The New Science of Stress Management - Theory & Application

We will learn to manage and reduce stress at individual and organizational levels:

• Introduction

  • Key Takeaway

    • Jedi mind tricks

    • Your mindset matters.

    • I have bad news and good news

      • "You are responsible for you."

    • "Mind is the forerunner of all things. As you think and act, so your world becomes."

    • die positive

      • positive, focused, action oriented

      • Chuck Yeager - test pilots - Edwards Air Force Base

      • Yeager: An Autobiography Paperback

  • Key Takeaways - The New Science of Stress

    • (1) stress doesn't kill you

      • your belief that stress is bad for you kills you

      • old message

        • stress is bad; makes you sick

        • stress was demonized

• (2) change your mind, change your body's response

  • " … how you think about stress matters …"

  • " … I am strong and I am ready to take on challenges …"

  • " … my body is ready to do what it needs to do …"

  • " … trust yourself to handle life's challenges …"

  • " … you don't have to face challenges alone …"

  • new message

    • stress is good; makes you strong; resilient; performant; focused

    • stress exists within us to help us

• (3) stress drives you to be social

  • oxytocin - neurohormone

    • the cuddle hormone

    • increases empathy, compassion, caring, connection

  • it's also a stress hormone

    • pituitary gland pumps it out during stress

    • motivates you to seek social support

      • connect with others

      • tell them how you feel

      • allows us to support each other

    • restores your body

      • natural anti-inflammatory

      • helps blood vessels stay relaxed

      • helps heart cells regenerate and heal

        • your heart has oxytocin receptors

  • social contact and support

    • releases even more oxytocin

  • your stress response has a built in mechanism for stress resilience

    • that mechanism is human connection

• Research

  • (1) Does the Perception that Stress Affects Health Matter? The Association with Health and Mortality

    • Questions asked of participants

      • How much stress have you experienced in the last year?

      • Do you believe stress is harmful to your health?

        • yes

          • 43% increased risk of dying

        • no

          • no increased risk of dying

    • 33.7% of nearly 186 million (n=28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death

    • Keller, Abiola, et al. "Does the perception that stress affects health matter? The association with health and mortality." Health psychology 31.5 (2012): 677.

  • (2) Mind over Matter: Reappraising Arousal Improves Cardiovascular and Cognitive Responses to Stress

    • Researchers have theorized that changing the way we think about our bodily responses can improve our physiological and cognitive reactions to stressful events. However, the underlying processes through which mental states improve downstream outcomes are not well understood. To this end, we examined whether reappraising stress-induced arousal could improve cardiovascular outcomes and decrease attentional bias for emotionally negative information. Participants were randomly assigned to either a reappraisal condition in which they were instructed to think about their physiological arousal during a stressful task as functional and adaptive, or to 1 of 2 control conditions: attention reorientation and no instructions. Relative to controls, participants instructed to reappraise their arousal exhibited more adaptive cardiovascular stress responses—increased cardiac efficiency and lower vascular resistance—and decreased attentional bias. Thus, reappraising arousal shows physiological and cognitive benefits. Implications for health and potential clinical applications are discussed.

    • They were told how the body’s stress response evolved to help us succeed, and that the increased arousal symptoms of stress can aid your performance during times of stress. The bottom line of the lesson was this: In a tough situation, stress makes you stronger.

    • Jamieson, Jeremy P., Matthew K. Nock, and Wendy Berry Mendes. "Mind over matter: reappraising arousal improves cardiovascular and cognitive responses to stress." Journal of experimental psychology: General 141.3 (2012): 417.

  • (3) Giving to Others and the Association Between Stress and Mortality

    • Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.

    • Poulin, Michael J., et al. "Giving to others and the association between stress and mortality." American journal of public health 103.9 (2013): 1649-1655.

summary: Ted Talk - How to make stress your friend | Kelly McGonigal

• additional resources:

  • World Economic Forum - The science of how mindset transforms the human experience | Alia Crum

    • mindsets

      • formed from our conditioning

        • micro and macro cultures

      • mindsets about

        • stress

        • beauty

        • eating

        • health

        • impacts of doctors

      • placebo

        • 60 - 90% efficacy for all diseases

        • belief makes it so

        • most people define placebo as

          • fake

          • woowoo mystery magic

          • not relevant

          • sugar pills

          • a joke

    • hotel maids

      • "...work is work…"

      • "…work is exercise…" (lost weight, lower blood pressure)

    • milkshakes

      • "sensishake"

      • "indulgence" - (3x impact more satiated)

  • Ted Talk - Change your mindset, change the game | Dr. Alia Crum | TEDxTraverseCity

    • (1) Dr. Fabrizio Benedetti

      • anesthesia

        • machine administered

        • doctor administered - (less pain)

      • treatments for anxiety, parkinson's disease, hypertension

        • same results

      • 
        

    • mindset

      • setting in the mind

    • mindset

      • plays a dramatic role in determining our health and well being

    • (2) hotel maids

      • "...work is work…"

      • "…work is exercise…" (lost weight, lower blood pressure)

    • (3) milkshakes

      • "sensishake"

      • "indulgence" - (3x impact more satiated)

    • (4) two videos

      • stress bad

      • stress good (better health; better engagement; better performance)

    • aging

      • positive mindset = extends longevity

    • 
      

    • our mindsets matter

  • Mindset: The New Psychology of Success - Carol Dweck

    • shift mindset from fixed to flexible

  • Harnessing the power of placebos | Dr. Alia Crum

    • histamine prick

      • "this cream will make it worse" (same chemically inert cream)

        • and it did

      • "this cream will make it better" (same chemically inert cream)

        • and it did

      • social context influences us

    • social context

      • cold and incompetent (same chemically inert cream)

        • worse placebo outcomes

      • warmth and competence (same chemically inert cream)

        • amplified positive placebo outcomes

• Course draws upon

  • Stanford Mind & Body Lab

  • Stanford's Stress Reduction Program

  • The American Psychological Association

  • Mental Health America - Mind the Workplace Survey

  • Google's research on effective workplace teams - Project Aristotle

  • Psycholog's best-practices & Academic research

  • Cognitive Behavioral Therapy (CBT)

  • mindfulness & meditation practices

• Overview and synthesis of best-practices

• Motivation:

  • Goal: increased quality …

    • quality of life

    • quality of work

  • impact on bottom line:

    • decrease stress = increased productivity and profits

  • we have room for improvement

    • individually and collectively as organizations

  • negative effects of stress

APA: "A stressful work environment can contribute to problems such as headache, stomachache, sleep disturbances, short temper, and difficulty concentrating. Chronic stress can result in anxiety, insomnia, high blood pressure, and a weakened immune system. It can also contribute to health conditions such as depression, obesity, and heart disease. Compounding the problem, people who experience excessive stress often deal with it in unhealthy ways, such as overeating, eating unhealthy foods, smoking cigarettes, or abusing drugs and alcohol."

