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STRESS MANAGEMENT GROUP
WAY BACK INN
ANITA PINDIUR
Stress Management Group
Anita Pindiur
07-17-2013
STRESS MANAGEMENT GROUP
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ANITA PINDIUR
Six (6) week didactic and in-vivo exercise
2 hour group
1hour of yoga, Pilates, Eurothmy, Tai Chi, etc..
1 hour of didactic education
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Curriculum
Week One Good Stress Vs. Bad Stress
Week Two Anger Management
Week Three Food, Diet and Stress
Week Four Unplug, De-clutter and Organize
Week Five Mental Health, Medication, Meditation
Week Six Positive vs. Negative Coping with Stress
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Group Rules
Be Relaxed and Happy
Have fun
Embrace new ideas
Try something new
Push yourself, but be respectful of your body
Others as applicable to organization
(WBI; no alcohol/drugs/gambling, no weapons, no
threats of or violent behavior)
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Group Suggestions
Keep the group fun and casual
Defer topics of trauma, severe mental health,
problem gambling or substance abuse to appropriate
group
If possible and budget allows bring in props
(i.e. food, stress toys, cd’s with relaxing
music, etc.)
If a person needs to leave group, have a pre-discussed
safe place, plan of action, and time to return.
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Take the stress assessment
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Stress is a person's response to a stressor such as
an environmental condition or a stimulus. Stress
is a body's way to react to a challenge. According
to the stressful event, the body's way to respond
to stress is by sympathetic nervous system
activation which results in the fight-or-flight
response. Stress typically describes a negative
condition or a positive condition that can have an
impact on a person's mental and physical well-
being - Wikipedia
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The term stress had none of its contemporary connotations before the 1920s. It is a form of the Middle English destresse, derived via Old French from the Latin stringere, "to draw tight."[1] The word had long been in use in physics to refer to the internal distribution of a force exerted on a material body, resulting in strain. In the 1920s and 1930s biological and psychological circles occasionally used the term to refer to a mental strain or to a harmful environmental agent that could cause illness. Walter Cannon used it in 1926 to refer to external factors that disrupted what he called homeostasis.[2] But "[...] Stress as an explanation of lived experience is absent from both lay and expert life narratives before the 1930s".[3]
Homeostasis is a concept central to the idea of stress. In biology, most biochemical processes strive to maintain equilibrium, a steady state that exists more as an ideal and less as an achievable condition. Environmental factors, internal or external stimuli, continually disrupt homeostasis; an organism’s present condition is a state in constant flux moving about a homeostatic point that is that organism’s optimal condition for living. Factors causing an organism’s condition to diverge too far from homeostasis can be experienced as stress. A life-threatening situation such as a physical insult or prolonged starvation can greatly disrupt homeostasis. On the other hand, an organism’s effortful attempt at restoring conditions back to or near homeostasis, often consuming energy and natural resources, can also be interpreted as stress. In such instances, an organism’s fight-or-flight response recruits the body's energy stores and focuses attention to overcome the challenge at hand.
The ambiguity in defining this phenomenon was first recognized by Hans Selye (1907-1982) in 1926. In 1951 a commentator loosely summarized Selye's view of stress as something that "…in addition to being itself, was also the cause of itself, and the result of itself."[4][5] First to use the term in a biological context, Selye continued to define stress as "the non-specific response of the body to any demand placed upon it". As of 2011 neuroscientists such as Bruce McEwen and Jaap Koolhaas believe that stress, based on years of empirical research, "should be restricted to conditions where an environmental demand exceeds the natural regulatory capacity of an organism".[6] Despite the numerous definitions[which?] given to stress, homeostasis appears to lie at its core.
• Wikipedia
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Stats and Data
75% of people experience stress 2x per month
50% of those, have “high” levels of stress 2x per month
In the last two decades the report of work stress has gone
up X 4.
