Managing Stress at University

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Managing Stress at University

Self-Reflective Questions 1. What situations are the most stressful for me as a student? 2. How does stress affect me (physically, psychologically, etc.)? 3. What do I do to cope with stress? Which coping mechanisms are the most/least effective for me? 4. What other strategies and techniques would I like to try?

What is Stress?
A stressful situation has little to do with your emotional response. It is your appraisal of the situation and how you interpret your own bodys response that creates your anxiety. In other words, it is your thoughts about a situation which is the critical factor in evaluating whether you feel stressed.

Common Stressors Affecting Students

Lack of time Availability of resources Finances Unclear expectations e.g. assignments, how to study for tests For international students: language, homesickness, adjustment stress, loneliness and isolation, lack of social support

Common reactions to high levels of stress may include:

Distractibility, loss of focus and concentration Irritability Tension in the body and/or somatic illnesses Avoidance/procrastination Exhaustion, lethargy Loss of self-confidence, self-esteem Sadness, low mood

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Multiple Life Stressors

Research has shown that stressful life events can lead to serious mental health issues such as depression1. Students can be at risk as their lives are very complicated and pressured. Be aware of your stressors and how they are impacting you. Attend to your stressors when you feel that your mood is being adversely affected. For international students, life stress is an important factor in cultural adjustment that is moderately related to the development of mental illness2. If adjusting to Queens and Canadian society is causing you emotional hardship, consider consulting the cross-cultural counsellor at Queens Counselling Service or at Queens University International Centre.

Overview of Module Content

I. II. III. IV. V. VI. Self-Awareness The Stress Response A Model of Stress Reduction Body Relaxation Strategies Mind Relaxation Strategies Mindfulness Based Stress Reduction

We have included additional information and hands-on tools in a TOOLS section at the end of the module. Each TOOL is designated with the icon

See Brown, G. W., Bifulco, A., & Harris, T. O. (1987). Life event, vulnerability, and onset of depression: Some refinements. British Journal of Psychiatry, 150, 30-42. Bulmash, E. L. (2007). Personality, stressful life events, and treatment response in major depression. Masters Thesis. Queens University, Kingston, Ontario, Canada. 2 Yang, B. & Clum, G.S. (1994). Life stress, social support, and problem-solving skills predictive of depressive symptoms, hopelessness, and suicide ideation in an Asian student population: A test of a model. Suicide & LifeThreathening Behaviour, 24(2). 127. Learning Strategies Development, Queens University [Link]/learningstrategies

I. SELF- AWARENESS
Self-Reflection Questions How stressed do I feel right now? How does stress manifest in my body? I am dealing well with my life stress? Why/ why not? What coping mechanisms do I have/ use to manage stressful situations?

The first step to managing your stress is to understand what part it plays in your life.

How stressed am I? Take a Stress Test. Heres one from the Canadian Mental Health Association (CMHA). [Link] For further information from CMHA see: [Link] My Stress Symptoms Over the next few days, observe your bodys physical reaction to stress. Notice subtle signals you might have overlooked before. Ask friends or family what they notice when youre stressed: do they notice signs you havent?

Self-Care Checklist Taking care of oneself is fundamental to a happy, healthy, low stress life. Assess your level of self-care using the TOOL below.

How well am I taking care of myself?

Tension Diary Become aware of what increases your stress and any strategies you use to help decrease your stress. Monitor your stress by using the Tension Diary in the TOOL section.

Tension Diary

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II. The Stress Response: How Our Body Responses to Stress

After thousands of years of human evolution, our bodies still respond to stress in the same way as our ancestors. During the stress response, also known as the fight or flight response, your nervous system is turned on (see symptoms in Figure 1 below) releasing stress hormones and preparing for battle or escape. Meanwhile your immune and digestive systems and your cognitive processes slow down. Conversely, during the relaxation response your nervous system slows down so you are able to think more clearly and creatively. Your immune and digestive systems function better. Although we still need both responses for human survival, the historical value of the stress response (e.g. when the tiger is at your cave door, you either run or slug it over the head with your club) no longer applies. Our modern stressors--academic, workplace, and relationships--do not allow us to release tension through physical action and the stress builds up. With prolonged exposure to stress hormones, it is the stress response itself that causes damage to the body. The good news is that the stress response and the relaxation response are opposite and mutually exclusive. That means if you induce the relaxation response, your stress response will be shut off.
Figure 1: How Stress & Relaxation Affect Us

Prolonged Stress is BAD NEWS! More susceptible to illnesses Irritability Exhaustion and burn-out Can lead to depressed mood
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III. A Model of Stress Reduction: Taking on the Creator Role

Figure 2 below describes two differences responses to the same stimulus: one negative (The Victim), the other positive (The Creator). The former response may increase stress while the latter response may reduce stress. Because the Creator chooses a problem-solving, action based solution, he/she feels more in control and, therefore, less stressed.
Figure 2: Adopting the Creator Role of Stress Reduction

Creators Believe they create everything in their lives Accept responsibility for creating ones own results Responsibility = making choice Make choices to influence the outcomes of their lives Figure 3 demonstrates how someone who takes on a Creator role reduces stress. Firstly, he/she asks whether this problem can be solved or not. If yes, the Creator gets on with the business of working through the problem. Engaging the mind in solving the problem overshadows the worries and fear which, in turn, helps the mind relax. However, even during problem-solving there might be some residual stress that needs attention and this is where having good stress management strategies can help. If you have little or no control over the stress-provoking
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situation, a Creator accepts the way things are at present while continuing to use stress management techniques and positive thinking.
Figure 3: Can I do something about the stress-provoking situation?