We are embarking into the domain of soft science …

• Social Emotional Intelligence (SEI)

  • SOFT SCIENCE

    • collect and analyze empirical data

    • results are more difficult to predict

    • ambiguous ← → wicked problem

      • 1) They do not have a definitive formulation.

      • 2) They do not have a “stopping rule.” In other words, these problems lack an inherent logic that signals when they are solved.

      • 3) Their solutions are not true or false, only better or worse.

      • 4) There is no way to test the solution to a wicked problem.

      • 5) They are hard to study through trial and error. Their solutions are irreversible so, as Rittel and Webber put it, “every trial counts.”

      • 6) There is no end to the number of solutions or approaches to a wicked problem.

      • 7) All wicked problems are essentially unique.

      • 8) Wicked problems can always be described as the symptom of other problems.

      • 9) The way a wicked problem is described determines its possible solutions.

      • 10) Planners, that is those who present solutions to these problems, have no right to be wrong. Unlike mathematicians, “planners are liable for the consequences of the solutions they generate; the effects can matter a great deal to the people who are touched by those actions.”

        • source: Horst Rittel and Melvin Webber

    • principles & guidelines

  • HARD SCIENCE

    • definitive, discrete, reproducible

    • more control over the variables and conclusions

    • math, physics, chemistry

    • formulas & recipes

• Understanding stress

  • the more we understand stress, the more effectively we can work with stress

  • the more we understand ourselves, the more effectively we can work with ourselves

  • the more we understand others, the more effectively we can work with others

  • the more we understand teams, the more effectively we can work in teams

• Immediate strategy

  • body techniques

    • stretching

    • yoga

    • mindfulness

    • meditation

    • music

    • massage

    • hot bath

• Long-term strategy

  • All of these techniques …

    • The Seven Skills for Managing Stress

      • from the American Psychological Association

    • The Stanford Stress Reduction Program

    • Using mindfulness to reduce stress

    • Using Cognitive Behavioral Therapy (CBT) to reduce stress

    • Google's Project Aristotle research

    • Using the ADA loop to reduce stress

      • assess, decide, act

      • ooda loop

  • … point to the same conclusion:

    • Clarity, Cognition, Behavior (more individual oriented)

      • clarity =

      • better decision making =

      • better actions

    • Social Emotional Intelligence (more group/organizational oriented)

      • psychological safety:

        • empathy

        • social sensitivity

        • equal communication

• 1 in 8 Americans is on antidepressants

• 1 in 8 Americans is on benzodiazepines

• 1 in 4 Americans is on some type of psychiatric pharmaceutical

• 1 in 8 Americans is an alcoholic

  • 88,000 Americans died from alcohol related deaths.

  • 70,000 Americans died from drug overdoses.

• Last year in America, 100,000 drug overdoses

• Every year, 1 in every 280 Americans attempts suicide

  • 1,400,000 Americans attempt suicide.

  • Every hour of every day, an American veteran takes their life.

• 1 in 3 couples have engaged in physical violence (source)

• 50% of marriages end in divorce

• 1 in 4 grew up with alcoholics

• Last year in America, there were 417 mass public shootings.

  • "List of mass shootings in the United States in"

• If you are thinking about harming yourself or others, seek the help of others.

  • United States Suicide Prevention Lifeline Call 988

• How have you grown because of challenges and stress?

• List the ways stress is beneficial.

• What is your current mindset about stress?

  • “stress is good for me”

  • "stress is bad for me”

  • something else

• What is the most effective mindset to have about stress?

• What do you want your future mindset to be about stress?

  • write your answers down

  • tell someone about your answers

• your purpose

  • learn, grown, change, iterative, improve, evolve

• core directives of the mind

  • survive

  • procreate

  • belong

How we live our lives determines our health, wealth, & happiness.

• sleep

  • Ted Talk - Sleep is your superpower

How we live our lives determines our health, wealth, & happiness.

• exercise

  • Ted Talk - The brain-changing benefits of exercise

How we live our lives determines our health, wealth, & happiness.

• nutrition

  • the body

    • Power Foods for the Brain | Neal Barnard

• Robert Waldinger: What makes a good life? Lessons from the longest study on happiness | TED

• NYT - sign Up for Well’s 7-Day Happiness Challenge

• nutrition

  • the mind

    • Ted Talk - Is Social Media Hurting Your Mental Health?

    • Books

    • Audio books

    • Mind is the forerunner of all things. As you think and act, so your world becomes.

• lifestyle, self-care, & resilience

  • The Doctor Of The Future: Prescribing Lifestyle As Medicine | Mark Rowe

  • How to live to be 100+ - Dan Buettner

• Elizabeth H. Blackburn, The Nobel Prize in Physiology or Medicine 2009

  • The discovery of how chromosomes are protected by telomeres and the enzyme telomerase

  • Have you wondered why some sixty-year-olds look and feel like forty-year-olds and why some forty-year-olds look and feel like sixty-year-olds? While many factors contribute to aging and illness, Dr. Elizabeth Blackburn discovered a biological indicator called telomerase, the enzyme that replenishes telomeres, which protect our genetic heritage. Dr. Blackburn and Dr. Elissa Epel's research shows that the length and health of one's telomeres are a biological underpinning of the long-hypothesized mind-body connection. They and other scientists have found that changes we can make to our daily habits can protect our telomeres and increase our health spans (the number of years we remain healthy, active, and disease-free). The Telemere Effect reveals how Blackburn and Epel's findings, together with research from colleagues around the world, cumulatively show that sleep quality, exercise, aspects of diet, and even certain chemicals profoundly affect our telomeres, and that chronic stress, negative thoughts, strained relationships, and even the wrong neighborhoods can eat away at them. Drawing from this scientific body of knowledge, they share lists of foods and suggest amounts and types of exercise that are healthy for our telomeres, mind tricks you can use to protect yourself from stress, and information about how to protect your children against developing shorter telomeres, from pregnancy through adolescence. And they describe how we can improve our health spans at the community level, with neighborhoods characterized by trust, green spaces, and safe streets.

