The Coping With Stress and Anxiety System
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The Coping with Stress and Anxiety System©
Welcome to the Coping with Stress and Anxiety System. This system will help you learn to effectively manage stress and anxiety. In order to get optimum results, it is recommended that you augment this program with the hypnosis audio CD program “Managing Stress and Anxiety”. These techniques are divided into 3 sets of 10 based upon the primary manner each helps relieve stress and anxiety. Accordingly, “adaptation interventions” help you better adjust or accommodate to stress and anxiety; “absorbing interventions” are preventative efforts to help you delay the onset of symptoms and reduce symptom intensity; and “management interventions” help you directly remove or modify the power of the challenge(s) you are currently facing. Choose and rotate these exercises depending on your needs and what you find helpful at the time. Regards, Randy A. Gilchrist, Psy.D Adaptation Interventions Abdominal Breathing Progressive Muscle Relaxation Biofeedback SelfHypnosis Cognitive Distortions Balanced Thinking Coping Statements SelfEsteem Support Systems Restful Sleep Absorbing Interventions Medical Checkup Nutrition Substances to Avoid or Minimize Exercise Relaxing Environment Meditation Visualizing a Peaceful Scene Guided Imagery Humor Stress Education Management Interventions: Coping with Hassles and Life Changes Problem Solving Time Management Play Time Taking Time Off Assertiveness Training Communication Skills Responding to Criticism Negotiation Skills Influencing Skills Cited References © Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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1
Abdominal Breathing
Abdominal breathing consists of breathing fully from the bottom of your lungs near your abdomen. This is exactly the reverse of how you breathe when you’re anxious or tense, which is typically shallow and high in your chest. Relaxing effects of abdominal breathing include drooping eyes and shoulders, lower heart rate, and increased oxygen into your system. To practice abdominal breathing, observe the following steps: 1) Place one hand on your abdomen right beneath your rib cage. 2) Inhale slowly and deeply through your nose into the bottom of your lungs to the lowest point you can reach for 4 slow counts. Your chest should move only slightly, while your stomach area rises and pushes your hand upward like an expanding balloon. 3) When you’ve inhaled fully, pause comfortably (13 seconds) and then exhale fully through your mouth (or nose, if you prefer) for 8 regular counts. As you exhale, let yourself go and imagine your entire body going loose and limp. Pause again (13 seconds) before continuing. 4) In order to fully relax, take and release ten or so of these breaths. Try to keep your breathing smooth and regular throughout, without gulping in a big breath or exhaling suddenly. You might count each breath as follows: Slowly inhale for 4 counts—Pause—Exhale for 8 counts—Pause (count 1) Slowly inhale for 4 counts—Pause—Exhale for 8 counts—Pause (count 2)—and so on (until you reach 10 series of breaths) *If you start to feel lightheaded while practicing abdominal breathing, stop for 30 seconds and then start again. If you still feel light headed, stop and resume at a later time. *If the breathing counts or pauses suggested here are uncomfortable, adjust them to your personal preference. The counts offered here are just suggestions. You’ll find that abdominal breathing will help to slow down or eliminate feelings of anxiety or panic. In fact, two or more minutes of abdominal breathing can abort a panic attack if you initiate it before the panic has gained momentum. Abdominal breathing also counteracts hyperventilation symptoms, which can be mistaken for symptoms of panic. In general, abdominal breathing exercises will help change your breathing from a stressful, anxious process into a more relaxed, soothing rhythm. This will help calm your body and provide more oxygen into your system.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
2
Progressive Muscle Relaxation
Progressive muscle relaxation is a timehonored relaxation technique that effectively reduces skeletal muscle tension, a principle contributor to anxiety and stress. This exercise tends to work best when it is done for at least 20 minutes, at a regular time, before or at least 1 hour after a meal, in a quiet setting, and with your head supported. Note: skip tensing any of the muscle groups below that are excessively sore, painful, or at risk to aggravate a preexisting physical condition. To engage in progressive muscle relaxation, follow these steps: 1) Clench your fists tightly, holding them 710 slowly counted seconds. 2) Feel the buildup of tension in your hands and visualize your muscles tightening. 3) After 710 seconds, relax the muscles in your hands abruptly, imagining them going loose and limp. Allow 1020 seconds to pass before proceeding. Use this same “tense, count, and relax while visualizing” process for all of the remaining exercises. 4) Tighten your biceps by drawing your forearms up towards your shoulders and “make a muscle” with both arms. 5) Tighten your triceps (the muscles opposite the undersides of your biceps). Do this by extending your arms straight and locking your elbows while tightening your muscles. 6) Tense up the muscles in your forehead by raising your eyebrows up as far as you can. 7) Tense up the muscles around your eyes by clenching them tightly shut. 8) Tighten your jaw by opening your mouth so wide that you stretch the muscles around the hinges of your jaw. 9) Tighten the muscles in the back of your neck by pulling your head back as if you were going to touch your head to your back. 10) Tighten your shoulders by raising them up as if you were going to touch your ears. 11) Tighten your muscles by pushing your shoulder blades back as if you were going to touch them together. 12) Tighten the muscles of your chest by taking in a deep breath and holding. 13) Tighten your stomach muscles by sucking your stomach in. 14) Tighten your lower back by arching it up. 15) Tighten your buttocks by pulling them together. 16) Squeeze the muscles in your hips and thighs all the way down to your knees. 17) Tighten your calf muscles by pulling your toes towards you. 18) Tighten your feet by curling your toes downward.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
3
Biofeedback
“Biofeedback” refers to a method of gaining information about the physiological activity occurring in your body to gain some control over these responses. To gain a reading of the physical distress or calm your body is experiencing, a monitoring device is attached to your body to alert you when you are stressed (or relaxed). Then, after paying attention to these alerts, you can lessen times of anxiety and stress by gaining some control over physical functions previously thought to be beyond your conscious control, including body temperature, heart rate, muscle tension, and brain waves. There are three basic forms of biofeedback equipment available for use: muscle tension feedback, skin temperature feedback, and sweat gland activity feedback. Because “skin temperature feedback” is the most cost effective and easy to implement, this is the biofeedback format that will be promoted for this exercise. There are three affordable, easy to use versions of skin temperature feedback: mood rings, body temperature cards, and body temperature dots (called “biodots”). All three make contact with your skin and give a color reading representing a continuum from anxious/tense to calm/relaxed. A mood ring is worn on your finger, a body temperature card fits in your wallet and works as you press your finger on it, and a body temperature dot is a small adhesive dot you place on your skin that continually changes color like a mood ring. You choose which version you prefer.
After attaining your biofeedback tool, follow these steps to lessen your anxiety. 1) Wear (or press) your biofeedback tool on your skin and check it often to notice when you are anxious or relaxed. 2) Notice the times you are relaxed and what is going on at those times so you can make them occur more often. 3) Notice the times when you are anxious, tense, and stressed and what is going on at those times so you can minimize these occurrences. You may even wish to keep a written log to increase your selfawareness of when you reach high stress levels. 4) When you find yourself anxious or tense, implement one or more of the Coping with Stress System©™ interventions promoting immediate stress relief: abdominal breathing, progressive muscle relaxation, visualizing a peaceful scene, selfhypnosis, meditation, rest, etc. 5) As you become more aware of your physical reactions and how to lessen your stress, practice addressing your anxiety immediately without using your biofeedback tool so you can lessen your reliance on outside biofeedback tools. Eventually you can detect and relieve anxiety and stress through you own efforts alone.
(Adapted from Greenberg, 1990)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
4
SelfHypnosis
Selfhypnosis in its basic form is a threestep process: 1) relaxing yourself in a quiet, comfortable environment, 2) absorbing your conscious thoughts in a very focused way (called a “trance”), and 3) unobtrusively giving yourself suggestions for positive change that bypass your conscious resistance. In short, selfhypnosis is telling yourself to be different under a trance state to minimize self sabotaging positive change. Follow these steps to engage in selfhypnosis: 1) Over a count of 4 seconds, breathe in deeply through your nose in a comfortable way. 2) Hold comfortably for 13 seconds. 3) Slowly exhale through your mouth (or nose, if your prefer) for a count of 8 seconds. 4) Wait 13 seconds before breathing again and repeat several times. Keep breathing in this rhythmic manner until you feel relaxed, comfortable, and ready to concentrate. 5) Gradually eliminate the formal breathing counts and pauses until you breathe in a deep, comfortable rhythm not requiring extra thought or attention. 6) Slowly allow your eyes to close. Visualize a place that is relaxing to you. Enjoy this experience with all of your senses—sight, smell, sound, touch, and taste. Examples may include the beach, the mountains, the woods, etc. Stay focused on this experience, thinking only of your experience there. Redirect yourself gently back if your thoughts wander to other subjects 7) When you are highly absorbed in your experience and your limbs feel heavy, slowly repeat positive statements to yourself consisting of the changes you want in life through single words or short phrases, such as “relax” or “more happiness”. Note: make sure you state the positive change you want to occur more, not the negative thing you want less of. For example, “more relaxed” is better than “not anxious”. 8) After continuing in this state for an adequate period (such as 1520 minutes), reorient yourself to your environment slowly and comfortably. Allow this whole process to occur naturally and comfortably. Do not use an alarm clock, a beeping timer, or anything else that may disrupt your experience. 9) Remember this relaxing experience throughout the day, such as when stressful events occur or when you are bored. 10) Revisit this place for at least 1520 minutes every morning.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
5
Cognitive Distortions
Cognitive distortions are extreme, irrational ways of thinking that aggravate stress. Review this list carefully, checking the distortions you engage in on a regular basis. Then, practice catching and balancing these distortions through the “balanced thinking” exercise following this list. 1) Allornothing thinking: You look at things as being either black or white, good or bad. If it’s not perfect, it is a failure. There is no middle ground. Overgeneralization: You view a single negative event or piece of evidence as a never ending pattern of defeat, or you balloon problems much bigger than they actually are. Negative Filtering: You magnify the negatives and ignore the positives of a situation. Jumping to conclusions: A) “mind reading”: you assume what people are thinking, and B) “fortune telling”: you arbitrarily predict how things will turn out in the future. Magnification or minimization: Two ways of doing this: A) “magnification”—you blow things way out of proportion, and B) “minimization”—you shrink their importance. Emotional reasoning: You reason from how you feel (“I feel bad, therefore I am bad”). Should statements: You have a list of ironclad rules about how you and other people “should” or “need” to act. You feel upset when others (or yourself) break the rules. Labeling: You identify yourself or other people globally according to shortcomings, such as “I am a jerk”, “she is stupid”, or “you’re a loser”. Blaming: You blame yourself or someone else for something you or they were not entirely responsible for (if at all). Discounting the positives: You insist that your (or others) accomplishments don’t count. Personalization: You think that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who’s better or worse. Control fallacies: You think that your feelings, thoughts, and behaviors are out of your control, and that you are the helpless victim of others “making” you be a certain way. Fallacy of fairness: You feel resentful because you think you know what’s fair, but other people won’t agree with you. Fallacy of change: You assume others will genuinely change in the ways you want if you just pressure them enough. When this doesn’t occur, you become upset. Being right: You are continually on trial to prove that your opinions and actions are correct. Being wrong is seen as a weakness to be avoided at all costs.
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(Adapted from Burns, 1990)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
6
Balanced Thinking
This exercise helps you change your feelings through challenging and changing how you think about difficult situations. To practice balanced thinking, write out each of the numbered headings below with a space beneath to write your answers: 1) The Situation: Think of the most recent (or current) situation that has left you feeling stressed or upset. Examples of stressful situations may include getting fired from a job, getting stuck in heavy traffic, learning a family member is sick, thinking of all of the work you have to do, etc. 2) My Automatic Thought: What was your immediate, reactive interpretation of this situation? This is where most of your stress will be triggered: not by the situation alone, but by your negative interpretation of the situation. When you write out your reaction to the situation, be as honest and complete as possible. Most automatic thoughts that lead to stress are extreme, generalized reactions to situations. Examples may include “this will never work”, “I’ll never be able to handle this”, “he hates me”, “I’m such a loser”, “she’s out to destroy me”, etc. 3) Scaling My Feelings: Pick a number between 0 – 100 to scale how stressful and upsetting your automatic thought has made you in response to the situation. Think of “0” as representing no stress or upset at all and “100” representing feeling as stressed and upset as possible. For instance, after you get fired from a job, your automatic thought of “I’m such a loser” upsets you at 90/100. 4) Evidence Against: Your automatic thought fueling your stress will likely be extreme and unrealistic in some way. To identify what cognitive distortions you may have adopted in your reaction, review the “cognitive distortions” list given in the last exercise and note which apply. Then, make a list of as much evidence against your reactive interpretation of the situation as possible. For example, evidence against you “being a loser” could include your main accomplishments in life, the friends and family you are close to, your previous successes at your job, the unfairness of the firing, etc. 5) Balanced Thought: Taking all of the evidence against your automatic thought into account, create a more balanced, realistic thought in response to the situation. In the case of losing your job, you could look at all of the positive evidence showing your successes and good points and think: “I am a good person with a lot of positive things going for me. I’ve handled setbacks before and been OK, and I will do so again!” 6) Scaling My Feelings Again: Now, scale your stress and upset feelings again as in stage 3, but now do so with your balanced thought in reaction to the situation. For instance, the balanced thought of “I am a good person…” may now scale the upset feelings at just a 40—a large decrease from the 90 after the “I’m such a loser” thought. **Write out as many formal “balanced thought” exercises as possible. Then, remind yourself of the evidence against your negative thoughts and focus on your balanced thoughts as much as possible throughout the day. Eventually with enough practice, your automatic thoughts will become balanced thoughts and your stress levels will be far easier to maintain.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
7
Coping Statements
When feeling stressed or anxious, you can cope better by reviewing and repeating some positive, reassuring, truthful statements to yourself until you calm down and gain control. If one statement stops working, try another until a better match is found for your particular situation. You can practice this exercise during deep abdominal breathing if you wish. You may come up with your own coping statements and/or use these examples: This feeling isn’t comfortable or pleasant, but I can handle it. I can be stressed (or anxious) and still deal with this situation. This is not an emergency. It’s okay to think slowly about what I need to do. This is not the worst thing that could happen. I’m going to go with this and wait for my stress (or anxiety) to decrease. This is an opportunity for me to learn to cope better. I’ll just let my body do its thing. This will pass. I’ll ride this through—I don’t need to let this get to me. I deserve to feel okay right now. I can take all the time I need to let go and relax. I can always leave if I need to. I’ve survived this before and I’ll survive this time, too. I can do what I have to do in spite of the stress (or anxiety). This is just stress (or anxiety)—it won’t hurt me. This is just stress (or anxiety)—I’m not going to let it get to me. Nothing serious is going to happen to me. Fighting and resisting isn’t going to help—so I’ll just let it pass. These are just thoughts—not reality. I don’t need these thoughts—I can choose to think differently. So what?
