Samantha Burns Artherholt, PhDSeattle Cancer Care Alliance
University of Washington School of Medicine
What is stress?
Stress management and coping
Relaxation exercises you can try
at home
Tips for the holidays
The physical, mental, or emotional tension experienced in reaction to an event
Typically experienced when we perceive demands
exceeding our resources
Adapted from Dr. Bonnie McGregor, Fred Hutchinson Cancer Research Center
ResourcesDemands
Typically experienced when we perceive demands
exceeding our resources
DemandsResources
Adapted from Dr. Bonnie McGregor, Fred Hutchinson Cancer Research Center
Hormones released and help us run and fight
Increased heart rate and blood pressure
Delivers more oxygen and blood sugar to important
muscles
Increased sweating to cool these muscles
Blood diverted away from the skin to the core of our
bodies
Reduces blood loss if we are injured
Attention is focused on the threat
Significantly improves our ability to survive life‐
threatening events
Must make two main judgments:
Must feel threatened by the situation
Must doubt that their capabilities and resources are
sufficient to meet the threat
Just as with real threats to our survival, perceived
threats trigger the full fight‐or‐flight response
Excitable, anxious, jumpy and irritable
Reduced ability to work effectively with other people
Accident‐prone and less able to make good decisions
Increased vulnerability to common cold
Slower wound healing
General decrements in immune function
High blood pressure and high cholesterol
Heart disease
Weight gain (central fat storage)
Poor control of blood sugar among diabetics
Poor health behaviors (e.g., diet, smoking, no exercise)
Shortened telomeres and telomerase activity
DNA damage and poor repair
Decrease perceived demands
Increase perceived resources
ResourcesDemands
Adapted from Dr. Bonnie McGregor, Fred Hutchinson Cancer Research Center
1. Recognize the signs of stress
2. Reappraise the situation
3. Respond
4. Relax
5. Rejuvenate
Hostility AngerResentment Irritable BowelHeadaches Muscle TensionBackaches IndigestionUlcers ConstipationMuscle Spasms Poor ConcentrationSleeping Difficulties Appetite ChangesDepression Low Self EsteemDrinking/Drug Use Chronic DiarrheaIrritability InsomniaFears Physical WeaknessNeck Aches Withdrawal
Stressful situation
cognitive
emotional
behavioralphysical
social
Notice your self‐talk
Overly negative:
“My back hurts. The cancer has spread! There will be
nothing my doctors can do this time.”
Overly positive:
“My back hurts. If I ignore it, it will go away.”
Balanced:
“My back hurts. I may have pulled a muscle. I should
make an appointment and have my doctor check it
out.”
Adapted from Dr. Bonnie McGregor, Fred Hutchinson Cancer Research Center
All or nothing thinking (black and white
thinking)
Overgeneralization
Disqualifying the positive
Jumping to conclusions (fortune telling)
Magnification or minimization
“Should”
statements
Challenge the overly negative thoughts
How accurate is this belief?
What would you say to a friend going through this same
situation?
What is the evidence for or against this thought?
What is the worst thing that could happen? What is the
best?
What are some things you can think about or say to
yourself to make yourself calmer?
Aim for balanced, rational thinking
Coping and control
Example:Example: ControllableControllable UncontrollableUncontrollable
A winter storm A winter storm warning has warning has been issuedbeen issued
Stocking up on Stocking up on suppliessupplies
Preparing your car Preparing your car and your homeand your home
Changing work or Changing work or travel planstravel plans
When the storm will When the storm will arrive arrive
How much snow How much snow there will bethere will be
ProblemProblem-- FocusedFocused
EmotionEmotion-- FocusedFocused
Adapted from Dr. Bonnie McGregor, Fred Hutchinson Cancer Research Center
Problem‐focused
Information seeking
Goal setting
Conflict resolution
Asking for help
Emotion‐focused
Reappraisal of the
situation
Reframing thoughts
Exercise
Relaxation exercises
Talk with friends
Once you recognize how you show stress,
catch it early and learn to relax.
Diaphragmatic Breathing/CALM exercise
Progressive Muscle Relaxation
Imagery
Meditation
Exercise YogaFresh airSocial supportHobbiesGet enough restEat a balanced diet
and drink plenty of water
Stress can have negative psychological and physical
effects
Stress can never be completely avoided, but you can
learn to better manage it
Five R’s of stress management
1.
Recognize YOUR signs of stress
2.
Reappraise the situation
3.
Respond (controllable vs. not)
4.
Relax
5.
Rejuvenate!
Source: National Mental Health Association survey, 2006. www.nmha.org
Increased spending for gifts, travel, food and
entertainment
Feeling pressure to buy the “perfect”
gifts, or to buy
for too many people
“Shoulds,”
black and white thinking
What to do:
Be realistic
Stick to a budget
Don’t try to buy happiness with too
many gifts
Start a family gift exchange or donate
to a charity in someone’s name
Give homemade gifts
Extra shopping and socializing
Easy to overindulge
Exercise and sleep may take a back seat to
chores and errands
Exhaustion increases your stress
More susceptible to colds and other illnesses
What to do:
Plan ahead
Learn to say no
Don't abandon healthy habits
Take a breather
The holidays need to be “perfect,”
our traditions can
never change
Black and white thinking
Lots of family time
Tensions are often heightened during the holidays
Family misunderstandings and conflicts can intensify
What to do:
Simplify
Don‘t overextend yourself with traditions
Call a truce on unfinished business
Set aside differences
Acknowledge your feelings
Set limits around holiday celebrations
or take a break
Holidays after a life‐changing loss are particularly
challenging
Grief often feels unwelcome or out‐of‐place during
the holidays
What to do:
Don’t deny your feelings
Reach out
Take care of yourself
Be accepting of other family members, who might express
their grief in different ways
Consider celebrating in a new way—maybe even in a new
place
Consider volunteering or other ways to lift your spirits
Focus on the positives
What would YOU like to do this holiday season?
What gives you joy?
Set appropriate boundaries with family and
with your responsibilities
Seek professional help if you need it
10‐week series
Classes offered through
the Seattle Cancer Care Alliance
Must have been treated at
SCCA or have been seen in the Survivorship Clinic
Contact: Katie Hanna,
SCCA Resource Center, 206‐288‐2081