1. Dr. Muhd. Najib Mohd. Alwi najib@kck.usm.my

2. 2 What is stress? A certain amount of stress is perfectly normal and in fact – necessary to ensure we are motivated enough and remain focussed to fulfil tasks in hand

3. 3 OVER- STIMULATION ZONE  IRRATIONAL PROBLEM SOLVING  EHXAUSTION  ILLNESS  LOW SELF-ESTEEM OPTIMUM STIMULATION ZONE  CREATIVITY  RATIONAL PROBLEM SOLVING  PROGRESS  CHANGE  SATISFACTION UNDERSTIMULATION ZONE  BOREDOM  FATIGUE  FRUSTRATION  DISSATISFACTION Lifeline Death from Lack of Stress Death from Stress PERFORMANCEPERFORMANCE STRESS

4. 4 However, usually STRESS is meant in the negative way : experiencing of unpleasant or uncomfortable feelings

5. 5 Two components of stress: External component : stressor External component : stressor Situations, tasks, problems, hassles that causes stress Internal component : inner reaction Internal component : inner reaction Different people react differently to the same stressor

6. 6 Another form of stress is “self-inflicted” because of demands put on oneself E.g. “I MUST get A in every exam”

7. 7 Management of Stress Involves: Working with ourselves (internal component) Working with ourselves (internal component) Working with events and demands facing us (external component) Working with events and demands facing us (external component) In most situations, both components of stress need to be worked at to relieve stress

8. 8 Recognizing Stress Human mind has the ability to interpret situations and thus provides an infinite variety of reaction to stress Our responses to stress: Physical Physical Psychological Psychological Behavioural Behavioural

9. 9 Physical Response To Stress Body response to alarm: Body response to alarm: Rapid pulse SweatingPalpitation Tightened stomach Tense arm, leg muscles Shortness of breath Gritted teeth Clenched jaw Inability to sit still Racing thoughts Compelling emotions Prime us to deal with danger, challenge or other real or imagined demands

10. 10 Psychological Responses Stress Inability to concentrate Loss of self-confidence Irritability Insatiable cravings Worry or anxiety Irrational fear or outright panic Difficulty in making simple decisions

11. 11 Behavioural Responses To Stress Excessive smoking Increased use of medication Nervous tics / mannerism Absent-mindednessAccident-proneness Hair-pulling, nail-biting, foot-tapping etc.  /  eating / sleep Drug misuse Reckless driving

12. 12 Stress Management: Basic Requirements A wareness Levels of stress Levels of stress Presence of stress Presence of stress Attributes in character that is stress-related Attributes in character that is stress-related Causes of stress and ways of managing it Causes of stress and ways of managing it S elf-acceptance What you are today is the result of all your life experience What you are today is the result of all your life experience Change is always possible Change is always possible Important changes don’t happen in an instant Important changes don’t happen in an instant Don’t judge yourself harshly Don’t judge yourself harshly Accept what you are and who you are Accept what you are and who you are R esponsibility Change begins with you, it’s your own responsibility Change begins with you, it’s your own responsibility You can instigate the necessary changes You can instigate the necessary changes C oping skills Learn adaptive coping skills Learn adaptive coping skills

13. 13 Strategies 4 basic strategies that you can use to manage stress: Build up general health: proper nutrition, rest, exercise Build up general health: proper nutrition, rest, exercise Change the situation: source of stress Change the situation: source of stress Change your mind: perceptions of and thoughts about the stressors Change your mind: perceptions of and thoughts about the stressors Learn to substitute: relaxation responses for stress responses Learn to substitute: relaxation responses for stress responses

14. 14 Tips on Managing Stress Stressful Situation Analysis 1. What happened? (When, where, who, what, why?) Results were shocking!!! 2. What was your immediate reaction? Panic! 3. What did you say to yourself? This is impossible! I never failed ever in my life!!!!! 4. How did you feel when it was over? FILL HERE ONLY AFTER YOU MANAGED TO RESOLVE THE STRESS