(Adapted from Bourne, 1992) © Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
8
SelfEsteem
Your selfesteem can be thought of as the extent to which you value yourself and see yourself as a good, worthwhile, acceptable person. Low selfesteem occurs when you unfairly criticize yourself, you push yourself hard with negative, critical pressure, and you believe the negative evaluations others give you more than the positive ones. Low selfesteem causes anxiety and stress from two sources: 1) the negative pressure and criticism you heap on yourself, and 2) worrying too much about gaining acceptance and validation from others. To increase selfesteem (and lower your anxiety), it is important to surround yourself with positive, supportive people. However, your selfesteem will be mostly made or broken by how you treat yourself. You can measure your selfesteem by asking yourself: would I treat my best friend the way I treat myself? If not, some selfesteem work is needed. To increase your selfesteem, consistently review and practice the following: 1) Stop Criticizing Yourself: Accept yourself exactly as you are and do not put yourself down. Putting yourself down will tear down your spirit more than motivate you to change. The trade off is not worth it. To accept yourself does not mean you are not driven to improve, but that you are “acceptable” now and will be even better with additional growth and development. 2) Use Positive Motivation: For the improvements you want in your life, practice thinking about and visualizing what it will be like when you accomplish your goals. Then, add some thoughts and visualizations consisting of the steps you’ll need to take to make it happen. This change in focus will be more motivating and energizing than focusing on either a) the negative thing that will happen if you don’t change, or b) all of the hard work it will take to make it happen. 3) Praise Yourself as Much as Possible: Whenever you succeed at something, privately give yourself credit for the part you played. Be generous with yourself (but still truthful). Praise yourself for your accomplishments whenever you can to build confidence and self worth. 4) Allow Mistakes: When you try and fail, that is a success in and of itself because the effort itself will act as learning experience to bring you closer to your goals. Be easy on yourself during your setbacks and pick yourself up. Life is a continual trial and error process. The only true failure is to give up, because then you are guaranteed failure. When you fail, give yourself a break, congratulate yourself on your effort, regroup, and try again. 5) Do Mirror Work: Practice looking at yourself in the mirror often. Look into your eyes and tell yourself whatever positive true statements you can. Remind yourself about your successes, what you are good at, what you are capable of, what positive things lay ahead for yourself, how you are improving, etc. Practice forgiving yourself and others in the mirror. Mirror work is a very intimate, vulnerable, exposing experience. This uncomfortable feeling will let you know the power this exercise has to help you change. 6) Be Happy and Relaxed NOW: Allow yourself to be happy and relaxed NOW—not after everything falls into place in your life. As soon as one anxiety or stress is taken away from you, another may soon follow. Therefore, allow yourself to enjoy life now, rather than waiting for happiness or relaxation at some mythical point in the future. Your life IS now—not later.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
9
Support Systems
Anxiety and stress levels can be much easier to cope with when you have others there to listen and give support, empathy and reassurance. To create a social support system, identify those people around you that are trustworthy and will support you without judging or criticizing. Typical support systems may include: family, friends, psychotherapists, coworkers, group therapy members, online support group members, religious leaders, fellow church members, sports associates, and/or anyone else you know and trust. Next, ask each support person if you can open up to them about the difficulties you are having with _______ . If you know them well, they will probably say yes and mean it. However, if you ask them to listen and they say no (or imply they aren’t interested), kindly refrain from opening up to them and go to someone else (or ask this person later when they are in the mood to listen). Opening up to a person who doesn’t want to listen will probably make your anxiety worse. Bad listeners tend to act impatient, give unsolicited advice, say “I told you so”, blame, criticize, switch the conversation to make it about them, etc. Finally, after choosing a good support person, let them know what your anxieties are, why they are affecting you like they are, what you wish you could do about it, etc. It’s usually more helpful to use “I” statements and express your feelings rather than just blaming and criticizing others. This empowering stance allows you to feel more in control of yourself and your feelings, rather than just feeling victimized and powerless. For example, it can be helpful to say “I feel anxious when my day starts out badly because I’m worried the rest of the day might go that way. I wish I could take better charge of my life and feel more confident”. This is the “I feel ___ when ___ because ___ I wish/I would like ___” format. Conversely, a less helpful way to vent may sound like “that S.O.B. always takes his problems out on me. He’s a loser.” This lose/lose approach will strain the ability of the listener to stay engaged and make you feel more like a victim. After opening up and having others listen to you, ask them for their advice, but only if you are open to it. Then, before going on too long, allow them to talk about their own issues or just allow the subject to change completely. At this point, you can just enjoy the rest of your time by listening to them or by getting involved in a different enjoyable activity. This helps you maintain your support system without “burning them out” or “draining them”. Everyone has a limit, so as soon as your support person has reached their limit in the discussion, allow the conversation about your worries and stresses to end, and then simply pick it up with someone else at a later time. You can expect your anxiety to be relieved with your support system through 3 means: 1) identifying and expressing your feelings in a healthy way to a sensitive listener, 2) hearing their advice (if you are open to it), and then 3) putting your worries aside and focusing on them for a while. Allow them to support you, but don’t make it always about you! Make it a balanced “give and take relationship”.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
10
Restful Sleep
Different people need different amounts of daily sleep—some need 8 hours, whereas others need 6 or 10. Furthermore, some can achieve restful sleep best with a nap during the day, whereas others need to sleep straight through the night. In any event, your body requires adequate rest to revitalize itself and cope with anxiety and stress. Busy lifestyles promoting sleep deprivation leave less physical resources to handle whatever stressors may arise. In short, get the amount of restful sleep you require every 24hour period in the form that works best for you. To get the restful sleep you need, practice the following: 1) Create a relaxing sleep environment, including a comfortable bed. 2) Remind yourself that skipping sleep will fail to revitalize your mind and body, and that the work you do under less sleep will probably be less productive anyway. 3) Sleep enough, but only as much as you need to feel refreshed and healthy. Under or oversleeping leads to fragmented, shallow rest. Sleeping for 78 hours a night is usually best. 4) Go to bed and wake up each morning at a regular, consistent time—preferably early. 5) Practice regular physical exercise at the same time of day to prepare you for your sleep. 6) Make your environment as quiet as possible—use earplugs if necessary. 7) Make sure you keep the room you sleep in at a moderate temperature. 8) Don’t go to bed with a full or an empty stomach; go to bed with a light snack. 9) Unless prescribed and recommended by a physician, avoid sleep medications, which may lose their effectiveness over time or even be harmful. 10) Reduce caffeine intake, which tends to disturb rest. 11) Avoid alcohol consumption, which results in fragmented, poorquality sleep. 12) Only lay on your bed when you are trying to sleep. This will make it easier to fall asleep. 13) When having trouble falling asleep, do something else for a period of time to help you relax, such as the following relaxing exercises and activities: abdominal breathing progressive muscle relaxation visualizing a peaceful scene selfhypnosis pleasure reading listening to soothing music taking a hot shower or sitting in a hot bubble bath, whirlpool, or spa
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
11
Medical Checkup
Because 7590% of all office visits to health care professionals are for stressrelated symptoms and disorders, anxiety and stress take an immense physical toll on the body. The body becomes very strained when confronted with stressful worries, threats, or changes, leading to the “fightorflight” syndrome and the “general adaptation syndrome”. Over time, these syndromes exhaust the body and can create or amplify many physical problems and illnesses. Physical symptoms from stress may include fatigue, sweating hands, paling or flushing of the face, sleeping problems, eating problems, skin problems, muscle tension, migraine headaches, cardiovascular diseases, stomach and intestinal problems, rheumatoid arthritis, aches and pains (especially in the neck and back), a weakened immune system, slowed recuperation from illness, high blood pressure, heart attacks, diabetes, ulcers, aging, or even death. Given the physically debilitating nature of anxiety and stress, visiting your medical doctor for a full medical exam is highly recommended. Your physician will help direct you to change your physical lifestyle habits in essential ways for your unique situation. Another benefit of visiting your medical doctor is to get a recommendation for what diet and exercise recommendations from this ebook will be acceptable for your specific situation (and which, if any, may not). Finally, a visit to your medical doctor can also be an opportunity to get a prescription for antianxiety medication to lessen your worry and stress. Please consult with your physician on all of these matters for the highest benefit and protection to yourself and your health.
(Sources: Stroebel, 1989; Greenberg, 1990; Manning, Curtis, & McMillen, 1999)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
12
Nutrition
Particular nutrients, herbs, and foods can help alleviate anxiety and stress in different ways. These recommendations are based upon a compilation of medical research and should only be used sparingly and as recommended on the label. Important: Consult a physician before using any supplement, especially if you are using any medications or if you have an allergy, illness, or other physical condition of concern. Discontinue supplement use immediately if negative symptoms occur. Nutrients GammaAminoButyric Acid Glutathione Nicotinamide Adenine Dinucleotide Vitamin B Complex Vitamin C Calcium & Magnesium LTyrosine Melatonin Fiber FreeForm Amino Complex Lecithin Multivitamin with Antioxidants Vitamin E & Zinc Herbs Ashwagandha Bilberry Ginkgo Biloba Milk Thistle Dong Quai, Rehmannia, Schizandra Hops Kava Kava Passionflower Polygala Root & Sour Jujube Seed St. John’s Wort Siberian Ginseng Skullcap Valerian Wild oat Foods Raw Fruits and Vegetables Purified Water (3264 ounces) Benefit/Effect acts as a tranquilizer; helps brain function protects the cells against damage aids in the creation and transfer of chemical energy for proper nervous system functioning helps produce antistress hormones reduces anxiety helps reduce stress on the body; a sleeping aid a natural hormone that promotes sound sleep for healthy bowel cleansing and functioning helps supply proteins used rapidly at stressful times for cellular protection and brain function replaces nutrients lost during stress needed for immune system functioning Benefit/Effect acts as a sedative and nerve tonic preserves cells throughout the body aids in circulation and proper brain function cleanses and protects liver; acts as an antioxidant supports major organs during stress eases nervousness, restlessness, and stress relaxes the mind and body has a calming effect Chinese herbs known to soothe and calm the spirit helps with nerve pain helps the body cope with stress good for nervousness and headaches; aids sleep aids nervous system; helps sleep; soothes headaches known to restore balance to the nervous system Benefit/Effect supply vitamins, minerals, and flavonoids cleanses liver, kidneys, and colon; flushes toxins
(Adapted from Balch and Balch, 2000)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
13
Substances to Avoid or Minimize
Particular foods and substances can aggravate anxiety and stress in different ways and are therefore helpful to minimize in your daily life. These recommendations are based upon a compilation of medical research and should act as a guide with your diet and lifestyle choices. Remember: these are general “rule of thumb” recommendations for most people. Consult your physician to construct a complete diet plan for your best individual health and relaxation needs. Furthermore, the assistance of a substance abuse inpatient or outpatient treatment program is recommended for those who need extra assistance in stopping addictive tendencies with alcohol, nicotine, or the abuse of illicit or prescription drugs—especially when tolerance, withdrawal symptoms, and/or psychological dependence has developed. Foods to minimize Processed foods and other unhealthy foods that aggravate stress: artificial sweeteners, carbonated soft drinks, chocolate, eggs, fried foods, junk food, pork, red meat, sugar, white flour products, foods containing preservatives or heavy spices, chips, and other similar foods
Dairy products (healthy in moderation, but may promote nervousness when taken in excess): milk, ice cream, butter, cheese, etc. Substances to minimize Caffeine (promotes nervousness, sleeplessness, and “the jitters”): cola soda drinks, coffee, iced tea, hot tea, “wakeup pills”, “alert drinks”, etc.
Alcohol, tobacco, moodaltering drugs (offer only temporary relief, do nothing to resolve main stresspromoting problems, hurt health) : beer, wine, hard liquor, cigarettes, tobacco chew, amphetamines (“meth”, diet pills), marijuana, cocaine, hallucinogens (LSD, ecstasy), inhalants (glue, paint), opioids (morphine, heroine), phencyclidine (PCP), etc.
Helpful links: www.na.org, www.aa.org, www.hypnosisnetwork.com
(Adapted from Balch and Balch, 2000)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
14
Exercise
In general, a program of regular physical exercise will help you to reduce your vulnerability to anxiety and stress. Exercise provides a natural outlet for the excess adrenaline and physiological arousal that accompany anxiety and stress states. It also releases muscle tension and stimulates production of endorphins in the brain, resulting in a state of increased calmness and wellbeing. To optimize the tensionreducing effects of exercise, it is best to do an aerobic form of exercise at least four times per week for at least 20 to 30 minutes. Aerobic exercise includes brisk walking, jogging, aerobic dancing, bicycling, riding a stationary bike, swimming, jumping rope, running in place, inline skating, etc. If you do brisk walking, you’ll want to double the minimum time of effectiveness from 20 to 40 minutes for the best results. If you haven’t been doing cardiovascular exercise recently, it is best to start exercising briskly for short periods (5 to 10 minutes) and then gradually extend to over 20 minutes. If you have any medical conditions that might limit exercise, experience symptoms of high blood pressure, diabetes, chest pains, fainting spells, or joint stress, and/or are forty or older, be sure to consult with your medical doctor before undertaking an exercise program. (Actually, it is best to consult with a medical doctor before undertaking any new exercise program). Many people find it helpful to vary the type of exercise they do. This can help reduce boredom and give you the chance to exercise different body parts. Popular combinations include doing a solo aerobic type of exercise such as jogging or cycling in combination with a social form of exercise such as tennis, racquetball, volleyball, or body building. If you are starting an exercise program or are otherwise not used to vigorous exercise, observe the following guidelines: 1) Approach exercise gradually 2) Commit yourself to at least a onemonth trial period of your program before giving up (unless your program is causing problems that logically warrant a change) 3) Expect some discomfort initially 4) Find ways to reward yourself for maintaining a commitment to your exercise program 5) Warm up before exercising, and have a cool down period before ending, such as with stretching, jumping jacks, or walking 6) Avoid exercising within 90 minutes of a meal 7) Stop exercising if you experience any sudden unexplainable pains or dizziness 8) If you find yourself getting bored with exercise, find a partner to go with you and/or choose aerobic activities that require you to have a partner (such as tennis or racquetball) 9) Exercise more than once a week 10) Make your goal of aerobic exercise be at least 4 days a week for 2030 minutes
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
15
Relaxing Environment
The sights and sounds of the environment can serve to either elevate or decrease your anxiety and stress levels. It is important to make whatever changes you can to make your home and work environments as relaxing as possible. The following are some helpful suggestions to create a relaxing, stressfree environment: *Keep your noise levels down. Loud noises are upsetting and invoke anxiety. Intermittent and loud noises tend to cause more upset than soft, constant noise. The more disturbing noises you can eliminate, the better. To minimize noise, consider padding and soundproofing the rooms you spend a lot of time in, such as with wall hangings, wall padding, and noise sealers at the bottom of your doors. Also, consider turning down the ringer of the telephone, turning down the television, stereo, and radio, having professional ear plugs made for you to wear (such as those made for swimmers), and periodically isolating yourself from others in a quiet place. *When not seeking after complete silence, play soft, relaxing sounds or music. “White noise” machines also can be used to muffle and drown out disturbing noise. Other options include playing soft classical or instrumental music. Finally, consider playing tapes or CDs of the various soothing sounds of nature, such as the ocean, a stream, or a babbling brook. *Have as much natural lighting in your home (or office) as possible. Unnatural fluorescent lighting can be especially aggravating. Consider opening your window blinds, opening your sky light (if you have one), or just spending more time outside. When using artificial lighting, consider using soft light lamps with lower wattage, rather than the brighter ceiling lights with higher watt light bulbs. *Keep the main rooms you spend your time in uncluttered. Cluttered rooms can be aggravating and tend to increase anxiety and stress levels. *How you position your furniture and wall hangings can either increase or decrease your stress levels, depending upon size, shape, angle, space, walkways, etc. Consider reconfiguring your rooms to a more practical, userfriendly, relaxing set up. If needed, you may wish to consult a professional interior decorator or feng shui expert. *The color themes that set the tone for your rooms should also be soothing, calming, and relaxing. The following colors tend to promote stress and anxiety, as well as higher blood pressure, heart rate, and respiration: red, orange, yellow, hot pink, and other striking fluorescent colors. These colors should be minimized to help promote a more relaxing environment. Conversely, the following colors tend to calm, soothe, and relax, as well as lower your blood pressure, heart rate, and respiration: blue, green, violet, and soft pink. *Keep your room temperature at a relaxing, comfortable level. Room temperatures should be no warmer than 72 degrees—preferably lower. Hot, humid room temperatures increase irritability and drain energy. When air conditioning becomes too expensive to run, consider wearing lighter clothes, running a fan, and periodically cooling down your skin with a cool bath or shower.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
16
Meditation
Meditation is a mental exercise that affects body processes. The purpose of meditation is to gain control over your attention so you can choose what to focus upon, rather than just reacting to whatever confronts you. The relaxation and control inherent in meditation can serve as an excellent relief to anxiety and stress. Meditation has its tradition grounded in Eastern cultures (such as India and Tibet), but has become popularized in Western cultures since the Beatles visited India in the 1960s. To practice a simple form of meditation, follow these directions: Find a quiet place where you can relax and be alone. Choose a time when you will not be so tired that you risk falling asleep. Use a comfortable straightbacked chair that helps you sit up with minimal effort. A chair that also supports your upper back and head is even better. Then be seated with your buttocks pushed against the back of the chair. Place your feet slightly forward of your knees with your hands resting either on the arms of the chair or in your lap. Let your muscles relax naturally. Don’t “try” to relax. Trying is work, not relaxation. Just assume a passive attitude in which you focus upon your breathing. Allow whatever happens to happen. If you feel relaxed, fine; if not, accept that too. Next, close your eyes and repeat in your mind the word “more” every time you inhale and the word “relaxed” every time you exhale. (If you have a preference, you can substitute any other two relaxing words, providing the words are short and either positive or neutral). Repeat this process for about twenty minutes. During you meditation, do not consciously alter or control your breathing; breathe naturally. Finally, when you are ready to stop your session, allow your body to become naturally readjusted to its normal state. Open your eyes gradually, first focusing on one object in the room, and then several. Take a number of deep breaths. Then, stretch while seated, and when you feel ready, stand and continue your stretching. Since your blood pressure and heart rate are decreased while meditating, rising from the chair too quickly might cause dizziness and is not recommended. If you rush to leave the meditation session, you are apt to feel tired or lose the sense of relaxation. In short, end your session slowly and comfortably for the best results. Further Recommendations: 1) 2) 3) 4) 5) 6) Have a goal to meditate twice a day for approximately twenty minutes. Cease your meditation if you feel uncomfortable, dizzy, or hallucinate (which is rare). The best two times to meditate tend to be immediately upon rising and just before dinner. To assist achieving a relaxed state in your meditation, avoid all stimulants, such as caffeine. Make sure your head is held up with support; otherwise, allow your head to droop forward. If you want to know when your time is up, simply peek at a clock or watch. Eventually, you should acquire a mental alarm clock that will alert you when your time is up. 7) Eliminate any loud sounds that may interrupt your experience: phones, alarms clocks, etc. 8) When you find your thoughts wandering, gently refocus and continue. 9) Slow yourself down as much as possible. Relax and enjoy this process.