Problem-Solving: What do I need to do to change this situation? Acceptance: How can I learn to accept that some things cannot be changed now or maybe ever? Stress Reduction: What techniques and strategies can I use to reduce and cope with stress? Adaptation: What positive attitudes and behaviours do I need to prepare for future events?

STRESS & ANXIETY MANAGEMENT STRATEGIES

For the greatest de-stressing effect, relax both your body and your mind!

10 Ways to Relax

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IV. Ways to Relax the Body

Deep Breathing Deep breathing is one of the best techniques for relieving stress. When youre under stress, your muscles tense and your breathing gets shallow and rapid as you breathe higher in the chest. You can stop this stress response by breathing deeply and slowly from the diaphragm or abdomen. It sounds simple and IT IS! Follow the steps in this TOOL: Take a Deep Breath and Relax! Progressive Muscle Relaxation Progressive muscle relaxation (PMR) increases your awareness of body tension versus relaxation and is a tool to induce a relaxed state. During PMR you tense then relax targeted muscle groups. The tensing and relaxing over 3-5 repetitions slowly forces the muscles into a state of relaxation. Imagine gently pulling a fresh elastic band until its taut and then releasing it. It starts out very stiff and hard to pull; however, after several stretches the elastic becomes more pliable and elongates. This is what happens when you employ PMR to your tense muscles. Progressive Muscle Relaxation - Script Stretching Graduate students tend to sit a great deal during the day, reading and writing. Muscles, especially the neck, shoulders, and lower back can take a beating. Combine stress with this sedentary picture and you have a recipe for muscle tension. Its good to take many mini power breaks of 510 minutes throughout the day to stretch out. In the TOOL below we have included some easy stretching exercises, many of which you can do in your office, lab, or library. Yoga is also an excellent way to learn how to combine stretching (postures or asanas) with breathing for full body relaxation. Yoga classes are offered at Queens University, the YMCA of Kingston, and at many private yoga studios throughout the city.

Do-anywhere Stretching Exercises For more exercises to do at work see [Link] Visualization Close your eyes and visualize a serene, comforting place e.g. a beach, a forest. Use all your senses to savour this place: what do you see, smell, hear, taste, and feel? For a prepared visualization, see the script in the TOOL below. Prepared scripts are fine, but its more powerful to use your own imagery which has meaning to you.

Visualization: Springtime in the Forest

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Guilt-Free Play Little kids know how to relaxthey play. Adults who take time for guilt-free play on a regular basis are happier, more energetic, have better interpersonal relationships, etc. Workaholics, on the other hand, can suffer from burn-out, become resentful, and have less time to nurture friendships and family ties. Grad students can sometimes get into a workaholic rut, especially when large deadlines loom. At these times more than ever, you need to schedule play into your week. Play helps you clear your head and allows ideas to percolate in the background which is important when you are working on complex, complicated projects. Play leads to higher levels of quality and creative work. So, get out there and PLAY today!
Suggested Resource: Neil Fiores 2007 edition of The NOW Habit: A strategic program for overcoming procrastination and enjoying guilt-free play.

Music Music can relax and heal, particularly serene, soothing music. Consider buying a relaxation CD available at most music stores. Laugh Laughing releases endorphins, the feel good hormones. So watch a funny movie, share a joke, or join a Laughing Group (yes, they exist in most big cities in Canada). By changing a frown into a smile, even when you dont feel like it, can improve your mood. Eye Movements to Reduce Stress In his bestseller book Mega Memory, Kevin Trudeau describes an eye movement technique to help reduce stress. Try it! Using Eye Movements to Reduce Stress & Improve Recall Get a good nights sleep What if Im wound up just before bedtime? Take a warm bath. Count sheep! Slow, repetitive cycles of counting can calm your mind and body. Drink warm milk or calming teas (milk contains an enzyme that makes you sleepy). Read a book for pleasure. Stop studying at least one hour before bedtime. Turn off electronic equipment a couple hours before bedtime. The electro-magnetic waves from computers, etc. stimulate your brain, not help it relax. Do gentle stretches, breathing, and/or meditation. Have a light, low-fat snack. Avoid caffeine, alcohol, cigarettes. Develop a regular sleep-wake routine so your body anticipates your cycle.

12 Rules for Better Sleep Hygiene

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V. Ways to Relax the Mind

1. Reframing Negative Thoughts
Self Talk We all have a voice in our head that talks to us. This self-talk includes the internal dialogues or silent conversations that go on within our minds most of the time and can be either positive, negative, or neutral. These dialogues often create self-fulfilling prophesies. For example, if you tell yourself you are relaxed and happy, we will start to feel better. In turn, if you continuously tell yourself you are stressed out, you will feel frazzled. In other words, we create our own stress! Some people dont like to face this truth; they prefer to blame their feelings on the external world (e.g. my boss/spouse/kid/etc makes me feelmy job is so awful/ boring/ unfulfilling etc.).