    • food

      • Telomere length is positively associated with the consumption of legumes, nuts, seaweed, fruits, and 100% fruit juice, dairy products, and coffee, whereas it is inversely associated with consumption of alcohol, red meat, or processed meat (source)

      • Flax · Spinach · Mushrooms · Berries · Oats (source)

    • exercise

      • Exercise has a beneficial effect on telomere length compared with usual care or inactivity. Exercise for more than six months is associated with changes in telomere length. (source)

    • reduce stress

      • The worse the stress was — and the longer they felt it — the more their telomeres wore down. (source)

      • Abstract – Numerous studies demonstrate links between chronic stress and indices of poor health, including risk factors for cardiovascular disease and poorer immune function. Nevertheless, the exact mechanisms of how stress gets “under the skin” remain elusive. We investigated the hypothesis that stress impacts health by modulating the rate of cellular aging. Here we provide evidence that psychological stress— both perceived stress and chronicity of stress—is significantly associated with higher oxidative stress, lower telomerase activity, and shorter telomere length, which are known determinants of cell senescence and longevity, in peripheral blood mononuclear cells from healthy premenopausal women. Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women. These findings have implications for understanding how, at the cellular level, stress may promote earlier onset of age-related diseases. source

    • community

      • trust

      • green spaces

      • safety

• Use a calendar to schedule these into your life

  • sleep

  • exercise

  • nutrition

  • belonging

  • career

"If you keep doing the same thing, you will continue doing the same thing."

• dr. weil

• technique

  • inhale 4 seconds

  • hold 7 seconds

  • exhale 8 seconds

• Book:

  • Breath: The New Science of a Lost Art

• Wim Hoff

  • breath

  • ice bath

    • Gwyneth Paltrow GOOP

    • Wim Hof website

• stretching

• yoga

• mindfulness

• meditation

• music

• massage

• hot bath

• stress definition

  • stress analogy - structural stress; metal bridge

• origins of stress

  • (1) stress is part of our heritage

    • we come from a lineage of warriors and worriers (worry-ers)

    • the vigilant survived

      • the overly calm / relaxed got eaten

    • stress is a tool

      • learn to use it, instead of it using you

      • use it when you need it to turbo-boost your response

    • stress is one more voice at the table

      • listen to its input and make your decision

  • (2) fight or flight

    • survival instinct

    • sympathetic nervous system

  • (3) difference between

    • where you are and where you would like to be

    • how things are and how you would like them to be

• stories

  • noticing stories

    • what stories are you telling yourself

  • surrendering stories

    • releasing stories you're telling yourself

  • choosing skillful stories

    • telling yourself more skillful stories

    • Stress arises because you care

      • values / love / goals are behind stress

      • "I am stressed because I care about …"

      • "We only stress about things that we care about. By owning our stress, we connect to the positive motivation or personal value behind our stress. If we deny or avoid our stress, we may actually be denying or disconnecting ourselves from the things we value and treasure most." source

    • You are a survivor!

Thinking is tied to emotional regulation

• examples of skillful narratives

  • It's okay to be late

  • The perfection of imperfection

  • I am human and am necessarily not an intellectual ideal

  • There is much for which I am grateful

    • I am blessed to have this job

    • I am blessed to be able to learn

    • I am blessed …

  • Acknowledging your wins

  • "I am a survivor"

  • Embracing the adventure of life

    • challenges are par for the course

  • Our superpower as a species

    • our social nature

    • helping and being helped

  • practice = progress

• ILLUSTRATIVE EXAMPLE

  • Willie Nelson - Just Breathe (Official Video)

    • What stories could Lukas Nelson tell himself?

• RESOURCES

  • The Upside of Stress: Why Stress Is Good for You, and How to Get Good at It

    • McGonigal shows readers how to cultivate a mindset that embraces stress, and activate the brain's natural ability to learn from challenging experiences. Both practical and life-changing, The Upside of Stress is not a guide to getting rid of stress, but a toolkit for getting better at it—by understanding, accepting, and leveraging it to your advantage.

Thinking is tied to emotional regulation

If you're going to tell yourself a story, make it a skillful one.

• two hemispheres of the brain

• talk integrates left (language) and right (emotion)

• "come to terms"

• The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child's Developing Mind

• Putting feelings into words

  • Labeling your stress consciously and deliberately moves neural activity from the amygdala — the center of emotion and fear — to the prefrontal cortex, which is responsible for executive control and planning.

  • Putting feelings into words (affect labeling) has long been thought to help manage negative emotional experiences; however, the mechanisms by which affect labeling produces this benefit remain largely unknown. Recent neuroimaging studies suggest a possible neurocognitive pathway for this process, but methodological limitations of previous studies have prevented strong inferences from being drawn. A functional magnetic resonance imaging study of affect labeling was conducted to remedy these limitations. The results indicated that affect labeling, relative to other forms of encoding, diminished the response of the amygdala and other limbic regions to negative emotional images. Additionally, affect labeling produced increased activity in a single brain region, right ventrolateral prefrontal cortex (RVLPFC). Finally, RVLPFC and amygdala activity during affect labeling were inversely correlated, a relationship that was mediated by activity in medial prefrontal cortex (MPFC). These results suggest that affect labeling may diminish emotional reactivity along a pathway from RVLPFC to MPFC to the amygdala.

  • Lieberman, Matthew D., et al. "Putting feelings into words." Psychological science 18.5 (2007): 421-428.

• Presence, Parenting and The Planet | Dan Siegel | Talks at Google

"A coach is someone who will tell you what you don't want to hear, show you want you don't want to see, so that you can be who you want to be."

