Monday, December 29, 2008

n. Create a relaxing place (create context and conditioning for relaxation).

n. Create a relaxing place (create context and conditioning for relaxation). Classical Conditioning, is incredibly powerful. Simply stated, it tells us that we develop certain responses to certain cues or stimuli. If a particular area is always used for story time, or for sleep, or for another activity and there are consistent stimuli in association with that place. It will be easier to get into that activity. For example if you have a routine before going to bed, that happens at the same time and in the same place every evening and if that routine is relaxing, it will be easier to fall asleep. (There is more to good sleep hygiene than just this; however, it is an important piece.) If you have a place where you always go to relax and there are relaxing sounds and smells that are always in that place, that place will make it easier for you to relax. If you want to teach children to relax and its ok for them to fall asleep, doing it in the same place with the same relaxing music smells and story, with no distractions, will make it easier as long as that is the only activity done in that location. If you do not have a different and seperate place available, change as many stimuli as possible and make them unique for relaxation. For example, in your living room with the lights off or down low and certain music and even a particular scent.

m. Music doth sooth the savage beast...and sometimes people too

m. Music doth soothe the savage beast...and sometimes people too Music is not as simple as you might think. There are concepts that are absolute some that are much more subtle and some that depend. It is a powerful tool no matter what your goals and intentions. There are some types of music that are simply not relaxing. Many years ago I was working with a young man in therapy. He was about 12 years old. We were talking about stress reduction and he said that he relaxed to music from the band Metalica. Instead of disagreeing with him, I suggested we check it out. He brought his Metalica in and I hooked him up to some simple biofeedback that would measure changes in his stress levels at his fingers tips. (Remember that under stress our blood is focused on the large muscle groups to allow us to fight or flee, the hands are not a large muscle group and while they may perspire, they do not generally warm under stress. Both the perspiration and the heat can be measured for an indicator, as well as muscle tension.) After doing this I turned on the Metalica as loud as he would like and left the room. After a few pieces had finished, I returned to the room, turned off Metalica and we looked at the readings. There was no need for any argument about whether Metalica would help him relax, it was obvious that it did the opposite. Point #1. In order for music to be relaxing, it needs to be enjoyable to the individual; however, some music, even if enjoyable, is not relaxing. Country music, especially some of the older pieces, can be relaxing, if the person listening, enjoys the music. Have you ever driven down a highway at 55mph, 65mph, 75mph or faster, then suddenly come across a town that you must drive through at 25mph? When ever I do this, it feels like it will drive me crazy. Going at what seems like a snails pace, in comparison to what I was going is not relaxing for me or for most people I know. It is more relaxing to gradually slow down. It can be stressful when it has to be done abruptly. Point #2. Most of us, unless very practiced and skilled in relaxation, need a gentle transition to a more relaxed state. The tempo of the music should be just a little slower than your tempo. As you relax, play quieter music with a slower tempo. Perhaps the most relaxing music available is baroque. The rhythm is almost perfectly suited to the rhythm of the brain when it is the most tranquil and open to learning. The most relaxing piece that I know of is Pachelbel's Canon. The version that is the most relaxing is at half the normal speed and is Daniel Kobialka’s found on Timeless Motion. He also has some great relaxing music for children. Gentle music can also help with transitions. Especially when working with children, if there are regular transitions that they go through during the day, start paring the instruction with a particular piece of music. After a while, you can delete the instruction. The music can be the cue that it’s time to transition. If going from a quiet activity to a louder more fast past activity, such as from reading to playing outside, try music that is just a little faster tempo than their current activity but not as fast as what they will go to. If there are things that must be done before going to play outside, it will make it easier to complete the transition activities. If you want to transition from a play time to story time (hopefully it will be in a different location even if in the same room as context is also very important), play music with a slower tempo than the play time tempo, but not slower than the story time tempo. Once in the story time place, you can play music with just a little slower tempo, but you want them to listen and enjoy the story, not go to sleep. Note: Music, with deep breathing and muscle tightening and relaxing are a great combination.

l. Attitude of Gratitude

l. Attitude of Gratitude Learn to say “please” and “thank you” and mean it. Teach your children the same.

