Thomas Milsted. www.stressfonden.dk
Thomas MilstedGeneralsekretær
www.stressfonden.dk
Tlf: 3141 8376
Thomas Milsted. www.stressfonden.dk
Thomas Milsted. www.stressfonden.dk 3
Fight-Flight reaction
• Flight• Fight• Freeze
Thomas Milsted. www.stressfonden.dk
Stress currently has five meanings:
The concept of stress actually used to designatefive different phenomena:
1. The actual stimulation2. The experience of stimulation3. The physiological and psychological reaction4. The length of stress5. Experiencing the reaction.
Thomas Milsted. www.stressfonden.dk
Conception of stress
• Based on genetic makeup, experience, and reinforcement, a person develops a preferential hierarchy of values. This determines the individual´s preference for one steady state rather than another, and hence, the range of stability for each of the variables he or she attempts to maintain in balance
Thomas Milsted. www.stressfonden.dk
Psychological needs
• We need food, water and rest if your body to function. That is ours basic physiological needs.
• Similarly, we also have some basic psychological needs:
Thomas Milsted. www.stressfonden.dk
• Need for self - satisfaction• Contact need• Need for control (internal control)• Competency Requirements (learning, mastering)• Pleasure Needs (sexual, culinary, cultural, etc.)• Need for bodily well-being (fitness, weight)• Need for meaningful• Safety needs
Thomas Milsted. www.stressfonden.dk
Discuss whether each of you have met your basicpsychological needs when it comes:
• Need for complacency(I have very much opportunity to do well and do not feel offended ifh. the quality of my work)
•Need to contact(I have good relations in relation to colleagues, clients or citizens)
•Need for control(I have very much opportunity to manage the content, quantity and pace of my work)
•Need formeaningful(My work gives me a certain degree of euphoria and an experience of working with something that benefits other than myself)
•Need for reassurance(I am comfortable expressing my own views, values and feelings at my work)
Thomas Milsted. www.stressfonden.dk 9
The autonomic nervous system
DecreasedLowDecreased blood flowIncreased blood flowIncreased activityDecreased passageDecreased sweat secretionConstricted
Relaxed
IncreasedHighIncreases blood flow Decreased blood flowDecreased activityIncreased passageIncreased sweat secretionDilated
Increased alert
Heart functionBlood pressureMusclesSkinBowelsLungsSweat glandsPupilsBrain activity
Parasympathetic nervous system
Sympathetic nervous system
Thomas Milsted. www.stressfonden.dk
TOIL ON NEUROLOGICAL SYSTEM
Max activity
SYMPATHETIC PARASYMPATHETIC
Normal rest
Thomas Milsted. www.stressfonden.dk
Changes in ”The big four”:
• Sleep
• Sex
• Eating habits
• Social habits
- at all changes in behavior
stress symptoms
Thomas Milsted. www.stressfonden.dk
Glucose Fat Protein Water
Co
rtiso
l AU
C
0
10
20
30
40
50
60
Time (min)
0 20 40 60 80 100 120 140
Co
rtisol (nmol/l)
0
2
4
6
8
10
12
14
16
18
20
22
24
26
Stres
s
G / F
/ P / W
Fat
Glucose
Protein Water
(Gonzalez-Bono et al., 2002)
Thomas Milsted. www.stressfonden.dk
Time (min)
-10 0 10 20 30 40 50 60 70 80
Sal
ivar
y C
ortis
ol (n
mol
/l)
0
2
4
6
8
10
12
14
AC
TH (p
g/m
l)
0
10
20
30
40
50
60
70
Cortisol ACTH
STR
ES
S
Thomas Milsted. www.stressfonden.dk 14
Stress can be seen in sleep
Thomas Milsted. www.stressfonden.dk
Changes in ”The big four”:
• Sleep
• Sex
• Eating habits
• Social habits
- at all changes in behavior
stress symptoms
Thomas Milsted. www.stressfonden.dk
Symptoms and consequences of stress
Behavioral
•Reduced performance
•Social isolation
• Indeciveness
•Conflicts with other
•Lack of commitment
• Increased use of stimulants
Cognitive
•Reduced concentration
•Loss of memory
•Confusion
•Tunnel vision
•Learning Difficulties
Physical
•Headache
•Dryness in throat and mouth
•Tensions
•Palpitation
•Dizziness
•Constipation, diarrhoea
• Insomnia
Emotionally
•Mood swings
• Irritability
• Impatience
•Restlessness
•Anger/aggressiveness, cynicism
•Guilt, anxiety
•Depression
Thomas Milsted. www.stressfonden.dk
What to do in cases of problems with myself?
• Stop up
• Map your behavior
• If possible, consider alternatives
• Use colleagues and manager
• Insist on follow-up
• In the worst case: compensate!
