1. 1 Stress Check-Up Group Appointment Hidden Stresses and Your Health

2. 2 A Baffling Illness

3. 3 Stress-Related Illness Illness caused by past or present mental or social stress.

4. 4 Cause of Presenting Symptoms

5. 5 A Wide Range of Symptoms

6. 6 Women Undergoing Laparoscopy

7. 7 Costly and Frustrating  No definitive tests  Unhelpful referrals to specialists  Misleading test results  Serious illness is ruled out but the person remains ill

8. 8 Symptoms Relieved after Nine Months of Normal Tests

9. 9 A note from the Referring Physician “Thank you for helping her. It is reassuring to know that I didn’t miss anything important.”

10. The Symptoms are Real They are NOT:  Due to Mental Illness or Mental Weakness  Imaginary or Delusional  An attempt to Deceive or Fake an Illness  Self-Inflicted 10

11. 11 Stress Symptoms The Same Process that produces a knot in your stomach when you feel tense or a blush when you are embarrassed.

12. 12 Two Simple Concepts Stress Causes Real Symptoms Effective Treatment is Available Stress Causes Real Symptoms Effective Treatment is Available

13. 13 Stress Check-Up Part I The Timing of the Symptoms

14. 14 Stress Check-Up Part II Stress in your life right now.

15. 15 Stress Check-Up Part II - a Insufficient Personal Time

16. 16 Stress Check-Up Part III Childhood Stress

17. 17 Adverse Childhood Experience Study Seven Factors Measured (n=18,000) Abuse: 1. Physical 2. Sexual 3. Psychological Household Occurrences: 4. Substance Abuse 5. Mental Illness 6. Domestic Violence 7. Householder Imprisoned

18. 18 4+ ACEs vs Zero ACEs Odds Ratios IV Drug Use 11.0 Suicide Attempt 9.5 Alcohol Abuse 5.3 Domestic Violence 5.0 Multiple Body Symptoms 2.7 Emphysema 2.4 Obesity 1.8

19. 19 Childhood Stress. Low Self-Esteem Caused By:  Physical or sexual abuse  Parental drug abuse  Neglect  Adult responsibilities  Witnessing violence  Lack of approval

20. 20 Childhood Stress: Negative Outcomes  Bad Partners  Addictions  Quick Temper  Eating Disorders  Mental Health Problems  Self-mutilation  Self-sacrifice  Inability to feel emotions

21. 21 Childhood Stress: Positive Outcomes  Reliable  Detail-Oriented  Compassionate  Hard-Working

22. 22 Childhood Stress Recovery: I Deserve Better  I Deserve more respect & support  To get as much as I give  “I am a great person who was born in a bad place.”

23. 23 Childhood Stress Recovery: Rage Often unexpressed due to:  Anger is unpleasant  Many years learning to suppress emotion  Hope for reconciliation