How Self Talk Affects Stress Identifying Your Stress-Inducing Self Talk Reframing The good news is that we can reframe negative thoughts into more positive, helpful ones. For most of us, our minds wont readily accept a new, positive thought, especially if the existing negative thought is well entrenched. So we need to design meaningful thoughts and practice them regularly until the new thought becomes the norm. Here are a few suggestions to guide you: a) Affirmations/Mantras Create a positive affirmation or mantra of the new thought, post it somewhere very visible, and repeat it many times until your mind starts to buy into the reframed thought. For example, imagine youve been telling yourself that your dissertation is just too big for you to manage and youll never finish on time. The outcome is that you start to feel overwhelmed, procrastinate, and avoid using effective time management. Instead, try saying: I can take one small step each day I am capable of completing this task well. Repeat this statement over and over, as a mantra. b) Thought Record Developed by psychologists Dennis Greenberger and Christina Padesky, the Thought Record helps you identify problematic thoughts or images, assess the veracity of the thought, and develop a more adaptive, balanced thought. The Thought Record has proven over the course of time to be a very powerful tool in helping people reframe negative thoughts and improve mood.

Using a Thought Record

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2. Stress Inoculation Training (SIT): Imagery, Relaxation, & Coping Statements

Stress Inoculation Training (SIT) was developed by psychologist Donald Meichenbaum in 1977. While other stress reduction programs aimed at mastering anxiety, Meichenbaum felt that being anxiety-free is unrealistic; anxiety can creep back in over time or new anxieties can form. Instead, he taught people how to cope with their anxiety, anywhere, anytime. SIT involves learning how to relax deeply and use coping thoughts as you visualize anxiety-provoking scenarios, starting from your least stressful scenarios and working up a hierarchy to your most feared. In traditional SIT the client would stick with the stressful situation no matter how unpleasant. However, in recent years Meichenbaums technique has been modified so that people can shut the scene off if their anxiety goes too high (see The Anxiety and Phobia Workbook, 1995). It is the combination of relaxation and coping thoughts which makes this technique most effective. For a full description of the SIT procedure, a list of coping statements, and an example go to the TOOLS.

Stress Inoculation Training

3. Imagining New Behaviour

We can all learn a new pattern of thinking or behaviour by observing and imitating others. Ideally, try to find a good role model who effectively manages lifes stressors. Is there someone in your department who, although he/she has so much to do, always seems to be calm and in control? Ask what strategies he/she uses. Try testing these strategies in your own life. Covert Modelling Unfortunately, good models are sometimes hard to find. A technique called covert modelling involves imagine yourself as a model of stress management. Once you can SEE yourself relaxing and being in control in your mind, you will be able to translate this into real life behaviour. Due to its unfamiliarity, you might find this difficult and awkward at first, so start with an easy scenario and work up to the really difficult ones. For example, if meeting your supervisor faceto-face causes huge anxiety, then start by imagining yourself calmly interacting with the supervisor over the phone.

4. Acceptance
When we cant change our situation, learning to let go will reduce your stress considerably. The serenity prayer encapsulates the wisdom of acceptance: Grant me the serenity to accept the things I cannot change, Courage to change the things I can and the Wisdom to know the difference.

Ways to Acceptance

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VI. Mindfulness-Based Stress Reduction

What is Mindfulness?
Mindfulness is bringing our full attention to the present. Mindfulness is observing the minds thoughts and emotions in a detached and non-judgemental way in the fullness of the moment. The goal of mindfulness is to be more aware of our automatic and destructive responses so that we can make conscious choices. Mindfulness encapsulates the principles of non-judging, nonstriving, patience, acceptance, letting go, trust, and having a beginners mind. Many cultures and religions practise forms of mindfulness through meditation and prayer. To help you be more mindful when communicating with others ask: "Am I defending myself or am I actually listening to what they are saying?" This question keeps us in the moment and reflecting on what is going on instead of reacting to our emotions and what we are telling ourselves is happening.

Mindfulness- Focusing & Awareness Mindfulness Exercises

What is Mindfulness-Based Stress Reduction?

Mindfulness-Based Stress Reduction (MBSR) was developed by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical Center for patients suffering from pain. MBSR teaches individuals the principles of mindfulness and how to apply them to deal more effectively with stress, pain, illness, psychological distress and the demands of daily life. It teaches participants to respond to stressful situations "mindfully". MSRB has been extensively researched and found to be a helpful adjunct to conventional treatments for a variety of medical and psychological conditions, particularly anxiety, stress, depression, pain and weight management. For a scientist research paper on the positive effects of MBSR: Grossman, P., Niemann, L., Schmidt, S. & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 35-43.

MBSR Training Program

An 8-9 week program, MBSR training teaches mindfulness through breathing, body awareness exercises, sitting and walking meditation, and gentle yoga. The MBSR program is offered in many hospitals in the Toronto area, including the MBSR Clinic at St. Josephs Health Centre [Link]/. There are also lots of private practitioners offering the program throughout Ontario. Mindful eating is one of the latest additions to MBSR training, offering a non-diet way to lose weight. The Centre for Mindfulness offers a "Mindfulness Weight Control Workshop.

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Stress Management Resource List

Websites
[Link]. Links between stress and your health. [Link] Information on stress and indepth strategies for coping with stress including alternative therapies. [Link]. Tips for how to cope with stress plus downloadable mp3s.

Books
David Posen, MD. Key Porter Books Ltd, Toronto. The Little Book of Stress Relief (2003) Staying Afloat When the Water Gets Rough (1998) Mind over Mood by Dennis Greenberger & Christine Padesky (1995). Includes many hands-on exercises and tools including the Thought Record. The Relaxation and Stress Reduction Workbook by M. Davis, E. Eshelman, & M. McKay. Now in its 5th edition (2000) this is still one of the best self-help books around. Stress Less: Break the Power of Worry, Fear And Other Unhealthy Habits by Don Colbert, MD (2008). Latest information on the affects of stress on your body and ways to help you de-stress. The Stress of Life by Hans Selye. The father of stress theory, Selye explains the medical effects of stress in his seminal work.