Thomas Milsted. www.stressfonden.dk 18
Effects of Stress
Sumof strains
-+
Copingstrategies
Personality (Temperament, expectations,
needs)
and background
+
=
Effects of Stress
Thomas Milsted. www.stressfonden.dk
Breaking point
Strain/stress
Time
BPThreshold of an individuals capability
Thomas Milsted. www.stressfonden.dk
Breaking point
Strain/stress
Time
BP
Rest
Thomas Milsted. www.stressfonden.dk
Stress coping
Relief Running Fishing
Gardening View movie
Play
Relaxation Rest
Relaxation Yoga
Meditation Breathing Exercises
Thomas Milsted. www.stressfonden.dk
High level
Use of reserves
Exhaustion:
What and who gives me energy?
What and who takes my energy
Thomas Milsted. www.stressfonden.dk 23
Each of these areas have helped you to preserve life joy! Write 2-3 acts in each area that you think you can do to preserve the joy of life:
Work Personal Family Contacts with other
1: 1: 1: 1:
2: 2: 2: 2:
3: 3: 3: 3:
How shall you or will you ensure that each of these points are present persistent in your life as a "security" of your life energy?
Thomas Milsted. www.stressfonden.dk
Prevention method Specific aim• Primary prevention• Learn optimism: Alters the individual's way of thinking
about adversity and stressful events or
people• Time management: Improves planning and prioritising of
activities and eliminates unnecessary
activities• Modifying type A: Reduces the anger, hostility and intensity
with this behaviour• Establishment of
supportive relation- Enhances resources, knowledge and
ships: support to manage demands, stressful
events adversity
Thomas Milsted. www.stressfonden.dk
Secondary prevention
• Physical fitness: Improves cardiovascular strength and improves
muscle strength and flexibility
• Relaxation training: Lowers all indicators of the stress response
provides calming skills for stressful times
• Diet: Improves overall physical health an lowers the
risk of cardiovascular disease and cancer
• Emotional outlets: Provides releases for emotional stress and
tension
Thomas Milsted. www.stressfonden.dk
Tertiary prevention
• Traumatic stress
debriefings: Releases the emotional stress and conflicts
resulting from traumatic events
• Professional help: Provides medical (e.g cardiology, oncology,
psychiatry) treatment, drug therapy and
psychological counselling to heal those with
specific distress and strain problems
Thomas Milsted. www.stressfonden.dk
Piece of advice about stress
• Bee you self• Control your own life• Relax once or twice a day• Try too avoid coffee,
alcohol and cigarettes• Know every time you
succeed• Laugh
• Do have positive visions• Ask for help, advice and
counselling freely...you are not the centre of the universe
• Solve the conflicts that unavoidable will come in your life
Thomas Milsted. www.stressfonden.dk
Principle, choice and changed behaviour as a strategy at the personal level
• Principle
• Choice
• Behaviour
Thomas Milsted. www.stressfonden.dk
Principle, choice and changed behaviour
Principle: A principle is a comprehensive resolution example: ”I will be happy when i go to work and when i come home””I will not work at home””I am present now…all the time!”Choices: Principles mean that you have to make choices in order to live up to yourprinciples. If for example your principle is to be happy when you go to work andwhen you come home, you have to create a balance between spare time andworking time. Generally, you have to focus on obtaining the balance necessaryto be happy!Behaviour: Choices entail a change in behaviour compared to what you normallydo/think/mean! If your principle is that your home and your work are bothimportant areas, maybe you have chosen to leave the office on time to be ableto spend more time with the family during the “awake” hours. Maybe then youhave had to change your behaviour and no longer stay for half an hour or morebeyond the official working time.
Thomas Milsted. www.stressfonden.dk
well-being is dependent on experience and expectations:
expectations
satisfaction=
experience
When the equation is = or greater than 1 there are wel-being where the equation is less than 1 there are not weel-being
Thomas Milsted. www.stressfonden.dk 31
A responsible employee – in terms of stress ….
• Is aware of himself/herself, can identify his/her symptoms and knows his/her limits
• Knows how to handle his/her own stress and uses the possibilities available in the workplace for protecting himself/herself and the possibilities outside work to prevent stress
• Tells others when stress could become a problem after all
• Looks further than his/her own nose and is aware of the influence his/her own stress may have on colleagues.
Thomas Milsted. www.stressfonden.dk
Specific tools for prevention and handling of stressors
1. Physical
2. Psychological
3. Behavioral
4. Fundamental
Thomas Milsted. www.stressfonden.dk
Physical tools
When the Cortisol-level must be reduced!!!
• Alfa-training• Deep breathing• Physical contact• Laughter• Joy • Exercise
Thomas Milsted. www.stressfonden.dk
Psychological tools
• Acknowledgement• Safety/ security (ex: clarification of roles, plan B)
• Job satisfaction (ex: focus on how to optimize it?)
• Criterias of succes (ex: when is the effort good enough?)