15. 15 Tips on Managing Stress Positive Self-Statements What is it I have to do? What is it I have to do? Don’t worry. Worry won’t help anything. Don’t worry. Worry won’t help anything. I can meet this challenge. I can meet this challenge. Relax; I’m in control. Take a slow, deep breath. That’s it… Relax; I’m in control. Take a slow, deep breath. That’s it…

16. 16 Tips on Managing Stress Proper breathing: Practice abdominal breathing (resting 6 - 10/min) and minimize chest breathing (resting 10 – 16/min) Practice abdominal breathing (resting 6 - 10/min) and minimize chest breathing (resting 10 – 16/min) Learn breathing / relaxation exercise, do it regularly Learn breathing / relaxation exercise, do it regularly

17. 17 Tips on Managing Stress Decreasing Mental Agitation / Worrying Techniques: CLEARING CLEARING THOUGHT-STOPPING THOUGHT-STOPPING CREATIVE WORRYING CREATIVE WORRYING PROBLEM SOLVING PROBLEM SOLVING

18. 18 Tips on Managing Stress CLEARING: Ensures completion of encountered tasks OR develop a plan for incomplete tasks STEPS: Making a list : daily listing of events Making a list : daily listing of eventslist Ongoing practice : leave the completed tasks, clear mind daily / weekly Ongoing practice : leave the completed tasks, clear mind daily / weekly Maintenance of clearing Maintenance of clearing

19. 19 CLEARING WORK SHEET PROBLEM, THOUGHT, POSITIVE EVENT C(Complete)I(Incomplete)PLAN 1. Seminar presentation next week  1.Group discussion ASAP 2.To complete by Sunday 2. Buy toiletries from Aini’s  3. Need to practise MCQ  1.Learn MCQ technique 2.Look for answers and learn 4. Telephone Y  Restrict to once a week ONLY! 5. Received praise from Dr. N for active participation in SGD 

20. 20 Tips on Managing Stress THOUGHT-STOPPING: We are continuously bugged by noise – externally and internally. Some people have too much internal noise (worries, doubts etc.) We are continuously bugged by noise – externally and internally. Some people have too much internal noise (worries, doubts etc.) Thought-stopping can slow down the internal conversation you carry with yourself. Thought-stopping can slow down the internal conversation you carry with yourself. Cycle: Cycle: NEGATIVE THOUGHT  say, visualise STOP!  inhale, exhale and say CALM  think of a PLEASANT THOUGHT This exercise may have to be repeated several times until the negative thoughts disappeared

21. 21 Tips on Managing Stress CREATIVE WORRYING: There are two kinds of worrying: useless worrying and constructive thinking / problem solving (effective worrying) There are two kinds of worrying: useless worrying and constructive thinking / problem solving (effective worrying)

22. 22 Tips on Managing Stress CREATIVE WORRYING: Spend about 30 minutes a day, create a WORRY LIST (5 minutes). Spend about 30 minutes a day, create a WORRY LIST (5 minutes). WORRY LIST WORRY LIST Look at minor worries first, omit those that can be dismissed by direct action. These are concerns not worries. 10 minutes: spend on useless worrying 2 minutes of physical relaxation and breathing exercise 15 minutes: problem solving Stop on time, continue another day if necessary

23. 23 WORRY LIST MAJOR WORRIES MINOR WORRIES 1. Will I survive in the Medical / Dental School??? 1. Library books expired 2. My study technique is wrong 2. Toothpaste finishing 3. Sister is sick at home 3. Need to return book borrowed from Nina 4.4. 5.5.

24. 24 Basic Problem Solving Steps: 1. Relax: single-breath relaxation, say “I am calm” 2. Define the problem 3. Generate alternative solutions 4. Evaluate the alternatives 5. Implement the solutions

25. 25 Additional Skills Goal-Setting Define goals Define goals Visualisation (with relaxation) Visualisation (with relaxation) Planning life goals Planning life goals Time Management Prepare a time budget Prepare a time budget Review time log Review time log Review goals and priorities Review goals and priorities

26. 26 When to Seek Help When everything else doesn’t work It’s never too early to ask for help Look around you, help your friends too

27. 27 Conclusion Stress management is important in our day to day activity It is easy to learn BUT perseverance is difficult Practice makes perfect Don’t be shy to ask for help

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