarus, coping refers to cognitive and behavioral efforts to master, reduce or tolerate the internal and/or external demands that are created by the stressful transaction. The best way to visualize stress it to think about it in terms of a system. External: Stressors on the system. Environment, job, home, trauma, injury, relationships, expectations, responsibilities, tasks. Internal: Stressors within the system. Thoughts, beliefs, memories, worries, emotions, illness, infection, lack of rest. Although there are physical ways to cope with stress, we will focus on the internal ways, on cognitive strategies.

5 !5 How You Process Stress Case Study:Joe Joe: My boss and I got into it again and he told me to go see somebody about my anger issues. I don t know why I blew up, it was like I went into a zone. Actually I always feel like something s brewing inside me, like I m sitting on a volcano. I blow-up with my wife too. Regardless, I always feel like a jerk when it happens. I know some things just set me off. But when I think about my career, every job I ve had has ended this same way, that is, with me blowing up and storming out. I turned 50 in May and I m sick of hearing myself blame other people for what I know is my stuff. I know I m smart, I should be able to figure out what s going on and stop it, but there s something I m not seeing. I like and respect Carl, he s the most insightful and tuned-in boss I ve ever had. I m glad he told me to do this instead of don t let the door hit you on the way out!

6 !6 General Adaptation Syndrome Described by Hans Selye ( ), an Austrian-born physician who emigrated to Canada in 1939, general adaptation syndrome represents a three-stage reaction to stress. Selye explained his choice of terminology as follows: "I call this syndrome general because it is produced only by agents which have a general effect upon large portions of the body. I call it adaptive because it stimulates defense. I call it a syndrome because its individual manifestations are coordinated and even partly dependent upon each other. Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older. - Hans Selye, MD, PhD

7 !7 Alarm Reaction (ar) Sensing a a stressor, the body reacts with a fight, flight or freeze response. The sympathetic nervous system is stimulated as the body s resources are mobilized to meet the threat or danger. Stage of Resistance (sr) As the body resists and tries to compensate, the parasympathetic nervous system attempts to return many physiological functions to normal levels while also remaining on alert. Stage of Exhaustion (se) If the stressor or stressors continue beyond the body s capacity, the resources become exhausted and the body begins to break down and becomes susceptible to disease and death. People who experience long-term stress may succumb to heart attacks or severe infection due to their reduced immunity. Fight - Flight - Freeze To switch effectively from defensive to social engagement the nervous system must do two things: 1. Assess risk 2. And, if the environment looks safe, it has to inhibit the primary defensive reactions from moving to fight, flight or freeze.

8 !8 Joe s Stressful Situation Situations like Joe s can be difficult to figure out. We can see his behavior, but we can t see what motivates it, so we make a guess. For example: Joe s an angry guy. He s a jerk. The truth is, Joe wonders why he responds the way he does. Always, is a clue. Over time, responses to stress become well-worn, patterns of thinking and responding. Patterns that are often below awareness. Joe feels stuck, frustrated and worried. Core Beliefs Core Beliefs are the essence of how we see ourselves, other people, the world and future. They are strongly held, inflexible beliefs that develop in childhood and are shaped over time. They are rooted in our experience of significant life events and circumstances.

9 !9 This is what the world sees Getting to Your Core Beliefs 1. Think about an environment or situation when you had protective thoughts like: I will not be hurt again I will not or cannot do this. I will not allow this or experience this I m not what you think 2. Separate what you know about yourself from what you believe about yourself: Know: I know I m a pushover Believe: I don t deserve to win

10 Know: Believe:!10 Example: Joe 1. What is obvious: Joe, got into an argument with his boss. Blew up. Turned 50 this year. Stormed out of the room. Blows-up with his wife and in other jobs. 2. What he knows: 1. Feels like a volcano inside. 2. Feels like a jerk. 3. Knows he s smart should figure it out. 4. There s something I m not seeing. 5. Sick of hearing myself blame other people.

11 !11 How Joe s Core Beliefs Were Formed At a baseball game when Joe was 10. Joe said to himself no one will ever embarrass me again. Connecting Core Beliefs and Stress Protection and safety are primary functions of your Autonomic Nervous System. When you re in situations that don t feel safe or experience something that is threatening, as a child you accommodate because you cannot care for yourself. Over time, you develop patterns of coping that are intended to protect and defend. Living in a continual state of protection or defense creates an extended (chronic) state of alarm and resistance with no exhaustion.

