KAPLAN UNIVERSITY

HW410 Stress: Critical Issues in

Management and Prevention

Stress
Management and
Prevention

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Program Resource
Guide

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 KA P L A N U N I V E R S I T Y

Stress Management and Prevention

Program Resource Guide

By

Deanna Rogne

Kaplan University

HW410: Stress: Critical Issues in Management and Prevention

February 12, 2018

Table of Contents
UNIT 1 THE NATU RE OF STRESS

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
Journal Writing...........................................................................................

UNIT 2 THE PHYSIO LOGY OF STRESS

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
Journal Writing...........................................................................................

UNIT 3 PSYCHOLOGY OF STRESS

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
Journal Writing...........................................................................................

UNIT 4 PERSONAL ITY TRAITS AND THE HUM AN SPIRITUAL ITY

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
Journal Writing...........................................................................................

UNIT 5 DEAL ING WITH STRESS: COPING STRATE GIES

Information to Remember..........................................................................
Journal Writing...........................................................................................

UNIT 6 REL AXATIO N TECHI QUES 1 : BREATHI NG , M EDITATI ON,

AND M ENTAL IM AGE RY

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
Journal Writing...........................................................................................

UNIT 7 NUTRITI ON AND STRESS

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
UNIT 8 PHYSIC AL EXERCISE AND ACTIV ITY

Information to Remember..........................................................................
Self-Assessment Exercises.........................................................................
Journal Writing...........................................................................................

UNIT 9 APPLYING STRESS: CRITICAL ISSUES F OR M ANAGEM EN T

AND PREVE NTIO N TO YOUR PROF ESSI ONAL L IF E

Information to Remember..........................................................................

ADDITI ONAL INF ORM ATIO N

REF EREN CES PGS 3 8

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Unit

Unit 1: The Nature of Stress

Information to Remember:
Key Learning Point: Stress does not always need to be viewed in a negative way. There are three

different types of stress Eustress which is good stress, Neustress which is neutral stress and Distress

which is bad stress (Seaward, 2015). There are two subcategories of distress, those include acute

distress and chronic distress (Seaward, 2015).

Key Learning Point: There are several stressors that may trigger stress hormones but they can be put into

three separate categories. Bioecological stressors include things like sun light, earth’s gravitational

pull, changing seasons and other things that are beyond our human control (Seaward, 2015). Psycho-

intrapersonal influences such as culture, values, traditions and beliefs (Seaward, 2015). Lastly there

are Social influences like

Key Learning Point: Mindfulness is the ability to be fully aware of all things occurring in the moment. It

is to be present in all situations without judgement (Stahl & Goldstein, 2010). Mindfulness can be

practiced formally or informally and can be practiced anywhere at any time (Stahl & Goldstein,

2010).

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Self-Assessment Exercise:

The Mandala is a personal representation of an individual’s well-being. The

mandala signifies the four components of well –being, spiritual well-being, mental

well-being, emotional well-being and physical well-being (Seaward, 2015). The

mandala represents the well-being of a particular individual and most commonly

looks like a pie chart with 4 slices ranging in sizes (Seaward, 2015). My mandala

can be viewed below and represents my 4 components of well-being. I do believe

that my components are unequal and that when balanced as such I am able to

feel as though I am providing my best service or self. I work with many people

from many different cultures, religions and walks of life. So to me it is always

important that I keep an open mind, keep my emotions in check and be able to

lend my heart, shoulder or ears as needed. This mandala is an important

reminder to me to keep my life together so that I am able to serve others in the

best way possible.

Journal Writing:

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Unit One Journal Writing

Situation Start Midway End

Raising my child, never know if I’m leading him in the 10 10 10
right direction.
Immunizations, is a child going to have a bad reaction 6 4 4
this time? Every time I draw a vaccine.
Am I going to get a lunch, can I take a moment to 3 8 2
unwind?
Am I making a difference in my patient’s lives? Am I 7 8 5
making a positive impact?
When can I find time to devote solely to my husband? 8 7 5
How can we create a healthy divide between our
relationship with each other and our relationship with our
child?
When the call center doesn’t follow our appointment 5 9 5
template!
Finding more time for my schoolwork 5 9 9
When I miss the opportunity to say something polite to 3 3 3
someone.
Driving home from the gym in the morning and not 3 3 3
knowing if I will hit a deer or cow in the middle of the
road.
Family outings with anyone other than the three of us 5 1 1

References:

Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA:

New Harbinger Publications, Inc.

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Unit 2: The Physiology of Stress

2
Unit

Information to Remember:
Key Learning Point: When stressful events occur the immune system is effected and can break down

leaving room for bacteria or viruses (Seaward, 2015). Emotional or chronic stress can even trigger

and fight against the immune systems physiological response (Seaward, 2015).

Key Learning Point: Chronic and unresolved stress can affect the entire body and all physiological

responses to the body (Seaward, 2015). Stress can allow for infection in the body and can put strain

on different body systems (Seaward, 2015). Too much strain on the body or individual systems can

cause health problems that can lead to death (Seaward, 2015).

Key Learning Point: Stress can be a factor or cause of certain disorders in individuals, it can cause several

nervous system disorders as well as immune system disorders (Seaward, 2015). Stress could be the

culprit for tension headaches, migraines, irritable bowel syndrome, congestive heart failure, thyroid

disease, asthma, allergies, viral illnesses and many other conditions (Seaward, 2015).

Self-Assessment Exercise:
Neuroscience is the study of the nervous system. Neuroscience focuses on how the nervous system

works, develops and changes (Brain Technology and Neuroscience Research Centre (BTNRC).org, 2013).

