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