1. Play music as participants enter the room.
Session #4

2. Review Take-Home Assignment:
Would anyone be willing to share theirs and how this went for them?
What did you learn?
What opportunities did you discover as a result of this?

3. Appreciation Appreciation: A strategy for resiliency.
One strategy for coping with stress is using appreciation. The idea of appreciation is something we have not mentioned yet, but it is closely related to one of the major topics of this program: awareness.
We need to practice noticing and appreciating our good fortune. The ordinary good fortune in our life make it hard to catch. We tend to take for granted the simplest yet most important things in our world. Using appreciation strategies gives us a new perspective. When we take the time to appreciate something, we focus on something positive, making our brain less able to focus on the negative. Appreciation helps us cope and deal with stress, worry, challenging situations, sadness and other distressing thoughts and emotions. It elevates our mood and helps us gain a more positive outlook on life. It even helps prevent depression.
Think of appreciation as taking a vitamin — it helps prevent negative thoughts and emotions, but it takes practice to learn to do it regularly. It gives us energy and better health overall. Appreciation, or being grateful, is also a strategy that helps keep us living in the moment. For example, taking time to appreciate those we love and those things we are able to do.
Appreciating things in life through our five senses — sight, hearing, smell, taste and touch — brings us into the moment as well. For example, appreciating the beauty of nature, sounds such as laughter or music, sensations such as a warm breeze, as well as the smell and tastes of good food.
Taking time out to appreciate things in life is another part of taking care of yourself. This is yet another strategy you can use in your daily life to deal with stress, and it takes no time at all. Take in moments with all five senses. It will help you capture a memory. You can keep a journal, a list, a jar with notes of the best moments you experience.

4. “Overriding Hurt” Story
Read story from Happiness & Health titled “Overriding Hurt,” and also the debriefing paragraph (Pages )

5. Thoughts That Stress Us Out
Thoughts = facts
Unrealistic expectations
Overthinking /
Sometimes our thoughts make things worse than they actually are. Thoughts are mental events; they are not always reality. Thoughts can feel like they have a “mind of their own.” Once triggered, they can set off other thoughts, and so on.
Although thoughts exist in our heads, they can be very powerful and affect how we feel and what we do. We must put our thoughts on trial and challenge their accuracy.

6. Thoughts That Stress Us Out
Thoughts are not equal to FACTS
Being aware of our thoughts as something separate from what is actually happening can help us deal with them and the tough situations that are creating the thoughts. Learning how to get some distance from our thoughts helps us to view our thoughts only as opening the door to gaining a new perspective on things.
This can help in freeing us from our old thought patterns that automatically come to mind. Times when we think of thoughts as reality, we assume others think poorly of us, when we assume we know something will turn out badly (or not the way we hope for), and/or making up mental scenarios of negative situations that could result.
Provide an example (see below or use your own example): I have a thought pattern that gets out of control. Every time I drive in bad weather, my fatalistic thoughts get out of control. I think of all the bad things that could happen. This makes me nervous, which makes me more likely to get in an accident. It is important to recognize that these are just thoughts and not reality, before they sink in and become who we are.

7. The Cognitive Model Situation/ Circumstance Automatic Thoughts
Intermediate
Beliefs
Core Beliefs/
Schemas
Reactions
Our Automatic Thoughts are not always accurate. They are reactions to our emotional, behavioral and physiological responses.
Emotional
Behavioral
Physiological
Adapted from Beck, J.S. (2011). Cognitive therapy: Basics and beyond (2nd ed.). New York, NY: Guilford Press.

8. Thoughts That Stress Us Out
Unrealistic expectations
An unrealistic expectation thought pattern is common in situations when you are being a perfectionist, holding extremely high expectations of yourself or when you’ve taken on too much and can’t do it all. For example, statements such as “I have to…,” “I must…” or “I should…”are common.
Thoughts can be filled with criticism and judgment toward oneself and others. The resulting emotions often include guilt, worry, fear and frustration. This thought pattern is often associated with constant doing, because relaxation does not feel deserved.
With this thought pattern, it is common to push yourself harder despite signs telling you to stop pushing and do something different.
Provide examples and request additional examples from participants (for example, striving to get straight As, working long hours trying to be the best employee, attempting to keep the house looking perfect, etc…)

9. Thoughts That Stress Us Out Overthinking
Another thought pattern that can make a stressful situation more stressful is over-thinking, or ruminating, about the situation.
Over-thinking is endlessly, needlessly and excessively pondering the meaning, causes, and/or consequences of a situation. It is obsessing about the whys, hows, and “what ifs” about problems.
Often when we feel down, we think that analyzing the situation will be helpful. This is helpful to some for a short time, when using the time to solve a problem, find meaning and/or learn from the situation. But after a point, it becomes harmful.
Over-thinking can drag out negative emotions and actually make it more difficult to solve a problem and concentrate. Most importantly, people who ruminate often believe they are gaining insight on their situation when in reality they are developing a more biased, negative perspective.

