ACT as part of a Comprehensive Stress Management Program Dr. Richard Blonna Professor, William Paterson University

What is Stress? Stress means different things to different people. What stresses some people challenges others . Four classic ways to define stress (stimulus, response, transaction, holistic phenomenon).

Stress is a Stimulus Stress is something in the external environment. Stress is defined by the stimuli that one is exposed to (stress is bills, work, taxes etc.) Some stimuli are defined as “life events” (Holmes & Rahe)

Stress is a Response Stress is something in the internal environment. Stress is defined as “the non-specific response of the body to any demand” (Hans Selye). The non-specific response include symptoms such as increased muscle tension, breathing rate, hormonal release, metabolic rate etc.

Stress as a Transaction Stress as a transaction between a stimulus and a response (Lazarus & Folkman, 1987). The transaction is mediated by an appraisal process. The stress response is triggered by appraising the stimulus as something one is threatened by and unable to cope with.

Stress as a Holistic Phenomenon Stress is a response that that occurs when the dimensions of one’s health (physical, social, spiritual, emotional, intellectual, occupational and environmental) are out of balance. Lack of balance causes one’s body to make adjustments in order to maintain homeostasis in the face of imbalance.

All of these Definitions are Partially Correct In actuality, stress is all of these things (stimulus, response, transaction, holistic phenomenon) combined. Each of the classic ways of defining stress accounts for a piece of the puzzle.

A New Way of Defining Stress “Stress is a holistic transaction between an individual and a potential stressor resulting in a stress response (Blonna, 2006).” Blonna’s definition draws from the four classic definitions to paint a new picture of stress.

Holistic Transaction A holistic transaction takes into account the effects of one’s overall level of wellness in the appraisal process at the time of exposure to the potential stressor. It involves the individual, the potential stressor, and the context (space & time) in which exposure occurs. It also involves the individual’s history of coping with similar potential stressors in the past.

Potential Stressor Appraisal During this transaction, the answers to two questions about the potential stressor determine whether or not it becomes an actual stressor capable of triggering a stress response The two questions are: - Is it a threat? - Can I cope?

Stress Response If one feels threatened and unable to cope, the brain sends chemical (hormonal) and electrical (nerve transmissions) messages throughout the body triggering the stress response. The response mimics the one described by Selye and is designed to mobilize energy to fight or flee.

Selye’s General Adaptation Syndrome (GAS) General, because it is the non-specific response of the body to any demand Adaptive, because it is the body’s way of maintaining homeostasis in the face of threat Syndrome, because the response involves multiple body systems that work together the same way every time the body is stressed.

Three Stages of GAS GAS is a three-phase, time-sequenced response Alarm – mobilizes energy to fight or flee Resistance- maintains homeostasis in the face of threat Exhaustion – breakdown of weak links

Blonna’s Five R’s of Coping Model Because stress is a complex, multifaceted phenomenon, a systematic plan for managing stress must also be multidimensional. Simple, band-aid approaches to stress management will fail over time because potential stressors, individuals, coping abilities, and the contexts in which stress transactions occur will change over time.

The Five R’s of Coping Rethink, Reorganize, Relax, Release, and Reduce. Each R describes a different level of coping skills. Although the five R’s can be used independently to cope with stress, a “synergistic” effect occurs when they are combined into a comprehensive stress management plan.

The Five R’s of Coping Model

Rethink Rethink helps clients examine their thoughts and self-talk about the big picture (values, goals) and the little picture (individual stressors). Rethink defuses stressors by helping clients be more mindful of them and view them differently (acknowledge, accept, be willing to act). Rethink strategies include Western (ACT) and Eastern (Morita) therapeutic techniques.

Reorganize Reorganize focuses on creating healthy, more stress-resistant lifestyles based on what clients value. Helping clients learn hardy health habits that provide the energy and resilience needed to cope with stress in a changing world. Helping clients improve all of the dimensions of their health.

Relax Relax is based on reciprocal inhibition; one can’t be relaxed and stressed at the same time. Relax teaches clients how to offset the stress response by initiating a relaxation response. Relax teaches clients proven techniques such as mindful meditation, visualization, systematic muscle relaxation, etc.

Release Release revolves around using healthy behaviors to get rid of the muscle tension and energy produced from the stress response. Release teaches clients how to use physical activity, exercise, and orgasm to get rid of the by-products of stress in healthy ways instead of relying on alcohol, tobacco, or other drugs

Reduce Reduce revolves around finding one’s optimal level of demand and stimulation. Reduce teaches clients how to maximize their potential by challenging themselves without creating harmful stress. Reduce helps clients understand how their optimal level of demand changes over time and teaches them how to adapt to change in healthy ways.

The Inverted, U-shaped Stress Curve

Seven Weeks to Conquering Your Stress Blonna’s (2006) unique seven week format for learning the Five R’s and developing a personal stress management plan incorporates: Book & Relaxation CD In-Person and At-A-Distance Sessions Original program did not include ACT

Incorporating ACT into The Five R’s Model Many of the specific strategies associated with ACT (mindfulness, acceptance, values clarification etc.) have been part of the Five R’s approach since the first model (1995). What was missing however was tying the pieces together in a meaningful way with a proven, theoretical framework. ACT and RFT provide such a framework.

Incorporating ACT into The Five R’s Model: Rethink Mindfulness, acceptance, and willingness are key aspects of Rethink and are central to acquiring new skills related to all of the other R’s. ACT will supplant REBT as the primary way to Rethink stressors. training is a key part of Rethink and Relax. Defusion training will

Incorporating ACT into The Five R’s Model: Reorganize Values Clarification is a key component in Reorganize and in the other R’s. Goal Setting and willingness to take valued action are central to all of the other R’s. Taking valued action despite painful thoughts and emotions is central to Rethink.

Incorporating ACT into The Five R’s Model: Rethink

Values Clarification A key aspect of the Five R’s approach has always been understanding the relationship between values and stress. The new Five R’s approach integrates ACT-specific values calrification tools (Polk’s Life Manual etc.) with those already being used (Krech’s DLCs etc.).

Willingness & Goal Setting Goal setting has always been a part of the Five R’s approach. The new Five R’s approach demonstrates how willingness is measured by taking valued action. Clients learn how to use short and long –term goal setting to put their values into action

Taking Valued Action Despite Painful Thoughts and Emotions The Five R’s approach has always used Morita Therapy (Japanese Psychotherapy) to teach this. The new Five R’s approach combines ACT metaphors and activities with Morita therapy to enhance this aspect of treatment. Clients benefit from a multicultural approach that reinforces the importance of coexisting with painful thoughts and emotions.

Mindfulness Training Mindfulness training has always been a big part of the Five R’s approach to stress management. The new Five R’s approach uses mindfulness in two additional ways; Integrates mindfulness into taking valued action. Integrates mindfulness into defusion.

Defusion Training The original Five R’s approach relied on REBT and Morita Therapy to Rethink stressful thoughts and emotions. The new Five R’s approach will use Defusion in consort with Morita Therapy to Rethink stressful thoughts and emotions. Instead of spending time trying to change illogical thought patterns, clients will learn how to acknowledge accept, and co-exist with them while taking valued action.