25% of drug prescription in the U.S.A are for treatment of
stress
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Week One
Good Stress Vs. Bad Stress
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Positive/Eustress/Good Stress
Motivation
Pushing factor
Need or desire to succeed
Passion
Joy
Love
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Life with no stress
Boring and Dull
Unhappy
Rudderless
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Stress is only bad
In large dosage
And chronic
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Examples of Good Stress
Wedding
Child (birth, and parenting)
Performance (fun activity, recital)
Roller coaster
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What do you feel with good Stress
Pulse quickens
Feel exited
Hormones change
No or little threat or fear
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Good Stress can turn to Bad Stress
Motivation to compulsion
Fun activity to chore
Overwhelming, no more fun, to much, now its
creating pressure not joy
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Gambling as a Good Stressor
Gambling start out as a fun activity
To socialize
To win =joy=good story
Adrenaline rush – good stress
Playing for fun, not money
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Gambling as a Bad Stressor
Playing to win to recoup loses
Highs and Lows when playing
Becomes a need not an activity
No more socializing
No more fun
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Good Stress when Gambling
Used to reduce “stress”
Used to enjoy time with others
Used to enhance life
Used in balance
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Bad Stress when Gambling
Causing “Stress”
Owing money
Lies and secrete keeping
Not taking care of self due to gambling
No balance in life
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Symptoms of Chronic or Bad Stress Headache
Insomnia
Decreased productivity
Low grade fever
Memory/Judgment/Concentration problems
Lowered Immune System
High blood pressure, heart disease,
obesity and diabetes
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Body Mood Behavior
Headache Anxiety Overeating or Under Eating
Muscle tension or pain Restlessness Angry outburst
Chest pain Lack of motivation Drug, Alcohol, Gambling abuse
Fatigue Lack of focus Tobacco abuse
Change in sex drive Irritability Social withdrawal
Stomach upset Anger
Sleep problems Sadness/ Depression
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Resources
Mayo Clinic
Stress Assessment
(online version)
http://www.mayoclinic.com/health/stress-
assessment/SR00029
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Week Two
Anger Management
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Anger Scale inventory
(take test)
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Anger is a feeling or emotion that ranges from
mild irritation to intense fury and rage.
Anger is a natural response Threatened, wronged, harm us
When child or loved one is in harms way or threatened
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Anger result from frustration
Needs, desires, and goals are not met
lose patience, act impulsive, aggressively or
violently
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Anger and Aggression are often confused
Aggression: behavior Intention to cause harm
Verbal abuse or threats or violent act
Anger is an emotion A feeling
We can be angry and not aggressive
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Feeling anger intensely or frequently will place
strain or stress on the body.
Anger = Stress= Flight or Fight
Increase in
Blood pressure
Heart rate
Problems:
Hypertension, heart disease and decreased immune system
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Extreme Anger that leads to aggression may
result in violence
This may result in negative consequences:
Arrest or jail
Injured
Feelings of guilt, shame or regret
Anger=Aggression=Stress
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Verbal violence can lead to
Intimidation or threatening behavior
Consequences:
Alienation
Others fear
Resent
And lack trust
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Short term benefits of Aggression
You feel better
Tension released
Others listen & do what you want
You can manipulate others
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Controlling Aggression
Immediate Timeout, deep breathing, thought stopping
Preventive
Exercise, and change irrational believes
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Think people, situations can make you angry
but they can not make you aggressive
Anger = choice
How do it deal with it
Aggression = loos of control over self and the
situation.
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Anger leads to stress
Our body know that when we get angry we respond a
certain way. We keep that anger with us for a long
time.
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Take away the power of anger by
Retelling the story- venting
(it looses power after a while)
Find humor in it
Laugh right away
Find the silver lining
Remember a past event, and how you handled it
This too shall pass
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Cues to Anger
Physical (heart rate increase)
Behavioral (clenched fist, pace, slam a door, raise
voice)
Emotional (feel abandoned, insecure, jealous,
rejected)
Cognitive (self talk is critical and hostile)
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What can I do? Use conflict resolution
Talk to a friend
Go for walk
Time out
Exercise (walk, go to gym)
Attend a 12 step meeting
Deep breathing
Write in a journal
Do something you like
Avoid something you don’t like
Explore feelings beneath the anger (seek therapy)
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Ways to limit Anger=Aggression
Good time management
Avoid People, places and things that make you
angry
Leave when you feel triggered by anger
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Cognitive Restructuring
A-B-C-D Model and Thought Stopping
Developed by Albert Ellis
“A” –Activating Event
“B” -Beliefs
“C” – Emotional Consequences (what I feel)
“D” - Dispute
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Words to avoid
Should
Must
Always
I have no power over things I cannot
control,
I have to accept that I cannot change (others or situations, you can change self)
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Thought Stopping
Simple: tell self to “stop thinking these thoughts”
Place in a box for review/analysis later
Cancel, Cancel, Cancel
(Silva Method, Jose Silva 1960)
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Conflict Resolution Model
1. identify the problem
2. identify feelings associate with the problem
3. identify specific impact
4. decide resolve conflict or let it go
5. address and resolve the conflict
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Do Anger
Symptom checklist
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ANITA PINDIUR BY: ROCHE DIETITIAN
Week Three
Food, Diet and Stress
SUBSTANCE ABUSE & NUTRITION
The Way Back Inn
Roche Dietitians LLC 2012
DIET AND SUBSTANCE ABUSE
Substance abuse can harm the body in two ways
The substance directly affects the body
Substance abuse can cause negative lifestyle changes
such as irregular eating and poor diet
Recovery from substance abuse can affect your
bodies metabolism, organ function and mental
well being
Roche Dietitians LLC 2012
IMPACT OF DRUGS ON NUTRITION
Opiates (codeine, oxycontin, heroin and
morphine) can affect the GI system. Symptoms
include: diarrhea, nausea and vomiting
Stimulants (crack, cocaine, and
methamphetamine) can reduce appetite and lead
to weight loss and poor nutrition
Marijuana can increase appetite leading to
overweight/obesity.
