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ASA NEWSLETTER
 
 
April 1998
Volume 62
Number 4
 
WHAT'S NEW IN ...

... Stress Management: Taming the Tiger

Jessie A. Leak, M.D.



Defining the Interloper

What is stress? What is the importance of even discussing this "stressful" topic. Webster's Dictionary defines this ubiquitous state as "any mental or physical tension or strain." Russ Hanlin, CFO, Sunkist, says that "it's always appeared to me that stress is within the individual and not manufactured by the situation."

Practically speaking, however, it is probably an exercise in futility to accurately define a condition that in large part uniquely affects all of us. Suffice it to say though, stress is the "disease of the 1990s."

The Mitchum Report on Stress in the '90s concluded that as of 1993, stress is on the rise, so much so that up to 90 percent of us report high stress levels at least once weekly; the majority of all over-the-counter medications were purchased for stress-related headaches, and the top three prescribed drugs were for "stress-related, preventable conditions." Between 75 percent and 90 percent of all visits to primary care physicians were for stress-related
disorders.

Why Is Stress on the Rise?

Probably the most obvious reason is sensory overload. We are in an age of nanosecond communication: faxes, cellular phones, voice mail, e-mail, Ethernet, Web sites, conference calling, video conferencing, sky paging, sky voice mail, computer docking, computer shopping, personal computing, Internet ... the very technologies that promise to simplify our lives are making it that much more complicated.

Today, we get on a plane and we have two suitcases, a carry-on for our 1.1 suits and another carry-on for our personal computer, our palm-top data assistant, our cellular phone, our pager and a collection of CDs and Zip-drive floppies just to make sure that we can back up everything we do.

Our higher mammalian brains are still functioning at the same speed. Our brains are not functioning faster.

To some degree, we do adapt. Hans Selye coined the scientific theory of General Adaptation Syndrome. Simply, our bodies develop a built-in ability to adapt to situations to a certain extent. Beyond this point, stress occurs. Everyone has a different 'steady-state.' However, stress can be cumulative and therefore insidiously destructive when homeostasis is no longer possible because of internal resource depletion.

Why Bother to Destress if You Don't See Any End in Sight?

The act of reducing stress is something that can be learned in a few easy steps. However, if your goal is stress reduction as a means to an end, for whatever reason, then you will surely fail to feel better in the long term. You have simply put a thumb in the dike.

Reframing the stress management exercise can allow one the means to create a quiet opening for self-exploration. We allow ourselves the luxury of time to search for inner and outer balance. This suggests a restatement of our mission for learning stress reduction strategies: the empowerment to change.

Failure to engage in reflection of one's belief system and subsequent life choices, while pursuing mundane stress-reduction exercises, sets up a vicious cycle. Just when we are able through 'cookbook' problem-solving to reduce our stress in the short term, we abandon the real work of attacking the stressors that perpetuate this cycle.

Barbara Larrivee tells us in Moving Into Balance that "the journey toward personal fulfillment and true transformation requires major restructuring that cannot be prescribed with an intervention formula ... The pathway cannot be preplanned. Each of us has our own internal gauge for when we are ready to deal with a critical life issue."

Ways to Destress, or Taming the Tiger

Managing Your Environment. Your office-operating room, your patients and your professional commitments are all bidding for your time. Prioritize, redefine and learn to say no. For instance, do you feel like your case assignments are unfair or that you are doing the job of directing the operating room without recognition? Why not define this as a consulting directorship in your hospital and encourage the most qualified individual in your department to take the job. You have: 1) defined an issue that made you feel out of control [stressed]; 2) come up with a solution that improved the bottom line; and 3) enabled the delegation of the work to the person most suited for the opportunity.

If the issues facing medicine today make you feel out of control [stressed], education may be the key. Get involved in organized medicine to the extent that time permits. Knowledge is power and control [less stress]. It is important to recognize the difference in actually choosing involvement in any of many areas in our lives versus passive avoidance. Many of us, for lack of any other action, lead our lives by procrastination, not by the active decision to not pursue an opportunity.

Unfortunately, when our tanks get low, the first area of compromise is our lives outside of the professional arena: family, home, children, aging parents, issues of personal aging, health, retirement planning and more. Somewhere along the way, we begin to realize that our work and personal lives are interdependent; a sort of zen-like phenomenon.

To destress, we must ask ourselves some very basic questions: a) do we have unmet or unrealistic expectations of ourselves or others; b) is life simply a series of "chores" that have no meaningful purpose; c) is stress an addiction, a drug-like substance that gives us a short-term buzz, but leaves us crashing after the adrenaline wears off; or d) do we have a snooze-alarm mentality? In other words, do we keep hitting the snooze button and, when we finally jump out of bed after lengthy procrastination, we are stressed?

Reframing our stress response is one of the most powerful management tools we have for managing this reaction. If we view every travesty, however small, as an opportunity to learn rather than an opportunity for failure, then we have regained some measures of control in our lives. Odetta Pollar shares some pearls in 365 Ways to Simplify Your Work Life:

  • "Have fewer things and see each of them better."
  • "Keep your job and your life in perspective. Success at the expense of relaxation and enjoyment is no success."
  • "Talk to other people about how they have simplified their work processes."
  • "Embrace change. It's going to happen whether you like it or not."


Jessie A. Leak, M.D., is Clinical Assistant Professor at the University of North Carolina, Chapel Hill, North Carolina. She is also Senior Partner at Cumberland Anesthesia Associates, P.A., and staff anesthesiologist at Cape Fear Valley Pain Management Center, Fayetteville, North Carolina.

 


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