resilience in combatting stress from coronavirus crisis · 4/4/2020 · the path there is a...

RESILIENCE IN COMBATTING

STRESS FROM CORONAVIRUS

CRISIS

HOW PROFESSIONALS CAN BE RESILIENT & MANAGE STRESS OF

CRISIS – A 9 STEP APPROACH & MODEL OF RESILIENCE

Stephen Sideroff, PhD

Departments of Psychiatry & Biobehavioral Sciences & Rheumatology

UCLA

&

The Mind Body RoomTM

© 2020 Stephen Sideroff, Ph.D.

OBJECTIVES OF PRESENTATION

Relationship between stress, emotions, autonomic dysregulation and cognitive functioning

Relationship between stress and physical symptoms

How coronavirus ramps up these relationships; straining ability to cope

A 9 step plan – The Path – for being resilient during this crisis

Be able to identify a model of resilience that can mitigate effects of current crisis and any stressful experience


FIND THE “BEST WAY”


CORONAVIRUS

MAGNIFIES THE IMPACT OF STRESS

Throughout this talk I’ll highlight how our current situation magnifies the already high impact of stress

Which is already magnified amongst the addict population

Professionals are not immune


The Stress Response

All the stress hormones circulating in the bloodstream and the neural effects of the sympathetic nervous system combine to create the ‘fight-or-fight’ response.

stress hormones (30 varieties) travel in blood stream

to relevant organs eg. Glands, heart, intestines

adrenal cortex secretes various stress

hormones (eg. cortisol)

pituitary gland releases “acth”

(adrenocorticotropic hormone)

crf (conticotrophin

Release factor)

flight or fight response

hypothalamus

stressor

sympathetic

nervous system

adrenal mudulla secretes

“stress hormones”

(eg. epinephrine)

nerve endings activate

various smooth muscles

and glands eg. pupils dilate

The flow diagram below shows what goes on in the body when the brain detects potentially harmful ‘stressor’


Effects On The Body

Hypothalamus activation → stimulates pituitary to

release hormones → stimulates adrenal glands to

produce other hormones → wide range of body effects

→ decreased protein synthesis; localized

inflammation (redness, swelling, heat & pain);

faster blood clotting & increased stomach

acids.

Chronic activation of muscles & slow mobilization

of lactic acid: muscles might ache & become

painful.

Liver discharges sugars into the blood for energy to

muscles: can produce & release excess cholesterol.

Blood drained away from skin: becomes pale.

Sweat Production is increased, ready to cool

down a body overheated by the exertion of fight

or flight.

Pupils dilate.

Salivary Glands stop secreting saliva:

dry mouth.

Breathing Rate speeds up to supply more

oxygen to the muscles.

Heart Rate increases: more

blood to muscles.

Blood Pressure rises.

Adrenal Glands release adrenaline.

Kidney blood supply reduced: work less efficiently.

Digestion ceases or slows down: system disruption.

Defecation & Urination prevented by

tightening of muscles: Diarrhea or

uncontrolled urination.

The Immune System is impaired, making a

Person susceptible to disease or/and

allergic reaction.


POLYVAGAL INVOLVEMENT

Trauma and the “freeze” response

The immobilization defense system

PTSD

Psychological effect: learned helplessness

Neuroception (Stephen Porges)

Great difficulty with physiological recovery


Human Cell has Two Functions:

Growth/heal or Protection


WE ARE ALL CHALLENGED DUE

TO

Imbalance between stimuli/events triggering stress response and those triggering opposite –parasympathetic response

Evolutionary defense bias

Psychological factors exacerbating imbalance

Need to be liked, to be perfect

Difficulty saying “no”

Fear of rejection

Negative expectations due to childhood history


WHAT IS DANGEROUS, A

THREAT, OR UNCERTAIN

Hunter gatherers a life threatening

Today a

Will I be liked; am I being judged?

Can I pay my bills; will I keep my job?

Is my friend mad at me?

Will I get the latest version of the IPhone?

Will I get the Coronavirus?


CORONAVIRUS STRESS

Unprecidented level of danger

Risk of death

High level of uncertainty

No clear end to crisis

Added economic uncertainty and hardship

Real survival threat; reduced sense of safety

Constriction of life, contact, distractions, relief


Evolutionary Mismatch Between Environment

of Hunter/Gatherers & Today


RESISTANCE TO MANAGING

STRESS

Our stress response mobilizes the body’s resources and within limits enhances performance.

The stress response is adaptive; a survival mechanism.

“Slippery slope”

Stress response conditioned to success

Preoccupation with stress masks emotional pain and other uncomfortable issues.


RESISTANCE CONTINUED

Adrenalin addiction and counteracting “deadness” or psychological numbing.

Unfinished business & emotional needs unconsciously drive stressful behavior.

Discomfort with vulnerability.

Sympathetic dominance of our nervous system.