Relaxation CDs
Learn to Unwind developed by local psychologist, Dr. Edward Leyton, $25.00 at Chapters, Indigo, Novel Ideas, Queens University Bookstores. Relaxation techniques including progressive muscle relaxation by Eli Bay. [Link] You can find lots of cheap CDs with relaxing sounds in music stores.

Resources on Mindfulness
Dr. Jon Kabat-Zinn, the creator of Mindfulness-Based Stress Reduction, outlines how to use mindfulness meditation to reduce stress in the following books: Full Catastrophe Living Using The Wisdom Of Your Body And Mind To Face Stress, Pain, And Illness (1991) Wherever You Go There You Are: Mindfulness Meditation in everyday life (1995) The Mindfulness & Acceptance Workbook for Anxiety by Forsyth, J.P. & Eifert, G.H. (2007). Great self-directed book filled with practical exercises and a CD with scripted meditations. Some websites about Mindfulness Meditation (there are many!) [Link] [Link]/meditation/mindfulness [Link]/[Link]
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Tools

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SELF-AWARENESS

How well am I taking care of myself?

Rate Yourself: 5=Frequently 4=Occasionally 3= Rarely 2= Never 1= Didnt occur to me Physical Self-Care Emotional Self-Care ___ Eat regularly ___ Spend time in the company of those I ___ Eat healthfully enjoy ___ Exercise ___ Stay in touch with important people in my ___ Get regular medical check ups life ___ Get medical care when needed ___ Give myself affirmations, praise ___ Take time off when sick ___ Love myself ___ Get massages/ body treatments ___ Revisit favourite books, movies ___ Dance, swim, walk, run, play, etc ___ Seek out comforting activities, objects, ___ Take time to be sexual people, relationships, places ___ Get enough sleep ___ Allow myself to cry ___ Wear clothes I like ___ Find things that make me laugh ___ Take vacations ___ Play with children ___ Make time away from phones, computers ___ Other: ______________________ ___ Other: ______________________ Psychological Self-Care Spiritual Self-Care ___ Make time for self-reflection ___ Make time for reflection ___ Have my own personal counselling ___ Spend time with nature ___ Write in a journal ___ Find a spiritual connection or community ___ Read literature unrelated to school/work ___ Be open to inspiration ___ Try something I am not expert in or in ___ Be aware of non-material aspects of life charge of ___ Try at times not to be the expert or in ___ Notice my inner thoughts, judgements, charge beliefs, attitudes, feelings ___ Be open to not knowing ___ Let others know different aspects of myself ___ Identify what is meaningful to me ___ Engage my intelligence in a new area ___ Meditate/pray ___ Practise receiving from others ___ Sing ___ Be curious ___ Have experiences of awe ___ Say no to extra responsibilities when I ___ Contribute to causes in which I believe need to ___ Read or listen to inspirational literature ___ Other: ______________________ ___ Other: ______________________ School/ Workplace Self-Care Balance ___ Take a break during the day ___ Strive for balance within my academic and ___ Take time to chat with colleagues/ other work life students ___ Strive for balance within my WHOLE life: ___ Make quiet time to complete tasks family, relationships, school, play, rest. ___ Identify exciting, rewarding projects ___ Set limits with clients, colleagues, friends ACTION PLAN: ___ Arrange a comfortable work space From the activities above, choose 5 which I ___ Get regular feedback from mentors, would like to start now: supervisors, etc 1. __________________________________ ___ Negotiate my needs e.g. schoolwork 2. __________________________________ extension, deadlines, etc. 3. __________________________________ ___ Have a peer support group 4. __________________________________ ___ Other: ______________________ 5. __________________________________
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SELF-AWARENESS

TENSION DIARY
What increased my stress/ tension? (e.g. event, person, mood, etc) Stress Level 1= low stress 10= high stress What did I do to decrease my stress/ tension level? How useful was this strategy? 1= not useful 10= very useful

Date

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RELAXING THE MIND & BODY

10 Ways to Relax Your Stress Away

1. Breathe deeply. 2. Stretch. Try yoga or tai chi. 3. Exercise aerobically. 4. Take a warm bath. 5. Get a massage. 6. Eat healthfully. 7. Let it all out: Laugh, Cry, Sing, or Talk. 8. Have guilt-free fun. 9. Hang out with people who you can relax with. 10. Drink calming liquids e.g. chamomile tea, warm milk.

