dr. Dharmawan A.

Purnama, SpKJ

Did you know?

80% of the diseases are caused by
psychosomatic reason.
Employees lost an average of 2 working
days/year because of illness due to stress.
Mental health disorders are one of the
fastest cause of job losses.
Medication that often missuse for stress
are xanax, ecstasy, et al.

Definition of stress
Stress is our mind and bodys response or
reaction to a real or imagined threat,
event, or change.
Barriers that interfere the function of
normal psychology and physiology.

Type of stress
Eustress or positive stress occurs when
your level of stress is high enough to
motivate you to move into action to get
things accomplished.
Distress or negative stress occurs when
your level of stress is either too high or too
low and your body and/or mind begin to
respond negatively to the stressors.

Type of stress
Eustress
Learn new things
Motivate us
Self confidence
Solve problem
Increasing creativity
High self esteem
High energy

Distress
Moody
Fatigue
Depression
Negative behavior
Negative feeling
Frustration
Angry

Stress and Achievement

Achievement

Stress

Source of stress
The threat, event or change are commonly
called stressors.
Stressors can be
internal (thoughts, beliefs, attitudes) or
external (loss, tragedy, change).

Source of stress
Types of stressors :
1.Biological: related to physical problems
2.Psychological: related psychological
problems
3.Social: eg natural disasters, floods, fires,
political unrest, economic, social and
cultural rights.

Source of stress
Factors that contribute to happen/least stress:
1. resistance to stressors (stress tolerance).
2. severity of the stressor.
3. type of stressor.
4. one's perception of the stressor.

Source of stress
Think about the sources of stress
whether physical and our emotional
responses appropriate and useful?
or
even hinder us to cope and accept it?

Stress in the modern era

Today, most of the stressor is not physical,
but psychological
Example:
uncertainty, threats to self-esteem,
financial insecurity, frustration.

Source of stress
THE GENERAL ADAPTATION SYNDROME
Hans Selye developed a model of stress
that he called the general adaptation
syndrome. It consisted of 3 phases:
The Alarm Reaction
The Resistance Stage : adaptation is
ideally achieved
The Exhaustion Stage : acquired
adaptation or resistance may be lost

Source of stress
In Alarm Stage, body prepares itself to
react FIGHT or FLIGHT causing tension in
the form of the body's physiologic
response is ready for action.
If the stressor continues, the body reaches
peak tension Resistance Stage
Body has limited energy adaptation. If the
stressor continues, the Exhaustion Stage
finally achieved.

Sign and Symptom of Stress

The body will eventually become weaker
and more susceptible to disease when
confronted with the old state of stress.
Recognize symptoms of stress beware
and be quick to act to protect yourself so
you do not experience greater stress.

Sign and Symptom of Stress

Physic
Palpitation
Gastric disorders
Dizziness
Headache
The cold sedentary
Weak
Hypertension

Back pain
Insomnia
Muscles tense
Pain and stiffness
Autoimmune
disorders
Itchy
Constipation /
diarrhea

Sign and Symptom of Stress

Psychology

Depression
Anxious
Outbursts
Grief
Agitation
Loneliness / feel
isolated
Attitudes / negative
thoughts
Nightmare

Powerless
Dizziness
Worry
Sensitive
Difficult to concentrate
Aggressive
Angry
Impulsive attitude

Sign and Symptom of Stress

Behavior
Behaviors in a person with stress can
change quickly.
Example: become a loner or a quiet, easy to cry,
complain
Maybe there is a change in sexual habits (loss of
interest or the increasing sexual needs than
usual).
Attitude change is often denied but seen clearly
by others.

Stress Measurement Scale

by Holmes and Rahe
Thomas Holmes and Richard Rahe constructed
a social readjustment rating scale after asking
hundreds of persons from varying backgrounds
to rank the relative degree of adjustment
required by changing life events.
Holmes and Rahe assigned each of these
events a certain number of units.

Stress Measurement Scale

by Holmes and Rahe
Accumulation of 200 or more life-change
units in a single year increases the risk of
developing a psychosomatic disorder in that
year.
Persons who face general stresses
optimistically, rather than pessimistically, are
less apt to experience psychosomatic
disorders
If they do, they are more apt to recover easily

Type A Personality
Characterized by easily aroused anger,
impatience, aggression, competitive
striving, and time urgency
High competitive spirit, ambitious, speak
quickly, like interrupting the conversation,
perfectionist, polyphasic
Harlock 1974: aggressive, quickly bored,
talking and walking fast, high competition

Type A Personality
Arnold and Fieldman 1990 :
Aggressive, willing to challenge others to
get what they want, have high standards
for himself, working too much with
incredible speed, always racing against
time.

Type B Personality
More relaxed in doing something, less
assertive, more patient to wait, avoid
competition, non-perfectionist, lack of
ambition, monophasic.
Sarwono 1998: calm characteristics,
relaxed, do not force himself in work, do
not like to compete, better in understand
others.

Type B Personality
Arnold and Fieldman:
tend to have feelings of depression,
working slowly, talking with regular and
relaxed, patient, low competitiveness.

Burnout Self Test

Check list that helps you check your ability to
cope with stressor.
Helps you see how you think about work and
working experience, so that you will know the
time when you in high risk of getting stressed.
An informal method, not scientifically
validated yet so that it is not used for making
a diagnose.