Alcohol is one of the major causes of nutritional
deficiency in the US
Roche Dietitians LLC 2012
RECOVERY AND NUTRITION
Most recovering addicts have developed
nutritional deficiencies of key proteins, fats,
vitamins and minerals.
Common food patterns include:
No breakfast
High consumption of sugar and refined
carbohydrates
High consumption of processed foods
Low consumption of protein
Low consumption of fresh fruits and vegetables
High milk consumption
Roche Dietitians LLC 2012
RECOVERY AND NUTRITION
Nutritional deficiencies may also…
Increase cravings of poor dietary choices
Contribute to major withdrawal like symptoms such
as fatigue, depression, irritability, mental
derangement
Possibly block recovery and lead to a relapse
Roche Dietitians LLC 2012
Lets take a closer look at the
following key nutrients:
Carbohydrates
Protein
Fat
Vitamins and Minerals
Roche Dietitians LLC 2012
CARBOHYDRATES
Simple vs. Complex carbohydrates
Many recovering drug and alcohol addicts, like many Americans, consume too many simple carbohydrates and too few complex carbohydrates
Simple carbohydrate: soda, alcohol, pastries
Complex carbohydrates: whole grains, nuts and seeds
• Simple vs.
• Complex Carbs
Roche Dietitians LLC 2012
CARBOHYDRATES AND ADDICTION
Carbohydrates and sugar are highly addictive
Consuming a diet high in simple carbohydrates
may lead to severe malnourishment or
digestive/nutrient absorption problems
Roche Dietitians LLC 2012
WHAT TO DO?
Replace simple carbohydrates with complex carbohydrates
Avoid: cereals (except oatmeal), breads, pies, cakes, spaghetti, soft drinks, caffeine and other ‘junk’ foods with little nutrients
Add: whole grains, nuts and seeds, vegetables
Increase protein in the diet!
Check labels for foods high in sugar
Roche Dietitians LLC 2012
PROTEIN
Protein is needed for growth tissue repair, and a
healthy immune system
The brain and body depend on protein
Protein can be found in:
Meat
Poultry
Eggs
Cheese
Milk
Nuts and Beans
Roche Dietitians LLC 2012
PROTEIN AND ADDICTION
Chemical substances such as alcohol can impair
the digestion of proteins
A deficiency of protein can lead to common
recovery problems such as depression, poor
recall, aggressive behavior, mental confusion,
anxiety and paranoia
When in recovery you need to eat even more protein
than normal!
Roche Dietitians LLC 2012
WHAT TO DO?
Increase protein in the diet by eating at least 3
high protein meals per day
Consume high quality proteins that are low in fat
High quality proteins include: beans, fish, tuna,
chicken, and low fat dairy
Supplement when medically necessary and under
medical supervision
Roche Dietitians LLC 2012
FATS
Fats are important in normal growth and
development as well as energy
Fats are needed to absorb certain vitamins and
maintain healthy cells in the body
Saturated fats vs. Unsaturated fats
It has been found that many recovering addicts
are deficient in Omega 3 and Omega 6 fatty acids
Roche Dietitians LLC 2012
WHAT TO DO?