• Pets

• Friends & family

• Colleagues & supervisors

  • "Many employers also offer employee assistance programs that have a variety of services, including short-term counseling from licensed therapists or referrals to outside experts who can help with the specific problem you’re having." source

• psychologists, therapists

  • talk therapy

  • integrate the brain

  • CBT

    • the choices we make

    • create new patterns of thought; new patterns of behavior

    • create a new mind set about how we think about our challenges

• psychiatrists

  • medication

  • educate yourself & make informed decisions

    • NYT article

    • Good Chemistry, June 16, 2020, by Julie Holland

    • Netflix: Take Your Pills: Xanax | Official Trailer

      • CBT & CBD is helpful for a lot of people

• asking for help

• Amazon - blank journal

• When you get stressed, write down

  • what caused the stress?

  • how did you react?

  • what stories were you telling yourself?

  • is there a more skillful story you can tell yourself?

  • what are skillful actions you can take to reduce stress?

• Mindfulness = choice, presence, focus

• example: wine culture

• benefit:

  • seeing more clearly

    • internally and externally

  • clarity = better

    • assessment – decision – action (ADA)

• hiker in the woods analogy

  • fog vs no fog

  • lacking clarity vs having clarity

• How to Be More Mindful at Work - The New York Times

  • No matter what your job, work can be anxiety-provoking. Mindfulness can help. In recent years, many companies — from Google to General Mills — have started teaching mindfulness in the office.

• mindfulness = awareness

• cultivating the customer experience

  • training customers

• ASSESS

  • identify stress

  • notice the stories you are telling yourself

    • difference between

      • reality & desired reality

      • how things are & how you want them to be

      • how someone is & how you want them to be

      • how you are & how you want yourself to be

• DECIDE

  • what choices are available?

    • discount / discard old stories

    • tell yourself new stories

• ACT

tell yourself new and more skillful stories

Case study: Google and Project Aristotle

• YouTube: How Psychological Safety has been the bedrock of key innovation programs at Google by Google

• What Google Learned From Its Quest to Build the Perfect Team - New research reveals surprising truths about why some work groups thrive and others falter.

  • takeaways

    • Group norms

    • Collective intelligence != individual intelligence

    • social emotional intelligence essential

      • psychological safety

        • social sensitivity

        • communication and empathy

          • equal turn taking

          • friendly, affable environment

          • people can be themselves

        • a ‘‘shared belief held by members of a team that the team is safe for interpersonal risk-taking.’’

• excerpts:

  • The researchers eventually concluded that what distinguished the ‘‘good’’ teams from the dysfunctional groups was how teammates treated one another. The right norms, in other words, could raise a group’s collective intelligence, whereas the wrong norms could hobble a team, even if, individually, all the members were exceptionally bright.

  • two behaviors that all the good teams generally shared.

    • First, on the good teams, members spoke in roughly the same proportion, a phenomenon the researchers referred to as ‘‘equality in distribution of conversational turn-taking.’’

    • Second, the good teams all had high ‘‘average social sensitivity’’ — a fancy way of saying they were skilled at intuiting how others felt based on their tone of voice, their expressions and other nonverbal cues.

      • One of the easiest ways to gauge social sensitivity is to show someone photos of people’s eyes and ask him or her to describe what the people are thinking or feeling — an exam known as the Reading the Mind in the Eyes test. People on the more successful teams in Woolley’s experiment scored above average on the Reading the Mind in the Eyes test. They seemed to know when someone was feeling upset or left out. People on the ineffective teams, in contrast, scored below average. They seemed, as a group, to have less sensitivity toward their colleagues.

  • A team climate characterized by interpersonal trust and mutual respect in which people are comfortable being themselves.

  • For Project Aristotle, research on psychological safety pointed to particular norms that are vital to success. There were other behaviors that seemed important as well — like making sure teams had clear goals and creating a culture of dependability. But Google’s data indicated that psychological safety, more than anything else, was critical to making a team work.

  • What Project Aristotle has taught people within Google is that no one wants to put on a ‘‘work face’’ when they get to the office. No one wants to leave part of their personality and inner life at home. But to be fully present at work, to feel ‘‘psychologically safe,’’ we must know that we can be free enough, sometimes, to share the things that scare us without fear of recriminations. We must be able to talk about what is messy or sad, to have hard conversations with colleagues who are driving us crazy. We can’t be focused just on efficiency. Rather, when we start the morning by collaborating with a team of engineers and then send emails to our marketing colleagues and then jump on a conference call, we want to know that those people really hear us. We want to know that work is more than just labor.

  • His wife has asked him why he doesn’t quit Google. At some point, he probably will. But right now, helping his team succeed ‘‘is the most meaningful work I’ve ever done,’’ he told me. He encourages the group to think about the way work and life mesh. Part of that, he says, is recognizing how fulfilling work can be. Project Aristotle ‘‘proves how much a great team matters,’’ he said. ‘‘Why would I walk away from that? Why wouldn’t I spend time with people who care about me?’’

New York Times articles on work and stress

• How to Be Better at Stress

  • having a lot of stress in your life and believing it was taking a toll on your health increased risk of premature death by 43 percent.

• ‘You’ve Lost Your Sparkle’: What to Do When Burnout Hits

  • What’s Really Holding Women Back?

  • 5 Steps for Women to Combat Burnout

• How to Be More Mindful at Work

  • No matter what your job, work can be anxiety-provoking. Mindfulness can help. In recent years, many companies — from Google to General Mills — have started teaching mindfulness in the office.

• In Stressful Times, Make Stress Work for You

  • Optimizing stress: An integrated intervention for regulating stress responses.

  • We can actually use that stress to improve our health and well-being. Over a decade of research — ours and that of others — suggests that it’s not the type or amount of stress that determines its impact. Instead, it’s our mind-set about stress that matters most.

  • In one study of 30,000 Americans, those who had the highest levels of stress were 43 percent more likely to die only if they also believed that stress was bad for their health.

  • In contrast, those who experienced high stress but didn’t view it as harmful were the least likely to die compared to any other group in the study — including people who experienced very little stress.

• When Your Job Harms Your Mental Health - Naomi Osaka advocated for her well-being at work. Here’s how you can, too.

  • Many of us have been stuck in situations that were detrimental to our mental health — at work or in our personal lives — feeling torn between societal expectations and self-preservation.

• Your Body Knows You’re Burned Out - Here’s how to recognize the physical symptoms of work-related stress — and what to do about them.

  • Burnout, as it is defined, is not a medical condition — it’s “a manifestation of chronic unmitigated stress,” explained Dr. Lotte Dyrbye, a physician scientist who studies burnout at the Mayo Clinic.

