stress management and biofeedback for the holidays maureen rice, phd november 21, 2013...
TRANSCRIPT
Stress Management
and Biofeedback
for the Holidays
Maureen Rice, PhD November 21, 2013
caps.byu.edu/biofeedback
HANDOUTS (see website)
• Mind/Body Connection
• Breathing• Resonant Breathing
• Basic Relaxation Skills
• Refresher Strategy• Stress Card• Thoughts & Perceptions
• Managing Stress• Deal with Anxiety• Insomnia Busters• Headache Treatment
SCRIPTURES….Relating to Stress• For it must needs be, that there is an opposition in all things…2 Nephi 2:11• Be patient in afflictions, for thou shalt have many, but endure them well…D&C 24:8• Search diligently, pray always, and be believing, and all things shall work together for your good, if ye walk uprightly…D&C 90:24• Do not run faster or labor more than you have strength and means provided…D&C 10:4• In the world ye shall have tribulation: but be of good cheer; I have overcome the world…John 16: 33
PHYSICAL AND PSYCHOLOGICAL STRESS
Constant Stress can result in a chronic state of stress in the
MIND and BODY
Negative thoughts cause unnecessary stress on the mind and
body resulting in a decrease in performance
CHANGING YOUR THOUGHTS
AND Actions
STRESS 80% stress in lives
2/3 MD stress relatedMedical costs $1 billion
$150 billion lost productivityImmune: colds infections, HA
GI disorders: irritable bowel, colitisSleep disturbances, fatigue, hormone
Depression, anxiety, emotional disordersCardiovascular: BP, heart attacks, palpitations, stroke
Major contributing factor to family discord and violenceMajor contributing factor to 6 leading causes of death
in USACAD, cancer, respiratory diseases,
accidental injuries, diabetessuicide
"When under stress, immune system cells are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease. Because inflammation plays a role in many diseases such as cardiovascular, asthma and auto-immune disorders, this model suggests why stress impacts them as well.“
Sheldon Cohen, PhD, Carnegie Melon University
Stress and Disease Process
Blood Pressure Reactivity to Psychological Stress Predicts Heart Disease
• Carroll et al., 2012, Psychophysiology – increased blood pressure reactions to acute
mental stress predicted 16-year cardiovascular disease mortality
• Carroll et al., 2011, Psychosomatic Medicine – systolic blood pressure reactivity to stress
predicted future resting blood pressure and risk of being hypertensive 12 years later
• Carroll et al., 2003, Psychosomatic Medicine – blood pressure reactions to stress predicted blood
pressure levels 5 years later
Short Term Consequences of Stress
PSYCHOLOGICAL Anxiety/Nervousness Anger/Irritability Concentration Depression Memory Performance
PHYSICAL Fatigue Frequent Illness Gastrointestinal problems Headaches Insomnia Tense Muscles
Long Term Consequences of Stress
Auto-Immune DiseasesDepressionDiabetesHeart DiseaseHigh Blood PressurePoor Immune SystemRespiratory DiseaseUlcers
PERFECTIONISM AND STRESS
“Perfectionism is not a quest for the best. It is a pursuit of the worst in ourselves, the part that tells us that nothing we do will ever be
good enough — that we should try again.”- Julia Cameron
Perfectionism
• Unreasonable goals
• Self worth based on achievements
• Can’t feel satisfied
• Based on comparisons with others
• Feels unloved and unvalidated unless performing well; cannot share mistakes without excessive shame
• Excessive fear of failure; chronic
• External standards for success
• Goals exceed present performance by a great degree
• Cannot find pleasure in progress toward the goal. Focus is only on the outcome
• Emphasis is on keeping life under control
Dr. Marleen Williams (BYU Counseling and Psychological Services)
Wholeness
• Obtainable, realistic goals
• Self worth is inherent
• Can self-reward and feel satisfied
• Recognizes individual uniqueness
• Accepts self as valuable while acknowledging human weakness; does not require approval of others
• Can accept failure as a part of learning process; able to keep trying
• Goals derived from inner awareness
• Goals reflect growth to next stage of progressive development
• Enjoys the “journey” as well as the outcome
• Emphasis is on keeping life in balance
Fight, Flight, Freeze
Real Danger• Threats to life: harm
or possible death
Perceived Threats• Worries, fears, regrets, self-criticisms, negative expectations, deadlines
Physical danger triggers the stress response to make us Faster and Stronger
for Survival
Fight or Flight or Freeze
Sympathetic (flight/fight/freeze)Parasympathetic (relaxed, balanced)
Muscles: Tense Up, Poised for Action
Mind: Instinctive, Higher Thinking Shuts Down
Stress Hormones Released: Adrenalin Cortisol, Immune Repair Shuts Down
Stomach: Digestion Shuts Down, “Butterflies”
Heart Rate/BP: Speeds Up Blood Flows to Large Muscles
Breathing: Shallow and Quick
Sweat Glands: Active
Strong Emotions: Fear, Anger, Panic
Stress and Performance
Level of Stress
Effe
ctiv
enes
s of
P
erfo
rman
ce
Normal Fight/Flight Responses to Psychological Stress Overload:
Decrease in Performance
Poor Concentration & Memory
Feeling Overwhelmed (Freeze)
Avoidance of Tasks (Flight)
Giving Up (all or nothing)
Emotions: Bottled up, Erupt, Roller-Coaster (Fight or Flight)
Anxiety, Nervousness
Peak Performance
Low High
High
Yerkes-Dodson Principle Robert M. Yerkes, M.D. and John D. Dodson, M.D, 1908.