10. Breaking Free From Thoughts That Stress You Out
How do we break free from thoughts that stress us out?
The bottom line is that all of these unhealthy thought patterns end up bringing more stress into our lives and bring on more negative emotions. Finding ways that enable you to disengage from these different types of thought patterns will help you lessen your stress levels and bring you peace.
I will provide some examples, but you’ll have to try things out and figure out what works best for you. First, sometimes we are not aware we are having these thoughts patterns I have described. One way to deal with negative thoughts is to become aware of them, which allows you to get a different perspective on them.
Then, notice how these thoughts affect your feelings, body sensations and how you act. You can use this awareness to take your thoughts in another direction. Awareness leads to the opportunity to make a choice in how we respond.
Second, doing things that engage your mind, such as the things you listed on your “Joy List” in session three, can help break the cycle of over-thinking and negative thoughts. Or, do something that is mentally challenging, even as simple as reading a good book. Choose mind activities that are engaging, not mind numbing (such as, TV, alcohol).

11. Thought Patterns Choose one of your negative thought patterns:
How does it make you feel?
Ways to change your negative thought patterns?
Refer participants to the handout, “Breaking Free from Stressful Thoughts.” Summarize handout for participants.
Activity: Have participants get into groups of two or three. Ask them to share the following with each other for the next five minutes:
What are common negative thoughts you may have? How do these thoughts make you feel and act? 
Using your handout, talk to each other about ways you could break free from these thoughts in the future.
Allow five minutes for them to talk.

12. We can always
have HOPE!
Hope is another strategy for coping with stress or problems that are out of our control. Hope is NOT about simply being optimistic about the future. It is about being realistic, but open to a pleasant surprise. Sometimes we are in situations where we don’t have options, or we FEEL that we have no options, such as the death of a loved one or being diagnosed with a chronic illness.
Being hopeful means that you are open to the possibility that a brighter future lies ahead — that you are open to the surprise of life when everything turns out better than we thought it could. In other words, when a situation seems hopeless, there is always room for surprise. Being open to this allows for a hopeful reality. As a self-fulfilling prophecy, this hopeful reality may just come true.
We may not have control over the situation, but we have control over our response. Choosing to be hopeful is one response that will help you deal better with it. No matter how dire the situation, we can always be hopeful about something. Hope is a powerful tool to get through tough situations.
We need hope to be able to cope when we feel trapped or out of options. Hope allows for inner peace and opens up the possibility for options and control over our happiness.
This class is all about helping you to explore new ways to see things and to think about things that can give you hope for the future. Hope is the feeling that gives us the strength to persevere.

13. Breathe One-minute breathing Activity: One-moment breathing
Throughout this program, we have worked on using the breath as a way to bring us back into the present and bring about a sense of calmness and peace. We started with one minute and we have been working down from there.
Explain:
Last week we dropped it down to just a three-breath cycle. I hope some of you found the time to fit this into your days over this past week.
This week we are going one step further— to a one-breath cycle. This makes it usable in ANY situation to calm you, bring you back into the moment, or to treasure the moment.
The one-breath cycle is short, but can be extremely valuable. Never try to do it quickly. Make sure to exhale completely.
OK, let’s give it a try. Find a comfortable position in your chair and gently close your eyes. When you are ready proceed with full awareness, take one full inhale and exhale slowly. Allow time for participants to do this.
If you find you are not getting as much out of the one-breath cycle as you were the three-breath cycle or the one-minute cycle, add breaths to it. You may want go back to the one-minute breath if you feel you need it.
Even though the one-breath cycle is short, it requires your full attention to be effective.