• How Does Your Body React to Stress?

  • Stress can have wear and tear effects on the body, especially when it doesn’t ease up after a while — so it makes sense that it can incite physical symptoms, too, Dr. Bennett said. When people are under stress, their bodies undergo changes that include making higher than normal levels of stress hormones such as cortisol, adrenaline, epinephrine and norepinephrine. These changes are helpful in the short term — they give us the energy to power through difficult situations — but over time, they start harming the body.

• The American Psychological Association Articles

  • Are your kids stressed about family finances? Psychologists offer answers for addressing anxiety over tight budgets

  • Burnout and stress are everywhere

  • Learn how to manage your workplace stress - Workers at every level are experiencing increased tension and uncertainty, and are updating their resumes.

  • The American workforce faces compounding pressure

Academic research on stress in the workplace

• Does the Perception that Stress Affects Health Matter? The Association with Health and Mortality

  • 33.7% of nearly 186 million (n=28,753) U.S. adults perceived that stress affected their health a lot or to some extent. Both higher levels of reported stress and the perception that stress affects health were independently associated with an increased likelihood of worse health and mental health outcomes. The amount of stress and the perception that stress affects health interacted such that those who reported a lot of stress and that stress impacted their health a lot had a 43% increased risk of premature death

  • Keller, Abiola, et al. "Does the perception that stress affects health matter? The association with health and mortality." Health psychology 31.5 (2012): 677.

• Giving to Others and the Association Between Stress and Mortality

  • Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.

  • Poulin, Michael J., et al. "Giving to others and the association between stress and mortality." American journal of public health 103.9 (2013): 1649-1655.

• Mind over Matter: Reappraising Arousal Improves Cardiovascular and Cognitive Responses to Stress

  • Researchers have theorized that changing the way we think about our bodily responses can improve our physiological and cognitive reactions to stressful events. However, the underlying processes through which mental states improve downstream outcomes are not well understood. To this end, we examined whether reappraising stress-induced arousal could improve cardiovascular outcomes and decrease attentional bias for emotionally negative information. Participants were randomly assigned to either a reappraisal condition in which they were instructed to think about their physiological arousal during a stressful task as functional and adaptive, or to 1 of 2 control conditions: attention reorientation and no instructions. Relative to controls, participants instructed to reappraise their arousal exhibited more adaptive cardiovascular stress responses—increased cardiac efficiency and lower vascular resistance—and decreased attentional bias. Thus, reappraising arousal shows physiological and cognitive benefits. Implications for health and potential clinical applications are discussed.

  • They were told how the body’s stress response evolved to help us succeed, and that the increased arousal symptoms of stress can aid your performance during times of stress. The bottom line of the lesson was this: In a tough situation, stress makes you stronger.

  • Jamieson, Jeremy P., Matthew K. Nock, and Wendy Berry Mendes. "Mind over matter: reappraising arousal improves cardiovascular and cognitive responses to stress." Journal of experimental psychology: General 141.3 (2012): 417.

• Understanding the burnout experience: recent research and its implications for psychiatry

  • burnout is “a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment.”

  • The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally‐specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.

  • Maslach, Christina, and Michael P. Leiter. "Understanding the burnout experience: recent research and its implications for psychiatry." World psychiatry 15.2 (2016): 103-111.

• Optimizing stress: An integrated intervention for regulating stress responses.

  • The dominant cultural valuation of stress is that it is “bad for me.” This valuation leads to regulatory goals of reducing or avoiding stress. In this article, we propose an alternative approach—stress optimization—which integrates theory and research on stress mindset (e.g., Crum, Salovey, & Achor, 2013) and stress reappraisal (e.g., Jamieson, Mendes, Blackstock, & Schmader, 2010) interventions. We further integrate these theories with the extended process model of emotion regulation (Gross, 2015). In so doing, we explain how altering second-level valuation systems—shifting the valuation of stress from “is bad for me” to “can be good for me”—fundamentally changes the overarching goal of stress regulation from reducing stress to optimizing stress responses to achieve valued goals. With this optimization goal in mind, individuals are invited to flexibly identify, select, and engage in specific regulation tactics (e.g., situation selection, attentional control, cognitive change, and response modulation) in ways that help them achieve valued ends as opposed to merely reducing or avoiding stressful experiences. We discuss definitions and issues related to key terms including stress, stressors, stress responses, and stress regulation and outline a research agenda for testing this new integrated theory as an intervention.

  • Crum, Alia J., Jeremy P. Jamieson, and Modupe Akinola. "Optimizing stress: An integrated intervention for regulating stress responses." Emotion 20.1 (2020): 120.

• Rethinking stress: the role of mindsets in determining the stress response

  • This article describes 3 studies that explore the role of mindsets in the context of stress. In Study 1, we present data supporting the reliability and validity of an 8-item instrument, the Stress Mindset Measure (SMM), designed to assess the extent to which an individual believes that the effects of stress are either enhancing or debilitating. In Study 2, we demonstrate that stress mindsets can be altered by watching short, multimedia film clips presenting factual information biased toward defining the nature of stress in 1 of 2 ways (stress-is-enhancing vs. stress-is-debilitating). In Study 3, we demonstrate the effect of stress mindset on physiological and behavioral outcomes, showing that a stress-is-enhancing mindset is associated with moderate cortisol reactivity and high desire for feedback under stress. Together, these 3 studies suggest that stress mindset is a distinct and meaningful variable in determining the stress response.

  • Crum, Alia J., Peter Salovey, and Shawn Achor. "Rethinking stress: the role of mindsets in determining the stress response." Journal of personality and social psychology 104.4 (2013): 716.

• Evaluating a mindset training program to unleash the enhancing nature of stress

  • Participants in the stress-mindset training reported significant improvements in their experience of physical symptoms, greater overall satisfaction with their health, and better performance at work with respect to generating new ideas, sustaining focus, being engaged, and collaborating well at work. Mediation analyses demonstrate that these improvements occurred primarily through changes in mindset initiated by the training intervention.

  • Crum, Alia. "Evaluating a mindset training program to unleash the enhancing nature of stress." Academy of Management Proceedings. Vol. 2011. No. 1. Briarcliff Manor, NY 10510: Academy of Management, 2011.