Biofeedback
bi·o·feed·back n.
The technique of furnishing information regarding an
autonomic bodily function, such as heart rate,
muscle tension, hand
temperature, or sweat gland
activity in an attempt to gain
some voluntary control
over the stress
response.
Activating our Relaxation ResponseOur inner gas pedal is automatic. We go from 0 to 60 in an instant in response to any stressor
Our mind does not differentiate danger from stress
Our inner brake is not automatic.
It takes awareness and practice to• Catch ourselves “speeding”• Develop skills to relax “at will”• Maintain appropriate cruising
speed• Make braking more automatic
3 Ways to Deal with Stress• Change the stressful situation• Change our perception of the stressful situation• Change our capacity to deal with the stressful situation
– Improve skills• Preparation and organization• Work and study efficiency• Assertiveness
– Increase body efficiency• Food• Sleep• Exercise• Relaxation: Fight tension with relaxation
Abdominal Diaphragmatic Breathing www.breath-sync.com
COACH:• Place one hand over upper chest, other over stomach
Make sure stomach moves more
• Think slow, gentle, smooth, and deep. Breathe in through your nose and Exhale through your mouth as if blowing out a candle to slow it down
• Let shoulder and chest muscles relax
• Pause before each in-breath and out-breath
• Think of your stomach as a balloon filling up with air and slowly releasing the air
• Release tension in body each time you exhale
Breathing as a Brake
• Diaphragmatic breathing is our best defenseagainst Stress
• Slower, deeper, smoother and gentler breathing is immediately calming
• Diaphragmatic breathing brings our Stress Response System, our Gas Pedal and Brake, into balance.
• Autonomic Balance = Less Sympathetic Activation = Increased Heart Rate Variability = Calmness and Mental Clarity = Peak Performance
• Peak performance comes from the balance of the energy of the stress response and the calmness of the relaxation response
Take a deep breath in and as
you exhale think of a calming
word or phrase such as…oI am relaxedoCalm downoI am competentoOne thing at a timeoI can do thisoMy best is good
enough oI am enoughoI am calm and
relaxedoIt’s okay to make
mistakes
Repeat Until You Feel Calmer
Minutes to Relaxation
Heart Math: emWave programHeart Rate Variability (HRV) Breathing/Biofeedback
• HRV is the beat to beat change in Heart Rate (HR)– HR speeds up as inhale and slows down as exhale
Calmness & Peak PerformanceGood heart Health
• HRV is decreased by shallow, fast breathing, anxiety, stress, negative thoughts
and emotions
• EASY-AIR PLUS
Strategies to Improve Heart-Brain Health Christine Moravec, PhD
Cardiac Physiologist Cleveland, Ohio Heart Clinic - Department of Cardiovascular Medicine Molecular Cardiology Center for Integrative Medicine
Michael McKee, PhD Psychiatry and Psychology, Cardiovascular Medicine PATIENTSo Work with patients with diseased hearts - heart transplant waiting
listo End-stage Congestive Heart Failureo Breathing 18+ BPM (normal 12 BPM), SOB, enlarged heart, no
energy, weak stiff heart muscle, cardio-pulmonary edema fluid accumulation, poor contractility for pumping action – only hope is transplant
STUDYo Study with 27 pre-teen–elderly patients, 11 outpatients, 16
inpatients (congenital and diseased hearts)o All taught to breath 6-8 BPM, 20 minutes for 3 months, to
increase HRVo Retrieved failed hearts after transplant to study muscle striations
– focus on 16 different individual muscles for contractility, relaxation and response to chemical stimulation
Research
RESULTS (unpublished)o Improvement and some degree of reversal on cellular, muscular and molecular level as seen on muscles on inside surface of left ventricle (muscle contractility and relaxation)
o Nearly half of 27 patients able to regulate HRV to improved wellness3 were removed from the heart transplant list
o Biofeedback training better than failing heart and heart on LVAD heart pump (left ventricular assist device)
o Improved cardiovascular flexibility
o Improved clinical status, quality of life and disease reversal
o Promising direction in causing some degree of disease reversal