Because the nervous system is so complex and consists of so many firing, evolving and changing parts

there are several different fields of Neuroscience each is just as interesting as the next.

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 Neuroplasticity is often described as the changing of the brain due to an individual’s experience

with the environment around them (Campbell, 2009). In other words it is the brains way of growing and

creating banks of knowledge each time an individual learns or experiences something new. The cells in a

person’s brains are forever changing and growing from their development in the womb until their deaths

(Campbell, 2009). Neuroplasticity is also the cornerstone of cognitive and physical rehabilitation

(Campbell, 2009).

There are several stress related diseases that can affect the nervous system. Stress can affect the

body in many different ways and can have an effect on the respiratory system, digestive system, nervous

system, musculoskeletal system, cardiovascular system, endocrine system and both male and female

reproductive systems (American Psychological Association (APA). ND).

Disease such as Hypertension is a common disease that occurs when the body becomes

stressed. Although Hypertension can be linked to certain behaviors or environmental stressors which

in turn cause chronic stress, things like eating to much or to little, smoking, drinking alcohol, drugs,

exercise, emotional outbursts or poor sleeping habits (Mayo Clinic Staff, 2015). Chronic Fatigue

Syndrome is another disorder that has not been linked directly to stress but stress is a risk factor and

can be an associating factor in known causes. PTSD is directly related to the stress of the event in

which a person was in some way a part of. It is suggested that PTSD can also be related to brain

injury sustained in direct blasts (ADAA, ND). PTSD can lead to depression, anxiety, and drug and

alcohol addiction. Studies suggest that chronic stress can be related to arthritis, thyroid conditions,

Parkinson’s disease, fatigue, overactive bladder, Chrons disease, cancer, depression and many other

conditions.

Journal Writing:
How is stress or anxiety about people affecting your life?

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 Stress and anxiety are affecting my life because I allow it to. I am constantly nervous about

people doing bad things. I am always worried about what people will think? How they will react? I

worry constantly about people getting hurt, being sick, not having something. I am constantly stressed

about my child and my husband, about if their needs are being met, about if they are happy or sad or

grateful for their lives. I worry about something bad happening to them, about my husband not

coming home from a fire, or getting hurt at work. I worry about if he is struggling emotionally with

the loss of his father. I am stressed about my child 24 hours a day, not knowing if we teach him

enough, show him enough, or talk to him the right way. Worried that we are not raising him right,

constantly stressed about the type of person he will grow up to be or if he will get the opportunity to

grow up at all. I am never at ease when it comes to them, I cry all the time thinking about all of the

bad things that could happen to them. I think about the patients I see at work and I wonder about their

lives, if they have people that love them and care about them unconditionally, I wonder if they are

abused or if their parents neglect them. Then I get stressed about other things. When I know that they

are abused or neglected I worry about them even more. I try my hardest to be their light when I get to

see them. I worry about the people I work with, the things that they are struggling with. I worry about

the old man/woman I see eating alone at lunch and I worry if they have someone to take care of them

or not. I am never not worried, stressed or anxious.

How is stress or anxiety about work affecting your life?

Stress and anxiety affect me at work because that is where I feel like I have the most control

and then there are so many changes all of the time with things and if you give your opinion or make a

suggestion then you get in trouble. People think you are negative when you aren’t. Patients stress me

out because I worry about them so much. I worry if things are okay at home, or if they aren’t. I worry

that a child will have an allergic reaction to a vaccine or that I will be the person they are scared of for

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years to come. I get upset about errors in scheduling when I have no control over the outcome. I get

upset about the janitor that doesn’t clean our rooms. I get upset at the insurance companies that halt a

child’s treatments or deny them altogether. I feel like work makes me stressed about all things I have

no control over.

How is stress or anxiety about the world affecting your life?

I am constantly stressed about the active shooters that seem like they are never going to stop,

about human trafficking and drugs. I am always sad for the homeless people in my town, I hate that I

can’t do more to help. I am on edge about every single person that walks by me, I am nervous about

every person that talks to my son. I am always worried that he will be taken from me, that someone

will hurt him. I am afraid to go to a theater, concert, or anywhere crowded for fear that we will be fish

in a barrel or that somehow, someone will take my child. I live in NV where the biggest active shooter

attack has happened to date. I am less nervous about a terrorist attack or even a missile or natural

disaster then I am those things.

How is stress or anxiety about food and eating habits affecting your life?

This doesn’t seem to affect my life very much. I actually tend to eat relatively well. I have my

days but I stop myself and I reset my diet. There are days when I have a bigger appetite and days

when I don’t. The only time I feel anxious about food is worrying that a new recipe will be good, or

that I will cook something correctly. Sometimes I stress about what we will have for dinner but it is

not something that bothers me often.

How is stress or anxiety about sleep and sleeplessness affecting your life?

This honestly doesn’t bother me very much. I feel like I get all of the sleep that I want or need.

There are days that the other stress in my life keeps me up or physically and mentally drains me of all

energy but I normally don’t worry or stress about sleep very much.

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How is stress or anxiety about exercise or lack of physical activity affecting your life?

I exercise every day and I truly think that it is the only time that I am not a giant ball of

anxiety or stress. The only time that I am not scared to make a mistake or to not be good at something

because I think of it as an equal playing field. Everyone at the gym is trying to better themselves in

some way. There may be a million different reasons they are there but we are all just trying to be

better.