• Personal space (ex: are you able to say no, when necessary )
Thomas Milsted. www.stressfonden.dk
Behavioral tools
Agreements of:
• How to care about each other! (ex: if a colleague is showing signs of stress, we will take action)
• How to take action? (ex: what kind of support do we need?)
• We implement a stress-reducing habit (ex: everyday check ups on well-being. Alfa-training)
.
Thomas Milsted. www.stressfonden.dk
Fundamental tools
• Personal values• Choice (ex: to be well!)
• Principle (ex: we don’t want to be stressed)
• Responsibility (ex: acknowledgement, support, presence…)
Some conditions can be changed only through a personaldecision of principle.
And some conditions can be changed only with yourcolleagues: with a common attitude and joint effort.
.
Thomas Milsted. www.stressfonden.dk
• Stress is a state of anxiety produced when events and responsibilities exceed one’s coping abilities.
Thomas Milsted. www.stressfonden.dk
• ”Coronary Artery Disease (CAD) with resultan Myocardial Infaction (MI) is repidly becoming the leading cause af death and disability in the intire world.”
• In ten years evry second will die of MI
WHO
Thomas Milsted. www.stressfonden.dk
What is the connexion between CAD og MI?
• Anger• Hostility• Depression
• Work-related stress/ job strain
• High demands• Lack of control and
poor influence. Low decision
Thomas Milsted. www.stressfonden.dk
Stress at work
• To much work• To little work• Time pressures and
deadlines• Poor physical working
conditions• Mistakes• To many decisions• Bad colleagues
Thomas Milsted. www.stressfonden.dk
Personal stress
• Life situation
• Own expectations
• Others expectations
• The personality
Thomas Milsted. www.stressfonden.dk
Senses
Thalamus
Cortex
Amygdala
Fight our flight response
The Brain
Thomas Milsted. www.stressfonden.dk
Feelings
Control No control
Anger
Joy
Fear
Sorrow
Furious
Mania
Panic
Depression
Irritation
Good mood
Tence
Bad mood
Thomas Milsted. www.stressfonden.dk
Adrenaline
• Fear • Flight/escape • Passivity
Thomas Milsted. www.stressfonden.dk
Noradrenaline
• Anger
• Aggressiveness
• Fight
Thomas Milsted. www.stressfonden.dk
• Depression. • Helpless. • Lack of control. • No desire/Not wanting • Discomfort
Cortisol
Thomas Milsted. www.stressfonden.dk
Oxytocin & Endorfins
• Tend and befriend
Thomas Milsted. www.stressfonden.dk
Joy & laughter
• Gamma interferon• White bloodcells• Antibody in the
mucosas• Endorfins
Thomas Milsted. www.stressfonden.dk
Emotional capturing
Situation
Object
Emotions:
Fear
Anger
Sorrow
Pleasure
Stress
Thoughts
Thomas Milsted. www.stressfonden.dk
Stress symptoms
• Irritable• Missing power of
concentration• Bad mood• Nervousness• Impatience• Worries• Isolation• Lost of appetite
Thomas Milsted. www.stressfonden.dk
• Insomnia and sleep disturbances
• Muscle tension and pain
• Heart palpitations• Stomach upset and
gastrointestinal pro-blems
• Headaches
Thomas Milsted. www.stressfonden.dk
The Healthy Human Being
• Try to have such a large reserve of energy that there is time and opportunity to play just for fun
• Encourage yourself to develop a deep interest and involvement in the activities you are engaged in.
• Develop an innocent curiosity. Have the courage to seek new areas.
• Have determined informality. You may consciously react against the formal stiffness that characterises many situations.
• Open self-criticism. Being self-critical, with the purpose of learning how to make things better and in a better way.
• Being in possession of an active, daydreaming imagination. This provides us with the breathing holes that are important in order to handle the complications that life contains, and in order to solve problems instead of living with them.
• Do not have a judgmental attitude towards other people
Thomas Milsted. www.stressfonden.dk
The Pleasure of one´s work
• Influence and control in your work• The feeling that your work are
appreciated and the experience that your work has a valuable point
• Personal and professional challenges
• Good fellowship with your colleagues
Thomas Milsted. www.stressfonden.dk
• Live with purpose and mission
• Keep your priorities clear and limited
• Focus on the good things in life, with-out ignoring the bad
• When angry, ask yourself: is it really justified?
• Get regular physical exercise and activity
• Express your positive emotions daily
Thomas Milsted. www.stressfonden.dk
The Brain
Physical world:Sight. HearingFeeling. Smell. TasteSence of time andspace.
Beta 2
Beta 1Daily
consciousness
I nner world:No sence of timeand space
Alf a (rem)Thought-activity Levels of inner
consciounessThetaChok. Hard
physical strain.
Deep sleep Delta Unconsciousness
Brain- oscillation (Hertz)
4
7
14
20
38
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