k. Mindfulness Meditation

To read more about mindfulness meditation and stress click here.

k. Mindfulness Meditation Many of us spend a good part of our life, thinking about one thing while doing something else. We often think about what we are going to do or say next, or we think about doing something we would prefer to be doing. This is a major cause of accidents and sometimes strife. Think about the potentially negative outcomes of a surgeon thinking about golfing, tennis, or a family problem, while performing surgery, or a pilot thinking about what s/he is going to do tomorrow while the plane is taking off or landing; and what about the driver who arrives at his or her destination, not sure of how they got there. We often do things by rote, or think about something other than what we are currently involved with. This is not always a bad thing (thinking about an enjoyable activity while the dentist is drilling can have a lot of benefits), except when you need to be extra careful and safe, or present (attentive) for a person. In additional to safety and relationship reasons, we often need to focus on what we are doing for better effectiveness and outcomes and from time to time for relaxation.It would be beneficial if each of us could be involved at least once a day in a very particular type of meditation called mindfulness. Some people are actually able to spend much of their life in this state; but, it is rare and my suggestion for you is to involve yourself in it at least once a day.Mindfulness Meditation requires three things.Enjoy the activity, like it was new.Focus completely on the activity.Loose track of time.(Watching TV does not count, you must be an active participant) The activity can be almost anything as long as it fits the criteria. For some it may be reading a good book, where you may have to set an alarm if you have to be somewhere or have something else to do. It can be gardening, or dirt biking, playing a video game, taking a hot bath, or even doing the dishes. It is absolutely individualized and can be extremely relaxing. Children are naturals at this, as long as we encourage it and give them the opportunity. It is usually done through play and/or discovery. Often it requires a partner, who is physically, emotionally and mindfully present.

j. Healthy Relationships

To learn more about relationships and stress click here.
j. Healthy Relationships Much of my early learning about stress management came from three different sources; Love Medicine & Miracles: Lessons Learned About Self-Healing From A Surgeon’s Experience With Exceptional Patients, Bernie S. Siegel, MD, Love Is Letting Go Of Fear, Gerald G. Jampolsky, MD, and Minding The Body Mending The Mind, Joan Borysenko, MD. One of the stories that has always stuck with me from Minding The Body Mending The Mind is about some research conducted decades ago in Rosetta Pennsylvania. At the time, Rosetta had surprisingly good health rates in comparison with the country as a whole. Researchers thought that they would find exceptionally good health habits in the community but they did not. What they did find was a very supportive and tight nit community. They also found that when people moved away from Rosetta, their level of health soon averaged out to be on par with the rest of the country. Another story from one of the books above was about a children’s hospital for infants. In those days, the recovery rate for hospitalized infants was very low. In one hospital and on one wing of the hospital, more babies were living. This surprised enough people that someone decided that they should try to find out why. The nursing care was the same, the doctors were the same. The wing was similar to others. If anything, this wing was a little dirtier than the others. What they discovered was an old German woman who was supposed to be cleaning, was holding the babies. Attachment is one of the most important and fundamental protective factors for children and adults. The key is not just quality time as you often hear, but quality, quantity, and consistent time. Babies and children need face to face enjoyable communication and interaction with consistent adults. Good attachment, relationships with warm support, have always been great stress mitigators. Having someone you trust, who you can can share thoughts, feeling and troubles with as well as bounce ideas off is essential for almost everyone. Often this relationship does not require any advice, sometimes that's even best, just a sympathetic and listening ear can help to relieve a troubled soul...often it's good for the listener too.

Tuesday, December 16, 2008

i. Improve the physiological state.