To summarize on my stress and anxiety I think that most of it is brought on by things I do not

always have control over. I think that I stress so much about what can go wrong that I forget to enjoy

what is going on. I think that I stress a lot about my child and husband and their needs to the point that

I am afraid to just live, to experience anything. I think that most of my stress can probably be related

to my husband or son in some way. Stress about the world, stress about people, work, food. In the end

I think I just need to calm down, take a breath and trust myself.

References:

Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook.

Oakland, CA: New Harbinger Publications, Inc.

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Unit 3: Psychology of Stress

3
Unit

Information to Remember:
Key Learning Point: Worry incapacitates the mind not giving it the option to live in the present moment

(Seaward, 2015). When people worry they think about events that have not yet occurred and that may

never occur, they become consumed with the thought of what could be and fail to see what is

(Seaward, 2015). Worry breeds stress and can lead to more serious health conditions including

depression (Seaward, 2015).

Key Learning Point: Fear is one of the body’s way of adapted survival. The body reacts to scary, difficult

or traumatic situations by activating the fight or flight response (Seaward, 2015). Fear has been

linked to Anxiety and being over anxious for long periods of time can cause the body’s immune

system to break down (Seaward, 2015).

Key Learning Point: Conflict management doesn’t necessarily mean that it is helpful, sometimes the way

that people deal with conflict can actually create more conflict (Seaward, 2015). Some the ways

conflict is managed includes withdrawal, surrender, hostile aggression, persuasion and dialogue

(Seaward, 2015). I think that the best management solution is dialogue, dialogue is process of talking,

listening to the other person, expressing concern and coming to a mutual understanding (Seaward,

2015).

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Self-Assessment Exercise:

Journal Writing:
While doing this practice I focused on being aware of my breath. I noticed that I really felt my

breath in my throat catching in an uncomfortable way. I continued to breathe with my eyes closed and

I tried to just focus on my breath. I started to feel relaxed and then noticed tightness in my chest, as I

continued to just breathe it began to unwind. My child came to my mind many times during this

exercise. Cooking came to mind for me as well, in the workbook it discussed entering into things with

a beginner mind. It suggested cooking and made me think about how I cook when I cook for fun and

not necessity. I always feel like what I imagine a chef to feel like. Smelling each herb, understanding

the flavors and the textures, the measurements and the love put into each delicious dish. The look and

feel and smell of the food is always so pleasant to me and truly surprising since I am not much of a

chef. I love to just pretend that I have been taught to cook from some of the most prestigious chefs

around the world and like I could totally be the next iron chef. Sometimes my meals are delightful and

sometimes I don’t like them.

Focusing on my breath again, bringing my mind back to where it needs to be brought visions

my son to mind, dancing and laughing. Those make me happy but I also noticed my breath catching in

my throat more and in my nose making me want to sneeze. I tried to focus on just my breath again not

the fact that I felt like choking. I wanted to just breathe, to just be at peace for a moment. I kept

repeating to focus on my breathing in my mind. To just let go of whatever it was that was consuming

me in the moment, to just relax. I was panicking that I wasn’t meditating right (who does that?). I

opened my eyes, contemplated moving on, and decided to try again.

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 I remembered to think of everything as though it was the first time, to try again. This time

4
Unit

when I closed my eyes I only saw the color black. I could feel my breath in my throat and then my

nose; I became aware of my breathing and my silent mind. I finally felt nothing but calm and my

mind finally allowed me to just be.

References:

Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA: New

Harbinger Publications, Inc.

Unit 4: Personality Traits and the Human

Spirituality
Information to Remember:
Key Learning Point: Physical pain can be overwhelming and frustrating. It can make it difficult to

get through a normal day. Mindfulness is proven to help those with chronic pain, there is a 3

step mindfulness practice that chronic pain sufferers can use (Stahl, 2010). Step 1 is taking

time to investigate the pain and tension in the body, scan the body to determine where you

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 hold tension and stress (Stahl, 2010). The second step is working with the emotions of

physical pain. Being mindful of your emotions gives you the power to control and change

them (Stahl, 2010). The final step is living in the present moment. (Stahl, 2010).

Key Learning Point: A hardy personality combines several personality characteristics and seems to be

resilient to stress (Seaward, 2015). People with hardy personalities are less likely to become stressed

and more likely to be able to deal with stress as it occurs (Seaward, 2015).

Key Learning Point: Self-esteem is something that must be practiced. Self-esteem can range from high to

low (Seaward, 2015). People with higher self-esteem seem to be better problem solvers, more

egotistical and less likely to let small things bother them (Seaward, 2015). People with lower self-

esteem may be less boisterous, and small things will bother them more (Seaward, 2015). Self-esteem

ranges from high to low and just because it’s high one moment doesn’t mean it will be the next. Same

as if it is low one moment, it may be high the next (Seaward 2015). There are six pillars of self-

esteem that include the practice of living consciously, the practice of self-acceptance, the practice of

self-responsibility, the practice of self-assertiveness, the practice of living purposefully and lastly, the

practice of personal integrity.

Self-Assessment Exercise:
Self-esteem stems from a combination of self-love, self-values and self-acceptance (Seaward,

2015). Self-esteem is aura of confidence that one exudes from themselves. People with low self-esteem

typically tend to have meeker personalities and are more prone to stress or stress related illness (Seaward,

2015). Whereas people with high self-esteem tend to have bigger personalities and don’t let stress bother

them as much (Seaward, 2015).