(Adapted from Greenberg, 1990)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
17
Visualizing a Peaceful Scene
By changing your thoughts to something relaxing and peaceful, you can ease your mind and soothe away psychological tension. To prepare for this exercise, say the words below into a tape recorder in a soothing, slowpaced tone of voice. Pause long enough at each noted “pause” to become fully absorbed in the experience (perhaps 13 minutes each). Then, relax and listen to the directions. Or, if you prefer, simply read and memorize the following script to rehearse these directives from memory. Choose a time you will not fall asleep, find a quiet place, and lie or sit in a comfortable position. Now, take several minutes to listen to your tape (or guide yourself from memory). Allow yourself to become absorbed in the following experience (or a similar one of your own making): Take a few deep breaths and slowly close your eyes. Imagine you’re in a very peaceful, comfortable setting that has a special meaning to you. It can be outdoors or indoors. It can be a realistic place or imaginary. You find that you feel very safe and supported there…this is a safe place. (Pause) Now look all about you and notice the colors of everything in this particular scene. (Pause) You might focus on one color in particular…and you find this color to be very relaxing. (Pause) As you feel more and more relaxed, take notice of any sounds that you can hear in this special place. (Pause) You might focus in on one sound in particular, and you find this sound to be very relaxing. (Pause) Now become very aware of anything that you are touching on the ground or elsewhere. How does it feel? Let these tactile sensations help to relax you still more. (Pause) Just continue allowing yourself to settle in, feeling relaxed and at peace in this wonderful place. You’re feeling very safe, secure, and at ease. Stay in the wonderful place as long as you wish. Continue experiencing your relaxing place with all of your senses. (Pause) You have the power and ability to revisit this wonderful, relaxing place whenever you wish during the day to enjoy these same feelings. At your own pace and as you are ready, reorient yourself to your surroundings and open your eyes at a comfortable, natural pace. Any scene that feels very calming to you will do for this exercise. It could be in the outdoors like a remote beach, a mountain stream, a lake, or a wooded area. Or, your scene may consist of an indoor scene such as a cozy fireplace or a comfortable bedroom. It is very important in a visualization exercise to take the appropriate amount time and to experience your scene in as much detail and through as many senses as possible. Focus on all of the objects you can see—their colors, shapes, and sizes. Also be aware of any sounds, smells, or things you can touch. Finally, take all of the time you need to fully experience the relaxing nature of your scene. Remember that the more you picture yourself in this peaceful scene, the easier it will be to return there whenever you’d like. You can eventually learn retreat to your own special scene—the safest place in your mind—whenever you’re feeling anxious or tense. This exercise can be as formal or informal as desired, as long as the effects are achieved.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
18
Guided Imagery
Guided imagery exercises help minimize the distressing nature of your worries and stresses by changing the way you see them. To prepare yourself for this exercise, choose one or more stressful situations that you currently struggle with (such as the things you have to do). Then, loosen your clothing, go to a quiet room away from others, and sit or lie in a comfortable position. Take a few slow, deep breaths, close your eyes, and slowly visualize one or more of the following scenes: 1) See yourself and the anxietyinvoking situation. Have yourself remain regular size, but have the anxiety situation slowly shrink. Have it become smaller and smaller until it eventually disappears. If desired, have yourself also grow in size until you dominate the picture and the anxiety is nowhere in site. Then, visualize yourself as relaxed and relieved as possible. 2) See yourself, along with the anxious situation. View yourself normally, but visualize the anxious situation fading to black and white. Then, allow the black and white anxiety scene to fade further until it becomes foggy, blurry, and then, completely invisible. All the while, see yourself in regular, sharp color, increasingly happy as the stress leaves. Feel free to wave goodbye to the anxiety. Finally, end the scene by seeing yourself engaging in some of your favorite relaxing activities (like having a bubble bath or lying in a hammock). 3) See yourself dealing with a anxietyinvoking situation from beginning to end, but have it be in the form of a movie you are watching on a wide screen. Add as many Hollywood features that you can to manipulate the mood in a humorous, different way that deflates your worries. Give it a funny dramatic title and name the cast with goofy nicknames (yourself and others involved with the stress). Then, speed the anxiety scene up (“fast forward”), change the scene to slow motion, add humorous or corny, dramatic music, rewind it, add laugh track sounds in the background, and change the scene by adding anything else that is humorous and different from how you currently experience the event. End the movie with either a very good, positive ending, or a catastrophic ending far worse than would occur in real life—so worse that it is actually humorous when you watch it. Finally, see yourself taking a final bow as if on a stage and roll the final credits with positive music. 4) Visualize yourself in a very relaxing scene, such as the mountains, the ocean, the woods, etc. Enjoy the scenery with all of your senses. Then, briefly switch to seeing the anxiety situation for 12 seconds only. Finally, stop seeing the anxiety situation and go back to your initial relaxing scene very quickly, where you will stay as long as you wish until you are very relaxed again. 5) Choose an anxietyinvoking situation, and transform it all into a funny little creature of some sort wearing a tshirt naming the worry. Notice how small, funny, and unthreatening the creature is. Laugh at it and see it walk away in shame until it is out of site. 6) Choose an anxietyinvoking person or situation, and transform it into a bag (like a suitcase). See yourself approaching a oneway bus or train, place the bag on board, and watch it drive away until it slowly disappears from view. Wave goodbye to the anxiety, and have yourself walk away in the opposite direction with a large smile on your face. **After deflating an upsetting image through one of the visualizations above, you may find it helpful to then switch the image to a positive, enjoyable, relaxing scene of your own choosing.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
19
Humor
Humor can be defined as the ability to appreciate or express that which is funny. Laughter is a universal genetic response to socially “funny” cues in a series of short syllables such as “haha”, “ho ho”, or “heehee”. The most obvious effect of humor is on our mood, helping us feel joy, surprise, and amusement. Correlational studies of anxiety and stress have connected humor with many positive outcomes, including: lower feelings of depression, anxiety, and alienation, as well as lower blood pressure, heart rate, pain, and stress hormones. Humor has also been associated with higher positive moods, a strengthened immune system, and increases in relaxation, endorphins, social cohesion, creative thinking, and feelings of control. In short, humor tends to lessen the physical and emotional impact of anxiety and stress—especially with those who have already cultivated a strong sense of humor. To increase the humor and laughter in your life, do the following: 1) Figure out and define what makes you laugh out loud. List everything that comes to mind that makes you laugh in this way, including where you are, who you are with, and what you are doing. Be honest with yourself. If needed, carry around a pad of paper and write out the situations and circumstances when you catch yourself laughing. 2) Next, use your list to build a “humor library” of all the artifacts that make you laugh: books, magazines, movies, music, TV shows, etc. Then, go to these resources whenever you need a “laugh lift”. 3) Finally, because humor intensifies when you have someone to share it with, list all of your friends, family, and associates you feel close enough to that you can laugh with. Then, engage in as many fun activities with them as possible from step 2, as well as additional fun activities typically enjoyed with others: going out to funny movies, playing funny “get to know you” games, going to comedy clubs, etc.
(Adapted from Provine, 2000 and Doskoch, 1996)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
20
Anxiety and Stress Education
It can be helpful to engage in some additional research and reading about anxiety and stress. The more you understand the problem, the better you will be able to control it.
Books on Anxiety and Phobia Management
The Shyness and Social Anxiety Workbook (2000). Oakland, CA: New Harbinger Publications. *offers plenty of simple ways to overcome shyness and social anxiety Triumph Over Shyness: Conquering Shyness & Social Anxiety (2001). Murray B. Stein and John R. Walker.New York: McGrawHill. *a good book on understanding social anxiety and shyness The Anxiety & Phobia Workbook(2001) by Edmund J Bourne. Oakland, CA: New Harbinger Publications *an easy to read workbook version with a variety of anxiety and phobia management techniques*
Books on Stress, Stress Management, and Relaxation
Stress: Living and Working in a Changing World (1999) by George Manning, Kent Curtis, and Steve McMillen. Duluth, Minnesota: Whole Person Associates, Inc. *this stress book is comprehensive, easy reading, and highly recommended* The Relaxation and Stress Reduction Workbook (2000) by Martha Davis, Matthew McKay, and Elizabeth Robbins Eschelman. Oakland, CA: New Harbinger. *an easy to read workbook version with a variety of stress management and relaxation techniques* Wherever You Go, There You Are (1995) by Jon KabatZinn. New York: Hyperion. *a helpful, indepth look at what meditation is an how to do it*
Web Sites
www.algy.com/anxiety *A comprehensive website for understanding anxiety, panic, and all of the forms of anxiety disorder. www.stress.org *The official website of The American Institute of Stress; offers some good, comprehensive stress information
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
21
Coping with Hassles and Life Changes
Hassles: The hassles in your life can be thought of as the small and mediumlevel annoyances that slowly build anxiety and stress levels in your life. To assess which hassles are currently affecting you in your life, answer the following questions: Y (Yes) Y Y Y Y Y Y Y Y Y N (No) N N N N N N N N N
1) I am concerned about my weight being too heavy or too light 2) The rising cost of living bothers me 3) I have a lot to do to maintain my home 4) Misplacing or losing things is a problem for me 5) I have too much to do and too little time to do it 6) I am not satisfied with my physical appearance 7) Managing finances and keeping records take a lot of time 8) Someone close to me is in poor health 9) I am concerned about crime and safety
Each of these hassles has the potential to build your stress levels and interfere in your life. Life Changes: Whenever major life changes occur in your life, the resultant stress takes a large physical and emotional toll. When life changes happen together, and/or are of strong enough intensity, the result can be illness, hospital visits, and even death. Note which of the following stressors you have experienced over the last 12 months (listed in order from most stressful life change to least): *death of spouse/partner, divorce, marital/partner separation, jail term, death of close family member, personal injury or illness, marriage, fired at work, marital/partner reconciliation, retirement, change in health of family member, pregnancy, sex difficulties, gain of new family member, business readjustment, change in financial state, death of a close friend, change to different line of work, change in number of arguments with spouse/partner, mortgage or loan for major purchase (home, etc.), foreclosure of mortgage or loan, change in responsibilities at work, son or daughter leaving home, trouble with inlaws, outstanding personal achievement, spouse/partner beginning or stopping work, change in living conditions, revision of personal habits, trouble with boss, change in work hours or conditions, change in residence, change in recreation, change in church activities, change in social activities, mortgage or loan for lesser purchase (car, TV, etc.), change in sleeping habits, change in number of family gettogethers, change in eating habits, vacation, Christmas, minor violations of the law* How you handle stress depends upon the total demands you face (your hassles + life changes) in combination with the resources you possess for meeting these demands. This system aims to build your stress absorbing, adapting, and management resources. Practice identifying the current and recent hassles and life changes you have faced. Then, match up and use appropriate interventions in this section that address both your specific anxiety and stress relief needs now, as well as the relevant concerns to address early to prevent future problems. (Adapted from Manning, Curtis, and McMillen, 1999)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
22
Problem Solving
How you conceptualize and plan to tackle your problems will greatly determine how well you resolve them and how much stress and anxiety you experience in the process. Most of these problems come from worrying or being upset about what we can’t control—leaving less time, energy, and focus for efforts that actually will resolve our problems. Write out the following exercise when you are facing a stressful problem to minimize your stress and better resolve the issue. Step 1—Identify your problem: Write out the specific problem you are facing: what the problem is and why it is a problem for you. (Only write out one problem at a time). (For example: My parents are visiting and I don’t like how they give me critical comments) Step 2—What do you WISH you could do to resolve your problem if you had the power? In other words, if you had a magic wand and had ultimate power to change this problem, what would you do? What would you make happen? (For example: I would make it so they would never give me advice or criticism again—unless I ask them for their opinion). Step 3—What are you NOT able to do to solve the problem? Realistically admit your limits and state what you are unable to do to solve the problem. (For example: I can’t change their personalities or make them more sensitive and respectful) Step 4—What ARE you able to do to solve the problem? What can you reasonably do to try to change the situation? What are all of the ways you could approach this that are within your power to do? (NOTE: the better you get at this brainstorming, the bigger your list will be. Usually, the bigger your list the better it will be). (For example, you could choose to 1) respectfully let them know your feelings and request they only give critical advice and opinions when asked for, 2) cancel their trip, 3) avoid talking to them about sensitive topics during their visit, 4) have a friend be with you during their visit to avoid their giving opinions on sensitive subjects, 5) pretend you are sick, and/or 6) read a book on responding to criticism and use the ideas during the visit). Stage 5—Choose your course of action to solve the problem: First, cross off what you “wish” you could do and what you “can’t” do. Then examine what you “can” do. Cross off the ideas you don’t prefer and plan for how you will implement whatever ideas are left. Expand on the remaining ideas until you have a very complete, “doable” plan. Then, persistently follow through on your chosen course of action until your problems are solved (or at least moderated). (For example, from your options of “what you can do” in step 4, you choose to prepare for their trip by reading a book on responding to criticism and then plan to use these ideas during the visit. Then when they arrive, you start off the visit by assertively and respectfully requesting that they only give their advice and opinion when asked for. Then you reassure them of your care and concern for the relationship).