To learn more about deep breathing and stress click here.
For videos click here.

i. Improve the physiological state. The tools and skills that I will talk about here provide perhaps the most immediate benefit for feelings of moderate to overwhelming stress; however, it would be a terrible mistake to only focus on this information. The rest of the information here is essential for both prevention and long term reduction of stress. As we become more and more stressed the physiology of our bodies change. There are numerous signs that this change has or is occurring. Some of the possible signs are: sweaty hands, cold hands, ringing in the ears, dry mouth and sometimes a resulting clicking sound, increasingly rapid movement and speech, less coherent speech, higher pitch in speech, louder speech, anger, withdrawal, muscle tension, and quick short breathing. When we become stressed, our body reduces the amount of blood it sends to the brain and sends more to the large muscle groups in our extremities. This is an adaptive change called Fight or Flight and helps us to run away or fight off an assailant or wild animal if needed. It is less adaptive in the work setting as less blood in the brain equates to a diminished ability to learn, think. and speak coherently. One organization that has provided great information and training for many years in helping others who are in crisis, while better managing ourselves, is The MANDT System. When we have a physiological change due to stress, in order to de-stress, we have to have another physiological change. The most important and beneficial thing that we can do to create this physiological change is Aerobic Exercise. The second most important thing is deep breathing. As stated previously, one of the signs of stress is short shallow breathing. Many of us have also adopted more shallow and chest breathing to hide a protruding stomach. There are a number of things you can do to change your breathing:1. Pay attention to your breathing. (Focus your attention to your breathing in and out. You may want to visualize a ball moving up and down a pole or a balloon getting larger and smaller. Eventually after you are better practiced, you may want to count your heart beats as you breathe in and then count them as you breathe out, starting over with each in and out breathe.)2. Breathe in through your nose and out through your mouth.3. Put your hand on your stomach and feel your stomach going up and down, in and out and try to get your stomach to go out as much as comfortably possible as you are breathing in. Consciously expand your stomach as you are taking in your breath. (Notice the stomach movement of a baby as s/he breathes in and out. Babies generally breathe more correctly than adults.) See your doctor if you have any breathing problems.4. To teach this to young children, blow large bubbles. Sometimes a large bubble blowing contest will work with the right age of children. In order to blow a large bubble, you have to take a deep breath and breathe out slowly. The third thing that you can do is muscle tightening and relaxing. There are many muscle stretches you can do, breathing in as your tighten or stretch the muscle and breathing out as you relax. Minding The Body, Mending The Mind teaches a number of these that can be fun to do with children. (Do not do the neck exercise where you roll your neck all the way around.) Some additional exercises can be found here.

h.Have fun and enjoy good humor.

To read more about humor and stress click here.


h. Have fun and enjoy good humor.
Norman Cousins, in his groundbreaking book, Anatomy of an Illness: As Perceived by the Patient speaks extensively about the power of humor in the healing process. (He also speaks a great deal about problems commonly found in hospitals of his day. Fortunately many of these problems have been remedied in many of the world’s hospitals.) Both Love Medicine and Miracles and Minding the Body Mending the Mind also speak about the power of humor. Since that time, extensive research has been conducted and much written about the power of importance of laughter and humor in the improvement of health and reduction of stress i.e. here.
In this context there are two types of fun and humor:
Fun and Humor that divides.
This type of fun and humor is usually at the expense of an individual or group. It actually causes stress, friction and discord.
Fun and Humor that unites.
This type of fun or humor provides opportunities for bonding, healthy laughter, and fun at the expense of no one. It often builds relationships and also helps create a physiological change and an actual improvement in well being.

g. Improve physical health to the extent possible.

g. Improve physical health to the extent possible.

Visit your doctor regularly. If you have health problems, check with your doctor about diet and exercise options. Eat right and get plenty of exercise.

f. Align values and behavior.

f. Align values and behavior.

We bring a great deal of stress on ourselves when we do not do, what we, deeply inside ourselves, believe is right. This is very close to the concept of Cognitive Dissonance. Almost all of us have values. Sometimes, though almost imperceptibly, values can show up in grand children and even great grandchildren that were not openly taught by the parents. I mention this because when our behaviors do not match our values, this causes an inner friction, sometimes called guilt, dissonance, uneasiness or stress.
Clearly teach values to your children and coach them in living up to those values. Do not too easily discount the wisdom of the ages. Seek to understand your own values and align your behaviors with your values. Elevating behaviors, though it may be hard work at first, is almost always more helpful than rationalizing, or depressing values. We used to read and tell moral stories that helped to build character and values. This doesn't happen as often as it once did. Books like Aesops Fables and The Book of Virtues can be valuable resources in teaching children; however, perhaps the most important book a child will read is the adults they are with. Be an example of what you would want them to be. "What you are shouts so loudly in my ears I cannot hear what you say." - Ralph Waldo Emerson http://www.karmaresources.com/quotes.html

e. Increase self-efficacy.