Relationships are affected by stress. It is stated that relationships must be nurtured and loved

in order to survive, without the love or nurturing that they require they will suffer and eventually die

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(Seaward, 2015). Stress wears down an individual’s body, mind and spirit and can likewise wear

down the relationships that individual has built with others. Stress may also have an effect on one’s

meaningful purpose in life, when an individual feels as though they have no more purpose in life all

facets of their life (mental, physical, spiritual well-being) may begin to feel as though they are

slipping away and can cause a significant decline in an individual’s mental, physical and spiritual

health (Seaward, 2015).

Proshaka’s Stages of Change model is also discussed. The first stage is the pre-contemplation

stage i.e.: know that there is a problem and knowing that you need to create a change (Seaward,

2015). The second stage is the contemplative stage: The stage in which an individual determines that a

change has to be made (Seaward, 2015). The third stage is the determination stage: A period in which

a person’s will power is challenged in order to make the life change (Seaward, 2015). Stage four is the

action stage this is the stage in which a person put’s their plan into place (Seaward, 2015). Stage five

is the maintenance stage, this is the stage in which the change has become a “new normal” for the

individual (Seaward, 2015). Stage six is the relapse stage this is a period in which a person continues

the behavior in which they were trying to change but then continues with changed behavior (Seaward,

2015).

Journal Writing:
FEAR: apprehension, anxiety, distress, edginess, jumpiness, nervousness, panic, tenseness, uneasiness,

worry, fright, feeling overwhelmed. Apprehension normally manifests in my mind, when someone asks

me to do something out of the ordinary, something that comes to mind is giving a vaccine to a new born

child. Anxiety normally manifests in my chest or upper abdominal area, I think I am just an anxious

person in general, stairwells at my work make me extra anxious. Tenseness, this normally manifests in

my head, neck, back, calves and feet, I often feel tense after a particularly frustrating day or when I get

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 upset with people. Worry normally manifests in my mind and then my heart or chest, I worry so much

about my child I’m seriously surprised he isn’t in a bubble, sometimes I can’t sleep at night because I am

so worried that someone is going to take him from my home while we are sleeping, it’s absurd. Fright, I

feel this in the pit of my stomach normally, when I hear my husband’s pager call an ambulance to a seen

for a down firefighter, or I feel worried that something happened to my mom. Fright leaves an

overwhelming cold heat directly in the middle my stomach.

CONFUSION: bewildered, uncertain, puzzled, mystified, perplexed, chaotic, foggy, or unaware.

Uncertain: I normally feel this in my mind but sometimes in the pit of my stomach, normally when

someone asks me to do something off kilter, double booking a patient. Perplexed, normally I feel that

in my mind first and sometimes in my eyes and head it gives me a headache. Feeling perplexed occurs

sometimes when others do something that they know is incorrect, but they do it anyways. Chaotic,

this is what I feel like my life is 100% of the time, I feel this manifest in my chest, my back, my head,

my eyes. It normally takes away my attention because I can’t concentrate on one task at a time.

Unaware, usually I feel like this manifests in my chest and behind my eyes, sometimes I enjoy being

unaware, sometimes I don’t. I don’t pay attention to a lot of people so there are a lot of times that I

don’t know the newest work drama or what is happening around me.

ANGER: aggravation, agitation, annoyance, destructiveness, disgust, envy, frustration, irritation,

grouchiness, grumpiness, rage.

Aggravation is something that I feel often normally I feel like my shoulders get tensed up or

tight, I feel that right now because the security window on my computer. Annoyance manifests in my

temples and behind my eyes, I mainly feel annoyance with people at my work that can't follow

directions. Frustration is something that I feel when my husband has no patience, he drives me crazy

with that, I normally feel my shoulder and back muscles tense up.

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Irritation is something that develops in my abdominal muscles a tightening, I get irritated when my

child doesn’t listen or when he screeches.

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SADNESS: alienation, anguish, despair, disappointment, gloom, grief, hopelessness, insecurity,

loneliness, misery, unhappiness, rejection.

Disappointment is such a big world and I dislike using the term but when I feel

disappointment I feel it all over the place, in every fiber of my being. It makes me physically ill and

noticeably sad. I have been disappointed in someone I love recently and it has been a hard pill to

swallow. Gloom when I become disappointed or heartbroken I feel like a little cloud of gloom follows

me around, it weighs so heavy on me, manifests in my chest making it difficult to breathe. Insecurity,

I feel this mostly in my stomach and mind, always with a question of if I did something or missed

something or could have done more. I get so insecure about what other people will think or feel or if I

am doing what is best for me.

SHAME: guilt, embarrassment, humiliation, invalidation, regret, remorse, mortification.

Guilt I feel this in my chest, I am not good at lying or hiding things and I feel terribly guilty

when I try or when I do it to spare someone’s feelings. I have a friend that only washes her hair 1 time

a week and she goes to the gym daily, her hair smells so bad and sometimes I don’t want to do things

with her because she smells and looks dirty. I always feel terribly guilty about that because she is such

a nice person. Invalidation, something that I think I feel quite often, I am not quite sure the reason but

it normally manifests in my neck and upper back.

LOVE: affection, arousal, attraction, caring, compassion, desire, fondness, infatuation, kindness,

liking, longing, warmth, sympathy, sentimentality.

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 Affection is calming and releasing it is usually felt by tension releasing in my head, neck,

shoulders, chest and back. Normally my child makes me feel the most affectionate. Caring is

something that I think I am most times, I care deeply about others and how they feel, sometimes I

leave cards with positive sayings in them around my town for people to find. I think that normally I

feel this in my chest. Compassion comes from the heart and is the cornerstone of my job serving

others. Fondness, when I think of fondness I think of my husband and this manifests behind my eyes

and in my chest. Kindness isn’t necessarily something that I feel but something that I do. I make it a

point to be kind to others even if I don’t want to be. Warmth manifests in my smile or my eyes,

normally something that occurs when I people watch. Sympathy this is something that I sometimes

struggle with, it manifests in my chest and sometimes makes it difficult to breathe although I feel

sympathetic I never know how to express it outwardly.