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
23
Time Management
Two common complaints of highly anxious and stressed individuals are that they have “too much to do in too little time” and they “wish they had more hours in the day”. The truth is, the more worried and stressed you are, the less energy and focus you’ll have for the tasks at hand because of the draining nature of stress itself. This often turns into a vicious cycle: the more anxious and stressed you are, the lower your energy and task performance, leading to more anxiety and stress, and so on. Therefore, the first way to better manage your time is to decrease your stress and increase your energy and task efficiency (such as with the interventions in this section). Remember—spend some daily time on your relaxation activities. Having 1 less clock hour to work but feeling more invigorated and relaxed for the tasks at hand will result in more output AND less anxiety and stress at the same time. Think about it. If you do not believe in this idea, then time management will not work for you. Second, in addition to doing relaxationpromoting activities, here are some simple, strategic activities you can do to better manage the time you have for what you need to do: *Every morning, list every major task you need to do that day, prioritizing your tasks numerically from highest to lowest in order of importance. Then, cross off your tasks during the day as you complete them (or delegate them). If you do not complete or delegate all of the lower priority tasks by the end of the day, it shouldn’t matter. By definition, these tasks are “lower priority” and don’t necessarily have to be done by the end of the day. Your anxiety and stress will lessen as you strike off the most critical tasks and go lower on the list. *List all of the current tasks you need to do during the next day, week, month, and year. Rank these tasks either “3” (critical), “2” (important), or “1” (optional). Cross off the “1s” (the optional tasks) from your list completely. Then, write out a plan for how and when you will accomplish the “3s” (critical tasks) and the “2s” (important tasks). Post your revised list and chart your progress for accomplishing them as you only focus on your essential tasks. Delegate whatever tasks you can and systematically work to accomplish the rest. Remember, you can’t do everything, so just do the best you can with the time and energy available. *Regularly clean up and organize your main work and living space. Don’t worry about cleaning and organizing the areas of your home or office you use least. Organize your work materials so you know “what is where” in a logical, userfriendly system that works best for you. *Use a “planner” every morning, night, and throughout the day. Plan, check off, and replan again and again. Make sure your planner is portable, userfriendly, and attractive (no one will use an ugly planner!). Your planner can either be of the oldfashioned paperandpen variety or a sleek, electronic palmpilot. Be selective and only choose a planner you like and will use. *Remember, the small work you’ll invest in all of these activities should be more than worth the invigorating, timereducing results. The above time management strategies are an investment in yourself. This is an excellent avenue to make your life easier. See yourself as a worthwhile person deserving of the help and assistance you will be giving yourself.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
24
Play Time
Spending your time engaged in some playful activities everyday can be an effective anxiety and stress reliever—even if for a short period of time. Play time helps to relax you by 1) diverting your attention away from your worries and stress, 2) giving you something else in your life to enjoy and feel productive with, and 3) giving you an outlet to enjoy, relax, and “blow off steam”. Play can be defined as any voluntary activity you choose to participate in whose only purpose is to provide enjoyment, fulfillment, satisfaction, and relief from the challenges and obligations in your life. In short, engaging in play is productive by providing times of enjoyment will help to calm you down and “take the edge off”. When considering which play time activities or hobbies to engage in, review the following complimentary exercises of this section: “taking time off” and “time management”. These activities will help you figure out how, when, and where you can plan to engage in your favorite anxiety/stress relieving play activity. Next, brainstorm which forms of play you can practice that will primarily promote either physical or emotional fulfillment. Finally, implement a consistent, daily, weekly, and monthly regiment of your activities in whatever practical, consistent way possible. A good activity or hobby will not only help you take your mind off of your worries, but it will also be productive in some way. A list of invigorating playtime activities or hobbies you may want to engage in include the following: Sports Exercise Arts/Crafts Shopping (actual or just “window shopping”) Spa/Massage Hiking/Camping/Outdoors Education/Classes/Groups/Therapy Spending Quality Time Connecting with Others (without mentioning your stress) Decorating/Designing Cleaning, Organizing, and Uncluttering Reading/Writing Games (board games, video games) TV/Movies Music Cooking/Nutrition Volunteer Work/Service Pets/Animals Photography Religion SelfHelp
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
25
Taking Time Off
Taking time off from your usual duties can be an effective way to regain energy, motivation, and composure for all that you have to do. Sometimes it is important to simply avoid the worries and stresses of life by engaging in reinvigorating activities. Because anxiety and stress causes both psychological and physiological strain, it is important to periodically do nothing but recuperate and “recharge your emotional and physical batteries”. It is important to note that this intervention alone will not resolve your worries, because the same issues that you temporarily gain relief from will still be waiting for you when you return. Therefore, combining this exercise with others in this section will produce the best short and longterm stress relief results. Here are some suggestions and considerations for taking time off and avoiding your worries and stress: *When you arrange to take time off, fully commit to taking a period of time completely away to allow for the maximum recuperation. Therefore, plan to leave your cell phone and pager at home (or off) if it’s safe to do so. *Arrange to take as much time off as you can reasonably afford to take without allowing your problems to multiply too greatly. Your considerations may include money, job security, family duties, and timepressure tasks that will multiply if left unattended for too long. A few hours away from your worries and stresses can be helpful, a day or a weekend even better, and a week or two away being the best. Vacations longer than two weeks are rare and usually impractical, but can be highly beneficial if you can manage it. *Choose activities to engage in that will reinvigorate you physically and emotionally. If the worry or stress you want to recover from is primarily emotional, you may want to spend your time in a physically invigorating activity to change the focus and allow for recuperation. Conversely, if you want to recover from a primarily physical stress, you may want to spend your time engaged in an emotionally invigorating (but physically relaxing) activity. *Brainstorm and plan an appropriate activity that offers relief from the specific type of anxiety or stress you are struggling with. Examples of physically invigorating activities may include skiing, swimming, rafting, rock climbing, hiking, scuba diving, kayaking, dancing, etc. (Note: only plan to engage in physically invigorating activities that are safe, so consult your physician). Conversely, examples of emotionally invigorating (yet physically relaxing) activities may include visiting a day spa, getting a massage, sunbathing, hottubbing, going on a cruise/sailing, siteseeing, taking a tour, seeing a play or musical, etc.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
26
Assertiveness Training
“Assertive communication” is a key to lessening your anxiety and stress levels when facing a problem or concern involving others. This exercise represents the underlying philosophy behind the “communication skills”, “negotiating skills”, and “responding to criticism” exercises of this system and is meant to be used in combination with them. Assertive communication involves clearly stating your opinions, how you feel, and what you want, without violating the rights or feelings of others. Assertive communicators are open, honest, and direct with their wants and needs, while at the same time being polite, respectful, and sensitive to the feelings of others as much as possible. The main advantages of assertive communication include active participation in decision making and getting what you want without alienating others. Assertiveness works because your openness allows you to clearly and completely express your wants and needs, while your sensitivity minimizes the other feeling attacked or threatened, which leads to defensiveness. Nonassertive communication increases worry and stress by decreasing cooperation and collaboration with others. On one extreme is “aggressive communication”: being open, honest, and direct, yet forceful and offensive. Examples of aggressive communication include arguing, yelling, calling names, not listening, making real or implied threats, etc. On the other extreme is “passive communication”: being polite, respectful, and sensitive to the feelings of others, but only expressing feelings partly (if at all). Examples of passive communication include talking softly, giving the silent treatment, avoiding eye contact, passive aggression, expecting mind reading, and having slouched, yet tense posture conveying a message of submission. Poor communication often switches between aggressive and passive, leading to negative outcomes with others. To develop your skills of assertive communication, practice the following: *Speak in a calm, clear, confident tone of voice—practice in the mirror and then with others *Make good eye contact *Have an upright, yet relaxed posture *Keep a focus on expressing your feelings, rather than attacking and blaming *Make requests and suggestions, rather than demands and orders *Take personal responsibility for your feelings *Focus more on facts and principles than personal differences *Focus on solutions, collaboration, agreement, and compromise *Consider taking martial arts or selfdefense classes *Express your feelings respectfully, but without apology when none is warranted *Remind yourself that your feelings, wants, and need are important and valid *Accept that to be heard, validated, and respected can be more valuable than having approval *Ask yourself before speaking: “how can I say this in an open, honest, forthright way”? *Also ask yourself: “how can I say this in a way that minimizes the other person feeling defensive, attacked, or threatened”? *Be OK with saying “no” *Pick your battles, but disagree and stand your ground when necessary *Stick to one sensitive topic at a time unless both are ready to move to another subject *When at odds, politely repeat your main argument and agree to disagree (Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
27
Communication Skills
The anxiety and stress we experience in life are highly connected to how difficult our interactions are with the significant others in our life: family, friends, coworkers, etc. How you communicate with others tends to be more important than what you may be discussing. Communicating in any way the other perceives as threatening or offensive generally results in others getting defensive and either arguing back or shutting down. Constructive communication at this point is usually futile, resulting further contention. Remember—whether you meant to be offensive or not, an offended person still will feel and react in the same way. Their perception is their reality. Therefore, in order to keep peace and minimize worry and stress levels, it is important to communicate to others about sensitive matters in ways that open and honest, but also polite, sensitive, and respectful. The following communication skills can help you achieve this balance: 1) Use “I” statements (instead of “You …”) I feel_________when_________because________ I would like it if / I wish that__________________ Otherwise I________________________________(optional—be careful with this) (Avoids blaming and shows you take responsibility for yourself and your feelings) 2) Bring up the past as little as necessary to make your point (This sensitive subject makes people defensive, so use minimally with great discretion) Be specific and don’t generalize (avoid “always”, “never”, names, and labels) (don’t make a problem bigger than it actually is) Stick to the subject (until you are both ready to move on) (it’s hard enough to talk about one sensitive subject; bringing up more is overwhelming) Be aware of your body language (keep it open, nonthreatening, and attentive) (keep your arms and legs uncrossed and unfolded, keep good eye contact) Keep a soft, respectful tone of voice (avoid yelling, sarcasm, patronizing, or sharpness) (the words you use won’t matter if you sound attacking, blaming, or defensive)
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7) Admit immediately where you are wrong / agree immediately where they are right (whenever you can honestly do so; this puts you both on the same side) 8) Be brief in your argument (avoid lecturing; allow for back and forth discussion) (if you ramble too long, you will lose the other person and they will tune out) Listen reflectively without interrupting (listen first, respond second) (respond only after the other feels heard, understood, and validated) Offer solutions and support the other person trying to (or wanting to) change (be a part of the solution—not the problem; don’t be negative)
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© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
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28
Responding to Criticism
A main cause of anxiety and stress comes from dealing with other people’s criticisms and putdowns. When critical people are open minded and willing to listen, refer to the “communication skills” and “negotiation skills” exercises to talk things out and come to a compromise. Conversely, rational, logical conversations with closedminded troublemakers are counterproductive because such people are only looking to manipulate you and give you a hard time. The key is this: how you choose to respond to their criticism will largely determine how much contention will follow. Therefore, you are never a helpless victim to critical people—even if they hold some sort of a power position over you. There are three ways of responding to closedminded critics that are usually not helpful. In fact, these responses usually just make things worse: 1) Trying to explain yourself and your position (which they will discredit) 2) Firing back a criticism towards them (leading to a backandforth argument) 3) Sitting there quietly and “taking it” (leading to further criticism and less respect) Responding in any of these three ways will just give ammunition for the other person to use against you. A rule of thumb is that when others are contentious and looking for a fight, they are not in the mood for reason. Just focus on deflating their argument and escaping damage until a later time when they’re ready to talk civilly and respectfully (although some troublemakers may never be open to civil discussion—sad, but true). The following four techniques serve to deflate closedminded criticism when executed politely, respectfully, and under control: 1) Summarize (or “paraphrase”) back to them what they’ve said to allow them to restate themselves more specifically and respectfully. 2) Ask for specifics to counteract and minimize the generalized, overblown criticism they have just delivered against you. 3) Agree in part with whatever portion of their statement you honestly can (without discounting it with “but”, “although”, or “however”—using “and” will be far more constructive). 4) Use a “broken record technique”: repeatedly agree with whatever part of their criticism that you honestly can, along with a brief resolution to improve until they finally see you will not be diverted from the subject and finally back off. These deflating techniques work because they allow you to politely and respectfully respond in ways that “send the ball back in their court” without giving them anything further ammunition to use against you. After they are deflated and run out of bullets, the conflict will end and they will go away— probably to find another person they can vent on with better success.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
29
Negotiation Skills
When your interests are in direct conflict with another, a fair settlement or negotiation that totally satisfies both sides is difficult, if not impossible to achieve. Anxiety, stress, frustration, and contention are often the result. Therefore, sometimes the best you can hope for is to find a “workable compromise” you can both live with. Examples may include the following: *My way when I do it, your way when you do it *My way this time, your way next time *Part of what I want with part of what you want *If you’ll do X for me, I’ll do Y for you *We’ll try my way this time; and if you don’t like it, you can veto it next time However, if one or both of you don’t feel open to creating a compromise, it can be helpful to first take turns listening to and validating each other’s feelings on the subject—even if you disagree with why they have those feelings. After both sides feel listened to and validated without criticism, negotiation should be possible. To listen to each other’s feelings effectively: 1) A first person respectfully shares their feelings on the subject for 1530 seconds. 2) A second person (the listener) does not respond back, but instead paraphrases back what was heard to show if what was said and what was heard are the same. 3) The first person either agrees if he or she feels heard and understood, or if not, clarifies and restates what was said until both sides are on the same page. 4) This process continues until the first person feels that their main position is heard, validated, and understood. 5) The roles are then reversed with the second person opening up and the first person listening. 6) This back and forth process continues until both sides feel listened to, heard, validated, and understood on all of the main aspects of their position. (*Note: neither side should be interrupted, criticized, or made to defend their position at any point of this exercise). If both sides are still not ready to engage in a workable compromise, take some time away from the situation and then revisit it when feelings have cooled off. When both sides are ready, begin a discussion and see if a workable compromise naturally results. If not: 1) Take out a piece of paper to list all of the possible solutions each of you can think of for the situation. Then, take turns making suggestions back and forth. As you are brainstorming, let your imaginations run wild while generating as many potential solutions as possible. NOTE: Don’t judge or criticize the other person’s suggestions. 2) After both sides have added as many potential solutions as possible (hopefully, at least 4 a piece), each takes turns crossing off the solutions onebyone they are most opposed to until there are only 2 solutions left. 3) Decide on a workable comprise you can both live with, even if just for a little while. Often this occurs by combining elements of the last 2 options (plus any desirable elements of the crossed out options that both can agree to). 4) Agree to revisit and renegotiate the issue in the future to create a new workable compromise (as needed if feelings or conditions change). (Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
30
Influencing Skills
Sometimes, we become anxious or stressed because we try to “fix”, “control”, “push”, or “pressure” others into the changes we feel they should make. Because no one can “make” someone else change, mutual stress and frustration usually result. People only change if they choose to do so. Therefore, the best we can do is to stop “pressuring” them, do more positive “influencing” for change, and accept the choices they make (or not make). “Positive reinforcement” creates the greatest likelihood that others will change because “positive influence” is used instead of “negative pressure”. Positive reinforcement leads to change because people feel they are choosing to change for positive reasons, rather than feeling forced to change to avoid negativity. People tend to not change under negative pressured because of pride, fear, or simply having a different opinions or values. Negative pressure works poorly in getting others to change because people tend to respond with rebellion or sabotage. One or more of the following responses to negative pressure are most common. People either: 1) stubbornly resist changing and argue back 2) temporarily change to stop the negativity, only to revert back to old ways when it’s “safe” 3) grudgingly change in the pressured way, but with a determination to “get revenge” as soon as opportunity presents itself in the future To help someone change through reinforcement, practice the following: 1) Politely and respectfully request the other to change occasionally in certain specific ways. For example: “I would appreciate it if…”, “I would like it if…”, “I really like it when…”. Then keep quiet about it for a while and let them choose what to do. Catch the other “in the act” of behaving how you’d like them to be, then praise them heavily for their efforts. Be genuine and avoid sarcasm. Model the behaviors you want the other to do yourself, then politely invite them to join in with you. Show appreciation if they join you and accept it if they say no. Be patient. After the other person acts in the ways you desire for a period of time, spontaneously give them a tangible reward or do a fun activity with them. Subtly let them know that the reward is partly out of appreciation for their positive efforts. (Be sly and don’t bribe!) Minimize all negative pressure tactics, including: nagging, yelling, criticizing, complaining, put downs, threats, ultimatums, arguments, disapproval, resentment, power struggles, passive aggression, etc. After using a combination of the 5 approaches above, decide when you have done all you feel like doing to promote the changes, and then “let go”. Allow them to make their choices and then accept things the way things are—now that you’ve done your best to promote change on your end. Remember—you wouldn’t like another person trying to force you to change, so don’t do it to someone else.