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RELAXING THE MIND & BODY

Take A Deep Breath and Relax

How Deep Breathing Works While babies breathe from the belly, adults tend to breathe from the chest causing shallower breathing. Consequently, less oxygen is taken in with each inhalation and the blood is forced to move through our system very quickly so that enough oxygen gets to the brain and organs. Deep breathing can reverse these effects. Calming Breath Exercise: 5 in 5 Hold 5 Out This calming breath exercise will help you achieve a deep state of relaxation quickly. Use it when you feel anxiety coming on. It will also reduce panic reactions such as hyperventilation. A note of caution: avoid taking excessively deep breaths repeatedly and stop the exercise if you feel faint. 1. Sit, stand, or lie down up to you. If sitting, ensure both feet on planted on the floor. Wear loose, comfortable clothing. 2. Breathing from the abdomen, inhale slowly through the nose to the count of 5. 12345 as you inhale. Imagine a balloon in your belly beginning to fill slowly with air. You may wish to put a hand on your belly to feel this sensation. 3. Pause and hold your breath for 5 breaths. 4. Exhale slowly, through the nose or mouth, to a count of 5. Feel the balloon in your belly deflating slowly. Exhale fully. Do this for about 2 minutes or more each time. As you relax more and more, you may increase the counting to 6, 7, or more. Added Options Use words Use words on the inhalation and exhalation. E.G. Inhale say in and exhale say out. Try the word RELAX: Inhale say re; exhale say lax. Or, the phrase CALM DOWN. Inhale say calm; exhale say down. Use imagery Adding a peaceful, safe scene to your breathing will increase the relaxation effect. Imagine breathing in ocean air, the scent of the forest, a flower. Effects of Deep Breathing Because it releases the bodys own painkillers (endorphins), deep breathing can relieve muscular-skeletal tension, headaches, stomach aches, and sleeplessness. It allows blood pressure to return to normal, which is good for your heart. Take time to practise deep breathing every day. By extending your practice to a month or longer, you will begin to retrain yourself to breathe from the abdomen Your breath goes with you wherever you go so you can use it anytime, anywhere.

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RELAXING THE MIND & BODY

Progressive Muscle Relaxation - Script

This exercise asks you to tense and release various muscles. If you have a special problem with any of the muscle groups, you can either skip that part of the exercise or do it very gently. During the exercise you can keep your eyes open or closed, whichever is more comfortable for you. Take a moment to get comfortable in your resting place. If you are in a chair, you may wish to uncross your arms and legs and make sure your back and neck are comfortable. Feet & Legs Begin by lifting the feet slightly off the floor. Point your feet and curl the toes inward until the toes are scrunched into a little ball. Curl as far as you need to feel the tension without strain. Concentrate on holding the toes and count to 5. Now uncurl your toes and gently drop your feet to the floor. Feel the blood rushing into the feet, thighs and calves. Can you feel the difference between the tension and relaxation? Buttocks/Low Back Next slowly, drawing your knees together and imagine placing a penny between the knees. Explore the sensation of your knees pressing into the coin. Can you feel the edges of the coin? How about the smooth flatness of its face? While you press and hold, breathe in and out, slowly and evenly. Now hold for 5. And release. Study the difference between the tension and the relaxation in the buttock, low back, and pelvis. Stomach Take your minds eye to your navel. Take a deep breath in and watch the navel push outwards. Exhale evenly and pull the navel towards the spine till you have squeezed all the air from your lungs. Hold for 5. Release and let the navel settle back to its normal resting place. Now let the breathing go back to its natural rhythm and the stomach totally relax. Relax deeply into the heaviness of your relaxed stomach. Shoulders Move to the shoulders. Shrug both shoulders up to the sky as high as they will go without straining. While you hold, listen to the tension in your shoulders. What is it saying to you? Hold for 5. Drop your shoulders back to their normal resting place and enjoy the calming breath. Allow the warmth and heaviness of the relaxation to suffuse this area. Arms/Hands Move to the arms and hands. Clench both your fists and bend your elbows, bringing your fists towards your chest. While you hold be aware of the tension in your hands, forearms and biceps. Continue to breathe in and out while you hold for 5. Now, open the hands slowly and feel the blood racing back into each finger. Study the warmth created by the fresh surge of blood or any other sensations you experience. Facial Muscles Now move to the muscles of the face. Playful make a big frown. Feel the corners of your mouth pull down till you look like a sad clown. At the same time, you may squint your eyes, clench your jaw and wrinkle up your nose. Whichever feels right for you. Enjoy imagining what you look like at this moment as you hold for 5. Let go and return to a relaxed expression. Be amazed by the softness of the face. Conclusion We are now finished relaxing the muscles of your body. You are now feeling completely relaxed and at peace. Let all residual tension leach out of your body slowly. If you find that there are places of tension, just note them. Then if you wish, breathe into those areas and let the breath help you loosen the tension.
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RELAXING THE MIND & BODY

Do-Anywhere Stretching Exercises

These exercises take only a few moments, and can help melt away both mental and muscle tension. For exercises done in your chair, sit up straight, pelvis in neutral position, and feet flat on the floor. Rag-Doll Dangle: Stand with your legs apart and bend at the waist. Shake your arms and hands loosely. Let your head hang and sway from side to side. Hang loosely for a few moments to relax completely. Slowly straighten up, one vertebrae at a time. You can also do the rag-doll while seated on a chair. Head Roll: Drop your chin to your chest. Rotate your head to the right and turn your chin to your shoulder. Repeat in the opposite direction. Head Tilt: Keeping the shoulders down, tilt the left ear to the left shoulder. Place your left hand on the right side of the head and allow the weight of your arm to pull your head GENTLY to the side. Extend your right arm straight down and flex your right hand. Hold for 10 counts. Repeat on the opposite side. Head Nod: Let your head fall forward so your chin almost touches your chest. Link your hands and place them at the back of your head. Apply GENTLE pressure. Head Lift: Curl your fingers around the sides of your neck, fingers meeting in the back. Lift straight upward and forward as though you were trying to lift your head off your shoulders. Turn your head slightly from right to left while you continue to lift. Full Body: Extend your right arm straight up and reach for the ceiling, as high as you can. Spread your fingers. You should feel your entire right side stretching. Lower the arms and repeat with your left arm. The Butterfly: Interlace your fingers around the back of your head. Wing your arms wide and hold in place. Slowly bend forward until your chin is close to your chest. Hold for a few moments. Come up slowly and repeat again. Pelvis Tilt: Tilt your pelvis forward so your lower back rounds, and then tip your pelvis backward so your lower back arches and your belly protrudes a little. Keep your neck, shoulders and stomach relaxed. Repeat several times slowly. This will not only help relax your lower body but will further instruct you in finding that neutral pelvic position that is not tilted to either extreme and helps you sit up straight comfortably. Basic Twist: Sit up straight on the forward part of the chair. Slowly twist to the right side, turning your head in the same direction while keeping your shoulders relaxed along the way. Observe how other muscles besides the twisting muscles near the spine jump into action. The right shoulder may rise up toward the ear or move backward. As you repeat, create more efficiency in the movement. Relax more of the body each time. Do the other side. Basic Twist With Variation: Do the same slow twist to the right while turning the head all the way to the left. This is impossible to do with hunched shoulders. An excessive arch in the lower back will also make it a struggle. Sit tall yet relaxed. Observe how the muscles around the shoulders and chest may want to force the motion. Try to resist this, and activate only the twisting muscles. Do-it-yourself Head Massage: Close your eyes and massage your head and neck in firm, small circles, working down the sides and back of the neck to the shoulders.
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RELAXING THE MIND & BODY