Relationship Between Performance &

Stress & Activation


We are all crying out


But then we don’t want to listen


“I save a lot of time by not unwinding”


Self-Regulation Impairment

Autonomic Dysregulation Syndrome


Consequences

Physical illness, impaired immune system, insomnia, chronic pain and other conditions

Cognitive impairment

Emotional reactivity, anxiety, depression, Burn out, depersonalization


EEG


RESILIENCE

The optimal management of psychic & physical energy

Optimal functioning

Optimal adaptability or learning

Optimal regeneration & Neurogenesis

Ability to relax and recover baseline

Optimal Self-Regulation


Nine Component Model of Resilience

Relationship Organismic Balance Process

Relationship with self

Relationship with other

Relationship with

something greater

Physical

Mental/cognitive

Emotional

Presence

Flexibility

Power: the ability to get

things done


THE PATH

There is a “Best Way”

To Address Coronavirus Situation

Making this decision puts you more in control

It helps you become more proactive instead of reactive

Defining The Path, and what it takes to be on The Path helps avoid a sense of overwhelm

Helplessness is a risk factor for negative stress

There is power in knowing how to find the “best way”

Distress → Eustress


Mental Balance and Mastery

Cognitive Framework

Chapter in your Life Journey of self-discovery & growth

Approach crisis as a challenge to learn and grow from; rather than problem, where you experience holding on, waiting for it to be over

Decide you are going to embrace the challenge

Get the best information; avoid rumors and biased opinions

Create structure to your day and your life

Set appropriate boundaries


Emotional Balance and Mastery

Don’t ignore or push down your feelings → increases anxiety and depression

Be willing to experience feelings without judgment

Be accepting of your feelings as part of current situation

Express and allow them to move through your body

After sufficient time, make the decision to switch to something more positive in your life; and let go

Recognize generalized anger


RELATIONSHIP WITH SELF

How do you treat yourself

Accepting or judgmental?

Supportive or critical?

Do you take in compliments?

Do you own your successes and gifts?


YOUR “INTERNAL PARENT”

Creation of survival learning & Primitive Gestalt Pattern

What “feels right” is based on childhood experience

The result of conditioning: it’s NOT in your DNA

Goal: developing a healthy internal parent or internal voice


DEVELOPING A HEALTHY

“INTERNAL PARENT”

With love

With acceptance

With compassion

With support

Value self (I deserve)

With appreciation

Self-care


Tools

Find your Healthy Internal parent/voice

Gestalt dialogue process between your critical and judgmental voice, and the healthy voice you want to further develop

Rule, 11th Commandment: Never OK to put self down

“Own”, accept successes & positive feedback

The Gottman Ratio


RELATIONSHIP WITH OTHERS

Relationships offer opportunity for emotional nourishment – stress antidote

Make sure to set appropriate boundaries and to say “No” when necessary

Be willing to ask for and give support

Discriminate between healthy and toxic relationships

Work on resolving unfinished business


TOOLS

Gottman Ratio

Limit contact with critical or negative people

Don’t get hijacked by feelings of others

Seek out positive supportive people

Don’t take those close to you for granted

Don’t carry around unfinished business

Make list of those close to you and reach out


Emotions and the heart

Heart Rate coherence


TOOLS

The Four Agreements – Miguel Ruiz

Impeccable with your word

Don’t take anything personal

Don’t make assumptions

Always do your best


RELATIONSHIP WITH

SOMETHING GREATER

Meaning, purpose, direction to life

Spiritual aspect to life

Giving service and enhancing personal value


PHYSICAL BALANCE AND

MASTERY

Sympathetic/parasympathetic balance

Ability to recover baseline after a stress response – stressful event

Ability to relax, and to remain calm


Tools

Practice some form of relaxation!

My website: www.DrStephenSideroff.com has relaxation exercises

6 Breathes per minute

Separate the “Stressor” from your Stress Response

Shift from “Fight or Flight” to a “Calm focus”

Use of cues to regularly check in with body

Create “Zones of Safety”


http://www.drstephensideroff.com/

Flexibility

Dealing With Loss of Adaptability

Primitive Gestalts (Old Patterns) → limit adaptability

Ability to learn and adapt based on new information

Ability to adjust – accept– current situation: don’t fight “What is”

Finding the silver lining

Ability to shift goals for easier success, less frustration

Openness to learn and grow from experience

Not restricted by rigid beliefs or perspectives


FOR MORE INFORMATION

www.DrStephenSideroff.com

Learn more about The Mind Body RoomTM for Resilience & Optimal Self-Regulation – Available for Treatment & Sober Living

To sign up for free “365 Steps on The Path of Resilience:

http://drstephensideroff.com/365-steps-on-the-path-to-resilience-and-success/

[email protected] – Audio visualization


http://www.drstephensideroff.com/

http://drstephensideroff.com/365-steps-on-the-path-to-resilience-and-success/

mailto:[email protected]

resilience in combatting stress from coronavirus crisis · 4/4/2020 · the path there is a...

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