14. “An attitude of gratitude” or “Gratitude is the best attitude”
Activity: An Attitude of Gratitude
Give participants the handout, “An Attitude of Gratitude”
Let’s take the next few minutes to reflect on those things in your life that you appreciate, and write them down on this handout. It can be simple things that make you happy, like a warm breeze, a good cup of coffee, or something bigger, like your family or a close friend that always makes you laugh. Don’t forget the little daily things like something a family member does for you or that your car started today. Whatever it is you appreciate in your life, take time to write it down on the handout.

15. Break
Play music
Play music

16. “Iceberg” of Health
This program has provided strategies for you to take better care of yourself, particularly in the lower layers of the iceberg. Summary of the Iceberg of Health: This iceberg model shows how every aspect is connected.
It is difficult to change a lifestyle behavior without first digging deeper to find out what is causing you to struggle in adopting a healthier behavior or what is drawing you to a less healthy lifestyle. The goal of this program has been to help you learn how to take better care of yourself to lead a healthier life.

17. Dimensions of Wellness Wheel
Taking care of all of these dimensions leads to a healthier you and helps you manage your stress. Being aware of the different aspects of your health and identifying areas where you excel and areas where you need to improve, lead to a healthier, more balanced life.
Refer to the “Dimensions of Wellness” handout and review a few examples of how to support each dimension.

18. Triangle of Awareness
Becoming more aware of the sensations or messages our bodies are sending us (which we often ignore, or are too busy to notice) helps us become more aware of how stress affects us.
Paying attention to these body sensations or messages can help bring awareness to our thoughts and emotions. As a result, this awareness brings us back into the moment and allows us to choose our response instead of reacting without thought. Sometimes, all it takes is one deep breath to bring us back to the moment.
Let’s do a one-breath cycle now. This time let’s try it with our eyes open. Remember to do it slowly and with full awareness. OK, go ahead.
Allow time for participants to do this.

19. Mindfulness “Paying attention/being aware in a particular way”
On purpose
In the present moment
Nonjudgmentaly
- Jon Kabat-Zinn
Benefits of Mindfulness: Mindfulness is simply bringing your awareness to the present moment and accepting whatever is happening in that moment. That is, accepting the situation even if you do not like what is happening.
Refer participants to handout, “Responding vs. Reacting.”
Mindful awareness can bring more peace to our lives by freeing us from our “monkey mind,” or constantly thinking about the past, future or what we need to do.
Also, mindful awareness allows us the opportunity to appreciate things in life. Most of all, it allows us to “take it all in,” or live life to the fullest. What are some strategies you can use to help bring you back to the moment, or bring more awareness to your life?
Refer participant to the “Living in the Moment” handout for more examples.

20. Recasting Find your feelings: - Sadness, fear, anger, joy
Find meaning in our feelings
Recognize opportunities
Recasting: Dealing with things in life you can’t change
Sometimes life throws you issues that you can’t change. Remember this strategy as one way to help you work through the situation and use the situation to your advantage. First, take time to really feel your feelings. Try to identify them.
Remember the four basic feelings: sadness, fear, anger and joy. When you are ready, search for meaning in your feelings and ask yourself the following questions.

21. Find Meaning
What are the causes of the problem? – What was out of my control, and
what was in my control?
2. What could I have done differently?
3. What are my feelings or instincts
telling me?
4. What can I learn from this?
Review the four questions. Finally, look for opportunities as a result of the situation, based on what you’ve learned.

22. “An attitude of gratitude” or “Gratitude is the best attitude”
Discuss using appreciation.
Take a moment every day to notice what you really appreciate in your life. Is it the blue sky, a friend or family member, the taste of food, etc.? Appreciation can be powerful in improving your mood and changing your outlook on life.
You need appreciation the most when things in life are not going your way.

23. Freeing Yourself From Time Stress
1. Time is a product of thought
2. Live more in the present moment
3. Take time each day to just be
4. Simplify your life
Just a little bit of non-doing can go a long way in bringing awareness to your life. It can be as simple as a few minutes of paying attention to your breath before going to sleep, or doing a short body scan when you wake up.
We can create stress for ourselves by not doing the things we value. Take a look at your life to see if you are spending your time, energy and resources on what is really important to you.

24. What I Value in My Life… Life is too short to...
Life is too short not to...
Remember your list of things you value in your life. Could you stop doing some of the things you don’t value and start doing more of the things you do value?

25. Freeing Yourself From Time Stress
Simplify your life
Don’t forget about the “Ways to Simplify Your Life” lists you made. Try to simplify your life by eliminating things that are not important to you.

26. All Is Well…