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© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Cited References
Balch, P.A., & Balch, J.F. (2000). Prescription for nutritional healing. New York: Penguin Putnam, Inc. Braden, N. (1982). The Romantic love and answer book. New York: Penguin Group, Inc. Bourne, E.J. (1992). The agoraphobic treatment group. In M. McKay and K. Paleg (Eds.), Focal group psychotherapy (pp. 67133). Burns, D.D. (1990). The feeling good handbook. New York: The Penguin Group. Chesser, B.R. (1984). Five myths that can wreck your marriage. Readers Digest, 6, 2328 Doskoch, P. (1996, July/August). Happily ever laughter. Retrieved July 4, 2002 from the World Wide Web: http://www.psychologytoday.org. Gottman, J. (1994a, May/June). Why marriages fail. Networker, 3, 4148. Gottman, J. (1994b). Why marriages succeed or fail. New York: Simon & Schuster. Gottman, J. (2000). The seven principles for making marriage work. New York: Crown Publishers. Greenberg, J.S. (1990). Comprehensive stress management. Dubuque, IA: Wm. C. Brown Publishers. Kurdek, L.A. (1993). Predicting marital dissolution: A 5year prospective longitudinal study of newlywed couples. Journal of Personality and Social Psychology, 64 (2), 221242. Jorgensen, S.R. (1986). Marriage and the family. New York: Macmillan. Manning, G., Curtis, K., & McMillen, S. (1999). Stress: Living and working in a changing world. Duluth, Minnesota: Whole Person Associates, Inc. Nevid, J.S. (1984). Sex differences in factors of romantic attraction. Sex Roles, 11, 401411. Provine, R.R. (2000, November/December). The science of laughter. Retrieved July 4, 2002 from the World Wide Web: http://www.psychologytoday.org. Sternberg, R.J. (1988). The triangle of love: Intimacy, passion, and commitment. New York: Basic Books. Stroebel, C.F. (1989). Qr: The quieting reflex. New York: Berkley Publishing Group. Warren, N.C. (1992). Finding the love of your life. Colorado Springs: Focus on the Family Publishing.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
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Note: This program is only meant to compliment—rather than replace—the services of a licensed and qualified psychotherapist or medical doctor. Always seek out the services of these licensed professionals as necessary. Consult with your primary care physician before utilizing the nutritional or exercise recommendations contained in this program. Only use this program with moderation and common sense. Use at your own risk.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
The Coping with Stress and Anxiety System©
Welcome to the Coping with Stress and Anxiety System. This system will help you learn to effectively manage stress and anxiety. In order to get optimum results, it is recommended that you augment this program with the hypnosis audio CD program “Managing Stress and Anxiety”. These techniques are divided into 3 sets of 10 based upon the primary manner each helps relieve stress and anxiety. Accordingly, “adaptation interventions” help you better adjust or accommodate to stress and anxiety; “absorbing interventions” are preventative efforts to help you delay the onset of symptoms and reduce symptom intensity; and “management interventions” help you directly remove or modify the power of the challenge(s) you are currently facing. Choose and rotate these exercises depending on your needs and what you find helpful at the time. Regards, Randy A. Gilchrist, Psy.D Adaptation Interventions Abdominal Breathing Progressive Muscle Relaxation Biofeedback SelfHypnosis Cognitive Distortions Balanced Thinking Coping Statements SelfEsteem Support Systems Restful Sleep Absorbing Interventions Medical Checkup Nutrition Substances to Avoid or Minimize Exercise Relaxing Environment Meditation Visualizing a Peaceful Scene Guided Imagery Humor Stress Education Management Interventions: Coping with Hassles and Life Changes Problem Solving Time Management Play Time Taking Time Off Assertiveness Training Communication Skills Responding to Criticism Negotiation Skills Influencing Skills Cited References © Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
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1
Abdominal Breathing
Abdominal breathing consists of breathing fully from the bottom of your lungs near your abdomen. This is exactly the reverse of how you breathe when you’re anxious or tense, which is typically shallow and high in your chest. Relaxing effects of abdominal breathing include drooping eyes and shoulders, lower heart rate, and increased oxygen into your system. To practice abdominal breathing, observe the following steps: 1) Place one hand on your abdomen right beneath your rib cage. 2) Inhale slowly and deeply through your nose into the bottom of your lungs to the lowest point you can reach for 4 slow counts. Your chest should move only slightly, while your stomach area rises and pushes your hand upward like an expanding balloon. 3) When you’ve inhaled fully, pause comfortably (13 seconds) and then exhale fully through your mouth (or nose, if you prefer) for 8 regular counts. As you exhale, let yourself go and imagine your entire body going loose and limp. Pause again (13 seconds) before continuing. 4) In order to fully relax, take and release ten or so of these breaths. Try to keep your breathing smooth and regular throughout, without gulping in a big breath or exhaling suddenly. You might count each breath as follows: Slowly inhale for 4 counts—Pause—Exhale for 8 counts—Pause (count 1) Slowly inhale for 4 counts—Pause—Exhale for 8 counts—Pause (count 2)—and so on (until you reach 10 series of breaths) *If you start to feel lightheaded while practicing abdominal breathing, stop for 30 seconds and then start again. If you still feel light headed, stop and resume at a later time. *If the breathing counts or pauses suggested here are uncomfortable, adjust them to your personal preference. The counts offered here are just suggestions. You’ll find that abdominal breathing will help to slow down or eliminate feelings of anxiety or panic. In fact, two or more minutes of abdominal breathing can abort a panic attack if you initiate it before the panic has gained momentum. Abdominal breathing also counteracts hyperventilation symptoms, which can be mistaken for symptoms of panic. In general, abdominal breathing exercises will help change your breathing from a stressful, anxious process into a more relaxed, soothing rhythm. This will help calm your body and provide more oxygen into your system.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
2
Progressive Muscle Relaxation
Progressive muscle relaxation is a timehonored relaxation technique that effectively reduces skeletal muscle tension, a principle contributor to anxiety and stress. This exercise tends to work best when it is done for at least 20 minutes, at a regular time, before or at least 1 hour after a meal, in a quiet setting, and with your head supported. Note: skip tensing any of the muscle groups below that are excessively sore, painful, or at risk to aggravate a preexisting physical condition. To engage in progressive muscle relaxation, follow these steps: 1) Clench your fists tightly, holding them 710 slowly counted seconds. 2) Feel the buildup of tension in your hands and visualize your muscles tightening. 3) After 710 seconds, relax the muscles in your hands abruptly, imagining them going loose and limp. Allow 1020 seconds to pass before proceeding. Use this same “tense, count, and relax while visualizing” process for all of the remaining exercises. 4) Tighten your biceps by drawing your forearms up towards your shoulders and “make a muscle” with both arms. 5) Tighten your triceps (the muscles opposite the undersides of your biceps). Do this by extending your arms straight and locking your elbows while tightening your muscles. 6) Tense up the muscles in your forehead by raising your eyebrows up as far as you can. 7) Tense up the muscles around your eyes by clenching them tightly shut. 8) Tighten your jaw by opening your mouth so wide that you stretch the muscles around the hinges of your jaw. 9) Tighten the muscles in the back of your neck by pulling your head back as if you were going to touch your head to your back. 10) Tighten your shoulders by raising them up as if you were going to touch your ears. 11) Tighten your muscles by pushing your shoulder blades back as if you were going to touch them together. 12) Tighten the muscles of your chest by taking in a deep breath and holding. 13) Tighten your stomach muscles by sucking your stomach in. 14) Tighten your lower back by arching it up. 15) Tighten your buttocks by pulling them together. 16) Squeeze the muscles in your hips and thighs all the way down to your knees. 17) Tighten your calf muscles by pulling your toes towards you. 18) Tighten your feet by curling your toes downward.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
3
Biofeedback
“Biofeedback” refers to a method of gaining information about the physiological activity occurring in your body to gain some control over these responses. To gain a reading of the physical distress or calm your body is experiencing, a monitoring device is attached to your body to alert you when you are stressed (or relaxed). Then, after paying attention to these alerts, you can lessen times of anxiety and stress by gaining some control over physical functions previously thought to be beyond your conscious control, including body temperature, heart rate, muscle tension, and brain waves. There are three basic forms of biofeedback equipment available for use: muscle tension feedback, skin temperature feedback, and sweat gland activity feedback. Because “skin temperature feedback” is the most cost effective and easy to implement, this is the biofeedback format that will be promoted for this exercise. There are three affordable, easy to use versions of skin temperature feedback: mood rings, body temperature cards, and body temperature dots (called “biodots”). All three make contact with your skin and give a color reading representing a continuum from anxious/tense to calm/relaxed. A mood ring is worn on your finger, a body temperature card fits in your wallet and works as you press your finger on it, and a body temperature dot is a small adhesive dot you place on your skin that continually changes color like a mood ring. You choose which version you prefer.
After attaining your biofeedback tool, follow these steps to lessen your anxiety. 1) Wear (or press) your biofeedback tool on your skin and check it often to notice when you are anxious or relaxed. 2) Notice the times you are relaxed and what is going on at those times so you can make them occur more often. 3) Notice the times when you are anxious, tense, and stressed and what is going on at those times so you can minimize these occurrences. You may even wish to keep a written log to increase your selfawareness of when you reach high stress levels. 4) When you find yourself anxious or tense, implement one or more of the Coping with Stress System©™ interventions promoting immediate stress relief: abdominal breathing, progressive muscle relaxation, visualizing a peaceful scene, selfhypnosis, meditation, rest, etc. 5) As you become more aware of your physical reactions and how to lessen your stress, practice addressing your anxiety immediately without using your biofeedback tool so you can lessen your reliance on outside biofeedback tools. Eventually you can detect and relieve anxiety and stress through you own efforts alone.
(Adapted from Greenberg, 1990)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
4
SelfHypnosis
Selfhypnosis in its basic form is a threestep process: 1) relaxing yourself in a quiet, comfortable environment, 2) absorbing your conscious thoughts in a very focused way (called a “trance”), and 3) unobtrusively giving yourself suggestions for positive change that bypass your conscious resistance. In short, selfhypnosis is telling yourself to be different under a trance state to minimize self sabotaging positive change. Follow these steps to engage in selfhypnosis: 1) Over a count of 4 seconds, breathe in deeply through your nose in a comfortable way. 2) Hold comfortably for 13 seconds. 3) Slowly exhale through your mouth (or nose, if your prefer) for a count of 8 seconds. 4) Wait 13 seconds before breathing again and repeat several times. Keep breathing in this rhythmic manner until you feel relaxed, comfortable, and ready to concentrate. 5) Gradually eliminate the formal breathing counts and pauses until you breathe in a deep, comfortable rhythm not requiring extra thought or attention. 6) Slowly allow your eyes to close. Visualize a place that is relaxing to you. Enjoy this experience with all of your senses—sight, smell, sound, touch, and taste. Examples may include the beach, the mountains, the woods, etc. Stay focused on this experience, thinking only of your experience there. Redirect yourself gently back if your thoughts wander to other subjects 7) When you are highly absorbed in your experience and your limbs feel heavy, slowly repeat positive statements to yourself consisting of the changes you want in life through single words or short phrases, such as “relax” or “more happiness”. Note: make sure you state the positive change you want to occur more, not the negative thing you want less of. For example, “more relaxed” is better than “not anxious”. 8) After continuing in this state for an adequate period (such as 1520 minutes), reorient yourself to your environment slowly and comfortably. Allow this whole process to occur naturally and comfortably. Do not use an alarm clock, a beeping timer, or anything else that may disrupt your experience. 9) Remember this relaxing experience throughout the day, such as when stressful events occur or when you are bored. 10) Revisit this place for at least 1520 minutes every morning.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
5
Cognitive Distortions
Cognitive distortions are extreme, irrational ways of thinking that aggravate stress. Review this list carefully, checking the distortions you engage in on a regular basis. Then, practice catching and balancing these distortions through the “balanced thinking” exercise following this list. 1) Allornothing thinking: You look at things as being either black or white, good or bad. If it’s not perfect, it is a failure. There is no middle ground. Overgeneralization: You view a single negative event or piece of evidence as a never ending pattern of defeat, or you balloon problems much bigger than they actually are. Negative Filtering: You magnify the negatives and ignore the positives of a situation. Jumping to conclusions: A) “mind reading”: you assume what people are thinking, and B) “fortune telling”: you arbitrarily predict how things will turn out in the future. Magnification or minimization: Two ways of doing this: A) “magnification”—you blow things way out of proportion, and B) “minimization”—you shrink their importance. Emotional reasoning: You reason from how you feel (“I feel bad, therefore I am bad”). Should statements: You have a list of ironclad rules about how you and other people “should” or “need” to act. You feel upset when others (or yourself) break the rules. Labeling: You identify yourself or other people globally according to shortcomings, such as “I am a jerk”, “she is stupid”, or “you’re a loser”. Blaming: You blame yourself or someone else for something you or they were not entirely responsible for (if at all). Discounting the positives: You insist that your (or others) accomplishments don’t count. Personalization: You think that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who’s better or worse. Control fallacies: You think that your feelings, thoughts, and behaviors are out of your control, and that you are the helpless victim of others “making” you be a certain way. Fallacy of fairness: You feel resentful because you think you know what’s fair, but other people won’t agree with you. Fallacy of change: You assume others will genuinely change in the ways you want if you just pressure them enough. When this doesn’t occur, you become upset. Being right: You are continually on trial to prove that your opinions and actions are correct. Being wrong is seen as a weakness to be avoided at all costs.
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(Adapted from Burns, 1990)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
6
Balanced Thinking
This exercise helps you change your feelings through challenging and changing how you think about difficult situations. To practice balanced thinking, write out each of the numbered headings below with a space beneath to write your answers: 1) The Situation: Think of the most recent (or current) situation that has left you feeling stressed or upset. Examples of stressful situations may include getting fired from a job, getting stuck in heavy traffic, learning a family member is sick, thinking of all of the work you have to do, etc. 2) My Automatic Thought: What was your immediate, reactive interpretation of this situation? This is where most of your stress will be triggered: not by the situation alone, but by your negative interpretation of the situation. When you write out your reaction to the situation, be as honest and complete as possible. Most automatic thoughts that lead to stress are extreme, generalized reactions to situations. Examples may include “this will never work”, “I’ll never be able to handle this”, “he hates me”, “I’m such a loser”, “she’s out to destroy me”, etc. 3) Scaling My Feelings: Pick a number between 0 – 100 to scale how stressful and upsetting your automatic thought has made you in response to the situation. Think of “0” as representing no stress or upset at all and “100” representing feeling as stressed and upset as possible. For instance, after you get fired from a job, your automatic thought of “I’m such a loser” upsets you at 90/100. 4) Evidence Against: Your automatic thought fueling your stress will likely be extreme and unrealistic in some way. To identify what cognitive distortions you may have adopted in your reaction, review the “cognitive distortions” list given in the last exercise and note which apply. Then, make a list of as much evidence against your reactive interpretation of the situation as possible. For example, evidence against you “being a loser” could include your main accomplishments in life, the friends and family you are close to, your previous successes at your job, the unfairness of the firing, etc. 5) Balanced Thought: Taking all of the evidence against your automatic thought into account, create a more balanced, realistic thought in response to the situation. In the case of losing your job, you could look at all of the positive evidence showing your successes and good points and think: “I am a good person with a lot of positive things going for me. I’ve handled setbacks before and been OK, and I will do so again!” 6) Scaling My Feelings Again: Now, scale your stress and upset feelings again as in stage 3, but now do so with your balanced thought in reaction to the situation. For instance, the balanced thought of “I am a good person…” may now scale the upset feelings at just a 40—a large decrease from the 90 after the “I’m such a loser” thought. **Write out as many formal “balanced thought” exercises as possible. Then, remind yourself of the evidence against your negative thoughts and focus on your balanced thoughts as much as possible throughout the day. Eventually with enough practice, your automatic thoughts will become balanced thoughts and your stress levels will be far easier to maintain.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
7
Coping Statements
When feeling stressed or anxious, you can cope better by reviewing and repeating some positive, reassuring, truthful statements to yourself until you calm down and gain control. If one statement stops working, try another until a better match is found for your particular situation. You can practice this exercise during deep abdominal breathing if you wish. You may come up with your own coping statements and/or use these examples: This feeling isn’t comfortable or pleasant, but I can handle it. I can be stressed (or anxious) and still deal with this situation. This is not an emergency. It’s okay to think slowly about what I need to do. This is not the worst thing that could happen. I’m going to go with this and wait for my stress (or anxiety) to decrease. This is an opportunity for me to learn to cope better. I’ll just let my body do its thing. This will pass. I’ll ride this through—I don’t need to let this get to me. I deserve to feel okay right now. I can take all the time I need to let go and relax. I can always leave if I need to. I’ve survived this before and I’ll survive this time, too. I can do what I have to do in spite of the stress (or anxiety). This is just stress (or anxiety)—it won’t hurt me. This is just stress (or anxiety)—I’m not going to let it get to me. Nothing serious is going to happen to me. Fighting and resisting isn’t going to help—so I’ll just let it pass. These are just thoughts—not reality. I don’t need these thoughts—I can choose to think differently. So what?