JOY: amusement, bliss, contentment, eagerness, elation, enjoyment, enthusiasm, excitement,

exhilaration, hope, optimism, pleasure, satisfaction.

Eagerness manifests in my eyes and my hands, Birthdays and Christmas are probably the

times I feel the most eager. Enjoyment manifests in my chest and head, being outside having

adventure creates so much enjoyment for me. Enthusiasm is normally something I feel in my chest it

is something that I can’t always stop and because of this I get myself into a lot of things. At work I am

in several groups and I have a difficult time saying no to volunteer opportunities. Excitement is

something that manifests behind my eyes and in my ears, once I am excited about something I can’t

quit smiling. Excitement reminds me of my instant pot, I have been excited about my instant pot since

July, I love that thing.

References:

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 Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA: New

5
Unit

Harbinger Publications, Inc.

Unit 5: Dealing with Stress: Coping Strategies

Information to Remember:
Key Learning Point: Laughter has both long and short term effects on the body (Seaward, 2015). A small

bout of laughter may trigger the stress response which can cause an increase in heart rate, blood

pressure, muscle tension, and breathing, however this is immediately followed by the body’s rebound

effect (Seaward, 2015). The rebound effect decreases the levels of blood pressure, heart rate, muscle

tension and breathing, which causes homeostasis (Seaward, 2015).

Key Learning Point: Humor therapy is a great way to relieve stress and practice skills in order to manage

stress. Humor therapy is to laugh and not take life to seriously (Seaward, 2015). Some way’s that one

can improve their ability to relax and laugh and see the lighter side of things is to find one humorous

thing a day whether that be a mistake you made, a funny thing you witnessed, or something you read,

just find something each day that makes you laugh (Seaward, 2015). Allow your imagination room to

grow (Seaward, 2015). As we get older we forget to let our imaginations grow and play, we forget the

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 fun in it. Build your imagination by reading a book, writing a story, adventuring or playing with

children (Seaward, 2015).

Key Learning Point: RAIN is an acronym used when doing meditation for self-inquiry (Stahl &

Goldstein, 2010). RAIN stands for: R-recognize strong emotions, A- Acknowledge that the emotion

is present, I-Investigate the emotion, thoughts or body, N-non-identify with what emotion or thought

is occurring at that moment (Stahl & Goldstein, 2010). RAIN can be practiced daily and can provide

further insight into the emotional triggers (Stahl & Goldstein, 2010).

Journal Writing:
I chose to do the walking meditation. I go to the gym each day, work out at home and I am on

my feet most of the day while at work or at home. Walking meditation was appealing to me because I

realized how often I am on my feet and how often I don’t necessarily pay attention to the world

around me, or just to me in general. I decided to try walking meditation at home first but honestly my

mind just kept sliding to all of things that I should be doing, it kept going to laundry, dinner,

homework, the closet. I wasn’t able to concentrate on my feet, I wasn’t able to concentrate on what I

was doing because I just couldn’t turn myself off.

I later tried walking meditation at the gym and I feel like even though it is busy there and even

though there are sounds and visual distractions in each direction I can truly turn my mind off and just

worry about what I am doing. I normally do 20-30 minutes of cardio during a workout so I used this

time to just practice this meditation. I took a deep breath set the treadmill to 4.0 and just tried to focus

on every breath, eventually I started focusing on every single step, I blocked out the things around me

and I just focused on every single step that I would take. I focused on the way my foot hit the belt of

the treadmill. I became cognizant of the way I step with my heels first and then the tops of my feet. I

noticed that I step towards the outside maybe a bit pigeon toed.

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 I noticed that if I stepped differently it would cramp my calves and I would have to step

normal to stop them from hurting. I could feel every breath that my lungs took and how some of them

burned while others did not. I could feel the soreness in my back and arms from past workouts that

week and with each tinge of uncomfortableness I would breathe and breathing seemed to loosen those

aches, the more I breathed the more relaxed I felt. I would breathe in slowly and deeply and breathe

out with a count. I developed a rhythm.

Thoughts crept into my mind that I was hard on myself, that I was anxious and unsure and that

I wanted a lot in situations I had no control over. I was hard on my body, my mind, my heart. I kept

having the thought that I was punishing my body in the gym and forgetting to listen to it. The more I

breathed the more I would listen to my body, the more I would feel a problem area and then I would

feel the tension release. The more the tension would release the more I would remind myself that I

didn’t need to be so hard on myself and that it was okay to just be.

I reminded myself of all the things that I could not control. I reminded myself that it is okay to

just breathe and to just let go. I reminded myself that not everything would be perfect as I saw perfect

and that it was okay. I felt the breath in my lungs and when I released I would feel a heaviness over

my abdomen. I kept breathing, I kept feeling each step, and I would hear my footsteps hitting the belt.

I wondered if anyone else could hear them. I brought myself back, I had to do this several times when

I would l think about the other people in my area. I would just breathe deep, feel my feet, hear my

steps and watch the wall in front of me.

I did this until the people around me didn’t really bother me. I would just breathe and refocus.