12 !12 Conclusion Stress has become a blanket word that is used to describe anything that feels uncomfortable and creates demands on the system. The system is you. You can t run from external stress because it s built into the context of your life. You can t run from internal stress because it s processed in your thinking and in your interpretations of protection. Since you cannot run from it or pretend it doesn t exist, you must make peace with it. Although there are tons of creative ideas that can help people manage emotional and stressful situations, many are generic and not specific to the person s life. Therefore, some just don t work which leave people wondering if anything will ever work. To find coping strategies that work, you have to go inside. You have to look at the events and situations that have helped make you who you are. It s here in the root, that part of your life that is only visible to you, where you can change how you cope with stress.

13 !13 References Csiksgentmihalyi, M. (2003). Good Business: Leadership, Flow and the Making of Meaning. Penguin Putnam. New York. Csiksgentmihalyi, M. (1990). Flow: The psychology of optional experience. Harper & Row, New York. Damasio, A. (1994). Descartes Error: Emotion Reason and the Human Brain. New York: AVON Books. Frisian, M. (2014). Influential Leadership: Change Your Organization, Change Your Health Care. Journal of Health Administration. Folkman S. (1984). Personal control and stress and coping processes: a theoretical analysis. J. Pers. Soc. Psychol. 46, [PubMed]. Folkman S., Lazarus R. S. (1980). An analysis of coping in a middle-aged community sample. J. Health Soc. Behav. 21, [PubMed]. Goleman, D. (2002). Primal leadership: Learning to Lead With Emotional Intelligence. Harvard Business School Press, 2004, 253. Holland, E. H. (2005). Emotion focused and problem focused coping strategies in children with chronic illness. Dissertation Research, Capella University. Lazarus R. S. (1991). Emotion and Adaptation. New York: Oxford University Press. Lazarus R. S. (1999). Stress and Emotion: A New Synthesis. New York: Springer. Mahoney, M. J. (1995). Emotionality and health: Lessons from and for psychotherapy. In J. W. Pennebaker (ed.), Emotion, Disclosure, and Health (pp ). Washington, DC: American Psychological Association. Ochsner, K., Bunge, S., Gross, J., and Gabrieli, J. (2002). Rethinking feelings: An fmri study of the cognitive regulation of emotion. Journal of Cognitive Neuroscience, 14: Porges, S. (2011). The Polyvagal Theory: Neurological Foundations of Emotions, Attachment, Communication and Self-Regulation. W.W. Norton & Company, New York. Selye, H. (1956). The Stress of Life. McGraw Hill, New York. Selye, H. (1974). Stress Without Distress. New York: J.B. Lippincott Company. von Bertalanffy, L. (1969). General Systems Theory: Foundations, development, applications. George Brazier, New York.

14 !14 Choosing a Therapist While any of these mental health professionals (all loosely known as psychotherapists) can help you deal with emotional issues, their effectiveness is largely determined by how much they are a fit for you and your goals. Psychiatrist (MD): A medical degree plus a four year residency in psychiatry. What distinguishes psychiatrists from other mental health professionals is their ability to prescribe medicines. They tend to deal with clinical disorders such as schizophrenia, phobic disorder, bipolar disorders that are treatable at least in part with medication. Psychologist (PhD or PsyD): To be licensed, a psychologist must have either a doctor of philosophy or psychology degree. All doctoral level therapists must complete internships. Psychologists are trained to diagnose and deal with the full range of disorders such as anxiety, substance abuse, eating disorders and abuse. They may also be trained to administer personality and educational assessments. Marriage and Family Therapist (LMFT): They may hold either doctoral degrees or master s degrees and all must complete internships. Essentially, MFTs are trained in systems theory and their work is focused on how people interact with each other and within larger systems. They work with individuals, couples, children and families. Licensed Professional Counselor (LPC): While they can have various mental health degrees, this license allows these clinicians to practice psychotherapy. All must complete an internship. LPC s typically focus on general every-day emotional issues brought on by changes in personal situations. Social Worker (MSW): A licensed clinical social worker has a master s degree and must complete an internship. Social Workers can practice psychotherapy, however, many work in inpatient facilities and focus on health related issues and case management.