To read more about self-efficacy and stress click here.

e. Increase self-efficacy.

This statement may come as a surprise to many; but, one of the problems with today’s society in the United States is the emphasis on self-esteem. Good self-esteem can be a great thing; however, self-esteem without appropriate boundaries, sense of responsibility, empathy and self-control can be dangerous. There are lots of criminals with great self-esteem. We all know, may be related to, and have probably worked with jerks who have great self-esteem. Often people without self-efficacy and without self-control have a tendency to try to control others. This is frustrating and stressful for everyone. Help a child or any individual build self-efficacy, help them develop appropriate boundaries, empathy, responsibility and self control and you will have self-esteem.
To build self-efficacy, set goals and accomplish them. Help others to set goals and accomplish them. It doesn't’t have to be formal, it can be very informal and in small increments such as giving more and more responsibility to children or employees, helping them, providing the right tools, and instructing them until they can do it on their own.
My youngest son was born in August, making him one of the youngest in his class. He struggled with speech and in school. I remember when he was young and in scouting (one of many great programs including 4-H that help to build self-efficacy) he was struggling to memorize something. I was speaking with him, trying to help him, and urged him to get it done and told him that he was capable. His reply shocked me. He said: “mom doesn't think I’m capable.” As soon as I possibly could, I had a conversation with my wife, his mom. She then had a conversation with our son. Today he is an Eagle Scout, gets mostly A’s, is taking college level classes as a High School Senior and plans to be an engineer. We worked a great deal with him to help him succeed and build self-efficacy. We read together almost every morning before school and continued through the summer. Every year as other children would loose ground in reading; our children would not and would be better set to continue in their formal schooling. For much more extensive information on self-efficacy, click here.Self-Efficacy provides confidence and calmness even in the presence of adversity. Help children to build Self-Efficacy by helping them to accomplish developmentally appropriate but increasingly difficult tasks. Remember it is a lazy parent that does everything for their child."We find that people's beliefs about their efficacy affects the sorts of choices they make in very significant ways. In particular, it affects their levels of motivation and perseverance in the face of obstacles. Most success requires persistent efforts, so low self-efficacy becomes a self-limiting process. In order to succeed, people need a sense of self-efficacy, strung together with resilience to meet the inevitable obstacles and inequities of life." – Albert Bandura “Persons who have a strong sense of efficacy deploy their attention and effort to the demands of the situation and are spurred by obstacles to greater effort”. – Albert Bandura“The content of most textbooks is perishable, but the tools of self-directness serve one well over time.”– Albert Bandura

d. Increase resiliency.

d. Increase resiliency
At least part of the beginning of the research on resiliency came out of research started in the 50’s in Hawaii . This research followed a multi-ethnic group with significant life obstacles. Through the research, they found that about two thirds of the group ended up with significant difficulties that might have been expected of the group, dropping out of school, early pregnancy, drugs, alcohol, criminal activity and various other problems. What caught the attention of the researchers though, was the approximately one third who did not have these problems. These children developed resiliency and though the researchers did not label it as such, self-efficacy.
From this early research came more research on resiliency, much of which was conducted as a part of extension programs in universities. In addition two further avenues of research were developed. Protective (and reflectively) Risk Factors as well as Developmental Assets. Resiliency, Protective Factors and Developmental Assets are all Strength Based. This represented a huge paradigm shift as the social sciences have long looked at finding and fixing problems while strength based approaches look for strengths, assets and resources and builds upon what is already there and what can be added, extended and expanded. Children and adults with greater resiliency are better able to weather the storms of life with minimal stress.
Be especially concerned with helping children develop strong healthy attachments, self-control and self-iniation. Some tools that are helpful for both assessing and building protective factors can be found at the Devereux and the Kaplan websites.

c. Align expectations appropriately.

