tom brown consultant psychiatrist big may 2012. latin “stringere”- to draw tight borrowed...
TRANSCRIPT
DEFINITIONS
Latin “stringere”- to draw tight Borrowed concepts from physics eg
external forces producing pressure and causing strain.
Other definitions emphasise an individuals response rather than the external pressures.
Results from a misfit between an individual and his/her environment
GOOD OR BAD?
Not always a bad thing
Very personal “One man’s stress may be great fun for him but it may kill another man” (Davies 1988)
COSTS OF STRESS
Illness-heart disease,stroke, psychiatric disorder(30-40% of absences)
Suicide Marital /relationship breakdown Alcohol misuse
SOURCES OF STRESS AT WORK(COOPER) Intrinsic to the job eg environment,
hours,shifts,travel,technology, overload Role in organisation-ambiguity, role
conflicts, responsibility Relationships at work-boss,
subordinates,colleagues
SOURCES OF STRESS II
Career development-training,job security,appraisal
Organisational structure-participation
External pressures eg home/personal life
BURNOUTFREUDENBERGER (1974), MASLACH ET AL (1996)
Emotional overextension and exhaustion
Negative, cynical and detached responses to others
Feelings of inefficiency and reducing personal accomplishment
RISK FACTORS
Job related(see earlier slide)eg time demands,lack of control,poor organisation
Personal vulnerability eg personality traits –avoidant,dependant, anti-social.
“DYSCOPIA”
Over engagement Irritability/short temper Anxiety Feeling on edge Increased vigilance Physical symptoms –headache, chest
pain, gastro –intestinal symptoms, breathlessness,aches and pains
BURNOUT
Disengagement Blunted emotions-sad,withdrawn Decreased motivation, negative
thinking Detachment and social withdrawal
DEPRESSION
Pervasive low mood Loss of enjoyment Feeling life not worth living/suicidal
thoughts Self neglect
BARRIERS TO COPING
Inadequate knowledge of symptoms and availability of help and treatment
Unwillingness to take time off work Concerns re confidentiality , job
security, career progression Bad organisational policies eg the
collective bonus
PREVENTION
Target occupational and personal risk factors
Regular supervision Realistic workload,clarity re goals,
ongoing training Required rest periods and vacations Education about causes and treatments Work based access to exercise and
stress reduction programmes
SELF CARE STRATEGIES-BIOLOGICAL
Sleep Rest and relaxation Food Exercise Sex Not ignoring health problems Stay off/reduce hours when ill Substance use-be careful
SELF CARE STRATEGIES -PSYCHOLOGICAL Relaxation Use of guided imagery/meditation/prayer Supervision Peer groups Confidantes Humour Increase self awareness-where are my achilles
heels and how am I going to deal with them? Professional help –if necessary
SELF CARE STRATEGIES-SOCIAL
Look after your key relationships-family/friends
Personal comfort-home/car/bike/work space
Finances Religion-spiritual and social function Hobbies Vacations
WHEN TO SEEK HELP
Signs of “Dyscopia”-act before the burnout stage.
Listen to family/colleagues you trust-ask their opinion
Heed signs of decreasing occupational performance or deteriorating relationships
WHAT HELP?
If you act early you may not need professional help-a trusted friend or partner may help you make adjustments which improve matters
By the burnout stage you should probably be seeing your GP
WHAT KIND OF HELP?
Loads of excellent self help books/websites(see list at end)- a good place to start unless you are seriously depressed.
Approaches-cognitive behavioural therapy, interpersonal therapy, mindfulness .
Don’t be “anti drugs” –though for most this is not what the first approach should be-only for moderate to severe depression and some anxiety disorders
SUMMARY
Practice the self care strategies mentioned earlier
Take breaks/holidays Have people in whom you can confide
and trust(preferably at home and work) Don’t delay in seeking help
REFERENCES
Managing Workplace Stress. Susan Cartwright and Cary L Cooper, Sage Press 1997.
Stress:the Challenge to Christian Caring. Gauis Davies. Kingsway Publications 1988.
Manage Your Mind. Gillian Butler and Tony Hope. OUP 2007 Overcoming Depression. Paul Gilbert. Robinson 2000. (there is
a whole series of “Overcoming” books which are all excellent-same publisher ,different authors)
www.lltf.com –free website, Glasgow based author(Chris Williams)