(Adapted from Bourne, 1992) © Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
8
SelfEsteem
Your selfesteem can be thought of as the extent to which you value yourself and see yourself as a good, worthwhile, acceptable person. Low selfesteem occurs when you unfairly criticize yourself, you push yourself hard with negative, critical pressure, and you believe the negative evaluations others give you more than the positive ones. Low selfesteem causes anxiety and stress from two sources: 1) the negative pressure and criticism you heap on yourself, and 2) worrying too much about gaining acceptance and validation from others. To increase selfesteem (and lower your anxiety), it is important to surround yourself with positive, supportive people. However, your selfesteem will be mostly made or broken by how you treat yourself. You can measure your selfesteem by asking yourself: would I treat my best friend the way I treat myself? If not, some selfesteem work is needed. To increase your selfesteem, consistently review and practice the following: 1) Stop Criticizing Yourself: Accept yourself exactly as you are and do not put yourself down. Putting yourself down will tear down your spirit more than motivate you to change. The trade off is not worth it. To accept yourself does not mean you are not driven to improve, but that you are “acceptable” now and will be even better with additional growth and development. 2) Use Positive Motivation: For the improvements you want in your life, practice thinking about and visualizing what it will be like when you accomplish your goals. Then, add some thoughts and visualizations consisting of the steps you’ll need to take to make it happen. This change in focus will be more motivating and energizing than focusing on either a) the negative thing that will happen if you don’t change, or b) all of the hard work it will take to make it happen. 3) Praise Yourself as Much as Possible: Whenever you succeed at something, privately give yourself credit for the part you played. Be generous with yourself (but still truthful). Praise yourself for your accomplishments whenever you can to build confidence and self worth. 4) Allow Mistakes: When you try and fail, that is a success in and of itself because the effort itself will act as learning experience to bring you closer to your goals. Be easy on yourself during your setbacks and pick yourself up. Life is a continual trial and error process. The only true failure is to give up, because then you are guaranteed failure. When you fail, give yourself a break, congratulate yourself on your effort, regroup, and try again. 5) Do Mirror Work: Practice looking at yourself in the mirror often. Look into your eyes and tell yourself whatever positive true statements you can. Remind yourself about your successes, what you are good at, what you are capable of, what positive things lay ahead for yourself, how you are improving, etc. Practice forgiving yourself and others in the mirror. Mirror work is a very intimate, vulnerable, exposing experience. This uncomfortable feeling will let you know the power this exercise has to help you change. 6) Be Happy and Relaxed NOW: Allow yourself to be happy and relaxed NOW—not after everything falls into place in your life. As soon as one anxiety or stress is taken away from you, another may soon follow. Therefore, allow yourself to enjoy life now, rather than waiting for happiness or relaxation at some mythical point in the future. Your life IS now—not later.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
9
Support Systems
Anxiety and stress levels can be much easier to cope with when you have others there to listen and give support, empathy and reassurance. To create a social support system, identify those people around you that are trustworthy and will support you without judging or criticizing. Typical support systems may include: family, friends, psychotherapists, coworkers, group therapy members, online support group members, religious leaders, fellow church members, sports associates, and/or anyone else you know and trust. Next, ask each support person if you can open up to them about the difficulties you are having with _______ . If you know them well, they will probably say yes and mean it. However, if you ask them to listen and they say no (or imply they aren’t interested), kindly refrain from opening up to them and go to someone else (or ask this person later when they are in the mood to listen). Opening up to a person who doesn’t want to listen will probably make your anxiety worse. Bad listeners tend to act impatient, give unsolicited advice, say “I told you so”, blame, criticize, switch the conversation to make it about them, etc. Finally, after choosing a good support person, let them know what your anxieties are, why they are affecting you like they are, what you wish you could do about it, etc. It’s usually more helpful to use “I” statements and express your feelings rather than just blaming and criticizing others. This empowering stance allows you to feel more in control of yourself and your feelings, rather than just feeling victimized and powerless. For example, it can be helpful to say “I feel anxious when my day starts out badly because I’m worried the rest of the day might go that way. I wish I could take better charge of my life and feel more confident”. This is the “I feel ___ when ___ because ___ I wish/I would like ___” format. Conversely, a less helpful way to vent may sound like “that S.O.B. always takes his problems out on me. He’s a loser.” This lose/lose approach will strain the ability of the listener to stay engaged and make you feel more like a victim. After opening up and having others listen to you, ask them for their advice, but only if you are open to it. Then, before going on too long, allow them to talk about their own issues or just allow the subject to change completely. At this point, you can just enjoy the rest of your time by listening to them or by getting involved in a different enjoyable activity. This helps you maintain your support system without “burning them out” or “draining them”. Everyone has a limit, so as soon as your support person has reached their limit in the discussion, allow the conversation about your worries and stresses to end, and then simply pick it up with someone else at a later time. You can expect your anxiety to be relieved with your support system through 3 means: 1) identifying and expressing your feelings in a healthy way to a sensitive listener, 2) hearing their advice (if you are open to it), and then 3) putting your worries aside and focusing on them for a while. Allow them to support you, but don’t make it always about you! Make it a balanced “give and take relationship”.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
10
Restful Sleep
Different people need different amounts of daily sleep—some need 8 hours, whereas others need 6 or 10. Furthermore, some can achieve restful sleep best with a nap during the day, whereas others need to sleep straight through the night. In any event, your body requires adequate rest to revitalize itself and cope with anxiety and stress. Busy lifestyles promoting sleep deprivation leave less physical resources to handle whatever stressors may arise. In short, get the amount of restful sleep you require every 24hour period in the form that works best for you. To get the restful sleep you need, practice the following: 1) Create a relaxing sleep environment, including a comfortable bed. 2) Remind yourself that skipping sleep will fail to revitalize your mind and body, and that the work you do under less sleep will probably be less productive anyway. 3) Sleep enough, but only as much as you need to feel refreshed and healthy. Under or oversleeping leads to fragmented, shallow rest. Sleeping for 78 hours a night is usually best. 4) Go to bed and wake up each morning at a regular, consistent time—preferably early. 5) Practice regular physical exercise at the same time of day to prepare you for your sleep. 6) Make your environment as quiet as possible—use earplugs if necessary. 7) Make sure you keep the room you sleep in at a moderate temperature. 8) Don’t go to bed with a full or an empty stomach; go to bed with a light snack. 9) Unless prescribed and recommended by a physician, avoid sleep medications, which may lose their effectiveness over time or even be harmful. 10) Reduce caffeine intake, which tends to disturb rest. 11) Avoid alcohol consumption, which results in fragmented, poorquality sleep. 12) Only lay on your bed when you are trying to sleep. This will make it easier to fall asleep. 13) When having trouble falling asleep, do something else for a period of time to help you relax, such as the following relaxing exercises and activities: abdominal breathing progressive muscle relaxation visualizing a peaceful scene selfhypnosis pleasure reading listening to soothing music taking a hot shower or sitting in a hot bubble bath, whirlpool, or spa
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
11
Medical Checkup
Because 7590% of all office visits to health care professionals are for stressrelated symptoms and disorders, anxiety and stress take an immense physical toll on the body. The body becomes very strained when confronted with stressful worries, threats, or changes, leading to the “fightorflight” syndrome and the “general adaptation syndrome”. Over time, these syndromes exhaust the body and can create or amplify many physical problems and illnesses. Physical symptoms from stress may include fatigue, sweating hands, paling or flushing of the face, sleeping problems, eating problems, skin problems, muscle tension, migraine headaches, cardiovascular diseases, stomach and intestinal problems, rheumatoid arthritis, aches and pains (especially in the neck and back), a weakened immune system, slowed recuperation from illness, high blood pressure, heart attacks, diabetes, ulcers, aging, or even death. Given the physically debilitating nature of anxiety and stress, visiting your medical doctor for a full medical exam is highly recommended. Your physician will help direct you to change your physical lifestyle habits in essential ways for your unique situation. Another benefit of visiting your medical doctor is to get a recommendation for what diet and exercise recommendations from this ebook will be acceptable for your specific situation (and which, if any, may not). Finally, a visit to your medical doctor can also be an opportunity to get a prescription for antianxiety medication to lessen your worry and stress. Please consult with your physician on all of these matters for the highest benefit and protection to yourself and your health.
(Sources: Stroebel, 1989; Greenberg, 1990; Manning, Curtis, & McMillen, 1999)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
12
Nutrition
Particular nutrients, herbs, and foods can help alleviate anxiety and stress in different ways. These recommendations are based upon a compilation of medical research and should only be used sparingly and as recommended on the label. Important: Consult a physician before using any supplement, especially if you are using any medications or if you have an allergy, illness, or other physical condition of concern. Discontinue supplement use immediately if negative symptoms occur. Nutrients GammaAminoButyric Acid Glutathione Nicotinamide Adenine Dinucleotide Vitamin B Complex Vitamin C Calcium & Magnesium LTyrosine Melatonin Fiber FreeForm Amino Complex Lecithin Multivitamin with Antioxidants Vitamin E & Zinc Herbs Ashwagandha Bilberry Ginkgo Biloba Milk Thistle Dong Quai, Rehmannia, Schizandra Hops Kava Kava Passionflower Polygala Root & Sour Jujube Seed St. John’s Wort Siberian Ginseng Skullcap Valerian Wild oat Foods Raw Fruits and Vegetables Purified Water (3264 ounces) Benefit/Effect acts as a tranquilizer; helps brain function protects the cells against damage aids in the creation and transfer of chemical energy for proper nervous system functioning helps produce antistress hormones reduces anxiety helps reduce stress on the body; a sleeping aid a natural hormone that promotes sound sleep for healthy bowel cleansing and functioning helps supply proteins used rapidly at stressful times for cellular protection and brain function replaces nutrients lost during stress needed for immune system functioning Benefit/Effect acts as a sedative and nerve tonic preserves cells throughout the body aids in circulation and proper brain function cleanses and protects liver; acts as an antioxidant supports major organs during stress eases nervousness, restlessness, and stress relaxes the mind and body has a calming effect Chinese herbs known to soothe and calm the spirit helps with nerve pain helps the body cope with stress good for nervousness and headaches; aids sleep aids nervous system; helps sleep; soothes headaches known to restore balance to the nervous system Benefit/Effect supply vitamins, minerals, and flavonoids cleanses liver, kidneys, and colon; flushes toxins
(Adapted from Balch and Balch, 2000)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
13
Substances to Avoid or Minimize
Particular foods and substances can aggravate anxiety and stress in different ways and are therefore helpful to minimize in your daily life. These recommendations are based upon a compilation of medical research and should act as a guide with your diet and lifestyle choices. Remember: these are general “rule of thumb” recommendations for most people. Consult your physician to construct a complete diet plan for your best individual health and relaxation needs. Furthermore, the assistance of a substance abuse inpatient or outpatient treatment program is recommended for those who need extra assistance in stopping addictive tendencies with alcohol, nicotine, or the abuse of illicit or prescription drugs—especially when tolerance, withdrawal symptoms, and/or psychological dependence has developed. Foods to minimize Processed foods and other unhealthy foods that aggravate stress: artificial sweeteners, carbonated soft drinks, chocolate, eggs, fried foods, junk food, pork, red meat, sugar, white flour products, foods containing preservatives or heavy spices, chips, and other similar foods
Dairy products (healthy in moderation, but may promote nervousness when taken in excess): milk, ice cream, butter, cheese, etc. Substances to minimize Caffeine (promotes nervousness, sleeplessness, and “the jitters”): cola soda drinks, coffee, iced tea, hot tea, “wakeup pills”, “alert drinks”, etc.
Alcohol, tobacco, moodaltering drugs (offer only temporary relief, do nothing to resolve main stresspromoting problems, hurt health) : beer, wine, hard liquor, cigarettes, tobacco chew, amphetamines (“meth”, diet pills), marijuana, cocaine, hallucinogens (LSD, ecstasy), inhalants (glue, paint), opioids (morphine, heroine), phencyclidine (PCP), etc.
Helpful links: www.na.org, www.aa.org, www.hypnosisnetwork.com
(Adapted from Balch and Balch, 2000)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
14
Exercise
In general, a program of regular physical exercise will help you to reduce your vulnerability to anxiety and stress. Exercise provides a natural outlet for the excess adrenaline and physiological arousal that accompany anxiety and stress states. It also releases muscle tension and stimulates production of endorphins in the brain, resulting in a state of increased calmness and wellbeing. To optimize the tensionreducing effects of exercise, it is best to do an aerobic form of exercise at least four times per week for at least 20 to 30 minutes. Aerobic exercise includes brisk walking, jogging, aerobic dancing, bicycling, riding a stationary bike, swimming, jumping rope, running in place, inline skating, etc. If you do brisk walking, you’ll want to double the minimum time of effectiveness from 20 to 40 minutes for the best results. If you haven’t been doing cardiovascular exercise recently, it is best to start exercising briskly for short periods (5 to 10 minutes) and then gradually extend to over 20 minutes. If you have any medical conditions that might limit exercise, experience symptoms of high blood pressure, diabetes, chest pains, fainting spells, or joint stress, and/or are forty or older, be sure to consult with your medical doctor before undertaking an exercise program. (Actually, it is best to consult with a medical doctor before undertaking any new exercise program). Many people find it helpful to vary the type of exercise they do. This can help reduce boredom and give you the chance to exercise different body parts. Popular combinations include doing a solo aerobic type of exercise such as jogging or cycling in combination with a social form of exercise such as tennis, racquetball, volleyball, or body building. If you are starting an exercise program or are otherwise not used to vigorous exercise, observe the following guidelines: 1) Approach exercise gradually 2) Commit yourself to at least a onemonth trial period of your program before giving up (unless your program is causing problems that logically warrant a change) 3) Expect some discomfort initially 4) Find ways to reward yourself for maintaining a commitment to your exercise program 5) Warm up before exercising, and have a cool down period before ending, such as with stretching, jumping jacks, or walking 6) Avoid exercising within 90 minutes of a meal 7) Stop exercising if you experience any sudden unexplainable pains or dizziness 8) If you find yourself getting bored with exercise, find a partner to go with you and/or choose aerobic activities that require you to have a partner (such as tennis or racquetball) 9) Exercise more than once a week 10) Make your goal of aerobic exercise be at least 4 days a week for 2030 minutes
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
15
Relaxing Environment
The sights and sounds of the environment can serve to either elevate or decrease your anxiety and stress levels. It is important to make whatever changes you can to make your home and work environments as relaxing as possible. The following are some helpful suggestions to create a relaxing, stressfree environment: *Keep your noise levels down. Loud noises are upsetting and invoke anxiety. Intermittent and loud noises tend to cause more upset than soft, constant noise. The more disturbing noises you can eliminate, the better. To minimize noise, consider padding and soundproofing the rooms you spend a lot of time in, such as with wall hangings, wall padding, and noise sealers at the bottom of your doors. Also, consider turning down the ringer of the telephone, turning down the television, stereo, and radio, having professional ear plugs made for you to wear (such as those made for swimmers), and periodically isolating yourself from others in a quiet place. *When not seeking after complete silence, play soft, relaxing sounds or music. “White noise” machines also can be used to muffle and drown out disturbing noise. Other options include playing soft classical or instrumental music. Finally, consider playing tapes or CDs of the various soothing sounds of nature, such as the ocean, a stream, or a babbling brook. *Have as much natural lighting in your home (or office) as possible. Unnatural fluorescent lighting can be especially aggravating. Consider opening your window blinds, opening your sky light (if you have one), or just spending more time outside. When using artificial lighting, consider using soft light lamps with lower wattage, rather than the brighter ceiling lights with higher watt light bulbs. *Keep the main rooms you spend your time in uncluttered. Cluttered rooms can be aggravating and tend to increase anxiety and stress levels. *How you position your furniture and wall hangings can either increase or decrease your stress levels, depending upon size, shape, angle, space, walkways, etc. Consider reconfiguring your rooms to a more practical, userfriendly, relaxing set up. If needed, you may wish to consult a professional interior decorator or feng shui expert. *The color themes that set the tone for your rooms should also be soothing, calming, and relaxing. The following colors tend to promote stress and anxiety, as well as higher blood pressure, heart rate, and respiration: red, orange, yellow, hot pink, and other striking fluorescent colors. These colors should be minimized to help promote a more relaxing environment. Conversely, the following colors tend to calm, soothe, and relax, as well as lower your blood pressure, heart rate, and respiration: blue, green, violet, and soft pink. *Keep your room temperature at a relaxing, comfortable level. Room temperatures should be no warmer than 72 degrees—preferably lower. Hot, humid room temperatures increase irritability and drain energy. When air conditioning becomes too expensive to run, consider wearing lighter clothes, running a fan, and periodically cooling down your skin with a cool bath or shower.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
16
Meditation
Meditation is a mental exercise that affects body processes. The purpose of meditation is to gain control over your attention so you can choose what to focus upon, rather than just reacting to whatever confronts you. The relaxation and control inherent in meditation can serve as an excellent relief to anxiety and stress. Meditation has its tradition grounded in Eastern cultures (such as India and Tibet), but has become popularized in Western cultures since the Beatles visited India in the 1960s. To practice a simple form of meditation, follow these directions: Find a quiet place where you can relax and be alone. Choose a time when you will not be so tired that you risk falling asleep. Use a comfortable straightbacked chair that helps you sit up with minimal effort. A chair that also supports your upper back and head is even better. Then be seated with your buttocks pushed against the back of the chair. Place your feet slightly forward of your knees with your hands resting either on the arms of the chair or in your lap. Let your muscles relax naturally. Don’t “try” to relax. Trying is work, not relaxation. Just assume a passive attitude in which you focus upon your breathing. Allow whatever happens to happen. If you feel relaxed, fine; if not, accept that too. Next, close your eyes and repeat in your mind the word “more” every time you inhale and the word “relaxed” every time you exhale. (If you have a preference, you can substitute any other two relaxing words, providing the words are short and either positive or neutral). Repeat this process for about twenty minutes. During you meditation, do not consciously alter or control your breathing; breathe naturally. Finally, when you are ready to stop your session, allow your body to become naturally readjusted to its normal state. Open your eyes gradually, first focusing on one object in the room, and then several. Take a number of deep breaths. Then, stretch while seated, and when you feel ready, stand and continue your stretching. Since your blood pressure and heart rate are decreased while meditating, rising from the chair too quickly might cause dizziness and is not recommended. If you rush to leave the meditation session, you are apt to feel tired or lose the sense of relaxation. In short, end your session slowly and comfortably for the best results. Further Recommendations: 1) 2) 3) 4) 5) 6) Have a goal to meditate twice a day for approximately twenty minutes. Cease your meditation if you feel uncomfortable, dizzy, or hallucinate (which is rare). The best two times to meditate tend to be immediately upon rising and just before dinner. To assist achieving a relaxed state in your meditation, avoid all stimulants, such as caffeine. Make sure your head is held up with support; otherwise, allow your head to droop forward. If you want to know when your time is up, simply peek at a clock or watch. Eventually, you should acquire a mental alarm clock that will alert you when your time is up. 7) Eliminate any loud sounds that may interrupt your experience: phones, alarms clocks, etc. 8) When you find your thoughts wandering, gently refocus and continue. 9) Slow yourself down as much as possible. Relax and enjoy this process.