I could tune out the loud conversations around me, the television and the machines. I could hear my

breath and my steps. I would just focus on my breath and my steps. My mom and some of the things

that I have gone through with her in the last few weeks continued to creep into my mind. My

24
supportive husband and child and I became mindful of everything that they mean to me. I became

mindful of things that my husband did to be supportive of me and the actions that he made that I

would take for granted. When I was done with walking meditation I was mindful of my breath, my

feet and even of how I wanted to stop walking. I was aware of the conversations and people around

me.

I enjoyed walking meditation and also realized that I may do a different form of meditation

when I run or walk. I may not be mindful of my steps but I am mindful of my body, my breath, and

my thoughts.

References:

Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA:

New Harbinger Publications, Inc.

25
Unit 6: Relaxation Techniques 1: Breathing,

6
Unit

Meditation, and Mental Imagery

Information to Remember:
Key Learning Point: The lack of self-compassion truly is a problem in the world. Most people

suffer with lacking self-compassion (Stahl & Goldstein, 2010). People are hard on

themselves, sometimes more hard on themselves than they are on others (Stahl & Goldstein,

2010). It is difficult for people to accept the fact that they made a mistake or that they can’t

have their way. People hold themselves to the highest standards and when they feel they are

not acting accordingly they criticize or punish themselves (Stahl & Goldstein, 2010).

Key Learning Point: There are several types of meditation and although they may look or feel different

from one to the next they all promote the same thought, to cleanse the mind and develop inner peace

(Seaward, 2015). Some different types of meditation include exclusive mediation, active meditation,

transcendental meditation, inclusive meditation and Zen meditation (Seaward, 2015).

Key Learning Point: Loving-kindness is a type of meditation that opens up the heart to love, compassion

and empathy Stahl & Goldstein, 2010). Practicing Loving-kindness in your daily life can help you

view others differently with less judgement (Stahl and Goldstein, 2010). Loving-kindness can help

26
 you feel better about yourself and can open different points of views to help you work through

stressful situations with ease (Stahl & Goldstein, 2010).

Self-Assessment Exercise:
Diaphragmatic breathing is the practice of breathing from the lower abdomen and to yogis is

known as Pranayama and is considered the life force (Seaward, 2015). Diaphragmatic breathing is

thought to be an effective relaxation technique because it interacts with both the sympathetic and

parasympathetic drives causing the body to go into homeostatic state (Seaward, 2015). There are three

important steps to remember in order to correctly perform diaphragmatic breathing, those steps are as

follows. Step 1: Finding a comfortable position it is recommended that at first while trying to master the

technique you sit or lie down with closed eyes, and that you place your hands on top of your stomach in

order to feel your breath. Step 2: Concentration. Step 3: Visualization (Seaward, 2015).

Diaphragmatic breathing is a form of meditation that is used to promote stress relief and

mindfulness, however there are many forms of meditation each offering their own set of physiological

effects on the mind and body. Some of the things that can occur through the consistent practice of

meditation is a decline in oxygen consumption, decline in blood lactate levels, lower heart rate, lower blood

pressure, less muscle tension, better skin elasticity, addition of alpha waves, increased sleep function, stress

release and a decline in pituitary adrenal stress and anxiety levels (Seaward, 2018). As mentioned

previously imagery is a key part to an individual’s meditation and can help an individual focus and

concentrate on breathing while blocking external sources. Mental imagery and visualization can also be

used to increase memory in patients with cancer, kidney failure, eating disorders or depression (Seaward,

2015).

27
Journal Writing:
Mindful of how you interact with yourself?

Being unkind to oneself is actually my biggest pet peeve. My heart breaks every time I hear

someone say “I’m worthless” or “I’m not enough”. I cry listening to my pediatric patients say things

like that about themselves. No one is perfect but truly feeling like you are not enough is

heartbreaking. There have been times when I didn’t feel like I was enough and then I reminded myself

that the only person that has control over the way I feel is me. I reminded myself that just because I

messed up, didn’t do as good as I wanted to or just because someone didn’t like me it didn’t mean that

I was worthless or stupid or disgusting, it just meant that it wasn’t meant to be yet.

I do find myself now struggling with body issues that I never struggled with in the past and I

often think of myself as fat, slow, ugly, sloppy, or lumpy. It makes me feel sad and anxious, it makes

me feel like everything I put into myself isn’t right. It makes me question every move I make. It

sometimes makes me feel like I am not good enough for my husband. Those feelings make me so

anxious that I try harder and then I stress even more. So anxious that I don’t believe my husband

when he tells me I am beautiful and that he loves me no matter what. So anxious that I don’t want him

to hug me.

I feel so anxious that it physically hurts to breathe, it hurts to take a deep breath and all of my

muscles get sore and achy. It hurts to feel like that, it makes tears in my eyes and brings tension to my

entire body. It makes my mind and my heart race.

Seeds of suffering?

28
 I think that if I stopped watering my seeds of suffering that I would be much happier. I think

that I would feel less like I had to be a certain way and I would have fun doing what I was doing. I

would feel less like I had to look a certain way to do certain activities. I think that I would have a

stronger marriage if I stopped watering those seeds. I would trust myself and my husband more. I

would feel like a weight has been lifted off of my shoulders and I would be able to relax my body

without all of the tension.

Day-to-day life feelings of resentment?

I think that when you come into any situation with an open mind and the realization that you

never know what someone else is going through you stop judging and becoming defensive at the first

sign of confrontation and you are able to easier diffuse a difficult situation before it escalates. People

call our work upset often, not because they are upset with us but because they are upset and normally

scared because something is wrong with their child and they feel helpless. I used to get upset because

I didn’t understand why someone was yelling at me, now I can calm them down and still be

compassionate and professional when I speak to them. I can fully explain the situation and make a

mutual understanding with the person. I think that the best part about maintaining an open mind is that

it does limit resentment that you will have towards individuals or situations.