Visualization: Springtime in the Forest

You are walking in the forest in early spring. Allow yourself to feel the soft, moist ground of the earth under your feet. Drink in the dark, earthly colours grounding you with Nature. You see fresh young green shoots springing up from the moist earth after their winter hibernation. Allow yourself to be drawn closer to one of these shoots near to the earths floor. Be interested in every detail of this little creation. Your hand reaches out to touch the leaves of a young plant. Perhaps a droplet of moisture clings to your finger like an infant to its mother. You draw your finger to your mouth and touch the droplet to your tongue. Allow your tongue to come alive with the replenishing liquid. Allow its hydrating properties to refresh your mouth as well as your spirit. You sense the warm sun touching the top of your head and it is time to continue on. You might wish to stand up and stretch your body up to the sky, where the tops of the tall trees meet the vastness of the universe. Notice how the dark greens and browns of the trees contrast the oceanic blue of the sky. You hear the songs of birds flying overhead. Allow yourself to be one with Nature as you listen to what the birds are saying to you. Surrender to the stillness and quiet in the forest now. Scan the soundscape for other noises and be amazed that there is life everywhere around you. Come alive with the feeling of being part of Natures rebirth. You walk deeper into the forests mysteries now and take deep invigorating breaths of the damp, cooling air. Your nostrils fill with Natures springtime delights. Focus closely on subtle smells of what a new season brings-perhaps the sweet aroma of wildflowers or mossy peat. The heady smell makes you feel slightly giddy and fully alive. Now it is time to leave the forest. You might wish to walk more briskly now. Notice how alive you feel with all the oxygen coursing through your veins. Even though it is time to leave this place, trust that you can hold onto the lessons of spring. Everything has a fresh new perspective. Allow the many possibilities in life to dance around you. Written by Barbara Fretz, 2005

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Using Eye Movements to Reduce Stress & Improve Recall

When a person is retelling a personal story, a lot of emotions arise. If you look closely at the persons eye movements, you will notice that he/she is periodically looking upwards. This involuntary action functions to reduce the stress associated by these emotions. When the stress is reduced, the mind can open up to more unconscious memory work (see Kevin Trudeaus 5 Stages of Information Processing in Mega Memory). Activity: Heres the quickest way to relax and get out of the thinking stage: 1. Relax and take a breath. 2. Look up to the right and hold for a few seconds. 3. Look up to the left and hold for a few seconds. 4. Continue back and forth for a few seconds. Trudeau, K. (1997). Mega Memory: How to release your superpower memory in 30 minutes or less a day. NY: HarperCollins.

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12 Rules for Better Sleep Hygiene

1. Sleep as much as needed to feel refreshed but not more. Excessively long times in bed can lead to fragmented and shallow sleep. 2. Have a regular wake-up time in the morning. This strengthens circadian cycling and leads to regular times of sleep onset. 3. Exercise daily to deepen sleep. Occasional exercise does not necessarily improve sleep the following night. 4. Use a fan to provide background white noise if occasional loud noises disturb your sleep. 5. Keep room temperature a little cool. Too hot or too cold rooms disturb sleep. 6. Hunger may disturb sleep so a light snack may help. Try low fat, non-spicy snacks. 7. An occasional sleeping pill may be of some benefit, but their chronic use is ineffective in most insomniacs. 8. Use deep breathing and muscle relaxation exercises to divert the mind from anxious thoughts and list making, which interfere with falling asleep. 9. Avoid caffeine, including coffee, tea, pop and chocolate. Caffeine disturbs sleep even in those who feel is does not. 10. Avoid alcohol. It may help tense people fall asleep more easily, but the ensuing sleep is then fragmented. 11. If you feel angry and frustrated because you cant sleep, dont try harder and harder to fall asleep. Turn on the light and do something different (but no electronics or rigorous exercise!). 12. Reduce number of cigarettes your smoke; chronic smoking disturbs sleep.

Adapted from 11 Rules for Better Sleep Hygiene in Peter Hauris (1982) book, Current Concepts: The Sleep Disorders.