• Putting feelings into words

  • Labeling your stress consciously and deliberately moves neural activity from the amygdala — the center of emotion and fear — to the prefrontal cortex, which is responsible for executive control and planning.

source: NYT

• Putting feelings into words (affect labeling) has long been thought to help manage negative emotional experiences; however, the mechanisms by which affect labeling produces this benefit remain largely unknown. Recent neuroimaging studies suggest a possible neurocognitive pathway for this process, but methodological limitations of previous studies have prevented strong inferences from being drawn. A functional magnetic resonance imaging study of affect labeling was conducted to remedy these limitations. The results indicated that affect labeling, relative to other forms of encoding, diminished the response of the amygdala and other limbic regions to negative emotional images. Additionally, affect labeling produced increased activity in a single brain region, right ventrolateral prefrontal cortex (RVLPFC). Finally, RVLPFC and amygdala activity during affect labeling were inversely correlated, a relationship that was mediated by activity in medial prefrontal cortex (MPFC). These results suggest that affect labeling may diminish emotional reactivity along a pathway from RVLPFC to MPFC to the amygdala.

• Lieberman, Matthew D., et al. "Putting feelings into words." Psychological science 18.5 (2007): 421-428.

• When the Antidote is the Poison: Ironic Mental Control Processes

  • Acknowledging your stress also helps us overcome what’s known as “ironic mental processing.” When we try to avoid thinking about something — say, how stressed we are about the coronavirus — our brain tries to help us not think of this thing by constantly checking in with us to see if we’re thinking of it.

source: NYT

• The theory of ironic processes of mental control holds that both the most and the least desired effects of attempts to control one's own mental states accrue from two processes an intentional operating process (a conscious, effortful search for mental contents that will produce a desired state of mind) and an ironic monitoring process (an unconscious, automatic search for mental contents that signal a failure to produce the desired state of mind) Although the monitoring process usually functions just to activate the operating process, during stress, distraction, time urgency, or other mental load, the monitor's effects on mind can supersede those of the operator, producing the very state of mind that is least desired An individual's attempts to gain mental control may thus precipitate the unwanted mental states they were intended to remedy

• Wegner, Daniel M. "When the antidote is the poison: Ironic mental control processes." Psychological Science 8.3 (1997): 148-150.

• Avoiding burnout: the personal health habits and wellness practices of US surgeons

  • Finally, while you may not want to add more to your plate, try to make a bit of time each day for something you love, Dr. Dyrbye said. Her work has found that surgeons who make time for hobbies and recreation — even just 15 to 20 minutes a day — are less likely to experience burnout than surgeons who don’t. source

  • This study suggests that weekly aerobic exercise and weight training, visits to primary care providers, and age-appropriate preventative health evaluations may help decrease the burnout rate of U.S. surgeons. Strategies to maintain surgeons in the work force are important for several reasons. There is a projected decrease of surgeons in the U.S. work force over the next 10 to 20 years, and one strategy to balance fewer surgeons is to keep surgeons practicing longer. In addition, there appears to an association between personal health habits and the care physicians provide their patients (Schwartz JS et al, Ann Intern Med 1991;114:46-53). Surgeons themselves and the health care system in general both have a stake maintaining a population of healthy and happy surgeons!

  • Shanafelt, Tait D., Michael R. Oreskovich, and Lotte N. Dyrbye. "Avoiding burnout: the personal health habits and wellness practices of US surgeons." Journal of Vascular Surgery 56.3 (2012): 875-876.

• Workplace Stress Management Interventions and Health Promotion

  • Employee health and wellness are important for employees, their families, and their organizations.

  • literature review

    • stress management interventions in organizations

    • workplace health promotion and wellness programs

  • Tetrick, Lois E., and Carolyn J. Winslow. "Workplace stress management interventions and health promotion." Annual Review of Organizational Psychology and Organizational Behavior 2.1 (2015): 583-603.

• Managing job performance, social support and work-life conflict to reduce workplace stress

  • negative correlation between social support and workplace stress

  • positive correlation between work–life conflict and workplace stress

  • negative correlation between job performance and workplace stress

  • Leaders can enable workplace change by developing and implementing social support and work–life strategies, and potential pathways to reduce levels of workplace stress and improve quality of life for employees and enhance performance.

  • Goel, Meghna, and J. P. Verma. "Workplace stress and coping mechanism in a cohort of Indian service industry." Asia Pacific Management Review 26.3 (2021): 113-119.

• Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review

  • Nurses experience moderate to high levels of stress. Several individual attributes and organizational resources are employed by nurses to manage workplace adversity. The individual attributes include the use of work–life balance and organizing work as a mindful strategy, as well as self-reliance, passion and interest, positive thinking, and emotional intelligence as self-efficacy mechanisms. The organizational resources used to build resilience are support services (both formal and informal), leadership, and role modeling.

  • Badu, Eric, et al. "Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review." International journal of mental health nursing 29.1 (2020): 5-34.

• Workplace stress: A neglected aspect of mental health wellbeing

  • Workplace stress is defined by the World Health Organization as ‘the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which challenge their ability to cope’, and elaborated that it can be caused by poor work organization (the way we design jobs and work systems, and the way we manage them), by poor work design (e.g., lack of control over work processes), poor management, unsatisfactory working conditions and lack of support from colleagues and supervisors. While workplace stress, stigma and attitudes towards employees suffering from stress or mental illness have been researched and interventions developed to address them better, globally it still remains an oft-neglected aspect across different industries and countries … and only a few of the learnings are actually implemented.

  • Maulik, Pallab K. "Workplace stress: A neglected aspect of mental health wellbeing." The Indian journal of medical research 146.4 (2017): 441.

• Supervisor Workplace Stress and Abusive Supervision: The Buffering Effect of Exercise

  • Results suggest that increased levels of supervisor-reported stress are related to the increased experience of employee-rated abusive supervision. We also find that the relationship between supervisor stress and abusive behavior can be diminished when supervisors engage in moderate levels of physical exercise.

  • Burton, James P., Jenny M. Hoobler, and Melinda L. Scheuer. "Supervisor workplace stress and abusive supervision: The buffering effect of exercise." Journal of Business and Psychology 27.3 (2012): 271-279.