(Adapted from Greenberg, 1990)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
17
Visualizing a Peaceful Scene
By changing your thoughts to something relaxing and peaceful, you can ease your mind and soothe away psychological tension. To prepare for this exercise, say the words below into a tape recorder in a soothing, slowpaced tone of voice. Pause long enough at each noted “pause” to become fully absorbed in the experience (perhaps 13 minutes each). Then, relax and listen to the directions. Or, if you prefer, simply read and memorize the following script to rehearse these directives from memory. Choose a time you will not fall asleep, find a quiet place, and lie or sit in a comfortable position. Now, take several minutes to listen to your tape (or guide yourself from memory). Allow yourself to become absorbed in the following experience (or a similar one of your own making): Take a few deep breaths and slowly close your eyes. Imagine you’re in a very peaceful, comfortable setting that has a special meaning to you. It can be outdoors or indoors. It can be a realistic place or imaginary. You find that you feel very safe and supported there…this is a safe place. (Pause) Now look all about you and notice the colors of everything in this particular scene. (Pause) You might focus on one color in particular…and you find this color to be very relaxing. (Pause) As you feel more and more relaxed, take notice of any sounds that you can hear in this special place. (Pause) You might focus in on one sound in particular, and you find this sound to be very relaxing. (Pause) Now become very aware of anything that you are touching on the ground or elsewhere. How does it feel? Let these tactile sensations help to relax you still more. (Pause) Just continue allowing yourself to settle in, feeling relaxed and at peace in this wonderful place. You’re feeling very safe, secure, and at ease. Stay in the wonderful place as long as you wish. Continue experiencing your relaxing place with all of your senses. (Pause) You have the power and ability to revisit this wonderful, relaxing place whenever you wish during the day to enjoy these same feelings. At your own pace and as you are ready, reorient yourself to your surroundings and open your eyes at a comfortable, natural pace. Any scene that feels very calming to you will do for this exercise. It could be in the outdoors like a remote beach, a mountain stream, a lake, or a wooded area. Or, your scene may consist of an indoor scene such as a cozy fireplace or a comfortable bedroom. It is very important in a visualization exercise to take the appropriate amount time and to experience your scene in as much detail and through as many senses as possible. Focus on all of the objects you can see—their colors, shapes, and sizes. Also be aware of any sounds, smells, or things you can touch. Finally, take all of the time you need to fully experience the relaxing nature of your scene. Remember that the more you picture yourself in this peaceful scene, the easier it will be to return there whenever you’d like. You can eventually learn retreat to your own special scene—the safest place in your mind—whenever you’re feeling anxious or tense. This exercise can be as formal or informal as desired, as long as the effects are achieved.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
18
Guided Imagery
Guided imagery exercises help minimize the distressing nature of your worries and stresses by changing the way you see them. To prepare yourself for this exercise, choose one or more stressful situations that you currently struggle with (such as the things you have to do). Then, loosen your clothing, go to a quiet room away from others, and sit or lie in a comfortable position. Take a few slow, deep breaths, close your eyes, and slowly visualize one or more of the following scenes: 1) See yourself and the anxietyinvoking situation. Have yourself remain regular size, but have the anxiety situation slowly shrink. Have it become smaller and smaller until it eventually disappears. If desired, have yourself also grow in size until you dominate the picture and the anxiety is nowhere in site. Then, visualize yourself as relaxed and relieved as possible. 2) See yourself, along with the anxious situation. View yourself normally, but visualize the anxious situation fading to black and white. Then, allow the black and white anxiety scene to fade further until it becomes foggy, blurry, and then, completely invisible. All the while, see yourself in regular, sharp color, increasingly happy as the stress leaves. Feel free to wave goodbye to the anxiety. Finally, end the scene by seeing yourself engaging in some of your favorite relaxing activities (like having a bubble bath or lying in a hammock). 3) See yourself dealing with a anxietyinvoking situation from beginning to end, but have it be in the form of a movie you are watching on a wide screen. Add as many Hollywood features that you can to manipulate the mood in a humorous, different way that deflates your worries. Give it a funny dramatic title and name the cast with goofy nicknames (yourself and others involved with the stress). Then, speed the anxiety scene up (“fast forward”), change the scene to slow motion, add humorous or corny, dramatic music, rewind it, add laugh track sounds in the background, and change the scene by adding anything else that is humorous and different from how you currently experience the event. End the movie with either a very good, positive ending, or a catastrophic ending far worse than would occur in real life—so worse that it is actually humorous when you watch it. Finally, see yourself taking a final bow as if on a stage and roll the final credits with positive music. 4) Visualize yourself in a very relaxing scene, such as the mountains, the ocean, the woods, etc. Enjoy the scenery with all of your senses. Then, briefly switch to seeing the anxiety situation for 12 seconds only. Finally, stop seeing the anxiety situation and go back to your initial relaxing scene very quickly, where you will stay as long as you wish until you are very relaxed again. 5) Choose an anxietyinvoking situation, and transform it all into a funny little creature of some sort wearing a tshirt naming the worry. Notice how small, funny, and unthreatening the creature is. Laugh at it and see it walk away in shame until it is out of site. 6) Choose an anxietyinvoking person or situation, and transform it into a bag (like a suitcase). See yourself approaching a oneway bus or train, place the bag on board, and watch it drive away until it slowly disappears from view. Wave goodbye to the anxiety, and have yourself walk away in the opposite direction with a large smile on your face. **After deflating an upsetting image through one of the visualizations above, you may find it helpful to then switch the image to a positive, enjoyable, relaxing scene of your own choosing.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
19
Humor
Humor can be defined as the ability to appreciate or express that which is funny. Laughter is a universal genetic response to socially “funny” cues in a series of short syllables such as “haha”, “ho ho”, or “heehee”. The most obvious effect of humor is on our mood, helping us feel joy, surprise, and amusement. Correlational studies of anxiety and stress have connected humor with many positive outcomes, including: lower feelings of depression, anxiety, and alienation, as well as lower blood pressure, heart rate, pain, and stress hormones. Humor has also been associated with higher positive moods, a strengthened immune system, and increases in relaxation, endorphins, social cohesion, creative thinking, and feelings of control. In short, humor tends to lessen the physical and emotional impact of anxiety and stress—especially with those who have already cultivated a strong sense of humor. To increase the humor and laughter in your life, do the following: 1) Figure out and define what makes you laugh out loud. List everything that comes to mind that makes you laugh in this way, including where you are, who you are with, and what you are doing. Be honest with yourself. If needed, carry around a pad of paper and write out the situations and circumstances when you catch yourself laughing. 2) Next, use your list to build a “humor library” of all the artifacts that make you laugh: books, magazines, movies, music, TV shows, etc. Then, go to these resources whenever you need a “laugh lift”. 3) Finally, because humor intensifies when you have someone to share it with, list all of your friends, family, and associates you feel close enough to that you can laugh with. Then, engage in as many fun activities with them as possible from step 2, as well as additional fun activities typically enjoyed with others: going out to funny movies, playing funny “get to know you” games, going to comedy clubs, etc.
(Adapted from Provine, 2000 and Doskoch, 1996)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
20
Anxiety and Stress Education
It can be helpful to engage in some additional research and reading about anxiety and stress. The more you understand the problem, the better you will be able to control it.
Books on Anxiety and Phobia Management
The Shyness and Social Anxiety Workbook (2000). Oakland, CA: New Harbinger Publications. *offers plenty of simple ways to overcome shyness and social anxiety Triumph Over Shyness: Conquering Shyness & Social Anxiety (2001). Murray B. Stein and John R. Walker.New York: McGrawHill. *a good book on understanding social anxiety and shyness The Anxiety & Phobia Workbook(2001) by Edmund J Bourne. Oakland, CA: New Harbinger Publications *an easy to read workbook version with a variety of anxiety and phobia management techniques*
Books on Stress, Stress Management, and Relaxation
Stress: Living and Working in a Changing World (1999) by George Manning, Kent Curtis, and Steve McMillen. Duluth, Minnesota: Whole Person Associates, Inc. *this stress book is comprehensive, easy reading, and highly recommended* The Relaxation and Stress Reduction Workbook (2000) by Martha Davis, Matthew McKay, and Elizabeth Robbins Eschelman. Oakland, CA: New Harbinger. *an easy to read workbook version with a variety of stress management and relaxation techniques* Wherever You Go, There You Are (1995) by Jon KabatZinn. New York: Hyperion. *a helpful, indepth look at what meditation is an how to do it*
Web Sites
www.algy.com/anxiety *A comprehensive website for understanding anxiety, panic, and all of the forms of anxiety disorder. www.stress.org *The official website of The American Institute of Stress; offers some good, comprehensive stress information
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
21
Coping with Hassles and Life Changes
Hassles: The hassles in your life can be thought of as the small and mediumlevel annoyances that slowly build anxiety and stress levels in your life. To assess which hassles are currently affecting you in your life, answer the following questions: Y (Yes) Y Y Y Y Y Y Y Y Y N (No) N N N N N N N N N
1) I am concerned about my weight being too heavy or too light 2) The rising cost of living bothers me 3) I have a lot to do to maintain my home 4) Misplacing or losing things is a problem for me 5) I have too much to do and too little time to do it 6) I am not satisfied with my physical appearance 7) Managing finances and keeping records take a lot of time 8) Someone close to me is in poor health 9) I am concerned about crime and safety
Each of these hassles has the potential to build your stress levels and interfere in your life. Life Changes: Whenever major life changes occur in your life, the resultant stress takes a large physical and emotional toll. When life changes happen together, and/or are of strong enough intensity, the result can be illness, hospital visits, and even death. Note which of the following stressors you have experienced over the last 12 months (listed in order from most stressful life change to least): *death of spouse/partner, divorce, marital/partner separation, jail term, death of close family member, personal injury or illness, marriage, fired at work, marital/partner reconciliation, retirement, change in health of family member, pregnancy, sex difficulties, gain of new family member, business readjustment, change in financial state, death of a close friend, change to different line of work, change in number of arguments with spouse/partner, mortgage or loan for major purchase (home, etc.), foreclosure of mortgage or loan, change in responsibilities at work, son or daughter leaving home, trouble with inlaws, outstanding personal achievement, spouse/partner beginning or stopping work, change in living conditions, revision of personal habits, trouble with boss, change in work hours or conditions, change in residence, change in recreation, change in church activities, change in social activities, mortgage or loan for lesser purchase (car, TV, etc.), change in sleeping habits, change in number of family gettogethers, change in eating habits, vacation, Christmas, minor violations of the law* How you handle stress depends upon the total demands you face (your hassles + life changes) in combination with the resources you possess for meeting these demands. This system aims to build your stress absorbing, adapting, and management resources. Practice identifying the current and recent hassles and life changes you have faced. Then, match up and use appropriate interventions in this section that address both your specific anxiety and stress relief needs now, as well as the relevant concerns to address early to prevent future problems. (Adapted from Manning, Curtis, and McMillen, 1999)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
22
Problem Solving
How you conceptualize and plan to tackle your problems will greatly determine how well you resolve them and how much stress and anxiety you experience in the process. Most of these problems come from worrying or being upset about what we can’t control—leaving less time, energy, and focus for efforts that actually will resolve our problems. Write out the following exercise when you are facing a stressful problem to minimize your stress and better resolve the issue. Step 1—Identify your problem: Write out the specific problem you are facing: what the problem is and why it is a problem for you. (Only write out one problem at a time). (For example: My parents are visiting and I don’t like how they give me critical comments) Step 2—What do you WISH you could do to resolve your problem if you had the power? In other words, if you had a magic wand and had ultimate power to change this problem, what would you do? What would you make happen? (For example: I would make it so they would never give me advice or criticism again—unless I ask them for their opinion). Step 3—What are you NOT able to do to solve the problem? Realistically admit your limits and state what you are unable to do to solve the problem. (For example: I can’t change their personalities or make them more sensitive and respectful) Step 4—What ARE you able to do to solve the problem? What can you reasonably do to try to change the situation? What are all of the ways you could approach this that are within your power to do? (NOTE: the better you get at this brainstorming, the bigger your list will be. Usually, the bigger your list the better it will be). (For example, you could choose to 1) respectfully let them know your feelings and request they only give critical advice and opinions when asked for, 2) cancel their trip, 3) avoid talking to them about sensitive topics during their visit, 4) have a friend be with you during their visit to avoid their giving opinions on sensitive subjects, 5) pretend you are sick, and/or 6) read a book on responding to criticism and use the ideas during the visit). Stage 5—Choose your course of action to solve the problem: First, cross off what you “wish” you could do and what you “can’t” do. Then examine what you “can” do. Cross off the ideas you don’t prefer and plan for how you will implement whatever ideas are left. Expand on the remaining ideas until you have a very complete, “doable” plan. Then, persistently follow through on your chosen course of action until your problems are solved (or at least moderated). (For example, from your options of “what you can do” in step 4, you choose to prepare for their trip by reading a book on responding to criticism and then plan to use these ideas during the visit. Then when they arrive, you start off the visit by assertively and respectfully requesting that they only give their advice and opinion when asked for. Then you reassure them of your care and concern for the relationship).