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How Self-Talk Affects Stress

Our internal dialogues or self-talk direct our thoughts and behaviours. Becoming aware of your self-talk and how it affects you is the first step to rewriting or reframing dialogues that cause you stress. Positive or Negative? Self-talk is like a self-fulfilling prophecy, that is, if you think about something long enough, you can actually make it come true! So, when your self-talk is positive, (e.g. I can get a good mark on the midterm), you give yourself permission to be successful. Conversely, negative self-talk (e.g. Im lousy at math) can turn into you giving up on yourself and your chances of success. Thoughts & Behaviours Self-talk can direct your thoughts and behaviours. For example, if you say I can learn these problems to pass the physics test, youll be more willing to put the effortin even when its tough goingand improve your chances of success. Stress Response Negative self-talk can cause or increase your stress and our bodies respond with aches and pains (or worse!). Negative self-talk may also encourage you to behave foolishly or destructively, putting a further strain on your body. The good news is that positive self-talk has the opposite effect it lowers stress and relaxes the body. How to Rewrite Your Script 1. Become aware of negative or destructive thoughts, especially longstanding ones. 2. Reframe your negative thought into a positive or more realistic one. 3. Repeat your new, positive thought as an affirmation or mantra. Eventually you will start to believe it. 4. Congratulate yourself for caring for yourself. For help with rewriting your script, see TOOL: Thought Record for Reframing Negative Thoughts

Source: Self-Talk: How Self-Talk Affects Stress from Parlay International. [Link] Parlay International provides information on health, education, safety and productivity training.

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Identifying Your Stress-Inducing Self Talk

The next time you have a stress reaction (large or small), pause to analyze what thoughts were going through you mind about the situation, i.e., identify your self-talk. 1. Write down some of the examples of your self-talk. Consider Why is this situation a problem for me? Whats really upsetting me? What was I saying to myself that caused my stress to increase? Is my self-image or self-esteem feeling threatened? Am I feeling intimidated or rejected? What fears, beliefs, insecurities may be operating here?

2. Notice if there are any patterns to your self-talk (bet there is!)

3. Notice whether your stress level lowers after you understand why you got upset.

Adapted from: Posen, D. (2003). The Little Book of Stress Relief. Toronto: Key Porter Books Ltd.

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Thought Record for Reframing Negative Thoughts

How to use the Thought Record

Column 1 Situation: Write down your anxiety-provoking situation. Column 2 Moods: Describe what you felt (e.g. panic, anxiety) and rate each moods intensity 1-100%. Column 3 Automatic Thoughts: Write down what was going through your mind, including images, just before you started to feel this way. Then, circle the hot thought, i.e., the thought that caused your anxiety to soar the highest. Column 4 Evidence For: Starting with the hot thought you circled in Column 3, look for factual evidence that supports this conclusion. Try to avoid interpretation of facts. Column 5 Evidence Against: Now look for evidence which does not support your hot thought. If you are having a hard time finding this evidence, try asking: If my best friend or someone who loves me knew I was having this thought, what would they say to me. Column 6 Alternative Thoughts: Now look at the evidence, for and against. If the evidence does not support your hot thought(s), ask Is there an alternative way to thinking about or understanding this situation? Write an alternative view of the situation. * If your hot thought is partially true, combine the evidence, for and against, into a balanced thought. e.g. Hot thought: I cant get this thesis done. Balanced thought: It is true that writing a thesis is a large project, but I have successfully undertaken other projects of this scale in the past. ** If your hot thought is true, ask yourself: What is the worst outcome? What is the best outcome? What is the most realistic outcome? Column 7 Rate New Moods: Finally, rerate the intensity of each feeling and compare to the intensity in Column 2. You might notice that the moods intensity has decreased. Learning Strategies Development, Queens University [Link]/learningstrategies

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Source: Greenberger, D. & Padesky, C.A. (1995). Mind Over Mood. NY: The Guilford Press.

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Stress Inoculation Training I. Stress Inoculation Procedure

Prepare i) An Anxiety Hierarchy: Before practicing this procedure, build an anxiety hierarchy, from least to most anxiety-provoking scenarios. Using this hierarchy will help you learn to cope with increasingly stressful situation. ii) Coping Statements: Choose coping statements to say to yourself before, during and after the interaction or stress situation. For a list of example coping statements, go to the next TOOL. 1. Before: Preparing for the situation 2. During: Confronting the situation 3. During: Coping with negative effects 4. After: Reinforcement: Reward yourself even though you were very anxious about it. Practice i) Get mentally and physically relaxed: e.g. deep breathing, muscle relaxation, imagining ii) Visualize the first scene in the anxiety hierarchy: Describe your anxiety-provoking situation as clearly and with as much detail as possible Identify escape routes iii) Start to cope: Once the visualized scene is clear in your mind, begin relaxing and using your coping statements/ thoughts. Continue for 30-60 seconds unless anxiety becomes too high. iv) Rate your anxiety 0 to 10 (0 = no anxiety 10 = major panic attack) v) Do more deep relaxation as you picture yourself successfully handling the situation. vi) Repeat above. vii) Rate your anxiety 0 to 10. viii) When anxiety is low, move onto the next most stressful scene in the hierarchy. Dont forget to reward yourself for having the courage to try new ways of coping with stress.

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Stress Inoculation Training: Coping Statements

Although its better to create your own stress-coping statement and memorize them, here are some examples to get you started. These coping statements were designed as part of Meichenbaums Stress Inoculation Training program. 1. PREPARATION Theres nothing to worry about. Im going to be all right. Ive succeeded with this before. I know I can do each one of these tasks. Its easier once I get started. Ill jump in and be all right. Tomorrow Ill be through it. 2. CONFRONTING THE STRESSFUL SITUATION Stay organized Take it step by step. I can do this; Im doing it now. I can only do my best. Any tension I feel is a signal to use my coping exercises. I can get help if I need it. If I dont think about fear, I wont be afraid. If I get tense, Ill take a breather and relax. 3. COPING WITH NEGATIVE EFFECTS Relax now! Just breathe deeply. Theres an end to it. Keep my mind on the task at hand. I can keep this within limits I can handle. I can always call _________. I am only afraid if I decide to be. I can decide not to be. Ive survived this and worse before. Being active will lessen the fear. 4. REINFORCING SUCCESS I did all right. I did well. Next time I wont have to worry so much. I am able to relax away anxiety. Its possible not to be scared. All I have to do is stop thinking Im scared.