• Effect of Workplace Stress on Job Performance

  • The study examines the relationship between workplace stress and job performance. A survey method was employed to gather self-administered questionnaires from executive and non-executive employees of a leading private investment bank in Peninsular Malaysia. The outcomes of SmartPLS path model analysis of the data showed two important findings: firstly, physiological stress was positively and significantly correlated with job performance. Secondly, psychological stress was positively and significantly correlated with job performance. This finding reveals that physiological and psychological stresses act as important predictors of job performance in the studied organization. The paper provides discussion, implications and conclusion.

  • Ismail, Azman, et al. "Effect of workplace stress on job performance." Economic Review: Journal of Economics and Business 13.1 (2015): 45-57.

• Workplace stress and health – the connection to quality management

  • Stress and bullying create severe pressure on workplace health. Although the connection between quality management and health is beginning to be well established, the association to workplace stress and workplace bullying has not been previously studied. The purpose of the paper is to examine associations between quality management values, workplace health and workplace stress. A questionnaire based on theory and previous research was constructed and delivered to a sample of Swedish secondary school teachers. The questionnaire included previously developed constructs of quality management values and workplace health. In addition, constructs measuring stress, demand, control and bullying were included. Correlation analyses and cluster analysis were carried out. The Findings confirm the connection between quality management and workplace health that previous research has identified. In addition, the results indicate that quality management can increase the level of control that the employees have over their work situation, thereby alleviating some of the effects of workplace stress. Furthermore, the results show an association between quality management and workplace bullying. Moreover, control but not demand was found to be related to workplace health. Four clusters of employees with different quality management,stress and health profiles were identified.

  • Ismail, Azman, et al. "Effect of workplace stress on job performance." Economic Review: Journal of Economics and Business 13.1 (2015): 45-57.

• Managing Workplace Stress: The Cognitive Behavioural Way

• Moreover, most people are in jobs that they do not love. If you enjoy what you do, you are among the very few lucky ones. There are of course many reasons for staying in a job that you don't particularly like. The proverbial "golden handcuff” - the salary, the status, the prestige, the benefits, the perks and the pension – all these can keep you tied down to a job regardless of the unhappiness and the stress. The alternative solution is to find a job you like or one that better matches your talents, aptitude, skills, abilities and interests – again, an almost impossible task - easier said than done. Many of us have no idea what kind of job would suit us, taking into account all the things we desire in our prospective dream job. Worse, we often don't have a clue as to how to go about finding out all this information about a new job, because actually there is no way. There is no way you can know in advance what kind of job in what kind of organization will make you happy, unless you actually start working and experiencing all the positive and negative sides of your new job and your new company. Last but not the least, there is the inertia, the pain and the effort of looking for another job.

• The book shows how Cognitive Behaviour Therapy can be used to challenge and overcome workplace stress issues such as criticism, abuse, animosity, conflicts, disagreements, insubordination, organizational politics, favoritism, prejudices, discriminations, job uncertainties, extreme work pressures, excessive workloads, poor job designs, job mismatches, role conflicts, role ambiguities, cultural and ethical maladjustments, workplace boredom and anger problems.

• https://www.amazon.com/Managing-Workplace-Stress-Cognitive-Behavioural/dp/8132206827

• Consequences of Workplace Stress–Company Case Study

  • The issue of work-related stress has been addressed by researchers for a decade, while less interest in the issue has been shown by company executives. In spite of the known effects of work-related stress, not sufficient attention is devoted to it by the top management. A case study was applied in our research to investigate the stress level of employees and consequences of workplace stress in the chosen company. Our research activity was supported by personal observation, document analysis, interviews and a questionnaire survey. The results show that negative impact of stress on the employee health (calculated economic effect of stress) is significantly higher than the cost of employee training. Creating a pleasant work environment and improving the cooperation of co-workers may result in reduction of sick leave and the employee fluctuation.

  • Bencsik, Andrea, Tímea Juhász, and Ladislav Mura. "Consequences of Workplace Stress–Company Case Study." Littera Scripta 12.2 (2019): 79-95.

• Conquering Workplace Stress through Emotional Intelligence: Strategies and Possibilities

  • Stress is an unavoidable part of life. It is a state, which reflects certain biochemical reactions in the human body. The stressed mind produces a mental and emotional pressure. Stress is not always bad. At a reasonable level, it can help infuse one with the energy to accomplish his/her goals. But its prolongation causes worry, loss of confidence and determination in life and decline in interest to do work. Workplace stress is the growing problem of most of the organization. Work stress factors such as work overloads, downsizing, overtime, shift work and an unhealthy work environment cause great impact on employees as well as organizational well-being, which decrease productivity and increase the health care cost of the organization. While on the one hand Emotional intelligence is the ability of a person to understand one’s own feelings and the feelings of others. On the other hand, timely and appropriately responding those feelings through empathic actions. However, effective management through EI is emerging as valuable competence for personal as well as professional life. This paper made an attempt to find out the causes of stress and its consequences and how emotional intelligence can help a better strategy to manage stress at workplace.

  • Rani, P. B., and P. S. Yadapadithaya. "Conquering workplace stress through emotional intelligence: strategies and possibilities." Indian Journal of Commerce and Management Studies 9.1 (2018): 06-12.

• Workplace stress evaluation tools: A Snapshot Review

  • This Snapshot Review is an investigation of workplace stress evaluation tools. The starting point for the review is an evaluation of the Stress Satisfaction Offset Score (SSOS), which is a four-item scale developed by Shain (1999) to enable individuals to assess the impact of workplace stressors on their health. The SSOS is one of several tools that have been developed to address the four elements embedded in the Demand Control model (Karasek &Theorell, 1990) and the Effort Reward Imbalance model (Siegrist, 1996) of workplace stress. The purpose of the review is to assess whether the SSOS is a suitable tool for inspectors to use to obtain a quick and valid initial indication of the presence of stress in a workplace. Two questions are addressed in this review: 1. Is the “Stress and Satisfaction Offset Score” tool reliable enough to be used as an initial indicator of workplace stress? 2. Are there any other tools of this type, available at no cost, which could be used for the same purpose?

  • Shea, Tracey, and Helen De Cieri. "Workplace stress evaluation tools: A Snapshot Review." ISCRR & Monash University (2011).