Decrease the saturated fats
Incorporate Omega 3 and Omega 6 fatty acids on
the diet
Salmon
Tuna
Nuts
Seeds
Consider an Omega 3 fish oil supplement
Roche Dietitians LLC 2012
VITAMINS AND MINERALS
Vitamin and minerals are needed each day for
the body to function properly
Alcohol and drug users are often deficient in
key minerals such as calcium, magnesium, zinc and
iron
AND
Vitamin C and B Vitamins
Roche Dietitians LLC 2012
CALCIUM AND MAGNESIUM
A calcium deficiency is due to a poor diet and
inadequate intake of calcium
Substances such as sugar, caffeine, alcohol and other
drugs can also cause the body to eliminate calcium
Magnesium deficiency is also common among those
that consume high amounts of sugar, caffeine, alcohol
and other drugs
LOW calcium and magnesium levels contribute to
irritability, pain, and muscular/nervous system
disorders that recovering addicts may face during
withdrawal
Roche Dietitians LLC 2012
ZINC
A poor diet and over consumption of sugar,
caffeine, alcohol and drugs can cause the stores of
zinc in the liver to be pulled out
Zinc may have benefits in recovery by adding to a
healthy immune system
Zinc deficiencies may produce symptoms such as
cold extremities, poor circulation, loss of taste
and smell, poor wound healing, lethargy and poor
appetite
Roche Dietitians LLC 2012
IRON
An iron deficiency can cause a disease called
anemia
A recovering addict may be deficient in iron due
to damage caused to the liver where iron is
absorbed
Iron deficiencies may have symptoms such as
fatigue, depression, poor memory and headaches
Roche Dietitians LLC 2012
VITAMIN C
Vitamin C plays an integral role in brain function
The body requires more Vitamin C in times of
stress
Vitamin C can help with withdrawal symptoms
and help rebuild the liver, and immune system
Roche Dietitians LLC 2012
B VITAMINS
B vitamins play a role in metabolism and are required
to break down carbohydrates that fuel the body
There are eight B vitamins Biotin
Folate
Niacin
Pantothenic acid
Riboflavin (B2)
Thiamin (B1)
Pryridoxine (B6)
Folic acid (or cobalamins, B12)
Vitamin B deficiencies have been found to cause
symptoms such as paranoia, hyperactivity, confusion
and depression
Vitamin B deficiencies have also been shown to cause
cravings for addictive substances
Roche Dietitians LLC 2012
FOODS TO CONSUME TO AVOID
VITAMIN/MINERAL DEFICIENCY
Zinc Oysters, gingerroot, round steak, lamb, pecans, peas, shrimp, parsley, and potatoes
Calcium Dairy products, almonds, sunflower seeds, parsley, meat, fish, eggs, whole grains, beans, and vegetables
Magnesium Leafy green vegetables, kelp, peas, molasses, nuts like almonds and cashews, brown rice, whole grains, and seafood
Iron Liver, oysters, leafy greens, red meat, kelp, brewer’s yeast, eggs, and beans
Vitamin C Fresh fruits and vegetables like green peppers, citrus fruits, tomatoes, potatoes, cauliflower, Brussels sprouts, broccoli, and cabbage
B-complex Found in most whole, unprocessed foods such as potatoes, lentils, chili peppers, beans, brewer’s yeast and molasses
Roche Dietitians LLC 2012
WHAT SHOULD I EAT?
To ensure you are eating a diet that includes all
nutrients, eat the following types of foods daily…
Whole Foods
Whole Grains
Fiber
Protein
Fats
Fruits and Vegetables
Roche Dietitians LLC 2012
WHAT FOODS TO AVOID!
Sugar
Processed Foods
White Flour
Caffeine
Roche Dietitians LLC 2012
MEAL PATTERN
Eat 3 main meals per day + 2-3 light snacks
Never go more than 6 hours without eating
(except overnight)
No skipping meals (especially breakfast!)
Roche Dietitians LLC 2012
REMEMBER…
A nutrient packed and healthy diet will give your body the fuel you need during recovery
Following a healthy diet and eating at regular intervals will help alleviate some of the withdrawal symptoms you may be experiencing
A poor diet may make you feel worse and delay your recovery
Listen to your body and make a plan that works for you!
Roche Dietitians LLC 2012
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Week Four
Unplug, De-clutter and Organize
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Un-Plug
We are overwhelmed with an inpute of technology
and information.
