Stress Management in a Wellness Coaching Practice Dr. Emily Matuszewicz Assistant Professor, Integrative Health Care Chair, Health Professions Department Metropolitan State University of Denver Integrative Health Major Foundational curriculum for wellness coaching minor/certificate: Holistic Health Complementary and Alternative Medical Therapies Lifestyle Medicine ------------------------------------- Stress and Sleep Clinical Pathophysiology Healthcare Research What is stress? 1
Evolution of Stress Ancestors experienced different types of stress Ancestors died from different diseases Now we have technology, mortgages, and many more forms of chronic stress Sustained psychological stress, emotions, thoughts We also deal with different chronic diseases Sapolsky s Why Zebras Don t get Ulcers Why Zebras Don't Get Ulcers; Sapolsky; 3rd Edition Stress can make us sick 60-90% of visits to primary care providers are related to mind-body-stress induced conditions (Herbert Benson 6/2013) But do we realize just how sick it can make us? Do we realize how many systems it impacts? Why Zebras Don't Get Ulcers; Sapolsky; 3rd Edition Autonomic Nervous System Sympathetic nervous system is activated by a stressor Fight or flight Adrenal glands secrete glucocorticoids Epinepherine and norepinepherine Parasympathetic nervous system Calming, energy storage, growth Opposing parts of one system Why Zebras Don't Get Ulcers; Sapolsky; 3rd Edition 2
The Stress Response Our body wants to help us flee from a predator Get energy to muscles now Don t store energy away for later because it s now that is the problem, energy storage can wait Heart rate increases to get glucose to muscles now! Blood pressure increases Respiratory rate increases And many other changes to help us flee quickly Why Zebras Don't Get Ulcers; Sapolsky; 3rd Edition Is stress good or bad? What are the typical conversations we have with others about stress? What about our internal conversation with ourselves? Is the stress response a malfunction of our physiology or an intelligent response? Are there benefits of stress? TED Talk by Kelly McGonigal, Health Psychologist Had been telling people that stress makes you sick, stress is the enemy Quotes study that tracked 30,000 US adults for 8 years Began by asking people, How much stress have you experienced in the last year? and Do you believe that stress is harmful for your health? Used public death records to find out who died http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend.html 3
How to make stress your friend Those who reported a lot of stress in the previous year had a 43% increased risk of dying But that was only true for the people who also believed that stress is harmful for your health People who experienced a lot of stress but did not view stress as harmful were no more likely to die (in fact they had the lowest risk of dying) If that estimate is correct, that would make believing stress is bad for you the 15 th largest cause of death in the US. http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend.html How to make stress your friend What if you viewed your stress response as a sign that your body was energized and preparing you to meet challenges? What is the lens through which you perceive stress? http://www.ted.com/talks/kelly_mcgonigal_how_to_make_stress_your_friend.html The Values Factor, Dr John Demartini Everyone has a unique set of values as specific as your fingerprint or retinal pattern Your unique purpose is to understand and fulfill your highest values 4
What are your highest values? Values vs social idealisms Social idealisms: socially acceptable ways of thinking and behaving Should, ought to, have to. Voids to Values Your values reflect what you perceive is most missing in your life Whatever we perceive is missing sets off a hunger for precisely that thing. Hierarchy of Values. 5
7 Dimensions Highest values - inspired, identity, order Lowest values - uninspired, disorder, chaos Motivation versus inspiration. Evidence-Based* Values True driving force that shapes your perceptions, actions and feelings Internal compass Deeply nourishes your innermost being Where s the evidence? Values Questionnaire (available on website) Creates the lens through which you perceive stressors *my terminology Highest Values if you want to know why you are not doing something you think you should, or why you can t stop doing something you think you shouldn t, the answer will almost always be the same: you are inevitably going to do what you truly value most. How does this shape our stress response? What are the implications for wellness coaching? 6
Different Values Being careless means talking in terms of your values but not the values of another. Being careful means talking to the values of another but not your values. Being caring means communicating your values in terms of the values of another. What s the problem with positive thinking? We are two-sided beings Perfect that way Why do I need the negativity? What purpose does it serve?. 7
Comparing Ourselves to Others No need to exaggerate or minimize ourselves in relation to others Injected values. Reasons why we have negative thoughts Show up as the ABCD s of negativity: o Anger, aggression o Blame, betrayal o Criticism, Challenge o Depression, Despair STRESS! Wake up? Feedback mechanism of ABCD s We experience the ABCD s of negativity when we are placing an unrealistic, one-sided expectations on ourselves, others or the world Those disappear when we set realistic expectations and see both sides and understand that everyone is responding according to their own values The Upside of Your Dark Side by Todd Kashdan Fundamental to stress management and the relaxation response 8
Power of Full Engagement by Loehr & Schwartz To be fully engaged, we must be: Physically energized Emotionally connected Mentally focused Spiritually aligned with our individual purpose Balancing STRESS & RECOVERY Tools Structure our days and fill them with inspiring actions Master the art of communicating what is important to us in terms of what is important to those we care about Give ourselves permission to say no to other people s unrealistic expectations and low priority distractions Reflect each day on what s working and not working Cultivate gratitude Practice mindfulness and breathing 9
Tools Lifestyle medicine modalities: mindful eating, movement, sleep Client has to understand how these behaviors will support the fulfillment of their highest values Identify highest values Link behaviors to highest values Make a list of 50-100 benefits, 50-100 drawbacks Stress-buster example: Anxiety worst-case scenario how will it serve me? Delusion We behave as if are right and assume that others should live inside of our values Can you be grateful for the ABCD s of negativity? We grow the most 10
When you see Support without challenge elated and manic Challenge without support.depressed and resentful See both = love Dialectic Began with the ancient Greeks Realized that there is always an argument for and against (logic evolved out of this dialectic debate) Discovered the dynamic equilibrium between complementary opposites Symmetry Opposites build and destroy, eternal law of change = transformation *Someone is building what you are trying to destroy and someone is destroying what you are trying to build 11
Simultaneous Build and destroy occur simultaneously While someone is challenging you, someone else is supporting you and vice versa Equal and opposite are always there Biased value system Our values filter our reality and we have a biased value system Only see one side Alert or shut out Someone else in the universe will see the opposite to maintain balanced awareness One-sided Expectation to be one-sided source of suffering Always positive, nice, giving Reality is that you have moments of revenge, anger, etc. 12
Autonomic Nervous System Sympathetic tackle challenges Parasympathetic support and protection Imbalance = disease Your physiology is helping you to become authentic Wholeness Feedback mechanism to bring us into a state of wholeness How can you have wellness without wholeness? Living in someone else s values Delusion: Unrealistic expectation to live outside your own values Leaves you uninspired Inspired doing things that are highest in your values 13
Conservation of Ease and Difficulty The easier you try to make your life, the more difficulties you attract The more challenges you take on, the more ease comes into your life Cause of Dis-ease Living outside your values self-defeating Lowered vitality, creates symptoms Diseases = gifts that guide us to be true to ourselves and set realistic expectations Stress Management Important takeaways How do we understand the drivers of stress, it s benefits and respond when we experience stress? Why is information and support frequently insufficient to alter underlying behaviors even when we think that s what we want? How do we not just suppress the stress response but truly listen and embrace it? 14