• An Explanation of Personality Change in Organizational Science: Personality as an Outcome of Workplace Stress

  • Organizational scholarship has recently begun to treat personality as malleable in workplace settings and has called for personality change to be incorporated into current research. The lack of a comprehensive, theoretical model of organizational personality change is a critical impediment to this research. We integrate recent advances in biological and epigenetic fields with the cognitive appraisal, personality, and stress literatures to introduce a comprehensive model of short- and long-term organizational personality change. This model explains when, how, and why appraisal of workplace stress alters employee personality through three important neurochemical systems and the mechanisms through which changes in these systems differentially impact dimensions of the Five Factor personality framework. By examining epigenetic changes affecting neurochemical systems, we explain how appraisal of chronic workplace stress can lead to long-term changes in various personality traits—a relationship with substantial implications for both practice and research. This model further provides a roadmap to understand how short- and long-term employee personality change influences workplace outcomes at the individual, team, and organizational levels and how interventions at these levels can mitigate or reverse deleterious effects of workplace stressors on employee personality change. We outline the processes necessary for organizational scholars to test the propositions described here and more robustly incorporate personality change into organizational scholarship.

  • Smallfield, Jarvis, and Donald H. Kluemper. "An explanation of personality change in organizational science: Personality as an outcome of workplace stress." Journal of Management 48.4 (2022): 851-877.

• Effect of workplace stress management strategies on employees' efficiency

  • The primary aim of the study is to examine the effectiveness of stress management strategies adopted by private enterprises and their effect on employees' efficiency.

  • great INTRODUCTION and REVIEW OF LITERATURE

    • effective stress management programs help an organization improve the performance of the individual, group and in turn that of the organization itself..

  • Patro, Chandra Sekhar, and K. Sudesh Kumar. "Effect of workplace stress management strategies on employees’ efficiency." International Journal of Scientific Development and Research 4.5 (2019): 412-418.

• The Effects of Workplace Stress, Work-Life Balance on Turnover Intention

  • Stressed and unhappy employees leads to retention problems

  • Kerdpitak, Chayanan, and Kittisak Jermsittiparsert. "The effects of workplace stress, work-life balance on turnover intention: An empirical evidence from pharmaceutical industry in Thailand." Systematic Reviews in Pharmacy 11.2 (2020): 586-594.

• An assessment of employer liability for workplace stress

  • The presence of effective workplace stress management policies were important interventions that played a particularly significant role in avoiding legal action and reducing employees’ detrimental experiences. A significant finding was that 94 per cent of the cases were found in favor of the employer as the defendant, and the implications of this for managerial practice are suggested. This analysis of 75 cases between 1992-2014 will shed valuable light on the nature of workplace stress claims heard in the courts and the likelihood of the claimant employee’s success in such cases.

  • Lockwood, Graeme, Claire Henderson, and Stephen Stansfeld. "An assessment of employer liability for workplace stress." International Journal of Law and Management (2017).

• Machine Learning Approaches to Automatic Stress Detection: A Review

  • People experience mental stress on a daily basis from a variety of different reasons, including environmental reasons (traffic, noise, or bad weather), social reasons (family issues, friends, and financial problems), or from events such as wedding planning or giving a presentation in front of large audience. A manageable amount of stress is healthy and can motivate a person; however, a large amount of continuous stress or a strong response to stress can be harmful. For this reason, the detection of mental stress, as well as its prediction, has become a significant area of research. In this paper, we review and summarize various approaches found in the literature for stress detection using machine learning and suggest directions for future research and interventions.

  • Elzeiny, Sami, and Marwa Qaraqe. "Machine learning approaches to automatic stress detection: A review." 2018 IEEE/ACS 15th International Conference on Computer Systems and Applications (AICCSA). IEEE, 2018.

The APA's seven skills for reducing stress

The seven skills for managing stress

• from the American Psychological Association.

The Seven Skills

• Track stressors

  • Understand how you stress

  • Identify your sources of stress

  • Learn your own stress signals

  • Recognize how you deal with stress

  • Keep a journal

    • what situations caused you stress?

    • how you respond to stress?

      • Did you raise your voice?

      • Get a snack from the vending machine?

      • Go for a walk?

• Develop healthy responses

  • Exercise

    • no caffeine after lunch

    • no screens two hours before bed

  • sleep

  • nutrition

    • physical

    • mental

  • family / social

• Establish boundaries

  • digital world: easy to feel pressure to be available 24 hours a day.

  • Establish work-life boundaries

    • maybe no work from home in the evening

    • people have different preferences how to blend work and home life

  • creating clear boundaries can reduce work-life conflict and the stress that goes with it.

• Take time to recharge

  • replenish and return to pre-stress levels of functioning

  • recovery requires “switching off” from work

    • periods of time not engaging in work nor thinking about work

  • disconnect in a way that fits your needs and preferences.

  • BALANCE

• Learn how to relax

  • breathing exercises

  • mindfulness, meditation

  • walking or enjoying a meal

  • " … emotional self-regulation …"

    • How do we soothe ourselves?

• Talk to your supervisor

  • increase employee health = increase productivity

    • your boss has an incentive for employee well-being

  • Have an open conversation with your supervisor.

    • come up with an effective plan for managing the stressors

      • = you perform at your best on the job.

  • examples

    • clarifying what’s expected of you

    • getting necessary resources or support

    • enriching your job to include more challenging or meaningful tasks

    • making changes to your physical workspace to make it more comfortable and reduce strain

    • employer-sponsored wellness resources

• Get support

  • seek out help & accept help

    • trusted friends

    • family members

    • employer

      • stress management resources

    • counseling, therapy, therapists, psychologists, psychiatrists

Next steps

• Activate with a list of todo items

  • one foot in front of the other

  • choose not to collapse

  • Prioritization

    • focus on what's important

    • google keep or similar to keep a todo list

• Consistent action in a skillful direction

• change your narratives / stories

  • tell yourself more skillful narratives / stories

  • stress is good for you / stress helps you

• change is possible

  • neuroplasticity

    • Ted Talks & other resources on neuroplasticity

  • nature

    • everything in nature is in a state of change

      • as you are nature, it is your nature to change

    • change is the only constant

  • the power of the mind

• become a scientist

  • document, investigate, become curious

• ADA loop

  • step 1 - Assess = awareness = mindfulness

  • step 2 - Decide

  • step 3 - Act = change

    • new patterns of thought

    • new patterns of behavior