We can live with out the information/news
We need to make a conscious effort to give ourself
time away from technology.
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We spend to much time sitting, not moving, and
looking at screens.
A study presented a the British Psychological
Society’s annual Occupational Conference (2012)
found that 70 percent of employees studied did
not meet the recommended guidelines for
physical activity, spending approximately 5 hours
and 41 minutes per day at their desk.
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Prolong sitting can cause many posture
problems, and can contribute to other illness
Hypertension, Heart Disease, and Diabetes
according to Equinox Fitness Training
Institute.
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Move around
Every hour take a break from the screen and
walk around the office, get some fresh air, do
some chair yoga, meditate.
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With screen time there is no People
time
Dinner are by the TV not the table
Checking emails or text during dinner
No real relationship with the person next to you
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Set rules for screen time
Each hour 10 minute break from the computer
Chores, responsibilities, before screen time
(clean up, practice instruments/sports, go to meeting or class)
After a certain time, 8pm, no more
computer/phone/TV
Phone/emails/text is not answered during dinner or other
human activities (teaching/re-teaching etiquette at dinner, movie’s, social engagements)
Only real emergencies are handled after hours
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Nature Deficit Disorder By Richard Louv
2005 Last Child in the Woods
Less time outdoors
Result wide range of behavioral problems
(lack of interest and respect for nature, shorter life span, attention disorders and depression, anxiety, lower grades, obesity)
Louv cause Parental fears
Restricted access to natural areas
Lure of the screen (44 hours a week on average)
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De-Clutter
Clutter
Can become a mental health problem –Hording
Makes you feel anxious and depressed
Often results when there is unhealthy attachment
and unresolved emotional issues.
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De-clutter a little at a time
15min to 1 hour per day
Have a plan
Create a chart
Cross off when done (you will feel that something was accomplished)
Don’t do to much all at once To overwhelming and to stressful
Do one room, section, or cabinet at a time
Finish the project that you start, don’t just move it from place to place
Don’t buy anything to help in the process (containers, boxes, specialty items)
Create sections
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Segregate
Keep- I need, I like, I want
Donate- I will not use or like it, can go to charity
Trash/Recycle – no use for it (old magazines,
broken)
Give away – read books, clothing that does not
fit, duplicates, borrowed items don’t feel bad about either section, that increases stress
Have a mantra while organizing (life will be simpler, I will be able to
find things, I will be less stressed when items are not falling on me out
of the closet)
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Don’t buy or bring stuff into the house
gifts – *Donate
*Return if gift receipt (baby, kids exchange small things for one large that you need)
*Store (in box, with label)
* If you don’t love it, get rid of it (don’t stress over others feelings, that is their issue)
Don’t Buy on impulse Keep a list (on phone, that way always by you)
Things I want
1.
2.
3.
*Ask when you buy what the return policy is. Then bring it back if its not perfect.
*Use the one in two out rule (or similar)
* Resist the urge to buy in bulk or on sale
(only what you need, and what you have space for)
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General Rule
I can only have and keep as much as I have space
prioritize what is important (wedding dress keep
Birthday card recycle)
Do not add or rent additional storage space
Set rules that work for you
One year box – if not used by date
Clothing (not used in a year, or does not fit)
Maybe pile
Vacation principal (I only need what I would take on vacation)
What can I not live with out
Unregister- magazines, yellow pages, etc.
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Organize
Change the way you think
Change the way you act
Keep up the change
De-clutter
Organize
Keep
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Motivation
I want to change, I want to be organized
Management
Keep doing it (shoes, keys, briefcase go in the same
place, everyday)
Monitoring
Small clean up, de-cluttering, organizing daily
Waiting for water to boil, clean up counter
Before going to bed, pick up and put things in place
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Time Management
To be organized, you need to have good time management
Only schedule, do as much as is possible
Do not under or over estimate
(include getting ready time, driving time)
Do a trial run
(morning; practice on Sunday )
Make a list, prioritize, eliminate
(seven invitations for one weekend, can only do three events)
Give yourself options
(I can’t go to all events, send a card, go next time)
Use a calendar
Create a daily plan, write down if necessary, review before
bed and in the morning.