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
23
Time Management
Two common complaints of highly anxious and stressed individuals are that they have “too much to do in too little time” and they “wish they had more hours in the day”. The truth is, the more worried and stressed you are, the less energy and focus you’ll have for the tasks at hand because of the draining nature of stress itself. This often turns into a vicious cycle: the more anxious and stressed you are, the lower your energy and task performance, leading to more anxiety and stress, and so on. Therefore, the first way to better manage your time is to decrease your stress and increase your energy and task efficiency (such as with the interventions in this section). Remember—spend some daily time on your relaxation activities. Having 1 less clock hour to work but feeling more invigorated and relaxed for the tasks at hand will result in more output AND less anxiety and stress at the same time. Think about it. If you do not believe in this idea, then time management will not work for you. Second, in addition to doing relaxationpromoting activities, here are some simple, strategic activities you can do to better manage the time you have for what you need to do: *Every morning, list every major task you need to do that day, prioritizing your tasks numerically from highest to lowest in order of importance. Then, cross off your tasks during the day as you complete them (or delegate them). If you do not complete or delegate all of the lower priority tasks by the end of the day, it shouldn’t matter. By definition, these tasks are “lower priority” and don’t necessarily have to be done by the end of the day. Your anxiety and stress will lessen as you strike off the most critical tasks and go lower on the list. *List all of the current tasks you need to do during the next day, week, month, and year. Rank these tasks either “3” (critical), “2” (important), or “1” (optional). Cross off the “1s” (the optional tasks) from your list completely. Then, write out a plan for how and when you will accomplish the “3s” (critical tasks) and the “2s” (important tasks). Post your revised list and chart your progress for accomplishing them as you only focus on your essential tasks. Delegate whatever tasks you can and systematically work to accomplish the rest. Remember, you can’t do everything, so just do the best you can with the time and energy available. *Regularly clean up and organize your main work and living space. Don’t worry about cleaning and organizing the areas of your home or office you use least. Organize your work materials so you know “what is where” in a logical, userfriendly system that works best for you. *Use a “planner” every morning, night, and throughout the day. Plan, check off, and replan again and again. Make sure your planner is portable, userfriendly, and attractive (no one will use an ugly planner!). Your planner can either be of the oldfashioned paperandpen variety or a sleek, electronic palmpilot. Be selective and only choose a planner you like and will use. *Remember, the small work you’ll invest in all of these activities should be more than worth the invigorating, timereducing results. The above time management strategies are an investment in yourself. This is an excellent avenue to make your life easier. See yourself as a worthwhile person deserving of the help and assistance you will be giving yourself.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Play Time
Spending your time engaged in some playful activities everyday can be an effective anxiety and stress reliever—even if for a short period of time. Play time helps to relax you by 1) diverting your attention away from your worries and stress, 2) giving you something else in your life to enjoy and feel productive with, and 3) giving you an outlet to enjoy, relax, and “blow off steam”. Play can be defined as any voluntary activity you choose to participate in whose only purpose is to provide enjoyment, fulfillment, satisfaction, and relief from the challenges and obligations in your life. In short, engaging in play is productive by providing times of enjoyment will help to calm you down and “take the edge off”. When considering which play time activities or hobbies to engage in, review the following complimentary exercises of this section: “taking time off” and “time management”. These activities will help you figure out how, when, and where you can plan to engage in your favorite anxiety/stress relieving play activity. Next, brainstorm which forms of play you can practice that will primarily promote either physical or emotional fulfillment. Finally, implement a consistent, daily, weekly, and monthly regiment of your activities in whatever practical, consistent way possible. A good activity or hobby will not only help you take your mind off of your worries, but it will also be productive in some way. A list of invigorating playtime activities or hobbies you may want to engage in include the following: Sports Exercise Arts/Crafts Shopping (actual or just “window shopping”) Spa/Massage Hiking/Camping/Outdoors Education/Classes/Groups/Therapy Spending Quality Time Connecting with Others (without mentioning your stress) Decorating/Designing Cleaning, Organizing, and Uncluttering Reading/Writing Games (board games, video games) TV/Movies Music Cooking/Nutrition Volunteer Work/Service Pets/Animals Photography Religion SelfHelp
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Taking Time Off
Taking time off from your usual duties can be an effective way to regain energy, motivation, and composure for all that you have to do. Sometimes it is important to simply avoid the worries and stresses of life by engaging in reinvigorating activities. Because anxiety and stress causes both psychological and physiological strain, it is important to periodically do nothing but recuperate and “recharge your emotional and physical batteries”. It is important to note that this intervention alone will not resolve your worries, because the same issues that you temporarily gain relief from will still be waiting for you when you return. Therefore, combining this exercise with others in this section will produce the best short and longterm stress relief results. Here are some suggestions and considerations for taking time off and avoiding your worries and stress: *When you arrange to take time off, fully commit to taking a period of time completely away to allow for the maximum recuperation. Therefore, plan to leave your cell phone and pager at home (or off) if it’s safe to do so. *Arrange to take as much time off as you can reasonably afford to take without allowing your problems to multiply too greatly. Your considerations may include money, job security, family duties, and timepressure tasks that will multiply if left unattended for too long. A few hours away from your worries and stresses can be helpful, a day or a weekend even better, and a week or two away being the best. Vacations longer than two weeks are rare and usually impractical, but can be highly beneficial if you can manage it. *Choose activities to engage in that will reinvigorate you physically and emotionally. If the worry or stress you want to recover from is primarily emotional, you may want to spend your time in a physically invigorating activity to change the focus and allow for recuperation. Conversely, if you want to recover from a primarily physical stress, you may want to spend your time engaged in an emotionally invigorating (but physically relaxing) activity. *Brainstorm and plan an appropriate activity that offers relief from the specific type of anxiety or stress you are struggling with. Examples of physically invigorating activities may include skiing, swimming, rafting, rock climbing, hiking, scuba diving, kayaking, dancing, etc. (Note: only plan to engage in physically invigorating activities that are safe, so consult your physician). Conversely, examples of emotionally invigorating (yet physically relaxing) activities may include visiting a day spa, getting a massage, sunbathing, hottubbing, going on a cruise/sailing, siteseeing, taking a tour, seeing a play or musical, etc.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Assertiveness Training
“Assertive communication” is a key to lessening your anxiety and stress levels when facing a problem or concern involving others. This exercise represents the underlying philosophy behind the “communication skills”, “negotiating skills”, and “responding to criticism” exercises of this system and is meant to be used in combination with them. Assertive communication involves clearly stating your opinions, how you feel, and what you want, without violating the rights or feelings of others. Assertive communicators are open, honest, and direct with their wants and needs, while at the same time being polite, respectful, and sensitive to the feelings of others as much as possible. The main advantages of assertive communication include active participation in decision making and getting what you want without alienating others. Assertiveness works because your openness allows you to clearly and completely express your wants and needs, while your sensitivity minimizes the other feeling attacked or threatened, which leads to defensiveness. Nonassertive communication increases worry and stress by decreasing cooperation and collaboration with others. On one extreme is “aggressive communication”: being open, honest, and direct, yet forceful and offensive. Examples of aggressive communication include arguing, yelling, calling names, not listening, making real or implied threats, etc. On the other extreme is “passive communication”: being polite, respectful, and sensitive to the feelings of others, but only expressing feelings partly (if at all). Examples of passive communication include talking softly, giving the silent treatment, avoiding eye contact, passive aggression, expecting mind reading, and having slouched, yet tense posture conveying a message of submission. Poor communication often switches between aggressive and passive, leading to negative outcomes with others. To develop your skills of assertive communication, practice the following: *Speak in a calm, clear, confident tone of voice—practice in the mirror and then with others *Make good eye contact *Have an upright, yet relaxed posture *Keep a focus on expressing your feelings, rather than attacking and blaming *Make requests and suggestions, rather than demands and orders *Take personal responsibility for your feelings *Focus more on facts and principles than personal differences *Focus on solutions, collaboration, agreement, and compromise *Consider taking martial arts or selfdefense classes *Express your feelings respectfully, but without apology when none is warranted *Remind yourself that your feelings, wants, and need are important and valid *Accept that to be heard, validated, and respected can be more valuable than having approval *Ask yourself before speaking: “how can I say this in an open, honest, forthright way”? *Also ask yourself: “how can I say this in a way that minimizes the other person feeling defensive, attacked, or threatened”? *Be OK with saying “no” *Pick your battles, but disagree and stand your ground when necessary *Stick to one sensitive topic at a time unless both are ready to move to another subject *When at odds, politely repeat your main argument and agree to disagree (Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
27
Communication Skills
The anxiety and stress we experience in life are highly connected to how difficult our interactions are with the significant others in our life: family, friends, coworkers, etc. How you communicate with others tends to be more important than what you may be discussing. Communicating in any way the other perceives as threatening or offensive generally results in others getting defensive and either arguing back or shutting down. Constructive communication at this point is usually futile, resulting further contention. Remember—whether you meant to be offensive or not, an offended person still will feel and react in the same way. Their perception is their reality. Therefore, in order to keep peace and minimize worry and stress levels, it is important to communicate to others about sensitive matters in ways that open and honest, but also polite, sensitive, and respectful. The following communication skills can help you achieve this balance: 1) Use “I” statements (instead of “You …”) I feel_________when_________because________ I would like it if / I wish that__________________ Otherwise I________________________________(optional—be careful with this) (Avoids blaming and shows you take responsibility for yourself and your feelings) 2) Bring up the past as little as necessary to make your point (This sensitive subject makes people defensive, so use minimally with great discretion) Be specific and don’t generalize (avoid “always”, “never”, names, and labels) (don’t make a problem bigger than it actually is) Stick to the subject (until you are both ready to move on) (it’s hard enough to talk about one sensitive subject; bringing up more is overwhelming) Be aware of your body language (keep it open, nonthreatening, and attentive) (keep your arms and legs uncrossed and unfolded, keep good eye contact) Keep a soft, respectful tone of voice (avoid yelling, sarcasm, patronizing, or sharpness) (the words you use won’t matter if you sound attacking, blaming, or defensive)
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7) Admit immediately where you are wrong / agree immediately where they are right (whenever you can honestly do so; this puts you both on the same side) 8) Be brief in your argument (avoid lecturing; allow for back and forth discussion) (if you ramble too long, you will lose the other person and they will tune out) Listen reflectively without interrupting (listen first, respond second) (respond only after the other feels heard, understood, and validated) Offer solutions and support the other person trying to (or wanting to) change (be a part of the solution—not the problem; don’t be negative)
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© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Responding to Criticism
A main cause of anxiety and stress comes from dealing with other people’s criticisms and putdowns. When critical people are open minded and willing to listen, refer to the “communication skills” and “negotiation skills” exercises to talk things out and come to a compromise. Conversely, rational, logical conversations with closedminded troublemakers are counterproductive because such people are only looking to manipulate you and give you a hard time. The key is this: how you choose to respond to their criticism will largely determine how much contention will follow. Therefore, you are never a helpless victim to critical people—even if they hold some sort of a power position over you. There are three ways of responding to closedminded critics that are usually not helpful. In fact, these responses usually just make things worse: 1) Trying to explain yourself and your position (which they will discredit) 2) Firing back a criticism towards them (leading to a backandforth argument) 3) Sitting there quietly and “taking it” (leading to further criticism and less respect) Responding in any of these three ways will just give ammunition for the other person to use against you. A rule of thumb is that when others are contentious and looking for a fight, they are not in the mood for reason. Just focus on deflating their argument and escaping damage until a later time when they’re ready to talk civilly and respectfully (although some troublemakers may never be open to civil discussion—sad, but true). The following four techniques serve to deflate closedminded criticism when executed politely, respectfully, and under control: 1) Summarize (or “paraphrase”) back to them what they’ve said to allow them to restate themselves more specifically and respectfully. 2) Ask for specifics to counteract and minimize the generalized, overblown criticism they have just delivered against you. 3) Agree in part with whatever portion of their statement you honestly can (without discounting it with “but”, “although”, or “however”—using “and” will be far more constructive). 4) Use a “broken record technique”: repeatedly agree with whatever part of their criticism that you honestly can, along with a brief resolution to improve until they finally see you will not be diverted from the subject and finally back off. These deflating techniques work because they allow you to politely and respectfully respond in ways that “send the ball back in their court” without giving them anything further ammunition to use against you. After they are deflated and run out of bullets, the conflict will end and they will go away— probably to find another person they can vent on with better success.
(Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Negotiation Skills
When your interests are in direct conflict with another, a fair settlement or negotiation that totally satisfies both sides is difficult, if not impossible to achieve. Anxiety, stress, frustration, and contention are often the result. Therefore, sometimes the best you can hope for is to find a “workable compromise” you can both live with. Examples may include the following: *My way when I do it, your way when you do it *My way this time, your way next time *Part of what I want with part of what you want *If you’ll do X for me, I’ll do Y for you *We’ll try my way this time; and if you don’t like it, you can veto it next time However, if one or both of you don’t feel open to creating a compromise, it can be helpful to first take turns listening to and validating each other’s feelings on the subject—even if you disagree with why they have those feelings. After both sides feel listened to and validated without criticism, negotiation should be possible. To listen to each other’s feelings effectively: 1) A first person respectfully shares their feelings on the subject for 1530 seconds. 2) A second person (the listener) does not respond back, but instead paraphrases back what was heard to show if what was said and what was heard are the same. 3) The first person either agrees if he or she feels heard and understood, or if not, clarifies and restates what was said until both sides are on the same page. 4) This process continues until the first person feels that their main position is heard, validated, and understood. 5) The roles are then reversed with the second person opening up and the first person listening. 6) This back and forth process continues until both sides feel listened to, heard, validated, and understood on all of the main aspects of their position. (*Note: neither side should be interrupted, criticized, or made to defend their position at any point of this exercise). If both sides are still not ready to engage in a workable compromise, take some time away from the situation and then revisit it when feelings have cooled off. When both sides are ready, begin a discussion and see if a workable compromise naturally results. If not: 1) Take out a piece of paper to list all of the possible solutions each of you can think of for the situation. Then, take turns making suggestions back and forth. As you are brainstorming, let your imaginations run wild while generating as many potential solutions as possible. NOTE: Don’t judge or criticize the other person’s suggestions. 2) After both sides have added as many potential solutions as possible (hopefully, at least 4 a piece), each takes turns crossing off the solutions onebyone they are most opposed to until there are only 2 solutions left. 3) Decide on a workable comprise you can both live with, even if just for a little while. Often this occurs by combining elements of the last 2 options (plus any desirable elements of the crossed out options that both can agree to). 4) Agree to revisit and renegotiate the issue in the future to create a new workable compromise (as needed if feelings or conditions change). (Adapted from Bourne, 1992)
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Influencing Skills
Sometimes, we become anxious or stressed because we try to “fix”, “control”, “push”, or “pressure” others into the changes we feel they should make. Because no one can “make” someone else change, mutual stress and frustration usually result. People only change if they choose to do so. Therefore, the best we can do is to stop “pressuring” them, do more positive “influencing” for change, and accept the choices they make (or not make). “Positive reinforcement” creates the greatest likelihood that others will change because “positive influence” is used instead of “negative pressure”. Positive reinforcement leads to change because people feel they are choosing to change for positive reasons, rather than feeling forced to change to avoid negativity. People tend to not change under negative pressured because of pride, fear, or simply having a different opinions or values. Negative pressure works poorly in getting others to change because people tend to respond with rebellion or sabotage. One or more of the following responses to negative pressure are most common. People either: 1) stubbornly resist changing and argue back 2) temporarily change to stop the negativity, only to revert back to old ways when it’s “safe” 3) grudgingly change in the pressured way, but with a determination to “get revenge” as soon as opportunity presents itself in the future To help someone change through reinforcement, practice the following: 1) Politely and respectfully request the other to change occasionally in certain specific ways. For example: “I would appreciate it if…”, “I would like it if…”, “I really like it when…”. Then keep quiet about it for a while and let them choose what to do. Catch the other “in the act” of behaving how you’d like them to be, then praise them heavily for their efforts. Be genuine and avoid sarcasm. Model the behaviors you want the other to do yourself, then politely invite them to join in with you. Show appreciation if they join you and accept it if they say no. Be patient. After the other person acts in the ways you desire for a period of time, spontaneously give them a tangible reward or do a fun activity with them. Subtly let them know that the reward is partly out of appreciation for their positive efforts. (Be sly and don’t bribe!) Minimize all negative pressure tactics, including: nagging, yelling, criticizing, complaining, put downs, threats, ultimatums, arguments, disapproval, resentment, power struggles, passive aggression, etc. After using a combination of the 5 approaches above, decide when you have done all you feel like doing to promote the changes, and then “let go”. Allow them to make their choices and then accept things the way things are—now that you’ve done your best to promote change on your end. Remember—you wouldn’t like another person trying to force you to change, so don’t do it to someone else.
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© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
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Cited References
Balch, P.A., & Balch, J.F. (2000). Prescription for nutritional healing. New York: Penguin Putnam, Inc. Braden, N. (1982). The Romantic love and answer book. New York: Penguin Group, Inc. Bourne, E.J. (1992). The agoraphobic treatment group. In M. McKay and K. Paleg (Eds.), Focal group psychotherapy (pp. 67133). Burns, D.D. (1990). The feeling good handbook. New York: The Penguin Group. Chesser, B.R. (1984). Five myths that can wreck your marriage. Readers Digest, 6, 2328 Doskoch, P. (1996, July/August). Happily ever laughter. Retrieved July 4, 2002 from the World Wide Web: http://www.psychologytoday.org. Gottman, J. (1994a, May/June). Why marriages fail. Networker, 3, 4148. Gottman, J. (1994b). Why marriages succeed or fail. New York: Simon & Schuster. Gottman, J. (2000). The seven principles for making marriage work. New York: Crown Publishers. Greenberg, J.S. (1990). Comprehensive stress management. Dubuque, IA: Wm. C. Brown Publishers. Kurdek, L.A. (1993). Predicting marital dissolution: A 5year prospective longitudinal study of newlywed couples. Journal of Personality and Social Psychology, 64 (2), 221242. Jorgensen, S.R. (1986). Marriage and the family. New York: Macmillan. Manning, G., Curtis, K., & McMillen, S. (1999). Stress: Living and working in a changing world. Duluth, Minnesota: Whole Person Associates, Inc. Nevid, J.S. (1984). Sex differences in factors of romantic attraction. Sex Roles, 11, 401411. Provine, R.R. (2000, November/December). The science of laughter. Retrieved July 4, 2002 from the World Wide Web: http://www.psychologytoday.org. Sternberg, R.J. (1988). The triangle of love: Intimacy, passion, and commitment. New York: Basic Books. Stroebel, C.F. (1989). Qr: The quieting reflex. New York: Berkley Publishing Group. Warren, N.C. (1992). Finding the love of your life. Colorado Springs: Focus on the Family Publishing.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
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Note: This program is only meant to compliment—rather than replace—the services of a licensed and qualified psychotherapist or medical doctor. Always seek out the services of these licensed professionals as necessary. Consult with your primary care physician before utilizing the nutritional or exercise recommendations contained in this program. Only use this program with moderation and common sense. Use at your own risk.
© Copyright 2004, Randy A. Gilchrist, Psy.D. All Rights Reserved
Best Used in Conjunction with Managing Stress and Anxiety by THE HYPNOSIS NETWORK