Click here for more information on expectations and stress.

c. Align expectations appropriately. This is closely related to “a.” above. One of the fundamental sources of stress is inappropriate expectations for both self and others. When the expectations of others are completely unreasonable, a great deal of stress can build up for both individuals. Adults and older teens have some responsibility for allowing these unreasonable expectations placed upon them by others to be stressful; however, and especially when speaking of young children (who do not have the understanding that the expectation is unreasonable), it can cause significant stress. Now there could be a great deal of disagreement on what a reasonable expectation may be. It is not the same for everyone. Whether it be for a spouse, employees, employers, or children, there are some extreme examples. You can not expect someone to know what you are thinking (they may from time to time but it is an unreasonable expectation), you can not expect an 8 or 9 year old child to cook all the meals or keep his or her baby sibling safe for extended periods of time and you can not expect others to fix everything or take care of you all the time (unless you have a very significant disability, illness, and/or are very very young or very very old (even people in these situations need to have reasonable responsibility and control over self). We all need to take responsibility for ourselves to the extent possible (for many of us, more is possible than we wish to admit). We need to have reasonable expectations of others. We need to develop an appropriate locus of control and self-efficacy (which we’ll talk about later) and our own goals and expectations need to be reasonable. While unreasonable expectations can cause undue stress to all involved, reasonable expectations can actually help to create a feeling of safety, security and even self-efficacy with appropriate training, tools and support. Remember that what is reasonable is a moving target with increasingly extended and expanding expectations being reasonable as the individual grows and matures.

b. Increase feelings of security and certainty.

b. Increase feelings of security and certainty. Both children and adults need the feelings of security, certainly, consistency and predictability. These are included within Maslow’s Hierarchy of Needs. For some adults with a great deal of resiliency and self-efficacy, these needs are more easily met. For children they are extremely important. Structure, routines, schedule and consistency are extremely important. Being watched by the same loving and nurturing adults, going to bed and waking up in the same place and at the same time, consistent and regular meals at the same time every day are all important for children; however, there is also benefit for adults. Good sleep hygiene, steady, loving, nurturing relationships are important for everyone. Meeting Maslow’s Hierarchy of Needs is important for stress reduction no matter what the age.

a. Decrease the dissonance between levels of control and expectations of control.

For more information on cognitive dissonance and stress click here

a. Decrease the dissonance between levels of control and expectations of control. One common source of stress comes from the belief that some have developed that they should have control over people and areas where they do not, or even should not have control. For example, as a parent of grown children, ideally your children are prepared for life and can and will make good decisions. From time to time they may approach you for help or advice but most of the time they will not. On the other hand, you may have significant concerns (justified or not) about your adult child and you may constantly attempt to control them. Unless they do everything you ask, which would be unfortunate, there will be stress. It is the same if the other person is a sibling, friend, neighbor etc. (There are times when all you can do is love, without enabling, have a crucial conversation or two, love some more without enabling, pray and have faith.) We want children to develop self control, initiation and motivation, making good choices within appropriate boundaries. While they need to learn that you and other caring adults are there to help; there needs to always be a proper balance, and appropriate boundaries, which change developmentally as the child matures. This goes both ways. Parents who are too strict, too permissive or too enabling will set their child and themselves up for future stress and difficulties. The Serenity Prayer provides some good wisdom for stress reduction. Children need to have their own boundaries and need to learn that others have boundaries and all appropriate boundaries need to be respected.

1. Stress is both a physiological and emotional state.

1. Stress is both a physiological and emotional state. In order to reduce the feelings of stress, there must be both a physiological and emotional change.

What is Stress.

Stress Reduction and Management, for Children and Adults: A Training Outline.
What is stress? There are many definitions. For our purposes I will define it as (for both adults and even very young children): Both a physiological and emotional state caused by the pressure and/or anxiety which can result from the difference or dissonance between what a person has control over and their expectations of control OR a state of doubt and/or insecurity and/or cognitive dissonance OR for those with low resilience and/or efficacy the state caused by unpredictability. It can also include the disequilibrium caused by health related issues.
Let’’s consider a few things.
For additional information go to the full web page here.