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Urgent/Important Chart
First thing First Covey, Merrill and Merrill, 2003
I II
Urgent and important Important not urgent (most
important)
III IV
Urgent but not important Unimportant and not urgent
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Learn to embrace and enjoy the organization
Disorganization = Chaos= Bad Stress
Replace the time you spend in Chaos with
something
Fun, soothing or relaxing
Take a class, paint, meditate, yoga, go outside, read a book
Don’t apologize for being organized
Don’t make excuses for it
Allow, encourage, enforce others to help
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Week Five
Mental Health, Medication, Meditation
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Mental Health
Mental Health is just as important as physical health
We see mental health as separate
And it gets separate treatment in the health care field
Things are changing; Parity law,
Obama Care
A healthy life style = Good Mental Health
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Anxiety
Symptoms
Persistent worry
feeling:
apprehensive
powerless
impending danger, panic or doom
Sweeting,
Increase heart rate
Hyperventilation
Trembling
Feeling week or tired
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Medication
Consult a physician and or a psychiatrist
See if medications are right for you
Know all your options
Choose from various options
Explore alternatives
Know risks and side effects
See how the medication works for you and with your body.
Don’t try the first day of a new job, on a Monday or the day of a big presentation.
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Meditation
Find time every day
Find a technique that works for you
(cd, book, self talk<mantra>, silent, journaling)
Do it together as a couple or family
Attach to another activity or instead of if the excuse is I don’t have time
-Before bed
-instead of TV in the evening (specially the news)
-while doing outdoor activities; gardening, cooking, walking Flow: The Psychology of Optimal Experience
by Mihaly Csikszentmihalyi
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The Butterflies Starbright
By: Maureen Garth
The air is fresh with a light breeze touching your cheek, and
the sun is beaming down on you. The green grass is like a
soft carpet under your feet, and the huge trees with their
spreading branches are protecting the smaller plants.
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Exercise for Mindfulness
Pulse Game
Count the beats of your pulse for 1 min
Jump up and down, run around, scream, shake for 1
min
Check pulse again for 1 min
Take three long deep breaths
Check pulse again
Book:
10 Mindful Minutes By: Goldie Hawn
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Deep Relaxation
Yoga Nidra Patty Townsent
CD
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Are you a Carrot, and Egg, or a Coffee Bean?
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Week Six
Positive vs. Negative Way to Cope with Stress
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Questioner
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Positive
Live a well balanced life
Take time for self
Relax
Go outside
Eat well and healthy
Exercise
Work, home, life, fun all in moderation
Have fun
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Use positive psychology and the benefits of humor
Laughter
-releases endorphins – fights pain
-Lowers cortisol levels and protects
the immune system
-Activates T-Cells
Laughter can decrease stress, lower blood pressure and decrease muscle tension
(Neuro Endocrine and Stress Hormone Changes During Mirthful Laughter-American Journal of Medical Sciences, 1990, 298: 390-396)
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Give yourself permission to be happy and laugh
Fake it till you make it
Laugh at self
Smiling/Laugher lowers the temperature in the
brain and decreases sadness, anxiety and
depression.
Activates Dopamine
Increase time around happy people, situations,
and exposure
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Negative
Problem/pathological Gambling
Alcohol
Psychoactive drugs
Over use/abuse of medications
Abuse: verbal or physical
Single focus Work
Isolation from others, from fun, from life
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When you feel stressed, anxious or overwhelmed at first gambling, alcohol or drugs take the edge off.
You might loos yourself in the activity, you might really enjoy the activity.
It feels and looks like a social activity, but soon leads to isolation and loneliness
The loos of time and money need to be covered up; leads to lies; leads to stress; leads to anxiety; can become suicidal or abusive.
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All I Really Need to Know I learned in Kindergarten By: Robert Fulghum
Share everything
Play fair
Don’t hit people
Put things back where you found them
Clean up your own mess
Don’t take things that aren’t yours
Say you’re sorry when you hurt somebody
Wash your hands before you eat
Flush
Warm cookies and cold milk are good for you
Live a balanced life – learn some and think some and draw and pain and sing and dance and play and work every day some.
Take a nap every afternoon
When you go out in the world, watch out for traffic, hold hands and stick together.
Be aware of wonder. Remember the little seed in the Styrofoam cup; the roots go down and the plant goes up and nobody really knows how or why, but we are all like that
Goldfish and hamsters and white mice and even the little seed they all die. So do we.
And then remember the Dick and Jane books and the first word you learned the biggest word of all LOOK