o Continued studies with CAD (Coronary Artery Disease), Diabetes, MS measuring blood markers and HRV
Mindfulness15 Second Refresher
• Become present moment to moment• Slow down – awareness of
thoughts/actions• Non-judgmental• Non-reactive• Decrease own internal harsh dialogue• Calmness • Mental Clarity• Peak Performance
Changing Thoughts and Perceptions
Tension Producing Statements
1. I should not feel this way2. If you really cared you would…3. I am not as smart and attractive as she is4. He makes me so mad5. I can’t understand it6. I’m getting nervous7. I’ll disappoint them and let them down8. I’m not good enough9. I’ve never been any good at this10. I’ll never do this right11. Everything depends on this12. If I don’t reach that goal, it will be terrible13. If others disagree with me, I must be wrong14. He ought to know what I’m feeling15. It must be my fault16. I will never get it done in time17. If I don’t get good grades, my future is ruined18. I’m not BYU material19. I’m so stupid20. I should be more like…21. S/he would never go out with me22. I hate it when…
Tension Reducing Statements
1. It is not worth getting upset over2. My best is good enough3. I can handle it4. It’s okay to make mistakes5. I am enough6. It is okay to be me and to feel the way I do7. I’ll compare myself with myself and not others8. Worry won’t help solve the problem9. I can do what I can do and that is all10. I am a fallible human being11. I’ll survive12. I’ll do what I can under the circumstances13. Five years from now, who will care14. The Lord will support me in my trials15. No one can be loved by everyone16. Being different doesn’t make me less than others17. What is the worst thing that can happen18. One thing at a time19. It is not requisite that I run faster than I have
strength20. I can figure this out21. I am a smart woman/man and can do this
Change Your BrainTelomeres: Clock of Cell Health
• Mindfulness and relaxation strategies change the physiobiology of your brain
• Telomeres are protective caps at the ends of our chromosomes (like plastic caps on shoe laces)
• Telomere shortening plays an important role in human disease and mortality, affecting our cardiovascular disease (strokes, heart attacks), diabetes, cancer, osteoporosis, arthritis, cognitive functioning, dementia
• Long telomeres are related to healthy aging and overall longevity, improved health
• Healthy eating, exercise, reduced stress levels
Stress Management and Biofeedback Services
Relaxation Recordingcaps.byu.edu/biofeedbackClick on Stress ManagementClick on Relaxation Recordings
Stress Busters for Resilience• BREATHE diaphragmatically, consciously, calmly• Mini RELAXATION of your mind and body - NOTICE
TENSION in the moment and release it• DEEPLY RELAX once a day (before bed is helpful)• Do something you find soothing
– Use Refresher strategies – 15 Second Refresher– Try Mindfulness practice or relaxation recordings– Take breaks for rest and fun
Develop realistic EXPECTATIONS - Seek EXCELLENCE instead of Perfection
Prioritize – improve TIME MANAGEMENT skillsLearn Skills to tolerate and manage
EMOTIONS-anxiety/depression/addictionsDeal with your SLEEP issuesEAT wellEXERCISE regularly
Paced Breathing Programs & Apps
• Breath-Sync Music Tracks and CD’swww.breath-sync.com
Diaphragmatic breathing training video Sample music tracks to choose Optimal rate of
breathing CD’s available for purchase
• EZ-Air Breath Pacerwww.bfe.org/ez.htm
Free for 30 days ($20 to keep it) CD’s available for purchase
• Free Smart Phone Apps
www.mybrainsolutions.com My Calm Beat Breathe 2 Relax t2health.org
Biofeedback Apps
• Inner Balance: $99– emWave HRV program for tablets and smart phones– Heartmathstore.com
• Stress Doctor: $4.99– HRV app for I-phone (not yet on Android)– measures heart rate and shows graph of
heart rate variability
• My Calm Beat: $79.99– Calculates personal breathing rate for optimum balance– MyBrainSolutions.com
• Sleep Time: $1.99– Evaluates sleep cycles and quality of sleep– Azumio.com
Contact Information
Maureen Rice–[email protected] – 1551 WSC– (801) 422-3035– Counseling and Psychological Services
(CAPS)
Stress Management and Biofeedback Services Website: caps.byu.edu/biofeedbackGoogle “byu biofeedback”