Reflection on writing?

29
 I realized that I am much harder on myself than other people. I have a very difficult time

7
Unit

forgiving myself and I always have a heavy conscience if I don’t forgive others or if I feel like I was

short with them. I think that I need to take some of my own advice into consideration and stop being

so judgmental and defensive about the person I am. I think that I need to see myself in a different light

and that despite my shortcomings know that it isn’t the outside that makes me who I am it is the inside

as well and I have a good heart and strong mind. I work hard day in and day out serving others and I

love what I do so very much. I work hard for the body that I have and even though it isn’t perfect it is

mine and it is wonderful.

References:

Stahl, B., & Goldstein, E. (2010). A mindfulness-based stress reduction

workbook. Oakland, CA: New Harbinger Publications, Inc.

Unit 7: Nutrition and Stress

Information to Remember:
Key Learning Point: Exercise triggers the stress response during activity, however the body reverts to

homeostasis once completed (Seaward, 2015). Exercise is a good and healthy way to detox the body

30
 and relieve stress (Seaward, 2015). Several different types of exercise can be done in order to reduce

stress in the body; Cardiovascular endurance, muscular strength or endurance, flexibility, agility,

power, balance and anaerobic exercise (Seaward, 2015).

Key Learning Point: Exercise produces many physiological response that are positive and can continue to

improve over time (Seaward, 2015). Decreased heart rate, decrease blood pressure, decreased muscle

tension, better sleep, immune resistance to colds and other viral illnesses, decreased cholesterol,

decreased body fat, better heart efficiency, decrease in bone demineralization, better aging and

increased tolerance of heat and cold (Seaward, 2015).

Key Learning Point: Eating for a healthy immune system may decrease stress and help the body fight

viruses, bacteria’s and other illnesses before they are able to make an individual sick (Seaward,

2015). Eating balanced healthy meals high in antioxidants, fiber, amino acids, vitamins and nutrients

and low in sugars, trans or saturated fat, sodium and excitotoxins can assist in the immune system in

functioning properly (Seaward, 2015).

Self-Assessment Exercise:
I chose the sitting meditation. I chose this because since beginning this class I feel like just

being still and breathing has opened my mind to more than I knew. At time it has made me feel

anxious but at other times it has calmed and relaxed and eased my mind and body. This is something

that I have been taking moment to do each day.

Today I sat in my chair, let my body be comfortable and just started breathing. Deep breaths

into my nose and out all at the same time. I counted those breaths and noticed how they made me feel.

I could feel the cool air on my throat and in my nose. I could feel my body relaxing and releasing built

up tension. I began to understand what breathing did for the body.

31
 I found a way to control my breath to channel the area’s in my body that I wanted to relieve

stress at. The deeper I breathed the further down the tension would release from, if I took a short deep

breath I could release tension spots up higher. I noticed my neck became very tense and I began to roll

it, slowly and methodically. As I sat there I noticed sounds like the clock and the coffee pot, the tick

tock, tick tock, tick tock and the dripping/gurgling sound the coffee pot makes. These sounds didn’t

bother me, they just kept me aware. My body felt tired and somewhat relaxed until this point. Then

my mind was a million miles an hour, with so many thoughts and emotions. One word kept presenting

itself at the forefront of my mind. Busy. Busy. Busy. I allowed myself to think of that one word and

the many meanings that it had for me at the moment. I allowed myself to think of the love and hate

that I have with the word Busy, or better yet what it stands for. Busy is what drives me, it is what

becomes me, overcomes me, frees me, and chains me. Busy is what I make of it.

I went back to my mind and it was calm, there was a white color I continued seeing one that I

felt signified a cleansing of some sort. Maybe busy was what I was but maybe busy was exactly what

I needed to address. There are so many things that I’d rather not address or think about and so I’ve

stayed busy. I’ve stayed busy from 3 in the morning until 1 in the morning when my mid shuts off for

a short time. I’ve just stayed busy.

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Unit 8: Physical Exercise and Activity

8
Unit

Information to Remember:
Key Learning Point: Hatha yoga has been proven helpful in removing or lessening symptoms of chronic

back pain (Seaward, 2015). Hatha yoga is also proven to decrease levels of stress, increase muscle

strength and flexibility and to promote a positive immune response (Seaward, 2015). Hatha yoga

couples activity with deep breathing and purposeful movements in in order to relax the mind and

body (Seaward, 2015).

Key Learning Point: T’ai Chi ch’uan (sometimes referred to as T’ai Chi) is a type of relaxation technique

and moving mediation (Seaward, 2015). T’ai Chi is practiced by using solid and strong movements

that go with the flow of energy (Seaward, 2015). T’ai Chi has many physiological advantages to

include improvement in balance, decrease in stress, decrease nervousness, promote healthy immune

response, improve mood and sleep (Seaward, 2015).

Key Learning Point: Interpersonal mindfulness is the practice of bring non-judgmental awareness to

others (Stahl & Goldstein, 2010). Practicing interpersonal mindfulness can help manage conflict in

relationships and navigate uncomfortable emotions or opinions (Stahl & Goldstein, 2010).

Interpersonal mindfulness can be helpful in many ways and can help an individual see and

understand others in a different light (Stahl & Goldstein, 2010).