Burnout Self Test

Answer
Not at all
Rarely

Weight
0
1

Sometimes
Often
Very often

2
3
4

Burnout Self Test

Personality Test with MMPI

The Minnesota Multiphasic Personality
Inventory (MMPI) is one of the most
frequently used personality test.
Used by professionals to identify the
structure of personality and
psychopathology.

Personality Test with MMPI

Personality Test with MMPI

Personality Test with MMPI

Individual reactions to stress

The reaction of each individual is not the
same :
1. Emotional reactions
2. Physical reaction
3. Behavior reaction
The ability to cope with stress is an inborn,
but can be improved through education,
care, and exercise.

Techniques to deal with stress

1. Managing Emotions
Learning to remain calm
2. Think positive

Techniques to deal with stress

3. Cognitive Restructuring
Techniques to find out what is behind the negative
thoughts.
Used when experiencing a negative mood, for
example: sad, angry, disappointed.
Negative thinking quality of work performance
and social relationships
Purpose: happier, more productive, turned into a
positive
Emotions and behavior can be influenced by the
mind.
Thoughts + Interpretation of the environment
Mood

Techniques to deal with stress

4. Imagery
quasi-perceptual experience :
Visualizing
Seeing in the mind's eye
Hearing in the head
Imagining the feel of

Techniques to deal with stress

5.Toffler Stability Zone
Stability Zones are places or things that
make you feel safe, relaxed, and secure.
Think of them as buffers types of
protection or defense against the outside
world.

Techniques to deal with stress

Identify your Stability Zone :

How stable are they?
How many of your Stability Zones can be
influenced by you?
Do you spend enough time nurturing these
Stability Zones?
Will your Stability Zones remain solid and
steady over time?

Techniques to deal with stress

6. Relaxation and Meditation
Preparation of Relaxation

Sit on the comfortable chair or lie on a bed

Sleep on your back, stretch your legs and arms

Close your eyes
Observe how you breathe
Make your body feel good

Techniques to deal with stress

Breathing to Relax
Inhale slowly and deeply through your
nose, hold 3-6 seconds, remove through
the mouth, empty the lungs until complete
Do not tense
Observe what your body feels when you
are relaxed and feeling of heaviness that
radiates throughout the body

Techniques to deal with stress

Benefits of Relaxation regularly:
Sleep more tight
Adding physical and mental endurance
Eliminates fatigue
Eliminate nervous and anxious
Not addictive

Techniques to deal with stress

7. Stay physically healthy
There is a unity between mind and body.
Mental and emotional disorders can be caused or
triggered by physical illnesses, and vice versa.
3 Keys: Get enough sleep, a balanced diet, and
physical exercise.

8. Social Networking
= Social structure which is formed from individuals
or organizations tied with one or more specific types
of relationships such as values, visions, ideas,
friends, descendants, etc.

Stress Management Plan

1. Stress Diary
Step :
Write down the situations that trigger
negative thoughts
Identify the mood that you feel
Write automatic thoughts that you
experience when you feel your mood
Identify evidence that supports that
thought

Stress Management Plan

Step:
Identification evidence does not support
this thought
Balancing the mind of the situation
Observation mood at the moment and
think about what you will do

Stress Management Plan

2. Job Analysis
3. Setting goals and priority scale
4. Effective Time Management
Plan your daily activities before
Stick to the plan
Work on schedule
Concentrate on how much time you will use
Be flexible, do not be enslaved by routine
Consider other alternatives if there are
something blocks your plan

Stress Management Plan

5. Effective delegation
6. Assertive behavior
7. Building self confidence

Stress Management Plan

8. Improving the way you feel about yourself

9. Recognize and overcoming self sabotage

10. Diversions : balancing work and life

Goal Setting
1. Make sure the goal you are working for is
something you really want, not just something that
sounds good.
When setting goals it is very important to remember that your goals must be
consistent with your values.

2. A goal can not contradict any of your other goals.

3. Develop goals in the 6 areas of life:
Family and Home
Spiritual and Ethical
Social and Cultural

Financial and Career

Physical and Health
Mental and Educational

4. Write your goal in the positive instead of the

negative.
Work for what you want, not for what you want to
leave behind. Part of the reason why we write
down and examine our goals is to create a set of
instructions for our subconscious mind to carry
out.
The more positive instructions you give it, the
more positive results you will get.
Thinking positively in everyday life will also help
in your growth as a human being. Don't limit it to
goal setting.

5. Write your goal out in complete detail.

Instead of writing "A new home," write "A 4,000
square foot contemporary with 4 bedrooms and 3
baths and a view of the mountain on 20 acres of
land.
The more information you give it, the more clear
the final outcome becomes.

6. By all means, make sure your goal is high

enough.

7. This is the most important, write down your goals.

Writing down your goals creates the roadmap to
your success.
It is also extremely important to review your goals
frequently.
Remember, the more focused you are on your
goals the more likely you are to accomplish them.
Sometimes we realize we have to revise a goal as
circumstances and other goals change.
If you need to change a goal do not consider it a
failure, consider it a victory as you had the insight
to realize something was different.

 Every time you make a decision during the day,

ask yourself this question, "Does it take me
closer to, or further from my goal."
If the answer is "closer to," then you've made the
right decision.
If the answer is "further from," well, you know
what to do.
If you follow this process everyday you will be on
your way to achieving unlimited success in every
aspect of your life.
The difference between a goal and a dream is
the written word.
-Gene Donohue

 Smart Mind Centre 2011