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Source: Davis, M., Eshelma, E.R. & McKay, M. (2000). 5th edition. The Relaxation & Stress Reduction Workbook. Oakland, CA: New Harbinger Publications.
RELAXING THE MIND & BODY

Ways to Accept
Love Your Problems Accept the problem by experiencing it, telling the truth about it, describing it in detail. Unconditional acceptance: this is not giving in to the problem, or giving up, but is a way to be with it and get to know it. Loving your problem frees you from it by draining it of its power, rather than denying its existence or struggling against it. Surrender Reach for help when you feel the problem is too big to handle by yourself. Trying to control a problem can result in the problem controlling you. Surrendering is not quitting, or resignation. You can use your resources to handle the problem and then surrender (e.g. to the outcome) with a trusting spirit. Surrender to a higher power or to the self. Detach and watch from a distance without judgement. Let things happen rather than making things happen leads to inner peace.

Celebrate Your Mistakes Celebrating allows us to notice the mistake. Mistakes are valuable feedback. Mistakes demonstrate that were taking risks and are willing to learn and grow. Celebrating mistakes reminds us that its OK to make them. Celebrating mistakes includes everyone. Mistakes occur only when we aim at a clear goal. Mistakes happen only when were committed to making things work. Celebrating mistakes cuts the problem down to size. Source: Ellis, D. (2000). Becoming a Master Student. Canadian 3rd Edition. Boston: Houghton Mifflin. pp 186-87.

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MINDFULNESS

Mindfulness-Focusing & Awareness

Mindfulness incorporates both focusing and awareness. Focusing is an excellent place to start training your mind. In order to make changes, however, you will want to shift from focusing to becoming more aware of your thoughts and feelings. At any time you may go back to simply focusing.

Focusing Inward Eyes on the road Anchor on an object (e.g. breath) to keep the mind centred Awareness Outward - seeing the thoughts and feelings from the outside. You see yourself and your mental dynamics in more detail from this perspective. You start to notice things youve never seen before. Seeing the scenery: watching the mental traffic as if it belongs to someone else. Imagine the mind as a stream of consciousness. When there is a deluge of thoughts and sensations and you are at risk of being drowned in the stream, thats when focusing comes in. Shifting emphasis from focusing to awareness a) watch the stream of consciousness, dispassionately b) pluck something from the stream and deliberately focus on it (e.g. a dream imagine, a memory, a pain) Awareness Exercise Start by taking your mind inwards for a moment by focusing on the breath. Take a few gentle deep breaths, from the belly. In and out. Re---lax Let goContinue to breathe for as long as you wish. Now take your mind outwards. See your thoughts, feelings, moods, and sensations as objects floating down a stream, coming into view and vanishing from sight. Simply watch without judgment or analysis. Just watch them pass by. Now pluck one of these objects from the stream and take a moment to focus on it. Let the other sensations and thoughts go by in the background. Note any new thoughts or feelings that arise from observing this object. Sit with these thoughts/feelings for a moment. Whenever you are ready to leave this object behind, simply deposit it on a leaf and let it float downstream.
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MINDFULNESS

Mindfulness Exercises
Focusing Exercises Practice focusing every day. It will help you learn to stay in the moment in your everyday life. The Breath. See TOOL Take A Deep Breath and Relax 1. Body Scan: Lie down with your eyes closed. Slowly scan up and down your body for tightness/ soreness. If you find a tight spot, stop and breathe into it until it relaxes. You might also imagine healing, white light radiating into the spot. 2. Object Meditation: Choose a favourite or interesting object e.g. a stone, a flower. Spend several minutes observing every aspect of the object: its shape, hues, textures, smells, tastes. Go for the detail. 3. Mindful Eating: eating slowly, mindfully. Be aware of all the sensations of the food: taste, texture, sounds, weight. 4. Walking Meditation: While you walk, focus on sensations of the body moving. Soften the eyes and look at the ground a few paces ahead of you. Pay attention to how you walk. Aim to walk with no tension: relax into it, letting your hips and shoulders swing easily. Breathe with your footsteps. It can help to scan your body as you walk allowing the movement to free up tensions. You may also consider saying a mantra or affirmation in time with the steps. 5. Mindful stretching e.g. slow, gentle Hatha yoga Awareness Exercises 1. Simply Watching This is a particularly useful activity when your mind is very busy and you are finding focusing difficult. Watch the passing thoughts without judging them. Just watch them like the clouds passing by. Identify (or say out loud) each mood, thought, feeling, and sensation that comes up: e.g. sore neck, pizza, best friend, anger, tingling, empty stomach, pizza again, grandma, I miss her 2. Practice new thought statements to detach: Thought are not facts. I am not my thoughts 3. Urge Surfing for cravings and urges. Be aware of the warning signs, i.e. the urge or craving is approaching. Imagine the wave as an urge, i.e. the urge crests then falls. Ride the wave without giving into the urge. Let the urge pass. Celebrate your effort to ride through the urge. Accept that new urges will appear.
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