33
Self-Assessment Exercises:
Pitch and idea for employee wellness to help reduce workplace stress. The purpose of this

program is to reduce workplace stress that can lead to health problems for employees including

but not limited to depression, difficulty focusing, exhaustion, lower immune response causing

illness, body pain, headaches, hypertension, etc. (Welcoa News, 2003). Work place stress can also

cause a lack in productivity, motivation and professionalism (Welcoa news, 2003). Problems of

this nature can cost the company a lot of money each year in healthcare expenses, employee

compensations, and employee coverage and employee turnover rates (Pattie Neighmond, 2016).

Creating a program to reduce workplace stress can help to ensure that we save money by helping

our employees stay healthy, happy and productive.

The Pitch: Promote employee wellness and stress reduction by partnering with a local gym in order to give

our employees premium access to the gym (24 hour access, classes included with membership, discounts

on trainers).This can be done with a simple phone call and most gyms offer employees of partnering

companies discounted rates because it promotes the gym, boosts membership and is free publicity for the

gym itself. Creating a more welcoming break room space that gives employees a relaxed and comfortable

setting to take a break, eat their lunches, and enjoy healthy snack options would be beneficial to the

employees and reduce workplace stress. Healthy food promotes the mind over body wellness that we are

looking for and in the long term can help the company save money in employee absences, and medical

costs. We could stock the break room with healthy snacks (granola bars, sugar free jello cups, packaged

nuts, jerky, etc.), a coffee machine and water machine.

34
Journal Writing:

9
Unit

Unit 9: Applying Stress: Critical Issues for

Management and Prevention to your
Professional Life
Information to Remember:
Key Learning Point: Hobbies are a good way to cope with stress (Seaward, 2015). When the mind is over

ridden with stress a person may suffer from a loss of focus, motivation or creativity. Doing something

that can take the mind off of the present moment will allow the mind to relax, focus on the task at

hand and to be creative (Seaward, 2015). Doing a hobby such as crafts, cooking, exercise allows the

individual to feel a sense of control which allows them to better deal with their stress when they shift

their focus back to the problem at hand (Seaward, 2015).

Key Learning Point: Dream therapy is a type of therapy that explores images or actions occurring in

dreams (Seaward, 2015). Dream therapy is a way of helping individuals discover what they believe is

the root of their stress for example (reoccurring dreams of a banana may signify unresolved issues

with a family member). By analyzing the dreams an individual may be able to discover and cope with

the underlying issues causing them stress (Seaward, 2015).

35
 Key Learning Point: Creating a stress management program is helpful and easy (Seaward, 2015). By

creating a stress management program you can balance your life and learn the best methods for you

to deal with and resolve stress (Seaward, 2015). You can build a stress management program by

identifying your stressors, setting interventions, integrating stress management practices, and

practicing your personal stress management strategy in order to cope (Seaward, 2015).

Additional Information
A Mindfulness Based Stress Reduction Work Book by Bob Stahl and Elisha Goldstein

- Primary Source- This is an interactive work book that teaches you how to practice

mindfulness, relieve stress and become a healthier person.

10 Tips to Manage your Worrying by Graham Davey.

https://www.psychologytoday.com/blog/why-we-worry/201206/10-tips-manage-your-worrying

- Secondary Source- An article on how to control and manage your worrying. Worry can be a

debilitating condition that leads to bigger health problems for some individuals. This article

teaches 10 easy to follow methods on how to reduce your worry.

https://adaa.org

- Secondary Source- provides education, materials and resources to those dealing with stress

related illnesses such as anxiety and depression.

36
https://www.doyogawithme.com/our-story

- Secondary Source- Website that provides free yoga videos and promotes a safe environment

for individuals to learn and practice yoga. This yoga website can be opened anywhere that

internet is available and can be practiced from a location most comfortable for the individual

practicing. This website provides a great deal of information on yoga and a strong focus on

health and well-being.

https://www.ted.com/talks/dan_gilbert_asks_why_are_we_happy

- Primary Source: This video is about how being happy can change your life for the better. How

when we are happy and put that good into the world we can change the views that we may

have on others or certain situations. Happier people are less stressed and often times healthier.

37
 References

ADAA. (N.D.). Post-Traumatic Stress Disorder. Retrieved from: https://adaa.org/understanding-

anxiety/posttraumatic-stress-disorder-ptsd#

APA. (N.D.). Stress Effects on the Body. Retrieved from: http://www.apa.org/helpcenter/stress-

body.aspx

BTNRC.org, (2013). What is Neuroscience? Retrieved from: http://www.btnrc.org/about-

neuroscience/what-is-neuroscience/

Campbell, C. (February 4, 2009). What is Neuroplasticity? Retrieved from:

https://www.brainline.org/author/celeste-campbell/qa/what-neuroplasticity

Mayo Clinic Staff. (October 5, 2015). Stress and High Blood Pressure: What is the Connection?

Retrieved from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-

depth/stress-and-high-blood-pressure/art-20044190?pg=1

Neighmond, P. (July 2016). Wellness Programs Take Aim at Workplace Stress. Retrieved from:

https://www.npr.org/sections/health-shots/2016/07/18/486093979/wellness-programs-take-

aim-at-workplace-stress

Seaward, B. (2015). Managing stress: Principles and strategies for health and well-being (8th ed.).

Boston, MA: Jones and Bartlett Publishers.

Stahl, B. & Goldstein, E. (2010). A mindfulness-based stress reduction workbook. Oakland, CA: New

Harbinger Publications, Inc.

Welcoa News. (July 2003). The Benefits of Stress Management for Employees. Retrieved from:

https://www.welcoa.org/blog/benefits-stress-management-employees/

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39